Youth Risk Behavior Surveillance--United States, 2007. Morbidity and Mortality Weekly Report. Surveillance Summaries. Volume 57, Number SS-4

ERIC Educational Resources Information Center

Eaton, Danice K.; Kann, Laura; Kinchen, Steve; Shanklin, Shari; Ross, James; Hawkins, Joseph; Harris, William A.; Lowry, Richard; McManus, Tim; Chyen, David; Lim, Connie; Brener, Nancy D.; Wechsler, Howell

2008-01-01

Problem: Priority health-risk behaviors, which are behaviors that contribute to the leading causes of morbidity and mortality among youth and adults, often are established during childhood and adolescence, extend into adulthood, are interrelated, and are preventable. Reporting Period Covered: January-December 2007. Description of the System: The…

Youth Risk Behavior Surveillance--United States, 2009. Morbidity and Mortality Weekly Report. Surveillance Summaries. Volume 59, Number SS-5

ERIC Educational Resources Information Center

Eaton, Danice K.; Kann, Laura; Kinchen, Steve; Shanklin, Shari; Ross, James; Hawkins, Joseph; Harris, William A.; Lowry, Richard; McManus, Tim; Chyen, David; Lim, Connie; Whittle, Lisa; Brener, Nancy D.; Wechsler, Howell

2010-01-01

Problem: Priority health-risk behaviors, which are behaviors that contribute to the leading causes of morbidity and mortality among youth and adults, often are established during childhood and adolescence, extend into adulthood, and are interrelated and preventable. Reporting Period Covered: September 2008-December 2009. Description of the…

Youth Risk Behavior Surveillance--United States, 2005. Morbidity and Mortality Weekly Report. Surveillance Summaries. Volume 55, Number SS-5

ERIC Educational Resources Information Center

Eaton, Danice K.; Kann, Laura; Kinchen, Steve; Ross, James; Hawkins, Joseph; Harris, William A.; Lowry, Richard; McManus, Tim; Chyen, David; Shanklin, Shari; Lim, Connie; Grunbaum, Jo Anne; Wechsler, Howell

2006-01-01

Problem: Priority health-risk behaviors, which contribute to the leading causes of morbidity and mortality among youth and adults, often are established during childhood and adolescence, extend into adulthood, are interrelated, and are preventable. Reporting Period Covered: October 2004-January 2006. Description of the System: The Youth Risk…

Integrating economic costs and biological traits into global conservation priorities for carnivores.

PubMed

Loyola, Rafael Dias; Oliveira-Santos, Luiz Gustavo Rodrigues; Almeida-Neto, Mário; Nogueira, Denise Martins; Kubota, Umberto; Diniz-Filho, José Alexandre Felizola; Lewinsohn, Thomas Michael

2009-08-27

Prioritization schemes usually highlight species-rich areas, where many species are at imminent risk of extinction. To be ecologically relevant these schemes should also include species biological traits into area-setting methods. Furthermore, in a world of limited funds for conservation, conservation action is constrained by land acquisition costs. Hence, including economic costs into conservation priorities can substantially improve their conservation cost-effectiveness. We examined four global conservation scenarios for carnivores based on the joint mapping of economic costs and species biological traits. These scenarios identify the most cost-effective priority sets of ecoregions, indicating best investment opportunities for safeguarding every carnivore species, and also establish priority sets that can maximize species representation in areas harboring highly vulnerable species. We compared these results with a scenario that minimizes the total number of ecoregions required for conserving all species, irrespective of other factors. We found that cost-effective conservation investments should focus on 41 ecoregions highlighted in the scenario that consider simultaneously both ecoregion vulnerability and economic costs of land acquisition. Ecoregions included in priority sets under these criteria should yield best returns of investments since they harbor species with high extinction risk and have lower mean land cost. Our study highlights ecoregions of particular importance for the conservation of the world's carnivores defining global conservation priorities in analyses that encompass socioeconomic and life-history factors. We consider the identification of a comprehensive priority-set of areas as a first step towards an in-situ biodiversity maintenance strategy.

Setting practical conservation priorities for birds in the Western Andes of Colombia.

PubMed

Ocampo-Peñuela, Natalia; Pimm, Stuart L

2014-10-01

We aspired to set conservation priorities in ways that lead to direct conservation actions. Very large-scale strategic mapping leads to familiar conservation priorities exemplified by biodiversity hotspots. In contrast, tactical conservation actions unfold on much smaller geographical extents and they need to reflect the habitat loss and fragmentation that have sharply restricted where species now live. Our aspirations for direct, practical actions were demanding. First, we identified the global, strategic conservation priorities and then downscaled to practical local actions within the selected priorities. In doing this, we recognized the limitations of incomplete information. We started such a process in Colombia and used the results presented here to implement reforestation of degraded land to prevent the isolation of a large area of cloud forest. We used existing range maps of 171 bird species to identify priority conservation areas that would conserve the greatest number of species at risk in Colombia. By at risk species, we mean those that are endemic and have small ranges. The Western Andes had the highest concentrations of such species-100 in total-but the lowest densities of national parks. We then adjusted the priorities for this region by refining these species ranges by selecting only areas of suitable elevation and remaining habitat. The estimated ranges of these species shrank by 18-100% after accounting for habitat and suitable elevation. Setting conservation priorities on the basis of currently available range maps excluded priority areas in the Western Andes and, by extension, likely elsewhere and for other taxa. By incorporating detailed maps of remaining natural habitats, we made practical recommendations for conservation actions. One recommendation was to restore forest connections to a patch of cloud forest about to become isolated from the main Andes. © 2014 Society for Conservation Biology.

Youth Risk Behavior Surveillance--United States, 2013. Morbidity and Mortality Weekly Report (MMWR). Surveillance Summaries. Volume 63, Number SS-4

ERIC Educational Resources Information Center

Kann, Laura; Kinchen, Steve; Shanklin, Shari L.; Flint, Katherine H.; Hawkins, Joseph; Harris, William A.; Lowry, Richard; Olsen, Emily O'Malley; McManus, Tim; Chyen, David; Whittle, Lisa; Taylor, Eboni; Demissie, Zewditu; Brener, Nancy; Thornton, Jemekia; Moore, John; Zaza, Stephanie

2014-01-01

Problem: Priority health-risk behaviors contribute to the leading causes of morbidity and mortality among youth and adults. Population-based data on these behaviors at the national, state, and local levels can help monitor the effectiveness of public health interventions designed to protect and promote the health of youth nationwide. Reporting…

Youth Risk Behavior Surveillance--United States, 2015. Morbidity and Mortality Weekly Report. Surveillance Summaries. Volume 65, Number 6

ERIC Educational Resources Information Center

Kann, Laura; McManus, Tim; Harris, William A.; Shanklin, Shari L.; Flint, Katherine H.; Hawkins, Joseph; Queen, Barbara; Lowry, Richard; Olsen, Emily O'Malley; Chyen, David; Whittle, Lisa; Thornton, Jemekia; Lim, Connie; Yamakawa, Yoshimi; Brener, Nancy; Zaza, Stephanie

2016-01-01

Problem: Priority health-risk behaviors contribute to the leading causes of morbidity and mortality among youth and adults. Population-based data on these behaviors at the national, state, and local levels can help monitor the effectiveness of public health interventions designed to protect and promote the health of youth nationwide. Reporting…

Integrating Economic Costs and Biological Traits into Global Conservation Priorities for Carnivores

PubMed Central

Loyola, Rafael Dias; Oliveira-Santos, Luiz Gustavo Rodrigues; Almeida-Neto, Mário; Nogueira, Denise Martins; Kubota, Umberto; Diniz-Filho, José Alexandre Felizola; Lewinsohn, Thomas Michael

2009-01-01

Background Prioritization schemes usually highlight species-rich areas, where many species are at imminent risk of extinction. To be ecologically relevant these schemes should also include species biological traits into area-setting methods. Furthermore, in a world of limited funds for conservation, conservation action is constrained by land acquisition costs. Hence, including economic costs into conservation priorities can substantially improve their conservation cost-effectiveness. Methodology/Principal Findings We examined four global conservation scenarios for carnivores based on the joint mapping of economic costs and species biological traits. These scenarios identify the most cost-effective priority sets of ecoregions, indicating best investment opportunities for safeguarding every carnivore species, and also establish priority sets that can maximize species representation in areas harboring highly vulnerable species. We compared these results with a scenario that minimizes the total number of ecoregions required for conserving all species, irrespective of other factors. We found that cost-effective conservation investments should focus on 41 ecoregions highlighted in the scenario that consider simultaneously both ecoregion vulnerability and economic costs of land acquisition. Ecoregions included in priority sets under these criteria should yield best returns of investments since they harbor species with high extinction risk and have lower mean land cost. Conclusions/Significance Our study highlights ecoregions of particular importance for the conservation of the world's carnivores defining global conservation priorities in analyses that encompass socioeconomic and life-history factors. We consider the identification of a comprehensive priority-set of areas as a first step towards an in-situ biodiversity maintenance strategy. PMID:19710911

Roadside vegetation barrier designs to mitigate near-road air pollution impacts

EPA Science Inventory

With increasing evidence that exposures to air pollution near large roadways increases risks of a number of adverse human health effects, identifying methods to reduce these exposures has become a public health priority. Roadside vegetation barriers have shown the potential to re...

Threats from urban expansion, agricultural transformation and forest loss on global conservation priority areas.

PubMed

Veach, Victoria; Moilanen, Atte; Di Minin, Enrico

2017-01-01

Including threats in spatial conservation prioritization helps identify areas for conservation actions where biodiversity is at imminent risk of extinction. At the global level, an important limitation when identifying spatial priorities for conservation actions is the lack of information on the spatial distribution of threats. Here, we identify spatial conservation priorities under three prominent threats to biodiversity (residential and commercial development, agricultural expansion, and forest loss), which are primary drivers of habitat loss and threaten the persistence of the highest number of species in the International Union for the Conservation of Nature (IUCN) Red List, and for which spatial data is available. We first explore how global priority areas for the conservation of vertebrate (mammals, birds, and amphibians) species coded in the Red List as vulnerable to each threat differ spatially. We then identify spatial conservation priorities for all species vulnerable to all threats. Finally, we identify the potentially most threatened areas by overlapping the identified priority areas for conservation with maps for each threat. We repeat the same with four other well-known global conservation priority area schemes, namely Key Biodiversity Areas, Biodiversity Hotspots, the global Protected Area Network, and Wilderness Areas. We find that residential and commercial development directly threatens only about 4% of the global top 17% priority areas for species vulnerable under this threat. However, 50% of the high priority areas for species vulnerable to forest loss overlap with areas that have already experienced some forest loss. Agricultural expansion overlapped with ~20% of high priority areas. Biodiversity Hotspots had the greatest proportion of their total area under direct threat from all threats, while expansion of low intensity agriculture was found to pose an imminent threat to Wilderness Areas under future agricultural expansion. Our results identify areas where limited resources should be allocated to mitigate risks to vertebrate species from habitat loss.

Threats from urban expansion, agricultural transformation and forest loss on global conservation priority areas

PubMed Central

Moilanen, Atte; Di Minin, Enrico

2017-01-01

Including threats in spatial conservation prioritization helps identify areas for conservation actions where biodiversity is at imminent risk of extinction. At the global level, an important limitation when identifying spatial priorities for conservation actions is the lack of information on the spatial distribution of threats. Here, we identify spatial conservation priorities under three prominent threats to biodiversity (residential and commercial development, agricultural expansion, and forest loss), which are primary drivers of habitat loss and threaten the persistence of the highest number of species in the International Union for the Conservation of Nature (IUCN) Red List, and for which spatial data is available. We first explore how global priority areas for the conservation of vertebrate (mammals, birds, and amphibians) species coded in the Red List as vulnerable to each threat differ spatially. We then identify spatial conservation priorities for all species vulnerable to all threats. Finally, we identify the potentially most threatened areas by overlapping the identified priority areas for conservation with maps for each threat. We repeat the same with four other well-known global conservation priority area schemes, namely Key Biodiversity Areas, Biodiversity Hotspots, the global Protected Area Network, and Wilderness Areas. We find that residential and commercial development directly threatens only about 4% of the global top 17% priority areas for species vulnerable under this threat. However, 50% of the high priority areas for species vulnerable to forest loss overlap with areas that have already experienced some forest loss. Agricultural expansion overlapped with ~20% of high priority areas. Biodiversity Hotspots had the greatest proportion of their total area under direct threat from all threats, while expansion of low intensity agriculture was found to pose an imminent threat to Wilderness Areas under future agricultural expansion. Our results identify areas where limited resources should be allocated to mitigate risks to vertebrate species from habitat loss. PMID:29182662

Preliminary Prioritization of California Oil and Gas Fields for Regional Groundwater Monitoring Based on Intensity of Petroleum Resource Development and Proximity to Groundwater Resources

NASA Astrophysics Data System (ADS)

Davis, T. A.; Landon, M. K.; Bennett, G.

2016-12-01

The California State Water Resources Control Board is collaborating with the U.S. Geological Survey to implement a Regional Monitoring Program (RMP) to assess where and to what degree groundwater resources may be at risk of contamination from oil and gas development activities including stimulation, well integrity issues, produced water ponds, and underground injection. A key issue in the implementation of the RMP is that the state has 487 onshore oil fields covering 8,785 square kilometers but detailed characterization work can only be done in a few oil fields annually. The first step in the RMP is to prioritize fields using available data that indicate potential risk to groundwater from oil and gas development, including vertical proximity of groundwater and oil/gas resources, density of petroleum and water wells, and volume of water injected in oil fields. This study compiled data for these factors, computed summary metrics for each oil field, analyzed statewide distributions of summary metrics, used those distributions to define relative categories of potential risk for each factor, and combined these into an overall priority ranking. Aggregated results categorized 22% (107 fields) of the total number of onshore oil and gas fields in California as high priority, 23% as moderate priority, and 55% as low priority. On an area-weighted basis, 41% of the fields ranked high, 30% moderate, and 29% low, highlighting that larger fields tend to have higher potential risk because of greater intensity of development, sometimes coupled with closer proximity to groundwater. More than half of the fields ranked as high priority were located in the southern Central Valley or the Los Angeles Basin. The prioritization does not represent an assessment of groundwater risk from oil and gas development; rather, such assessments are planned to follow based on detailed analysis of data from the RMP near the oil fields selected for study in the future.

Risk management of key issues of FPSO

NASA Astrophysics Data System (ADS)

Sun, Liping; Sun, Hai

2012-12-01

Risk analysis of key systems have become a growing topic late of because of the development of offshore structures. Equipment failures of offloading system and fire accidents were analyzed based on the floating production, storage and offloading (FPSO) features. Fault tree analysis (FTA), and failure modes and effects analysis (FMEA) methods were examined based on information already researched on modules of relex reliability studio (RRS). Equipment failures were also analyzed qualitatively by establishing a fault tree and Boolean structure function based on the shortage of failure cases, statistical data, and risk control measures examined. Failure modes of fire accident were classified according to the different areas of fire occurrences during the FMEA process, using risk priority number (RPN) methods to evaluate their severity rank. The qualitative analysis of FTA gave the basic insight of forming the failure modes of FPSO offloading, and the fire FMEA gave the priorities and suggested processes. The research has practical importance for the security analysis problems of FPSO.

Application of failure mode and effect analysis in managing catheter-related blood stream infection in intensive care unit

PubMed Central

Li, Xixi; He, Mei; Wang, Haiyan

2017-01-01

Abstract In this study, failure mode and effect analysis (FMEA), a proactive tool, was applied to reduce errors associated with the process which begins with assessment of patient and ends with treatment of complications. The aim of this study is to assess whether FMEA implementation will significantly reduce the incidence of catheter-related bloodstream infections (CRBSIs) in intensive care unit. The FMEA team was constructed. A team of 15 medical staff from different departments were recruited and trained. Their main responsibility was to analyze and score all possible processes of central venous catheterization failures. Failure modes with risk priority number (RPN) ≥100 (top 10 RPN scores) were deemed as high-priority-risks, meaning that they needed immediate corrective action. After modifications were put, the resulting RPN was compared with the previous one. A centralized nursing care system was designed. A total of 25 failure modes were identified. High-priority risks were “Unqualified medical device sterilization” (RPN, 337), “leukopenia, very low immunity” (RPN, 222), and “Poor hand hygiene Basic diseases” (RPN, 160). The corrective measures that we took allowed a decrease in the RPNs, especially for the high-priority risks. The maximum reduction was approximately 80%, as observed for the failure mode “Not creating the maximal barrier for patient.” The averaged incidence of CRBSIs was reduced from 5.19% to 1.45%, with 3 months of 0 infection rate. The FMEA can effectively reduce incidence of CRBSIs, improve the security of central venous catheterization technology, decrease overall medical expenses, and improve nursing quality. PMID:29390515

Risk assessment and quality improvement of liquid waste management in Taiwan University chemical laboratories.

PubMed

Ho, Chao-Chung; Chen, Ming-Shu

2018-01-01

The policy of establishing new universities across Taiwan has led to an increase in the number of universities, and many schools have constructed new laboratories to meet students' academic needs. In recent years, there has been an increase in the number of laboratory accidents from the liquid waste in universities. Therefore, how to build a safety system for laboratory liquid waste disposal has become an important issue in the environmental protection, safety, and hygiene of all universities. This study identifies the risk factors of liquid waste disposal and presents an agenda for practices to laboratory managers. An expert questionnaire is adopted to probe into the risk priority procedures of liquid waste disposal; then, the fuzzy theory-based FMEA method and the traditional FMEA method are employed to analyze and improve the procedures for liquid waste disposal. According to the research results, the fuzzy FMEA method is the most effective, and the top 10 potential disabling factors are prioritized for improvement according to the risk priority number (RNP), including "Unclear classification", "Gathering liquid waste without a funnel or a drain pan", "Lack of a clearance and transport contract", "Liquid waste spill during delivery", "Spill over", "Decentralized storage", "Calculating weight in the wrong way", "Compatibility between the container material and the liquid waste", "Lack of dumping and disposal tools", and "Lack of a clear labels for liquid waste containers". After tracking improvements, the overall improvement rate rose to 60.2%. Copyright © 2017 Elsevier Ltd. All rights reserved.

Design Process Improvement for Electric CAR Harness

NASA Astrophysics Data System (ADS)

Sawatdee, Thiwarat; Chutima, Parames

2017-06-01

In an automobile parts design company, the customer satisfaction is one of the most important factors for product design. Therefore, the company employs all means to focus its product design process based on the various requirements of customers resulting in high number of design changes. The objective of this research is to improve the design process of the electric car harness that effects the production scheduling by using Fault Tree Analysis (FTA) and Failure Mode and Effect Analysis (FMEA) as the main tools. FTA is employed for root cause analysis and FMEA is used to ranking a High Risk Priority Number (RPN) which is shows the priority of factors in the electric car harness that have high impact to the design of the electric car harness. After the implementation, the improvements are realized significantly since the number of design change is reduced from 0.26% to 0.08%.

Improving FMEA risk assessment through reprioritization of failures

NASA Astrophysics Data System (ADS)

Ungureanu, A. L.; Stan, G.

2016-08-01

Most of the current methods used to assess the failure and to identify the industrial equipment defects are based on the determination of Risk Priority Number (RPN). Although conventional RPN calculation is easy to understand and use, the methodology presents some limitations, such as the large number of duplicates and the difficulty of assessing the RPN indices. In order to eliminate the afore-mentioned shortcomings, this paper puts forward an easy and efficient computing method, called Failure Developing Mode and Criticality Analysis (FDMCA), which takes into account the failures and the defect evolution in time, from failure appearance to a breakdown.

Marketing nutrition & health-related benefits of food & beverage products: enforcement, litigation & liability issues.

PubMed

Roller, Sarah; Pippins, Raqiyyah

2010-01-01

Over the past decade, the liability risks associated with food and beverage product marketing have increased significantly, particularly with respect to nutrition and health-related product benefit claims. FDA and FTC enforcement priorities appear to have contributed to the increasing liability trends that are associated with these nutrition and health-related claims. This article examines key enforcement and litigation developments involving conventional food and beverage product marketing claims during the first 18 months of President Obama's administration: Part I considers FDA enforcement priorities and recent warning letters; Part II considers FTC enforcement priorities, warning letters, and consent orders; and Part III considers the relationship between FDA and FTC enforcement priorities and recent false advertising cases brought by private parties challenging nutrition and health-related marketing claims for food and beverage products. The article makes recommendations concerning ways in which food and beverage companies can help minimize liability risks associated with health-related marketing claims. In addition, the article suggests that federal policy reforms may be required to counter the perverse chilling effects current food liability trends appear to be having on health-related marketing claims for food and beverage products, and proposes a number of specific reforms that would help encourage the responsible use of well-substantiated marketing claims that can help foster healthy dietary practices. In view of the obesity prevention and other diet-related public health priorities of the Obama administration, the article suggests that this is an opportune time to address the apparent chilling effects increasing food liability risks are having on nutrition and health-related marketing claims for healthy food and beverage products, and potential adverse consequences for public health.

Application of Fuzzy Logic to Matrix FMECA

NASA Astrophysics Data System (ADS)

Shankar, N. Ravi; Prabhu, B. S.

2001-04-01

A methodology combining the benefits of Fuzzy Logic and Matrix FMEA is presented in this paper. The presented methodology extends the risk prioritization beyond the conventional Risk Priority Number (RPN) method. Fuzzy logic is used to calculate the criticality rank. Also the matrix approach is improved further to develop a pictorial representation retaining all relevant qualitative and quantitative information of several FMEA elements relationships. The methodology presented is demonstrated by application to an illustrative example.

What's wrong with hazard-ranking systems? An expository note.

PubMed

Cox, Louis Anthony Tony

2009-07-01

Two commonly recommended principles for allocating risk management resources to remediate uncertain hazards are: (1) select a subset to maximize risk-reduction benefits (e.g., maximize the von Neumann-Morgenstern expected utility of the selected risk-reducing activities), and (2) assign priorities to risk-reducing opportunities and then select activities from the top of the priority list down until no more can be afforded. When different activities create uncertain but correlated risk reductions, as is often the case in practice, then these principles are inconsistent: priority scoring and ranking fails to maximize risk-reduction benefits. Real-world risk priority scoring systems used in homeland security and terrorism risk assessment, environmental risk management, information system vulnerability rating, business risk matrices, and many other important applications do not exploit correlations among risk-reducing opportunities or optimally diversify risk-reducing investments. As a result, they generally make suboptimal risk management recommendations. Applying portfolio optimization methods instead of risk prioritization ranking, rating, or scoring methods can achieve greater risk-reduction value for resources spent.

Use of FMEA analysis to reduce risk of errors in prescribing and administering drugs in paediatric wards: a quality improvement report

PubMed Central

Lago, Paola; Bizzarri, Giancarlo; Scalzotto, Francesca; Parpaiola, Antonella; Amigoni, Angela; Putoto, Giovanni; Perilongo, Giorgio

2012-01-01

Objective Administering medication to hospitalised infants and children is a complex process at high risk of error. Failure mode and effect analysis (FMEA) is a proactive tool used to analyse risks, identify failures before they happen and prioritise remedial measures. To examine the hazards associated with the process of drug delivery to children, we performed a proactive risk-assessment analysis. Design and setting Five multidisciplinary teams, representing different divisions of the paediatric department at Padua University Hospital, were trained to analyse the drug-delivery process, to identify possible causes of failures and their potential effects, to calculate a risk priority number (RPN) for each failure and plan changes in practices. Primary outcome To identify higher-priority potential failure modes as defined by RPNs and planning changes in clinical practice to reduce the risk of patients harm and improve safety in the process of medication use in children. Results In all, 37 higher-priority potential failure modes and 71 associated causes and effects were identified. The highest RPNs related (>48) mainly to errors in calculating drug doses and concentrations. Many of these failure modes were found in all the five units, suggesting the presence of common targets for improvement, particularly in enhancing the safety of prescription and preparation of endovenous drugs. The introductions of new activities in the revised process of administering drugs allowed reducing the high-risk failure modes of 60%. Conclusions FMEA is an effective proactive risk-assessment tool useful to aid multidisciplinary groups in understanding a process care and identifying errors that may occur, prioritising remedial interventions and possibly enhancing the safety of drug delivery in children. PMID:23253870

Use of FMEA analysis to reduce risk of errors in prescribing and administering drugs in paediatric wards: a quality improvement report.

PubMed

Lago, Paola; Bizzarri, Giancarlo; Scalzotto, Francesca; Parpaiola, Antonella; Amigoni, Angela; Putoto, Giovanni; Perilongo, Giorgio

2012-01-01

Administering medication to hospitalised infants and children is a complex process at high risk of error. Failure mode and effect analysis (FMEA) is a proactive tool used to analyse risks, identify failures before they happen and prioritise remedial measures. To examine the hazards associated with the process of drug delivery to children, we performed a proactive risk-assessment analysis. Five multidisciplinary teams, representing different divisions of the paediatric department at Padua University Hospital, were trained to analyse the drug-delivery process, to identify possible causes of failures and their potential effects, to calculate a risk priority number (RPN) for each failure and plan changes in practices. To identify higher-priority potential failure modes as defined by RPNs and planning changes in clinical practice to reduce the risk of patients harm and improve safety in the process of medication use in children. In all, 37 higher-priority potential failure modes and 71 associated causes and effects were identified. The highest RPNs related (>48) mainly to errors in calculating drug doses and concentrations. Many of these failure modes were found in all the five units, suggesting the presence of common targets for improvement, particularly in enhancing the safety of prescription and preparation of endovenous drugs. The introductions of new activities in the revised process of administering drugs allowed reducing the high-risk failure modes of 60%. FMEA is an effective proactive risk-assessment tool useful to aid multidisciplinary groups in understanding a process care and identifying errors that may occur, prioritising remedial interventions and possibly enhancing the safety of drug delivery in children.

Range-wide connectivity of priority areas for Greater Sage-Grouse: Implications for long-term conservation from graph theory

USGS Publications Warehouse

Crist, Michele R.; Knick, Steven T.; Hanser, Steven E.

2017-01-01

The delineation of priority areas in western North America for managing Greater Sage-Grouse (Centrocercus urophasianus) represents a broad-scale experiment in conservation biology. The strategy of limiting spatial disturbance and focusing conservation actions within delineated areas may benefit the greatest proportion of Greater Sage-Grouse. However, land use under normal restrictions outside priority areas potentially limits dispersal and gene flow, which can isolate priority areas and lead to spatially disjunct populations. We used graph theory, representing priority areas as spatially distributed nodes interconnected by movement corridors, to understand the capacity of priority areas to function as connected networks in the Bi-State, Central, and Washington regions of the Greater Sage-Grouse range. The Bi-State and Central networks were highly centralized; the dominant pathways and shortest linkages primarily connected a small number of large and centrally located priority areas. These priority areas are likely strongholds for Greater Sage-Grouse populations and might also function as refugia and sources. Priority areas in the Central network were more connected than those in the Bi-State and Washington networks. Almost 90% of the priority areas in the Central network had ≥2 pathways to other priority areas when movement through the landscape was set at an upper threshold (effective resistance, ER12). At a lower threshold (ER4), 83 of 123 priority areas in the Central network were clustered in 9 interconnected subgroups. The current conservation strategy has risks; 45 of 61 priority areas in the Bi-State network, 68 of 123 in the Central network, and all 4 priority areas in the Washington network had ≤1 connection to another priority area at the lower ER4threshold. Priority areas with few linkages also averaged greater environmental resistance to movement along connecting pathways. Without maintaining corridors to larger priority areas or a clustered group, isolation of small priority areas could lead to regional loss of Greater Sage-Grouse

Application of failure mode and effect analysis in managing catheter-related blood stream infection in intensive care unit.

PubMed

Li, Xixi; He, Mei; Wang, Haiyan

2017-12-01

In this study, failure mode and effect analysis (FMEA), a proactive tool, was applied to reduce errors associated with the process which begins with assessment of patient and ends with treatment of complications. The aim of this study is to assess whether FMEA implementation will significantly reduce the incidence of catheter-related bloodstream infections (CRBSIs) in intensive care unit.The FMEA team was constructed. A team of 15 medical staff from different departments were recruited and trained. Their main responsibility was to analyze and score all possible processes of central venous catheterization failures. Failure modes with risk priority number (RPN) ≥100 (top 10 RPN scores) were deemed as high-priority-risks, meaning that they needed immediate corrective action. After modifications were put, the resulting RPN was compared with the previous one. A centralized nursing care system was designed.A total of 25 failure modes were identified. High-priority risks were "Unqualified medical device sterilization" (RPN, 337), "leukopenia, very low immunity" (RPN, 222), and "Poor hand hygiene Basic diseases" (RPN, 160). The corrective measures that we took allowed a decrease in the RPNs, especially for the high-priority risks. The maximum reduction was approximately 80%, as observed for the failure mode "Not creating the maximal barrier for patient." The averaged incidence of CRBSIs was reduced from 5.19% to 1.45%, with 3 months of 0 infection rate.The FMEA can effectively reduce incidence of CRBSIs, improve the security of central venous catheterization technology, decrease overall medical expenses, and improve nursing quality. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Priorities for Autism Spectrum Disorder Risk Communication and Ethics

ERIC Educational Resources Information Center

Yudell, Michael; Tabor, Holly K.; Dawson, Geraldine; Rossi, John; Newschaffer, Craig

2013-01-01

Autism spectrum disorders are an issue of increasing public health significance. The incidence of autism spectrum disorders has been increasing in recent years, and they are associated with significant personal and financial impacts for affected persons and their families. In recent years, a large number of scientific studies have been undertaken,…

Failure mode and effect analysis: improving intensive care unit risk management processes.

PubMed

Askari, Roohollah; Shafii, Milad; Rafiei, Sima; Abolhassani, Mohammad Sadegh; Salarikhah, Elaheh

2017-04-18

Purpose Failure modes and effects analysis (FMEA) is a practical tool to evaluate risks, discover failures in a proactive manner and propose corrective actions to reduce or eliminate potential risks. The purpose of this paper is to apply FMEA technique to examine the hazards associated with the process of service delivery in intensive care unit (ICU) of a tertiary hospital in Yazd, Iran. Design/methodology/approach This was a before-after study conducted between March 2013 and December 2014. By forming a FMEA team, all potential hazards associated with ICU services - their frequency and severity - were identified. Then risk priority number was calculated for each activity as an indicator representing high priority areas that need special attention and resource allocation. Findings Eight failure modes with highest priority scores including endotracheal tube defect, wrong placement of endotracheal tube, EVD interface, aspiration failure during suctioning, chest tube failure, tissue injury and deep vein thrombosis were selected for improvement. Findings affirmed that improvement strategies were generally satisfying and significantly decreased total failures. Practical implications Application of FMEA in ICUs proved to be effective in proactively decreasing the risk of failures and corrected the control measures up to acceptable levels in all eight areas of function. Originality/value Using a prospective risk assessment approach, such as FMEA, could be beneficial in dealing with potential failures through proposing preventive actions in a proactive manner. The method could be used as a tool for healthcare continuous quality improvement so that the method identifies both systemic and human errors, and offers practical advice to deal effectively with them.

A new methodology for surcharge risk management in urban areas (case study: Gonbad-e-Kavus city).

PubMed

Hooshyaripor, Farhad; Yazdi, Jafar

2017-02-01

This research presents a simulation-optimization model for urban flood mitigation integrating Non-dominated Sorting Genetic Algorithm (NSGA-II) with Storm Water Management Model (SWMM) hydraulic model under a curve number-based hydrologic model of low impact development technologies in Gonbad-e-Kavus, a small city in the north of Iran. In the developed model, the best performance of the system relies on the optimal layout and capacity of retention ponds over the study area in order to reduce surcharge from the manholes underlying a set of storm event loads, while the available investment plays a restricting role. Thus, there is a multi-objective optimization problem with two conflicting objectives solved successfully by NSGA-II to find a set of optimal solutions known as the Pareto front. In order to analyze the results, a new factor, investment priority index (IPI), is defined which shows the risk of surcharging over the network and priority of the mitigation actions. The IPI is calculated using the probability of pond selection for candidate locations and average depth of the ponds in all Pareto front solutions. The IPI can help the decision makers to arrange a long-term progressive plan with the priority of high-risk areas when an optimal solution has been selected.

Nanomaterials in consumer's goods: the problems of risk assessment

NASA Astrophysics Data System (ADS)

Gmoshinski, I. V.; Khotimchenko, S. A.

2015-11-01

Nanotechnology and engineered nanomaterials are currently used in wide variety of cosmetic products, while their use in food industry, packaging materials, household chemicals etc. still includes a limited number of items and does not show a significant upward trend. However, the problem of priority nanomaterials associated risks is relevant due to their high production volumes and an constantly growing burden on the environment and population. In accordance with the frequency of use in mass-produced consumer goods, leading priority nanomaterials are silver nanoparticles (NPs) and (by a wide margin) NPs of gold, platinum, and titanium dioxide. Frequency of nanosized silica introduction into food products as a food additive, at the moment, seems to be underestimated, since the use of this nanomaterial is not declared by manufacturers of products and objective control of its content is difficult. Analysis of literature data on toxicological properties of nanomaterials shows that currently accumulated amount of information is sufficient to establish the safe doses of nanosized silver, gold and titanium dioxide. Data have been provided in a series of studies concerning the effect of oral intake of nanosized silica on the condition of laboratory animals, including on the performance of the immune system. The article examines the existing approaches to the assessment of population exposure to priority nanomaterials, characteristics of existing problems and risk management.

Research priorities about stoma-related quality of life from the perspective of people with a stoma: A pilot survey.

PubMed

Hubbard, Gill; Taylor, Claire; Beeken, Becca; Campbell, Anna; Gracey, Jackie; Grimmett, Chloe; Fisher, Abi; Ozakinci, Gozde; Slater, Sarah; Gorely, Trish

2017-12-01

There is a recognized need to include patients in setting research priorities. Research priorities identified by people with a stoma are rarely elicited. To improve the quality of life of people with a stoma through use of evidence-based practice based on research priorities set by patients. Online pilot survey publicized in 2016 via United Kingdom stoma charities. People ranked nine stoma-related quality of life topics in order of research priority. People 16 years of age and over who currently have or have had a stoma for treatment for any medical condition. Distributions of the priority scores for each of the nine research topics were examined. Group differences were explored using either the Mann-Whitney U-test or the Kruskal-Wallis test depending on the number of groups. In total, 225 people completed the survey. The most important research priority was pouch leak problems and stoma bag/appliance problems followed by hernia risk. There were statistically significant differences in ranking research priorities between males and females, age, underlying disease that led to a stoma, stoma type and length of time with a stoma. People with a stoma are willing to engage in and set research priorities. The results should contribute towards future research about setting the research agenda for the study of stoma-related concerns that impact quality of life. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Failure mode and effects analysis based risk profile assessment for stereotactic radiosurgery programs at three cancer centers in Brazil.

PubMed

Teixeira, Flavia C; de Almeida, Carlos E; Saiful Huq, M

2016-01-01

The goal of this study was to evaluate the safety and quality management program for stereotactic radiosurgery (SRS) treatment processes at three radiotherapy centers in Brazil by using three industrial engineering tools (1) process mapping, (2) failure modes and effects analysis (FMEA), and (3) fault tree analysis. The recommendations of Task Group 100 of American Association of Physicists in Medicine were followed to apply the three tools described above to create a process tree for SRS procedure for each radiotherapy center and then FMEA was performed. Failure modes were identified for all process steps and values of risk priority number (RPN) were calculated from O, S, and D (RPN = O × S × D) values assigned by a professional team responsible for patient care. The subprocess treatment planning was presented with the highest number of failure modes for all centers. The total number of failure modes were 135, 104, and 131 for centers I, II, and III, respectively. The highest RPN value for each center is as follows: center I (204), center II (372), and center III (370). Failure modes with RPN ≥ 100: center I (22), center II (115), and center III (110). Failure modes characterized by S ≥ 7, represented 68% of the failure modes for center III, 62% for center II, and 45% for center I. Failure modes with RPNs values ≥100 and S ≥ 7, D ≥ 5, and O ≥ 5 were considered as high priority in this study. The results of the present study show that the safety risk profiles for the same stereotactic radiotherapy process are different at three radiotherapy centers in Brazil. Although this is the same treatment process, this present study showed that the risk priority is different and it will lead to implementation of different safety interventions among the centers. Therefore, the current practice of applying universal device-centric QA is not adequate to address all possible failures in clinical processes at different radiotherapy centers. Integrated approaches to device-centric and process specific quality management program specific to each radiotherapy center are the key to a safe quality management program.

Research priorities in the field of HIV and AIDS in Iran

PubMed Central

Haghdoost, AliAkbar; Sadeghi, Masoomeh; Nasirian, Maryam; Mirzazadeh, Ali; Navadeh, Soodabeh

2012-01-01

Background: HIV is a multidimensional problem. Therefore, prioritization of research topics in this field is a serious challenge. We decided to prioritize the major areas of research on HIV/AIDS in Iran. Materials ans Methods: In a brain-storming session with the main national and provincial stakeholders and experts from different relevant fields, the direct and indirect dimensions of HIV/AIDS and its related research issues were explored. Afterward, using the Delphi method, we sent questionnaires to 20 experts (13 respondents) from different sectors. In this electronic based questioner, we requested experts to evaluate main topics and their subtopics. The ranges of scores were between 0 and 100. Results: The score of priorities of main themes were preventive activities (43.2), large scale planning (25.4), the estimation of the HIV/AIDS burden (20.9), and basic scientific research (10.5). The most important priority in each main theme was education particularly in high risk groups (52.5), developing the national strategy to address the epidemic (31.8), estimation of the incidence and prevalence among high-risk groups (59.5) and developing new preventive methods (66.7), respectively. Conclusions: The most important priorities of researches on HIV/AIDS were preventive activities and developing national strategy. As high risk groups are the most involved people in the epidemic, and they are also the most hard-to-reach sub-populations, a national well designated comprehensive strategy is essential. However, we believe with a very specific and directed scheme, special attention to research in basic sciences is necessary, at least in limited number of institutes. PMID:23626616

Source-oriented risk assessment of inhalation exposure to ambient polycyclic aromatic hydrocarbons and contributions of non-priority isomers in urban Nanjing, a megacity located in Yangtze River Delta, China.

PubMed

Zhuo, Shaojie; Shen, Guofeng; Zhu, Ying; Du, Wei; Pan, Xuelian; Li, Tongchao; Han, Yang; Li, Bengang; Liu, Junfeng; Cheng, Hefa; Xing, Baoshan; Tao, Shu

2017-05-01

Sixteen U.S. EPA priority polycyclic aromatic hydrocarbons (PAHs) and eleven non-priority isomers including some dibenzopyrenes were analyzed to evaluate health risk attributable to inhalation exposure to ambient PAHs and contributions of the non-priority PAHs in a megacity Nanjing, east China. The annual average mass concentration of the total 16 EPA priority PAHs in air was 51.1 ± 29.8 ng/m 3 , comprising up to 93% of the mass concentration of all 27 PAHs, however, the estimated Incremental Lifetime Cancer Risk (ILCR) due to inhalation exposure would be underestimated by 63% on average if only accounting the 16 EPA priority PAHs. The risk would be underestimated by 13% if only particulate PAHs were considered, though gaseous PAHs made up to about 70% of the total mass concentration. During the last fifteen years, ambient Benzo[a]pyrene decreased significantly in the city which was consistent with the declining trend of PAHs emissions. Source contributions to the estimated ILCR were much different from the contributions for the total mass concentration, calling for the introduce of important source-oriented risk assessments. Emissions from gasoline vehicles contributed to 12% of the total mass concentration of 27 PAHs analyzed, but regarding relative contributions to the overall health risk, gasoline vehicle emissions contributed 45% of the calculated ILCR. Dibenzopyrenes were a group of non-priority isomers largely contributing to the calculated ILCR, and vehicle emissions were probably important sources of these high molecular weight isomers. Ambient dibenzo[a,l]pyrene positively correlated with the priority PAH Benzo[g,h,i]perylene. The study indicates that inclusion of non-priority PAHs could be valuable for both PAH source apportionment and health risk assessment. Copyright © 2017 Elsevier Ltd. All rights reserved.

The priority group index: a proposed new method incorporating high risk and population burden to identify target populations for public health interventions.

PubMed

Zhang, Bo; Cohen, Joanna E; OʼConnor, Shawn

2014-01-01

Selection of priority groups is important for health interventions. However, no quantitative method has been developed. To develop a quantitative method to support the process of selecting priority groups for public health interventions based on both high risk and population health burden. Secondary data analysis of the 2010 Canadian Community Health Survey. Canadian population. Survey respondents. We identified priority groups for 3 diseases: heart disease, stroke, and chronic lower respiratory diseases. Three measures--prevalence, population counts, and adjusted odds ratios (OR)--were calculated for subpopulations (sociodemographic characteristics and other risk factors). A Priority Group Index (PGI) was calculated by summing the rank scores of these 3 measures. Of the 30 priority groups identified by the PGI (10 for each of the 3 disease outcomes), 7 were identified on the basis of high prevalence only, 5 based on population count only, 3 based on high OR only, and the remainder based on combinations of these. The identified priority groups were all in line with the literature as risk factors for the 3 diseases, such as elderly people for heart disease and stroke and those with low income for chronic lower respiratory diseases. The PGI was thus able to balance both high risk and population burden approaches in selecting priority groups, and thus it would address health inequities as well as disease burden in the overall population. The PGI is a quantitative method to select priority groups for public health interventions; it has the potential to enhance the effective use of limited public resources.

The no-show rate in a high-risk obstetric clinic.

PubMed

Campbell, J D; Chez, R A; Queen, T; Barcelo, A; Patron, E

2000-10-01

We wished to determine the reasons for an average missed appointment rate of 28% in a high-risk pregnancy clinic. Only 41% of the 261 women in the study group could be reached by telephone. The reasons included not having a phone, the phone had been disconnected, incorrect phone number on the chart, the patient had moved, and the patient did not respond to the answering machine message. The reasons for missing the appointment included lack of transportation, scheduling problems, overslept or forgot, presence of a sick child or relative, and lack of child care. The response of patients to assessing prenatal care may reflect their priority of medical care relative to other priorities associated with day-to-day existence. There may be a baseline missed appointment rate for prenatal care in lower socioeconomic populations of women. The commitment of personnel time and energy to attempt to modify the no-show rate should be reexamined.

Getting offshoring right.

PubMed

Aron, Ravi; Singh, Jitendra V

2005-12-01

The prospect of offshoring and outsourcing business processes has captured the imagination of CEOs everywhere. In the past five years, a rising number of companies in North America and Europe have experimented with this strategy, hoping to reduce costs and gain strategic advantage. But many businesses have had mixed results. According to several studies, half the organizations that have shifted processes offshore have failed to generate the expected financial benefits. What's more, many of them have faced employee resistance and consumer dissatisfaction. Clearly, companies have to rethink how they formulate their offshoring strategies. A three-part methodology can help. First, companies need to prioritize their processes, ranking each based on two criteria: the value it creates for customers and the degree to which the company can capture some of that value. Companies will want to keep their core (highest-priority) processes in-house and consider outsourcing their commodity (low-priority) processes; critical (moderate-priority) processes are up for debate and must be considered carefully. Second, businesses should analyze all the risks that accompany offshoring and look systematically at their critical and commodity processes in terms of operational risk (the risk that processes won't operate smoothly after being offshored) and structural risk (the risk that relationships with service providers may not work as expected). Finally, companies should determine possible locations for their offshore efforts, as well as the organizational forms--such as captive centers and joint ventures--that those efforts might take. They can do so by examining each process's operational and structural risks side by side. This article outlines the tools that will help companies choose the right processes to offshore. It also describes a new organizational structure called the extended organization, in which companies specify the quality of services they want and work alongside providers to get that quality.

Three Case Studies in Making Fair Choices on the Path to Universal Health Coverage.

PubMed

Voorhoeve, Alex; Edejer, Tessa T T; Kapiriri, Lydia; Norheim, Ole F; Snowden, James; Basenya, Olivier; Bayarsaikhan, Dorjsuren; Chentaf, Ikram; Eyal, Nir; Folsom, Amanda; Tun Hussein, Rozita Halina; Morales, Cristian; Ostmann, Florian; Ottersen, Trygve; Prakongsai, Phusit; Saenz, Carla; Saleh, Karima; Sommanustweechai, Angkana; Wikler, Daniel; Zakariah, Afisah

2016-12-01

The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity, and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC , the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These case studies show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for those who are worse off in a number of dimensions (including health, access to health services, and social and economic status), and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting.

Three Case Studies in Making Fair Choices on the Path to Universal Health Coverage

PubMed Central

Edejer, Tessa T.T.; Kapiriri, Lydia; Norheim, Ole F.; Snowden, James; Basenya, Olivier; Bayarsaikhan, Dorjsuren; Chentaf, Ikram; Eyal, Nir; Folsom, Amanda; Tun Hussein, Rozita Halina; Morales, Cristian; Ostmann, Florian; Ottersen, Trygve; Prakongsai, Phusit; Saenz, Carla; Saleh, Karima; Sommanustweechai, Angkana; Wikler, Daniel; Zakariah, Afisah

2016-01-01

Abstract The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity, and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC, the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These case studies show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for those who are worse off in a number of dimensions (including health, access to health services, and social and economic status), and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting. PMID:28559673

Priorities for autism spectrum disorder risk communication and ethics.

PubMed

Yudell, Michael; Tabor, Holly K; Dawson, Geraldine; Rossi, John; Newschaffer, Craig

2013-11-01

Autism spectrum disorders are an issue of increasing public health significance. The incidence of autism spectrum disorders has been increasing in recent years, and they are associated with significant personal and financial impacts for affected persons and their families. In recent years, a large number of scientific studies have been undertaken, which investigate genetic and environmental risk factors for autism, with more studies underway. At present, much remains unknown regarding autism spectrum disorder risk factors, but the emerging picture of causation is in many cases complex, with multiple genes and gene-environment interactions being at play. The complexity and uncertainty surrounding autism spectrum disorder risk factors raise a number of questions regarding the ethical considerations that should be taken into account when undertaking autism spectrum disorder risk communication. At present, however, little has been written regarding autism spectrum disorder risk communication and ethics. This article summarizes the findings of a recent conference investigating ethical considerations and policy recommendations in autism spectrum disorder risk communication, which to the authors' knowledge is the first of its kind. Here, the authors discuss a number of issues, including uncertainty; comprehension; inadvertent harm; justice; and the appropriate roles of clinicians, scientists, and the media in autism spectrum disorder risk communication.

Priority arbitration mechanism

DOEpatents

Garmire, Derrick L [Kingston, NY; Herring, Jay R [Poughkeepsie, NY; Stunkel, Craig B [Bethel, CT

2007-03-06

A method is provided for selecting a data source for transmission on one of several logical (virtual) lanes embodied in a single physical connection. Lanes are assigned to either a high priority class or to a low priority class. One of six conditions is employed to determine when re-arbitration of lane priorities is desired. When this occurs a next source for transmission is selected based on a the specification of the maximum number of high priority packets that can be sent after a lower priority transmission has been interrupted. Alternatively, a next source for transmission is selected based on a the specification of the maximum number of high priority packets that can be sent while a lower priority packet is waiting. If initialized correctly, the arbiter keeps all of the packets of a high priority packet contiguous, while allowing lower priority packets to be interrupted by the higher priority packets, but not to the point of starvation of the lower priority packets.

Setting priorities for reducing risk and advancing patient safety.

PubMed

Gaffey, Ann D

2016-04-01

We set priorities every day in both our personal and professional lives. Some decisions are easy, while others require much more thought, participation, and resources. The difficult or less appealing priorities may not be popular, may receive push-back, and may be resource intensive. Whether personal or professional, the urgency that accompanies true priorities becomes a driving force. It is that urgency to ensure our patients' safety that brings many of us to work each day. This is not easy work. It requires us to be knowledgeable about the enterprise we are working in and to have the professional skills and competence to facilitate setting the priorities that allow our organizations to minimize risk and maximize value. © 2016 American Society for Healthcare Risk Management of the American Hospital Association.

Optimizing critical source control of five priority-regulatory trace elements from industrial wastewater in China: Implications for health management.

PubMed

Wu, Wenjun; Wang, Jinnan; Yu, Yang; Jiang, Hongqiang; Liu, Nianlei; Bi, Jun; Liu, Miaomiao

2018-04-01

Anthropogenic emissions of toxic trace elements (TEs) have caused worldwide concern due to their adverse effects on human health and ecosystems. Based on a stochastic simulation of factors' probability distribution, we established a bottom-up model to estimate the amounts of five priority-regulatory TEs released to aquatic environments from industrial processes in China. Total TE emissions in China in 2010 were estimated at approximately 2.27 t of Hg, 310.09 t of As, 318.17 t of Pb, 79.72 t of Cd, and 1040.32 t of Cr. Raw chemicals, smelting, and mining were the leading sources of TE emissions. There are apparent regional differences in TE pollution. TE emissions are much higher in eastern and central China than in the western provinces and are higher in the south than in the north. This spatial distribution was characterized in detail by allocating the emissions to 10 km × 10 km grid cells. Furthermore, the risk control for the overall emission grid was optimized according to each cell's emission and risk rank. The results show that to control 80% of TE emissions from major sources, the number of top-priority control cells would be between 200 and 400, and less than 10% of the total population would be positively affected. Based on TE risk rankings, decreasing the population weighted risk would increase the number of controlled cells by a factor of 0.3-0.5, but the affected population would increase by a factor of 0.8-1.5. In this case, the adverse effects on people's health would be reduced significantly. Finally, an optimized strategy to control TE emissions is proposed in terms of a cost-benefit trade-off. The estimates in this paper can be used to help establish a regional TE inventory and cyclic simulation, and it can also play supporting roles in minimizing TE health risks and maximizing resilience. Copyright © 2018 Elsevier Ltd. All rights reserved.

TU-FG-201-12: Designing a Risk-Based Quality Assurance Program for a Newly Implemented Y-90 Microspheres Procedure

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

Vile, D; Zhang, L; Cuttino, L

2016-06-15

Purpose: To create a quality assurance program based upon a risk-based assessment of a newly implemented SirSpheres Y-90 procedure. Methods: A process map was created for a newly implemented SirSpheres procedure at a community hospital. The process map documented each step of this collaborative procedure, as well as the roles and responsibilities of each member. From the process map, different potential failure modes were determined as well as any current controls in place. From this list, a full failure mode and effects analysis (FMEA) was performed by grading each failure mode’s likelihood of occurrence, likelihood of detection, and potential severity.more » These numbers were then multiplied to compute the risk priority number (RPN) for each potential failure mode. Failure modes were then ranked based on their RPN. Additional controls were then added, with failure modes corresponding to the highest RPNs taking priority. Results: A process map was created that succinctly outlined each step in the SirSpheres procedure in its current implementation. From this, 72 potential failure modes were identified and ranked according to their associated RPN. Quality assurance controls and safety barriers were then added for failure modes associated with the highest risk being addressed first. Conclusion: A quality assurance program was created from a risk-based assessment of the SirSpheres process. Process mapping and FMEA were effective in identifying potential high-risk failure modes for this new procedure, which were prioritized for new quality assurance controls. TG 100 recommends the fault tree analysis methodology to design a comprehensive and effective QC/QM program, yet we found that by simply introducing additional safety barriers to address high RPN failure modes makes the whole process simpler and safer.« less

Prioritizing Avian Species for Their Risk of Population-Level Consequences from Wind Energy Development

PubMed Central

Beston, Julie A.; Diffendorfer, Jay E.; Loss, Scott R.; Johnson, Douglas H.

2016-01-01

Recent growth in the wind energy industry has increased concerns about its impacts on wildlife populations. Direct impacts of wind energy include bird and bat collisions with turbines whereas indirect impacts include changes in wildlife habitat and behavior. Although many species may withstand these effects, species that are long-lived with low rates of reproduction, have specialized habitat preferences, or are attracted to turbines may be more prone to declines in population abundance. We developed a prioritization system to identify the avian species most likely to experience population declines from wind facilities based on their current conservation status and their expected risk from turbines. We developed 3 metrics of turbine risk that incorporate data on collision fatalities at wind facilities, population size, life history, species’ distributions relative to turbine locations, number of suitable habitat types, and species’ conservation status. We calculated at least 1 measure of turbine risk for 428 avian species that breed in the United States. We then simulated 100,000 random sets of cutoff criteria (i.e., the metric values used to assign species to different priority categories) for each turbine risk metric and for conservation status. For each set of criteria, we assigned each species a priority score and calculated the average priority score across all sets of criteria. Our prioritization system highlights both species that could potentially experience population decline caused by wind energy and species at low risk of population decline. For instance, several birds of prey, such as the long-eared owl, ferruginous hawk, Swainson’s hawk, and golden eagle, were at relatively high risk of population decline across a wide variety of cutoff values, whereas many passerines were at relatively low risk of decline. This prioritization system is a first step that will help researchers, conservationists, managers, and industry target future study and management activity. PMID:26963254

Prioritizing avian species for their risk of population-level consequences from wind energy development

USGS Publications Warehouse

Beston, Julie A.; Diffendorfer, James E.; Loss, Scott; Johnson, Douglas H.

2016-01-01

Recent growth in the wind energy industry has increased concerns about its impacts on wildlife populations. Direct impacts of wind energy include bird and bat collisions with turbines whereas indirect impacts include changes in wildlife habitat and behavior. Although many species may withstand these effects, species that are long-lived with low rates of reproduction, have specialized habitat preferences, or are attracted to turbines may be more prone to declines in population abundance. We developed a prioritization system to identify the avian species most likely to experience population declines from wind facilities based on their current conservation status and their expected risk from turbines. We developed 3 metrics of turbine risk that incorporate data on collision fatalities at wind facilities, population size, life history, species’ distributions relative to turbine locations, number of suitable habitat types, and species’ conservation status. We calculated at least 1 measure of turbine risk for 428 avian species that breed in the United States. We then simulated 100,000 random sets of cutoff criteria (i.e., the metric values used to assign species to different priority categories) for each turbine risk metric and for conservation status. For each set of criteria, we assigned each species a priority score and calculated the average priority score across all sets of criteria. Our prioritization system highlights both species that could potentially experience population decline caused by wind energy and species at low risk of population decline. For instance, several birds of prey, such as the long-eared owl, ferruginous hawk, Swainson’s hawk, and golden eagle, were at relatively high risk of population decline across a wide variety of cutoff values, whereas many passerines were at relatively low risk of decline. This prioritization system is a first step that will help researchers, conservationists, managers, and industry target future study and management activity.

Prioritizing Avian Species for Their Risk of Population-Level Consequences from Wind Energy Development.

PubMed

Beston, Julie A; Diffendorfer, Jay E; Loss, Scott R; Johnson, Douglas H

2016-01-01

Recent growth in the wind energy industry has increased concerns about its impacts on wildlife populations. Direct impacts of wind energy include bird and bat collisions with turbines whereas indirect impacts include changes in wildlife habitat and behavior. Although many species may withstand these effects, species that are long-lived with low rates of reproduction, have specialized habitat preferences, or are attracted to turbines may be more prone to declines in population abundance. We developed a prioritization system to identify the avian species most likely to experience population declines from wind facilities based on their current conservation status and their expected risk from turbines. We developed 3 metrics of turbine risk that incorporate data on collision fatalities at wind facilities, population size, life history, species' distributions relative to turbine locations, number of suitable habitat types, and species' conservation status. We calculated at least 1 measure of turbine risk for 428 avian species that breed in the United States. We then simulated 100,000 random sets of cutoff criteria (i.e., the metric values used to assign species to different priority categories) for each turbine risk metric and for conservation status. For each set of criteria, we assigned each species a priority score and calculated the average priority score across all sets of criteria. Our prioritization system highlights both species that could potentially experience population decline caused by wind energy and species at low risk of population decline. For instance, several birds of prey, such as the long-eared owl, ferruginous hawk, Swainson's hawk, and golden eagle, were at relatively high risk of population decline across a wide variety of cutoff values, whereas many passerines were at relatively low risk of decline. This prioritization system is a first step that will help researchers, conservationists, managers, and industry target future study and management activity.

The Effect of State Regulations on Motor Vehicle Fatalities for Younger and Older Drivers: A Review and Analysis

PubMed Central

Grabowski, David C.; Morrisey, Michael A.

2001-01-01

Policymakers have had a long-standing interest in improving the motor vehicle safety of both younger and older drivers. Although younger and older drivers share the distinction of having more crashes and fatalities per mile driven than other age groups, the problems posed by these two groups stem from different origins and manifest in different ways. A number of state-level policies and regulations may affect the number of motor vehicle crashes and fatalities in these two high-risk groups. A critical review of the existing literature in regard to the risk factors and the effects of various policy measures on motor vehicle crashes in these two high-risk populations provides direction for policymakers and high-priority areas of interest for the research community. PMID:11789116

Use of a systematic risk analysis method (FMECA) to improve quality in a clinical laboratory procedure.

PubMed

Serafini, A; Troiano, G; Franceschini, E; Calzoni, P; Nante, N; Scapellato, C

2016-01-01

Risk management is a set of actions to recognize or identify risks, errors and their consequences and to take the steps to counter it. The aim of our study was to apply FMECA (Failure Mode, Effects and Criticality Analysis) to the Activated Protein C resistance (APCR) test in order to detect and avoid mistakes in this process. We created a team and the process was divided in phases and sub phases. For each phase we calculated the probability of occurrence (O) of an error, the detectability score (D) and the severity (S). The product of these three indexes yields the RPN (Risk Priority Number). Phases with a higher RPN need corrective actions with a higher priority. The calculation of RPN showed that more than 20 activities have a score higher than 150 and need important preventive actions; 8 have a score between 100 and 150. Only 23 actions obtained an acceptable score lower than 100. This was one of the first experience of application of FMECA analysis to a laboratory process, and the first one which applies this technique to the identification of the factor V Leiden, and our results confirm that FMECA could be a simple, powerful and useful tool in risk management and helps to identify quickly the criticality in a laboratory process.

International scientists' priorities for research on pharmaceutical and personal care products in the environment.

PubMed

Rudd, Murray A; Ankley, Gerald T; Boxall, Alistair B A; Brooks, Bryan W

2014-10-01

Pharmaceuticals and personal care products (PPCPs) are widely discharged into the environment via diverse pathways. The effects of PPCPs in the environment have potentially important human and ecosystem health implications, so credible, salient, and legitimate scientific evidence is needed to inform regulatory and policy responses that address potential risks. A recent "big questions" exercise with participants largely from North America identified 22 important research questions around the risks of PPCP in the environment that would help address the most pressing knowledge gaps over the next decade. To expand that analysis, we developed a survey that was completed by 535 environmental scientists from 57 countries, of whom 49% identified environmental or analytical chemistry as their primary disciplinary background. They ranked the 22 original research questions and submitted 171 additional candidate research questions they felt were also of high priority. Of the original questions, the 3 perceived to be of highest importance related to: 1) the effects of long-term exposure to low concentrations of PPCP mixtures on nontarget organisms, 2) effluent treatment methods that can reduce the effects of PPCPs in the environment while not increasing the toxicity of whole effluents, and 3) the assessment of the environmental risks of metabolites and environmental transformation products of PPCPs. A question regarding the role of cultural perspectives in PPCP risk assessment was ranked as the lowest priority. There were significant differences in research orientation between scientists who completed English and Chinese language versions of the survey. We found that the Chinese respondents were strongly orientated to issues of managing risk profiles, effluent treatment, residue bioavailability, and regional assessment. Among English language respondents, further differences in research orientation were associated with respondents' level of consistency when ranking the survey's 15 comparisons. There was increasing emphasis on the role of various other stressors relative to PPCPs and on risk prioritization as internal decision making consistency increased. Respondents' consistency in their ranking choices was significantly and positively correlated with SETAC membership, authors' number of publications, and longer survey completion times. Our research highlighted international scientists' research priorities and should help inform decisions about the type of hazard and risk-based research needed to best inform decisions regarding PPCPs in the environment. Disciplinary training of a scientist or engineer appears to strongly influence preferences for research priorities to understand PPCPs in the environment. Selection of participants and the depth and breadth of research prioritization efforts thus have potential effects on the outcomes of research prioritization exercises. Further elucidation of how patterns of research priority vary between academic and government scientists and between scientists and other government and stakeholders would be useful in the future and provide information that helps focus scientific effort on socially relevant challenges relating to PPCPs in the environment. It also suggests the potential for future collaborative research between industry, government, and academia on environmental contaminants beyond PPCPs. © 2014 SETAC.

Global Conservation Priorities for Marine Turtles

PubMed Central

Wallace, Bryan P.; DiMatteo, Andrew D.; Bolten, Alan B.; Chaloupka, Milani Y.; Hutchinson, Brian J.; Abreu-Grobois, F. Alberto; Mortimer, Jeanne A.; Seminoff, Jeffrey A.; Amorocho, Diego; Bjorndal, Karen A.; Bourjea, Jérôme; Bowen, Brian W.; Briseño Dueñas, Raquel; Casale, Paolo; Choudhury, B. C.; Costa, Alice; Dutton, Peter H.; Fallabrino, Alejandro; Finkbeiner, Elena M.; Girard, Alexandre; Girondot, Marc; Hamann, Mark; Hurley, Brendan J.; López-Mendilaharsu, Milagros; Marcovaldi, Maria Angela; Musick, John A.; Nel, Ronel; Pilcher, Nicolas J.; Troëng, Sebastian; Witherington, Blair; Mast, Roderic B.

2011-01-01

Where conservation resources are limited and conservation targets are diverse, robust yet flexible priority-setting frameworks are vital. Priority-setting is especially important for geographically widespread species with distinct populations subject to multiple threats that operate on different spatial and temporal scales. Marine turtles are widely distributed and exhibit intra-specific variations in population sizes and trends, as well as reproduction and morphology. However, current global extinction risk assessment frameworks do not assess conservation status of spatially and biologically distinct marine turtle Regional Management Units (RMUs), and thus do not capture variations in population trends, impacts of threats, or necessary conservation actions across individual populations. To address this issue, we developed a new assessment framework that allowed us to evaluate, compare and organize marine turtle RMUs according to status and threats criteria. Because conservation priorities can vary widely (i.e. from avoiding imminent extinction to maintaining long-term monitoring efforts) we developed a “conservation priorities portfolio” system using categories of paired risk and threats scores for all RMUs (n = 58). We performed these assessments and rankings globally, by species, by ocean basin, and by recognized geopolitical bodies to identify patterns in risk, threats, and data gaps at different scales. This process resulted in characterization of risk and threats to all marine turtle RMUs, including identification of the world's 11 most endangered marine turtle RMUs based on highest risk and threats scores. This system also highlighted important gaps in available information that is crucial for accurate conservation assessments. Overall, this priority-setting framework can provide guidance for research and conservation priorities at multiple relevant scales, and should serve as a model for conservation status assessments and priority-setting for widespread, long-lived taxa. PMID:21969858

The role of failure modes and effects analysis in showing the benefits of automation in the blood bank.

PubMed

Han, Tae Hee; Kim, Moon Jung; Kim, Shinyoung; Kim, Hyun Ok; Lee, Mi Ae; Choi, Ji Seon; Hur, Mina; St John, Andrew

2013-05-01

Failure modes and effects analysis (FMEA) is a risk management tool used by the manufacturing industry but now being applied in laboratories. Teams from six South Korean blood banks used this tool to map their manual and automated blood grouping processes and determine the risk priority numbers (RPNs) as a total measure of error risk. The RPNs determined by each of the teams consistently showed that the use of automation dramatically reduced the RPN compared to manual processes. In addition, FMEA showed where the major risks occur in each of the manual processes and where attention should be prioritized to improve the process. Despite no previous experience with FMEA, the teams found the technique relatively easy to use and the subjectivity associated with assigning risk numbers did not affect the validity of the data. FMEA should become a routine technique for improving processes in laboratories. © 2012 American Association of Blood Banks.

Maritime Security: Potential Terrorist Attacks and Protection Priorities

DTIC Science & Technology

2007-01-09

Liquefied Natural Gas: Siting and Safety .” Feb. 15, 2005. 108 U.S. Coast Guard. U.S. Coast Guard Captain of the Port Long Island Sound Waterways...Order Code RL33787 Maritime Security: Potential Terrorist Attacks and Protection Priorities January 9, 2007 Paul W. Parfomak and John Frittelli...Terrorist Attacks and Protection Priorities 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK

[Leather bags production: organization study, general identification of hazards, biomechanical overload risk pre-evaluation using an easily applied evaluation tool].

PubMed

Montomoli, Loretta; Coppola, Giuseppina; Sarrini, Daniela; Sartorelli, P

2011-01-01

Craft industries are the backbone of the Italian manufacturing system and in this sector the leather trade plays a crucial role. The aim of the study was to experiment with a risk pre-mapping data sheet in leather bag manufacture by analyzing the production cycle. The prevalence of biomechanical, organizational and physical factors was demonstrated in tanneries. With regard to chemical agents the lack of any priority of intervention could be due to the lack of information on the chemicals used. In the 2 enterprises that used mechanical processes the results showed different priorities for intervention and a different level of the extent of such intervention. In particular in the first enterprise biomechanical overload was a top priority, while in the second the results were very similar to those of the tannery. The analysis showed in both companies that there was a high prevalence of risk of upper limb biomechanical overload in leather bag manufacture. Chemical risk assessment was not shown as a priority because the list of chemicals used was neither complete nor sufficient. The risk pre-mapping data sheet allowed us to obtain a preliminary overview of all the major existing risks in the leather industry. Therefore the method can prove a useful tool for employers as it permits instant identification of priorities for intervention for the different risks.

Prenatal knowledge and informational priorities of pregnant adolescents.

