The implementation of medical monitoring programs following potentially hazardous exposures: a medico-legal perspective.

PubMed

Vearrier, David; Greenberg, Michael I

2017-11-01

Clinical toxicologists may be called upon to determine the appropriateness of medical monitoring following documented or purported exposures to toxicants in the occupational, environmental, and medical settings. We searched the MEDLINE database using the Ovid ® search engine for the following terms cross-referenced to the MeSH database: ("occupational exposures" OR "environmental exposures") AND ("physiologic monitoring" OR "population surveillance"). The titles and abstracts of the resulted articles were reviewed for relevance. We expanded our search to include non-peer-reviewed publications and gray literature and resources using the same terms as utilized in the MEDLINE search. There were a total of 48 relevant peer-reviewed and non-peer-reviewed publications. Publications excluded contained no information relevant to medical monitoring following potentially harmful toxicologic exposures, discussed only worker screening/surveillance and/or population biomonitoring, contained redundant information, or were superseded by more recent information. Approaches to medical monitoring: A consensus exists in the peer-reviewed medical literature, legal literature, and government publications that for medical monitoring to be a beneficial public health activity, careful consideration must be given to potential benefits and harms of the program. Characteristics of the exposure, the adverse human health effect, the screening test, and the natural history of the disease are important in determining whether an exposed population will reap a net benefit or harm from a proposed monitoring program. Broader interpretations of medical monitoring: Some have argued that medical monitoring programs should not be limited to exposure-related outcomes but should duplicate general preventive medicine efforts to improve public health outcomes although an overall reduction of morbidity, mortality and disability by modifying correctable risk factors and disease conditions. This broader approach is inconsistent with the targeted approach advocated by the Agency for Toxic Substances and Disease Registry and the United States Preventive Services Task Force and the bulk of the peer-reviewed medical literature. Medical monitoring in legal contexts: Numerous medical monitoring actions have been litigated. Legal rationales for allowing medical monitoring claims often incorporate some of the scientific criteria for the appropriateness of monitoring programs. In the majority of cases in which plaintiffs were awarded medical monitoring relief, plaintiffs were required to demonstrate both that the condition for which medical monitoring was sought could be detected early, and that early detection and treatment will improve morbidity and mortality. However, the treatment of medical monitoring claims varies significantly depending upon jurisdiction. Examples of large-scale, comprehensive medical monitoring programs: Large-scale, comprehensive medical monitoring programs have been implemented, such as the Fernald Medical Monitoring Program and the World Trade Center Health Program, both of which exceeded the scope of medical monitoring typically recommended in the peer-reviewed medical literature and the courts. The Fernald program sought to prevent death and disability due to non-exposure-related conditions in a manner similar to general preventive medicine. The World Trade Center Health Program provides comprehensive medical care for World Trade Center responders and may be viewed as a large-scale, federally--funded research effort, which distinguishes it from medical monitoring in a medico-legal context. Synthesis of public health approaches to medical monitoring: Medical monitoring may be indicated following a hazardous exposure in limited circumstances. General causation for a specific adverse health effect must be either established by scientific consensus through a formal causal analysis using a framework such as the Bradford-Hill criteria. The exposure must be characterized and must be of sufficient severity that the exposed population has a significantly elevated risk of an adverse health effect. Monitoring must result in earlier detection of the condition than would otherwise occur and must confer a benefit in the form of primary, secondary or tertiary prevention. Outcome tables may be of use in describing the potential benefits and harms of a proposed monitoring program. In the context of litigation, plaintiffs may seek medical monitoring programs after documented or putative exposures. The role of the clinical toxicologist, in this setting, is to evaluate the scientific justifications and medical risks and assist the courts in determining whether monitoring would be expected to result in a net public health benefit.

Data Analyses and Modelling for Risk Based Monitoring of Mycotoxins in Animal Feed

PubMed Central

van der Fels-Klerx, H.J. (Ine); Adamse, Paulien; Punt, Ans; van Asselt, Esther D.

2018-01-01

Following legislation, European Member States should have multi-annual control programs for contaminants, such as for mycotoxins, in feed and food. These programs need to be risk based implying the checks are regular and proportional to the estimated risk for animal and human health. This study aimed to prioritize feed products in the Netherlands for deoxynivalenol and aflatoxin B1 monitoring. Historical mycotoxin monitoring results from the period 2007–2016 were combined with data from other sources. Based on occurrence, groundnuts had high priority for aflatoxin B1 monitoring; some feed materials (maize and maize products and several oil seed products) and complete/complementary feed excluding dairy cattle and young animals had medium priority; and all other animal feeds and feed materials had low priority. For deoxynivalenol, maize by-products had a high priority, complete and complementary feed for pigs had a medium priority and all other feed and feed materials a low priority. Also including health consequence estimations showed that feed materials that ranked highest for aflatoxin B1 included sunflower seed and palmkernel expeller/extracts and maize. For deoxynivalenol, maize products were ranked highest, followed by various small grain cereals (products); all other feed materials were of lower concern. Results of this study have proven to be useful in setting up the annual risk based control program for mycotoxins in animal feed and feed materials. PMID:29373559

Legal implications of monitoring workers for carcinogenic and mutagenic risk.

PubMed

Damme, C J

1982-01-01

Many industries have initiated testing programs designed to identify workers who are especially vulnerable to workplace assaults by carcinogenic or mutagenic agents. This paper examines a number of legal issues attendant on such programs, including disclosure and consent, confidentiality, and other potential liability-producing factors. This paper also briefly looks at the legal issues that might arise if the federal government were to mandate similar programs. Finally, the basic rationale of industrial monitoring programs is discussed within the context of the emerging legal issues.

Impact of a Pharmacy-Cardiology Collaborative Practice on Dofetilide Safety Monitoring.

PubMed

Quffa, Lieth H; Panna, Mark; Kaufmann, Michael R; McKillop, Matthew; Dietrich, Nicole Maltese; Franck, Andrew J

2017-01-01

Limited studies have been published examining dofetilide's postmarketing use and its recommended monitoring. To evaluate the impact of a collaborative pharmacy-cardiology antiarrhythmic drug (AAD) monitoring program on dofetilide monitoring. This retrospective cohort study was performed to assess if a novel monitoring program improved compliance with dofetilide-specific monitoring parameters based on the Food and Drug Administration's Risk Evaluation and Mitigation Strategy. A total of 30 patients were included in the analysis. The monitoring parameters evaluated included electrocardiogram, serum potassium, serum magnesium, and kidney function. The primary outcome evaluated was the composite of these dofetilide monitoring parameters obtained in each cohort. In the standard cohort, 245 of 352 (69.6%) monitoring parameters were completed versus 134 of 136 (98.5%) in the intervention group ( P < 0.05). A collaborative pharmacy-cardiology AAD monitoring program was associated with a significant improvement in dofetilide monitoring. This improvement could potentially translate into enhanced patient safety outcomes, such as prevention of adverse drug reactions and decreased hospitalizations.

48 CFR 39.102 - Management of risk.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Management of risk. 39.102... CONTRACTING ACQUISITION OF INFORMATION TECHNOLOGY General 39.102 Management of risk. (a) Prior to entering... monitored, funding availability, and program management risk. (c) Appropriate techniques should be applied...

40 CFR 35.710 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... operate compliance monitoring programs to prevent or eliminate unreasonable risks to health or the... Administrator is unable or not likely to take action for their prevention or elimination. (c) Associated program...

Evaluation and Use of Water Monitoring Data in Pesticide Aquatic Exposure Assessments

EPA Pesticide Factsheets

The EPA Office of Pesticide Programs uses a tiered approach to risk assessment. The tiered approach screens out low-risk pesticides and focuses refined assessments and resources on pesticides most likely to pose a risk of concern.

JAVA CLASSES FOR NONPROCEDURAL VARIOGRAM MONITORING

EPA Science Inventory

A set of Java classes was written for variogram modeling to support research for US EPA's Regional Vulnerability Assessment Program (ReVA). The modeling objectives of this research program are to use conceptual programming tools for numerical analysis for regional risk assessm...

Enhanced surveillance strategies for detecting and monitoring chronic wasting disease in free-ranging cervids

USGS Publications Warehouse

Walsh, Daniel P.

2012-01-01

The purpose of this document is to provide wildlife management agencies with the foundation upon which they can build scientifically rigorous and cost-effective surveillance and monitoring programs for chronic wasting disease (CWD) or refine their existing programs. The first chapter provides an overview of potential demographic and spatial risk factors of susceptible wildlife populations that may be exploited for CWD surveillance and monitoring. The information contained in this chapter explores historic as well as recent developments in our understanding of CWD disease dynamics. It also contains many literature references for readers who may desire a more thorough review of the topics or CWD in general. The second chapter examines methods for enhancing efforts to detect CWD on the landscape where it is not presently known to exist and focuses on the efficiency and cost-effectiveness of the surveillance program. Specifically, it describes the means of exploiting current knowledge of demographic and spatial risk factors, as described in the first chapter, through a two-stage surveillance scheme that utilizes traditional design-based sampling approaches and novel statistical methods to incorporate information about the attributes of the landscape, environment, populations and individual animals into CWD surveillance activities. By accounting for these attributes, efficiencies can be gained and cost-savings can be realized. The final chapter is unique in relation to the first two chapters. Its focus is on designing programs to monitor CWD once it is discovered within a jurisdiction. Unlike the prior chapters that are more detailed or prescriptive, this chapter by design is considerably more general because providing comprehensive direction for creating monitoring programs for jurisdictions without consideration of their monitoring goals, sociopolitical constraints, or their biological systems, is not possible. Therefore, the authors draw upon their collective experiences implementing disease-monitoring programs to present the important questions to consider, potential tools, and various strategies for those wildlife management agencies endeavoring to create or maintain a CWD monitoring program. Its intent is to aid readers in creating efficient and cost-effective monitoring programs, while avoiding potential pitfalls. It is hoped that these three chapters will be useful tools for wildlife managers struggling to implement efficient and effective CWD disease management programs.

MID-ATLANTIC REGIONAL VULNERABILITY ASSESSMENT

EPA Science Inventory

ORD's Regional Vulnerability Assessment (REVA) Program is developing and demonstrating approaches to assess current and future environmental vulnerabilities so that risk management activities can be targeted. The sister program to EMA.P (Environmental Monitoring Assessment Progr...

TAPESTRY on Display.

ERIC Educational Resources Information Center

Rapp, Katie

1992-01-01

Describes three programs funded by the Toyota Appreciation Program for Excellence to Science Teachers Reaching Youth (TAPESTRY) program: (1) High School Hawk Watch promotes wildlife awareness student research; (2) Science without Bounds makes science accessible to at-risk and minority students; and (3) Kansas Environmental Monitoring Network…

Implementation of Water Safety Plans (WSPs): A Case Study in the Coastal Area in Semarang City, Indonesia

NASA Astrophysics Data System (ADS)

Budiyono; Ginandjar, P.; Saraswati, L. D.; Pangestuti, D. R.; Martini; Jati, S. P.

2018-02-01

An area of 508.28 hectares in North Semarang is flooded by tidal inundation, including Bandarharjo village, which could affect water quality in the area. People in Bandarharjo use safe water from deep groundwater, without disinfection process. More than 90% of water samples in the Bandaharjo village had poor bacteriological quality. The aimed of the research was to describe the implementation of Water Safety Plans (WSPs) program in Bandarharjo village. This was a descriptive study with steps for implementations adopted the guidelines and tools of the World Health Organization. The steps consist of introducing WSPs program, team building, training the team, examination of water safety before risk assessment, risk assessment, minor repair I, examination of water safety risk, minor repair II (after monitoring). Data were analyzed using descriptive methods. WSPs program has been introduced and formed WSPs team, and the training of the team has been conducted. The team was able to conduct risks assessment, planned the activities, examined water quality, conduct minor repair and monitoring at the source, distribution, and households connection. The WSPs program could be implemented in the coastal area in Semarang, however regularly supervision and some adjustment are needed.

Control and monitoring of Salmonella in egg-laying chickens

USDA-ARS?s Scientific Manuscript database

Contaminated eggs have been internationally significant sources for the transmission of Salmonella infection to humans for several decades. Both the public and private sectors have invested substantial resources in comprehensive risk reduction and monitoring programs for Salmonella in commercial egg...

Impact of Florida's prescription drug monitoring program and pill mill law on high-risk patients: A comparative interrupted time series analysis.

PubMed

Chang, Hsien-Yen; Murimi, Irene; Faul, Mark; Rutkow, Lainie; Alexander, G Caleb

2018-04-01

We quantified the effects of Florida's prescription drug monitoring program and pill mill law on high-risk patients. We used QuintilesIMS LRx Lifelink data to identify patients receiving prescription opioids in Florida (intervention state, N: 1.13 million) and Georgia (control state, N: 0.54 million). The preintervention, intervention, and postintervention periods were July 2010 to June 2011, July 2011 to September 2011, and October 2011 to September 2012. We identified 3 types of high-risk patients: (1) concomitant users: patients with concomitant use of benzodiazepines and opioids; (2) chronic users: long-term, high-dose, opioid users; and (3) opioid shoppers: patients receiving opioids from multiple sources. We compared changes in opioid prescriptions between Florida and Georgia before and after policy implementation among high-risk/low-risk patients. Our monthly measures included (1) average morphine milligram equivalent per transaction, (2) total opioid volume across all prescriptions, (3) average days supplied per transaction, and (4) total number of opioid prescriptions dispensed. Among opioid-receiving individuals in Florida, 6.62% were concomitant users, 1.96% were chronic users, and 0.46% were opioid shoppers. Following policy implementation, Florida's high-risk patients experienced relative reductions in morphine milligram equivalent (opioid shoppers: -1.08 mg/month, 95% confidence interval [CI] -1.62 to -0.54), total opioid volume (chronic users: -4.58 kg/month, CI -5.41 to -3.76), and number of dispensed opioid prescriptions (concomitant users: -640 prescriptions/month, CI -950 to -340). Low-risk patients generally did not experience statistically significantly relative reductions. Compared with Georgia, Florida's prescription drug monitoring program and pill mill law were associated with large relative reductions in prescription opioid utilization among high-risk patients. Copyright © 2018 John Wiley & Sons, Ltd.

Public Participation, Education, and Engagement in Drought Planning

NASA Astrophysics Data System (ADS)

Bathke, D. J.; Wall, N.; Haigh, T.; Smith, K. H.; Bernadt, T.

2014-12-01

Drought is a complex problem that typically goes beyond the capacity, resources, and jurisdiction of any single person, program, organization, political boundary, or sector. Thus, by nature, monitoring, planning for, and reducing drought risk must be a collaborative process. The National Drought Mitigation Center, in partnership with the National Integrated Drought Information System (NIDIS) Program Office and others, provides active engagement and education drought professionals, stakeholders, and the general public about managing drought-related risks through resilience planning, monitoring, and education. Using case studies, we discuss recruitment processes, network building, participation techniques, and educational methods as they pertain to a variety of unique audiences with distinct objectives. Examples include collaborative decision-making at a World Meteorological Organization conference; planning, and peer-learning among drought professionals in a community of practice; drought condition monitoring through citizen science networks; research and education dissemination with stakeholder groups; and informal learning activities for all ages. Finally, we conclude with evaluation methods, indicators of success, and lessons learned for increasing the effectiveness of our programs in increasing drought resilience.

Legacy of Environmental Research During the Space Shuttle Program

NASA Technical Reports Server (NTRS)

Lane, Helen W.

2011-01-01

The Space Shuttle Program provided many opportunities to study the role of spaceflight on human life for over the last 30 years and represents the longest and largest U.S. human spaceflight program. Risks to crewmembers were included in the research areas of nutrition, microbiology, toxicology, radiation, and sleep quality. To better understand the Shuttle environment, Crew Health Care System was developed. As part of this system, the Environmental Health Subsystem was developed to monitor the atmosphere for gaseous contaminants and microbial contamination levels and to monitor water quality and radiation. This program expended a great deal of effort in studying and mitigating risks related to contaminations due to food, water, air, surfaces, crewmembers, and payloads including those with animals. As the Shuttle had limited stowage space and food selection, the development of nutritional requirements for crewmembers was imperative. As the Shuttle was a reusable vehicle, microbial contamination was of great concern. The development of monitoring instruments that could withstand the space environment took several years and many variations to come up with a suitable instrument. Research with space radiation provided an improved understanding of the various sources of ionizing radiation and the development of monitoring instrumentation for space weather and the human exposure within the orbiter's cabin. Space toxicology matured to include the management of offgassing products that could pollute the crewmembers air quality. The Shuttle Program implemented a 5-level toxicity rating system and developed new monitoring instrumentation to detect toxic compounds. The environment of space caused circadian desynchrony, sleep deficiency, and fatigue leading to much research and major emphasis on countermeasures. Outcomes of the research in these areas were countermeasures, operational protocols, and hardware. Learning Objectives: This symposium will provide an overview of the major environmental lessons learned and the development of countermeasures, monitoring hardware, and procedures.

Microbiological Monitoring for the Constellation Program: Current Requirements and Future Considerations

NASA Technical Reports Server (NTRS)

Ott, C. Mark

2007-01-01

Microbiological requirements for spaceflight are based on assessments of infectious disease risk which could impact crew health or mission success. The determination of risk from infectious disease is composed of several factors including (1) crew susceptibility, (2) crew exposure to the infectious disease agent, (3) the concentration of the infectious agent, and (4) the characteristics of the infectious agent. As a result of the Health Stabilization Program, stringent monitoring, and cleaning protocols, in-flight environmental microbial monitoring is not necessary for short-duration spaceflights. However, risk factors change for long-duration missions, as exemplified by the presence of medically significant organisms in the environments of both the Mir and International Space Station (ISS). Based upon this historical evidence, requirements for short duration usage aboard the Orion Crew Exploration Vehicle and Lunar Lander Vehicle will not require in-flight monitoring; however, as mission duration increases with a Lunar Outpost, an ability to detect microbial hazard will be necessary. The nature of the detection requirements will depend on the maturity of technology in a rapidly evolving marketplace. Regardless, the hardware will still need to maximize information to discipline experts and the crew, while minimizing the size, mass, power consumption, and crew time usage. The refinement of these monitors will be a major goal in our efforts to travel successfully to Mars.

DESIGN AND IMPLEMENTATION OF EFFECTIVE MONITORING PROGRAMS FOR DREDGING CONTAMINATED SEDIMENT

EPA Science Inventory

Currently, there is a growing national debate about dredging contaminated sediments, including risks to human health and the environment as well as the overall effectiveness of remedial activities. Presently, monitoring methods are available to address both concerns. This present...

Continuous Risk Management: A NASA Program Initiative

NASA Technical Reports Server (NTRS)

Hammer, Theodore F.; Rosenberg, Linda

1999-01-01

NPG 7120.5A, "NASA Program and Project Management Processes and Requirements" enacted in April, 1998, requires that "The program or project manager shall apply risk management principles..." The Software Assurance Technology Center (SATC) at NASA GSFC has been tasked with the responsibility for developing and teaching a systems level course for risk management that provides information on how to comply with this edict. The course was developed in conjunction with the Software Engineering Institute at Carnegie Mellon University, then tailored to the NASA systems community. This presentation will briefly discuss the six functions for risk management: (1) Identify the risks in a specific format; (2) Analyze the risk probability, impact/severity, and timeframe; (3) Plan the approach; (4) Track the risk through data compilation and analysis; (5) Control and monitor the risk; (6) Communicate and document the process and decisions.

San Diego Multiple Species Conservation Program (MSCP) Rare Plant Monitoring Review and Revision

USGS Publications Warehouse

McEachern, Kathryn; Pavlik, Bruce M.; Rebman, Jon; Sutter, Rob

2007-01-01

Introduction The San Diego Multiple Species Conservation Program (MSCP) was developed for the conservation of plants and animals in the south part of San Diego County, under the California Natural Community Conservation Planning Act of 1991 (California Department of Fish and Game) and the Federal Endangered Species Act of 1973, as amended (16 U.S. Code 1531-1544.) The Program is on the leading edge of conservation, as it seeks to both guide development and conserve at-risk species with the oversight of both State and Federal agencies. Lands were identified for inclusion in the MSCP based on their value as habitat for at-risk plants or plant communities (Natural Community Conservation Planning, 2005). Since its inception in the mid-1990s the Program has protected over 100,000 acres, involving 15 jurisdictions and the U.S. Fish and Wildlife Service (USFWS) and California Department of Fish and Game (CDFG) in the conservation of 87 taxa. Surveys for covered species have been conducted, and management and monitoring have been implemented at some high priority sites. Each jurisdiction or agency manages and monitors their conservation areas independently, while collaborating regionally for long-term protection. The San Diego MSCP is on the forefront of conservation, in one of the most rapidly growing urban areas of the country. The planning effort that developed the MSCP was state-of-the-art, using expert knowledge, spatial habitat modeling, and principles of preserve design to identify and prioritize areas for protection. Land acquisition and protection are ahead of schedule for most jurisdictions. Surveys have verified the locations of many rare plant populations known from earlier collections, and they provide general information on population size and health useful for further conservation planning. Management plans have been written or are in development for most MSCP parcels under jurisdictional control. Several agencies are developing databases for implementation and management tracking. In many ways this program is at the cutting edge of regional conservation, testing concepts, developing techniques, and demonstrating conservation effectiveness in new and uncharted ways. Periodic program review is crucial to the continued success of the program, as it moves from a phase of planning and acquisition to one of management and monitoring. Ecological monitoring is the key to assessing the success of the protection and management implemented at each individual reserve and for the MSCP as a whole. The ultimate goal of the Program is conservation of at-risk taxa and their habitats, as well as underlying ecological processes that contribute to sustainability of the ecosystem. Monitoring guidelines and timetables were developed by Ogden Environmental and Energy Services Co., Inc. (1996), and reviewed by Conservation Biology Institute (2001). The Program is in transition now, from the initial stage of land protection to one of land management and monitoring to determine population responses to management regimes. Several agencies have already invested substantial effort in status and trend monitoring, while others are developing their monitoring plans. Management is ongoing at several sites. With both management and monitoring, collaboration and coordination among jurisdictions can be especially fruitful in conserving resources and maximizing success.

Microseismic monitoring of Chocolate Bayou, Texas. The Pleasant Bayou No. 2 geopressured/geothermal energy test-well program. 1982 annual progress report

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

Mauk, F.J.; Davis, R.A.

1982-01-01

To investigate the seismic risks associated with geopressured fluid production from the Pleasant Bayou No. 2 design well a seismic monitoring program was conducted in the vicinity of the Brazoria County design wells since 1979. The monitoring program was designed first to establish the nature of the local ambient seismicity prior to production, and second to provide continued surveillance of the area during the well tests to determine if production altered ambient seismic conditions significantly. The operation, data analyses, results and conclusions of the Brazoria seismic network during the operational period from 1 January through 31 December 1982 are described.

Improving health aid for a better planet: The planning, monitoring and evaluation tool (PLANET).

PubMed

Sridhar, Devi; Car, Josip; Chopra, Mickey; Campbell, Harry; Woods, Ngaire; Rudan, Igor

2015-12-01

International development assistance for health (DAH) quadrupled between 1990 and 2012, from US$ 5.6 billion to US$ 28.1 billion. This generates an increasing need for transparent and replicable tools that could be used to set investment priorities, monitor the distribution of funding in real time, and evaluate the impact of those investments. In this paper we present a methodology that addresses these three challenges. We call this approach PLANET, which stands for planning, monitoring and evaluation tool. Fundamentally, PLANET is based on crowdsourcing approach to obtaining information relevant to deployment of large-scale programs. Information is contributed in real time by a diverse group of participants involved in the program delivery. PLANET relies on real-time information from three levels of participants in large-scale programs: funders, managers and recipients. At each level, information is solicited to assess five key risks that are most relevant to each level of operations. The risks at the level of funders involve systematic neglect of certain areas, focus on donor's interests over that of program recipients, ineffective co-ordination between donors, questionable mechanisms of delivery and excessive loss of funding to "middle men". At the level of managers, the risks are corruption, lack of capacity and/or competence, lack of information and /or communication, undue avoidance of governmental structures / preference to non-governmental organizations and exclusion of local expertise. At the level of primary recipients, the risks are corruption, parallel operations / "verticalization", misalignment with local priorities and lack of community involvement, issues with ethics, equity and/or acceptability, and low likelihood of sustainability beyond the end of the program's implementation. PLANET is intended as an additional tool available to policy-makers to prioritize, monitor and evaluate large-scale development programs. In this, it should complement tools such as LiST (for health care/interventions), EQUIST (for health care/interventions) and CHNRI (for health research), which also rely on information from local experts and on local context to set priorities in a transparent, user-friendly, replicable, quantifiable and specific, algorithmic-like manner.

Mussels and sediment as monitoring tools for contaminants: which to use when?

EPA Science Inventory

For decades, sediments and mussels have been used to assess the ecological and human health risks associated with concentrations of bioavailable organic and metal contaminants in a variety of coastal-wide and localized monitoring programs. Mussels (Mytilus edulis) bioaccumulate o...

40 CFR 257.25 - Assessment monitoring program.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Minimum distance between upgradient edge of the unit and downgradient monitoring well screen (minimum... that is likely to be without appreciable risk of deleterious effects during a lifetime. For purposes of this subpart, systemic toxicants include toxic chemicals that cause effects other than cancer or...

40 CFR 257.25 - Assessment monitoring program.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Minimum distance between upgradient edge of the unit and downgradient monitoring well screen (minimum... that is likely to be without appreciable risk of deleterious effects during a lifetime. For purposes of this subpart, systemic toxicants include toxic chemicals that cause effects other than cancer or...

40 CFR 257.25 - Assessment monitoring program.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Minimum distance between upgradient edge of the unit and downgradient monitoring well screen (minimum... that is likely to be without appreciable risk of deleterious effects during a lifetime. For purposes of this subpart, systemic toxicants include toxic chemicals that cause effects other than cancer or...

Risk assessment and risk management at the Canadian Food Inspection Agency (CFIA): a perspective on the monitoring of foods for chemical residues.

PubMed

Bietlot, Henri P; Kolakowski, Beata

2012-08-01

The Canadian Food Inspection Agency (CFIA) uses 'Ranked Risk Assessment' (RRA) to prioritize chemical hazards for inclusion in monitoring programmes or method development projects based on their relative risk. The relative risk is calculated for a chemical by scoring toxicity and exposure in the 'risk model scoring system' of the Risk Priority Compound List (RPCL). The relative ranking and the risk management options are maintained and updated in the RPCL. The ranking may be refined by the data generated by the sampling and testing programs. The two principal sampling and testing programmes are the National Chemical Residue Monitoring Program (NCRMP) and the Food Safety Action Plan (FSAP). The NCRMP sampling plans focus on the analysis of federally registered products (dairy, eggs, honey, meat and poultry, fresh and processed fruit and vegetable commodities, and maple syrup) for residues of veterinary drugs, pesticides, environmental contaminants, mycotoxins, and metals. The NCRMP is complemented by the Food Safety Action Plan (FSAP) targeted surveys. These surveys focus on emerging chemical hazards associated with specific foods or geographical regions for which applicable maximum residue limits (MRLs) are not set. The data from the NCRMP and FSAP also influence the risk management (follow-up) options. Follow-up actions vary according to the magnitude of the health risk, all with the objective of preventing any repeat occurrence to minimize consumer exposure to a product representing a potential risk to human health. © Her Majesty the Queen in Right of Canada 2012. Drug Testing and Analysis © 2012 John Wiley & Sons, Ltd.

The Influence of Microbiology on Spacecraft Design and Controls: A Historical Perspective of the Shuttle and International Space Station Programs

NASA Technical Reports Server (NTRS)

Castro, Victoria A.; Bruce, Rebekah J.; Ott, C. Mark; Pierson, D. L.

2006-01-01

For over 40 years, NASA has been putting humans safely into space in part by minimizing microbial risks to crew members. Success of the program to minimize such risks has resulted from a combination of engineering and design controls as well as active monitoring of the crew, food, water, hardware, and spacecraft interior. The evolution of engineering and design controls is exemplified by the implementation of HEPA filters for air treatment, antimicrobial surface materials, and the disinfection regimen currently used on board the International Space Station. Data from spaceflight missions confirm the effectiveness of current measures; however, fluctuations in microbial concentrations and trends in contamination events suggest the need for continued diligence in monitoring and evaluation as well as further improvements in engineering systems. The knowledge of microbial controls and monitoring from assessments of past missions will be critical in driving the design of future spacecraft.

Workplace Violence Training Programs for Health Care Workers: An Analysis of Program Elements.

PubMed

Arbury, Sheila; Hodgson, Michael; Zankowski, Donna; Lipscomb, Jane

2017-06-01

Commercial workplace violence (WPV) prevention training programs differ in their approach to violence prevention and the content they present. This study reviews 12 such programs using criteria developed from training topics in the Occupational Safety and Health Administration's (OSHA) Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers and a review of the WPV literature. None of the training programs addressed all the review criteria. The most significant gap in content was the lack of attention to facility-specific risk assessment and policies. To fill this gap, health care facilities should supplement purchased training programs with specific training in organizational policies and procedures, emergency action plans, communication, facility risk assessment, and employee post-incident debriefing and monitoring. Critical to success is a dedicated program manager who understands risk assessment, facility clinical operations, and program management and evaluation.

EMAP and other tools for measuring biodiversity, habitat conditions, and environmental trends

Treesearch

Eric M. Preston; Christine A. Ribic

1993-01-01

We describe research efforts that contribute to assessment and monitoring of neotropical migratory birds, including: I) use of neotropical migrants in the Environmental Monitoring and Assessment Program (EMAP) as potential indicators of general environmental condition and biodiversity; 2) EPA's Habitat/Biodiversity Research Initiative to assess comparative risks...

EXTRAPOLATING ACUTE MORTALITY OF AMPELISCA ABDITA TO POPULATION RISK USING A POPULATION MODEL AND MONITORING DATA

EPA Science Inventory

Ten-day acute mortality of the benthic amphipod, Ampelisca abdita, is used in a number of regulatory, research, and monitoring programs to evaluate chemical contamination of marine sediments. Although this endpoint has proven to be valuable for characterizing the relative toxicit...

Improving health aid for a better planet: The planning, monitoring and evaluation tool (PLANET)

PubMed Central

Sridhar, Devi; Car, Josip; Chopra, Mickey; Campbell, Harry; Woods, Ngaire; Rudan, Igor

2015-01-01

Background International development assistance for health (DAH) quadrupled between 1990 and 2012, from US$ 5.6 billion to US$ 28.1 billion. This generates an increasing need for transparent and replicable tools that could be used to set investment priorities, monitor the distribution of funding in real time, and evaluate the impact of those investments. Methods In this paper we present a methodology that addresses these three challenges. We call this approach PLANET, which stands for planning, monitoring and evaluation tool. Fundamentally, PLANET is based on crowdsourcing approach to obtaining information relevant to deployment of large–scale programs. Information is contributed in real time by a diverse group of participants involved in the program delivery. Findings PLANET relies on real–time information from three levels of participants in large–scale programs: funders, managers and recipients. At each level, information is solicited to assess five key risks that are most relevant to each level of operations. The risks at the level of funders involve systematic neglect of certain areas, focus on donor’s interests over that of program recipients, ineffective co–ordination between donors, questionable mechanisms of delivery and excessive loss of funding to “middle men”. At the level of managers, the risks are corruption, lack of capacity and/or competence, lack of information and /or communication, undue avoidance of governmental structures / preference to non–governmental organizations and exclusion of local expertise. At the level of primary recipients, the risks are corruption, parallel operations / “verticalization”, misalignment with local priorities and lack of community involvement, issues with ethics, equity and/or acceptability, and low likelihood of sustainability beyond the end of the program’s implementation. Interpretation PLANET is intended as an additional tool available to policy–makers to prioritize, monitor and evaluate large–scale development programs. In this, it should complement tools such as LiST (for health care/interventions), EQUIST (for health care/interventions) and CHNRI (for health research), which also rely on information from local experts and on local context to set priorities in a transparent, user–friendly, replicable, quantifiable and specific, algorithmic–like manner. PMID:26322228

Association of melanoma and natalizumab therapy in the Italian MS population: a second case report.

PubMed

Laroni, A; Bedognetti, M; Uccelli, A; Capello, E; Mancardi, G L

2011-02-01

There is debate about a possible association between natalizumab treatment and higher risk of melanoma. Here we report a case of melanoma in a patient who developed melanoma after 77 infusions of natalizumab, without known risk factors. Pharmacovigilance programs of new drugs can help to monitor adverse events in patients at risk.

Toward an HRD Auditing Protocol: Assessing HRD Risk Management Practices

ERIC Educational Resources Information Center

Clardy, Alan

2004-01-01

Even though HRD-related programs and activities carry risks that should be monitored and assessed, there is little literature on how auditing applies to the HRD function; the existing literature on the topic defines HRD auditing in widely different ways. The nature of risk for organizational process is discussed, followed by a review of the…

24 CFR 266.115 - Program monitoring and evaluation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... relative to project management and servicing (including disposition) will be required after endorsement. (2... AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS... principal balances on mortgages the HFA has underwritten, and the status of all projects insured under this...

24 CFR 266.115 - Program monitoring and evaluation.

Code of Federal Regulations, 2013 CFR

2013-04-01

... relative to project management and servicing (including disposition) will be required after endorsement. (2... AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS... principal balances on mortgages the HFA has underwritten, and the status of all projects insured under this...

24 CFR 266.115 - Program monitoring and evaluation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... relative to project management and servicing (including disposition) will be required after endorsement. (2... AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS... principal balances on mortgages the HFA has underwritten, and the status of all projects insured under this...

24 CFR 266.115 - Program monitoring and evaluation.

Code of Federal Regulations, 2012 CFR

2012-04-01

... relative to project management and servicing (including disposition) will be required after endorsement. (2... AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS... principal balances on mortgages the HFA has underwritten, and the status of all projects insured under this...

Migrants in transit: the importance of monitoring HIV risk among migrant flows at the Mexico-US border.

PubMed

Martinez-Donate, Ana P; Hovell, Melbourne F; Rangel, Maria Gudelia; Zhang, Xiao; Sipan, Carol L; Magis-Rodriguez, Carlos; Gonzalez-Fagoaga, J Eduardo

2015-03-01

We conducted a probability-based survey of migrant flows traveling across the Mexico-US border, and we estimated HIV infection rates, risk behaviors, and contextual factors for migrants representing 5 distinct migration phases. Our results suggest that the influence of migration is not uniform across genders or risk factors. By considering the predeparture, transit, and interception phases of the migration process, our findings complement previous studies on HIV among Mexican migrants conducted at the destination and return phases. Monitoring HIV risk among this vulnerable transnational population is critical for better understanding patterns of risk at different points of the migration process and for informing the development of protection policies and programs.

Migrants in Transit: The Importance of Monitoring HIV Risk Among Migrant Flows at the Mexico–US Border

PubMed Central

Martinez-Donate, Ana P.; Hovell, Melbourne F.; Rangel, Maria Gudelia; Zhang, Xiao; Sipan, Carol L.; Magis-Rodriguez, Carlos; Gonzalez-Fagoaga, J. Eduardo

2015-01-01

We conducted a probability-based survey of migrant flows traveling across the Mexico–US border, and we estimated HIV infection rates, risk behaviors, and contextual factors for migrants representing 5 distinct migration phases. Our results suggest that the influence of migration is not uniform across genders or risk factors. By considering the predeparture, transit, and interception phases of the migration process, our findings complement previous studies on HIV among Mexican migrants conducted at the destination and return phases. Monitoring HIV risk among this vulnerable transnational population is critical for better understanding patterns of risk at different points of the migration process and for informing the development of protection policies and programs. PMID:25602882

A conceptual framework for the design of environmental post-market monitoring of genetically modified plants.

PubMed

Sanvido, Olivier; Widmer, Franco; Winzeler, Michael; Bigler, Franz

2005-01-01

Genetically modified plants (GMPs) may soon be cultivated commercially in several member countries of the European Union (EU). According to EU Directive 2001/18/EC, post-market monitoring (PMM) for commercial GMP cultivation must be implemented, in order to detect and prevent adverse effects on human health and the environment. However, no general PMM strategies for GMP cultivation have been established so far. We present a conceptual framework for the design of environmental PMM for GMP cultivation based on current EU legislation and common risk analysis procedures. We have established a comprehensive structure of the GMP approval process, consisting of pre-market risk assessment (PMRA) as well as PMM. Both programs can be distinguished conceptually due to principles inherent to risk analysis procedures. The design of PMM programs should take into account the knowledge gained during approval for commercialization of a specific GMP and the decisions made in the environmental risk assessments (ERAs). PMM is composed of case-specific monitoring (CSM) and general surveillance. CSM focuses on anticipated effects of a specific GMP. Selection of case-specific indicators for detection of ecological exposure and effects, as well as definition of effect sizes, are important for CSM. General surveillance is designed to detect unanticipated effects on general safeguard subjects, such as natural resources, which must not be adversely affected by human activities like GMP cultivation. We have identified clear conceptual differences between CSM and general surveillance, and propose to adopt separate frameworks when developing either of the two programs. Common to both programs is the need to put a value on possible ecological effects of GMP cultivation. The structure of PMM presented here will be of assistance to industry, researchers, and regulators, when assessing GMPs during commercialization.

12 CFR Appendix B to Part 741 - Guidance for an Interest Rate Risk Policy and an Effective Program

Code of Federal Regulations, 2013 CFR

2013-01-01

... Measurement Methods C. Components of IRR Measurement Methods V. Internal Controls VI. Decision-Making Informed... effective IRR management program identifies, measures, monitors, and controls IRR and is central to safe and... critical to the control of IRR exposure. All FICUs required to have an IRR policy and program should...

12 CFR Appendix B to Part 741 - Guidance for an Interest Rate Risk Policy and an Effective Program

Code of Federal Regulations, 2014 CFR

2014-01-01

... Measurement Methods C. Components of IRR Measurement Methods V. Internal Controls VI. Decision-Making Informed... effective IRR management program identifies, measures, monitors, and controls IRR and is central to safe and... critical to the control of IRR exposure. All FICUs required to have an IRR policy and program should...

Quality of pancreatic transplant program assessment using a risk-adjusted cumulative sum chart: experience from a single, small center.

PubMed

Grochowiecki, T; Jakimowicz, T; Grabowska-Derlatka, L; Szmidt, J

2014-10-01

The high rate of complication after pancreas transplantation not only had an impact on recipient quality of life and survival but also had significant financial implications. Thus, monitoring transplant center performance was crucial to indentifying changes in clinical practice that result in quality deterioration. To evaluate retrospectively the quality of the single, small pancreatic transplant program and to establish prospective monitoring of the center using risk-adjusted cumulative sum (CUSUM). From 1988 to 2014, 119 simultaneous pancreas and the kidney transplantations (SPKTx) were performed. The program was divided into 3 eras, based on surgical technique and immunosuppression. Analyses of the 15 fatal outcomes due to complication from pancreatic graft were performed. The risk model was developed using multivariable logistic regression analysis based on retrospective data of 112 SPKTx recipients. The risk-adjusted 1-sided CUSUM chart was plotted for retrospective and prospective events. The upper control limit was set to 2. There were 2 main causes of death: multiorgan failure (73.3%; 11/15) and septic hemorrhage (26.7%; 4/15). Quality analysis using the CUSUM chart revealed that the process was not homogeneous; however, no significant signal of program deterioration was obtained and the performance of the whole program was within the settled control limit. For a single pancreatic transplant center. The risk-adjusted CUSUM chart was a useful tool for quality program assessment. It could support decision making during traditional surgical morbidity and mortality conferences. For small transplant centers, increasing the sensitivity of the CUSUM method by lowering the upper control limit should be considered. However, an individual assessment approach of the for particular centers is recommended.

Interpretation of the Ecological Significance of Atrazine Stream-Water Concentrations Using a Statistically-Designed Monitoring Program

EPA Science Inventory

A risk assessment was conducted by the US Environmental Protection Agency (EPA) as part of the 2003 Interim Registration Eligibility Document (IRED) on atrazine. The assessment indicated potential community- and population-level risk to sensitive aquatic ecosystems at prolonged ...

The dilemma in prioritizing chemicals for environmental analysis: known versus unknown hazards.

PubMed

Anna, Sobek; Sofia, Bejgarn; Christina, Rudén; Magnus, Breitholtz

2016-08-10

A major challenge for society is to manage the risks posed by the many chemicals continuously emitted to the environment. All chemicals in production and use cannot be monitored and science-based strategies for prioritization are essential. In this study we review available data to investigate which substances are included in environmental monitoring programs and published research studies reporting analyses of chemicals in Baltic Sea fish between 2000 and 2012. Our aim is to contribute to the discussion of priority settings in environmental chemical monitoring and research, which is closely linked to chemical management. In total, 105 different substances or substance groups were analyzed in Baltic Sea fish. Polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans (PCDD/Fs) and polychlorinated biphenyls (PCBs) were the most studied substances or substance groups. The majority, 87%, of all analyses comprised 20% of the substances or substance groups, whereas 46 substance groups (44%) were analyzed only once. Almost three quarters of all analyses regarded a POP-substance (persistent organic pollutant). These results demonstrate that the majority of analyses on environmental contaminants in Baltic Sea fish concern a small number of already regulated chemicals. Legacy pollutants such as POPs pose a high risk to the Baltic Sea due to their hazardous properties. Yet, there may be a risk that prioritizations for chemical analyses are biased based on the knowns of the past. Such biases may lead to society failing in identifying risks posed by yet unknown hazardous chemicals. Alternative and complementary ways to identify priority chemicals are needed. More transparent communication between risk assessments performed as part of the risk assessment process within REACH and monitoring programs, and information on chemicals contained in consumer articles, would offer ways to identify chemicals for environmental analysis.

Intervening with High Risk Youth: A Program Model.

ERIC Educational Resources Information Center

Davis, Ruth B.; And Others

1994-01-01

Describes a program for older adolescents exhibiting substance use problems. After initial assessment and referral, most patients enter outpatient treatment groups. Groups fulfill three purposes: (1) Staff monitors clients; (2) Help clients recognize the promise of recovery; and (3) Change behavior. Difficulties of working with multiple community…

Early Monitoring Approaches Developed from a Case Study on a Vulnerable Great Lakes Embayment

EPA Science Inventory

Great Lakes harbors/embayments are at high risk of introduction of invasive species. Monitoring is needed to inform on new introductions, and to track success of programs to limit invasion or spread. A field case study was conducted in the Duluth-Superior Harbor/St. Louis River, ...

But I Trust My Teen: Parents' Attitudes and Response to a Parental Monitoring Intervention

PubMed Central

Metzger, Aaron; Ice, Christa; Cottrell, Lesley

2012-01-01

Parental knowledge gained from monitoring activities protects against adolescent risk involvement. Parental monitoring approaches are varied and may be modified with successful interventions but not all parents or adolescents respond to monitoring programs the same way. 339 parent-adolescent dyads randomized to receive a parental monitoring intervention and 169 parent-adolescent dyads in the control group were followed for one year over four measurement periods. Parent attitudes about the usefulness of monitoring, the importance of trust and respecting their teens' privacy, and the appropriateness of adolescent risk-taking behavior and experimentation were examined as predictors of longitudinal change in parental monitoring and open communication. Similar effects were found in both the intervention and control group models regarding open communication. Parental attitudes impacted longitudinal patterns of teen-reported parent monitoring, and these patterns differed across experimental groups. In the intervention group, parents' beliefs about the importance of trust and privacy were associated with a steeper decline in monitoring across time. Finally, parents' attitudes about the normative nature of teen experimentation were associated with a quadratic parental monitoring time trend in the intervention but not the control group. These findings suggest that parental attitudes may impact how families respond to an adolescent risk intervention. PMID:22720144

Linking indices for biodiversity monitoring to extinction risk theory.

PubMed

McCarthy, Michael A; Moore, Alana L; Krauss, Jochen; Morgan, John W; Clements, Christopher F

2014-12-01

Biodiversity indices often combine data from different species when used in monitoring programs. Heuristic properties can suggest preferred indices, but we lack objective ways to discriminate between indices with similar heuristics. Biodiversity indices can be evaluated by determining how well they reflect management objectives that a monitoring program aims to support. For example, the Convention on Biological Diversity requires reporting about extinction rates, so simple indices that reflect extinction risk would be valuable. We developed 3 biodiversity indices that are based on simple models of population viability that relate extinction risk to abundance. We based the first index on the geometric mean abundance of species and the second on a more general power mean. In a third index, we integrated the geometric mean abundance and trend. These indices require the same data as previous indices, but they also relate directly to extinction risk. Field data for butterflies and woodland plants and experimental studies of protozoan communities show that the indices correlate with local extinction rates. Applying the index based on the geometric mean to global data on changes in avian abundance suggested that the average extinction probability of birds has increased approximately 1% from 1970 to 2009. © 2014 The Authors. Conservation Biology published by Wiley Periodicals, Inc., on behalf of the Society for Conservation Biology.

Heart failure remote monitoring: evidence from the retrospective evaluation of a real-world remote monitoring program.

PubMed

Agboola, Stephen; Jethwani, Kamal; Khateeb, Kholoud; Moore, Stephanie; Kvedar, Joseph

2015-04-22

Given the magnitude of increasing heart failure mortality, multidisciplinary approaches, in the form of disease management programs and other integrative models of care, are recommended to optimize treatment outcomes. Remote monitoring, either as structured telephone support or telemonitoring or a combination of both, is fast becoming an integral part of many disease management programs. However, studies reporting on the evaluation of real-world heart failure remote monitoring programs are scarce. This study aims to evaluate the effect of a heart failure telemonitoring program, Connected Cardiac Care Program (CCCP), on hospitalization and mortality in a retrospective database review of medical records of patients with heart failure receiving care at the Massachusetts General Hospital. Patients enrolled in the CCCP heart failure monitoring program at the Massachusetts General Hospital were matched 1:1 with usual care patients. Control patients received care from similar clinical settings as CCCP patients and were identified from a large clinical data registry. The primary endpoint was all-cause mortality and hospitalizations assessed during the 4-month program duration. Secondary outcomes included hospitalization and mortality rates (obtained by following up on patients over an additional 8 months after program completion for a total duration of 1 year), risk for multiple hospitalizations and length of stay. The Cox proportional hazard model, stratified on the matched pairs, was used to assess primary outcomes. A total of 348 patients were included in the time-to-event analyses. The baseline rates of hospitalizations prior to program enrollment did not differ significantly by group. Compared with controls, hospitalization rates decreased within the first 30 days of program enrollment: hazard ratio (HR)=0.52, 95% CI 0.31-0.86, P=.01). The differential effect on hospitalization rates remained consistent until the end of the 4-month program (HR=0.74, 95% CI 0.54-1.02, P=.06). The program was also associated with lower mortality rates at the end of the 4-month program: relative risk (RR)=0.33, 95% 0.11-0.97, P=.04). Additional 8-months follow-up following program completion did not show residual beneficial effects of the CCCP program on mortality (HR=0.64, 95% 0.34-1.21, P=.17) or hospitalizations (HR=1.12, 95% 0.90-1.41, P=.31). CCCP was associated with significantly lower hospitalization rates up to 90 days and significantly lower mortality rates over 120 days of the program. However, these effects did not persist beyond the 120-day program duration.

Chemically dependent physicians and informed consent disclosure.

PubMed

Ackerman, T F

1996-01-01

Developments in law, professional guidelines, and public attitudes support informed consent disclosure by physicians who have been treated for chemical dependency. This view is built on the apparent materiality of the risk of relapse to informed treatment decisions by patients. Several considerations undercut this position. The probability is remote that a patient will be injured by a recovering physician who suffers an undetected relapse while being properly monitored. Monitoring by impaired physicians programs provides a more sensitive and specific mechanism for detecting relapsed physicians. Moreover, compromise of the privacy and employment rights of recovering physicians by consent disclosure is not justified if programs provide rigorous monitoring that protects the welfare of patients. Finally, required consent disclosure will reduce referrals of chemically dependent physicians to impaired physicians programs, thereby increasing the danger to patients. Limiting demands for required consent disclosure necessitates effective operation of impaired physicians programs.

Cyanobacteria: State Monitoring Programs, Beach Closures, and Potential Human Health Risks

EPA Science Inventory

New England is rich in freshwater lakes and ponds, many of which are subject to cyanobacteria (blue-green algae) blooms that can limit recreational use and cause health problems. This study was conducted to better understand the health risks to human and animal populations that a...

12 CFR 1200.2 - Organization of the Federal Housing Finance Agency.

Code of Federal Regulations, 2014 CFR

2014-01-01

... presence, the division monitors and assesses the amount of risk each Enterprise assumes, the quality of... and assesses their compliance with regulations, the amount of risk they assume, and the quality of... office manages the Freedom of Information, Privacy Act and ethics programs. The Designated Agency Ethics...

12 CFR 1200.2 - Organization of the Federal Housing Finance Agency.

Code of Federal Regulations, 2013 CFR

2013-01-01

... presence, the division monitors and assesses the amount of risk each Enterprise assumes, the quality of... and assesses their compliance with regulations, the amount of risk they assume, and the quality of... office manages the Freedom of Information, Privacy Act and ethics programs. The Designated Agency Ethics...

QUALITY ASSURANCE AND SITE MANAGEMENT FOR PRIMENET AND URBAN ULTRAVIOLET RADIATION RESEARCH MONITORING PROGRAM.

EPA Science Inventory

Because exposure to ultraviolet (UV) radiation is an ecosystem stressor and poses a human health risk, the National Exposure Research Laboratory (NERL) has undertaken a research program to measure the intensity of UV-B radiation at various locations throughout the U.S. In Septem...

Shared Risk Factors for the Perpetration of Physical Dating Violence, Bullying, and Sexual Harassment Among Adolescents Exposed to Domestic Violence.

PubMed

Foshee, Vangie A; McNaughton Reyes, H Luz; Chen, May S; Ennett, Susan T; Basile, Kathleen C; DeGue, Sarah; Vivolo-Kantor, Alana M; Moracco, Kathryn E; Bowling, J Michael

2016-04-01

The high risk of perpetrating physical dating violence, bullying, and sexual harassment by adolescents exposed to domestic violence points to the need for programs to prevent these types of aggression among this group. This study of adolescents exposed to domestic violence examined whether these forms of aggression share risk factors that could be targeted for change in single programs designed to prevent all three types of aggression. Analyses were conducted on 399 mother victims of domestic violence and their adolescents, recruited through community advertising. The adolescents ranged in age from 12 to 16 years; 64 % were female. Generalized estimating equations was used to control for the covariation among the aggression types when testing for shared risk factors. Approximately 70 % of the adolescents reported perpetrating at least one of the three forms of aggression. In models examining one risk factor at a time, but controlling for demographics, adolescent acceptance of sexual violence, mother-adolescent discord, family conflict, low maternal monitoring, low mother-adolescent closeness, low family cohesion, depressed affect, feelings of anger, and anger reactivity were shared across all three aggression types. In multivariable models, which included all of the risk factors examined and the demographic variables, low maternal monitoring, depressed affect and anger reactivity remained significant shared risk factors. Our findings suggest that programs targeting these risk factors for change have the potential to prevent all three forms of aggression. In multivariable models, poor conflict management skills was a risk for bullying and sexual harassment, but not dating violence; acceptance of dating violence was a risk for dating violence and bullying, but not sexual harassment; and none of the examined risk factors were unique to aggression type. The study's implications for the development of interventions and future research are discussed.

Understanding Acceptable Level of Risk: Incorporating the Economic Cost of Under-Managing Invasive Species.

PubMed

Davidson, Alisha D; Hewitt, Chad L; Kashian, Donna R

2015-01-01

Management of nonindigenous species includes prevention, early detection and rapid response and control. Early detection and rapid response depend on prioritizing and monitoring sites at risk for arrival or secondary spread of nonindigenous species. Such monitoring efforts require sufficient biosecurity budgets to be effective and meet management or policy directives for reduced risk of introduction. Such consideration of risk reduction is rarely considered, however. Here, we review the concepts of acceptable level of risk (ALOR) and associated costs with respect to nonindigenous species and present a framework for aligning risk reduction priorities with available biosecurity resources. We conclude that available biosecurity resources may be insufficient to attain stated and desired risk reduction. This outcome highlights the need to consider policy and management directives when beginning a biosecurity program to determine the feasibility of risk reduction goals, given available resources.

A Cost-Benefit Study of a Breaking the Cycle Program for Juveniles

ERIC Educational Resources Information Center

Cowell, Alexander J.; Lattimore, Pamela K.; Krebs, Christopher P.

2010-01-01

The authors present a cost-benefit analysis of a Juvenile Breaking the Cycle (JBTC) program in Oregon designed to provide juvenile justice system monitoring and coordinated treatment and services to youth who are assessed as at high risk for recidivism and substance use. Detailed cost analyses are presented for youth in the JBTC program and a…

A new methodology to identify surface water bodies at risk by using pesticide monitoring data: The glyphosate case study in Lombardy Region (Italy).

PubMed

Di Guardo, Andrea; Finizio, Antonio

2018-01-01

In the last decades, several monitoring programs were established as an effect of EU Directives addressing the quality of water resources (drinking water, groundwater and surface water). Plant Protection Products (PPPs) are an obvious target of monitoring activities, since they are directly released into the environment. One of the challenges in managing the risk of pesticides at the territorial scale is identifying the locations in water bodies needing implementation of risk mitigation measures. In this, the national pesticides monitoring plans could be very helpful. However, monitoring of pesticides is a challenging task because of the high number of registered pesticides, cost of analyses, and the periodicity of sampling related to pesticide application and use. Extensive high-quality data-sets are consequently often missing. More in general, the information that can be obtained from monitoring studies are frequently undervalued by risk managers. In this study, we propose a new methodology providing indications about the need to implement mitigation measures in stretches of surface water bodies on a territory by combining historical series of monitoring data and GIS. The methodology is articulated in two distinct phases: a) acquisition of monitoring data and setting-up of informative layers of georeferenced data (phase 1) and b) statistical and expert analysis for the identification of areas where implementation of limitation or mitigation measures are suggested (phase 2). Our methodology identifies potentially vulnerable water bodies, considering temporal contamination trends and relative risk levels at selected monitoring stations. A case study is presented considering glyphosate monitoring data in Lombardy Region (Northern of Italy) for the 2008-2014 period. Copyright © 2017 Elsevier B.V. All rights reserved.

Targeted surveillance for postnatal hearing loss: a program evaluation.

PubMed

Beswick, Rachael; Driscoll, Carlie; Kei, Joseph; Glennon, Shirley

2012-07-01

The importance of monitoring hearing throughout early childhood cannot be understated. However, there is a lack of evidence available regarding the most effective method of monitoring hearing following the newborn screen. The goal of this study was to describe a targeted surveillance program using a risk factor registry to identify children with a postnatal hearing loss. All children who were born in Queensland, Australia between September 2004 and December 2009, received a bilateral 'pass' on newborn hearing screening, and had at least one risk factor, were referred for targeted surveillance and were included in this study. The cohort was assessed throughout early childhood in accordance with Queensland's diagnostic assessment protocols. During the study period, 7320 (2.8% of 261,328) children were referred for targeted surveillance, of which 56 were identified with a postnatal hearing loss (0.77%). Of these, half (50.0%) were identified with a mild hearing loss, and 64.3% were identified with a sensorineural hearing loss. In regards to risk factors, syndrome, craniofacial anomalies, and severe asphyxia had the highest yield of positive cases of postnatal hearing loss for children referred for targeted surveillance, whereas, low birth weight, bacterial meningitis, and professional concern had a particularly low yield. Limitations of the targeted surveillance program were noted and include: (1) a lost contact rate of 32.4%; (2) delays in first surveillance assessment; (3) a large number of children who required on-going monitoring; and (4) extensive diagnostic assessments were completed on children with normal hearing. Examination of the lost contact rate revealed indigenous children were more likely to be documented as lost contact. In addition, children with one risk factor only were significantly more likely to not attend a surveillance appointment. Positive cases of postnatal hearing loss were detected through the targeted surveillance program. However, the limitations of the program question the usefulness of this service delivery model. For targeted surveillance to continue, time frames for assessment, assessments performed, and discharge criteria need to be revisited. The contribution of individual and combined risk factors in detecting postnatal hearing loss should also be examined in more detail. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

Levels of Viable Enterococci Fecal Indicator Bacteria at a Marine Subtropical Beach: Assessing Temporal and Spatial Variability

EPA Science Inventory

Beach water quality monitoring is an important tool to inform the public of health risks from recreational beach use, as well as to assess the impacts of land-based sources of pollution on coastal ecosystems. Many beach monitoring programs in the US currently utilize a strategy o...

Ozone injury in west coast forests: 6 years of monitoring.

Treesearch

Sally J. Campbell; Ron Wanek; John W. Coulston

2007-01-01

Six years of monitoring for ozone injury by the Pacific Northwest Research Station Forest Inventory and Analysis Program are reported. The methods used to evaluate injury, compute an injury index, and estimate risk are described. Extensive injury was detected on ozone biomonitoring sites for all years in California, with ponderosa and Jeffrey pines, mugwort, skunkbush...

1987 Oak Ridge model conference: Proceedings: Volume 2, Environmental protection

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

Not Available

1987-01-01

See the abstract for Volume I for general information on the conference. Topics discussed in Volume II include data management techiques for environmental protection efforts, the use of models in environmental auditing, in emergency plans, chemical accident emergency response, risk assessment, monitoring of waste sites, air and water monitoring of waste sites, and in training programs. (TEM)

40 CFR 35.310 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... establish and operate compliance monitoring programs to prevent or eliminate unreasonable risks to health or... which the Administrator is unable or not likely to take action for their prevention or elimination. (c...

An Analysis of Academic Assistance Programs on At-Risk Students at the United States Naval Academy

DTIC Science & Technology

2005-06-01

ADDRESS(ES) N/ A 10. SPONSORING/MONITORING AGENCY REPORT NUMBER 11. SUPPLEMENTARY NOTES The views expressed in this thesis are those of the...programs are available to these students. In particular, the Naval Academy administers a program known as the Midshipmen Group Study Program, which...is based on the supplemental instruction model. This study examines the impact of participation in each of these programs as a determinant to

A collaborative university model for employee wellness.

PubMed

Carter, Melondie R; Kelly, Rebecca C; Alexander, Chelley K; Holmes, Lauren M

2011-01-01

Universities are taking a more active approach in understanding and monitoring employees' modifiable health risk factors and chronic care conditions by developing strategies to encourage employees to start and sustain healthy behaviors. WellBama, the University of Alabama's signature health and wellness program, utilizes a collaborative model in partnership with select colleges and departments to implement strategies to improve employees' health status. The program provides onsite health screenings and assessments, timely health advising sessions, assistance in setting and monitoring individual health goals to promote improved health, and preventive examination referrals.

Sampling and monitoring for closure

USGS Publications Warehouse

McLemore, Virginia T.; Smith, Kathleen S.; Russell, Carol C.

2007-01-01

An important aspect of planning a new mine or mine expansion within the modern regulatory framework is to design for ultimate closure. Sampling and monitoring for closure is a form of environmental risk management. By implementing a sampling and monitoring program early in the life of the mining operation, major costs can be avoided or minimized. The costs for treating mine drainage in perpetuity are staggering, especially if they are unanticipated. The Metal Mining Sector of the Acid Drainage Technology Initiative (ADTI-MMS), a cooperative government-industry-academia organization, was established to address drainage-quality technologies of metal mining and metallurgical operations. ADTI-MMS recommends that sampling and monitoring programs consider the entire mine-life cycle and that data needed for closure of an operation be collected from exploration through postclosure.

The Surveillance Error Grid

PubMed Central

Lias, Courtney; Vigersky, Robert; Clarke, William; Parkes, Joan Lee; Sacks, David B.; Kirkman, M. Sue; Kovatchev, Boris

2014-01-01

Introduction: Currently used error grids for assessing clinical accuracy of blood glucose monitors are based on out-of-date medical practices. Error grids have not been widely embraced by regulatory agencies for clearance of monitors, but this type of tool could be useful for surveillance of the performance of cleared products. Diabetes Technology Society together with representatives from the Food and Drug Administration, the American Diabetes Association, the Endocrine Society, and the Association for the Advancement of Medical Instrumentation, and representatives of academia, industry, and government, have developed a new error grid, called the surveillance error grid (SEG) as a tool to assess the degree of clinical risk from inaccurate blood glucose (BG) monitors. Methods: A total of 206 diabetes clinicians were surveyed about the clinical risk of errors of measured BG levels by a monitor. The impact of such errors on 4 patient scenarios was surveyed. Each monitor/reference data pair was scored and color-coded on a graph per its average risk rating. Using modeled data representative of the accuracy of contemporary meters, the relationships between clinical risk and monitor error were calculated for the Clarke error grid (CEG), Parkes error grid (PEG), and SEG. Results: SEG action boundaries were consistent across scenarios, regardless of whether the patient was type 1 or type 2 or using insulin or not. No significant differences were noted between responses of adult/pediatric or 4 types of clinicians. Although small specific differences in risk boundaries between US and non-US clinicians were noted, the panel felt they did not justify separate grids for these 2 types of clinicians. The data points of the SEG were classified in 15 zones according to their assigned level of risk, which allowed for comparisons with the classic CEG and PEG. Modeled glucose monitor data with realistic self-monitoring of blood glucose errors derived from meter testing experiments plotted on the SEG when compared to the data plotted on the CEG and PEG produced risk estimates that were more granular and reflective of a continuously increasing risk scale. Discussion: The SEG is a modern metric for clinical risk assessments of BG monitor errors that assigns a unique risk score to each monitor data point when compared to a reference value. The SEG allows the clinical accuracy of a BG monitor to be portrayed in many ways, including as the percentages of data points falling into custom-defined risk zones. For modeled data the SEG, compared with the CEG and PEG, allows greater precision for quantifying risk, especially when the risks are low. This tool will be useful to allow regulators and manufacturers to monitor and evaluate glucose monitor performance in their surveillance programs. PMID:25562886

The surveillance error grid.

PubMed

Klonoff, David C; Lias, Courtney; Vigersky, Robert; Clarke, William; Parkes, Joan Lee; Sacks, David B; Kirkman, M Sue; Kovatchev, Boris

2014-07-01

Currently used error grids for assessing clinical accuracy of blood glucose monitors are based on out-of-date medical practices. Error grids have not been widely embraced by regulatory agencies for clearance of monitors, but this type of tool could be useful for surveillance of the performance of cleared products. Diabetes Technology Society together with representatives from the Food and Drug Administration, the American Diabetes Association, the Endocrine Society, and the Association for the Advancement of Medical Instrumentation, and representatives of academia, industry, and government, have developed a new error grid, called the surveillance error grid (SEG) as a tool to assess the degree of clinical risk from inaccurate blood glucose (BG) monitors. A total of 206 diabetes clinicians were surveyed about the clinical risk of errors of measured BG levels by a monitor. The impact of such errors on 4 patient scenarios was surveyed. Each monitor/reference data pair was scored and color-coded on a graph per its average risk rating. Using modeled data representative of the accuracy of contemporary meters, the relationships between clinical risk and monitor error were calculated for the Clarke error grid (CEG), Parkes error grid (PEG), and SEG. SEG action boundaries were consistent across scenarios, regardless of whether the patient was type 1 or type 2 or using insulin or not. No significant differences were noted between responses of adult/pediatric or 4 types of clinicians. Although small specific differences in risk boundaries between US and non-US clinicians were noted, the panel felt they did not justify separate grids for these 2 types of clinicians. The data points of the SEG were classified in 15 zones according to their assigned level of risk, which allowed for comparisons with the classic CEG and PEG. Modeled glucose monitor data with realistic self-monitoring of blood glucose errors derived from meter testing experiments plotted on the SEG when compared to the data plotted on the CEG and PEG produced risk estimates that were more granular and reflective of a continuously increasing risk scale. The SEG is a modern metric for clinical risk assessments of BG monitor errors that assigns a unique risk score to each monitor data point when compared to a reference value. The SEG allows the clinical accuracy of a BG monitor to be portrayed in many ways, including as the percentages of data points falling into custom-defined risk zones. For modeled data the SEG, compared with the CEG and PEG, allows greater precision for quantifying risk, especially when the risks are low. This tool will be useful to allow regulators and manufacturers to monitor and evaluate glucose monitor performance in their surveillance programs. © 2014 Diabetes Technology Society.

Investing: reducing risks to enhance returns.

PubMed

West, J; Glickman, S; Seidner, A G

1996-09-01

The financial assets of a healthcare organization can present many opportunities for investment. In order to develop a profitable investment program that avoids risky speculation, however, healthcare financial managers must fully understand the nature and risks of their organizations' investments. They must define and monitor their investment objectives, limitations, levels of acceptable risk and policies and conditions through a statement of investment policy and comprehensive investment guidelines.

Development of a new risk assessment procedure for pinewood nematode in Europe

Treesearch

Hugh F. Evans; Sam Evans; Makihiko Ikegami

2007-01-01

Research, partly funded under the EU PHRAME (Plant Health Risk And Monitoring Evaluation) program has provided new information on the biology and ecology of pinewood nematode (PWN), Bursaphelenchus xylophilus, in Portugal. Studies have been carried out by eight partner research teams in six countries (UK -coordinator, Austria, France, Germany,...

The Modular Borehole Monitoring Program. A research program to optimize well-based monitoring for geologic carbon sequestration

DOE PAGES

Freifeld, Barry; Daley, Tom; Cook, Paul; ...

2014-12-31

Understanding the impacts caused by injection of large volumes of CO 2 in the deep subsurface necessitates a comprehensive monitoring strategy. While surface-based and other remote geophysical methods can provide information on the general morphology of a CO 2 plume, verification of the geochemical conditions and validation of the remote sensing data requires measurements from boreholes that penetrate the storage formation. Unfortunately, the high cost of drilling deep wellbores and deploying instrumentation systems constrains the number of dedicated monitoring borings as well as limits the technologies that can be incorporated in a borehole completion. The objective of the Modular Boreholemore » Monitoring (MBM) Program was to develop a robust suite of well-based tools optimized for subsurface monitoring of CO 2 that could meet the needs of a comprehensive well-based monitoring program. It should have enough flexibility to be easily reconfigured for various reservoir geometries and geologies. The MBM Program sought to provide storage operators with a turn-key fully engineered design that incorporated key technologies, function over the decades long time-span necessary for post-closure reservoir monitoring, and meet industry acceptable risk profiles for deep-well installations. While still within the conceptual design phase of the MBM program, the SECARB Anthropogenic Test in Citronelle, Alabama, USA was identified as a deployment site for our engineered monitoring systems. The initial step in designing the Citronelle MBM system was to down-select from the various monitoring tools available to include technologies that we considered essential to any program. Monitoring methods selected included U-tube geochemical sampling, discrete quartz pressure and temperature gauges, an integrated fibre-optic bundle consisting of distributed temperature and heat-pulse sensing, and a sparse string of conventional 3C-geophones. While not originally planned within the initial MBM work scope, the fibre-optic cable was able to also be used for the emergent technology of distributed acoustic sensing. The MBM monitoring string was installed in March, 2012. To date, the Citronelle MBM instruments continue to operate reliably. Results and lessons learned from the Citronelle MBM deployment are addressed along with examples of data being collected.« less

Validating a Children's Self-Report Plate Waste Questionnaire

ERIC Educational Resources Information Center

Forrestal, Sarah G.; Issel, L. Michele; Kviz, Frederick J.; Chávez, Noel

2008-01-01

Purpose/Objectives: The National School Lunch Program is well situated to address the vulnerability of lower income children at increased risk for both under and overnutrition. Evidence suggests, however, that a significant amount of food served in the program goes uneaten. One way to monitor this problem is through children's self-reported plate…

A Dynamic Programming Model for Optimizing Frequency of Time-Lapse Seismic Monitoring in Geological CO2 Storage

NASA Astrophysics Data System (ADS)

Bhattacharjya, D.; Mukerji, T.; Mascarenhas, O.; Weyant, J.