PubMed

Smith, P B; Levenson, P M; Morrow, J R

1985-01-01

One hundred and forty-six indigent pregnant adolescents (12 to 18 years of age) were asked to complete a questionnaire concerning their prenatal care priorities (Scale I) and their knowledge of correct perinatal behaviors (Scale II). On Scale I, over 75% of teens considered parenting skills, infant care, and diet extremely important. On Scale II correctly answered items focused on the need to avoid substance abuse and smoking during pregnancy, visit the doctor, and eat balanced meals. The mean number of correct answers, however, was only 11.8 out of a total possible scale of 18 items. Less than 50% correctly answered statements about the effects of weight gain and other health behaviors on risk for high blood pressure and toxemia, safety of laxatives during pregnancy, possibility of becoming pregnant again before resuming menstruation, and the safety of various physical activities. Performance on both knowledge and health priority scales showed correct health information was limited to basic concrete facts. Abstract and technical aspects of health care did not appear to be easily assimilated.

Preeclampsia in low and middle income countries-health services lessons learned from the PRE-EMPT (PRE-Eclampsia-Eclampsia Monitoring, Prevention and Treatment) project.

PubMed

von Dadelszen, Peter; Firoz, Tabassum; Donnay, France; Gordon, Rebecca; Justus Hofmeyr, G; Lalani, Shifana; Payne, Beth A; Roberts, James M; Teela, Katherine C; Vidler, Marianne; Sawchuck, Diane; Magee, Laura A

2012-10-01

The hypertensive disorders of pregnancy, in particular preeclampsia, matter because adverse events occur in women with preeclampsia and, to a lesser extent, in women with the other hypertensive disorders. These adverse events are maternal, perinatal, and neonatal and can alter the life trajectory of each individual, should that life not be ended by complications. In this review we discuss a number of priorities and dilemmas that we perceive to be facing health services in low and middle income countries as they try to prioritize interventions to reduce the health burden related to preeclampsia. These priorities and dilemmas relate to calcium for preeclampsia prevention, risk stratification, antihypertensive and magnesium sulphate therapy, and mobile health. Significant progress has been and is being made to reduce the impact of preeclampsia in low and middle income countries, but it remains a priority focus as we attempt to achieve Millennium Development Goal 5.

Irrigation, risk aversion, and water right priority under water supply uncertainty.

PubMed

Li, Man; Xu, Wenchao; Rosegrant, Mark W

2017-09-01

This paper explores the impacts of a water right's allocative priority-as an indicator of farmers' risk-bearing ability-on land irrigation under water supply uncertainty. We develop and use an economic model to simulate farmers' land irrigation decision and associated economic returns in eastern Idaho. Results indicate that the optimal acreage of land irrigated increases with water right priority when hydroclimate risk exhibits a negatively skewed or right-truncated distribution. Simulation results suggest that prior appropriation enables senior water rights holders to allocate a higher proportion of their land to irrigation, 6 times as much as junior rights holders do, creating a gap in the annual expected net revenue reaching up to $141.4 acre -1 or $55,800 per farm between the two groups. The optimal irrigated acreage, expected net revenue, and shadow value of a water right's priority are subject to substantial changes under a changing climate in the future, where temporal variation in water supply risks significantly affects the profitability of agricultural land use under the priority-based water sharing mechanism.

Engaging Patients and Clinicians in Establishing Research Priorities for Gestational Diabetes Mellitus.

PubMed

Rees, Sandra E; Chadha, Rati; Donovan, Lois E; Guitard, Adrienne L T; Koppula, Sudha; Laupacis, Andreas; Simpson, Sara; Johnson, Jeffrey A

2017-04-01

We involved patients and clinicians in Alberta, Canada, to establish research priorities in gestational diabetes mellitus (GDM), using an approach based on a model proposed by the James Lind Alliance (JLA). We adapted the 4-step JLA process to engage women with GDM and clinicians to identify uncertainties about the management of GDM. Uncertainties were identified through a survey and a review of the clinical practice guidelines (CPG). Uncertainties were short-listed by a steering committee, followed by a 1-day facilitated workshop using a nominal group format and involving a similar number of patients and clinicians, who identified the top 10 research priorities. Across the various survey formats, 75 individuals submitted 389 uncertainties, the majority (44; 59%) coming from patients. We removed 9 questions as being out of scope or unclear, and 41 were identified on a review of CPG, resulting in a total of 421 uncertainties. After the priority setting process, the final top 10 research priorities included questions about a simpler, more accurate and convenient screening test; risk factors for GDM; improving postpartum diabetes screening; the impact of GDM on the future health of the children; lifestyle challenges and mental health issues; safety, effectiveness and/or impact of diet and/or medication treatments; appropriate timing for delivery; and how care is provided, organized or communicated. These top 10 research priorities were informed through a comprehensive and transparent process involving women who have experienced GDM as well as clinicians, and they may be regarded as research priorities for GDM. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Risk prioritisation using the analytic hierarchy process

NASA Astrophysics Data System (ADS)

Sum, Rabihah Md.

2015-12-01

This study demonstrated how to use the Analytic Hierarchy Process (AHP) to prioritise risks of an insurance company. AHP is a technique to structure complex problems by arranging elements of the problems in a hierarchy, assigning numerical values to subjective judgements on the relative importance of the elements and synthesizing the judgements to determine which elements have the highest priority. The study is motivated by wide application of AHP as a prioritisation technique in complex problems. It aims to show AHP is able to minimise some limitations of risk assessment technique using likelihood and impact. The study shows AHP is able to provide consistency check on subjective judgements, organise a large number of risks into a structured framework, assist risk managers to make explicit risk trade-offs, and provide an easy to understand and systematic risk assessment process.

Occupational cancer in Britain

PubMed Central

Chen, Yiqun; Osman, John

2012-01-01

Although only a relatively small proportion of cancer is attributable to occupational exposure to carcinogenic agents, the estimated number of deaths due to occupational cancer is high when compared to other deaths due to work-related ill health and injury. However, risk from occupational exposure to carcinogens can be minimised through proportionate but effective risk management. The Health and Safety Executive (HSE) is the regulator of workplace health and safety in Great Britain. As part of its aim to reduce ill health arising from failures to control properly exposure to hazards at work, HSE commissioned the research presented elsewhere in this supplement to enable it to identify priorities for preventing occupational cancer. The research has shown that occupational cancer remains a key health issue and that low-level exposure of a large number of workers to carcinogens is important. The finding that a small number of carcinogens have been responsible for the majority of the burden of occupational cancer provides key evidence in the development of priorities for significant reduction of occupational cancer. Although the research presented in this supplement reflects the consequences of past exposures to carcinogens, occupational cancer remains a problem. The potential for exposure to the agents considered in this research is still present in the workplace and the findings are relevant to prevention of future disease. In this article, the principle approaches for risk reduction are described. It provides supporting information on some of the initiatives already being undertaken, or those being put in place, to reduce occupational cancer in Great Britain. The need also for systematic collection of exposure information and the importance of raising awareness and changing behaviours are discussed. PMID:22710673

Occupational cancer in Britain. Preventing occupational cancer.

PubMed

Chen, Yiqun; Osman, John

2012-06-19

Although only a relatively small proportion of cancer is attributable to occupational exposure to carcinogenic agents, the estimated number of deaths due to occupational cancer is high when compared to other deaths due to work-related ill health and injury. However, risk from occupational exposure to carcinogens can be minimised through proportionate but effective risk management. The Health and Safety Executive (HSE) is the regulator of workplace health and safety in Great Britain. As part of its aim to reduce ill health arising from failures to control properly exposure to hazards at work, HSE commissioned the research presented elsewhere in this supplement to enable it to identify priorities for preventing occupational cancer. The research has shown that occupational cancer remains a key health issue and that low-level exposure of a large number of workers to carcinogens is important. The finding that a small number of carcinogens have been responsible for the majority of the burden of occupational cancer provides key evidence in the development of priorities for significant reduction of occupational cancer. Although the research presented in this supplement reflects the consequences of past exposures to carcinogens, occupational cancer remains a problem. The potential for exposure to the agents considered in this research is still present in the workplace and the findings are relevant to prevention of future disease. In this article, the principle approaches for risk reduction are described. It provides supporting information on some of the initiatives already being undertaken, or those being put in place, to reduce occupational cancer in Great Britain. The need also for systematic collection of exposure information and the importance of raising awareness and changing behaviours are discussed.

Prioritized LT Codes

NASA Technical Reports Server (NTRS)

Woo, Simon S.; Cheng, Michael K.

2011-01-01

The original Luby Transform (LT) coding scheme is extended to account for data transmissions where some information symbols in a message block are more important than others. Prioritized LT codes provide unequal error protection (UEP) of data on an erasure channel by modifying the original LT encoder. The prioritized algorithm improves high-priority data protection without penalizing low-priority data recovery. Moreover, low-latency decoding is also obtained for high-priority data due to fast encoding. Prioritized LT codes only require a slight change in the original encoding algorithm, and no changes at all at the decoder. Hence, with a small complexity increase in the LT encoder, an improved UEP and low-decoding latency performance for high-priority data can be achieved. LT encoding partitions a data stream into fixed-sized message blocks each with a constant number of information symbols. To generate a code symbol from the information symbols in a message, the Robust-Soliton probability distribution is first applied in order to determine the number of information symbols to be used to compute the code symbol. Then, the specific information symbols are chosen uniform randomly from the message block. Finally, the selected information symbols are XORed to form the code symbol. The Prioritized LT code construction includes an additional restriction that code symbols formed by a relatively small number of XORed information symbols select some of these information symbols from the pool of high-priority data. Once high-priority data are fully covered, encoding continues with the conventional LT approach where code symbols are generated by selecting information symbols from the entire message block including all different priorities. Therefore, if code symbols derived from high-priority data experience an unusual high number of erasures, Prioritized LT codes can still reliably recover both high- and low-priority data. This hybrid approach decides not only "how to encode" but also "what to encode" to achieve UEP. Another advantage of the priority encoding process is that the majority of high-priority data can be decoded sooner since only a small number of code symbols are required to reconstruct high-priority data. This approach increases the likelihood that high-priority data is decoded first over low-priority data. The Prioritized LT code scheme achieves an improvement in high-priority data decoding performance as well as overall information recovery without penalizing the decoding of low-priority data, assuming high-priority data is no more than half of a message block. The cost is in the additional complexity required in the encoder. If extra computation resource is available at the transmitter, image, voice, and video transmission quality in terrestrial and space communications can benefit from accurate use of redundancy in protecting data with varying priorities.

Leveraging Epidemiology and Clinical Studies of Cancer Outcomes: Recommendations and Opportunities for Translational Research

PubMed Central

2013-01-01

As the number of cancer survivors continues to grow, research investigating the factors that affect cancer outcomes, such as disease recurrence, risk of second malignant neoplasms, and the late effects of cancer treatments, becomes ever more important. Numerous epidemiologic studies have investigated factors that affect cancer risk, but far fewer have addressed the extent to which demographic, lifestyle, genomic, clinical, and psychosocial factors influence cancer outcomes. To identify research priorities as well as resources and infrastructure needed to advance the field of cancer outcomes and survivorship research, the National Cancer Institute sponsored a workshop titled “Utilizing Data from Cancer Survivor Cohorts: Understanding the Current State of Knowledge and Developing Future Research Priorities” on November 3, 2011, in Washington, DC. This commentary highlights recent findings presented at the workshop, opportunities to leverage existing data, and recommendations for future research, data, and infrastructure needed to address high priority clinical and research questions. Multidisciplinary teams that include epidemiologists, clinicians, biostatisticians, and bioinformaticists will be essential to facilitate future cancer outcome studies focused on improving clinical care of cancer patients, identifying those at high risk of poor outcomes, and implementing effective interventions to ultimately improve the quality and duration of survival. PMID:23197494

SU-E-T-420: Failure Effects Mode Analysis for Trigeminal Neuralgia Frameless Radiosurgery

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

Howe, J

2015-06-15

Purpose: Functional radiosurgery has been used successfully in the treatment of trigeminal neuralgia but presents significant challenges to ensuring the high prescription dose is delivered accurately. A review of existing practice should help direct the focus of quality improvement for this treatment regime. Method: Failure modes and effects analysis was used to identify the processes in preparing radiosurgery treatment for TN. The map was developed by a multidisciplinary team including: neurosurgeon, radiation oncology, physicist and therapist. Potential failure modes were identified for each step in the process map as well as potential causes and end effect. A risk priority numbermore » was assigned to each cause. Results: The process map identified 66 individual steps (see attached supporting document). Corrective actions were developed for areas of high risk priority number. Wrong site treatment is at higher risk for trigeminal neuralgia treatment due to the lack of site specific pathologic imaging on MR and CT – additional site specific checks were implemented to minimize the risk of wrong site treatment. Failed collision checks resulted from an insufficient collision model in the treatment planning system and a plan template was developed to address this problem. Conclusion: Failure modes and effects analysis is an effective tool for developing quality improvement in high risk radiotherapy procedures such as functional radiosurgery.« less

A risk assessment methodology using intuitionistic fuzzy set in FMEA

NASA Astrophysics Data System (ADS)

Chang, Kuei-Hu; Cheng, Ching-Hsue

2010-12-01

Most current risk assessment methods use the risk priority number (RPN) value to evaluate the risk of failure. However, conventional RPN methodology has been criticised as having five main shortcomings as follows: (1) the assumption that the RPN elements are equally weighted leads to over simplification; (2) the RPN scale itself has some non-intuitive statistical properties; (3) the RPN elements have many duplicate numbers; (4) the RPN is derived from only three factors mainly in terms of safety; and (5) the conventional RPN method has not considered indirect relations between components. To address the above issues, an efficient and comprehensive algorithm to evaluate the risk of failure is needed. This article proposes an innovative approach, which integrates the intuitionistic fuzzy set (IFS) and the decision-making trial and evaluation laboratory (DEMATEL) approach on risk assessment. The proposed approach resolves some of the shortcomings of the conventional RPN method. A case study, which assesses the risk of 0.15 µm DRAM etching process, is used to demonstrate the effectiveness of the proposed approach. Finally, the result of the proposed method is compared with the listing approaches of risk assessment methods.

Setting Priorities in Global Child Health Research Investments: Guidelines for Implementation of the CHNRI Method

PubMed Central

Rudan, Igor; Gibson, Jennifer L.; Ameratunga, Shanthi; El Arifeen, Shams; Bhutta, Zulfiqar A.; Black, Maureen; Black, Robert E.; Brown, Kenneth H.; Campbell, Harry; Carneiro, Ilona; Chan, Kit Yee; Chandramohan, Daniel; Chopra, Mickey; Cousens, Simon; Darmstadt, Gary L.; Gardner, Julie Meeks; Hess, Sonja Y.; Hyder, Adnan A.; Kapiriri, Lydia; Kosek, Margaret; Lanata, Claudio F.; Lansang, Mary Ann; Lawn, Joy; Tomlinson, Mark; Tsai, Alexander C.; Webster, Jayne

2008-01-01

This article provides detailed guidelines for the implementation of systematic method for setting priorities in health research investments that was recently developed by Child Health and Nutrition Research Initiative (CHNRI). The target audience for the proposed method are international agencies, large research funding donors, and national governments and policy-makers. The process has the following steps: (i) selecting the managers of the process; (ii) specifying the context and risk management preferences; (iii) discussing criteria for setting health research priorities; (iv) choosing a limited set of the most useful and important criteria; (v) developing means to assess the likelihood that proposed health research options will satisfy the selected criteria; (vi) systematic listing of a large number of proposed health research options; (vii) pre-scoring check of all competing health research options; (viii) scoring of health research options using the chosen set of criteria; (ix) calculating intermediate scores for each health research option; (x) obtaining further input from the stakeholders; (xi) adjusting intermediate scores taking into account the values of stakeholders; (xii) calculating overall priority scores and assigning ranks; (xiii) performing an analysis of agreement between the scorers; (xiv) linking computed research priority scores with investment decisions; (xv) feedback and revision. The CHNRI method is a flexible process that enables prioritizing health research investments at any level: institutional, regional, national, international, or global. PMID:19090596

Risk assessment in the upstream crude oil supply chain: Leveraging analytic hierarchy process

NASA Astrophysics Data System (ADS)

Briggs, Charles Awoala

For an organization to be successful, an effective strategy is required, and if implemented appropriately the strategy will result in a sustainable competitive advantage. The importance of decision making in the oil industry is reflected in the magnitude and nature of the industry. Specific features of the oil industry supply chain, such as its longer chain, the complexity of its transportation system, its complex production and storage processes, etc., pose challenges to its effective management. Hence, understanding the risks, the risk sources, and their potential impacts on the oil industry's operations will be helpful in proposing a risk management model for the upstream oil supply chain. The risk-based model in this research uses a three-level analytic hierarchy process (AHP), a multiple-attribute decision-making technique, to underline the importance of risk analysis and risk management in the upstream crude oil supply chain. Level 1 represents the overall goal of risk management; Level 2 is comprised of the various risk factors; and Level 3 represents the alternative criteria of the decision maker as indicated on the hierarchical structure of the crude oil supply chain. Several risk management experts from different oil companies around the world were surveyed, and six major types of supply chain risks were identified: (1) exploration and production, (2) environmental and regulatory compliance, (3) transportation, (4) availability of oil, (5) geopolitical, and (6) reputational. Also identified are the preferred methods of managing risks which include; (1) accept and control the risks, (2) avoid the risk by stopping the activity, or (3) transfer or share the risks to other companies or insurers. The results from the survey indicate that the most important risk to manage is transportation risk with a priority of .263, followed by exploration/production with priority of .198, with an overall inconsistency of .03. With respect to major objectives the most preferred risk management policy option based on the result of the composite score is accept and control risk with a priority of .446, followed by transfer or share risk with a priority of .303. The least likely option is to terminate or forgo activity with a priority of .251.

Comparison of international food allergen labeling regulations.

PubMed

Gendel, Steven M

2012-07-01

Food allergy is a significant public health issue worldwide. Regulatory risk management strategies for allergic consumers have focused on providing information about the presence of food allergens through label declarations. A number of countries and regulatory bodies have recognized the importance of providing this information by enacting laws, regulations or standards for food allergen labeling of "priority allergens". However, different governments and organizations have taken different approaches to identifying these "priority allergens" and to designing labeling declaration regulatory frameworks. The increasing volume of the international food trade suggests that there would be value in supporting sensitive consumers by harmonizing (to the extent possible) these regulatory frameworks. As a first step toward this goal, an inventory of allergen labeling regulations was assembled and analyzed to identify commonalities, differences, and future needs. Published by Elsevier Inc.

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

Failure mode and effects analysis using intuitionistic fuzzy hybrid weighted Euclidean distance operator

NASA Astrophysics Data System (ADS)

Liu, Hu-Chen; Liu, Long; Li, Ping

2014-10-01

Failure mode and effects analysis (FMEA) has shown its effectiveness in examining potential failures in products, process, designs or services and has been extensively used for safety and reliability analysis in a wide range of industries. However, its approach to prioritise failure modes through a crisp risk priority number (RPN) has been criticised as having several shortcomings. The aim of this paper is to develop an efficient and comprehensive risk assessment methodology using intuitionistic fuzzy hybrid weighted Euclidean distance (IFHWED) operator to overcome the limitations and improve the effectiveness of the traditional FMEA. The diversified and uncertain assessments given by FMEA team members are treated as linguistic terms expressed in intuitionistic fuzzy numbers (IFNs). Intuitionistic fuzzy weighted averaging (IFWA) operator is used to aggregate the FMEA team members' individual assessments into a group assessment. IFHWED operator is applied thereafter to the prioritisation and selection of failure modes. Particularly, both subjective and objective weights of risk factors are considered during the risk evaluation process. A numerical example for risk assessment is given to illustrate the proposed method finally.

Illustrative case using the RISK21 roadmap and matrix: prioritization for evaluation of chemicals found in drinking water

PubMed Central

Wolf, Douglas C.; Bachman, Ammie; Barrett, Gordon; Bellin, Cheryl; Goodman, Jay I.; Jensen, Elke; Moretto, Angelo; McMullin, Tami; Pastoor, Timothy P.; Schoeny, Rita; Slezak, Brian; Wend, Korinna; Embry, Michelle R.

2016-01-01

ABSTRACT The HESI-led RISK21 effort has developed a framework supporting the use of twenty-first century technology in obtaining and using information for chemical risk assessment. This framework represents a problem formulation-based, exposure-driven, tiered data acquisition approach that leads to an informed decision on human health safety to be made when sufficient evidence is available. It provides a transparent and consistent approach to evaluate information in order to maximize the ability of assessments to inform decisions and to optimize the use of resources. To demonstrate the application of the framework’s roadmap and matrix, this case study evaluates a large number of chemicals that could be present in drinking water. The focus is to prioritize which of these should be considered for human health risk as individual contaminants. The example evaluates 20 potential drinking water contaminants, using the tiered RISK21 approach in combination with graphical representation of information at each step, using the RISK21 matrix. Utilizing the framework, 11 of the 20 chemicals were assigned low priority based on available exposure data alone, which demonstrated that exposure was extremely low. The remaining nine chemicals were further evaluated, using refined estimates of toxicity based on readily available data, with three deemed high priority for further evaluation. In the present case study, it was determined that the greatest value of additional information would be from improved exposure models and not from additional hazard characterization. PMID:26451723

Illustrative case using the RISK21 roadmap and matrix: prioritization for evaluation of chemicals found in drinking water.

PubMed

Wolf, Douglas C; Bachman, Ammie; Barrett, Gordon; Bellin, Cheryl; Goodman, Jay I; Jensen, Elke; Moretto, Angelo; McMullin, Tami; Pastoor, Timothy P; Schoeny, Rita; Slezak, Brian; Wend, Korinna; Embry, Michelle R

2016-01-01

The HESI-led RISK21 effort has developed a framework supporting the use of twenty-first century technology in obtaining and using information for chemical risk assessment. This framework represents a problem formulation-based, exposure-driven, tiered data acquisition approach that leads to an informed decision on human health safety to be made when sufficient evidence is available. It provides a transparent and consistent approach to evaluate information in order to maximize the ability of assessments to inform decisions and to optimize the use of resources. To demonstrate the application of the framework's roadmap and matrix, this case study evaluates a large number of chemicals that could be present in drinking water. The focus is to prioritize which of these should be considered for human health risk as individual contaminants. The example evaluates 20 potential drinking water contaminants, using the tiered RISK21 approach in combination with graphical representation of information at each step, using the RISK21 matrix. Utilizing the framework, 11 of the 20 chemicals were assigned low priority based on available exposure data alone, which demonstrated that exposure was extremely low. The remaining nine chemicals were further evaluated, using refined estimates of toxicity based on readily available data, with three deemed high priority for further evaluation. In the present case study, it was determined that the greatest value of additional information would be from improved exposure models and not from additional hazard characterization.

Adapting Technological Interventions to Meet the Needs of Priority Populations.

PubMed

Linke, Sarah E; Larsen, Britta A; Marquez, Becky; Mendoza-Vasconez, Andrea; Marcus, Bess H

2016-01-01

Cardiovascular diseases (CVD) comprise the leading cause of mortality worldwide, accounting for 3 in 10 deaths. Individuals with certain risk factors, including tobacco use, obesity, low levels of physical activity, type 2 diabetes mellitus, racial/ethnic minority status and low socioeconomic status, experience higher rates of CVD and are, therefore, considered priority populations. Technological devices such as computers and smartphones are now routinely utilized in research studies aiming to prevent CVD and its risk factors, and they are also rampant in the public and private health sectors. Traditional health behavior interventions targeting these risk factors have been adapted for technology-based approaches. This review provides an overview of technology-based interventions conducted in these priority populations as well as the challenges and gaps to be addressed in future research. Researchers currently possess tremendous opportunities to engage in technology-based implementation and dissemination science to help spread evidence-based programs focusing on CVD risk factors in these and other priority populations. Copyright © 2016 Elsevier Inc. All rights reserved.

75 FR 59803 - Endangered and Threatened Wildlife and Plants; Determination for the Gunnison Sage-grouse as a...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-28

... higher priority listing activities. A listing priority of 5 is assigned to species with high magnitude... number for Gunnison sage-grouse as a 2. A listing priority number of 2 is assigned to species with high... that are rich in calcium, phosphorous, and protein to meet the nutritional needs of females during the...

Do People Taking Flu Vaccines Need Them the Most?

PubMed Central

Gu, Qian; Sood, Neeraj

2011-01-01

Background A well targeted flu vaccine strategy can ensure that vaccines go to those who are at the highest risk of getting infected if unvaccinated. However, prior research has not explicitly examined the association between the risk of flu infection and vaccination rates. Purpose This study examines the relationship between the risk of flu infection and the probability of getting vaccinated. Methods Nationally representative data from the US and multivariate regression models were used to estimate what individual characteristics are associated with (1) the risk of flu infection when unvaccinated and (2) flu vaccination rates. These results were used to estimate the correlation between the probability of infection and the probability of getting vaccinated. Separate analyses were performed for the general population and the high priority population that is at increased risk of flu related complications. Results We find that the high priority population was more likely to get vaccinated compared to the general population. However, within both the high priority and general populations the risk of flu infection when unvaccinated was negatively correlated with vaccination rates (r = −0.067, p<0.01). This negative association between the risk of infection when unvaccinated and the probability of vaccination was stronger for the high priority population (r = −0.361, p<0.01). Conclusions There is a poor match between those who get flu vaccines and those who have a high risk of flu infection within both the high priority and general populations. Targeting vaccination to people with low socioeconomic status, people who are engaged in unhealthy behaviors, working people, and families with kids will likely improve effectiveness of flu vaccine policy. PMID:22164202

An improved method for risk evaluation in failure modes and effects analysis of CNC lathe

NASA Astrophysics Data System (ADS)

Rachieru, N.; Belu, N.; Anghel, D. C.

2015-11-01

Failure mode and effects analysis (FMEA) is one of the most popular reliability analysis tools for identifying, assessing and eliminating potential failure modes in a wide range of industries. In general, failure modes in FMEA are evaluated and ranked through the risk priority number (RPN), which is obtained by the multiplication of crisp values of the risk factors, such as the occurrence (O), severity (S), and detection (D) of each failure mode. However, the crisp RPN method has been criticized to have several deficiencies. In this paper, linguistic variables, expressed in Gaussian, trapezoidal or triangular fuzzy numbers, are used to assess the ratings and weights for the risk factors S, O and D. A new risk assessment system based on the fuzzy set theory and fuzzy rule base theory is to be applied to assess and rank risks associated to failure modes that could appear in the functioning of Turn 55 Lathe CNC. Two case studies have been shown to demonstrate the methodology thus developed. It is illustrated a parallel between the results obtained by the traditional method and fuzzy logic for determining the RPNs. The results show that the proposed approach can reduce duplicated RPN numbers and get a more accurate, reasonable risk assessment. As a result, the stability of product and process can be assured.

Ethical Challenges in the Provision of Dialysis in Resource-Constrained Environments.

PubMed

Luyckx, Valerie A; Miljeteig, Ingrid; Ejigu, Addisu M; Moosa, M Rafique

2017-05-01

The number of patients requiring dialysis by 2030 is projected to double worldwide, with the largest increase expected in low- and middle-income countries (LMICs). Dialysis is seldom considered a high priority by health care funders, consequently, few LMICs develop policies regarding dialysis allocation. Dialysis facilities may exist, but access remains highly inequitable in LMICs. High out-of-pocket payments make dialysis unsustainable and plunge many families into poverty. Patients, families, and clinicians suffer significant emotional and moral distress from daily life-and-death decisions imposed by dialysis. The health system's obligation to provide financial risk protection is an important component of global and national strategies to achieve universal health coverage. An ethical imperative therefore exists to develop transparent dialysis priority-setting guidelines to facilitate public understanding and acceptance of the realistic limits within the health system, and facilitate fair allocation of scarce resources. In this article, we present ethical challenges faced by patients, families, clinicians, and policy makers where dialysis is not universally accessible and discuss the potential ethical consequences of various dialysis allocation strategies. Finally, we suggest an ethical framework for use in policy development for priority setting of dialysis care. The accountability for reasonableness framework is proposed as a procedurally fair decision-making, priority-setting process. Copyright © 2017 Elsevier Inc. All rights reserved.

Foresight Infectious Diseases China Project--a novel approach to anticipating future trends in risk of infectious diseases in China: methodology and results from an initial application.

PubMed

Nicoll, A; Huang, J; Xie, Z

2009-07-09

The project devised a simple but novel methodology for identifying possible future trends in infectious diseases in animals and humans in China, of priority concern to the Chinese authorities. It used a model of disease drivers (social, economic, biological or environmental factors that affect disease outcomes, by changing the behaviour of diseases, sources or pathways) devised for the Foresight Programme in the United Kingdom. Nine families of drivers were adapted to Chinese circumstances and matrices were constructed to identify the likely relationship of single infectious diseases or families of diseases to the drivers. The likely future trends in those drivers in China were determined by interviews with 36 independent Chinese experts. These trends included not only potentially adverse animal and human movements but also opportunities for innovative surveillance methods, more use of hospitals, antimicrobials and vaccines. Some human behaviours and social trends were expected to increase the risk of infections (in particular sexually transmitted and healthcare-associated infections) while at the same time the experts thought the awareness of risk in the Chinese population would increase. The results suggested a number of areas where the Chinese authorities may experience difficulties in the future, such as rising numbers of healthcare-associated infections, zoonoses and other emerging diseases and sexually transmitted infections (including HIV). Not making firm predictions, this work identifies priority disease groups requiring surveillance and consideration of countermeasures as well as recommending strengthening basic surveillance and response mechanisms for unanticipatable zoonoses and other emerging disease threats.

Medical Surveillance Monthly Report (MSMR). Volume 23, Number 9, September 2016

DTIC Science & Technology

2016-09-01

service and U.S. Armed Forces, active and reserve components, January 2011–June 2016 P A G E 9 Update: Diagnoses of overweight and obesity , active...effect on operational effectiveness and increase the risk of both acute and chronic health effects related to overweight and obesity . During 2011–2015...a priority of military medical and line leaders at every level. Update: Diagnoses of Overweight and Obesity , Active Component, U.S. Armed Forces

Coastal sedimentary research examines critical issues of national and global priority

USGS Publications Warehouse

Fletcher, Chip; Anderson, John; Crook, Keith A.W.; Kaminsky, George; Larcombe, Piers; Murray-Wallace, Colin V.; Sansone, Frank; Scott, David B.; Riggs, Stan; Sallenger, Asbury; Shennan, Ian; Thieler, E. Robert; Wehmiller, John F.

2000-01-01

An international conference was held recently in Honolulu, Hawaii, to examine and plan for coastal sedimentary research in the United States and globally. Participants agreed that sedimentary coastal environments constitute a critical national and global resource that suffers widespread degradation due to human impacts. Moreover, human population growth and inappropriate development in the coastal zone are escalating public asset losses due to coastal hazards and placing large numbers of communities at growing risk (Figure 1).

Priorities for development of research methods in occupational cancer.

PubMed Central

Ward, Elizabeth M; Schulte, Paul A; Bayard, Steve; Blair, Aaron; Brandt-Rauf, Paul; Butler, Mary Ann; Dankovic, David; Hubbs, Ann F; Jones, Carol; Karstadt, Myra; Kedderis, Gregory L; Melnick, Ronald; Redlich, Carrie A; Rothman, Nathaniel; Savage, Russell E; Sprinker, Michael; Toraason, Mark; Weston, Ainsley; Olshan, Andrew F; Stewart, Patricia; Zahm, Sheila Hoar

2003-01-01

Occupational cancer research methods was identified in 1996 as 1 of 21 priority research areas in the National Occupational Research Agenda (NORA). To implement NORA, teams of experts from various sectors were formed and given the charge to further define research needs and develop strategies to enhance or augment research in each priority area. This article is a product of that process. Focus on occupational cancer research methods is important both because occupational factors play a significant role in a number of cancers, resulting in significant morbidity and mortality, and also because occupational cohorts (because of higher exposure levels) often provide unique opportunities to evaluate health effects of environmental toxicants and understand the carcinogenic process in humans. Despite an explosion of new methods for cancer research in general, these have not been widely applied to occupational cancer research. In this article we identify needs and gaps in occupational cancer research methods in four broad areas: identification of occupational carcinogens, design of epidemiologic studies, risk assessment, and primary and secondary prevention. Progress in occupational cancer will require interdisciplinary research involving epidemiologists, industrial hygienists, toxicologists, and molecular biologists. PMID:12524210

A Fair Contention Access Scheme for Low-Priority Traffic in Wireless Body Area Networks

PubMed Central

Sajeel, Muhammad; Bashir, Faisal; Asfand-e-yar, Muhammad; Tauqir, Muhammad

2017-01-01

Recently, wireless body area networks (WBANs) have attracted significant consideration in ubiquitous healthcare. A number of medium access control (MAC) protocols, primarily derived from the superframe structure of the IEEE 802.15.4, have been proposed in literature. These MAC protocols aim to provide quality of service (QoS) by prioritizing different traffic types in WBANs. A contention access period (CAP)with high contention in priority-based MAC protocols can result in higher number of collisions and retransmissions. During CAP, traffic classes with higher priority are dominant over low-priority traffic; this has led to starvation of low-priority traffic, thus adversely affecting WBAN throughput, delay, and energy consumption. Hence, this paper proposes a traffic-adaptive priority-based superframe structure that is able to reduce contention in the CAP period, and provides a fair chance for low-priority traffic. Simulation results in ns-3 demonstrate that the proposed MAC protocol, called traffic- adaptive priority-based MAC (TAP-MAC), achieves low energy consumption, high throughput, and low latency compared to the IEEE 802.15.4 standard, and the most recent priority-based MAC protocol, called priority-based MAC protocol (PA-MAC). PMID:28832495

[Economic evaluation and rationale for human health risk management decisions].

PubMed

Fokin, S G; Bobkova, T E

2011-01-01

The priority task of human health maintenance and improvement is risk management using the new economic concepts based on the assessment of potential and real human risks from exposure to poor environmental factors and on the estimation of cost-benefit and cost-effectiveness ratios. The application of economic tools to manage a human risk makes it possible to assess various measures both as a whole and their individual priority areas, to rank different scenarios in terms of their effectiveness, to estimate costs per unit of risk reduction and benefit increase (damage decrease).

In vivo and in vitro methods for evaluating soil arsenic bioavailability: relevant to human health risk assessment

EPA Science Inventory

Arsenic (As) is the most frequently occurring contaminant on the priority list of hazardous substances, which lists substances of greatest public health concern to people living at or near U.S. National Priorities List site. Accurate assessment of human health risks from exposure...

Irrigation, risk aversion, and water right priority under water supply uncertainty

NASA Astrophysics Data System (ADS)

Li, Man; Xu, Wenchao; Rosegrant, Mark W.

2017-09-01

This paper explores the impacts of a water right's allocative priority—as an indicator of farmers' risk-bearing ability—on land irrigation under water supply uncertainty. We develop and use an economic model to simulate farmers' land irrigation decision and associated economic returns in eastern Idaho. Results indicate that the optimal acreage of land irrigated increases with water right priority when hydroclimate risk exhibits a negatively skewed or right-truncated distribution. Simulation results suggest that prior appropriation enables senior water rights holders to allocate a higher proportion of their land to irrigation, 6 times as much as junior rights holders do, creating a gap in the annual expected net revenue reaching up to 141.4 acre-1 or 55,800 per farm between the two groups. The optimal irrigated acreage, expected net revenue, and shadow value of a water right's priority are subject to substantial changes under a changing climate in the future, where temporal variation in water supply risks significantly affects the profitability of agricultural land use under the priority-based water sharing mechanism.

Identification of Chemicals of Interest to the Department of Defense and U.S. Air Force Among the U.S. Environmental Protection Agency’s Integrated Risk Information System Chemicals that are Due for Reassessment of their Toxicity Values

DTIC Science & Technology

2010-03-16

Exceeded at ERP Soil and Groundwater Sites 86 A-2a. Identification of IRIS Chemicals of Interest on the ATSDR CERCLA Priority List of Hazardous...the Number (Bold Font) of Air Force ERP Samples in Which They Were Detected 317 A-4d. Air Force ERP Soil Samples: IRIS Chemicals of Interest...Ranked by the Number (Bold Font) of Air Force ERP Soil Samples in Which They Were Detected 333 A-4e. Air Force ERP Groundwater Samples: IRIS Chemicals of

Climate Change Is Increasing the Risk of the Reemergence of Malaria in Romania.

PubMed

Ivanescu, Larisa; Bodale, Ilie; Florescu, Simin-Aysel; Roman, Constantin; Acatrinei, Dumitru; Miron, Liviu

2016-01-01

The climatic modifications lead to global warming; favouring the risk of the appearance and development of diseases are considered until now tropical diseases. Another important factor is the workers' immigration, the economic crisis favouring the passive transmission of new species of culicidae from different areas. Malaria is the disease with the widest distribution in the globe. Millions of people are infected every year in Africa, India, South-East Asia, Middle East, and Central and South America, with more than 41% of the global population under the risk of infestation with malaria. The increase of the number of local cases reported in 2007-2011 indicates that the conditions can favour the high local transmission in the affected areas. In the situation presented, the establishment of the level of risk concerning the reemergence of malaria in Romania becomes a priority.

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

Teixeira, Flavia C., E-mail: flavitiz@gmail.com; Almeida, Carlos E. de; Saiful Huq, M.

Purpose: The goal of this study was to evaluate the safety and quality management program for stereotactic radiosurgery (SRS) treatment processes at three radiotherapy centers in Brazil by using three industrial engineering tools (1) process mapping, (2) failure modes and effects analysis (FMEA), and (3) fault tree analysis. Methods: The recommendations of Task Group 100 of American Association of Physicists in Medicine were followed to apply the three tools described above to create a process tree for SRS procedure for each radiotherapy center and then FMEA was performed. Failure modes were identified for all process steps and values of riskmore » priority number (RPN) were calculated from O, S, and D (RPN = O × S × D) values assigned by a professional team responsible for patient care. Results: The subprocess treatment planning was presented with the highest number of failure modes for all centers. The total number of failure modes were 135, 104, and 131 for centers I, II, and III, respectively. The highest RPN value for each center is as follows: center I (204), center II (372), and center III (370). Failure modes with RPN ≥ 100: center I (22), center II (115), and center III (110). Failure modes characterized by S ≥ 7, represented 68% of the failure modes for center III, 62% for center II, and 45% for center I. Failure modes with RPNs values ≥100 and S ≥ 7, D ≥ 5, and O ≥ 5 were considered as high priority in this study. Conclusions: The results of the present study show that the safety risk profiles for the same stereotactic radiotherapy process are different at three radiotherapy centers in Brazil. Although this is the same treatment process, this present study showed that the risk priority is different and it will lead to implementation of different safety interventions among the centers. Therefore, the current practice of applying universal device-centric QA is not adequate to address all possible failures in clinical processes at different radiotherapy centers. Integrated approaches to device-centric and process specific quality management program specific to each radiotherapy center are the key to a safe quality management program.« less

Survey on the micro-pollutants presence in surface water system of northern Serbia and environmental and health risk assessment.

PubMed

Škrbić, Biljana D; Kadokami, Kiwao; Antić, Igor

2018-06-07

This study demonstrates the occurrence of 940 organic micro-pollutants in surface water of four rivers, one irrigation canal system, and two lakes in Vojvodina Province, the northern part of Serbia, summing in total eighteen samples. The number of detected chemicals ranged from 22 to 84, with 127 micro-pollutants detected at least once, representing 13% of the studied substances. The targeted compounds include n-alkanes, sterols, polycyclic aromatic hydrocarbons (PAHs), organochlorine pesticides polychlorinated biphenyls, pesticides, pharmaceutical active compounds, industrial chemicals, plasticizers, etc. Among the analysed compounds, sterols were the most dominant with maximum quantified concentrations. The substances which were quantified with frequency over 50% were two PAHs (2-methylnaphthalene, benzo(ghi)perylene), five sterols (cholesterol, cholestanol, stigmasterol, fucosterol, beta-sitosterol), three pharmaceuticals and personal care products (L-menthol, diethyltoluamide, caffeine), and ten household chemicals (4-tert-octylphenol, dimethyl phthalate, methyl palmitate, phenylethyl alcohol, 1-nonanol, alpha-terpineol, 2-phenoxy-ethanol, methyl myristate, acetophenone, and 2-ethyl-1-hexanol). The list of priority substances under the European Union Directive 2013/39/EU includes 49 priority substances (PSs) out of which 34 were analysed. Among these, eleven PSs were quantified, and only two compounds (fluoranthene and benzo (a) pyrene) exceeded EU Environmental Quality Standards targeted values. The obtained results were compared with the previously published data that dealt with the same targeted number of micro-pollutants in sediment samples. This revealed connections between the same sampling locations. Environmental risk assessment showed the existence of potential ecological risk as 72% of the obtained values for the ecological hazard index (HI) at investigated locations were higher that the targeted value (HI > 1). Estimated values for hazard quotient (HQ) and hazard index (HI) for non-carcinogenic risk were lower than the targeted value, indicating no non-carcinogenic risk through dermal contact and non-intentional ingestion of water. Estimated values for cancer risk were all below 1 × 10 -6 , which is not considered to pose significant human health risk. Copyright © 2018. Published by Elsevier Inc.

Comprehensive Environmental Assessment Applied to Multiwalled Carbon Nanotube Flame-Retardant Coatings in Upholstery Textiles: A Case Study Presenting Priority Research Gaps for Future Risk Assessments (Final Report)

EPA Science Inventory

In September 2013, EPA announced the availability of the final report, Comprehensive Environmental Assessment Applied to Multiwalled Carbon Nanotube Flame-Retardant Coatings in Upholstery Textiles: A Case Study Presenting Priority Research Gaps for Future Risk Assessments...

Risk analysis by FMEA as an element of analytical validation.

PubMed

van Leeuwen, J F; Nauta, M J; de Kaste, D; Odekerken-Rombouts, Y M C F; Oldenhof, M T; Vredenbregt, M J; Barends, D M

2009-12-05

We subjected a Near-Infrared (NIR) analytical procedure used for screening drugs on authenticity to a Failure Mode and Effects Analysis (FMEA), including technical risks as well as risks related to human failure. An FMEA team broke down the NIR analytical method into process steps and identified possible failure modes for each step. Each failure mode was ranked on estimated frequency of occurrence (O), probability that the failure would remain undetected later in the process (D) and severity (S), each on a scale of 1-10. Human errors turned out to be the most common cause of failure modes. Failure risks were calculated by Risk Priority Numbers (RPNs)=O x D x S. Failure modes with the highest RPN scores were subjected to corrective actions and the FMEA was repeated, showing reductions in RPN scores and resulting in improvement indices up to 5.0. We recommend risk analysis as an addition to the usual analytical validation, as the FMEA enabled us to detect previously unidentified risks.

Individual traveller health priorities and the pre-travel health consultation.

PubMed

Flaherty, Gerard T; Chen, Bingling; Avalos, Gloria

2017-09-01

The purpose of this study was to examine the principal travel health priorities of travellers. The most frequently selected travel health concerns were accessing medical care abroad, dying abroad, insect bites, malaria, personal safety and travel security threats. The travel health risks of least concern were culture shock, fear of flying, jet lag and sexually transmitted infections. This study is the first to develop a hierarchy of self-declared travel health risk priorities among travellers. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Promotion of mental health and prevention of mental disorders: priorities for implementation.

PubMed

Barry, M M; Clarke, A M; Petersen, I

2015-09-28

There is compelling evidence from high-quality studies that mental health promotion and primary prevention interventions can reduce the risk of mental disorders, enhance protective factors for good mental and physical health, and lead to lasting positive effects on a range of social and economic outcomes. This paper reviews the available evidence in order to guide the implementation of mental health promotion and prevention interventions in the Eastern Mediterranean Region. The paper identifies a number of priority areas that can generate clear health and social gains in the population and be implemented and sustained at a reasonable cost. The interventions cover population groups across the lifespan from infancy to adulthood and include actions delivered across different settings and delivery platforms. "Best practices" were identified as interventions for which there is evidence not only of their effectiveness but also of their feasibility within resource constraints. The implications of the findings for capacity development are considered.

Human Factors Process Task Analysis Liquid Oxygen Pump Acceptance Test Procedure for the Advanced Technology Development Center

NASA Technical Reports Server (NTRS)

Diorio, Kimberly A.

2002-01-01

A process task analysis effort was undertaken by Dynacs Inc. commencing in June 2002 under contract from NASA YA-D6. Funding was provided through NASA's Ames Research Center (ARC), Code M/HQ, and Industrial Engineering and Safety (IES). The John F. Kennedy Space Center (KSC) Engineering Development Contract (EDC) Task Order was 5SMA768. The scope of the effort was to conduct a Human Factors Process Failure Modes and Effects Analysis (HF PFMEA) of a hazardous activity and provide recommendations to eliminate or reduce the effects of errors caused by human factors. The Liquid Oxygen (LOX) Pump Acceptance Test Procedure (ATP) was selected for this analysis. The HF PFMEA table (see appendix A) provides an analysis of six major categories evaluated for this study. These categories include Personnel Certification, Test Procedure Format, Test Procedure Safety Controls, Test Article Data, Instrumentation, and Voice Communication. For each specific requirement listed in appendix A, the following topics were addressed: Requirement, Potential Human Error, Performance-Shaping Factors, Potential Effects of the Error, Barriers and Controls, Risk Priority Numbers, and Recommended Actions. This report summarizes findings and gives recommendations as determined by the data contained in appendix A. It also includes a discussion of technology barriers and challenges to performing task analyses, as well as lessons learned. The HF PFMEA table in appendix A recommends the use of accepted and required safety criteria in order to reduce the risk of human error. The items with the highest risk priority numbers should receive the greatest amount of consideration. Implementation of the recommendations will result in a safer operation for all personnel.

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.

Maine Environmental Priorities Project: Summary of the Reports from the Technical Working Groups to the Steering Committee.

ERIC Educational Resources Information Center

National Association for Environmental Education, Miami, FL.

The Maine Environmental Priorities Project (MEPP) is a comparative risk project designed to identify, compare, and rank the most serious environmental problems facing Maine. Once the problems are analyzed and ranked according to their threat or risk to Maine's ecological health, human health, and quality of life, the project will propose…

Perceptions of risk among households in two Australian coastal communities

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

Elrick-Barr, Carmen E.; Smith, Timothy F.; Thomsen, Dana C.

There is limited knowledge of risk perceptions in coastal communities despite their vulnerability to a range of risks including the impacts of climate change. A survey of 400 households in two Australian coastal communities, combined with semi-structured interviews, provides insight into household perceptions of the relative importance of climatic and non-climatic risks and the subsequent risk priorities that may inform household adaptive action. In contrast to previous research, the results demonstrated that geographic location and household characteristics might not affect perceptions of vulnerability to environmental hazards. However, past experience was a significant influence, raising the priority of environmental concerns. Overall,more » the results highlight the priority concerns of coastal households (from finance, to health and environment) and suggest to increase the profile of climate issues in coastal communities climate change strategies need to better demonstrate links between climate vulnerability and other household concerns. Moreover, promoting generic capacities in isolation from understanding the context in which households construe climate risks is unlikely to yield the changes required to decrease the vulnerability of coastal communities.« less

Perceptions of risk among households in two Australian coastal communities

DOE PAGES

Elrick-Barr, Carmen E.; Smith, Timothy F.; Thomsen, Dana C.; ...

2015-04-20

There is limited knowledge of risk perceptions in coastal communities despite their vulnerability to a range of risks including the impacts of climate change. A survey of 400 households in two Australian coastal communities, combined with semi-structured interviews, provides insight into household perceptions of the relative importance of climatic and non-climatic risks and the subsequent risk priorities that may inform household adaptive action. In contrast to previous research, the results demonstrated that geographic location and household characteristics might not affect perceptions of vulnerability to environmental hazards. However, past experience was a significant influence, raising the priority of environmental concerns. Overall,more » the results highlight the priority concerns of coastal households (from finance, to health and environment) and suggest to increase the profile of climate issues in coastal communities climate change strategies need to better demonstrate links between climate vulnerability and other household concerns. Moreover, promoting generic capacities in isolation from understanding the context in which households construe climate risks is unlikely to yield the changes required to decrease the vulnerability of coastal communities.« less

Support to triage and public risk perception considering long-term response to a Cs-137 radiological dispersive device scenario.

PubMed

Andrade, Cristiane Ps; Souza, Cláudio J; Camerini, Eduardo Sn; Alves, Isabela S; Vital, Hélio C; Healy, Matthew Jf; Ramos De Andrade, Edson

2018-06-01

A radiological dispersive device (RDD) spreads radioactive material, complicates the treatment of physical injuries, raises cancer risk, and induces disproportionate fear. Simulating such an event enables more effective and efficient utilization of the triage and treatment resources of staff, facilities, and space. Fast simulation can give detail on events in progress or future events. The resources for triage and treatment of contaminated trauma victims can differ for pure exposure individuals, while discouraging the "worried well" from presenting in the crisis phase by media announcement would relieve pressure on hospital facilities. The proposed methodology integrates capabilities from different platforms in a convergent way composed of three phases: (a) scenario simulation, (b) data generation, and (c) risk assessment for triage focused on follow-up epidemiological assessment. Simulations typically indicate that most of the affected population does not require immediate medical assistance. Medical triage for the few severely injured and the radiological triage to diminish the contamination with radioactivity will always be the priority. For this study, however, higher priorities should be given to individuals from radiological "warm" and "hot" zones as required by risk criteria. The proposed methodology could thus help to (a) filter and reduce the number of individuals to be attended, (b) optimize the prioritization of medical care, (c) reduce or prepare for future costs, (d) effectively locate the operational triage site to avoid possible contamination on the main facility, and (e) provide the scientific data needed to develop an adequate approach to risk and its proper communication.

Climate Change Is Increasing the Risk of the Reemergence of Malaria in Romania

PubMed Central

Bodale, Ilie; Florescu, Simin-Aysel; Roman, Constantin; Acatrinei, Dumitru

2016-01-01

The climatic modifications lead to global warming; favouring the risk of the appearance and development of diseases are considered until now tropical diseases. Another important factor is the workers' immigration, the economic crisis favouring the passive transmission of new species of culicidae from different areas. Malaria is the disease with the widest distribution in the globe. Millions of people are infected every year in Africa, India, South-East Asia, Middle East, and Central and South America, with more than 41% of the global population under the risk of infestation with malaria. The increase of the number of local cases reported in 2007–2011 indicates that the conditions can favour the high local transmission in the affected areas. In the situation presented, the establishment of the level of risk concerning the reemergence of malaria in Romania becomes a priority. PMID:27847824

Health Hazard Appraisal in Patient Counseling

PubMed Central

LaDou, Joseph; Sherwood, John N.; Hughes, Lewis

1975-01-01

A program of annual health examinations was expanded to include counseling based on a computerized appraisal of individual patients' specific health hazard factors. Data obtained from a specially designed questionnaire, laboratory tests and a physical examination yielded a printout showing a number of weighted risk factors and their relation to ten leading causes of death as determined for that patient. From all of this information, a risk (“apparent”) age was developed for the patient. The results were reviewed with each patient, and methods of correcting health hazards were stressed. A total of 488 persons were appraised, and 107 were randomly reappraised in less than a year, with the finding that the net risk age was reduced by 1.4 years. Such a reduction in risk age is significant; it indicates that appraisal-based counseling is an effective method of altering priorities of health practices. PMID:1114813

Risk analysis of analytical validations by probabilistic modification of FMEA.

PubMed

Barends, D M; Oldenhof, M T; Vredenbregt, M J; Nauta, M J

2012-05-01

Risk analysis is a valuable addition to validation of an analytical chemistry process, enabling not only detecting technical risks, but also risks related to human failures. Failure Mode and Effect Analysis (FMEA) can be applied, using a categorical risk scoring of the occurrence, detection and severity of failure modes, and calculating the Risk Priority Number (RPN) to select failure modes for correction. We propose a probabilistic modification of FMEA, replacing the categorical scoring of occurrence and detection by their estimated relative frequency and maintaining the categorical scoring of severity. In an example, the results of traditional FMEA of a Near Infrared (NIR) analytical procedure used for the screening of suspected counterfeited tablets are re-interpretated by this probabilistic modification of FMEA. Using this probabilistic modification of FMEA, the frequency of occurrence of undetected failure mode(s) can be estimated quantitatively, for each individual failure mode, for a set of failure modes, and the full analytical procedure. Copyright © 2012 Elsevier B.V. All rights reserved.

78 FR 31343 - Final Priorities, Requirement, Definitions, and Selection Criteria-Enhanced Assessment Instruments

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... Assessment Instruments [CFDA Number: 84.368.] AGENCY: Office of Elementary and Secondary Education...: The Assistant Secretary for Elementary and Secondary Education announces priorities, a requirement... Elementary and Secondary Education Act of 1965, as amended (ESEA). DATES: These priorities, requirement...

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.

78 FR 14483 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-06

... DEPARTMENT OF EDUCATION 34 CFR Chapter III [CFDA Number: 84.133B-10.] Proposed Priority--National...: Office of Special Education and Rehabilitative Services, Department of Education. ACTION: Proposed priority. SUMMARY: The Assistant Secretary for Special Education and Rehabilitative Services proposes a...

76 FR 37341 - Final Priority; Rehabilitation Research and Training Center-Interventions To Promote Community...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-27

... research, demonstration projects, training, and related activities, to develop methods, procedures, and... DEPARTMENT OF EDUCATION [CFDA Number: 84.133B-1] Final Priority; Rehabilitation Research and... priority for a Rehabilitation Research and Training Center (RRTC) on Interventions to Promote Community...

45 CFR 1620.5 - Annual review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION PRIORITIES IN USE OF RESOURCES § 1620.5 Annual review. (a) Priorities shall be set periodically and shall be reviewed by the... number of emergency cases outside of its priorities. (b) The following factors should be among those...

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

PubMed

Clarke, Bradley O; Smith, Stephen R

2011-01-01

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

Focusing on cardiovascular disease in type 2 diabetes mellitus: an introduction to bromocriptine QR.

PubMed

Bell, David S

2012-09-01

Cardiovascular risk reduction is a key priority in patients with diabetes. The relationship between glycemic control and macrovascular outcomes, such as the benefit of intensive glucose control and the importance of postprandial or fasting blood glucose, is still under debate. A number of pharmacologic options are available to treat type 2 diabetes mellitus and these options have differing evidence for their cardiovascular safety. In this article, the novel agent bromocriptine quick release is discussed. Recently approved, this once-daily treatment provides glycemic control as monotherapy or in combination with other antihyperglycemic medications and has been shown in a prospective phase 3 safety study to not increase cardiovascular risk. Therefore, bromocriptine quick release increases the range of options available to treat patients with type 2 diabetes mellitus without increasing cardiovascular risk.

What to say and how to say it: effective communication for cardiovascular disease prevention.

PubMed

Navar, Ann Marie; Stone, Neil J; Martin, Seth S

2016-09-01

Current guidelines for cholesterol treatment emphasize the importance of engaging patients in a risk-benefit discussion prior to initiating statin therapy. Although current risk prediction algorithms are well defined, there is less data on how to communicate with patients about cardiovascular disease risk, benefits of treatment, and possible adverse effects. We propose a four-part model for effective shared decision-making: 1) Assessing patient priorities, perceived risk, and prior experience with cardiovascular risk reduction; 2) Arriving at a recommendation for therapy based on the patient's risk of disease, guideline recommendations, new clinical trial data, and patient preferences; 3) Communicating this recommendation along with risks, benefits, and alternatives to therapy following best practices for discussing numeric risk; and 4) Arriving at a shared decision with the patient with ongoing reassessment as risk factors and patient priorities change.

Tuberculosis Infection Control in Health-Care Facilities: Environmental Control and Personal Protection.

PubMed

Lee, Ji Yeon

2016-10-01

Transmission of tuberculosis (TB) is a recognized risk to patients and healthcare workers in healthcare settings. The literature review suggests that implementation of combination control measures reduces the risk of TB transmission. Guidelines suggest a three-level hierarchy of controls including administrative, environmental, and respiratory protection. Among environmental controls, installation of ventilation systems is a priority because ventilation reduces the number of infectious particles in the air. Natural ventilation is cost-effective but depends on climatic conditions. Supplemented intervention such as air-cleaning methods including high efficiency particulate air filtration and ultraviolet germicidal irradiation should be considered in areas where adequate ventilation is difficult to achieve. Personal protective equipment including particulate respirators provides additional benefit when administrative and environmental controls cannot assure protection.

Refugee camps, fire disasters and burn injuries.

PubMed

Atiyeh, B S; Gunn, S W A

2017-09-30

In the past five years, no fewer than 15 conflicts have brought unspeakable tragedy and misery to millions across the world. At present, nearly 20 people are forcibly displaced every minute as a result of conflict or persecution, representing a crisis of historic proportions. Many displaced persons end up in camps generally developing in an impromptu fashion, and are totally dependent on humanitarian aid. The precarious condition of temporary installations puts the nearly 700 refugee camps worldwide at high risk of disease, child soldier and terrorist recruitment, and physical and sexual violence. Poorly planned, densely packed refugee settlements are also one of the most pathogenic environments possible, representing high risk for fires with potential for uncontrolled fire spread and development over sometimes quite large areas. Moreover, providing healthcare to refugees comes with its own unique challenges. Internationally recognized guidelines for minimum standards in shelters and settlements have been set, however they remain largely inapplicable. As for fire risk reduction, and despite the high number of fire incidents, it is not evident that fire safety can justify a higher priority. In that regard, a number of often conflicting influences will need to be considered. The greatest challenge remains in balancing the various risks, such as the need/cost of shelter against the fire risk/cost of fire protection.

Refugee camps, fire disasters and burn injuries

PubMed Central

Atiyeh, B.S.; Gunn, S.W.A.

2017-01-01

Summary In the past five years, no fewer than 15 conflicts have brought unspeakable tragedy and misery to millions across the world. At present, nearly 20 people are forcibly displaced every minute as a result of conflict or persecution, representing a crisis of historic proportions. Many displaced persons end up in camps generally developing in an impromptu fashion, and are totally dependent on humanitarian aid. The precarious condition of temporary installations puts the nearly 700 refugee camps worldwide at high risk of disease, child soldier and terrorist recruitment, and physical and sexual violence. Poorly planned, densely packed refugee settlements are also one of the most pathogenic environments possible, representing high risk for fires with potential for uncontrolled fire spread and development over sometimes quite large areas. Moreover, providing healthcare to refugees comes with its own unique challenges. Internationally recognized guidelines for minimum standards in shelters and settlements have been set, however they remain largely inapplicable. As for fire risk reduction, and despite the high number of fire incidents, it is not evident that fire safety can justify a higher priority. In that regard, a number of often conflicting influences will need to be considered. The greatest challenge remains in balancing the various risks, such as the need/cost of shelter against the fire risk/cost of fire protection. PMID:29849526

22 CFR 42.55 - Reports on numbers and priority dates of applications on record.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Reports on numbers and priority dates of applications on record. 42.55 Section 42.55 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF... subject to the numerical limitations prescribed in INA 201, 202, and 203 whose immigrant visa applications...

22 CFR 42.55 - Reports on numbers and priority dates of applications on record.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Reports on numbers and priority dates of applications on record. 42.55 Section 42.55 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF... subject to the numerical limitations prescribed in INA 201, 202, and 203 whose immigrant visa applications...

22 CFR 42.55 - Reports on numbers and priority dates of applications on record.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Reports on numbers and priority dates of applications on record. 42.55 Section 42.55 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF... subject to the numerical limitations prescribed in INA 201, 202, and 203 whose immigrant visa applications...

22 CFR 42.55 - Reports on numbers and priority dates of applications on record.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Reports on numbers and priority dates of applications on record. 42.55 Section 42.55 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF... subject to the numerical limitations prescribed in INA 201, 202, and 203 whose immigrant visa applications...

22 CFR 42.55 - Reports on numbers and priority dates of applications on record.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Reports on numbers and priority dates of applications on record. 42.55 Section 42.55 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF... subject to the numerical limitations prescribed in INA 201, 202, and 203 whose immigrant visa applications...

Big data privacy protection model based on multi-level trusted system

NASA Astrophysics Data System (ADS)

Zhang, Nan; Liu, Zehua; Han, Hongfeng

2018-05-01

This paper introduces and inherit the multi-level trusted system model that solves the Trojan virus by encrypting the privacy of user data, and achieve the principle: "not to read the high priority hierarchy, not to write the hierarchy with low priority". Thus ensuring that the low-priority data privacy leak does not affect the disclosure of high-priority data privacy. This paper inherits the multi-level trustworthy system model of Trojan horse and divides seven different risk levels. The priority level 1˜7 represent the low to high value of user data privacy, and realize seven kinds of encryption with different execution efficiency Algorithm, the higher the priority, the greater the value of user data privacy, at the expense of efficiency under the premise of choosing a more encrypted encryption algorithm to ensure data security. For enterprises, the price point is determined by the unit equipment users to decide the length of time. The higher the risk sub-group algorithm, the longer the encryption time. The model assumes that users prefer the lower priority encryption algorithm to ensure efficiency. This paper proposes a privacy cost model for each of the seven risk subgroups. Among them, the higher the privacy cost, the higher the priority of the risk sub-group, the higher the price the user needs to pay to ensure the privacy of the data. Furthermore, by introducing the existing pricing model of economics and the human traffic model proposed by this paper and fluctuating with the market demand, this paper improves the price of unit products when the market demand is low. On the other hand, when the market demand increases, the profit of the enterprise will be guaranteed under the guidance of the government by reducing the price per unit of product. Then, this paper introduces the dynamic factors of consumers' mood and age to optimize. At the same time, seven algorithms are selected from symmetric and asymmetric encryption algorithms to define the enterprise costs at different levels. Therefore, the proposed model solves the continuous influence caused by cascading events and ensures that the disclosure of low-level data privacy of users does not affect the high-level data privacy, thus greatly improving the safety of the private information of user.

A review of soil heavy metal pollution from industrial and agricultural regions in China: Pollution and risk assessment.

PubMed

Yang, Qianqi; Li, Zhiyuan; Lu, Xiaoning; Duan, Qiannan; Huang, Lei; Bi, Jun

2018-06-14

Soil heavy metal pollution has been becoming serious and widespread in China. To date, there are few studies assessing the nationwide soil heavy metal pollution induced by industrial and agricultural activities in China. This review obtained heavy metal concentrations in soils of 402 industrial sites and 1041 agricultural sites in China throughout the document retrieval. Based on the database, this review assessed soil heavy metal concentration and estimated the ecological and health risks on a national scale. The results revealed that heavy metal pollution and associated risks posed by cadmium (Cd), lead (Pb) and arsenic (As) are more serious. Besides, heavy metal pollution and associated risks in industrial regions are severer than those in agricultural regions, meanwhile, those in southeast China are severer than those in northwest China. It is worth noting that children are more likely to be affected by heavy metal pollution than adults. Based on the assessment results, Cd, Pb and As are determined as the priority control heavy metals; mining areas are the priority control areas compared to other areas in industrial regions; food crop plantations are the priority control areas in agricultural regions; and children are determined as the priority protection population group. This paper provides a comprehensive ecological and health risk assessment on the heavy metals in soils in Chinese industrial and agricultural regions and thus provides insights for the policymakers regarding exposure reduction and management. Copyright © 2018. Published by Elsevier B.V.

Competing priorities that rival health in adults on probation in Rhode Island: substance use recovery, employment, housing, and food intake.

PubMed

Dong, Kimberly R; Must, Aviva; Tang, Alice M; Beckwith, Curt G; Stopka, Thomas J

2018-02-27

Individuals on probation experience economic disadvantage because their criminal records often prohibit gainful employment, which compromises their ability to access the basic components of wellbeing. Unemployment and underemployment have been studied as distinct phenomenon but no research has examined multiple determinants of health in aggregate or explored how these individuals prioritize each of these factors. This study identified and ranked competing priorities in adults on probation and qualitatively explored how these priorities impact health. We conducted in-depth interviews in 2016 with 22 adults on probation in Rhode Island to determine priority rankings of basic needs. We used Maslow's hierarchy of needs theory and the literature to guide the priorities we pre-selected for probationers to rank. Within a thematic analysis framework, we used a modified ranking approach to identify the priorities chosen by participants and explored themes related to the top four ranked priorities. We found that probationers ranked substance use recovery, employment, housing, and food intake as the top four priorities. Probationers in recovery reported sobriety as the most important issue, a necessary basis to be able to address other aspects of life. Participants also articulated the interrelatedness of difficulties in securing employment, food, and housing; these represent stressors for themselves and their families, which negatively impact health. Participants ranked healthcare last and many reported underinsurance as an issue to accessing care. Adults on probation are often faced with limited economic potential and support systems that consistently place them in high-risk environments with increased risk for recidivism. These findings emphasize the need for policies that address the barriers to securing gainful employment and safe housing. Interventions that reflect probationer priorities are necessary to begin to mitigate the health disparities in this population.