2005-12-01

Designing a cost-effective and reliable monitoring program is crucial to the success of any geological CO2 storage project. Effective design entails determining both, the optimal measurement modality, as well as the frequency of monitoring the site. Time-lapse seismic provides the best spatial coverage and resolution for reservoir monitoring. Initial results from Sleipner (Norway) have demonstrated effective monitoring of CO2 plume movement. However, time-lapse seismic is an expensive monitoring technique especially over the long term life of a storage project and should be used judiciously. We present a mathematical model based on dynamic programming that can be used to estimate site-specific optimal frequency of time-lapse surveys. The dynamics of the CO2 sequestration process are simplified and modeled as a four state Markov process with transition probabilities. The states are M: injected CO2 safely migrating within the target zone; L: leakage from the target zone to the adjacent geosphere; R: safe migration after recovery from leakage state; and S: seepage from geosphere to the biosphere. The states are observed only when a monitoring survey is performed. We assume that the system may go to state S only from state L. We also assume that once observed to be in state L, remedial measures are always taken to bring it back to state R. Remediation benefits are captured by calculating the expected penalty if CO2 seeped into the biosphere. There is a trade-off between the conflicting objectives of minimum discounted costs of performing the next time-lapse survey and minimum risk of seepage and its associated costly consequences. A survey performed earlier would spot the leakage earlier. Remediation methods would have been utilized earlier, resulting in savings in costs attributed to excessive seepage. On the other hand, there are also costs for the survey and remedial measures. The problem is solved numerically using Bellman's optimality principal of dynamic programming to optimize over the entire finite time horizon. We use a Monte Carlo approach to explore trade-offs between survey costs, remediation costs, and survey frequency and to analyze the sensitivity to leakage probabilities, and carbon tax. The model can be useful in determining a monitoring regime appropriate to a specific site's risk and set of remediation options, rather than a generic one based on a maximum downside risk threshold for CO2 storage as a whole. This may have implications on the overall costs associated with deploying Carbon capture and storage on a large scale.

Genetic Factors Involved in Fumonisin Accumulation in Maize Kernels and Their Implications in Maize Agronomic Management and Breeding

PubMed Central

Santiago, Rogelio; Cao, Ana; Butrón, Ana

2015-01-01

Contamination of maize with fumonisins depends on the environmental conditions; the maize resistance to contamination and the interaction between both factors. Although the effect of environmental factors is a determinant for establishing the risk of kernel contamination in a region, there is sufficient genetic variability among maize to develop resistance to fumonisin contamination and to breed varieties with contamination at safe levels. In addition, ascertaining which environmental factors are the most important in a region will allow the implementation of risk monitoring programs and suitable cultural practices to reduce the impact of such environmental variables. The current paper reviews all works done to address the influence of environmental variables on fumonisin accumulation, the genetics of maize resistance to fumonisin accumulation, and the search for the biochemical and/or structural mechanisms of the maize plant that could be involved in resistance to fumonisin contamination. We also explore the outcomes of breeding programs and risk monitoring of undertaken projects. PMID:26308050

Genetic Factors Involved in Fumonisin Accumulation in Maize Kernels and Their Implications in Maize Agronomic Management and Breeding.

PubMed

Santiago, Rogelio; Cao, Ana; Butrón, Ana

2015-08-20

Contamination of maize with fumonisins depends on the environmental conditions; the maize resistance to contamination and the interaction between both factors. Although the effect of environmental factors is a determinant for establishing the risk of kernel contamination in a region, there is sufficient genetic variability among maize to develop resistance to fumonisin contamination and to breed varieties with contamination at safe levels. In addition, ascertaining which environmental factors are the most important in a region will allow the implementation of risk monitoring programs and suitable cultural practices to reduce the impact of such environmental variables. The current paper reviews all works done to address the influence of environmental variables on fumonisin accumulation, the genetics of maize resistance to fumonisin accumulation, and the search for the biochemical and/or structural mechanisms of the maize plant that could be involved in resistance to fumonisin contamination. We also explore the outcomes of breeding programs and risk monitoring of undertaken projects.

Implementation of evidence-based home visiting programs aimed at reducing child maltreatment: A meta-analytic review.

PubMed

Casillas, Katherine L; Fauchier, Angèle; Derkash, Bridget T; Garrido, Edward F

2016-03-01

In recent years there has been an increase in the popularity of home visitation programs as a means of addressing risk factors for child maltreatment. The evidence supporting the effectiveness of these programs from several meta-analyses, however, is mixed. One potential explanation for this inconsistency explored in the current study involves the manner in which these programs were implemented. In the current study we reviewed 156 studies associated with 9 different home visitation program models targeted to caregivers of children between the ages of 0 and 5. Meta-analytic techniques were used to determine the impact of 18 implementation factors (e.g., staff selection, training, supervision, fidelity monitoring, etc.) and four study characteristics (publication type, target population, study design, comparison group) in predicting program outcomes. Results from analyses revealed that several implementation factors, including training, supervision, and fidelity monitoring, had a significant effect on program outcomes, particularly child maltreatment outcomes. Study characteristics, including the program's target population and the comparison group employed, also had a significant effect on program outcomes. Implications of the study's results for those interested in implementing home visitation programs are discussed. A careful consideration and monitoring of program implementation is advised as a means of achieving optimal study results. Copyright © 2015 Elsevier Ltd. All rights reserved.

Monitoring Results in Routine Immunization: Development of Routine Immunization Dashboard in Selected African Countries in the Context of the Polio Eradication Endgame Strategic Plan.

PubMed

Poy, Alain; van den Ent, Maya M V X; Sosler, Stephen; Hinman, Alan R; Brown, Sidney; Sodha, Samir; Ehlman, Daniel C; Wallace, Aaron S; Mihigo, Richard

2017-07-01

To monitor immunization-system strengthening in the Polio Eradication Endgame Strategic Plan 2013-2018 (PEESP), the Global Polio Eradication Initiative identified 1 indicator: 10% annual improvement in third dose of diphtheria- tetanus-pertussis-containing vaccine (DTP3) coverage in polio high-risk districts of 10 polio focus countries. A multiagency team, including staff from the African Region, developed a comprehensive list of outcome and process indicators measuring various aspects of the performance of an immunization system. The development and implementation of the dashboard to assess immunization system performance allowed national program managers to monitor the key immunization indicators and stratify by high-risk and non-high-risk districts. Although only a single outcome indicator goal (at least 10% annual increase in DTP3 coverage achieved in 80% of high-risk districts) initially existed in the endgame strategy, we successfully added additional outcome indicators (eg, decreasing the number of DTP3-unvaccinated children) as well as program process indicators focusing on cold chain, stock availability, and vaccination sessions to better describe progress on the pathway to raising immunization coverage. When measuring progress toward improving immunization systems, it is helpful to use a comprehensive approach that allows for measuring multiple dimensions of the system. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Monitoring minimization of grade B environments based on risk assessment using three-dimensional airflow measurements and computer simulation.

PubMed

Katayama, Hirohito; Higo, Takashi; Tokunaga, Yuji; Katoh, Shigeo; Hiyama, Yukio; Morikawa, Kaoru

2008-01-01

A practical, risk-based monitoring approach using the combined data collected from actual experiments and computer simulations was developed for the qualification of an EU GMP Annex 1 Grade B, ISO Class 7 area. This approach can locate and minimize the representative number of sampling points used for microbial contamination risk assessment. We conducted a case study on an aseptic clean room, newly constructed and specifically designed for the use of a restricted access barrier system (RABS). Hotspots were located using three-dimensional airflow analysis based on a previously published empirical measurement method, the three-dimensional airflow analysis. Local mean age of air (LMAA) values were calculated based on computer simulations. Comparable results were found using actual measurements and simulations, demonstrating the potential usefulness of such tools in estimating contamination risks based on the airflow characteristics of a clean room. Intensive microbial monitoring and particle monitoring at the Grade B environmental qualification stage, as well as three-dimensional airflow analysis, were also conducted to reveal contamination hotspots. We found representative hotspots were located at perforated panels covering the air exhausts where the major piston airflows collect in the Grade B room, as well as at any locations within the room that were identified as having stagnant air. However, we also found that the floor surface air around the exit airway of the RABS EU GMP Annex 1 Grade A, ISO Class 5 area was always remarkably clean, possibly due to the immediate sweep of the piston airflow, which prevents dispersed human microbes from falling in a Stokes-type manner on settling plates placed on the floor around the Grade A exit airway. In addition, this airflow is expected to be clean with a significantly low LMAA. Based on these observed results, we propose a simplified daily monitoring program to monitor microbial contamination in Grade B environments. To locate hotspots we propose using a combination of computer simulation, actual airflow measurements, and intensive environmental monitoring at the qualification stage. Thereafter, instead of particle or microbial air monitoring, we recommend the use of microbial surface monitoring at the main air exhaust. These measures would be sufficient to assure the efficiency of the monitoring program, as well as to minimize the number of surface sampling points used in environments surrounding a RABS.

Revision of Viable Environmental Monitoring in a Development Pilot Plant Based on Quality Risk Assessment: A Case Study.

PubMed

Ziegler, Ildikó; Borbély-Jakab, Judit; Sugó, Lilla; Kovács, Réka J

2017-01-01

In this case study, the principles of quality risk management were applied to review sampling points and monitoring frequencies in the hormonal tableting unit of a formulation development pilot plant. In the cleanroom area, premises of different functions are located. Therefore a general method was established for risk evaluation based on the Hazard Analysis and Critical Control Points (HACCP) method to evaluate these premises (i.e., production area itself and ancillary clean areas) from the point of view of microbial load and state in order to observe whether the existing monitoring program met the emerged advanced monitoring practice. LAY ABSTRACT: In pharmaceutical production, cleanrooms are needed for the manufacturing of final dosage forms of drugs-intended for human or veterinary use-in order to protect the patient's weakened body from further infections. Cleanrooms are premises with a controlled level of contamination that is specified by the number of particles per cubic meter at a specified particle size or number of microorganisms (i.e. microbial count) per surface area. To ensure a low microbial count over time, microorganisms are detected and counted by environmental monitoring methods regularly. It is reasonable to find the easily infected places by risk analysis to make sure the obtained results really represent the state of the whole room. This paper presents a risk analysis method for the optimization of environmental monitoring and verification of the suitability of the method. © PDA, Inc. 2017.

Health risk evaluation associated to Planktothrix rubescens: An integrated approach to design tailored monitoring programs for human exposure to cyanotoxins.

PubMed

Manganelli, Maura; Scardala, Simona; Stefanelli, Mara; Vichi, Susanna; Mattei, Daniela; Bogialli, Sara; Ceccarelli, Piegiorgio; Corradetti, Ernesto; Petrucci, Ines; Gemma, Simonetta; Testai, Emanuela; Funari, Enzo

2010-03-01

Increasing concern for human health related to cyanotoxin exposure imposes the identification of pattern and level of exposure; however, current monitoring programs, based on cyanobacteria cell counts, could be inadequate. An integrated approach has been applied to a small lake in Italy, affected by Planktothrix rubescens blooms, to provide a scientific basis for appropriate monitoring program design. The cyanobacterium dynamic, the lake physicochemical and trophic status, expressed as nutrients concentration and recycling rates due to bacterial activity, the identification/quantification of toxic genotype and cyanotoxin concentration have been studied. Our results indicate that low levels of nutrients are not a marker for low risk of P. rubescens proliferation and confirm that cyanobacterial density solely is not a reliable parameter to assess human exposure. The ratio between toxic/non-toxic cells, and toxin concentrations, which can be better explained by toxic population dynamic, are much more diagnostic, although varying with time and environmental conditions. The toxic fraction within P. rubescens population is generally high (30-100%) and increases with water depth. The ratio toxic/non-toxic cells is lowest during the bloom, suggesting a competitive advantage for non-toxic cells. Therefore, when P. rubescens is the dominant species, it is important to analyze samples below the thermocline, and quantitatively estimate toxic genotype abundance. In addition, the identification of cyanotoxin content and congeners profile, with different toxic potential, are crucial for risk assessment. Copyright 2009 Elsevier Ltd. All rights reserved.

Early detection monitoring for larval dreissenid mussels: How much plankton sampling is enough?

USGS Publications Warehouse

Counihan, Timothy D.; Bollens, Stephen M.

2017-01-01

The development of quagga and zebra mussel (dreissenids) monitoring programs in the Pacific Northwest provides a unique opportunity to evaluate a regional invasive species detection effort early in its development. Recent studies suggest that the ecological and economic costs of a dreissenid infestation in the Pacific Northwest of the USA would be significant. Consequently, efforts are underway to monitor for the presence of dreissenids. However, assessments of whether these efforts provide for early detection are lacking. We use information collected from 2012 to 2014 to characterize the development of larval dreissenid monitoring programs in the states of Idaho, Montana, Oregon, and Washington in the context of introduction and establishment risk. We also estimate the effort needed for high-probability detection of rare planktonic taxa in four Columbia and Snake River reservoirs and assess whether the current level of effort provides for early detection. We found that the effort expended to monitor for dreissenid mussels increased substantially from 2012 to 2014, that efforts were distributed across risk categories ranging from high to very low, and that substantial gaps in our knowledge of both introduction and establishment risk exist. The estimated volume of filtered water required to fully census planktonic taxa or to provide high-probability detection of rare taxa was high for the four reservoirs examined. We conclude that the current level of effort expended does not provide for high-probability detection of larval dreissenids or other planktonic taxa when they are rare in these reservoirs. We discuss options to improve early detection capabilities.

Vaccine safety monitoring systems in developing countries: an example of the Vietnam model.

PubMed

Ali, Mohammad; Rath, Barbara; Thiem, Vu Dinh

2015-01-01

Only few health intervention programs have been as successful as vaccination programs with respect to preventing morbidity and mortality in developing countries. However, the success of a vaccination program is threatened by rumors and misunderstanding about the risks of vaccines. It is short-sighted to plan the introduction of vaccines into developing countries unless effective vaccine safety monitoring systems are in place. Such systems that track adverse events following immunization (AEFI) is currently lacking in most developing countries. Therefore, any rumor may affect the entire vaccination program. Public health authorities should implement the safety monitoring system of vaccines, and disseminate safety issues in a proactive mode. Effective safety surveillance systems should allow for the conduct of both traditional and alternative epidemiologic studies through the use of prospective data sets. The vaccine safety data link implemented in Vietnam in mid-2002 indicates that it is feasible to establish a vaccine safety monitoring system for the communication of vaccine safety in developing countries. The data link provided the investigators an opportunity to evaluate AEFI related to measles vaccine. Implementing such vaccine safety monitoring system is useful in all developing countries. The system should be able to make objective and clear communication regarding safety issues of vaccines, and the data should be reported to the public on a regular basis for maintaining their confidence in vaccination programs.

Environmental monitoring and research at the John F. Kennedy Space Center

NASA Technical Reports Server (NTRS)

Hall, C. R.; Hinkle, C. R.; Knott, W. M.; Summerfield, B. R.

1992-01-01

The Biomedical Operations and Research Office at the NASA John F. Kennedy Space Center has been supporting environmental monitoring and research since the mid-1970s. Program elements include monitoring of baseline conditions to document natural variability in the ecosystem, assessments of operations and construction of new facilities, and ecological research focusing on wildlife habitat associations. Information management is centered around development of a computerized geographic information system that incorporates remote sensing and digital image processing technologies along with traditional relational data base management capabilities. The proactive program is one in which the initiative is to anticipate potential environmental concerns before they occur and, by utilizing in-house expertise, develop impact minimization or mitigation strategies to reduce environmental risk.

Atypical antipsychotics and metabolic syndrome in patients with schizophrenia: risk factors, monitoring, and healthcare implications.

PubMed

Riordan, Henry J; Antonini, Paola; Murphy, Michael F

2011-09-01

Metabolic syndrome is a leading cause of morbidity and mortality in patients with schizophrenia, with a prevalence rate double that of nonpsychiatric populations. Given the amount of evidence suggesting a link between atypical antipsychotic medications and metabolic syndrome, several agencies have recommended regular clinical monitoring of weight, symptoms of hyperglycemia, and glucose in chronically medicated patients with schizophrenia. To summarize the current literature on atypical antipsychotic-induced metabolic syndrome in patients with schizophrenia, outline some of the molecular mechanisms behind this syndrome, identify demographic and disease-related risk factors, and describe cost-effective methods for surveillance. The differential prevalence of metabolic syndrome associated with various atypical antipsychotic medications has been evidenced across numerous studies, with higher effects seen for certain antipsychotic medications on weight gain, waist circumference, fasting triglyceride level, and glucose levels. Given the association of these symptoms, all atypical antipsychotic medications currently include a warning about the risk of hyperglycemia and diabetes, as well as suggestions for regular monitoring. Despite this, very little data are available to support adherence to these monitoring recommendations. Lack of awareness and resources, diffusion of responsibility, policy implementation, and organizational structure have all been implicated. The treatment of schizophrenia involves a balance in terms of risks and benefits. Failing to treat because of risk for complications from metabolic syndrome may place the patient at a higher risk for more serious health outcomes. Supporting programs aimed at increasing monitoring of simple laboratory and clinical measures associated with metabolic syndrome may decrease important risk factors, improve patients' quality of life, and reduce healthcare costs.

Using adaptive processes and adverse outcome pathways to develop meaningful, robust, and actionable environmental monitoring programs.

PubMed

Arciszewski, Tim J; Munkittrick, Kelly R; Scrimgeour, Garry J; Dubé, Monique G; Wrona, Fred J; Hazewinkel, Rod R

2017-09-01

The primary goals of environmental monitoring are to indicate whether unexpected changes related to development are occurring in the physical, chemical, and biological attributes of ecosystems and to inform meaningful management intervention. Although achieving these objectives is conceptually simple, varying scientific and social challenges often result in their breakdown. Conceptualizing, designing, and operating programs that better delineate monitoring, management, and risk assessment processes supported by hypothesis-driven approaches, strong inference, and adverse outcome pathways can overcome many of the challenges. Generally, a robust monitoring program is characterized by hypothesis-driven questions associated with potential adverse outcomes and feedback loops informed by data. Specifically, key and basic features are predictions of future observations (triggers) and mechanisms to respond to success or failure of those predictions (tiers). The adaptive processes accelerate or decelerate the effort to highlight and overcome ignorance while preventing the potentially unnecessary escalation of unguided monitoring and management. The deployment of the mutually reinforcing components can allow for more meaningful and actionable monitoring programs that better associate activities with consequences. Integr Environ Assess Manag 2017;13:877-891. © 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 Management for Human Support Technology Development

NASA Technical Reports Server (NTRS)

jones, Harry

2005-01-01

NASA requires continuous risk management for all programs and projects. The risk management process identifies risks, analyzes their impact, prioritizes them, develops and carries out plans to mitigate or accept them, tracks risks and mitigation plans, and communicates and documents risk information. Project risk management is driven by the project goal and is performed by the entire team. Risk management begins early in the formulation phase with initial risk identification and development of a risk management plan and continues throughout the project life cycle. This paper describes the risk management approach that is suggested for use in NASA's Human Support Technology Development. The first step in risk management is to identify the detailed technical and programmatic risks specific to a project. Each individual risk should be described in detail. The identified risks are summarized in a complete risk list. Risk analysis provides estimates of the likelihood and the qualitative impact of a risk. The likelihood and impact of the risk are used to define its priority location in the risk matrix. The approaches for responding to risk are either to mitigate it by eliminating or reducing the effect or likelihood of a risk, to accept it with a documented rationale and contingency plan, or to research or monitor the risk, The Human Support Technology Development program includes many projects with independently achievable goals. Each project must do independent risk management, considering all its risks together and trading them against performance, budget, and schedule. Since the program can succeed even if some projects fail, the program risk has a complex dependence on the individual project risks.

Health-Based Cyanotoxin Guideline Values Allow for Cyanotoxin-Based Monitoring and Efficient Public Health Response to Cyanobacterial Blooms

PubMed Central

Farrer, David; Counter, Marina; Hillwig, Rebecca; Cude, Curtis

2015-01-01

Human health risks from cyanobacterial blooms are primarily related to cyanotoxins that some cyanobacteria produce. Not all species of cyanobacteria can produce toxins. Those that do often do not produce toxins at levels harmful to human health. Monitoring programs that use identification of cyanobacteria genus and species and enumeration of cyanobacterial cells as a surrogate for cyanotoxin presence can overestimate risk and lead to unnecessary health advisories. In the absence of federal criteria for cyanotoxins in recreational water, the Oregon Health Authority (OHA) developed guideline values for the four most common cyanotoxins in Oregon’s fresh waters (anatoxin-a, cylindrospermopsin, microcystins, and saxitoxins). OHA developed three guideline values for each of the cyanotoxins found in Oregon. Each of the guideline values is for a specific use of cyanobacteria-affected water: drinking water, human recreational exposure and dog recreational exposure. Having cyanotoxin guidelines allows OHA to promote toxin-based monitoring (TBM) programs, which reduce the number of health advisories and focus advisories on times and places where actual, rather than potential, risks to health exist. TBM allows OHA to more efficiently protect public health while reducing burdens on local economies that depend on water recreation-related tourism. PMID:25664510

Spatial-temporal and cancer risk assessment of selected hazardous air pollutants in Seattle.

PubMed

Wu, Chang-fu; Liu, L-J Sally; Cullen, Alison; Westberg, Hal; Williamson, John

2011-01-01

In the Seattle Air Toxics Monitoring Pilot Program, we measured 15 hazardous air pollutants (HAPs) at 6 sites for more than a year between 2000 and 2002. Spatial-temporal variations were evaluated with random-effects models and principal component analyses. The potential health risks were further estimated based on the monitored data, with the incorporation of the bootstrapping technique for the uncertainty analysis. It is found that the temporal variability was generally higher than the spatial variability for most air toxics. The highest temporal variability was observed for tetrachloroethylene (70% temporal vs. 34% spatial variability). Nevertheless, most air toxics still exhibited significant spatial variations, even after accounting for the temporal effects. These results suggest that it would require operating multiple air toxics monitoring sites over a significant period of time with proper monitoring frequency to better evaluate population exposure to HAPs. The median values of the estimated inhalation cancer risks ranged between 4.3 × 10⁻⁵ and 6.0 × 10⁻⁵, with the 5th and 95th percentile levels exceeding the 1 in a million level. VOCs as a whole contributed over 80% of the risk among the HAPs measured and arsenic contributed most substantially to the overall risk associated with metals. Copyright © 2010 Elsevier Ltd. All rights reserved.

All That Money and for What Purpose? Examining Selected State Departments' of Education Accountability for Implementation, Monitoring, and Evaluation of Supplemental Education Services

ERIC Educational Resources Information Center

Giles, Bethany A.

2013-01-01

This study examined the accountability of selected state departments of education on how they implemented, monitored, and evaluated Supplemental Education Services (SES). No Child Left Behind (NCLB) requires low-performing Title I schools to use federal funds to extend the school day for at-risk children by providing SES afterschool programs. This…

Mountain birdwatch: developing a coordinated monitoring program for high-elevation birds in the Atlantic northern forest

Treesearch

John D. Lloyd; Julie Hart; J. Dan Lambert

2010-01-01

Birds occupying high-elevation forests in the northeast are perceived to be at risk from a variety of external forces, most notably the potential loss and alteration of habitat associated with global climate change and the increased deployment of wind-energy facilities. However, the Breeding Bird Survey (BBS), a standardized national monitoring scheme widely used to...

A comprehensive perinatal patient safety program to reduce preventable adverse outcomes and costs of liability claims.

PubMed

Simpson, Kathleen Rice; Kortz, Carol C; Knox, G Eric

2009-11-01

To achieve the goal of safe care for mothers and infants during labor and birth, Catholic Healthcare Partners (CHP; Cincinnati) conducted on-site risk assessments at the 16 hospitals with perinatal units in 2004-2005, with follow-up visits in 2006 through 2008. ON-SITE RISK ASSESSMENTS: In addition to assessing overall organizational risk, the assessments provided each hospital a gap analysis demonstrating up-to-date and outdated practices and strategies and resources necessary to make all practices consistent with current evidence and national guidelines and standards. CRITICAL ASPECTS OF CLINICAL CARE: Review of claims and near-miss data indicate that fetal assessment, labor induction, and second-stage labor care comprise the majority of risk of perinatal harm. Therefore, these clinical areas were the focus of strategies to promote safety. To promote consistency in knowledge and practice, in 2004 a variety of strategies were recommended, including interdisciplinary fetal monitoring education and routine medical record reviews to monitor ongoing adherence to appropriate practice and documentation. Success in implementing essential structural and process components of the perinatal patient safety program have resulted in improvement from 2003 to 2008 in specific outcomes for the 16 perinatal units surveyed, including reduction of perinatal harm, number of claims, and costs of claims. The program continues to evolve with modifications as needed as more evidence becomes available to guide best perinatal practices and new guidelines/standards are published. A patient safety program guided and supported by a health care system can result in safer clinical environments in individual hospitals and in decreased risk of preventable perinatal harm and liability costs.

Shared Risk Factors for the Perpetration of Physical Dating Violence, Bullying, and Sexual Harassment Among Adolescents Exposed to Domestic Violence

PubMed Central

McNaughton Reyes, H. Luz; Chen, May S.; Ennett, Susan T.; Basile, Kathleen C.; DeGue, Sarah; Vivolo-Kantor, Alana M.; Moracco, Kathryn E.; Bowling, J. Michael

2016-01-01

The high risk of perpetrating physical dating violence, bullying, and sexual harassment by adolescents exposed to domestic violence points to the need for programs to prevent these types of aggression among this group. This study of adolescents exposed to domestic violence examined whether these forms of aggression share risk factors that could be targeted for change in single programs designed to prevent all three types of aggression. Analyses were conducted on 399 mother victims of domestic violence and their adolescents, recruited through community advertising. The adolescents ranged in age from 12 to 16 years; 64 % were female. Generalized estimating equations was used to control for the covariation among the aggression types when testing for shared risk factors. Approximately 70 % of the adolescents reported perpetrating at least one of the three forms of aggression. In models examining one risk factor at a time, but controlling for demographics, adolescent acceptance of sexual violence, mother–adolescent discord, family conflict, low maternal monitoring, low mother–adolescent closeness, low family cohesion, depressed affect, feelings of anger, and anger reactivity were shared across all three aggression types. In multivariable models, which included all of the risk factors examined and the demographic variables, low maternal monitoring, depressed affect and anger reactivity remained significant shared risk factors. Our findings suggest that programs targeting these risk factors for change have the potential to prevent all three forms of aggression. In multivariable models, poor conflict management skills was a risk for bullying and sexual harassment, but not dating violence; acceptance of dating violence was a risk for dating violence and bullying, but not sexual harassment; and none of the examined risk factors were unique to aggression type. The study’s implications for the development of interventions and future research are discussed. PMID:26746242

Cost-effectiveness of workplace wellness to prevent cardiovascular events among U.S. firefighters.

PubMed

Patterson, P Daniel; Smith, Kenneth J; Hostler, David

2016-11-21

The leading cause of death among firefighters in the United States (U.S.) is cardiovascular events (CVEs) such as sudden cardiac arrest and myocardial infarction. This study compared the cost-effectiveness of three strategies to prevent CVEs among firefighters. We used a cost-effectiveness analysis model with published observational and clinical data, and cost quotes for physiologic monitoring devices to determine the cost-effectiveness of three CVE prevention strategies. We adopted the fire department administrator perspective and varied parameter estimates in one-way and two-way sensitivity analyses. A wellness-fitness program prevented 10% of CVEs, for an event rate of 0.9% at $1440 over 10-years, or an incremental cost-effectiveness ratio of $1.44 million per CVE prevented compared to no program. In one-way sensitivity analyses, monitoring was favored if costs were < $116/year. In two-way sensitivity analyses, monitoring was not favored if cost was ≥ $399/year. A wellness-fitness program was not favored if its preventive relative risk was >0.928. Wellness-fitness programs may be a cost-effective solution to preventing CVE among firefighters compared to real-time physiologic monitoring or doing nothing.

Preventing falls in assisted living: Results of a quality improvement pilot study.

PubMed

Zimmerman, Sheryl; Greene, Angela; Sloane, Philip D; Mitchell, Madeline; Giuliani, Carol; Nyrop, Kirsten; Walsh, Edith

Residents of assisted living (AL) communities are at high risk for falls, which result in negative outcomes and high health care costs. Adapting effective falls prevention programs for AL quality improvement (QI) has the potential to reduce falls, improve resident quality of life, and reduce costs. This project tested the feasibility and outcomes of an evidence-based multi-component QI program, the Assisted Living Falls Prevention and Monitoring Program (AL-FPMP). Resident posture and gait improved, likely due to exercise and/or physical therapy. Effective falls prevention QI programs can be implemented in AL, and are advised to (1) establish and maintain a falls team to create a culture focused on the reduction of falls risk; (2) teach staff to assess residents using the Morse Falls Scale to increase their awareness of residents' falls risk and improvement; and (3) modify existing exercise programs to address balance and lower body strength. Copyright © 2016 Elsevier Inc. All rights reserved.

Monitoring and Evaluating the National Program to Prevent Mother-to-Child HIV Transmission in Thailand

ERIC Educational Resources Information Center

Kanshana, Siripon; Naiwatanakul, Thananda; Simonds, R. J.; Amornwichet, Pornsinee; Teeraratkul, Achara; Culnane, Mary; Chantharojwong, Nartlada; Limpakarnjanarat, Khanchit

2004-01-01

Thailand has had an epidemic of heterosexually transmitted human immunodeficiency virus (HIV) infection since the mid-1980s that has affected both high-risk populations (such as commercial sex workers) and low-risk populations (such as wives of men who have sex with commercial sex workers). As a result, the prevalence of HIV infection among…

Data Safety Monitoring Boards and Other Study Methodologies that Address Subject Safety in "High-Risk" Therapeutic Trials in Youths

ERIC Educational Resources Information Center

Carandang, Carlo; Santor, Darcy; Gardner, David M.; Carrey, Normand; Kutcher, Stan

2007-01-01

The underlying proposition for any experimental/therapeutic trial is the uncertainty that the risks of treatment will be outweighed by its benefits. For some therapeutic interventions (e.g., exercise programs, vitamin supplementation), the potential for treatment-emergent adverse events may prima facie be low or negligible, whereas for others…

Monitoring for Renal Stone Recurrence in Astronauts With History of Stone

NASA Technical Reports Server (NTRS)

Reyes, David P.; Sargsyan, Ashot; Locke, James; Davis, Jeffrey

2014-01-01

After an initial stone episode persons are at increased risk for future stone formation. A systematic approach is required to monitor the efficacy of treatment and preventive measures, and to assess the risk of developing new stones. This is important for persons working in critical jobs or austere environments, such as astronauts. A literature review of the current standards of care for renal stone monitoring and imaging was done. Military and civil aviation standards were also reviewed, as well as the medical precedents from the space program. Additionally, a new, more effective, renal stone ultrasound protocol has been developed. Using this work, a monitoring algorithm was proposed that takes into consideration the unique mission and operational environment of spaceflight. The approach to imaging persons with history of renal stones varies widely in the literature. Imaging is often done yearly or biannually, which may be too long for mission critical personnel. In the proposed algorithm astronauts with a history of renal stone, who may be under consideration for assignment, are imaged by a detailed, physiciandriven, ultrasound protocol. Unassigned personnel are monitored by yearly ultrasound and urine studies. Any positive ultrasound study is then followed by low-dose renal computed tomography scan. Other criteria are also established. The proposed algorithm provides a balanced approach between efficacy and reduced radiation exposure for the monitoring of astronauts with a renal stone history. This may eventually allow a transition from a risk-averse, to a risk-modifying approach that can enable continued service of individuals with history of renal stone that have adequately controlled risk factors.

A Changing Landscape for Vitamin A Programs: Implications for Optimal Intervention Packages, Program Monitoring, and Safety.

PubMed

Klemm, Rolf D W; Palmer, Amanda C; Greig, Alison; Engle-Stone, Reina; Dalmiya, Nita

2016-06-01

Vitamin A deficiency (VAD) remains a widespread public health problem in the developing world, despite changes in under-5 mortality rates, morbidity patterns, and intervention options. This article considers the implications of a changing epidemiologic and programmatic landscape for vitamin A (VA) programs. We review progress to prevent VAD and its health consequences, assess gaps in VA status and intervention coverage data, and assess data needed to guide decisions regarding the optimal mix, targeting, and dose of VA interventions to maximize benefit and minimize risk. Vitamin A supplementation programs have contributed to the reduction in under-5 mortality rates, but alone, do not address the underlying problem of inadequate dietary VA intakes and VAD among preschool-aged children in the developing world. A combination of VA interventions (eg, supplementation, fortified foods, multiple micronutrient powders, and lipid-based nutrient supplements) will be required to achieve VA adequacy in most settings. Current efforts to measure the coverage of multiple VA interventions, as well as whether and how much VA children are receiving, are few and fragmented. Where intervention overlap exists, further effort is needed to monitor VA intakes, ensuring that targeted groups are consuming adequate amounts but not exceeding the tolerable upper intake level. Vitamin A status data will also be critical for navigating the changing landscape of VA programs. Data from these monitoring efforts will help to guide decisions on the optimal mix, targeting, and exposure to VA interventions to maximize public health benefit while minimizing any potential risk. © The Author(s) 2016.

Process Evaluation of the Type 2 Diabetes Mellitus PULSE Program Randomized Controlled Trial: Recruitment, Engagement, and Overall Satisfaction.

PubMed

Aguiar, Elroy J; Morgan, Philip J; Collins, Clare E; Plotnikoff, Ronald C; Young, Myles D; Callister, Robin

2017-07-01

Men are underrepresented in weight loss and type 2 diabetes mellitus (T2DM) prevention studies. To determine the effectiveness of recruitment, and acceptability of the T2DM Prevention Using LifeStyle Education (PULSE) Program-a gender-targeted, self-administered intervention for men. Men (18-65 years, high risk for T2DM) were randomized to intervention ( n = 53) or wait-list control groups ( n = 48). The 6-month PULSE Program intervention focused on weight loss, diet, and exercise for T2DM prevention. A process evaluation questionnaire was administered at 6 months to examine recruitment and selection processes, and acceptability of the intervention's delivery and content. Associations between self-monitoring and selected outcomes were assessed using Spearman's rank correlation. A pragmatic recruitment and online screening process was effective in identifying men at high risk of T2DM (prediabetes prevalence 70%). Men reported the trial was appealing because it targeted weight loss, T2DM prevention, and getting fit, and because it was perceived as "doable" and tailored for men. The intervention was considered acceptable, with men reporting high overall satisfaction (83%) and engagement with the various components. Adherence to self-monitoring was poor, with only 13% meeting requisite criteria. However, significant associations were observed between weekly self-monitoring of weight and change in weight ( r s = -.47, p = .004) and waist circumference ( r s = -.38, p = .026). Men reported they would have preferred more intervention contact, for example, by phone or email. Gender-targeted, self-administered lifestyle interventions are feasible, appealing, and satisfying for men. Future studies should explore the effects of additional non-face-to-face contact on motivation, accountability, self-monitoring adherence, and program efficacy.

Space Station Freedom Environmental Health Care Program

NASA Technical Reports Server (NTRS)

Richard, Elizabeth E.; Russo, Dane M.

1992-01-01

The paper discusses the environmental planning and monitoring aspects of the Space Station Freedom (SSF) Environmental Health Care Program, which encompasses all phases of the SSF assembly and operation from the first element entry at MB-6 through the Permanent Manned Capability and beyond. Environmental planning involves the definition of acceptability limits and monitoring requirements for the radiation dose barothermal parameters and potential contaminants in the SSF air and water and on internal surfaces. Inflight monitoring will be implemented through the Environmental Health System, which consists of five subsystems: Microbiology, Toxicology, Water Quality, Radiation, and Barothermal Physiology. In addition to the environmental data interpretation and analysis conducted after each mission, the new data will be compared to archived data for statistical and long-term trend analysis and determination of risk exposures. Results of these analyses will be used to modify the acceptability limits and monitoring requirements for the future.

Monitoring the welfare of polar bear populations in a rapidly changing Arctic

USGS Publications Warehouse

Atwood, Todd C.; Duncan, Colleen G.; Patyk, Kelly A.; Sonsthagen, Sarah A.

2017-01-01

Most programs for monitoring the welfare of wildlife populations support efforts aimed at reaching discrete management objectives, like mitigating conflict with humans. While such programs can be effective, their limited scope may preclude systemic evaluations needed for large-scale conservation initiatives, like the recovery of at-risk species. We discuss select categories of metrics that can be used to monitor how polar bears (Ursus maritimus) are responding to the primary threat to their long-term persistence—loss of sea ice habitat due to the unabated rise in atmospheric greenhouse gas (GHG; e.g., CO2) concentrations—that can also provide information on ecosystem function and health. Monitoring key aspects of polar bear population dynamics, spatial behavior, health and resiliency can provide valuable insight into ecosystem state and function, and could be a powerful tool for achieving Arctic conservation objectives, particularly those that have transnational policy implications.

Environmental exposure modeling and monitoring of human pharmaceutical concentrations in the environment

USGS Publications Warehouse

Versteeg, D.J.; Alder, A. C.; Cunningham, V. L.; Kolpin, D.W.; Murray-Smith, R.; Ternes, T.

2005-01-01

Human pharmaceuticals are receiving increased attention as environmental contaminants. This is due to their biological activity and the number of monitoring programs focusing on analysis of these compounds in various environmental media and compartments. Risk assessments are needed to understand the implications of reported concentrations; a fundamental part of the risk assessment is an assessment of environmental exposures. The purpose of this chapter is to provide guidance on the use of predictive tools (e.g., models) and monitoring data in exposure assessments for pharmaceuticals in the environment. Methods to predict environmental concentrations from equations based on first principles are presented. These equations form the basis of existing GIS (geographic information systems)-based systems for understanding the spatial distribution of pharmaceuticals in the environment. The pharmaceutical assessment and transport (PhATE), georeferenced regional exposure assessment tool for European rivers (GREAT-ER), and geographical information system (GIS)-ROUT models are reviewed and recommendations are provided concerning the design and execution of monitoring studies. Model predictions and monitoring data are compared to evaluate the relative utility of each approach in environmental exposure assessments. In summary, both models and monitoring data can be used to define representative exposure concentrations of pharmaceuticals in the environment in support of environmental risk assessments.

Control charts for monitoring accumulating adverse event count frequencies from single and multiple blinded trials.

PubMed

Gould, A Lawrence

2016-12-30

Conventional practice monitors accumulating information about drug safety in terms of the numbers of adverse events reported from trials in a drug development program. Estimates of between-treatment adverse event risk differences can be obtained readily from unblinded trials with adjustment for differences among trials using conventional statistical methods. Recent regulatory guidelines require monitoring the cumulative frequency of adverse event reports to identify possible between-treatment adverse event risk differences without unblinding ongoing trials. Conventional statistical methods for assessing between-treatment adverse event risks cannot be applied when the trials are blinded. However, CUSUM charts can be used to monitor the accumulation of adverse event occurrences. CUSUM charts for monitoring adverse event occurrence in a Bayesian paradigm are based on assumptions about the process generating the adverse event counts in a trial as expressed by informative prior distributions. This article describes the construction of control charts for monitoring adverse event occurrence based on statistical models for the processes, characterizes their statistical properties, and describes how to construct useful prior distributions. Application of the approach to two adverse events of interest in a real trial gave nearly identical results for binomial and Poisson observed event count likelihoods. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

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

NASA Technical Reports Server (NTRS)

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

1993-01-01

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

Investigation of the use and feasibility of speed warning systems.

DOT National Transportation Integrated Search

2014-05-01

This report summarizes a feasibility evaluation of a speed monitoring system that provided speed warning feedback to drivers enrolled in a voluntary program, with particular emphasis on at-risk drivers, especially chronic speeders. This project inclu...

LOOP marine and estuarine monitoring program, 1978-95 : volume 1 : executive summary.

DOT National Transportation Integrated Search

1998-01-01

In recognition of the potential for significant environmental impacts much attention was given to environmental safeguards by state and federal agencies and by the Superport developers. Because of the potential risks associated with the construction ...

THE US ENVIRONMENTAL PROTECTION AGENCY'S MONITORING AND ASSESSMENT PROGRAM

EPA Science Inventory

A scientifically rigorous determination of the condition of an aquatic resource is fundamental to all subsequent research, modeling, protection, and restoration issues. Environmental risk characterization is predicated on knowledge of condition and the rate at which that conditio...

Review of 5 years of a combined dietary and physical fitness intervention for control of serum cholesterol

NASA Technical Reports Server (NTRS)

Angotti, C. M.; Levine, M. S.

1994-01-01

A chart review covering the first 5 years of clinical experience with a combined dietary and exercise intervention program for the reduction of hypercholesterolemia at the National Aeronautics and Space Administration headquarters demonstrated the program's success in maintaining high-density lipoprotein cholesterol (HDL-C) levels while significantly lowering total serum cholesterol levels. This combined program also resulted in improved ratios of total serum cholesterol to HDL-C and lowered levels of low-density lipoprotein cholesterol, thus further reducing the risk for cardiovascular disease. The National Aeronautics and Space Administration Cardiovascular Risk Reduction Program was developed after it was determined that although dietary intervention alone improved total cholesterol levels, it often resulted in a more than proportionate decrease in HDL-C and a worsening of the ratio of cholesterol to HDL-C. An approach was needed that would positively affect all factors of the lipid profile. The findings from the program indicate that reduction of cardiovascular risk can be accomplished easily and effectively at the worksite through dietary intervention, personal monitoring, and a reasonable exercise program.

Organic chemicals jeopardize the health of freshwater ecosystems on the continental scale

PubMed Central

Malaj, Egina; von der Ohe, Peter C.; Grote, Matthias; Kühne, Ralph; Mondy, Cédric P.; Usseglio-Polatera, Philippe; Brack, Werner; Schäfer, Ralf B.

2014-01-01

Organic chemicals can contribute to local and regional losses of freshwater biodiversity and ecosystem services. However, their overall relevance regarding larger spatial scales remains unknown. Here, we present, to our knowledge, the first risk assessment of organic chemicals on the continental scale comprising 4,000 European monitoring sites. Organic chemicals were likely to exert acute lethal and chronic long-term effects on sensitive fish, invertebrate, or algae species in 14% and 42% of the sites, respectively. Of the 223 chemicals monitored, pesticides, tributyltin, polycyclic aromatic hydrocarbons, and brominated flame retardants were the major contributors to the chemical risk. Their presence was related to agricultural and urban areas in the upstream catchment. The risk of potential acute lethal and chronic long-term effects increased with the number of ecotoxicologically relevant chemicals analyzed at each site. As most monitoring programs considered in this study only included a subset of these chemicals, our assessment likely underestimates the actual risk. Increasing chemical risk was associated with deterioration in the quality status of fish and invertebrate communities. Our results clearly indicate that chemical pollution is a large-scale environmental problem and requires far-reaching, holistic mitigation measures to preserve and restore ecosystem health. PMID:24979762

[Therapeutic options for weight management in schizophrenic patients treated with atypical antipsychotics].

PubMed

Cordes, J; Sinha-Röder, A; Kahl, K G; Malevani, J; Thuenker, J; Lange-Asschenfeldt, C; Hauner, H; Agelink, M W; Klimke, A

2008-12-01

Extensive, selective literature review of 2500 articles from the last years (up to December 2007) predominantly from Medline and Cochrane, using as search terms "antipsychotic or schizophrenia or individual drug names (amisulpride, aripiprazole, clozapine, olanzapine, quetiapine, risperidone, ziprasidone)" and the terms "BMI, weight gain, metabolic syndrome, diabetes, lipid(s), cholesterol, triglycerides" was conducted. Regardless of the advantages ascribed to atypical antipsychotics and the special effectiveness of clozapine in patients resistant to therapy and at risk for suicide, the probability of weight gain is considerably increased for some of these substances. Patients with schizophrenia have a considerably reduced life expectancy associated with an increased prevalence of cardiovascular risk factors. There is a lack of practical guidelines integrated into clinical psychiatric care for the management of cardiovascular risk factors. The monitoring of patients treated with atypics, which has been recommended in the APA/ADA Consensus Paper in light of these facts, is insufficiently established in clinical practice. A regular monitoring can convey self control and motivation to the patient. In the case of corresponding risk constellations further decisions regarding indication and therapy have to be considered. Especially patients with a high cardiovascular risk profile are highly recommended to participate in a weight-management program for prevention purposes. Such a special program should include elements of dietetic treatment and behaviour and exercise therapy. First controlled studies suggest an effective prevention of weight gain and metabolic changes when applying such a structured program. The practice oriented step by step concept presented here is meant to provide points of reference for the implementation of required medical and psychoeducative measures facilitating the management of weight and further cardiovascular risk factors in the context of psychiatric care in patients with schizophrenia.

Efforts Toward an Early Warning Crop Monitor for Countries at Risk

NASA Astrophysics Data System (ADS)

Budde, M. E.; Verdin, J. P.; Barker, B.; Humber, M. L.; Becker-Reshef, I.; Justice, C. O.; Magadzire, T.; Galu, G.; Rodriguez, M.; Jayanthi, H.

2015-12-01

Assessing crop growing conditions is a crucial aspect of monitoring food security in the developing world. One of the core components of the Group on Earth Observations - Global Agricultural Monitoring (GEOGLAM) targets monitoring Countries at Risk (component 3). The Famine Early Warning Systems Network (FEWS NET) has a long history of utilizing remote sensing and crop modeling to address food security threats in the form of drought, floods, pest infestation, and climate change in some of the world's most at risk countries. FEWS NET scientists at the U.S. Geological Survey Earth Resources Observation and Science (EROS) Center and the University of Maryland Department of Geography have undertaken efforts to address component 3, by promoting the development of a collaborative Early Warning Crop Monitor (EWCM) that would specifically address Countries at Risk. A number of organizations utilize combinations of satellite earth observations, field campaigns, network partner inputs, and crop modeling techniques to monitor crop conditions throughout the world. Agencies such as the Food and Agriculture Organization of the United Nations (FAO), United Nations World Food Programme (WFP), and the European Commission's Joint Research Centre (JRC) provide agricultural monitoring information and reporting across a broad number of areas at risk and in many cases, organizations routinely report on the same countries. The latter offers an opportunity for collaboration on crop growing conditions among agencies. The reduction of uncertainty and achievement of consensus will help strengthen confidence in decisions to commit resources for mitigation of acute food insecurity and support for resilience and development programs. In addition, the development of a collaborative global EWCM will provide each of the partner agencies with the ability to quickly gather crop condition information for areas where they may not typically work or have access to local networks. Using a framework developed by GEOGLAM for monitoring crop conditions in support of the Agricultural Market Information System, we developed an EWCM system for countries at risk. We present the current status of that implementation and highlight achievements to date along with future plans to support the needs of the global agricultural monitoring community.

24 CFR 266.500 - General.

Code of Federal Regulations, 2010 CFR

2010-04-01

... AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Project Management and... of this subpart and for managing and servicing projects insured under this part. The HFA is responsible for monitoring and determining the compliance of the project owner in accordance with the...

EPA APPROACH TO EVALUATION OF INDICATORS FOR ECOLOGICAL RISK ASSESSMENT

EPA Science Inventory

The U.S. Environmental Protection Agency's Office of Research and Development (ORD) is continuing research efforts initiated by the Environmental Monitoring and Assessment Program (EMAP) on ecological indicator development. An ORD Ecological Indicators Working Group has been form...

Teachers Make the Critical Difference in Dropout Prevention.

ERIC Educational Resources Information Center

Bucci, John A.; Reitzammer, Ann F.

1992-01-01

Teachers' daily interaction is a powerful influence on at-risk students. Effective dropout prevention components include positive instructional environment, enhancement of self-esteem, alternative education, absence monitoring, mentoring, parent involvement, social and health services, teen parent programs, and transition strategies. (SK)

24 CFR 266.500 - General.

Code of Federal Regulations, 2012 CFR

2012-04-01

... AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Project Management and... of this subpart and for managing and servicing projects insured under this part. The HFA is responsible for monitoring and determining the compliance of the project owner in accordance with the...

24 CFR 266.500 - General.

Code of Federal Regulations, 2013 CFR

2013-04-01

... AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Project Management and... of this subpart and for managing and servicing projects insured under this part. The HFA is responsible for monitoring and determining the compliance of the project owner in accordance with the...

24 CFR 266.500 - General.

Code of Federal Regulations, 2014 CFR

2014-04-01

... AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Project Management and... of this subpart and for managing and servicing projects insured under this part. The HFA is responsible for monitoring and determining the compliance of the project owner in accordance with the...

24 CFR 266.500 - General.

Code of Federal Regulations, 2011 CFR

2011-04-01

... AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Project Management and... of this subpart and for managing and servicing projects insured under this part. The HFA is responsible for monitoring and determining the compliance of the project owner in accordance with the...

LOOKING INTO THE FUTURE OF A REGION

EPA Science Inventory

The U .S. EP A's Regional Vulnerability Assessment (ReVA) program addresses the latter phases of an integrated ecological risk assessment (U .S. EP A 1998) by building on available monitoring data, focusing on synthesizing information on spatial patterns, analyzing and displaying...

CONTAMINANT CONCENTRATIONS IN WHOLE-BODY FISH AND SHELLFISH FROM U.S. ESTUARIES

EPA Science Inventory

Persistent bioaccumulative and toxic (PBT) pollutants are chemical contaminants that pose risks to ecosystems and human health. For these reasons, available tissue contaminant data from the US EPA Environmental Monitoring and Assessment Program's National Coastal Assessment were...

HOLDING THE LINE WITH A WATCHFUL EYE: THE IMPACT OF PERCEIVED PARENTAL PERMISSIVENESS AND PARENTAL MONITORING ON RISKY SEXUAL BEHAVIOR AMONG ADOLESCENTS IN PSYCHIATRIC CARE

PubMed Central

Donenberg, Geri R.; Wilson, Helen W.; Emerson, Erin; Bryant, Fred B.

2005-01-01

Adolescents in psychiatric care are at increased risk of HIV, yet little is known about the family factors related to sexual risk taking among these youth. We explored whether perceived parental monitoring and perceived parental permissiveness were linked to high-risk sexual behavior in 169 ethnically diverse urban youth seeking mental health services in Chicago, and we tested whether adolescent gender moderated these associations. We evaluated sexual risk taking at a global level and for specific risk behaviors (e.g., sex without a condom, sex while using drugs and alcohol). Girls reported more risky sex overall than boys, and girls were more likely than boys to report having sex without a condom. At low levels of parental permissiveness, rates of risky sex among boys and girls’ did not differ, but at high levels of permissiveness girls reported more sexual risk taking than boys, and girls were more likely than boys to report having sex while using drugs and alcohol and having sex without a condom. Findings highlight the complexity of adolescent sexual behavior and the need for multilevel assessment of risk taking. Results suggest that parental monitoring and permissiveness are more strongly associated with sexual risk taking in troubled girls than troubled boys, and they underscore a need for gender-sensitive, family-focused HIV-prevention programs. PMID:12000232

Linking Geophysical Networks to International Economic Development Through Integration of Global and National Monitoring

NASA Astrophysics Data System (ADS)

Lerner-Lam, A.

2007-05-01

Outside of the research community and mission agencies, global geophysical monitoring rarely receives sustained attention except in the aftermath of a humanitarian disaster. The recovery and rebuilding period focuses attention and resources for a short time on regional needs for geophysical observation, often at the national or sub-national level. This can result in the rapid deployment of national monitoring networks, but may overlook the longer-term benefits of integration with global networks. Even in the case of multinational disasters, such as the Indian Ocean tsunami, it has proved difficult to promote the integration of national solutions with global monitoring, research and operations infrastructure. More importantly, continuing operations at the national or sub-national scale are difficult to sustain once the resources associated with recovery and rebuilding are depleted. Except for some notable examples, the vast infrastructure associated with global geophysical monitoring is not utilized constructively to promote the integration of national networks with international efforts. This represents a missed opportunity not only for monitoring, but for developing the international research and educational collaborations necessary for technological transfer and capacity building. The recent confluence of highly visible disasters, global multi-hazard risk assessments, evaluations of the relationships between natural disasters and socio-economic development, and shifts in development agency policies, provides an opportunity to link global geophysical monitoring initiatives to central issues in international development. Natural hazard risk reduction has not been the first priority of international development agendas for understandable, mainly humanitarian reasons. However, it is now recognized that the so-called risk premium associated with making development projects more risk conscious or risk resilient is relatively small relative to potential losses. Thus there is an attitudinal shift emerging whereby disaster risk management can be "mainstreamed" into the sustainable development programs in many countries. Consequently, it is incumbent to demonstrate that multi-scale geophysical monitoring, comprising integration of global networks with national and sub-national operations, is a foundational component of sustainable development infrastructure. This suggests even greater emphasis on developing dynamic and adaptive multi- hazard risk assessments, encompassing valid estimates of social and physical vulnerabilities; designing multi- scale network integration strategies that consider risk as well as hazard; providing operational and flexible templates for developing national networks in a global context; emphasizing the backbone characteristics of global geophysical monitoring to nations seeking to develop their own monitoring capacity; promoting sustained international research, education and training collaborations coinciding with the development of monitoring capacity; and continuing to promote the free and open exchange of data as a necessary component of sustained intellectual interest in monitoring. A combination of these strategies may counteract the decay of interest in regional geophysical monitoring after a disaster.

Development and Implementation of the Ebola Traveler Monitoring Program and Clinical Outcomes of Monitored Travelers during October - May 2015, Minnesota.

PubMed

DeVries, Aaron; Talley, Pamela; Sweet, Kristin; Kline, Susan; Stinchfield, Patricia; Tosh, Pritish; Danila, Richard

2016-01-01

In October 2014, the United States began actively monitoring all persons who had traveled from Guinea, Liberia, and Sierra Leone in the previous 21 days. State public health departments were responsible for monitoring all travelers; Minnesota has the largest Liberian population in the United States. The MDH Ebola Clinical Team (ECT) was established to assess travelers with symptoms of concern for Ebola virus disease (EVD), coordinate access to healthcare at appropriate facilities including Ebola Assessment and Treatment Units (EATU), and provide guidance to clinicians. Minnesota Department of Health (MDH) began receiving traveler information collected by U.S. Customs and Border Control and Centers for Disease Control and Prevention staff on October 21, 2014 via encrypted electronic communication. All travelers returning from Liberia, Sierra Leone, and Guinea during 10/21/14-5/15/15 were monitored by MDH staff in the manner recommended by CDC based on the traveler's risk categorization as "low (but not zero)", "some" and "high" risk. When a traveler reported symptoms or a temperature ≥100.4° F at any time during their 21-day monitoring period, an ECT member would speak to the traveler and perform a clinical assessment by telephone or via video-chat. Based on the assessment the ECT member would recommend 1) continued clinical monitoring while at home with frequent telephone follow-up by the ECT member, 2) outpatient clinical evaluation at an outpatient site agreed upon by all parties, or 3) inpatient clinical evaluation at one of four Minnesota EATUs. ECT members assessed and approved testing for Ebola virus infection at MDH. Traveler data, calls to the ECT and clinical outcomes were logged on a secure server at MDH. During 10/21/14-5/15/15, a total of 783 travelers were monitored; 729 (93%) traveled from Liberia, 30 (4%) Sierra Leone, and 24 (3%) Guinea. The median number monitored per week was 59 (range 45-143). The median age was 35 years; 136 (17%) were aged <18 years. Thirteen of 256 women of reproductive age (5%) were pregnant. The country of passport issuance was known for 720 of the travelers. The majority of monitored travelers (478 [66%]) used a non-U.S. passport including 442 (61%) Liberian nationals. A total of 772 (99%) travelers were "low (but not zero)" risk; 11 (1%) were "some" risk. Among monitored travelers, 43 (5%) experienced illness symptoms; 29 (67%) had a symptom consistent with EVD. Two were tested for Ebola virus disease and had negative results. Most frequently reported symptoms were fever (20/43, 47%) and abdominal pain (12/43, 28%). During evaluation, 16 (37%) of 43 travelers reported their symptoms began prior to travel; chronic health conditions in 24 travelers including tumors/cancer, pregnancy, and orthopedic conditions were most common. Infectious causes in 19 travelers included upper respiratory infection, malaria, and gastrointestinal infections. Prior to 2014, no similar active monitoring program for travelers had been performed in Minnesota; assessment and management of symptomatic travelers was a new activity for MDH. Ensuring safe entrance into healthcare was particularly challenging for children, and pregnant women, as well as those without an established connection to healthcare. Unnecessary inpatient evaluations were successfully avoided by close clinical follow-up by phone. Before similar monitoring programs are considered in the future, careful thought must be given to necessary resources and the impact on affected populations, public health, and the healthcare system.

Behavioral Health and Performance (BHP) Work-Rest Cycles

NASA Technical Reports Server (NTRS)

Leveton, Lauren B.; Whitmire, Alexandra

2011-01-01

BHP Program Element Goal: Identify, characterize, and prevent or reduce behavioral health and performance risks associated with space travel, exploration and return to terrestrial life. BHP Requirements: a) Characterize and assess risks (e.g., likelihood and consequences). b) Develop tools and technologies to prevent, monitor, and treat adverse outcomes. c) Inform standards. d) Develop technologies to: 1) reduce risks and human systems resource requirements (e.g., crew time, mass, volume, power) and 2) ensure effective human-system integration across exploration mission.

CT scans for pulmonary surveillance may be overused in lower-grade sarcoma.

PubMed

Miller, Benjamin J; Carmody Soni, Emily E; Reith, John D; Gibbs, C Parker; Scarborough, Mark T

2012-01-01

Chest CT scans are often used to monitor patients after excision of a sarcoma. Although sensitive, CT scans are more expensive than chest radiographs and are associated with possible health risks from a higher radiation dose. We hypothesized that a program based upon limited CT scans in lower-grade sarcoma could be efficacious and less expensive. We retrospectively assigned patients to a high-risk or low-risk hypothetical protocol. Eighty-three low- or intermediate-grade soft tissue sarcomas met our inclusion criteria. Eight patients had pulmonary metastasis. A protocol based on selective CT scans for high-risk patients would have identified seven out of eight lesions. The incremental cost-effectiveness ratio for routine CT scans was $731,400. A program based upon selective CT scans for higher-risk patients is accurate, spares unnecessary radiation to many patients, and is less expensive.

Observatory Improvements for SOFIA

NASA Technical Reports Server (NTRS)

Peralta, Robert A.; Jensen, Stephen C.

2012-01-01

The Stratospheric Observatory for Infrared Astronomy (SOFIA) is a joint project between NASA and Deutsches Zentrum fuer Luft- und Raumfahrt (DLR), the German Space Agency. SOFIA is based in a Boeing 747 SP and flown in the stratosphere to observe infrared wavelengths unobservable from the ground. In 2007 Dryden Flight Research Center (DFRC) inherited and began work on improving the plane and its telescope. The improvements continue today with upgrading the plane and improving the telescope. The Observatory Verification and Validation (V&V) process is to ensure that the observatory is where the program says it is. The Telescope Status Display (TSD) will provide any information from the on board network to monitors that will display the requested information. In order to assess risks to the program, one must work through the various threats associate with that risk. Once all the risks are closed the program can work towards improving the observatory.

Design and assessment of molecular assays to genotype male-specific (F+RNA) coliphages (Family Leviviridae)

EPA Science Inventory

Monitoring programs for recreational waters utilize indicator bacteria concentrations as predictors of sewage-exposure related illness risks. However, most illnesses contracted through exposure to recreational waters may be of viral etiology. Identifying the fecal sources (non-...

Adapting an ambient monitoring program to the challenge of managing emerging pollutants in the San Francisco Estuary.

PubMed

Hoenicke, Rainer; Oros, Daniel R; Oram, John J; Taberski, Karen M

2007-09-01

While over seven million organic and inorganic compounds that have been indexed by the American Chemical Society's Chemical Abstracts Service in their CAS Registry are commercially available, most pollution monitoring programs focus only on those chemical stressors for which regulatory benchmarks exist, and have been traditionally considered responsible for the most significant human and environmental health risks. Until the late 1990s, the San Francisco Estuary Regional Monitoring Program was no exception in that regard. After a thorough external review, the monitoring program responded to the need for developing a pro-active surveillance approach for emerging pollutants in recognition of the fact that the potential for the growing list of widely used chemical compounds to alter the integrity of water is high. We describe (1) the scientific and analytical bases underlying a new surveillance monitoring approach; (2) summarize approaches used and results obtained from a forensic retrospective; (3) present the growing data set on emerging pollutants from surveillance monitoring and related efforts in the San Francisco Bay Area to characterize newly targeted compounds in wastewater streams, sediment, storm water runoff, and biota; and (4) suggest next steps in monitoring program development and applied research that could move beyond traditional approaches of pollutant characterization. Based on the forensic analysis of archived chromatograms and chemical and toxicological properties of candidate compounds, we quantified a variety of synthetic organic compounds which had previously not been targeted for analysis. Flame retardant compounds, pesticides and insecticide synergists, insect repellents, pharmaceuticals, personal care product ingredients, plasticizers, non-ionic surfactants, and other manufacturing ingredients were detected in water, sediment, and/or biological tissue samples. Several of these compounds, especially polybrominated diphenyl ether flame retardants, exhibited concentrations of environmental concern. We also describe environmental management challenges associated with emerging pollutants and how pro-active surveillance monitoring might assist in implementing a more holistic approach to pollution prevention and control before emerging pollutants become a burden on future generations.

An Effective Health and Medical Technical Authority

NASA Technical Reports Server (NTRS)

Fogarty, Jennifer A.

2009-01-01

The NASA Governance model directed the formation of three Technical Authorities, Engineering; Safety and Mission Assurance; and Health and Medical, to ensure that risks are identified and adjudicated efficiently and transparently in concert with the spaceflight programs and projects. The Health and Medical Technical Authority (HMTA) has been implemented at the Johnson Space Center (JSC) and consists of the Chief Medical Office (CMO), the Deputy CMO, and HMTA Delegates. The JSC HMTA achieves the goals of risk identification and adjudication through the discharge of the appropriate technical expertise to human space flight programs and projects and the escalation of issues within program and technical authority boards. The JSC HMTA relies on subject matter experts (SMEs) in the Space Life Sciences Directorate at JSC as well as experts from other Centers to work crew health and performance issues at the technical level, develop requirements, oversee implementation and validation of requirements, and identify risks and non-compliances. Once a risk or potential noncompliance has been identified and reported to the programs or projects, the JSC HMTA begins to track it and closely monitor the program's or project's response. As a risk is developed or a non-compliance negotiated, positions from various levels of decision makers are sought at the program and project control boards. The HMTA may support a program or project position if it is satisfied with the decision making and vetting processes (ex. the subject matter expert voiced his/her concerns and all dissenting opinions were documented) and finds that the position both acknowledges the risk and cost of the mitigation and resolves the issue without changing NASA risk posture. The HMTA may disagree with a program or project position if the NASA risk posture has been elevated or obfuscated. If the HMTA does disagree with the program or project position, it will appeal to successively higher levels of authority so that risk acceptance and risk trades will be acknowledged and sanctioned at the highest appropriate level; this includes Program Managers, Mission Directorate Associate Administrators and the Agency Administrator.

The Building Assets-Reducing Risks Program: Replication and Expansion of an Effective Strategy to Turn Around Low-Achieving Schools. i3 Development Grant. Final Report

ERIC Educational Resources Information Center

Corsello, Maryann; Sharma, Anu

2015-01-01

The Building Assets Reducing Risks (BARR) Model BARR is a comprehensive model that addresses the challenges that are part of the 9th grade transition year. BARR employs eight different school-wide and individual strategies that are built on positive relationships and ongoing monitoring of student data. In 2010, BARR received an Investing in…

Promotion of Home-Based Exercise Training as Secondary Prevention of Coronary Heart Disease: A PILOT WEB-BASED INTERVENTION.

PubMed

Torri, Anna; Panzarino, Claudia; Scaglione, Anna; Modica, Maddalena; Bordoni, Bruno; Redaelli, Raffaella; De Maria, Renata; Ferratini, Maurizio

2018-07-01

Although cardiac rehabilitation (CR) is cost- effective in improving the health of patients with coronary heart disease (CHD), less than half of eligible CHD patients attend a CR program. Innovative web-based technologies might improve CR delivery and utilization. We assessed the feasibility and impact on functional capacity and secondary prevention targets of a long-term web-monitored exercise-based CR maintenance program. Low- to moderate-risk CHD patients were recruited at discharge from inpatient CR after a coronary event or revascularization. We developed an interactive web-based platform for secure home individual access control, monitoring, and validation of exercise training. Of 86 eligible patients, 26 consented to participate in the study intervention (IG). Using a quasi-experimental design, we recruited in parallel 27 eligible patients, unavailable for regular web monitoring, who consented to a follow-up visit as usual care (UC). Among IG, active daily data transmission was 100% during month 1, 88% at month 3, and 81% at 6 months, with sustained improvement in self-reported physical activity beginning with the first week after discharge from inpatient CR (2467 [1854-3554] MET-min/wk) to month 3 (3411 [1981-5347] MET-min/wk, P = .019). Both groups showed favorable changes over time in lipid profile, ventricular function, distance walked in 6 min, and quality of life. At 6 mo, IG achieved a significantly higher proportion of cardiovascular risk factor targets than UC (75 ± 20% vs 59 ± 30%, P = .029). Our web-based home CR maintenance program was feasible, well-accepted, and effective in improving physical activity during 6 mo and achieved higher overall adherence to cardiovascular risk targets than UC.

Continuous Risk Management at NASA

NASA Technical Reports Server (NTRS)

Hammer, Theodore F.; Rosenberg, Linda

1999-01-01

NPG 7120.5A, "NASA Program and Project Management Processes and Requirements" enacted in April, 1998, requires that "The program or project manager shall apply risk management principles..." The Software Assurance Technology Center (SATC) at NASA GSFC has been tasked with the responsibility for developing and teaching a systems level course for risk management that provides information on how to comply with this edict. The course was developed in conjunction with the Software Engineering Institute at Carnegie Mellon University, then tailored to the NASA systems community. This presentation will briefly discuss the six functions for risk management: (1) Identify the risks in a specific format; (2) Analyze the risk probability, impact/severity, and timeframe; (3) Plan the approach; (4) Track the risk through data compilation and analysis; (5) Control and monitor the risk; (6) Communicate and document the process and decisions. This risk management structure of functions has been taught to projects at all NASA Centers and is being successfully implemented on many projects. This presentation will give project managers the information they need to understand if risk management is to be effectively implemented on their projects at a cost they can afford.

Survey of Injuries and Injury Risk Factors in the 2nd Brigade Combat Team, 3rd Infantry Division, November 2014 - January 2015

DTIC Science & Technology

2017-07-10

physical training programs, health behaviors, and perceptions of leadership and medical support related to injury. Survey responses were received...illness, and health behavior data is recommended for monitoring of physical training program effects and collection of data necessary to inform future...calculated for demographics, personal characteristics, physical fitness and occupational demands, leadership and medical support, health behaviors

Development of the performance confirmation program at YUCCA mountain, nevada

USGS Publications Warehouse

LeCain, G.D.; Barr, D.; Weaver, D.; Snell, R.; Goodin, S.W.; Hansen, F.D.

2006-01-01

The Yucca Mountain Performance Confirmation program consists of tests, monitoring activities, experiments, and analyses to evaluate the adequacy of assumptions, data, and analyses that form the basis of the conceptual and numerical models of flow and transport associated with a proposed radioactive waste repository at Yucca Mountain, Nevada. The Performance Confirmation program uses an eight-stage risk-informed, performance-based approach. Selection of the Performance Confirmation activities for inclusion in the Performance Confirmation program was done using a risk-informed performance-based decision analysis. The result of this analysis was a Performance Confirmation base portfolio that consists of 20 activities. The 20 Performance Confirmation activities include geologic, hydrologie, and construction/engineering testing. Some of the activities began during site characterization, and others will begin during construction, or post emplacement, and continue until repository closure.

Effective health care corporate compliance.

PubMed

Saum, T B; Byassee, J

2000-01-01

The pace and intensity of oversight and investigation of health care organizations has greatly increased at all levels. Well run organizations with ethical management committed to following all laws and regulations are still at risk for compliance violations and punitive penalties. Under the Federal Sentencing Guidelines, organizations with an "effective" corporate compliance program may receive reduced penalties. The seven components of an effective program as defined in the guidelines are: (1) Standards and procedures; (2) oversight responsibilities; (3) employee training; (4) monitoring and auditing; (5) reporting systems; (6) enforcement and discipline; and (7) response and prevention. Lack of a compliance program needlessly exposes the organization to an avoidable risk of damage from non-compliance--whether intentional or not. Moreover, an effective program can contribute to the efficient operation of the organization and be a key piece of its corporate culture.

Chronic kidney disease management program in Shahreza, Iran.

PubMed

Barahimi, Hamid; Aghighi, Mohammad; Aghayani, Katayon; Rahimi Foroushani, Abbas

2014-11-01

Chronic kidney disease (CKD) is a public health problem that needs an integrated program to be detected, monitored, and controlled. This study reports the results of a CKD program designed and implemented in Shahreza, Iran. After initial evaluation of CKD in Shahreza, a CKD management program was developed in the Ministry of Health and the pilot project was started in February 2011 in Shahreza rural areas. The patients at risk, including those with diabetes mellitus and hypertension, were tested with serum creatinine and urine albumin-creatinine ratio. The CKD management program included training, screening, monitoring, and controlling of weight, hypertension, diabetes mellitus, lipids, and vitamin D. This pilot program was organized in the rural population aged over 30 years who were suffering from hypertension, diabetes mellitus, or both, and resulted in the discovery of cases in various stages of CKD. The prevalence of CKD in this high-risk group was 21.5%. Persistent albuminuria and a glomerular filtration rate less than 60 mL/min/1.73 m(2) were 13% and 11%, respectively. The rate of CKD stages 1, 2, 3a, 3b, 4, and 5 were 2.75%, 6.82%, 10.08%, 0.92%, 0.31%, and 0.17% respectively. After 1 year of the program implemented, incidence rate of CKD was 24% and improvement rate was 21%. In diabetic patients, the mean of hemoglobin A1c decreased from 8.5 ± 1.9% to 7.5% ± 1.8%. Integration of CKD programs in primary health care is possible and results in improvement in management of CKD patients.

The Aviation System Monitoring and Modeling (ASMM) Project: A Documentation of its History and Accomplishments: 1999-2005

NASA Technical Reports Server (NTRS)

Statler, Irving C. (Editor)

2007-01-01

The Aviation System Monitoring and Modeling (ASMM) Project was one of the projects within NASA s Aviation Safety Program from 1999 through 2005. The objective of the ASMM Project was to develop the technologies to enable the aviation industry to undertake a proactive approach to the management of its system-wide safety risks. The ASMM Project entailed four interdependent elements: (1) Data Analysis Tools Development - develop tools to convert numerical and textual data into information; (2) Intramural Monitoring - test and evaluate the data analysis tools in operational environments; (3) Extramural Monitoring - gain insight into the aviation system performance by surveying its front-line operators; and (4) Modeling and Simulations - provide reliable predictions of the system-wide hazards, their causal factors, and their operational risks that may result from the introduction of new technologies, new procedures, or new operational concepts. This report is a documentation of the history of this highly successful project and of its many accomplishments and contributions to improved safety of the aviation system.

Enhanced Capabilities for Subcritical Experiments (ECSE) Risk Management Plan

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

Urban, Mary Elizabeth

Risk is a factor, element, constraint, or course of action that introduces an uncertainty of outcome that could impact project objectives. Risk is an inherent part of all activities, whether the activity is simple and small, or large and complex. Risk management is a process that identifies, evaluates, handles, and monitors risks that have the potential to affect project success. The risk management process spans the entire project, from its initiation to its successful completion and closeout, including both technical and programmatic (non-technical) risks. This Risk Management Plan (RMP) defines the process to be used for identifying, evaluating, handling, andmore » monitoring risks as part of the overall management of the Enhanced Capabilities for Subcritical Experiments (ECSE) ‘Project’. Given the changing nature of the project environment, risk management is essentially an ongoing and iterative process, which applies the best efforts of a knowledgeable project staff to a suite of focused and prioritized concerns. The risk management process itself must be continually applied throughout the project life cycle. This document was prepared in accordance with DOE O 413.3B, Program and Project Management for the Acquisition of Capital Assets, its associated guide for risk management DOE G 413.3-7, Risk Management Guide, and LANL ADPM AP-350-204, Risk and Opportunity Management.« less

Randomized clinical trial to change parental practices for drug use in a telehealth prevention program: a pilot study.

PubMed

Valente, Juliana Y; Moreira, Tais Campos; Ferigolo, Maristela; Barros, Helena M T

2018-03-21

Programs for parents have been found to have a direct positive impact on reducing the consumption of psychoactive substances by adolescents, as well as having an indirect impact on reducing risk factors and increasing protective factors. The present study aimed to verify if a telehealth prevention program based on a brief motivational intervention helps to reduce parental risk practices and increase parental protective practices for drug use in comparison with psychoeducation. A pilot randomized controlled trial was performed at the National Service of Guidance and Information on Drug Use (Ligue 132), from September 2014 to December 2015, with the parents of adolescents (n=26). The outcome measures were parental style, risk, and protective parental practices. The brief motivational intervention was found to be more effective than psychoeducation in reducing the negligent behavior of parents. Furthermore, when comparing pre- and post-intervention data, the brief motivational intervention helped to change parental style and the large majority of parental practices: increasing positive monitoring, as well as decreasing physical abuse, relaxed discipline, inconsistent punishment, and negative monitoring. These results demonstrate that the telehealth intervention is effective in modifying the parental practices known to help in preventing drug use. Studies with more number of subjects are required so that the results can be substantiated and generalized. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

An object-oriented, knowledge-based system for cardiovascular rehabilitation--phase II.

PubMed Central

Ryder, R. M.; Inamdar, B.

1995-01-01

The Heart Monitor is an object-oriented, knowledge-based system designed to support the clinical activities of cardiovascular (CV) rehabilitation. The original concept was developed as part of graduate research completed in 1992. This paper describes the second generation system which is being implemented in collaboration with a local heart rehabilitation program. The PC UNIX-based system supports an extensive patient database organized by clinical areas. In addition, a knowledge base is employed to monitor patient status. Rule-based automated reasoning is employed to assess risk factors contraindicative to exercise therapy and to monitor administrative and statutory requirements. PMID:8563285

75 FR 80056 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-21

... Risk Factor Surveillance System (BRFSS), DBS implemented a standalone survey designed to monitor mental... additional questions taken from standardized scales or from other surveys designed to measure anxiety... Surveillance (DBS) Gulf States Population Survey--New--Public Health Surveillance Program Office (PHSPO...

CONVERGENCE OF ECOLOGICAL ASSESSMENT AND RISK ASSESSMENT: TOWARDS HOLISTIC ENVIRONMENTAL PROTECTION

EPA Science Inventory

A major emphasis of environmental monitoring and assessment programs is to characterize the condition of natural resources. When repeated through time, ecological assessments (EA) can be used to track changes in environmental condition that reflect on the efficacy of regulatory a...

77 FR 5155 - Interest Rate Risk Policy and Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-02

... directors and management; appropriate IRR measurement and monitoring systems; good internal controls; and informed decision-making based on IRR measurement system results. It also provides guidelines for... technical aspects of IRR measurement methods. Of these, some said Appendix B implied a preference for the...

Molecular sequence data of hepatitis B virus and genetic diversity after vaccination.

PubMed

van Ballegooijen, W Marijn; van Houdt, Robin; Bruisten, Sylvia M; Boot, Hein J; Coutinho, Roel A; Wallinga, Jacco

2009-12-15

The effect of vaccination programs on transmission of infectious disease is usually assessed by monitoring programs that rely on notifications of symptomatic illness. For monitoring of infectious diseases with a high proportion of asymptomatic cases or a low reporting rate, molecular sequence data combined with modern coalescent-based techniques offer a complementary tool to assess transmission. Here, the authors investigate the added value of using viral sequence data to monitor a vaccination program that was started in 1998 and was targeted against hepatitis B virus in men who have sex with men in Amsterdam, the Netherlands. The incidence in this target group, as estimated from the notifications of acute infections with hepatitis B virus, was low; therefore, there was insufficient power to show a significant change in incidence. In contrast, the genetic diversity, as estimated from the viral sequence collected from the target group, revealed a marked decrease after vaccination was introduced. Taken together, the findings suggest that introduction of vaccination coincided with a change in the target group toward behavior with a higher risk of infection. The authors argue that molecular sequence data provide a powerful additional monitoring instrument, next to conventional case registration, for assessing the impact of vaccination.

ASSESSMENT OF THE RATES OF INJURY AND MORTALITY IN WATERFOWL CAPTURED WITH FIVE METHODS OF CAPTURE AND TECHNIQUES FOR MINIMIZING RISKS.

PubMed

O'Brien, Michelle F; Lee, Rebecca; Cromie, Ruth; Brown, Martin J

2016-04-01

Swan pipes, duck decoys, cage traps, cannon netting, and roundups are widely used to capture waterfowl in order to monitor populations. These methods are often regulated in countries with national ringing or banding programs and are considered to be safe, and thus justifiable given the benefits to conservation. However, few published studies have addressed how frequently injuries and mortalities occur, or the nature of any injuries. In the present study, rates of mortality and injury during captures with the use of these methods carried out by the Wildfowl & Wetlands Trust as part of conservation programs were assessed. The total rate of injury (including mild dermal abrasions) was 0.42% across all species groups, whereas total mortality was 0.1% across all capture methods. Incidence of injury varied among species groups (ducks, geese, swans, and rails), with some, for example, dabbling ducks, at greater risk than others. We also describe techniques used before, during, and after a capture to reduce stress and injury in captured waterfowl. Projects using these or other capture methods should monitor and publish their performance to allow sharing of experience and to reduce risks further.

Current status and evolving role of abuse-deterrent opioids in managing patients with chronic pain.

PubMed

Webster, Lynn; St Marie, Barbara; McCarberg, Bill; Passik, Steven D; Panchal, Sunil J; Voth, Eric

2011-01-01

Opioids are widely used for the treatment of patients with chronic pain; yet, the increase in their abuse, misuse, and diversion is an ongoing focus of regulatory, governmental, and legal scrutiny. As a consequence, clinicians are faced with numerous challenges in an effort to use opioids in appropriate patients with pain while minimizing the potential for opioid abuse, misuse, and diversion. Policies and programs such as state prescription monitoring programs, which have been in existence for decades, are but one attempt to address some of the issues regarding the prescribing of opioids. Another is a risk evaluation and mitigation strategy for opioids under consideration by the US Food and Drug Administration. At the clinical level, a universal precautions and risk management package that includes risk assessment and patient monitoring is a recommended approach. This approach can also include the use of abuse-deterrent and abuse-resistant formulations designed to reduce the nonmedical use of opioids. Several of these opioid formulations have been approved or should soon be on the market for use in the United States; however, their role and other questions regarding their use remain unanswered. The authors offer their clinical perspective on several of these key questions.

Surface water sampling and analysis plan for environmental monitoring in Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee. Environmental Restoration Program

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

Not Available

1994-06-01

This Sampling and Analysis Plan addresses surface water monitoring, sampling, and analysis activities that will be conducted in support of the Environmental Monitoring Plan for Waste Area Grouping (WAG) 6. WAG 6 is a shallow-burial land disposal facility for low-level radioactive waste at the Oak Ridge National Laboratory, a research facility owned by the US Department of Energy and managed by Martin Marietta Energy Systems, Inc. Surface water monitoring will be conducted at nine sites within WAG 6. Activities to be conducted will include the installation, inspection, and maintenance of automatic flow-monitoring and sampling equipment and manual collection of variousmore » water and sediment samples. The samples will be analyzed for various organic, inorganic, and radiological parameters. The information derived from the surface water monitoring, sampling, and analysis will aid in evaluating risk associated with contaminants migrating off-WAG, and will be used in calculations to establish relationships between contaminant concentration (C) and flow (Q). The C-Q relationship will be used in calculating the cumulative risk associated with the off-WAG migration of contaminants.« less

Towards a Long-Term Strategy for Voluntary-Based Internal Radiation Contamination Monitoring: A Population-Level Analysis of Monitoring Prevalence and Factors Associated with Monitoring Participation Behavior in Fukushima, Japan.

PubMed

Nomura, Shuhei; Tsubokura, Masaharu; Ozaki, Akihiko; Murakami, Michio; Hodgson, Susan; Blangiardo, Marta; Nishikawa, Yoshitaka; Morita, Tomohiro; Oikawa, Tomoyoshi

2017-04-09

Following Japan's 2011 Fukushima nuclear incident, we assessed voluntary-based monitoring behavior in Minamisoma City-located 10-40 km from the Fukushima nuclear plant-to inform future monitoring strategies. The monitoring in Minamisoma included occasional free of charge internal-radiation-exposure measurements. Out of around 70,000 individuals residing in the city before the incident, a total of 45,788 residents (female: 52.1%) aged ≥21 were evaluated. The monitoring prevalence in 2011-2012 was only 30.2%, and this decreased to 17.9% in 2013-2014. Regression analyses were performed to estimate factors associated with the monitoring prevalence and participation behavior. The results show that, in comparison with the age cohort of 21-30 years, the cohort of 71-80 and ≥81 years demonstrated significantly lower monitoring prevalence; female residents had higher monitoring prevalence than male residents; those who were living in evacuation zones at the time of the incident had higher monitoring prevalence than those who lived outside any of the evacuation zones; for those living outside Fukushima and neighboring Prefectures post-incident monitoring prevalence decreased significantly in 2013-2014. Our findings inform the discussion on the concepts of radiation risk perception and accessibility to monitoring and societal decision-making regarding the maintenance of the monitoring program with low monitoring prevalence. We also stress the possibility that the monitoring can work both to check that internal contamination levels are within acceptable limits, and as a risk communication tool, alleviating individuals' concern and anxiety over radiation contamination.

Pattern-Based Design of Insider Threat Programs

DTIC Science & Technology

2014-12-01

also applied these models to develop best practices and technical controls for mitigating insider threat. In some cases of in- sider threat...departing insiders might take valuable IP with them. One set of practices and controls designed to reduce the risk of insider IP theft is based on case data...describing this set of practices and controls helps to balance the costs of monitoring employee behavior for suspicious actions against the risk of

28 CFR 550.30 - Purpose and scope.

Code of Federal Regulations, 2013 CFR

2013-07-01

... drug use, to monitor specific groups or individual inmates who are considered as high risk for drug use, such as those involved in community activities, those with a history of drug use, and those inmates... Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS...

28 CFR 550.30 - Purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-07-01

... drug use, to monitor specific groups or individual inmates who are considered as high risk for drug use, such as those involved in community activities, those with a history of drug use, and those inmates... Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS...

28 CFR 550.30 - Purpose and scope.

Code of Federal Regulations, 2014 CFR

2014-07-01

... drug use, to monitor specific groups or individual inmates who are considered as high risk for drug use, such as those involved in community activities, those with a history of drug use, and those inmates... Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS...

28 CFR 550.30 - Purpose and scope.

Code of Federal Regulations, 2012 CFR

2012-07-01

... drug use, to monitor specific groups or individual inmates who are considered as high risk for drug use, such as those involved in community activities, those with a history of drug use, and those inmates... Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS...

A Collaborative University Model for Employee Wellness

ERIC Educational Resources Information Center

Carter, Melondie R.; Kelly, Rebecca C.; Alexander, Chelley K.; Holmes, Lauren M.

2011-01-01

Universities are taking a more active approach in understanding and monitoring employees' modifiable health risk factors and chronic care conditions by developing strategies to encourage employees to start and sustain healthy behaviors. WellBama, the University of Alabama's signature health and wellness program, utilizes a collaborative model in…

The New Bedford Harbor Superfund Site Long Term Monitoring Program (1993-2009)

EPA Science Inventory

New Bedford Harbor (NBH), located in southeastern Massachusetts, was designated as a marine Superfund site in 1983 due to sediment contamination by polychlorinated biphenyls (PCBs). Based on risks to human health and the environment, the first two phases of the site cleanup invo...

28 CFR 550.30 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-07-01

... drug use, to monitor specific groups or individual inmates who are considered as high risk for drug use, such as those involved in community activities, those with a history of drug use, and those inmates... Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS...

Characterizing the Breadth and Depth of Volunteer Water Monitoring Programs in the United States.

PubMed

Stepenuck, Kristine F; Genskow, Kenneth D

2018-01-01

A survey of 345 volunteer water monitoring programs in the United States was conducted to document their characteristics, and perceived level of support for data to inform natural resource management or policy decisions. The response rate of 86% provided information from 46 states. Programs represented a range of ages, budgets, objectives, scopes, and level of quality assurance, which influenced data uses and perceived support by sponsoring agency administrators and external decision makers. Most programs focused on rivers, streams, and lakes. Programs had not made substantial progress to develop EPA or state-approved quality assurance plans since 1998, with only 48% reporting such plans. Program coordinators reported feeling slightly more support for data to be used for management as compared to policy decisions. Programs with smaller budgets may be at particular risk of being perceived to lack credibility due to failure to develop quality assurance plans. Over half of programs identified as collaborative, in that volunteers assisted scientists in program design, data analysis and/or dissemination of results. Just under a third were contributory, in which volunteers primarily collected data in a scientist-defined program. Recommendations to improve perceived data credibility, and to augment limited budgets include developing quality assurance plans and gaining agency approval, and developing partnerships with other organizations conducting monitoring in the area to share resources and knowledge. Funding agencies should support development of quality assurance plans to help ensure data credibility. Service providers can aid in plan development by providing training to program staff over time to address high staff turnover rates.

Characterizing the Breadth and Depth of Volunteer Water Monitoring Programs in the United States

NASA Astrophysics Data System (ADS)

Stepenuck, Kristine F.; Genskow, Kenneth D.

2018-01-01

A survey of 345 volunteer water monitoring programs in the United States was conducted to document their characteristics, and perceived level of support for data to inform natural resource management or policy decisions. The response rate of 86% provided information from 46 states. Programs represented a range of ages, budgets, objectives, scopes, and level of quality assurance, which influenced data uses and perceived support by sponsoring agency administrators and external decision makers. Most programs focused on rivers, streams, and lakes. Programs had not made substantial progress to develop EPA or state-approved quality assurance plans since 1998, with only 48% reporting such plans. Program coordinators reported feeling slightly more support for data to be used for management as compared to policy decisions. Programs with smaller budgets may be at particular risk of being perceived to lack credibility due to failure to develop quality assurance plans. Over half of programs identified as collaborative, in that volunteers assisted scientists in program design, data analysis and/or dissemination of results. Just under a third were contributory, in which volunteers primarily collected data in a scientist-defined program. Recommendations to improve perceived data credibility, and to augment limited budgets include developing quality assurance plans and gaining agency approval, and developing partnerships with other organizations conducting monitoring in the area to share resources and knowledge. Funding agencies should support development of quality assurance plans to help ensure data credibility. Service providers can aid in plan development by providing training to program staff over time to address high staff turnover rates.

Medication-use evaluation with a Web application.

PubMed

Burk, Muriel; Moore, Von; Glassman, Peter; Good, Chester B; Emmendorfer, Thomas; Leadholm, Thomas C; Cunningham, Francesca

2013-12-15

A Web-based application for coordinating medication-use evaluation (MUE) initiatives within the Veterans Affairs (VA) health care system is described. The MUE Tracker (MUET) software program was created to improve VA's ability to conduct national medication-related interventions throughout its network of 147 medical centers. MUET initiatives are centrally coordinated by the VA Center for Medication Safety (VAMedSAFE), which monitors the agency's integrated databases for indications of suboptimal prescribing or drug therapy monitoring and adverse treatment outcomes. When a pharmacovigilance signal is detected, VAMedSAFE identifies "trigger groups" of at-risk veterans and uploads patient lists to the secure MUET application, where locally designated personnel (typically pharmacists) can access and use the data to target risk-reduction efforts. Local data on patient-specific interventions are stored in a centralized database and regularly updated to enable tracking and reporting for surveillance and quality-improvement purposes; aggregated data can be further analyzed for provider education and benchmarking. In a three-year pilot project, the MUET program was found effective in promoting improved prescribing of erythropoiesis-stimulating agents (ESAs) and enhanced laboratory monitoring of ESA-treated patients in all specified trigger groups. The MUET initiative has since been expanded to target other high-risk drugs, and efforts are underway to refine the tool for broader utility. The MUET application has enabled the increased standardization of medication safety initiatives across the VA system and may serve as a useful model for the development of pharmacovigilance tools by other large integrated health care systems.

Developing a Gap Taxonomy to Address Crew Health Risks in NASA's Human Research Program

NASA Technical Reports Server (NTRS)

Kundrot, Craig E.; Edwards, J. Michelle

2009-01-01

The mission of NASA's Human Research Program (HRP) is to understand and reduce the risk to crew health and performance in exploration missions. The HRP addresses 27 specific risks by identifying and then filling gaps in understanding the risks and in the ability to disposition the risks. The primary bases for identifying gaps have been past experience and requirements definition. This approach has been very effective in identifying some important, relevant gaps, but may be inadequate for identifying gaps outside the past experience base. We are exploring the use of a gap taxonomy as a comprehensive, underlying conceptual framework that allows a more systematic identification of gaps. The taxonomy is based on these stages in medical care: prediction, prevention, detection/diagnosis, treatment, monitoring, rehabilitation, and lifetime surveillance. This gap taxonomy approach identifies new gaps in HRP health risks. Many of the new gaps suggest risk reduction approaches that are more cost effective than present approaches. A major benefit of the gap taxonomy approach is to identify new, economical approaches that reduce the likelihood and/or consequence of a risk.

The design of a purpose-built exergame for fall prediction and prevention for older people.

PubMed

Marston, Hannah R; Woodbury, Ashley; Gschwind, Yves J; Kroll, Michael; Fink, Denis; Eichberg, Sabine; Kreiner, Karl; Ejupi, Andreas; Annegarn, Janneke; de Rosario, Helios; Wienholtz, Arno; Wieching, Rainer; Delbaere, Kim

2015-01-01

Falls in older people represent a major age-related health challenge facing our society. Novel methods for delivery of falls prevention programs are required to increase effectiveness and adherence to these programs while containing costs. The primary aim of the Information and Communications Technology-based System to Predict and Prevent Falls (iStoppFalls) project was to develop innovative home-based technologies for continuous monitoring and exercise-based prevention of falls in community-dwelling older people. The aim of this paper is to describe the components of the iStoppFalls system. The system comprised of 1) a TV, 2) a PC, 3) the Microsoft Kinect, 4) a wearable sensor and 5) an assessment and training software as the main components. The iStoppFalls system implements existing technologies to deliver a tailored home-based exercise and education program aimed at reducing fall risk in older people. A risk assessment tool was designed to identify fall risk factors. The content and progression rules of the iStoppFalls exergames were developed from evidence-based fall prevention interventions targeting muscle strength and balance in older people. The iStoppFalls fall prevention program, used in conjunction with the multifactorial fall risk assessment tool, aims to provide a comprehensive and individualised, yet novel fall risk assessment and prevention program that is feasible for widespread use to prevent falls and fall-related injuries. This work provides a new approach to engage older people in home-based exercise programs to complement or provide a potentially motivational alternative to traditional exercise to reduce the risk of falling.

Bridging the two cultures of risk analysis

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

Jasanoff, S.

1993-04-01

During the past 15 years, risk analysis has come of age as an interdisciplinary field of remarkable breadth, nurturing connections among fields as diverse as mathematics, biostatistics, toxicology, and engineering on one hand, and law, psychology, sociology, and economics on the other hand. In this editorial, the author addresses the question: What has the presence of social scientists in the network meant to the substantive development of the field of risk analysis The answers offered here discuss the substantial progress in bridging the two cultures of risk analysis. Emphasis is made of the continual need for monitoring risk analysis. Topicsmore » include: the micro-worlds of risk assessment; constraining assumptions; and exchange programs. 14 refs.« less

The critical role of volcano monitoring in risk reduction

USGS Publications Warehouse

Tilling, R.I.

2008-01-01

Data from volcano-monitoring studies constitute the only scientifically valid basis for short-term forecasts of a future eruption, or of possible changes during an ongoing eruption. Thus, in any effective hazards-mitigation program, a basic strategy in reducing volcano risk is the initiation or augmentation of volcano monitoring at historically active volcanoes and also at geologically young, but presently dormant, volcanoes with potential for reactivation. Beginning with the 1980s, substantial progress in volcano-monitoring techniques and networks - ground-based as well space-based - has been achieved. Although some geochemical monitoring techniques (e.g., remote measurement of volcanic gas emissions) are being increasingly applied and show considerable promise, seismic and geodetic methods to date remain the techniques of choice and are the most widely used. Availability of comprehensive volcano-monitoring data was a decisive factor in the successful scientific and governmental responses to the reawakening of Mount St. Helens (Washington, USA) in 1980 and, more recently, to the powerful explosive eruptions at Mount Pinatubo (Luzon, Philippines) in 1991. However, even with the ever-improving state-ofthe-art in volcano monitoring and predictive capability, the Mount St. Helens and Pinatubo case histories unfortunately still represent the exceptions, rather than the rule, in successfully forecasting the most likely outcome of volcano unrest.

Geophysical Monitoring Methods Evaluation for the FutureGen 2.0 Project

DOE PAGES

Strickland, Chris E.; USA, Richland Washington; Vermeul, Vince R.; ...

2014-12-31

A comprehensive monitoring program will be needed in order to assess the effectiveness of carbon sequestration at the FutureGen 2.0 carbon capture and storage (CCS) field-site. Geophysical monitoring methods are sensitive to subsurface changes that result from injection of CO 2 and will be used for: (1) tracking the spatial extent of the free phase CO 2 plume, (2) monitoring advancement of the pressure front, (3) identifying or mapping areas where induced seismicity occurs, and (4) identifying and mapping regions of increased risk for brine or CO 2 leakage from the reservoir. Site-specific suitability and cost effectiveness were evaluated formore » a number of geophysical monitoring methods including: passive seismic monitoring, reflection seismic imaging, integrated surface deformation, time-lapse gravity, pulsed neutron capture logging, cross-borehole seismic, electrical resistivity tomography, magnetotellurics and controlled source electromagnetics. The results of this evaluation indicate that CO 2 injection monitoring using reflection seismic methods would likely be difficult at the FutureGen 2.0 site. Electrical methods also exhibited low sensitivity to the expected CO 2 saturation changes and would be affected by metallic infrastructure at the field site. Passive seismic, integrated surface deformation, time-lapse gravity, and pulsed neutron capture monitoring were selected for implementation as part of the FutureGen 2.0 storage site monitoring program.« less

Geophysical Monitoring Methods Evaluation for the FutureGen 2.0 Project

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

Strickland, Chris E.; USA, Richland Washington; Vermeul, Vince R.

A comprehensive monitoring program will be needed in order to assess the effectiveness of carbon sequestration at the FutureGen 2.0 carbon capture and storage (CCS) field-site. Geophysical monitoring methods are sensitive to subsurface changes that result from injection of CO 2 and will be used for: (1) tracking the spatial extent of the free phase CO 2 plume, (2) monitoring advancement of the pressure front, (3) identifying or mapping areas where induced seismicity occurs, and (4) identifying and mapping regions of increased risk for brine or CO 2 leakage from the reservoir. Site-specific suitability and cost effectiveness were evaluated formore » a number of geophysical monitoring methods including: passive seismic monitoring, reflection seismic imaging, integrated surface deformation, time-lapse gravity, pulsed neutron capture logging, cross-borehole seismic, electrical resistivity tomography, magnetotellurics and controlled source electromagnetics. The results of this evaluation indicate that CO 2 injection monitoring using reflection seismic methods would likely be difficult at the FutureGen 2.0 site. Electrical methods also exhibited low sensitivity to the expected CO 2 saturation changes and would be affected by metallic infrastructure at the field site. Passive seismic, integrated surface deformation, time-lapse gravity, and pulsed neutron capture monitoring were selected for implementation as part of the FutureGen 2.0 storage site monitoring program.« less

Implementation science and the pregnancy risk assessment monitoring system.

PubMed

Grigorescu, Violanda I; D'Angelo, Denise V; Harrison, Leslie L; Taraporewalla, Aspy J; Shulman, Holly; Smith, Ruben A

2014-12-01

This paper describes the restructuring of the Pregnancy Risk Assessment Monitoring System (PRAMS), a surveillance system of the Centers for Disease Control and Prevention (CDC)'s Division of Reproductive Health conducted for 25 years in collaboration with state and city health departments. With the ultimate goal to better inform health care providers, public health programs, and policy, changes were made to various aspects of PRAMS to enhance its capacity on assessing and monitoring public health interventions and clinical practices in addition to risk behaviors, disease prevalence, comorbidities, and service utilization. Specifically, the three key PRAMS changes identified as necessary and described in this paper are questionnaire revision, launching the web-based centralized PRAMS Integrated Data Collection System, and enhancing the access to PRAMS data through the web query system known as Centers for Disease Control and Prevention's PRAMS Online Data for Epidemiologic Research/PRAMStat. The seven action steps of Knowledge To Action cycle, an illustration of the implementation science process, that reflect the milestones necessary in bridging the knowledge-to-action gap were used as framework for each of these key changes.

Human Research Program (HRP) Exploration Medical Capability (ExMC) Standing Review Panel (SRP)

NASA Technical Reports Server (NTRS)

Cintron, Nitza; Dutson, Eric; Friedl, Karl; Hyman, William; Jemison, Mae; Klonoff, David

2009-01-01

The SRP believes strongly that regularly performed in-flight crew assessments are needed in order to identify a change in health status before a medical condition becomes clinically apparent. It is this early recognition in change that constitutes the foundation of the "occupational health model" expounded in the HRP Requirements Document as a key component of the HRP risk mitigation strategy that will enable its objective of "prevention and mitigation of human health and performance risks". A regular crew status examination of physiological and clinical performance is needed. This can be accomplished through instrumented monitoring of routine embedded tasks. The SRP recommends addition of a new gap to address this action under Category 3.0 Mitigate the Risk. This new gap is closely associated with Task 4.19 which addresses the lack of adequate biomedical monitoring capabilities for performing periodic clinical status evaluations and contingency medical monitoring. A corollary to these gaps is the critical emphasis on preventive medicine, not only during pre- and post-flight phases of a mission as is the current practice, but continued into the in-flight phases of exploration class missions.

Preliminary Design Program: Vapor Compression Distillation Flight Experiment Program

NASA Technical Reports Server (NTRS)

Schubert, F. H.; Boyda, R. B.

1995-01-01

This document provides a description of the results of a program to prepare a preliminary design of a flight experiment to demonstrate the function of a Vapor Compression Distillation (VCD) Wastewater Processor (WWP) in microgravity. This report describes the test sequence to be performed and the hardware, control/monitor instrumentation and software designs prepared to perform the defined tests. the purpose of the flight experiment is to significantly reduce the technical and programmatic risks associated with implementing a VCD-based WWP on board the International Space Station Alpha.

Pharmaceuticals in the environment--exposure, effects and risks to humans and ecosystems: what we think we know, and what we need to know

EPA Science Inventory

U.S., European and Korean environmental monitoring and research programs have confirmed the occurrence of low levels of pharmaceuticals in stream waters, in soils and streambed sediments, in ground water, in estuaries, and in drinking water.

Health Care Services for Children and Adolescents.

ERIC Educational Resources Information Center

Perrin, James; And Others

1992-01-01

Identifies health risks and other factors that determine the need for health care services among children and adolescents. Recommendations are made to develop reforms through a coordinated care program rather than through competing systems of services. Models for community-based health care monitoring and coordination exist in other industrialized…

An Overview of Exposure Assessment Models Used by the U.S. Environmental Protection Agency

EPA Science Inventory

Models are often used in addition to or in lieu of monitoring data to estimate environmental concentrations and exposures for use in risk assessments or epidemiological studies, and to support regulatory standards and voluntary programs (Jayjock et al., 2007; US EPA, 1989, 1992)....

Harnessing High-Throughput Monitoring Methods to Strengthen 21st Century Risk-Based Evaluations (SETAC Presentation)

EPA Science Inventory

Over the past ten years, the US government has invested in high-throughput (HT) methods to screen chemicals for biological activity. Under the interagency Tox21 consortium and the US Environmental Protection Agency’s (EPA) ToxCast™ program, thousands of chemicals have...

The New Bedford Harbor Superfund Site Long Term Monitoring Program: Results from 1993 to 2014

EPA Science Inventory

Background. New Bedford Harbor (NBH), located in southeastern Massachusetts, was designated as a marine Superfund site in 1983 due to sediment contamination by polychlorinated biphenyls (PCBs). Based on risks to human health and the environment, the first two phases of the site ...

Surveillance Recommendations in Reducing Risk of and Optimally Managing Breast Cancer-Related Lymphedema

PubMed Central

Ostby, Pamela L.; Armer, Jane M.; Dale, Paul S.; Van Loo, Margaret J.; Wilbanks, Cassie L.; Stewart, Bob R.

2014-01-01

Breast cancer survivors are at increased risk for the development of breast cancer-related lymphedema (BCRL), a chronic, debilitating, and disfiguring condition that is progressive and requires lifelong self-management of symptoms. It has been reported that over 40% of the 2.5 million breast cancer survivors in the United States may meet the criteria for BCRL during their lifetimes. Ongoing surveillance, beginning with pre-operative assessment, has been effective in identifying subclinical lymphedema (LE). A prospective model for surveillance is necessary in order to detect BCRL at an early stage when there is the best chance to reduce risk or slow progression. Physical methods for monitoring and assessment, such as circumferential arm measures, perometry, bioimpedance; exercise programs; prophylactic and early-intervention compression garments; and referral for complete decongestive therapy are all interventions to consider in the development of a BCRL surveillance program. In addition, supportive-educative programs and interactive engagement for symptom self-management should also be implemented. The importance of interdisciplinary collaboration is integral to the success of an effective personalized medicine program in breast cancer-related lymphedema surveillance. PMID:25563360

Eligibility and enrollment in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)--27 states and New York City, 2007-2008.

PubMed

2013-03-15

The national Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutrition education, growth monitoring, breastfeeding promotion and support, and food to low-income pregnant or postpartum women, infants, and children aged <5 years. Several studies have linked WIC services with improved maternal and infant health outcomes. Most population-based studies have lacked information needed to identify eligible women who are not receiving WIC services and might be at risk for poor health outcomes. This report uses multistate, population-based 2007-2008 survey data from CDC's Pregnancy Risk Assessment Monitoring System (PRAMS) and California's Maternal and Infant Health Assessment (MIHA) to estimate how many women were eligible but not enrolled in WIC during pregnancy and to describe their characteristics and their prevalence of markers of risk for poor maternal or infant health outcomes. Approximately 17% of all women surveyed were eligible but not enrolled in WIC during pregnancy. The proportion of women eligible for WIC and WIC participation rates varied by state. WIC participants had higher prevalences of markers of risk for poor maternal or infant health outcomes than eligible nonparticipants, but both groups had higher prevalences of risk markers than ineligible women, suggesting that many eligible women and their children might benefit from WIC services. The results of this analysis can help identify the scope of WIC outreach needed to include more eligible nonparticipants in WIC and whom to target.

Family Functioning and High Risk Adolescents' Aggressive Behavior: Examining Effects by Ethnicity.

PubMed

Henneberger, Angela K; Varga, Shannon M; Moudy, Alyssa; Tolan, Patrick H

2016-01-01

The relationship between family functioning and adolescents' physical aggression has been well established, but whether these relationships might differ by ethnicity has received less attention. Ethnic variations may be important for targeting prevention programs to specific youth and families. This study examined the longitudinal relationship between family cohesion, parental monitoring, and physical aggression using data from the Multisite Violence Prevention Project sample of high-risk youth (elevated aggression). Participants were 1,232 high-risk middle school students (65% male; 70% African American; 15% Hispanic). Meaningful demographic variations were identified. After controlling for intervention condition and study site, family cohesion was significantly negatively related to physical aggression, more so for Hispanic youth. Parental monitoring was negatively associated with physical aggression for African American youth only. Our findings point to the importance of developing culturally sensitive family interventions to prevent physical aggression in middle school.

Family Functioning and High Risk Adolescents’ Aggressive Behavior: Examining Effects by Ethnicity

PubMed Central

Varga, Shannon M.; Moudy, Alyssa; Tolan, Patrick H.

2014-01-01

The relationship between family functioning and adolescents’ physical aggression has been well established, but whether these relationships might differ by ethnicity has received less attention. Ethnic variations may be important for targeting prevention programs to specific youth and families. This study examined the longitudinal relationship between family cohesion, parental monitoring, and physical aggression using data from the Multisite Violence Prevention Project sample of high-risk youth (elevated aggression). Participants were 1,232 high-risk middle school students (65% male; 70% African American; 15% Hispanic). Meaningful demographic variations were identified. After controlling for intervention condition and study site, family cohesion was significantly negatively related to physical aggression, more so for Hispanic youth. Parental monitoring was negatively associated with physical aggression for African American youth only. Our findings point to the importance of developing culturally sensitive family interventions to prevent physical aggression in middle school. PMID:25416227

Medical-device risk management and public safety: using cost-benefit as a measurement of effectiveness

NASA Astrophysics Data System (ADS)

Hughes, Allen A.

1994-12-01

Public safety can be enhanced through the development of a comprehensive medical device risk management. This can be accomplished through case studies using a framework that incorporates cost-benefit analysis in the evaluation of risk management attributes. This paper presents a framework for evaluating the risk management system for regulatory Class III medical devices. The framework consists of the following sixteen attributes of a comprehensive medical device risk management system: fault/failure analysis, premarket testing/clinical trials, post-approval studies, manufacturer sponsored hospital studies, product labeling, establishment inspections, problem reporting program, mandatory hospital reporting, medical literature surveillance, device/patient registries, device performance monitoring, returned product analysis, autopsy program, emergency treatment funds/interim compensation, product liability, and alternative compensation mechanisms. Review of performance histories for several medical devices can reveal the value of information for many attributes, and also the inter-dependencies of the attributes in generating risk information flow. Such an information flow network is presented as a starting point for enhancing medical device risk management by focusing on attributes with high net benefit values and potential to spur information dissemination.

Impact of prescription drug monitoring programs and pill mill laws on high-risk opioid prescribers: A comparative interrupted time series analysis.

PubMed

Chang, Hsien-Yen; Lyapustina, Tatyana; Rutkow, Lainie; Daubresse, Matthew; Richey, Matt; Faul, Mark; Stuart, Elizabeth A; Alexander, G Caleb

2016-08-01

Prescription drug monitoring programs (PDMPs) and pill mill laws were implemented to reduce opioid-related injuries/deaths. We evaluated their effects on high-risk prescribers in Florida. We used IMS Health's LRx Lifelink database between July 2010 and September 2012 to identify opioid-prescribing prescribers in Florida (intervention state, N: 38,465) and Georgia (control state, N: 18,566). The pre-intervention, intervention, and post-intervention periods were: July 2010-June 2011, July 2011-September 2011, and October 2011-September 2012. High-risk prescribers were those in the top 5th percentile of opioid volume during four consecutive calendar quarters. We applied comparative interrupted time series models to evaluate policy effects on clinical practices and monthly prescribing measures for low-risk/high-risk prescribers. We identified 1526 (4.0%) high-risk prescribers in Florida, accounting for 67% of total opioid volume and 40% of total opioid prescriptions. Relative to their lower-risk counterparts, they wrote sixteen times more monthly opioid prescriptions (79 vs. 5, p<0.01), and had more prescription-filling patients receiving opioids (47% vs. 19%, p<0.01). Following policy implementation, Florida's high-risk providers experienced large relative reductions in opioid patients and opioid prescriptions (-536 patients/month, 95% confidence intervals [CI] -829 to -243; -847 prescriptions/month, CI -1498 to -197), morphine equivalent dose (-0.88mg/month, CI -1.13 to -0.62), and total opioid volume (-3.88kg/month, CI -5.14 to -2.62). Low-risk providers did not experience statistically significantly relative reductions, nor did policy implementation affect the status of being high- vs. low- risk prescribers. High-risk prescribers are disproportionately responsive to state policies. However, opioids-prescribing remains highly concentrated among high-risk providers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Impact of prescription drug monitoring programs and pill mill laws on high-risk opioid prescribers: A comparative interrupted time series analysis

PubMed Central

Chang, Hsien-Yen; Lyapustina, Tatyana; Rutkow, Lainie; Daubresse, Matthew; Richey, Matt; Faul, Mark; Stuart, Elizabeth A.; Alexander, G. Caleb

2016-01-01

Background Prescription drug monitoring programs (PDMPs) and pill mill laws were implemented to reduce opioid-related injuries/deaths. We evaluated their effects on high-risk prescribers in Florida. Methods We used IMS Health's LRx Lifelink database between July 2010 and September 2012 to identify opioid-prescribing prescribers in Florida (intervention state, N: 38,465) and Georgia (control state, N: 18,566). The pre-intervention, intervention, and post-intervention periods were: July 2010–June 2011, July 2011–September 2011, and October 2011–September 2012. High-risk prescribers were those in the top 5th percentile of opioid volume during four consecutive calendar quarters. We applied comparative interrupted time series models to evaluate policy effects on clinical practices and monthly prescribing measures for low-risk/high-risk prescribers. Results We identified 1526 (4.0%) high-risk prescribers in Florida, accounting for 67% of total opioid volume and 40% of total opioid prescriptions. Relative to their lower-risk counterparts, they wrote sixteen times more monthly opioid prescriptions (79 vs. 5, p < 0.01), and had more prescription-filling patients receiving opioids (47% vs. 19%, p < 0.01). Following policy implementation, Florida's high-risk providers experienced large relative reductions in opioid patients and opioid prescriptions (−536 patients/month, 95% confidence intervals [CI] −829 to −243; −847 prescriptions/month, CI −1498 to −197), morphine equivalent dose (−0.88 mg/month, CI −1.13 to −0.62), and total opioid volume (−3.88 kg/month, CI −5.14 to −2.62). Low-risk providers did not experience statistically significantly relative reductions, nor did policy implementation affect the status of being high- vs. low- risk prescribers. Conclusions High-risk prescribers are disproportionately responsive to state policies. However, opioidsprescribing remains highly concentrated among high-risk providers. PMID:27264166

The quality of clinical maternal and neonatal healthcare - a strategy for identifying 'routine care signal functions'.

PubMed

Brenner, Stephan; De Allegri, Manuela; Gabrysch, Sabine; Chinkhumba, Jobiba; Sarker, Malabika; Muula, Adamson S

2015-01-01

A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH) programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs), a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC), the 'EmOC signal functions', a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example. We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi. Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants' adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks. The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes will contribute to streamlining MNH program evaluations in LMICs.

The Quality of Clinical Maternal and Neonatal Healthcare – A Strategy for Identifying ‘Routine Care Signal Functions’

PubMed Central

Brenner, Stephan; De Allegri, Manuela; Gabrysch, Sabine; Chinkhumba, Jobiba; Sarker, Malabika; Muula, Adamson S.

2015-01-01

Background A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH) programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs), a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC), the ‘EmOC signal functions’, a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example. Methods We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi. Results Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants’ adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks. Conclusion The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes will contribute to streamlining MNH program evaluations in LMICs. PMID:25875252

APPLICATION OF BAYESIAN AND GEOSTATISTICAL MODELING TO THE ENVIRONMENTAL MONITORING OF CS-137 AT THE IDAHO NATIONAL LABORATORY

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

Kara G. Eby

2010-08-01

At the Idaho National Laboratory (INL) Cs-137 concentrations above the U.S. Environmental Protection Agency risk-based threshold of 0.23 pCi/g may increase the risk of human mortality due to cancer. As a leader in nuclear research, the INL has been conducting nuclear activities for decades. Elevated anthropogenic radionuclide levels including Cs-137 are a result of atmospheric weapons testing, the Chernobyl accident, and nuclear activities occurring at the INL site. Therefore environmental monitoring and long-term surveillance of Cs-137 is required to evaluate risk. However, due to the large land area involved, frequent and comprehensive monitoring is limited. Developing a spatial model thatmore » predicts Cs-137 concentrations at unsampled locations will enhance the spatial characterization of Cs-137 in surface soils, provide guidance for an efficient monitoring program, and pinpoint areas requiring mitigation strategies. The predictive model presented herein is based on applied geostatistics using a Bayesian analysis of environmental characteristics across the INL site, which provides kriging spatial maps of both Cs-137 estimates and prediction errors. Comparisons are presented of two different kriging methods, showing that the use of secondary information (i.e., environmental characteristics) can provide improved prediction performance in some areas of the INL site.« less

Reply to comment by Rainer Facius et al. on "U.S. Government shutdown degrades aviation radiation monitoring during solar radiation storm"

NASA Astrophysics Data System (ADS)

Tobiska, W. Kent; Gersey, Brad; Wilkins, Richard; Mertens, Chris; Atwell, William; Bailey, Justin

2014-05-01

The premise of this comment perpetuates an unfortunate trend among some radiation researchers to minimize potential risks to human tissue from low-radiation sources. In fact, this discussion on the risk uncertainties of low-dose radiation further illustrates the need for more measurements and a program of active monitoring, especially when solar eruptive events can substantially elevate the radiation environment. This debate also highlights the context of a bigger problem; i.e., how do we as professionals act with due diligence to take the immense body of knowledge of space weather radiation effects on human tissue and distil it into ideas that regulatory agencies can use to maximize the safety of a population at risk. The focus of our article on radiation risks due to solar energetic particle events starts with our best assessment of risks and is based on the body of scientific knowledge while, at the same time, erring on the side of public safety. The uncertainty inherent in our assessment is accepted and described with this same philosophy in mind.

Towards a Long-Term Strategy for Voluntary-Based Internal Radiation Contamination Monitoring: A Population-Level Analysis of Monitoring Prevalence and Factors Associated with Monitoring Participation Behavior in Fukushima, Japan

PubMed Central

Nomura, Shuhei; Tsubokura, Masaharu; Ozaki, Akihiko; Murakami, Michio; Hodgson, Susan; Blangiardo, Marta; Nishikawa, Yoshitaka; Morita, Tomohiro; Oikawa, Tomoyoshi

2017-01-01

Following Japan’s 2011 Fukushima nuclear incident, we assessed voluntary-based monitoring behavior in Minamisoma City—located 10–40 km from the Fukushima nuclear plant—to inform future monitoring strategies. The monitoring in Minamisoma included occasional free of charge internal-radiation-exposure measurements. Out of around 70,000 individuals residing in the city before the incident, a total of 45,788 residents (female: 52.1%) aged ≥21 were evaluated. The monitoring prevalence in 2011–2012 was only 30.2%, and this decreased to 17.9% in 2013–2014. Regression analyses were performed to estimate factors associated with the monitoring prevalence and participation behavior. The results show that, in comparison with the age cohort of 21–30 years, the cohort of 71–80 and ≥81 years demonstrated significantly lower monitoring prevalence; female residents had higher monitoring prevalence than male residents; those who were living in evacuation zones at the time of the incident had higher monitoring prevalence than those who lived outside any of the evacuation zones; for those living outside Fukushima and neighboring Prefectures post-incident monitoring prevalence decreased significantly in 2013–2014. Our findings inform the discussion on the concepts of radiation risk perception and accessibility to monitoring and societal decision-making regarding the maintenance of the monitoring program with low monitoring prevalence. We also stress the possibility that the monitoring can work both to check that internal contamination levels are within acceptable limits, and as a risk communication tool, alleviating individuals’ concern and anxiety over radiation contamination. PMID:28397769

Space Environment Forecasting with Neutron Monitors: Establishing a novel service for the ESA SSA Program

NASA Astrophysics Data System (ADS)

Papaioannou, Athanasios; Mavromichalaki, Helen; Souvatzoglou, George; Paschalis, Pavlos; Sarlanis, Christos; Dimitroulakos, John; Gerontidou, Maria

2013-04-01

High-energy particles released at the Sun during a solar flare or a very energetic coronal mass ejection, result to a significant intensity increase at neutron monitor measurements known as Ground Level Enhancements (GLEs). Due to their space weather impact (i.e. risks and failures at communication and navigation systems, spacecraft electronics and operations, space power systems, manned space missions, and commercial aircraft operations) it is crucial to establish a real-time operational system that would be in place to issue reliable and timely GLE Alerts. Currently, the Cosmic Ray group of the National and Kapodistrian University of Athens is working towards the establishment of a Neutron Monitor Service that will be made available via the Space Weather Portal operated by the European Space Agency (ESA), under the Space Situational Awareness (SSA) Program. To this end, a web interface providing data from multiple Neutron Monitor stations as well as an upgraded GLE Alert will be provided. Both services are now under testing and validation and they will probably enter to an operational phase next year. The core of this Neutron Monitor Service is the GLE Alert software, and therefore, the main goal of this research effort is to upgrade the existing GLE Alert software, to minimize the probability of a false alarm and to enhance the usability of the corresponding results. The ESA Neutron Monitor Service is building upon the infrastructure made available with the implementation of the High-Resolution Neutron Monitor Database (NMDB). In this work the structure of the Neutron Monitor Service for ESA SSA Program and the impact of the novel GLE Alert Service that will be made available to future users via ESA SSA web portal will be presented and further discussed.

Mapping real-time air pollution health risk for environmental management: Combining mobile and stationary air pollution monitoring with neural network models.

PubMed

Adams, Matthew D; Kanaroglou, Pavlos S

2016-03-01

Air pollution poses health concerns at the global scale. The challenge of managing air pollution is significant because of the many air pollutants, insufficient funds for monitoring and abatement programs, and political and social challenges in defining policy to limit emissions. Some governments provide citizens with air pollution health risk information to allow them to limit their exposure. However, many regions still have insufficient air pollution monitoring networks to provide real-time mapping. Where available, these risk mapping systems either provide absolute concentration data or the concentrations are used to derive an Air Quality Index, which provides the air pollution risk for a mix of air pollutants with a single value. When risk information is presented as a single value for an entire region it does not inform on the spatial variation within the region. Without an understanding of the local variation residents can only make a partially informed decision when choosing daily activities. The single value is typically provided because of a limited number of active monitoring units in the area. In our work, we overcome this issue by leveraging mobile air pollution monitoring techniques, meteorological information and land use information to map real-time air pollution health risks. We propose an approach that can provide improved health risk information to the public by applying neural network models within a framework that is inspired by land use regression. Mobile air pollution monitoring campaigns were conducted across Hamilton from 2005 to 2013. These mobile air pollution data were modelled with a number of predictor variables that included information on the surrounding land use characteristics, the meteorological conditions, air pollution concentrations from fixed location monitors, and traffic information during the time of collection. Fine particulate matter and nitrogen dioxide were both modelled. During the model fitting process we reserved twenty percent of the data to validate the predictions. The models' performances were measured with a coefficient of determination at 0.78 and 0.34 for PM2.5 and NO2, respectively. We apply a relative importance measure to identify the importance of each variable in the neural network to partially overcome the black box issues of neural network models. Copyright © 2015 Elsevier Ltd. All rights reserved.

Design and Operation of the Transformed National Healthy Start Evaluation.

PubMed

Banks, Jamelle E; Dwyer, Maura; Hirai, Ashley; Ghandour, Reem M; Atrash, Hani K

2017-12-01

Purpose Improving pregnancy outcomes for women and children is one of the nation's top priorities. The Healthy Start (HS) program was created to address factors that contribute to high infant mortality rates (IMRs) and persistent disparities in IMRs. The program began in 1991 and was transformed in 2014 to apply lessons from emerging research, past evaluation findings, and expert recommendations. To understand the implementation and impact of the transformed program, there is a need for a robust and comprehensive evaluation. Description The national HS evaluation will include an implementation evaluation, which will describe program components that affect outcomes; a utilization evaluation, which will examine the characteristics of women and infants who did and did not utilize the program; and an outcome evaluation, which will assess the program's effectiveness with regard to producing expected outcomes among the target population. Data sources include the National HS Program Survey, a HS participant survey, and individual-level program data linked to vital records and the Pregnancy Risk Assessment Monitoring System (PRAMS) survey. Assessment Descriptive analyses will be used to examine differences in risk profiles between participants and non-participants, as well as to calculate penetration rates for high-risk women in respective service areas. Multivariable analyses will be used to determine the impact of the program on key outcomes and will explore variation by dose, type of services received, and grantee characteristics. Conclusion Evaluation findings are expected to inform program decisions and direction, including identification of effective program components that can be spread and scaled.

Emergent Toxins in North Atlantic Temperate Waters: A Challenge for Monitoring Programs and Legislation

PubMed Central

Silva, Marisa; Pratheepa, Vijaya K.; Botana, Luis M.; Vasconcelos, Vitor

2015-01-01

Harmful Algal Blooms (HAB) are complex to manage due to their intermittent nature and their severe impact on the economy and human health. The conditions which promote HAB have not yet been fully explained, though climate change and anthropogenic intervention are pointed as significant factors. The rise of water temperature, the opening of new sea canals and the introduction of ship ballast waters all contribute to the dispersion and establishment of toxin-producing invasive species that promote the settling of emergent toxins in the food-chain. Tetrodotoxin, ciguatoxin, palytoxin and cyclic imines are commonly reported in warm waters but have also caused poisoning incidents in temperate zones. There is evidence that monitoring for these toxins exclusively in bivalves is simplistic and underestimates the risk to public health, since new vectors have been reported for these toxins and as well for regulated toxins such as PSTs and DSTs. In order to avoid public health impacts, there is a need for adequate monitoring programs, a need for establishing appropriate legislation, and a need for optimizing effective methods of analysis. In this review, we will compile evidence concerning emergent marine toxins and provide data that may indicate the need to restructure the current monitoring programs of HAB. PMID:25785464

Emergent toxins in North Atlantic temperate waters: a challenge for monitoring programs and legislation.

PubMed

Silva, Marisa; Pratheepa, Vijaya K; Botana, Luis M; Vasconcelos, Vitor

2015-03-16

Harmful Algal Blooms (HAB) are complex to manage due to their intermittent nature and their severe impact on the economy and human health. The conditions which promote HAB have not yet been fully explained, though climate change and anthropogenic intervention are pointed as significant factors. The rise of water temperature, the opening of new sea canals and the introduction of ship ballast waters all contribute to the dispersion and establishment of toxin-producing invasive species that promote the settling of emergent toxins in the food-chain. Tetrodotoxin, ciguatoxin, palytoxin and cyclic imines are commonly reported in warm waters but have also caused poisoning incidents in temperate zones. There is evidence that monitoring for these toxins exclusively in bivalves is simplistic and underestimates the risk to public health, since new vectors have been reported for these toxins and as well for regulated toxins such as PSTs and DSTs. In order to avoid public health impacts, there is a need for adequate monitoring programs, a need for establishing appropriate legislation, and a need for optimizing effective methods of analysis. In this review, we will compile evidence concerning emergent marine toxins and provide data that may indicate the need to restructure the current monitoring programs of HAB.

Enhancing the ecological risk assessment process.

PubMed

Dale, Virginia H; Biddinger, Gregory R; Newman, Michael C; Oris, James T; Suter, Glenn W; Thompson, Timothy; Armitage, Thomas M; Meyer, Judith L; Allen-King, Richelle M; Burton, G Allen; Chapman, Peter M; Conquest, Loveday L; Fernandez, Ivan J; Landis, Wayne G; Master, Lawrence L; Mitsch, William J; Mueller, Thomas C; Rabeni, Charles F; Rodewald, Amanda D; Sanders, James G; van Heerden, Ivor L

2008-07-01

The Ecological Processes and Effects Committee of the US Environmental Protection Agency Science Advisory Board conducted a self-initiated study and convened a public workshop to characterize the state of the ecological risk assessment (ERA), with a view toward advancing the science and application of the process. That survey and analysis of ERA in decision making shows that such assessments have been most effective when clear management goals were included in the problem formulation; translated into information needs; and developed in collaboration with decision makers, assessors, scientists, and stakeholders. This process is best facilitated when risk managers, risk assessors, and stakeholders are engaged in an ongoing dialogue about problem formulation. Identification and acknowledgment of uncertainties that have the potential to profoundly affect the results and outcome of risk assessments also improves assessment effectiveness. Thus we suggest 1) through peer review of ERAs be conducted at the problem formulation stage and 2) the predictive power of risk-based decision making be expanded to reduce uncertainties through analytical and methodological approaches like life cycle analysis. Risk assessment and monitoring programs need better integration to reduce uncertainty and to evaluate risk management decision outcomes. Postdecision audit programs should be initiated to evaluate the environmental outcomes of risk-based decisions. In addition, a process should be developed to demonstrate how monitoring data can be used to reduce uncertainties. Ecological risk assessments should include the effects of chemical and nonchemical stressors at multiple levels of biological organization and spatial scale, and the extent and resolution of the pertinent scales and levels of organization should be explicitly considered during problem formulation. An approach to interpreting lines of evidence and weight of evidence is critically needed for complex assessments, and it would be useful to develop case studies and/or standards of practice for interpreting lines of evidence. In addition, tools for cumulative risk assessment should be developed because contaminants are often released into stressed environments.

The impact of parent involvement in an effective adolescent risk reduction intervention on sexual risk communication and adolescent outcomes

PubMed Central

Wang, Bo; Stanton, Bonita; Deveaux, Lynette; Li, Xiaoming; Koci, Veronica; Lunn, Sonja

2014-01-01

Parent involvement in prevention efforts targeting adolescents increases the impact of such programs. However, the majority of risk-reduction intervention programs that are implemented through schools do not include parents, in part because most existing parental interventions require significant time commitment by parents. We designed a brief parent-adolescent sexual risk communication intervention to be delivered with an effective HIV prevention intervention as part of a randomized, controlled trial among 2564 grade 10 students and their parents in The Bahamas. Mixed effects modeling analysis was conducted to evaluate the effect of the brief parent-adolescent communication intervention using four waves of longitudinal data. Results indicate that a brief parent-adolescent communication intervention is effective in improving parent-adolescent communication on sex-related issues and perceived parental monitoring as well as the youth's condom use skills and self-efficacy. There is a marginal effect on consistent condom use. In addition, there is an apparent dose effect of the brief parent intervention on perceived parent-adolescent sexual risk communication and adolescent outcomes. These findings suggest that adolescent risk reduction interventions should include a brief parent-adolescent communication intervention which should be reinforced by periodic boosters in order to enhance the impact of adolescent HIV prevention programs. PMID:25490732

The impact of parent involvement in an effective adolescent risk reduction intervention on sexual risk communication and adolescent outcomes.

PubMed

Wang, Bo; Stanton, Bonita; Deveaux, Lynette; Li, Xiaoming; Koci, Veronica; Lunn, Sonja

2014-12-01

Parent involvement in prevention efforts targeting adolescents increases the impact of such programs. However, the majority of risk-reduction intervention programs that are implemented through schools do not include parents, in part because most existing parental interventions require significant time commitment by parents. We designed a brief parent-adolescent sexual risk communication intervention to be delivered with an effective HIV prevention intervention as part of a randomized, controlled trial among 2,564 grade 10 students and their parents in the Bahamas. Mixed effects modeling analysis was conducted to evaluate the effect of the brief parent-adolescent communication intervention using four waves of longitudinal data. Results indicate that a brief parent-adolescent communication intervention is effective in improving parent-adolescent communication on sex-related issues and perceived parental monitoring as well as the youth's condom use skills and self-efficacy. There is a marginal effect on consistent condom use. In addition, there is an apparent dose effect of the brief parent intervention on perceived parent-adolescent sexual risk communication and adolescent outcomes. These findings suggest that adolescent risk reduction interventions should include a brief parent-adolescent communication intervention that should be reinforced by periodic boosters in order to enhance the impact of adolescent HIV prevention programs.

Cyberpark 2000: Protected Areas Management Pilot Project. Satellite time series vegetation monitoring

NASA Astrophysics Data System (ADS)

Monteleone, M.; Lanorte, A.; Lasaponara, R.

2009-04-01

Cyberpark 2000 is a project funded by the UE Regional Operating Program of the Apulia Region (2000-2006). The main objective of the Cyberpark 2000 project is to develop a new assessment model for the management and monitoring of protected areas in Foggia Province (Apulia Region) based on Information and Communication Technologies. The results herein described are placed inside the research activities finalized to develop an environmental monitoring system knowledge based on the use of satellite time series. This study include: - A- satellite time series of high spatial resolution data for supporting the analysis of fire static risk factors through land use mapping and spectral/quantitative characterization of vegetation fuels; - B- satellite time series of MODIS for supporting fire dynamic risk evaluation of study area - Integrated fire detection by using thermal imaging cameras placed on panoramic view-points; - C - integrated high spatial and high temporal satellite time series for supporting studies in change detection factors or anomalies in vegetation covers; - D - satellite time-series for monitoring: (i) post fire vegetation recovery and (ii) spatio/temporal vegetation dynamics in unburned and burned vegetation covers.

Use of oil shale ash in road construction: results of follow-up environmental monitoring.

PubMed

Reinik, Janek; Irha, Natalya; Koroljova, Arina; Meriste, Tõnis

2018-01-05

Oil shale ash (OSA) was used for road construction in a pristine swamp area in East-Estonia during 2013-2014. OSA was used as a binder both in mass stabilization of soft peat soil and in the upper layer. Use of OSA in civil engineering always raises questions about the environmental safety of such activities. Post-construction environmental monitoring of the pilot section was carried out in 2014 and 2015. The monitoring program involved surface water and soil sampling campaigns. Samples were analyzed for selected constituents and parameters of environmental concern. The paper gives data for assessing the environmental impact and evaluation of potential risks associated with construction of roads using OSA. Leaching of hazardous compounds from the pilot section to surrounding aqueous environment was not observed during the monitoring program. Still, the road construction affected the concentration of sulfates in surrounding surface water. Also, the water-soluble content of barium in surface water correlated significantly with the concentrations of chloride and sulfate ion and electric conductivity of the surface water. Therefore, it is recommended to monitor the electric conductivity, concentrations of sulfates, chlorides, and barium in nearby surface water when OSA is used in road construction.

Folic Acid Food Fortification—Its History, Effect, Concerns, and Future Directions

PubMed Central

Crider, Krista S.; Bailey, Lynn B.; Berry, Robert J.

2011-01-01

Periconceptional intake of folic acid is known to reduce a woman’s risk of having an infant affected by a neural tube birth defect (NTD). National programs to mandate fortification of food with folic acid have reduced the prevalence of NTDs worldwide. Uncertainty surrounding possible unintended consequences has led to concerns about higher folic acid intake and food fortification programs. This uncertainty emphasizes the need to continually monitor fortification programs for accurate measures of their effect and the ability to address concerns as they arise. This review highlights the history, effect, concerns, and future directions of folic acid food fortification programs. PMID:22254102

NASA's Agency-Wide Strategy for Environmental Regulatory Risk Analysis and Communication

NASA Technical Reports Server (NTRS)

Duda, Kristen; Scroggins, Sharon

2008-01-01

NASA's mission is to pioneer the future in space exploration, scientific discovery, and aeronautics research. To help enable existing and future programs to pursue this mission, NASA has established the Principal Center for Regulatory Risk Analysis and Communication (RRAC PC) to proactively identify, analyze, and communicate environmental regulatory risks to the NASA community. The RRAC PC is chartered to evaluate the risks posed to NASA Programs and facilities by environmentally related drivers. The RRAC PC focuses on emerging environmental regulations, as well as risks related to operational changes that can trigger existing environmental requirements. Changing regulations have the potential to directly affect program activities. For example, regulatory changes can restrict certain activities or operations by mandating changes in how operations may be done or limiting where or how certain operations can take place. Regulatory changes also can directly affect the ability to use certain materials by mandating a production phase-out or restricting usage applications of certain materials. Such changes can result in NASA undertaking material replacement efforts. Even if a regulation does not directly affect NASA operations, U.S. and international regulations can pose program risks indirectly through requirements levied on manufacturers and vendors of components and materials. For example, manufacturers can change their formulations to comply with new regulatory requirements. Such changes can require time-consuming and costly requalification certification for use in human spaceflight programs. The RRAC PC has implemented several strategies for proactively managing regulatory change to minimize potential adverse impacts to NASA Programs and facilities. This presentation highlights the lessons learned through establishing the RRAC PC, the process by which the RRAC PC monitors and distributes information about emerging regulatory requirements, and the cross-Agency cooperation that is vital to supporting NASA's mission.

NASA's Agency-wide Strategy for Environmental Regulatory Risk Analysis and Communication

NASA Technical Reports Server (NTRS)

Duda, Kristen; Scroggins. Sharon

2008-01-01

NASA's mission is to pioneer the future in space exploration, scientific discovery, and aeronautics research. To help enable existing and future programs to pursue this mission, NASA has established the Principal Center for Regulatory Risk Analysis and Communication (RRAC PC) to proactively identify, analyze, and communicate environmental regulatory risks to the NASA community. The RRAC PC is chartered to evaluate the risks posed to NASA Programs and facilities by environmentally related drivers. The RRAC PC focuses on emerging environmental regulations, as well as risks related to operational changes that can trigger existing environmental requirements. Changing regulations have the potential to directly affect program activities. For example, regulatory changes can restrict certain activities or operations by mandating changes in how operations may be done or limiting where or how certain operations can take place. Regulatory changes also can directly affect the ability to use certain materials by mandating a production phase-out or restricting usage aPi'iications of certain materials. Such changes can result in NASA undertaking material replacement efforts. Even if a regulation does not directly affect NASA operations, U.S. and international regulations can pose program risks indirectly through requirements levied on manufacturers and vendors of components and materials. For example, manufacturers can change their formulations to comply with new regulatory requirements. Such changes can require time-consuming and costly requalification certification for use in human spaceflight programs. The RRAC PC has implemented several strategies for proactively managing regulatory change to minimize potential adverse impacts to NASA Programs and facilities. This presentation highlights the lessons learned through establishing the RRAC PC, the process by which the RRAC PC monitors and distributes information about emerging regulatory requirements, and the cross-Agency cooperation that is vital to supporting NASA's mission.

A Personalized Risk Stratification Platform for Population Lifetime Healthcare.