Supply chain risk management in newspaper company: House of risk approach

NASA Astrophysics Data System (ADS)

Ratnasari, Sintya; Hisjam, Muhammad; Sutopo, Wahyudi

2018-02-01

In the supply chain (SC) of newspapers, the printing company is the main entity that has several processes, i.e. procure raw materials, print plate and newspapers, and also distribute newspaper to consumers. The existing risks in the newspaper printing company are quite high. A wide range of disturbances or risks needs to be identified to map out the characteristics of the risk sources that will impact on the performance of the supply chain. Therefore, the printing companies need to manage their supply chain risk of the five major SC processes (such as plan, source, deliver, make, and return). In a case study of a newspaper company in Surakarta, the company have not implemented a risk management process that affects the company. This study is aimed to map the risks in the printing company and formulate risk mitigation alternatives to mitigate the risks. The house of risk (HOR) method was chosen to select a set of proactive actions deemed cost-effective in managing SC Risks in the newspaper company. The model consisting of two stages, the first stage (HOR1) was done by identifying risk, risk causing agents and then measured the severity and occurrences to calculate the Aggregate Risk Priority (ARP) value. The second stage (HOR2) is intended to formulate and prioritize the action of mitigation that the company should pursue to reduce the probability of risk agents to occur. The result shows that the innovative model of HOR in Newspaper Company was presented. There are 24 risk events, 20 causing agents and two priority risks in HOR1. The HOR 2 was proposed 9 ranks of mitigation strategy for priority risk agents, from the easiest to the hardest strategy for the company to implement it.

The robust corrective action priority-an improved approach for selecting competing corrective actions in FMEA based on principle of robust design

NASA Astrophysics Data System (ADS)

Sutrisno, Agung; Gunawan, Indra; Vanany, Iwan

2017-11-01

In spite of being integral part in risk - based quality improvement effort, studies improving quality of selection of corrective action priority using FMEA technique are still limited in literature. If any, none is considering robustness and risk in selecting competing improvement initiatives. This study proposed a theoretical model to select risk - based competing corrective action by considering robustness and risk of competing corrective actions. We incorporated the principle of robust design in counting the preference score among corrective action candidates. Along with considering cost and benefit of competing corrective actions, we also incorporate the risk and robustness of corrective actions. An example is provided to represent the applicability of the proposed model.

The Big Rocks: Priority Management for Principals

ERIC Educational Resources Information Center

Marshall, Kim

2008-01-01

How can a dedicated principal work really, really hard but fail to get significant gains in student achievement? The answer is obvious: by spending too much time on the wrong things and not enough on the right things. The principal's number-one priority is zeroing in on the highest-priority activities for bringing all students to high levels of…

Phylogenetically-informed priorities for amphibian conservation.

PubMed

Isaac, Nick J B; Redding, David W; Meredith, Helen M; Safi, Kamran

2012-01-01

The amphibian decline and extinction crisis demands urgent action to prevent further large numbers of species extinctions. Lists of priority species for conservation, based on a combination of species' threat status and unique contribution to phylogenetic diversity, are one tool for the direction and catalyzation of conservation action. We describe the construction of a near-complete species-level phylogeny of 5713 amphibian species, which we use to create a list of evolutionarily distinct and globally endangered species (EDGE list) for the entire class Amphibia. We present sensitivity analyses to test the robustness of our priority list to uncertainty in species' phylogenetic position and threat status. We find that both sources of uncertainty have only minor impacts on our 'top 100' list of priority species, indicating the robustness of the approach. By contrast, our analyses suggest that a large number of Data Deficient species are likely to be high priorities for conservation action from the perspective of their contribution to the evolutionary history.

Regional and international approaches on prevention and control of animal transboundary and emerging diseases.

PubMed

Domenech, J; Lubroth, J; Eddi, C; Martin, V; Roger, F

2006-10-01

Transboundary animal diseases pose a serious risk to the world animal agriculture and food security and jeopardize international trade. The world has been facing devastating economic losses from major outbreaks of transboundary animal diseases (TADs) such as foot-and-mouth disease, classical swine fever, rinderpest, peste des petits ruminants (PPR), and Rift Valley fever. Lately the highly pathogenic avian influenza (HPAI) due to H5N1 virus, has become an international crisis as all regions around the world can be considered at risk. In the past decades, public health authorities within industrialized countries have been faced with an increasing number of food safety issues. The situation is equally serious in developing countries. The globalization of food (and feed) trade, facilitated by the liberalization of world trade, while offering many benefits and opportunities, also represents new risks. The GF-TADs Global Secretariat has carried out several regional consultations for the identification of priority diseases and best ways for their administration, prevention and control. In the questionnaires carried out and through the consultative process, it was noted that globally, FMD was ranked as the first and foremost priority. Rift Valley fever, and today highly pathogenic avian influenza, are defined as major animal diseases which also affect human health. PPR and CBPP, a disease which is particularly serious in Africa and finally, African swine fever (ASF) and classical swine fever (CSF) are also regionally recognised as top priorities on which the Framework is determined to work. The FAO philosophy--shared by the OIE--embraces the need to prevent and control TADs and emerging diseases at their source, which is most of the time in developing countries. Regional and international approaches have to be followed, and the FAO and OIE GF-TADs initiative provides the appropriate concepts and objectives as well as an organizational framework to link international and regional organizations at the service of their countries to better prevent and control the risks on animal and human health and the economic impact of TADs and emerging animal diseases.

Spatial decision on allocating automated external defibrillators (AED) in communities by multi-criterion two-step floating catchment area (MC2SFCA).

PubMed

Lin, Bo-Cheng; Chen, Chao-Wen; Chen, Chien-Chou; Kuo, Chiao-Ling; Fan, I-Chun; Ho, Chi-Kung; Liu, I-Chuan; Chan, Ta-Chien

2016-05-25

The occurrence of out-of-hospital cardiac arrest (OHCA) is a critical life-threatening event which frequently warrants early defibrillation with an automated external defibrillator (AED). The optimization of allocating a limited number of AEDs in various types of communities is challenging. We aimed to propose a two-stage modeling framework including spatial accessibility evaluation and priority ranking to identify the highest gaps between demand and supply for allocating AEDs. In this study, a total of 6135 OHCA patients were defined as demand, and the existing 476 publicly available AEDs locations and 51 emergency medical service (EMS) stations were defined as supply. To identify the demand for AEDs, Bayesian spatial analysis with the integrated nested Laplace approximation (INLA) method is applied to estimate the composite spatial risks from multiple factors. The population density, proportion of elderly people, and land use classifications are identified as risk factors. Then, the multi-criterion two-step floating catchment area (MC2SFCA) method is used to measure spatial accessibility of AEDs between the spatial risks and the supply of AEDs. Priority ranking is utilized for prioritizing deployment of AEDs among communities because of limited resources. Among 6135 OHCA patients, 56.85 % were older than 65 years old, and 79.04 % were in a residential area. The spatial distribution of OHCA incidents was found to be concentrated in the metropolitan area of Kaohsiung City, Taiwan. According to the posterior mean estimated by INLA, the spatial effects including population density and proportion of elderly people, and land use classifications are positively associated with the OHCA incidence. Utilizing the MC2SFCA for spatial accessibility, we found that supply of AEDs is less than demand in most areas, especially in rural areas. Under limited resources, we identify priority places for deploying AEDs based on transportation time to the nearest hospital and population size of the communities. The proposed method will be beneficial for optimizing resource allocation while considering multiple local risks. The optimized deployment of AEDs can broaden EMS coverage and minimize the problems of the disparity in urban areas and the deficiency in rural areas.

Improving College Enrollment of At-Risk Students at the School Level.

PubMed

Goodwin, Ryan N; Li, Wei; Broda, Michael; Johnson, Heather; Schneider, Barbara

2016-01-01

Many federal, state, and local education policy priorities are aimed at preparing high school students, especially those at risk, to be college- and career-ready when they graduate from high school. A number of programs across different institutional entities have been initiated to achieve these goals, encompassing individual partnerships with schools. Many of these programs include a variety of interventions, ranging from college and course counseling to college visits. Although there have been some evaluations of the larger federal programs, and some state and district programs, few have examined national observational data on the impact of these programmatic efforts on college enrollments. This study uses the HSLS:09 database to investigate the impact of specific treatments in at-risk schools on college enrollments. Results show that several of these programmatic initiatives have a positive effect on college enrollment; however the effects are small compared to some of those reported by other national studies.

[Adolescent health in numbers].

PubMed

2008-01-01

Adolescent health is not a priority to public health services. The physical, psychological and social changes lived by youngsters expose these individuals to several health risks and events that are determinant to their actual and future health status. The main health problems in adolescents are infectious respiratory and gastrointestinal diseases but traumatisms are very important in males. Female adolescents demand services related to their reproductive life and link to early and not desired pregnancies. Another important health problem is overweight and obesity in both sexes. The main causes of death in this age group are malignant tumors, specially leukemias, and accidents. We do not have information related to health risks like addictions and mental health. Data show how important adolescents health should be to the public health sector specially because it will be more easy to tackle their health risks and negative health life-styles at this age than further in their lives.

Improving College Enrollment of At-Risk Students at the School Level

PubMed Central

Goodwin, Ryan N.; Li, Wei; Broda, Michael; Johnson, Heather; Schneider, Barbara

2016-01-01

Many federal, state, and local education policy priorities are aimed at preparing high school students, especially those at risk, to be college- and career-ready when they graduate from high school. A number of programs across different institutional entities have been initiated to achieve these goals, encompassing individual partnerships with schools. Many of these programs include a variety of interventions, ranging from college and course counseling to college visits. Although there have been some evaluations of the larger federal programs, and some state and district programs, few have examined national observational data on the impact of these programmatic efforts on college enrollments. This study uses the HSLS:09 database to investigate the impact of specific treatments in at-risk schools on college enrollments. Results show that several of these programmatic initiatives have a positive effect on college enrollment; however the effects are small compared to some of those reported by other national studies. PMID:28138217

NASA Human Health and Performance Center (NHHPC)

NASA Technical Reports Server (NTRS)

Davis, J. R.; Richard, E. E.

2010-01-01

The NASA Human Health and Performance Center (NHHPC) will provide a collaborative and virtual forum to integrate all disciplines of the human system to address spaceflight, aviation, and terrestrial human health and performance topics and issues. The NHHPC will serve a vital role as integrator, convening members to share information and capture a diverse knowledge base, while allowing the parties to collaborate to address the most important human health and performance topics of interest to members. The Center and its member organizations will address high-priority risk reduction strategies, including research and technology development, improved medical and environmental health diagnostics and therapeutics, and state-of-the art design approaches for human factors and habitability. Once full established in 2011, the NHHPC will focus on a number of collaborative projects focused on human health and performance, including workshops, education and outreach, information sharing and knowledge management, and research and technology development projects, to advance the study of the human system for spaceflight and other national and international priorities.

Health assessment for Ninth Avenue Dump National Priorities List (NPL) Site, Gary, Indiana, Region 5. CERCLIS No. IND980794432. Final report

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

Not Available

1989-01-18

The Ninth Avenue Dump is a 17-acre National Priorities List Site located in an industrialized area within the city limits of Gary, Indiana. A number of contaminants were detected in on-site and off-site ground water, surface water, sediments, and soil samples. Contaminants of concern at the Ninth Avenue Dump Site include: chromium, lead, benzene, polychlorinated biphenyls, 2-butanone, ethylbenzene, toluene, trichloroethylene, vinyl chloride, and xylenes. The pathways for human exposure to site contaminants is through the dermal absorption, ingestion, or inhalation of contaminants from ground water, surface water, soil, air, or contaminated food-chain entities. There is currently no documented exposure tomore » site contaminants. However, the site is considered to be of potential public health concern because of the potential risk to human health resulting from possible exposure to hazardous substances at concentrations that may result in adverse health effects.« less

Prioritizing human pharmaceuticals for ecological risks in the freshwater environment of Korea.

PubMed

Ji, Kyunghee; Han, Eun Jeong; Back, Sunhyoung; Park, Jeongim; Ryu, Jisung; Choi, Kyungho

2016-04-01

Pharmaceutical residues are potential threats to aquatic ecosystems. Because more than 3000 active pharmaceutical ingredients (APIs) are in use, identifying high-priority pharmaceuticals is important for developing appropriate management options. Priority pharmaceuticals may vary by geographical region, because their occurrence levels can be influenced by demographic, societal, and regional characteristics. In the present study, the authors prioritized human pharmaceuticals of potential ecological risk in the Korean water environment, based on amount of use, biological activity, and regional hydrologic characteristics. For this purpose, the authors estimated the amounts of annual production of 695 human APIs in Korea. Then derived predicted environmental concentrations, using 2 approaches, to develop an initial candidate list of target pharmaceuticals. Major antineoplastic drugs and hormones were added in the initial candidate list regardless of their production amount because of their high biological activity potential. The predicted no effect concentrations were derived for those pharmaceuticals based on ecotoxicity information available in the literature or by model prediction. Priority lists of human pharmaceuticals were developed based on ecological risks and availability of relevant information. Those priority APIs identified include acetaminophen, clarithromycin, ciprofloxacin, ofloxacin, metformin, and norethisterone. Many of these pharmaceuticals have been neither adequately monitored nor assessed for risks in Korea. Further efforts are needed to improve these lists and to develop management decisions for these compounds in Korean water. © 2015 SETAC.

A systematic narrative review of the effectiveness of behavioural smoking cessation interventions in selected disadvantaged groups (2010-2017).

PubMed

Wilson, Amanda; Guillaumier, Ashleigh; George, Johnson; Denham, Alexandra; Bonevski, Billie

2017-08-01

Tobacco remains the key modifiable risk factor for the development of a number of diseases, including cardiovascular disease, cerebrovascular disease, lower respiratory infections, chronic obstructive pulmonary disease, tuberculosis and cancer. Among priority populations, smoking prevalence remains high, smokers tend to relapse more often and earlier and fewer are able to sustain quit attempts. This systematic review provides an update on the literature. Areas covered: Twenty-four randomized controlled trials published from 2010-2017, in English language, were identified after searching on Medline, Ovid, Embase and PsycINFO databases. Studies reported on the effectiveness of smoking cessation interventions among six disadvantaged groups known to have high smoking rates: (i) homeless, (ii) prisoners, (iii) indigenous populations, (iv) at-risk youth, (v) people with low income, and (vi) those with a mental illness. Narrative review and assessment of methodological quality of included papers was undertaken. Expert commentary: There is a growing evidence base of methodologically robust studies evaluating a variety of behavioural smoking cessation interventions for priority populations. Multi-component interventions and those examining behavioural interventions incorporating mindfulness training, financial incentives, motivational interviewing and extended telephone-delivered counseling may be effective in the short-term, particularly for smokers on low incomes and people with a mental illness.

What is behind the priority heuristic? A mathematical analysis and comment on Brandstätter, Gigerenzer, and Hertwig (2006).

PubMed

Rieger, Marc Oliver; Wang, Mei

2008-01-01

Comments on the article by E. Brandstätter, G. Gigerenzer, and R. Hertwig. The authors discuss the priority heuristic, a recent model for decisions under risk. They reanalyze the experimental validity of this approach and discuss how these results compare with cumulative prospect theory, the currently most established model in behavioral economics. They also discuss how general models for decisions under risk based on a heuristic approach can be understood mathematically to gain some insight in their limitations. They finally consider whether the priority heuristic model can lead to some understanding of the decision process of individuals or whether it is better seen as an as-if model. (c) 2008 APA, all rights reserved

Promoting breast health among women in the U.S. Virgin Islands: a focused study of the needs of Caribbean women.

PubMed

Underwood, Sandra; Johnson, Edith Ramsay; Callwood, Gloria; Evans, Edris E; Matthew, Alina; Scotland-Brooks, Casandra; Hanley, Chantal; Johnson-Harrigan, Damali; LeFlore, Devette; Williams, Dionne; Samuels, Harricia; Francis, Jahtara; Arthur, Jamela; Clinkscales, Jowana; Joseph, Martha; Heskey, Nihjole; D'Abreau, Rachel; Fleming, Rashima; Penn, Stacey; Browne, Tameka A; Donastorg, Tiffany; Scarbriel, Yvette

2007-12-01

Breast cancer is the number one cause of cancer death among women in the United States Virgin Islands. Consequently, the Bureau of Health has identified breast cancer as a priority health concern. Within the medical community, increasing emphasis is being placed on the importance of hereditary, familial, environmental, and behavioral risk factors to breast cancer control. Little research has been conducted regarding these factors, however, to explore their influence on breast cancer detection and breast cancer risk management. This report highlights the outcomes of a study undertaken to explore the associations between breast cancer risk, risk assessment, risk communication, screening, and receptivity to the management of breast cancer risk among women from the United States Virgin Islands. Results of this study suggest a need within the territory to expand the systems that are responsible for monitoring and reporting breast cancer trends; forums to discuss concerns of women relative to breast health; forums to discuss communication with health-care providers; and, research efforts that address breast cancer detection and control among women in the United States Virgin Islands.

Risk management for outsourcing biomedical waste disposal - using the failure mode and effects analysis.

PubMed

Liao, Ching-Jong; Ho, Chao Chung

2014-07-01

Using the failure mode and effects analysis, this study examined biomedical waste companies through risk assessment. Moreover, it evaluated the supervisors of biomedical waste units in hospitals, and factors relating to the outsourcing risk assessment of biomedical waste in hospitals by referring to waste disposal acts. An expert questionnaire survey was conducted on the personnel involved in waste disposal units in hospitals, in order to identify important factors relating to the outsourcing risk of biomedical waste in hospitals. This study calculated the risk priority number (RPN) and selected items with an RPN value higher than 80 for improvement. These items included "availability of freezing devices", "availability of containers for sharp items", "disposal frequency", "disposal volume", "disposal method", "vehicles meeting the regulations", and "declaration of three lists". This study also aimed to identify important selection factors of biomedical waste disposal companies by hospitals in terms of risk. These findings can serve as references for hospitals in the selection of outsourcing companies for biomedical waste disposal. Copyright © 2014 Elsevier Ltd. All rights reserved.

Promoting Breast Health among Women in the U.S. Virgin Islands: A Focused Study of the Needs of Caribbean Women

PubMed Central

Underwood, Sandra Millon; Ramsay-Johnson, Edith M.; Callwood, Gloria; Evans, Edris E.; Matthew, Alina; Scotland-Brooks, Casandra; Hanley, Chantal; Johnson-Harrigan, Damali; LeFlore, Devette; Williams, Dionne; Samuels, Harricia; Francis, Jahtara; Arthur, Jamela; Clinkscales, Jowana; Joseph, Martha; Heskey, Nihjole; D’Abreau, Rachel; Fleming, Rashima; Penn, Stacey; Browne, Tameka A.; Donastorg, Tiffany; Scarbriel, Yvette

2011-01-01

Breast cancer is the number one cause of cancer death among women in the United States Virgin Islands. Consequently, the Bureau of Health has identified breast cancer as a priority health concern. Within the medical community, increasing emphasis is being placed on the importance of hereditary, familial, environmental, and behavioral risk factors to breast cancer control. Little research has been conducted regarding these factors, however, to explore their influence on breast cancer detection and breast cancer risk management. This report highlights the outcomes of a study undertaken to explore the associations between breast cancer risk, risk assessment, risk communication, screening, and receptivity to the management of breast cancer risk among women from the United States Virgin Islands. Results of this study suggest a need within the territory to expand the systems that are responsible for monitoring and reporting breast cancer trends; forums to discuss concerns of women relative to breast health; forums to discuss communication with health-care providers; and, research efforts that address breast cancer detection and control among women in the United States Virgin Islands. PMID:18318332

Identifying environmental health priorities in underserved populations: a study of rural versus urban communities

PubMed Central

Bernhard, M.C.; Evans, M.B.; Kent, S.T.; Johnson, E.; Threadgill, S.L.; Tyson, S.; Becker, S.M.; Gohlke, J.M.

2013-01-01

Objectives Understanding and effectively addressing persistent health disparities in minority communities requires a clear picture of members’ concerns and priorities. This study was intended to engage residents in urban and rural communities in order to identify environmental health priorities. Specific emphasis was placed on how the communities defined the term environment, their perceptions of environmental exposures as affecting their health, specific priorities in their communities, and differences in urban versus rural populations. Study design A community-engaged approach was used to develop and implement focus groups and compare environmental health priorities in urban versus rural communities. Methods A total of eight focus groups were conducted: four in rural and four in urban communities. Topics included defining the term environment, how the environment may affect health, and environmental priorities within their communities, using both open discussion and a predefined list. Data were analysed both qualitatively and quantitatively to identify patterns and trends. Results There were important areas of overlap in priorities between urban and rural communities; both emphasized the importance of the social environment and shared a concern over air pollution from industrial sources. In contrast, for urban focus groups, abandoned houses and their social and physical sequelae were a high priority while concerns about adequate sewer and water services and road maintenance were high priorities in rural communities. Conclusions This study was able to identify environmental health priorities in urban versus rural minority communities. In contrast to some previous risk perception research, the results of this study suggest prioritization of tangible, known risks in everyday life instead of rare, disaster-related events, even in communities that have recently experienced devastating damage from tornadoes. The findings can help inform future efforts to study, understand and effectively address environmental issues, and are particularly relevant to developing effective community-based strategies in vulnerable populations. PMID:24239281

Setting the top 10 research priorities to improve the health of people with Type 2 diabetes: a Diabetes UK-James Lind Alliance Priority Setting Partnership.

PubMed

Finer, S; Robb, P; Cowan, K; Daly, A; Shah, K; Farmer, A

2018-07-01

To describe processes and outcomes of a priority setting partnership to identify the 'top 10 research priorities' in Type 2 diabetes, involving people living with the condition, their carers, and healthcare professionals. We followed the four-step James Lind Alliance Priority Setting Partnership process which involved: gathering uncertainties using a questionnaire survey distributed to 70 000 people living with Type 2 diabetes and their carers, and healthcare professionals; organizing the uncertainties; interim priority setting by resampling of participants with a second survey; and final priority setting in an independent group of participants, using the nominal group technique. At each step the steering group closely monitored and guided the process. In the first survey, 8227 uncertainties were proposed by 2587 participants, of whom 18% were from black, Asian and minority ethnic groups. Uncertainties were formatted and collated into 114 indicative questions. A total of 1506 people contributed to a second survey, generating a shortlist of 24 questions equally weighted to the contributions of people living with diabetes and their carers and those of healthcare professionals. In the final step the 'top 10 research priorities' were selected, including questions on cure and reversal, risk identification and prevention, and self-management approaches in Type 2 diabetes. Systematic and transparent methodology was used to identify research priorities in a large and genuine partnership of people with lived and professional experience of Type 2 diabetes. The top 10 questions represent consensus areas of research priority to guide future research, deliver responsive and strategic allocation of research resources, and improve the future health and well-being of people living with, and at risk of, Type 2 diabetes. © 2018 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

[METHODICAL APPROACHES, EXPERIENCE AND PERSPECTIVES OF THE IMPLEMENTATION OF THE RISK MODEL OF SURVEILLANCE ACTIVITIES IN THE SPHERE OF THE ASSURANCE OF SANITARY AND EPIDEMIOLOGICAL WELFARE OF POPULATION, POPULATION'S HEALTH RISK MANAGEMENT AND THE CONSUMER RIGHTS PROTECTION].

PubMed

Gurvich, V B; Kuz'min, S V; Dikonskaia, O V; Gileva, M A; Boiarskiĭ, A P

2015-01-01

Control and supervision measures--one of the main technologies of Federal Service for Supervision of Consumer Rights protection and Human Welfare in the overall system of risk management for public health and damage to property consumers, aimed at the solution of the prior tasks in the field of assurance of the sanitary and epidemiological welfare of the population and consumer rights protection. The effectiveness of this technology depends on the correct choice of priority objects of supervision, which form the main problems in the sanitary and epidemiological situation and in the consumer market. The application of is approach has led to more effective oversight activity and the improvement of a number of indices characterizing the achievement of the objectives in the common system of risk management for public health and property of consumers.

FMEA: a model for reducing medical errors.

PubMed

Chiozza, Maria Laura; Ponzetti, Clemente

2009-06-01

Patient safety is a management issue, in view of the fact that clinical risk management has become an important part of hospital management. Failure Mode and Effect Analysis (FMEA) is a proactive technique for error detection and reduction, firstly introduced within the aerospace industry in the 1960s. Early applications in the health care industry dating back to the 1990s included critical systems in the development and manufacture of drugs and in the prevention of medication errors in hospitals. In 2008, the Technical Committee of the International Organization for Standardization (ISO), licensed a technical specification for medical laboratories suggesting FMEA as a method for prospective risk analysis of high-risk processes. Here we describe the main steps of the FMEA process and review data available on the application of this technique to laboratory medicine. A significant reduction of the risk priority number (RPN) was obtained when applying FMEA to blood cross-matching, to clinical chemistry analytes, as well as to point-of-care testing (POCT).

[Hygienic assessment of living conditions and morbidity of the population in the port cities of the Sakhalin region].

PubMed

Alikbayeva, L A; Kim, A V; Iakubova, Sh; Ok, Im En; Darizhapov, B B

The aim of this study was to perform a comprehensive hygienic assessment of environmental conditions in the port cities of the Sakhalin region to identify priority risk factors affecting on population health and management decisions for the optimization of living conditions. As a result of the assessment of risk and damages for public health from the effects of air pollution on the dose-response, effects were found to excess of impact on the target organs by 10 times. The main ecotoxicant was determined to be manganese oxide, which is associated with a priority manganese content in soil samples ofport cities. The positive dynamics of the gain in the accumulation of soil heavy metals according to the total index indicates to the existence of problems for soil contamination. Analysis of demographic variables shows that the population of the Sakhalin region in general and the port cities in particular relates to a regressive type. The main causes of the population decline are mortality and migration outflow of able-bodied population in other regions of Russia. However, in the port cities there is an increase in the number of work places, contributing to an increase in the labor force. The primary and general morbidity of the population ofport cities is characterized by higher levels compared with the average for the Sakhalin Region and the Far Eastern Federal District. Among all the classes of diseases as priority ones there are marked “neoplasm”, “diseases of the nervous system”, “respiratory diseases”, “diseases of the skin and subcutaneous tissue”. Port cities occupy the top ranking places on the incidence of malignant tumors among the cities of the Sakhalin region.

Cancer surgeons' attitudes and practices about discussing the chance of operative "cure".

PubMed

Winner, Megan; Wilson, Ana; Yahanda, Alexander; Gani, Faiz; Pawlik, Timothy M

2016-12-01

While physician attitudes about treatment goals have been examined around end-of-life care, surgeon attitudes regarding communication of therapeutic goals prior to cancer-directed operations have not been investigated. We examined how surgeons discuss the potential for cancer "cure" prior to operative treatment and how surgeons perceive patient priorities and treatment goals. Surgeons were invited to complete a Web-based survey about attitudes and practices when discussing cancer-directed operations, including how they defined cancer cure and whether and how they discussed cure as a treatment goal. A total of 551 e-mail invitations were sent and opened; 205 responses were received (response rate 37.2%). While 44.9% of surgeons reported being asked about cure in all or most discussions, only 37.6% used the word cure as often. When discussing cure, an equal number of surgeons reported using qualitative versus quantitative language to express probability of cure (45.7% and 47.4%, respectively). Roughly one third of surgeons (n = 65, 31.7%) defined cure as 5-year, disease-free survival; 36.1% (n = 74) defined cure as absence of recurrence over the patient's lifetime; and 21 (10.2%) defined cure as return to baseline population risk for that specific cancer. Over half of surgeons (n = 112, 56.9%) perceived that to "be cured" was among the top 2 priorities of patients presenting for operative treatment. When discussing relative benefits and goals of therapy, surgeon self-reported discussions of cure varied considerably. Despite identifying cure as a top priority for patients, surgeons were not inclined to incorporate cure into discussions of risks, benefits, and goals of therapy. Copyright © 2016 Elsevier Inc. All rights reserved.

Fertility as a priority among at-risk adolescent males newly diagnosed with cancer and their parents.

PubMed

Klosky, James L; Simmons, Jessica L; Russell, Kathryn M; Foster, Rebecca H; Sabbatini, Gina M; Canavera, Kristin E; Hodges, Jason R; Schover, Leslie R; McDermott, Michael J

2015-02-01

Infertility is a frequent consequence of cancer therapy and is often associated with psychological distress. Although adult survivors prioritize fertility and parenthood, this issue remains unexplored among adolescent males. This study examined future fertility as a priority (relative to other life goals) at time of diagnosis for at-risk adolescents and their parents. Newly diagnosed adolescent males (n = 96; age = 13.0-21.9 years) at increased risk for infertility secondary to cancer treatment prioritized eight life goals: to have school/work success, children, friends, wealth, health, a nice home, faith, and a romantic relationship. Patients' parents (fathers, n = 30; mothers, n = 61) rank-ordered the same priorities for their children. "Having children" was ranked as a "top 3" life goal among 43.8 % of adolescents, 36.7 % of fathers, and 21.3 % of mothers. Fertility ranked third among adolescents, fourth among fathers, and fifth among mothers. Future health was ranked the top priority across groups, distinct from all other goals (ps < 0.001), and fertility ranked higher than home ownership and wealth for all groups (ps < 0.001). For adolescents, low/moderate fertility risk perception was associated with higher fertility rankings than no/high risk perceptions (p = 0.01). Good health is the most important life goal among adolescents newly diagnosed with cancer and their parents. In this relatively small sample, adolescents prioritized fertility as a top goal, parents also rated fertility as being more important than home ownership and financial wealth. Health care providers should communicate fertility risk and preservation options at diagnosis and facilitate timely discussion among families, who may differ in prioritization of future fertility.

Fertility as a Priority among At-Risk Adolescent Males Newly Diagnosed with Cancer and Their Parents

PubMed Central

Klosky, James L.; Simmons, Jessica L.; Russell, Kathryn M.; Foster, Rebecca H.; Sabbatini, Gina M.; Canavera, Kristin E.; Hodges, Jason R.; Schover, Leslie R.; McDermott, Michael J.

2014-01-01

Purpose Infertility is a frequent consequence of cancer therapy and is often associated with psychological distress. Although adult survivors prioritize fertility and parenthood, this issue remains unexplored among adolescent males. This study examined future fertility as a priority (relative to other life goals) at time of diagnosis for at-risk adolescents and their parents. Methods Newly diagnosed adolescent males (n=96; age=13.0-21.9 years) at increased risk for infertility secondary to cancer treatment prioritized eight life goals: to have school/work success, children, friends, wealth, health, a nice home, faith, and a romantic relationship. Patients' parents (fathers, n=30; mothers, n=61) rank-ordered the same priorities for their children. Results “Having children” was ranked as a “top 3” life goal among 43.8% of adolescents, 36.7% of fathers, and 21.3% of mothers. Fertility ranked 3rd among adolescents, 4th among fathers, and 5th among mothers. Future health was ranked the top priority across groups, distinct from all other goals (ps<.001), and fertility ranked higher than home ownership and wealth for all groups (ps<.001). For adolescents, low/moderate fertility risk perception was associated with higher fertility rankings than no/high risk perceptions (p=.01). Conclusions Good health is the most important life goal among adolescents newly diagnosed with cancer and their parents. In this relatively small sample, adolescents prioritized fertility as a top goal, parents also rated fertility as being more important than home ownership and financial wealth. Health care providers should communicate fertility risk and preservation options at diagnosis and facilitate timely discussion among families, who may differ in prioritization of future fertility. PMID:25082365

Investigating into composition, distribution, sources and health risk of phthalic acid esters in street dust of Xi'an City, Northwest China.

PubMed

Wang, Lijun; Zhang, Wenjuan; Tao, Wendong; Wang, Li; Shi, Xingmin; Lu, Xinwei

2017-08-01

Phthalic acid esters (PAEs) are widely used as plasticizers and in consumer products, which may enter the environment and present risks to human health. U.S. EPA classifies six PAEs as priority pollutants, which could be accumulated in street dust at the interface of atmosphere, biosphere and geosphere. This study collected a total of 58 street dust samples from Xi'an City in Northwest China and analyzed for concentrations of the priority PAEs. Composition, distribution, sources and health risk of the PAEs were further examined. All the priority PAEs were detected in the street dust. The concentrations of individual PAEs varied between not detected and 183.19 mg/kg. The sum of the 6 priority PAEs (∑6PAEs) ranged from 0.87 to 250.30 mg/kg with a mean of 40.48 mg/kg. The most abundant PAEs in the street dust were di-n-butyl phthalate and di (2-ethylhexyl) phthalate (DEHP). Higher concentrations of ∑6PAEs in the street dust were found in the south and west parts of Xi'an City as well as its urban center, which were possibly attributed to the prevailing northerly Asian winter monsoon. The PAEs in the street dust originated mainly from wide application of plasticizers as well as cosmetics and personal care products. The main pathways of human exposure to PAEs in the street dust were ingestion and dermal adsorption of dust particles. The non-cancer risk of human exposure to PAEs in the street dust was relatively low, while the risk to children was higher than that to adults. The cancer risk of human exposure to DEHP in the street dust was lower than the standard limit value of 10 -6 .

Screening for male osteoporosis at an academic medical center: retrospective analysis of DXA usage patterns over 5 years.

PubMed

Ivory, Dedri Markita; Siva, Chokkalingam; Velázquez, Celso; Abdinoor, Abdillahi Abdi

2012-01-01

Recent findings suggest that men have higher mortality rates than women after a hip fracture. Although the risk of osteoporotic fractures in men is increasing, male osteoporosis still remains underdiagnosed and undertreated. In general, male osteoporosis is given low priority by policy makers in public health initiatives. The purpose of this study is to examine the patterns of use and gender distribution of DXA (dual-energy X-ray absorptiometry) scan usage at a university medical center in the United States. The total number of DXA scans increased during the study period while the percentage of men studied actually declined. The results of this study may lead to heightened awareness among providers who are caring for male patients at risk for osteoporosis.

Environmentally Related Diseases and the Possibility of Valuation of Their Social Costs

PubMed Central

Hajok, Ilona; Marchwińska, Ewa; Dziubanek, Grzegorz; Kuraszewska, Bernadeta; Piekut, Agata

2014-01-01

The risks of the morbidity of the asbestos-related lung cancer was estimated in the general population of Poles as the result of increased exposure to asbestos fibers during the removal of asbestos-cement products and the possibility of the valuation of the social costs related to this risk. The prediction of the new incidences was made using linear regression model. The forecast shows that to the end of 2030 about 3,500 new cases of lung cancer can be expected as a result of occupational exposure to asbestos in the past which makes together with paraoccupational exposure about 14.000 new cases. The forecast shows the increasing number of asbestos-related lung cancer in Poland and indicates the priority areas where preventive action should be implemented. PMID:25374934

A situational picture of HIV/AIDS and injection drug use in Vinnitsya, Ukraine

PubMed Central

Barcal, Katerina; Schumacher, Joseph E; Dumchev, Kostyantyn; Moroz, Larisa Vasiliyevna

2005-01-01

Background New and explosive HIV epidemics are being witnessed in certain countries of Eastern Europe, including Ukraine, as well as a rapid and dramatic increase in the supply, use, and negative public health consequences of illicit drugs. A majority of registered HIV cases in Ukraine occur among injection drug users (IDUs), large numbers of whom report HIV risk behaviors such as needle sharing. The purpose of this study was to apply the World Health Organization's Rapid Assessment and Response on Injection Drug Use (IDU-RAR) guide to create a situational picture in the Vinnitsya Oblast, Ukraine, a region with very scarce information about the HIV/AIDS and injection drug use (IDU) epidemics. Methods The IDU-RAR uses a combination of qualitative data collection techniques commonly employed in social science and evaluation research to quickly depict the extent and nature of the given health problem and propose locally relevant recommendations for improvement. The investigators focused their assessment on the contextual factors, drug use, and intervention and policy components of the IDU-RAR. A combination of network and block sampling techniques was used. Data collection methods included direct observation, review of existing data, structured and unstructured interviews, and focus group discussions. Key informants and locations were visited until no new information was being generated. Results The number of registered HIV cases in Vinnitsya has increased from 3 (1987–1995) to 860 (1999–10/2004), 57 of whom have already died. Ten percent of annual admissions to the area's Regional Narcological Dispensary were for opiate disorders, and the number of registered IDUs rose by 20% from 1999 to 2000. The level of HIV/AIDS awareness is generally poor among the general population but high among high-risk populations. Both HIV/AIDS and injection drug use carry a strong stigma in the community, even among medical professionals. There was very little evidence of primary HIV/AIDS prevention efforts, and IDU prevention efforts focused on promotion of anti-drug messages in the schools. Conclusion Given that Ukraine has sparse resources to be devoted to this problem, action recommendations should be prioritized, realistic, and initially targeted to persons in greatest need. The following action recommendations are prioritized by the following categories: First priority: Voluntary Counseling and Testing; Second Priority: Prevention and Education; and Third Priority: Harm Reduction and Treatment. They are provided in this sequence based on what response can realistically be implemented first with limited additional resources and can make the greatest immediate impact. The persons at greatest risk, HIV positive persons and IDUs, should be attended to first. PMID:16164758

Is Combat Exposure Predictive of Higher Preoperative Stress in Military Members?

DTIC Science & Technology

2015-01-26

Bopp, Eric, Joseph USU Project Number: N12-P16 4 TSNRP Research Priorities that Study or Project Addresses Primary Priority Force Health...of the caregiver Other: Principal Investigator: Bopp, Eric, Joseph USU Project Number: N12-P16 5 Background The preoperative...e.g., diabetes, thyroid disorders), and (c) autoimmune disorders (e.g., Sjogren’s syndrome ). Patients arriving to the Preoperative Teaching Unit

Occupational risk assessment in the construction industry in Iran.

PubMed

Seifi Azad Mard, Hamid Reza; Estiri, Ali; Hadadi, Parinaz; Seifi Azad Mard, Mahshid

2017-12-01

Occupational accidents in the construction industry are more common compared with other fields and these accidents are more severe compared with the global average in developing countries, especially in Iran. Studies which lead to the source of these accidents and suggest solutions for them are therefore valuable. In this study a combination of the failure mode and effects analysis method and fuzzy theory is used as a semi-qualitative-quantitative method for analyzing risks and failure modes. The main causes of occupational accidents in this field were identified and analyzed based on three factors; severity, detection and occurrence. Based on whether the risks are high or low priority, modifying actions were suggested to reduce the occupational risks. Finally, the results showed that high priority risks had a 40% decrease due to these actions.

14 CFR 93.223 - Slot withdrawal.

Code of Federal Regulations, 2010 CFR

2010-01-01

... shall assign, by random lottery, withdrawal priority numbers for the recall priority of slots at each... that slot or one acquired by trade of that slot, if the resulting total of slots held or operated at...

Environmental risk analysis and prioritization of pharmaceuticals in a developing world context.

PubMed

Mansour, Fatima; Al-Hindi, Mahmoud; Saad, Walid; Salam, Darine

2016-07-01

The impact of residual pharmaceuticals on the aquatic environment has gained widespread attention over the past years. Various studies have established the occurrence of pharmaceutical compounds in different water bodies throughout the world. In view of the absence of occurrence data in a number of developing world countries, and given the limited availability of analytical resources in these countries, it is prudent to devise methodologies to prioritize pharmaceuticals for environmental monitoring purposes that are site specific. In this work, several prioritization approaches are used to rank the 88 most commonly consumed pharmaceuticals in Lebanon. A simultaneous multi-criteria decision analysis method utilizing the exposure, persistence, bioaccumulation, and toxicity (EPBT) approach is applied to a smaller subset of the original list (69 pharmaceuticals). Several base cases are investigated and sensitivity analysis is applied to one of these base case runs. The similarities and differences in the overall ranking of individual, and classes of, pharmaceuticals for the base cases and the sensitivity runs are elucidated. An environmental risk assessment (ERA), where predicted environmental concentrations (PEC) and risk quotients (RQ) are determined at different dilution factors, is performed as an alternative method of prioritization for a total of 84 pharmaceuticals. The ERA results indicate that metformin and amoxicillin have the highest PECs while 17β-estradiol, naftidrofuryl and dimenhydrinate have the highest RQs. The two approaches, EPBT prioritization and ERA, are compared and a priority list consisting of 26 pharmaceuticals of various classes is developed. Nervous system and alimentary tract and metabolism pharmaceuticals (9/26 and 5/26 respectively) constitute more than half of the numbers on the priority list with the balance consisting of anti-infective (4/26), musculo-skeletal (3/26), genito-urinary (2/26), respiratory (2/26) and cardiovascular (1/26) pharmaceuticals. This list will serve as a basis for the selection of candidate compounds to focus on for future monitoring campaigns. Copyright © 2016 Elsevier B.V. All rights reserved.

Minimizing treatment planning errors in proton therapy using failure mode and effects analysis

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

Zheng, Yuanshui, E-mail: yuanshui.zheng@okc.procure.com; Johnson, Randall; Larson, Gary

Purpose: Failure mode and effects analysis (FMEA) is a widely used tool to evaluate safety or reliability in conventional photon radiation therapy. However, reports about FMEA application in proton therapy are scarce. The purpose of this study is to apply FMEA in safety improvement of proton treatment planning at their center. Methods: The authors performed an FMEA analysis of their proton therapy treatment planning process using uniform scanning proton beams. The authors identified possible failure modes in various planning processes, including image fusion, contouring, beam arrangement, dose calculation, plan export, documents, billing, and so on. For each error, the authorsmore » estimated the frequency of occurrence, the likelihood of being undetected, and the severity of the error if it went undetected and calculated the risk priority number (RPN). The FMEA results were used to design their quality management program. In addition, the authors created a database to track the identified dosimetric errors. Periodically, the authors reevaluated the risk of errors by reviewing the internal error database and improved their quality assurance program as needed. Results: In total, the authors identified over 36 possible treatment planning related failure modes and estimated the associated occurrence, detectability, and severity to calculate the overall risk priority number. Based on the FMEA, the authors implemented various safety improvement procedures into their practice, such as education, peer review, and automatic check tools. The ongoing error tracking database provided realistic data on the frequency of occurrence with which to reevaluate the RPNs for various failure modes. Conclusions: The FMEA technique provides a systematic method for identifying and evaluating potential errors in proton treatment planning before they result in an error in patient dose delivery. The application of FMEA framework and the implementation of an ongoing error tracking system at their clinic have proven to be useful in error reduction in proton treatment planning, thus improving the effectiveness and safety of proton therapy.« less

Minimizing treatment planning errors in proton therapy using failure mode and effects analysis.

PubMed

Zheng, Yuanshui; Johnson, Randall; Larson, Gary

2016-06-01

Failure mode and effects analysis (FMEA) is a widely used tool to evaluate safety or reliability in conventional photon radiation therapy. However, reports about FMEA application in proton therapy are scarce. The purpose of this study is to apply FMEA in safety improvement of proton treatment planning at their center. The authors performed an FMEA analysis of their proton therapy treatment planning process using uniform scanning proton beams. The authors identified possible failure modes in various planning processes, including image fusion, contouring, beam arrangement, dose calculation, plan export, documents, billing, and so on. For each error, the authors estimated the frequency of occurrence, the likelihood of being undetected, and the severity of the error if it went undetected and calculated the risk priority number (RPN). The FMEA results were used to design their quality management program. In addition, the authors created a database to track the identified dosimetric errors. Periodically, the authors reevaluated the risk of errors by reviewing the internal error database and improved their quality assurance program as needed. In total, the authors identified over 36 possible treatment planning related failure modes and estimated the associated occurrence, detectability, and severity to calculate the overall risk priority number. Based on the FMEA, the authors implemented various safety improvement procedures into their practice, such as education, peer review, and automatic check tools. The ongoing error tracking database provided realistic data on the frequency of occurrence with which to reevaluate the RPNs for various failure modes. The FMEA technique provides a systematic method for identifying and evaluating potential errors in proton treatment planning before they result in an error in patient dose delivery. The application of FMEA framework and the implementation of an ongoing error tracking system at their clinic have proven to be useful in error reduction in proton treatment planning, thus improving the effectiveness and safety of proton therapy.

Health Hazard Appraisal Counseling—Continuing Evaluation

PubMed Central

LaDou, Joseph; Sherwood, John N.; Hughes, Lewis

1979-01-01

A program of annual health examinations was expanded to include counseling based on a computerized appraisal of individual patients' specific health risk factors. Data obtained from a specially designed questionnaire, laboratory tests and a physical examination yielded a health hazard appraisal showing a number of weighted risk factors and their relation to ten leading causes of death as determined for that patient. From all of this information, a “risk age” was developed which could then be compared with the patient's “true age.” The results were reviewed with each patient, and methods of correcting health hazards were stressed. The first annual retesting of a group of 107 examinees showed a net risk age reduction of 1.4 years (formerly reported in this journal). The longer term follow-up reported in this paper showed a net risk reduction of 2.38 years in a group of 26 examinees. The net risk age reduction in the two groups represented 32 and 40 percent, respectively, of the achievable risk age reduction when patients comply with suggestions made during risk reduction counseling. These findings indicate that health hazard appraisal counseling is an effective method of altering priorities of health practices. PMID:425518

Crude estimates of cannabis-attributable mortality and morbidity in Canada-implications for public health focused intervention priorities.

PubMed

Fischer, Benedikt; Imtiaz, Sameer; Rudzinski, Katherine; Rehm, Jürgen

2016-03-01

Cannabis is the most commonly used drug in Canada; while its use is currently controlled by criminal prohibition, debates about potential control reforms are intensifying. There is substantive evidence about cannabis-related risks to health in various key outcome domains; however, little is known about the actual extent of these harms specifically in Canada. Based on epidemiological data (e.g. prevalence of relevant cannabis use rates and relevant risk behaviors; risk ratios; and annual numbers of morbidity/mortality cases in relevant domains), and applying the methodology of comparative risk assessment, we estimated attributable fractions for cannabis-related morbidity and mortality, specifically for: (i) motor-vehicle accidents (MVAs); (ii) use disorders; (iii) mental health (psychosis) and (iv) lung cancer. MVAs and lung cancer are the only domains where cannabis-attributable mortality is estimated to occur. While cannabis use results in morbidity in all domains, MVAs and use disorders by far outweigh the other domains in the number of cases; the popularly debated mental health consequences (e.g., psychosis) translate into relatively small case numbers. The present crude estimates should guide and help prioritize public health-oriented interventions for the cannabis-related health burden in the population in Canada; formal burden of disease calculations should be conducted. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Evaluating the application of failure mode and effects analysis technique in hospital wards: a systematic review

PubMed Central

Asgari Dastjerdi, Hoori; Khorasani, Elahe; Yarmohammadian, Mohammad Hossein; Ahmadzade, Mahdiye Sadat

2017-01-01

Abstract: Background: Medical errors are one of the greatest problems in any healthcare systems. The best way to prevent such problems is errors identification and their roots. Failure Mode and Effects Analysis (FMEA) technique is a prospective risk analysis method. This study is a review of risk analysis using FMEA technique in different hospital wards and departments. Methods: This paper has systematically investigated the available databases. After selecting inclusion and exclusion criteria, the related studies were found. This selection was made in two steps. First, the abstracts and titles were investigated by the researchers and, after omitting papers which did not meet the inclusion criteria, 22 papers were finally selected and the text was thoroughly examined. At the end, the results were obtained. Results: The examined papers had focused mostly on the process and had been conducted in the pediatric wards and radiology departments, and most participants were nursing staffs. Many of these papers attempted to express almost all the steps of model implementation; and after implementing the strategies and interventions, the Risk Priority Number (RPN) was calculated to determine the degree of the technique’s effect. However, these papers have paid less attention to the identification of risk effects. Conclusions: The study revealed that a small number of studies had failed to show the FMEA technique effects. In general, however, most of the studies recommended this technique and had considered it a useful and efficient method in reducing the number of risks and improving service quality. PMID:28039688

National Priorities: PER- AND POLYFLUOROALKYL SUBSTANCES

EPA Pesticide Factsheets

EPA seeks applications for research on identifying communities at high risk of adverse health effects of lead in drinking water, identifying opportunities to mitigate these risks, conduct efforts to inform interested parties of these risks & opportunities.

Ordinary risks and accepted fictions: how contrasting and competing priorities work in risk assessment and mental health care planning.

PubMed

Coffey, Michael; Cohen, Rachel; Faulkner, Alison; Hannigan, Ben; Simpson, Alan; Barlow, Sally

2017-06-01

Communication and information sharing are considered crucial to recovery-focused mental health services. Effective mental health care planning and coordination includes assessment and management of risk and safety. Using data from our cross-national mixed-method study of care planning and coordination, we examined what patients, family members and workers say about risk assessment and management and explored the contents of care plans. Thematic analysis of qualitative research interviews (n = 117) with patients, family members and workers, across four English and two Welsh National Health Service sites. Care plans were reviewed (n = 33) using a structured template. Participants have contrasting priorities in relation to risk. Patients see benefit in discussions about risk, but cast the process as a worker priority that may lead to loss of liberty. Relationships with workers are key to family members and patients; however, worker claims of involving people in the care planning process do not extend to risk assessment and management procedures for fear of causing upset. Workers locate risk as coming from the person rather than social or environmental factors, are risk averse and appear to prioritize the procedural aspects of assessment. Despite limitations, risk assessment is treated as legitimate work by professionals. Risk assessment practice operates as a type of fiction in which poor predictive ability and fear of consequences are accepted in the interests of normative certainty by all parties. As a consequence, risk adverse options are encouraged by workers and patients steered away from opportunities for ordinary risks thereby hindering the mobilization of their strengths and abilities. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Towards Risk-Based Test Protocols: Estimating the Contribution of Intensive Testing to the UK Bovine Tuberculosis Problem

PubMed Central

van Dijk, Jan

2013-01-01

Eradicating disease from livestock populations involves the balancing act of removing sufficient numbers of diseased animals without removing too many healthy individuals in the process. As ever more tests for bovine tuberculosis (BTB) are carried out on the UK cattle herd, and each positive herd test triggers more testing, the question arises whether ‘false positive’ results contribute significantly to the measured BTB prevalence. Here, this question is explored using simple probabilistic models of test behaviour. When the screening test is applied to the average UK herd, the estimated proportion of test-associated false positive new outbreaks is highly sensitive to small fluctuations in screening test specificity. Estimations of this parameter should be updated as a priority. Once outbreaks have been confirmed in screening-test positive herds, the following rounds of intensive testing with more sensitive, albeit less specific, tests are highly likely to remove large numbers of false positive animals from herds. Despite this, it is unlikely that significantly more truly infected animals are removed. BTB test protocols should become based on quantified risk in order to prevent the needless slaughter of large numbers of healthy animals. PMID:23717517

Reducing the Number of Uninsured Children: Outreach and Enrollment Efforts. Testimony of Donna Cohen Ross, Center on Budget and Policy Priorities, before the Senate Finance Committee.

ERIC Educational Resources Information Center

Ross, Donna Cohen

This testimony of Donna Cohen Ross describes the Center on Budget and Policy Priorities' work to reduce the number of uninsured children. The Center specializes in programs and policies affecting low- and moderate-income families, including issues related to health coverage for the uninsured. It works with many groups on strategies to identify…

High-risk health and credit behavior among 18- to 25-year-old college students.

PubMed

Adams, Troy; Moore, Monique

2007-01-01

The number of students accumulating credit card debt--and the amount of debt itself--on college campuses is increasing. If high-risk credit and health behavior are associated, health behavior interventions might apply to high-risk credit behavior. The authors' purpose was to examine these possible associations. They used a retrospective design with existing data from a sample of 45,213 US college students and several ordinal regression models, which corresponded with high priority college health issues. Students with high-risk credit behavior were more likely to have driven after drinking, used amphetamines in the previous 30 days, felt functionally impaired by depression in the previous 12 months, had a higher body mass index (BMI), or had a lower grade-point average (GPA). They were less likely to have participated in vigorous physical activity, used condoms for oral or vaginal sex in the prior 30 days, or used marijuana. The findings support the notion that high-risk health and credit behaviors are associated. Further research could clarify the nature of this relation.

Gonorrhea prevention and clinical care in the private sector: lessons learned and priorities for quality improvement.

PubMed

Tao, Guoyu; Irwin, Kathleen L

2006-11-01

We reviewed literature on gonorrhea prevention and clinical care in the private sector, the setting where most gonorrhea cases in the United States are now diagnosed. Although most private-sector health settings had a low prevalence of gonorrhea (0.1-2.5%), some private emergency departments and specialty clinics that serve a large number of high-risk or infected patients had prevalences ranged from 1.7% to 11.0%. Studies of diverse settings and populations suggest that, in general, diagnostic testing of symptomatic patients (69-83%), appropriate treatment (61-100%), and case reporting (64-94%) are delivered more commonly than risk assessment for asymptomatic patients (15-28%), routine screening of pregnant women (31-77%), risk-reduction counseling (35-78%), and sex partner management (0-82%). To sustain the recent declines in gonorrhea incidence in the United States, private-sector providers and health systems must continue to offer gonorrhea prevention and clinical services and consider implementing interventions to improve delivery of risk assessment, risk-reduction counseling, and partner management services.

Use of Failure Mode and Effects Analysis to Improve Emergency Department Handoff Processes.

PubMed

Sorrentino, Patricia

2016-01-01

The purpose of this article is to describe a quality improvement process using failure mode and effects analysis (FMEA) to evaluate systems handoff communication processes, improve emergency department (ED) throughput and reduce crowding through development of a standardized handoff, and, ultimately, improve patient safety. Risk of patient harm through ineffective communication during handoff transitions is a major reason for breakdown of systems. Complexities of ED processes put patient safety at risk. An increased incidence of submitted patient safety event reports for handoff communication failures between the ED and inpatient units solidified a decision to implement the use of FMEA to identify handoff failures to mitigate patient harm through redesign. The clinical nurse specialist implemented an FMEA. Handoff failure themes were created from deidentified retrospective reviews. Weekly meetings were held over a 3-month period to identify failure modes and determine cause and effect on the process. A functional block diagram process map tool was used to illustrate handoff processes. An FMEA grid was used to list failure modes and assign a risk priority number to quantify results. Multiple areas with actionable failures were identified. A majority of causes for high-priority failure modes were specific to communications. Findings demonstrate the complexity of transition and handoff processes. The FMEA served to identify and evaluate risk of handoff failures and provide a framework for process improvement. A focus on mentoring nurses to quality handoff processes so that it becomes habitual practice is crucial to safe patient transitions. Standardizing content and hardwiring within the system are best practice. The clinical nurse specialist is prepared to provide strong leadership to drive and implement system-wide quality projects.

GAR Global Risk Assessment

NASA Astrophysics Data System (ADS)

Maskrey, Andrew; Safaie, Sahar

2015-04-01

Disaster risk management strategies, policies and actions need to be based on evidence of current disaster loss and risk patterns, past trends and future projections, and underlying risk factors. Faced with competing demands for resources, at any level it is only possible to priorities a range of disaster risk management strategies and investments with adequate understanding of realised losses, current and future risk levels and impacts on economic growth and social wellbeing as well as cost and impact of the strategy. The mapping and understanding of the global risk landscape has been greatly enhanced by the latest iteration of the GAR Global Risk Assessment and the objective of this submission is to present the GAR global risk assessment which contributed to Global Assessment Report (GAR) 2015. This initiative which has been led by UNISDR, was conducted by a consortium of technical institutions from around the world and has covered earthquake, cyclone, riverine flood, and tsunami probabilistic risk for all countries of the world. In addition, the risks associated with volcanic ash in the Asia-Pacific region, drought in various countries in sub-Saharan Africa and climate change in a number of countries have been calculated. The presentation will share thee results as well as the experience including the challenges faced in technical elements as well as the process and recommendations for the future of such endeavour.

Utilization of stat test priority in the clinical laboratory: a College of American Pathologists q-probes study of 52 institutions.

PubMed

Volmar, Keith E; Wilkinson, David S; Wagar, Elizabeth A; Lehman, Christopher M

2013-02-01

Utilization of stat testing priority is a balance between safe, efficient patient management and resource expenditure. To determine the rate of stat testing, compare rates among institutions, and determine the distribution of turnaround time expectations for different turnaround time priorities. During a 7-day period, participants prospectively determined the total number of chemistry, hematology, and coagulation billable tests from inpatients and emergency department patients. Among these, the total numbers of billable tests performed stat were identified. Laboratories also reported the levels of test priority they offered and turnaround expectations for each level of test priority. Fifty institutions submitted data for the study, with 2 additional participants submitting partial results. Participants identified 639 589 chemistry, hematology, and coagulation billable tests, with 229 896 (35.9%) performed stat. The stat rate varied from 21.3% at the 10th percentile to 55.4% at the 90th percentile, with a median of 37.0% of participants' tests performed stat. Laboratories include a mean of 206 tests in chemistry, hematology, and coagulation test menus, with 67% of these tests offered stat. The fraction of the test menu offered stat varied from 29.0% at the 10th percentile to 97.8% at the 90th percentile, with a median of 73.3% of tests on the menu offered stat. The most common number of testing priorities offered by participating laboratories was 3 (44.2%). Among the 52 participating laboratories, the median stat testing rate was 37.0% and a median 73.3% of the test menu was offered stat.

Incorporating Target Priorities in the Sensor Tasking Reward Function

NASA Astrophysics Data System (ADS)

Gehly, S.; Bennett, J.

2016-09-01

Orbital debris tracking poses many challenges, most fundamentally the need to track a large number of objects from a limited number of sensors. The use of information theoretic sensor allocation provides a means to efficiently collect data on the multitarget system. An additional need of the community is the ability to specify target priorities, driven both by user needs and environmental factors such as collision warnings. This research develops a method to incorporate target priorities in the sensor tasking reward function, allowing for several applications in different tasking modes such as catalog maintenance, calibration, and collision monitoring. A set of numerical studies is included to demonstrate the functionality of the method.

Territory management an appropriate approach for taking into account dynamic risks

NASA Astrophysics Data System (ADS)

Fernandez, M.; Ruegg, J.

2012-04-01

The territorial approach in risk analysis is well established in scientific communications in recent years, especially in the francophone literature. It is an especially appropriate approach for exploring a large number of criteria and factors influencing, on the territory, the composition of the vulnerabilities and risks. In these sense, this approach is appropriate to identify not only risks due to natural hazards but also social and environmental risks. Our case study explores the catastrophic landslide, a collapse of 6 millions cubic meters of rock in Los Chorros, in the municipality of San Cristobal Verapaz-Guatemala, in January 2009. We demonstrate that the same natural hazard has different consequences within this territory and may also increase or even create new vulnerabilities and risks for the population. The analysis shows that the same event can endanger various aspects of the territory: resources, functions (agriculture, or houses uses for example) and allocations and highlights the different types of vulnerabilities that land users (i.e., farmers, merchants transport drivers) face. To resolve a post-disaster situation, the actors choose one vulnerability among a set of vulnerabilities (in a multi-vulnerability context) and with this choice they define their own acceptable risk limits. To give an example, the transport driver choose to reduce the economic vulnerability when going to the local market and crossing the landslide (physical vulnerability). In the context of a developing country with weak development and limited resources, land users that become the Risk managers after the disaster are compelled to prioritize between different actions for reducing risks This study provides a novel approach to risk management by adding a political science and geography dimension through the territory approach for improving our understanding of multi-hazard and multi-risk management. Based on findings from this case study, this work asserts that risk is not unequivocal. On the contrary, in the case of the Los Chorros, the "primary" risk (the landslide), as evaluated by the authorities, was not perceived as such by the local community, which prioritized economic risks by creating their own road through the landslide area in defiance of authorities. In other words, certain attributes and characteristics of risk will be emphasized by some actors over others, (i.e. economic considerations over the perceived probability of another landslide). Their priorities will depend on their needs and mandates and as priorities change, so individual definitions of risk may change over time. This paper demonstrates that the risk is not uniform, that multiple risks persist especially in a developing country context becomes diffuse, changes or endures because it depends on the implications on the territory and on the risk definition made by the actors. The risk is variable, the result of a choice because its existence is attributed by the characteristics or criteria of vulnerability fostered by actors in their territories. Finally, the case study demonstrates that in developing countries, actors are forced to address and prioritize multiple risks due to limited resources. In this context, the challenge for managers of natural hazards is to move from risk management in the strict sense (i.e., pure hazard approach) to a broader risk management, taking into consideration what is important for the society and for the functioning of systems. Territory management in this sense is an appropriate approach for taking into account multiple stakeholder priorities, their relationships, available resources and limitations.

Environmental Programs: Status of Work and Current Priorities for FY13

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

Jones, Patricia

2012-08-17

Presentation outline is: Mission/overview, Regulatory framework, Current status of cleanup, Shift in priorities to address highest risk, Removal of above-ground waste, Continued focus on protecting water resources, and Priorities for fiscal year 2013. LANL's Environmental Mission is to: (1) Repack and ship legacy transuranic waste containers; (2) Investigate and remediate Cold War (legacy) hazardous and radioactive waste areas; (3) Demolish unused buildings; (4) Disposition solid waste from Laboratory operations; and (5) Lifecycle cost nearly $3 billion.

Criteria for choosing clinically effective glaucoma treatment: A discussion panel consensus

PubMed Central

Thygesen, John; Burk, Reinhard; Carassa, Roberto; Crichton, Andrew; Goñi, Francisco Javier; Menage, Mitch; Miglior, Stefano; Montgomery, Donald; Nordmann, John-Philippe; Roberts, Tim; Singh, Kuldev

2007-01-01

Abstract Background: In the clinical management of patients at risk for or diagnosed with primary open-angle glaucoma (POAG), the aim of medical treatment is to reduce intraocular pressure (IOP) and then maintain it over time at a level that preserves both the structure and function of the optic nerve. Objective: The objective of this report was to establish a consensus on the criteria that should be used to determine the characteristics of IOP-lowering medication. Methods: Discussion was held among a panel of 12 physicians considered to be experts in glaucoma to develop a consensus on the criteria used by them to determine the characteristics of the IOP-lowering medication chosen for initial monotherapy and adjunctive treatment of ocular hypertension (OHT) or POAG. Consensus development combined available evidence and the impressions of these physicians regarding the clinical effectiveness of IOP-lowering medication for OHT and POAG. Once the panel identified the criteria, the order of priority and the relative importance of these criteria were then established in the setting of 3 risk categories (low, medium, and high) for a patient to experience significant visual disability from glaucoma over their expected life span. Results: The panel identified 5 criteria to determine the characteristics of IOP-lowering medication for OHT and POAG: IOP-lowering effect, systemic adverse events (AEs), ocular tolerability, compliance/administration, and cost of treatment. IOP-lowering effect was consistently ranked as the highest priority and cost as the lowest. The priority of compliance/administration did not vary by clinical situation. Systemic AEs and ocular tolerability were ranked as higher priorities in initial monotherapy than in adjunctive treatment and ranked lower as the risk for visual disability increased. The priority given to the criteria used to determine clinical effectiveness varied both with the risk for functional vision loss from glaucoma and whether initial monotherapy or adjunctive treatment was being considered. Conclusion: Glaucoma treatment should be assessed with regard to the need not only to lower IOP but also to minimize systemic and ocular AEs, promote patient compliance, and minimize cost. The order of priority and relative importance given to these treatment criteria will vary as part of individualizing patient care. PMID:24683204

Engaging with Comparative Risk Appraisals: Public Views on Policy Priorities for Environmental Risk Governance.

PubMed

Rocks, Sophie A; Schubert, Iljana; Soane, Emma; Black, Edgar; Muckle, Rachel; Petts, Judith; Prpich, George; Pollard, Simon J

2017-09-01

Communicating the rationale for allocating resources to manage policy priorities and their risks is challenging. Here, we demonstrate that environmental risks have diverse attributes and locales in their effects that may drive disproportionate responses among citizens. When 2,065 survey participants deployed summary information and their own understanding to assess 12 policy-level environmental risks singularly, their assessment differed from a prior expert assessment. However, participants provided rankings similar to those of experts when these same 12 risks were considered as a group, allowing comparison between the different risks. Following this, when individuals were shown the prior expert assessment of this portfolio, they expressed a moderate level of confidence with the combined expert analysis. These are important findings for the comprehension of policy risks that may be subject to augmentation by climate change, their representation alongside other threats within national risk assessments, and interpretations of agency for public risk management by citizens and others. © 2017 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

Hormonal contraceptive use and women's risk of HIV acquisition: priorities emerging from recent data.

PubMed

Ralph, Lauren J; Gollub, Erica L; Jones, Heidi E

2015-12-01

Understanding whether hormonal contraception increases women's risk of HIV acquisition is a public health priority. This review summarizes recent epidemiologic and biologic data, and considers the implications of new evidence on research and programmatic efforts. Two secondary analyses of HIV prevention trials demonstrated increased HIV risk among depot medroxyprogesterone acetate (DMPA) users compared with nonhormonal/no method users and norethisterone enanthate (NET-EN) users. A study of women in serodiscordant partnerships found no significant association for DMPA or implants. Two meta-analyses found elevated risks of HIV among DMPA users compared with nonhormonal/no method users, with no association for NET-EN or combined oral contraceptive pills. In-vitro and animal model studies identified plausible biological mechanisms by which progestin exposure could increase risk of HIV, depending on the type and dose of progestin, but such mechanisms have not been definitively observed in humans. Recent epidemiologic and biologic evidence on hormonal contraception and HIV suggests a harmful profile for DMPA but not combined oral contraceptives. In limited data, NET-EN appears safer than DMPA. More research is needed on other progestin-based methods, especially implants and Sayana Press. Future priorities include updating modeling studies with new pooled estimates, continued basic science to understand biological mechanisms, expanding contraceptive choice, and identifying effective ways to promote dual method use.

Shaping innovations in long-term care for stroke survivors with multimorbidity through stakeholder engagement.

PubMed

Sadler, Euan; Porat, Talya; Marshall, Iain; Hoang, Uy; Curcin, Vasa; Wolfe, Charles D A; McKevitt, Christopher

2017-01-01

Stroke, like many long-term conditions, tends to be managed in isolation of its associated risk factors and multimorbidity. With increasing access to clinical and research data there is the potential to combine data from a variety of sources to inform interventions to improve healthcare. A 'Learning Health System' (LHS) is an innovative model of care which transforms integrated data into knowledge to improve healthcare. The objective of this study is to develop a process of engaging stakeholders in the use of clinical and research data to co-produce potential solutions, informed by a LHS, to improve long-term care for stroke survivors with multimorbidity. We used a stakeholder engagement study design informed by co-production principles to engage stakeholders, including service users, carers, general practitioners and other health and social care professionals, service managers, commissioners of services, policy makers, third sector representatives and researchers. Over a 10 month period we used a range of methods including stakeholder group meetings, focus groups, nominal group techniques (priority setting and consensus building) and interviews. Qualitative data were recorded, transcribed and analysed thematically. 37 participants took part in the study. The concept of how data might drive intervention development was difficult to convey and understand. The engagement process led to four priority areas for needs for data and information being identified by stakeholders: 1) improving continuity of care; 2) improving management of mental health consequences; 3) better access to health and social care; and 4) targeting multiple risk factors. These priorities informed preliminary design interventions. The final choice of intervention was agreed by consensus, informed by consideration of the gap in evidence and local service provision, and availability of robust data. This shaped a co-produced decision support tool to improve secondary prevention after stroke for further development. Stakeholder engagement to identify data-driven solutions is feasible but requires resources. While a number of potential interventions were identified, the final choice rested not just on stakeholder priorities but also on data availability. Further work is required to evaluate the impact and implementation of data-driven interventions for long-term stroke survivors.

Shaping innovations in long-term care for stroke survivors with multimorbidity through stakeholder engagement

PubMed Central

Porat, Talya; Marshall, Iain; Hoang, Uy; Curcin, Vasa; Wolfe, Charles D. A.; McKevitt, Christopher

2017-01-01

Background Stroke, like many long-term conditions, tends to be managed in isolation of its associated risk factors and multimorbidity. With increasing access to clinical and research data there is the potential to combine data from a variety of sources to inform interventions to improve healthcare. A ‘Learning Health System’ (LHS) is an innovative model of care which transforms integrated data into knowledge to improve healthcare. The objective of this study is to develop a process of engaging stakeholders in the use of clinical and research data to co-produce potential solutions, informed by a LHS, to improve long-term care for stroke survivors with multimorbidity. Methods We used a stakeholder engagement study design informed by co-production principles to engage stakeholders, including service users, carers, general practitioners and other health and social care professionals, service managers, commissioners of services, policy makers, third sector representatives and researchers. Over a 10 month period we used a range of methods including stakeholder group meetings, focus groups, nominal group techniques (priority setting and consensus building) and interviews. Qualitative data were recorded, transcribed and analysed thematically. Results 37 participants took part in the study. The concept of how data might drive intervention development was difficult to convey and understand. The engagement process led to four priority areas for needs for data and information being identified by stakeholders: 1) improving continuity of care; 2) improving management of mental health consequences; 3) better access to health and social care; and 4) targeting multiple risk factors. These priorities informed preliminary design interventions. The final choice of intervention was agreed by consensus, informed by consideration of the gap in evidence and local service provision, and availability of robust data. This shaped a co-produced decision support tool to improve secondary prevention after stroke for further development. Conclusions Stakeholder engagement to identify data-driven solutions is feasible but requires resources. While a number of potential interventions were identified, the final choice rested not just on stakeholder priorities but also on data availability. Further work is required to evaluate the impact and implementation of data-driven interventions for long-term stroke survivors. PMID:28475606

Development of a Traumatic Brain Injury Assessment Score using Novel Biomarkers Discovered Through Autoimmune Profiling

DTIC Science & Technology

2014-08-15

N12-P12 TSNRP Research Priorities that Study or Project Addresses Primary Priority Force Health Protection: Fit and ready force Deploy...Mentoring: Health policy Recruitment and retention Preparing tomorrow’s leaders Care of the caregiver Other: Secondary Priority Force... caregiver Other: 5 Principal Investigator (Buonora, John, E) USU Project Number: N12-P12 Progress Towards Achievement of Specific Aims of

Range-wide network of priority areas for greater sage-grouse - a design for conserving connected distributions or isolating individual zoos?

USGS Publications Warehouse

Crist, Michele R.; Knick, Steven T.; Hanser, Steven E.

2015-09-08

The network of areas delineated in 11 Western States for prioritizing management of greater sage-grouse (Centrocercus urophasianus) represents a grand experiment in conservation biology and reserve design. We used centrality metrics from social network theory to gain insights into how this priority area network might function. The network was highly centralized. Twenty of 188 priority areas accounted for 80 percent of the total centrality scores. These priority areas, characterized by large size and a central location in the range-wide distribution, are strongholds for greater sage-grouse populations and also might function as sources. Mid-ranking priority areas may serve as stepping stones because of their location between large central and smaller peripheral priority areas. The current network design and conservation strategy has risks. The contribution of almost one-half (n = 93) of the priority areas combined for less than 1 percent of the cumulative centrality scores for the network. These priority areas individually are likely too small to support viable sage-grouse populations within their boundary. Without habitat corridors to connect small priority areas either to larger priority areas or as a clustered group within the network, their isolation could lead to loss of sage-grouse within these regions of the network. 

40 CFR 60.16 - Priority list.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Categories Priority Number 1 Source Category 1. Synthetic Organic Chemical Manufacturing Industry (SOCMI) and Volatile Organic Liquid Storage Vessels and Handling Equipment (a) SOCMI unit processes (b) Volatile organic liquid (VOL) storage vessels and handling equipment (c) SOCMI fugitive sources (d) SOCMI secondary...

Effectiveness of Bus Signal Priority : Final Report

DOT National Transportation Integrated Search

2002-01-01

Effectiveness of Bus Signal Priority (BSP) study evaluates BSP?s impact on traffic operations. The goal was to examine how different situations, such as the level of congestion, placement of bus stops, presence of express bus service, and number of t...

SPECIES RICHNESS AND BIODIVERSITY CONSERVATION PRIORITIES IN BRITISH COLUMBIA

EPA Science Inventory

Patterns in the geographic distribution of seven species groups were used to identify important areas for conservation in British Columbia, Canada. Potential priority sites for conservation were determined using an integer programming algorithm that maximized the number of speci...

A Study on Project Priority Evaluation Method on Road Slope Disaster Prevention Management

NASA Astrophysics Data System (ADS)

Sekiguchi, Nobuyasu; Ohtsu, Hiroyasu; Izu, Ryuutarou

To improve the safety and security of driving while coping with today's stagnant economy and frequent natural disasters, road slopes should be appropriately managed. To achieve the goals, road managers should establish project priority evaluation methods for each stage of road slope management by clarifying social losses that would result by drops in service levels. It is important that road managers evaluate a project priority properly to manage the road slope effectively. From this viewpoint, this study proposed "project priority evaluation methods" in road slope disaster prevention, which use available slope information at each stage of road slope management under limited funds. In addition, this study investigated the effect of managing it from the high slope of the priority by evaluating a risk of slope failure. In terms of the amount of available information, staged information provision is needed ranging from macroscopic studies, which involves evaluation of the entire route at each stage of decision making, to semi- and microscopic investigations for evaluating slopes, and microscopic investigations for evaluating individual slopes. With limited funds, additional detailed surveys are difficult to perform. It is effective to use the slope risk assessment system, which was constructed to complement detailed data, to extract sites to perform precise investigations.

Growth and Remodeling in Blood Vessels Studied In Vivo With Fractal Analysis

NASA Technical Reports Server (NTRS)

Parsons-Wingerter, Patricia A.

2003-01-01

Every cell in the human body must reside in close proximity to a blood vessel (within approximately 200 mm) because blood vessels provide the oxygen, metabolite, and fluid exchanges required for cellular existence. The growth and remodeling of blood vessels are required to support the normal physiology of embryonic development, reproductive biology, wound healing and adaptive remodeling to exercise, as well as abnormal tissue change in diseases such as cancer, diabetes, and coronary heart disease. Cardiovascular and hemodynamic (blood flow dynamics) alterations experienced by astronauts during long-term spaceflight, including orthostatic intolerance, fluid shifts in the body, and reduced numbers of red (erythrocyte) and white (immune) blood cells, are identified as risk factors of very high priority in the NASA task force report on risk reduction for human spaceflight, the "Critical Path Roadmap."

The Priority Heuristic: Making Choices Without Trade-Offs

PubMed Central

Brandstätter, Eduard; Gigerenzer, Gerd; Hertwig, Ralph

2010-01-01

Bernoulli's framework of expected utility serves as a model for various psychological processes, including motivation, moral sense, attitudes, and decision making. To account for evidence at variance with expected utility, we generalize the framework of fast and frugal heuristics from inferences to preferences. The priority heuristic predicts (i) Allais' paradox, (ii) risk aversion for gains if probabilities are high, (iii) risk seeking for gains if probabilities are low (lottery tickets), (iv) risk aversion for losses if probabilities are low (buying insurance), (v) risk seeking for losses if probabilities are high, (vi) certainty effect, (vii) possibility effect, and (viii) intransitivities. We test how accurately the heuristic predicts people's choices, compared to previously proposed heuristics and three modifications of expected utility theory: security-potential/aspiration theory, transfer-of-attention-exchange model, and cumulative prospect theory. PMID:16637767

The application of Lean Six Sigma methodology to reduce the risk of healthcare-associated infections in surgery departments.

PubMed

Montella, Emma; Di Cicco, Maria Vincenza; Ferraro, Anna; Centobelli, Piera; Raiola, Eliana; Triassi, Maria; Improta, Giovanni

2017-06-01

Nowadays, the monitoring and prevention of healthcare-associated infections (HAIs) is a priority for the healthcare sector. In this article, we report on the application of the Lean Six Sigma (LSS) methodology to reduce the number of patients affected by sentinel bacterial infections who are at risk of HAI. The LSS methodology was applied in the general surgery department by using a multidisciplinary team of both physicians and academics. Data on more than 20 000 patients who underwent a wide range of surgical procedures between January 2011 and December 2014 were collected to conduct the study using the departmental information system. The most prevalent sentinel bacteria were determined among the infected patients. The preintervention (January 2011 to December 2012) and postintervention (January 2013 to December 2014) phases were compared to analyze the effects of the methodology implemented. The methodology allowed the identification of variables that influenced the risk of HAIs and the implementation of corrective actions to improve the care process, thereby reducing the percentage of infected patients. The improved process resulted in a 20% reduction in the average number of hospitalization days between preintervention and control phases, and a decrease in the mean (SD) number of days of hospitalization amounted to 36 (15.68), with a data distribution around 3 σ. The LSS is a helpful strategy that ensures a significant decrease in the number of HAIs in patients undergoing surgical interventions. The implementation of this intervention in the general surgery departments resulted in a significant reduction in both the number of hospitalization days and the number of patients affected by HAIs. This approach, together with other tools for reducing the risk of infection (surveillance, epidemiological guidelines, and training of healthcare personnel), could be applied to redesign and improve a wide range of healthcare processes. © 2016 John Wiley & Sons, Ltd.

[Research priorities and research topics for cardiovascular nursing: the Swiss Research Agenda for Nursing].

PubMed

Mahrer-Imhof, Romy; Imhof, Lorenz

2008-12-01

Cardiovascular diseases are worldwide a major challenge for the health care system and the number one reason for premature mortality and lost life years. Many accomplishments to reduce risk factors and improve treatment in acute and chronic disease and rehabilitation have been initiated by medical research but were also embraced by nursing research, which provided valuable knowledge about supporting risk factor modification and patients' self-management. Nursing research in the cardiovascular field has a long tradition in the US. In Europe cardiovascular nursing research also developed over the past decade, with increasing participation of Swiss nurse researchers. Efforts in this field of cardiovascular nursing have been made to convey projects in nursing research that help to enhance the health of the population sustainably and improve well-being in patients with acute and chronic courses of cardiovascular disease. Scientific knowledge is pivotal in developing evidence-based nursing interventions. Since both the German and the French speaking part of Switzerland have been lacking a literature-based and expert-supported agenda for nursing research, the aim of the Swiss Research Agenda for Nursing (SRAN) project was to develop an agenda providing researchers, funding agencies, and politics with orientation. This article takes the seven priorities of the SRAN project and links them to the topics of risk factor modification, rehabilitation programs, self-care, and patient education. The article presents the first agenda for cardiovascular nursing for the years 2007 to 2017. The agenda will serve to develop an action plan and to promote nursing research projects in the field of cardiovascular nursing in Switzerland.

National Priorities: Transdisciplinary Research into Detecting and Controlling Lead in Drinking Water

EPA Pesticide Factsheets

EPA seeks applications for research on identifying communities at high risk of adverse health effects of lead in drinking water, identifying opportunities to mitigate these risks, conduct efforts to inform interested parties of these risks & opportunities.

A macro environmental risk assessment methodology for establishing priorities among risks to human health and the environment in the Philippines

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

Gernhofer, S.; Oliver, T.J.; Vasquez, R.

1994-12-31

A macro environmental risk assessment (ERA) methodology was developed for the Philippine Department of Environment and Natural Resources (DENR) as part of the US Agency for International Development Industrial Environmental Management Project. The DENR allocates its limited resources to mitigate those environmental problems that pose the greatest threat to human health and the environment. The National Regional Industry Prioritization Strategy (NRIPS) methodology was developed as a risk assessment tool to establish a national ranking of industrial facilities. The ranking establishes regional and national priorities, based on risk factors, that DENR can use to determine the most effective allocation of itsmore » limited resources. NRIPS is a systematic framework that examines the potential risk to human health and the environment from hazardous substances released from a facility, and, in doing so, generates a relative numerical score that represents that risk. More than 3,300 facilities throughout the Philippines were evaluated successfully with the NRIPS.« less

Survey of Foods to Improve Logistic Support and Extend Mission Endurance of Submarines

DTIC Science & Technology

1981-12-01

lower priority. For example, in the computer run, Chicken , Frozen, Broiler -Fryer, Whole (National Stock Number (NSN) 8905-00-126-3416) is specified...Increase ration density 1 (Decrease Logistical costs 2 Reduce number of line items 3 Conserve onboard refrigeration space 4 i Reduce food service labor...selection priority is based primarily on the ability of the substitute item to achieve increased ration density , and each subsequent I criterion has a

Research Priorities for the Intersection of Alcohol and HIV/AIDS in Low and Middle Income Countries: A Priority Setting Exercise.

PubMed

Gordon, Sara; Rotheram-Borus, Mary Jane; Skeen, Sarah; Perry, Charles; Bryant, Kendall; Tomlinson, Mark

2017-11-01

The harmful use of alcohol is a component cause for more than 200 diseases. The association between alcohol consumption, risk taking behavior and a range of infectious diseases such as HIV/AIDS is well established. The prevalence of HIV/AIDS as well as harmful alcohol use in low and middle income countries is high. Alcohol has been identified as a modifiable risk factor in the prevention and treatment of HIV/AIDS. The objective of this paper is to define research priorities for the interaction of alcohol and HIV/AIDS in low and middle income countries. The Child Health and Nutrition Research Initiative (CHNRI) priority setting methodology was applied in order to assess research priorities of the interaction of alcohol and HIV/AIDS. A group of 171 global and local experts in the field of alcohol and or HIV/AIDS related research were identified and invited to generate research questions. This resulted in 205 research questions which have been categorized and refined by senior researchers into 48 research questions to be evaluated using five criteria: answerability, effectiveness, feasibility, applicability and impact, as well as equity. A total of 59 experts participated independently in the voluntary scoring exercise (a 34% response rate). There was substantial consensus among experts on priorities for research on alcohol and HIV. These tended to break down into two categories, those focusing on better understanding the nexus between alcohol and HIV and those directed towards informing practical interventions to reduce the impact of alcohol use on HIV treatment outcomes, which replicates what Bryant (Subst Use Misuse 41:1465-1507, 2006) and Parry et al. (Addiction 108:1-2, 2012) found. Responses from experts were stratified by location in order to determine any differences between groups. On average experts in the LMIC gave higher scores than the HIC experts. Recent research has shown the causal link between alcohol consumption and the incidence of HIV/AIDS including a better understanding of the pathways through which alcohol use affects ARV adherence (and other medications to treat opportunistic infections) and CD4 counts. The results of this process clearly indicated that the important priorities for future research related to the development and assessment of interventions focusing on addressing alcohol and HIV/AIDS, addressing and exploring the impact of HIV risk and comorbid alcohol use, as well as exploring the risk and protective factors in the field of alcohol and HIV/AIDS. The findings from this priority setting exercise could guide international research agenda and make research funding more effective in addressing the research on intersection of alcohol and HIV/AIDS.

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

PubMed Central

2012-01-01

Background Blood pressure, lipid, and glycemic control are essential for reducing cardiovascular disease (CVD) risk. Many health care systems have successfully shifted aspects of chronic disease management, including population-based outreach programs designed to address CVD risk factor control, to non-physicians. The purpose of this study is to evaluate provision of new information to non-physician outreach teams on need for treatment intensification in patients with increased CVD risk. Methods Cluster randomized trial (July 1-December 31, 2008) in Kaiser Permanente Northern California registry of members with diabetes mellitus, prior CVD diagnoses and/or chronic kidney disease who were high-priority for treatment intensification: blood pressure ≥ 140 mmHg systolic, LDL-cholesterol ≥ 130 mg/dl, or hemoglobin A1c ≥ 9%; adherent to current medications; no recent treatment intensification). Randomization units were medical center-based outreach teams (4 intervention; 4 control). For intervention teams, priority flags for intensification were added monthly to the registry database with recommended next pharmacotherapeutic steps for each eligible patient. Control teams used the same database without this information. Outcomes included 3-month rates of treatment intensification and risk factor levels during follow-up. Results Baseline risk factor control rates were high (82-90%). In eligible patients, the intervention was associated with significantly greater 3-month intensification rates for blood pressure (34.1 vs. 30.6%) and LDL-cholesterol (28.0 vs 22.7%), but not A1c. No effects on risk factors were observed at 3 months or 12 months follow-up. Intervention teams initiated outreach for only 45-47% of high-priority patients, but also for 27-30% of lower-priority patients. Teams reported difficulties adapting prior outreach strategies to incorporate the new information. Conclusions Information enhancement did not improve risk factor control compared to existing outreach strategies at control centers. Familiarity with prior, relatively successful strategies likely reduced uptake of the innovation and its potential for success at intervention centers. Trial registration ClinicalTrials.gov Identifier NCT00517686 PMID:22747998

Method and system for conserving power in a telecommunications network during emergency situations

DOEpatents

Conrad, Stephen H [Algodones, NM; O'Reilly, Gerard P [Manalapan, NJ

2011-10-11

Disclosed is a method and apparatus for conserving power in a telecommunications network during emergency situations. A permissible number list of emergency and/or priority numbers is stored in the telecommunications network. In the event of an emergency or power failure, input digits of a call to the telecommunications network are compared to the permissible number list. The call is processed in the telecommunications network and routed to its destination if the input digits match an entry in the permissible number list. The call is dropped without any further processing if the input digits do not match an entry in the permissible number list. Thus, power can be conserved in emergency situations by only allowing emergency and/or priority calls.

Relevance of Global Health Security to the US Export Economy.

PubMed

Cassell, Cynthia H; Bambery, Zoe; Roy, Kakoli; Meltzer, Martin I; Ahmed, Zara; Payne, Rebecca L; Bunnell, Rebecca E

To reduce the health security risk and impact of outbreaks around the world, the US Centers for Disease Control and Prevention and its partners are building capabilities to prevent, detect, and contain outbreaks in 49 global health security priority countries. We examine the extent of economic vulnerability to the US export economy posed by trade disruptions in these 49 countries. Using 2015 US Department of Commerce data, we assessed the value of US exports and the number of US jobs supported by those exports. US exports to the 49 countries exceeded $308 billion and supported more than 1.6 million jobs across all US states in agriculture, manufacturing, mining, oil and gas, services, and other sectors. These exports represented 13.7% of all US export revenue worldwide and 14.3% of all US jobs supported by all US exports. The economic linkages between the United States and these global health security priority countries illustrate the importance of ensuring that countries have the public health capacities needed to control outbreaks at their source before they become pandemics.

Relevance of Global Health Security to the US Export Economy

PubMed Central

Cassell, Cynthia H.; Bambery, Zoe; Roy, Kakoli; Meltzer, Martin I.; Ahmed, Zara; Payne, Rebecca L.

2017-01-01

To reduce the health security risk and impact of outbreaks around the world, the US Centers for Disease Control and Prevention and its partners are building capabilities to prevent, detect, and contain outbreaks in 49 global health security priority countries. We examine the extent of economic vulnerability to the US export economy posed by trade disruptions in these 49 countries. Using 2015 US Department of Commerce data, we assessed the value of US exports and the number of US jobs supported by those exports. US exports to the 49 countries exceeded $308 billion and supported more than 1.6 million jobs across all US states in agriculture, manufacturing, mining, oil and gas, services, and other sectors. These exports represented 13.7% of all US export revenue worldwide and 14.3% of all US jobs supported by all US exports. The economic linkages between the United States and these global health security priority countries illustrate the importance of ensuring that countries have the public health capacities needed to control outbreaks at their source before they become pandemics. PMID:29199867

Risk-Screening Environmental Indicators (RSEI)

EPA Pesticide Factsheets

EPA's Risk-Screening Environmental Indicators (RSEI) is a geographically-based model that helps policy makers and communities explore data on releases of toxic substances from industrial facilities reporting to EPA??s Toxics Release Inventory (TRI). By analyzing TRI information together with simplified risk factors, such as the amount of chemical released, its fate and transport through the environment, each chemical??s relative toxicity, and the number of people potentially exposed, RSEI calculates a numeric score, which is designed to only be compared to other scores calculated by RSEI. Because it is designed as a screening-level model, RSEI uses worst-case assumptions about toxicity and potential exposure where data are lacking, and also uses simplifying assumptions to reduce the complexity of the calculations. A more refined assessment is required before any conclusions about health impacts can be drawn. RSEI is used to establish priorities for further investigation and to look at changes in potential impacts over time. Users can save resources by conducting preliminary analyses with RSEI.

Irrigation, risk aversion, and water right priority under water supply uncertainty

PubMed Central

Xu, Wenchao; Rosegrant, Mark W.

2017-01-01

Abstract This paper explores the impacts of a water right's allocative priority—as an indicator of farmers' risk‐bearing ability—on land irrigation under water supply uncertainty. We develop and use an economic model to simulate farmers' land irrigation decision and associated economic returns in eastern Idaho. Results indicate that the optimal acreage of land irrigated increases with water right priority when hydroclimate risk exhibits a negatively skewed or right‐truncated distribution. Simulation results suggest that prior appropriation enables senior water rights holders to allocate a higher proportion of their land to irrigation, 6 times as much as junior rights holders do, creating a gap in the annual expected net revenue reaching up to $141.4 acre−1 or $55,800 per farm between the two groups. The optimal irrigated acreage, expected net revenue, and shadow value of a water right's priority are subject to substantial changes under a changing climate in the future, where temporal variation in water supply risks significantly affects the profitability of agricultural land use under the priority‐based water sharing mechanism. PMID:29200529

Three years experience with forward-site mass casualty triage-, evacuation-, operating room-, ICU-, and radiography-enabled disaster vehicles: development of usage strategies from drills and deployments.

PubMed

Griffiths, Jane L; Kirby, Neil R; Waterson, James A

2014-01-01

Delineation of the advantages and problems related to the use of forward-site operating room-, Intensive Care Unit (ICU)-, radiography-, and mass casualty-enabled disaster vehicles for site evacuation, patient stabilization, and triage. The vehicles discussed have six ventilated ICU spaces, two ORs, on-site radiography, 21 intermediate acuity spaces with stretchers, and 54 seated minor acuity spaces. Each space has piped oxygen with an independent vehicle-loaded supply. The vehicles are operated by the Dubai Corporate Ambulance Services. Their support hospital is the main trauma center for the Emirate of Dubai and provides the vehicles' surgical, intensivist, anesthesia, and nursing staff. The disaster vehicles have been deployed 264 times in the last 5 years (these figures do not include deployments for drills). Introducing this new service required extensive initial planning and ongoing analysis of the performance of the disaster vehicles that offer ambulance services and receiving hospitals a large array of possibilities in terms of triage, stabilization of priority I and II patients, and management of priority III patients. In both drills and in disasters, the vehicles were valuable in forward triage and stabilization and in the transport of large numbers of priority III patients. This has avoided the depletion of emergency transport available for priority I and II patients. The successful utilization of disaster vehicles requires seamless cooperation between the hospital staffing the vehicles and the ambulance service deploying them. They are particularly effective during preplanned deployments to high-risk situations. These vehicles also potentially provide self-sufficient refuges for forward teams in hostile environments.

Failure mode and effects analysis: too little for too much?

PubMed

Dean Franklin, Bryony; Shebl, Nada Atef; Barber, Nick

2012-07-01

Failure mode and effects analysis (FMEA) is a structured prospective risk assessment method that is widely used within healthcare. FMEA involves a multidisciplinary team mapping out a high-risk process of care, identifying the failures that can occur, and then characterising each of these in terms of probability of occurrence, severity of effects and detectability, to give a risk priority number used to identify failures most in need of attention. One might assume that such a widely used tool would have an established evidence base. This paper considers whether or not this is the case, examining the evidence for the reliability and validity of its outputs, the mathematical principles behind the calculation of a risk prioirty number, and variation in how it is used in practice. We also consider the likely advantages of this approach, together with the disadvantages in terms of the healthcare professionals' time involved. We conclude that although FMEA is popular and many published studies have reported its use within healthcare, there is little evidence to support its use for the quantitative prioritisation of process failures. It lacks both reliability and validity, and is very time consuming. We would not recommend its use as a quantitative technique to prioritise, promote or study patient safety interventions. However, the stage of FMEA involving multidisciplinary mapping process seems valuable and work is now needed to identify the best way of converting this into plans for action.

Identifying high-risk small business industries for occupational safety and health interventions.

PubMed

Okun, A; Lentz, T J; Schulte, P; Stayner, L

2001-03-01

Approximately one-third (32%) of U.S. workers are employed in small business industries (those with 80% of workers in establishments with fewer than 100 employees), and approximately 53 million persons in private industry work in small business establishments. This study was performed to identify small business industries at high risk for occupational injuries, illnesses, and fatalities. Small business industries were identified from among all three- and four-digit Standard Industrial Classification (SIC) codes and ranked using Bureau of Labor Statistics (BLS) data by rates and numbers of occupational injuries, illnesses, and fatalities. Both incidence rates and number of injury, illness, and fatality cases were evaluated. The 253 small business industries identified accounted for 1,568 work-related fatalities (34% of all private industry). Transportation incidents and violent acts were the leading causes of these fatalities. Detailed injury and illness data were available for 105 small business industries, that accounted for 1,476,400 work-related injuries, and 55,850 occupational illnesses. Many of the small business industries had morbidity and mortality rates exceeding the average rates for all private industry. The highest risk small business industries, based on a combined morbidity and mortality index, included logging, cut stone and stone products, truck terminals, and roofing, siding, and sheet metal work. Identification of high-risk small business industries indicates priorities for those interested in developing targeted prevention programs.

Setting conservation priorities.

PubMed

Wilson, Kerrie A; Carwardine, Josie; Possingham, Hugh P

2009-04-01

A generic framework for setting conservation priorities based on the principles of classic decision theory is provided. This framework encapsulates the key elements of any problem, including the objective, the constraints, and knowledge of the system. Within the context of this framework the broad array of approaches for setting conservation priorities are reviewed. While some approaches prioritize assets or locations for conservation investment, it is concluded here that prioritization is incomplete without consideration of the conservation actions required to conserve the assets at particular locations. The challenges associated with prioritizing investments through time in the face of threats (and also spatially and temporally heterogeneous costs) can be aided by proper problem definition. Using the authors' general framework for setting conservation priorities, multiple criteria can be rationally integrated and where, how, and when to invest conservation resources can be scheduled. Trade-offs are unavoidable in priority setting when there are multiple considerations, and budgets are almost always finite. The authors discuss how trade-offs, risks, uncertainty, feedbacks, and learning can be explicitly evaluated within their generic framework for setting conservation priorities. Finally, they suggest ways that current priority-setting approaches may be improved.

Perspectives for food research and European collaboration in the European Research Area and the new Framework Programme.

PubMed

Breslin, L

2001-08-01

Since 1987, successive framework programmes have contributed to strengthen European food research through the establishment of networks between research institutions, universities and companies from various European countries. In the FAIR programme (1994-1998), 118 research projects comprising nearly 1,000 participants from the European Union and Associated States have been supported in the food area with a European funding of about [symbol: see text] 108 million. Within the Quality of Life and Management of Living Resources programme (1998-2002), food research is mostly supported within the key action 'food, nutrition and health' with a budget of [symbol: see text] 290 million. After the first four deadlines, 735 eligible research proposals have already been received. Further to their evaluation by a panel of independent experts, 108 proposals have been funded or selected for funding representing a total contribution of about [symbol: see text] 168 million. Among those, several clusters of projects are now running on important topics such as probiotics, coeliac diseases, mycotoxins, GMO, safety and food for the elderly. In addition, technology stimulation measures are largely benefiting SMEs to foster their innovation potential. In January 2000, the European Commission adopted a Communication entitled "Towards the European Research Area (ERA)" with the objective to contribute to developing better framework conditions for research in Europe. On 21 February 2001, the Commission adopted proposals to be submitted to the European Parliament and Council for the next framework programme for research and innovation (2002-2006). The new framework programme that is becoming one of the financial instruments of the ERA aims at catalysing the integration of European research by: strengthening of links between the Community research effort and national and regional research policies; concentrating on a limited number of priority fields or research to which activities at the Union level can add real value. One of the seven priority areas, entitled 'food safety and health risks', is intended to help establish the integrated scientific and technological bases needed to develop a system of production and distribution of safe and healthy food and control food-related risks, relying in particular on biotechnology tools, as well as health risks associated with environmental changes. A total budget of [symbol: see text] 600 million is proposed for this priority. In the priority areas, the new framework programme will work mainly by supporting the development of cooperation within networks of excellence bringing together the best research capabilities in Europe's regions to conduct common research programmes and integrated projects involving public and private partners, with clearly stated scientific and technological objectives.

Process-based quality management for clinical implementation of adaptive radiotherapy

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

Noel, Camille E.; Santanam, Lakshmi; Parikh, Parag J.

Purpose: Intensity-modulated adaptive radiotherapy (ART) has been the focus of considerable research and developmental work due to its potential therapeutic benefits. However, in light of its unique quality assurance (QA) challenges, no one has described a robust framework for its clinical implementation. In fact, recent position papers by ASTRO and AAPM have firmly endorsed pretreatment patient-specific IMRT QA, which limits the feasibility of online ART. The authors aim to address these obstacles by applying failure mode and effects analysis (FMEA) to identify high-priority errors and appropriate risk-mitigation strategies for clinical implementation of intensity-modulated ART. Methods: An experienced team of twomore » clinical medical physicists, one clinical engineer, and one radiation oncologist was assembled to perform a standard FMEA for intensity-modulated ART. A set of 216 potential radiotherapy failures composed by the forthcoming AAPM task group 100 (TG-100) was used as the basis. Of the 216 failures, 127 were identified as most relevant to an ART scheme. Using the associated TG-100 FMEA values as a baseline, the team considered how the likeliness of occurrence (O), outcome severity (S), and likeliness of failure being undetected (D) would change for ART. New risk priority numbers (RPN) were calculated. Failures characterized by RPN ≥ 200 were identified as potentially critical. Results: FMEA revealed that ART RPN increased for 38% (n = 48/127) of potential failures, with 75% (n = 36/48) attributed to failures in the segmentation and treatment planning processes. Forty-three of 127 failures were identified as potentially critical. Risk-mitigation strategies include implementing a suite of quality control and decision support software, specialty QA software/hardware tools, and an increase in specially trained personnel. Conclusions: Results of the FMEA-based risk assessment demonstrate that intensity-modulated ART introduces different (but not necessarily more) risks than standard IMRT and may be safely implemented with the proper mitigations.« less

Process-based quality management for clinical implementation of adaptive radiotherapy

PubMed Central

Noel, Camille E.; Santanam, Lakshmi; Parikh, Parag J.; Mutic, Sasa

2014-01-01

Purpose: Intensity-modulated adaptive radiotherapy (ART) has been the focus of considerable research and developmental work due to its potential therapeutic benefits. However, in light of its unique quality assurance (QA) challenges, no one has described a robust framework for its clinical implementation. In fact, recent position papers by ASTRO and AAPM have firmly endorsed pretreatment patient-specific IMRT QA, which limits the feasibility of online ART. The authors aim to address these obstacles by applying failure mode and effects analysis (FMEA) to identify high-priority errors and appropriate risk-mitigation strategies for clinical implementation of intensity-modulated ART. Methods: An experienced team of two clinical medical physicists, one clinical engineer, and one radiation oncologist was assembled to perform a standard FMEA for intensity-modulated ART. A set of 216 potential radiotherapy failures composed by the forthcoming AAPM task group 100 (TG-100) was used as the basis. Of the 216 failures, 127 were identified as most relevant to an ART scheme. Using the associated TG-100 FMEA values as a baseline, the team considered how the likeliness of occurrence (O), outcome severity (S), and likeliness of failure being undetected (D) would change for ART. New risk priority numbers (RPN) were calculated. Failures characterized by RPN ≥ 200 were identified as potentially critical. Results: FMEA revealed that ART RPN increased for 38% (n = 48/127) of potential failures, with 75% (n = 36/48) attributed to failures in the segmentation and treatment planning processes. Forty-three of 127 failures were identified as potentially critical. Risk-mitigation strategies include implementing a suite of quality control and decision support software, specialty QA software/hardware tools, and an increase in specially trained personnel. Conclusions: Results of the FMEA-based risk assessment demonstrate that intensity-modulated ART introduces different (but not necessarily more) risks than standard IMRT and may be safely implemented with the proper mitigations. PMID:25086527

Process-based quality management for clinical implementation of adaptive radiotherapy.

PubMed

Noel, Camille E; Santanam, Lakshmi; Parikh, Parag J; Mutic, Sasa

2014-08-01

Intensity-modulated adaptive radiotherapy (ART) has been the focus of considerable research and developmental work due to its potential therapeutic benefits. However, in light of its unique quality assurance (QA) challenges, no one has described a robust framework for its clinical implementation. In fact, recent position papers by ASTRO and AAPM have firmly endorsed pretreatment patient-specific IMRT QA, which limits the feasibility of online ART. The authors aim to address these obstacles by applying failure mode and effects analysis (FMEA) to identify high-priority errors and appropriate risk-mitigation strategies for clinical implementation of intensity-modulated ART. An experienced team of two clinical medical physicists, one clinical engineer, and one radiation oncologist was assembled to perform a standard FMEA for intensity-modulated ART. A set of 216 potential radiotherapy failures composed by the forthcoming AAPM task group 100 (TG-100) was used as the basis. Of the 216 failures, 127 were identified as most relevant to an ART scheme. Using the associated TG-100 FMEA values as a baseline, the team considered how the likeliness of occurrence (O), outcome severity (S), and likeliness of failure being undetected (D) would change for ART. New risk priority numbers (RPN) were calculated. Failures characterized by RPN ≥ 200 were identified as potentially critical. FMEA revealed that ART RPN increased for 38% (n = 48/127) of potential failures, with 75% (n = 36/48) attributed to failures in the segmentation and treatment planning processes. Forty-three of 127 failures were identified as potentially critical. Risk-mitigation strategies include implementing a suite of quality control and decision support software, specialty QA software/hardware tools, and an increase in specially trained personnel. Results of the FMEA-based risk assessment demonstrate that intensity-modulated ART introduces different (but not necessarily more) risks than standard IMRT and may be safely implemented with the proper mitigations.

Setting priorities for surveillance, prevention, and control of zoonoses in Bogotá, Colombia.

PubMed

Cediel, Natalia; Villamil, Luis Carlos; Romero, Jaime; Renteria, Libardo; De Meneghi, Daniele

2013-05-01

To establish priorities for zoonoses surveillance, prevention, and control in Bogotá, Colombia. A Delphi panel of experts in veterinary and human medicine was conducted using a validated prioritization method to assess the importance of 32 selected zoonoses. This exercise was complemented by a questionnaire survey, using the knowledge, attitudes, and practices (KAP) methodology, administered in 19 districts of Bogotá from September 2009 to April 2010 to an at-risk population (workers at veterinary clinics; pet shops; butcher shops; and traditional food markets that sell poultry, meat, cheese, and eggs). A risk indicator based on level of knowledge about zoonoses was constructed using categorical principal component and logistic regression analyses. Twelve experts participated in the Delphi panel. The diseases scored as highest priority were: influenza A(H1N1), salmonellosis, Escherichia coli infection, leptospirosis, and rabies. The diseases scored as lowest priority were: ancylostomiasis, scabies, ringworm, and trichinellosis. A total of 535 questionnaires were collected and analyzed. Respondents claimed to have had scabies (21%), fungi (8%), brucellosis (8%), and pulicosis (8%). Workers with the most limited knowledge on zoonoses and therefore the highest health risk were those who 1) did not have a professional education, 2) had limited or no zoonoses prevention training, and 3) worked in Usme, Bosa, or Ciudad Bolívar districts. According to the experts, influenza A(H1N1) was the most important zoonoses. Rabies, leptospirosis, brucellosis, and toxoplasmosis were identified as priority diseases by both the experts and the exposed workers. This is the first prioritization exercise focused on zoonoses surveillance, prevention, and control in Colombia. These results could be used to guide decision-making for resource allocation in public health.

Trends and priorities in occupational health research and knowledge transfer in Italy.

PubMed

Rondinone, Bruna Maria; Boccuni, Fabio; Iavicoli, Sergio

2010-06-01

In 2000-2001, the Italian National Institute for Occupational Safety and Prevention (ISPESL) carried out a survey to identify the research priorities in the field of occupational safety and health (OSH). The present study, carried out in 2007-2008, was a follow-up designed to (i) review the themes identified earlier, (ii) detect emerging issues linked to new risks and forms of work, and (iii) look for any shifts in focus. The survey was extended to cover not only research but also the concept of knowledge transfer. In the first round, ISPESL distributed questionnaires to the heads of both university occupational medicine departments and prevention departments in local national health units (known as ASL in Italy) asking respondents to identify OSH priority themes. In the latest survey covering both research and the need for knowledge transfer, the same experts were asked to rank the importance of the earlier-identified topics and list any emerging issues in the OSH field. The two most important themes identified were "work accidents" and "occupational carcinogenesis". In the overall sample and among ASL experts, they received the 1st and 2nd highest mean scores. The university respondents also prioritized them but in reverse order. Some of the new priority topics included: risks associated with nanotechnologies; assessment of psychosocial and organizational risks; migration and work; and cost-benefit analysis of prevention. In light of the findings, efforts are urgently needed to identify research and knowledge transfer priorities related to workers' health and safety on an international scale using a standardized method in order to obtain comparable results, avoid wasteful duplication of resources, and reduce occupational accidents and illness.

Exploring Citizen Infrastructure and Environmental Priorities in Mumbai, India

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

Sperling, Joshua; Romero-Lankao, Patricia; Beig, Gufran

Many cities worldwide seek to understand local policy priorities among their general populations. This study explores how differences in local conditions and among citizens within and across Mumbai, India shape local infrastructure (e.g. energy, water, transport) and environmental (e.g. managing pollution, climate-related extreme weather events) policy priorities for change that may or may not be aligned with local government action or global environmental sustainability concerns such as low-carbon development. In this rapidly urbanizing city, multiple issues compete for prominence, ranging from improved management of pollution and extreme weather to energy and other infrastructure services. To inform a broader perspective ofmore » policy priorities for urban development and risk mitigation, a survey was conducted among over 1200 citizens. The survey explored the state of local conditions, the challenges citizens face, and the ways in which differences in local conditions (socio-institutional, infrastructure, and health-related) demonstrate inequities and influence how citizens perceive risks and rank priorities for the future design and implementation of local planning, policy, and community-based efforts. With growing discussion and tensions surrounding the new urban sustainable development goal, announced by the UN in late September 2015, and a new global urban agenda document to be agreed upon at 'Habitat III', issues on whether sustainable urbanization priorities should be set at the international, national or local level remain controversial. As such, this study aims to first understand determinants of and variations in local priorities across one city, with implications discussed for local-to-global urban sustainability. Findings from survey results indicate the determinants and variation in conditions such as age, assets, levels of participation in residential action groups, the health outcome of chronic asthma, and the infrastructure service of piped water provision to homes are significant in shaping the top infrastructure and environmental policy priorities that include water supply and sanitation, air pollution, waste, and extreme heat.« less

Priority service needs and receipt across the lifespan for individuals with autism spectrum disorder

PubMed Central

Lai, Jonathan K. Y.

2017-01-01

Abstract Individuals with Autism Spectrum Disorder (ASD) have a range of health, community, and social support needs across the lifespan that create age‐specific challenges in navigating service sectors. In this study, we set out to identify the priority needs of individuals with ASD across the lifespan, and the factors that predict receiving priority services. Participants included 3,317 individuals with ASD from a Canada‐wide online caregiver survey, stratified into five age groups (preschool, elementary school age, adolescence, emerging adulthood, adulthood). Priority receipt was calculated as a ratio of current services that corresponded to individualized priority need. Age‐stratified Poisson regression analyses were used to identify the sociodemographic, clinical and systemic predictors of priority receipt. Results indicate that the distribution of priority need varied by age, except for social skills programming, which was a high across all groups. The number of high and moderate priority needs diversified with age. Overall, 30% of individuals had none of their priority needs met and priority receipt decreased with age. Systemic factors were most consistently related to priority receipt across the lifespan. Understanding patterns and correlates of priority needs and use that currently exist in different age groups can inform policies to improve service access. Autism Res 2017, 10: 1436–1447. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. PMID:28383156

Working towards an integrated land contamination management framework for Nigeria.

PubMed

Sam, Kabari; Coulon, Frédéric; Prpich, George

2016-11-15

Over the past five decades, Nigeria has developed a number of contaminated land legislations to address the damage caused primarily by oil and gas exploitation activities. Within these legislations exists elements of risk assessment and risk-based corrective action. Despite this progress, we argue that contaminated land management approaches in Nigeria need further development to be able to integrate new scientific information, and to address environmental, economic, and social values. By comparison, advanced contaminated land regimes in the United Kingdom (UK), the Netherlands, Australia, New Zealand, and the United States of America (USA) apply a number of integrative approaches (e.g. sustainability appraisal, liability regime, funding mechanisms, technology demonstration) that enable them to meet the environmental, economic, and social needs of their populations. In comparison, Nigerian governance lacks many of these mechanisms and management of contaminated land is ad hoc. In this paper we propose an integrated risk assessment framework for Nigeria that incorporates the principles of sustainability and stakeholder engagement into the decision-making processes for contaminated land risk assessment and risk management. The integrated approach relies on transparency to promote acceptance and build trust in institutions, and uses stakeholder engagement to address data deficiencies. We conclude this paper with a roadmap for how Nigeria might implement such an integrative approach into their existing contaminated land regulatory system, as well as identify a series of policy priorities that should be addressed. Copyright © 2016 Elsevier B.V. All rights reserved.

Method ranks competing projects by priorities, risk. [A method to help prioritize oil and gas pipeline project goals

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

Moeckel, D.R.

A practical, objective guide for ranking projects based on risk-based priorities has been developed by Sun Pipe Line Co. The deliberately simple system guides decisions on how to allocate scarce company resources because all managers employ the same criteria in weighing potential risks to the company versus benefits. Managers at all levels are continuously having to comply with an ever growing amount of legislative and regulatory requirements while at the same time trying to run their businesses effectively. The system primarily is designed for use as a compliance oversight and tracking process to document, categorize, and follow-up on work concerningmore » various issues or projects. That is, the system consists of an electronic database which is updated periodically, and is used by various levels of management to monitor progress of health, safety, environmental and compliance-related projects. Criteria used in determining a risk factor and assigning a priority also have been adapted and found useful for evaluating other types of projects. The process enables management to better define potential risks and/or loss of benefits that are being accepted when a project is rejected from an immediate work plan or budget. In times of financial austerity, it is extremely important that the right decisions are made at the right time.« less

75 FR 77642 - Priority Setting for the Children's Health Insurance Program Reauthorization Act (CHIPRA...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Priority Setting for the Children's Health Insurance Program Reauthorization Act (CHIPRA) Pediatric Quality Measures Program--Notice of Correction On pages 75469 and 75470, Volume 75, Number 232, Federal Register...

A prioritization of generic safety issues. Supplement 19, Revision insertion instructions

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

None

1995-11-01

The report presents the safety priority ranking for generic safety issues related to nuclear power plants. The purpose of these rankings is to assist in the timely and efficient allocation of NRC resources for the resolution of those safety issues that have a significant potential for reducing risk. The safety priority rankings are HIGH, MEDIUM, LOW, and DROP, and have been assigned on the basis of risk significance estimates, the ratio of risk to costs and other impacts estimated to result if resolution of the safety issues were implemented, and the consideration of uncertainties and other quantitative or qualitative factors.more » To the extent practical, estimates are quantitative. This document provides revisions and amendments to the report.« less

Italian Euromelanoma Day Screening Campaign (2005-2007) and the planning of melanoma screening strategies.

PubMed

Seidenari, Stefania; Benati, Elisa; Ponti, Giovanni; Borsari, Stefania; Ferrari, Chiara; Albertini, Giuseppe; Altomare, Gianfranco; Arcangeli, Fabio; Aste, Nicola; Bernengo, Maria Grazia; Bongiorno, Maria Rita; Borroni, Giovanni; Calvieri, Stefano; Chimenti, Sergio; Cusano, Francesco; Fracchiolla, Claudio; Gaddoni, Giuseppe; Girolomoni, Giampiero; Guarneri, Biagio; Lanzoni, Anna; Lombardi, Mara; Lotti, Torello; Mariotti, Antonio; Marsili, Franco; Micali, Giuseppe; Parodi, Aurora; Peris, Ketty; Peserico, Andrea; Quaglino, Pietro; Santini, Marcello; Schiavon, Sergio; Tonino, Camillo; Trevisan, Giusto; Tribuzi, Paola; Valentini, Paolo; Vena, Gino A; Virgili, Annarosa

2012-01-01

Although no study has definitively shown that unfocused screening of skin cancer is effective, many campaigns have been organized with the aim of increasing awareness on melanoma risk factors. The objective of this study was to analyse the results of the Skin Cancer Screening Day in Italy during the period 2005-2007, to determine the priorities for melanoma control plans in a Mediterranean country. A total of 5002 patients were screened by dermatologists in 31 cities. Individuals who considered themselves to have many naevi and those with a family history of melanoma showed a higher number of common and atypical naevi. Ten melanomas, 20 basal cell carcinomas and two squamous cell carcinomas were histopathologically confirmed. Our observations provide the following suggestions for melanoma prevention strategies: (a) an unfocused campaign is suitable to inform the public about the importance of self-examination of the skin, but is not useful to identify a larger number of melanomas; and (b) melanoma screening campaigns should focus on a selected population, which meets rigorous risk criteria to maintain higher cost-effectiveness. The financial support to effective melanoma screening programmes could be increased, especially in southern populations where lower levels of self-surveillance and socioeconomic conditions represent risk factors for late identification of melanoma.

The impact of fragility fracture and approaches to osteoporosis risk assessment worldwide

PubMed Central

Curtis, Elizabeth M; Moon, Rebecca J; Harvey, Nicholas C; Cooper, Cyrus

2017-01-01

Osteoporosis constitutes a major public health problem, through its association with age-related fractures, particularly of the hip, vertebrae, distal forearm and humerus. Substantial geographic variation has been noted in the incidence of osteoporotic fractures worldwide, with Western populations (North America, Europe and Oceania), reporting increases in hip fracture throughout the second half of the 20th century, with a stabilisation or decline in the last two decades. In developing populations however, particularly in Asia, the rates of osteoporotic fracture appears to be increasing. The massive global burden consequent to osteoporosis means that fracture risk assessment should be a high priority amongst health measures considered by policy makers. The WHO operational definition of osteoporosis, based on a measurement of bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA), has been used globally since the mid-1990s. However, although this definition identifies those at greatest individual risk of fracture, in the population overall a greater total number of fractures occur in individuals with BMD values above threshold for osteoporosis diagnosis. A number of web-based tools to enable the inclusion of clinical risk factors, with or without BMD, in fracture prediction algorithms have been developed to improve the identification of individuals at high fracture risk, the most commonly used globally being FRAX®. Access to DXA, osteoporosis risk assessment, case finding and treatment varies worldwide, but despite such advances studies indicate that a minority of men and women at high fracture risk receive treatment. Importantly, research is ongoing to demonstrate the clinical efficacy and cost-effectiveness of osteoporosis case finding and risk assessment strategies worldwide. The huge burden caused by osteoporosis related fractures to individuals, healthcare systems and societies should provide a clear impetus for the progression of such approaches. PMID:28119181

The impact of fragility fracture and approaches to osteoporosis risk assessment worldwide

PubMed Central

Curtis, Elizabeth M; Moon, Rebecca J; Harvey, Nicholas C; Cooper, Cyrus

2017-01-01

Osteoporosis constitutes a major public health problem, through its association with age-related fractures, particularly of the hip, vertebrae, distal forearm and humerus. Substantial geographic variation has been noted in the incidence of osteoporotic fractures worldwide, with Western populations (North America, Europe and Oceania), reporting increases in hip fracture throughout the second half of the 20th century, with a stabilisation or decline in the last two decades. In developing populations however, particularly in Asia, the rates of osteoporotic fracture appears to be increasing. The massive global burden consequent to osteoporosis means that fracture risk assessment should be a high priority amongst health measures considered by policy makers. The WHO operational definition of osteoporosis, based on a measurement of bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA), has been used globally since the mid-1990s. However, although this definition identifies those at greatest individual risk of fracture, in the population overall a greater total number of fractures occur in individuals with BMD values above threshold for osteoporosis diagnosis. A number of web-based tools to enable the inclusion of clinical risk factors, with or without BMD, in fracture prediction algorithms have been developed to improve the identification of individuals at high fracture risk, the most commonly used globally being FRAX®. Access to DXA, osteoporosis risk assessment, case finding and treatment varies worldwide, but despite such advances studies indicate that a minority of men and women at high fracture risk receive treatment. Importantly, research is ongoing to demonstrate the clinical efficacy and cost-effectiveness of osteoporosis case finding and risk assessment strategies worldwide. The huge burden caused by osteoporosis related fractures to individuals, healthcare systems and societies should provide a clear impetus for the progression of such approaches. PMID:28578992

Towards a harmonized approach for risk assessment of genotoxic carcinogens in the European Union.

PubMed

Crebelli, Riccardo

2006-01-01

The EU Scientific Committees have considered in the past the use of matematical models for human cancer risk estimation not adequately supported by the available scientific knowledge. Therefore, the advice given to risk managers was to reduce the exposure as far as possible, following the as low as reasonably achievable (ALARA) principle. However, ALARA does not allow to set priorities for risk management, as it does not take into consideration carcinogenic potency and level of human exposure. For this reason the European Food Safety Authority (EFSA) has identified as a priority task the development of a transparent, scientically justifiable and harmonized approach for risk assessment of genotoxic carcinogens. This approach, proposed at the end of 2005, is based on the definition of the (MOE), i.e. the relationship between a given point of the dose reponse curve in the animal and human exposure. As point of comparison EFSA recommends the BMDL10, i.e. the lower limit of the confidence interval of the Benchmark Dose associated with an incidence of 10% of induced tumors. Based on current scientific knowkedge, EFSA concluded that a MOE of 10000 or greater is associated with a low risk and low priority for risk management actions. The approach proposed does not replace the ALARA. It should find application on food contaminants, process by-product, and other substances unintentionally present in food. On the other hand, it is not intended to provide a tool for the definition of tolerable intake levels for genotoxic carcinogens deliberately added to food.

Risk assessment [Chapter 9

Treesearch

Dennis S. Ojima; Louis R. Iverson; Brent L. Sohngen; James M. Vose; Christopher W. Woodall; Grant M. Domke; David L. Peterson; Jeremy S. Littell; Stephen N. Matthews; Anantha M. Prasad; Matthew P. Peters; Gary W. Yohe; Megan M. Friggens

2014-01-01

What is "risk" in the context of climate change? How can a "risk-based framework" help assess the effects of climate change and develop adaptation priorities? Risk can be described by the likelihood of an impact occurring and the magnitude of the consequences of the impact (Yohe 2010) (Fig. 9.1). High-magnitude impacts are always...

Prioritizing strategies for comprehensive liver cancer control in Asia: a conjoint analysis.

PubMed

Bridges, John F P; Dong, Liming; Gallego, Gisselle; Blauvelt, Barri M; Joy, Susan M; Pawlik, Timothy M

2012-10-30

Liver cancer is a complex and burdensome disease, with Asia accounting for 75% of known cases. Comprehensive cancer control requires the use of multiple strategies, but various stakeholders may have different views as to which strategies should have the highest priority. This study identified priorities across multiple strategies for comprehensive liver cancer control (CLCC) from the perspective of liver cancer clinical, policy, and advocacy stakeholders in China, Japan, South Korea and Taiwan. Concordance of priorities was assessed across the region and across respondent roles. Priorities for CLCC were examined as part of a cross-sectional survey of liver cancer experts. Respondents completed several conjoint-analysis choice tasks to prioritize 11 strategies. In each task, respondents judged which of two competing CLCC plans, consisting of mutually exclusive and exhaustive subsets of the strategies, would have the greatest impact. The dependent variable was the chosen plan, which was then regressed on the strategies of different plans. The restricted least squares (RLS) method was utilized to compare aggregate and stratified models, and t-tests and Wald tests were used to test for significance and concordance, respectively. Eighty respondents (69.6%) were eligible and completed the survey. Their primary interests were hepatitis (26%), hepatocellular carcinoma (HCC) (58%), metastatic liver cancer (10%) and transplantation (6%). The most preferred strategies were monitoring at-risk populations (p<0.001), clinician education (p<0.001), and national guidelines (p<0.001). Most priorities were concordant across sites except for three strategies: transplantation infrastructure (p=0.009) was valued lower in China, measuring social burden (p=0.037) was valued higher in Taiwan, and national guidelines (p=0.025) was valued higher in China. Priorities did not differ across stakeholder groups (p=0.438). Priorities for CLCC in Asia include monitoring at-risk populations, clinician education, national guidelines, multidisciplinary management, public awareness and centers of excellence. As most priorities are relatively concordant across the region, multilateral approaches to addressing comprehensive liver cancer would be beneficial. However, where priorities are discordant among sites, such as transplantation infrastructure, strategies should be tailored to local needs.

[Cardiovascular disease prevention and health promotion in the French speaking community of Belgium].

PubMed

Coppieters, Y; Béduwé, C; Collignon, J L; Hubens, V; Levêque, A

2010-01-01

Cardiovascular diseases remain the first cause of mortality in Belgium and are a priority for the Five-year program of health promotion in the French speaking Community. It is declined in operational programs by priority thematics, including the heart health. With this framework, it appeared necessary to operationalize cardiovascular priorities. A process of systemic and participative planning was set up in order to seek operational strategies and actions, and to cover the whole population and actors concerned with these health problems. The various cardiovascular risk factors, which potentiate one another, are approached together and in a global way. Upstream to the risk factors, social health determinants play an important role in cardiovascular diseases and others diseases like cancers. Tracking cardiovascular risk factors among people 30 to 75 years is also proposed. It makes it possible to identify people at risk and to put forward individual and adapted measures. The plan integrates actions of health promotion (acting on the health determinants and factors which influence them) as well as actions aiming at improving tracking and the accompaniment of the patients in secondary and tertiary prevention. Actions on health determinants and the factors influencing them present moreover the advantage of being often common to many chronic diseases.

Increasing access by priority populations to Australian sexual health clinics.

PubMed

Ali, Hammad; Donovan, Basil; Fairley, Christopher K; Chen, Marcus Y; O'Connor, Catherine C; Grulich, Andrew E; McNulty, Anna; Ryder, Nathan; Hellard, Margaret E; Guy, Rebecca J

2013-10-01

Data from a network of 35 Australian sexual health clinics, in geographically diverse locations, showed that the number and proportion of patients from priority populations (ie, young people, men who have sex with men, indigenous people, and female sex workers) increased significantly between 2004 and 2011.

Decision Making for the Environment: Social and Behavioral Science Research Priorities

ERIC Educational Resources Information Center

Brewer, Garry D., Ed.; Stern, Paul C., Ed.

2005-01-01

With the growing number, complexity, and importance of environmental problems come demands to include a full range of intellectual disciplines and scholarly traditions to help define and eventually manage such problems more effectively. "Decision Making for the Environment: Social and Behavioral Science Research Priorities" is the result…

78 FR 13600 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Traumatic Brain...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-28

... designs. The research must focus on outcomes in one or more of the following domains identified in NIDRR's... Rehabilitation Research--Traumatic Brain Injury Model Systems Centers Collaborative Research Project [CFDA Number... Services proposes a priority under the Disability and Rehabilitation Research Projects and Centers Program...

Gore's Controversial Priorities for Higher Education.

ERIC Educational Resources Information Center

Gose, Ben

2000-01-01

Evaluates presidential candidate Al Gore's priorities for higher education, noting criticism by some educators of his emphasis on benefits for the middle class and the large number of specific proposals he has offered, including the College Opportunity Tax Cut, 21st Century Teachers' Corps, 401(j) Educational Savings Accounts, the National Tuition…

Examining individual factors according to health risk appraisal data as determinants of absenteeism among US utility employees.

PubMed

Marzec, Mary L; Scibelli, Andrew F; Edington, Dee W

2013-07-01

To investigate predictors of absenteeism and discuss potential implications for policy/program design. Health Risk Appraisal (HRA) data and self-reported and objective absenteeism (personnel records) were used to develop a structural equation model, controlling for age, sex, and job classification. A Medical Condition Burden Index (MCBI) was created by summing the number of self-reported medical conditions. Higher MCBI and stress were direct predictors of absenteeism. Physical activity was not associated with absenteeism but mediated both stress and MCBI. Because stress impacted both absenteeism and MCBI, organizations may benefit by placing stress management as a priority for wellness program and policy focus. Physical activity was not directly associated with absenteeism but was a mediating variable for stress and MCBI. Measures of stress and physical health may be more meaningful as outcome measures for physical activity programs than absenteeism.

Leveraging paraprofessionals and family strengths to improve coverage and penetration of nutrition and early child development services.

PubMed

Tomlinson, Mark; Rahman, Atif; Sanders, David; Maselko, Joanna; Rotheram-Borus, Mary Jane

2014-01-01

Children need to be protected in intergenerational networks, with parents who have positive mood, resources to feed their children, and skills to promote early childhood development (ECD). Globally, more than 200 million children are raised annually without these resources. This article reviews the potential contributions of increasing coverage and penetration of services for these children, challenges to achieving penetration of services in high-risk families, opportunities created by bundling multiple services within one provider, potential leveraging of paraprofessionals to deliver care, and mobilizing communities to support children in households at high risk for negative outcomes. We end with a number of suggestions for how to ensure the equitable scale-up of integrated ECD and nutrition services that take into account current global priorities, as well as coverage and penetration of services. © 2013 New York Academy of Sciences.

Risk assessment of component failure modes and human errors using a new FMECA approach: application in the safety analysis of HDR brachytherapy.

PubMed

Giardina, M; Castiglia, F; Tomarchio, E

2014-12-01

Failure mode, effects and criticality analysis (FMECA) is a safety technique extensively used in many different industrial fields to identify and prevent potential failures. In the application of traditional FMECA, the risk priority number (RPN) is determined to rank the failure modes; however, the method has been criticised for having several weaknesses. Moreover, it is unable to adequately deal with human errors or negligence. In this paper, a new versatile fuzzy rule-based assessment model is proposed to evaluate the RPN index to rank both component failure and human error. The proposed methodology is applied to potential radiological over-exposure of patients during high-dose-rate brachytherapy treatments. The critical analysis of the results can provide recommendations and suggestions regarding safety provisions for the equipment and procedures required to reduce the occurrence of accidental events.

[Chronic non-communicable diseases in Brazil: priorities for disease management and research].

PubMed

Duncan, Bruce Bartholow; Chor, Dóra; Aquino, Estela M L; Bensenor, Isabela M; Mill, José Geraldo; Schmidt, Maria Inês; Lotufo, Paulo Andrade; Vigo, Alvaro; Barreto, Sandhi Maria

2012-12-01

Chronic Non-Communicable Diseases are the main source of disease burden in Brazil. In 2011, the Brazilian Ministry of Health launched the Strategic Plan of Action for Management of Chronic Non-Communicable Diseases focusing on population-based interventions to manage cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases mainly through fighting tobacco use, unhealthy diets, physical inactivity and the harmful use of alcohol. Although a significant number of scientific studies on chronic diseases and their risk factors have been undertaken in Brazil, few are of cohort design. In this context, the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a cohort study of 15,105 Brazilian public servants reflects the reality of high prevalences of diabetes, hypertension and the main chronic diseases risk factors. The diversity of information that the Study will produce can provide important input to better understand the causes of chronic diseases and to support public policies for fighting them.

2014 Decompression Sickness/Extravehicular Activity Risks Standing Review Panel

NASA Technical Reports Server (NTRS)

Steinberg, Susan; Mahon, Richard; Klaus, David; Neuman, Tom; Pilmanis, Andrew; Regis, David

2014-01-01

The 2014 Decompression Sickness (DCS)/Extravehicular Activity (EVA) Risks Standing Review Panel (from here on referred to as the SRP) met for a site visit in Houston, TX on November 4 - 5, 2014. The SRP reviewed the Research Plans for The Risk of Decompression Sickness and the Risk of Injury and Compromised Performance due to EVA Operations, as well as the Evidence Reports for both of these Risks. The SRP found that the NASA DCS/EVA team did an excellent job of presenting their research plans. The SRP considers it critical that NASA proceeds with the high priority tasks identified in this report (DCS1, DCS3, DCS5). The highest priority is to determine the acceptable DCS and hypoxia risk associated with the planned human exploration beyond low Earth orbit. The risk of DCS is highly dependent upon the pressure within the exploration vehicle. If slightly more hypoxia is permitted then (even with the same percentage of oxygen) the pressure within the exploration vehicle can be lowered thus further mitigating the risk of DCS. The second highest priority is to test and validate the recommended 8.2psi/34% O2 atmosphere. Development of procedures and equipment for human exploration missions are very limited until the results of this testing are completed. The SRP also suggests that DCS7 be separated into two Gaps. Gap DCS7 should deal with DCS treatment while a new Gap should be created to deal with the long-term effects of DCS. The SRP also encourages NASA to increase collaboration with other organizations and pool resources where possible. The current NASA DCS/EVA team has the extensive expertise and a wealth of knowledge in this area. The SRP suggests that increased manpower for this team would be highly productive.

The Bellagio Report: Cardiovascular risks of spaceflight: implications for the future of space travel.

PubMed

Sides, Marian B; Vernikos, Joan; Convertino, Victor A; Stepanek, Jan; Tripp, Lloyd D; Draeger, Jorg; Hargens, Alan R; Kourtidou-Papadeli, Chrysoula; Pavy-LeTraon, Anne; Russomano, Thais; Wong, Julielynn Y; Buccello, Regina R; Lee, Peter H; Nangalia, Vishal; Saary, M Joan

2005-09-01

Long-duration space missions, as well as emerging civilian tourist space travel activities, prompted review and assessment of data available to date focusing on cardiovascular risk and available risk mitigation strategies. The goal was the creation of tools for risk priority assessments taking into account the probability of the occurrence of an adverse cardiovascular event and available and published literature from spaceflight data as well as available risk mitigation strategies. An international group of scientists convened in Bellagio, Italy, in 2004 under the auspices of the Aerospace Medical Association to review available literature for cardiac risks identified in the Bioastronautics Critical Path Roadmap (versions 2000, 2004). This effort led to the creation of a priority assessment framework to allow for an objective assessment of the hazard, probability of its occurrence, mission impact, and available risk mitigation measures. Spaceflight data are presented regarding evidence/ no evidence of cardiac dysrhythmias, cardiovascular disease, and cardiac function as well as orthostatic intolerance, exercise capacity, and peripheral resistance in presyncopal astronauts compared to non-presyncopal astronauts. Assessment of the priority of different countermeasures was achieved with a tabular framework with focus on probability of occurrence, mission impact, compliance, practicality, and effectiveness of countermeasures. Special operational settings and circumstances related to sensitive portions of any mission and the impact of environmental influences on mission effectiveness are addressed. The need for development of diagnostic tools, techniques, and countermeasure devices, food preparation, preservation technologies and medication, as well as an infrastructure to support these operations are stressed. Selected countermeasure options, including artificial gravity and pharmacological countermeasures need to be systematically evaluated and validated in flight, especially after long-duration exposures. Data need to be collected regarding the emerging field of suborbital and orbital civilian space travel, to allow for sound risk assessment.

HySafe research priorities workshop report Summary of the workshop organized in cooperation with US DOE and supported by EC JRC in Washington DC November 10-11 2014.