PubMed

Daowd, Ali; Abidi, Samina Raza; Abusharekh, Ashraf; Abidi, Syed Sibte Raza

2018-01-01

Chronic diseases are the leading cause of death worldwide. It is well understood that if modifiable risk factors are targeted, most chronic diseases can be prevented. Lifetime health is an emerging health paradigm that aims to assist individuals to achieve desired health targets, and avoid harmful lifecycle choices to mitigate the risk of chronic diseases. Early risk identification is central to lifetime health. In this paper, we present a digital health-based platform (PRISM) that leverages artificial intelligence, data visualization and mobile health technologies to empower citizens to self-assess, self-monitor and self-manage their overall risk of major chronic diseases and pursue personalized chronic disease prevention programs. PRISM offers risk assessment tools for 5 chronic conditions, 2 psychiatric disorders and 8 different cancers.

Development and Implementation of the Ebola Traveler Monitoring Program and Clinical Outcomes of Monitored Travelers during October – May 2015, Minnesota

PubMed Central

DeVries, Aaron; Talley, Pamela; Sweet, Kristin; Kline, Susan; Stinchfield, Patricia; Tosh, Pritish; Danila, Richard

2016-01-01

Background In October 2014, the United States began actively monitoring all persons who had traveled from Guinea, Liberia, and Sierra Leone in the previous 21 days. State public health departments were responsible for monitoring all travelers; Minnesota has the largest Liberian population in the United States. The MDH Ebola Clinical Team (ECT) was established to assess travelers with symptoms of concern for Ebola virus disease (EVD), coordinate access to healthcare at appropriate facilities including Ebola Assessment and Treatment Units (EATU), and provide guidance to clinicians. Methods Minnesota Department of Health (MDH) began receiving traveler information collected by U.S. Customs and Border Control and Centers for Disease Control and Prevention staff on October 21, 2014 via encrypted electronic communication. All travelers returning from Liberia, Sierra Leone, and Guinea during 10/21/14–5/15/15 were monitored by MDH staff in the manner recommended by CDC based on the traveler’s risk categorization as “low (but not zero)”, “some” and “high” risk. When a traveler reported symptoms or a temperature ≥100.4° F at any time during their 21-day monitoring period, an ECT member would speak to the traveler and perform a clinical assessment by telephone or via video-chat. Based on the assessment the ECT member would recommend 1) continued clinical monitoring while at home with frequent telephone follow-up by the ECT member, 2) outpatient clinical evaluation at an outpatient site agreed upon by all parties, or 3) inpatient clinical evaluation at one of four Minnesota EATUs. ECT members assessed and approved testing for Ebola virus infection at MDH. Traveler data, calls to the ECT and clinical outcomes were logged on a secure server at MDH. Results During 10/21/14–5/15/15, a total of 783 travelers were monitored; 729 (93%) traveled from Liberia, 30 (4%) Sierra Leone, and 24 (3%) Guinea. The median number monitored per week was 59 (range 45–143). The median age was 35 years; 136 (17%) were aged <18 years. Thirteen of 256 women of reproductive age (5%) were pregnant. The country of passport issuance was known for 720 of the travelers. The majority of monitored travelers (478 [66%]) used a non-U.S. passport including 442 (61%) Liberian nationals. A total of 772 (99%) travelers were “low (but not zero)” risk; 11 (1%) were “some” risk. Among monitored travelers, 43 (5%) experienced illness symptoms; 29 (67%) had a symptom consistent with EVD. Two were tested for Ebola virus disease and had negative results. Most frequently reported symptoms were fever (20/43, 47%) and abdominal pain (12/43, 28%). During evaluation, 16 (37%) of 43 travelers reported their symptoms began prior to travel; chronic health conditions in 24 travelers including tumors/cancer, pregnancy, and orthopedic conditions were most common. Infectious causes in 19 travelers included upper respiratory infection, malaria, and gastrointestinal infections. Discussion Prior to 2014, no similar active monitoring program for travelers had been performed in Minnesota; assessment and management of symptomatic travelers was a new activity for MDH. Ensuring safe entrance into healthcare was particularly challenging for children, and pregnant women, as well as those without an established connection to healthcare. Unnecessary inpatient evaluations were successfully avoided by close clinical follow-up by phone. Before similar monitoring programs are considered in the future, careful thought must be given to necessary resources and the impact on affected populations, public health, and the healthcare system. PMID:27907013

Cardiac rehabilitation after myocardial infarction.

PubMed

Contractor, Aashish S

2011-12-01

Cardiac rehabilitation/secondary prevention programs are recognized as integral to the comprehensive care of patients with coronary heart disease (CHD), and as such are recommended as useful and effective (Class I) by the American Heart Association and the American College of Cardiology in the treatment of patients with CHD. The term cardiac rehabilitation refers to coordinated, multifaceted interventions designed to optimize a cardiac patient's physical, psychological, and social functioning, in addition to stabilizing, slowing, or even reversing the progression of the underlying atherosclerotic processes, thereby reducing morbidity and mortality. Cardiac rehabilitation, aims at returning the patient back to normal functioning in a safe and effective manner and to enhance the psychosocial and vocational state of the patient. The program involves education, exercise, risk factor modification and counselling. A meta-analysis based on a review of 48 randomized trials that compared outcomes of exercise-based rehabilitation with usual medical care, showed a reduction of 20% in total mortality and 26% in cardiac mortality rates, with exercise-based rehabilitation compared with usual medical care. Risk stratification helps identify patients who are at increased risk for exercise-related cardiovascular events and who may require more intensive cardiac monitoring in addition to the medical supervision provided for all cardiac rehabilitation program participants. During exercise, the patients' ECG is continuously monitored through telemetry, which serves to optimize the exercise prescription and enhance safety. The safety of cardiac rehabilitation exercise programs is well established, and the occurrence of major cardiovascular events during supervised exercise is extremely low. As hospital stays decrease, cardiac rehabilitation is assuming an increasingly important role in secondary prevention. In contrast with its growing importance internationally, there are very few cardiac rehabilitation centers in India at the present moment.

40 CFR 141.85 - Public education and supplemental monitoring requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... risk of lead exposure is to infants, young children, and pregnant women. Scientists have linked the... or school boards. (2) Women, Infants and Children (WIC) and Head Start programs. (3) Public and... young children. Please read this information closely to see what you can do to reduce lead in your...

40 CFR 141.85 - Public education and supplemental monitoring requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... risk of lead exposure is to infants, young children, and pregnant women. Scientists have linked the... or school boards. (2) Women, Infants and Children (WIC) and Head Start programs. (3) Public and... young children. Please read this information closely to see what you can do to reduce lead in your...

40 CFR 141.85 - Public education and supplemental monitoring requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... risk of lead exposure is to infants, young children, and pregnant women. Scientists have linked the... or school boards. (2) Women, Infants and Children (WIC) and Head Start programs. (3) Public and... young children. Please read this information closely to see what you can do to reduce lead in your...

40 CFR 141.85 - Public education and supplemental monitoring requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... risk of lead exposure is to infants, young children, and pregnant women. Scientists have linked the... or school boards. (2) Women, Infants and Children (WIC) and Head Start programs. (3) Public and... young children. Please read this information closely to see what you can do to reduce lead in your...

40 CFR 141.85 - Public education and supplemental monitoring requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... risk of lead exposure is to infants, young children, and pregnant women. Scientists have linked the... or school boards. (2) Women, Infants and Children (WIC) and Head Start programs. (3) Public and... young children. Please read this information closely to see what you can do to reduce lead in your...

Influence of limiting and regulating factors on populations of Asian citrus psyllid and the risk of insect and disease outbreaks

USDA-ARS?s Scientific Manuscript database

Data from long term monitoring programs in two Florida citrus groves were used to assess Asian citrus psyllid demography and population ecology, which is needed to implement more effective management strategies for huanglongbing. We describe and interpret seasonal patterns and correlations between A...

Concepts in ecological risk assessment. Professional paper

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

Johnston, R.K.; Seligman, P.F.

1991-05-01

Assessing the risk of impact to natural ecosystems from xenobiotic compounds requires an accurate characterization of the threatened ecosystem, direct measures or estimates of environmental exposure, and a comprehensive evaluation of the biological effects from actual and potential contamination. Field and laboratory methods have been developed to obtain direct measures of environmental health. These methods have been implemented in monitoring programs to assess and verify the ecological risks of contamination from past events, such as hazardous waste disposal sites, as well as future scenarios, such as the environmental consequences from the use of biocides in antifouling bottom paints for ships.

The Value of Continued Followup in a Preventive Medicine Program

NASA Technical Reports Server (NTRS)

Villafana, C.; Mockbee, J.

1970-01-01

Continued monitoring of hypertension and cholesterol levels in NASA employees by regularly scheduled medical examinations prevents an increase in employee disability and cardiovascular mortality rates. Adequate therapeutic control for younger hypertensive employees is demonstrated by records on mortality and heart diseases over a period of 28 months. It confirmed the importance of systolic blood pressure as diagnostic tool for the inherent risk factor. The prevalence of additional coronary risk factors among employees with hypercholesterolemia is considerably less than in employees with hypertension.

Atrial Fibrillation Burden: Moving Beyond Atrial Fibrillation as a Binary Entity: A Scientific Statement From the American Heart Association.

PubMed

Chen, Lin Y; Chung, Mina K; Allen, Larry A; Ezekowitz, Michael; Furie, Karen L; McCabe, Pamela; Noseworthy, Peter A; Perez, Marco V; Turakhia, Mintu P

2018-05-15

Our understanding of the risk factors and complications of atrial fibrillation (AF) is based mostly on studies that have evaluated AF in a binary fashion (present or absent) and have not investigated AF burden. This scientific statement discusses the published literature and knowledge gaps related to methods of defining and measuring AF burden, the relationship of AF burden to cardiovascular and neurological outcomes, and the effect of lifestyle and risk factor modification on AF burden. Many studies examine outcomes by AF burden classified by AF type (paroxysmal versus nonparoxysmal); however, quantitatively, AF burden can be defined by longest duration, number of AF episodes during a monitoring period, and the proportion of time an individual is in AF during a monitoring period (expressed as a percentage). Current guidelines make identical recommendations for anticoagulation regardless of AF pattern or burden; however, a review of recent evidence suggests that higher AF burden is associated with higher risk of stroke. It is unclear whether the risk increases continuously or whether a threshold exists; if a threshold exists, it has not been defined. Higher burden of AF is also associated with higher prevalence and incidence of heart failure and higher risk of mortality, but not necessarily lower quality of life. A structured and comprehensive risk factor management program targeting risk factors, weight loss, and maintenance of a healthy weight appears to be effective in reducing AF burden. Despite this growing understanding of AF burden, research is needed into validation of definitions and measures of AF burden, determination of the threshold of AF burden that results in an increased risk of stroke that warrants anticoagulation, and discovery of the mechanisms underlying the weak temporal correlations of AF and stroke. Moreover, developments in monitoring technologies will likely change the landscape of long-term AF monitoring and could allow better definition of the significance of changes in AF burden over time. © 2018 American Heart Association, Inc.

Integrated NHANES: uses in national policy.

PubMed

Woteki, Catherine E

2003-02-01

The National Nutrition Monitoring and Related Research Program (NNMRRP) arose from Congressional concern about lack of information regarding the occurrence in the American population of undernutrition and diet-related risk factors for chronic diseases. Congressional appropriations and executive branch decisions about budget priorities have been the major determinants of the scope and number of nutrition monitoring surveys and surveillance activities fielded and therefore the information available for policy and research uses. The nutrition data collected in the NNMRRP are used by federal agencies, the private sector and academia for a variety of purposes, including public policy (e.g., development and evaluation of monitoring and surveillance, regulatory and nutrition programs), normative standards (e.g., growth charts, reference data for hematological and biochemical indicators of nutritional status or Dietary Reference Intakes) and research (e.g., cross-sectional, longitudinal and time-trends studies of dietary and nutritional status, health status, disease morbidity and mortality). Although the importance of the NNMRRP to national policy is difficult to quantify, in a 5-y period 97 proposed and final regulations citing NNMRRP data were published in the Federal Register by federal agencies responsible for nutrition and food safety programs. The NNMRRP-derived dietary and nutritional status data are essential information for quantitative risk assessments increasingly relied on by regulatory agencies as the basis for programmatic decisions and regulations development. Users of NNMRRP data in government agencies, academic institutions and the private sector have come to recognize the value of data from the surveys and surveillance systems for a wide variety of programmatic and research purposes.

Effectiveness of a CD-ROM Nutrient Analysis Program on Self-Monitoring Behavior of Active Duty Military Personnel Receiving Nutrition Counseling for Weight Loss.

DTIC Science & Technology

1999-12-01

classified as "obese" with resulting elevated risk for co- morbid conditions (2). However, only one study is published regarding use of computer...described as one of the single most important predictors of successful weight loss in multiple studies (4,5,6,7,8); however, it consistently remains a...Considering this study as well as previously published studies , the authors propose a target of self-monitoring all foods eaten on at least 75% of

Iatrogenic effects of psychosocial interventions: treatment, life context, and personal risk factors.

PubMed

Moos, Rudolf H

2012-01-01

Between 7% and 15% of individuals who participate in psychosocial interventions for substance use disorders may be worse off after treatment than before. Intervention-related predictors of iatrogenic effects include lack of bonding; lack of goal direction and monitoring; confrontation, criticism, and high emotional arousal; models and norms for substance use; and stigma and inaccurate expectations. Life context and personal predictors include lack of support, criticism, and more severe substance use and psychological problems. Ongoing monitoring and safety standards are needed to identify and counteract adverse consequences of intervention programs.

Methods of Measuring and Mapping of Landslide Areas

NASA Astrophysics Data System (ADS)

Skrzypczak, Izabela; Kokoszka, Wanda; Kogut, Janusz; Oleniacz, Grzegorz

2017-12-01

The problem of attracting new investment areas and the inability of current zoning areas, allows us to understand why it is impossible to completely rule out building on landslide areas. Therefore, it becomes important issue of monitoring areas at risk of landslides. Only through appropriate monitoring and proper development of measurements resulting as maps of areas at risk of landslides enables us to estimate the risk and the relevant economic calculation for the realization of the anticipated investment in such areas. The results of monitoring of the surface and in-depth of the landslides are supplemented with constant observation of precipitation. The previous analyses and monitoring of landslides show that some of them are continuously active. GPS measurements, especially with laser scanning provide a unique activity data acquired on the surface of each individual landslide. The development of high resolution numerical models of terrain and the creation of differential models based on subsequent measurements, informs us about the size of deformation, both in units of distance (displacements) and volume. The compatibility of the data with information from in-depth monitoring allows the generation of a very reliable in-depth model of landslide, and as a result proper calculation of the volume of colluvium. Programs presented in the article are a very effective tool to generate in-depth model of landslide. In Poland, the steps taken under the SOPO project i.e. the monitoring and description of landslides are absolutely necessary for social and economic reasons and they may have a significant impact on the economy and finances of individual municipalities and also a whole country economy.

Human health risk constrained naphthalene-contaminated groundwater remediation management through an improved credibility method.

PubMed

Li, Jing; Lu, Hongwei; Fan, Xing; Chen, Yizhong

2017-07-01

In this study, a human health risk constrained groundwater remediation management program based on the improved credibility is developed for naphthalene contamination. The program integrates simulation, multivariate regression analysis, health risk assessment, uncertainty analysis, and nonlinear optimization into a general framework. The improved credibility-based optimization model for groundwater remediation management with consideration of human health risk (ICOM-HHR) is capable of not only effectively addressing parameter uncertainties and risk-exceeding possibility in human health risk but also providing a credibility level that indicates the satisfaction of the optimal groundwater remediation strategies with multiple contributions of possibility and necessity. The capabilities and effectiveness of ICOM-HHR are illustrated through a real-world case study in Anhui Province, China. Results indicate that the ICOM-HHR would generate double remediation cost yet reduce approximately 10 times of the naphthalene concentrations at monitoring wells, i.e., mostly less than 1 μg/L, which implies that the ICOM-HHR usually results in better environmental and health risk benefits. And it is acceptable to obtain a better environmental quality and a lower health risk level with sacrificing a certain economic benefit.

Northeast Regional Cancer Institute's Cancer Surveillance and Risk Factor Program

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

Lesko, Samuel M.

2007-07-31

OBJECTIVES The Northeast Regional Cancer Institute is conducting a program of ongoing epidemiologic research to address cancer disparities in northeast Pennsylvania. Of particular concern are disparities in the incidence of, stage at diagnosis, and mortality from colorectal cancer. In northeast Pennsylvania, age-adjusted incidence and mortality rates for colorectal cancer are higher, and a significantly smaller proportion of new colorectal cancer cases are diagnosed with local stage disease than is observed in comparable national data. Further, estimates of the prevalence of colorectal cancer screening in northeast Pennsylvania are lower than the US average. The Northeast Regional Cancer Institute’s research program supportsmore » surveillance of common cancers, investigations of cancer risk factors and screening behaviors, and the development of resources to further cancer research in this community. This project has the following specific objectives: I. To conduct cancer surveillance in northeast Pennsylvania. a. To monitor incidence and mortality for all common cancers, and colorectal cancer, in particular, and b. To document changes in the stage at diagnosis of colorectal cancer in this high-risk, underserved community. II. To conduct a population-based study of cancer risk factors and screening behavior in a six county region of northeast Pennsylvania. a. To monitor and document changes in colorectal cancer screening rates, and b. To document the prevalence of cancer risk factors (especially factors that increase the risk of colorectal cancer) and to identify those risk factors that are unusually common in this community. APPROACH Cancer surveillance was conducted using data from the Northeast Regional Cancer Institute’s population-based Regional Cancer Registry, the Pennsylvania Cancer Registry, and NCI’s SEER program. For common cancers, incidence and mortality were examined by county within the region and compared to data for similar populations in the US. For colorectal cancer, the stage at diagnosis of cases diagnosed in northeast Pennsylvania was compared to data from prior years. A population-based interview study of healthy adults was conducted to document the status of cancer screening and to estimate the prevalence of established cancer risk factors in this community. This study is similar in design to that used by the Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System (BRFSS). EXPERIMENTAL METHODS AND PROCEDURES: This program includes two distinct but related projects. The first project uses existing data to conduct cancer surveillance in northeast Pennsylvania, and the second is a population-based study of cancer risk factors and cancer screening behaviors in this same population. HUMAN SUBJECTS CONSIDERATIONS This program includes two projects: cancer surveillance and a population-based study of cancer risk factors and screening behavior. The cancer surveillance project involves only the use of existing aggregate data or de-identified data. As such, the surveillance project is exempt from human subjects considerations. The study of cancer risk factors and screening behaviors includes data from a random sample of adult residents of northeast Pennsylvania who are 18 or more years of age. All races, ethnicities and both sexes are included in proportion to their representation in the population. Subjects are interviewed anonymously by telephone; those who are unable to complete an interview in English are ineligible. This project has been reviewed and approved by the Scranton-Temple Residency Program IRB (IRB00001355), which is the IRB for the Northeast Regional Cancer Institute.« less

Essentials for starting a pediatric clinical study (4): Clinical pediatric safety planning based on preclinical toxicity studies and pediatric pharmacovigilance guidance.

PubMed

Sheth, Neha

2009-01-01

Juvenile toxicology studies in animals provide useful information to guide monitoring of potential adverse effects in children especially on growth and development. In order to continue to gain knowledge and build upon these preclinical studies, recent experience has suggested that additional approaches for monitoring of safety concerns in the pediatric population may be required. Recently, pediatric guidance has become available from the health authorities which provide pharmacovigilance concepts as they specifically relate to drugs being developed for pediatric indications. Clinical trials are typically not robust enough to detect rare or delayed safety effects as the pediatric trials are relatively short-term. Furthermore, such long term or rare effects may not be detected via standard voluntary postmarketing surveillance. Safety monitoring of children with Juvenile Inflammatory Arthritis (JIA) taking nonsteroid anti-inflammatory drug (NSAID)s will be used as an example to describe a post-marketing risk management and pharmacovigilance program that serves to better evaluate safety data from various sources. The intent of this program is to identify adverse events (AE), including events with longer latency, which may be associated with NSAID use in a pediatric population. In this presentation, the 4 major components of the program are to be addressed. Such a program may serve as a model to proactively generate and monitor safety data in order to identify AEs that may be associated with new therapeutics for a pediatric population.

Meeting the Needs for Radiation Protection: Diagnostic Imaging.

PubMed

Frush, Donald P

2017-02-01

Radiation and potential risk during medical imaging is one of the foremost issues for the imaging community. Because of this, there are growing demands for accountability, including appropriate use of ionizing radiation in diagnostic and image-guided procedures. Factors contributing to this include increasing use of medical imaging; increased scrutiny (from awareness to alarm) by patients/caregivers and the public over radiation risk; and mounting calls for accountability from regulatory, accrediting, healthcare coverage (e.g., Centers for Medicare and Medicaid Services), and advisory agencies and organizations as well as industry (e.g., NEMA XR-29, Standard Attributes on CT Equipment Related to Dose Optimization and Management). Current challenges include debates over uncertainty with risks with low-level radiation; lack of fully developed and targeted products for diagnostic imaging and radiation dose monitoring; lack of resources for and clarity surrounding dose monitoring programs; inconsistencies across and between practices for design, implementation and audit of dose monitoring programs; lack of interdisciplinary programs for radiation protection of patients; potential shortages in personnel for these and other consensus efforts; and training concerns as well as inconsistencies for competencies throughout medical providers' careers for radiation protection of patients. Medical care providers are currently in a purgatory between quality- and value-based imaging paradigms, a state that has yet to mature to reward this move to quality-based performance. There are also deficits in radiation expertise personnel in medicine. For example, health physics academic programs and graduates have recently declined, and medical physics residency openings are currently at a third of the number of graduates. However, leveraging solutions to the medical needs will require money and resources, beyond personnel alone. Energy and capital will need to be directed to:• innovative and cooperative cross-disciplinary institutional/practice oversight of and guidance for the use of diagnostic imaging (e.g., radiology, surgical specialties, cardiologists, and intensivists);• initiatives providing practical benchmarks (e.g., dose index registries);• comprehensive (consisting of access, integrity, metrology, analytics, informatics) and effective and efficient dose monitoring programs;• collaboration with industry;• improved use of imaging, such as through decision support combined with evidence-based appropriateness for imaging use;• integration with e-health such as medical records;• education, including information extending beyond the medical imaging community that is relevant to patients, public, and providers and administration;• identification of opportunities for alignment with salient media and advocacy organizations to deliver balanced information regarding medical radiation and risk;• open lines of communication between medical radiation experts and appropriate bodies such as the U.S. Environmental Protection Agency, the U.S. Food and Drug Administration, and the Joint Commission to assure appropriate guidance on documents and actions originating from these organizations; and• increased grant funding to foster translational work that advances understanding of low-level radiation and biological effects.

The Impact of Apollo-Era Microbiology on Human Space Flight

NASA Technical Reports Server (NTRS)

Elliott, T. F; Castro, V. A.; Bruce, R. J.; Pierson, D. L.

2014-01-01

The microbiota of crewmembers and the spacecraft environment contributes significant risk to crew health during space flight missions. NASA reduces microbial risk with various mitigation methods that originated during the Apollo Program and continued to evolve through subsequent programs: Skylab, Shuttle, and International Space Station (ISS). A quarantine of the crew and lunar surface samples, within the Lunar Receiving Laboratory following return from the Moon, was used to prevent contamination with unknown extraterrestrial organisms. The quarantine durations for the crew and lunar samples were 21 days and 50 days, respectively. A series of infections among Apollo crewmembers resulted in a quarantine before launch to limit exposure to infectious organisms. This Health Stabilization Program isolated the crew for 21 days before flight and was effective in reducing crew illness. After the program developed water recovery hardware for Apollo spacecraft, the 1967 National Academy of Science Space Science Board recommended the monitoring of potable water. NASA implemented acceptability limits of 10 colony forming units (CFU) per mL and the absence of viable E. coli, anaerobes, yeasts, and molds in three separate 150 mL aliquots. Microbiological investigations of the crew and spacecraft environment were conducted during the Apollo program, including the Apollo-Soyuz Test Project and Skylab. Subsequent space programs implemented microbial screening of the crew for pathogens and acceptability limits on spacecraft surfaces and air. Microbiology risk mitigation methods have evolved since the Apollo program. NASA cancelled the quarantine of the crew after return from the lunar surface, reduced the duration of the Health Stabilization Program; and implemented acceptability limits for spacecraft surfaces and air. While microbial risks were not a main focus of the early Mercury and Gemini programs, the extended duration of Apollo flights resulted in the increased scrutiny of impact of the space flight environment on crew health. The lessons learned during that era of space flight continue to impact microbiology risk mitigation in space programs today.

Programs to Increase High School Completion

PubMed Central

Hahn, Robert A.; Knopf, John A.; Wilson, Sandra Jo; Truman, Benedict I.; Milstein, Bobby; Johnson, Robert L.; Fielding, Jonathan E.; Muntaner, Carles J.M.; Jones, Camara Phyllis; Fullilove, Mindy T.; Moss, Regina Davis; Uefffng, Erin; Hunt, Pete C.

2015-01-01

Context High school completion (HSC) is an established predictor of long-term morbidity and mortality. U.S. rates of HSC are substantially lower among students from low-income families and most racial/ethnic minority populations than students from high-income families and the non-Hispanic white population. This systematic review assesses the effectiveness of programs to increase HSC and the potential of these programs to improve lifelong health among at-risk students. Evidence acquisition A search located a meta-analysis (search period 1985–2010/2011) on the effects of programs to increase HSC or General Educational Development (GED) diploma receipt; the meta-analysis was concordant with Community Guide definitions and methodologic standards. Programs were assessed separately for the general student population (152 studies) and students who were parents or pregnant (15 studies). A search for studies published between 2010 and August 2012 located ten more recent studies, which were assessed for consistency with the meta-analysis. Analyses were conducted in 2013. Evidence synthesis The review focused on the meta-analysis. Program effectiveness was measured as the increased rate of HSC (or GED receipt) by the intervention group compared with controls. All assessed program types were effective in increasing HSC in the general student population: vocational training, alternative schooling, social–emotional skills training, college-oriented programming, mentoring and counseling, supplemental academic services, school and class restructuring, multiservice packages, attendance monitoring and contingencies, community service, and case management. For students who had children or were pregnant, attendance monitoring and multiservice packages were effective. Ten studies published after the search period for the meta-analysis were consistent with its findings. Conclusions There is strong evidence that a variety of HSC programs can improve high school or GED completion rates. Because many programs are targeted to high-risk students and communities, they are likely to advance health equity. PMID:25818117

A Broadly-Based Training Program in Volcano Hazards Monitoring at the Center for the Study of Active Volcanoes

NASA Astrophysics Data System (ADS)

Thomas, D. M.; Bevens, D.

2015-12-01

The Center for the Study of Active Volcanoes, in cooperation with the USGS Volcano Hazards Program at HVO and CVO, offers a broadly based volcano hazards training program targeted toward scientists and technicians from developing nations. The program has been offered for 25 years and provides a hands-on introduction to a broad suite of volcano monitoring techniques, rather than detailed training with just one. The course content has evolved over the life of the program as the needs of the trainees have changed: initially emphasizing very basic monitoring techniques (e.g. precise leveling, interpretation of seismic drum records, etc.) but, as the level of sophistication of the trainees has increased, training in more advanced technologies has been added. Currently, topics of primary emphasis have included volcano seismology and seismic networks; acquisition and modeling of geodetic data; methods of analysis and monitoring of gas geochemistry; interpretation of volcanic deposits and landforms; training in LAHARZ, GIS mapping of lahar risks; and response to and management of volcanic crises. The course also provides training on public outreach, based on CSAV's Hawaii-specific hazards outreach programs, and volcano preparedness and interactions with the media during volcanic crises. It is an intensive eight week course with instruction and field activities underway 6 days per week; it is now offered in two locations, Hawaii Island, for six weeks, and the Cascades volcanoes of the Pacific Northwest, for two weeks, to enable trainees to experience field conditions in both basaltic and continental volcanic environments. The survival of the program for more than two decades demonstrates that a need for such training exists and there has been interaction and contribution to the program by the research community, however broader engagement with the latter continues to present challenges. Some of the reasons for this will be discussed.

Neighborhood perceptions and parent outcomes in family based prevention programs for Thai adolescents: the role of program engagement.

PubMed

Byrnes, Hilary F; Miller, Brenda A; Chamratrithirong, Aphichat; Rhucharoenpornpanich, Orratai; Cupp, Pamela K; Atwood, Katharine A; Fongkaew, Warunee; Rosati, Michael J; Chookhare, Warunee

2011-01-01

Due to concerns over Thai adolescent risky behaviors, effective prevention strategies are needed. Determining the role neighborhood context plays in program engagement and outcomes may inform these strategies. This study includes 170 mother-adolescent pairs (M = 13.44, SD = .52) in Bangkok, Thailand in a prevention program for adolescent substance use and sexual risk. Neighborhoods were related to engagement, which was critical to outcomes. Neighborhood disorganization was related to confidence in program effects and program completion. Completion was related to increased ATOD communication. Neighborhood cohesion was related to less program enjoyment, while neighborhood social control was related to more enjoyment. Enjoyment was related to increased ATOD communication and formation and monitoring of alcohol rules. Prevention strategies should focus on neighborhood contexts and enhancing engagement.

Prevalence of birth defects among American-Indian births in California, 1983-2010.

PubMed

Aggarwal, Deepa; Warmerdam, Barbara; Wyatt, Katrina; Ahmad, Shabbir; Shaw, Gary M

2015-02-01

Approximately 6.3 million live births and fetal deaths occurred during the ascertainment period in the California Birth Defects Monitoring Program registry. American-Indian and non-Hispanic white women delivered 40,268 and 2,044,118 births, respectively. While much information has been published about non-Hispanic white infants, little is known regarding the risks of birth defects among infants born to American-Indian women. This study used data from the California Birth Defects Monitoring Program to explore risks of selected birth defects in offspring of American-Indian relative to non-Hispanic white women in California. The study population included all live births and fetal deaths 20 weeks or greater from 1983 to 2010. Prevalence ratios and corresponding 95% confidence intervals (CI) were computed using Poisson regression for 51 groupings of birth defects. Prevalence ratios were estimated for 51 groupings of birth defects. Of the 51, nine had statistically precise results ranging from 0.78 to 1.85. The eight groups with elevated risks for American-Indian births were reduction deformities of brain, anomalies of anterior segments, specified anomalies of ear, ostium secundum type atrial septal defect, specified anomalies of heart, anomalies of the aorta, anomalies of great veins, and cleft lip with cleft palate. Our results suggest that American-Indian women having babies in California may be at higher risk for eight birth defect phenotypes compared with non-Hispanic whites. Further research is needed to determine whether these risks are observed among other populations of American-Indian women or when adjusted for potential covariates. © 2015 Wiley Periodicals, Inc.

Peri-operative physiotherapy.

PubMed

Makhabah, Dewi Nurul; Martino, Federica; Ambrosino, Nicolino

2013-01-23

Postoperative pulmonary complications (PPC) are a major cause of morbidity, mortality, prolonged hospital stay, and increased cost of care. Physiotherapy (PT) programs in post-surgical and critical area patients are aimed to reduce the risks of PPC due to long-term bed-rest, to improve the patient's quality of life and residual function, and to avoid new hospitalizations. At this purpose, PT programs apply advanced cost-effective therapeutic modalities to decrease complications and patient's ventilator-dependency. Strategies to reduce PPC include monitoring and reduction of risk factors, improving preoperative status, patient education, smoking cessation, intra-operative and postoperative pulmonary care. Different PT techniques, as a part of the comprehensive management of patients undergoing cardiac, upper abdominal, and thoracic surgery, may prevent and treat PPC such as secretion retention, atelectasis, and pneumonia.

Cleaning and disinfection of patient care items, in relation to small animals.

PubMed

Weese, J Scott

2015-03-01

Patient care involves several medical and surgical items, including those that come into contact with sterile or other high-risk body sites and items that have been used on other patients. These situations create a risk for infection if items are contaminated, and the implications can range from single infections to large outbreaks. To minimize the risk, proper equipment cleaning, disinfection/sterilization, storage, and monitoring practices are required. Risks posed by different items; the required level of cleaning, disinfection, or sterilization; the methods that are available and appropriate; and how to ensure efficacy, must be considered when designing and implementing an infection control program. Copyright © 2015 Elsevier Inc. All rights reserved.

Active Monitoring of Travelers Arriving from Ebola-Affected Countries - New York City, October 2014-April 2015.

PubMed

Millman, Alexander J; Chamany, Shadi; Guthartz, Seth; Thihalolipavan, Sayone; Porter, Michael; Schroeder, Andrew; Vora, Neil M; Varma, Jay K; Starr, David

2016-01-29

The Ebola virus disease (Ebola) outbreak in West Africa has claimed approximately 11,300 lives (1), and the magnitude and course of the epidemic prompted many nonaffected countries to prepare for Ebola cases imported from affected countries. In October 2014, CDC and the Department of Homeland Security (DHS) implemented enhanced entry risk assessment and management at five U.S. airports: John F. Kennedy (JFK) International Airport in New York City (NYC), O'Hare International Airport in Chicago, Newark Liberty International Airport in New Jersey, Hartsfield-Jackson International Airport in Atlanta, and Dulles International Airport in Virginia (2). Enhanced entry risk assessment began at JFK on October 11, 2014, and at the remaining airports on October 16 (3). On October 21, DHS exercised its authority to direct all travelers flying into the United States from an Ebola-affected country to arrive at one of the five participating airports. At the time, the Ebola-affected countries included Guinea, Liberia, Mali, and Sierra Leone. On October 27, CDC issued updated guidance for monitoring persons with potential Ebola virus exposure (4), including recommending daily monitoring of such persons to ascertain the presence of fever or symptoms for a period of 21 days (the maximum incubation period of Ebola virus) after the last potential exposure; this was termed "active monitoring." CDC also recommended "direct active monitoring" of persons with a higher risk for Ebola virus exposure, including health care workers who had provided direct patient care in Ebola-affected countries. Direct active monitoring required direct observation of the person being monitored by the local health authority at least once daily (5). This report describes the operational structure of the NYC Department of Health and Mental Hygiene's (DOHMH) active monitoring program during its first 6 months (October 2014-April 2015) of operation. Data collected on persons who required direct active monitoring are not included in this report.

A SOA-Based Solution to Monitor Vaccination Coverage Among HIV-Infected Patients in Liguria.

PubMed

Giannini, Barbara; Gazzarata, Roberta; Sticchi, Laura; Giacomini, Mauro

2016-01-01

Vaccination in HIV-infected patients constitutes an essential tool in the prevention of the most common infectious diseases. The Ligurian Vaccination in HIV Program is a proposed vaccination schedule specifically dedicated to this risk group. Selective strategies are proposed within this program, employing ICT (Information and Communication) tools to identify this susceptible target group, to monitor immunization coverage over time and to manage failures and defaulting. The proposal is to connect an immunization registry system to an existing regional platform that allows clinical data re-use among several medical structures, to completely manage the vaccination process. This architecture will adopt a Service Oriented Architecture (SOA) approach and standard HSSP (Health Services Specification Program) interfaces to support interoperability. According to the presented solution, vaccination administration information retrieved from the immunization registry will be structured according to the specifications within the immunization section of the HL7 (Health Level 7) CCD (Continuity of Care Document) document. Immunization coverage will be evaluated through the continuous monitoring of serology and antibody titers gathered from the hospital LIS (Laboratory Information System) structured into a HL7 Version 3 (v3) Clinical Document Architecture Release 2 (CDA R2).

Weqaya: A Population-Wide Cardiovascular Screening Program in Abu Dhabi, United Arab Emirates

PubMed Central

Harrison, Oliver; Al Siksek, Zaid

2012-01-01

Objectives. We sought to determine cardiovascular risk factor prevalence rates among adults in Abu Dhabi, United Arab Emirates. Methods. We used self-reported indicators, anthropometric measures, and blood tests to screen 50 138 adults aged 18 years or older taking part in a population-wide cardiovascular screening program. Results. Participants’ mean age was 36.82 years (SD = 14.3); 43% were men. Risk factor prevalence rates were as follows: obesity, 35%; overweight, 32%; central obesity, 55%; diabetes, 18%; prediabetes, 27%; dyslipidemia, 44%; and hypertension, 23.1%. In addition, 26% of men were smokers, compared with 0.8% of women. Age-standardized diabetes and prediabetes rates were 25% and 30%, respectively, and age-standardized rates of obesity and overweight were 41% and 34%. Conclusions. This population-wide cardiovascular screening program demonstrated a high cardiovascular burden for our small sample in Abu Dhabi. The data form a baseline against which interventions can be implemented and progress monitored as part of the population-wide Abu Dhabi Cardiovascular Disease Program. PMID:21940918

The effectiveness of a staff education program on the use of continuous EEG with patients in neuroscience intensive care units.

PubMed

Seiler, Lisa; Fields, Jennifer; Peach, Elizabeth; Zwerin, Suzanne; Savage, Christine

2012-04-01

Approximately a third of patients in neuroscience intensive care units (ICUs) experience subclinical seizures and, as a result, are at higher risk for poor outcomes. The use of continuous electroencephalography (cEEG) monitoring can help nurses detect seizure activity and initiate early prevention. Nurse competency in the use of cEEG is important to facilitate effective bedside monitoring. The objective of this study was to evaluate the effectiveness of a staff educational program aimed at improving the knowledge of nurses in the use of cEEG monitoring in adults. A quasi-experimental pretest/posttest 1-group design was utilized. Neuroscience ICU registered nurses, whose experience ranged from 2 months to 24 years, participated in the study. Participants completed a pretest on seizure knowledge and the use of cEEG monitoring. Participants received a 4-hour educational session on the use of cEEG monitoring. Immediately after the program and again 1 month later, they completed a posttest. Test scores improved significantly from pretest to the first posttest (t = -15.093, p < .001). Although there was a slight decline in the mean score from the posttest to the 1-month follow-up, posttest scores were significantly better than the pretest score (t = -12.42, df = 44, p < .001). Whereas years of experience correlated positively to the pretest score, after the intervention, no such correlation was evident. The results demonstrated that an educational program improved the competency of nurses in the use of cEEG with adult patients in a neuroscience ICU and that this knowledge was sustained over time. Further research is needed to demonstrate the effectiveness of this intervention in other settings.

THE VISUAL BEACH NUMERICAL MODEL: A DIAGNOSTIC AND PROGNOSTIC MODELING APPROACH TO ACHIEVING US BEACHES AESTHETIC AND PUBLIC HEALTH PROTECTION

EPA Science Inventory

Under the BEACH Act of 2000, EPA has committed to a program to monitor beach water quality and develop strategies, including modeling, for timely notification of the public when bacterial contamination poses a risk to bathers. EPA's goal is to manage 100% of significant public be...

Developing survey grids to substantiate freedom from exotic pests

Treesearch

John W. Coulston; Frank H. Koch; William D. Smith

2009-01-01

Systematic, hierarchical intensification of the Environmental Monitoring and Assessment Program hexagon for North America yields a simple procedure for developing national-scale survey grids. In this article, we describe the steps to create a national-scale survey grid using a risk map as the starting point. We illustrate the steps using an exotic pest example in which...

Management of women at high risk of hereditary breast cancer in the Veneto Regional Program for Prevention.

PubMed

Del Sole, Annamaria; Cinquetti, Sandro; Fedato, Chiara; Montagna, Marco; Russo, Francesca; Sbrogiò, Luca Gino; Zorzi, Manuel

2015-01-01

Today it is well-known that high risk of genetic breast cancer concerns a very limited part of the population: no more than 2-3 women are affected every thousand and this condition as a whole accounts for no more than 3%-5% of all breast cancers. Following the directions contained in the 2014-2018 National Prevention Plan, Veneto's 2014-2018 Regional Program of Prevention (PRP), approved by Regional Council Resolution (DGR) No. 749 of 14.5.2015, consolidation of a pathway of diagnosis, observation, and prophylaxis for women at high risk of hereditary breast carcinoma is thus proposed. The principal activities of this policy will be the following: creation of a regional working group, survey of currently existing pathways for the identification of women at risk of hereditary breast cancer and adoption of the same, approval and consolidation of a structured regional pathway for women at high risk of hereditary breast and/or ovarian cancer, from paths of oncogenetic consultation and genetic testing to management of disease risk. Subsequent to the recognition of the pathway of diagnosis, observation, and prophylaxis for women at high risk of hereditary breast carcinoma, the Veneto region undertakes to develop a co-ordinated program of information and training on this pathway directed at the population and healthcare workers. It is firmly hoped that with the inclusion of a program for the management of women at high risk of hereditary breast cancer within the Veneto PRP this topic may become more defined and structured in terms of sustainability, integration with the existing regional networks (mammography network, Breast Unit), contrasting inequality, monitoring and evaluation, in this way pursuing the objectives of a reduction of cause-specific mortality and improvement of quality of life.

Taking Risk Assessment and Management to the Next Level: Program-Level Risk Analysis to Enable Solid Decision-Making on Priorities and Funding

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

Nelson, J. G.; Morton, R. L.; Castillo, C.

2011-02-01

A multi-level (facility and programmatic) risk assessment was conducted for the facilities in the Nevada National Security Site (NNSS) Readiness in Technical Base and Facilities (RTBF) Program and results were included in a new Risk Management Plan (RMP), which was incorporated into the fiscal year (FY) 2010 Integrated Plans. Risks, risk events, probability, consequence(s), and mitigation strategies were identified and captured, for most scope areas (i.e., risk categories) during the facilitated risk workshops. Risk mitigations (i.e., efforts in addition to existing controls) were identified during the facilitated risk workshops when the risk event was identified. Risk mitigation strategies fell intomore » two broad categories: threats or opportunities. Improvement projects were identified and linked to specific risks they mitigate, making the connection of risk reduction through investments for the annual Site Execution Plan. Due to the amount of that was collected, analysis to be performed, and reports to be generated, a Risk Assessment/ Management Tool (RAMtool) database was developed to analyze the risks in real-time, at multiple levels, which reinforced the site-level risk management process and procedures. The RAMtool database was developed and designed to assist in the capturing and analysis of the key elements of risk: probability, consequence, and impact. The RAMtool calculates the facility-level and programmatic-level risk factors to enable a side-by-side comparison to see where the facility manager and program manager should focus their risk reduction efforts and funding. This enables them to make solid decisions on priorities and funding to maximize the risk reduction. A more active risk management process was developed where risks and opportunities are actively managed, monitored, and controlled by each facility more aggressively and frequently. risk owners have the responsibility and accountability to manage their assigned risk in real-time, using the RAMtool database.« less

Adherence to and effectiveness of an individually tailored home-based exercise program for frail older adults, driven by mobility monitoring: design of a prospective cohort study.

PubMed

Geraedts, Hilde A E; Zijlstra, Wiebren; Zhang, Wei; Bulstra, Sjoerd; Stevens, Martin

2014-06-07

With the number of older adults in society rising, frailty becomes an increasingly prevalent health condition. Regular physical activity can prevent functional decline and reduce frailty symptoms. In particular, home-based exercise programs can be beneficial in reducing frailty of older adults and fall risk, and in improving associated physiological parameters. However, adherence to home-based exercise programs is generally low among older adults. Current developments in technology can assist in enlarging adherence to home-based exercise programs. This paper presents the rationale and design of a study evaluating the adherence to and effectiveness of an individually tailored, home-based physical activity program for frail older adults driven by mobility monitoring through a necklace-worn physical activity sensor and remote feedback using a tablet PC. Fifty transitionally frail community-dwelling older adults will join a 6-month home-based physical activity program in which exercises are provided in the form of exercise videos on a tablet PC and daily activity is monitored by means of a necklace-worn motion sensor. Participants exercise 5 times a week. Exercises are built up in levels and are individually tailored in consultation with a coach through weekly telephone contact. The physical activity program driven by mobility monitoring through a necklace-worn sensor and remote feedback using a tablet PC is an innovative method for physical activity stimulation in frail older adults. We hypothesize that, if participants are sufficiently adherent, the program will result in higher daily physical activity and higher strength and balance assessed by physical tests compared to baseline. If adherence to and effectiveness of the program is considered sufficient, the next step would be to evaluate the effectiveness with a randomised controlled trial. The knowledge gained in this study can be used to develop and fine-tune the application of innovative technology in home-based exercise programs. Nederlands Trial Register (NTR); trial number 4265. The study was prospectively registered (registration date 14/11/2013).

Escherichia coli sampling reliability at a frequently closed Chicago beach: monitoring and management implications

USGS Publications Warehouse

Whitman, Richard L.; Nevers, Meredith B.

2004-01-01

Monitoring beaches for recreational water quality is becoming more common, but few sampling designs or policy approaches have evaluated the efficacy of monitoring programs. The authors intensively sampled water for E. coli (N=1770) at 63rd Street Beach, Chicago for 6 months in 2000 in order to (1) characterize spatial-temporal trends, (2) determine between and within transect variation, and (3) estimate sample size requirements and determine sampling reliability.E. coli counts were highly variable within and between sampling sites but spatially and diurnally autocorrelated. Variation in counts decreased with water depth and time of day. Required number of samples was high for 70% precision around the critical closure level (i.e., 6 within or 24 between transect replicates). Since spatial replication may be cost prohibitive, composite sampling is an alternative once sources of error have been well defined. The results suggest that beach monitoring programs may be requiring too few samples to fulfill management objectives desired. As the recreational water quality national database is developed, it is important that sampling strategies are empirically derived from a thorough understanding of the sources of variation and the reliability of collected data. Greater monitoring efficacy will yield better policy decisions, risk assessments, programmatic goals, and future usefulness of the information.

To What Extent is Drinking Water Tested in Sub-Saharan Africa? A Comparative Analysis of Regulated Water Quality Monitoring.

PubMed

Peletz, Rachel; Kumpel, Emily; Bonham, Mateyo; Rahman, Zarah; Khush, Ranjiv

2016-03-02

Water quality information is important for guiding water safety management and preventing water-related diseases. To assess the current status of regulated water quality monitoring in sub-Saharan Africa, we evaluated testing programs for fecal contamination in 72 institutions (water suppliers and public health agencies) across 10 countries. Data were collected through written surveys, in-person interviews, and analysis of microbial water quality testing levels. Though most institutions did not achieve the testing levels specified by applicable standards or World Health Organization (WHO) Guidelines, 85% of institutions had conducted some microbial water testing in the previous year. Institutions were more likely to meet testing targets if they were suppliers (as compared to surveillance agencies), served larger populations, operated in urban settings, and had higher water quality budgets (all p < 0.05). Our results indicate that smaller water providers and rural public health offices will require greater attention and additional resources to achieve regulatory compliance for water quality monitoring in sub-Saharan Africa. The cost-effectiveness of water quality monitoring should be improved by the application of risk-based water management approaches. Efforts to strengthen monitoring capacity should pay greater attention to program sustainability and institutional commitment to water safety.

To What Extent is Drinking Water Tested in Sub-Saharan Africa? A Comparative Analysis of Regulated Water Quality Monitoring

PubMed Central

Peletz, Rachel; Kumpel, Emily; Bonham, Mateyo; Rahman, Zarah; Khush, Ranjiv

2016-01-01

Water quality information is important for guiding water safety management and preventing water-related diseases. To assess the current status of regulated water quality monitoring in sub-Saharan Africa, we evaluated testing programs for fecal contamination in 72 institutions (water suppliers and public health agencies) across 10 countries. Data were collected through written surveys, in-person interviews, and analysis of microbial water quality testing levels. Though most institutions did not achieve the testing levels specified by applicable standards or World Health Organization (WHO) Guidelines, 85% of institutions had conducted some microbial water testing in the previous year. Institutions were more likely to meet testing targets if they were suppliers (as compared to surveillance agencies), served larger populations, operated in urban settings, and had higher water quality budgets (all p < 0.05). Our results indicate that smaller water providers and rural public health offices will require greater attention and additional resources to achieve regulatory compliance for water quality monitoring in sub-Saharan Africa. The cost-effectiveness of water quality monitoring should be improved by the application of risk-based water management approaches. Efforts to strengthen monitoring capacity should pay greater attention to program sustainability and institutional commitment to water safety. PMID:26950135

Decreased rates of nosocomial endometritis and urinary tract infection after vaginal delivery in a French surveillance network, 1997-2003.

PubMed

Ayzac, Louis; Caillat-Vallet, Emmanuelle; Girard, Raphaële; Chapuis, Catherine; Depaix, Florence; Dumas, Anne-Marie; Gignoux, Chantal; Haond, Catherine; Lafarge-Leboucher, Joëlle; Launay, Carine; Tissot-Guerraz, Françoise; Vincent, Agnès; Fabry, Jacques

2008-06-01

To identify independent risk factors for endometritis and urinary tract infection (UTI) after vaginal delivery, and to monitor changes in nosocomial infection rates and derive benchmarks for prevention. Prospective study. We analyzed routine surveillance data for all vaginal deliveries between January 1997 and December 2003 at 66 maternity units participating in the Mater Sud-Est surveillance network. Adjusted odds ratios for risk of endometritis or UTI were obtained using a logistic regression model. The overall incidence rates were 0.5% for endometritis and 0.3% for UTI. There was a significant decrease in the incidence and risk of endometritis but not of UTI during the 7-year period. Significant risk factors for endometritis were fever during labor, parity of 1, and instrumental delivery and/or manual removal of the placenta. Significant risk factors for UTI were urinary infection on admission, premature rupture of membranes (more than 12 hours before admission), blood loss of more than 800 mL, parity of 1, instrumental delivery, and receipt of more than 5 vaginal digital examinations. Each maternity unit received a poster showing graphs of the number of expected and observed cases of UTI and endometritis associated with vaginal deliveries, which enabled each maternity unit to determine their rank within the network and to initiate prevention programs. Although routine surveillance means additional work for maternity units, our results demonstrate the usefulness of regular targeted monitoring of risk factors and of the most common nosocomial infections in obstetrics. Most of the information needed for monitoring is already present in the patients' records.

Biomedical Monitoring and Countermeasures Facility

NASA Technical Reports Server (NTRS)

Stewart, Donald F.

1992-01-01

The Space Station Freedom Program (SSFP) represents the transition within the US Space program from the 'heroic' era of space flight (characterized most vividly by the Mercury and Apollo programs) to an epoch characterized by routine access to the space environment. In this new era, the unique characteristics of the microgravity environment will enable new types of research activities, primarily in the life sciences, materials science, and biotechnology fields. In addition to its role as a'microgravity science laboratory,' Space Station Freedom (SSF) constitutes the operational platform on which the knowledge and skills needed to continue our exploration of space will be acquired. In the area of spacecraft operations, these skills include the ability to assemble, operate, and maintain large structures in space. In the area of crew operations, the potentially harmful effects of extended exposure to microgravity must be understood in order to keep the crew mission capable. To achieve this goal, the complex process of physiological deconditioning must be monitored, and countermeasures utilized as needed to keep the individual crew members within acceptable physiological limits. The countermeasures program under development for the SSF Program is titled the Biomedical Monitoring and Countermeasures (BMAC) program. As implied by the name, this activity has two primary products, a biomedical monitoring element and a countermeasures development effort. The program is a critical path element in the overall SSF Program, and should be considered an essential element of operations on board the space station. It is readily apparent that the capability to both protect and optimize the health and performance of the human operators on board SSF will be a critical element in the overall success of the SSFP. Previous experience within the Russian space program has demonstrated that the time required for countermeasures on extended missions can become a monumental operational burden. Therefore, one of the primary objectives of the countermeasures development activity will be to design and implement countermeasures which are significantly more effective than the existing generation. Other primary objectives include the following: to set health and human performance standards for all mission phases; to determine critical issues that affect performance or return to flight status; to develop and implement monitoring systems to follow health and performance status; and to understand risk, and balance the resource costs of countermeasures vs. the benefit gained.

Environmental Science and Research Foundation annual technical report to DOE-ID, January , 1995--December 31, 1995

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

NONE

1996-06-01

The foundation conducts an environmental monitoring and surveillance program over an area covering much of the upper Snake River Plain and provide environmental education and support services related to INEL natural resource issues. Also, the foundation, with its university affiliates, conducts ecological and radioecological research on the Idaho National Environmental Research Park. This research benefits major DOE-ID programs including waste management, environmental restoration, spent nuclear fuels, and land management issues. Major accomplishments during CY1995 can be divided into five categories: environmental surveillance program, environmental education, environmental services and support, ecological risk assessment, and research benefitting the DOE-ID mission.

Soccer-Specific Warm-Up and Lower Extremity Injury Rates in Collegiate Male Soccer Players

PubMed Central

Grooms, Dustin R.; Palmer, Thomas; Onate, James A.; Myer, Gregory D.; Grindstaff, Terry

2013-01-01

Context: A number of comprehensive injury-prevention programs have demonstrated injury risk-reduction effects but have had limited adoption across athletic settings. This may be due to program noncompliance, minimal exercise supervision, lack of exercise progression, and sport specificity. A soccer-specific program described as the F-MARC 11+ was developed by an expert group in association with the Federation Internationale de Football Association (FIFA) Medical Assessment and Research Centre (F-MARC) to require minimal equipment and implementation as part of regular soccer training. The F-MARC 11+ has been shown to reduce injury risk in youth female soccer players but has not been evaluated in an American male collegiate population. Objective: To investigate the effects of a soccer-specific warm-up program (F-MARC 11+) on lower extremity injury incidence in male collegiate soccer players. Design: Cohort study. Setting: One American collegiate soccer team followed for 2 seasons. Patients or Other Participants: Forty-one male collegiate athletes aged 18–25 years. Intervention(s): The F-MARC 11+ program is a comprehensive warm-up program targeting muscular strength, body kinesthetic awareness, and neuromuscular control during static and dynamic movements. Training sessions and program progression were monitored by a certified athletic trainer. Main Outcome Measure(s): Lower extremity injury risk and time lost to lower extremity injury. Results: The injury rate in the referent season was 8.1 injuries per 1000 exposures with 291 days lost and 2.2 injuries per 1000 exposures and 52 days lost in the intervention season. The intervention season had reductions in the relative risk (RR) of lower extremity injury of 72% (RR = 0.28, 95% confidence interval = 0.09, 0.85) and time lost to lower extremity injury (P < .01). Conclusions: This F-MARC 11+ program reduced overall risk and severity of lower extremity injury compared with controls in collegiate-aged male soccer athletes. PMID:23848519

Considering a new domain for antimicrobial stewardship: Topical antibiotics in the open surgical wound.

PubMed

Edmiston, Charles E; Leaper, David; Spencer, Maureen; Truitt, Karen; Litz Fauerbach, Loretta; Graham, Denise; Johnson, Helen Boehm

2017-11-01

The global push to combat the problem of antimicrobial resistance has led to the development of antimicrobial stewardship programs (ASPs), which were recently mandated by The Joint Commission and the Centers for Medicare and Medicaid Services. However, the use of topical antibiotics in the open surgical wound is often not monitored by these programs nor is it subject to any evidence-based standardization of care. Survey results indicate that the practice of using topical antibiotics intraoperatively, in both irrigation fluids and powders, is widespread. Given the risks inherent in their use and the lack of evidence supporting it, the practice should be monitored as a core part of ASPs, and alternative agents, such as antiseptics, should be considered. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Evaluation of a Voluntary Worksite Weight Loss Program on Metabolic Syndrome.

PubMed

Earnest, Conrad P; Church, Timothy S

2015-11-01

Health care costs increase with the presence of metabolic syndrome and present a significant burden to companies throughout the world. Identifying effective behavioral programs within the workplace can reduce health care costs. We examined the effect of a voluntary worksite program on weight loss and metabolic syndrome. Participants (N = 3880, from 93 companies) volunteered within their workplaces to participate in a 10-week weight loss program (Naturally Slim) focused on self-monitoring, eating behaviors, understanding hunger signals, reducing refined carbohydrate and sugar intake, and increasing protein intake to 25%-30%. Primary outcomes included weight loss and metabolic syndrome prevalence. Secondary analyses examined the individual components of metabolic syndrome and a categorical analysis within each World Health Organization body mass index category. Overall, women and men lost 9.4 (-4.8%) and 13.2 pounds (-5.8%), respectively. Each metabolic risk factor for both genders had a significant improvement but men exhibited the largest relative improvement for each risk factor. At baseline, 43% of women and 52% of men presented with metabolic syndrome, which was reduced to 30% in women and 26% in men (P < 0.001 for each) at the conclusion of the program. Secondary analysis demonstrated that individuals with greater baseline levels of metabolic dysfunction had larger metabolic improvements, similar benefits to risk factors across baseline body mass index categories, and the greater the weight loss, the greater the metabolic benefit. Our results demonstrate that a worksite program targeting core behavioral skills associated with weight loss is an effective strategy to reduce weight and improve the components of metabolic syndrome amongst at-risk employees.

Reducing the loss of vaccines from accidental freezing in the cold chain: the experience of continuous temperature monitoring in Tunisia.

PubMed

Lloyd, John; Lydon, Patrick; Ouhichi, Ramzi; Zaffran, Michel

2015-02-11

Accidental freezing of vaccines is a growing threat and a real risk for national immunization programs when the potency of many vaccines can be compromised if these are exposed to sub-zero temperatures in the cold chain. In Tunisia, this issue is compounded by using sub-standard domestic cold chain equipment instead of equipping the program with medical refrigerators designed specifically for storing vaccines and temperature sensitive pharmaceuticals. Against this backdrop, this paper presents the findings of a demonstration project conducted in Tunisia in 2012 that tested the impact of introducing several freeze prevention solutions to mitigate the risk of accidental freezing of vaccines. The main finding is that, despite the continued use of underperforming domestic refrigerators, continuous temperature monitoring using new technologies combined with other technological interventions significantly reduced the prevalence of accidental exposure to freezing temperatures. These improvements were noticed for cold chain storage at regional, district and health center levels, and during the transport legs that were part of the demonstration conducted in the regions of Kasserine in the South-Eastern part of Tunisia. Subsequent to introducing these freeze prevention solutions, the incidence of freeze alarms was reduced and the percent of time the temperatures dropped below the 2 °C recommended threshold. The incidence of freeze alarms at health center level was reduced by 40%. Lastly, the solutions implemented reduced risk of freezing during transport from 13.8% to 1.7%. Although the solution implemented is not optimal in the longer term because domestic refrigerators are used extensively in district stores and health centers, the risk of accidental freezing is significantly reduced by introducing the practice of continuous temperature monitoring as a standard. The management of the cold chain equipment was strengthened as a result which helps protect the potency of vaccines to the areas of most difficult access. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

PubMed

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

2014-02-01

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

Advances in Atmospheric Radiation Measurements and Modeling Needed to Improve Air Safety

NASA Astrophysics Data System (ADS)

Tobiska, W. Kent; Atwell, William; Beck, Peter; Benton, Eric; Copeland, Kyle; Dyer, Clive; Gersey, Brad; Getley, Ian; Hands, Alex; Holland, Michael; Hong, Sunhak; Hwang, Junga; Jones, Bryn; Malone, Kathleen; Meier, Matthias M.; Mertens, Chris; Phillips, Tony; Ryden, Keith; Schwadron, Nathan; Wender, Stephen A.; Wilkins, Richard; Xapsos, Michael A.

2015-04-01

Air safety is tied to the phenomenon of ionizing radiation from space weather, primarily from galactic cosmic rays but also from solar energetic particles. A global framework for addressing radiation issues in this environment has been constructed, but more must be done at international and national levels. Health consequences from atmospheric radiation exposure are likely to exist. In addition, severe solar radiation events may cause economic consequences in the international aviation community due to exposure limits being reached by some crew members. Impacts from a radiation environment upon avionics from high-energy particles and low-energy, thermalized neutrons are now recognized as an area of active interest. A broad community recognizes that there are a number of mitigation paths that can be taken relative to the human tissue and avionics exposure risks. These include developing active monitoring and measurement programs as well as improving scientific modeling capabilities that can eventually be turned into operations. A number of roadblocks to risk mitigation still exist, such as effective pilot training programs as well as monitoring, measuring, and regulatory measures. An active international effort toward observing the weather of atmospheric radiation must occur to make progress in mitigating radiation exposure risks. Stakeholders in this process include standard-making bodies, scientific organizations, regulatory organizations, air traffic management systems, aircraft owners and operators, pilots and crew, and even the public.

Preparing a prescription drug monitoring program data set for research purposes.

PubMed

O'Kane, Nicole; Hallvik, Sara E; Marino, Miguel; Van Otterloo, Joshua; Hildebran, Christi; Leichtling, Gillian; Deyo, Richard A

2016-09-01

To develop a complete and consistent prescription drug monitoring program (PDMP) data set for use by drug safety researchers in evaluating patterns of high-risk use and potential abuse of scheduled drugs. Using publically available data references from the US Food and Drug Administration and the Centers for Disease Control and Prevention, we developed a strategic methodology to assign drug categories based on pharmaceutical class for the majority of prescriptions in the PDMP data set. We augmented data elements required to calculate morphine milligram equivalents and assigned duration of action (short-acting or long acting) properties for a majority of opioids in the data set. About 10% of prescriptions in the PDMP data set did not have a vendor-assigned drug category, and 20% of opioid prescriptions were missing data needed to calculate risk metrics. Using inclusive methods, 19 133 167 (>99.9%) of prescriptions in the PDMP data set were assigned a drug category. For the opioid category, augmenting data elements resulted in 10 760 669 (99.8%) having required values to calculate morphine milligram equivalents and evaluate duration of action properties. Drug safety researchers who require a complete and consistent PDMP data set can use the methods described here to ensure that prescriptions of interest are assigned consistent drug categories and complete opioid risk variable values. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Rotavirus vaccination and intussusception – Science, surveillance, and safety: A review of evidence and recommendations for future research priorities in low and middle income countries

PubMed Central

Yen, Catherine; Healy, Kelly; Tate, Jacqueline E.; Parashar, Umesh D.; Bines, Julie; Neuzil, Kathleen; Santosham, Mathuram; Steele, A. Duncan

2016-01-01

ABSTRACT As of January 2016, 80 countries have introduced rotavirus vaccines into their national immunization programs. Many have documented significant declines in rotavirus-specific and all-cause diarrheal illnesses following vaccine introduction. Two globally licensed rotavirus vaccines have been associated with a low risk of intussusception in several studies. In July 2014, the Rotavirus Organization of Technical Allies Council convened a meeting of research and advocacy organizations, public health experts, funders, and vaccine manufacturers to discuss post-marketing intussusception surveillance and rotavirus vaccine impact data. Meeting objectives were to evaluate updated data, identify and prioritize research gaps, discuss best practices for intussusception monitoring in lower-income settings and risk communication, and provide insight to country-level stakeholders on best practices for intussusception monitoring and communication. Meeting participants agreed with statements from expert bodies that the benefits of vaccination with currently available rotavirus vaccines outweigh the low risk of vaccination-associated intussusception. However, further research is needed to better understand the relationship of intussusception to wild-type rotavirus and rotavirus vaccines and delineate potential etiologies and mechanisms of intussusception. Additionally, evidence from research and post-licensure evaluations should be presented with evidence of the benefits of vaccination to best inform policymakers deciding on vaccine introduction or vaccination program sustainability. PMID:27322835

Families at risk of poor parenting: a model for service delivery, assessment, and intervention.

PubMed

Ayoub, C; Jacewitz, M M

1982-01-01

The At Risk Parent Child Program is a multidisciplinary network agency designed for the secondary prevention of poor parenting and the extremes of child abuse and neglect. This model system of service delivery emphasizes (1) the coordination of existing community resources to access a target population of families at risk of parenting problems, (2) the provision of multiple special services in a neutral location (ambulatory pediatric clinic), and (3) the importance of intensive individual contact with a clinical professional who serves as primary therapist, social advocate and service coordinator for client families. Identification and assessment of families is best done during prenatal and perinatal periods. Both formal and informal procedures for screening for risk factors are described, and a simple set of at risk criteria for use by hospital nursing staff is provided. Preventive intervention strategies include special medical, psychological, social and developmental services, offered in an inpatient; outpatient, or in-home setting. Matching family needs to modality and setting of treatment is a major program concern. All direct services to at risk families are supplied by professionals employed within existing local agencies (hospital, public health department, state guidance center, and medical school pediatric clinic). Multiple agency involvement allows a broad-based screening capacity which allows thousands of families routine access to program services. The administrative center of the network stands as an independent, community-funded core which coordinates and monitors direct clinical services, and provides local political advocacy for families at risk of parenting problems.

Impact of the Climate Change on Cultural Heritage Sites in Cyprus

NASA Astrophysics Data System (ADS)

Cuca, Branka; Agapiou, Athos; Lysandrou, Vasiliki; Themistocleous, Kyriacos; Nisantzi, Argyro; Michaelides, Silas; Hadjimitsis, Diofantos G.

2016-04-01

Climate change is one of the main factors with a significant impact on changes of cultural heritage and landscapes. Exposed and buried archaeological remains are particularly endangered by effects of climate change processes hence it is of great importance to understand the type of risks and the degree of their impact on such assets. Some of the potential risks for cultural heritage and landscape include flooding, intense rainfall, increase in time of wetness, extreme events in temperature change, coastal flooding, drought, wind driven/transported agents (sand, rain or salt) and so forth. From the geo-science perspective, the topic of climate change and the risks it causes is of crucial importance for environmental monitoring in general and it is one of the main applications of the European program on Earth Observation Copernicus. The activities performed in CLIMA project - "Cultural Landscape risk Identification, Management and Assessment" have as one of the main tasks to combining the fields of remote sensing technologies, including the Sentinel data, and cultural heritage monitoring. Such interdisciplinary approach was undertaken in order to identify major climate change risks affecting archaeological heritage in rural areas in Cyprus and to identify the most suitable Earth Observation (EO) and ground-based methods that might be effective in the mapping, diagnostics and monitoring of such risks. This thorough analysis will support the overall design of the CLIMA platform based in EO data analysis, risk models and ground-based methods to provide integrated information for specialists in remote sensing but also to archeologists and policy makers engaged in heritage preservation and management. The case study selected for Cyprus is the awarded Nea Paphos archeological site and historical center of Paphos that is surrounding this UNSECO World Heritage site.

Dissolved organochlorine and PAH pollution profiles in Lithuanian and Swedish surface waters.

PubMed

Bergqvist, Per-Anders; Jegorova, Ilona; Kauneliene, Violeta; Zaliauskiene, Audrone

2007-08-01

In recent decades, knowledge and concern regarding persistent organic pollutants and the environmental hazards they may pose have increased considerably, leading to international agreements such as the United Nations environment program Stockholm convention on persistent organic pollutants (POPs), to minimize further release of POPs into the environment (UNECE Protocol, 1979; UNEP Stockholm convention, 2001; UNECE Convention, 1998). National POP monitoring programs should be designed to identify, characterize and address the release of the POPs listed in the Stockholm convention. However, analyses of grab samples only provide crude snapshots of total concentrations at single points in space and time, which may be highly unrepresentative of average concentrations, and fail to account for differences in the POPs' bioavailability and various other relevant factors. To obtain a better understanding of the fate and availability of pollutants in the environment it is necessary to obtain data regarding their site-specific and regional exposure levels. Exposure levels expressed in terms of total chemical concentrations do not reflect the actual exposure of organisms, and thus may not accurately reflect the true risks posed. Therefore, environmental monitoring programs would be improved by using reliable, integrative sampling methods that would not only allow time-weighted average concentrations of pollutants in the environment to be determined, but also facilitate assessments of the risks these chemicals pose to the environment.