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

Keller, Jay; Hill, Laura; Kiuru, Kristian

The HySafe research priorities workshop is held on the even years between the International Conference on Hydrogen Safety (ICHS) which is held on the odd years. The research priorities workshop is intended to identify the state-of-the-art in understanding of the physical behavior of hydrogen and hydrogen systems with a focus on safety. Typical issues addressed include behavior of unintended hydrogen releases, transient combustion phenomena, effectiveness of mitigation measures, and hydrogen effects in materials. In the workshop critical knowledge gaps are identified. Areas of research and coordinated actions for the near and medium term are derived and prioritized from these knowledgemore » gaps. The stimulated research helps pave the way for the rapid and safe deployment of hydrogen technologies on a global scale. To support the idea of delivering globally accepted research priorities for hydrogen safety the workshop is organized as an internationally open meeting. In attendance are stakeholders from the academic community (universities, national laboratories), funding agencies, and industry. The industry participation is critically important to ensure that the research priorities align with the current needs of the industry responsible for the deployment of hydrogen technologies. This report presents the results of the HySafe Research Priorities Workshop held in Washing- ton, D.C. on November 10-11, 2014. At the workshop the participants presented updates (since the previous workshop organized two years before in Berlin, Germany) of their research and development work on hydrogen safety. Following the workshop, participants were asked to provide feedback on high-priority topics for each of the research areas discussed and to rank research area categories and individual research topics within these categories. The research areas were ranked as follows (with the percentage of the vote in parenthesis): 1. Quantitative Risk Assessment (QRA) Tools (23%) 2. Reduced Model Tools (15%) 3. Indoor (13%) 4. Unintended Release-Liquid (11%) 5. Unintended Release-Gas (8%) 6. Storage (8%) 7. Integration Platforms (7%) 8. Hydrogen Safety Training (7%) 9. Materials Compatibility/Sensors (7%) 10. Applications (2%) The workshop participants ranked the need for Quantitative Risk Analysis (QRA) tools as the top priority by a large margin. QRA tools enable an informed expert to quantify the risk asso- ciated with a particular hydrogen system in a particular scenario. With appropriate verification and validation such tools will enable: * system designers to achieve a desired level of risk with suitable risk mitigation strategies, * permitting officials to determine if a particular system installation meets the desired risk level (performance based Regulations, Codes, and Standards (RCS) rather than prescrip- tive RCS), and * allow code developers to develop code language based on rigorous and validated physical models, statistics and standardized QRA methodologies. Another important research topic identified is the development of validated reduced physical models for use in the QRA tools. Improvement of the understanding and modeling of specific release phenomena, in particular liquid releases, are also highly ranked research topics. Acknowledgement The International Association HySafe, represented here by the authors, would like to thank all participants of the workshop for their valuable contributions. Particularly appreciated is the active participation of the industry representatives and the steady support by the European Com- mission's Joint Research Centre (JRC). Deep gratitude is owed for the great support by the United States Department of Energy (DOE) Office of Energy Efficiency and Renewable Energy's Fuel Cell Technologies Office (EERE/FCTO) for the organization of the 2014 version of the hydrogen safety research priorities workshop. This page intentionally left blank.« less

Failure mode and effects analysis drastically reduced potential risks in clinical trial conduct.

PubMed

Lee, Howard; Lee, Heechan; Baik, Jungmi; Kim, Hyunjung; Kim, Rachel

2017-01-01

Failure mode and effects analysis (FMEA) is a risk management tool to proactively identify and assess the causes and effects of potential failures in a system, thereby preventing them from happening. The objective of this study was to evaluate effectiveness of FMEA applied to an academic clinical trial center in a tertiary care setting. A multidisciplinary FMEA focus group at the Seoul National University Hospital Clinical Trials Center selected 6 core clinical trial processes, for which potential failure modes were identified and their risk priority number (RPN) was assessed. Remedial action plans for high-risk failure modes (RPN >160) were devised and a follow-up RPN scoring was conducted a year later. A total of 114 failure modes were identified with an RPN score ranging 3-378, which was mainly driven by the severity score. Fourteen failure modes were of high risk, 11 of which were addressed by remedial actions. Rescoring showed a dramatic improvement attributed to reduction in the occurrence and detection scores by >3 and >2 points, respectively. FMEA is a powerful tool to improve quality in clinical trials. The Seoul National University Hospital Clinical Trials Center is expanding its FMEA capability to other core clinical trial processes.

The Fraction of Cancer Attributable to Ways of Life, Infections, Occupation, and Environmental Agents in Brazil in 2020

PubMed Central

Azevedo e Silva, Gulnar; de Moura, Lenildo; Curado, Maria Paula; Gomes, Fabio da Silva; Otero, Ubirani; de Rezende, Leandro Fórnias Machado; Daumas, Regina Paiva; Guimarães, Raphael Mendonça; Meira, Karina Cardoso; Leite, Iuri da Costa; Valente, Joaquim Gonçalves; Moreira, Ronaldo Ismério; Koifman, Rosalina; Malta, Deborah Carvalho; Mello, Marcia Sarpa de Campos; Guedes, Thiago Wagnos Guimarães; Boffetta, Paolo

2016-01-01

Many human cancers develop as a result of exposure to risk factors related to the environment and ways of life. The aim of this study was to estimate attributable fractions of 25 types of cancers resulting from exposure to modifiable risk factors in Brazil. The prevalence of exposure to selected risk factors among adults was obtained from population-based surveys conducted from 2000 to 2008. Risk estimates were based on data drawn from meta-analyses or large, high quality studies. Population-attributable fractions (PAF) for a combination of risk factors, as well as the number of preventable deaths and cancer cases, were calculated for 2020. The known preventable risk factors studied will account for 34% of cancer cases among men and 35% among women in 2020, and for 46% and 39% deaths, respectively. The highest attributable fractions were estimated for tobacco smoking, infections, low consumption of fruits and vegetables, excess weight, reproductive factors, and physical inactivity. This is the first study to systematically estimate the fraction of cancer attributable to potentially modifiable risk factors in Brazil. Strategies for primary prevention of tobacco smoking and control of infection and the promotion of a healthy diet and physical activity should be the main priorities in policies for cancer prevention in the country. PMID:26863517

What Is behind the Priority Heuristic? A Mathematical Analysis and Comment on Brandstatter, Gigerenzer, and Hertwig (2006)

ERIC Educational Resources Information Center

Rieger, Marc Oliver; Wang, Mei

2008-01-01

Comments on the article by E. Brandstatter, G. Gigerenzer, and R. Hertwig (2006). The authors discuss the priority heuristic, a recent model for decisions under risk. They reanalyze the experimental validity of this approach and discuss how these results compare with cumulative prospect theory, the currently most established model in behavioral…

Estimation of Soil Erosion Dynamics in the Koshi Basin Using GIS and Remote Sensing to Assess Priority Areas for Conservation

PubMed Central

Uddin, Kabir; Murthy, M. S. R.; Wahid, Shahriar M.; Matin, Mir A.

2016-01-01

High levels of water-induced erosion in the transboundary Himalayan river basins are contributing to substantial changes in basin hydrology and inundation. Basin-wide information on erosion dynamics is needed for conservation planning, but field-based studies are limited. This study used remote sensing (RS) data and a geographic information system (GIS) to estimate the spatial distribution of soil erosion across the entire Koshi basin, to identify changes between 1990 and 2010, and to develop a conservation priority map. The revised universal soil loss equation (RUSLE) was used in an ArcGIS environment with rainfall erosivity, soil erodibility, slope length and steepness, cover-management, and support practice factors as primary parameters. The estimated annual erosion from the basin was around 40 million tonnes (40 million tonnes in 1990 and 42 million tonnes in 2010). The results were within the range of reported levels derived from isolated plot measurements and model estimates. Erosion risk was divided into eight classes from very low to extremely high and mapped to show the spatial pattern of soil erosion risk in the basin in 1990 and 2010. The erosion risk class remained unchanged between 1990 and 2010 in close to 87% of the study area, but increased over 9.0% of the area and decreased over 3.8%, indicating an overall worsening of the situation. Areas with a high and increasing risk of erosion were identified as priority areas for conservation. The study provides the first assessment of erosion dynamics at the basin level and provides a basis for identifying conservation priorities across the Koshi basin. The model has a good potential for application in similar river basins in the Himalayan region. PMID:26964039

Estimation of Soil Erosion Dynamics in the Koshi Basin Using GIS and Remote Sensing to Assess Priority Areas for Conservation.

PubMed

Uddin, Kabir; Murthy, M S R; Wahid, Shahriar M; Matin, Mir A

2016-01-01

High levels of water-induced erosion in the transboundary Himalayan river basins are contributing to substantial changes in basin hydrology and inundation. Basin-wide information on erosion dynamics is needed for conservation planning, but field-based studies are limited. This study used remote sensing (RS) data and a geographic information system (GIS) to estimate the spatial distribution of soil erosion across the entire Koshi basin, to identify changes between 1990 and 2010, and to develop a conservation priority map. The revised universal soil loss equation (RUSLE) was used in an ArcGIS environment with rainfall erosivity, soil erodibility, slope length and steepness, cover-management, and support practice factors as primary parameters. The estimated annual erosion from the basin was around 40 million tonnes (40 million tonnes in 1990 and 42 million tonnes in 2010). The results were within the range of reported levels derived from isolated plot measurements and model estimates. Erosion risk was divided into eight classes from very low to extremely high and mapped to show the spatial pattern of soil erosion risk in the basin in 1990 and 2010. The erosion risk class remained unchanged between 1990 and 2010 in close to 87% of the study area, but increased over 9.0% of the area and decreased over 3.8%, indicating an overall worsening of the situation. Areas with a high and increasing risk of erosion were identified as priority areas for conservation. The study provides the first assessment of erosion dynamics at the basin level and provides a basis for identifying conservation priorities across the Koshi basin. The model has a good potential for application in similar river basins in the Himalayan region.

A challenge for land and risk managers: differents stakeholders, differents definitions of the risks

NASA Astrophysics Data System (ADS)

Fernandez, M.; Ruegg, J.

2012-04-01

In developing countries, mountain populations and territories are subject to multiple risks and vulnerabilities. In addition, they face even greater challenges than developed countries due to lack of knowledge, resources and technology. There are many different types of actors in society that manage risk at various scales and levels (i.e. engineers, geologists, administrators, land use planners, merchants and local indigenous and non-indigenous people). Because of limited resources and possibilities to reduce all types of risk, these different actors, or 'risk managers' have to choose and compete to prioritize which types of risks to address. This paper addresses a case study from San Cristobal Altaverapaz, Guatemala where a large landslide "Los Chorros", a catastrophic collapse of 6 millions cubic meters of rock, is affecting several communities and one of the country's main west-east access highways. In this case, the government established that the "primary" risk is the landslide, whereas other local stakeholders consider the primary risks to be economic This paper, situated at the cross section between political science, geography and disaster risk management, addresses the social conflict and competition for priorities and solutions for risk management, depending on the group of actors based on the on-going Los Chorros, Guatemala landslide mitigation process. This work is based on the analysis of practices, (Practical Science), policies and institutions in order to understand how the inclusion of multiple stakeholders in determining risk priorities can lead to more sustainable risk management in a given territory. The main objective of this investigation is first to identify and understand the juxtaposition of different readings of the risk equation, usually considered the interface between vulnerability, exposure and hazards. Secondly, it is to analyze the mechanisms of actions taken by various stakeholders, or risk managers. The analysis focuses on the various solutions proposed for reducing vulnerabilities (and consequentially their risks). To resolve a post-disaster situation, the actors prioritize one main type of vulnerability to address a set of vulnerabilities (in a multi-vulnerability context). With this choice, they define their own acceptable risk limits and the type of action that is most relevant. In doing so, they have to determine what elements can be changed and improved and which elements must be considered essential and preserved or the priority variables. These may include: equipment, production facilities, networks, services, modes of production and organizations, etc. or various economic and social capitals upon which individuals and groups rely for recovering from a post-disaster situation. Depending on the actor, certain factors will be will be emphasized over others and these may change over time. Linked with this political, institutional and geographical analysis of risk management, this work also questions who are the legitimate actors and the right criteria to prioritize risk reduction actions using public funds criteria and finally, which motivations are satisfied. In this sense, the challenge for managers of natural hazards is to move from risk management in the strict sense, which focuses mainly on hazards only, to a broader risks management, taking into consideration what is important for society and for the functioning of systems (what have not be vulnerable in a territorial system). In a context where risk and risk management is produced and managed by both formal and informal stakeholders, the main issue is how to engage the various stakeholders and evaluate different priorities of risk in order to determine which actions are best suited for a more balanced approach to risk management. This case study demonstrates that reducing landslide risk is subject to interpretation depending on the stakeholder and the result of priorities, providing on the role of each actor, their needs and range of action with a territory.

Risk Leading Indicators for DOD Acquisition Programs

DTIC Science & Technology

2014-08-12

Adverse consequences include development time and cost overrun, technical performance and reliability shortfall, and excessive production , operation...prior to contract award, but is outside the scope of this paper. Risk exposure early warning complements the risk identification practices and...likelihood and magnitude are priorities for tracking and mitigation. The practices and procedures in the guide start with identifying risk events. Risk

Microbial Impact on Success of Human Exploration Missions

NASA Technical Reports Server (NTRS)

Pierson, Duane L.; Ott, C. Mark; Groves, T. O.; Paloski, W. H. (Technical Monitor)

2000-01-01

The purpose of this study is to identify microbiological risks associated with space exploration and identify potential countermeasures available. Identification of microbial risks associated with space habitation requires knowledge of the sources and expected types of microbial agents. Crew data along with environmental data from water, surfaces, air, and free condensate are utilized in risk examination. Data from terrestrial models are also used. Microbial risks to crew health include bacteria, fungi, protozoa, and viruses. Adverse effects of microbes include: infections, allergic reactions, toxin production, release of volatiles, food spoilage, plant disease, material degradation, and environmental contamination. Risk is difficult to assess because of unknown potential changes in microbes (e.g., mutation) and the human host (e.g., immune changes). Prevention of adverse microbial impacts is preferred over remediation. Preventative measures include engineering measures (e.g., air filtration), crew microbial screening, acceptability standards, and active verification by onboard monitoring. Microbiological agents are important risks to human health and performance during space flight and risks increase with mission duration. Acceptable risk level must be defined. Prevention must be given high priority. Careful screening of crewmembers and payloads is an important element of any risk mitigation plan. Improved quantitation of microbiological risks is a high priority.

A situational analysis of priority disaster hazards in Uganda: findings from a hazard and vulnerability analysis.

PubMed

Mayega, R W; Wafula, M R; Musenero, M; Omale, A; Kiguli, J; Orach, G C; Kabagambe, G; Bazeyo, W

2013-06-01

Most countries in sub-Saharan Africa have not conducted a disaster risk analysis. Hazards and vulnerability analyses provide vital information that can be used for development of risk reduction and disaster response plans. The purpose of this study was to rank disaster hazards for Uganda, as a basis for identifying the priority hazards to guide disaster management planning. The study as conducted in Uganda, as part of a multi-country assessment. A hazard, vulnerability and capacity analysis was conducted in a focus group discussion of 7 experts representing key stakeholder agencies in disaster management in Uganda. A simple ranking method was used to rank the probability of occurance of 11 top hazards, their potential impact and the level vulnerability of people and infrastructure. In-terms of likelihood of occurance and potential impact, the top ranked disaster hazards in Uganda are: 1) Epidemics of infectious diseases, 2) Drought/famine, 3) Conflict and environmental degradation in that order. In terms of vulnerability, the top priority hazards to which people and infrastructure were vulnerable were: 1) Conflicts, 2) Epidemics, 3) Drought/famine and, 4) Environmental degradation in that order. Poverty, gender, lack of information, and lack of resilience measures were some of the factors promoting vulnerability to disasters. As Uganda develops a disaster risk reduction and response plan, it ought to prioritize epidemics of infectious diseases, drought/famine, conflics and environmental degradation as the priority disaster hazards.

Work, Aging, and Risks to Family Life: The Case of Australia.

PubMed

Biggs, Simon; Carr, Ashley; Haapala, Irja

2015-09-01

The relationship between work and family is considered with an emphasis on policy solutions. Australian policy is a case example in the context of international trends. A mismatch between policy initiatives and familial and personal priorities constitutes a new social risk associated with demographic and sociocultural development. Contemporary trends, both nationally and internationally, evidence solutions to the “problem of demographic aging” by adopting a form of economic instrumentalism. This restricts legitimate age identities to those associated with work and work-related activity. When applied to family life, such a focus runs the risk of reducing policy interest in intergenerational engagement to unpaid care roles, while personal development and age-related life priorities are ignored. The need for cultural adaptation to population aging is becoming accepted in policy debate and is considered here as an effective response to the personal, social, and economic risks of population aging and associated impacts on family life.

Development and use of role model stories in a community level HIV risk reduction intervention.

PubMed Central

Corby, N H; Enguídanos, S M; Kay, L S

1996-01-01

A theory-based HIV prevention intervention was implemented as part of a five-city AIDS Community Demonstration Project for the development and testing of a community-level intervention to reduce AIDS risk among historically underserved groups. This intervention employed written material containing stories of risk-reducing experiences of members of the priority populations, in this case, injecting drug users, their female sex partners, and female sex workers. These materials were distributed to members of these populations by their peers, volunteers from the population who were trained to deliver social reinforcement for interest in personal risk reduction and the materials. The participation of the priority populations in the development and implementation of the intervention was designed to increase the credibility of the intervention and the acceptance of the message. The techniques involved in developing role-model stories are described in this paper. PMID:8862158

The priority heuristic: making choices without trade-offs.

PubMed

Brandstätter, Eduard; Gigerenzer, Gerd; Hertwig, Ralph

2006-04-01

Bernoulli's framework of expected utility serves as a model for various psychological processes, including motivation, moral sense, attitudes, and decision making. To account for evidence at variance with expected utility, the authors generalize the framework of fast and frugal heuristics from inferences to preferences. The priority heuristic predicts (a) the Allais paradox, (b) risk aversion for gains if probabilities are high, (c) risk seeking for gains if probabilities are low (e.g., lottery tickets), (d) risk aversion for losses if probabilities are low (e.g., buying insurance), (e) risk seeking for losses if probabilities are high, (f) the certainty effect, (g) the possibility effect, and (h) intransitivities. The authors test how accurately the heuristic predicts people's choices, compared with previously proposed heuristics and 3 modifications of expected utility theory: security-potential/aspiration theory, transfer-of-attention-exchange model, and cumulative prospect theory. ((c) 2006 APA, all rights reserved).

Youth Risk Behavior Surveillance System: 2011 National Overview

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2011

2011-01-01

The national Youth Risk Behavior Survey (YRBS) monitors six priority health-risk behaviors that contribute markedly to the leading causes of death, disability, and social problems among youth and adults in the United States. These behaviors, often established during childhood and early adolescence, include: (1) Behaviors that contribute to…

Middle School Risk Behavior 1995 Survey Results.

ERIC Educational Resources Information Center

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

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

Scientific Opinion on Risk Assessment of Synthetic Biology.

PubMed

Epstein, Michelle M; Vermeire, Theo

2016-08-01

In 2013, three Scientific Committees of the European Commission (EC) drafted Scientific Opinions on synthetic biology that provide an operational definition and address risk assessment methodology, safety aspects, environmental risks, knowledge gaps, and research priorities. These Opinions contribute to the international discussions on the risk governance for synthetic biology developments. Copyright © 2016 Elsevier Ltd. All rights reserved.

Approaches for assessing health risks from complex mixtures in indoor air: a panel overview.

PubMed Central

Henry, C J; Fishbein, L; Meggs, W J; Ashford, N A; Schulte, P A; Anderson, H; Osborne, J S; Sepkovic, D W

1991-01-01

Critical to a more definitive human health assessment of the potential health risks from exposure to complex mixtures in indoor air is the need for a more definitive clinical measure and etiology of the health effects of complex mixtures. This panel overview highlights six of the eight presentations of the conference panel discussion and features a number of the major topical areas of indoor air concern. W. G. Meggs assessed clinical research priorities with primary focus on the role of volatile organic chemicals in human health, recognizing the areas where definitive data are lacking. By recognizing many types of chemical sensitivity, it may be possible to design studies that can illuminate the mechanisms by which chemical exposure may cause disease. The critically important topic of multiple chemical sensitivity was discussed by N. A. Ashford, who identified four high risk groups and defined the demographics of these groups. P. A. Schulte addressed the issue of biological markers of susceptibility with specific considerations of both methodological and societal aspects that may be operative in the ability to detect innate or inborne differences between individuals and populations. Three case studies were reviewed. H. Anderson discussed the past and present priorities from a public health perspective, focusing on those issues dealing with exposures to environmental tobacco smoke and formaldehyde off-gassing from materials used in mobile home construction. J. J. Osborne described several case studies involving wood smoke exposure to children, with emphasis on the significantly greater occurrence of chronic respiratory symptoms and acute chest illness for children from homes heated with woodburning stoves.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1821367

FMEA of manual and automated methods for commissioning a radiotherapy treatment planning system.

PubMed

Wexler, Amy; Gu, Bruce; Goddu, Sreekrishna; Mutic, Maya; Yaddanapudi, Sridhar; Olsen, Lindsey; Harry, Taylor; Noel, Camille; Pawlicki, Todd; Mutic, Sasa; Cai, Bin

2017-09-01

To evaluate the level of risk involved in treatment planning system (TPS) commissioning using a manual test procedure, and to compare the associated process-based risk to that of an automated commissioning process (ACP) by performing an in-depth failure modes and effects analysis (FMEA). The authors collaborated to determine the potential failure modes of the TPS commissioning process using (a) approaches involving manual data measurement, modeling, and validation tests and (b) an automated process utilizing application programming interface (API) scripting, preloaded, and premodeled standard radiation beam data, digital heterogeneous phantom, and an automated commissioning test suite (ACTS). The severity (S), occurrence (O), and detectability (D) were scored for each failure mode and the risk priority numbers (RPN) were derived based on TG-100 scale. Failure modes were then analyzed and ranked based on RPN. The total number of failure modes, RPN scores and the top 10 failure modes with highest risk were described and cross-compared between the two approaches. RPN reduction analysis is also presented and used as another quantifiable metric to evaluate the proposed approach. The FMEA of a MTP resulted in 47 failure modes with an RPN ave of 161 and S ave of 6.7. The highest risk process of "Measurement Equipment Selection" resulted in an RPN max of 640. The FMEA of an ACP resulted in 36 failure modes with an RPN ave of 73 and S ave of 6.7. The highest risk process of "EPID Calibration" resulted in an RPN max of 576. An FMEA of treatment planning commissioning tests using automation and standardization via API scripting, preloaded, and pre-modeled standard beam data, and digital phantoms suggests that errors and risks may be reduced through the use of an ACP. © 2017 American Association of Physicists in Medicine.

Frequent Use of Emergency Departments by the Elderly Population When Continuing Care Is Not Well Established.

PubMed

Legramante, Jacopo M; Morciano, Laura; Lucaroni, Francesca; Gilardi, Francesco; Caredda, Emanuele; Pesaresi, Alessia; Coscia, Massimo; Orlando, Stefano; Brandi, Antonella; Giovagnoli, Germano; Di Lecce, Vito N; Visconti, Giuseppe; Palombi, Leonardo

2016-01-01

The elderly, who suffer from multiple chronic diseases, represent a substantial proportion of Emergency Department (ED) frequent users, thus contributing to ED overcrowding, although they could benefit from other health care facilities, if those were available. The aim of this study was to evaluate and characterize hospital visits of older patients (age 65 or greater) to the ED of a university teaching hospital in Rome from the 1st of January to the 31st of December 2014, in order to identify clinical and social characteristics potentially associated with "elderly frequent users". A retrospective study was performed during the calendar year 2014 (1st January 2014 - 31st December 2014) analyzing all ED admissions to the University Hospital of Rome Tor Vergata. Variables collected included age, triage code, arrival data, discharge diagnosis, and visit outcome. We performed a risk analysis using univariate binary logistic regression models. A total number of 38,016 patients accessed the ED, generating 46,820 accesses during the study period, with an average of 1.23 accesses for patient. The elderly population represented a quarter of the total ED population and had an increased risk of frequent use (OR 1.5: CI 1.4-1.7) and hospitalization (OR 3.8: CI 3.7-4). Moreover, they showed a greater diagnostic complexity, as demonstrated by the higher incidence of yellow and red priority codes compared to other ED populations (OR 3.1: CI 2.9-3.2). Older patients presented clinical and social characteristics related to the definition of "elderly frail frequent users". The fact that a larger number of hospitalizations occurred in such patients is indirect evidence of frailty in this specific population, suggesting that hospital admissions may be an inappropriate response to frailty, especially when continued care is not established. Enhancement of continuity of care, establishment of a tracking system for those who are at greater risk of visiting the ED and evaluating fragile individuals should be the highest priority in addressing ED frequent usage by the elderly.

Reduction of Defects in Jewelry Manufacturing

NASA Astrophysics Data System (ADS)

Ayudhya, Phitchaya Phanomwan na; Tangjitsitcharoen, Somkiat

2017-06-01

The aim of this research was to reduce the defects of gem bracelet found during manufacturing process at a jewelry company. It was found that gem bracelet product has the highest rejects compared to the rejects found in ring, earring, and pendant products. Types of defect were classified by using Pareto Diagram consisting of gem falling, seam, unclean casting, impinge, and deformation. The causes of defect were analyzed by Cause and Effect Diagram and applied Failure Mode and Effects Analysis (FMEA) was applied during manufacturing processes. This research found that the improvement of manufacturing process could reduce the Risk Priority Number (RPN) and total of all defects by 48.70% and 48.89%, respectively.

Canine and feline parasitic zoonoses in China

PubMed Central

2012-01-01

Canine and feline parasitic zoonoses have not been given high priority in China, although the role of companion animals as reservoirs for zoonotic parasitic diseases has been recognized worldwide. With an increasing number of dogs and cats under unregulated conditions in China, the canine and feline parasitic zoonoses are showing a trend towards being gradually uncontrolled. Currently, canine and feline parasitic zoonoses threaten human health, and cause death and serious diseases in China. This article comprehensively reviews the current status of major canine and feline parasitic zoonoses in mainland China, discusses the risks dogs and cats pose with regard to zoonotic transmission of canine and feline parasites, and proposes control strategies and measures. PMID:22839365

Use of mechanistic simulations as a quantitative risk-ranking tool within the quality by design framework.

PubMed

Stocker, Elena; Toschkoff, Gregor; Sacher, Stephan; Khinast, Johannes G

2014-11-20

The purpose of this study is to evaluate the use of computer simulations for generating quantitative knowledge as a basis for risk ranking and mechanistic process understanding, as required by ICH Q9 on quality risk management systems. In this specific publication, the main focus is the demonstration of a risk assessment workflow, including a computer simulation for the generation of mechanistic understanding of active tablet coating in a pan coater. Process parameter screening studies are statistically planned under consideration of impacts on a potentially critical quality attribute, i.e., coating mass uniformity. Based on computer simulation data the process failure mode and effects analysis of the risk factors is performed. This results in a quantitative criticality assessment of process parameters and the risk priority evaluation of failure modes. The factor for a quantitative reassessment of the criticality and risk priority is the coefficient of variation, which represents the coating mass uniformity. The major conclusion drawn from this work is a successful demonstration of the integration of computer simulation in the risk management workflow leading to an objective and quantitative risk assessment. Copyright © 2014. Published by Elsevier B.V.

A quality risk management model approach for cell therapy manufacturing.

PubMed

Lopez, Fabio; Di Bartolo, Chiara; Piazza, Tommaso; Passannanti, Antonino; Gerlach, Jörg C; Gridelli, Bruno; Triolo, Fabio

2010-12-01

International regulatory authorities view risk management as an essential production need for the development of innovative, somatic cell-based therapies in regenerative medicine. The available risk management guidelines, however, provide little guidance on specific risk analysis approaches and procedures applicable in clinical cell therapy manufacturing. This raises a number of problems. Cell manufacturing is a poorly automated process, prone to operator-introduced variations, and affected by heterogeneity of the processed organs/tissues and lot-dependent variability of reagent (e.g., collagenase) efficiency. In this study, the principal challenges faced in a cell-based product manufacturing context (i.e., high dependence on human intervention and absence of reference standards for acceptable risk levels) are identified and addressed, and a risk management model approach applicable to manufacturing of cells for clinical use is described for the first time. The use of the heuristic and pseudo-quantitative failure mode and effect analysis/failure mode and critical effect analysis risk analysis technique associated with direct estimation of severity, occurrence, and detection is, in this specific context, as effective as, but more efficient than, the analytic hierarchy process. Moreover, a severity/occurrence matrix and Pareto analysis can be successfully adopted to identify priority failure modes on which to act to mitigate risks. The application of this approach to clinical cell therapy manufacturing in regenerative medicine is also discussed. © 2010 Society for Risk Analysis.

JPRS Report, Science & Technology, Europe & Latin America

DTIC Science & Technology

1988-04-06

courses and in polytechnics a growing number of undergraduate research theses [ tesi di laurea] are increasingly coming to resemble authentic feasibility...Information Science Eleven Priorities Research Priority Actions — Microbiological engineering —Enzyme engineering —Biotechnological engineering —Food...Foodstuffs Medicine Human and social sciences Technology, computer-integrated manufacturing Electronics, data processing Microbiological

Using Wildlife Species Richness to Identify Land Protection Priorities in California's Hardwood Woodlands

Treesearch

Robert S. Motroni; Daniel A. Airola; Robin K. Ma rose; Nancy D. Tosta

1991-01-01

A geographic information system was used to assess wildlife species richness (number of species) in valley-foothill hardwood habitats throughout California to set priorities for conservation attention. Species richness values were assessed and compared using three methods: one that included all species without considering canopy cover conditions and species preferences...

Effects of gaps in priorities between ideal and real lives on psychological burnout among academic faculty members at a medical university in Japan: a cross-sectional study.

PubMed

Chatani, Yuki; Nomura, Kyoko; Horie, Saki; Takemoto, Keisuke; Takeuchi, Masumi; Sasamori, Yukifumi; Takenoshita, Shinichi; Murakami, Aya; Hiraike, Haruko; Okinaga, Hiroko; Smith, Derek

2017-04-04

Accumulating evidence from medical workforce research indicates that poor work/life balance and increased work/home conflict induce psychological distress. In this study we aim to examine the existence of a priority gap between ideal and real lives, and its association with psychological burnout among academic professionals. This cross-sectional survey, conducted in 2014, included faculty members (228 men, 102 women) at a single medical university in Tokyo, Japan. The outcome of interest was psychological burnout, measured with a validated inventory. Discordance between ideal- and real-life priorities, based on participants' responses (work, family, individual life, combinations thereof), was defined as a priority gap. The majority (64%) of participants chose "work" as the greatest priority in real life, but only 28% chose "work" as the greatest priority in their conception of an ideal life. Priority gaps were identified in 59.5% of respondents. A stepwise multivariable general linear model demonstrated that burnout scores were associated positively with respondents' current position (P < 0.0018) and the presence of a priority gap (P < 0.0001), and negatively with the presence of social support (P < 0.0001). Among participants reporting priority gaps, burnout scores were significantly lower in those with children than in those with no children (P interaction  = 0.011); no such trend was observed in participants with no priority gap. A gap in priorities between an ideal and real life was associated with an increased risk of burnout, and the presence of children, which is a type of "family" social support, had a mitigating effect on burnout among those reporting priority gaps.

Risk-informed Management of Water Infrastructure in the United States: History, Development, and Best Practices

NASA Astrophysics Data System (ADS)

Wolfhope, J.

2017-12-01

This presentation will focus on the history, development, and best practices for evaluating the risks associated with the portfolio of water infrastructure in the United States. These practices have evolved from the early development of the Federal Guidelines for Dam Safety and the establishment of the National Dam Safety Program, to the most recent update of the Best Practices for Dam and Levee Risk Analysis jointly published by the U.S. Department of Interior Bureau of Reclamation and the U.S. Army Corps of Engineers. Since President Obama signed the Water Infrastructure Improvements for the Nation Act (WIIN) Act, on December 16, 2016, adding a new grant program under FEMA's National Dam Safety Program, the focus has been on establishing a risk-based priority system for use in identifying eligible high hazard potential dams for which grants may be made. Finally, the presentation provides thoughts on the future direction and priorities for managing the risk of dams and levees in the United States.

Development of a novel scoring system for identifying emerging chemical risks in the food chain.

PubMed

Oltmanns, J; Licht, O; Bitsch, A; Bohlen, M-L; Escher, S E; Silano, V; MacLeod, M; Serafimova, R; Kass, G E N; Merten, C

2018-02-21

The European Food Safety Authority (EFSA) is responsible for risk assessment of all aspects of food safety, including the establishment of procedures aimed at the identification of emerging risks to food safety. Here, a scoring system was developed for identifying chemicals registered under the European REACH Regulation that could be of potential concern in the food chain using the following parameters: (i) environmental release based on maximum aggregated tonnages and environmental release categories; (ii) biodegradation in the environment; (iii) bioaccumulation and in vivo and in vitro toxicity. The screening approach was tested on 100 data-rich chemicals registered under the REACH Regulation at aggregated volumes of at least 1000 tonnes per annum. The results show that substance-specific data generated under the REACH Regulation can be used to identify potential emerging risks in the food chain. After application of the screening procedure, priority chemicals can be identified as potentially emerging risk chemicals through the integration of exposure, environmental fate and toxicity. The default approach is to generate a single total score for each substance using a predefined weighting scenario. However, it is also possible to use a pivot table approach to combine the individual scores in different ways that reflect user-defined priorities, which enables a very flexible, iterative definition of screening criteria. Possible applications of the approaches are discussed using illustrative examples. Either approach can then be followed by in-depth evaluation of priority substances to ensure the identification of substances that present a real emerging chemical risk in the food chain.

Hazards of solid waste management: bioethical problems, principles, and priorities

PubMed Central

Maxey, Margaret N.

1978-01-01

The putative hazards of solid waste management cannot be evaluated without placing the problem within a cultural climate of crisis where some persons consider such by-products of “high, hard technology” to have raised unresolved moral and ethical issues. In order to assist scientific and technical efforts to protect public health and safety, a bioethical perspective requires us to examine three controversial aspects of policy-making about public safety. Failure to recognize the qualitative difference between two cognitive activities—risk-measurements (objective, scientific probabilities) and safety-judgments (subjective, shifting value priorities)—has had three unfortunate consequences. Sophisticated methods of risk analysis have been applied in a piecemeal, haphazard, ad hoc fashion within traditional institutions with the false expectation that incremental risk-reducing programs automatically ensure public health and safety. Ethical priorities require, first and foremost, a whole new field of data arranged for comparable risk-analyses. Critics of cost/risk/benefit quantifications attack the absurdity of “putting a price on human life” but have not been confronted with its threefold ethical justification. The widening discrepancy in risk-perceptions and loss of mutual confidence between scientific experts and ordinary citizens has placed a burden of social responsibility on members of the scientific and technical community to engage in more effective public education through the political process, notwithstanding advocates of a nonscientific adversary process. The urgency of effective public education has been demonstrated by the extent to which we have lost our historically balanced judgment about the alleged environmental hazards posed by advanced technology. PMID:738238

Toward an understanding of global change: Initial priorities for US contributions to the International Geosphere-Biosphere Program

NASA Technical Reports Server (NTRS)

1988-01-01

A limited number of high-priority research initiatives are recommended for early implementation as part of the U.S. contribution to the preparatory phase of the International Geosphere-Biosphere Program. The recommendations are based on the committee's analysis of the most critical gaps in the scientific knowledge needed to understand the changes that are occurring in the earth system not being addressed by existing programs. The report articulates a number of important key issues and interactions that characterize global change in the geosphere-biosphere system on time scales of decades to centuries; identifies the knowledge that is the most urgently needed to improve understanding of those issues and interactions; and formulates initial priorities for initial U.S. contributions to the IGBP, recognizing the contributions of other ongoing and proposed programs.

Development of a new model to engage patients and clinicians in setting research priorities.

PubMed

Pollock, Alex; St George, Bridget; Fenton, Mark; Crowe, Sally; Firkins, Lester

2014-01-01

Equitable involvement of patients and clinicians in setting research and funding priorities is ethically desirable and can improve the quality, relevance and implementation of research. Survey methods used in previous priority setting projects to gather treatment uncertainties may not be sufficient to facilitate responses from patients and their lay carers for some health care topics. We aimed to develop a new model to engage patients and clinicians in setting research priorities relating to life after stroke, and to explore the use of this model within a James Lind Alliance (JLA) priority setting project. We developed a model to facilitate involvement through targeted engagement and assisted involvement (FREE TEA model). We implemented both standard surveys and the FREE TEA model to gather research priorities (treatment uncertainties) from people affected by stroke living in Scotland. We explored and configured the number of treatment uncertainties elicited from different groups by the two approaches. We gathered 516 treatment uncertainties from stroke survivors, carers and health professionals. We achieved approximately equal numbers of contributions; 281 (54%) from stroke survivors/carers; 235 (46%) from health professionals. For stroke survivors and carers, 98 (35%) treatment uncertainties were elicited from the standard survey and 183 (65%) at FREE TEA face-to-face visits. This contrasted with the health professionals for whom 198 (84%) were elicited from the standard survey and only 37 (16%) from FREE TEA visits. The FREE TEA model has implications for future priority setting projects and user-involvement relating to populations of people with complex health needs. Our results imply that reliance on standard surveys may result in poor and unrepresentative involvement of patients, thereby favouring the views of health professionals.

Placing and preserving priorities: projects, productivity, progress and people

PubMed Central

Babiak, John

1998-01-01

High throughput screening (HTS) involves using automated equipment to test a large number of samples against a defined molecular target to identify a reasonable number of active molecules in a timely fashion. Major factors which can influence priorities for the limited resources of the HTS group are projects, productivity, progress and people. The challenge to the HTS group is to provide excellent and timely screening services, but still devote efforts to new technologies and personnel development. This article explains why these factors are so important. PMID:18924829

Cognitive and memory training in adults at risk of dementia: A Systematic Review

PubMed Central

2011-01-01

Background Effective non-pharmacological cognitive interventions to prevent Alzheimer's dementia or slow its progression are an urgent international priority. The aim of this review was to evaluate cognitive training trials in individuals with mild cognitive impairment (MCI), and evaluate the efficacy of training in memory strategies or cognitive exercises to determine if cognitive training could benefit individuals at risk of developing dementia. Methods A systematic review of eligible trials was undertaken, followed by effect size analysis. Cognitive training was differentiated from other cognitive interventions not meeting generally accepted definitions, and included both cognitive exercises and memory strategies. Results Ten studies enrolling a total of 305 subjects met criteria for cognitive training in MCI. Only five of the studies were randomized controlled trials. Meta-analysis was not considered appropriate due to the heterogeneity of interventions. Moderate effects on memory outcomes were identified in seven trials. Cognitive exercises (relative effect sizes ranged from .10 to 1.21) may lead to greater benefits than memory strategies (.88 to -1.18) on memory. Conclusions Previous conclusions of a lack of efficacy for cognitive training in MCI may have been influenced by not clearly defining the intervention. Our systematic review found that cognitive exercises can produce moderate-to-large beneficial effects on memory-related outcomes. However, the number of high quality RCTs remains low, and so further trials must be a priority. Several suggestions for the better design of cognitive training trials are provided. PMID:21942932

A review of soil heavy metal pollution from mines in China: pollution and health risk assessment.

PubMed

Li, Zhiyuan; Ma, Zongwei; van der Kuijp, Tsering Jan; Yuan, Zengwei; Huang, Lei

2014-01-15

Heavy metal pollution has pervaded many parts of the world, especially developing countries such as China. This review summarizes available data in the literature (2005-2012) on heavy metal polluted soils originating from mining areas in China. Based on these obtained data, this paper then evaluates the soil pollution levels of these collected mines and quantifies the risks these pollutants pose to human health. To assess these potential threat levels, the geoaccumulation index was applied, along with the US Environmental Protection Agency (USEPA) recommended method for health risk assessment. The results demonstrate not only the severity of heavy metal pollution from the examined mines, but also the high carcinogenic and non-carcinogenic risks that soil heavy metal pollution poses to the public, especially to children and those living in the vicinity of heavily polluted mining areas. In order to provide key management targets for relevant government agencies, based on the results of the pollution and health risk assessments, Cd, Pb, Cu, Zn, Hg, As, and Ni are selected as the priority control heavy metals; tungsten, manganese, lead-zinc, and antimony mines are selected as the priority control mine categories; and southern provinces and Liaoning province are selected as the priority control provinces. This review, therefore, provides a comprehensive assessment of soil heavy metal pollution derived from mines in China, while identifying policy recommendations for pollution mitigation and environmental management of these mines. © 2013.

[Priority pollutants ranking and screening of coke industry based on USEtox model].

PubMed

Hao, Tian; Du, Peng-Fei; Du, Bin; Zeng, Si-Yu

2014-01-01

Thesis aims at evaluating and setting priority to human toxicity and ecotoxicity of coking pollutants. A field research and sampling project are conducted in coke plant in Shanxi so as to complete the coke emission inventory. The USEtox model representing recommended practice in LCIA characterization is applied to the emission inventory to quantify the potential impacts on human toxicity and ecotoxicity of emerging pollutants. Priority pollutants, production procedures and effects of changing plant site on the toxicity are analyzed. As conclusions, benzo(a) pyrene, benzene, Zn and As are identified as the priority pollutants in human toxicity, while pyrene and anthracene in ecotoxicity. Coal charging is the dominant procedure for organic toxicity and priority pollutants include benzo (a) pyrene, benzene, naphthalene, etc. While coke drenching is the dominant procedure for metal toxicity and priority pollutants include Zn, As, Ti, Hg etc. Emission to rural environment can reduce the organic toxicity significantly compared to the emission to urban environment. However, the site changing has no effect on metal toxicity and might increase the risk of the metal pollution to rural water and soil.

A new risk assessment approach for the prioritization of 500 classical and emerging organic microcontaminants as potential river basin specific pollutants under the European Water Framework Directive.

PubMed

von der Ohe, Peter Carsten; Dulio, Valeria; Slobodnik, Jaroslav; De Deckere, Eric; Kühne, Ralph; Ebert, Ralf-Uwe; Ginebreda, Antoni; De Cooman, Ward; Schüürmann, Gerrit; Brack, Werner

2011-05-01

Given the huge number of chemicals released into the environment and existing time and budget constraints, there is a need to prioritize chemicals for risk assessment and monitoring in the context of the European Union Water Framework Directive (EU WFD). This study is the first to assess the risk of 500 organic substances based on observations in the four European river basins of the Elbe, Scheldt, Danube and Llobregat. A decision tree is introduced that first classifies chemicals into six categories depending on the information available, which allows water managers to focus on the next steps (e.g. derivation of Environmental Quality Standards (EQS), improvement of analytical methods, etc.). The priority within each category is then evaluated based on two indicators, the Frequency of Exceedance and the Extent of Exceedance of Predicted No-Effect Concentrations (PNECs). These two indictors are based on maximum environmental concentrations (MEC), rather than the commonly used statistically based averages (Predicted Effect Concentration, PEC), and compared to the lowest acute-based (PNEC(acute)) or chronic-based thresholds (PNEC(chronic)). For 56% of the compounds, PNECs were available from existing risk assessments, and the majority of these PNECs were derived from chronic toxicity data or simulated ecosystem studies (mesocosm) with rather low assessment factors. The limitations of this concept for risk assessment purposes are discussed. For the remainder, provisional PNECs (P-PNECs) were established from read-across models for acute toxicity to the standard test organisms Daphnia magna, Pimephales promelas and Selenastrum capricornutum. On the one hand, the prioritization revealed that about three-quarter of the 44 substances with MEC/PNEC ratios above ten were pesticides. On the other hand, based on the monitoring data used in this study, no risk with regard to the water phase could be found for eight of the 41 priority substances, indicating a first success of the implementation of the WFD in the investigated river basins. Copyright © 2011 Elsevier B.V. All rights reserved.

Research priority setting for integrated early child development and violence prevention (ECD+) in low and middle income countries: An expert opinion exercise.

PubMed

Tomlinson, Mark; Jordans, Mark; MacMillan, Harriet; Betancourt, Theresa; Hunt, Xanthe; Mikton, Christopher

2017-10-01

Child development in low and middle income countries (LMIC) is compromised by multiple risk factors. Reducing children's exposure to harmful events is essential for early childhood development (ECD). In particular, preventing violence against children - a highly prevalent risk factor that negatively affects optimal child development - should be an intervention priority. We used the Child Health and Nutrition Initiative (CHNRI) method for the setting of research priorities in integrated Early Childhood Development and violence prevention programs (ECD+). An expert group was identified and invited to systematically list and score research questions. A total of 186 stakeholders were asked to contribute five research questions each, and contributions were received from 81 respondents. These were subsequently evaluated using a set of five criteria: answerability; effectiveness; feasibility and/or affordability; applicability and impact; and equity. Of the 400 questions generated, a composite group of 50 were scored by 55 respondents. The highest scoring research questions related to the training of Community Health Workers (CHW's) to deliver ECD+ interventions effectively and whether ECD+ interventions could be integrated within existing delivery platforms such as HIV, nutrition or mental health platforms. The priority research questions can direct new research initiatives, mainly in focusing on the effectiveness of an ECD+ approach, as well as on service delivery questions. To the best of our knowledge, this is the first systematic exercise of its kind in the field of ECD+. The findings from this research priority setting exercise can help guide donors and other development actors towards funding priorities for important future research related to ECD and violence prevention. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Public health implications of environmental exposures.

PubMed Central

De Rosa, C T; Pohl, H R; Williams, M; Ademoyero, A A; Chou, C H; Jones, D E

1998-01-01

The Agency for Toxic Substances and Disease Registry (ATSDR) is a public health agency with responsibility for assessing the public health implications associated with uncontrolled releases of hazardous substances into the environment. The biological effects of low-level exposures are a primary concern in these assessments. One of the tools used by the agency for this purpose is the risk assessment paradigm originally outlined and described by the National Academy of Science in 1983. Because of its design and inherent concepts, risk assessment has been variously employed by a number of environmental and public health agencies and programs as a means to organize information, as a decision support tool, and as a working hypothesis for biologically based inference and extrapolation. Risk assessment has also been the subject of significant critical review. The ATSDR recognizes the utility of both the qualitative and quantitative conclusions provided by traditional risk assessment, but the agency uses such estimates only in the broader context of professional judgment, internal and external peer review, and extensive public review and comment. This multifaceted approach is consistent with the Council on Environmental Quality's description and use of risk analysis as an organizing construct based on sound biomedical and other scientific judgment in concert with risk assessment to define plausible exposure ranges of concern rather than a single numerical estimate that may convey an artificial sense of precision. In this approach biomedical opinion, host factors, mechanistic interpretation, molecular epidemiology, and actual exposure conditions are all critically important in evaluating the significance of environmental exposure to hazardous substances. As such, the ATSDR risk analysis approach is a multidimensional endeavor encompassing not only the components of risk assessment but also the principles of biomedical judgment, risk management, and risk communication. Within this framework of risk analysis, the ATSDR may rely on one or more of a number of interrelated principles and approaches to screen, organize information, set priorities, make decisions, and define future research needs and directions. Images Figure 1 PMID:9539032

Patient Safety in Complementary Medicine through the Application of Clinical Risk Management in the Public Health System

PubMed Central

Rossi, Elio G.; Picchi, Marco; Baccetti, Sonia; Monechi, Maria Valeria; Vuono, Catia; Sabatini, Federica; Traversi, Antonella; Di Stefano, Mariella; Firenzuoli, Fabio; Albolino, Sara; Tartaglia, Riccardo

2017-01-01

Aim: To develop a systematic approach to detect and prevent clinical risks in complementary medicine (CM) and increase patient safety through the analysis of activities in homeopathy and acupuncture centres in the Tuscan region using a significant event audit (SEA) and failure modes and effects analysis (FMEA). Methods: SEA is the selected tool for studying adverse events (AE) and detecting the best solutions to prevent future incidents in our Regional Healthcare Service (RHS). This requires the active participation of all the actors and external experts to validate the analysis. FMEA is a proactive risk assessment tool involving the selection of the clinical process, the input of a multidisciplinary group of experts, description of the process, identification of the failure modes (FMs) for each step, estimates of the frequency, severity, and detectability of FMs, calculation of the risk priority number (RPN), and prioritized improvement actions to prevent FMs. Results: In homeopathy, the greatest risk depends on the decision to switch from allopathic to homeopathic therapy. In acupuncture, major problems can arise, mainly from delayed treatment and from the modalities of needle insertion. Conclusions: The combination of SEA and FMEA can reveal potential risks for patients and suggest actions for safer and more reliable services in CM. PMID:29258191

Patient Safety in Complementary Medicine through the Application of Clinical Risk Management in the Public Health System.

PubMed

Rossi, Elio G; Bellandi, Tommaso; Picchi, Marco; Baccetti, Sonia; Monechi, Maria Valeria; Vuono, Catia; Sabatini, Federica; Traversi, Antonella; Di Stefano, Mariella; Firenzuoli, Fabio; Albolino, Sara; Tartaglia, Riccardo

2017-12-16

Aim: To develop a systematic approach to detect and prevent clinical risks in complementary medicine (CM) and increase patient safety through the analysis of activities in homeopathy and acupuncture centres in the Tuscan region using a significant event audit (SEA) and failure modes and effects analysis (FMEA). Methods: SEA is the selected tool for studying adverse events (AE) and detecting the best solutions to prevent future incidents in our Regional Healthcare Service (RHS). This requires the active participation of all the actors and external experts to validate the analysis. FMEA is a proactive risk assessment tool involving the selection of the clinical process, the input of a multidisciplinary group of experts, description of the process, identification of the failure modes (FMs) for each step, estimates of the frequency, severity, and detectability of FMs, calculation of the risk priority number (RPN), and prioritized improvement actions to prevent FMs. Results: In homeopathy, the greatest risk depends on the decision to switch from allopathic to homeopathic therapy. In acupuncture, major problems can arise, mainly from delayed treatment and from the modalities of needle insertion. Conclusions: The combination of SEA and FMEA can reveal potential risks for patients and suggest actions for safer and more reliable services in CM.

Application of failure mode and effects analysis (FMEA) to pretreatment phases in tomotherapy

PubMed Central

Broggi, Sara; Cantone, Marie Claire; Chiara, Anna; Muzio, Nadia Di; Longobardi, Barbara; Mangili, Paola

2013-01-01

The aim of this paper was the application of the failure mode and effects analysis (FMEA) approach to assess the risks for patients undergoing radiotherapy treatments performed by means of a helical tomotherapy unit. FMEA was applied to the preplanning imaging, volume determination, and treatment planning stages of the tomotherapy process and consisted of three steps: 1) identification of the involved subprocesses; 2) identification and ranking of the potential failure modes, together with their causes and effects, using the risk probability number (RPN) scoring system; and 3) identification of additional safety measures to be proposed for process quality and safety improvement. RPN upper threshold for little concern of risk was set at 125. A total of 74 failure modes were identified: 38 in the stage of preplanning imaging and volume determination, and 36 in the stage of planning. The threshold of 125 for RPN was exceeded in four cases: one case only in the phase of preplanning imaging and volume determination, and three cases in the stage of planning. The most critical failures appeared related to (i) the wrong or missing definition and contouring of the overlapping regions, (ii) the wrong assignment of the overlap priority to each anatomical structure, (iii) the wrong choice of the computed tomography calibration curve for dose calculation, and (iv) the wrong (or not performed) choice of the number of fractions in the planning station. On the basis of these findings, in addition to the safety strategies already adopted in the clinical practice, novel solutions have been proposed for mitigating the risk of these failures and to increase patient safety. PACS number: 87.55.Qr PMID:24036868

Wavelength assignment algorithm considering the state of neighborhood links for OBS networks

NASA Astrophysics Data System (ADS)

Tanaka, Yu; Hirota, Yusuke; Tode, Hideki; Murakami, Koso

2005-10-01

Recently, Optical WDM technology is introduced into backbone networks. On the other hand, as the future optical switching scheme, Optical Burst Switching (OBS) systems become a realistic solution. OBS systems do not consider buffering in intermediate nodes. Thus, it is an important issue to avoid overlapping wavelength reservation between partially interfered paths. To solve this problem, so far, the wavelength assignment scheme which has priority management tables has been proposed. This method achieves the reduction of burst blocking probability. However, this priority management table requires huge memory space. In this paper, we propose a wavelength assignment algorithm that reduces both the number of priority management tables and burst blocking probability. To reduce priority management tables, we allocate and manage them for each link. To reduce burst blocking probability, our method announces information about the change of their priorities to intermediate nodes. We evaluate its performance in terms of the burst blocking probability and the reduction rate of priority management tables.

TREATMENT AFTER ACUTE CORONARY SYNDROME: ANALYSIS OF PATIENT'S PRIORITIES WITH ANALYTIC HIERARCHY PROCESS.

PubMed

Mühlbacher, Axel C; Bethge, Susanne; Kaczynski, Anika

2016-01-01

Cardiovascular disease is one of the most common causes of death worldwide, with many individuals having experienced acute coronary syndrome (ACS). How patients with a history of ACS value aspects of their medical treatment have been evaluated rarely. The aim of this study was to determine patient priorities for long-term drug therapy after experiencing ACS. To identify patient-relevant treatment characteristics, a systematic literature review and qualitative patient interviews were conducted. A questionnaire was developed to elicit patient's priorities for different characteristics of ACS treatment using Analytic Hierarchy Process (AHP). To evaluate the patient-relevant outcomes, the eigenvector method was applied. Six-hundred twenty-three patients participated in the computer-assisted personal interviews and were included in the final analysis. Patients showed a clear priority for the attribute "reduction of mortality risk" (weight: 0.402). The second most preferred attribute was the "prevention of a new myocardial infarction" (weight: 0.272), followed by "side effect: dyspnea" (weight: 0.165) and "side effect: bleeding" (weight: 0.117). The "frequency of intake" was the least important attribute (weight: 0.044). In conclusion, this study shows that patients strongly value a reduction of the mortality risk in post-ACS treatment. Formal consideration of patient preferences and priorities can help to inform a patient-centered approach, clinical practice, development of future effective therapies, and health policy for decision makers that best represents the needs and goals of the patient.

Distribution and potential ecological risk of 50 phenolic compounds in three rivers in Tianjin, China.

PubMed

Zhong, Wenjue; Wang, Donghong; Wang, Zijian

2018-04-01

Phenolic compounds widely exist in the surface water of many countries; however, few studies have simultaneously analyzed and evaluated broad-spectrum phenolic compounds in various components of the water environment. Therefore this study analyzed the distribution and potential ecological risk of 50 phenolic compounds in the surface water, sediment and suspended particulate matter of three important rivers in Tianjin, the main heavy industry city with high pollution in China. The qualitative results show that phenolic pollution existed extensively in the three rivers and the kinds of phenolic compounds in the water were relatively higher than in both sediment and suspended particulate matter. The quantitative results show that the phenolic pollution in the wet-season samples was serious than dry-season samples. Meanwhile, total concentrations of phenolic compounds in three components from the Dagu Drainage River (DDR) were all much higher than those in the Beitang Drainage River (BDR) and Yongdingxin River (YDXR). The highest total concentrations of phenolic compounds in three components all appeared in wet-season samples in DDR, and the highest total concentration was 1354 μg/L in surface water, 719 μg/kg dw in suspended particulate matter and 2937 μg/kg dw in sediment, respectively. The ecological risk of phenolic compounds in surface water was evaluated using the quotient method, and phenolic compounds with risk quotient (RQ) > 1 (RQ > 0.3 for YDXR) were identified as priority pollutants. Five kinds of phenolic compounds were identified as priority phenolic compounds in BDR, and the order of risk was 2-cresol > 2,4-xylenol > 2-sec-butylphenol > 2-naphthol > 3-cresol. Six kinds of phenolic compounds were identified as priority phenolic compounds in DDR, and the order of risk was 2-naphthol > p-chloro-m-xylenol > 4-cresol > 3-cresol > 2,4-xylenol > 2,3,6-Trimethylphenol. In YDXR, only phenol, 2-naphthol and 2,4-xylenol were identified as priority phenolic compounds. Copyright © 2017 Elsevier Ltd. All rights reserved.

A comparative critical study between FMEA and FTA risk analysis methods

NASA Astrophysics Data System (ADS)

Cristea, G.; Constantinescu, DM

2017-10-01

Today there is used an overwhelming number of different risk analyses techniques with acronyms such as: FMEA (Failure Modes and Effects Analysis) and its extension FMECA (Failure Mode, Effects, and Criticality Analysis), DRBFM (Design Review by Failure Mode), FTA (Fault Tree Analysis) and and its extension ETA (Event Tree Analysis), HAZOP (Hazard & Operability Studies), HACCP (Hazard Analysis and Critical Control Points) and What-if/Checklist. However, the most used analysis techniques in the mechanical and electrical industry are FMEA and FTA. In FMEA, which is an inductive method, information about the consequences and effects of the failures is usually collected through interviews with experienced people, and with different knowledge i.e., cross-functional groups. The FMEA is used to capture potential failures/risks & impacts and prioritize them on a numeric scale called Risk Priority Number (RPN) which ranges from 1 to 1000. FTA is a deductive method i.e., a general system state is decomposed into chains of more basic events of components. The logical interrelationship of how such basic events depend on and affect each other is often described analytically in a reliability structure which can be visualized as a tree. Both methods are very time-consuming to be applied thoroughly, and this is why it is oftenly not done so. As a consequence possible failure modes may not be identified. To address these shortcomings, it is proposed to use a combination of FTA and FMEA.

Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Sex

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2011

2011-01-01

The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

Estimating the Number of Low-Income Americans Exposed to Household Air Pollution from Burning Solid Fuels

PubMed Central

Rogalsky, Derek K.; Mendola, Pauline; Metts, Tricia A.

2014-01-01

Background: Exposure to household air pollution (HAP) from inefficient biomass and coal stoves kills nearly 4 million people every year worldwide. HAP is an environmental risk associated with poverty that affects an estimated 3 billion people mostly in low- and middle-income countries. Objectives: Our goal was to estimate the number of low-income Americans exposed to potentially health-damaging concentrations of HAP. Methods: We mapped county-level data for the percentage of households using wood, coal, and/or coke as their primary heating fuel along with percent of the population below the federal poverty level. Using U.S. Census data and the likelihood of fugitive emissions as reported in the literature, we estimated the number of low-income Americans potentially exposed to HAP. Results: Solid fuel is the primary heating source for > 2.5 million U.S. households, or 6.5 million people. The mapping exercise showed several rural areas, primarily in the northern and western regions, that have high levels of solid-fuel use and poverty. We then identified 117 counties with high co-incident poverty and solid-fuel use as high-priority counties for research into potential health risks from HAP. We estimate that between 500,000 and 600,000 low-income people in the United States are likely exposed to HAP from burning solid fuels within their homes. Conclusion: HAP occurs within the United States and should be further investigated for adverse health risks, especially among those living in areas with rural poverty. Citation: Rogalsky DK, Mendola P, Metts TA, Martin WJ II. 2014. Estimating the number of low-income Americans exposed to household air pollution from burning solid fuels. Environ Health Perspect 122:806–810; http://dx.doi.org/10.1289/ehp.1306709 PMID:24833615

Risks to Students in School.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Office of Technology Assessment.

Every day, school-aged children encounter a wide variety of hazards that occur both outside and inside schools. This document presents findings of a report that examined the scientific data on the risks for student injury and illness in the school environment. The information is designed to help administrators set priorities for reducing risks to…

[Concomitant influence of occupational and social risk factors on health of workers engaged into powder metallurgy].

PubMed

Shur, P Z; Zaĭtseva, N V; Kostarev, V G; Lebedeva-Nesevria, N A; Shliapnikov, D M

2012-01-01

Results of health risk evaluation in workers engaged into powder metallurgy, using complex of hygienic, medical, epidemiologic and sociologic studies, enable to define priority occupational and social risk factors, to assess degree of their influence on the workers' health and to identify occupationally induced diseases.

Wisconsin Youth Risk Behavior Survey, 2001.

ERIC Educational Resources Information Center

Wisconsin State Dept. of Public Instruction, Madison.

The 2001 Wisconsin Youth Risk Behavior Survey (YRBS) was conducted as part of a national effort by the U.S. Centers for Disease Control and Prevention to monitor health-risk behaviors of the nations high school students. This report contains findings from the 2001 Wisconsin YRBS in eight priority areas: protective assets, unintentional injuries,…

Colorado: Youth Risk Behavior Survey, 1991.

ERIC Educational Resources Information Center

Colorado Univ. Health Sciences Center, Denver.

In April 1991, the Youth Risk Behavior Survey was administered to a sample of 1,412 high school students in Colorado public schools to collect information about priority health-risk behaviors among adolescents. Questionnaires were received from 1,170 students, a response rate of 83%. Classes in Colorado's 280 public schools were also selected to…

Impact of climate change on human health and health systems in Tanzania: a review.

PubMed

Mboera, Leonard E G; Mayala, Benjamin K; Kweka, Eliningaya J; Mazigo, Humphrey D

2011-12-01

Climate change (CC) has a number of immediate and long-term impacts on the fundamental determinants of human health. A number of potential human health effects have been associated either directly or indirectly with global climate change. Vulnerability to the risks associated with CC may exacerbate ongoing socio-economic challenges. The objective of this review was to analyse the potential risk and vulnerability in the context of climate-sensitive human diseases and health system in Tanzania. Climate sensitive vector- and waterborne diseases and other health related problems and the policies on climate adaptation in Tanzania during the past 50 years are reviewed. The review has shown that a number of climate-associated infectious disease epidemics have been reported in various areas of the country; mostly being associated with increase in precipitation and temperature. Although, there is no single policy document that specifically addresses issues of CC in the country, the National Environmental Management Act of 1997 recognizes the importance of CC and calls for the government to put up measures to address the phenomenon. A number of strategies and action plans related to CC are also in place. These include the National Biodiversity Strategy and Action Plan, the National Action Programme, and the National Bio-safety Framework. The government has put in place a National Climate Change Steering Committee and the National Climate Change Technical Committee to oversee and guide the implementation of CC activities in the country. Recognizing the adverse impacts of natural disasters and calamities, the government established a Disaster Management Division under the Prime Minister's Office. Epidemic Preparedness and Response Unit of the Ministry of Health and Social Welfare is responsible for emergency preparedness, mostly disease outbreaks. However, specific climate changes associated with human health issues are poorly addressed in the MoHSW strategies and the national health research priorities. In conclusion, CC threatens to slow, halt or reverses the progress the country has made or is making to achieve its national and millennium development goals. It is therefore important that Tanzania prepares itself to appropriately address CC impact on human health. It is equally important that policy makers and other stakeholders are engaged in a process to update and adapt priorities, mobilize resources and build interdisciplinary research and implementation capacity on climate change and its mitigation.

HUMAN EXPOSURE MODELING FOR CUMULATIVE RISK

EPA Science Inventory

US EPA's Office of Research and Development (ORD) has identified cumulative risk assessment as a priority research area. This is because humans and other organisms are exposed to a multitude of chemicals, physical agents, and other stressors through multiple pathways, routes, an...

Exponential error reduction in pretransfusion testing with automation.

PubMed

South, Susan F; Casina, Tony S; Li, Lily

2012-08-01

Protecting the safety of blood transfusion is the top priority of transfusion service laboratories. Pretransfusion testing is a critical element of the entire transfusion process to enhance vein-to-vein safety. Human error associated with manual pretransfusion testing is a cause of transfusion-related mortality and morbidity and most human errors can be eliminated by automated systems. However, the uptake of automation in transfusion services has been slow and many transfusion service laboratories around the world still use manual blood group and antibody screen (G&S) methods. The goal of this study was to compare error potentials of commonly used manual (e.g., tiles and tubes) versus automated (e.g., ID-GelStation and AutoVue Innova) G&S methods. Routine G&S processes in seven transfusion service laboratories (four with manual and three with automated G&S methods) were analyzed using failure modes and effects analysis to evaluate the corresponding error potentials of each method. Manual methods contained a higher number of process steps ranging from 22 to 39, while automated G&S methods only contained six to eight steps. Corresponding to the number of the process steps that required human interactions, the risk priority number (RPN) of the manual methods ranged from 5304 to 10,976. In contrast, the RPN of the automated methods was between 129 and 436 and also demonstrated a 90% to 98% reduction of the defect opportunities in routine G&S testing. This study provided quantitative evidence on how automation could transform pretransfusion testing processes by dramatically reducing error potentials and thus would improve the safety of blood transfusion. © 2012 American Association of Blood Banks.

A currency for offsetting energy development impacts: horse-trading sage-grouse on the open market.

PubMed

Doherty, Kevin E; Naugle, David E; Evans, Jeffrey S

2010-04-28

Biodiversity offsets provide a mechanism to compensate for unavoidable damages from new energy development as the U.S. increases its domestic production. Proponents argue that offsets provide a partial solution for funding conservation while opponents contend the practice is flawed because offsets are negotiated without the science necessary to backup resulting decisions. Missing in negotiations is a biologically-based currency for estimating sufficiency of offsets and a framework for applying proceeds to maximize conservation benefits. Here we quantify a common currency for offsets for greater sage-grouse (Centrocercus urophasianus) by estimating number of impacted birds at 4 levels of development commonly permitted. Impacts were indiscernible at 1-12 wells per 32.2 km(2). Above this threshold lek losses were 2-5 times greater inside than outside of development and bird abundance at remaining leks declined by -32 to -77%. Findings reiterated the importance of time-lags as evidenced by greater impacts 4 years after initial development. Clustering well locations enabled a few small leks to remain active inside of developments. Documented impacts relative to development intensity can be used to forecast biological trade-offs of newly proposed or ongoing developments, and when drilling is approved, anticipated bird declines form the biological currency for negotiating offsets. Monetary costs for offsets will be determined by true conservation cost to mitigate risks such as sagebrush tillage to other populations of equal or greater number. If this information is blended with landscape level conservation planning, the mitigation hierarchy can be improved by steering planned developments away from conservation priorities, ensuring compensatory mitigation projects deliver a higher return for conservation that equate to an equal number of birds in the highest priority areas, provide on-site mitigation recommendations, and provide a biologically based cost for mitigating unavoidable impacts.

76 FR 40898 - Final Priorities, Requirements, and Selection Criteria; Charter Schools Program (CSP) Grants for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-12

... schools. (3) A multi-year financial and operating model for the organization, a demonstrated commitment of... school model and to expand the number of high-quality charter schools available to students across the... percent threshold in this priority is consistent with the average percentage of students in large urban...