A program needs-driven approach to selecting dietary assessment methods for decision-making in food fortification programs.

PubMed

Coates, Jennifer; Colaiezzi, Brooke; Fiedler, John L; Wirth, James; Lividini, Keith; Rogers, Beatrice

2012-09-01

Dietary assessment data are essential for designing, monitoring, and evaluating food fortification and other food-based nutrition programs. Planners and managers must understand the validity, usefulness, and cost tradeoffs of employing alternative dietary assessment methods, but little guidance exists. To identify and apply criteria to assess the tradeoffs of using alternative dietary methods for meeting fortification programming needs. Twenty-five semistructured expert interviews were conducted and literature was reviewed for information on the validity, usefulness, and cost of using 24-hour recalls, Food Frequency Questionnaires/Fortification Rapid Assessment Tool (FFQ/FRAT), Food Balance Sheets (FBS), and Household Consumption and Expenditures Surveys (HCES) for program stage-specific information needs. Criteria were developed and applied to construct relative rankings of the four methods. Needs assessment: HCES offers the greatest suitability at the lowest cost for estimating the risk of inadequate intakes, but relative to 24-hour recall compromises validity. HCES should be used to identify vehicles and to estimate coverage and likely impact due to its low cost and moderate-to-high validity. Baseline assessment: 24-hour recall should be applied using a representative sample. Monitoring: A simple, low-cost FFQ can be used to monitor coverage. Impact evaluation: 24-hour recall should be used to assess changes in nutrient intakes. FBS have low validity relative to other methods for all programmatic purposes. Each dietary assessment method has strengths and weaknesses that vary by context and purpose. Method selection must be driven by the program's data needs, the suitability of the methods for the purpose, and a clear understanding of the tradeoffs involved.

Evaluation of the US Army Institute of Public Health Destination Monitoring Program, a food safety surveillance program.

PubMed

Rapp-Santos, Kamala; Havas, Karyn; Vest, Kelly

2015-01-01

The Destination Monitoring Program, operated by the US Army Public Health Command (APHC), is one component that supports the APHC Veterinary Service's mission to ensure safety and quality of food procured for the Department of Defense (DoD). This program relies on retail product testing to ensure compliance of production facilities and distributors that supply food to the DoD. This program was assessed to determine the validity and timeliness by specifically evaluating whether sample size of items collected was adequate, if food samples collected were representative of risk, and whether the program returns results in a timely manner. Data was collected from the US Army Veterinary Services Lotus Notes database, including all food samples collected and submitted from APHC Region-North for the purposes of destination monitoring from January 1, 2013 to December 31, 2013. For most food items, only one sample was submitted for testing. The ability to correctly identify a contaminated food lot may be limited by reliance on test results from only one sample, as the level of confidence in a negative test result is low. The food groups most frequently sampled by APHC correlated with the commodities that were implicated in foodborne illness in the United States. Food items to be submitted were equally distributed among districts and branches, but sections within large branches submitted relatively few food samples compared to sections within smaller branches and districts. Finally, laboratory results were not available for about half the food items prior to their respective expiration dates.

Planned Environmental Microbiology Aspects of Future Lunar and Mars Missions

NASA Technical Reports Server (NTRS)

Ott, C. Mark; Castro, Victoria A.; Pierson, Duane L.

2006-01-01

With the establishment of the Constellation Program, NASA has initiated efforts designed similar to the Apollo Program to return to the moon and subsequently travel to Mars. Early lunar sorties will take 4 crewmembers to the moon for 4 to 7 days. Later missions will increase in duration up to 6 months as a lunar habitat is constructed. These missions and vehicle designs are the forerunners of further missions destined for human exploration of Mars. Throughout the planning and design process, lessons learned from the International Space Station (ISS) and past programs will be implemented toward future exploration goals. The standards and requirements for these missions will vary depending on life support systems, mission duration, crew activities, and payloads. From a microbiological perspective, preventative measures will remain the primary techniques to mitigate microbial risk. Thus, most of the effort will focus on stringent preflight monitoring requirements and engineering controls designed into the vehicle, such as HEPA air filters. Due to volume constraints in the CEV, in-flight monitoring will be limited for short-duration missions to the measurement of biocide concentration for water potability. Once long-duration habitation begins on the lunar surface, a more extensive environmental monitoring plan will be initiated. However, limited in-flight volume constraints and the inability to return samples to Earth will increase the need for crew capabilities in determining the nature of contamination problems and method of remediation. In addition, limited shelf life of current monitoring hardware consumables and limited capabilities to dispose of biohazardous trash will drive flight hardware toward non-culture based methodologies, such as hardware that rapidly distinguishes biotic versus abiotic surface contamination. As missions progress to Mars, environmental systems will depend heavily on regeneration of air and water and biological waste remediation and regeneration systems, increasing the need for environmental monitoring. Almost complete crew autonomy will be needed for assessment and remediation of contamination problems. Cabin capacity will be limited; thus, current methods of microbial monitoring will be inadequate. Future methodology must limit consumables, and these consumables must have a shelf life of over three years. In summary, missions to the moon and Mars will require a practical design that prudently uses available resources to mitigate microbial risk to the crew.

The Dams and Monitoring Systems and Case Study: Ataturk and Karakaya Dams

NASA Astrophysics Data System (ADS)

Kalkan, Y.; Bilgi, S.; Gülnerman, A. G.

2017-12-01

Dams are among the most important engineering structures used for flood controls, agricultural purposes as well as drinking and hydroelectric power. Especially after the Second World War, developments on the construction technology, increase the construction of larger capacity dams. There are more than 150.000 dams in the world and almost 1000 dams in Turkey, according to international criteria. Although dams provide benefits to humans, they possess structural risks too. To determine the performance of dams on structural safety, assessing the spatial data is very important. These are movement, water pressure, seepage, reservoir and tail-water elevations, local seismic activities, total pressure, stress and strain, internal concrete temperature, ambient temperature and precipitation. These physical data are measured and monitored by the instruments and equipment. Dams and their surroundings have to be monitored by using essential methods at periodic time intervals in order to determine the possible changes that may occur over the time. Monitoring programs typically consist of; surveillance or visual observation. These programs on dams provide information for evaluating the dam's performance related to the design intent and expected changes that could affect the safety performance of the dam. Additionally, these programs are used for investigating and evaluating the abnormal or degrading performance where any remedial action is necessary. Geodetic and non-geodetic methods are used for monitoring. Monitoring the performance of the dams is critical for producing and maintaining the safe dams. This study provides some general information on dams and their different monitoring systems by taking into account two different dams and their structural specifications with the required information. The case study in this paper depends on a comparison of the monitoring surveys on Atatürk Dam and Karakaya Dam, which are constructed on Firat River with two different structural type in Turkey. In addition, brief information is given about these dams and the methods of geodetic and non-geodetic monitoring measurements applied by various disciplines. The last part of the study focuses on the inference of the geodetic monitoring methods, which depend on a seven years of geodetic monitoring.

Ambient & Vessel Noise Measurement and Marine Mammal Monitoring in the Stait of Georgia, British-Columbia, Canada.

NASA Astrophysics Data System (ADS)

Moloney, J. E.; Hannay, D.; Mouy, X.; Mouy, P. A.; Urazghildiiev, I.; Dakin, T.

2016-02-01

Recently JASCO Applied Sciences (Canada) Ltd (JASCO), Ocean Networks Canada (ONC) and the Port of Metro Vancouver (PMV) have collaborated in the installation of a novel, real-time ocean observing (listening) system (PMV-ECHO system deployed in the Strait of Georgia, BC. This system was designed specifically to measure ambient noise, vessel source levels, and to detect, classify, localize and track marine mammals using their vocalization in order to estimate population density. The listening station deployment and monitoring activities are part of the Enhancing Cetacean Habitat and Observation (ECHO) Program. The program aims to better understand and manage the impact of shipping activities on at-risk whales throughout the southern coast of British Columbia. The PMV-ECHO system is composed of two unique spatial arrays of four hydrophones and one active projector each. Both arrays are used to measure and monitor the environment and calibrate the hydrophones over time. Further, a new shored-based data processing and visualization system (JMesh) is used automatically process the data and to enable operators to easily provide measurement information, navigate through large time series of detections, examine spectrograms, listen to detected sounds, validate detections, and compare detections for different species over time and space. The JMesh web platform has been designed to overcome the otherwise overwhelming volume of acoustic data collected by the PMV-ECHO sensor systems. This paper will describe how the PMV-ECHO system along with the automated real-time analysis and visualization software suite can be used study marine mammal distribution and behavior, variation of vessel noises and potential effects of anthropogenic activities on marine mammals. The goal of the PMV-ECHO program is to find ways to reduce shipping impact on at-risk species especially in the approaches to large ports. This program and its scientific and technical approaches should be of interest to many marine organizations, industries, researchers and enforcement agencies.

Program for Volcanic Risk Reduction in the Americas: Translation of Science into Policy and Practice

NASA Astrophysics Data System (ADS)

Mangan, Margaret; Pierson, Thomas; Wilkinson, Stuart; Westby, Elizabeth; Driedger, Carolyn; Ewert, John

2016-04-01

In 2013, the United States Geological Survey (USGS) and the U.S. Agency for International Development/Office of Foreign Disaster Assistance (USAID/OFDA) inaugurated Volcanic Risk Reduction in the Americas, a program that brings together binational delegations of scientists, civil authorities, and emergency response managers to discuss the challenges of integrating volcano science into crisis response and risk reduction practices. During reciprocal visits, delegations tour areas impacted by volcanic unrest and/or eruption, meet with affected communities, and exchange insights and best practices. The 2013 exchange focused on hazards at Mount Rainier (Washington, USA) and Nevado del Ruiz (Caldas/Tolima, Colombia). Both of these volcanoes are highly susceptible to large volcanic mudflows (lahars). The Colombia-USA exchange allowed participants to share insights on lahar warning systems, self-evacuation planning, and effective education programs for at-risk communities. [See Driedger and Ewert (2015) Abstract 76171 presented at 2015 Fall AGU, San Francisco, Calif., Dec 14-18]. The second exchange, in 2015, took place between the USA and Chile, focusing on the Long Valley volcanic region (California, USA) and Chaitén volcano (Lagos, Chile) - both are centers of rhyolite volcanism. The high viscosity of rhyolite magma can cause explosive eruptions with widespread destruction. The rare but catastrophic "super eruptions" of the world have largely been the result of rhyolite volcanism. Chaitén produced the world's first explosive rhyolite eruption in the age of modern volcano monitoring in 2008-2009. Rhyolite eruptions of similar scale and style have occurred frequently in the Long Valley volcanic region, most recently about 600 years ago. The explosivity and relative rarity of rhyolite eruptions create unique challenges to risk reduction efforts. The recent Chaitén eruption was unexpected - little was known of Chaitén's eruptive history, and because of this, monitoring instrumentation and response protocols were nonexistent. Though devastating to the community, no lives were lost during the eruption - largely due to the impromptu, yet decisive, actions by local leaders. The situation at Long Valley is at the other end of the preparedness/response spectrum - the eruptive history is well known, and because of sporadic, intense volcanic unrest over the last three decades, sophisticated monitoring networks are in place to detect eruption precursors. The challenge for the Long Valley community is thus maintaining readiness in the face of waxing and waning unrest without eruption. Collectively, the stories heard by delegates visiting Chaitén and Long Valley confirm that communities are not prepared for natural disasters unless both risk awareness and risk reduction efforts become an integral and ongoing part of community life. Each delegate left with new perspectives on how best to achieve this.

Monitored Natural Attenuation as a Remediation Strategy for Nuclear Power Plant Applications

NASA Astrophysics Data System (ADS)

Kim, K.; Bushart, S.

2009-12-01

A NRC Information Notice (IN 2006-13) was produced to inform holders of nuclear operating licenses “of the occurrence of radioactive contamination of ground water at multiple facilities due to undetected leakage from facility structures, systems, or components (SSCs) that contain or transport radioactive fluids” so that they could consider actions, as appropriate, to avoid similar problems. To reinforce their commitment to environmental stewardship the nuclear energy industry has committed to improving management of situations that have the potential to lead to the inadvertent release of radioactive fluids. This Industry Groundwater Protection Initiative, finalized in June 2007 as [NEI 07-07], calls for implementation and improvement of on-site groundwater monitoring programs and enhanced communications with stakeholders and regulators about situations related to inadvertent releases. EPRI developed its Groundwater Protection Program to provide the nuclear energy industry with the technical support needed to implement the Industry Groundwater Initiative. An objective of the EPRI Groundwater Protection Program is to provide the nuclear industry with technically sound guidance for implementing and enhancing on-site groundwater monitoring programs. EPRI, in collaboration with the EPRI Groundwater Protection Committee of utility members, developed the EPRI Groundwater Protection Guidelines for Nuclear Power Plants (EPRI Report 1015118, November 2007), which provides site-specific guidance for implementing a technically sound groundwater monitoring program. The guidance applies a graded approach for nuclear plants to tailor a technically effective and cost efficient groundwater monitoring program to the site’s hydrogeology and risk for groundwater contamination. As part of the Groundwater Protection Program, EPRI is also investigating innovative remediation technologies for addressing low-level radioactive contamination in soils and groundwater at nuclear power plant sites. One of these remediation technologies is monitored natural attenuation (MNA), which has been widely used in other industries for the remediation of contaminants in soil and groundwater. Monitored natural attenuation (MNA) is a non-intervention, but not a no-action, groundwater and soil remediation approach that involves monitoring the dilution, dispersion, and decay of contaminants to meet remediation objectives. MNA has been commonly applied at sites where soil and groundwater have been contaminated by volatile organic compounds. This method has also been applied to remediation of radiological contamination at U.S. DOE facilities and decommissioning nuclear power plant sites. The EPRI published report (1016764) provides guidance for implementing MNA at nuclear power plants for remediation of radiological contaminants in groundwater and soil. The goal of the EPRI Groundwater Protection program is to bring together experience and technologies - both from within the nuclear industry and other industries - to support the industry’s commitment to environmental stewardship. Results from the program are being published in an extensive series of reports and software, and are being communicated to members in an annual EPRI Groundwater Protection technical exchange workshop.

[Risk/protective factors and prevention programs for drug dependence in Peru].

PubMed

Cabanillas-Rojas, William

2012-03-01

Risk/ protective factors (RPF) are main elements for the analysis, understanding and formulation of answers for the prevention of drug dependences. The objective of this article is to present a literature review about the RPF and their implications in the design of preventive programs. It will focus on individual (genetic aspects, early experiences and psicosocial skills), family (parental control and monitoring, permissiveness, parenting styles), peer (group pressure and social norms) and communitarian (disorganization) RPF. On the other hand, the need of incorporating a multifactor conceptual framework for the preventive approach to drug dependences, articulating the intervention spaces (school, family and community), assuming and evolving perspective allowing the implementations of sustained actions is evidenced. On top, the implications for future research and public policy formulation are discussed.

Tips and Traps: Lessons From Codesigning a Clinician E-Monitoring Tool for Computerized Cognitive Behavioral Therapy

PubMed Central

Hawken, Susan J; Stasiak, Karolina; Lucassen, Mathijs FG; Fleming, Theresa; Shepherd, Matthew; Greenwood, Andrea; Osborne, Raechel; Merry, Sally N

2017-01-01

Background Computerized cognitive behavioral therapy (cCBT) is an acceptable and promising treatment modality for adolescents with mild-to-moderate depression. Many cCBT programs are standalone packages with no way for clinicians to monitor progress or outcomes. We sought to develop an electronic monitoring (e-monitoring) tool in consultation with clinicians and adolescents to allow clinicians to monitor mood, risk, and treatment adherence of adolescents completing a cCBT program called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts). Objective The objectives of our study were as follows: (1) assess clinicians’ and adolescents’ views on using an e-monitoring tool and to use this information to help shape the development of the tool and (2) assess clinician experiences with a fully developed version of the tool that was implemented in their clinical service. Methods A descriptive qualitative study using semistructured focus groups was conducted in New Zealand. In total, 7 focus groups included clinicians (n=50) who worked in primary care, and 3 separate groups included adolescents (n=29). Clinicians were general practitioners (GPs), school guidance counselors, clinical psychologists, youth workers, and nurses. Adolescents were recruited from health services and a high school. Focus groups were run to enable feedback at 3 phases that corresponded to the consultation, development, and postimplementation stages. Thematic analysis was applied to transcribed responses. Results Focus groups during the consultation and development phases revealed the need for a simple e-monitoring registration process with guides for end users. Common concerns were raised in relation to clinical burden, monitoring risk (and effects on the therapeutic relationship), alongside confidentiality or privacy and technical considerations. Adolescents did not want to use their social media login credentials for e-monitoring, as they valued their privacy. However, adolescents did want information on seeking help and personalized monitoring and communication arrangements. Postimplementation, clinicians who had used the tool in practice revealed no adverse impact on the therapeutic relationship, and adolescents were not concerned about being e-monitored. Clinicians did need additional time to monitor adolescents, and the e-monitoring tool was used in a different way than was originally anticipated. Also, it was suggested that the registration process could be further streamlined and integrated with existing clinical data management systems, and the use of clinician alerts could be expanded beyond the scope of simply flagging adolescents of concern. Conclusions An e-monitoring tool was developed in consultation with clinicians and adolescents. However, the study revealed the complexity of implementing the tool in clinical practice. Of salience were privacy, parallel monitoring systems, integration with existing electronic medical record systems, customization of the e-monitor, and preagreed monitoring arrangements between clinicians and adolescents. PMID:28077345

78 FR 35310 - Implementation of the Privacy Act of 1974, as Amended; Privacy Act System of Records, Family Self...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-12

... research in support of program operations, management, performance monitoring, evaluation, risk management... the Privacy Act of 1974 (U.S.C. 552a(e)(4)), as amended, and Office of Management and Budget (OMB... submitted to the Office of Management and Budget (OMB), the Senate Committee on Homeland Security and...

The Role of the Admissions Office in the Academic Intervention and Support Program.

ERIC Educational Resources Information Center

Stumhofer, Nancy C.

At the Schuykill Campus of Pennsylvania State University, an academic intervention and support system has been developed which identifies and monitors high-risk students until they are able to succeed on their own or decide to leave school. The campus's LOFT Learning Center has created a link with the Admission's Office that is central to the…

Linking International Development Actors to Geophysical Infrastructure: Exploring an IRIS Community Role in Bridging a Communications Gap

NASA Astrophysics Data System (ADS)

Lerner-Lam, A.; Aster, R.; Beck, S.; Ekstrom, G.; Fisher, K.; Meltzer, A.; Nyblade, A.; Sandvol, E.; Willemann, R.

2008-12-01

Over the past quarter century, national investments in high-fidelity digital seismograph networks have resulted in a global infrastructure for real-time in situ earthquake monitoring. Many network operators adhere to community-developed standards, with the result that there are few technical impediments to data sharing and real-time information exchange. Two unanswered questions, however, are whether the existing models of international collaboration will ensure the stability and sustainability of global earthquake monitoring, and whether the participating institutions can work with international development agencies and non- governmental organizations in meeting linked development and natural hazard risk reduction goals. Since the 2004 Indian Ocean tsunami, many of these actors are enlarging their commitments to natural hazard risk reduction and building national technical capacities, among broader programs in poverty alleviation and adaptation to environmental stress. Despite this renewed commitment, international development organizations, with notable exceptions, have been relatively passive in discussions of how the existing earthquake monitoring infrastructure could be leveraged to support risk-reduction programs and meet sustainable development goals. At the same time, the international seismological community - comprising universities and government seismological surveys - has built research and education initiatives such as EarthScope, AfricaArray, and similar programs in China, Europe and South America, that use innovative instrumentation technologies and deployment strategies to enable new science and applications, and promote education and training in critical sectors. Can these developments be combined? Recognizing this communication or knowledge gap, the IRIS International Working Group (IWG) explores the link between the activities of IRIS Members using IRIS facilities and the missions of international development agencies, such as US AID, the World Bank, other international development banks, and agencies of the United Nations. Interests of US seismologists are served by encouraging development of modern seismographic systems in countries around the world to collect data that are useful in research as well as hazard mitigation and other national interests. Activities of the IWG to date include communicating the benefits of geophysical infrastructure and training to disaster risk reduction programs within the United Nations and development banks, coordinating an initiative to leverage retired PASSCAL data loggers through long-term loans to network operators in foreign countries, preparing a white paper outlining IRIS capabilities relevant to international development, and conducting a workshop, "Out of Africa", on modernizing geophysical infrastructure in the Americas and Southeast Asia through projects that are closely tied to university education and academic research.

Moderating roles of primary social influences in the relationship between adolescent self-reported exposure to antismoking messages and smoking intention.

PubMed

Paek, Hye-Jin

2008-11-01

This study explores moderating roles of primary social influences in the relationship between adolescent triers' and experimenters' self-reported exposure to antismoking messages and their smoking intentions. The theoretical arguments are drawn from primary socialization theory, group socialization theory, and the social development model, and the data are from the 2004 National Youth Tobacco Survey. The tobit regression models demonstrate that, as a primary social influence, peer smoking seems to be a strong risk factor for all of the adolescent segments' smoking intentions, whereas parental monitoring can be a significant counter-risk factor for middle-schoolers' smoking intentions. In addition, school intervention programs and parental monitoring against smoking appear to play a moderating role in the relationship between high-school triers' self-reported exposure to antismoking messages and their smoking intentions. The findings seem to suggest that campaigners should make more efforts to incorporate primary social influences to prevent adolescent smoking. The findings also suggest that campaigners should tailor antismoking programs to fit specific target audiences. In particular, middle-school experimenters deserve more attention from antismoking campaigners because they seem most vulnerable to future smoking.

A history of being prescribed controlled substances and risk of drug overdose death.

PubMed

Paulozzi, Leonard J; Kilbourne, Edwin M; Shah, Nina G; Nolte, Kurt B; Desai, Hema A; Landen, Michael G; Harvey, William; Loring, Larry D

2012-01-01

The abuse of prescription drugs has increased dramatically since 1990. Persons who overdose on such drugs frequently consume large doses and visit multiple providers. The risk of fatal overdose for different patterns of use of opioid analgesics and sedative/hypnotics has not been fully quantified. Matched case-control study. Cases were 300 persons who died of unintentional drug overdoses in New Mexico during 2006-2008, and controls were 5,993 patients identified through the state prescription monitoring program with matching 6-month exposure periods. Death from drug overdose or death from opioid overdose. Exposures were demographic variables and characteristics of prescription history. Crude and adjusted odds ratios (AOR) were calculated. Increased risk was associated with male sex (AOR 2.4, 95% confidence interval [CI] 1.8-3.1), one or more sedative/hypnotic prescriptions (AOR 3.0, CI 2.2-4.2), greater age (AOR 1.3, CI 1.2-1.4 for each 10-year increment), number of prescriptions (AOR 1.1, CI 1.1-1.1 for each additional prescription), and a prescription for buprenorphine (AOR 9.5, CI 3.0-30.0), fentanyl (AOR 3.5, CI 1.7-7.0), hydromorphone (AOR 3.3, CI 1.4-7.5), methadone (AOR 4.9, CI 2.5-9.6), or oxycodone (AOR 1.9, CI 1.4-2.6). Patients receiving a daily average of >40 morphine milligram equivalents had an OR of 12.2 (CI 9.2-16.0). Patients being prescribed opioid analgesics frequently or at high dosage face a substantial overdose risk. Prescription monitoring programs might be the best way for prescribers to know their patients' prescription histories and accurately assess overdose risk. Wiley Periodicals, Inc.

Dynamic Relationships Between Parental Monitoring, Peer Risk Involvement and Sexual Risk Behavior Among Bahamian Mid-Adolescents

PubMed Central

Wang, Bo; Stanton, Bonita; Deveaux, Lynette; Li, Xiaoming; Lunn, Sonja

2015-01-01

CONTEXT Considerable research has examined reciprocal relationships between parenting, peers and adolescent problem behavior; however, such studies have largely considered the influence of peers and parents separately. It is important to examine simultaneously the relationships between parental monitoring, peer risk involvement and adolescent sexual risk behavior, and whether increases in peer risk involvement and changes in parental monitoring longitudinally predict adolescent sexual risk behavior. METHODS Four waves of sexual behavior data were collected between 2008/2009 and 2011 from high school students aged 13–17 in the Bahamas. Structural equation and latent growth curve modeling were used to examine reciprocal relationships between parental monitoring, perceived peer risk involvement and adolescent sexual risk behavior. RESULTS For both male and female youth, greater perceived peer risk involvement predicted higher sexual risk behavior index scores, and greater parental monitoring predicted lower scores. Reciprocal relationships were found between parental monitoring and sexual risk behavior for males and between perceived peer risk involvement and sexual risk behavior for females. For males, greater sexual risk behavior predicted lower parental monitoring; for females, greater sexual risk behavior predicted higher perceived peer risk involvement. According to latent growth curve models, a higher initial level of parental monitoring predicted decreases in sexual risk behavior, whereas both a higher initial level and a higher growth rate of peer risk involvement predicted increases in sexual risk behavior. CONCLUSION Results highlight the important influence of peer risk involvement on youths’ sexual behavior and gender differences in reciprocal relationships between parental monitoring, peer influence and adolescent sexual risk behavior. PMID:26308261

Dynamic Relationships Between Parental Monitoring, Peer Risk Involvement and Sexual Risk Behavior Among Bahamian Mid-Adolescents.

PubMed

Wang, Bo; Stanton, Bonita; Deveaux, Lynette; Li, Xiaoming; Lunn, Sonja

2015-06-01

Considerable research has examined reciprocal relationships between parenting, peers and adolescent problem behavior; however, such studies have largely considered the influence of peers and parents separately. It is important to examine simultaneously the relationships between parental monitoring, peer risk involvement and adolescent sexual risk behavior, and whether increases in peer risk involvement and changes in parental monitoring longitudinally predict adolescent sexual risk behavior. Four waves of sexual behavior data were collected between 2008/2009 and 2011 from high school students aged 13-17 in the Bahamas. Structural equation and latent growth curve modeling were used to examine reciprocal relationships between parental monitoring, perceived peer risk involvement and adolescent sexual risk behavior. For both male and female youth, greater perceived peer risk involvement predicted higher sexual risk behavior index scores, and greater parental monitoring predicted lower scores. Reciprocal relationships were found between parental monitoring and sexual risk behavior for males and between perceived peer risk involvement and sexual risk behavior for females. For males, greater sexual risk behavior predicted lower parental monitoring; for females, greater sexual risk behavior predicted higher perceived peer risk involvement. According to latent growth curve models, a higher initial level of parental monitoring predicted decreases in sexual risk behavior, whereas both a higher initial level and a higher growth rate of peer risk involvement predicted increases in sexual risk behavior. Results highlight the important influence of peer risk involvement on youths' sexual behavior and gender differences in reciprocal relationships between parental monitoring, peer influence and adolescent sexual risk behavior.

Hydrogeologic Modeling for Monitoring, Reporting and Verification of Geologic Sequestration

NASA Astrophysics Data System (ADS)

Kolian, M.; De Figueiredo, M.; Lisa, B.

2011-12-01

In December 2010, EPA finalized Subpart RR of the Greenhouse Gas (GHG) Reporting Program, which requires facilities that conduct geologic sequestration (GS) of carbon dioxide (CO2) to report GHG data to EPA annually. The GHG Reporting Program requires reporting of GHGs and other relevant information from certain source categories in the United States, and information obtained through Subpart RR will inform Agency decisions under the Clean Air Act related to the use of carbon dioxide capture and sequestration for mitigating GHGs. This paper examines hydrogeologic modeling necessities and opportunities in the context of Subpart RR. Under Subpart RR, facilities that conduct GS by injecting CO2 for long-term containment in subsurface geologic formations are required to develop and implement an EPA-approved site-specific monitoring, reporting, and verification (MRV) plan; and report basic information on CO2 received for injection, annual monitoring activities and the amount of CO2 geologically sequestered using a mass balance approach. The major components of the MRV plan include: identification of potential surface leakage pathways for CO2 and the likelihood, magnitude, and timing, of surface leakage of CO2 through these pathways; delineation of the monitoring areas; strategy for detecting and quantifying any surface leakage of CO2; and the strategy for establishing the expected baselines for monitoring CO2 surface leakage. Hydrogeologic modeling is an integral aspect of the design of an MRV plan. In order to prepare an adequate monitoring program that addresses site specific risks over the full life of the project the MRV plan must reflect the full spatial extent of the free phase CO2 over time. Facilities delineate the maximum area that the CO2 plume is predicted to cover and how monitoring can be phased in over this area. The Maximum Monitoring Area (MMA) includes the extent of the free phase CO2 plume over the lifetime of the project plus a buffer zone of one-half mile. The Active Monitoring Area (AMA) is the area that will be monitored over a specified time interval chosen by the reporter, which must be greater than one year. All of the area in the MMA will eventually be covered by one or more AMAs. This allows operators to phase in monitoring so that during any given time interval, only that part of the MMA in which surface leakage might occur needs to be monitored. EPA designed the MRV plan approach to be site-specific, flexible, and adaptive to future technology developments. This approach allows the reporter to leverage the site characterization, modeling, and monitoring approaches (e.g. monitoring of injection pressures, injection well integrity, groundwater quality and geochemistry, and CO2 plume location, etc.) developed for their Underground Injection Control (UIC) permit. UIC requirements provide the foundation for the safe sequestration of CO2 by helping to ensure that injected fluids remain isolated in the subsurface and away from underground sources of drinking water, thereby serving to reduce the risk of CO2 leakage to the atmosphere.

Psychosocial Correlates of Clinicians' Prescription Drug Monitoring Program Utilization.

PubMed

Pugliese, John A; Wintemute, Garen J; Henry, Stephen G

2018-05-01

The purpose of this study is to extend prior research on barriers to use of a prescription drug monitoring program by examining psychosocial correlates of intended use among physicians and pharmacists. Overall, 1,904 California physicians and pharmacists responded to a statewide survey (24.1% response rate) from August 2016 to January 2017. Participants completed an online survey examining attitudes toward prescription drug misuse and abuse, prescribing practices, prescription drug monitoring program design and ease of use, professional obligations, and normative beliefs regarding prescription drug monitoring program use. Data were analyzed in 2017. Perceived prescription drug monitoring program usefulness and normative beliefs fully mediated the relationship between concern about prescription drug abuse and intentions to use the prescription drug monitoring program. Clinicians' sense of professional and moral obligation to use the prescription drug monitoring program was unrelated to intention to use the prescription drug monitoring program despite a positive relationship with concern about misuse and abuse. Compared with physicians, pharmacists reported greater concern about prescription drug misuse, greater professional and moral obligation to use prescription drug monitoring program, and greater rating of prescription drug monitoring program usefulness. Interventions that target normative beliefs surrounding prescription drug monitoring program use and how to use prescription drug monitoring programs effectively are likely to be more effective than those that target professional obligations or moralize to the medical community. Published by Elsevier Inc.

Automated size-specific CT dose monitoring program: assessing variability in CT dose.

PubMed

Christianson, Olav; Li, Xiang; Frush, Donald; Samei, Ehsan

2012-11-01

The potential health risks associated with low levels of ionizing radiation have created a movement in the radiology community to optimize computed tomography (CT) imaging protocols to use the lowest radiation dose possible without compromising the diagnostic usefulness of the images. Despite efforts to use appropriate and consistent radiation doses, studies suggest that a great deal of variability in radiation dose exists both within and between institutions for CT imaging. In this context, the authors have developed an automated size-specific radiation dose monitoring program for CT and used this program to assess variability in size-adjusted effective dose from CT imaging. The authors radiation dose monitoring program operates on an independent health insurance portability and accountability act compliant dosimetry server. Digital imaging and communication in medicine routing software is used to isolate dose report screen captures and scout images for all incoming CT studies. Effective dose conversion factors (k-factors) are determined based on the protocol and optical character recognition is used to extract the CT dose index and dose-length product. The patient's thickness is obtained by applying an adaptive thresholding algorithm to the scout images and is used to calculate the size-adjusted effective dose (ED(adj)). The radiation dose monitoring program was used to collect data on 6351 CT studies from three scanner models (GE Lightspeed Pro 16, GE Lightspeed VCT, and GE Definition CT750 HD) and two institutions over a one-month period and to analyze the variability in ED(adj) between scanner models and across institutions. No significant difference was found between computer measurements of patient thickness and observer measurements (p = 0.17), and the average difference between the two methods was less than 4%. Applying the size correction resulted in ED(adj) that differed by up to 44% from effective dose estimates that were not adjusted by patient size. Additionally, considerable differences were noted in ED(adj) distributions between scanners, with scanners employing iterative reconstruction exhibiting significantly lower ED(adj) (range: 9%-64%). Finally, a significant difference (up to 59%) in ED(adj) distributions was observed between institutions, indicating the potential for dose reduction. The authors developed a robust automated size-specific radiation dose monitoring program for CT. Using this program, significant differences in ED(adj) were observed between scanner models and across institutions. This new dose monitoring program offers a unique tool for improving quality assurance and standardization both within and across institutions.

Automated size-specific CT dose monitoring program: Assessing variability in CT dose

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

Christianson, Olav; Li Xiang; Frush, Donald

2012-11-15

Purpose: The potential health risks associated with low levels of ionizing radiation have created a movement in the radiology community to optimize computed tomography (CT) imaging protocols to use the lowest radiation dose possible without compromising the diagnostic usefulness of the images. Despite efforts to use appropriate and consistent radiation doses, studies suggest that a great deal of variability in radiation dose exists both within and between institutions for CT imaging. In this context, the authors have developed an automated size-specific radiation dose monitoring program for CT and used this program to assess variability in size-adjusted effective dose from CTmore » imaging. Methods: The authors radiation dose monitoring program operates on an independent health insurance portability and accountability act compliant dosimetry server. Digital imaging and communication in medicine routing software is used to isolate dose report screen captures and scout images for all incoming CT studies. Effective dose conversion factors (k-factors) are determined based on the protocol and optical character recognition is used to extract the CT dose index and dose-length product. The patient's thickness is obtained by applying an adaptive thresholding algorithm to the scout images and is used to calculate the size-adjusted effective dose (ED{sub adj}). The radiation dose monitoring program was used to collect data on 6351 CT studies from three scanner models (GE Lightspeed Pro 16, GE Lightspeed VCT, and GE Definition CT750 HD) and two institutions over a one-month period and to analyze the variability in ED{sub adj} between scanner models and across institutions. Results: No significant difference was found between computer measurements of patient thickness and observer measurements (p= 0.17), and the average difference between the two methods was less than 4%. Applying the size correction resulted in ED{sub adj} that differed by up to 44% from effective dose estimates that were not adjusted by patient size. Additionally, considerable differences were noted in ED{sub adj} distributions between scanners, with scanners employing iterative reconstruction exhibiting significantly lower ED{sub adj} (range: 9%-64%). Finally, a significant difference (up to 59%) in ED{sub adj} distributions was observed between institutions, indicating the potential for dose reduction. Conclusions: The authors developed a robust automated size-specific radiation dose monitoring program for CT. Using this program, significant differences in ED{sub adj} were observed between scanner models and across institutions. This new dose monitoring program offers a unique tool for improving quality assurance and standardization both within and across institutions.« less

Biomarkers of cardiometabolic risk in obese/overweight children: effect of lifestyle intervention.

PubMed

Vrablík, M; Dobiášová, M; Zlatohlávek, L; Urbanová, Z; Češka, R

2014-01-01

Obesity is a strong cardiometabolic (CM) risk factor in children. We tested potential CM risk in obese/overweight children and the effect of an intensive lifestyle intervention using newer CM markers: atherogenic index of plasma AIP [Log(TG/HDL-C)], apoB/apoAI ratio and a marker of insulin resistance HOMA-IR. The participants (194 girls, 115 boys, average age 13) were enrolled in an intensive, one-month, inpatient weight reduction program. The program consisted of individualised dietary changes and the exercise program comprised aerobic and resistance training. Anthropometrical and biochemical parameters in plasma and CM risk biomarkers - (AIP, apoB/apoAI ratio and HOMA-IR) were examined before and after the intervention. AIP and HOMA-IR significantly correlated with BMI while apoB/apoAI ratio did not. Only AIP and HOMA-IR showed systematic increases according to the level of obesity by BMI quartiles. Lifestyle intervention significantly improved anthropometrical and biochemical values and the biomarkers too. The response of lipid parameters to the intervention was considerably higher in boys than in girls. The children were stratified into three risk categories according to AIP, where 13.8 % of boys and 5.3 % of girls fell into high risk category. The monitored biomarkers may complement each other in the prognosis of CM risk. AIP was strongly related to obesity and to lipid and glycid metabolism, while the relationship of the apoB/apoAI ratio to obesity and glycid metabolism was not significant. The obese children benefited from the intensive lifestyle intervention which improved the anthropometrical and biochemical parameters and CM risk biomarkers.

A modular, prospective, semi-automated drug safety monitoring system for use in a distributed data environment.

PubMed

Gagne, Joshua J; Wang, Shirley V; Rassen, Jeremy A; Schneeweiss, Sebastian

2014-06-01

The aim of this study was to develop and test a semi-automated process for conducting routine active safety monitoring for new drugs in a network of electronic healthcare databases. We built a modular program that semi-automatically performs cohort identification, confounding adjustment, diagnostic checks, aggregation and effect estimation across multiple databases, and application of a sequential alerting algorithm. During beta-testing, we applied the system to five databases to evaluate nine examples emulating prospective monitoring with retrospective data (five pairs for which we expected signals, two negative controls, and two examples for which it was uncertain whether a signal would be expected): cerivastatin versus atorvastatin and rhabdomyolysis; paroxetine versus tricyclic antidepressants and gastrointestinal bleed; lisinopril versus angiotensin receptor blockers and angioedema; ciprofloxacin versus macrolide antibiotics and Achilles tendon rupture; rofecoxib versus non-selective non-steroidal anti-inflammatory drugs (ns-NSAIDs) and myocardial infarction; telithromycin versus azithromycin and hepatotoxicity; rosuvastatin versus atorvastatin and diabetes and rhabdomyolysis; and celecoxib versus ns-NSAIDs and myocardial infarction. We describe the program, the necessary inputs, and the assumed data environment. In beta-testing, the system generated four alerts, all among positive control examples (i.e., lisinopril and angioedema; rofecoxib and myocardial infarction; ciprofloxacin and tendon rupture; and cerivastatin and rhabdomyolysis). Sequential effect estimates for each example were consistent in direction and magnitude with existing literature. Beta-testing across nine drug-outcome examples demonstrated the feasibility of the proposed semi-automated prospective monitoring approach. In retrospective assessments, the system identified an increased risk of myocardial infarction with rofecoxib and an increased risk of rhabdomyolysis with cerivastatin years before these drugs were withdrawn from the market. Copyright © 2014 John Wiley & Sons, Ltd.

[Control of cardiovascular risk factors in coronary patients one year after cardiac rehabilitation].

PubMed

Denolle, T; Dib, M; Brune, M; Nicolas, S; Richard, A; Auguste, V; Bourdet, S; Crozet, A; Marivain, A; Salin, S; Revault d'Allonnes, F

2017-06-01

To assess risk factors monitoring in coronary patients one year after cardiac rehabilitation. From 2015 to 2015, cardiac morbidity, total mortality and risk factors data were collected from a 4-week ambulatory cardiac rehabilitation program with a control one year later and were compared with the results of Euroaspire and Reach studies. Out of 1091 (87%) coronary patients, 746 (68%) were re-examined 12months later (aged 60years (ranging from 20 to 85years), 15% women, 44% hypertensive, 36% smokers, 17% diabetics, 74% with dyslipidemia). At the end of the program, management of CV risk factors was improved (BP ≤ 140/90mmHg and BMI > 30: 80 and 20% vs 65 and 25% at the beginning of the program; LDL < 0.7g/L: 42% and smoking: 4% vs 18% when hospitalized for their cardiac event). Unfortunately, this benefit decreased significantly at one year (BP ≤ 140/90mmHg: 63%, LDL < 0.7g/L: 27%; smoking: 6%) but it remains better than in Euroaspire IV study: 57, 20 et 16% respectively). While 54% had insufficient physical activity before cardiac rehabilitation, they were only 23% at 1-year vs 60% in Euroaspire study. We reported a total mortality of 0.6% vs 2.9% in Reach study and 12% cardiac hospitalization (53% for a new coronary event). Participation of coronary patients in a cardiac rehabilitation program significantly improves management of CV risk factors, morbidity and mortality. However, the control obtained at the end of the program decreases at one year. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Development and applications of the Veterans Health Administration's Stratification Tool for Opioid Risk Mitigation (STORM) to improve opioid safety and prevent overdose and suicide.

PubMed

Oliva, Elizabeth M; Bowe, Thomas; Tavakoli, Sara; Martins, Susana; Lewis, Eleanor T; Paik, Meenah; Wiechers, Ilse; Henderson, Patricia; Harvey, Michael; Avoundjian, Tigran; Medhanie, Amanuel; Trafton, Jodie A

2017-02-01

Concerns about opioid-related adverse events, including overdose, prompted the Veterans Health Administration (VHA) to launch an Opioid Safety Initiative and Overdose Education and Naloxone Distribution program. To mitigate risks associated with opioid prescribing, a holistic approach that takes into consideration both risk factors (e.g., dose, substance use disorders) and risk mitigation interventions (e.g., urine drug screening, psychosocial treatment) is needed. This article describes the Stratification Tool for Opioid Risk Mitigation (STORM), a tool developed in VHA that reflects this holistic approach and facilitates patient identification and monitoring. STORM prioritizes patients for review and intervention according to their modeled risk for overdose/suicide-related events and displays risk factors and risk mitigation interventions obtained from VHA electronic medical record (EMR)-data extracts. Patients' estimated risk is based on a predictive risk model developed using fiscal year 2010 (FY2010: 10/1/2009-9/30/2010) EMR-data extracts and mortality data among 1,135,601 VHA patients prescribed opioid analgesics to predict risk for an overdose/suicide-related event in FY2011 (2.1% experienced an event). Cross-validation was used to validate the model, with receiver operating characteristic curves for the training and test data sets performing well (>.80 area under the curve). The predictive risk model distinguished patients based on risk for overdose/suicide-related adverse events, allowing for identification of high-risk patients and enrichment of target populations of patients with greater safety concerns for proactive monitoring and application of risk mitigation interventions. Results suggest that clinical informatics can leverage EMR-extracted data to identify patients at-risk for overdose/suicide-related events and provide clinicians with actionable information to mitigate risk. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Caresoil: A multidisciplinar Project to characterize, remediate, monitor and evaluate the risk of contaminated soils in Madrid (Spain)

NASA Astrophysics Data System (ADS)

Muñoz-Martín, Alfonso; Antón, Loreto; Granja, Jose Luis; Villarroya, Fermín; Montero, Esperanza; Rodríguez, Vanesa

2016-04-01

Soil contamination can come from diffuse sources (air deposition, agriculture, etc.) or local sources, these last being related to anthropogenic activities that are potentially soil contaminating activities. According to data from the EU, in Spain, and particularly for the Autonomous Community of Madrid, it can be considered that heavy metals, toxic organic compounds (including Non Aqueous Phases Liquids, NAPLs) and combinations of both are the main problem of point sources of soil contamination in our community. The five aspects that will be applied in Caresoil Program (S2013/MAE-2739) in the analysis and remediation of a local soil contamination are: 1) the location of the source of contamination and characterization of soil and aquifer concerned, 2) evaluation of the dispersion of the plume, 3) application of effective remediation techniques, 4) monitoring the evolution of the contaminated soil and 5) risk analysis throughout this process. These aspects involve advanced technologies (hydrogeology, geophysics, geochemistry,...) that require new developing of knowledge, being necessary the contribution of several researching groups specialized in the fields previously cited, as they are those integrating CARESOIL Program. Actually two cases concerning hydrocarbon spills, as representative examples of soil local contamination in Madrid area, are being studied. The first is being remediated and we are monitoring this process to evaluate its effectiveness. In the second location we are defining the extent of contamination in soil and aquifer to define the most effective remediation technique.

Factors Associated With Peer Victimization Among Adolescents in Taiwan.

PubMed

Huang, Hui-Wen; Chen, Jyu-Lin; Wang, Ruey-Hsia

2018-02-01

Adolescents who have experienced peer victimization face a higher risk of negative health outcomes. However, little is known about the factors that are associated with peer victimization among adolescents in Taiwan. The aim of this study was to examine the factors related to peer victimization among Taiwanese adolescents. A cross-sectional design was employed. Three hundred seventy-seven adolescents aged 13-16 years from seven middle schools in southern Taiwan were recruited as participants. Validated, self-reported questionnaires were used to gather data on demographic characteristics, resilience, peer relationship, parental monitoring, school connectedness, social support, and peer victimization. Logistic regression analysis was used to examine the factors that were related to peer victimization. About 17% (n = 64) of the participants experienced peer victimization during the previous 1-year period. Logistic regression analysis indicated that parental monitoring of daily life, school connectedness, and peer support were significant predictors of a reduced risk of peer victimization. The final model explained 23.1% of the total variance in less peer victimization and predicted 80.1% of peer victimization. School connectedness and peer support were identified as important factors facilitating the avoidance of peer victimization among adolescents in Taiwan. Healthcare providers and school personnel should consider school-based programs to improve school connectedness and to build an atmosphere of peer support to reduce peer victimization. Educating parents to monitor their adolescents' daily activities is also encouraged in concert with these school-based programs.

Effectiveness of workplace diabetes prevention programs: A systematic review of the evidence.

PubMed

Brown, Sharon A; García, Alexandra A; Zuñiga, Julie A; Lewis, Kimberly A

2018-01-05

The primary purpose is to review diabetes workplace interventions and the degree to which they improve diabetes-related outcomes in employees diagnosed with or at risk for T2DM. Three electronic databases and ancestry searches were used to identify peer reviewed articles published in English from 2000 to June 2017. The number of participants represented by the 22 selected studies, excluding one large outlier, was 4243. On average, the samples were 57% female and ethnically diverse. Interventions-healthy eating behaviors, physical activity, and/or monitoring and self-managing diabetes and cardiovascular risk factors-were delivered in group sessions of fewer than 20 employees. Programs involved 1-h weekly sessions held during lunch hour or at other times during the workday for 12 to 24 weeks. Study outcomes, commonly measured at 6 and/or 12 months, were consistently positive. The literature search uncovered beginning evidence that workplace interventions hold promise for preventing diabetes and/or its complications. More rigorous, creatively designed, workplace studies, are needed for employees at high-risk for developing diabetes. Implications include the need for employer education about the benefits of employer support for such programs and attention to motivational strategies so employees will take full advantage of programs that are offered. Copyright © 2018 Elsevier B.V. All rights reserved.

Operating boundaries of full-scale advanced water reuse treatment plants: many lessons learned from pilot plant experience.

PubMed

Bele, C; Kumar, Y; Walker, T; Poussade, Y; Zavlanos, V

2010-01-01

Three Advanced Water Treatment Plants (AWTP) have recently been built in South East Queensland as part of the Western Corridor Recycled Water Project (WCRWP) producing Purified Recycled Water from secondary treated waste water for the purpose of indirect potable reuse. At Luggage Point, a demonstration plant was primarily operated by the design team for design verification. The investigation program was then extended so that the operating team could investigate possible process optimisation, and operation flexibility. Extending the demonstration plant investigation program enabled monitoring of the long term performance of the microfiltration and reverse osmosis membranes, which did not appear to foul even after more than a year of operation. The investigation primarily identified several ways to optimise the process. It highlighted areas of risk for treated water quality, such as total nitrogen. Ample and rapid swings of salinity from 850 to 3,000 mg/l-TDS were predicted to affect the RO process day-to-day operation and monitoring. Most of the setpoints used for monitoring under HACCP were determined during the pilot plant trials.

Antifungal stewardship considerations for adults and pediatrics.

PubMed

Hamdy, Rana F; Zaoutis, Theoklis E; Seo, Susan K

2017-08-18

Antifungal stewardship refers to coordinated interventions to monitor and direct the appropriate use of antifungal agents in order to achieve the best clinical outcomes and minimize selective pressure and adverse events. Antifungal utilization has steadily risen over time in concert with the increase in number of immunocompromised adults and children at risk for invasive fungal infections (IFI). Challenges in diagnosing IFI often lead to delays in treatment and poorer outcomes. There are also emerging data linking prior antifungal exposure and suboptimal dosing to the emergence of antifungal resistance, particularly for Candida. Antimicrobial stewardship programs can take a multi-pronged bundle approach to ensure suitable prescribing of antifungals via post-prescription review and feedback and/or prior authorization. Institutional guidelines can also be developed to guide diagnostic testing in at-risk populations; appropriate choice, dose, and duration of antifungal agent; therapeutic drug monitoring; and opportunities for de-escalation and intravenous-to-oral conversion.

Development and Validation of Remote Sensing-Based Surface Inundation Products for Vector-Borne Disease Risk in East Africa

NASA Astrophysics Data System (ADS)

Jensen, K.; McDonald, K. C.; Ceccato, P.; Schroeder, R.; Podest, E.

2014-12-01

The potential impact of climate variability and change on the spread of infectious disease is of increasingly critical concern to public health. Newly-available remote sensing datasets may be combined with predictive modeling to develop new capabilities to mitigate risks of vector-borne diseases such as malaria, leishmaniasis, and rift valley fever. We have developed improved remote sensing-based products for monitoring water bodies and inundation dynamics that have potential utility for improving risk forecasts of vector-borne disease epidemics. These products include daily and seasonal surface inundation based on the global mappings of inundated area fraction derived at the 25-km scale from active and passive microwave instruments ERS, QuikSCAT, ASCAT, and SSM/I data - the Satellite Water Microwave Product Series (SWAMPS). Focusing on the East African region, we present validation of this product using multi-temporal classification of inundated areas in this region derived from high resolution PALSAR (100m) and Landsat (30m) observations. We assess historical occurrence of malaria in the east African country of Eritrea with respect to the time series SWAMPS datasets, and we aim to construct a framework for use of these new datasets to improve prediction of future malaria risk in this region. This work is supported through funding from the NASA Applied Sciences Program, the NASA Terrestrial Ecology Program, and the NASA Making Earth System Data Records for Use in Research Environments (MEaSUREs) Program. This study is also supported and monitored by National Oceanic and Atmospheric Administration (NOAA) under Grant - CREST Grant # NA11SEC4810004. The statements contained within the manuscript/research article are not the opinions of the funding agency or the U.S. government, but reflect the authors' opinions. This work was conducted in part under the framework of the ALOS Kyoto and Carbon Initiative. ALOS PALSAR data were provided by JAXA EORC.

Safe motherhood -- from advocacy to action.

PubMed

Tinker, A

1991-12-01

Every minute a woman dies from complications related to pregnancy or childbirth. That translates to 500,000 annually, of which, 99% live in developing countries. A woman in Africa has a 1:18 lifetime chance of dying from pregnancy-related causes, compared with a northern European woman who has a 1:10,000 chance. Thus, in 1987 international and regional agencies and national governments started a global program titled the Safe Motherhood Initiative. Its goal is to reduce maternal morbidity and mortality 50% by 2000. The death of a woman during pregnancy or child birth means that her surviving children are much more likely to die. In a bangladesh study it was found that the death of the mother was associated with a 200% increase in mortality for her sons and 350% for her daughters for children up to 10. Family planning is the key, since it is the single best tool of preventing these deaths, by reducing the number of times a woman gets pregnant. Family planning also reduces the number of abortions which are estimated to kill 200,000 women annually in developing countries. Trained midwives who can provide obstetrical emergency assistance will also make a large impact. Risk assessment was once considered very important, but studies have shown that the majority of pregnancy complications develop without being detected. Further, the number of women with risk factors that develop complications is much lower than the number of women who develop complications during pregnancy. So monitoring women with risk factors misses most complications. Regular monitoring and medical examinations are much more effective for preventing complications. Safe motherhood can only be achieved if each program is tailored to the needs of the community. Donor nations are necessary for this program to succeed, but ultimate success rests in the hands of each country. National priorities must be set, resources must be allocated, and programs must be designed to be effective.

[Safe drinking water supply to the Vologda Region's population using risk assessment methodology].

PubMed

Kuznetsova, I A; Figurina, T Ia; Shadrina, S Iu

2011-01-01

To supply the population with qualitative potable water is a priority problem in the provision of sanitary-and-epidemiologic well-being and in the prevention of disease in the Vologda Region. The monitoring of the results of laboratory control over the quality of drinking-water and the assessment of health risk enabled a package of measures to be proposed to optimize the conditions of drinking water supply in the Vologda Region. The risk assessment technology used by a state agency for sanitary-and-epidemiological surveillance makes it possible to substantiate a system of actions to organize household water use and to include scientifically grounded proposals into the developed regional and local programs.

A Total Quality-Control Plan with Right-Sized Statistical Quality-Control.

PubMed

Westgard, James O

2017-03-01

A new Clinical Laboratory Improvement Amendments option for risk-based quality-control (QC) plans became effective in January, 2016. Called an Individualized QC Plan, this option requires the laboratory to perform a risk assessment, develop a QC plan, and implement a QC program to monitor ongoing performance of the QC plan. Difficulties in performing a risk assessment may limit validity of an Individualized QC Plan. A better alternative is to develop a Total QC Plan including a right-sized statistical QC procedure to detect medically important errors. Westgard Sigma Rules provides a simple way to select the right control rules and the right number of control measurements. Copyright © 2016 Elsevier Inc. All rights reserved.

[Algorithm for taking into account the average annual background of air pollution in the assessment of health risks].

PubMed

Fokin, M V

2013-01-01

State Budgetary Educational Institution of Higher Professional Education "I.M. Sechenov First Moscow State Medical University" of the Ministry of Health care and Social Development, Moscow, Russian Federation. The assessment of health risks from air pollution with emissions from industrial facilities, without the average annual background of air pollution does not meet sanitary legislation. However Russian Federal Service for Hydrometeorology and Environmental Monitoring issues official certificates for a limited number of areas covered by the observations of the full program on the stationary points. Questions of accounting average background air pollution in the evaluation of health risks from exposure to emissions from industrial facilities are considered.

Accumulation and potential health effects of organohalogenated compounds in the arctic fox (Vulpes lagopus)--a review.

PubMed

Pedersen, Kathrine Eggers; Styrishave, Bjarne; Sonne, Christian; Dietz, Rune; Jenssen, Bjørn Munro

2015-01-01

This review addresses biological effects of anthropogenic organohalogenated compounds in the arctic fox (Vulpes lagopus). When considering the current levels, spatial and tissue distributions of selected organic pollutants in arctic fox subpopulations, especially the Svalbard based populations accumulate high levels. The dominating contaminant groups are the polychlorinated biphenyls (PCBs) and chlordanes (CHLs), which reach high levels in adipose tissues, adrenals and liver. Recent controlled exposure studies on domesticated arctic fox and Greenland sledge dogs, show adverse health effects associated with OC concentrations lower than those measured in free-ranging populations. This indicates that especially populations at Svalbard may be at risk of experiencing OC related effects. The arctic fox as such may be an overlooked species in the Arctic Monitoring and Assessment Programs and it would add further information about pollution in the Arctic to include this species in the monitoring program. Copyright © 2014 Elsevier B.V. All rights reserved.

Prospective Epstein-Barr virus-related post-transplant lymphoproliferative disorder prevention program in pediatric allogeneic hematopoietic stem cell transplant: virological monitoring and first-line treatment.

PubMed

Chiereghin, A; Prete, A; Belotti, T; Gibertoni, D; Piccirilli, G; Gabrielli, L; Pession, A; Lazzarotto, T

2016-02-01

In 28 pediatric allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients, we aimed to evaluate: (i) the impact of routine Epstein-Barr virus (EBV) DNA monitoring on the development of EBV-related post-transplant lymphoproliferative disorder (EBV-PTLD); (ii) the incidence of EBV infection and the potential risk factors; and (iii) the suitability of whole blood (WB) as clinical specimen to monitor the risk of patients to develop EBV-PTLD. Quantitative real-time polymerase chain reaction assay was performed on WB samples for all patients. EBV DNA quantification also in peripheral blood mononuclear cells (PBMCs) samples was adopted for the patients at higher risk of developing EBV-PTLD (≥ 10,000 copies/mL WB). High EBV DNAemia levels were observed in 37.5% of the actively infected recipients (57.1%). Severe aplastic anemia, matched-unrelated donor transplant, the reduced-intensity conditioning regimen and, to a lesser extent, the in vivo T-cell depletion with anti-thymocyte immunoglobulin were associated with high viral load. A significant correlation between EBV DNA levels in WB and PBMC samples was obtained (r = 0.755, P < 0.001). A similar kinetics of EBV DNA in the 2 blood compartments was observed. Clinically, both specimen types appeared to be equally informative to assess the risk of patients to develop PTLD. On the basis of EBV DNAemia levels, in 3 patients (10.7%) immunosuppressive therapy was reduced and 1 patient (3.5%) received early treatment for probable EBV disease. No patients developed EBV-PTLD. WB proved to be a suitable clinical specimen to monitor EBV DNA load after allo-HSCT for the management of EBV infection and PTLD prevention. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Biomedical Risk Mitigation: 1994-2004

NASA Technical Reports Server (NTRS)

2004-01-01

This custom bibliography from the NASA Scientific and Technical Information Program lists a sampling of records found in the NASA Aeronautics and Space Database. The scope of this topic includes space medicine, remote monitoring, diagnosis, and treatment. This area of focus is one of the enabling technologies as defined by NASA s Report of the President s Commission on Implementation of United States Space Exploration Policy, published in June 2004.

Measurement and Modeling of Ecosystem Risk and Recovery for In Situ Treatment of Contaminated Sediments

DTIC Science & Technology

2013-08-01

Hydrocarbons in Petroleum- Impacted Sediments." Environmental Science & Technology 47(2): 1024-1032. Choi, Y., Y. M. Cho, et al. (2013). "Measurement and...4020 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) Strategic Environmental Research and Development...was prepared under contract to the Department of Defense Strategic Environmental Research and Development Program (SERDP). The publication of this

Developing Memory Reconsolidation Blockers as Novel PTSD Treatments

DTIC Science & Technology

2011-06-01

REPORT DATE: June 20 TYPE OF REPORT: Annual PREPARED FOR: U.S. Army Medical Research and Materiel...MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland...Diabetes Program.10 Given our duty as health care pro- viders to reduce the risk of our treat- ments (ie, psychiatric medications ) to our patients, we

In Search of Black Swans: Identifying Students at Risk of Failing Licensing Examinations.

PubMed

Barber, Cassandra; Hammond, Robert; Gula, Lorne; Tithecott, Gary; Chahine, Saad

2018-03-01

To determine which admissions variables and curricular outcomes are predictive of being at risk of failing the Medical Council of Canada Qualifying Examination Part 1 (MCCQE1), how quickly student risk of failure can be predicted, and to what extent predictive modeling is possible and accurate in estimating future student risk. Data from five graduating cohorts (2011-2015), Schulich School of Medicine & Dentistry, Western University, were collected and analyzed using hierarchical generalized linear models (HGLMs). Area under the receiver operating characteristic curve (AUC) was used to evaluate the accuracy of predictive models and determine whether they could be used to predict future risk, using the 2016 graduating cohort. Four predictive models were developed to predict student risk of failure at admissions, year 1, year 2, and pre-MCCQE1. The HGLM analyses identified gender, MCAT verbal reasoning score, two preclerkship course mean grades, and the year 4 summative objective structured clinical examination score as significant predictors of student risk. The predictive accuracy of the models varied. The pre-MCCQE1 model was the most accurate at predicting a student's risk of failing (AUC 0.66-0.93), while the admissions model was not predictive (AUC 0.25-0.47). Key variables predictive of students at risk were found. The predictive models developed suggest, while it is not possible to identify student risk at admission, we can begin to identify and monitor students within the first year. Using such models, programs may be able to identify and monitor students at risk quantitatively and develop tailored intervention strategies.

Ciguatera risk management in French Polynesia: the case study of Raivavae Island (Australes Archipelago).

PubMed

Chinain, Mireille; Darius, H Taiana; Ung, André; Fouc, Mote Tchou; Revel, Taina; Cruchet, Philippe; Pauillac, Serge; Laurent, Dominique

2010-10-01

Based on epidemiological data available through long-term monitoring surveys conducted by both the Public Health Directorate and the Louis Malardé Institute, ciguatera is highly endemic in French Polynesia, most notably in Raivavae (Australes) which appears as a hot spot of ciguatera with an average incidence rate of 140 cases/10,000 population for the period 2007-2008. In order to document the ciguatera risk associated with Raivavae lagoon, algal and toxin-based field monitoring programs were conducted in this island from April 2007 to May 2008. Practically, the distribution, abundance and toxicity of Gambierdiscus populations, along with the toxicity levels in 160 fish distributed within 25 distinct species, were assessed in various sampling locations. Herbivores such as Scarids (parrotfish) and Acanthurids (unicornfish) were rated as high-risk species based on receptor-binding assay toxicity data. A map of the risk stratification within the Raivavae lagoon was also produced, which indicates that locations where both natural and man-made disturbances have occurred remained the most susceptible to CFP incidents. Our findings also suggest that, locally, the traditional knowledge about ciguatera may not be scientifically complete but is functionally correct. Community education resulted in self-regulating behaviour towards avoidance of high-risk fish species and fishing locations. Copyright 2009 Elsevier Ltd. All rights reserved.

Evaluation of dental implants as a risk factor for the development of bisphosphonate-related osteonecrosis of the jaw in breast cancer patients.

PubMed

Matsuo, Akira; Hamada, Hayato; Takahashi, Hidetoshi; Okamoto, Ayako; Kaise, Hiroshi; Chikazu, Daichi

2016-09-01

It remains unclear whether dental implants are a risk factor for the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ). We retrospectively evaluated the status of dental implants in patients given intravenous bisphosphonates (BPs) in a breast cancer cohort to elucidate the risk for BRONJ at the implant site. We established a BRONJ oral monitoring program for 247 breast cancer patients given intravenous BP in our institution. The 3-year cumulative incidence rate was determined. The systemic and local risk factors of 44 patients who completed comprehensive oral examinations were evaluated by logistic regression analysis. The 3-year cumulative incidence rate of the 247 patients was 0.074 % (8/247, 95 % CI 0.0081-0.014). In the 44 orally examined patients, 6 (13.6 %: 6/44) had dental implants. Of these 6 patients, 1 developed BRONJ at the implant site. There were no significant differences in the age, total BP treatment period, number of residual teeth, time of regular oral monitoring, oral hygiene level, or dental implant insertion. Although a case of ONJ was identified, dental implants which were inserted before intravenous BP administration were not a risk factor for the development of ONJ in breast cancer patients.

Risk-adapted monitoring is not inferior to extensive on-site monitoring: Results of the ADAMON cluster-randomised study.

PubMed

Brosteanu, Oana; Schwarz, Gabriele; Houben, Peggy; Paulus, Ursula; Strenge-Hesse, Anke; Zettelmeyer, Ulrike; Schneider, Anja; Hasenclever, Dirk

2017-12-01

Background According to Good Clinical Practice, clinical trials must protect rights and safety of patients and make sure that the trial results are valid and interpretable. Monitoring on-site has an important role in achieving these objectives; it controls trial conduct at trial sites and informs the sponsor on systematic problems. In the past, extensive on-site monitoring with a particular focus on formal source data verification often lost sight of systematic problems in study procedures that endanger Good Clinical Practice objectives. ADAMON is a prospective, stratified, cluster-randomised, controlled study comparing extensive on-site monitoring with risk-adapted monitoring according to a previously published approach. Methods In all, 213 sites from 11 academic trials were cluster-randomised between extensive on-site monitoring (104) and risk-adapted monitoring (109). Independent post-trial audits using structured manuals were performed to determine the frequency of major Good Clinical Practice findings at the patient level. The primary outcome measure is the proportion of audited patients with at least one major audit finding. Analysis relies on logistic regression incorporating trial and monitoring arm as fixed effects and site as random effect. The hypothesis was that risk-adapted monitoring is non-inferior to extensive on-site monitoring with a non-inferiority margin of 0.60 (logit scale). Results Average number of monitoring visits and time spent on-site was 2.1 and 2.7 times higher in extensive on-site monitoring than in risk-adapted monitoring, respectively. A total of 156 (extensive on-site monitoring: 76; risk-adapted monitoring: 80) sites were audited. In 996 of 1618 audited patients, a total of 2456 major audit findings were documented. Depending on the trial, findings were identified in 18%-99% of the audited patients, with no marked monitoring effect in any of the trials. The estimated monitoring effect is -0.04 on the logit scale with two-sided 95% confidence interval (-0.40; 0.33), demonstrating that risk-adapted monitoring is non-inferior to extensive on-site monitoring. At most, extensive on-site monitoring could reduce the frequency of major Good Clinical Practice findings by 8.2% compared with risk-adapted monitoring. Conclusion Compared with risk-adapted monitoring, the potential benefit of extensive on-site monitoring is small relative to overall finding rates, although risk-adapted monitoring requires less than 50% of extensive on-site monitoring resources. Clusters of findings within trials suggest that complicated, overly specific or not properly justified protocol requirements contributed to the overall frequency of findings. Risk-adapted monitoring in only a sample of patients appears sufficient to identify systematic problems in the conduct of clinical trials. Risk-adapted monitoring has a part to play in quality control. However, no monitoring strategy can remedy defects in quality of design. Monitoring should be embedded in a comprehensive quality management approach covering the entire trial lifecycle.

Risk-adapted monitoring is not inferior to extensive on-site monitoring: Results of the ADAMON cluster-randomised study

PubMed Central

Brosteanu, Oana; Schwarz, Gabriele; Houben, Peggy; Paulus, Ursula; Strenge-Hesse, Anke; Zettelmeyer, Ulrike; Schneider, Anja; Hasenclever, Dirk

2017-01-01

Background According to Good Clinical Practice, clinical trials must protect rights and safety of patients and make sure that the trial results are valid and interpretable. Monitoring on-site has an important role in achieving these objectives; it controls trial conduct at trial sites and informs the sponsor on systematic problems. In the past, extensive on-site monitoring with a particular focus on formal source data verification often lost sight of systematic problems in study procedures that endanger Good Clinical Practice objectives. ADAMON is a prospective, stratified, cluster-randomised, controlled study comparing extensive on-site monitoring with risk-adapted monitoring according to a previously published approach. Methods In all, 213 sites from 11 academic trials were cluster-randomised between extensive on-site monitoring (104) and risk-adapted monitoring (109). Independent post-trial audits using structured manuals were performed to determine the frequency of major Good Clinical Practice findings at the patient level. The primary outcome measure is the proportion of audited patients with at least one major audit finding. Analysis relies on logistic regression incorporating trial and monitoring arm as fixed effects and site as random effect. The hypothesis was that risk-adapted monitoring is non-inferior to extensive on-site monitoring with a non-inferiority margin of 0.60 (logit scale). Results Average number of monitoring visits and time spent on-site was 2.1 and 2.7 times higher in extensive on-site monitoring than in risk-adapted monitoring, respectively. A total of 156 (extensive on-site monitoring: 76; risk-adapted monitoring: 80) sites were audited. In 996 of 1618 audited patients, a total of 2456 major audit findings were documented. Depending on the trial, findings were identified in 18%–99% of the audited patients, with no marked monitoring effect in any of the trials. The estimated monitoring effect is −0.04 on the logit scale with two-sided 95% confidence interval (−0.40; 0.33), demonstrating that risk-adapted monitoring is non-inferior to extensive on-site monitoring. At most, extensive on-site monitoring could reduce the frequency of major Good Clinical Practice findings by 8.2% compared with risk-adapted monitoring. Conclusion Compared with risk-adapted monitoring, the potential benefit of extensive on-site monitoring is small relative to overall finding rates, although risk-adapted monitoring requires less than 50% of extensive on-site monitoring resources. Clusters of findings within trials suggest that complicated, overly specific or not properly justified protocol requirements contributed to the overall frequency of findings. Risk-adapted monitoring in only a sample of patients appears sufficient to identify systematic problems in the conduct of clinical trials. Risk-adapted monitoring has a part to play in quality control. However, no monitoring strategy can remedy defects in quality of design. Monitoring should be embedded in a comprehensive quality management approach covering the entire trial lifecycle. PMID:28786330

Optimal Design of Air Quality Monitoring Network and its Application in an Oil Refinery Plant: An Approach to Keep Health Status of Workers.