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

PubMed

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

2012-03-01

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

Identifying research priorities for public health research to address health inequalities: use of Delphi-like survey methods.

PubMed

Turner, S; Ollerhead, E; Cook, A

2017-10-09

In the funding of health research and public health research it is vital that research questions posed are important and that funded research meets a research need or a gap in evidence. Many methods are used in the identification of research priorities, however, these can be resource intensive, costly and logistically challenging. Identifying such research priorities can be particularly challenging for complex public health problems as there is a need to consult a number of experts across disciplines and with a range of expertise. This study investigated the use of Delphi-like survey methods in identifying important research priorities relating to health inequalities and framing tractable research questions for topic areas identified. The study was conducted in two phases, both using Delphi-like survey methods. Firstly, public health professionals with an interest in health inequalities were asked to identify research priorities. Secondly academic researchers were asked to frame tractable research questions relating to the priorities identified. These research priorities identified using Delphi-like survey methods were subsequently compared to those identified using different methods. A total of 52 public health professionals and 21 academics across the United Kingdom agreed to take part. The response rates were high, from public health professionals across three survey rounds (69%, 50% and 40%) and from academics across one round (52%), indicating that participants were receptive to the method and motivated to respond. The themes identified as encompassing the most important research priorities were mental health, healthy environment and health behaviours. Within these themes, the topic areas that emerged most strongly included community interventions for prevention of mental health problems and the food and alcohol environment. Some responses received from academic researchers were (as requested) in the form of tractable research questions, whereas others contributed further potential topic areas instead. Delphi-like survey methods are practical and productive as a means of obtaining opinions from a wide number of relevant experts identifying potential priority topic areas for research; however, this method is less appropriate for framing tractable research questions.

An early look at the Organ Procurement and Transplantation Network explant pathology form data.

PubMed

Harper, Ann M; Edwards, Erick; Washburn, W Kenneth; Heimbach, Julie

2016-06-01

In April 2012, the Organ Procurement and Transplantation Network (OPTN) implemented an online explant pathology form for recipients of liver transplantation who received additional wait-list priority for their diagnosis of hepatocellular carcinoma (HCC). The purpose of the form was to standardize the data being reported to the OPTN, which had been required since 2002 but were submitted to the OPTN in a variety of formats via facsimile. From April 2012 to December 2014, over 4500 explant forms were submitted, allowing for detailed analysis of the characteristics of the explanted livers. Data from the explant pathology forms were used to assess agreement with pretransplant imaging. Explant data were also used to assess the risk of recurrence. Of those with T2 priority, 55.7% were found to be stage T2 on explant. Extrahepatic spread (odds ratio [OR] = 6.8; P < 0.01), poor tumor differentiation (OR = 2.8; P < 0.01), microvascular invasion (OR = 2.6; P < 0.01), macrovascular invasion (OR = 3.2; P < 0.01), and whether the Milan stage based on the number and size of tumors on the explant form was T4 (OR = 2.4; P < 0.01) were the strongest predictors of recurrence. In conclusion, this analysis confirms earlier findings that showed an incomplete agreement between pretransplant imaging and posttransplant pathology in terms of HCC staging, though the number of patients with both no pretransplant treatment and no tumor in the explant was reduced from 20% to <1%. In addition, several factors were identified (eg, tumor burden, age, sex, region, ablative therapy, alpha-fetoprotein, Milan stage, vascular invasion, satellite lesions, etc.) that were predictive of HCC recurrence, allowing for more targeted surveillance of high-risk recipients. Continued evaluation of these data will help shape future guidelines or policy recommendations. Liver Transplantation 22 757-764 2016 AASLD. © 2016 American Association for the Study of Liver Diseases.

Global research priorities to mitigate plastic pollution impacts on marine wildlife

USGS Publications Warehouse

Vegter, Amanda C.; Barletta, Mário; Beck, Cathy A.; Borrero, Jose C.; Burton, Harry; Campbell, Marnie L.; Costa, Monica F.; Eriksen, Marcus; Eriksson, Cecilia; Estrades, Andres; Gilardi, Kirsten V.; Hardesty, Britta D.; do Sul, Juliana A. Ivar; Lavers, Jennifer L.; Lazar, Bojan; Lebreton, Laurent; Nichols, Wallace J.; Ribic, Christine A.; Ryan, Peter G.; Schuyler, Qamar A.; Smith, Stephen D. A.; Takada, Hideshige; Townsend, Kathy A.; Wabnitz, Colette C. C.; Wilcox, Chris; Young, Lindsay C.; Hamann, Mark

2014-01-01

Marine wildlife faces a growing number of threats across the globe, and the survival of many species and populations will be dependent on conservation action. One threat in particular that has emerged over the last 4 decades is the pollution of oceanic and coastal habitats with plastic debris. The increased occurrence of plastics in marine ecosystems mirrors the increased prevalence of plastics in society, and reflects the high durability and persistence of plastics in the environment. In an effort to guide future research and assist mitigation approaches to marine conservation, we have generated a list of 16 priority research questions based on the expert opinions of 26 researchers from around the world, whose research expertise spans several disciplines, and covers each of the world’s oceans and the taxa most at risk from plastic pollution. This paper highlights a growing concern related to threats posed to marine wildlife from microplastics and fragmented debris, the need for data at scales relevant to management, and the urgent need to develop interdisciplinary research and management partnerships to limit the release of plastics into the environment and curb the future impacts of plastic pollution.

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

PubMed

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

2017-01-01

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

Remotely Sensed Data Informs Red List Evaluations and Conservation Priorities in Southeast Asia.

PubMed

Li, Binbin V; Hughes, Alice C; Jenkins, Clinton N; Ocampo-Peñuela, Natalia; Pimm, Stuart L

2016-01-01

The IUCN Red List has assessed the global distributions of the majority of the world's amphibians, birds and mammals. Yet these assessments lack explicit reference to widely available, remotely-sensed data that can sensibly inform a species' risk of extinction. Our first goal is to add additional quantitative data to the existing standardised process that IUCN employs. Secondly, we ask: do our results suggest species of concern-those at considerably greater risk than hitherto appreciated? Thirdly, these assessments are not only important on a species-by-species basis. By combining distributions of species of concern, we map conservation priorities. We ask to what degree these areas are currently protected and how might knowledge from remote sensing modify the priorities? Finally, we develop a quick and simple method to identify and modify the priority setting in a landscape where natural habitats are disappearing rapidly and so where conventional species' assessments might be too slow to respond. Tropical, mainland Southeast Asia is under exceptional threat, yet relatively poorly known. Here, additional quantitative measures may be particularly helpful. This region contains over 122, 183, and 214 endemic mammals, birds, and amphibians, respectively, of which the IUCN considers 37, 21, and 37 threatened. When corrected for the amount of remaining natural habitats within the known elevation preferences of species, the average sizes of species ranges shrink to <40% of their published ranges. Some 79 mammal, 49 bird, and 184 amphibian ranges are <20,000km2-an area at which IUCN considers most other species to be threatened. Moreover, these species are not better protected by the existing network of protected areas than are species that IUCN accepts as threatened. Simply, there appear to be considerably more species at risk than hitherto appreciated. Furthermore, incorporating remote sensing data showing where habitat loss is prevalent changes the locations of conservation priorities.

Identification of current priorities for research in humanitarian action: proceedings of the First Annual UN OCHA Policy and Research Conference.

PubMed

Foran, Mark P; Greenough, Paul G; Thow, Andrew; Gilman, Daniel; Schütz, Andreas; Chandran, Rahul; Baiocchi, Allegra

2012-06-01

On December 12-13, 2011, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) hosted a humanitarian policy and research conference on the theme of "Risk, Adaptation and Innovation in Humanitarian Action." The four sessions of the conference covered humanitarian action in a changing world, adaptation and innovation in humanitarian action, humanitarian action in protracted and violent conflict, and effective humanitarian action. This special report contains summaries of presentations in each session and the conclusions resulting from the discussions throughout. Through a process of open discussion, debate, and a closing survey, the conference participants identified four top priorities in humanitarian research for the coming years: evidence-driven humanitarian decision-making; accountability and transparency; risk and agility; and partnership. In addition to plans for a 2nd Annual Research and Policy conference in December of 2012, specific outcomes of the conference include a series of regional workshops in 2012 and 2013, launching with Asia, Africa and the Middle East; creation of Policy Working Groups (PWG) for each research priority identified; and a new flagship OCHA publication, to be launched in late 2012 or early 2013, which will share the progress made on the research priorities identified.

Wyoming Basin Rapid Ecoregional Assessment

USGS Publications Warehouse

Carr, Natasha B.; Means, Robert E.

2013-01-01

The overall goal of the Wyoming Basin Rapid Ecoregional Assessment (REA) is to provide information that supports regional planning and analysis for the management of ecological resources. The REA provides an assessment of baseline ecological conditions, an evaluation of current risks from drivers of ecosystem change (including energy development, fire, and invasive species), and a predictive capacity for evaluating future risks (including climate change). Additionally, the REA may be used for identifying priority areas for conservation or restoration and for assessing cumulative effects of multiple land uses. The Wyoming Basin REA will address Management Questions developed by the Bureau of Land Management and other agency partners for 8 major biomes and 19 species or species assemblages. The maps developed for addressing Management Questions will be integrated into overall maps of landscape-level ecological values and risks. The maps can be used to address the goals of the REA at a number of levels: for individual species, species assemblages, aquatic and terrestrial systems, and for the entire ecoregion. This allows flexibility in how the products of the REA are compiled to inform planning and management actions across a broad range of spatial scales.

[Postbular duodenal ulcer. Problems of diagnosis and treatment. Role of vagotomy in surgical treatment].

PubMed

Juvara, I; Rădulescu, D; Păcescu, E; Dragomirescu, C; Gavrilescu, S

1977-01-01

A number of 43 cases is presented, of post-bulbar duodenal ulcers in which surgery has been performed between 1965 and 1974, of which 30 were located in the first portion of the duodenum, in the postbulbar area, and 15 in the second portion, above the ampula of Vater. Problems of terminology and pathological anatomy are discussed, especially in connection with the symptomatology, complications, methodology of investigations and treatment of post-bulbar ulcers. The particular frequency is stressed, of complicated clinical forms, with stenosis and hemorrhagies, and a detailed description is made of atypical forms, with misleading, predominantly biliary or pancreatic symptomatology. Conditions are stressed, of the radiologic gastroduodenal exploration, of major importance in the diagnosis preceding surgery, as well as of pre- and intra-surgery cholangiography. The risk must be carefully evaluated, in the choice of the surgical method, and exeresis of the ulcer must be balanced with the risk of its continued presence. Priority should be given to th risks entailed by surgery. The choice solution in many cases is vagotomy associated to exclusion resection or to gastric derivation.

Colorectal cancer and its association with the metabolic syndrome: a Malaysian multi-centric case-control study.

PubMed

Ulaganathan, V; Kandiah, M; Zalilah, M S; Faizal, J A; Fijeraid, H; Normayah, K; Gooi, B H; Othman, R

2012-01-01

Colorectal cancer (CRC) and the metabolic syndrome (MetS) are both on the rise in Malaysia. A multi-centric case-control study was conducted from December 2009 to January 2011 to determine any relationship between the two. Patients with confirmed CRC based on colonoscopy findings and cancer free controls from five local hospitals were assessed for MetS according to the International Diabetes Federation (IDF) definition. Each index case was matched for age, gender and ethnicity with two controls (140: 280). MetS among cases was highly prevalent (70.7%), especially among women (68.7%). MetS as an entity increased CRC risk by almost three fold independently (OR=2.61, 95%CI=1.53-4.47). In men MetS increased the risk of CRC by two fold (OR=2.01, 95%CI, 1.43-4.56), demonstrating an increasing trend in risk with the number of Mets components observed. This study provides evidence for a positive association between the metabolic syndrome and colorectal cancer. A prospective study on the Malaysian population is a high priority to confirm these findings.

The impact of hospitalisation on a visiting family member: A case study and discussion.

PubMed

Rückholdt, Monica; Tofler, Geoffrey H; Buckley, Thomas

2017-05-01

Evidence suggests that when an immediate family member of a spouse is hospitalised, the partner's risk of death significantly increases. Hospitalisation can represent a time of great vulnerability and imposed stress for both the patient and their family members. Family members have been reported to give priority to the welfare of their ill relative and in their heightened emotional state, often adversely put their own health at risk. The paper presents a case study highlighting how an intensive care hospitalisation and discharge to rehabilitation experience for a patient's mother triggered an episode of myocardial infarction for her adult son. Discussion focuses on the caregiving burden and potential mechanisms for how hospitalisation may contribute to the health risk of immediate family members of hospitalised patients. Discussion also highlights the importance of family members receiving clear, continuous and consistent information from a limited number of clinicians to help reduce the stress associated with caregiving during acute hospitalisation. Copyright © 2016 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Meeting national response time targets for priority 1 incidents in an urban emergency medical services system in South Africa: More ambulances won't help.

PubMed

Stein, Christopher; Wallis, Lee; Adetunji, Olufemi

2015-09-19

Response time is viewed as a key performance indicator in most emergency medical services (EMS) systems. To determine the effect of increased emergency vehicle numbers on response time performance for priority 1 incidents in an urban EMS system in Cape Town, South Africa, using discrete-event computer simulation. A simulation model was created, based on input data from part of the EMS operations. Two different versions of the model were used, one with primary response vehicles and ambulances and one with only ambulances. In both cases the models were run in seven different scenarios. The first scenario used the actual number of emergency vehicles in the real system, and in each subsequent scenario vehicle numbers were increased by adding the baseline number to the cumulative total. The model using only ambulances had shorter response times and a greater number of responses meeting national response time targets than models using primary response vehicles and ambulances. In both cases an improvement in response times and the number of responses meeting national response time targets was observed with the first incremental addition of vehicles. After this the improvements rapidly diminished and eventually became negligible with each successive increase in vehicle numbers. The national response time target for urban areas was never met, even with a seven-fold increase in vehicle numbers. The addition of emergency vehicles to an urban EMS system improves response times in priority 1 incidents, but alone is not capable of the magnitude of response time improvement needed to meet the national response time targets.

Future initiatives to reduce lung cancer incidence in the United Kingdom: smoking cessation, radon remediation and the impact of social change.

PubMed

Denman, Antony R; Rogers, Stephen; Timson, Karen; Phillips, Paul S; Crockett, Robin Gm; Groves-Kirkby, Christopher J

2015-03-01

Smoking and radon cause lung cancer, with smoking being the more significant risk factor. Although programmes to identify UK houses with raised radon levels and to encourage remedial action started in 1990, uptake has been limited and those most at risk, smokers and young families, are not being reached. The risks from smoking and radon are multiplicative. Public health campaigns have reduced smoking prevalence significantly. Since most radon-induced lung cancers occur in smokers, reducing the number of smokers will reduce the number of radon-induced lung cancers. This article considers the impact of reducing smoking prevalence on the effectiveness of radon remediation programmes, combining this with demographic trends and regional variations to assess implications for future public health. Results on cost-effectiveness of smoking cessation and radon remediation programmes were combined with government figures for smoking prevalence to estimate the number of cancers averted and the cost-effectiveness of such programmes, taking into account demographic changes, including increasing life expectancy. Regional variations in smoking prevalence and smoking cessation programmes were reviewed, comparing these to the geographic variation of radon. The continuing impact of smoking cessation programmes in reducing smoking prevalence will reduce the number of radon-induced lung cancers, but with a lag. Smoking cessation programmes are more cost-effective than radon remediation programmes, presenting an additional opportunity to reduce radon risk to smokers. Regional data show no correlation between smoking prevalence and radon levels. Reduced smoking prevalence reduces the effectiveness of radon remediation programmes. This, coupled with limited uptake of radon remediation, suggests that radon remediation programmes should be targeted, and that an integrated public health policy for smoking and radon is appropriate. Lack of correlation between smoking prevalence and radon suggests that local assessment of relative priorities for public health strategies, such as the 'Total Place' initiative, is appropriate. © Royal Society for Public Health 2014.

Attentional priority determines working memory precision.

PubMed

Klyszejko, Zuzanna; Rahmati, Masih; Curtis, Clayton E

2014-12-01

Visual working memory is a system used to hold information actively in mind for a limited time. The number of items and the precision with which we can store information has limits that define its capacity. How much control do we have over the precision with which we store information when faced with these severe capacity limitations? Here, we tested the hypothesis that rank-ordered attentional priority determines the precision of multiple working memory representations. We conducted two psychophysical experiments that manipulated the priority of multiple items in a two-alternative forced choice task (2AFC) with distance discrimination. In Experiment 1, we varied the probabilities with which memorized items were likely to be tested. To generalize the effects of priority beyond simple cueing, in Experiment 2, we manipulated priority by varying monetary incentives contingent upon successful memory for items tested. Moreover, we illustrate our hypothesis using a simple model that distributed attentional resources across items with rank-ordered priorities. Indeed, we found evidence in both experiments that priority affects the precision of working memory in a monotonic fashion. Our results demonstrate that representations of priority may provide a mechanism by which resources can be allocated to increase the precision with which we encode and briefly store information. Copyright © 2014 Elsevier Ltd. All rights reserved.

Priority setting in clinical nursing practice: literature review.

PubMed

Hendry, Charles; Walker, Anne

2004-08-01

Time is a valuable resource. When nurses experience demands on their services which exceed their available time, then 'rationing' must occur. In clinical practice such rationing requires practitioners to set priorities for care. The aim of this paper is establish what is currently known about priority setting in nursing, including how nurses set priorities and what factors influence this. CINAHL, Medline, ASSIA, and PsychLit databases for the years 1982-2002 were searched, using the terms (clinical decision-making or problem-solving or planning) and (setting priorities or prioriti*). The publications found were used in a selective, descriptive review. Priority setting is an important skill in nursing, and a skill deficit can have serious consequences for patients. Recent studies have suggested that it is a difficult skill for newly qualified nurses to acquire and may not be given sufficient attention in nurse education. Priority setting can be defined as the ordering of nursing problems using notions of urgency and/or importance, in order to establish a preferential order for nursing actions. A number of factors that may impact on priority setting have been identified in the literature. These include: the expertise of the nurse; the patient's condition; the availability of resources; ward organization; philosophies and models of care; the nurse-patient relationship; and the cognitive strategy used by the nurse to set priorities. However, very little empirical work has been conducted in this area. Further study of priority setting in a range of clinical practice settings is necessary. This could inform both practice and education, promote better use of limited resources and maximize patient outcomes.

Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Race/Ethnicity

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2011

2011-01-01

The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

An integrated Shannon's Entropy-TOPSIS methodology for environmental risk assessment of Helleh protected area in Iran.

PubMed

Jozi, S A; Shafiee, M; MoradiMajd, N; Saffarian, S

2012-11-01

This study aims to use integrated Shannon's Entropy-TOPSIS methodology for environmental risk assessment of the Helleh protected area in Iran. In this research, first, with regard to field visits, interview with natives of the area, and investigation of the environment of the study area, the risks existing in the region were identified. Then, for final identification of the risks, the Delphi method was applied. Analysis and prioritization of risks of the area of Helleh were performed by multi-criteria decision-making methods of Shannon's Entropy and the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). In this research, risks were assessed by three criteria of severity, probability of occurrence, and vulnerability. Twenty six of the risks were identified which were specified in two groups, natural events and environmental risks. The environmental ones were classified into four groups: physicochemical, biological, social-economic, and cultural. Results of the research showed that the construction of the Rayis-Ali-Delvari Dam at the upper part of the study area threatens the wetland. Water supply for the dam 75 km away from the area with concession of 0.9999 holds the first priority of risk-generating factors. Of the managerial workable solutions suggested controlling the risks, the stopping of the pumping of water from the wetland and observation of hunting season length and permissible type and number of hunting in the area can be mentioned.

The Role of Space Medicine in Management of Risk in Spaceflight

NASA Technical Reports Server (NTRS)

Clark, Jonathan B.

2001-01-01

The purpose of Space Medicine is to ensure mission success by providing quality and comprehensive health care throughout all mission phases to optimize crew health and performance and to prevent negative long-term health consequences. Space flight presents additional hazards and associated risks to crew health, performance, and safety. With an extended human presence in space it is expected that illness and injury will occur on orbit, which may present a significant threat to crew health and performance and to mission success. Maintaining crew health, safety and performance and preventing illness and injury are high priorities necessary for mission success and agency goals. Space flight health care should meet the standards of practice of evidence based clinical medicine. The function of Space Medicine is expected to meet the agency goals as stated in the 1998 NASA Strategic Plan and the priorities established by the Critical Path Roadmap Project. The Critical Path Roadmap Project is an integrated NASA cross-disciplinary strategy to assess, understand, mitigate, and manage the risks associated with long-term exposure to the space flight environment. The evidence based approach to space medicine should be standardized, objective process yielding expected results and establishing clinical practice standards while balancing individual risk with mission (programmatic) risk. The ability to methodically apply available knowledge and expertise to individual and mission health issues will ensure appropriate priorities are assigned and resources are allocated. NASA Space Medicine risk management process is a combined clinical and engineering approach. Competition for weight, power, volume, cost, and crew time must be balanced in making decisions about the care of individual crew with competing agency resources.

Establishing research priorities for patient safety in emergency medicine: a multidisciplinary consensus panel.

PubMed

Plint, Amy C; Stang, Antonia S; Calder, Lisa A

2015-01-01

Patient safety in the context of emergency medicine is a relatively new field of study. To date, no broad research agenda for patient safety in emergency medicine has been established. The objective of this study was to establish patient safety-related research priorities for emergency medicine. These priorities would provide a foundation for high-quality research, important direction to both researchers and health-care funders, and an essential step in improving health-care safety and patient outcomes in the high-risk emergency department (ED) setting. A four-phase consensus procedure with a multidisciplinary expert panel was organized to identify, assess, and agree on research priorities for patient safety in emergency medicine. The 19-member panel consisted of clinicians, administrators, and researchers from adult and pediatric emergency medicine, patient safety, pharmacy, and mental health; as well as representatives from patient safety organizations. In phase 1, we developed an initial list of potential research priorities by electronically surveying a purposeful and convenience sample of patient safety experts, ED clinicians, administrators, and researchers from across North America using contact lists from multiple organizations. We used simple content analysis to remove duplication and categorize the research priorities identified by survey respondents. Our expert panel reached consensus on a final list of research priorities through an in-person meeting (phase 3) and two rounds of a modified Delphi process (phases 2 and 4). After phases 1 and 2, 66 unique research priorities were identified for expert panel review. At the end of phase 4, consensus was reached for 15 research priorities. These priorities represent four themes: (1) methods to identify patient safety issues (five priorities), (2) understanding human and environmental factors related to patient safety (four priorities), (3) the patient perspective (one priority), and (4) interventions for improving patient safety (five priorities). This study established expert, consensus-based research priorities for patient safety in emergency medicine. This framework could be used by researchers and health-care funders and represents an essential guiding step towards enhancing quality of care and patient safety in the ED.

Risk management for outsourcing biomedical waste disposal – Using the failure mode and effects analysis

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

Liao, Ching-Jong; Ho, Chao Chung, E-mail: ho919@pchome.com.tw

Highlights: • This study is based on a real case in hospital in Taiwan. • We use Failure Mode and Effects Analysis (FMEA) as the evaluation method. • We successfully identify the evaluation factors of bio-medical waste disposal risk. - Abstract: Using the failure mode and effects analysis, this study examined biomedical waste companies through risk assessment. Moreover, it evaluated the supervisors of biomedical waste units in hospitals, and factors relating to the outsourcing risk assessment of biomedical waste in hospitals by referring to waste disposal acts. An expert questionnaire survey was conducted on the personnel involved in waste disposalmore » units in hospitals, in order to identify important factors relating to the outsourcing risk of biomedical waste in hospitals. This study calculated the risk priority number (RPN) and selected items with an RPN value higher than 80 for improvement. These items included “availability of freezing devices”, “availability of containers for sharp items”, “disposal frequency”, “disposal volume”, “disposal method”, “vehicles meeting the regulations”, and “declaration of three lists”. This study also aimed to identify important selection factors of biomedical waste disposal companies by hospitals in terms of risk. These findings can serve as references for hospitals in the selection of outsourcing companies for biomedical waste disposal.« less

Assessment of Inhalation Risk to Public Health in the Southern Ural

NASA Astrophysics Data System (ADS)

Ulrikh, D. V.; Ivanova, S. V.; Riabchikova, I. A.

2017-11-01

A large number of iron and steel companies in the Southern Ural cause severe air pollution in the towns of Karabash (Chelyabinsk region), Sibay (Republic of Bashkortostan), Gai (Orenburg region). The article aims to assess the inhalation effects of hazardous substances on the Southern Ural population. The analysis focused on cancer and non-cancer risks to public health that arise from the surface air pollution caused by the metallurgical industry emissions. The assessment was carried out on the basis of methodological guidelines R 2.1.10.1920-04 using modern sanitary and hygienic standards. We analysed the level of ambient air pollution in the impact area of the metallurgical industry of Karabash, Sibay and Gai over the past eleven years. We established that the ambient air of all the studied towns contain carcinogenic substances that cause unacceptable cancer risks. Formaldehyde has the main share in this risk. We calculated the hazard quotients HQ for the identified priority pollutants and the total hazard indices HI. It is shown that the non-cancer inhalation risk to the Southern Ural population exceeds the safe level manyfold. Sulfur dioxide has the main share in this risk. The conducted assessment showed that in 2006-2016, there was a continuous inhalation exposure of the population to hazardous substances. Sanitary and technological solutions that will allow a reduction of risk to acceptable values are required.

Nutritional Risk Needs Assessment of Community-Living Seniors: Prevalence of Nutrition Problems and Priorities for Action.

ERIC Educational Resources Information Center

Keller, Heather H.; Hedley, Margaret R.

2002-01-01

Surveyed community-dwelling older adults to examine the prevalence of nutritional risk, specific nutrition problems, and educational format preferences. Results revealed that nutrition problems and risk were prevalent among community-dwelling older adults. Common problems included significant weight change in 6 months and low intake of fruits,…

Developing risk-based priorities for reducing air pollution in urban settings in Ukraine.

PubMed

Brody, Michael; Caldwell, Jane; Golub, Alexander

2007-02-01

Ukraine, when part of the former Soviet Union, was responsible for about 25% of its overall industrial production. This aging industrial infrastructure continues to emit enormous volumes of air and water pollution and wastes. The National Report on the State of Environment in Ukraine 1999 (Ukraine Ministry of Environmental Protection [MEP], 2000) shows significant air pollution. There are numerous emissions that have been associated with developmental effects, chronic long-term health effects, and cancer. Ukraine also has been identified as a major source of transboundary air pollution for the eastern Mediterranean region. Ukraine's Environment Ministry is not currently able to strategically target high-priority emissions and lacks the resources to address all these problems. For these reasons, the U.S. Environmental Protection Agency set up a partnership with Ukraine's Ministry of Environmental Protection to strengthen its capacity to set environmental priorities through the use of comparative environmental risk assessment and economic analysis--the Capacity Building Project. The project is also addressing improvements in the efficiency and effectiveness of the use of its National Environmental Protection Fund. The project consists of a series of workshops with Ukrainian MEP officials in comparative risk assessment of air pollutant emissions in several heavily industrialized oblasts; cost-benefit and cost-effectiveness analysis; and environmental finance. Pilot risk assessment analyses have been completed. At the end of the Capacity Building Project it is expected that the use of the National Environmental Protection fund and the regional level oblast environmental protection funds will begin to target and identify the highest health and environmental risk emissions.

Condom availability in high risk places and condom use: a study at district level in Kenya, Tanzania and Zambia

PubMed Central

2012-01-01

Background A number of studies from countries with severe HIV epidemics have found gaps in condom availability, even in places where there is a substantial potential for HIV transmission. Although reported condom use has increased in many African countries, there are often big differences by socioeconomic background. The aim of this study was to assess equity aspects of condom availability and uptake in three African districts to evaluate whether condom programmes are given sufficient priority. Methods Data on condom availability and use was examined in one district in Kenya, one in Tanzania and one in Zambia. The study was based on a triangulation of data collection methods in the three study districts: surveys in venues where people meet new sexual partners, population-based surveys and focus group discussions. The data was collected within an overall study on priority setting in health systems. Results At the time of the survey, condoms were observed in less than half of the high risk venues in two of the three districts and in 60% in the third district. Rural respondents in the population-based surveys perceived condoms to be less available and tended to be less likely to report condom use than urban respondents. Although focus group participants reported that condoms were largely available in their district, they expressed concerns related to the accessibility of free condoms. Conclusion As late as thirty years into the HIV epidemic there are still important gaps in the availability of condoms in places where people meet new sexual partners in these three African districts. Considering that previous studies have found that improved condom availability and accessibility in high risk places have a potential to increase condom use among people with multiple partners, the present study findings indicate that substantial further efforts should be made to secure that condoms are easily accessible in places where sexual relationships are initiated. Although condom distribution in drinking places has been pinpointed in the HIV/AIDS prevention strategies of all the three countries, its priority relative to other HIV/AIDS measures must be reassessed locally, nationally and regionally. In practical terms very clear supply chains of condoms to both formal and informal drinking places could make condom provision better and more reliable. PMID:23181969

Condom availability in high risk places and condom use: a study at district level in Kenya, Tanzania and Zambia.

PubMed

Sandøy, Ingvild Fossgard; Blystad, Astrid; Shayo, Elizabeth H; Makundi, Emmanuel; Michelo, Charles; Zulu, Joseph; Byskov, Jens

2012-11-26

A number of studies from countries with severe HIV epidemics have found gaps in condom availability, even in places where there is a substantial potential for HIV transmission. Although reported condom use has increased in many African countries, there are often big differences by socioeconomic background. The aim of this study was to assess equity aspects of condom availability and uptake in three African districts to evaluate whether condom programmes are given sufficient priority. Data on condom availability and use was examined in one district in Kenya, one in Tanzania and one in Zambia. The study was based on a triangulation of data collection methods in the three study districts: surveys in venues where people meet new sexual partners, population-based surveys and focus group discussions. The data was collected within an overall study on priority setting in health systems. At the time of the survey, condoms were observed in less than half of the high risk venues in two of the three districts and in 60% in the third district. Rural respondents in the population-based surveys perceived condoms to be less available and tended to be less likely to report condom use than urban respondents. Although focus group participants reported that condoms were largely available in their district, they expressed concerns related to the accessibility of free condoms. As late as thirty years into the HIV epidemic there are still important gaps in the availability of condoms in places where people meet new sexual partners in these three African districts. Considering that previous studies have found that improved condom availability and accessibility in high risk places have a potential to increase condom use among people with multiple partners, the present study findings indicate that substantial further efforts should be made to secure that condoms are easily accessible in places where sexual relationships are initiated. Although condom distribution in drinking places has been pinpointed in the HIV/AIDS prevention strategies of all the three countries, its priority relative to other HIV/AIDS measures must be reassessed locally, nationally and regionally. In practical terms very clear supply chains of condoms to both formal and informal drinking places could make condom provision better and more reliable.

Trace Elements Contamination and Human Health Risk Assessment in Drinking Water from the Agricultural and Pastoral Areas of Bay County, Xinjiang, China.

PubMed

Turdi, Muyessar; Yang, Linsheng

2016-09-23

Tap water samples were collected from 180 families in four agricultural (KYR: Keyir, KRW: Kariwak, YTR: Yatur, DW: Dawanqi) and two pastoral areas (B: Bulong and Y: Yangchang) in Bay County, Xinjiang, China, and levels of seven trace elements (Cd, Cr, As Ni, Pb, Zn, Se) were analyzed using inductively-coupled plasma mass spectrometry (ICP-MS) to assess potential health risks. Remarkable spatial variations of contamination were observed. Overall, the health risk was more severe for carcinogenic versus non-carcinogenic pollutants due to heavy metal. The risk index was greater for children overall (Cr > As > Cd and Zn > Se for carcinogenic and non-carcinogenic elements, respectively). The total risk index was greater in agricultural areas (DW > KYR > YTR > KRW > B > Y). Total risk indices were greater where well water was the source versus fountain water; for the latter, the total health risk index was greater versus glacier water. Main health risk factors were Cr and As in DW, KYR, YTR, KRW, and B, and Zn, Cr, and As in the Y region. Overall, total trace element-induced health risk (including for DW adults) was higher than acceptable (10(-6)) and lower than priority risk levels (10(-4)) (KYR, YTR, KRW, Y, and B). For DW children, total health risk reached 1.08 × 10(-4), higher than acceptable and priority risk levels (10(-4)).

Understanding School District Budgets: A Guide For Local Leaders

ERIC Educational Resources Information Center

Perry, Mary

2005-01-01

A school district budget is more than numbers. It is a record of a district?s past decisions and a spending plan for its future. It shows a district?s priorities whether they have been clearly articulated or simply occurred by default. And it is a communications document that can tell constituents a lot about the district?s priorities and goals. A…

African Language Resource Handbook: A Resource Handbook of the Eighty-two Highest Priority African Languages. Prepublication Edition.

ERIC Educational Resources Information Center

Dwyer, David J.; Yankee, Everyl

A directory of the 82 African languages given high priority for instruction in the United States contains a profile for each language that includes its classification and where it is spoken, the number of speakers, dialect situation, usage, orthography status, and listings of related human and institutional resources for the purpose of…

Defining Family Health Needs, Standards of Care and Priorities with Particular Reference to Family Planning. Occasional Essay Number 4.

ERIC Educational Resources Information Center

Sai, Fred T.

This essay discusses family health needs in the developing world, their priorities, and the standards of health required, with particular reference to family planning. The author takes into account medical, social, and economic factors that influence those concerns. Some of the material presented in this essay first appeared in other international…

Policy in Transition: The Emergence of Tackling Early School Leaving (ESL) as EU Policy Priority

ERIC Educational Resources Information Center

Gillies, Donald; Mifsud, Denise

2016-01-01

This paper explores, from a Foucauldian perspective, the emergence and nature of the current EU education policy priority issue of "early school leaving". The paper suggests that a number of problematisations developing from the failure to secure Lisbon Strategy objectives have served to create a much stronger focus on the issue of young…

34 CFR 403.111 - How must funds be used under the Secondary School Vocational Education Program and the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... individuals who are members of special populations. Examples: Methods by which an eligible recipient may give... special populations include, but are not limited to, the following: Example 1: Method to give priority to...: Method to give priority to a limited number of program areas. Based on data from the preceding fiscal...

34 CFR 403.111 - How must funds be used under the Secondary School Vocational Education Program and the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... individuals who are members of special populations. Examples: Methods by which an eligible recipient may give... special populations include, but are not limited to, the following: Example 1: Method to give priority to...: Method to give priority to a limited number of program areas. Based on data from the preceding fiscal...

34 CFR 403.111 - How must funds be used under the Secondary School Vocational Education Program and the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... individuals who are members of special populations. Examples: Methods by which an eligible recipient may give... special populations include, but are not limited to, the following: Example 1: Method to give priority to...: Method to give priority to a limited number of program areas. Based on data from the preceding fiscal...

US EPA Environmental Justice Research Roadmap: Cross Agency Research Priority

EPA Science Inventory

Consideration of how to assess the health risk of mixtures and to characterize cumulative risk have long been challenges in toxicology and public health. The 1994 White House Executive Order (EO) 12898 Federal Actions to Address Environmental Justice (EJ) in Minority Populations...

Failure mode and effects analysis of witnessing protocols for ensuring traceability during IVF.

PubMed

Rienzi, Laura; Bariani, Fiorenza; Dalla Zorza, Michela; Romano, Stefania; Scarica, Catello; Maggiulli, Roberta; Nanni Costa, Alessandro; Ubaldi, Filippo Maria

2015-10-01

Traceability of cells during IVF is a fundamental aspect of treatment, and involves witnessing protocols. Failure mode and effects analysis (FMEA) is a method of identifying real or potential breakdowns in processes, and allows strategies to mitigate risks to be developed. To examine the risks associated with witnessing protocols, an FMEA was carried out in a busy IVF centre, before and after implementation of an electronic witnessing system (EWS). A multidisciplinary team was formed and moderated by human factors specialists. Possible causes of failures, and their potential effects, were identified and risk priority number (RPN) for each failure calculated. A second FMEA analysis was carried out after implementation of an EWS. The IVF team identified seven main process phases, 19 associated process steps and 32 possible failure modes. The highest RPN was 30, confirming the relatively low risk that mismatches may occur in IVF when a manual witnessing system is used. The introduction of the EWS allowed a reduction in the moderate-risk failure mode by two-thirds (highest RPN = 10). In our experience, FMEA is effective in supporting multidisciplinary IVF groups to understand the witnessing process, identifying critical steps and planning changes in practice to enable safety to be enhanced. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Failure mode and effects analysis drastically reduced potential risks in clinical trial conduct

PubMed Central

Baik, Jungmi; Kim, Hyunjung; Kim, Rachel

2017-01-01

Background Failure mode and effects analysis (FMEA) is a risk management tool to proactively identify and assess the causes and effects of potential failures in a system, thereby preventing them from happening. The objective of this study was to evaluate effectiveness of FMEA applied to an academic clinical trial center in a tertiary care setting. Methods A multidisciplinary FMEA focus group at the Seoul National University Hospital Clinical Trials Center selected 6 core clinical trial processes, for which potential failure modes were identified and their risk priority number (RPN) was assessed. Remedial action plans for high-risk failure modes (RPN >160) were devised and a follow-up RPN scoring was conducted a year later. Results A total of 114 failure modes were identified with an RPN score ranging 3–378, which was mainly driven by the severity score. Fourteen failure modes were of high risk, 11 of which were addressed by remedial actions. Rescoring showed a dramatic improvement attributed to reduction in the occurrence and detection scores by >3 and >2 points, respectively. Conclusions FMEA is a powerful tool to improve quality in clinical trials. The Seoul National University Hospital Clinical Trials Center is expanding its FMEA capability to other core clinical trial processes. PMID:29089745

Bioastronautics Roadmap: A Risk Reduction Strategy for Human Space Exploration

NASA Technical Reports Server (NTRS)

2005-01-01

The Bioastronautics Critical Path Roadmap is the framework used to identify and assess the risks to crews exposed to the hazardous environments of space. It guides the implementation of research strategies to prevent or reduce those risks. Although the BCPR identifies steps that must be taken to reduce the risks to health and performance that are associated with human space flight, the BCPR is not a "critical path" analysis in the strict engineering sense. The BCPR will evolve to accommodate new information and technology development and will enable NASA to conduct a formal critical path analysis in the future. As a management tool, the BCPR provides information for making informed decisions about research priorities and resource allocation. The outcome-driven nature of the BCPR makes it amenable for assessing the focus, progress and success of the Bioastronautics research and technology program. The BCPR is also a tool for communicating program priorities and progress to the research community and NASA management.

Future health applications of genomics: priorities for communication, behavioral, and social sciences research.

PubMed

McBride, Colleen M; Bowen, Deborah; Brody, Lawrence C; Condit, Celeste M; Croyle, Robert T; Gwinn, Marta; Khoury, Muin J; Koehly, Laura M; Korf, Bruce R; Marteau, Theresa M; McLeroy, Kenneth; Patrick, Kevin; Valente, Thomas W

2010-05-01

Despite the quickening momentum of genomic discovery, the communication, behavioral, and social sciences research needed for translating this discovery into public health applications has lagged behind. The National Human Genome Research Institute held a 2-day workshop in October 2008 convening an interdisciplinary group of scientists to recommend forward-looking priorities for translational research. This research agenda would be designed to redress the top three risk factors (tobacco use, poor diet, and physical inactivity) that contribute to the four major chronic diseases (heart disease, type 2 diabetes, lung disease, and many cancers) and account for half of all deaths worldwide. Three priority research areas were identified: (1) improving the public's genetic literacy in order to enhance consumer skills; (2) gauging whether genomic information improves risk communication and adoption of healthier behaviors more than current approaches; and (3) exploring whether genomic discovery in concert with emerging technologies can elucidate new behavioral intervention targets. Important crosscutting themes also were identified, including the need to: (1) anticipate directions of genomic discovery; (2) take an agnostic scientific perspective in framing research questions asking whether genomic discovery adds value to other health promotion efforts; and (3) consider multiple levels of influence and systems that contribute to important public health problems. The priorities and themes offer a framework for a variety of stakeholders, including those who develop priorities for research funding, interdisciplinary teams engaged in genomics research, and policymakers grappling with how to use the products born of genomics research to address public health challenges. 2010. Published by Elsevier Inc.

Health assessment for Koppers Coke, St. Paul, Minnesota, Region 5. CERCLIS No. MND000819359. Preliminary report

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

Not Available

1989-06-27

In 1981, the Koppers Coke Company Site was listed on the National Priorities List, due to extensive ground-water contamination. The 38-acre site, located in St. Paul, Minnesota, is a former coking facility that began operation in 1918. Eighteen contaminants have been identified in ground water from the surficial aquifer. Contamination has been found at a number of monitoring wells on-site and off-site, and at a residential well, a commercial well, and a cemetery well. The site is considered to be of potential public health concern because of the risk to human health caused by the possibility of exposure to hazardousmore » substances via ground water.« less

Six Common Mistakes in Conservation Priority Setting

PubMed Central

Game, Edward T; Kareiva, Peter; Possingham, Hugh P

2013-01-01

Abstract A vast number of prioritization schemes have been developed to help conservation navigate tough decisions about the allocation of finite resources. However, the application of quantitative approaches to setting priorities in conservation frequently includes mistakes that can undermine their authors’ intention to be more rigorous and scientific in the way priorities are established and resources allocated. Drawing on well-established principles of decision science, we highlight 6 mistakes commonly associated with setting priorities for conservation: not acknowledging conservation plans are prioritizations; trying to solve an ill-defined problem; not prioritizing actions; arbitrariness; hidden value judgments; and not acknowledging risk of failure. We explain these mistakes and offer a path to help conservation planners avoid making the same mistakes in future prioritizations. Seis Errores Comunes en la Definición de Prioridades de Conservación Resumen Se ha desarrollado un vasto número de esquemas de priorización para ayudar a que la conservación navegue entre decisiones difíciles en cuanto a la asignación de recursos finitos. Sin embargo, la aplicación de métodos cuantitativos para la definición de prioridades en la conservación frecuentemente incluye errores que pueden socavar la intención de sus autores de ser más rigurosos y científicos en la manera en que se establecen las prioridades y se asignan los recursos. Con base en los bien establecidos principios de la ciencia de la decisión, resaltamos seis errores comúnmente asociados con la definición de prioridades para la conservación: no reconocer que los planes de conservación son priorizaciones; tratar de resolver un problema mal definido; no priorizar acciones; arbitrariedad; juicios de valor ocultos y no reconocer el riesgo de fracasar. Explicamos estos errores y ofrecemos un camino para que planificadores de la conservación no cometan los mismos errores en priorizaciones futuras. PMID:23565990

The role of parental risk judgements, transport safety attitudes, transport priorities and accident experiences on pupils' walking to school.

PubMed

Mehdizadeh, Milad; Nordfjaern, Trond; Mamdoohi, Amir Reza; Shariat Mohaymany, Afshin

2017-05-01

Walking to school could improve pupils' health condition and might also reduce the use of motorized transport modes, which leads to both traffic congestion and air pollution. The current study aims to examine the role of parental risk judgements (i.e. risk perception and worry), transport safety attitudes, transport priorities and accident experiences on pupils' walking and mode choices on school trips in Iran, a country with poor road safety records. A total of 1078 questionnaires were randomly distributed among pupils at nine public and private schools in January 2014 in Rasht, Iran. Results from valid observations (n=711) showed that parents with high probability assessments of accidents and strong worry regarding pupils' accident risk while walking were less likely to let their children walk to school. Parents with high safety knowledge were also more likely to allow their pupils to walk to school. Parents who prioritized convenience and accessibility in transport had a stronger tendency to choose motorized modes over walking modes. Also, parents who prioritized safety and security in transport were less likely to allow pupils to walk to school. Elasticities results showed that a one percent increase in priorities of convenience and accessibility, priorities of safety and security, car ownership and walking time from home to school reduced walking among pupils by a probability of 0.62, 0.20, 0.86 and 0.57%, respectively. A one percent increase in parental safety knowledge increased the walking probability by around 0.25%. A 1 unit increase in parental probability assessment and worry towards pupils' walking, decreased the probability of choosing walking mode by 0.11 and 0.05, respectively. Policy-makers who aim to promote walking to schools should improve safety and security of the walking facilities and increase parental safety knowledge. Copyright © 2017 Elsevier Ltd. All rights reserved.

Risk factors of coercion among psychiatric inpatients: a nationwide register-based cohort study.

PubMed

Thomsen, Christoffer; Starkopf, Liis; Hastrup, Lene Halling; Andersen, Per Kragh; Nordentoft, Merete; Benros, Michael Eriksen

2017-08-01

Reducing the use of coercion among patients with mental disorders has long been a political priority. However, risk factors for coercive measures have primarily been investigated in smaller studies. To reduce the use of coercion, it is crucial to identify people at risk which we aim to do in this first large-scale study. A cohort study was conducted among all psychiatric inpatients in Denmark, following 112,233 individuals during 1999-2014. Data from Danish registers were analysed using logistic regression for repeated measures. 24,594 inpatients were exposed to a coercive measure (21.9%). Clinical characteristics were the foremost predictors of coercion and patients with organic mental disorder had the highest increased risk of being subjected to a coercive measure (OR = 5.56; 95% CI = 5.04, 6.14). The risk of coercion was the highest in the first admission and decreased with the number of admissions (all p < 0.001). The following socioeconomic variables were associated with an increased risk of coercion: male sex, unemployment, lower social class and immigrants from low and middle income countries (all p < 0.001). Early retirement and social relations, such as being married and having children, reduced the risk of being subjected to coercive measure (all p < 0.05). From our nationwide data, we identified a broad range of risk factors associated with coercive measures. Our findings can assist researchers in identifying patients at risk of coercion and thereby help targeting new coercion reduction programs.

Perioperative leadership: managing change with insights, priorities, and tools.

PubMed

Taylor, David L

2014-07-01

The personal leadership of the perioperative director is a critical factor in the success of any change management initiative. This article presents an approach to perioperative nursing leadership that addresses obstacles that prevent surgical departments from achieving high performance in clinical and financial outcomes. This leadership approach consists of specific insights, priorities, and tools: key insights include self-understanding of personal barriers to leadership and accuracy at understanding economic and strategic considerations related to the OR environment; key priorities include creating a customer-centered organization, focusing on process improvement, and concentrating on culture change; and key tools include using techniques (e.g., direct engagement, collaborative leadership) to align surgical organizations with leadership priorities and mitigate specific perioperative management risks. Included in this article is a leadership development plan for perioperative directors. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Assessment of perceived injury risks and priorities among truck drivers and trucking companies in Washington State.

PubMed

Spielholz, Peregrin; Cullen, Jennifer; Smith, Caroline; Howard, Ninica; Silverstein, Barbara; Bonauto, David

2008-01-01

The trucking industry experiences one of the highest work-related injury rates. Little work has been conducted previously in the United States to assess the hazards, needs, and injury prevention priorities in trucking. Two separate industry-wide surveys of 359 trucking companies and 397 commercial truck drivers were conducted in Washington State. Trucking companies and drivers both ranked musculoskeletal and slip, trip, fall injuries as the top two priorities. Controlling heavy lifting, using appropriate equipment, and addressing slippery surfaces were frequently listed as solutions. There appears to be a gap in safety climate perception between workers and employers. However, driver and company priorities agreed with industry workers' compensation claims. There is room for safety program management improvement in the industry. The study findings detail opportunities for prioritizing and reducing injuries. This information can be used to focus and design interventions for the prevention of work-related injuries while improving industry competitiveness.

Characterization and assessment of potential environmental risk of tailings stored in seven impoundments in the Aries river basin, Western Romania

PubMed Central

2013-01-01

Background The objective of this study was to examine the potential environmental risk of tailings resulted after precious and base metal ores processing, stored in seven impoundments located in the Aries river basin, Romania. The tailings were characterized by mineralogical and elemental composition, contamination indices, acid rock drainage generation potential and water leachability of hazardous/priority hazardous metals and ions. Multivariate statistical methods were used for data interpretation. Results Tailings were found to be highly contaminated with several hazardous/priority hazardous metals (As, Cu, Cd, Pb), and pose potential contamination risk for soil, sediments, surface and groundwater. Two out of the seven studied impoundments does not satisfy the criteria required for inert wastes, shows acid rock drainage potential and thus can contaminate the surface and groundwater. Three impoundments were found to be highly contaminated with As, Pb and Cd, two with As and other two with Cu. The tailings impoundments were grouped based on the enrichment factor, geoaccumulation index, contamination factor and contamination degree of 7 hazardous/priority hazardous metals (As, Cd, Cr, Cu, Ni, Pb, Zn) considered typical for the studied tailings. Principal component analysis showed that 47% of the elemental variability was attributable to alkaline silicate rocks, 31% to acidic S-containing minerals, 12% to carbonate minerals and 5% to biogenic elements. Leachability of metals and ions was ascribed in proportion of 61% to silicates, 11% to acidic minerals and 6% to the organic matter. A variability of 18% was attributed to leachability of biogenic elements (Na, K, Cl-, NO3-) with no potential environmental risk. Pattern recognition by agglomerative hierarchical clustering emphasized the grouping of impoundments in agreement with their contamination degree and acid rock drainage generation potential. Conclusions Tailings stored in the studied impoundments were found to be contaminated with some hazardous/ priority hazardous metals, fluoride and sulphate and thus presents different contamination risk for the environment. A long term monitoring program of these tailings impoundments and the expansion of the ecologization measures in the area is required. PMID:23311708

U.S. ENVIRONMENTAL PROTECTION AGENCY'S ECOLOGICAL RESEARCH STRATEGY

EPA Science Inventory

EPA's Office of Research and Development (ORD) has recently released a research strategy to guide its program to improve ecosystem risk assessment and risk management, which is one of the Agency's higheset priority search areas (http://www.epa.gov/ORD/WebPubs/fmal/eco.pdf). It is...

The impact of early outcome events on the effect of tranexamic acid in post-partum haemorrhage: an exploratory subgroup analysis of the WOMAN trial.

PubMed

Brenner, Amy; Shakur-Still, Haleema; Chaudhri, Rizwana; Fawole, Bukola; Arulkumaran, Sabaratnam; Roberts, Ian

2018-06-07

In severe post-partum haemorrhage, death can occur within hours of bleeding onset so interventions to control the bleeding must be given immediately. In clinical trials of treatments for life-threatening bleeding, established treatments are given priority and the trial treatment is usually given last. However, enrolling patients in whom severe maternal morbidity or death is imminent or inevitable at the time of randomisation may dilute the effects of a trial treatment. We conducted an exploratory analysis of data from the WOMAN trial, an international, randomised placebo-controlled trial of the effects of tranexamic acid on death and surgical intervention in 20,060 women with post-partum haemorrhage. We assessed the impact of early maternal death or hysterectomy due to exsanguination on the effect of tranexamic acid on each of these respective outcomes. We conducted repeated analyses excluding patients with these outcomes at increasing intervals from the time of randomisation. We quantified treatment effects using risk ratios (RR) and 99% confidence intervals (CI) and prepared cumulative failure plots. Among 14,923 women randomised within 3 h of delivery (7518 tranexamic acid and 7405 placebo), there were 216 bleeding deaths (1.5%) and 383 hysterectomies due to bleeding (2.8%). After excluding deaths from exsanguination at increasing time intervals following randomization, there was a significant reduction in the risk of death due to bleeding with tranexamic acid (RR = 0.41; 99% CI 0.19-0.89). However, after excluding hysterectomies at increasing time intervals post-randomization, there was no reduction in the risk of hysterectomy due to bleeding with tranexamic acid (RR = 0.79; 99% CI 0.33-1.86). Findings from this analysis provide further evidence that tranexamic acid reduces the risk of death from exsanguination in women who experience postpartum haemorrhage. It is uncertain whether tranexamic acid reduces the risk of hysterectomy for bleeding after excluding early hysterectomies. ISRCTN trial registration number ISRCTN76912190, 8 Dec 2008; ClinicalTrials.gov number NCT00872469, 30 March 2009; PACTR number PACTR201007000192283, 9 Feb 2010; EudraCT number 2008-008441-38, 8 Dec 2010 (retrospectively registered).

Using a Delphi process to define priorities for prison health research in Canada

PubMed Central

Kouyoumdjian, Fiona G; Schuler, Andrée; McIsaac, Kathryn E; Pivnick, Lucie; Matheson, Flora I; Brown, Glenn; Kiefer, Lori; Silva, Diego; Hwang, Stephen W

2016-01-01

Objectives A large number of Canadians spend time in correctional facilities each year, and they are likely to have poor health compared to the general population. Relatively little health research has been conducted in Canada with a focus on people who experience detention or incarceration. We aimed to conduct a Delphi process with key stakeholders to define priorities for research in prison health in Canada for the next 10 years. Setting We conducted a Delphi process using an online survey with two rounds in 2014 and 2015. Participants We invited key stakeholders in prison health research in Canada to participate, which we defined as persons who had published research on prison health in Canada since 1994 and persons in the investigators’ professional networks. We invited 143 persons to participate in the first round and 59 participated. We invited 137 persons to participate in the second round and 67 participated. Primary and secondary outcome measures Participants suggested topics in the first round, and these topics were collated by investigators. We measured the level of agreement among participants that each collated topic was a priority for prison health research in Canada for the next 10 years, and defined priorities based on the level of agreement. Results In the first round, participants suggested 71 topics. In the second round, consensus was achieved that a large number of suggested topics were research priorities. Top priorities were diversion and alternatives to incarceration, social and community re-integration, creating healthy environments in prisons, healthcare in custody, continuity of healthcare, substance use disorders and the health of Aboriginal persons in custody. Conclusions Generated in an inclusive and systematic process, these findings should inform future research efforts to improve the health and healthcare of people who experience detention and incarceration in Canada. PMID:26769790

Priority pollutants in urban stormwater: part 2 - case of combined sewers.

PubMed

Gasperi, Johnny; Zgheib, Sally; Cladière, Mathieu; Rocher, Vincent; Moilleron, Régis; Chebbo, Ghassan

2012-12-15

This study has evaluated the quality of combined sewer overflows (CSOs) in an urban watershed, such as Paris, by providing accurate data on the occurrence of priority pollutants (PPs) and additional substances, as well as on the significance of their concentrations in comparison with wastewater and stormwater. Of the 88 substances monitored, 49 PPs were detected, with most of these also being frequently encountered in wastewater and stormwater, thus confirming their ubiquity in urban settings. For the majority of organic substances, concentrations range between 0.01 and 1 μgl(-1), while metals tend to display concentrations above 10 μgl(-1). Despite this ubiquity, CSO, wastewater and stormwater feature a number of differences in both their concentration ranges and pollutant patterns. For most hydrophobic organic pollutants and some particulate-bound metals, CSOs exhibit higher concentrations than those found in stormwater and wastewater, due to the contribution of in-sewer deposit erosion. For pesticides and Zn, CSOs have shown concentrations close to those of stormwater, suggesting runoff as the major contributor, while wastewater appears to be the main source of volatile organic compounds. Surprisingly, similar concentration ranges have been found for DEHP and tributyltin compounds in CSOs, wastewater and stormwater. The last section of this article identifies substances for which CSO discharges might constitute a major risk of exceeding Environmental Quality Standards in receiving waters and moreover indicates a significant risk for PAHs, tributyltin compounds and chloroalkanes. The data generated during this survey can subsequently be used to identify PPs of potential significance that merit further investigation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Identification and assessment of common errors in the admission process of patients in Isfahan Fertility and Infertility Center based on "failure modes and effects analysis".

PubMed

Dehghan, Ashraf; Abumasoudi, Rouhollah Sheikh; Ehsanpour, Soheila

2016-01-01

Infertility and errors in the process of its treatment have a negative impact on infertile couples. The present study was aimed to identify and assess the common errors in the reception process by applying the approach of "failure modes and effects analysis" (FMEA). In this descriptive cross-sectional study, the admission process of fertility and infertility center of Isfahan was selected for evaluation of its errors based on the team members' decision. At first, the admission process was charted through observations and interviewing employees, holding multiple panels, and using FMEA worksheet, which has been used in many researches all over the world and also in Iran. Its validity was evaluated through content and face validity, and its reliability was evaluated through reviewing and confirmation of the obtained information by the FMEA team, and eventually possible errors, causes, and three indicators of severity of effect, probability of occurrence, and probability of detection were determined and corrective actions were proposed. Data analysis was determined by the number of risk priority (RPN) which is calculated by multiplying the severity of effect, probability of occurrence, and probability of detection. Twenty-five errors with RPN ≥ 125 was detected through the admission process, in which six cases of error had high priority in terms of severity and occurrence probability and were identified as high-risk errors. The team-oriented method of FMEA could be useful for assessment of errors and also to reduce the occurrence probability of errors.

Identification and assessment of common errors in the admission process of patients in Isfahan Fertility and Infertility Center based on “failure modes and effects analysis”

PubMed Central

Dehghan, Ashraf; Abumasoudi, Rouhollah Sheikh; Ehsanpour, Soheila

2016-01-01

Background: Infertility and errors in the process of its treatment have a negative impact on infertile couples. The present study was aimed to identify and assess the common errors in the reception process by applying the approach of “failure modes and effects analysis” (FMEA). Materials and Methods: In this descriptive cross-sectional study, the admission process of fertility and infertility center of Isfahan was selected for evaluation of its errors based on the team members’ decision. At first, the admission process was charted through observations and interviewing employees, holding multiple panels, and using FMEA worksheet, which has been used in many researches all over the world and also in Iran. Its validity was evaluated through content and face validity, and its reliability was evaluated through reviewing and confirmation of the obtained information by the FMEA team, and eventually possible errors, causes, and three indicators of severity of effect, probability of occurrence, and probability of detection were determined and corrective actions were proposed. Data analysis was determined by the number of risk priority (RPN) which is calculated by multiplying the severity of effect, probability of occurrence, and probability of detection. Results: Twenty-five errors with RPN ≥ 125 was detected through the admission process, in which six cases of error had high priority in terms of severity and occurrence probability and were identified as high-risk errors. Conclusions: The team-oriented method of FMEA could be useful for assessment of errors and also to reduce the occurrence probability of errors. PMID:28194208

Engaging patients in health research: identifying research priorities through community town halls.

PubMed

Etchegary, Holly; Bishop, Lisa; Street, Catherine; Aubrey-Bassler, Kris; Humphries, Dale; Vat, Lidewij Eva; Barrett, Brendan

2017-03-11

The vision of Canada's Strategy for Patient-Oriented Research is that patients be actively engaged as partners in health research. Support units have been created across Canada to build capacity in patient-oriented research and facilitate its conduct. This study aimed to explore patients' health research priorities in the province of Newfoundland and Labrador (NL). Eight town halls were held with members of the general public in rural and urban settings across the province. Sessions were a hybrid information-consultation event, with key questions about health research priorities and outcomes guiding the discussion. Sixty eight members of the public attended town hall sessions. A broad range of health experiences in the healthcare system were recounted. Key priorities for the public included access and availability of providers and services, disease prevention and health promotion, and follow-up support and community care. In discussing their health research priorities, participants spontaneously raised a broad range of suggestions for improving the healthcare system in our jurisdiction. Public research priorities and suggestions for improving the provision of healthcare provide valuable information to guide Support Units' planning and priority-setting processes. A range of research areas were raised as priorities for patients that are likely comparable to other healthcare systems. These create a number of health research questions that would be in line with public priorities. Findings also provide lessons learned for others and add to the evidence base on patient engagement methods.

Reprint of: The impact of fragility fracture and approaches to osteoporosis risk assessment worldwide.

PubMed

Curtis, Elizabeth M; Moon, Rebecca J; Harvey, Nicholas C; Cooper, Cyrus

2017-08-01

Osteoporosis constitutes a major public health problem, through its association with age-related fractures, particularly of the hip, vertebrae, distal forearm and humerus. Substantial geographic variation has been noted in the incidence of osteoporotic fractures worldwide, with Western populations (North America, Europe and Oceania), reporting increases in hip fracture throughout the second half of the 20th century, with a stabilisation or decline in the last two decades. In developing populations however, particularly in Asia, the rates of osteoporotic fracture appears to be increasing. The massive global burden consequent to osteoporosis means that fracture risk assessment should be a high priority amongst health measures considered by policy makers. The WHO operational definition of osteoporosis, based on a measurement of bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA), has been used globally since the mid-1990s. However, although this definition identifies those at greatest individual risk of fracture, in the population overall a greater total number of fractures occur in individuals with BMD values above threshold for osteoporosis diagnosis. A number of web-based tools to enable the inclusion of clinical risk factors, with or without BMD, in fracture prediction algorithms have been developed to improve the identification of individuals at high fracture risk, the most commonly used globally being FRAX ® . Access to DXA, osteoporosis risk assessment, case finding and treatment varies worldwide, but despite such advances studies indicate that a minority of men and women at high fracture risk receive treatment. Importantly, research is ongoing to demonstrate the clinical efficacy and cost-effectiveness of osteoporosis case finding and risk assessment strategies worldwide. The huge burden caused by osteoporosis related fractures to individuals, healthcare systems and societies should provide a clear impetus for the progression of such approaches. Copyright © 2017 Elsevier Ltd. All rights reserved.

The impact of fragility fracture and approaches to osteoporosis risk assessment worldwide.

PubMed

Curtis, Elizabeth M; Moon, Rebecca J; Harvey, Nicholas C; Cooper, Cyrus

2017-11-01

Osteoporosis constitutes a major public health problem, through its association with age-related fractures, particularly of the hip, vertebrae, distal forearm and humerus. Substantial geographic variation has been noted in the incidence of osteoporotic fractures worldwide, with Western populations (North America, Europe and Oceania), reporting increases in hip fracture throughout the second half of the 20th century, with a stabilisation or decline in the last two decades. In developing populations however, particularly in Asia, the rates of osteoporotic fracture appears to be increasing. The massive global burden consequent to osteoporosis means that fracture risk assessment should be a high priority among health measures considered by policy makers. The WHO operational definition of osteoporosis, based on a measurement of bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA), has been used globally since the mid-1990s. However, although this definition identifies those at greatest individual risk of fracture, in the population overall a greater total number of fractures occur in individuals with BMD values above the threshold for osteoporosis diagnosis. A number of web-based tools to enable the inclusion of clinical risk factors, with or without BMD, in fracture prediction algorithms have been developed to improve the identification of individuals at high fracture risk, the most commonly used globally being FRAX®. Access to DXA, osteoporosis risk assessment, case finding and treatment varies worldwide, but despite such advances studies indicate that a minority of men and women at high fracture risk receive treatment. Importantly, research is ongoing to demonstrate the clinical efficacy and cost-effectiveness of osteoporosis case finding and risk assessment strategies worldwide. The huge burden caused by osteoporosis related fractures to individuals, healthcare systems and societies should provide a clear impetus for the progression of such approaches. Copyright © 2017 Elsevier Inc. All rights reserved.

FireSmart®-ForestWise: Managing Wildlife and Wildfire Risk in the Wildland/Urban Interface-a Canadian Case Study

Treesearch

Alan Westhaver; Richard D. Revel; Brad C. Hawkes

2007-01-01

Reducing the risk of losses from wildfires that threaten homes and communities is a growing priority in Canada. To reduce risk, “FireSmart®” standards have been adopted nationwide for managing forest fuel. However, these standards largely disregard interests of wildlife and conservation of wildlife habitat – thus raising concerns...

Youth Risk Behavior Survey 2003: Commonwealth of the Northern Mariana Islands, Republic of the Marshall Islands, Republic of Palau

ERIC Educational Resources Information Center

Balling, Allison; Grunbaum, Jo Anne; Speicher, Nancy; McManus, Tim; Kann, Laura

2005-01-01

To monitor priority health-risk behaviors among youth and young adults, the Centers for Disease Control and Prevention developed the Youth Risk Behavior Surveillance System (YRBSS). The YRBSS includes national, state, territory, and local school-based surveys of high school students in grades 9-12. In addition, some states, territories, and cities…

Youth Risk Behavior Survey 2005: Commonwealth of the Northern Mariana Islands, Republic of Palau, Commonwealth of Puerto Rico

ERIC Educational Resources Information Center

Lippe, Jaclynn; Brener, Nancy D.; McManus, Tim; Kann, Laura; Speicher, Nancy

2008-01-01

To monitor priority health-risk behaviors among youth and young adults, the Centers for Disease Control and Prevention (CDC) developed the Youth Risk Behavior Surveillance System (YRBSS). The YRBSS includes national, state, territorial, and local school-based surveys of high school students in grades 9-12. In addition, some states, territories,…

Uses of Youth Risk Behavior Survey and School Health Profiles Data: Applications for Improving Adolescent and School Health

ERIC Educational Resources Information Center

Foti, Kathryn; Balaji, Alexandra; Shanklin, Shari

2011-01-01

Background: To monitor priority health risk behaviors and school health policies and practices, respectively, the Centers for Disease Control and Prevention (CDC) developed the Youth Risk Behavior Surveillance System (YRBSS) and the School Health Profiles (Profiles). CDC is often asked about the use and application of these survey data to improve…

Fault Management in an Objectives-Based/Risk-Informed View of Safety and Mission Success

NASA Technical Reports Server (NTRS)

Groen, Frank

2012-01-01

Theme of this talk: (1) Net-benefit of activities and decisions derives from objectives (and their priority) -- similarly: need for integration, value of technology/capability. (2) Risk is a lack of confidence that objectives will be met. (2a) Risk-informed decision making requires objectives. (3) Consideration of objectives is central to recent guidance.