PubMed

ZoroufchiBenis, Khaled; Fatehifar, Esmaeil; Ahmadi, Javad; Rouhi, Alireza

2015-01-01

Industrial air pollution is a growing challenge to humane health, especially in developing countries, where there is no systematic monitoring of air pollution. Given the importance of the availability of valid information on population exposure to air pollutants, it is important to design an optimal Air Quality Monitoring Network (AQMN) for assessing population exposure to air pollution and predicting the magnitude of the health risks to the population. A multi-pollutant method (implemented as a MATLAB program) was explored for configur-ing an AQMN to detect the highest level of pollution around an oil refinery plant. The method ranks potential monitoring sites (grids) according to their ability to represent the ambient concentration. The term of cluster of contiguous grids that exceed a threshold value was used to calculate the Station Dosage. Selection of the best configuration of AQMN was done based on the ratio of a sta-tion's dosage to the total dosage in the network. Six monitoring stations were needed to detect the pollutants concentrations around the study area for estimating the level and distribution of exposure in the population with total network efficiency of about 99%. An analysis of the design procedure showed that wind regimes have greatest effect on the location of monitoring stations. The optimal AQMN enables authorities to implement an effective program of air quality management for protecting human health.

Optimal Design of Air Quality Monitoring Network and its Application in an Oil Refinery Plant: An Approach to Keep Health Status of Workers

PubMed Central

ZoroufchiBenis, Khaled; Fatehifar, Esmaeil; Ahmadi, Javad; Rouhi, Alireza

2015-01-01

Background: Industrial air pollution is a growing challenge to humane health, especially in developing countries, where there is no systematic monitoring of air pollution. Given the importance of the availability of valid information on population exposure to air pollutants, it is important to design an optimal Air Quality Monitoring Network (AQMN) for assessing population exposure to air pollution and predicting the magnitude of the health risks to the population. Methods: A multi-pollutant method (implemented as a MATLAB program) was explored for configur­ing an AQMN to detect the highest level of pollution around an oil refinery plant. The method ranks potential monitoring sites (grids) according to their ability to represent the ambient concentration. The term of cluster of contiguous grids that exceed a threshold value was used to calculate the Station Dosage. Selection of the best configuration of AQMN was done based on the ratio of a sta­tion’s dosage to the total dosage in the network. Results: Six monitoring stations were needed to detect the pollutants concentrations around the study area for estimating the level and distribution of exposure in the population with total network efficiency of about 99%. An analysis of the design procedure showed that wind regimes have greatest effect on the location of monitoring stations. Conclusion: The optimal AQMN enables authorities to implement an effective program of air quality management for protecting human health. PMID:26933646

Evaluation of the National Guard Health Promotion Program for Chronic Diseases and Comorbid Conditions Among Military Personnel in Jeddah City, Saudi Arabia, 2016.

PubMed

Aljasir, Badr A; Al-Mugti, Hani Saad; Alosaimi, Majed Naif; Al-Mugati, Amer Saad

2017-11-01

Cardiovascular diseases (CVDs) are the leading cause of death worldwide. Preventive efforts mainly target the reduction of modifiable CVD risk factors through community-based promotion programs. One of these programs is the National Guard Health Promotion Program for Chronic Diseases and Comorbid Conditions among military personnel in Jeddah City, Saudi Arabia. Researchers have asserted that to improve every intervention program, especially those targeting public health issues, regular monitoring and evaluation are needed to determine the strength and weakness of the program. The objective of this study was to assess the effectiveness of National Guard Health Promotion Program for Chronic Diseases and Comorbid Conditions among military personnel in Jeddah City by estimating Framingham risk score, diabetes risk score, and satisfaction level for the participants covered by the program for at least 6 months. Through pre- and poststudy design, a systematic random sample of military personnel who fulfilled the inclusion criteria (n = 267) were enrolled in the study. To assess the program's effectiveness, participants were subjected to clinical and laboratory assessment based mainly on Framingham risk scores before and after involvement in the program; satisfaction was assessed concurrently using a self-administered questionnaire. The Wilcoxon signed rank test was used to compare changes in non-normally distributed quantitative variables. Multiple logistic regression analysis was used to identify independent predictors of risk of CVDs. The subjects were all military men, with mean age of 35.8 ± 6.6 years; 6% officers with the remainder "non-officers" primarily working in the combat services. After at least 6 months of the preventive program, there were statistically significant decreases in body mass index (-0.4 ± 1.5 kg/m 2 ), waist circumference (-0.9 ± 6.2 cm), fasting blood glucose (-12.3 ± 29.6 mg/dL), and total cholesterol (-15.4 ± 40.2 mg/dL). Despite this observed improvement, the overall Framingham risk score showed a modest nonsignificant change (-0.1 ± 2.1 points). Similarly, although specific predictors scores of diabetes mellitus showed significant improvement (decreased blood glucose [-0.4 ± 1.8 points] and increased fruit and vegetable consumption [-0.2 ± 0.6 points]), there was no significant change in the overall diabetes risk score (-0.01 ± 2.5). The majority of the participants (96%) expressed that they were satisfied with the program. The National Guard Health Promotion Program is effective in improving specific risk factors such as body mass index, waist circumference, blood glucose, and intake of fruits and vegetables; in addition, it was perceived as being satisfactory. Nevertheless, it had no statistically significant impact on the overall total risk scores for CVDs and diabetes mellitus. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Designs for Risk Evaluation and Management

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

The Designs for Risk Evaluation and Management (DREAM) tool was developed as part of the effort to quantify the risk of geologic storage of carbon dioxide (CO 2) under the U.S. Department of Energy's National Risk Assessment Partnership (NRAP). DREAM is an optimization tool created to identify optimal monitoring schemes that minimize the time to first detection of CO 2 leakage from a subsurface storage formation. DREAM acts as a post-processer on user-provided output from subsurface leakage simulations. While DREAM was developed for CO 2 leakage scenarios, it is applicable to any subsurface leakage simulation of the same output format.more » The DREAM tool is comprised of three main components: (1) a Java wizard used to configure and execute the simulations, (2) a visualization tool to view the domain space and optimization results, and (3) a plotting tool used to analyze the results. A secondary Java application is provided to aid users in converting common American Standard Code for Information Interchange (ASCII) output data to the standard DREAM hierarchical data format (HDF5). DREAM employs a simulated annealing approach that searches the solution space by iteratively mutating potential monitoring schemes built of various configurations of monitoring locations and leak detection parameters. This approach has proven to be orders of magnitude faster than an exhaustive search of the entire solution space. The user's manual illustrates the program graphical user interface (GUI), describes the tool inputs, and includes an example application.« less

Development of GUI Type On-Line Condition Monitoring Program for a Turboprop Engine Using Labview

NASA Astrophysics Data System (ADS)

Kong, Changduk; Kim, Keonwoo

2011-12-01

Recently, an aero gas turbine health monitoring system has been developed for precaution and maintenance action against faults or performance degradations of the advanced propulsion system which occurs in severe environments such as high altitude, foreign object damage particles, hot and heavy rain and snowy atmospheric conditions. However to establish this health monitoring system, the online condition monitoring program is firstly required, and the program must monitor the engine performance trend through comparison between measured engine performance data and base performance results calculated by base engine performance model. This work aims to develop a GUI type on-line condition monitoring program for the PT6A-67 turboprop engine of a high altitude and long endurance operation UAV using LabVIEW. The base engine performance of the on-line condition monitoring program is simulated using component maps inversely generated from the limited performance deck data provided by engine manufacturer. The base engine performance simulation program is evaluated because analysis results by this program agree well with the performance deck data. The proposed on-line condition program can monitor the real engine performance as well as the trend through precise comparison between clean engine performance results calculated by the base performance simulation program and measured engine performance signals. In the development phase of this monitoring system, a signal generation module is proposed to evaluate the proposed online monitoring system. For user friendly purpose, all monitoring program are coded by LabVIEW, and monitoring examples are demonstrated using the proposed GUI type on-condition monitoring program.

Obesity Prevention and Weight Maintenance After Loss.

PubMed

German, Alexander James

2016-09-01

Obesity is one of the most prevalent medical diseases in pets. Outcomes are often disappointing; many animals either fail to reach target weight or regain weight. This article discusses managing obesity, focusing on prevention. It gives guidance on establishing monitoring programs that use regular body weight and condition assessments to identify animals at risk of inappropriate weight gain, enabling early intervention. Weight management in obese animals is a lifelong process. Regular weight and body condition monitoring are key to identifying animals that rebound early, while continuing to feed a therapeutic weight loss diet can help prevent it from happening. Copyright © 2016 Elsevier Inc. All rights reserved.

The Stress Check Program: a new national policy for monitoring and screening psychosocial stress in the workplace in Japan.

PubMed

Kawakami, Norito; Tsutsumi, Akizumi

2016-01-01

The Japanese government launched a new occupational health policy called the Stress Check Program. This program mandates that all workplaces with 50 or more employees conduct the Stress Check Program for workers at least once a year. This article gives a brief overview and critical review of the program. We reviewed relevant laws, guidelines, and manuals, as well as the policy development process. The policy and the components of the program were compared using available scientific evidence and trends in the management of psychosocial factors at work according to the policies and guidelines of international bodies and European countries. The process of program policy development was based on a discussion among employer and employee representatives, occupational health professionals, and mental health experts. Scientific evidence shows that mandated components of the program (i.e., feedback of stress survey results and physician's interview) may be ineffective. However, additional components recommended to employers, such as stress management skill provision and work environment improvement, in conjunction with the program may be effective in improving psychosocial stress at work. The Stress Check Program is unique compared with the global trend for psychosocial risk management because it focuses on the assessment of stress among individual workers. The new program may be effective in improving worker mental health by facilitating the psychosocial risk management approach in Japan. Concerns regarding the program include mass leakage of collected information, and possible disadvantages for workers labeled as having high stress.

Possibilities of using the German Federal States' permanent soil monitoring program for the monitoring of potential effects of genetically modified organisms (GMO).

PubMed

Toschki, Andreas; Jänsch, Stephan; Roß-Nickoll, Martina; Römbke, Jörg; Züghart, Wiebke

2015-01-01

In the Directive 2001/18/EC on the deliberate release of genetically modified organisms (GMO) into the environment, a monitoring of potential risks is prescribed after their deliberate release or placing on the market. Experience and data of already existing monitoring networks should be included. The present paper summarizes the major findings of a project funded by the Federal Agency for Nature Conservation (Nutzungsmöglichkeiten der Boden-Dauerbeobachtung der Länder für das Monitoring der Umweltwirkungen gentechnisch veränderter Pflanzen. BfN Skripten, Bonn-Bad Godesberg 369, 2014). The full report in german language can be accessed on http://www.bfn.de and is available as Additional file 1. The aim of the project was to check if it is possible to use the German permanent soil monitoring program (PSM) for the monitoring of GMO. Soil organism communities are highly diverse and relevant with respect to the sustainability of soil functions. They are exposed to GMO material directly by feeding or indirectly through food chain interactions. Other impacts are possible due to their close association to soil particles. The PSM program can be considered as representative with regard to different soil types and ecoregions in Germany, but not for all habitat types relevant for soil organisms. Nevertheless, it is suitable as a basic grid for monitoring the potential effects of GMO on soil invertebrates. PSM sites should be used to derive reference values, i.e. range of abundance and presence of different relevant species of soil organisms. Based on these references, it is possible to derive threshold values to define the limit of acceptable change or impact. Therefore, a minimum set of sites and minimum set of standardized methods are needed, i.e. characterization of each site, sampling of selected soil organism groups, adequate adaptation of methods for the purpose of monitoring of potential effects of GMO. Finally, and probably most demanding, it is needed to develop a harmonized evaluation concept.

QuEChERS GC-MS validation and monitoring of pesticide residues in different foods in the tomato classification group.

PubMed

Ramírez Restrepo, Andrés; Gallo Ortiz, Andrés Fernando; Hoyos Ossa, Duvan Esteban; Peñuela Mesa, Gustavo Antonio

2014-09-01

The objective of this study was to validate (SANCO/12495/2011 and NTC-ISO/IEC 17025) multi-residue multi-class methods using QuEChERS sample preparation and GC-MS for the analysis of regulated pesticides in tomatoes (Solanum lycopersicum), tamarillos (Solanum betaceum) and goldenberries (Physalis peruviana). These Latin American products are representative and widely produced in Antioquia (Colombia). Sample preparation followed the UNE-EN 15662 method (150 mg MgSO4, 25mg primary secondary amines and 25mg of octadecylsiloxane for cleanup; graphitized carbon black was added for tomatoes). Extracts were injected using a programmed temperature-vaporizing injector. The residues were validated over a range from 0.02 mg/kg to 0.20 mg/kg, with 24 analytes validated in tomatoes, 33 in tamarillos and 28 in goldenberries. An initial risk assessment was enabled by monitoring 24 samples in the municipalities of El Peñol, Marinilla and San Vicente Ferrer. Risks were found for tomatoes, but no significant risks were found for tamarillos or goldenberries. Copyright © 2014 Elsevier Ltd. All rights reserved.

Exercise During the Childbearing Year

PubMed Central

Hammer, Roger L.; Perkins, Jan; Parr, Richard

2000-01-01

Many women wish to continue to pursue an active lifestyle during pregnancy, while the pregnancy itself may provide the motivation for other more sedentary women to begin an exercise program for the sake of improved health/fitness. Also, female competitive athletes, upon becoming pregnant, may wish to continue sports performance and require careful monitoring to assure maternal-fetal safety. This review is designed to assist the perinatal educator who is in the position to advise the pregnant patient on the risks and benefits of physical activity during the childbearing year and provide suggestions for developing individualized exercise programs. PMID:17273187

The IRS and the Internet: new issues for tax-exempt organizations.

PubMed

Griffith, Gerald M

2002-01-01

Tax-exempt healthcare organizations increasingly are using the Internet to provide an inexpensive, easily accessible forum for information exchange, organization publicity, and community-relations programs. A tax-exempt organization that engages in certain activities on its Web site, however, risks losing its tax-exempt status. Such activities may include political messages and lobbying, substantial advertising and other revenue-generating programs, and inappropriate solicitation of charitable contributions. Therefore, providers should carefully monitor all information on their Web sites, including hyperlinks to other Web sites, chat-room and bulletin-board content, and advertisements, to make certain they comply with IRS rules.

The SISMA Project: A pre-operative seismic hazard monitoring system.

NASA Astrophysics Data System (ADS)

Massimiliano Chersich, M. C.; Amodio, A. A. Angelo; Francia, A. F. Andrea; Sparpaglione, C. S. Claudio

2009-04-01

Galileian Plus is currently leading the development, in collaboration with several Italian Universities, of the SISMA (Seismic Information System for Monitoring and Alert) Pilot Project financed by the Italian Space Agency. The system is devoted to the continuous monitoring of the seismic risk and is addressed to support the Italian Civil Protection decisional process. Completion of the Pilot Project is planned at the beginning of 2010. Main scientific paradigm of SISMA is an innovative deterministic approach integrating geophysical models, geodesy and active tectonics. This paper will give a general overview of project along with its progress status and a particular focus will be put on the architectural design details and to the software implementation choices. SISMA is built on top of a software infrastructure developed by Galileian Plus to integrate the scientific programs devoted to the update of seismic risk maps. The main characteristics of the system may be resumed as follow: automatic download of input data; integration of scientific programs; definition and scheduling of chains of processes; monitoring and control of the system through a graphical user interface (GUI); compatibility of the products with ESRI ArcGIS, by mean of post-processing conversion. a) automatic download of input data SISMA needs input data such as GNSS observations, updated seismic catalogue, SAR satellites orbits, etc. that are periodically updated and made available from remote servers through FTP and HTTP. This task is accomplished by a dedicated user configurable component. b) integration of scientific programs SISMA integrates many scientific programs written in different languages (Fortran, C, C++, Perl and Bash) and running into different operating systems. This design requirements lead to the development of a distributed system which is platform independent and is able to run any terminal-based program following few simple predefined rules. c) definition and scheduling of chains of processes Processes are bound each other, in the sense that the output of process "A" should be passed as input to process "B". In this case the process "B" must run automatically as soon as the required input is ready. In SISMA this issue is handled with the "data-driven" activation concept allowing specifying that a process should be started as soon as the needed input datum has been made available in the archive. Moreover SISMA may run processes on a "time-driven" base. The infrastructure of SISMA provides a configurable scheduler allowing the user to define the start time and the periodicity of such processes. d) monitoring and control The operator of the system needs to monitor and control every process running in the system. The SISMA infrastructure allows, through its GUI, the user to: view log messages of running and old processes; stop running processes; monitor processes executions; monitor resource status (available ram, network reachability, and available disk space) for every machine in the system. e) compatibility with ESRI Shapefiles Nearly all the SISMA data has some geographic information, and it is useful to integrate it in a Geographic Information System (GIS). Processors output are georeferred, but they are generated as ASCII files in a proprietary format, and thus cannot directly loaded in a GIS. The infrastructures provides a simple framework for adding filters that reads the data in the proprietary format and converts it to ESRI Shapefile format.

Electronic fetal heart rate monitoring and its relationship to neonatal and infant mortality in the United States.

PubMed

Chen, Han-Yang; Chauhan, Suneet P; Ananth, Cande V; Vintzileos, Anthony M; Abuhamad, Alfred Z

2011-06-01

To examine the association between electronic fetal heart rate monitoring and neonatal and infant mortality, as well as neonatal morbidity. We used the United States 2004 linked birth and infant death data. Multivariable log-binomial regression models were fitted to estimate risk ratio for association between electronic fetal heart rate monitoring and mortality, while adjusting for potential confounders. In 2004, 89% of singleton pregnancies had electronic fetal heart rate monitoring. Electronic fetal heart rate monitoring was associated with significantly lower infant mortality (adjusted relative risk, 0.75); this was mainly driven by the lower risk of early neonatal mortality (adjusted relative risk, 0.50). In low-risk pregnancies, electronic fetal heart rate monitoring was associated with decreased risk for Apgar scores <4 at 5 minutes (relative risk, 0.54); in high-risk pregnancies, with decreased risk of neonatal seizures (relative risk, 0.65). In the United States, the use of electronic fetal heart rate monitoring was associated with a substantial decrease in early neonatal mortality and morbidity that lowered infant mortality. Copyright © 2011 Mosby, Inc. All rights reserved.

Microbial Monitoring of the International Space Station

NASA Technical Reports Server (NTRS)

Pierson, Duane L.; Botkin, Douglas J.; Bruce, Rebekah J.; Castro, Victoria A.; Smith, Melanie J.; Oubre, Cherie M.; Ott, C. Mark

2013-01-01

Humans living and working in the harsh environment of space present many challenges for habitability engineers and microbiologists. Spacecraft must provide an internal environment in which physical (gas composition, pressure, temperature, and humidity), chemical, and biological environmental parameters are maintained at safe levels. Microorganisms are ubiquitous and will accompany all human-occupied spacecraft, but if biological contamination were to reach unacceptable levels, long-term human space flight would be impossible. Prevention of microbiological problems, therefore, must have a high priority. Historically, prevention of infectious disease in the crew has been the highest priority, but experience gained from the NASA-Mir program showed that microbial contamination of vehicle and life-support systems, such as biofouling of water and food, are of equal importance. The major sources of microbiological risk factors for astronauts include food, drinking water, air, surfaces, payloads, research animals, crew members, and personnel in close contact with the astronauts. In our efforts to eliminate or mitigate the negative effects of microorganisms in spacecraft, the National Aeronautics and Space Administration (NASA) implemented comprehensive microbial analyses of the major risk factors. This included the establishment of acceptability requirements for food, water, air, surfaces, and crew members. A robust monitoring program was then implemented to verify that the risks were within acceptable limits. Prevention of microbiological problems is preferred over mitigation of problems during flight, and preventive steps must begin very early in the design phase. Spacecraft development must include requirements to control free water from humidity, condensate, hygiene activities, and other releases. If water is available, microbes are likely to grow because sufficient nutrients are potentially available. Materials selected for the spacecraft must not promote or support microbial growth. Air filtration can dramatically reduce the number of airborne bacteria, fungi, and particulates in spacecraft breathing air. Waterborne bacteria can be reduced to acceptable levels by thermal inactivation of bacteria during water processing, along with a residual biocide, and filtration at the point of use can ensure safety. System design must include onboard capability to achieve recovery of the system from contamination. Robust housekeeping procedures that include periodic cleaning and disinfection will prevent high levels of microbial growth on surfaces. Food for consumption in space must be thoroughly tested for excessive microbial content and pathogens before launch. Thorough preflight examination of flight crews, consumables, payloads, and the environment can greatly reduce pathogens in spacecraft. Many of the lessons learned from the Space Shuttle and previous programs were applied in the early design phase of the International Space Station, resulting in the safest space habitat to date. This presentation describes the monitoring program for the International Space Station and will summarize results from preflight and on-orbit monitoring.

Using a Lean Six Sigma Approach to Yield Sustained Pressure Ulcer Prevention for Complex Critical Care Patients.

PubMed

Donovan, Elizabeth A; Manta, Christine J; Goldsack, Jennifer C; Collins, Michelle L

2016-01-01

Under value-based purchasing, Medicare withholds reimbursements for hospital-acquired pressure ulcer occurrence and rewards hospitals that meet performance standards. With little evidence of a validated prevention process, nurse managers are challenged to find evidence-based interventions. The aim of this study was to reduce the unit-acquired pressure ulcer (UAPU) rate on targeted intensive care and step-down units by 15% using Lean Six Sigma (LSS) methodology. An interdisciplinary team designed a pilot program using LSS methodology to test 4 interventions: standardized documentation, equipment monitoring, patient out-of-bed-to-chair monitoring, and a rounding checklist. During the pilot, the UAPU rate decreased from 4.4% to 2.8%, exceeding the goal of a 15% reduction. The rate remained below the goal through the program control phase at 2.9%, demonstrating a statistically significant reduction after intervention implementation. The program significantly reduced UAPU rates in high-risk populations. LSS methodologies are a sustainable approach to reducing hospital-acquired conditions that should be broadly tested and implemented.

A new Web-based medical tool for assessment and prevention of comprehensive cardiovascular risk

PubMed Central

Franchi, Daniele; Cini, Davide; Iervasi, Giorgio

2011-01-01

Background: Multifactor cardiovascular disease is the leading cause of death; besides well-known cardiovascular risk factors, several emerging factors such as mental stress, diet type, and physical inactivity, have been associated to cardiovascular disease. To date, preventive strategies are based on the concept of absolute risk calculated by different algorithms and scoring systems. However, in general practice the patient’s data collection represents a critical issue. Design: A new multipurpose computer-based program has been developed in order to:1) easily calculate and compare the absolute cardiovascular risk by the Framingham, Procam, and Progetto Cuore algorithms; 2) to design a web-based computerized tool for prospective collection of structured data; 3) to support the doctor in the decision-making process for patients at risk according to recent international guidelines. Methods: During a medical consultation the doctor utilizes a common computer connected by Internet to a medical server where all the patient’s data and software reside. The program evaluates absolute and relative cardiovascular risk factors, personalized patient’s goals, and multiparametric trends, monitors critical parameter values, and generates an automated medical report. Results: In a pilot study on 294 patients (47% males; mean age 60 ± 12 years [±SD]) the global time to collect data at first consultation was 13 ± 11 minutes which declined to 8 ± 7 minutes at the subsequent consultation. In 48.2% of cases the program revealed 2 or more primary risk factor parameters outside guideline indications and gave specific clinical suggestions to return altered parameters to target values. Conclusion: The web-based system proposed here may represent a feasible and flexible tool for clinical management of patients at risk of cardiovascular disease and for epidemiological research. PMID:21445280

Volunteer water monitoring: A guide for state managers

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

Not Available

1990-08-01

Contents: executive summary; volunteers in water monitoring; planning a volunteer monitoring program; implementing a volunteer monitoring program; providing credible information; costs and funding; and descriptions of five successful programs.

Air Quality Monitoring: Risk-Based Choices

NASA Technical Reports Server (NTRS)

James, John T.

2009-01-01

Air monitoring is secondary to rigid control of risks to air quality. Air quality monitoring requires us to target the credible residual risks. Constraints on monitoring devices are severe. Must transition from archival to real-time, on-board monitoring. Must provide data to crew in a way that they can interpret findings. Dust management and monitoring may be a major concern for exploration class missions.

Markers and Time Course of Neurodegenerative Risk With Androgen Deprivation Therapy

DTIC Science & Technology

2011-04-01

The views, opinions and/or findings contained in this report are those of the author( s ) and should not be construed as an...NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR( S ) 5d. PROJECT NUMBER 5e. TASK NUMBER E-Mail: 5f. WORK UNIT NUMBER...7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING / MONITORING AGENCY

Parental influences on adolescent sexual behaviors.

PubMed

Rupp, Richard; Rosenthal, Susan L

2007-12-01

Parents play a significant role in the sexual development and behaviors of their children. Parental monitoring and supervision are important avenues for keeping adolescents from risky situations and activities while the teen develops responsible decision-making skills. A supportive relationship between the parent and adolescent is important for enhancing communication and supervision. In this article we discuss programs that were designed to improve parenting skills to decrease adolescent sexual risk behaviors.

The future of monitoring in clinical research - a holistic approach: linking risk-based monitoring with quality management principles.

PubMed

Ansmann, Eva B; Hecht, Arthur; Henn, Doris K; Leptien, Sabine; Stelzer, Hans Günther

2013-01-01

Since several years risk-based monitoring is the new "magic bullet" for improvement in clinical research. Lots of authors in clinical research ranging from industry and academia to authorities are keen on demonstrating better monitoring-efficiency by reducing monitoring visits, monitoring time on site, monitoring costs and so on, always arguing with the use of risk-based monitoring principles. Mostly forgotten is the fact, that the use of risk-based monitoring is only adequate if all mandatory prerequisites at site and for the monitor and the sponsor are fulfilled.Based on the relevant chapter in ICH GCP (International Conference on Harmonisation of technical requirements for registration of pharmaceuticals for human use - Good Clinical Practice) this publication takes a holistic approach by identifying and describing the requirements for future monitoring and the use of risk-based monitoring. As the authors are operational managers as well as QA (Quality Assurance) experts, both aspects are represented to come up with efficient and qualitative ways of future monitoring according to ICH GCP.

Usefulness of Maintaining a Normal Electrocardiogram Over Time for Predicting Cardiovascular Health.

PubMed

Soliman, Elsayed Z; Zhang, Zhu-Ming; Chen, Lin Y; Tereshchenko, Larisa G; Arking, Dan; Alonso, Alvaro

2017-01-15

We hypothesized that maintaining a normal electrocardiogram (ECG) status over time is associated with low cardiovascular (CV) disease in a dose-response fashion and subsequently could be used to monitor programs aimed at promoting CV health. This analysis included 4,856 CV disease-free participants from the Atherosclerosis Risk in Communities study who had a normal ECG at baseline (1987 to 1989) and complete electrocardiographic data in subsequent 3 visits (1990 to 1992, 1993 to 1995, and 1996 to 1998). Participants were classified based on maintaining their normal ECG status during these 4 visits into "maintained," "not maintained," or "inconsistent" normal ECG status as defined by the Minnesota ECG classification. CV disease events (coronary heart disease, heart failure, and stroke) were adjudicated from Atherosclerosis Risk in Communities visit-4 through 2010. Over a median follow-up of 13.2 years, 885 CV disease events occurred. The incidence rate of CV disease events was lowest among study participants who maintained a normal ECG status, followed by those with an inconsistent pattern, and then those who did not maintain their normal ECG status (trend p value <0.001). Similarly, the greater the number of visits with a normal ECG status, the lower was the incidence rate of CV disease events (trend p value <0.001). Maintaining (vs not maintaining) a normal ECG status was associated with a lower risk of CV disease, which was lower than that observed in those with inconsistent normal ECG pattern (trend p value <0.01). In conclusion, maintaining a normal ECG status over time is associated with low risk of CV disease in a dose-response fashion, suggesting its potential use as a monitoring tool for programs promoting CV health. Copyright © 2016 Elsevier Inc. All rights reserved.

40 CFR 264.99 - Compliance monitoring program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... be based on a compliance monitoring program developed to meet the requirements of this section. (i... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Compliance monitoring program. 264.99... Releases From Solid Waste Management Units § 264.99 Compliance monitoring program. An owner or operator...

Using prescription monitoring program data to characterize out-of-pocket payments for opioid prescriptions in a state Medicaid program.

PubMed

Hartung, Daniel M; Ahmed, Sharia M; Middleton, Luke; Van Otterloo, Joshua; Zhang, Kun; Keast, Shellie; Kim, Hyunjee; Johnston, Kirbee; Deyo, Richard A

2017-09-01

Out-of-pocket payment for prescription opioids is believed to be an indicator of abuse or diversion, but few studies describe its epidemiology. Prescription drug monitoring programs (PDMPs) collect controlled substance prescription fill data regardless of payment source and thus can be used to study this phenomenon. To estimate the frequency and characteristics of prescription fills for opioids that are likely paid out-of-pocket by individuals in the Oregon Medicaid program. Cross-sectional analysis using Oregon Medicaid administrative claims and PDMP data (2012 to 2013). Continuously enrolled nondually eligible Medicaid beneficiaries who could be linked to the PDMP with two opioid fills covered by Oregon Medicaid. Patient characteristics and fill characteristics for opioid fills that lacked a Medicaid pharmacy claim. Fill characteristics included opioid name, type, and association with indicators of high-risk opioid use. A total of 33 592 Medicaid beneficiaries filled a total of 555 103 opioid prescriptions. Of these opioid fills, 74 953 (13.5%) could not be matched to a Medicaid claim. Hydromorphone (30%), fentanyl (18%), and methadone (15%) were the most likely to lack a matching claim. The 3 largest predictors for missing claims were opioid fills that overlapped with other opioids (adjusted odds ratio [aOR] 1.37; 95% confidence interval [CI], 1.34-1.4), long-acting opioids (aOR 1.52; 95% CI, 1.47-1.57), and fills at multiple pharmacies (aOR 1.45; 95% CI, 1.39-1.52). Prescription opioid fills that were likely paid out-of-pocket were common and associated with several known indicators of high-risk opioid use. Copyright © 2017 John Wiley & Sons, Ltd.

Environmental surveillance at Los Alamos during 2008

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

Fuehne, David; Gallagher, Pat; Hjeresen, Denny

2009-09-30

Environmental Surveillance at Los Alamos reports are prepared annually by the Los Alamos National Laboratory (the Laboratory) Environmental Programs Directorate, as required by US Department of Energy Order 450.1, General Environmental Protection Program, and US Department of Energy Order 231.1A, Environment, Safety, and Health Reporting. These annual reports summarize environmental data that are used to determine compliance with applicable federal, state, and local environmental laws and regulations, executive orders, and departmental policies. Additional data, beyond the minimum required, are also gathered and reported as part of the Laboratory’s efforts to ensure public safety and to monitor environmental quality at andmore » near the Laboratory. Chapter 1 provides an overview of the Laboratory’s major environmental programs and explains the risks and the actions taken to reduce risks at the Laboratory from environmental legacies and waste management operations. Chapter 2 reports the Laboratory’s compliance status for 2007. Chapter 3 provides a summary of the maximum radiological dose the public and biota populations could have potentially received from Laboratory operations and discusses chemical exposures. The environmental surveillance and monitoring data are organized by environmental media (Chapter 4, air; Chapters 5 and 6, water and sediments; Chapter 7, soils; and Chapter 8, foodstuffs and biota) in a format to meet the needs of a general and scientific audience. Chapter 9 provides a summary of the status of environmental restoration work around LANL. A glossary and a list of acronyms and abbreviations are in the back of the report. Appendix A explains the standards for environmental contaminants, Appendix B explains the units of measurements used in this report, Appendix C describes the Laboratory’s technical areas and their associated programs, and Appendix D provides web links to more information.« less

Protecting the Health of Astronauts: Enhancing Occupational Health Monitoring and Surveillance for Former NASA Astronauts to Understand Long-Term Outcomes of Spaceflight-Related Exposures

NASA Technical Reports Server (NTRS)

Rossi, Meredith; Lee, Lesley; Wear, Mary; Van Baalen, Mary; Rhodes, Bradley

2017-01-01

The astronaut community is unique, and may be disproportionately exposed to occupational hazards not commonly seen in other communities. The extent to which the demands of the astronaut occupation and exposure to spaceflight-related hazards affect the health of the astronaut population over the life course is not completely known. A better understanding of the individual, population, and mission impacts of astronaut occupational exposures is critical to providing clinical care, targeting occupational surveillance efforts, and planning for future space exploration. The ability to characterize the risk of latent health conditions is a significant component of this understanding. Provision of health screening services to active and former astronauts ensures individual, mission, and community health and safety. Currently, the NASA-Johnson Space Center (JSC) Flight Medicine Clinic (FMC) provides extensive medical monitoring to active astronauts throughout their careers. Upon retirement, astronauts may voluntarily return to the JSC FMC for an annual preventive exam. However, current retiree monitoring includes only selected screening tests, representing an opportunity for augmentation. The potential long-term health effects of spaceflight demand an expanded framework of testing for former astronauts. The need is two-fold: screening tests widely recommended for other aging populations are necessary to rule out conditions resulting from the natural aging process (e.g., colonoscopy, mammography); and expanded monitoring will increase NASA's ability to better characterize conditions resulting from astronaut occupational exposures. To meet this need, NASA has begun an extensive exploration of the overall approach, cost, and policy implications of e an Astronaut Occupational Health program to include expanded medical monitoring of former NASA astronauts. Increasing the breadth of monitoring services will ultimately enrich the existing evidence base of occupational health risks to astronauts. Such an expansion would therefore improve the understanding of the health of the astronaut population as a whole, and the ability to identify, mitigate, and manage such risks in preparation for deep space exploration missions.

A Risk-Based Multi-Objective Optimization Concept for Early-Warning Monitoring Networks

NASA Astrophysics Data System (ADS)

Bode, F.; Loschko, M.; Nowak, W.

2014-12-01

Groundwater is a resource for drinking water and hence needs to be protected from contaminations. However, many well catchments include an inventory of known and unknown risk sources which cannot be eliminated, especially in urban regions. As matter of risk control, all these risk sources should be monitored. A one-to-one monitoring situation for each risk source would lead to a cost explosion and is even impossible for unknown risk sources. However, smart optimization concepts could help to find promising low-cost monitoring network designs.In this work we develop a concept to plan monitoring networks using multi-objective optimization. Our considered objectives are to maximize the probability of detecting all contaminations and the early warning time and to minimize the installation and operating costs of the monitoring network. A qualitative risk ranking is used to prioritize the known risk sources for monitoring. The unknown risk sources can neither be located nor ranked. Instead, we represent them by a virtual line of risk sources surrounding the production well.We classify risk sources into four different categories: severe, medium and tolerable for known risk sources and an extra category for the unknown ones. With that, early warning time and detection probability become individual objectives for each risk class. Thus, decision makers can identify monitoring networks which are valid for controlling the top risk sources, and evaluate the capabilities (or search for least-cost upgrade) to also cover moderate, tolerable and unknown risk sources. Monitoring networks which are valid for the remaining risk also cover all other risk sources but the early-warning time suffers.The data provided for the optimization algorithm are calculated in a preprocessing step by a flow and transport model. Uncertainties due to hydro(geo)logical phenomena are taken into account by Monte-Carlo simulations. To avoid numerical dispersion during the transport simulations we use the particle-tracking random walk method.

QT Interval Screening in Methadone Maintenance Treatment: Report of a SAMHSA Expert Panel

PubMed Central

Martin, Judith A.; Campbell, Anthony; Killip, Thomas; Kotz, Margaret; Krantz, Mori J.; Kreek, Mary Jeanne; McCarroll, Brian A.; Mehta, Davendra; Payte, J. Thomas; Stimmel, Barry; Taylor, Trusandra; Wilford, Bonnie B.

2014-01-01

In an effort to enhance patient safety in Opioid Treatment Programs (OTPs), the Substance Abuse and Mental Health Services Administration (SAMHSA) convened a multi-disciplinary Expert Panel on the Cardiac Effects of Methadone. Panel members reviewed the literature, regulatory actions, professional guidances, and OTPs’ experiences regarding adverse cardiac events associated with methadone. The Panel concluded that, to the extent possible, every OTP should have a universal Cardiac Risk Management Plan (incorporating clinical assessment, ECG assessment, risk stratification, and prevention of drug interactions) for all patients, and should strongly consider patient-specific risk minimization strategies (such as careful patient monitoring, obtaining ECGs as indicated by a particular patient’s risk profile, and adjusting the methadone dose as needed) for patients with identified risk factors for adverse cardiac events. The Panel also suggested specific modifications to informed consent documents, patient education, staff education, and methadone protocols. PMID:22026519

Conducting HIV Seroprevalence and Behavioral Epidemiology Risk Surveys (SABERS) Among Partner Military Populations.

PubMed

Macera, Caroline A; Ito, Stanley I; Hale, Braden R; Shaffer, Richard A; Thomas, Anne G; Dickieson, Janet

2017-01-01

Characterizing HIV infection and associated risk behaviors within military populations is critical for understanding the epidemic and informing prevention activities. However, the prevalence of HIV and related risk behaviors is often unknown. Further, militaries may not have the systems in place or the staff expertise to conduct HIV surveillance and risk behavior studies. The Department of Defense HIV/AIDS Prevention Program (DHAPP), funded by the President's Emergency Plan for AIDS Relief and the US Department of Defense, provides technical assistance, management and administrative support for HIV/AIDS prevention, care and treatment for approximately 65 partner militaries. Collaborating with partner militaries in conducting Seroprevalence and Behavioral Epidemiology Risk Surveys (SABERS) and using the data to monitor the epidemic and inform activities is a key component of DHAPP. This paper describes the methodology used to plan, adapt, implement and report SABERS studies. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Assessing the risk of foliar injury from ozone on vegetation in parks in the U.S. National Park Service's Vital Signs Network.

PubMed

Kohut, Robert

2007-10-01

The risk of ozone injury to plants was assessed in support of the National Park Service's Vital Signs Monitoring Network program. The assessment examined bioindicator species, evaluated levels of ozone exposure, and investigated soil moisture conditions during periods of exposure for a 5-year period in each park. The assessment assigned each park a risk rating of high, moderate, or low. For the 244 parks for which assessments were conducted, the risk of foliar injury was high in 65 parks, moderate in 46 parks, and low in 131 parks. Among the well-known parks with a high risk of ozone injury are Gettysburg, Valley Forge, Delaware Water Gap, Cape Cod, Fire Island, Antietam, Harpers Ferry, Manassas, Wolf Trap Farm Park, Mammoth Cave, Shiloh, Sleeping Bear Dunes, Great Smoky Mountains, Joshua Tree, Sequoia and Kings Canyon, and Yosemite.

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

LaFreniere, L. M.; Environmental Science Division

In September 2005, the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) initiated periodic sampling of groundwater in the vicinity of a grain storage facility formerly operated by the CCC/USDA at Morrill, Kansas. On the basis of available information, the CCC/USDA believes that one or more third parties operated this facility after termination of the CCC/USDA's lease in 1971. The sampling at Morrill is being performed on behalf of the CCC/USDA by Argonne National Laboratory, in accord with a monitoring program approved by the Kansas Department of Health and Environment (KDHE), to monitor levels of carbon tetrachloride contaminationmore » identified in the groundwater at this site (Argonne 2004, 2005a). Under the KDHE-approved monitoring plan (Argonne 2005b), the groundwater has been sampled twice yearly for a recommended period of two years. The samples are analyzed for volatile organic compounds (VOCs), as well as for selected geochemical parameters to aid in the evaluation of possible natural contaminant degradation (reductive dechlorination) processes in the subsurface environment. The sampling is presently conducted in a network of 12 monitoring wells and 3 private wells (Figure 1.1), at locations approved by the KDHE. The scope of the originally approved monitoring has been expanded to include vegetation sampling (initiated in October 2006) and surface water and stream bed sediment sampling (initiated in March 2007). The analytical results for groundwater sampling events at Morrill in September 2005, March 2006, September 2006, and March 2007 were documented previously (Argonne 2006a, 2007c,e). The results have demonstrated the presence of carbon tetrachloride contamination, at levels exceeding the KDHE Tier 2 Risk-Based Screening Level (5.0 {micro}g/L) for this compound, in a groundwater plume extending generally south-southeastward from the former CCC/USDA facility, toward Terrapin Creek at the south edge of the town. Little clear pattern of change in the concentrations observed at the individual monitoring points and little plume migration have been observed in previous monitoring events. Low levels ({le} 1.3 {micro}g/L) of carbon tetrachloride have persistently been detected at monitoring well MW8S, however, along an intermittent tributary to Terrapin Creek. This observation suggests a possible risk of contamination of the surface waters of the creek. In light of these findings, in 2006 the CCC/USDA recommended expansion of the approved monitoring program to include the collection and analysis of surface water samples along Terrapin Creek (Argonne 2007e). At the request of the KDHE (KDHE 2007a), locations for both surface water and shallow sediment sampling were discussed with the KDHE in January 2007. An addendum to the existing monitoring plan and a standard operating procedure (SOP AGEM-15) for sediment sampling were submitted to the KDHE on the basis of these discussions (Argonne 2007a,b). This report presents the results of groundwater, surface water, and sediment sampling performed at Morrill in October 2007, in accord with the monitoring plan (Argonne 2005b) and the addendum to that plan (Argonne 2007a). To supplement these studies, Argonne also sampled natural vegetation along Terrapin Creek in October 2006, April 2007, and July 2007 for analyses for VOCs. The results of the plant tissue analyses are included in this report. The October 2007 groundwater sampling at Morrill represents the fifth and final monitoring event performed under the recommended two-year monitoring program approved by the KDHE.« less

Understanding Program Monitoring: The Relationships among Outcomes, Indicators, Measures, and Targets. REL 2014-011

ERIC Educational Resources Information Center

Malone, Nolan; Mark, Lauren; Narayan, Krishna

2014-01-01

This guide offers educators, program managers, administrators, and researchers a resource for building capacity for monitoring program outcomes. It provides concise definitions of program monitoring components and a framework for assessing program progress. Examples demonstrate the relationships among program components: outcomes, indicators,…

Designing a risk-based surveillance program for Mycobacterium avium ssp. paratuberculosis in Norwegian dairy herds using multivariate statistical process control analysis.

PubMed

Whist, A C; Liland, K H; Jonsson, M E; Sæbø, S; Sviland, S; Østerås, O; Norström, M; Hopp, P

2014-11-01

Surveillance programs for animal diseases are critical to early disease detection and risk estimation and to documenting a population's disease status at a given time. The aim of this study was to describe a risk-based surveillance program for detecting Mycobacterium avium ssp. paratuberculosis (MAP) infection in Norwegian dairy cattle. The included risk factors for detecting MAP were purchase of cattle, combined cattle and goat farming, and location of the cattle farm in counties containing goats with MAP. The risk indicators included production data [culling of animals >3 yr of age, carcass conformation of animals >3 yr of age, milk production decrease in older lactating cows (lactations 3, 4, and 5)], and clinical data (diarrhea, enteritis, or both, in animals >3 yr of age). Except for combined cattle and goat farming and cattle farm location, all data were collected at the cow level and summarized at the herd level. Predefined risk factors and risk indicators were extracted from different national databases and combined in a multivariate statistical process control to obtain a risk assessment for each herd. The ordinary Hotelling's T(2) statistic was applied as a multivariate, standardized measure of difference between the current observed state and the average state of the risk factors for a given herd. To make the analysis more robust and adapt it to the slowly developing nature of MAP, monthly risk calculations were based on data accumulated during a 24-mo period. Monitoring of these variables was performed to identify outliers that may indicate deviance in one or more of the underlying processes. The highest-ranked herds were scattered all over Norway and clustered in high-density dairy cattle farm areas. The resulting rankings of herds are being used in the national surveillance program for MAP in 2014 to increase the sensitivity of the ongoing surveillance program in which 5 fecal samples for bacteriological examination are collected from 25 dairy herds. The use of multivariate statistical process control for selection of herds will be beneficial when a diagnostic test suitable for mass screening is available and validated on the Norwegian cattle population, thus making it possible to increase the number of sampled herds. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Student assistance program outcomes for students at risk for suicide.

PubMed

Biddle, Virginia Sue; Kern, John; Brent, David A; Thurkettle, Mary Ann; Puskar, Kathryn R; Sekula, L Kathleen

2014-06-01

Pennsylvania's response to adolescent suicide is its Student Assistance Program (SAP). SAP has been funded for 27 years although no statewide outcome studies using case-level data have been conducted. This study used logistic regression to examine drug-/alcohol-related behaviors and suspensions of suicidal students who participated in SAP. Of the 46 services, 10 best predicted (p<.01) that these undesirable outcomes would cease. Although no study subjects died by suicide, 42 of 374,626 referred students did die by suicide. Suicidal students who did not participate had double the rate of suicide of suicidal participants of SAP. Students referred for other reasons also killed themselves. Further work must be done to assess all referred students for suicide risk, examine educational outcomes, monitor substance-related crimes and overdoses, and examine school-related factors postmortem. Evidence from this study can be used by researchers to plan future studies and by Pennsylvania's school nurses when planning services.

Establishing a national biological laboratory safety and security monitoring program.

PubMed

Blaine, James W

2012-12-01

The growing concern over the potential use of biological agents as weapons and the continuing work of the Biological Weapons Convention has promoted an interest in establishing national biological laboratory biosafety and biosecurity monitoring programs. The challenges and issues that should be considered by governments, or organizations, embarking on the creation of a biological laboratory biosafety and biosecurity monitoring program are discussed in this article. The discussion focuses on the following questions: Is there critical infrastructure support available? What should be the program focus? Who should be monitored? Who should do the monitoring? How extensive should the monitoring be? What standards and requirements should be used? What are the consequences if a laboratory does not meet the requirements or is not willing to comply? Would the program achieve the results intended? What are the program costs? The success of a monitoring program can depend on how the government, or organization, responds to these questions.

Development of an interprofessional program for cardiovascular prevention in primary care: A participatory research approach

PubMed Central

Goudreau, Johanne; Hudon, Éveline; Lussier, Marie-Thérèse; Bareil, Céline; Duhamel, Fabie; Lévesque, Lise; Turcotte, Alain; Lalonde, Gilles

2014-01-01

Background: The chronic care model provides a framework for improving the management of chronic diseases. Participatory research could be useful in developing a chronic care model–based program of interventions, but no one has as yet offered a description of precisely how to apply the approach. Objectives: An innovative, structured, multi-step participatory process was applied to select and develop (1) chronic care model–based interventions program to improve cardiovascular disease prevention that can be adapted to a particular regional context and (2) a set of indicators to monitor its implementation. Methods: Primary care clinicians (n = 16), administrative staff (n = 2), patients and family members (n = 4), decision makers (n = 5), researchers, and a research coordinator (n = 7) took part in the process. Additional primary care actors (n = 26) validated the program. Results: The program targets multimorbid patients at high or moderate risk of cardiovascular disease with uncontrolled hypertension, dyslipidemia or diabetes. It comprises interprofessional follow-up coordinated by case-management nurses, in which motivated patients are referred in a timely fashion to appropriate clinical and community resources. The program is supported by clinical tools and includes training in motivational interviewing. A set of 89 process and clinical indicators were defined. Conclusion: Through a participatory process, a contextualized interventions program to optimize cardiovascular disease prevention and a set of quality indicators to monitor its implementation were developed. Similar approach might be used to develop other health programs in primary care if program developers are open to building on community strengths and priorities. PMID:26770705

Foreword: Contributions of Arctic PRISM to monitoring western hemispheric shorebirds

USGS Publications Warehouse

Skagen, Susan K.; Smith, Paul A.; Andres, Brad A.; Donaldson, Garry; Brown, Stephen; Bart, Jonathan R.; Johnston, Victoria H.

2012-01-01

Long-term monitoring of populations is of paramount importance to understanding responses of organisms to global environmental change and to evaluating whether conservation practices are yielding intended results through time (Wiens 2009). The population status of many shorebird species, the focus of this volume, remain poorly known. Long-distance migrant shorebirds have proven particularly difficult to monitor, in part because of their highly inaccessible regions. As migrant shorebirds travel the length of the hemisphere, the congregate and disperse in ways that vary among species, locations, and years, presenting serious challenges to designing and implementing monitoring programs. Rigorous field and quantitative methods that estimate population size and monitor trends are vitally needed to direct and evaluate effective conservation measures. Many management efforts depend on unbiased population size estimates; for examples, the shorebird conservation plans for both Canada and the United States seek to restore populations to levels calculated for the 1970s based on the best information available from existing surveys. Further, federal wildlife agencies within the United States and Canada have mandates to understand the state of their nations' resources under various conventions for the protection of migratory birds. Accurate estimates of population size are vital statistics for a variety of conservation activities, such as prioritizing species for conservation action and setting management targets. Areas of essential habitat, such as those designated under the Western Hemisphere Shorebird Reserve Network, the Important Bird Areas program of BirdLife Internationals and the National Audubon Society, or Canada's National Wildlife Areas program, are all evaluated on the basis of proportions of species' populations which they contain. The size, and trends in size, of a species' population are considered key information for assessing its vulnerability and subsequent listing under the U.S. Endangered Species Act and the Canadian Species at Risk Act. To meet the need for information on population size and trends, shorebird biologists from Canada and the United States proposed a shared blueprint for shorebird monitoring across the Western Hemisphere in the late 1990s; this effort was undertaken in concert with the development of the Canadian and the U.S. Shorebird Conservation Plans. Soon thereafter, partners in the monitoring effort adopted the name "Program for Regional and International Shorebird Monitoring" (PRISM). Among the primary objectives of PRISM were to estimate the population sizes and trends of breeding North American shorebirds and describe their distributions. PRISM members evaluated ongoing and potential monitoring approached to address 74 taxa (including subspecies) and proposed a combination of arctic and boreal breeding surveys, temperate breeding and non-breeding surveys, and neotropical surveys.

Use of Modal Acoustic Emission to Monitor Damage Progression in Carbon Fiber/Epoxy Tows and Implications for Composite Structures

NASA Technical Reports Server (NTRS)

Waller, Jess M.; Saulsberry, Regor L.; Nichols, Charles T.; Wentzel, Daniel J.

2010-01-01

This slide presentation reviews the use of Modal Acoustic Emission to monitor damage progression to carbon fiber/epoxy tows. There is a risk for catastrophic failure of composite overwrapped pressure vessels (COPVs) due to burst-before-leak (BBL) stress rupture (SR) failure of carbon-epoxy (C/Ep) COPVs. A lack of quantitative nondestructive evaluation (NDE) is causing problems in current and future spacecraft designs. It is therefore important to develop and demonstrate critical NDE that can be implemented during stages of the design process since the observed rupture can occur with little of no advanced warning. Therefore a program was required to develop quantitative acoustic emission (AE) procedures specific to C/Ep overwraps, but which also have utility for monitoring damage accumulation in composite structure in general, and to lay the groundwork for establishing critical thresholds for accumulated damage in composite structures, such as COPVs, so that precautionary or preemptive engineering steps can be implemented to minimize of obviate the risk of catastrophic failure. A computed Felicity Ratio (FR) coupled with fast Fourier Transform (FFT) frequency analysis shows promise as an analytical pass/fail criterion. The FR analysis and waveform and FFT analysis are reviewed

Advanced Monitoring to Improve Combustion Turbine/Combined Cycle Reliability, Availability & Maintainability

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

Leonard Angello

2005-09-30

Power generators are concerned with the maintenance costs associated with the advanced turbines that they are purchasing. Since these machines do not have fully established Operation and Maintenance (O&M) track records, power generators face financial risk due to uncertain future maintenance costs. This risk is of particular concern, as the electricity industry transitions to a competitive business environment in which unexpected O&M costs cannot be passed through to consumers. These concerns have accelerated the need for intelligent software-based diagnostic systems that can monitor the health of a combustion turbine in real time and provide valuable information on the machine's performancemore » to its owner/operators. EPRI, Impact Technologies, Boyce Engineering, and Progress Energy have teamed to develop a suite of intelligent software tools integrated with a diagnostic monitoring platform that, in real time, interpret data to assess the 'total health' of combustion turbines. The 'Combustion Turbine Health Management System' (CTHMS) will consist of a series of 'Dynamic Link Library' (DLL) programs residing on a diagnostic monitoring platform that accepts turbine health data from existing monitoring instrumentation. CTHMS interprets sensor and instrument outputs, correlates them to a machine's condition, provide interpretative analyses, project servicing intervals, and estimate remaining component life. In addition, the CTHMS enables real-time anomaly detection and diagnostics of performance and mechanical faults, enabling power producers to more accurately predict critical component remaining useful life and turbine degradation.« less

Acceptability Study of "Ascenso": An Online Program for Monitoring and Supporting Patients with Depression in Chile.

PubMed

Espinosa, H Daniel; Carrasco, Álvaro; Moessner, Markus; Cáceres, Cristian; Gloger, Sergio; Rojas, Graciela; Perez, J Carola; Vanegas, Jorge; Bauer, Stephanie; Krause, Mariane

2016-07-01

Major depression is a highly prevalent and severe mental disease. Despite the effective treatment options available, the risk of relapse is high. Interventions based on information and communication technologies generate innovative opportunities to provide support to patients after they completed treatment for depression. This acceptability study evaluated the Internet-based program Apoyo, Seguimiento y Cuidado de Enfermedades a partir de Sistemas Operativos (ASCENSO) in terms of its feasibility and acceptability in a sample of 35 patients in Chile. The study reveals high rates of acceptance and satisfaction among patients who actively used the program. As obstacles, patients mentioned technical problems, a lack of contact with other participants, and an insufficient connection between the program and the health service professionals. ASCENSO appears to be a promising complement to regular care for depression. Following improvements of the program based on participants' feedback, future research should evaluate its efficacy and cost-effectiveness.

Needs and Problems of Posbindu Program: Community Health Volunteers Perspective

NASA Astrophysics Data System (ADS)

Putri, S. T.; Andriyani, S.

2018-01-01

Posbindu is a form of public participation to conduct early detection and monitoring of risk factors for non-communicable diseases(NCD), and where it was carried out in as an integrated manner, routine and periodic event. This paper aims to investigates the needs and problems on Posbindu Program based on community health volunteers(CHVs) perspective. This study used descriptive qualitative method by open ended questions. Content analysis using to explicating the result. There are 3 theme finding about elderly needs in Posbindu; medical care, support group community, and health education. We found four theme problems which in Posbindu program: low motivation from elderly, Inadequate of facilities, physical disability, failed communication. To be effective in Posbindu program, all the stakeholders have reached consensus on the Posbindu program as elderly need. CHVs need given wide knowledge about early detection, daily care, control disease continuously so that the elderly keep feeling the advantages of coming to the Posbindu.

Not All Are Lost: Interrupted Laboratory Monitoring, Early Death, and Loss to Follow-Up (LTFU) in a Large South African Treatment Program

PubMed Central

Ahonkhai, Aima A.; Noubary, Farzad; Munro, Alison; Stark, Ruth; Wilke, Marisa; Freedberg, Kenneth A.; Wood, Robin; Losina, Elena

2012-01-01

Background Many HIV treatment programs in resource-limited settings are plagued by high rates of loss to follow-up (LTFU). Most studies have not distinguished between those who briefly interrupt, but return to care, and those more chronically lost to follow-up. Methods We conducted a retrospective cohort study of 11,397 adults initiating antiretroviral therapy (ART) in 71 Southern African Catholic Bishops Conference/Catholic Relief Services HIV treatment clinics between January 2004 and December 2008. We distinguished among patients with early death, within the first 7 months on ART; patients with interruptions in laboratory monitoring (ILM), defined as missing visits in the first 7 months on ART, but returning to care by 12 months; and those LTFU, defined as missing all follow-up visits in the first 12 months on ART. We used multilevel logistic regression models to determine patient and clinic-level characteristics associated with these outcomes. Results In the first year on ART, 60% of patients remained in care, 30% missed laboratory visits, and 10% suffered early death. Of the 3,194 patients who missed laboratory visits, 40% had ILM, resuming care by 12 months. After 12 months on ART, patients with ILM had a 30% increase in detectable viremia compared to those who remained in care. Risk of LTFU decreased with increasing enrollment year, and was lowest for patients who enrolled in 2008 compared to 2004 [OR 0.49, 95%CI 0.39–0.62]. Conclusions In a large community-based cohort in South Africa, nearly 30% of patients miss follow-up visits for CD4 monitoring in the first year after starting ART. Of those, 40% have ILM but return to clinic with worse virologic outcomes than those who remain in care. The risk of chronic LTFU decreased with enrollment year. As ART availability increases, interruptions in care may become more common, and should be accounted for in addressing program LTFU. PMID:22427925

Strategies for monitoring the emerging polar organic contaminants in water with emphasis on integrative passive sampling.

PubMed

Söderström, Hanna; Lindberg, Richard H; Fick, Jerker

2009-01-16

Although polar organic contaminants (POCs) such as pharmaceuticals are considered as some of today's most emerging contaminants few of them are regulated or included in on-going monitoring programs. However, the growing concern among the public and researchers together with the new legislature within the European Union, the registration, evaluation and authorisation of chemicals (REACH) system will increase the future need of simple, low cost strategies for monitoring and risk assessment of POCs in aquatic environments. In this article, we overview the advantages and shortcomings of traditional and novel sampling techniques available for monitoring the emerging POCs in water. The benefits and drawbacks of using active and biological sampling were discussed and the principles of organic passive samplers (PS) presented. A detailed overview of type of polar organic PS available, and their classes of target compounds and field of applications were given, and the considerations involved in using them such as environmental effects and quality control were discussed. The usefulness of biological sampling of POCs in water was found to be limited. Polar organic PS was considered to be the only available, but nevertheless, an efficient alternative to active water sampling due to its simplicity, low cost, no need of power supply or maintenance, and the ability of collecting time-integrative samples with one sample collection. However, the polar organic PS need to be further developed before they can be used as standard in water quality monitoring programs.

Safeguarding the Health of the NASA Astronaut Community: the Need for Expanded Medical Monitoring for Former NASA Astronauts Under the Astronaut Occupational Health Program

NASA Technical Reports Server (NTRS)

Rossi, Meredith; Lee, Lesley; Wear, Mary; Van Baalen, Mary; Rhodes, Bradley

2016-01-01

The astronaut community is unique, and may be disproportionately exposed to occupational hazards not commonly seen in other communities. The extent to which the demands of the astronaut occupation and exposure to spaceflight-related hazards affect the health of the astronaut population over the life course is not completely known. Provision of health screening services to active and former astronauts ensures individual, mission, and community health and safety. Currently, the NASA Johnson Space Center (JSC) Flight Medicine Clinic (FMC) provides extensive medical monitoring to active astronauts throughout their careers. Upon retirement, astronauts may voluntarily return to the JSC FMC for an annual preventive exam. However, current retiree monitoring includes only selected screening tests, representing an opportunity for augmentation. The potential latent health effects of spaceflight demand an expanded framework of testing for former astronauts. The need is two-fold: screening tests widely recommended for other aging communities are necessary for astronauts to rule out conditions resulting from the natural aging process (e.g., colonoscopy, mammography), as opposed to conditions resulting directly from the astronaut occupation; and increased breadth of monitoring services will improve the understanding of occupational health risks and longitudinal health of the astronaut community, past, present, and future. To meet this need, NASA has begun an extensive exploration of the overall approach, cost, and policy implications of expanding existing medical monitoring under the Astronaut Occupational Health program for former NASA astronauts.

Resource Conservation and Recovery Act, Part B permit application [of the Waste Isolation Pilot Plant (WIPP)]. Volume 11, Chapter D, Appendix D4--Chapter D, Appendix D17: Revision 3

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

Not Available

1993-03-01

This volume contains appendices D4 through D17 which cover the following: Waste Isolation Pilot Plant site environmental report; ecological monitoring program at the Waste Isolation Pilot Plant; site characterization; regional and site geology and hydrology; general geology; dissolution features; ground water hydrology; typical carbon sorption bed efficiency; VOC monitoring plan for bin-room tests; chemical compatibility analysis of waste forms and container materials; probable maximum precipitation; WHIP supplementary roof support system room 1, panel 1; and corrosion risk assessment of the Waste Isolation Pilot Plant ``humid`` test bins.

Energy drink consumption and the perceived risk and disapproval of drugs: Monitoring the Future, 2010-2016.

PubMed

Jackson, Dylan B; Leal, Wanda E

2018-07-01

Energy drinks have become quite popular in recent years among adolescents, prompting a wealth of recent research examining the potential deleterious consequences of energy drink consumption among youth. The present study adds to this body of work by exploring perceptions of risk and disapproval of soft and hard drugs among adolescents and whether such attitudes are predicted by patterns of energy drink/shot consumption. Data were derived from the seven most recent cohorts (2010-2016) of the Monitoring the Future (MTF) study, a nationally representative survey of U.S. youth. The significance of associations between energy drink/shot consumption and drug perceptions/attitudes was tested using logistic regression techniques employing adjustments for covariates and cohort-specific fixed effects. Energy drink/shot consumption was largely associated with significant increases in the odds of failing to perceive any risk of drug use and failing to disapprove of drug use among youths, regardless of whether attitudes concerning soft or hard drugs were examined. These associations were particularly robust in the case of habitual energy drink/shot consumers (relative to occasional consumers or abstainers). Additional efforts should be made to heighten awareness and education concerning the potential dangers of energy drink consumption among youth, particularly as it pertains to drug attitudes and diminished perceptions of substance use risk. Policies that minimize energy drink consumption among youth as well as programs that educate parents and teachers about the drug attitudes of youths who regularly consume energy drinks and promote active monitoring of these adolescents may be worthwhile. Copyright © 2018 Elsevier B.V. All rights reserved.

Randomized trial of a phone- and web-based weight loss program for women at elevated breast cancer risk: the HELP study.

PubMed

Cadmus-Bertram, Lisa; Nelson, Sandahl H; Hartman, Sheri; Patterson, Ruth E; Parker, Barbara A; Pierce, John P

2016-08-01

Excess weight and physical inactivity are modifiable risk factors for breast cancer. Behavioral intervention is particularly important among women with an elevated risk profile. This trial tested an intervention that trained women to use a self-monitoring website to increase activity and lose weight. Women with BMI ≥27.5 kg/m(2) at elevated breast cancer risk were randomized to the intervention (N = 71) or usual care (N = 34). The intervention group received telephone-based coaching and used web-based self-monitoring tools. At 6 months, significant weight loss was observed in the intervention group (4.7 % loss from starting weight; SD = 4.7 %) relative to usual care (0.4 % gain; SD = 3.0 %) (p < 0.0001). By 12 months, the intervention group had lost 3.7 % of weight (SD = 5.4 %), compared to 1.3 % (SD = 4.2) for usual care (p = 0.003). At 12 months, accelerometer-measured moderate-to-vigorous physical activity increased by 12 min/day (SD = 24) compared to no change in usual care (p = 0.04. In summary, this web- and phone-based approach produced modest but significant improvements in weight and physical activity for women at elevated breast cancer risk.

Sexual risk among African American girls: psychopathology and mother-daughter relationships.

PubMed

Donenberg, Geri R; Emerson, Erin; Mackesy-Amiti, Mary Ellen

2011-04-01

To examine the associations among mental health problems, maternal monitoring and permissiveness, mother-daughter communication and attachment, and sexual behaviors among African American girls receiving outpatient psychiatric care. Youths with mental health problems report higher rates of HIV-risk behavior than do their peers, and African American girls have higher rates of sexually transmitted infections than do girls of all other racial groups. A sample of 12- to 16-year-old African American girls (N = 266, mean age = 14.46 years) and their female caregivers (73% biological mothers) completed computerized assessments of girls' mental health symptoms, maternal monitoring and permissiveness, and mother-daughter communication and attachment. Girls indicated their sexual risk behaviors (vaginal/anal sex, consistent condom use, number of partners). African American girls who reported clinically significant externalizing problems, more permissive parenting, less open mother-daughter sexual communication, and more frequent mother-daughter communication were more likely to report having had vaginal and/or anal sex. Sexually active girls with greater maternal attachment were less likely to report inconsistent condom use. Findings revealed important risk and protective factors for African American girls in psychiatric care. HIV-prevention programs may be strengthened by improving mother-daughter relationships and communication and by reducing girls' mental health problems. (c) 2011 APA, all rights reserved.

40 CFR 122.48 - Requirements for recording and reporting of monitoring results (applicable to State programs, see...

Code of Federal Regulations, 2013 CFR

2013-07-01

... representative of the monitored activity including, when appropriate, continuous monitoring; (c) Applicable... reporting of monitoring results (applicable to State programs, see § 123.25). 122.48 Section 122.48... recording and reporting of monitoring results (applicable to State programs, see § 123.25). All permits...

40 CFR 122.48 - Requirements for recording and reporting of monitoring results (applicable to State programs, see...

Code of Federal Regulations, 2014 CFR

2014-07-01

... representative of the monitored activity including, when appropriate, continuous monitoring; (c) Applicable... reporting of monitoring results (applicable to State programs, see § 123.25). 122.48 Section 122.48... recording and reporting of monitoring results (applicable to State programs, see § 123.25). All permits...

40 CFR 122.48 - Requirements for recording and reporting of monitoring results (applicable to State programs, see...

Code of Federal Regulations, 2012 CFR

2012-07-01

... representative of the monitored activity including, when appropriate, continuous monitoring; (c) Applicable... reporting of monitoring results (applicable to State programs, see § 123.25). 122.48 Section 122.48... recording and reporting of monitoring results (applicable to State programs, see § 123.25). All permits...

40 CFR 122.48 - Requirements for recording and reporting of monitoring results (applicable to State programs, see...

Code of Federal Regulations, 2010 CFR

2010-07-01

... representative of the monitored activity including, when appropriate, continuous monitoring; (c) Applicable... reporting of monitoring results (applicable to State programs, see § 123.25). 122.48 Section 122.48... recording and reporting of monitoring results (applicable to State programs, see § 123.25). All permits...

40 CFR 122.48 - Requirements for recording and reporting of monitoring results (applicable to State programs, see...

Code of Federal Regulations, 2011 CFR

2011-07-01

... representative of the monitored activity including, when appropriate, continuous monitoring; (c) Applicable... reporting of monitoring results (applicable to State programs, see § 123.25). 122.48 Section 122.48... recording and reporting of monitoring results (applicable to State programs, see § 123.25). All permits...

A comparison of the temporally integrated monitoring of ecosystems and Adirondack Long Term-Monitoring programs in the Adirondack Mountain region of New Yrok

EPA Science Inventory

This paper compares lake chemistry in the Adirondack region of New York measured by the Temporally Integrated Monitoring of Ecosystems (TIME) and Adirondack Long-Term Monitoring (ALTM) programs by examining the data from six lakes common to both programs. Both programs were initi...

Process Control Migration of 50 LPH Helium Liquefier

NASA Astrophysics Data System (ADS)

Panda, U.; Mandal, A.; Das, A.; Behera, M.; Pal, Sandip

2017-02-01

Two helium liquefier/refrigerators are operational at VECC while one is dedicated for the Superconducting Cyclotron. The first helium liquefier of 50 LPH capacity from Air Liquide has already completed fifteen years of operation without any major trouble. This liquefier is being controlled by Eurotherm PC3000 make PLC. This PLC has become obsolete since last seven years or so. Though we can still manage to run the PLC system with existing spares, risk of discontinuation of the operation is always there due to unavailability of spare. In order to eliminate the risk, an equivalent PLC control system based on Siemens S7-300 was thought of. For smooth migration, total programming was done keeping the same field input and output interface, nomenclature and graphset. New program is a mix of S7-300 Graph, STL and LAD languages. One to one program verification of the entire process graph was done manually. The total program was run in simulation mode. Matlab mathematical model was also used for plant control simulations. EPICS based SCADA was used for process monitoring. As of now the entire hardware and software is ready for direct replacement with minimum required set up time.

Do Parents Meet Adolescents' Monitoring Standards? Examination of the Impact on Teen Risk Disclosure and Behaviors if They Don't.

PubMed

Cottrell, Lesley; Rishel, Carrie; Lilly, Christa; Cottrell, Scott; Metzger, Aaron; Ahmadi, Halima; Wang, Bo; Li, Xiaoming; Stanton, Bonita

2015-01-01

In this study, we examined how adolescents compare monitoring efforts by their parents to those of a "good parent" standard and assessed the impact of these comparisons on adolescent self-disclosure and risk behavior and their perceptions of their parents' monitoring knowledge. Survey responses from 519 adolescents (12-17 years) at baseline of a larger, longitudinal study examining parental monitoring and adolescent risk were examined. Adolescents' "good parent comparisons" differed greatly by monitoring areas (e.g., telephone use, health, money); however, between 5.5% and 25.8% of adolescents believed their parents needed to monitor their activities more than they currently were monitoring. Alternatively, between 8.5% and 23.8% of adolescents believed their parents needed to monitor their activities less often. These perceptions significantly distinguished adolescents in terms of their level of disclosure, perceived monitoring knowledge, and risk involvement. Adolescents who viewed their parents as needing to monitor more were less likely to disclose information to their parents (p<.001), less likely to perceive their parents as having greater monitoring knowledge (p<.001), and more likely to be involved in a risk behaviors (p<.001) than adolescents who perceived their parents needed no change. Adolescent disclosure to a parent is a powerful predictor of adolescent risk and poor health outcomes. These findings demonstrate that adolescents' comparisons of their parents' monitoring efforts can predict differences in adolescent disclosure and future risk. Obtaining adolescent "good parent" comparisons may successfully identify intervention opportunities with the adolescent and parent by noting the areas of need and direction of monitoring improvement.

Integrated Immune

NASA Technical Reports Server (NTRS)

Crucian, Brian; Mehta, Satish; Stowe, Raymond; Uchakin, Peter; Quiriarte, Heather; Pierson, Duane; Sams, Clarnece

2010-01-01

This slide presentation reviews the program to replace several recent studies about astronaut immune systems with one comprehensive study that will include in-flight sampling. The study will address lack of in-flight data to determine the inflight status of immune systems, physiological stress, viral immunity, to determine the clinical risk related to immune dysregulation for exploration class spaceflight, and to determine the appropriate monitoring strategy for spaceflight-associated immune dysfunction, that could be used for the evaluation of countermeasures.

12 CFR 1291.7 - Monitoring.

Code of Federal Regulations, 2011 CFR

2011-01-01

...' discretion. (iii) Risk factors and other monitoring—(A) Risk factors; other monitoring. A Bank's written monitoring policies shall take into account risk factors such as the amount of AHP subsidy in the project... reasonable risk-based sampling plan to review the back-up project documentation. (2) Reliance on long-term...

12 CFR 1291.7 - Monitoring.

Code of Federal Regulations, 2010 CFR

2010-01-01

...' discretion. (iii) Risk factors and other monitoring—(A) Risk factors; other monitoring. A Bank's written monitoring policies shall take into account risk factors such as the amount of AHP subsidy in the project... reasonable risk-based sampling plan to review the back-up project documentation. (2) Reliance on long-term...

Environmental and human risk hierarchy of pesticides: A prioritization method, based on monitoring, hazard assessment and environmental fate.

PubMed

Tsaboula, Aggeliki; Papadakis, Emmanouil-Nikolaos; Vryzas, Zisis; Kotopoulou, Athina; Kintzikoglou, Katerina; Papadopoulou-Mourkidou, Euphemia

2016-05-01

A pesticide prioritization approach was developed and implemented in the Pinios River Basin of Central Greece. It takes under consideration the Level of Environmental Risk containing information on the frequency of occurrence of pesticides above environmental thresholds, the intensity of this occurrence and the spatial distribution as well as information about the fate and behavior of pesticides in the environment and the potential to have adverse impact on humans' health. Original 3-year monitoring data from 102 Stationary Sampling Sites located on rivers and their tributaries, reservoirs, streams and irrigation/drainage canals giving rise to a collection of 2382 water samples resulting in 7088 data sets, were included in this integrated prioritization study. Among 302 monitored active ingredients, 119 were detected at least once and the concentrations found in the aquatic systems for 41% of compounds were higher than the respective lowest Predicted Non-Effect Concentration (PNEC) values. Sixteen and 5 pesticides were found with risk ratios (MECmax/PNEC) above 10 (high concern) and 100 (very high concern), respectively. However, pesticides with maximum Measured Environmental Concentration (MECmax) values exceeding by 1000 times the respective lowest PNEC values were also found which were considered of extremely high concern; in the latter group were included prometryn, chlorpyrifos, diazinon, λ-cyhalothrin, cypermethrin, α-cypermethrin deltamethrin, ethalfluralin and phosmet. The sensitivity of the analytical methods used in the monitoring study was considered inadequate to meet the toxicological endpoints for 32 pesticides. The widest distribution of occurrence in the Stationary Sampling Sites of the monitoring program was found for the pesticides, prometryn, fluometuron, terbuthylazine, S-metolachlor, chlorpyrifos, diphenylamine, acetochlor, alachlor, 2,4-D, etridiazole, imidacloprid and lindane (γ-ΗCH). Among the 27 priority pesticides included in the Directive 2013/39/EU, in the present study 13 pesticides were considered as candidates for River Basin Specific Pollutants (RBSP) for the River Basin of Pinios. Among the 30 pesticide specific pollutants that were established by the Greek authorities, in the present study only 6 were considered as candidates for RBSP for the river basin of Pinios. As a result of the implementation of the prioritization approach developed in this study a total of 71 pesticides were identified as being RBSP for the river basin of Pinios. The higher Level of Environmental Risk was found to be exerted by the organophosphorus insecticide chlorpyrifos, followed by lindane and prometryn. The present study provides background information for important decisions to be made concerning the selection of pesticides which should be included in the target analyte list of new monitoring and screening programs of surface water quality in the Pinios River Basin. In addition, the prioritization approach proposed here can be useful for the development of River Basin Management Plans. Copyright © 2016 Elsevier Ltd. All rights reserved.

Risk evaluation and mitigation strategies: a focus on belatacept.

PubMed

Sam, Teena; Gabardi, Steven; Tichy, Eric M

2013-03-01

To review the elements and components of the risk evaluation and mitigation strategies (REMS) for the costimulation blocker belatacept and associated implications for health care providers working with transplant recipients. The MEDLINE and EMBASE databases (January 1990 to March 2012) were searched by using risk evaluation and mitigation strategies, REMS, belatacept, and organ transplant as search terms (individual organs were also searched). Retrieved articles were supplemented with analysis of information obtained from the Federal Register, the Food and Drug Administration, and the manufacturer of belatacept. REMS are risk-management strategies implemented to ensure that a product's benefits outweigh its known safety risks. Although belatacept offers a novel strategy in maintenance immunosuppression and was associated with superior renal function compared with cyclosporine in phase 2 and 3 trials, belatacept is also associated with increased risk of posttransplant lymphoproliferative disorder and central nervous system infections. The Food and Drug Administration required development of a REMS program as part of belatacept's approval process to ensure safe and appropriate use of the medication and optimization of its risk-benefit profile. Elements of the belatacept REMS include a medication guide that must be dispensed with each infusion and a communication plan. In the management of a complex population of patients, it is essential that those who care for transplant recipients, and patients, recognize the implications of potential and known risks of belatacept. The REMS program aims to facilitate careful selection and education of patients and vigilant monitoring.

Cost considerations for long-term ecological monitoring

USGS Publications Warehouse

Caughlan, L.; Oakley, K.L.

2001-01-01

For an ecological monitoring program to be successful over the long-term, the perceived benefits of the information must justify the cost. Financial limitations will always restrict the scope of a monitoring program, hence the program's focus must be carefully prioritized. Clearly identifying the costs and benefits of a program will assist in this prioritization process, but this is easier said than done. Frequently, the true costs of monitoring are not recognized and are, therefore, underestimated. Benefits are rarely evaluated, because they are difficult to quantify. The intent of this review is to assist the designers and managers of long-term ecological monitoring programs by providing a general framework for building and operating a cost-effective program. Previous considerations of monitoring costs have focused on sampling design optimization. We present cost considerations of monitoring in a broader context. We explore monitoring costs, including both budgetary costs--what dollars are spent on--and economic costs, which include opportunity costs. Often, the largest portion of a monitoring program budget is spent on data collection, and other, critical aspects of the program, such as scientific oversight, training, data management, quality assurance, and reporting, are neglected. Recognizing and budgeting for all program costs is therefore a key factor in a program's longevity. The close relationship between statistical issues and cost is discussed, highlighting the importance of sampling design, replication and power, and comparing the costs of alternative designs through pilot studies and simulation modeling. A monitoring program development process that includes explicit checkpoints for considering costs is presented. The first checkpoint occur during the setting of objectives and during sampling design optimization. The last checkpoint occurs once the basic shape of the program is known, and the costs and benefits, or alternatively the cost-effectiveness, of each program element can be evaluated. Moving into the implementation phase without careful evaluation of costs and benefits is risky because if costs are later found to exceed benefits, the program will fail. The costs of development, which can be quite high, will have been largely wasted. Realistic expectations of costs and benefits will help ensure that monitoring programs survive the early, turbulent stages of development and the challenges posed by fluctuating budgets during implementation.

Spatial analysis of county-based gonorrhoea incidence in mainland China, from 2004 to 2009.

PubMed

Yin, Fei; Feng, Zijian; Li, Xiaosong

2012-07-01

Gonorrhoea is one of the most common sexually transmissible infections in mainland China. Effective spatial monitoring of gonorrhoea incidence is important for successful implementation of control and prevention programs. The county-level gonorrhoea incidence rates for all of mainland China was monitored through examining spatial patterns. County-level data on gonorrhoea cases between 2004 and 2009 were obtained from the China Information System for Disease Control and Prevention. Bayesian smoothing and exploratory spatial data analysis (ESDA) methods were used to characterise the spatial distribution pattern of gonorrhoea cases. During the 6-year study period, the average annual gonorrhoea incidence was 12.41 cases per 100000 people. Using empirical Bayes smoothed rates, the local Moran test identified one significant single-centre cluster and two significant multi-centre clusters of high gonorrhoea risk (all P-values <0.01). Bayesian smoothing and ESDA methods can assist public health officials in using gonorrhoea surveillance data to identify high risk areas. Allocating more resources to such areas could effectively reduce gonorrhoea incidence.

Development of the Veterans Healthcare Administration (VHA) Ophthalmic Surgical Outcome Database (OSOD) project and the role of ophthalmic nurse reviewers.

PubMed

Lara-Smalling, Agueda; Cakiner-Egilmez, Tulay; Miller, Dawn; Redshirt, Ella; Williams, Dale

2011-01-01

Currently, ophthalmic surgical cases are not included in the Veterans Administration Surgical Quality Improvement Project data collection. Furthermore, there is no comprehensive protocol in the health system for prospectively measuring outcomes for eye surgery in terms of safety and quality. There are 400,000 operative cases in the system per year. Of those, 48,000 (12%) are ophthalmic surgical cases, with 85% (41,000) of those being cataract cases. The Ophthalmic Surgical Outcome Database Pilot Project was developed to incorporate ophthalmology into VASQIP, thus evaluating risk factors and improving cataract surgical outcomes. Nurse reviewers facilitate the monitoring and measuring of these outcomes. Since its inception in 1778, the Veterans Administration (VA) Health System has provided comprehensive healthcare to millions of deserving veterans throughout the U.S. and its territories. Historically, the quality of healthcare provided by the VA has been the main focus of discussion because it did not meet a standard of care comparable to that of the private sector. Information regarding quality of healthcare services and outcomes data had been unavailable until 1986, when Congress mandated the VA to compare its surgical outcomes to those of the private sector (PL-99-166). 1 Risk adjustment of VA surgical outcomes began in 1987 with the Continuous Improvement in Cardiac Surgery Program (CICSP) in which cardiac surgical outcomes were reported and evaluated. 2 Between 1991 and 1993, the National VA Surgical Risk Study (NVASRS) initiated a validated risk-adjustment model for predicting surgical outcomes and comparative assessment of the quality of surgical care in 44 VA medical centers. 3 The success of NVASRS encouraged the VA to establish an ongoing program for monitoring and improving the quality of surgical care, thus developing the National Surgical Quality Improvement Program (NSQIP) in 1994. 4 According to a prospective study conducted between 1991-1997 in 123 VA medical centers by Khuri et al., the 30-day mortality and morbidity rates for major surgeries had decreased by 9% and 30%, respectively. 5 Recently renamed the VA Surgical Quality Improvement Program (VASQIP) in 2010, the quality of surgical outcomes has continued to improve among all documented surgical specialties. Ophthalmic surgery is presumed to have a very low mortality rate and therefore has not been included in the VASQIP database.

7 CFR 246.19 - Management evaluation and monitoring reviews.

Code of Federal Regulations, 2014 CFR

2014-01-01

... SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN Monitoring and Review § 246.19 Management evaluation and monitoring reviews... reports, the development of corrective action plans to resolve Program deficiencies, the monitoring of the...

7 CFR 246.19 - Management evaluation and monitoring reviews.

Code of Federal Regulations, 2012 CFR

2012-01-01

... SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN Monitoring and Review § 246.19 Management evaluation and monitoring reviews... reports, the development of corrective action plans to resolve Program deficiencies, the monitoring of the...

7 CFR 246.19 - Management evaluation and monitoring reviews.

Code of Federal Regulations, 2013 CFR

2013-01-01

... SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN Monitoring and Review § 246.19 Management evaluation and monitoring reviews... reports, the development of corrective action plans to resolve Program deficiencies, the monitoring of the...

7 CFR 246.19 - Management evaluation and monitoring reviews.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN Monitoring and Review § 246.19 Management evaluation and monitoring reviews... reports, the development of corrective action plans to resolve Program deficiencies, the monitoring of the...

7 CFR 246.19 - Management evaluation and monitoring reviews.

Code of Federal Regulations, 2011 CFR

2011-01-01

... SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN Monitoring and Review § 246.19 Management evaluation and monitoring reviews... reports, the development of corrective action plans to resolve Program deficiencies, the monitoring of the...

45 CFR 2543.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Property Standards § 2543.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to...

15 CFR 14.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2011 CFR

2011-01-01

...-PROFIT, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Reports and Records § 14.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to...

14 CFR 1260.151 - Monitoring and reporting program performance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Records § 1260.151 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subcontract, function or activity supported by the award. Recipients shall monitor subcontracts to ensure subcontractors have met the audit requirements as delineated...

14 CFR 1260.151 - Monitoring and reporting program performance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Records § 1260.151 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subcontract, function or activity supported by the award. Recipients shall monitor subcontracts to ensure subcontractors have met the audit requirements as delineated...

15 CFR 14.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2013 CFR

2013-01-01

...-PROFIT, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Reports and Records § 14.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to...

45 CFR 2543.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Property Standards § 2543.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to...

14 CFR 1260.151 - Monitoring and reporting program performance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Records § 1260.151 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subcontract, function or activity supported by the award. Recipients shall monitor subcontracts to ensure subcontractors have met the audit requirements as delineated...

45 CFR 2543.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Property Standards § 2543.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to...

45 CFR 2543.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Property Standards § 2543.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to...

15 CFR 14.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2014 CFR

2014-01-01

...-PROFIT, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Reports and Records § 14.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to...

15 CFR 14.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2012 CFR

2012-01-01

...-PROFIT, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Reports and Records § 14.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to...

Specimen banking of marine organisms in the United States: Current status and long-term prospective

USGS Publications Warehouse

Becker, P.R.; Wise, S.A.; Thorsteinson, L.; Koster, B.J.; Rowles, T.

1997-01-01

A major part of the activities conducted over the last decade by the National Biomonitoring Specimen Bank (NBSB) has involved the archival of marine specimens collected by ongoing environmental monitoring programs. These archived specimens include bivalves, marine sediments, and fish tissues collected by the National Status and Trends and the Exxon Valdez Oil Spill Damage Assessment programs, and marine mammal tissues collected by the Marine Mammal Health and Stranding Response Program and the Alaska Marine Mammal Tissue Archival Project. In addition to supporting these programs, the specimens have been used to investigate circumpolar patterns of chlorinated hydrocarbon concentrations, genetic separation of marine animal stocks, baseline levels of essential and nonessential elements in marine mammals, and the potential risk to human consumers in the Arctic from anthropogenic contaminants found in local subsistence foods. The NBSB specimens represent a resource that has the potential for addressing future issues of marine environmental quality and ecosystem changes through retrospective analysis; however, an ecosystem-based food web approach would maximize this potential. The current status of the NBSB activities related to the banking of marine organisms is presented and discussed, the long-term prospective of these activities is presented, and the importance of an ecosystem-based food web monitoring approach to the value of specimen banking is discussed.

Design of a continuous quality improvement program to prevent falls among community-dwelling older adults in an integrated healthcare system.

PubMed

Ganz, David A; Yano, Elizabeth M; Saliba, Debra; Shekelle, Paul G

2009-11-16

Implementing quality improvement programs that require behavior change on the part of health care professionals and patients has proven difficult in routine care. Significant randomized trial evidence supports creating fall prevention programs for community-dwelling older adults, but adoption in routine care has been limited. Nationally-collected data indicated that our local facility could improve its performance on fall prevention in community-dwelling older people. We sought to develop a sustainable local fall prevention program, using theory to guide program development. We planned program development to include important stakeholders within our organization. The theory-derived plan consisted of 1) an initial leadership meeting to agree on whether creating a fall prevention program was a priority for the organization, 2) focus groups with patients and health care professionals to develop ideas for the program, 3) monthly workgroup meetings with representatives from key departments to develop a blueprint for the program, 4) a second leadership meeting to confirm that the blueprint developed by the workgroup was satisfactory, and also to solicit feedback on ideas for program refinement. The leadership and workgroup meetings occurred as planned and led to the development of a functional program. The focus groups did not occur as planned, mainly due to the complexity of obtaining research approval for focus groups. The fall prevention program uses an existing telephonic nurse advice line to 1) place outgoing calls to patients at high fall risk, 2) assess these patients' risk factors for falls, and 3) triage these patients to the appropriate services. The workgroup continues to meet monthly to monitor the progress of the program and improve it. A theory-driven program development process has resulted in the successful initial implementation of a fall prevention program.

Review of present groundwater monitoring programs at the Nevada Test Site

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

Hershey, R.L.; Gillespie, D.

1993-09-01

Groundwater monitoring at the Nevada Test Site (NTS) is conducted to detect the presence of radionuclides produced by underground nuclear testing and to verify the quality and safety of groundwater supplies as required by the State of Nevada and federal regulations, and by U.S. Department of Energy (DOE) Orders. Groundwater is monitored at water-supply wells and at other boreholes and wells not specifically designed or located for traditional groundwater monitoring objectives. Different groundwater monitoring programs at the NTS are conducted by several DOE Nevada Operations Office (DOE/NV) contractors. Presently, these individual groundwater monitoring programs have not been assessed or administeredmore » under a comprehensive planning approach. Redundancy exists among the programs in both the sampling locations and the constituents analyzed. Also, sampling for certain radionuclides is conducted more frequently than required. The purpose of this report is to review the existing NTS groundwater monitoring programs and make recommendations for modifying the programs so a coordinated, streamlined, and comprehensive monitoring effort may be achieved by DOE/NV. This review will be accomplished in several steps. These include: summarizing the present knowledge of the hydrogeology of the NTS and the potential radionuclide source areas for groundwater contamination; reviewing the existing groundwater monitoring programs at the NTS; examining the rationale for monitoring and the constituents analyzed; reviewing the analytical methods used to quantify tritium activity; discussing monitoring network design criteria; and synthesizing the information presented and making recommendations based on the synthesis. This scope of work was requested by the DOE/NV Hydrologic Resources Management Program (HRMP) and satisfies the 1993 (fiscal year) HRMP Groundwater Monitoring Program Review task.« less

Stroke mortality in Tennessee: an eco-epidemiologic perspective.

PubMed

Flowers, Joanne; Vutla, Balaji; Aldrich, Tim E

2008-04-01

Prevention of stroke mortality in Tennessee is a statewide public health priority. These analyses describe how the distribution of Caucasian stroke mortality is greater among the state's Appalachian Counties. For African-American residents, the elevated stroke mortality risk is not distinctive for geographic regions, although Upper East Tennessee rates are elevated. If the Caucasian criteria for assigning "high" rates were used with African-American stroke mortality data, the entire state would be designated as having elevated levels for stroke mortality. Race-gender specific analyses at the county-level (ecological attributes) illustrate the greater risks for "high" county-level stroke mortality rates are present for urban and poor communities in our state. African-American males are a clear exception, where the poorer, rural communities show a protective effect for "high" county-level stroke mortality rates. We support implementing stroke prevention programming and public health interventions based on the mortality data distributions; compatible statewide initiatives are underway We recommend strategic over-sampling of the state's priority populations for stroke risk to facilitate the monitoring of prevention and intervention program impacts over time.

Cancer Incidence in Appalachia, 2004-2011.

PubMed

Wilson, Reda J; Ryerson, A Blythe; Singh, Simple D; King, Jessica B

2016-02-01

Limited literature is available about cancer in the Appalachian Region. This is the only known analysis of all cancers for Appalachia and non-Appalachia covering 100% of the US population. Appalachian cancer incidence and trends were evaluated by state, sex, and race and compared with those found in non-Appalachian regions. US counties were identified as Appalachian or non-Appalachian. Age-adjusted cancer incidence rates, standard errors, and confidence intervals were calculated using the most recent data from the United States Cancer Statistics for 2004 to 2011. Generally, Appalachia carries a higher cancer burden compared with non-Appalachia, particularly for tobacco-related cancers. For all cancer sites combined, Appalachia has higher rates regardless of sex, race, or region. The Appalachia and non-Appalachia cancer incidence gap has narrowed, with the exception of oral cavity and pharynx, larynx, lung and bronchus, and thyroid cancers. Higher cancer incidence continues in Appalachia and appears at least in part to reflect high tobacco use and potential differences in socioeconomic status, other risk factors, patient health care utilization, or provider practices. It is important to continue to evaluate this population to monitor results from screening and early detection programs, understand behavioral risk factors related to cancer incidence, increase efforts to reduce tobacco use and increase cancer screening, and identify other areas where effective interventions may mediate disparities. Surveillance and evaluation of special populations provide means to monitor screening and early detection programs, understand behavioral risk factors, and increase efforts to reduce tobacco use to mediate disparities. ©2016 American Association for Cancer Research.

Does a History of Gestational Diabetes Mellitus Affect Key Outcomes in Women Participating in a Diabetes Prevention Program?

PubMed

Brokaw, Sarah M; Carpenedo, Dorota; Campbell, Paul; Butcher, Marcene K; Helgerson, Steven D; Harwell, Todd S

2018-04-01

Objectives To evaluate lifestyle change outcomes among women with and without a history of gestational diabetes mellitus (GDM) enrolled in the Montana Diabetes Prevention Program (DPP). Methods Participation, self-monitoring behavior, weight loss, and cardiometabolic risk reduction were compared among 5091 women at high-risk for type 2 diabetes, with and without a history of GDM, enrolled in the Montana DPP between 2008 and 2015. Results Women with a history of GDM (6% of enrolled women, n = 283) were significantly younger than women without GDM. No significant differences in participation, self-monitoring fat intake, achievement of the physical activity goal, or weight loss were found among women with and without a history of GDM. Overall, women lost an average of 5.0 kg (± 6.5), and 45 and 29% of women achieved 5 and 7% weight loss, respectively. Both groups lost significant and comparable amounts of weight. After adjusting for age and other factors, no differences were found in achievement of ≥ 5% weight loss (AOR 0.84; 95% CI 0.61-1.16) or the ≥ 7% weight loss goal (AOR 1.04; 95% CI 0.73-1.47) among women with and without a history of GDM. Conclusions for Practice Our findings suggest that women with and without a history of GDM successfully participate in and achieve significant weight loss in the DPP. Health care providers should identify and refer women with risk factors for type 2 diabetes, including a history of GDM, to a DPP within their community.

Preemptive treatment approach to cytomegalovirus (CMV) infection in solid organ transplant patients: relationship between compliance with the guidelines and prevention of CMV morbidity.

PubMed

Künzle, N; Petignat, C; Francioli, P; Vogel, G; Seydoux, C; Corpataux, J M; Sahli, R; Meylan, P R

2000-09-01

Cytomegalovirus (CMV) remains a major cause of morbidity in solid organ transplant patients. In order to reduce CMV morbidity, we designed a program of routine virological monitoring that included throat and urine CMV shell vial culture, along with peripheral blood leukocyte (PBL) shell vial quantitative culture for 12 weeks post-transplantation, as well as 8 weeks after treatment for acute rejection. The program also included preemptive ganciclovir treatment for those patients with the highest risk of developing CMV disease, i.e., with either high-level viremia (>10 infectious units [IU]/106 PBL) or low-level viremia (<10 IU/106 PBL) and either D+/R- CMV serostatus or treatment for graft rejection. During 1995-96, 90 solid organ transplant recipients (39 kidneys, 28 livers, and 23 hearts) were followed up. A total of 60 CMV infection episodes occurred in 45 patients. Seventeen episodes were symptomatic. Of 26 episodes managed according to the program, only 4 presented with CMV disease and none died. No patient treated preemptively for asymptomatic infection developed disease. In contrast, among 21 episodes managed in non-compliance with the program (i.e., the monitoring was not performed or preemptive treatment was not initiated despite a high risk of developing CMV disease), 12 episodes turned into symptomatic infection (P=0.0048 compared to patients treated preemptively), and 2 deaths possibly related to CMV were recorded. This difference could not be explained by an increased proportion of D+/R- patients or an increased incidence of rejection among patients with episodes treated in non-compliance with the program. Our data identify compliance with guidelines as an important factor in effectively reducing CMV morbidity through preemptive treatment, and suggest that the complexity of the preemptive approach may represent an important obstacle to the successful prevention of CMV morbidity by this approach in the regular healthcare setting.

Inter-observer agreement of a multi-parameter campsite monitoring program on the Dixie National Forest, Utah

Treesearch

Nicholas J. Glidden; Martha E. Lee

2007-01-01

Precision is crucial to campsite monitoring programs. Yet, little empirical research has ever been published on the level of precision of this type of monitoring programs. The purpose of this study was to evaluate the level of agreement between observers of campsite impacts using a multi-parameter campsite monitoring program. Thirteen trained observers assessed 16...

An overview of a landbird monitoring program at Tortuguero, on the Caribbean coast of Costa Rica

Treesearch

C. John Ralph; Margaret J. Widdowson; Robert I. Frey; Pablo A. Herrera; Brian P. O' Donnell

2005-01-01

Since 1994, the Tortuguero Integrated Bird Monitoring Program has been monitoring birds in a coastal lowland rain forest of northeast Costa Rica. The Program has combined the use of area searches, constanteffort mist netting, and migration counts into a longterm landbird monitoring and training program following the recommendations of the Partners In Flight &ndash...

Dealing with incomplete and variable detectability in multi-year, multi-site monitoring of ecological populations

USGS Publications Warehouse

Converse, Sarah J.; Royle, J. Andrew; Gitzen, Robert A.; Millspaugh, Joshua J.; Cooper, Andrew B.; Licht, Daniel S.

2012-01-01

An ecological monitoring program should be viewed as a component of a larger framework designed to advance science and/or management, rather than as a stand-alone activity. Monitoring targets (the ecological variables of interest; e.g. abundance or occurrence of a species) should be set based on the needs of that framework (Nichols and Williams 2006; e.g. Chapters 2–4). Once such monitoring targets are set, the subsequent step in monitoring design involves consideration of the field and analytical methods that will be used to measure monitoring targets with adequate accuracy and precision. Long-term monitoring programs will involve replication of measurements over time, and possibly over space; that is, one location or each of multiple locations will be monitored multiple times, producing a collection of site visits (replicates). Clearly this replication is important for addressing spatial and temporal variability in the ecological resources of interest (Chapters 7–10), but it is worth considering how this replication can further be exploited to increase the effectiveness of monitoring. In particular, defensible monitoring of the majority of animal, and to a lesser degree plant, populations and communities will generally require investigators to account for imperfect detection (Chapters 4, 18). Raw indices of population state variables, such as abundance or occupancy (sensu MacKenzie et al. 2002), are rarely defensible when detection probabilities are < 1, because in those cases detection may vary over time and space in unpredictable ways. Myriad authors have discussed the risks inherent in making inference from monitoring data while failing to correct for differences in detection, resulting in indices that have an unknown relationship to the parameters of interest (e.g. Nichols 1992, Anderson 2001, MacKenzie et al. 2002, Williams et al. 2002, Anderson 2003, White 2005, Kéry and Schmidt 2008). While others have argued that indices may be preferable in some cases due to the challenges associated with estimating detection probabilities (e.g. McKelvey and Pearson 2001, Johnson 2008), we do not attempt to resolve this debate here. Rather, we are more apt to agree with MacKenzie and Kendall (2002) that the burden of proof ought to be on the assertion that detection probabilities are constant. Furthermore, given the wide variety of field methods available for estimating detection probabilities and the inability for an investigator to know, a priori, if detection probabilities will be constant over time and space, we believe that development of monitoring programs ought to include field and analytical methods to account for the imperfect detection of organisms.

Multidisciplinary approach to increasing Resilience in communities versus the hydrogeological and volcanic risk

NASA Astrophysics Data System (ADS)

Avvisati, Gala; Colucci, Orazio; Marotta, Enrica; Masucci, Armando; Nave, Rosella; Peluso, Rosario; Tomasone, Mario

2017-04-01

A given area may be exposed to different natural hazards, such as landslides, floods, earthquakes, volcanic events etc. which could affect usual human activities at many levels. The goal of our work is to increase the resilience level in communities exposed to natural hazards through an innovative and multidisciplinary research approach integrating engineering, geological, medical and sociological skills. We are going to use an analytical approach to consider simultaneously the Natural Environment and their dwellers, taking into account the sanitary protocols. We'll start by studying the hazards to which the Natural Environment could be exposed evaluating the deriving risks level trough technical studies. For each scenario it's vital to assess the defining aspects such as magnitude and frequency, through a statistical analysis of the specific data-bases in possession of relevant Authorities in charge. Regarding the Inhabitants, it's also vital to analyse the dwellers Risk Perception and their Historical Resilience through a sociological and psychological approach, in order to define the specific information and education program on natural risks. This study is of particular relevance, as even the most advanced risk management plan could fail if locals are not aware and informed about it. A correct disaster management policy must consider the medics role as paramount. Emergency first aid and emergency medicine are to be considered specific field of partitioning, and to be seen as the most appropriate way to deal with a dire situation, especially when the resources vs. magnitude of event ratio is low. The study of best practices helping to improve the resilience and reaction of areas exposed to different natural hazards with different socio-cultural layers is hence crucial. A possible model is to directly involve the residents into controlling the environment and improving/detailing the risks' and emergency areas mapping. These make the population more aware of both risks and reaction measures, with a correspondent increase in resilience. Some municipalities in Campania Region (Italy) have already undergone the phase of assessment of risks perception and historical resilience trough questionnaires submitted to residents. In some District of Campania Region (Italy), apps for mobile devices have been developed, in order to activate a bi-directional flow of information between local authorities and single citizens. Another level of participated monitoring could be issuing to residents low-cost, specifically designed devices, such as seismic micro-sensor and/or CO2 gauges to be positioned in schools. With advantage both information/education and monitoring. Local authorities have recently started to consider medical emergency assistance in disaster-affected areas as a specific tool to activate and use to handle such situations as best as possible. The results of these studies will result in: the development of an early warning network specifically targeted on each area and run by specifically trained operators; specific skills for medical personnel to be mastered to handle civilian casualties and/or shocked people in huge numbers; the locals in a condition of improved knowledge and preparedness, to the point to be involved actively in the program in a community-based monitoring procedure (participated monitoring).

28 CFR 70.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., HOSPITALS AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Reports and Records § 70.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients must monitor subawards...

29 CFR 95.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2012 CFR

2012-07-01

...-Award Requirements Reports and Records § 95.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to ensure subrecipients have met the audit...

29 CFR 95.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2011 CFR

2011-07-01

...-Award Requirements Reports and Records § 95.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to ensure subrecipients have met the audit...

29 CFR 95.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2013 CFR

2013-07-01

...-Award Requirements Reports and Records § 95.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to ensure subrecipients have met the audit...

22 CFR 226.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2014 CFR

2014-04-01

... ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Reports and Records § 226.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor...

22 CFR 226.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2012 CFR

2012-04-01

... ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Reports and Records § 226.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor...

29 CFR 95.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2014 CFR

2014-07-01

...-Award Requirements Reports and Records § 95.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to ensure subrecipients have met the audit...

22 CFR 226.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2013 CFR

2013-04-01

... ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Reports and Records § 226.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor...

28 CFR 70.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., HOSPITALS AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Reports and Records § 70.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients must monitor subawards...

28 CFR 70.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., HOSPITALS AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Reports and Records § 70.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients must monitor subawards...

28 CFR 70.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., HOSPITALS AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Reports and Records § 70.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients must monitor subawards...

14 CFR § 1260.151 - Monitoring and reporting program performance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Records § 1260.151 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subcontract, function or activity supported by the award. Recipients shall monitor subcontracts to ensure subcontractors have met the audit requirements as delineated...

22 CFR 226.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Reports and Records § 226.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor...

Central Alaska Network vital signs monitoring plan

USGS Publications Warehouse

MacCluskie, Margaret C.; Oakley, Karen L.; McDonald, Trent; Wilder, Doug

2005-01-01

Denali National Park and Preserve, Wrangell-St. Elias National Park and Preserve, and Yukon-Charley Rivers National Preserve have been organized into the Central Alaska Network (CAKN) for the purposes of carrying out ecological monitoring activities under the National Park Services’ Vital Signs Monitoring program. The Phase III Report is the initial draft of the Vital Signs Monitoring Plan for the Central Alaska Network. It includes updated material from the Phase I and II documents. This report, and draft protocols for 11 of the network’s Vital Signs, were peer reviewed early in 2005. Review comments were incorporated into the document bringing the network to the final stage of having a Vital Signs Monitoring Plan. Implementation of the program will formally begin in FY 2006. The broad goals of the CAKN monitoring program are to: (1) better understand the dynamic nature and condition of park ecosystems; and (2) provide reference points for comparisons with other, altered environments. The focus of the CAKN program will be to monitor ecosystems in order to detect change in ecological components and in the relationships among the components. Water quality monitoring is fully integrated within the CAKN monitoring program. A monitoring program for lentic (non-moving water) has been determined, and the program for lotic systems (moving water) is under development.

HIPAA Compliant Wireless Sensing Smartwatch Application for the Self-Management of Pediatric Asthma

PubMed Central

Hosseini, Anahita; Buonocore, Chris M.; Hashemzadeh, Sepideh; Hojaiji, Hannaneh; Kalantarian, Haik; Sideris, Costas; Bui, Alex A.T.; King, Christine E.; Sarrafzadeh, Majid

2018-01-01

Asthma is the most prevalent chronic disease among pediatrics, as it is the leading cause of student absenteeism and hospitalization for those under the age of 15. To address the significant need to manage this disease in children, the authors present a mobile health (mHealth) system that determines the risk of an asthma attack through physiological and environmental wireless sensors and representational state transfer application program interfaces (RESTful APIs). The data is sent from wireless sensors to a smartwatch application (app) via a Health Insurance Portability and Accountability Act (HIPAA) compliant cryptography framework, which then sends data to a cloud for real-time analytics. The asthma risk is then sent to the smartwatch and provided to the user via simple graphics for easy interpretation by children. After testing the safety and feasibility of the system in an adult with moderate asthma prior to testing in children, it was found that the analytics model is able to determine the overall asthma risk (high, medium, or low risk) with an accuracy of 80.10±14.13%. Furthermore, the features most important for assessing the risk of an asthma attack were multifaceted, highlighting the importance of continuously monitoring different wireless sensors and RESTful APIs. Future testing this asthma attack risk prediction system in pediatric asthma individuals may lead to an effective self-management asthma program. PMID:29354688

The Quest CCS Project - MMV Technology Deployment Through Two Years of Operation

NASA Astrophysics Data System (ADS)

O'Brien, S.

2017-12-01

In September 2012, Shell, on behalf of the Athabasca Oil Sands Project venture (Shell Canada Energy, Chevron Canada Limited, Marathon Oil Canada Corporation), announced that it was proceeding to construct the Quest Carbon Capture and Storage (CCS) project near Fort Saskatchewan. Quest is the world's first large-scale commercial application of CCS at an oil sands operation, and it is now capturing more than one million tonnes of CO2 per year from the Scotford Upgrader. It is a fully integrated project, involving CO2 capture at the bitumen upgrader, transportation along a 65 km pipeline, and CO2 storage in a deep saline aquifer (the Basal Cambrian Sands). Construction was completed in August 2015, and the Quest project was certified for commercial operation in September 2015. The Measurement, Monitoring and Verification (MMV) program for Quest is comprehensive, with a variety of technologies being used to monitor the atmosphere, hydrosphere, biosphere and geosphere. These include a Lightsource system for atmospheric monitoring, extensive groundwater sampling, DAS VSPs to assess the development of the CO2 plume, a microseismic array to measure any induced seismic activity, and temperature and pressure gauges for reservoir monitoring. Over two years of operations, this program has been optimized to address key risks while improving operational efficiency. Quest has now successfully captured and stored more than 2 million tonnes of CO2 with no MMV indications of any storage issues.

The impact of vehicle moving violations and freeway traffic flow on crash risk: An application of plugin development for microsimulation.

PubMed

Wang, Junhua; Kong, Yumeng; Fu, Ting; Stipancic, Joshua

2017-01-01

This paper presents the use of the Aimsun microsimulation program to simulate vehicle violating behaviors and observe their impact on road traffic crash risk. Plugins for violations of speeding, slow driving, and abrupt stopping were developed using Aimsun's API and SDK module. A safety analysis plugin for investigating probability of rear-end collisions was developed, and a method for analyzing collision risk is proposed. A Fuzzy C-mean Clustering algorithm was developed to identify high risk states in different road segments over time. Results of a simulation experiment based on the G15 Expressway in Shanghai showed that abrupt stopping had the greatest impact on increasing collision risk, and the impact of violations increased with traffic volume. The methodology allows for the evaluation and monitoring of risks, alerting of road hazards, and identification of hotspots, and could be applied to the operations of existing facilities or planning of future ones.

The impact of vehicle moving violations and freeway traffic flow on crash risk: An application of plugin development for microsimulation

PubMed Central

Kong, Yumeng; Stipancic, Joshua

2017-01-01

This paper presents the use of the Aimsun microsimulation program to simulate vehicle violating behaviors and observe their impact on road traffic crash risk. Plugins for violations of speeding, slow driving, and abrupt stopping were developed using Aimsun’s API and SDK module. A safety analysis plugin for investigating probability of rear-end collisions was developed, and a method for analyzing collision risk is proposed. A Fuzzy C-mean Clustering algorithm was developed to identify high risk states in different road segments over time. Results of a simulation experiment based on the G15 Expressway in Shanghai showed that abrupt stopping had the greatest impact on increasing collision risk, and the impact of violations increased with traffic volume. The methodology allows for the evaluation and monitoring of risks, alerting of road hazards, and identification of hotspots, and could be applied to the operations of existing facilities or planning of future ones. PMID:28886141

DCS: A Case Study of Identification of Knowledge and Disposition Gaps Using Principles of Continuous Risk Management

NASA Technical Reports Server (NTRS)

Norcross, Jason; Steinberg, Susan; Kundrot, Craig; Charles, John

2011-01-01

The Human Research Program (HRP) is formulated around the program architecture of Evidence-Risk-Gap-Task-Deliverable. Review of accumulated evidence forms the basis for identification of high priority risks to human health and performance in space exploration. Gaps in knowledge or disposition are identified for each risk, and a portfolio of research tasks is developed to fill them. Deliverables from the tasks inform the evidence base with the ultimate goal of defining the level of risk and reducing it to an acceptable level. A comprehensive framework for gap identification, focus, and metrics has been developed based on principles of continuous risk management and clinical care. Research towards knowledge gaps improves understanding of the likelihood, consequence or timeframe of the risk. Disposition gaps include development of standards or requirements for risk acceptance, development of countermeasures or technology to mitigate the risk, and yearly technology assessment related to watching developments related to the risk. Standard concepts from clinical care: prevention, diagnosis, treatment, monitoring, rehabilitation, and surveillance, can be used to focus gaps dealing with risk mitigation. The research plan for the new HRP Risk of Decompression Sickness (DCS) used the framework to identify one disposition gap related to establishment of a DCS standard for acceptable risk, two knowledge gaps related to DCS phenomenon and mission attributes, and three mitigation gaps focused on prediction, prevention, and new technology watch. These gaps were organized in this manner primarily based on target for closure and ease of organizing interim metrics so that gap status could be quantified. Additional considerations for the knowledge gaps were that one was highly design reference mission specific and the other gap was focused on DCS phenomenon.

Evaluation of an Environmental Monitoring Program for the Microbial Safety of Air and Surfaces in a Dairy Plant Environment.

PubMed

Zacharski, Krzysztof A; Southern, Mark; Ryan, Alan; Adley, Catherine C

2018-07-01

Microbiological hazards can occur when foodstuffs come into contact with contaminated surfaces or infectious agents dispersed by air currents in the manufacturing environment. An environmental monitoring program (EMP) is a critical aspect of sustainable and safe food manufacturing used to evaluate the effectiveness of the microbial controls in place. An effective EMP should be based on risk analysis, taking into account previous sampling history to determine the selection of the sampling points, the scope of the test, and the frequency of analysis. This study involved evaluation of the environmental monitoring regime and microbiological status of a medium-sized dairy plant manufacturing food ingredients, e.g., proteins, milk powders, and dairy fats. The data specific to microbial tests ( n = 3,468), recorded across 124 fixed sampling locations over a 2-year period (2014 to 2015) from air ( n = 1,787) and surfaces ( n = 1,681) were analyzed. The aim of this study was to highlight the strengths and weaknesses of the EMP in a select dairy processing plant. The results of this study outline the selection of sampling locations, the scope of the test, and the frequency of analysis. An analysis of variance revealed subsections of the manufacturing areas with high risk factors, especially the packaging subsection specified for bulk packaging, the atomizer, and the fluidized bed. The temporal and spatial analysis showed the potential to reduce or relocate the monitoring effort, most notably related to total coliforms and Staphylococcus aureus, across the dairy plant due to homogeneity across the sampling subsections with little or no deviations. The results suggest a need to reevaluate the current EMP and the corrective action plan, especially with regard to detection of pathogens. Recommendations for optimization of the EMP are presented to assist the dairy industry with reviewing and revising the control measures and hazard assessment with regard to existing contamination issues.

Do Parents Meet Adolescents’ Monitoring Standards? Examination of the Impact on Teen Risk Disclosure and Behaviors if They Don’t

PubMed Central

Cottrell, Lesley; Cottrell, Scott; Metzger, Aaron; Ahmadi, Halima; Wang, Bo; Li, Xiaoming; Stanton, Bonita

2015-01-01

In this study, we examined how adolescents compare monitoring efforts by their parents to those of a "good parent" standard and assessed the impact of these comparisons on adolescent self-disclosure and risk behavior and their perceptions of their parents' monitoring knowledge. Survey responses from 519 adolescents (12–17 years) at baseline of a larger, longitudinal study examining parental monitoring and adolescent risk were examined. Adolescents’ “good parent comparisons” differed greatly by monitoring areas (e.g., telephone use, health, money); however, between 5.5% and 25.8% of adolescents believed their parents needed to monitor their activities more than they currently were monitoring. Alternatively, between 8.5% and 23.8% of adolescents believed their parents needed to monitor their activities less often. These perceptions significantly distinguished adolescents in terms of their level of disclosure, perceived monitoring knowledge, and risk involvement. Adolescents who viewed their parents as needing to monitor more were less likely to disclose information to their parents (p<.001), less likely to perceive their parents as having greater monitoring knowledge (p<.001), and more likely to be involved in a risk behaviors (p<.001) than adolescents who perceived their parents needed no change. Adolescent disclosure to a parent is a powerful predictor of adolescent risk and poor health outcomes. These findings demonstrate that adolescents' comparisons of their parents' monitoring efforts can predict differences in adolescent disclosure and future risk. Obtaining adolescent "good parent" comparisons may successfully identify intervention opportunities with the adolescent and parent by noting the areas of need and direction of monitoring improvement. PMID:25955160

Predictors of loss to follow-up among children registered in an HIV prevention mother-to-child transmission cohort study in Pernambuco, Brazil.

PubMed

Gouveia, Pedro Alves da Cruz; da Silva, Gerlane Alves Pontes; de Albuquerque, Maria de Fatima Pessoa Militão

2014-11-27

Mother-to-child transmission of HIV (MTCT) is the major form of acquiring the disease among children. The loss to follow-up (LTF) of mothers and their children is a problem that affects the effectiveness of programs for the prevention of mother-to-child transmission (PMTCT). The aim of this study is to identify risk factors associated with the LTF of HIV-exposed children in the state of Pernambuco, Brazil. A retrospective cohort study was carried out with 1200 HIV-exposed children born between 2000 and 2009, registered up to the age of 2 months in a public health PMTCT program. Children were considered LTF if they did not return for scheduled visits to monitor infection status. Univariate and multivariate logistic regression analyses were conducted to identify risk factors for LTF. A total of 185 children (15.4%; CI: 95%: 13.4-17.4%) met the case definition of LTF before the determination of serological HIV status. Risk factors independently associated with LTF were mother-child pairs who reside in rural and remote areas (OR 1.86; 95% CI: 1.30-2.66) and mothers who use illicit drugs (OR 1.8; 95% CI: 1.08-3.0). Initiation of the PMTCT during pregnancy was a protective factor for LTF (OR 0.69; 95% CI: 0.49-0.96). The decentralization of support services for HIV-exposed children to other cities in the state seems to be crucial for the accurate monitoring of outcomes. It is also important to introduce additional measures addressing mothers who are drug users so that they remain in the program: an intensive follow-up program that actively searches for absentee mother-child pairs, support from social services and treatment for drug-dependency. The findings of this study highlight the importance of diagnosing mothers as early as possible in order to conduct a more complete follow-up period of the children. Solving the above-mentioned problems is a challenge, which must be overcome so as to improve the quality of PMTCT.

The role of population monitoring in the management of North American waterfowl

USGS Publications Warehouse

Nichols, J.D.; Williams, B.K.; Johnson, F.A.

2000-01-01

Despite the effort and expense devoted to large-scale monitoring programs, few existing programs have been designed with specific objectives in mind and few permit strong inferences about the dynamics of monitored systems. The waterfowl population monitoring programs of the U.S. Fish and Wildlife Service, Canadian Wildlife Service and state and provincial agencies provide a nice example with respect to program objectives, design and implementation. The May Breeding Grounds Survey provides an estimate of system state (population size) that serves two primary purposes in the adaptive management process: identifying the appropriate time-specific management actions and updating the information state (model weights) by providing a basis for evaluating predictions of competing models. Other waterfowl monitoring programs (e.g., banding program, hunter questionnaire survey, parts collection survey, winter survey) provide estimates of vital rates (rates of survival, reproduction and movement) associated with system dynamics and variables associated with management objectives (e.g., harvest). The reliability of estimates resulting from monitoring programs depends strongly on whether considerations about spatial variation and detection probability have been adequately incorporated into program design and implementation. Certain waterfowl surveys again provide nice examples of monitoring programs that incorporate these considerations.

Assessing the Impact of Agricultural Pressures on N and P Loads and Potential Eutrophication Risk at Regional Scales

NASA Astrophysics Data System (ADS)

Dupas, R.; Gascuel-odoux, C.; Delmas, M.; Moatar, F.

2014-12-01

Excessive nutrient loading of freshwater bodies results in increased eutrophication risk worldwide. The processes controlling N/P transfer in agricultural landscapes are well documented through scientific studies conducted in intensively monitored catchments. However, managers need tools to assess water quality and evaluate the contribution of agriculture to eutrophication at regional scales, including unmonitored or poorly monitored areas. To this end, we present an assessment framework which includes: i) a mass-balance model to estimate diffuse N/P transfer and retention and ii) indicators based on N:P:Si molar ratios to assess potential eutrophication risk from external loads. The model, called Nutting (Dupas et al., 2013), integrates variables for both detailed description of agricultural pressures (N surplus, soil P content) and characterisation of physical attributes of catchments (including spatial attributes). It was calibrated on 160 catchments, and applied to 2210 unmonitored headwater bodies in France (Dupas et al., under review). N and P retention represented 53% and 95% of soil N and P surplus, respectively, and was mainly controlled by runoff and an index characterising infiltration/runoff properties. According to our estimates, diffuse agricultural sources represented a mean of 97% of N loads and N exceeded Si in 93% of the catchments, whilst they represented 46% of P loads and P exceeded Si in 26-65% of the catchments. Estimated eutrophication risk was highly sensitive to assumptions about P bioavailability, hence the range of headwaters potentially at risk spanned 26-63% of the catchments, depending on assumptions. To reduce this uncertainty, we recommend introducing P bioavailability tests in water monitoring programs, especially in sensitive areas. Dupas R et al. Assessing N emissions in surface water at the national level: comparison of country-wide vs. regionalized models. Sci Total Environ 2013; 443: 152-62. Dupas R et al. Assessing the impact of agricultural pressures on N and P loads and eutrophication risk (under review).

Ecological Monitoring and Compliance Program 2011 Report

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

Hansen, D. J.; Anderson, D. C.; Hall, D. B.

The Ecological Monitoring and Compliance (EMAC) Program, funded through the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, monitors the ecosystem of the Nevada National Security Site and ensures compliance with laws and regulations pertaining to NNSS biota. This report summarizes the program's activities conducted by National Security Technologies, LLC, during calendar year 2011. Program activities included (a) biological surveys at proposed construction sites, (b) desert tortoise compliance, (c) ecosystem monitoring, (d) sensitive plant species monitoring, (e) sensitive and protected/regulated animal monitoring, (f) habitat restoration monitoring, and (g) monitoring of the Nonproliferation Test and Evaluation Complex. Duringmore » 2011, all applicable laws, regulations, and permit requirements were met, enabling EMAC to achieve its intended goals and objectives.« less

Changes in Student Knowledge and Views of Geohazards, Societal Risks, and Monitoring at Active Plate Boundaries Using a Data-Rich Curriculum

NASA Astrophysics Data System (ADS)

Selkin, P. A.; Goodell, L. P.; Teasdale, R.

2015-12-01

The "Living on the Edge: Building Resilient Societies on Active Plate Margins" curriculum consists of six data-rich activities, each intended for a 50-minute class, in which students assess risk at active plate boundaries due to earthquakes and volcanoes. Developed as part of the InTeGrate NSF STEP Center the peer-reviewed, publically available materials (http://serc.carleton.edu/104296) have been used at several institutions in diverse classroom settings including small laboratory sections, large lecture courses, medium-sized upper division courses and professional development programs for middle and high school teachers. Pre- and post-instruction surveys measured content knowledge and geoscience literacy, self-efficacy in using geologic data to assess hazards and risk, and attitudes towards the value of monitoring plate margins. The activities have overall positive effects on knowledge of geohazard concepts. Views about the value of scientific practice also became more positive: 74% of students indicated they "agree" or "strongly agree" that monitoring geologic activity has value to them personally (even if they don't live on an active plate margin) and 94% indicated that such monitoring is valuable to society. Most became more confident in evaluating geologic hazard and risk (>60% of students self-described increased confidence by one or more Likert levels). Student knowledge of both the types and limits of data in forecasting geological hazards and their effects also improved. However, attitudes toward sustainability and geoscience careers did not change. Learning and attitudinal improvements are true for all classroom types, but the degree of change varies with class size and the amount of time spent on activities. Learning data and instructor feedback suggest that interactive classroom activities that use real-world data to address societally relevant issues increase student learning and enhance students' ability to synthesize scientific information.

GB-InSAR monitoring and observational method for landslide emergency management: the Montaguto earthflow (AV, Italy)

NASA Astrophysics Data System (ADS)

Ferrigno, Federica; Gigli, Giovanni; Fanti, Riccardo; Intrieri, Emanuele; Casagli, Nicola

2017-06-01

On 10 March 2010, because of the heavy rainfall in the preceding days, the Montaguto landslide (Southern Italy) reactivated, affecting both state road 90 Delle Puglie and the Rome-Bari railway. A similar event occurred on May 2005 and on September 2009. As a result, the National Civil Protection Department (DPC) started an accurate monitoring and analysis program. A monitoring project using the GB-InSAR (ground-based interferometric synthetic aperture radar) system was emplaced to investigate the landslide kinematics, plan urgent safety measures for risk mitigation and design long-term stabilization work.Here, we present the GB-InSAR monitoring system results and its applications in the observational method (OM) approach. GB-InSAR is an established instrument for long-term campaigns aimed at early warning and monitoring during construction works. Our paper further develops these aspects in that it highlights how the OM based on the GB-InSAR technique can produce savings in terms of cost and time in engineering projects without compromising safety. This study focuses on the key role played by the monitoring activities during the design and planning activities, with special reference to the emergency phase.

Completion of risk assessment and monitoring within forensic psychiatry.

PubMed

Galappathie, Nuwan; Heeramun, Ragini; Jethwa, Krishma

2009-04-01

There is a clear need for high standards of risk assessment and monitoring within forensic psychiatry. This has been highlighted by a number of high profile homicide enquires which have called for better standards of multidisciplinary risk assessment and monitoring. There are no national standards for risk assessment. We conducted a study to audit electronically the completion rate of a service-designed risk assessment document within Fromside, a medium secure unit in the UK. The completion rates for key sections of 64 risk assessment documents were assessed. Only 48 of the 64 (75%) documents were electronically available. The completion rates ranged from 59/64 (92%) for the retrospective risk review to 46/64 (72%) for relapse indicators. Only 35/64 (55%) risk documents were updated within the last three months. We found that the use of risk profile documents has helped achieve good standards of risk assessment, however greater priority needs to be given to ongoing monitoring. We recommend that consideration is given to the development of national guidelines for multidisciplinary risk assessment and monitoring.

The future role of next-generation DNA sequencing and metagenetics in aquatic biology monitoring programs

EPA Science Inventory

The development of current biological monitoring and bioassessment programs was a drastic improvement over previous programs created for monitoring a limited number of specific chemical pollutants. Although these assessment programs are better designed to address the transient an...

Burden of Cancer from Chemicals in North Carolina Drinking Water

NASA Astrophysics Data System (ADS)

DeFelice, N.

2013-12-01

Monitoring programs required by the U.S. Safe Drinking Water Act (SDWA) currently do not consider potential differences in chemical exposure patterns and human health risks. Rather, U.S. agencies establish monitoring requirements based on the type of water system and the number of people the system serves; within categories of systems, all potentially carcinogenic chemicals must be monitored with equal frequency, regardless of the potential level of risk these chemicals pose. To inform future policies concerning contaminant monitoring under the SDWA, we examined the potential health threats in North Carolina from the 34 carcinogenic chemicals covered under the SDWA. We analyzed reported contaminant concentration data for all community water systems (CWSs) for the years 1998-2011. We employed an attributable fraction approach that uses probabilistic inputs to evaluate the percent of cancer cases that may be attributable to chemical exposure in drinking water. We found that cancer risks are dominated by 3 of the 34 chemicals and chemical classes (total trihalomethanes (TTHMs), arsenic and gross alpha particles); all other chemicals contribute to less than one cancer case per year in the state. We showed that around 840 cases of cancer annually (2% of annual cancer cases) are attributable to contaminated drinking water. The majority cases are due to TTHMs, arsenic and gross alpha particles, which contributed 810 (95% CI 560-1,280), 14 (95% CI 3 -32), and 13 (95% CI 2-48) cases, respectively. Sixty-seven counties had annual cancer rates higher than 1 in 10,000 attributable to community water systems. Annual cancer rate attributable to chemicals found in drinking water that are regulated under the safe drinking water act.

Using a Novel Spatial Tool to Inform Invasive Species Early Detection and Rapid Response Efforts

NASA Astrophysics Data System (ADS)

Davidson, Alisha D.; Fusaro, Abigail J.; Kashian, Donna R.

2015-07-01

Management of invasive species has increasingly emphasized the importance of early detection and rapid response (EDRR) programs in limiting introductions, establishment, and impacts. These programs require an understanding of vector and species spatial dynamics to prioritize monitoring sites and efficiently allocate resources. Yet managers often lack the empirical data necessary to make these decisions. We developed an empirical mapping tool that can facilitate development of EDRR programs through identifying high-risk locations, particularly within the recreational boating vector. We demonstrated the utility of this tool in the Great Lakes watershed. We surveyed boaters to identify trips among water bodies and to quantify behaviors associated with high likelihood of species transfer (e.g., not removing organic materials from boat trailers) during that trip. We mapped water bodies with high-risk inbound and outbound boater movements using ArcGIS. We also tested for differences in high-risk behaviors based on demographic variables to understand risk differences among boater groups. Incorporation of boater behavior led to identification of additional high-risk water bodies compared to using the number of trips alone. Therefore, the number of trips itself may not fully reflect the likelihood of invasion. This tool can be broadly applied in other geographic contexts and with different taxa, and can be adjusted according to varying levels of information concerning the vector or species of interest. The methodology is straightforward and can be followed after a basic introduction to ArcGIS software. The visual nature of the mapping tool will facilitate site prioritization by managers and stakeholders from diverse backgrounds.

Rationale and Methods for Archival Sampling and Analysis of Atmospheric Trace Chemical Contaminants On Board Mir and Recommendations for the International Space Station

NASA Technical Reports Server (NTRS)

Perry, J. L.; James, J. T.; Cole, H. E.; Limero, T. F.; Beck, S. W.

1997-01-01

Collection and analysis of spacecraft cabin air samples are necessary to assess the cabin air quality with respect to crew health. Both toxicology and engineering disciplines work together to achieve an acceptably clean cabin atmosphere. Toxicology is concerned with limiting the risk to crew health from chemical sources, setting exposure limits, and analyzing air samples to determine how well these limits are met. Engineering provides the means for minimizing the contribution of the various contaminant generating sources by providing active contamination control equipment on board spacecraft and adhering to a rigorous material selection and control program during the design and construction of the spacecraft. A review of the rationale and objectives for sampling spacecraft cabin atmospheres is provided. The presently-available sampling equipment and methods are reviewed along with the analytical chemistry methods employed to determine trace contaminant concentrations. These methods are compared and assessed with respect to actual cabin air quality monitoring needs. Recommendations are presented with respect to the basic sampling program necessary to ensure an acceptably clean spacecraft cabin atmosphere. Also, rationale and recommendations for expanding the scope of the basic monitoring program are discussed.

34 CFR 303.501 - Supervision and monitoring of programs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... supervision of programs and activities receiving assistance under this part; and (2) The monitoring of... 34 Education 2 2011-07-01 2010-07-01 true Supervision and monitoring of programs. 303.501 Section... INFANTS AND TODDLERS WITH DISABILITIES State Administration General § 303.501 Supervision and monitoring...

34 CFR 303.501 - Supervision and monitoring of programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... supervision of programs and activities receiving assistance under this part; and (2) The monitoring of... 34 Education 2 2010-07-01 2010-07-01 false Supervision and monitoring of programs. 303.501 Section... INFANTS AND TODDLERS WITH DISABILITIES State Administration General § 303.501 Supervision and monitoring...

A western state perspective on monitoring and managing neotropical migratory birds

Treesearch

Frank Howe

1993-01-01

Neotropical migratory bird monitoring programs can contribute greatly to a more holistic and proactive management approach for state agencies. It is, however, imperative that these monitoring programs be scientifically designed and clearly communicated to managers. Information from monitoring programs can be used to develop multiple-species habitat management...

10 CFR 26.406 - Fitness monitoring.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Fitness monitoring. 26.406 Section 26.406 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS FFD Program for Construction § 26.406 Fitness monitoring. (a...) Licensees and other entities shall implement a fitness monitoring program to deter substance abuse and...

10 CFR 26.406 - Fitness monitoring.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Fitness monitoring. 26.406 Section 26.406 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS FFD Program for Construction § 26.406 Fitness monitoring. (a...) Licensees and other entities shall implement a fitness monitoring program to deter substance abuse and...

10 CFR 26.406 - Fitness monitoring.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Fitness monitoring. 26.406 Section 26.406 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS FFD Program for Construction § 26.406 Fitness monitoring. (a...) Licensees and other entities shall implement a fitness monitoring program to deter substance abuse and...

10 CFR 26.406 - Fitness monitoring.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Fitness monitoring. 26.406 Section 26.406 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS FFD Program for Construction § 26.406 Fitness monitoring. (a...) Licensees and other entities shall implement a fitness monitoring program to deter substance abuse and...

10 CFR 26.406 - Fitness monitoring.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Fitness monitoring. 26.406 Section 26.406 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS FFD Program for Construction § 26.406 Fitness monitoring. (a...) Licensees and other entities shall implement a fitness monitoring program to deter substance abuse and...

Nonnative Fishes in the Upper Mississippi River System

USGS Publications Warehouse

Irons, Kevin S.; DeLain, Steven A.; Gittinger, Eric; Ickes, Brian S.; Kolar, Cindy S.; Ostendort, David; Ratcliff, Eric N.; Benson, Amy J.; Irons, Kevin S.

2009-01-01

The introduction, spread, and establishment of nonnative species is widely regarded as a leading threat to aquatic biodiversity and consequently is ranked among the most serious environmental problems facing the United States today. This report presents information on nonnative fish species observed by the Long Term Resource Monitoring Program on the Upper Mississippi River System a nexus of North American freshwater fish diversity for the Nation. The Long Term Resource Monitoring Program, as part of the U.S. Army Corps of Engineers' Environmental Management Plan, is the Nation's largest river monitoring program and stands as the primary source of standardized ecological information on the Upper Mississippi River System. The Long Term Resource Monitoring Program has been monitoring fish communities in six study areas on the Upper Mississippi River System since 1989. During this period, more than 3.5 million individual fish, consisting of 139 species, have been collected. Although fish monitoring activities of the Long Term Resource Monitoring Program focus principally on entire fish communities, data collected by the Program are useful for detecting and monitoring the establishment and spread of nonnative fish species within the Upper Mississippi River System Basin. Sixteen taxa of nonnative fishes, or hybrids thereof, have been observed by the Long Term Resource Monitoring Program since 1989, and several species are presently expanding their distribution and increasing in abundance. For example, in one of the six study areas monitored by the Long Term Resource Monitoring Program, the number of established nonnative species has increased from two to eight species in less than 10 years. Furthermore, contributions of those eight species can account for up to 60 percent of the total annual catch and greater than 80 percent of the observed biomass. These observations are critical because the Upper Mississippi River System stands as a nationally significant pathway for nonnative species expansion between the Mississippi River and the Great Lakes Basin. This report presents a synthesis of data on nonnative fish species observed during Long Term Resource Monitoring Program monitoring activities.

The personalized medicine for diabetes meeting summary report.

PubMed

Klonoff, David C

2009-07-01

Personalized medicine for diabetes is a potential method to specifically identify people who are at high risk of developing type 2 diabetes based on a combination of personal history, family history, physical examination, circulating biomarkers, and genome. High-risk individuals can then be referred to lifestyle programs for risk reduction and disease prevention. Using a personalized medicine approach, a patient with already-diagnosed type 2 diabetes can be treated individually based on information specific to that individual. The field of personalized medicine for diabetes is rapidly exploding. Diabetes Technology Society convened the Personalized Medicine for Diabetes (PMFD) Meeting March 19-20, 2009 in San Francisco. The meeting was funded through a contract from the US Air Force. Diabetes experts from the military, government, academic, and industry communities participated. The purpose was to reach a consensus about PMFD in type 2 diabetes to (a) establish screening programs, (b) diagnose cases at an early stage, and (c) monitor and treat the disease with specific measures. The group defined what a PMFD program should encompass, what the benefits and drawbacks of such a PMFD program would be, and how to overcome barriers. The group reached six conclusions related to the power of PMFD to improve care of type 2 diabetes by resulting in (1) better prediction, (2) better prophylactic interventions, (3) better treatments, and (4) decreased cardiovascular disease burden. Additional research is needed to demonstrate the benefits of this approach. The US Air Force is well positioned to conduct research and develop clinical programs in PMFD. Copyright 2009 Diabetes Technology Society.

Modifying Risk Factors for Total Joint Arthroplasty: Strategies That Work Nicotine.

PubMed

Springer, Bryan D

2016-08-01

Smoking and nicotine use remain a major health care crisis in the United States. Although rates have dropped dramatically over the last 50 years, approximately 18% of the US adult population still smokes. The musculoskeletal effects of nicotine and other byproducts of smoking place patients at increased risk for perioperative complications including medical complication, wound healing problems, infection, and death. A comprehensive behavioral modification program with or without the use of nicotine replacement therapy has been shown to be most effective at smoking cessation around the time of planned surgery. Although literature suggests that smoking cessation 4-6 weeks before surgery can diminish risk, both current and former smokers are at increased risk for perioperative complications compared with those that have never smoked. Cotinine, a metabolite of nicotine, can be used to monitor smoking cessation before surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

Analogs and the BHP Risk Reduction Strategy for Future Spaceflight Missions

NASA Technical Reports Server (NTRS)

Whitmire, Sandra; Leveton, Lauren

2011-01-01

In preparation for future exploration missions to distant destinations (e.g., Moon, Near Earth Objects (NEO), and Mars), the NASA Human Research Program s (HRP) Behavioral Health and Performance Element (BHP) conducts and supports research to address four human health risks: Risk of Behavioral Conditions; Risk of Psychiatric Conditions; Risk of Performance Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team; and Risk of Performance Errors due to Sleep Loss, Fatigue, Circadian Desynchronization, and Work Overload (HRP Science Management Plan, 2008). BHP Research, in collaboration with internal and external research investigators, as well as subject matter experts within NASA operations including flight surgeons, astronauts, and mission planners and others within the Mission Operations Directorate (MOD), identifies knowledge and technology gaps within each Risk. BHP Research subsequently manages and conducts research tasks to address and close the gaps, either through risk assessment and quantification, or the development of countermeasures and monitoring technologies. The resulting deliverables, in many instances, also support current Medical Operations and/or Mission Operations for the International Space Station (ISS).