Glaucoma and quality of life: fall and driving risk.

PubMed

Montana, Cynthia L; Bhorade, Anjali M

2018-03-01

Numerous population-based studies suggest that glaucoma is an independent risk factor for falling and motor vehicle collisions, particularly for older adults. These adverse events lead to increased healthcare expenditures and decreased quality of life. Current research priorities, therefore, include identifying factors that predispose glaucoma patients to falling and unsafe driving, and developing screening strategies and targeted rehabilitation. The purpose of this article is to review recent studies that address these priorities. Studies continue to support that glaucoma patients, particularly those with advanced disease, have an increased risk of falling or unsafe driving. Risk factors, however, remain variable and include severity and location of visual field defects, contrast sensitivity, and performance on divided attention tasks. Such variability is likely because of the multifactorial nature of ambulating and driving and compensatory strategies used by patients. Falls and unsafe driving remain a serious public health issue for older adults with glaucoma. Ambulation and driving are complex tasks and there is no consensus yet, regarding the best methods for risk stratification and targeted interventions to increase safety. Therefore, comprehensive and individualized assessments are recommended to most effectively evaluate a patient's risk for falling or unsafe driving.

Redefining the Practice of Peer Review Through Intelligent Automation Part 2: Data-Driven Peer Review Selection and Assignment.

PubMed

Reiner, Bruce I

2017-12-01

In conventional radiology peer review practice, a small number of exams (routinely 5% of the total volume) is randomly selected, which may significantly underestimate the true error rate within a given radiology practice. An alternative and preferable approach would be to create a data-driven model which mathematically quantifies a peer review risk score for each individual exam and uses this data to identify high risk exams and readers, and selectively target these exams for peer review. An analogous model can also be created to assist in the assignment of these peer review cases in keeping with specific priorities of the service provider. An additional option to enhance the peer review process would be to assign the peer review cases in a truly blinded fashion. In addition to eliminating traditional peer review bias, this approach has the potential to better define exam-specific standard of care, particularly when multiple readers participate in the peer review process.

The behaviour and sexual health of young international travellers (backpackers) in Australia.

PubMed

McNulty, A M; Egan, C; Wand, H; Donovan, B

2010-06-01

To study the demographics, risk behaviours and morbidity of young long-term international travellers (backpackers) attending a sexual health service in Sydney, Australia. Data on new patients were extracted from the Sydney Sexual Health Centre database for the period 1998 to 2006. The sexual risk behaviours and morbidity of the backpackers were compared with other patients of a similar age. The 5698 backpackers who attended the centre reported higher numbers of sexual partners (three or more partners in the past 3 months, 18% vs 12%, p<0.001) and a greater proportion drank alcohol at hazardous levels (22%) than the comparison group (9%, p<0.001). Rates of consistent (100%) condom use in the past 3 months were low in both backpackers (22%) and the comparison population (19%). Backpackers had higher rates of genital chlamydia infection (7% vs 5%, p<0.001) and reported higher rates of previous sexually transmitted infections (15% vs 10%, p<0.001). Backpackers should be a priority population for sexual health promotion and access to services.

Emergency medical dispatch priority in chest pain patients due to life threatening conditions: A cohort study examining circadian variations and impact of the education.

PubMed

Rawshani, Araz; Rawshani, Nina; Gelang, Carita; Andersson, Jan-Otto; Larsson, Anna; Bång, Angela; Herlitz, Johan; Gellerstedt, Martin

2017-06-01

We examined the accuracy in assessments of emergency dispatchers according to their education and time of the day. We examined this in chest pain patients who were diagnosed with a potentially life-threatening condition (LTC) or died within 30days. Among 2205 persons, 482 died, 1631 experienced an acute coronary syndrome (ACS), 1914 had a LTC. Multivariable logistic regression was used to study how time of the call and the dispatcher's education were associated with the risk of missing to give priority 1 (the highest). Among patients who died, a 7-fold increase in odds of missing to give priority 1 was noted at 1.00pm, as compared with midnight. Compared with assistant nurses, odds ratio for dispatchers with no (medical) training was 0.34 (95% CI 0.14 to 0.77). Among patients with an ACS, odds ratio for calls arriving before lunch was 2.02 (95% CI 1.22 to 3.43), compared with midnight. Compared with assistant nurses, odds ratio for operators with no training was 0.23 (95% CI 0.13 to 0.40). Similar associations were noted for those with any LTC. Dispatcher's education was not associated with the patient's survival. In this group of patients, which experience substantial mortality and morbidity, the risk of not obtaining highest dispatch priority was increased up to 7-fold during lunchtime. Dispatch operators without medical education had the lowest risk, compared with nurses and assistant nurses, of missing to give priority 1, at the expense of lower positive predictive value. What is already known about this subject? Use of the emergency medical service (EMS) increases survival among patients with acute coronary syndromes. It is unknown whether the efficiency - as judged by the ability to identify life-threatening cases among patients with chest pain - varies according to the dispatcher's educational level and the time of day. What does this study add? We provide evidence that the dispatcher's education does not influence survival among patients calling the EMS due to chest discomfort. However, medically educated dispatchers are at greatest risk of missing to identify life-threatening cases, which is explained by more parsimonious use of the highest dispatch priority. We also show that the risk of missing life-threatening cases is at highest around lunch time. How might this impact on clinical practice? Dispatch centers are operated differently all over the world and chest discomfort is one of the most frequent symptoms encountered; we provide evidence that it is safe to operate a dispatch center without medically trained personnel, who actually miss fewer cases of acute coronary syndromes. However, non-medically trained dispatchers consume more pre-hospital resources. Copyright © 2017 Elsevier B.V. All rights reserved.

Examining alternative fuel management strategies and the relative contribution of National Forest System land to wildfire risk to adjacent homes - A pilot assessment on the Sierra National Forest, California, USA

Treesearch

Joe H. Scott; Matthew P. Thompson; Julie W. Gilbertson-Day

2016-01-01

Determining the degree of risk that wildfires pose to homes, where across the landscape the risk originates, and who can best mitigate risk are integral elements of effective co-management of wildfire risk. Developing assessments and tools to help provide this information is a high priority for federal land management agencies such as the US Forest Service (...

Adding Only One Priority Rule Allows Extending CIP Rules to Supramolecular Systems.

PubMed

Alkorta, Ibon; Elguero, José; Cintas, Pedro

2015-05-01

There are frequent situations both in supramolecular chemistry and in crystallography that result in stereogenic centers, whose absolute configuration needs to be specified. With this aim we propose the inclusion of one simple additional rule to the Cahn-Ingold-Prelog (CIP) system of priority rules stating that noncovalent interactions have a fictitious number between 0 and 1. © 2015 Wiley Periodicals, Inc.

The common objectives of the European Nordic countries and the role of space

NASA Astrophysics Data System (ADS)

Lehnert, Christopher; Giannopapa, Christina; Vaudo, Ersilia

2016-11-01

The European Space Agency (ESA) has twenty two Member States with common goals of engaging in European space activities. However, the various Member States have a variety of governance structures, strategic priorities regarding space and other sectorial areas depending on their cultural and geopolitical aspirations. The Nordic countries, namely Denmark, Finland, Norway and Sweden, have similarities which result often in common geopolitical and cultural aspects. These in turn shape their respective priorities and interests in setting up their policies in a number of sectorial areas like shipping and fisheries, energy, immigration, agriculture, security and defence, infrastructures, climate change and the Arctic. Space technology, navigation, earth observation, telecommunication and integrated applications can assist the Nordic countries in developing, implementing and monitoring policies of common interest. This paper provides an in-depth overview and a comprehensive assessment of these common interests in policy areas where space can provide support in their realisation. The first part provides a synthesis of the Nordic countries respective priorities through analysing their government programmes and plans. The priorities are classified according to the six areas of sustainability: energy, environment and climate change, transport, knowledge and innovation, natural resources (fisheries, agriculture, forestry, mining, etc), and security and external relations. Although the national strategies present different national perspectives, at the same time, there are a number of similarities when it comes to overall policy objectives in a number of areas such as the Arctic and climate change. In other words, even though the Arctic plays a different role in each country's national context and there are clear differences as regards geography, access to resources and security policies, the strategies display common general interest in sustainable development and management of resources, protection of the environment, international cooperation and regional security. The second part of this paper focuses on the national space strategies and indicates the main priorities and trends. The priorities vary from one country to the other and can include science, navigation, earth observation, human space flight, launchers, technology development, and/or applications. The motivation for investing in space activities also change (e.g. international cooperation, industrial competitiveness, societal benefits, job creation).

Identifying management and disease priorities of Canadian dairy industry stakeholders.

PubMed

Bauman, C A; Barkema, H W; Dubuc, J; Keefe, G P; Kelton, D F

2016-12-01

The objective of this study was to identify the key management and disease issues affecting the Canadian dairy industry. An online questionnaire (FluidSurveys, http://fluidsurveys.com/) was conducted between March 1 and May 31, 2014. A total of 1,025 responses were received from across Canada of which 68% (n=698) of respondents were dairy producers, and the remaining respondents represented veterinarians, university researchers, government personnel, and other allied industries. Participants were asked to identify their top 3 management and disease priorities from 2 lists offered. Topics were subsequently ranked from highest to lowest using 3 different ranking methods based on points: 5-3-1 (5 points for first priority, 3 for second, and 1 for first), 3-2-1, and 1-1-1 (equal ranking). The 5-3-1 point system was selected because it minimized the number of duplicate point scores. Stakeholder groups showed general agreement with the top management issue identified as animal welfare and the number one health concern as lameness. Other areas identified as priorities were reproductive health, antibiotic use, bovine viral diarrhea, and Staphylococcus aureus mastitis with these rankings influenced by region, herd size, and stakeholder group. This is the first national comprehensive assessment of priorities undertaken in the Canadian dairy industry and will assist researchers, policymakers, program developers, and funding agencies make future decisions based on direct industry feedback. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Strategic Research Action Plans 2016-2019

EPA Pesticide Factsheets

EPA's six research priorities: Air, Climate, Energy; Chemical Safety for Sustainability, Homeland Security, Human Health Risk Assessment, Sustainable and Healthy Communities, Safe and Sustainable Water Resources.

Safety measures for prevention of PCB accidents.

PubMed Central

Pajari, J

1985-01-01

This paper attempts to clarify the most common measures available for the fire and electrical engineer in the prevention of polychlorinated biphenyl (PCB) hazards. It points out the risks and the potential for making large risks involved in the use of transformers and capacitors more manageable. The focus in solving the PCB problem is on priority. This should be reflected in the agenda of the workshop: it should discuss not only transformers and capacitors as such, but deal more with questions concerning waste disposal, getting correct information to people on substances containing PCBs and on the proper and nonpanicky handling of such substances. The PCB issue does not lend itself to any black and white solution. Instead, a number of different aspects have to be taken into account. Any solutions arrived at are therefore always compromises between risk evaluation and cost effectiveness. Reduction of PCB risks does not have to result, for example, in an increase in fire risks. It is preferable to move step by step and avoid making irretractable decisions. Alternatives available for replacing PCB-filled devices or the widely used method of refilling PCB-filled transformers with silicone oils are not discussed. Refilling is not dealt with because its capacity to reduce the fire risk sufficiently in locations where these transformers are usually found in northern Europe is not known with certainty. PMID:3928364

Scientific background of contemporary approach in the priority areas of medical science in the field of radiation medicine and radiobiology.

PubMed

Chumak, A A; Medvedovska, N V; Ovsannikova, L M

2013-01-01

OBJECTIVE. To analyze the results of scientific research on the problems of radiation medicine and radiobiology for the further outlining of the priority fields of research in this area. MATERIALS. Perspective plans and annual summary of research (R & D) NAMS of Ukraine, interim and final reports on implementation of research, reports on the activities of institutions, thematic scientific publications. METHODS. Semantic and content analysis, bibliometry, historical and logical analysis. RESULTS. The definition of major oncological risks of radiation effects, study of radiation risks of morbidity and mortality from cardiovascular and cerebrovascular diseases, cognitive effects and cataract in liquidators of the Chornobyl nuclear power plant accident, study of transgenic effects of the brain irradiation, other organs and systems in various stages of ontogenesis in exposed in utero, in offspring of exposed parents; study of the effects of occupational exposure were recognized as perspective and requiring further research in radiation medicine. CONCLUSION. Issues of NNCRM scientific activity are consistent with priority areas of research in Ukraine defined by the Law "On priority directions of science and technology", namely, aimed at substantiating of the development and preservation of human potential, aimed at the creation of modern technologies on prevention and treatment of most common diseases. Chumak A. A., Medvedovska N. V., Ovsjannikova L. M. 2013.

Understanding Perceptions of Climate Change, Priorities, and Decision-Making among Municipalities in Lima, Peru to Better Inform Adaptation and Mitigation Planning.

PubMed

Siña, Mariella; Wood, Rachel C; Saldarriaga, Enrique; Lawler, Joshua; Zunt, Joseph; Garcia, Patricia; Cárcamo, César

2016-01-01

Climate change poses multiple risks to the population of Lima, the largest city and capital of Peru, located on the Pacific coast in a desert ecosystem. These risks include increased water scarcity, increased heat, and the introduction and emergence of vector-borne and other climate sensitive diseases. To respond to these threats, it is necessary for the government, at every level, to adopt more mitigation and adaptation strategies. Here, focus groups were conducted with representatives from five Lima municipalities to determine priorities, perception of climate change, and decision-making processes for implementing projects within each municipality. These factors can affect the ability and desire of a community to implement climate change adaptation and mitigation strategies. The results show that climate change and other environmental factors are of relatively low priority, whereas public safety and water and sanitation services are of highest concern. Perhaps most importantly, climate change is not well understood among the municipalities. Participants had trouble distinguishing climate change from other environmental issues and did not fully understand its causes and effects. Greater understanding of what climate change is and why it is important is necessary for it to become a priority for the municipalities. Different aspects of increased climate change awareness seem to be connected to having experienced extreme weather events, whether related or not to climate change, and to higher socioeconomic status.

What should autism research focus upon? Community views and priorities from the United Kingdom

PubMed Central

Dinsmore, Adam; Charman, Tony

2014-01-01

The rise in the measured prevalence of autism has been accompanied by much new research and research investment internationally. This study sought to establish whether the pattern of current UK autism research funding maps on to the concerns of the autism community. Interviews and focus groups were conducted with autistic adults, family members, practitioners and researchers to identify their priorities for research. We also captured the views of a large number of stakeholders via an online survey. There was a clear disparity between the United Kingdom’s pattern of funding for autism research and the priorities articulated by the majority of participants. There was general consensus that future priorities for autism research should lie in those areas that make a difference to people’s day-to-day lives. There needs to be greater involvement of the autism community both in priority setting and in research more broadly to ensure that resources reach where they are most needed and can make the most impact. PMID:24789871

Application of failure mode and effects analysis (FMEA) to pretreatment phases in tomotherapy.

PubMed

Broggi, Sara; Cantone, Marie Claire; Chiara, Anna; Di Muzio, Nadia; Longobardi, Barbara; Mangili, Paola; Veronese, Ivan

2013-09-06

The aim of this paper was the application of the failure mode and effects analysis (FMEA) approach to assess the risks for patients undergoing radiotherapy treatments performed by means of a helical tomotherapy unit. FMEA was applied to the preplanning imaging, volume determination, and treatment planning stages of the tomotherapy process and consisted of three steps: 1) identification of the involved subprocesses; 2) identification and ranking of the potential failure modes, together with their causes and effects, using the risk probability number (RPN) scoring system; and 3) identification of additional safety measures to be proposed for process quality and safety improvement. RPN upper threshold for little concern of risk was set at 125. A total of 74 failure modes were identified: 38 in the stage of preplanning imaging and volume determination, and 36 in the stage of planning. The threshold of 125 for RPN was exceeded in four cases: one case only in the phase of preplanning imaging and volume determination, and three cases in the stage of planning. The most critical failures appeared related to (i) the wrong or missing definition and contouring of the overlapping regions, (ii) the wrong assignment of the overlap priority to each anatomical structure, (iii) the wrong choice of the computed tomography calibration curve for dose calculation, and (iv) the wrong (or not performed) choice of the number of fractions in the planning station. On the basis of these findings, in addition to the safety strategies already adopted in the clinical practice, novel solutions have been proposed for mitigating the risk of these failures and to increase patient safety.

Education

ERIC Educational Resources Information Center

Conde, David

1977-01-01

Today there is a need for an increasing number of properly trained Spanish-speaking and culturally sensitive teachers and administrators. The glaring disparity between the number of bilingual educators at all levels and the Hispanic American population manifest this as a priority. (Author/NQ)

Threatened species and the potential loss of phylogenetic diversity: conservation scenarios based on estimated extinction probabilities and phylogenetic risk analysis.

PubMed

Faith, Daniel P

2008-12-01

New species conservation strategies, including the EDGE of Existence (EDGE) program, have expanded threatened species assessments by integrating information about species' phylogenetic distinctiveness. Distinctiveness has been measured through simple scores that assign shared credit among species for evolutionary heritage represented by the deeper phylogenetic branches. A species with a high score combined with a high extinction probability receives high priority for conservation efforts. Simple hypothetical scenarios for phylogenetic trees and extinction probabilities demonstrate how such scoring approaches can provide inefficient priorities for conservation. An existing probabilistic framework derived from the phylogenetic diversity measure (PD) properly captures the idea of shared responsibility for the persistence of evolutionary history. It avoids static scores, takes into account the status of close relatives through their extinction probabilities, and allows for the necessary updating of priorities in light of changes in species threat status. A hypothetical phylogenetic tree illustrates how changes in extinction probabilities of one or more species translate into changes in expected PD. The probabilistic PD framework provided a range of strategies that moved beyond expected PD to better consider worst-case PD losses. In another example, risk aversion gave higher priority to a conservation program that provided a smaller, but less risky, gain in expected PD. The EDGE program could continue to promote a list of top species conservation priorities through application of probabilistic PD and simple estimates of current extinction probability. The list might be a dynamic one, with all the priority scores updated as extinction probabilities change. Results of recent studies suggest that estimation of extinction probabilities derived from the red list criteria linked to changes in species range sizes may provide estimated probabilities for many different species. Probabilistic PD provides a framework for single-species assessment that is well-integrated with a broader measurement of impacts on PD owing to climate change and other factors.

Methodology for determining motorcycle operator crash risk and alcohol impairment. Vol. 1, Synthesis report on alternative approaches with priorities for research

DOT National Transportation Integrated Search

2007-04-01

Alcohol-involvement continues to be a prominent factor in motorcycle crashes. Automobile-driver drinking and driving has been researched extensively, and the relationship between drivers' blood alcohol concentrations (BAC) and crash risk is well-unde...

Psychological Issues in Cancer Genetics: Current Research and Future Priorities.

ERIC Educational Resources Information Center

Hopwood, Penelope

1997-01-01

Data concerning the psychological impact of high risk of cancer are reviewed, including implications of genetic testing, breast screening,and accuracy of women's risk estimates. Work in progress on prophylactic mastectomy and chemoprevention is reviewed. Research on cancer families, and interventions and prevention strategies for high-risk…

Environmental Policy--a Priority for Schools in the '90s.

ERIC Educational Resources Information Center

Ehrhardt, Cathryn

1989-01-01

A transformation of public attitudes on the environment has resulted in more stringent standards on almost all school programs for hazardous waste management, air quality, groundwater, and emergency planning and response. A comprehensive environmental risk reduction and management policy should highlight the potential for environmental risks in…

Overview of the National Risk Management Research Laboratory: The Environmental Research Institute of the States Environmental Council of the States 2007

EPA Science Inventory

An overview of the EPA Science and Research Organization, The National Risk Management Research Lab, the current research being conducted, priority Environmental Technology Research Issues, and new approaches to environmental management and sustainability taking place at the Nati...

Promoting At-Risk Preschool Children's Comprehension through Research-Based Strategy Instruction

ERIC Educational Resources Information Center

DeBruin-Parecki, Andrea; Squibb, Kathryn

2011-01-01

Young children living in poor urban neighborhoods are often at risk for reading difficulties, in part because developing listening comprehension strategies and vocabulary knowledge may not be a priority in their prekindergarten classrooms, whose curriculums typically focus heavily on phonological awareness and alphabet knowledge. Prereading…

Development of Normal Human Colonocyte Cultures to Identify a Carcinogenic Potential for Priority Disinfection Byproducts

EPA Science Inventory

Epidemiological studies have linked the consumption of disinfected surface waters to an increased risk of colorectal cancer. Of the approximately >600 disinfection byproducts (DBPs) identified, the US EPA regulates 11 DBPS for an increased risk of cancer. An in-depth mechanism-ba...

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

PubMed

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

2013-12-01

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

Policies for Reducing Coastal Risk on the East and Gulf Coasts

NASA Astrophysics Data System (ADS)

Glickson, D.; Johnson, S.

2014-12-01

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

The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors

PubMed Central

Danaei, Goodarz; Ding, Eric L.; Mozaffarian, Dariush; Taylor, Ben; Rehm, Jürgen; Murray, Christopher J. L.; Ezzati, Majid

2009-01-01

Background Knowledge of the number of deaths caused by risk factors is needed for health policy and priority setting. Our aim was to estimate the mortality effects of the following 12 modifiable dietary, lifestyle, and metabolic risk factors in the United States (US) using consistent and comparable methods: high blood glucose, low-density lipoprotein (LDL) cholesterol, and blood pressure; overweight–obesity; high dietary trans fatty acids and salt; low dietary polyunsaturated fatty acids, omega-3 fatty acids (seafood), and fruits and vegetables; physical inactivity; alcohol use; and tobacco smoking. Methods and Findings We used data on risk factor exposures in the US population from nationally representative health surveys and disease-specific mortality statistics from the National Center for Health Statistics. We obtained the etiological effects of risk factors on disease-specific mortality, by age, from systematic reviews and meta-analyses of epidemiological studies that had adjusted (i) for major potential confounders, and (ii) where possible for regression dilution bias. We estimated the number of disease-specific deaths attributable to all non-optimal levels of each risk factor exposure, by age and sex. In 2005, tobacco smoking and high blood pressure were responsible for an estimated 467,000 (95% confidence interval [CI] 436,000–500,000) and 395,000 (372,000–414,000) deaths, accounting for about one in five or six deaths in US adults. Overweight–obesity (216,000; 188,000–237,000) and physical inactivity (191,000; 164,000–222,000) were each responsible for nearly 1 in 10 deaths. High dietary salt (102,000; 97,000–107,000), low dietary omega-3 fatty acids (84,000; 72,000–96,000), and high dietary trans fatty acids (82,000; 63,000–97,000) were the dietary risks with the largest mortality effects. Although 26,000 (23,000–40,000) deaths from ischemic heart disease, ischemic stroke, and diabetes were averted by current alcohol use, they were outweighed by 90,000 (88,000–94,000) deaths from other cardiovascular diseases, cancers, liver cirrhosis, pancreatitis, alcohol use disorders, road traffic and other injuries, and violence. Conclusions Smoking and high blood pressure, which both have effective interventions, are responsible for the largest number of deaths in the US. Other dietary, lifestyle, and metabolic risk factors for chronic diseases also cause a substantial number of deaths in the US. Please see later in the article for Editors' Summary PMID:19399161

Spatial analysis on school environment characteristics in mangrove management based on local wisdom (Case study at Lhokseumawe, Aceh)

NASA Astrophysics Data System (ADS)

Susiloningtyas, Dewi; Handayani, Tuty; Amalia, Naila; Nadhira, Arum Ira

2017-01-01

After 2004 tsunami, lots of efforts have been made, such as building school and distributing mangrove forests. This study examines the perception of teachers and students about mangrove management which spread in the administrative area of Lhokseumawe to become a reference then applied as local education regarding mangrove after tsunami disaster. This paper was based on primary data taken using questionnaire with a predetermined analysis unit to interview teachers and students in the study area. The result presented with quantitative and descriptive analysis. The result is of the total number of junior high schools in the city of Lhokseumawe as many as 41 Public Schools, Private and Religious School, there are 31 schools with priority for local wisdom education implemented mangrove. The result is classified with 3 class. The school’s first priority is schools with a melee, with mangroves mangrove poor condition. Educational priority 2 is schools with close proximity to the mangrove and mangrove condition with moderate levels of damage. Schools with third priority are school with a close range, and mangrove good condition. Priority I as many as 18 schools, 10 schools priority II and 3 school for priority with learning competency standards that differ from each other.

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EPA Pesticide Factsheets

EPA's six research priorities: Air, Climate, Energy; Chemical Safety for Sustainability, Homeland Security, Human Health Risk Assessment, Sustainable and Healthy Communities, Safe and Sustainable Water Resources.

Ecological risk assessment of sedimentary hydrocarbons in a subtropical estuary as tools to select priority areas for environmental management.

PubMed

Dauner, Ana L L; Dias, Thais H; Ishii, Fernanda K; Libardoni, Bruno G; Parizzi, Rafael A; Martins, César C

2018-06-23

The concentration, distribution, and ecological risk of hydrocarbons, as well as bulk parameters, were determined in surface sediments of the Babitonga Bay, a subtropical human-impacted estuary in South Atlantic. Total aliphatic and polycyclic aromatic hydrocarbons (PAHs) ranged between 0.8 and 201.2 μg g -1 and from 8.7 to 5489 ng g -1 , respectively. Saguaçú Lagoon, the region near the ferry boat and the vicinity of São Francisco harbour (SFH), presented high hydrocarbon concentrations. Despite the low accumulation trend in this region, the SFH and city may act as a punctual hydrocarbon source. The inner portion of the estuary had the finest sediment grains and the highest concentrations of carbon, nitrogen, and sulphur, indicating its importance as a depositional and cumulative area. The occurrence of unresolved complex mixture suggested chronic oil contamination. Petrogenic (based on the high percentage of alkylated PAHs) and pyrolytic (according to the diagnostic ratios of PAH isomer pairs) sources were confirmed. Ecological risk assessment was evaluated by the risk quotient (RQ). All samples had at least one priority PAH present at above the negligible concentration, including naphthalene, which was observed in all samples. Only the sites near the ferry boat and at the Saguaçú Lagoon contained compounds with concentrations above their maximum permissible concentrations, while all other sampling sites are classified as "Low-risk." The spatial distribution of RQs coincides with PAHs distribution, indicating that the regions near SFH, ferry-boat, and the Saguaçú Lagoon should be considered to be priority areas when making environmental monitoring policies. Copyright © 2018 Elsevier Ltd. All rights reserved.

Trace Elements Contamination and Human Health Risk Assessment in Drinking Water from the Agricultural and Pastoral Areas of Bay County, Xinjiang, China

PubMed Central

Turdi, Muyessar; Yang, Linsheng

2016-01-01

Tap water samples were collected from 180 families in four agricultural (KYR: Keyir, KRW: Kariwak, YTR: Yatur, DW: Dawanqi) and two pastoral areas (B: Bulong and Y: Yangchang) in Bay County, Xinjiang, China, and levels of seven trace elements (Cd, Cr, As Ni, Pb, Zn, Se) were analyzed using inductively-coupled plasma mass spectrometry (ICP-MS) to assess potential health risks. Remarkable spatial variations of contamination were observed. Overall, the health risk was more severe for carcinogenic versus non-carcinogenic pollutants due to heavy metal. The risk index was greater for children overall (Cr > As > Cd and Zn > Se for carcinogenic and non-carcinogenic elements, respectively). The total risk index was greater in agricultural areas (DW > KYR > YTR > KRW > B > Y). Total risk indices were greater where well water was the source versus fountain water; for the latter, the total health risk index was greater versus glacier water. Main health risk factors were Cr and As in DW, KYR, YTR, KRW, and B, and Zn, Cr, and As in the Y region. Overall, total trace element–induced health risk (including for DW adults) was higher than acceptable (10−6) and lower than priority risk levels (10−4) (KYR, YTR, KRW, Y, and B). For DW children, total health risk reached 1.08 × 10−4, higher than acceptable and priority risk levels (10−4). PMID:27669274

When should we save the most endangered species?

PubMed

Wilson, Howard B; Joseph, Liana N; Moore, Alana L; Possingham, Hugh P

2011-09-01

At the heart of our efforts to protect threatened species, there is a controversial debate about whether to give priority to cost-effective actions or whether focusing solely on the most endangered species will ultimately lead to preservation of the greatest number of species. By framing this debate within a decision-analytic framework, we show that allocating resources solely to the most endangered species will typically not minimise the number of extinctions in the long-term, as this does not account for the risk of less endangered species going extinct in the future. It is only favoured when our planning timeframe is short or we have a long-term view and we are optimistic about future conditions. Conservation funding tends to be short-term in nature, which biases allocations to more endangered species. Our work highlights the need to consider resource allocation for biodiversity over the long-term; 'preventive conservation', rather than just short-term fire-fighting. © 2011 Blackwell Publishing Ltd/CNRS.

Cost-efficient scheduling of FAST observations

NASA Astrophysics Data System (ADS)

Luo, Qi; Zhao, Laiping; Yu, Ce; Xiao, Jian; Sun, Jizhou; Zhu, Ming; Zhong, Yi

2018-03-01

A cost-efficient schedule for the Five-hundred-meter Aperture Spherical radio Telescope (FAST) requires to maximize the number of observable proposals and the overall scientific priority, and minimize the overall slew-cost generated by telescope shifting, while taking into account the constraints including the astronomical objects visibility, user-defined observable times, avoiding Radio Frequency Interference (RFI). In this contribution, first we solve the problem of maximizing the number of observable proposals and scientific priority by modeling it as a Minimum Cost Maximum Flow (MCMF) problem. The optimal schedule can be found by any MCMF solution algorithm. Then, for minimizing the slew-cost of the generated schedule, we devise a maximally-matchable edges detection-based method to reduce the problem size, and propose a backtracking algorithm to find the perfect matching with minimum slew-cost. Experiments on a real dataset from NASA/IPAC Extragalactic Database (NED) show that, the proposed scheduler can increase the usage of available times with high scientific priority and reduce the slew-cost significantly in a very short time.

National occupational health research priorities, agenda and strategy of Japan: invited report in NORA symposium 2001, USA.

PubMed

Araki, Shunichi; Tachi, Masatomo

2003-01-01

An invited report on national occupational health research priorities, agenda and strategy of Japan was delivered in the NORA (National Occupational Research Agenda) Symposium 2001, USA. The third NORA Symposium was held by the US National Institute for Occupational Safety and Health (NIOSH) in Washington DC on June 27, 2001. The national conference in Japan entitled "Conference on Occupational Health Research Strategies in the 21st Century" was organized by the Japanese Ministry of Labour (Currently, Ministry of Health, Labour and Welfare) in the years 1998-2001, and the national occupational health research agenda and strategy for the next decade in Japan was identified. A total of 50 Conference members, i.e., representatives from various fields of occupational health in Japan, ranked 58 comprehensive research topics, yielding short-term (5-year) and long-term (6-10 year) priority research topics. Overall (10-year) priority research topics were calculated by combining the short-term and long-term priority scores. Together with the ranking by 145 extramural occupational health specialists, it was identified that work stress (i.e., one of the 58 research topics) was the first overall priority research topic for the next 10 years in Japan. Three other topics, i.e., elderly workers, women workers and maternity protection, and mental health and quality of work and life, were the second group of priority topics; and hazard and risk assessment and biological effect index were the third priority group. Based on the scores for the short-term and long-term priority research topics, all 58 research topics were classified into three key research areas with 18 key research issues (National Occupational Health Research Agenda, NOHRA). Finally, eight implementation measures of national strategy for the Japanese Government to promote occupational health research were introduced.

Space Weather Impacts on Spacecraft Operations: Identifying and Establishing High-Priority Operational Services

NASA Astrophysics Data System (ADS)

Lawrence, G.; Reid, S.; Tranquille, C.; Evans, H.

2013-12-01

Space Weather is a multi-disciplinary and cross-domain system defined as, 'The physical and phenomenological state of natural space environments. The associated discipline aims, through observation, monitoring, analysis and modelling, at understanding and predicting the state of the Sun, the interplanetary and planetary environments, and the solar and non-solar driven perturbations that affect them, and also at forecasting and nowcasting the potential impacts on biological and technological systems'. National and Agency-level efforts to provide services addressing the myriad problems, such as ESA's SSA programme are therefore typically complex and ambitious undertakings to introduce a comprehensive suite of services aimed at a large number and broad range of end users. We focus on some of the particular threats and risks that Space Weather events pose to the Spacecraft Operations community, and the resulting implications in terms of User Requirements. We describe some of the highest-priority service elements identified as being needed by the Operations community, and outline some service components that are presently available, or under development. The particular threats and risks often vary according to orbit, so the particular User Needs for Operators at LEO, MEO and GEO are elaborated. The inter-relationship between these needed service elements and existing service components within the broader Space Weather domain is explored. Some high-priority service elements and potential correlation with Space Weather drivers include: solar array degradation and energetic proton storms; single event upsets at GEO and solar proton events and galactic cosmic rays; surface charging and deep dielectric charging at MEO and radiation belt dynamics; SEUs at LEO and the South Atlantic Anomaly and its variability. We examine the current capability to provide operational services addressing such threats and identify some advances that the Operations community can expect to benefit from in the short- and medium-term, such as: enhanced forecasting eg. using Bayesian statistics; optimization and standardization of effects tools; operations-ready real-time data tools, with customization options tailored around the operator's views; next-generation SWE-specific sensors and provision of key data to Operators.

Research Priorities in Environmental Risk Assessment. Workshop on Research Needs in Environmental Toxicology and Chemistry Held in Breckenridge, Colorado on August 16-21, 1987

DTIC Science & Technology

1988-06-30

accordance with SETAC’s goal of providing a forum for communication among professionals involved with the use, protection, and management of the...templated action. Risk assessment provides technical input to risk management , the process of making decisions about the acceptability of risks and the need... management and computerized information-processing capabilities needed for risk assessment is also essential. Aquatic Toxicology In order to quantify and

Climate Change Impacts and Adaptation on Southwestern DoD Facilities

DTIC Science & Technology

2017-03-03

integrating climate change risks into decision priorities. 15. SUBJECT TERMS adaptation, baseline sensitivity, climate change, climate exposure...four bases we found that integrating climate change risks into the current decision matrix, by linking projected risks to current or past impacts...data and decision tools and methods. Bases have some capacity to integrate climate-related information, but they have limited resources to undertake

Trends in the Prevalence of Selected Risk Behaviors and Obesity for White Students. National YRBS: 1991-2011

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2011

2011-01-01

The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

Trends in the Prevalence of Selected Risk Behaviors and Obesity for All Students. National YRBS: 1991-2011

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2011

2011-01-01

The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

Trends in the Prevalence of Selected Risk Behaviors and Obesity for Black Students. National YRBS: 1991-2011

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2011

2011-01-01

The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

Trends in the Prevalence of Selected Risk Behaviors and Obesity for Hispanic Students. National YRBS: 1991-2011

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2011

2011-01-01

The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

[Assessment of risk of contamination of drinking water for the health of children in the Tula region].

PubMed

Grigorev, Yu I; Lyapina, N V

2014-01-01

The hygienic analysis of centralized drinking water supply in Tula region was performed. Priority contaminants of drinking water were established. On the base of the application of risk assessment methodology there was calculated carcinogenic risk for children's health. A direct relationship between certain classes of diseases and pollution of drinking water with chemical contaminants has been determined.

Officer Accessions Flow Model

DTIC Science & Technology

2011-07-31

officers select their own BOLC-B dates completely divorced of their unit assignment and that unit’s ARFORGEN cycle. We reschedule all FY10 cohort LTs...for BOLC-B based upon unit priority based upon number of days until LAD. Rescheduling all FY10 cohort LTs for BOLC-B based upon unit priority...with specialty branches (doctors, lawyers, nurses , chaplains, etc) which have minimal representation in BCT-level units.  DCs are not generally

Setting health research priorities using the CHNRI method: IV. Key conceptual advances.

PubMed

Rudan, Igor

2016-06-01

Child Health and Nutrition Research Initiative (CHNRI) started as an initiative of the Global Forum for Health Research in Geneva, Switzerland. Its aim was to develop a method that could assist priority setting in health research investments. The first version of the CHNRI method was published in 2007-2008. The aim of this paper was to summarize the history of the development of the CHNRI method and its key conceptual advances. The guiding principle of the CHNRI method is to expose the potential of many competing health research ideas to reduce disease burden and inequities that exist in the population in a feasible and cost-effective way. The CHNRI method introduced three key conceptual advances that led to its increased popularity in comparison to other priority-setting methods and processes. First, it proposed a systematic approach to listing a large number of possible research ideas, using the "4D" framework (description, delivery, development and discovery research) and a well-defined "depth" of proposed research ideas (research instruments, avenues, options and questions). Second, it proposed a systematic approach for discriminating between many proposed research ideas based on a well-defined context and criteria. The five "standard" components of the context are the population of interest, the disease burden of interest, geographic limits, time scale and the preferred style of investing with respect to risk. The five "standard" criteria proposed for prioritization between research ideas are answerability, effectiveness, deliverability, maximum potential for disease burden reduction and the effect on equity. However, both the context and the criteria can be flexibly changed to meet the specific needs of each priority-setting exercise. Third, it facilitated consensus development through measuring collective optimism on each component of each research idea among a larger group of experts using a simple scoring system. This enabled the use of the knowledge of many experts in the field, "visualising" their collective opinion and presenting the list of many research ideas with their ranks, based on an intuitive score that ranges between 0 and 100. Two recent reviews showed that the CHNRI method, an approach essentially based on "crowdsourcing", has become the dominant approach to setting health research priorities in the global biomedical literature over the past decade. With more than 50 published examples of implementation to date, it is now widely used in many international organisations for collective decision-making on health research priorities. The applications have been helpful in promoting better balance between investments in fundamental research, translation research and implementation research.

1988 Delphi survey of nursing research priorities for New York State.

PubMed

Shortridge, L; Doswell, W; Evans, M E; Levin, R F; Millor, G K; Carter, E

1989-09-01

In order to inform decisions about nursing research and health care policy, the Council on Nursing Research of the New York State Nurses Association (NYSNA) conducted a Delphi survey to identify the priorities for nursing research in New York state. The Delphi technique is a method of eliciting judgements from experts for the purpose of short-term forecasting and planning. The survey was conducted by mail in three rounds during 1988. Round I required participants to identify three primary research priorities for the nursing profession. In Round II participants ranked the 37 most frequently identified categories from Round I. The highest 16 categories from Round II were ranked by participants in Round III to provide the final 10 nursing research priority categories for New York state. All members of the New York State Nurses Association holding a minimum of a master's degree in nursing were invited to participate. The response rates were: Round I, 34% (N = 872); Round II, 38% (N = 985); Round III 37% (N = 974). Of the 10 nursing research priority categories identified in the final round, 5 relate to nurses, 2 relate to nursing, and 3 relate to clients. None of the high-risk conditions or populations with whom nurses work appear in the top 10, and only 2 of these are ranked in the top 15 priority categories. These priority categories will be used by the NYSNA Council on Nursing Research to influence its future agenda and activities. They can be used by the nursing profession and others for planning, policy making, and establishing nursing research funding priorities.(ABSTRACT TRUNCATED AT 250 WORDS)

Mental health education in occupational therapy professional preparation programs: Alignment between clinician priorities and coverage in university curricula.

PubMed

Scanlan, Justin Newton; Meredith, Pamela J; Haracz, Kirsti; Ennals, Priscilla; Pépin, Geneviève; Webster, Jayne S; Arblaster, Karen; Wright, Shelley

2017-12-01

Occupational therapy programs must prepare graduates for work in mental health. However, this area of practice is complex and rapidly changing. This study explored the alignment between educational priorities identified by occupational therapists practising in mental health and level of coverage of these topics in occupational therapy programs in Australia and New Zealand. Surveys were distributed to heads of all occupational therapy programs across Australia and New Zealand. The survey included educational priorities identified by occupational therapists in mental health from a previous study. Respondents were requested to identify the level of coverage given to each of these priorities within their curriculum. These data were analysed to determine a ranking of educational topics in terms of level of coverage in university programs. Responses were received for 19 programs from 16 universities. Thirty-four topics were given 'High-level coverage' in university programs, and these were compared against the 29 topics classified as 'Essential priorities' by clinicians. Twenty topics were included in both the 'Essential priorities' and 'High-level coverage' categories. Topics considered to be 'Essential priorities' by clinicians which were not given 'High-level coverage' in university programs included the following: mental health fieldwork experiences; risk assessment and management; professional self-care resilience and sensory approaches. While there appears to be overall good alignment between mental health curricula and priorities identified by practising occupational therapists, there are some discrepancies. These discrepancies are described and establish a strong foundation for further discussion between clinicians, academics and university administration to support curriculum review and revision. © 2017 Occupational Therapy Australia.

Enhanced Handover Decision Algorithm in Heterogeneous Wireless Network

PubMed Central

Abdullah, Radhwan Mohamed; Zukarnain, Zuriati Ahmad

2017-01-01

Transferring a huge amount of data between different network locations over the network links depends on the network’s traffic capacity and data rate. Traditionally, a mobile device may be moved to achieve the operations of vertical handover, considering only one criterion, that is the Received Signal Strength (RSS). The use of a single criterion may cause service interruption, an unbalanced network load and an inefficient vertical handover. In this paper, we propose an enhanced vertical handover decision algorithm based on multiple criteria in the heterogeneous wireless network. The algorithm consists of three technology interfaces: Long-Term Evolution (LTE), Worldwide interoperability for Microwave Access (WiMAX) and Wireless Local Area Network (WLAN). It also employs three types of vertical handover decision algorithms: equal priority, mobile priority and network priority. The simulation results illustrate that the three types of decision algorithms outperform the traditional network decision algorithm in terms of handover number probability and the handover failure probability. In addition, it is noticed that the network priority handover decision algorithm produces better results compared to the equal priority and the mobile priority handover decision algorithm. Finally, the simulation results are validated by the analytical model. PMID:28708067

Energy in the Environment - Initiatives 2004-08

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

Paul Jehn

Under the Energy and Environment Initiative, the GWPC/GWPRF will expand the oil and gas electronic commerce initiatives used to enhance the Risk Based Data Management System (RBDMS) and the Cost Effective Regulatory Approach (CERA). The GWPC/GWPRF has identified the following priorities for work efforts during the time period that will act as the base from which selections for each work period will be proposed. Work tasks will be presented for each reporting period by the GWPC from areas selected from the general list of priorities.

MANAGING INTERNAL RADIATION CONTAMINATION FOLLOWING AN EMERGENCY: IDENTIFICATION OF GAPS AND PRIORITIES

PubMed Central

Li, Chunsheng; Ansari, Armin; Etherington, George; Jourdain, Jean-Rene; Kukhta, Boris; Kurihara, Osamu; Lopez, Maria Antonia; Ménétrier, Florence; dos Reis, Arlene Alves; Solomon, Stephen; Zhang, Jiangfeng; Carr, Zhanat

2017-01-01

Following a radiological or nuclear emergency, first responders and the public may become internally contaminated with radioactive materials, as demonstrated during the Goiânia, Chernobyl and Fukushima accidents. Timely monitoring of the affected populations for potential internal contamination, assessment of radiation dose and the provision of necessary medical treatment are required to minimize the health risks from the contamination. This paper summarizes the guidelines and tools that have been developed, and identifies the gaps and priorities for future projects. PMID:27521210

The impact of dietary habits and metabolic risk factors on cardiovascular and diabetes mortality in countries of the Middle East and North Africa in 2010: a comparative risk assessment analysis.

PubMed

Afshin, Ashkan; Micha, Renata; Khatibzadeh, Shahab; Fahimi, Saman; Shi, Peilin; Powles, John; Singh, Gitanjali; Yakoob, Mohammad Yawar; Abdollahi, Morteza; Al-Hooti, Suad; Farzadfar, Farshad; Houshiar-Rad, Anahita; Hwalla, Nahla; Koksal, Eda; Musaiger, Abdulrahman; Pekcan, Gulden; Sibai, Abla Mehio; Zaghloul, Sahar; Danaei, Goodarz; Ezzati, Majid; Mozaffarian, Dariush

2015-05-20

We conducted a comparative risk assessment analysis to estimate the cardiometabolic disease (CMD) mortality attributable to 11 dietary and 4 metabolic risk factors in 20 countries of the Middle East by age, sex and time. The national exposure distributions were obtained from a systematic search of multiple databases. Missing exposure data were estimated using a multilevel Bayesian hierarchical model. The aetiological effect of each risk factor on disease-specific mortality was obtained from clinical trials and observational studies. The number of disease-specific deaths was obtained from the 2010 Global Burden of Disease mortality database. Mortality due to each risk factor was determined using the population attributable fraction and total number of disease-specific deaths. Adult population in the Middle East by age, sex, country and time. Suboptimal diet was the leading risk factor for CMD mortality in 11 countries accounting for 48% (in Morocco) to 72% (in the United Arab Emirates) of CMD deaths. Non-optimal systolic blood pressure was the leading risk factor for CMD deaths in eight countries causing 45% (in Bahrain) to 68% (in Libya) of CMD deaths. Non-optimal body mass index and fasting plasma glucose were the third and fourth leading risk factors for CMD mortality in most countries. Among individual dietary factors, low intake of fruits accounted for 8% (in Jordan) to 21% (in Palestine) of CMD deaths and low intake of whole grains was responsible for 7% (in Palestine) to 22% (in the United Arab Emirates) of CMD deaths. Between 1990 and 2010, the CMD mortality attributable to most risk factors had decreased except for body mass index and trans-fatty acids. Our findings highlight key similarities and differences in the impact of the dietary and metabolic risk factors on CMD mortality in the countries of the Middle East and inform priorities for policy measures to prevent CMD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The impact of dietary habits and metabolic risk factors on cardiovascular and diabetes mortality in countries of the Middle East and North Africa in 2010: a comparative risk assessment analysis

PubMed Central

Afshin, Ashkan; Micha, Renata; Khatibzadeh, Shahab; Fahimi, Saman; Shi, Peilin; Powles, John; Singh, Gitanjali; Yakoob, Mohammad Yawar; Abdollahi, Morteza; Al-Hooti, Suad; Farzadfar, Farshad; Houshiar-rad, Anahita; Hwalla, Nahla; Koksal, Eda; Musaiger, Abdulrahman; Pekcan, Gulden; Sibai, Abla Mehio; Zaghloul, Sahar; Danaei, Goodarz; Ezzati, Majid; Mozaffarian, Dariush

2015-01-01

Objective/design We conducted a comparative risk assessment analysis to estimate the cardiometabolic disease (CMD) mortality attributable to 11 dietary and 4 metabolic risk factors in 20 countries of the Middle East by age, sex and time. The national exposure distributions were obtained from a systematic search of multiple databases. Missing exposure data were estimated using a multilevel Bayesian hierarchical model. The aetiological effect of each risk factor on disease-specific mortality was obtained from clinical trials and observational studies. The number of disease-specific deaths was obtained from the 2010 Global Burden of Disease mortality database. Mortality due to each risk factor was determined using the population attributable fraction and total number of disease-specific deaths. Setting/population Adult population in the Middle East by age, sex, country and time. Results Suboptimal diet was the leading risk factor for CMD mortality in 11 countries accounting for 48% (in Morocco) to 72% (in the United Arab Emirates) of CMD deaths. Non-optimal systolic blood pressure was the leading risk factor for CMD deaths in eight countries causing 45% (in Bahrain) to 68% (in Libya) of CMD deaths. Non-optimal body mass index and fasting plasma glucose were the third and fourth leading risk factors for CMD mortality in most countries. Among individual dietary factors, low intake of fruits accounted for 8% (in Jordan) to 21% (in Palestine) of CMD deaths and low intake of whole grains was responsible for 7% (in Palestine) to 22% (in the United Arab Emirates) of CMD deaths. Between 1990 and 2010, the CMD mortality attributable to most risk factors had decreased except for body mass index and trans-fatty acids. Conclusions Our findings highlight key similarities and differences in the impact of the dietary and metabolic risk factors on CMD mortality in the countries of the Middle East and inform priorities for policy measures to prevent CMD. PMID:25995236

Comparing the sustainability impacts of solar thermal and natural gas combined cycle for electricity production in Mexico: Accounting for decision makers' priorities

NASA Astrophysics Data System (ADS)

Rodríguez-Serrano, Irene; Caldés, Natalia; Oltra, Christian; Sala, Roser

2017-06-01

The aim of this paper is to conduct a comprehensive sustainability assessment of the electricity generation with two alternative electricity generation technologies by estimating its economic, environmental and social impacts through the "Framework for Integrated Sustainability Assessment" (FISA). Based on a Multiregional Input Output (MRIO) model linked to a social risk database (Social Hotspot Database), the framework accounts for up to fifteen impacts across the three sustainability pillars along the supply chain of the electricity production from Solar Thermal Electricity (STE) and Natural Gas Combined Cycle (NGCC) technologies in Mexico. Except for value creation, results show larger negative impacts for NGCC, particularly in the environmental pillar. Next, these impacts are transformed into "Aggregated Sustainability Endpoints" (ASE points) as a way to support the decision making in selecting the best sustainable project. ASE points obtained are later compared to the resulting points weighted by the reported priorities of Mexican decision makers in the energy sector obtained from a questionnaire survey. The comparison shows that NGCC achieves a 1.94 times worse negative score than STE, but after incorporating decision makerś priorities, the ratio increases to 2.06 due to the relevance given to environmental impacts such as photochemical oxidants formation and climate change potential, as well as social risks like human rights risks.

Reducing Adverse Polypharmacy in Patients With Borderline Personality Disorder: An Empirical Case Study

PubMed Central

Oldham, John M.; Gonzalez, Sylvia; Fowler, J. Christopher

2015-01-01

Objective: Polypharmacy is common and especially challenging in the context of borderline personality disorder in light of impulsivity and self-harm associated with the disorder, risk of adverse drug-drug interactions, and financial burden. Reduction in polypharmacy could be conceptualized as a high priority in the treatment of borderline personality disorder. This case aims to demonstrate that potential. Method: This case report presents outcomes data for an individual with borderline personality disorder during the course of an extended psychiatric hospitalization. Symptomatic change is based on the Patient Health Questionnaire Somatic, Anxiety, and Depression Symptoms scales and World Health Organization 5-Item Well-Being Index. Change in polypharmacy is presented both in terms of absolute number and complexity of the medication regimen. Clinical outcomes data are provided at 2, 12, and 24 weeks postdischarge. Results: During a 56-day hospitalization, the patient demonstrated clinical improvement across clinical domains—all occurred within the context of reduced number (43%) and complexity (40%) of her medication regimen. Symptomatic improvement was sustained up to 6 months postdischarge. Conclusions: Despite good intentions, polypharmacy can be associated with iatrogenic harm and contribute to functional impairment, especially in the context of borderline personality disorder, in which symptomatic fluctuations are part of the illness itself. A reduction in the patient’s high-risk polypharmacy during treatment represents a noteworthy treatment outcome in and of itself. Additional measures of medication risk and liability have the potential to become markers of clinical effectiveness. PMID:26693036

The lasting legacy of war: epidemiology of injuries from landmines and unexploded ordnance in Afghanistan, 2002-2006.

PubMed

Bilukha, Oleg O; Brennan, Muireann; Anderson, Mark

2008-01-01

Due to several decades of armed conflict and civil unrest, Afghanistan is one of the countries most affected by landmines and unexploded ordnance worldwide. The study was performed to assess the magnitude of injuries due to landmines and unexploded ordnance in Afghanistan during 2002-2006 and to describe epidemiological patterns and potential risk factors for these events. Surveillance data including 5,471 injuries caused by landmines and unexploded ordnance in Afghanistan during 2002-2006 were analyzed. The International Committee of the Red Cross collects data on such injuries from 490 reporting health facilities and volunteers throughout the country. These surveillance data were used to describe injury trends, victim demographics, injury types, risk behaviors, and explosive types related to landmine and unexploded ordnance accidents. The largest number of injuries (1,706) occurred in 2002. The number declined sharply to 1,049 injuries in 2003, and remained relatively stable with slight decline thereafter. Overall, 92% of victims were civilians, 91% were males, and 47% were children <18 years of age. The case-fatality ratio was 17%. Approximately 50% of all injuries were caused by unexploded ordnance and 42% by landmines. Among children, 65% of injuries were caused by unexploded ordnance and only 27% by landmines, whereas in adults, most injuries (56%) were caused by landmines. The most common risk behaviors among children were tending animals, playing, and tampering with explosive devices. In adults, most common risk behaviors were traveling, performing activities of economic necessity, and tampering with explosives. Twenty-eight percent of the surviving victims who received mine awareness training and 2% of those who did not receive such training reported that the area where event occurred was marked. The large number of injuries and high proportion of child victims suggest that clearance and risk education activities fall short of achieving their goals, and must be substantially improved or expanded. Especially concerning is the high proportion of injuries caused by unexploded ordnance, and the high number of injuries sustained while tampering with explosive devices. Because unexploded ordnance is more visible than are landmines, and ordnance-contaminated areas are cheaper to clear than are minefields, these injuries are highly preventable and should be a priority for clearance and risk education efforts.

Strategic funding priorities in the pharmaceutical sciences allied to Quality by Design (QbD) and Process Analytical Technology (PAT).

PubMed

Aksu, Buket; De Beer, Thomas; Folestad, Staffan; Ketolainen, Jarkko; Lindén, Hans; Lopes, Joao Almeida; de Matas, Marcel; Oostra, Wim; Rantanen, Jukka; Weimer, Marco

2012-09-29

Substantial changes in Pharmaceutical R&D strategy are required to address existing issues of low productivity, imminent patent expirations and pressures on pricing. Moves towards personalized healthcare and increasing diversity in the nature of portfolios including the rise of biopharmaceuticals however have the potential to provide considerable challenges to the establishment of cost effective and robust supply chains. To guarantee product quality and surety of supply for essential medicines it is necessary that manufacturing science keeps pace with advances in pharmaceutical R&D. In this position paper, the EUFEPS QbD and PAT Sciences network make recommendations that European industry, academia and health agencies focus attention on delivering step changes in science and technology in a number of key themes. These subject areas, all underpinned by the sciences allied to QbD and PAT, include product design and development for personalized healthcare, continuous-processing in pharmaceutical product manufacture, quantitative quality risk assessment for pharmaceutical development including life cycle management and the downstream processing of biopharmaceutical products. Plans are being established to gain commitment for inclusion of these themes into future funding priorities for the Innovative Medicines Initiative (IMI). Copyright © 2012 Elsevier B.V. All rights reserved.

Priorities in the investigation of human health hazards in the plastics and synthetic rubber industries

PubMed Central

Selikoff, Irving J.

1976-01-01

Experiences in the past decade provide guidance in selecting priorities for investigation of health hazards in chemical industries. Pride of place should be given to the experience of large industrial populations, in part simply because large numbers of people are at risk and in part because such studies are more likely to give reliable answers. This recommendation has further strength when there is community exposure as well. Parenthetically, large populations provide opportunity to study multiple factor interaction; without this, toxic potential of a single agent may be obscured. Second, investigations should be mounted when there is reason for suspicion, as with particular chemical configurations, observed organ toxicity, animal carcinogenicity, unusual clinical experience (“signal” tumors). It may be added that when agents have already been used several decades, evaluation of human experience with them is now in order, if only to document absence of toxicity. The same recommendations hold for planned introduction of new agents or widened distribution of existing ones, until we have better information concerning validity of “pretesting” programs. Major advances have been made in epidemiological methods for these investigations. These now allow us to successfully focus on small defined groups as well as to manage large populations. PMID:1026418

[Mortality from Suicide in the Municipalities of Mainland Portugal: Spatio-Temporal Evolution between 1980 and 2015].

PubMed

Loureiro, Adriana; Almendra, Ricardo; Costa, Cláudia; Santana, Paula

2018-01-31

Suicide is considered a public health priority. It is a complex phenomenon resulting from the interaction of several factors, which do not depend solely on individual conditions. This study analyzes the spatio-temporal evolution of suicide mortality between 1980 and 2015, identifying areas of high risk, and their variation, in the 278 municipalities of Continental Portugal. Based on the number of self-inflicted injuries and deaths from suicide and the resident population, the spatio-temporal evolution of the suicide mortality rate was assessed via: i) a Poisson joinpoint regression model, and ii) spatio-temporal clustering methods. The suicide mortality rate evolution showed statistically significant increases over three periods (1980 - 1984; 1999 - 2002 and 2006 - 2015) and two statistically significant periods of decrease (1984 - 1995 and 1995 - 1999). The spatio-temporal analysis identified five clusters of high suicide risk (relative risk >1) and four clusters of low suicide risk (relative risk < 1). The periods when suicide mortality increases seem to overlap with times of economic and financial instability. The geographical pattern of suicide risk has changed: presently, the suicide rates from the municipalities in the Center and North are showing more similarity with those seen in the South, thus increasing the ruralization of the phenomenon of suicide. Between 1980 and 2015 the spacio-temporal pattern of mortality from suicide has been changing and is a phenomenon that is currently experiencing a growing trend (since 2006) and is of higher risk in rural areas.

[Failure mode and effects analysis to improve quality in clinical trials].

PubMed

Mañes-Sevilla, M; Marzal-Alfaro, M B; Romero Jiménez, R; Herranz-Alonso, A; Sanchez Fresneda, M N; Benedi Gonzalez, J; Sanjurjo-Sáez, M

The failure mode and effects analysis (FMEA) has been used as a tool in risk management and quality improvement. The objective of this study is to identify the weaknesses in processes in the clinical trials area, of a Pharmacy Department (PD) with great research activity, in order to improve the safety of the usual procedures. A multidisciplinary team was created to analyse each of the critical points, identified as possible failure modes, in the development of clinical trial in the PD. For each failure mode, the possible cause and effect were identified, criticality was calculated using the risk priority number and the possible corrective actions were discussed. Six sub-processes were defined in the development of the clinical trials in PD. The FMEA identified 67 failure modes, being the dispensing and prescription/validation sub-processes the most likely to generate errors. All the improvement actions established in the AMFE were implemented in the Clinical Trials area. The FMEA is a useful tool in proactive risk management because it allows us to identify where we are making mistakes and analyze the causes that originate them, to prioritize and to adopt solutions to risk reduction. The FMEA improves process safety and quality in PD. Copyright © 2018 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Safety analysis of occupational exposure of healthcare workers to residual contaminations of cytotoxic drugs using FMECA security approach.

PubMed

Le, Laetitia Minh Mai; Reitter, Delphine; He, Sophie; Bonle, Franck Té; Launois, Amélie; Martinez, Diane; Prognon, Patrice; Caudron, Eric

2017-12-01

Handling cytotoxic drugs is associated with chemical contamination of workplace surfaces. The potential mutagenic, teratogenic and oncogenic properties of those drugs create a risk of occupational exposure for healthcare workers, from reception of starting materials to the preparation and administration of cytotoxic therapies. The Security Failure Mode Effects and Criticality Analysis (FMECA) was used as a proactive method to assess the risks involved in the chemotherapy compounding process. FMECA was carried out by a multidisciplinary team from 2011 to 2016. Potential failure modes of the process were identified based on the Risk Priority Number (RPN) that prioritizes corrective actions. Twenty-five potential failure modes were identified. Based on RPN results, the corrective actions plan was revised annually to reduce the risk of exposure and improve practices. Since 2011, 16 specific measures were implemented successively. In six years, a cumulative RPN reduction of 626 was observed, with a decrease from 912 to 286 (-69%) despite an increase of cytotoxic compounding activity of around 23.2%. In order to anticipate and prevent occupational exposure, FMECA is a valuable tool to identify, prioritize and eliminate potential failure modes for operators involved in the cytotoxic drug preparation process before the failures occur. Copyright © 2017 Elsevier B.V. All rights reserved.

Estimation of permanent noise-induced hearing loss in an urban setting.

PubMed

Lewis, Ryan C; Gershon, Robyn R M; Neitzel, Richard L

2013-06-18

The potential burden of noise-induced permanent threshold shift (NIPTS) in U.S. urban settings is not well-characterized. We used ANSI S3.44-1996 to estimate NIPTS for a sample of 4585 individuals from New York City (NYC) and performed a forward stepwise logistic regression analysis to identify predictors of NIPTS >10 dB. The average individual is projected to develop a small NIPTS when averaged across 1000-4000 Hz for 1- to 20-year durations. For some individuals, NIPTS is expected to be substantial (>25 dB). At 4000 Hz, a greater number of individuals are at risk of NIPTS from MP3 players and stereos, but risk for the greatest NIPTS is for those with high occupational and episodic nonoccupational (e.g., power tool use) exposures. Employment sector and time spent listening to MP3 players and stereos and participating in episodic nonoccupational activities associated with excessive noise levels increased the odds of NIPTS >10 dB at 4000 Hz for 20-year durations. Our results indicate that the risk of NIPTS may be substantial for NYC and perhaps other urban settings. Noise exposures from "noisy" occupational and episodic nonoccupational activities and MP3 players and stereos are important risk factors and should be a priority for public health interventions.

Major vessel involvement in Behçet disease.

PubMed

Calamia, Kenneth T; Schirmer, Michael; Melikoglu, Melike

2005-01-01

Large vessel vasculitis occurs in a subgroup of patients with Behçet disease at high risk for disease-related morbidity and mortality. Recognition of patients at risk, early detection of vasculitis, and the need for aggressive treatment are essential for optimal care of these patients. The authors review the clinical spectrum and management of large vessel problems in Behçet disease, highlighting contributions over the past year. Vasculo-Behçet patients are at risk for multiple vessel-related complications including thromboses, stenoses, occlusions, and aneurysms. A number of factors may contribute to thrombosis in individual cases, but the primary reason for clot seems to reside in the inflammatory process in the arterial wall, still incompletely understood. An appreciation for the challenges in the perioperative period requires the joint efforts of physicians and surgeons, and fuels the study of alternate, less invasive procedures for Behçet patients. Because of earlier recognition, aggressive medical treatment, and novel surgical procedures, the morbidity and mortality of large vessel vasculitis in Behçet disease are beginning to change. In the absence of controlled treatment studies, reports of clinical experience remain an important source of information for clinicians. Identification of patients at risk for vascular complications remains a priority.

Application of failure mode and effect analysis in an assisted reproduction technology laboratory.

PubMed

Intra, Giulia; Alteri, Alessandra; Corti, Laura; Rabellotti, Elisa; Papaleo, Enrico; Restelli, Liliana; Biondo, Stefania; Garancini, Maria Paola; Candiani, Massimo; Viganò, Paola

2016-08-01

Assisted reproduction technology laboratories have a very high degree of complexity. Mismatches of gametes or embryos can occur, with catastrophic consequences for patients. To minimize the risk of error, a multi-institutional working group applied failure mode and effects analysis (FMEA) to each critical activity/step as a method of risk assessment. This analysis led to the identification of the potential failure modes, together with their causes and effects, using the risk priority number (RPN) scoring system. In total, 11 individual steps and 68 different potential failure modes were identified. The highest ranked failure modes, with an RPN score of 25, encompassed 17 failures and pertained to "patient mismatch" and "biological sample mismatch". The maximum reduction in risk, with RPN reduced from 25 to 5, was mostly related to the introduction of witnessing. The critical failure modes in sample processing were improved by 50% in the RPN by focusing on staff training. Three indicators of FMEA success, based on technical skill, competence and traceability, have been evaluated after FMEA implementation. Witnessing by a second human operator should be introduced in the laboratory to avoid sample mix-ups. These findings confirm that FMEA can effectively reduce errors in assisted reproduction technology laboratories. Copyright © 2016 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Trade Liberalisation in Education Services: Opportunities and Risks for SADC Countries

ERIC Educational Resources Information Center

Mpinganjira, M.

2009-01-01

Education has become a "commodity" widely tradable on the international market. This has resulted in the sector being subjected to multinational as well as global priorities and agreements. This paper looks at the opportunities and risks of international trade liberalisation moves in the high education sector on member countries of the…

SPECIATION OF ARSENIC IN EDIBLE BIOTA TO SUPPORT RISK ASSESSMENT DETERMINATION OF RELATIVE SOURCE CONTRIBUTION FOR ARSENIC

EPA Science Inventory

The Office of Research and Development has designated the study of arsenic as a high priority research area because of the health risk associated from exposure to this element. Present monitoring efforts are primarily focused on total concentration of arsenic in drinking water. ...

Brief Alcohol Interventions and Multiple Risk Factors in Primary Care

ERIC Educational Resources Information Center

Funderburk, Jennifer S.; Maisto, Stephen A.; Sugarman, Dawn E.

2007-01-01

Early identification and intervention of harmful/hazardous drinking in primary care are U.S. healthcare priorities. Traditionally, research has focused on designing interventions for patients in primary care who report hazardous/harmful alcohol use, even though it is likely for a patient to be at risk for multiple problems. This article has three…

Prioritizing Sites for Protection and Restoration for Grizzly Bears (Ursus arctos) in Southwestern Alberta, Canada.

PubMed

Braid, Andrew C R; Nielsen, Scott E

2015-01-01

As the influence of human activities on natural systems continues to expand, there is a growing need to prioritize not only pristine sites for protection, but also degraded sites for restoration. We present an approach for simultaneously prioritizing sites for protection and restoration that considers landscape patterns for a threatened population of grizzly bears (Ursus arctos) in southwestern Alberta, Canada. We considered tradeoffs between bottom-up (food resource supply) and top-down (mortality risk from roads) factors affecting seasonal habitat quality for bears. Simulated annealing was used to prioritize source-like sites (high habitat productivity, low mortality risk) for protection, as well as sink-like sites (high habitat productivity, high mortality risk) for restoration. Priority source-like habitats identified key conservation areas where future developments should be limited, whereas priority sink-like habitats identified key areas for mitigating road-related mortality risk with access management. Systematic conservation planning methods can be used to complement traditional habitat-based methods for individual focal species by identifying habitats where conservation actions (both protection and restoration) have the highest potential utility.