High-Risk Obtainment of Prescription Drugs by Older Adults in New Jersey: The Role of Prescription Opioids.

PubMed

Gold, Sarah L; Powell, Kristen Gilmore; Eversman, Michael H; Peterson, N Andrew; Borys, Suzanne; Hallcom, Donald K

2016-10-01

To explore the high-risk ways in which older adults obtain prescription opioids and to identify predictors of obtaining prescription opioids from high-risk sources, such as obtaining the same drug from multiple doctors, sharing drugs, and stealing prescription pads. Logistic regression analyses of cross-sectional survey data from the New Jersey Older Adult Survey on Drug Use and Health, a representative random-sample survey. Adults aged 60 and older (N = 725). Items such as obtaining prescriptions for the same drug from more than one doctor and stealing prescription drugs were measured to determine high-risk obtainment of prescription opioids. Almost 15% of the sample used high-risk methods of obtaining prescription opioids. Adults who previously used a prescription opioid recreationally had three times the risk of high-risk obtainment of prescription opioids. These findings illustrate the importance of strengthening prescription drug monitoring programs to reduce high-risk use of prescription drugs in older adults by alerting doctors and pharmacists to potential prescription drug misuse and interactions. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Nonadherence with Employer-Mandated Sleep Apnea Treatment and Increased Risk of Serious Truck Crashes

PubMed Central

Burks, Stephen V.; Anderson, Jon E.; Bombyk, Matthew; Haider, Rebecca; Ganzhorn, Derek; Jiao, Xueyang; Lewis, Connor; Lexvold, Andrew; Liu, Hong; Ning, Jiachen; Toll, Alice; Hickman, Jeffrey S.; Mabry, Erin; Berger, Mark; Malhotra, Atul; Czeisler, Charles A.; Kales, Stefanos N.

2016-01-01

Study Objectives: To evaluate the effect of an employer-mandated obstructive sleep apnea (OSA) program on the risk of serious preventable truck crashes. Methods: Data are from the first large-scale, employer-mandated program to screen, diagnose, and monitor OSA treatment adherence in the US trucking industry. A retrospective analysis of cohorts was constructed: polysomnogram-diagnosed drivers (OSA positive n = 1,613, OSA negative n = 403) were matched to control drivers unlikely to have OSA (n = 2,016) on two factors affecting crash risk, experience-at-hire and length of job tenure; tenure was matched on the date of each diagnosed driver's polysomnogram. Auto-adjusting positive airway pressure (APAP) treatment was provided to all cases (i.e. OSA positive drivers); treatment adherence was objectively monitored. Cases were grouped by treatment adherence: “Full Adherence” (n = 682), “Partial Adherence” (n = 571), or “No Adherence” (n = 360). Preventable Department-of-Transportation-reportable crashes/100,000 miles were compared across study subgroups. Robustness was assessed. Results: After the matching date, “No Adherence” cases had a preventable Department of Transportation-reportable crash rate that was fivefold greater (incidence rate ratio = 4.97, 95% confidence interval: 2.09, 10.63) than that of matched controls (0.070 versus 0.014 per 100,000 miles). The crash rate of “Full Adherence” cases was statistically similar to controls (incidence rate ratio = 1.02, 95% confidence interval: 0.48, 2.04; 0.014 per 100,000 miles). Conclusions: Nontreatment-adherent OSA-positive drivers had a fivefold greater risk of serious preventable crashes, but were discharged or quit rapidly, being retained only one-third as long as other subjects. Thus, the mandated program removed risky nontreatment-adherent drivers and retained adherent drivers at the study firm. Current regulations allow nonadherent OSA cases to drive at another firm by keeping their diagnosis private. Commentary: A commentary on this article appears in this issue on page 961. Citation: Burks SV, Anderson JE, Bombyk M, Haider R, Ganzhorn D, Jiao X, Lewis C, Lexvold A, Liu H, Ning J, Toll A, Hickman JS, Mabry E, Berger M, Malhotra A, Czeisler CA, Kales SN. Nonadherence with employer-mandated sleep apnea treatment and increased risk of serious truck crashes. SLEEP 2016;39(5):967–975. PMID:27070139

Immunization-Safety Monitoring Systems for the 2009 H1N1 Monovalent Influenza Vaccination Program

DTIC Science & Technology

2011-01-01

central nervous system, optic neuritis, chronic inflammatory demyelinating polyneuropathy ) 340, 341.0, 341.8, 341.9, 377.30, 377.31, 377.32, 377.34...neuropathy, polyneuropathy due to drugs or other toxic agents, critical illness polyneuropathy , other inflammatory and toxic neuropathy) 337.0, 337.9, 354.1...Popula- tions at high risk, such as those with chronic diseases, are sometimes not well represented in clinical studies; however, additional efforts

Living with a volcano in your backyard: an educator's guide with emphasis on Mount Rainier

USGS Publications Warehouse

Driedger, Carolyn L.; Doherty, Anne; Dixon, Cheryl; Faust, Lisa M.

2005-01-01

The National Park Service and the U.S. Geological Survey’s Volcano Hazards Program (USGS-VHP) support development and publication of this educator’s guide as part of their mission to educate the public about volcanoes. The USGS-VHP studies the dynamics of volcanoes, investigates eruption histories, develops hazard assessments, monitors volcano-related activity, and collaborates with local officials to lower the risk of disruption when volcanoes become restless.

Do Adverse Childhood Experiences Increase the Risk of Postdeployment Posttraumatic Stress Disorder in US Marines

DTIC Science & Technology

2010-01-01

GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR( S ) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME( S ) AND...REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME( S ) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM( S ) 11. SPONSOR/MONITOR’S REPORT NUMBER( S ) 12...retardation, and substance abuse or dependence. Coding was based on the International Classification of Diseases , Ninth Revision, Clinical

2014 Space Radiation Standing Review Panel

NASA Technical Reports Server (NTRS)

Steinberg, Susan

2015-01-01

The 2014 Space Radiation Standing Review Panel (from here on referred to as the SRP) participated in a WebEx/teleconference with members of the Space Radiation Program Element, representatives from the Human Research Program (HRP), the National Space Biomedical Research Institute (NSBRI), and NASA Headquarters on November 21, 2014 (list of participants is in Section XI of this report). The SRP reviewed the updated Research Plan for the Risk of Cardiovascular Disease and Other Degenerative Tissue Effects from Radiation Exposure (Degen Risk). The SRP also received a status update on the Risk of Acute and Late Central Nervous System Effects from Radiation Exposure (CNS Risk), the Risk of Acute Radiation Syndromes Due to Solar Particle Events (ARS Risk), and the Risk of Radiation Carcinogenesis (Cancer Risk). The SRP thought the teleconference was very informative and that the Space Radiation Program Element did a great job of outlining where the Element is with respect to our state of knowledge on the risks of carcinogenesis, central nervous system effects, and the risk of cardiovascular disease and other degenerative tissue effects from exposure to space radiation. The SRP was impressed with the quality of research that is being conducted and the progress the Space Radiation Program Element has made in the past year. While much work has been done, the SRP had a few remaining questions regarding the broad applicability of these findings to a manned deep space mission (in terms of cognitive function, the paradigms were still hippocampal based and also using Alzheimer disease models). The SRP believes that NASA should consider developing an approach to follow astronauts long-term (beyond retirement) for potential side-effects/risks of space exposure that may be unknown. Radiation toxicities often occur decades after exposure, and potential consequences would be missed if intensified exams stop after retirement of the astronauts. In addition, while cancer is one consequence of radiation exposure that is monitored, potential other side effects (CNS, Alzheimer Disease, loss of cognitive function, etc.) are not included in long-term studies and would be missed. Inclusion of long-term data would be of benefit to the astronauts themselves who have given their service to the corps but also to future astronauts and the future of space exploration.

Using an eHealth Intervention to Stimulate Health Behavior for the Prevention of Cognitive Decline in Dutch Adults: A Study Protocol for the Brain Aging Monitor.

PubMed

Aalbers, Teun; Baars, Maria Ae; Qin, Li; de Lange, Annet; Kessels, Roy Pc; Olde Rikkert, Marcel Gm

2015-11-10

Internet-delivered intervention programs are an effective way of changing health behavior in an aging population. The same population has an increasing number of people with cognitive decline or cognitive impairments. Modifiable lifestyle risk factors such as physical activity, nutrition, smoking, alcohol consumption, sleep, and stress all influence the probability of developing neurodegenerative diseases such as Alzheimer's disease. This study aims to answer two questions: (1) Is the use of a self-motivated, complex eHealth intervention effective in changing multiple health behaviors related to cognitive aging in Dutch adults in the work force, especially those aged 40 and over? and (2) Does this health behavior change result in healthier cognitive aging patterns and contribute to preventing or delaying future onset of neurodegenerative syndromes? The Brain Aging Monitor study uses a quasi-experimental 2-year pre-posttest design. The Brain Aging Monitor is an online, self-motivated lifestyle intervention program. Recruitment is done both in medium to large organizations and in the Dutch general population over the age of 40. The main outcome measure is the relationship between lifestyle change and cognitive aging. The program uses different strategies and modalities such as Web content, email, online newsletters, and online games to aid its users in behavior change. To build self-regulatory skills, the Brain Aging Monitor offers its users goal-setting activities, skill-building activities, and self-monitoring. Study results are expected to be published in early 2016. This study will add to the body of evidence on the effectiveness of eHealth intervention programs with the combined use of state-of-the-art applied games and established behavior change techniques. This will lead to new insights on how to use behavior change techniques and theory in multidimensional lifestyle eHealth research, and how these techniques and theories apply when they are used in a setting where no professional back-end is available. Nederlands Trial Register: NTR4144; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4144 (Archived by WebCite at http://www.webcitation.org/6cZzwZSg3).

Estuarine monitoring programs in the Albemarle Sound study area, North Carolina

USGS Publications Warehouse

Moorman, Michelle; Kolb, Katharine R.; Supak, Stacy

2014-01-01

The purpose of this report is to identify major natural resource management issues for the region, provide information on current monitoring activities occurring within the Albemarle Sound study area, determine how the current monitoring network fits into the design of the NMN, and determine what additional monitoring data are needed to address these issues. In order to address these questions, a shapefile and data table were created to document monitoring and research programs in the Albemarle Sound study area with an emphasis on current monitoring programs within the region. This database was queried to determine monitoring gaps that existed in the Albemarle Sound by comparing current monitoring programs with the design indicated by the NMN. The report uses this information to provide recommendations on how monitoring could be improved in the Albemarle Sound study area.

Evolving Hazard Monitoring and Communication at San Vicente Volcano, El Salvador

NASA Astrophysics Data System (ADS)

Bowman, L. J.; Gierke, J. S.

2014-12-01

El Salvador has 20 potentially active volcanoes, four of which have erupted in the last 100 years. Since San Vicente Volcano has had no historic eruptions, monitoring is not a high priority; especially given the current eruptive crisis at San Miguel Volcano. Though probability of eruptive hazards remains low at San Vicente, it is arguably one of the most hazardous volcanoes in the country due to rainfall-induced landslides and debris-flow risk. At least 250 deaths occurred in November 2009 from landslides and debris flows triggered by Hurricane Ida. This disaster caused the Universidad de El Salvador - Facultad Multidisciplinaria Paracentral (UES-FMP, San Vicente, El Salvador) to partner with governmental and nongovernmental organizations (including the U.S. Peace Corps, U.S. Fulbright Program, Korean International Cooperation Agency, Protección Civil and the Centro de Protección para Desastres (CEPRODE)) to focus its faculty and student research toward hazard monitoring and risk studies. Newly established monitoring efforts include: measurement of surface cracks and localized rainfall by Protección Civil and local residents using crude extensometers and rain gauges; installation of six weather stations that operate within the most at-risk municipalities; seismic refraction surveys to better characterize stratigraphy and seasonal water table changes; and most recently, a USAID/NSF-funded initiative partnered with the UES-FMP to monitor seasonal hydrologic conditions related to flooding and groundwater recharge. The information from these initiatives is now used to communicate current conditions and warnings through a network of two-way radios established by CEPRODE and Protección Civil. Representatives from the multi-institutional team also communicate the data to authorities who make better-informed decisions regarding warnings and evacuations, as well as determine suitable areas for population relocation in the event of a crisis. Data will eventually be used to model and forecast potential hazard events.

Development of Smart Grid for Community and Cyber based Landslide Hazard Monitoring and Early Warning System

NASA Astrophysics Data System (ADS)

Karnawati, D.; Wilopo, W.; Fathani, T. F.; Fukuoka, H.; Andayani, B.

2012-12-01

A Smart Grid is a cyber-based tool to facilitate a network of sensors for monitoring and communicating the landslide hazard and providing the early warning. The sensor is designed as an electronic sensor installed in the existing monitoring and early warning instruments, and also as the human sensors which comprise selected committed-people at the local community, such as the local surveyor, local observer, member of the local task force for disaster risk reduction, and any person at the local community who has been registered to dedicate their commitments for sending reports related to the landslide symptoms observed at their living environment. This tool is designed to be capable to receive up to thousands of reports/information at the same time through the electronic sensors, text message (mobile phone), the on-line participatory web as well as various social media such as Twitter and Face book. The information that should be recorded/ reported by the sensors is related to the parameters of landslide symptoms, for example the progress of cracks occurrence, ground subsidence or ground deformation. Within 10 minutes, this tool will be able to automatically elaborate and analyse the reported symptoms to predict the landslide hazard and risk levels. The predicted level of hazard/ risk can be sent back to the network of electronic and human sensors as the early warning information. The key parameters indicating the symptoms of landslide hazard were recorded/ monitored by the electrical and the human sensors. Those parameters were identified based on the investigation on geological and geotechnical conditions, supported with the laboratory analysis. The cause and triggering mechanism of landslide in the study area was also analysed in order to define the critical condition to launch the early warning. However, not only the technical but also social system were developed to raise community awareness and commitments to serve the mission as the human sensors, which will be responsible for reporting and informing the early warning. Therefore, a community empowerment and encouragement program through public education was conducted. Strategy and approach for this program was formulated based on the socio-engineering investigation. Finally, the results of technical and social engineering investigations, have been elaborated to further enhance the performance of expert system of the Smart Grid, in order to completely establish this system as an innovative and effective tool for the landslide monitoring and early warning in tropical-developing country.

Risk management in air protection in the Republic of Croatia.

PubMed

Peternel, Renata; Toth, Ivan; Hercog, Predrag

2014-03-01

In the Republic of Croatia, according to the Air Protection Act, air pollution assessment is obligatory on the whole State territory. For individual regions and populated areas in the State a network has been established for permanent air quality monitoring. The State network consists of stations for measuring background pollution, regional and cross-border remote transfer and measurements as part of international government liabilities, then stations for measuring air quality in areas of cultural and natural heritage, and stations for measuring air pollution in towns and industrial zones. The exceeding of alert and information threshold levels of air pollutants are related to emissions from industrial plants, and accidents. Each excess represents a threat to human health in case of short-time exposure. Monitoring of alert and information threshold levels is carried out at stations from the state and local networks for permanent air quality monitoring according to the Air Quality Measurement Program in the State network for permanent monitoring of air quality and air quality measurement programs in local networks for permanent air quality monitoring. The State network for permanent air quality monitoring has a developed automatic system for reporting on alert and information threshold levels, whereas many local networks under the competence of regional and local self-governments still lack any fully installed systems of this type. In case of accidents, prompt action at all responsibility levels is necessary in order to prevent crisis and this requires developed and coordinated competent units of State Administration as well as self-government units. It is also necessary to be continuously active in improving the implementation of legislative regulations in the field of crises related to critical and alert levels of air pollutants, especially at local levels.

Generic command interpreter for robot controllers

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

Werner, J.

1991-04-09

Generic command interpreter programs have been written for robot controllers at Sandia National Laboratories (SNL). Each interpreter program resides on a robot controller and interfaces the controller with a supervisory program on another (host) computer. We call these interpreter programs monitors because they wait, monitoring a communication line, for commands from the supervisory program. These monitors are designed to interface with the object-oriented software structure of the supervisory programs. The functions of the monitor programs are written in each robot controller's native language but reflect the object-oriented functions of the supervisory programs. These functions and other specifics of the monitormore » programs written for three different robots at SNL will be discussed. 4 refs., 4 figs.« less

Airflow obstruction case finding in community-pharmacies: a novel strategy to reduce COPD underdiagnosis.

PubMed

Castillo, D; Burgos, F; Guayta, R; Giner, J; Lozano, P; Estrada, M; Soriano, J B; Flor, X; Barau, M; Casan, P

2015-04-01

Community pharmacies (CP) have access to subjects at high-risk of suffering Chronic Obstructive Pulmonary Disease (COPD). We investigated if a COPD case finding program in CP could be a new strategy to reduce COPD underdiagnosis. Prospective, cross-sectional, descriptive, uncontrolled, remotely supported study in 100 CP in Barcelona, Spain. Pharmacists were trained in a four-day workshop on spirometry and COPD, and each was provided with a spirometer for 12 weeks. The program included questionnaires and forced spirometry measurements, whose quality was controlled and monitored by web-assistance. Overall 2295 (73.5%), of 3121 CP customers invited to participate in the program accepted, and 1.456 (63.4%) were identified as "high risk" for COPD using the GOLD questionnaire. Only 33 could not conduct spirometry, and a pre-bronchodilator airflow limitation (FEV1/FVC ratio <0.7) was confirmed in 282 (19.8%); 244 of these were referred to their primary care (PC) physician for further diagnostic and therapeutic work-up, but only 39 of them (16%) fed-back this information to the pharmacist. Clinically acceptable quality spirometries (grade A or B) were obtained in 69.4% of the cases. This study shows that adequately trained and supported community pharmacists can effectively identify individuals at high risk of having COPD and can thus contribute to ameliorate underdiagnosis in this disease. Links between PC and CP should be improved to achieve a useful program. Copyright © 2015 Elsevier Ltd. All rights reserved.

Green Open Space: Awareness for Health or Sustainability?

NASA Astrophysics Data System (ADS)

Dewi, O. C.; Chairunnisa, I.; Hidayat, T.; Anggraini, M.; Napitupulu, A.

2018-03-01

Universitas Indonesia in cooperation with American Red Cross and Indonesian Red Cross have been assisting green open space revitalisation program in 7 locations in Bogor Regency (2016-2017). The program was held under The Urban Disaster Risk Reduction Greater Jakarta Project; an initiative program from American Red Cross Indonesia. This project was not only improving the existing green open space quality, but also creating one adapted from public land. The revitalization project figures what happened on daily basis on the existing land, proposing new programming facilities, community-based construction, monitoring and handing over. This paper discovers the meaning of a green space for the community, whether the community aware of its benefit on human health or environmental sustainability. The research question is does the community aware of green open space benefit for human health or environmental sustainability? Or both? The original data from the community was gathered and grouped based on its relevance with environmental quality and public health.

Program Monitoring Practices for Teachers of the Deaf and Hard of Hearing in Early Intervention

ERIC Educational Resources Information Center

Thomas, Anne E.; Marvin, Christine A.

2016-01-01

Program monitoring is an important and necessary assessment practice within the field of early childhood deaf education. Effective program monitoring requires a focus on both the consistent implementation of intervention strategies (fidelity) and the assessment of children's ongoing progress in response to interventions (progress monitoring).…

NCCN Mountain Lakes Monitoring Strategy: Guidelines to Resolution

USGS Publications Warehouse

Hoffman, Robert L.; Huff, Mark H.

2008-01-01

The North Coast and Cascades Network (NCCN) Inventory and Monitoring Program provides funds to its Network Parks to plan and implement the goals and objectives of the National Park Services? (NPS) Inventory and Monitoring (I&M) Program. The primary purpose of the I&M program is to develop and implement a long-term monitoring program in each network. The purpose of this document is to describe the outcome of a meeting held to find solutions to obstacles inhibiting development of a unified core design and methodology for mountain lake monitoring.

Long-term fish monitoring in large rivers: Utility of “benchmarking” across basins

USGS Publications Warehouse

Ward, David L.; Casper, Andrew F.; Counihan, Timothy D.; Bayer, Jennifer M.; Waite, Ian R.; Kosovich, John J.; Chapman, Colin; Irwin, Elise R.; Sauer, Jennifer S.; Ickes, Brian; McKerrow, Alexa

2017-01-01

In business, benchmarking is a widely used practice of comparing your own business processes to those of other comparable companies and incorporating identified best practices to improve performance. Biologists and resource managers designing and conducting monitoring programs for fish in large river systems tend to focus on single river basins or segments of large rivers, missing opportunities to learn from those conducting fish monitoring in other rivers. We briefly examine five long-term fish monitoring programs in large rivers in the United States (Colorado, Columbia, Mississippi, Illinois, and Tallapoosa rivers) and identify opportunities for learning across programs by detailing best monitoring practices and why these practices were chosen. Although monitoring objectives, methods, and program maturity differ between each river system, examples from these five case studies illustrate the important role that long-term monitoring programs play in interpreting temporal and spatial shifts in fish populations for both established objectives and newly emerging questions. We suggest that deliberate efforts to develop a broader collaborative network through benchmarking will facilitate sharing of ideas and development of more effective monitoring programs.

1996 LMITCO environmental monitoring program report for the Idaho National Engineering and Environmental Laboratory

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

NONE

1997-09-01

This report describes the calendar year 1996 environmental surveillance and compliance monitoring activities of the Lockheed Martin Idaho Technologies Company Environmental Monitoring Program performed at the Idaho National Engineering and Environmental Laboratory (INEEL). Results of sampling performed by the Radiological Environmental Surveillance, Site Environmental Surveillance, Drinking Water, Effluent Monitoring, Storm Water Monitoring, Groundwater Monitoring, and Special Request Monitoring Programs are included in this report. The primary purposes of the surveillance and monitoring activities are to evaluate environmental conditions, to provide and interpret data, to verify compliance with applicable regulations or standards, and to ensure protection of human health and themore » environment. This report compares 1996 data with program-specific regulatory guidelines and past data to evaluate trends.« less

Research to support optimization of prescription drug monitoring programs.

PubMed

Doyle, Sheri; Leichtling, Gillian; Hildebran, Christi; Reilly, Cynthia

2017-11-01

Research is needed to evaluate the impact of prescription drug monitoring programs (PDMPs). This paper describes research priorities for PDMPs that were initially discussed at a 2015 meeting of PDMP administrators, researchers, public health officials, and other stakeholders. Meeting participants defined the current landscape of PDMP research and identified research gaps. Research priorities were grouped by theme. Prescription drug monitoring program research priorities were identified for 3 key areas: individual patient health outcomes, prescriber use and decision making, and population-level outcomes. Research areas for individual patient outcomes include examining drug-use thresholds that best predict risk for overdose or substance use disorder and unintended consequences of PDMP use. Proposed research on prescriber PDMP use include evaluating how enhancements to the content and format of PDMP reports informs clinical decision making and optimal clinician actions in response to a concerning PDMP report. Finally, research topics related to population-level outcomes include measuring the impact of PDMP policies on the incidence of substance misuse and harms and assessing the return on investment for these databases. The clinical, public health, and economic impacts of PDMPs must be evaluated, using both quantitative and qualitative methods. In addition to assessing patient outcomes, qualitative research should examine how clinicians use and interpret PDMP information. Research should also examine the impact of PDMP features and policies on prescriber utilization. Comparative analyses across states with differing PDMP policies should be conducted to inform best practices. Copyright © 2017 John Wiley & Sons, Ltd.

An assessment of potential health impacts on Utrok Atoll from exposure to cesium-137 (137Cs) and plutonium

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

Hamilton, T

2007-07-24

Residual fallout contamination from the nuclear test program in the Marshall Islands is a concern to Marshall Islanders because of the potential health risks associated with exposure to residual fallout contamination in the environment. Scientists from Lawrence Livermore National Laboratory (LLNL) have been monitoring the amount of fallout radiation delivered to Utrok Atoll residents over the past 4 years. This briefing document gives an outline of our findings from the whole body counting and plutonium bioassay monitoring programs. Additional information can be found on the Marshall Islands web site (http://eed.lnl.gov/mi/). Cesium-137 is an important radioactive isotope produced in nuclear detonationsmore » and can be taken up from coral soils into locally grown food crop products that form an important part of the Marshallese diet. The Marshall Islands whole body counting program has clearly demonstrated that the majority of Utrok Atoll residents acquire a very small but measurable quantity of cesium-137 in their bodies (Hamilton et al., 2006; Hamilton et. al., 2007a; 2007b;). During 2006, a typical resident of Utrok Atoll received about 3 mrem of radiation from internally deposited cesium-137 (Hamilton et al., 2007a). The population-average dose contribution from cesium-137 is around 2% of the total radiation dose that people normally experience from naturally occurring radiation sources in the Marshall Islands and is thousands of times lower than the level where radiation exposure is known to produce measurable health effects. The existing dose estimates from the whole body counting and plutonium bioassay programs are also well below radiological protection standards for protection of the public as prescribed by U.S. regulators and international agencies including the Marshall Islands Nuclear Claim Tribunal (NCT). Similarly, the level of internally deposited plutonium found in Utrok Atoll residents is well within the range normally expected for people living in the Northern Hemisphere. In addition, the preliminary results of the bioassay program on Utrok Atoll (Hamilton et al., 2007b) provide clear evidence that residents of Utrok Atoll have never acquired a significant uptake of plutonium either through an acute exposure event or from long-term chronic exposure to plutonium in the environment. This information and data should provide a level of assurance to the Utrok Atoll population group and its leadership that the dose contribution from exposure to residual radioactive fallout contamination on Utrok Atoll is very low, and is not likely to have any discernible impact on human health. We also estimate that the dose contribution based on current radiological exposure conditions will not produce any additional cancer fatalities (or any other measurable health condition) above that normally expected to arise in a population group of similar size. The potential risks from any genetic illnesses caused by exposure to residual fallout contamination in the environment will be even lower still. In conclusion, the data and information developed from the radiological protection monitoring program on Utrok appear to support a consensus that it is safe to live on Utrok Atoll. The health risks from exposure to residual fallout contamination on the atoll are minimal when compared with other lifetime risks that people normally experience, and are very small when compared to the threshold where radiation health effects could be either medically diagnosed in an individual or epidemiologically discerned in a group of people.« less

Ecological Monitoring and Compliance Program 2007 Report

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

Hansen, Dennis; Anderson, David; Derek, Hall

2008-03-01

In accordance with U.S. Department of Energy (DOE) Order 450.1, 'Environmental Protection Program', the Office of the Assistant Manager for Environmental Management of the DOE, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) requires ecological monitoring and biological compliance support for activities and programs conducted at the Nevada Test Site (NTS). National Security Technologies, LLC (NSTec), Ecological Services has implemented the Ecological Monitoring and Compliance (EMAC) Program to provide this support. EMAC is designed to ensure compliance with applicable laws and regulations, delineate and define NTS ecosystems, and provide ecological information that can be used to predict and evaluate themore » potential impacts of proposed projects and programs on those ecosystems. This report summarizes the EMAC activities conducted by NSTec during calendar year 2007. Monitoring tasks during 2007 included eight program areas: (a) biological surveys, (b) desert tortoise compliance, (c) ecosystem mapping and data management, (d) sensitive plant monitoring, (e) sensitive and protected/regulated animal monitoring, (f) habitat monitoring, (g) habitat restoration monitoring, and (h) biological monitoring at the Nonproliferation Test and Evaluation Complex (NPTEC). The following sections of this report describe work performed under these eight areas.« less

Design and implementation of a wearable healthcare monitoring system.

PubMed

Sagahyroon, Assim; Raddy, Hazem; Ghazy, Ali; Suleman, Umair

2009-01-01

A wearable healthcare monitoring unit that integrates various technologies was developed to provide patients with the option of leading a healthy and independent life without risks or confinement to medical facilities. The unit consists of various sensors integrated to a microcontroller and attached to the patient's body, reading vital signs and transmitting these readings via a Bluetooth link to the patient's mobile phone. Short-Messaging-Service (SMS) is incorporated in the design to alert a physician in emergency cases. Additionally, an application program running on the mobile phone uses the internet to update (at regular intervals) the patient records in a hospital database with the most recent readings. To reduce development costs, the components used were both off-the-shelf and affordable.

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.

A novel and cost-effective monitoring approach for outcomes in an Australian biodiversity conservation incentive program.

PubMed

Lindenmayer, David B; Zammit, Charles; Attwood, Simon J; Burns, Emma; Shepherd, Claire L; Kay, Geoff; Wood, Jeff

2012-01-01

We report on the design and implementation of ecological monitoring for an Australian biodiversity conservation incentive scheme - the Environmental Stewardship Program. The Program uses competitive auctions to contract individual land managers for up to 15 years to conserve matters of National Environmental Significance (with an initial priority on nationally threatened ecological communities). The ecological monitoring was explicitly aligned with the Program's policy objective and desired outcomes and was applied to the Program's initial Project which targeted the critically endangered White Box-Yellow Box-Blakely's Red Gum Grassy Woodland and Derived Native Grassland ecological community in south eastern Australia. These woodlands have been reduced to <3% of their original extent and persist mostly as small remnants of variable condition on private farmland. We established monitoring sites on 153 farms located over 172,232 sq km. On each farm we established a monitoring site within the woodland patch funded for management and, wherever possible, a matched control site. The monitoring has entailed gathering data on vegetation condition, reptiles and birds. We also gathered data on the costs of experimental design, site establishment, field survey, and data analysis. The costs of monitoring are approximately 8.5% of the Program's investment in the first four years and hence are in broad accord with the general rule of thumb that 5-10% of a program's funding should be invested in monitoring. Once initial monitoring and site benchmarking are completed we propose to implement a novel rotating sampling approach that will maintain scientific integrity while achieving an annual cost-efficiency of up to 23%. We discuss useful lessons relevant to other monitoring programs where there is a need to provide managers with reliable early evidence of program effectiveness and to demonstrate opportunities for cost-efficiencies.

Flexible risk metrics for identifying and monitoring conservation-priority species

USGS Publications Warehouse

Stanton, Jessica C.; Semmens, Brice X.; McKann, Patrick C.; Will, Tom; Thogmartin, Wayne E.

2016-01-01

Region-specific conservation programs should have objective, reliable metrics for species prioritization and progress evaluation that are customizable to the goals of a program, easy to comprehend and communicate, and standardized across time. Regional programs may have vastly different goals, spatial coverage, or management agendas, and one-size-fits-all schemes may not always be the best approach. We propose a quantitative and objective framework for generating metrics for prioritizing species that is straightforward to implement and update, customizable to different spatial resolutions, and based on readily available time-series data. This framework is also well-suited to handling missing-data and observer error. We demonstrate this approach using North American Breeding Bird Survey (NABBS) data to identify conservation priority species from a list of over 300 landbirds across 33 bird conservation regions (BCRs). To highlight the flexibility of the framework for different management goals and timeframes we calculate two different metrics. The first identifies species that may be inadequately monitored by NABBS protocols in the near future (TMT, time to monitoring threshold), and the other identifies species likely to decline significantly in the near future based on recent trends (TPD, time to percent decline). Within the individual BCRs we found up to 45% (mean 28%) of the species analyzed had overall declining population trajectories, which could result in up to 37 species declining below a minimum NABBS monitoring threshold in at least one currently occupied BCR within the next 50 years. Additionally, up to 26% (mean 8%) of the species analyzed within the individual BCRs may decline by 30% within the next decade. Conservation workers interested in conserving avian diversity and abundance within these BCRs can use these metrics to plan alternative monitoring schemes or highlight the urgency of those populations experiencing the fastest declines. However, this framework is adaptable to many taxa besides birds where abundance time-series data are available.

Design and operation of internal dosimetry programs

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

LaBone, T.R.

1991-01-01

The proposed revision to USNRC 10 CFR 20 and the USDOE Order 5480.11 require intakes of radioactive material to be evaluated. Radiation dose limits are based on the sum of effective dose equivalent from intakes and the whole body dose from external sources. These significant changes in the regulations will require, at a minimum, a complete review of personnel monitoring programs to determine their adequacy. In this session we will review a systematic method of designing a routine personnel monitoring program that will comply with the requirements of the new regulations. Specific questions discussed are: (a) What are the goalsmore » and objectives of a routine personnel monitoring program (b) When is a routine personnel monitoring program required (c) What are the required capabilities of the routine personnel monitoring program (d) What should be done with the information generated in a personnel monitoring program Specific recommendations and interpretations are given in the session. 5 refs., 3 figs., 33 tabs.« less

1993 Annual Report: San Francisco estuary regional monitoring program for trace substances

USGS Publications Warehouse

Thompson, B.; Lacy, Jessica; Hardin, Dane; Grovhaug, Tom; Taberski, K.; Jassby, Alan D.; Cloern, James E.; Caffrey, J.; Cole, B.; Schoellhamer, David H.

1993-01-01

Summaries of other monitoring activities pertinent to regional monitoring are also included in the Report: a description of the Regional Board’s Bay Protection Studies, the Sacramento Coordinated Monitoring Program, and a wetlands monitoring plan are included.

Contributions of Arctic PRISM to monitoring western hemispheric shorebirds

USGS Publications Warehouse

Skagen, Susan K.; Smith, Paul A.; Andres, Brad A.; Donaldson, Garry; Brown, Stephen

2012-01-01

Long-term monitoring of populations is of paramount importance to understanding responses oforganisms to global environmental change and to evaluating whether conservation practices are yielding intended results through time (Wiens 2009). The population status of many shorebird species, the focus of this volume, remain poorly known. Long-distance migrant shorebirds have proven particularly difficult to monitor, in part because of their highly migratory nature and ranges that extend into highly inaccessible regions. As migrant shorebirds travel the length of the hemisphere, they congregate and disperse in ways that vary among species, locations, and years, presenting serious challenges to designing and implementing monitoring programs. Rigorous field and quantitative methods that estimate population size and monitor trends are vitally needed to direct and evaluate effective conservation measures. Many management efforts depend on unbiased population size estimates; for example, the shorebird conservation plans for both Canada and the United States seek to restore populations to levels calculated for the 1970s based on the best information available from existing surveys. Further, federal wildlife agencies within the United States and Canada have mandates to understand the state of their nations' resources under various conventions for the protection of migratory birds. Accurate estimates of population size are vital statistics for a variety of conservation activities, such as prioritizing species for conservation action and setting management targets. Areas of essential habitat, such as those designated under the Western Hemisphere Shorebird Reserve Network, the Important Bird Areas program of BirdLife International and the National Audubon Society, or Canada's National Wildlife Areas program, are all evaluated on the basis ofproportions of species' populations which they contain. The size, and trends in size, ofa species' population are considered key information for assessing its vulnerability and subsequent listing under the U.S. Endangered Species Act and the Canadian Species at Risk Act. To meet the need for information on population size and trends, shorebird biologists from Canada and the United States proposed a shared blueprint for shorebird monitoring across the Western Hemisphere in the late 1990s; this effort was undertaken in concert with the development of the Canadian and U.S. Shorebird Conservation Plans (Donaldson et al. 2000, Brown et aL 2001). Soon thereafter, partners in the monitoring effort adopted the name "Program for Regional and International Shorebird Monitoring" (PRISM). Among the primary objectives of PRISM were to estimate the population sizes and trends of breeding North American shorebirds and describe their distributions (Bart et al. 2002). PRISM members evaluated ongoing and potential monitoring approaches to address 74 taxa (including subspecies) and proposed a combination of arctic andboreal breeding surveys, temperate breeding and non-breeding surveys, and neotropical surveys.

C-B3-03: Development and Pilot Testing of Guidelines to Monitor High-Risk Medications in the Ambulatory Setting

PubMed Central

Tjia, Jennifer; Field, Terry; Garber, Lawrence; Raebel, Marsha; Donovan, Jennifer; Kanaan, Abir; Fischer, Shira; Gagne, Shawn; Zhao, Yanfang; Fuller, Jackie; Gurwitz, Jerry

2010-01-01

Background: Inadequate laboratory monitoring of high-risk medications contributes to preventable adverse drug events. One barrier to appropriate monitoring is lack of standardized monitoring guidelines. The study aims were to develop guidelines to monitor high-risk medications and to assess the prevalence of laboratory testing for these medications in a multispecialty group practice. Methods: We developed guidelines for laboratory monitoring of high-risk medications as part of a patient safety intervention trial. An advisory committee of national experts and local leaders (clinicians, pharmacists, pharmacoepidemiologists, and patient safety experts) used a two-round, internet-based Delphi process to select guideline medications based on the importance of monitoring for efficacy, safety, and drug-drug interactions. Test frequency recommendations were developed by academic pharmacists based on literature review and local interdisciplinary consensus. To estimate the potential impact of the intervention, we determined the prevalence of high-risk drug dispensings and laboratory testing for guideline medications between January 1, 2008 and July 31, 2008. Results: Consensus on medications to include in the guidelines was achieved in two rounds. Final guidelines included 35 drugs/drug classes and 61 laboratory tests. The prevalence of monitoring ranged from <50% to >90%, with infrequently prescribed drugs having a lower prevalence of recommended testing. When more than one test was recommended for a selected medication, monitoring within a medication sometimes differed by > 50%. Conclusions: Even among drugs where there is general consensus that laboratory monitoring is important, prevalence of monitoring is highly variable. Further, infrequently prescribed medications are at higher risk for poor monitoring.

How to Decide? Multi-Objective Early-Warning Monitoring Networks for Water Suppliers

NASA Astrophysics Data System (ADS)

Bode, Felix; Loschko, Matthias; Nowak, Wolfgang

2015-04-01

Groundwater is a resource for drinking water and hence needs to be protected from contaminations. However, many well catchments include an inventory of known and unknown risk sources, which cannot be eliminated, especially in urban regions. As a matter of risk control, all these risk sources should be monitored. A one-to-one monitoring situation for each risk source would lead to a cost explosion and is even impossible for unknown risk sources. However, smart optimization concepts could help to find promising low-cost monitoring network designs. In this work we develop a concept to plan monitoring networks using multi-objective optimization. Our considered objectives are to maximize the probability of detecting all contaminations, to enhance the early warning time before detected contaminations reach the drinking water well, and to minimize the installation and operating costs of the monitoring network. Using multi-objectives optimization, we avoid the problem of having to weight these objectives to a single objective-function. These objectives are clearly competing, and it is impossible to know their mutual trade-offs beforehand - each catchment differs in many points and it is hardly possible to transfer knowledge between geological formations and risk inventories. To make our optimization results more specific to the type of risk inventory in different catchments we do risk prioritization of all known risk sources. Due to the lack of the required data, quantitative risk ranking is impossible. Instead, we use a qualitative risk ranking to prioritize the known risk sources for monitoring. Additionally, we allow for the existence of unknown risk sources that are totally uncertain in location and in their inherent risk. Therefore, they can neither be located nor ranked. Instead, we represent them by a virtual line of risk sources surrounding the production well. We classify risk sources into four different categories: severe, medium and tolerable for known risk sources and an extra category for the unknown ones. With that, early warning time and detection probability become individual objectives for each risk class. Thus, decision makers can identify monitoring networks valid for controlling the top risk sources, and evaluate the capabilities (or search for least-cost upgrades) to also cover moderate, tolerable and unknown risk sources. Monitoring networks, which are valid for the remaining risk also cover all other risk sources, but only with a relatively poor early-warning time. The data provided for the optimization algorithm are calculated in a preprocessing step by a flow and transport model. It simulates, which potential contaminant plumes from the risk sources would be detectable where and when by all possible candidate positions for monitoring wells. Uncertainties due to hydro(geo)logical phenomena are taken into account by Monte-Carlo simulations. These include uncertainty in ambient flow direction of the groundwater, uncertainty of the conductivity field, and different scenarios for the pumping rates of the production wells. To avoid numerical dispersion during the transport simulations, we use particle-tracking random walk methods when simulating transport.

Active Surveillance for Prostate Cancer: Contemporary State of Practice

PubMed Central

Tosoian, Jeffrey J.; Carter, H. Ballentine; Lepor, Abbey; Loeb, Stacy

2016-01-01

Prostate cancer remains among the most commonly diagnosed malignancies worldwide. Early diagnosis and curative treatment appear to improve survival in men with unfavorable-risk cancers, but significant concerns exist regarding the overdiagnosis and overtreatment of men with lower-risk cancers. To this end, active surveillance (AS) has emerged as a primary management strategy in men with favorable-risk disease, and contemporary data suggest that use of AS has increased worldwide. Although published surveillance cohorts differ by protocol, reported rates of metastatic disease and prostate cancer-specific mortality are exceedingly low in the intermediate term (5–10 years). Such outcomes appear to be closely associated with program-specific criteria for selection, monitoring, and intervention, suggesting that AS – like other management strategies – could be individualized based on the level of risk acceptable to patients in light of personal preferences. Additional data are needed to better establish the risks associated with AS and to identify patient-specific characteristics that could modify prognosis. PMID:26954332

ASI-Sistema Rischio Vulcanico SRV: a pilot project to develop EO data processing modules and products for volcanic activity monitoring based on Italian Civil Protection Department requirements and needs

NASA Astrophysics Data System (ADS)

Buongiorno, Maria Fabrizia; Musacchio, Massimo; Silvestri, Malvina; Spinetti, Claudia; Corradini, Stefano; Lombardo, Valerio; Merucci, Luca; Sansosti, Eugenio; Pugnagli, Sergio; Teggi, Sergio; Pace, Gaetano; Fermi, Marco; Zoffoli, Simona

2007-10-01

The Project called Sistema Rischio Vulcanico (SRV) is funded by the Italian Space Agency (ASI) in the frame of the National Space Plan 2003-2005 under the Earth Observations section for natural risks management. The SRV Project is coordinated by the Istituto Nazionale di Geofisica e Vulcanologia (INGV) which is responsible at national level for the volcanic monitoring. The objective of the project is to develop a pre-operative system based on EO data and ground measurements integration to support the volcanic risk monitoring of the Italian Civil Protection Department which requirements and need are well integrated in the GMES Emergency Core Services program. The project philosophy is to implement, by incremental versions, specific modules which allow to process, store and visualize through Web GIS tools EO derived parameters considering three activity phases: 1) knowledge and prevention; 2) crisis; 3) post crisis. In order to combine effectively the EO data and the ground networks measurements the system will implement a multi-parametric analysis tool, which represents and unique tool to analyze contemporaneously a large data set of data in "near real time". The SRV project will be tested his operational capabilities on three Italian Volcanoes: Etna,Vesuvio and Campi Flegrei.

Very high rate programming in primary prevention patients with reduced ejection fraction implanted with a defibrillator: Results from a large multicenter controlled study.

PubMed

Clementy, Nicolas; Challal, Farid; Marijon, Eloi; Boveda, Serge; Defaye, Pascal; Leclercq, Christophe; Deharo, Jean-Claude; Sadoul, Nicolas; Klug, Didier; Piot, Olivier; Gras, Daniel; Bordachar, Pierre; Algalarrondo, Vincent; Fauchier, Laurent; Babuty, Dominique

2017-02-01

Programming implantable cardioverter-defibrillators (ICDs) with a high-rate therapy strategy has proven to be effective in reducing shocks and is associated with a reduced mortality. We sought to determine the impact of a very high rate cutoff programming strategy on outcomes in patients with a primary indication for an ICD due to reduced left ventricular ejection fraction. Using data from the multicenter French DAI-PP registry, this cohort-controlled study compared outcomes in 500 patients programmed with a very high rate cutoff (VH-RATE group: monitor zone 170-219 beats/min; ventricular fibrillation zone ≥220 beats/min with 13 ± 4 detection intervals) with 1500 matched control patients programmed with 1 or 2 therapy zone. All ICDs were implanted for primary prevention in patients with systolic dysfunction. Risks of events were compared after propensity score matching of sex, age, ejection fraction, New York Heart Association class, cardiomyopathy, atrial fibrillation, and type of device. After a mean follow-up of 3.6 ± 2.3 years, VH-RATE programming was associated with a reduction of appropriate therapy risk (hazard ratio [HR] 0.40; 95% confidence interval [CI] 0.31-0.51; P < .0001) and inappropriate shock (HR 0.42; 95% CI 0.27-0.63; P < .0001). It was also associated with a decreased risk of sudden cardiac death (HR 0.43; 95% CI 0.17-0.99; P = .04) as compared with patients programmed with 2 therapy zones. There was no significant difference in overall survival between the groups. In patients implanted with an ICD in primary prevention with left ventricular dysfunction, very high rate cutoff programming (single therapy zone ≥220 beats/min) was associated with a 60% reduction of appropriate therapies as well as inappropriate shocks, without affecting mortality. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Statistical Techniques to Analyze Pesticide Data Program Food Residue Observations.

PubMed

Szarka, Arpad Z; Hayworth, Carol G; Ramanarayanan, Tharacad S; Joseph, Robert S I

2018-06-26

The U.S. EPA conducts dietary-risk assessments to ensure that levels of pesticides on food in the U.S. food supply are safe. Often these assessments utilize conservative residue estimates, maximum residue levels (MRLs), and a high-end estimate derived from registrant-generated field-trial data sets. A more realistic estimate of consumers' pesticide exposure from food may be obtained by utilizing residues from food-monitoring programs, such as the Pesticide Data Program (PDP) of the U.S. Department of Agriculture. A substantial portion of food-residue concentrations in PDP monitoring programs are below the limits of detection (left-censored), which makes the comparison of regulatory-field-trial and PDP residue levels difficult. In this paper, we present a novel adaption of established statistical techniques, the Kaplan-Meier estimator (K-M), the robust regression on ordered statistic (ROS), and the maximum-likelihood estimator (MLE), to quantify the pesticide-residue concentrations in the presence of heavily censored data sets. The examined statistical approaches include the most commonly used parametric and nonparametric methods for handling left-censored data that have been used in the fields of medical and environmental sciences. This work presents a case study in which data of thiamethoxam residue on bell pepper generated from registrant field trials were compared with PDP-monitoring residue values. The results from the statistical techniques were evaluated and compared with commonly used simple substitution methods for the determination of summary statistics. It was found that the maximum-likelihood estimator (MLE) is the most appropriate statistical method to analyze this residue data set. Using the MLE technique, the data analyses showed that the median and mean PDP bell pepper residue levels were approximately 19 and 7 times lower, respectively, than the corresponding statistics of the field-trial residues.

Changing patterns in water toxicity associated with current use pesticides in three California agriculture regions.

PubMed

Anderson, Brian S; Phillips, Bryn M; Voorhees, Jennifer P; Deng, Xin; Geraci, Jeff; Worcester, Karen; Tjeerdema, Ron S

2018-03-01

Regulation of agriculture irrigation water discharges in California, USA, is assessed and controlled by its 9 Regional Water Quality Control Boards under the jurisdiction of the California State Water Resources Control Board. Each Regional Water Board has developed programs to control pesticides in runoff as part of the waste discharge requirements implemented through each region's Irrigated Lands Regulatory Program. The present study assessed how pesticide use patterns differ in the Imperial (Imperial County) and the Salinas and Santa Maria (Monterey County) valleys, which host 3 of California's prime agriculture areas. Surface-water toxicity associated with current use pesticides was monitored at several sites in these areas in 2014 and 2015, and results were linked to changes in pesticide use patterns in these areas. Pesticide use patterns appeared to coincide with differences in the way agriculture programs were implemented by the 2 respective Regional Water Quality Control Boards, and these programs differed in the 2 Water Board Regions. Different pesticide use patterns affected the occurrence of pesticides in agriculture runoff, and this influenced toxicity test results. Greater detection frequency and higher concentrations of the organophosphate pesticide chlorpyrifos were detected in agriculture runoff in Imperial County compared to Monterey County, likely due to more rigorous monitoring requirements for growers using this pesticide in Monterey County. Monterey County agriculture runoff contained toxic concentrations of pyrethroid and neonicotinoid pesticides, which impacted amphipods (Hyalella azteca) and midge larvae (Chironomus dilutus) in toxicity tests. Study results illustrate how monitoring strategies need to evolve as regulatory actions affect change in pesticide use and demonstrate the importance of using toxicity test indicator species appropriate for the suite of contaminants in runoff in order to accurately assess environmental risk. Integr Environ Assess Manag 2018;14:270-281. © 2017 SETAC. © 2017 SETAC.

The impact of a multidisciplinary information technology-supported program on blood pressure control in primary care.

PubMed

Rinfret, Stéphane; Lussier, Marie-Thérèse; Peirce, Anthony; Duhamel, Fabie; Cossette, Sylvie; Lalonde, Lyne; Tremblay, Chantal; Guertin, Marie-Claude; LeLorier, Jacques; Turgeon, Jacques; Hamet, Pavel

2009-05-01

Hypertension is a leading mortality risk factor yet inadequately controlled in most affected subjects. Effective programs to address this problem are lacking. We hypothesized that an information technology-supported management program could help improve blood pressure (BP) control. This randomized controlled trial included 223 primary care hypertensive subjects with mean 24-hour BP >130/80 and daytime BP >135/85 mm Hg measured with ambulatory monitoring (ABPM). Intervention subjects received a BP monitor and access to an information technology-supported adherence and BP monitoring system providing nurses, pharmacists, and physicians with monthly reports. Control subjects received usual care. The mean (+/-SD) follow-up was 348 (+/-78) and 349 (+/-84) days in the intervention and control group, respectively. The primary end point of the change in the mean 24-hour ambulatory BP was consistently greater in intervention subjects for both systolic (-11.9 versus -7.1 mm Hg; P<0.001) and diastolic BP (-6.6 versus -4.5 mm Hg; P=0.007). The proportion of subjects that achieved Canadian Guideline target BP (46.0% versus 28.6%) was also greater in the intervention group (P=0.006). We observed similar BP declines for ABPM and self-recorded home BP suggesting the latter could be an alternative for confirming BP control. The intervention was associated with more physician-driven antihypertensive dose adjustments or changes in agents (P=0.03), more antihypertensive classes at study end (P=0.007), and a trend toward improved adherence measured by prescription refills (P=0.07). This multidisciplinary information technology-supported program that provided feedback to patients and healthcare providers significantly improved blood pressure levels in a primary care setting.

Identifying Patterns in Implementation of Hospital Pressure Ulcer Prevention Programs: A Multisite Qualitative Study.

PubMed

Soban, Lynn M; Finley, Erin P; Miltner, Rebecca S

2016-01-01

To describe the presence or absence of key components of hospital pressure ulcer (PU) prevention programs in 6 acute care hospitals. Multisite comparative case study. Using purposeful selection based on PU rates (high vs low) and hospital size, 6 hospitals within the Veterans Health Administration health care system were invited to participate. Key informant interviews (n = 48) were conducted in each of the 6 participating hospitals among individuals playing key roles in PU prevention: senior nursing leadership (n = 9), nurse manager (n = 7), wound care specialist (n = 6), frontline RNs (n = 26). Qualitative data were collected during face-to-face, semistructured interviews. Interview protocols were tailored to each interviewee's role with a core set of common questions covering 3 major content areas: (1) practice environment (eg, policies and wound care specialists), (2) current prevention practices (eg, conduct of PU risk assessment and skin inspection), and (3) barriers to PU prevention. We conducted structured coding of 5 key components of PU prevention programs and cross-case analysis to identify patterns in operationalization and implementation of program components across hospitals based on facility size and PU rates (low vs high). All hospitals had implemented all PU prevention program components. Component operationalization varied considerably across hospitals. Wound care specialists were integral to the operationalization of the 4 other program components examined; however, staffing levels and work assignments of wound care specialists varied widely. Patterns emerged among hospitals with low and high PU rates with respect to wound care specialist staffing, data monitoring, and staff education. We found hospital-level variations in PU prevention programs. Wound care specialist staffing may represent a potential point of leverage in achieving other PU program components, particularly performance monitoring and staff education.

DAM Safety and Deformation Monitoring in Dams

NASA Astrophysics Data System (ADS)

Kalkan, Y.; Bilgi, S.; Potts, L.; Miiama, J.; Mahgoub, M.; Rahman, S.

2013-12-01

Water is the life and necessity to water is increasing day by day with respect to the World population, rising of living standards and destruction of nature. Thus, the importance of water and water structures have been increasing gradually. Dams are among the most important engineering structures used for water supplies, flood controls, agricultural purposes as well as drinking and hydroelectric power. There are about 150.000 large size dams in the World. Especially after the Second World War, higher and larger capacity dams have been constructed. Dams create certain risks like the other manmade structures. No one knows precisely how many dam failures have occurred in the World, whereas hundreds of dam failures have occurred throughout the U.S. history. Some basic physical data are very important for assessing the safety and performance of dams. These are movement, water pressure, seepage, reservoir and tail-water elevations, local seismic activities, total pressure, stress and strain, internal concrete temperature, ambient temperature and precipitation. These physical data are measured and monitored by the instruments and equipment. Dams and their surroundings have to be monitored by using essential methods at periodic time intervals in order to determine the possible changes that may occur over the time. Monitoring programs typically consist of; surveillance or visual observation. These programs on dams provide information for evaluating the dam's performance related to the design intent and expected changes that could affect the safety performance of the dam. Additionally, these programs are used for investigating and evaluating the abnormal or degrading performance where any remedial action is necessary. Geodetic and non-geodetic methods are used for monitoring. Monitoring the performance of the dams is critical for producing and maintaining the safe dams. This study provides some information, safety and the techniques about the deformation monitoring of the dams. Therefore, this study gives essential information about the dam safety and related analysis. Monitoring of dams is crucial since deformation might have occurred as a result of erosion, water load, hydraulic gradients, and water saturation. The case study is the deformation measurements of Ataturk Dam. This dam was constructed on Firat River and it has importance for providing drinking water, hydroelectric power and especially irrigation. In addition, brief information is given about this dam and the methods of geodetic and non-geodetic monitoring measurements applied by various disciplines. Geodetic monitoring methods are emphasized in this study. Some results have been obtained from this method for nearly seven years are presented in this work. In addition, some deformation predictions have been made especially for the cross sections where the maximum deformations took place.

Chemical Manufacturing and Refining Industry Legitimacy: Reflective Management, Trust, Precrisis Communication to Achieve Community Efficacy.

PubMed

Heath, Robert L; Lee, Jaesub

2016-06-01

Calls for emergency right-to-know in the 1980s, and, in the 1990s, risk management planning, motivated U.S. chemical manufacturing and refining industries to operationalize a three-pronged approach to risk minimization and communication: reflective management to increase legitimacy, operational safety programs to raise trust, and community engagement designed to facilitate citizens' emergency response efficacy. To assess these management, operational, and communication initiatives, communities (often through Local Emergency Planning Committees) monitored the impact of such programs. In 2012, the fourth phase of a quasi-longitudinal study was conducted to assess the effectiveness of operational change and community outreach in one bellwether community. This study focuses on legitimacy, trust, and response efficacy to suggest that an industry can earn legitimacy credits by raising its safety and environmental impact standards, by building trust via that change, and by communicating emergency response messages to near residents to raise their response efficacy. As part of its campaign to demonstrate its concern for community safety through research, planning, and implementation of safe operations and viable emergency response systems, this industry uses a simple narrative of risk/emergency response-shelter-in-place-communicated by a spokes-character: Wally Wise Guy. © 2015 Society for Risk Analysis.

Critical factors in case management: practical lessons from a cardiac case management program.

PubMed

Stafford, Randall S; Berra, Kathy

2007-08-01

Case management (CM) is an important strategy for chronic disease care. By utilizing non-physician providers for conditions requiring ongoing care and follow-up, CM can facilitate guideline-concordant care, patient empowerment, and improvement in quality of life. We identify a series of critical factors required for successful CM implementation. Heart to Heart is a clinical trial evaluating CM for coronary heart disease (CHD) risk reduction in a multiethnic, low-income population. Patients at elevated cardiac risk were randomized to CM plus primary care (212 patients) or to primary care alone (207). Over a mean follow-up of 17 months, patients received face-to-face nurse and dietitian visits. Mean contact time was 14 hours provided at an estimated cost of $1250 per patient for the 341 (81%) patients completing follow-up. Visits emphasized behavior change, risk-factor monitoring, self-management skills, and guideline-based pharmacotherapy. A statistically significant reduction in mean Framingham risk probability occurred in CM plus primary care relative to primary care alone (1.6% decrease in 10-year CHD risk, p = 0.007). Favorable changes were noted across individual risk factors. Our findings suggest that successful CM implementation relies on choosing appropriate case managers and investing in training, integrating CM into existing care systems, delineating the scope and appropriate levels of clinical decision making, using information systems, and monitoring outcomes and costs. While our population, setting, and intervention model are unique, these insights are broadly relevant. If implemented with attention to critical factors, CM has great potential to improve the process and outcomes of chronic disease care.

Cost considerations for long-term ecological monitoring

USGS Publications Warehouse

Caughlan, L.; Oakley, K.L.

2001-01-01

For an ecological monitoring program to be successful over the long-term, the perceived benefits of the information must justify the cost. Financial limitations will always restrict the scope of a monitoring program, hence the program’s focus must be carefully prioritized. Clearly identifying the costs and benefits of a program will assist in this prioritization process, but this is easier said than done. Frequently, the true costs of monitoring are not recognized and are, therefore, underestimated. Benefits are rarely evaluated, because they are difficult to quantify. The intent of this review is to assist the designers and managers of long-term ecological monitoring programs by providing a general framework for building and operating a cost-effective program. Previous considerations of monitoring costs have focused on sampling design optimization. We present cost considerations of monitoring in a broader context. We explore monitoring costs, including both budgetary costs, what dollars are spent on, and economic costs, which include opportunity costs. Often, the largest portion of a monitoring program budget is spent on data collection, and other, critical aspects of the program, such as scientific oversight, training, data management, quality assurance, and reporting, are neglected. Recognizing and budgeting for all program costs is therefore a key factor in a program’s longevity. The close relationship between statistical issues and cost is discussed, highlighting the importance of sampling design, replication and power, and comparing the costs of alternative designs through pilot studies and simulation modeling. A monitoring program development process that includes explicit checkpoints for considering costs is presented. The first checkpoint occurs during the setting of objectives and during sampling design optimization. The last checkpoint occurs once the basic shape of the program is known, and the costs and benefits, or alternatively the cost-effectiveness, of each program element can be evaluated. Moving into the implementation phase without careful evaluation of costs and benefits is risky because if costs are later found to exceed benefits, the program will fail. The costs of development, which can be quite high, will have been largely wasted. Realistic expectations of costs and benefits will help ensure that monitoring programs survive the early, turbulent stages of development and the challenges posed by fluctuating budgets during implementation.

An integrated comprehensive occupational surveillance system for health care workers.

PubMed

Dement, John M; Pompeii, Lisa A; Østbye, Truls; Epling, Carol; Lipscomb, Hester J; James, Tamara; Jacobs, Michael J; Jackson, George; Thomann, Wayne

2004-06-01

Workers in the health care industry may be exposed to a variety of work-related stressors including infectious, chemical, and physical agents; ergonomic hazards; psychological hazards; and workplace violence. Many of these hazards lack surveillance systems to evaluate exposures and health outcomes. The development and implementation of a comprehensive surveillance system within the Duke University Health System (DUHS) that tracks occupational exposures and stressors as well as injuries and illnesses among a defined population of health care workers (HCWs) is presented. Human resources job and work location data were used to define the DUHS population at risk. Outcomes and exposure data from existing occupational health and safety programs, health promotion programs, and employee health insurance claims, were linked with human resources data and de-identified to create the Duke Health and Safety Surveillance System (DHSSS). The surveillance system is described and four examples are presented demonstrating how the system has successfully been used to study consequences of work-related stress, hearing conservation program evaluation, risk factors for back pain and inflammation, and exposures to blood and body fluids (BBF). Utilization of existing data, often collected for other purposes, can be successfully integrated and used for occupational health surveillance monitoring of HCWs. Use of the DHSSS for etiologic studies, benchmarking, and intervention program evaluation are discussed. Copyright 2004 Wiley-Liss, Inc.

Spirituality within the Family and the Prevention of Health Risk Behavior among Adolescents in Bangkok, Thailand

PubMed Central

Chamratrithirong, Aphichat; Miller, Brenda A; Byrnes, Hilary F; Rhucharoenpornpanich, Orratai; Cupp, Pamela K; Rosati, Michael J; Fongkaew, Warunee; Atwood, Katharine A; Chookhare, Warunee

2010-01-01

This study investigates the influences of a family's spiritual beliefs and practices on substance use and sexual risk behaviors among young adolescents 13 to 14 years old in Bangkok, Thailand. Independent predictor variables are the parents' and teens' spiritual beliefs and practices in Buddhism and parental monitoring behaviors. The study uses data from the 2007 Baseline Survey of the Thai Family Matters Project, which adapted a U.S. based family prevention program for Thai culture. A representative sample of 420 pairs of parents and teens from the Bangkok metropolitan area was recruited to participate in the study. Structural equation models indicate that positive direct and indirect associations of the spirituality of parents and teens within a family and the prevention of adolescent risk behaviors are significant and consistent. PMID:20926170

Position of the American Dietetic Association, American Society for Nutrition, and Society for Nutrition Education: Food and nutrition programs for community-residing older adults.

PubMed

Kamp, Barbara J; Wellman, Nancy S; Russell, Carlene

2010-03-01

Given the federal cost-containment policy to rebalance long-term care away from nursing homes to home- and community-based services, it is the position of the American Dietetic Association, the American Society for Nutrition, and the Society for Nutrition Education that all older adults should have access to food and nutrition programs that ensure the availability of safe, adequate food to promote optimal nutritional status. Appropriate food and nutrition programs include adequately funded food assistance and meal programs, nutrition education, screening, assessment, counseling, therapy, monitoring, evaluation, and outcomes documentation to ensure more healthful aging. The growing number of older adults, the health care focus on prevention, and the global economic situation accentuate the fundamental need for these programs. Yet far too often food and nutrition programs are disregarded or taken for granted. Growing older generally increases nutritional risk. Illnesses and chronic diseases; physical, cognitive, and social challenges; racial, ethnic, and linguistic differences; and low socioeconomic status can further complicate a situation. The beneficial effects of nutrition for health promotion, risk reduction, and disease management need emphasis. Although many older adults are enjoying longer and more healthful lives in their own homes, others, especially those with health disparities and poor nutritional status, would benefit from greater access to food and nutrition programs and services. Food and nutrition practitioners can play a major role in promoting universal access and integrating food and nutrition programs and nutrition services into home- and community-based services.

Aerospace Safety Advisory Panel

NASA Technical Reports Server (NTRS)

1989-01-01

This report provides findings, conclusions and recommendations regarding the National Space Transportation System (NSTS), the Space Station Freedom Program (SSFP), aeronautical projects and other areas of NASA activities. The main focus of the Aerospace Safety Advisory Panel (ASAP) during 1988 has been monitoring and advising NASA and its contractors on the Space Transportation System (STS) recovery program. NASA efforts have restored the flight program with a much better management organization, safety and quality assurance organizations, and management communication system. The NASA National Space Transportation System (NSTS) organization in conjunction with its prime contractors should be encouraged to continue development and incorporation of appropriate design and operational improvements which will further reduce risk. The data from each Shuttle flight should be used to determine if affordable design and/or operational improvements could further increase safety. The review of Critical Items (CILs), Failure Mode Effects and Analyses (FMEAs) and Hazard Analyses (HAs) after the Challenger accident has given the program a massive data base with which to establish a formal program with prioritized changes.

The Infrastructure Necessary to Support a Sustainable Material Protection, Control and Accounting (MPC&A) Program in Russia

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

Bachner, Katherine M.; Mladineo, Stephen V.

The NNSA Material Protection, Control, and Accounting (MPC&A) program has been engaged for fifteen years in upgrading the security of nuclear materials in Russia. Part of the effort has been to establish the conditions necessary to ensure the long-term sustainability of nuclear security. A sustainable program of nuclear security requires the creation of an indigenous infrastructure, starting with sustained high level government commitment. This includes organizational development, training, maintenance, regulations, inspections, and a strong nuclear security culture. The provision of modern physical protection, control, and accounting equipment to the Russian Federation alone is not sufficient. Comprehensive infrastructure projects support themore » Russian Federation's ability to maintain the risk reduction achieved through upgrades to the equipment. To illustrate the contributions to security, and challenges of implementation, this paper discusses the history and next steps for an indigenous Tamper Indication Device (TID) program, and a Radiation Portal Monitoring (RPM) program.« less

A framework for evaluating and designing citizen science programs for natural resources monitoring.

PubMed

Chase, Sarah K; Levine, Arielle

2016-06-01

We present a framework of resource characteristics critical to the design and assessment of citizen science programs that monitor natural resources. To develop the framework we reviewed 52 citizen science programs that monitored a wide range of resources and provided insights into what resource characteristics are most conducive to developing citizen science programs and how resource characteristics may constrain the use or growth of these programs. We focused on 4 types of resource characteristics: biophysical and geographical, management and monitoring, public awareness and knowledge, and social and cultural characteristics. We applied the framework to 2 programs, the Tucson (U.S.A.) Bird Count and the Maui (U.S.A.) Great Whale Count. We found that resource characteristics such as accessibility, diverse institutional involvement in resource management, and social or cultural importance of the resource affected program endurance and success. However, the relative influence of each characteristic was in turn affected by goals of the citizen science programs. Although the goals of public engagement and education sometimes complimented the goal of collecting reliable data, in many cases trade-offs must be made between these 2 goals. Program goals and priorities ultimately dictate the design of citizen science programs, but for a program to endure and successfully meet its goals, program managers must consider the diverse ways that the nature of the resource being monitored influences public participation in monitoring. © 2016 Society for Conservation Biology.

Development of a New ICT-Based Multisensor Blood Pressure Monitoring System for Use in Hemodynamic Biomarker-Initiated Anticipation Medicine for Cardiovascular Disease: The National IMPACT Program Project.

PubMed

Kario, Kazuomi; Tomitani, Naoko; Kanegae, Hiroshi; Yasui, Nobuhiko; Nishizawa, Masafumi; Fujiwara, Takeshi; Shigezumi, Takeya; Nagai, Ryozo; Harada, Hiroshi

We have developed a multisensor home and ambulatory blood pressure (BP) monitoring system for monitoring 24-h central and brachial BP variability concurrent with physical activity (PA), temperature, and atmospheric pressure. The new BP monitoring system utilizes our recently developed biological and environmental signal monitoring Information Communication Technology/Internet of Things system, which can simultaneously monitor the environment (temperature, illumination, etc.) of different rooms in a house (entryway, bedroom, living room, bathing room, and toilet), and a wrist-type high-sensitivity actigraph for identifying the location of patients. By collecting both data on BP and environmental parameters, the system can assess the brachial and central hemodynamic BP reactivity profiles of patients, such as actisensitivity (BP change with PA), thermosensitivity (with temperature), and atmospheric sensitivity (with atmospheric pressure). We used this new system to monitor ambulatory BP variability in outpatients with one or more cardiovascular disease (CVD) risk factors both in summer and winter. Actisensitivity (the slope of the regression line of ambulatory BP against the log-physical activity) was higher in winter than summer. By multi-level analysis using the parameters monitored by this system, we estimated the ambulatory BPs under different conditions. The individual time-series big data collected by this system will contribute to anticipation medicine for CVD. Copyright © 2017 Elsevier Inc. All rights reserved.