Vulnerability in Determining the Cost of Information System Project to Avoid Loses

NASA Astrophysics Data System (ADS)

Haryono, Kholid; Ikhsani, Zulfa Amalia

2018-03-01

Context: This study discusses the priority of cost required in software development projects. Objectives: To show the costing models, the variables involved, and how practitioners assess and decide the priorities of each variable. To strengthen the information, each variable also confirmed the risk if ignored. Method: The method is done by two approaches. First, systematic literature reviews to find the models and variables used to decide the cost of software development. Second, confirm and take judgments about the level of importance and risk of each variable to the software developer. Result: Obtained about 54 variables that appear on the 10 models discussed. The variables are categorized into 15 groups based on the similarity of meaning. Each group becomes a variable. Confirmation results with practitioners on the level of importance and risk. It shown there are two variables that are considered very important and high risk if ignored. That is duration and effort. Conclusion: The relationship of variable rates between the results of literature studies and confirmation of practitioners contributes to the use of software business actors in considering project cost variables.

Priorities for research in miscarriage: a priority setting partnership between people affected by miscarriage and professionals following the James Lind Alliance methodology

PubMed Central

Bagness, Carmel; Brewin, Jane; Coomarasamy, Arri; Easthope, Lucy; Hepworth-Jones, Barbara; Hinshaw, Kim; O'Toole, Emily; Orford, Julie; Regan, Lesley; Raine-Fenning, Nick; Shakespeare, Judy; Small, Rachel; Thornton, Jim; Metcalf, Leanne

2017-01-01

Objectives To identify and prioritise important research questions for miscarriage. Design A priority setting partnership using prospective surveys and consensus meetings following methods advocated by the James Lind Alliance. Setting UK. Participants Women and those affected by miscarriage working alongside healthcare professionals. Results In the initial survey, 1093 participants (932 women who have experienced miscarriage, 8 partners, 17 family members, friends or colleagues, 104 healthcare professionals and eight charitable organisations) submitted 3279 questions. A review of existing literature identified a further 64. Non-questions were removed, and the remaining questions were categorised and summarised into 58 questions. In an interim electronic survey, 2122 respondents chose their top 10 priorities from the 58 summary questions. The 25 highest ranked in the survey were prioritised at a final face-to-face workshop. In summary, the top 10 priorities were ranked as follows: research into preventative treatment, emotional aspects in general, investigation, relevance of pre-existing medical conditions, emotional support as a treatment, importance of lifestyle factors, importance of genetic and chromosomal causes, preconception tests, investigation after different numbers of miscarriage and male causal factors. Conclusions These results should be the focus of future miscarriage research. Presently, studies are being conducted to address the top priority; however, many other priorities, especially psychological and emotional support, are less well researched areas. We hope our results will encourage both researchers and funders to focus on these priorities. PMID:28838896

The Environmental Protection Agency's Community-Focused Exposure and Risk Screening Tool (C-FERST) and its potential use for environmental justice efforts.

PubMed

Zartarian, Valerie G; Schultz, Bradley D; Barzyk, Timothy M; Smuts, Marybeth; Hammond, Davyda M; Medina-Vera, Myriam; Geller, Andrew M

2011-12-01

Our primary objective was to provide higher quality, more accessible science to address challenges of characterizing local-scale exposures and risks for enhanced community-based assessments and environmental decision-making. After identifying community needs, priority environmental issues, and current tools, we designed and populated the Community-Focused Exposure and Risk Screening Tool (C-FERST) in collaboration with stakeholders, following a set of defined principles, and considered it in the context of environmental justice. C-FERST is a geographic information system and resource access Web tool under development for supporting multimedia community assessments. Community-level exposure and risk research is being conducted to address specific local issues through case studies. C-FERST can be applied to support environmental justice efforts. It incorporates research to develop community-level data and modeled estimates for priority environmental issues, and other relevant information identified by communities. Initial case studies are under way to refine and test the tool to expand its applicability and transferability. Opportunities exist for scientists to address the many research needs in characterizing local cumulative exposures and risks and for community partners to apply and refine C-FERST.

Perceived barriers to smoking cessation in selected vulnerable groups: a systematic review of the qualitative and quantitative literature

PubMed Central

Twyman, Laura; Bonevski, Billie; Paul, Christine; Bryant, Jamie

2014-01-01

Objectives To identify barriers that are common and unique to six selected vulnerable groups: low socioeconomic status; Indigenous; mental illness and substance abuse; homeless; prisoners; and at-risk youth. Design A systematic review was carried out to identify the perceived barriers to smoking cessation within six vulnerable groups. Data sources MEDLINE, EMBASE, CINAHL and PsycInfo were searched using keywords and MeSH terms from each database's inception published prior to March 2014. Study selection Studies that provided either qualitative or quantitative (ie, longitudinal, cross-sectional or cohort surveys) descriptions of self-reported perceived barriers to quitting smoking in one of the six aforementioned vulnerable groups were included. Data extraction Two authors independently assessed studies for inclusion and extracted data. Results 65 eligible papers were identified: 24 with low socioeconomic groups, 16 with Indigenous groups, 18 involving people with a mental illness, 3 with homeless groups, 2 involving prisoners and 1 involving at-risk youth. One study identified was carried out with participants who were homeless and addicted to alcohol and/or other drugs. Barriers common to all vulnerable groups included: smoking for stress management, lack of support from health and other service providers, and the high prevalence and acceptability of smoking in vulnerable communities. Unique barriers were identified for people with a mental illness (eg, maintenance of mental health), Indigenous groups (eg, cultural and historical norms), prisoners (eg, living conditions), people who are homeless (eg, competing priorities) and at-risk youth (eg, high accessibility of tobacco). Conclusions Vulnerable groups experience common barriers to smoking cessation, in addition to barriers that are unique to specific vulnerable groups. Individual-level, community-level and social network-level interventions are priority areas for future smoking cessation interventions within vulnerable groups. Trial registration number: A protocol for this review has been registered with PROSPERO International Prospective Register of Systematic Reviews (Identifier: CRD42013005761). PMID:25534212

An Assessment of Climate Change Impacts on Los Angeles (California USA) Hospitals, Wildfires Highest Priority.

PubMed

Adelaine, Sabrina A; Sato, Mizuki; Jin, Yufang; Godwin, Hilary

2017-10-01

Introduction Although many studies have delineated the variety and magnitude of impacts that climate change is likely to have on health, very little is known about how well hospitals are poised to respond to these impacts. Hypothesis/Problem The hypothesis is that most modern hospitals in urban areas in the United States need to augment their current disaster planning to include climate-related impacts. Using Los Angeles County (California USA) as a case study, historical data for emergency department (ED) visits and projections for extreme-heat events were used to determine how much climate change is likely to increase ED visits by mid-century for each hospital. In addition, historical data about the location of wildfires in Los Angeles County and projections for increased frequency of both wildfires and flooding related to sea-level rise were used to identify which area hospitals will have an increased risk of climate-related wildfires or flooding at mid-century. Only a small fraction of the total number of predicted ED visits at mid-century would likely to be due to climate change. By contrast, a significant portion of hospitals in Los Angeles County are in close proximity to very high fire hazard severity zones (VHFHSZs) and would be at greater risk to wildfire impacts as a result of climate change by mid-century. One hospital in Los Angeles County was anticipated to be at greater risk due to flooding by mid-century as a result of climate-related sea-level rise. This analysis suggests that several Los Angeles County hospitals should focus their climate-change-related planning on building resiliency to wildfires. Adelaine SA , Sato M , Jin Y , Godwin H . An assessment of climate change impacts on Los Angeles (California USA) hospitals, wildfires highest priority. Prehosp Disaster Med. 2017;32(5):556-562.

Unheard Voices: The Need for HIV Research and Prevention Priorities for YMSM in the Global Context.

PubMed

Hall, Casey D; Murdock, Daniel; Nehl, Eric J; Wong, Frank Y

2016-06-01

This commentary considers the AIDS Education and Prevention special issue (volume 28, number 3) entitled "Behavioral HIV Prevention Interventions for Diverse Young Men Who Have Sex with Men (MSM)." The research presented in this special issue highlights the importance of addressing sub-populations of young MSM in order to better understand the unique realities and risk-factors affecting HIV epidemics and intervention needs. Here, we focus on several broad topics raised in this special issue and comment on their implications for HIV research and practice targeting young MSM in low- and middle-income countries. We consider issues relevant to reaching hidden populations, tailoring interventions, and integrating new communications and bio-medical technologies in research and practice in low-resource settings.

Optimizing the Benefits of Exercise on Physical Function in Older Adults

PubMed Central

Buford, Thomas W.; Anton, Stephen D.; Clark, David J.; Higgins, Torrance J.; Cooke, Matthew B.

2014-01-01

As the number of older adults continues to rise worldwide, the prevention of physical disability among seniors is an increasingly important public health priority. Physical exercise is among the best known methods of preventing disability, but accumulating evidence indicates that considerable variability exists in the responsiveness of older adults to standard training regimens. Accordingly, a need exists to develop tailored interventions to optimize the beneficial effects of exercise on the physical function of older adults at risk for becoming disabled. The present review summarizes the available literature related to the use of adjuvant or alternative strategies intended to enhance the efficacy of exercise in improving the physical function of older adults. Within this work, we also discuss potential future research directions in this area. PMID:24361365

A Global Perspective on Hantavirus Ecology, Epidemiology, and Disease

PubMed Central

Jonsson, Colleen B.; Figueiredo, Luiz Tadeu Moraes; Vapalahti, Olli

2010-01-01

Summary: Hantaviruses are enzootic viruses that maintain persistent infections in their rodent hosts without apparent disease symptoms. The spillover of these viruses to humans can lead to one of two serious illnesses, hantavirus pulmonary syndrome and hemorrhagic fever with renal syndrome. In recent years, there has been an improved understanding of the epidemiology, pathogenesis, and natural history of these viruses following an increase in the number of outbreaks in the Americas. In this review, current concepts regarding the ecology of and disease associated with these serious human pathogens are presented. Priorities for future research suggest an integration of the ecology and evolution of these and other host-virus ecosystems through modeling and hypothesis-driven research with the risk of emergence, host switching/spillover, and disease transmission to humans. PMID:20375360

Use of portable X-ray fluorescence spectroscopy and geostatistics for health risk assessment.

PubMed

Yang, Meng; Wang, Cheng; Yang, Zhao-Ping; Yan, Nan; Li, Feng-Ying; Diao, Yi-Wei; Chen, Min-Dong; Li, Hui-Ming; Wang, Jin-Hua; Qian, Xin

2018-05-30

Laboratory analysis of trace metals using inductively coupled plasma (ICP) spectroscopy is not cost effective, and the complex spatial distribution of soil trace metals makes their spatial analysis and prediction problematic. Thus, for the health risk assessment of exposure to trace metals in soils, portable X-ray fluorescence (PXRF) spectroscopy was used to replace ICP spectroscopy for metal analysis, and robust geostatistical methods were used to identify spatial outliers in trace metal concentrations and to map trace metal distributions. A case study was carried out around an industrial area in Nanjing, China. The results showed that PXRF spectroscopy provided results for trace metal (Cu, Ni, Pb and Zn) levels comparable to ICP spectroscopy. The results of the health risk assessment showed that Ni posed a higher non-carcinogenic risk than Cu, Pb and Zn, indicating a higher priority of concern than the other elements. Sampling locations associated with adverse health effects were identified as 'hotspots', and high-risk areas were delineated from risk maps. These 'hotspots' and high-risk areas were in close proximity to and downwind from petrochemical plants, indicating the dominant role of industrial activities as the major sources of trace metals in soils. The approach used in this study could be adopted as a cost-effective methodology for screening 'hotspots' and priority areas of concern for cost-efficient health risk management. Copyright © 2018 Elsevier Inc. All rights reserved.

[Risk profiling in cancer surveillance in contaminated sites: an example from the ISS-AIRTUM collaborative study].

PubMed

Catelan, Dolores; Buzzoni, Carlotta; Coviello, Enzo; Crocetti, Emanuele; Pasetto, Roberto; Pirastu, Roberta; Biggeri, Annibale

2014-01-01

Epidemiological surveillance on high risk environmental areas or areas covered by cancer registration yields long inventories of relative risks. Summaries of the results' tables must be produced to identify priorities and tailor public health actions. The aim is, therefore, to draw conclusions from each area's disease profile, or from the area signature of each disease.With this inmind, we used data on cancer incidence from 17 Cancer Registries that participated in the ISS-AIRTUM (National Institute of Health-Italian Network of Cancer Registries) study, and we produced conditional and marginal rankings of areas/diseases using a multivariate hierarchical Bayesian model. In this context, it is important to obtain an uncertainty evaluation by calculating the credibility intervals of ranks. The areas marginal ranking shows a large overlapping of credibility intervals, such that it is not possible to speak of a limited number of ISS-AIRTUM areas as being particularly affected. Every ISS-AIRTUMarea, therefore,must be considered individually and ordering themby ranking of cancer incidence wouldn't be appropriate. Instead,marginal ranking of diseases highlights the impact of asbestos exposure in all the analyzed areas.

[Occupational injury, a public health priority].

PubMed

Benavides, Fernando G; Delclos, Jordi; Benach, Joan; Serra, Consol

2006-01-01

The aim of this review is to stimulate new ideas and actions for the prevention of this important public health problem. In 2002 and 2003, respectively, the number of non-fatal occupational injuries was 971,406 and 906,638. Thus, every day in Spain there are more than 2500 non-fatal and between 2 and 3 fatal occupational injuries. Although the profile of the at-risk worker population has changed greatly over the past decade, both quantitatively and qualitatively, the risk of occupational injury still centers on blue collar workers, whether qualified or nonqualified, in the primary and secondary sectors of economic activity. The most common mechanisms of occupational injuries are overexertion for non-fatal injuries and traffic-related for fatal events. The adverse health consequences of new types of employment, which emphasize flexibility and deregulation of the labour market, are exemplified by the association between temporary employment and increased risk of occupational injury. New injury prevention programs have emerged in the last decade, but they appear to have had limited impact. Preventive activities should focus both on working conditions at the company level (micro) as well as on employment and industrial public policies (macro). Greater evaluation is needed of these latter policies.

Extinction risks of Amazonian plant species.

PubMed

Feeley, Kenneth J; Silman, Miles R

2009-07-28

Estimates of the number, and preferably the identity, of species that will be threatened by land-use change and habitat loss are an invaluable tool for setting conservation priorities. Here, we use collections data and ecoregion maps to generate spatially explicit distributions for more than 40,000 vascular plant species from the Amazon basin (representing more than 80% of the estimated Amazonian plant diversity). Using the distribution maps, we then estimate the rates of habitat loss and associated extinction probabilities due to land-use changes as modeled under 2 disturbance scenarios. We predict that by 2050, human land-use practices will have reduced the habitat available to Amazonian plant species by approximately 12-24%, resulting in 5-9% of species becoming "committed to extinction," significantly fewer than other recent estimates. Contrary to previous studies, we find that the primary determinant of habitat loss and extinction risk is not the size of a species' range, but rather its location. The resulting extinction risk estimates are a valuable conservation tool because they indicate not only the total percentage of Amazonian plant species threatened with extinction but also the degree to which individual species and habitats will be affected by current and future land-use changes.

Building on IUCN regional red lists to produce lists of species of conservation priority: a model with Irish bees.

PubMed

Fitzpatrick, Una; Murray, Tomás E; Paxton, Robert J; Brown, Mark J F

2007-10-01

A World Conservation Union (IUCN) regional red list is an objective assessment of regional extinction risk and is not the same as a list of conservation priority species. Recent research reveals the widespread, but incorrect, assumption that IUCN Red List categories represent a hierarchical list of priorities for conservation action. We developed a simple eight-step priority-setting process and applied it to the conservation of bees in Ireland. Our model is based on the national red list but also considers the global significance of the national population; the conservation status at global, continental, and regional levels; key biological, economic, and societal factors; and is compatible with existing conservation agreements and legislation. Throughout Ireland, almost one-third of the bee fauna is threatened (30 of 100 species), but our methodology resulted in a reduced list of only 17 priority species. We did not use the priority species list to broadly categorize species to the conservation action required; instead, we indicated the individual action required for all threatened, near-threatened, and data-deficient species on the national red list based on the IUCN's conservation-actions template file. Priority species lists will strongly influence prioritization of conservation actions at national levels, but action should not be exclusive to listed species. In addition, all species on this list will not necessarily require immediate action. Our method is transparent, reproducible, and readily applicable to other taxa and regions.

Sustaining “Meaningful Use” of Health Information Technology in Low-Resource Practices

PubMed Central

Green, Lee A.; Potworowski, Georges; Day, Anya; May-Gentile, Rachelle; Vibbert, Danielle; Maki, Bruce; Kiesel, Leslie

2015-01-01

PURPOSE The implementation of electronic health records (EHRs) has been extensively studied, but their maintenance once implemented has not. The Regional Extension Center (REC) program provides implementation assistance to priority practices—those with limited financial, technical, and organizational resources—but the assistance is time limited. Our objective was to identify potential barriers to maintenance of meaningful use of EHRs in priority primary care practices using a qualitative observational study for federally qualified health centers (FQHCs) and priority practices in Michigan. METHODS We conducted cognitive task analysis (CTA) interviews and direct observations of health information technology implementation in FQHCs. In addition, we conducted semistructured interviews with implementation specialists serving priority practices to detect emergent themes relevant to maintenance. RESULTS Maintaining EHR technology will require ongoing expert technical support indefinitely beyond implementation to address upgrades and security needs. Maintaining meaningful use for quality improvement will require ongoing support for leadership and change management. Priority practices not associated with larger systems lack access to the necessary technical expertise, financial resources, and leverage with vendors to continue alone. Rural priority practices are particularly challenged, because expertise is often not available locally. CONCLUSIONS Priority practices, especially in rural areas, are at high risk for falling on the wrong side of a “digital divide” as payers and regulators enact increasing expectations for EHR use and information management. For those without affiliation to maintain the necessary expert staff, ongoing support will be needed for those practices to remain viable. PMID:25583887

Sustaining "meaningful use" of health information technology in low-resource practices.

PubMed

Green, Lee A; Potworowski, Georges; Day, Anya; May-Gentile, Rachelle; Vibbert, Danielle; Maki, Bruce; Kiesel, Leslie

2015-01-01

The implementation of electronic health records (EHRs) has been extensively studied, but their maintenance once implemented has not. The Regional Extension Center (REC) program provides implementation assistance to priority practices-those with limited financial, technical, and organizational resources-but the assistance is time limited. Our objective was to identify potential barriers to maintenance of meaningful use of EHRs in priority primary care practices using a qualitative observational study for federally qualified health centers (FQHCs) and priority practices in Michigan. We conducted cognitive task analysis (CTA) interviews and direct observations of health information technology implementation in FQHCs. In addition, we conducted semistructured interviews with implementation specialists serving priority practices to detect emergent themes relevant to maintenance. Maintaining EHR technology will require ongoing expert technical support indefinitely beyond implementation to address upgrades and security needs. Maintaining meaningful use for quality improvement will require ongoing support for leadership and change management. Priority practices not associated with larger systems lack access to the necessary technical expertise, financial resources, and leverage with vendors to continue alone. Rural priority practices are particularly challenged, because expertise is often not available locally. Priority practices, especially in rural areas, are at high risk for falling on the wrong side of a "digital divide" as payers and regulators enact increasing expectations for EHR use and information management. For those without affiliation to maintain the necessary expert staff, ongoing support will be needed for those practices to remain viable. © 2015 Annals of Family Medicine, Inc.

Mental health research priorities in low- and middle-income countries of Africa, Asia, Latin America and the Caribbean.

PubMed

Sharan, P; Gallo, C; Gureje, O; Lamberte, E; Mari, J J; Mazzotti, G; Patel, V; Swartz, L; Olifson, S; Levav, I; de Francisco, A; Saxena, S

2009-10-01

Studies suggest a paucity of and lack of prioritisation in mental health research from low- and middle-income (LAMI) countries. To investigate research priorities in mental health among researchers and other stakeholders in LAMI countries. We used a two-stage design that included identification, through literature searches and snowball technique, of researchers and stakeholders in 114 countries of Africa, Asia, Latin America and the Caribbean; and a mail survey on priorities in research. The study identified broad agreement between researchers and stakeholders and across regions regarding research priorities. Epidemiology (burden and risk factors), health systems and social science ranked highest for type of research. Depression/anxiety, substance use disorders and psychoses; and children and adolescents, women, and people exposed to violence/trauma were prioritised among the disorders and population groups respectively. Important criteria for prioritising research were burden of disease, social justice, and availability of funds. Stakeholder groups differed in the importance they gave to the personal interest of researchers as a criterion for prioritising research. Researchers' and stakeholders' priorities were consistent with burden of disease estimates, however suicide was underprioritised compared with its burden. Researchers' and stakeholders' priorities were also largely congruent with the researchers' projects. The results of this first ever conducted survey of researchers and stakeholders regarding research priorities in mental health suggest that it should be possible to develop consensus at regional and international levels regarding the research agenda that is necessary to support health system objectives in LAMI countries.

An approach for environmental risk assessment of engineered nanomaterials using Analytical Hierarchy Process (AHP) and fuzzy inference rules.

PubMed

Topuz, Emel; van Gestel, Cornelis A M

2016-01-01

The usage of Engineered Nanoparticles (ENPs) in consumer products is relatively new and there is a need to conduct environmental risk assessment (ERA) to evaluate their impacts on the environment. However, alternative approaches are required for ERA of ENPs because of the huge gap in data and knowledge compared to conventional pollutants and their unique properties that make it difficult to apply existing approaches. This study aims to propose an ERA approach for ENPs by integrating Analytical Hierarchy Process (AHP) and fuzzy inference models which provide a systematic evaluation of risk factors and reducing uncertainty about the data and information, respectively. Risk is assumed to be the combination of occurrence likelihood, exposure potential and toxic effects in the environment. A hierarchy was established to evaluate the sub factors of these components. Evaluation was made with fuzzy numbers to reduce uncertainty and incorporate the expert judgements. Overall score of each component was combined with fuzzy inference rules by using expert judgements. Proposed approach reports the risk class and its membership degree such as Minor (0.7). Therefore, results are precise and helpful to determine the risk management strategies. Moreover, priority weights calculated by comparing the risk factors based on their importance for the risk enable users to understand which factor is effective on the risk. Proposed approach was applied for Ag (two nanoparticles with different coating) and TiO2 nanoparticles for different case studies. Results verified the proposed benefits of the approach. Copyright © 2016 Elsevier Ltd. All rights reserved.

Research priorities by professional background - A detailed analysis of the James Lind Alliance Priority Setting Partnership.

PubMed

Arulkumaran, Nishkantha; Reay, Hannah; Brett, Stephen J

2016-05-01

The Intensive Care Foundation, in partnership with the James Lind Alliance, has supported a national project to identify and prioritise unanswered questions about adult intensive care that are important to people who have been critically ill, their families, and the health professionals who care for them. We conducted a secondary analysis to explore differences in priorities determined by different respondent groups in order to identify different groups' perceptions of gaps in knowledge. There were two surveys conducted as part of the original project. Survey 1 comprised a single open question to identify important research topics; survey 2 aimed to prioritise these topics using a 10-point Likert scale. In survey 1, despite clear differences in suggestions amongst the respondent groups, themes of comfort/communication and post-ICU rehabilitation were the within the top 2 suggestions across all groups. Patients and relatives suggested research topics to which they could easily relate, whereas there was a greater breadth of suggestions from clinicians. In survey 2, the number of research priorities that received a mode score of 10 varied from 1 to 36. Patients scored 36 out of the 37 topics with a mode score of 10. All other groups scored topics with more discrimination, with the number of topics with a mode score of 10 ranging from 1 to 20. Differences in the proportions of the representative groups are therefore unlikely to have translated to an impartial conclusion. Clinicians, patients, and family members have jointly identified the research priorities for UK ICM practice.

Priority Planetary Science Missions Identified

NASA Astrophysics Data System (ADS)

Showstack, Randy

2011-03-01

The U.S. National Research Council's (NRC) planetary science decadal survey report, released on 7 March, lays out a grand vision for priority planetary science missions for 2013-2022 within a tightly constrained fiscal environment. The cost-conscious report, issued by NRC's Committee on the Planetary Science Decadal Survey, identifies high-priority flagship missions, recommends a number of potential midsized missions, and indicates support for some smaller missions. The report states that the highest-priority flagship mission for the decade is the Mars Astrobiology Explorer-Cacher (MAX-C)—the first of three components of a NASA/European Space Agency Mars sample return campaign—provided that the mission scope can be reduced so that MAX-C costs no more than $2.5 billion. The currently estimated mission cost of $3.5 billion “would take up a disproportionate near-term share of the overall budget for NASA's Planetary Science Division,” the report notes.

Risk factors for child maltreatment recurrence: An updated systematic review.

PubMed

White, Oliver G; Hindley, Nick; Jones, David P H

2015-10-01

Children who have been maltreated are at increased risk of further maltreatment. Identification of those at highest risk of further maltreatment is a priority for professionals working in child protection services. The current study is intended to consolidate and expand on previous work on recurrence of child maltreatment. It has sought to identify risk factors for maltreatment recurrence in the recent literature in the expectation that this may help in the practical identification of children at risk. We conducted a systematic review of cohort studies published between 2003 and 2009, identifying factors associated with maltreatment recurrence in children. Studies included demonstrated differing levels of substantiation of maltreatment. Fifteen studies met inclusion criteria but showed significant heterogeneity, varying in setting, recruitment of subjects, types of maltreatment considered and length of follow-up. Previous findings were replicated and expanded in the current study in relation to a range of factors, including rates of maltreatment recurrence, maltreatment types, frequency of previous episodes of maltreatment, child and family considerations, home environment and service provision. Factors were identified irrespective of level of maltreatment substantiation. This study provides further systematic evidence of the existence of a number of factors associated with child maltreatment recurrence. It points to the possibility of practical application of its findings within the wider context of decision making in child protection services, with the ultimate aim of reducing recurrence of maltreatment in individual cases. © The Author(s) 2014.

Research Priorities in Spasmodic Dysphonia

PubMed Central

Ludlow, Christy L.; Adler, Charles H.; Berke, Gerald S.; Bielamowicz, Steven A.; Blitzer, Andrew; Bressman, Susan B.; Hallett, Mark; Jinnah, H. A.; Juergens, Uwe; Martin, Sandra B.; Perlmutter, Joel S.; Sapienza, Christine; Singleton, Andrew; Tanner, Caroline M.; Woodson, Gayle E.

2009-01-01

OBJECTIVE To identify research priorities for increasing understanding of the pathogenesis, diagnosis and improved treatment of spasmodic dysphonia. STUDY DESIGN AND SETTING A multidisciplinary working group was formed including both scientists and clinicians from multiple disciplines, otolaryngology, neurology, speech pathology, genetics and neuroscience, to review currently available information on spasmodic dysphonia and to identify research priorities. RESULTS Operational definitions for spasmodic dysphonia at different levels of certainty were recommended for diagnosis and recommendations made for a multi-center multidisciplinary validation study. CONCLUSIONS The highest priority is to characterize the disorder and identify risk factors that may contribute to its onset. Future research should compare and contrast spasmodic dysphonia with other forms of focal dystonia. Development of animal models is recommended to explore hypotheses related to pathogenesis. Improved understanding of the pathophysiology of SD should provide the basis for developing new treatment options and exploratory clinical trials. SIGNIFICANCE This document should foster future research to improve the care of patients with this chronic debilitating voice and speech disorder by otolaryngology, neurology, and speech pathology. PMID:18922334

Yerington Paiute Tribe Energy Plan Version 1

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

Consulting, BB9; Director, Environmental

The Yerington Paiute Tribe has made energy management and planning a priority. The Tribal Council has recognized that energy is an important component of their goal of self-sufficiency. Recognizing energy development as a component of the Tribe’s natural resources provides for needed economic development.A number of priorities have been identified for energy development. These range from immediate housing needs such as weatherization and solar to interest in energy as economic development.

7 CFR 636.5 - National priorities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... wildlife habitat to benefit at-risk species; (3) Reduce the impacts of invasive species on fish and... species' habitats; and (5) Protect, restore, develop, or enhance important migration and other movement...

7 CFR 636.5 - National priorities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... wildlife habitat to benefit at-risk species; (3) Reduce the impacts of invasive species on fish and... species' habitats; and (5) Protect, restore, develop, or enhance important migration and other movement...

7 CFR 636.5 - National priorities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... wildlife habitat to benefit at-risk species; (3) Reduce the impacts of invasive species on fish and... species' habitats; and (5) Protect, restore, develop, or enhance important migration and other movement...

Frequency and prioritization of patient health risks from a structured health risk assessment.

PubMed

Phillips, Siobhan M; Glasgow, Russell E; Bello, Ghalib; Ory, Marcia G; Glenn, Beth A; Sheinfeld-Gorin, Sherri N; Sabo, Roy T; Heurtin-Roberts, Suzanne; Johnson, Sallie Beth; Krist, Alex H

2014-01-01

To describe the frequency and patient-reported readiness to change, desire to discuss, and perceived importance of 13 health risk factors in a diverse range of primary care practices. Patients (n = 1,707) in 9 primary care practices in the My Own Health Report (MOHR) trial reported general, behavioral, and psychosocial risk factors (body mass index [BMI], health status, diet, physical activity, sleep, drug use, stress, anxiety or worry, and depression). We classified responses as "at risk" or "healthy" for each factor, and patients indicated their readiness to change and/or desire to discuss identified risk factors with providers. Patients also selected 1 of the factors they were ready to change as most important. We then calculated frequencies within and across these factors and examined variation by patient characteristics and across practices. On average, patients had 5.8 (SD = 2.12; range, 0-13) unhealthy behaviors and mental health risk factors. About 55% of patients had more than 6 risk factors. On average, patients wanted to change 1.2 and discuss 0.7 risks. The most common risks were inadequate fruit/vegetable consumption (84.5%) and overweight/obesity (79.6%). Patients were most ready to change BMI (33.3%) and depression (30.7%), and most wanted to discuss depression (41.9%) and anxiety or worry (35.2%). Overall, patients rated health status as most important. Implementing routine comprehensive health risk assessments in primary care will likely identify a high number of behavioral and psychosocial health risks. By soliciting patient priorities, providers and patients can better manage counseling and behavior change. © 2014 Annals of Family Medicine, Inc.

Understanding Perceptions of Climate Change, Priorities, and Decision-Making among Municipalities in Lima, Peru to Better Inform Adaptation and Mitigation Planning

PubMed Central

Saldarriaga, Enrique; Lawler, Joshua; Zunt, Joseph; Garcia, Patricia; Cárcamo, César

2016-01-01

Climate change poses multiple risks to the population of Lima, the largest city and capital of Peru, located on the Pacific coast in a desert ecosystem. These risks include increased water scarcity, increased heat, and the introduction and emergence of vector-borne and other climate sensitive diseases. To respond to these threats, it is necessary for the government, at every level, to adopt more mitigation and adaptation strategies. Here, focus groups were conducted with representatives from five Lima municipalities to determine priorities, perception of climate change, and decision-making processes for implementing projects within each municipality. These factors can affect the ability and desire of a community to implement climate change adaptation and mitigation strategies. The results show that climate change and other environmental factors are of relatively low priority, whereas public safety and water and sanitation services are of highest concern. Perhaps most importantly, climate change is not well understood among the municipalities. Participants had trouble distinguishing climate change from other environmental issues and did not fully understand its causes and effects. Greater understanding of what climate change is and why it is important is necessary for it to become a priority for the municipalities. Different aspects of increased climate change awareness seem to be connected to having experienced extreme weather events, whether related or not to climate change, and to higher socioeconomic status. PMID:26808087

Future Health Applications of Genomics

PubMed Central

McBride, Colleen M.; Bowen, Deborah; Brody, Lawrence C.; Condit, Celeste M.; Croyle, Robert T.; Gwinn, Marta; Khoury, Muin J.; Koehly, Laura M.; Korf, Bruce R.; Marteau, Theresa M.; McLeroy, Kenneth; Patrick, Kevin; Valente, Thomas W.

2014-01-01

Despite the quickening momentum of genomic discovery, the communication, behavioral, and social sciences research needed for translating this discovery into public health applications has lagged behind. The National Human Genome Research Institute held a 2-day workshop in October 2008 convening an interdisciplinary group of scientists to recommend forward-looking priorities for translational research. This research agenda would be designed to redress the top three risk factors (tobacco use, poor diet, and physical inactivity) that contribute to the four major chronic diseases (heart disease, type 2 diabetes, lung disease, and many cancers) and account for half of all deaths worldwide. Three priority research areas were identified: (1) improving the public’s genetic literacy in order to enhance consumer skills; (2) gauging whether genomic information improves risk communication and adoption of healthier behaviors more than current approaches; and (3) exploring whether genomic discovery in concert with emerging technologies can elucidate new behavioral intervention targets. Important crosscutting themes also were identified, including the need to: (1) anticipate directions of genomic discovery; (2) take an agnostic scientific perspective in framing research questions asking whether genomic discovery adds value to other health promotion efforts; and (3) consider multiple levels of influence and systems that contribute to important public health problems. The priorities and themes offer a framework for a variety of stakeholders, including those who develop priorities for research funding, interdisciplinary teams engaged in genomics research, and policymakers grappling with how to use the products born of genomics research to address public health challenges. PMID:20409503

Effective stakeholder participation in setting research priorities using a Global Evidence Mapping approach.

PubMed

Clavisi, Ornella; Bragge, Peter; Tavender, Emma; Turner, Tari; Gruen, Russell L

2013-05-01

We present a multistep process for identifying priority research areas in rehabilitation and long-term care of traumatic brain-injured (TBI) patients. In particular, we aimed to (1) identify which stakeholders should be involved; (2) identify what methods are appropriate; (3) examine different criteria for the generation of research priority areas; and (4) test the feasibility of linkage and exchange among researchers, decision makers, and other potential users of the research. Potential research questions were identified and developed using an initial scoping meeting and preliminary literature search, followed by a facilitated mapping workshop and an online survey. Identified research questions were then prioritized against specific criteria (clinical importance, novelty, and controversy). Existing evidence was then mapped to the high-priority questions using usual processes for search, screening, and selection. A broad range of stakeholders were then brought together at a forum to identify priority research themes for future research investment. Using clinical and research leaders, smaller targeted planning workshops prioritized specific research projects for each of the identified themes. Twenty-six specific questions about TBI rehabilitation were generated, 14 of which were high priority. No one method identified all high-priority questions. Methods that relied solely on the views of clinicians and researchers identified fewer high-priority questions compared with methods that used broader stakeholder engagement. Evidence maps of these high-priority questions yielded a number of evidence gaps. Priority questions and evidence maps were then used to inform a research forum, which identified 12 priority themes for future research. Our research demonstrates the value of a multistep and multimethod process involving many different types of stakeholders for prioritizing research to improve the rehabilitation outcomes of people who have suffered TBI. Enhancing stakeholder representation can be augmented using a combination of methods and a process of linkage and exchange. This process can inform decisions about prioritization of research areas. Copyright © 2013 Elsevier Inc. All rights reserved.

Identifying research priorities with nurses at a tertiary children's hospital in the United Kingdom.

PubMed

Williams, A; Sell, D; Oulton, K; Wilson, N; Wray, J; Gibson, F

2017-03-01

The objective of this study was to undertake a research priority setting exercise with the aim of maximizing efficiency and impact in research activity undertaken by nurses at one children's tertiary healthcare institution by ensuring the clinical staff directly shaped a coherent, transparent and consensus driven nurse-led research agenda. In Round 1, the research topics of 147 nurses were elicited using a modified nominal group technique as the consensus method. The number of participants in the 24 separate discussions ranged from 3 to 21, generating lists of between 6 and 23 topics. In Round 2, nurses from the clinical areas ranked topics of importance resulting in a set of four to five priorities. In Round 3, the divisional heads of nursing consulted with staff in all of their clinical areas to each finalize their five divisional priorities. The Nursing Research Working Group discussed and refined the divisions' priorities and voted on the final list to agree the top five research priorities for the organization. A total of 269 research topics were initially generated. Following three rounds of ranking and prioritizing, five priorities were agreed at Divisional level, and from these, the five top organizational priorities were selected. These were (i) understanding and improving all aspects of the patient journey through the hospital system; (ii) play; (iii) staff wellbeing, patient care and productivity; (iv) team work - linking to a more efficient service; and (v) supporting parents/parent pathway. Divisional priorities have been disseminated widely to clinical teams to inform a patient-specific nurse-led research agenda. Organizational priorities agreed upon have been disseminated through management structures and processes to ensure engagement at all levels. A subgroup of the Nursing Research Working Group has been delegated to take this work forward so that the agreed priorities continue to contribute towards shaping nurse-led research activity, thereby going some way to inform and embed an evidence-based culture of inquiry. © 2016 John Wiley & Sons Ltd.

From papers to practices: district level priority setting processes and criteria for family planning, maternal, newborn and child health interventions in Tanzania.

PubMed

Chitama, Dereck; Baltussen, Rob; Ketting, Evert; Kamazima, Switbert; Nswilla, Anna; Mujinja, Phares G M

2011-10-21

Successful priority setting is increasingly known to be an important aspect in achieving better family planning, maternal, newborn and child health (FMNCH) outcomes in developing countries. However, far too little attention has been paid to capturing and analysing the priority setting processes and criteria for FMNCH at district level. This paper seeks to capture and analyse the priority setting processes and criteria for FMNCH at district level in Tanzania. Specifically, we assess the FMNCH actor's engagement and understanding, the criteria used in decision making and the way criteria are identified, the information or evidence and tools used to prioritize FMNCH interventions at district level in Tanzania. We conducted an exploratory study mixing both qualitative and quantitative methods to capture and analyse the priority setting for FMNCH at district level, and identify the criteria for priority setting. We purposively sampled the participants to be included in the study. We collected the data using the nominal group technique (NGT), in-depth interviews (IDIs) with key informants and documentary review. We analysed the collected data using both content analysis for qualitative data and correlation analysis for quantitative data. We found a number of shortfalls in the district's priority setting processes and criteria which may lead to inefficient and unfair priority setting decisions in FMNCH. In addition, participants identified the priority setting criteria and established the perceived relative importance of the identified criteria. However, we noted differences exist in judging the relative importance attached to the criteria by different stakeholders in the districts. In Tanzania, FMNCH contents in both general development policies and sector policies are well articulated. However, the current priority setting process for FMNCH at district levels are wanting in several aspects rendering the priority setting process for FMNCH inefficient and unfair (or unsuccessful). To improve district level priority setting process for the FMNCH interventions, we recommend a fundamental revision of the current FMNCH interventions priority setting process. The improvement strategy should utilize rigorous research methods combining both normative and empirical methods to further analyze and correct past problems at the same time use the good practices to improve the current priority setting process for FMNCH interventions. The suggested improvements might give room for efficient and fair (or successful) priority setting process for FMNCH interventions.

Development of a common priority list of pharmaceuticals relevant for the water cycle.

PubMed

de Voogt, P; Janex-Habibi, M-L; Sacher, F; Puijker, L; Mons, M

2009-01-01

Pharmaceutically active compounds (PhACs), including prescription drugs, over-the-counter medications, drugs used in hospitals and veterinary drugs, have been found throughout the water cycle. A desk study was initiated by the Global Water Research Coalition to consolidate a uniform selection of such compounds in order to judge risks of PhACs for the water cycle. By identifying major existing prioritization efforts and evaluating the criteria they use, this study yields a representative and qualitative profile ('umbrella view') of priority pharmaceuticals based on an extensive set of criteria. This can then be used for further studies on analytical methods, occurrence, treatability and potential risks associated with exposure to PhACs in water supply, identifying compounds most likely to be encountered and that may have significant impact on human health. For practical reasons, the present study excludes veterinary drugs. The pragmatic approach adopted provides an efficient tool to manage risks related to pharmaceuticals and provides assistance for selecting compounds for future studies.

An advanced approach to traditional round robin CPU scheduling algorithm to prioritize processes with residual burst time nearest to the specified time quantum

NASA Astrophysics Data System (ADS)

Swaraj Pati, Mythili N.; Korde, Pranav; Dey, Pallav

2017-11-01

The purpose of this paper is to introduce an optimised variant to the round robin scheduling algorithm. Every algorithm works in its own way and has its own merits and demerits. The proposed algorithm overcomes the shortfalls of the existing scheduling algorithms in terms of waiting time, turnaround time, throughput and number of context switches. The algorithm is pre-emptive and works based on the priority of the associated processes. The priority is decided on the basis of the remaining burst time of a particular process, that is; lower the burst time, higher the priority and higher the burst time, lower the priority. To complete the execution, a time quantum is initially specified. In case if the burst time of a particular process is less than 2X of the specified time quantum but more than 1X of the specified time quantum; the process is given high priority and is allowed to execute until it completes entirely and finishes. Such processes do not have to wait for their next burst cycle.

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.

RMP Guidance for Warehouses - Chapter 5: Management System

EPA Pesticide Factsheets

Your management system should oversee the implementation of the risk management program elements, and designate and assign responsibility in order to make process safety a constant priority. Includes sample documentation.

Environmental and occupational health needs assessment in West Africa: opportunities for research and training.

PubMed

Sanyang, Edrisa; Butler-Dawson, Jaime; Mikulski, Marek A; Cook, Thomas; Kuye, Rex A; Venzke, Kristina; Fuortes, Laurence J

2017-03-01

Data are lacking on environmental and occupational health risks and resources available for the prevention of related diseases in the West African subregion. A needs assessment survey was conducted to identify environmental and occupational health concerns, and needs and strategies for skills training in the region. The survey was followed by a consensus-building workshop to discuss research and training priorities with representatives from countries participating in the study. Two hundred and two respondents from 12 countries participated in the survey. Vector-borne diseases, solid waste, deforestation, surface and ground water contamination together with work-related stress, occupational injury and pesticide toxicity were ranked as top environmental and occupational health priorities, respectively, in the region. Top training priorities included occupational health, environmental toxicology and analytic laboratory techniques with semester-long Africa-based courses as the preferred type of training for the majority of the courses. Major differences were found between the subregion's three official language groups, both in perceived health risks and training courses needed. The study results have implications for regional policies and practice in the area of environmental and occupational health research and training.

Policy and Practice-Relevant Youth Physical Activity Research Center Agenda.

PubMed

Botchwey, Nisha; Floyd, Myron F; Pollack Porter, Keshia; Cutter, Carmen L; Spoon, Chad; Schmid, Tom L; Conway, Terry L; Hipp, J Aaron; Kim, Anna J; Umstattd Meyer, M Renee; Walker, Amanda L; Kauh, Tina J; Sallis, Jim F

2018-06-08

The Physical Activity Research Center developed a research agenda that addresses youth physical activity (PA) and healthy weight, and aligns with the Robert Wood Johnson Foundation's Culture of Health. This paper summarizes prioritized research studies with a focus on youth at higher risk for inactive lifestyles and childhood obesity in urban and rural communities. Systematic literature reviews, a survey, and discussions with practitioners and researchers provided guidance on research questions to build evidence and inform effective strategies to promote healthy weight and PA in youth across race, cultural, and economic groups. The research team developed a matrix of potential research questions, identified priority questions, and designed targeted studies to address some of the priority questions and inform advocacy efforts. The studies selected examine strategies advocating for activity-friendly communities, Play Streets, park use, and PA of youth in the summer. A broader set of research priorities for youth PA is proposed. Establishing the Physical Activity Research Center research agenda identified important initial and future research studies to promote and ensure healthy weight and healthy levels of PA for at-risk youth. Results will be disseminated with the goal of promoting equitable access to PA for youth.

Environmental and occupational health needs assessment in West Africa: opportunities for research and training

PubMed Central

Sanyang, Edrisa; Butler-Dawson, Jaime; Mikulski, Marek A.; Cook, Thomas; Kuye, Rex A.; Venzke, Kristina

2016-01-01

Objectives Data are lacking on environmental and occupational health risks and resources available for the prevention of related diseases in the West African subregion. Methods A needs assessment survey was conducted to identify environmental and occupational health concerns, and needs and strategies for skills training in the region. The survey was followed by a consensus-building workshop to discuss research and training priorities with representatives from countries participating in the study. Results Two hundred and two respondents from 12 countries participated in the survey. Vector-borne diseases, solid waste, deforestation, surface and ground water contamination together with work-related stress, occupational injury and pesticide toxicity were ranked as top environmental and occupational health priorities, respectively, in the region. Top training priorities included occupational health, environmental toxicology and analytic laboratory techniques with semester-long Africa-based courses as the preferred type of training for the majority of the courses. Major differences were found between the subregion’s three official language groups, both in perceived health risks and training courses needed. Conclusions The study results have implications for regional policies and practice in the area of environmental and occupational health research and training. PMID:27592360

A rainfall risk analysis thanks to an GIS based estimation of urban vulnerability

NASA Astrophysics Data System (ADS)

Renard, Florent; Pierre-Marie, Chapon

2010-05-01

The urban community of Lyon, situated in France in the north of the Rhône valley, comprises 1.2 million inhabitants within 515 km ². With such a concentration of issues, policy makers and local elected officials therefore attach great importance to the management of hydrological risks, particularly due to the inherent characteristics of the territory. If the hazards associated with these risks in the territory of Lyon have been the subject of numerous analyses, studies on the vulnerability of greater Lyon are rare and have common shortcomings that impair their validity. We recall that the risk is seen as the classic relationship between the probability of occurrence of hazards and vulnerability. In this article, this vulnerability will be composed of two parts. The first one is the sensitivity of the stakes facing hydrological hazards as urban runoff, that is to say, their propensity to suffer damage during a flood (Gleize and Reghezza, 2007). The second factor is their relative importance in the functioning of the community. Indeed, not all the stakes could provide the same role and contribution to the Greater Lyon. For example, damage to the urban furniture such as bus shelter seems less harmful to the activities of the urban area than that of transport infrastructure (Renard and Chapon, 2010). This communication proposes to assess the vulnerability of Lyon urban area facing to hydrological hazards. This territory is composed of human, environmental and material stakes. The first part of this work is to identify all these issues so as to completeness. Then, is it required to build a "vulnerability index" (Tixier et al, 2006). Thus, it is necessary to use methods of multicriteria decision aid to evaluate the two components of vulnerability: the sensitivity and the contribution to the functioning of the community. Finally, the results of the overall vulnerability are presented, and then coupled to various hazards related to water such as runoff associated with heavy rains, to locate areas of risk in the urban area. The targets that share the same rank of this vulnerability index do not possess the same importance, or the same sensitivity to the flood hazard. Therefore, the second part of this work is to define the priorities and sensitivities of different targets based on the judgments of experts. Multicriteria decision methods are used to prioritize elements and are therefore adapted to the modelling of the sensitivity of the issues of greater Lyon (Griot, 2008). The purpose of these methods is the assessment of priorities between the different components of the situation. Thomas Saaty's analytic hierarchy process (1980) is the most frequently used because of its many advantages. On this basis, the formal calculations of priorities and sensitivities of the elements have been conducted. These calculations are based on the judgments of experts. Indeed, during semi-structured interview, the 38 experts in our sample delivered a verdict on issues that seem relatively more important than others by binary comparison. They carry the same manner to determine sensitivity's stakes to hazard flooding. Finally, the consistency of answers given by experts is validated by calculating a ratio of coherence, and their results are aggregated to provide functions of priority (based on the relative importance of each stakes), and functions of sensitivity (based on the relative sensitivity of each stakes). From these functions of priority and sensitivity is obtained the general function of vulnerability. The vulnerability functions allow defining the importance of the stakes of Greater Lyon and their sensitivity to hydrological hazards. The global vulnerability function is obtained from sensitivity and priority functions and shows the great importance of human issues (75 %). The vulnerability factor of environmental targets represents 12 % of the global vulnerability function, as much as the materials issues. However, it can be seen that the environmental and material stakes do not represent the same weight into the priority and sensitivity functions. Indeed, the environmental issues seem more important than the material ones (17 % for the environmental stakes whereas only 5 % for the material stakes in the priority function), but less sensitive to an hydrological hazard (6 % for the environmental issues while 20 % for the material issues in the sensitivity function). Similarly, priority functions and sensitivity are established for all stakes at all levels. The stakes are then converted into a mesh form (100 meters wide). This will standardize the collection framework and the heterogeneous nature of data to allow their comparison. Finally, it is obtained a detailed, consistent and objective vulnerability of the territory of Greater Lyon. At the end, to get a direct reading of risk, combination of hazard and vulnerability, it is overlaid the two maps.

Thrombosis in Cancer: Research Priorities Identified by a National Cancer Institute/National Heart, Lung, and Blood Institute Strategic Working Group.

PubMed

Key, Nigel S; Khorana, Alok A; Mackman, Nigel; McCarty, Owen J T; White, Gilbert C; Francis, Charles W; McCrae, Keith R; Palumbo, Joseph S; Raskob, Gary E; Chan, Andrew T; Sood, Anil K

2016-07-01

The risk for venous thromboembolism (VTE) is increased in cancer and particularly with chemotherapy, and it portends poorer survival among patients with cancer. However, many fundamental questions about cancer-associated VTE, or Trousseau syndrome, remain unanswered. This report summarizes the proceedings of a working group assembled by the NCI and NHLBI in August 2014 to explore the state of the science in cancer-associated VTE, identify clinically important research gaps, and develop consensus on priorities for future research. Representing a convergence of research priorities between the two NIH Institutes, the workshop addressed epidemiologic, basic science, clinical, and translational issues in cancer-associated VTE. Cancer Res; 76(13); 3671-5. ©2016 AACR. ©2016 American Association for Cancer Research.

Stillbirths: the way forward in high-income countries.

PubMed

Flenady, Vicki; Middleton, Philippa; Smith, Gordon C; Duke, Wes; Erwich, Jan Jaap; Khong, T Yee; Neilson, Jim; Ezzati, Majid; Koopmans, Laura; Ellwood, David; Fretts, Ruth; Frøen, J Frederik

2011-05-14

Stillbirth rates in high-income countries declined dramatically from about 1940, but this decline has slowed or stalled over recent times. The present variation in stillbirth rates across and within high-income countries indicates that further reduction in stillbirth is possible. Large disparities (linked to disadvantage such as poverty) in stillbirth rates need to be addressed by providing more educational opportunities and improving living conditions for women. Placental pathologies and infection associated with preterm birth are linked to a substantial proportion of stillbirths. The proportion of unexplained stillbirths associated with under investigation continues to impede efforts in stillbirth prevention. Overweight, obesity, and smoking are important modifiable risk factors for stillbirth, and advanced maternal age is also an increasingly prevalent risk factor. Intensified efforts are needed to ameliorate the effects of these factors on stillbirth rates. Culturally appropriate preconception care and quality antenatal care that is accessible to all women has the potential to reduce stillbirth rates in high-income countries. Implementation of national perinatal mortality audit programmes aimed at improving the quality of care could substantially reduce stillbirths. Better data on numbers and causes of stillbirth are needed, and international consensus on definition and classification related to stillbirth is a priority. All parents should be offered a thorough investigation including a high-quality autopsy and placental histopathology. Parent organisations are powerful change agents and could have an important role in raising awareness to prevent stillbirth. Future research must focus on screening and interventions to reduce antepartum stillbirth as a result of placental dysfunction. Identification of ways to reduce maternal overweight and obesity is a high priority for high-income countries. Copyright © 2011 Elsevier Ltd. All rights reserved.

Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries

PubMed Central

Ademuyiwa, Adesoji O

2016-01-01

Background Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally. Methods Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression. Results This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed. Conclusions Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas. Trial registration number NCT02179112; Pre-results. PMID:28588977

Can streamlined multi-criteria decision analysis be used to implement shared decision making for colorectal cancer screening?

PubMed Central

Dolan, James G.; Boohaker, Emily; Allison, Jeroan; Imperiale, Thomas F.

2013-01-01

Background Current US colorectal cancer screening guidelines that call for shared decision making regarding the choice among several recommended screening options are difficult to implement. Multi-criteria decision analysis (MCDA) is an established methodology well suited for supporting shared decision making. Our study goal was to determine if a streamlined form of MCDA using rank order based judgments can accurately assess patients’ colorectal cancer screening priorities. Methods We converted priorities for four decision criteria and three sub-criteria regarding colorectal cancer screening obtained from 484 average risk patients using the Analytic Hierarchy Process (AHP) in a prior study into rank order-based priorities using rank order centroids. We compared the two sets of priorities using Spearman rank correlation and non-parametric Bland-Altman limits of agreement analysis. We assessed the differential impact of using the rank order-based versus the AHP-based priorities on the results of a full MCDA comparing three currently recommended colorectal cancer screening strategies. Generalizability of the results was assessed using Monte Carlo simulation. Results Correlations between the two sets of priorities for the seven criteria ranged from 0.55 to 0.92. The proportions of absolute differences between rank order-based and AHP-based priorities that were more than ± 0.15 ranged from 1% to 16%. Differences in the full MCDA results were minimal and the relative rankings of the three screening options were identical more than 88% of the time. The Monte Carlo simulation results were similar. Conclusion Rank order-based MCDA could be a simple, practical way to guide individual decisions and assess population decision priorities regarding colorectal cancer screening strategies. Additional research is warranted to further explore the use of these methods for promoting shared decision making. PMID:24300851

Consulting patients in setting priorities in Myalgic Encephalomyelitis (M.E.) research: findings from a national on-line survey.

PubMed

Childs, Nicola; Robinson, Lisa; Chowdhury, Sonya; Ogden, Clare; Newton, Julia L

2015-01-01

Myalgic encephalitis (M.E.) is a common condition, the cause of which is not known and there are no treatments available. In this study the national patient support group Action for M.E. sought the opinions of their members via an online survey as to what they felt should be future priorities for M.E. Respondents were asked what they considered first, second and third research priorities to be from a list of 13 pre-defined options. Individuals were invited to provide additional free text comments about Action for M.E.'s research priorities in general. Of the 1144 respondents: 822 had M.E.; 94 were a supporting a member of Action for M.E. ; 66 were carers for someone with M.E.; 26 were professionals with an interest in M.E.; 136 had a family member or colleague with M.E. Individuals selected more than one category as applicable. The top five research priorities identified were: disease processes to achieve a better understanding of the causes of M.E.; more effective treatments; faster and more accurate diagnosis; clinical course of M.E.; outcomes and natural history; and severely affected patients. Least popular priorities were: sleep; economic research towards identifying the cost of ME; and psychological aspects. Much of the free text comments emphasised the importance of funding biomedical research into disease processes to achieve a better understanding of the causes of M.E. Three themes were identified in relation to this topic: accurate diagnosis and awareness; risk factors and causes; drug development and curative therapies. In conclusion; individuals affected by M.E. have clear views regarding priorities for research investment. These have informed Action for M.E.'s ongoing research strategy and ultimately will inform national and international research priorities.

High-priority and low-priority drug-drug interactions in different international electronic health record systems: A comparative study.

PubMed

Cornu, Pieter; Phansalkar, Shobha; Seger, Diane L; Cho, Insook; Pontefract, Sarah; Robertson, Alexandra; Bates, David W; Slight, Sarah P

2018-03-01

To investigate whether alert warnings for high-priority and low-priority drug-drug interactions (DDIs) were present in five international electronic health record (EHR) systems, to compare and contrast the severity level assigned to them, and to establish the proportion of alerts that were overridden. We conducted a comparative, retrospective, multinational study using a convenience sample of 5 EHRs from the U.S., U.K., Republic of Korea and Belgium. Of the 15 previously defined, high-priority, class-based DDIs, alert warnings were found to exist for 11 in both the Korean and UK systems, 9 in the Belgian system, and all 15 in the two US systems. The specific combinations that were included in these class-based DDIs varied considerably in number, type and level of severity amongst systems. Alerts were only active for 8.4% (52/619) and 52.4% (111/212) of the specific drug-drug combinations contained in the Belgian and UK systems, respectively. Hard stops (not possible to override) existed in the US and UK systems only. The override rates for high-priority alerts requiring provider action ranged from 56.7% to 83.3%. Of the 33 previously defined low-priority DDIs, active alerts existed only in the US systems, for three class-based DDIs. The majority were non-interruptive. Alert warnings existed for most of the high-priority DDIs in the different EHRs but overriding them was easy in most of the systems. In addition to validating the high- and low-priority DDIs, this study reported a lack of standardization in DDI levels across different international knowledge bases. Copyright © 2017. Published by Elsevier B.V.

Setting research priorities across science, technology, and health sectors: the Tanzania experience.

PubMed

de Haan, Sylvia; Kingamkono, Rose; Tindamanyire, Neema; Mshinda, Hassan; Makandi, Harun; Tibazarwa, Flora; Kubata, Bruno; Montorzi, Gabriela

2015-03-12

Identifying research priorities is key to innovation and economic growth, since it informs decision makers on effectively targeting issues that have the greatest potential public benefit. As such, the process of setting research priorities is of pivotal importance for favouring the science, technology, and innovation (STI)-driven development of low- and middle-income countries. We report herein on a major cross-sectoral nationwide research priority setting effort recently carried out in Tanzania by the Tanzania Commission for Science and Technology (COSTECH) in partnership with the Council on Health Research for Development (COHRED) and the NEPAD Agency. The first of its type in the country, the process brought together stakeholders from 42 sub-sectors in science, technology, and health. The cross-sectoral research priority setting process consisted of a 'training-of-trainers' workshop, a demonstration workshop, and seven priority setting workshops delivered to representatives from public and private research and development institutions, universities, non-governmental organizations, and other agencies affiliated to COSTECH. The workshops resulted in ranked listings of research priorities for each sub-sector, totalling approximately 800 priorities. This large number was significantly reduced by an expert panel in order to build a manageable instrument aligned to national development plans that could be used to guide research investments. The Tanzania experience is an instructive example of the challenges and issues to be faced in when attempting to identify research priority areas and setting an STI research agenda in low- and middle-income countries. As countries increase their investment in research, it is essential to increase investment in research management and governance as well, a key and much needed capacity for countries to make proper use of research investments.

Environmental hazard and risk characterisation of petroleum substances: a guided "walking tour" of petroleum hydrocarbons.

PubMed

Bierkens, Johan; Geerts, Lieve

2014-05-01

Petroleum substances are used in large quantities, primarily as fuels. They are complex mixtures whose major constituents are hydrocarbons derived from crude oil by distillation and fractionation. Determining the complete molecular composition of petroleum and its refined products is not feasible with current analytical techniques because of the huge number of molecular components. This complex nature of petroleum products, with their varied number of constituents, all of them exhibiting different fate and effect characteristics, merits a dedicated hazard and risk assessment approach. From a regulatory perspective they pose a great challenge in a number of REACH processes, in particular in the context of dossier and substance evaluation but also for priority setting activities. In order to facilitate the performance of hazard and risk assessment for petroleum substances the European oil company association, CONCAWE, has developed the PETROTOX and PETRORISK spreadsheet models. Since the exact composition of many petroleum products is not known, an underlying assumption of the PETROTOX and PETRORISK tools is that the behaviour and fate of a total petroleum substance can be simulated based on the physical-chemical properties of representative structures mapped to hydrocarbon blocks (HBs) and on the relative share of each HB in the total mass of the product. To assess how differing chemical compositions affect the simulated chemical fate and toxicity of hydrocarbon mixtures, a series of model simulations were run using an artificial petroleum substance, containing 386 (PETROTOX) or 160 (PETRORISK) HBs belonging to different chemical classes and molecular weight ranges, but with equal mass assigned to each of them. To this artificial petroleum substance a guided series of subsequent modifications in mass allocation to a delineated number of HBs belonging to different chemical classes and carbon ranges was performed, in what we perceived as a guided "walking tour" through the chemical space of petroleum substances. We show that the PETROTOX and PETRORISK predictions reflect changes in mass distribution introduced to selected HBs by affecting hazard and risk estimates in correspondence with what is expected based on physical-chemical properties of individual constituents in the corresponding HBs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Job strain — Attributable depression in a sample of working Australians: Assessing the contribution to health inequalities

PubMed Central

LaMontagne, Anthony D; Keegel, Tessa; Vallance, Deborah; Ostry, Aleck; Wolfe, Rory

2008-01-01

Background The broad aim of this study was to assess the contribution of job strain to mental health inequalities by (a) estimating the proportion of depression attributable to job strain (low control and high demand jobs), (b) assessing variation in attributable risk by occupational skill level, and (c) comparing numbers of job strain–attributable depression cases to numbers of compensated 'mental stress' claims. Methods Standard population attributable risk (PAR) methods were used to estimate the proportion of depression attributable to job strain. An adjusted Odds Ratio (OR) of 1.82 for job strain in relation to depression was obtained from a recently published meta-analysis and combined with exposure prevalence data from the Australian state of Victoria. Job strain exposure prevalence was determined from a 2003 population-based telephone survey of working Victorians (n = 1101, 66% response rate) using validated measures of job control (9 items, Cronbach's alpha = 0.80) and psychological demands (3 items, Cronbach's alpha = 0.66). Estimates of absolute numbers of prevalent cases of depression and successful stress-related workers' compensation claims were obtained from publicly available Australian government sources. Results Overall job strain-population attributable risk (PAR) for depression was 13.2% for males [95% CI 1.1, 28.1] and 17.2% [95% CI 1.5, 34.9] for females. There was a clear gradient of increasing PAR with decreasing occupational skill level. Estimation of job strain–attributable cases (21,437) versus "mental stress" compensation claims (696) suggest that claims statistics underestimate job strain–attributable depression by roughly 30-fold. Conclusion Job strain and associated depression risks represent a substantial, preventable, and inequitably distributed public health problem. The social patterning of job strain-attributable depression parallels the social patterning of mental illness, suggesting that job strain is an important contributor to mental health inequalities. The numbers of compensated 'mental stress' claims compared to job strain-attributable depression cases suggest that there is substantial under-recognition and under-compensation of job strain-attributable depression. Primary, secondary, and tertiary intervention efforts should be substantially expanded, with intervention priorities based on hazard and associated health outcome data as an essential complement to claims statistics. PMID:18505559

Trends in Tobacco Use by Alabama Youth (1995-1999).

ERIC Educational Resources Information Center

Sun, Feng; Bruess, Clint

To examine changes in tobacco use among high school students in Alabama from 1995 to 1999, Alabama Youth Risk Behavior Surveillance System (YRBS) survey data were analyzed. The survey has been used since 1990 to examine the health practices of adolescents and to monitor priority health-risk behaviors that contribute to the leading causes of…

Cognitive Impairment among the Aging Population in a Community in Southwest Nigeria

ERIC Educational Resources Information Center

Adebiyi, Akindele O.; Ogunniyi, Adesola; Adediran, Babatunde A.; Olakehinde, Olaide O.; Siwoku, Akeem A.

2016-01-01

Background: Vascular risk models can be quite informative in assisting the clinician to make a prediction of an individual's risk of cognitive impairment. Thus, a simple marker is a priority for low-capacity settings. This study examines the association of selected simple to deploy vascular markers with cognitive impairment in an elderly…

The Cost of Inclusion in the Community: Funding Special Needs in First Nations Community Schools in Quebec

ERIC Educational Resources Information Center

Paquette, Jerry E.; Smith, William J.

2004-01-01

Currently, severe economic restraint is reshaping the educational policy scene in Canada. Among other consequences, this policy environment places vulnerable populations at risk of having their needs subordinated to budgetary priorities. First Nations students with disabilities constitute one such group that is doubly at risk. Once segregated in…

Trends in the Prevalence of Suicide-Related Behaviors. National YRBS: 1991-2011

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2011

2011-01-01

The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

Trends in the Prevalence of Tobacco Use. National YRBS: 1991-2011

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2011

2011-01-01

The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

Trends in the Prevalence of Alcohol Use. National YRBS: 1991-2011

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2011

2011-01-01

The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

Integrating Family Visitation and Risk Evaluation: A Practical Bonding Model for Decision Makers.

ERIC Educational Resources Information Center

Ansay, Sylvia J.; Perkins, Daniel F.

2001-01-01

Child welfare legislation and policy have shifted away from a standard of reasonable efforts toward reunification for children in foster care to a standard in which the best interests of the child have priority. Authors apply a family bonding perspective to address risk assessment for children in foster care and demonstrate potential for…

Exploring Instructional Differences and School Performance in High-Poverty Elementary Schools

ERIC Educational Resources Information Center

Hirn, Regina G.; Hollo, Alexandra; Scott, Terrance M.

2018-01-01

In the United States, federal funding under Title 1 is provided to schools to improve academic achievement for disadvantaged students. Many students attending schools eligible for Title 1 funding are from families in poverty and at risk for negative outcomes. Identifying instructional factors that mitigate this risk must be a priority for teachers…

NATIONAL-SCALE ASSESSMENT OF AIR TOXICS RISKS ...

EPA Pesticide Factsheets

The national-scale assessment of air toxics risks is a modeling assessment which combines emission inventory development, atmospheric fate and transport modeling, exposure modeling, and risk assessment to characterize the risk associated with inhaling air toxics from outdoor sources. This national-scale effort will be initiated for the base year 1996 and repeated every three years thereafter to track trends and inform program development. Provide broad-scale understanding of inhalation risks for a subset of atmospherically-emitted air toxics to inform further data-gathering efforts and priority-setting for the EPA's Air Toxics Programs.

78 FR 9889 - Proposed Information Collection; Comment Request; State and Local Implementation Grant Program...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

... rural as well as urban areas. Because the appointment of the FirstNet Board occurred on August 20, 2012... resiliency requirements; (v) assignment of priority to local users and selection of entities seeking network... format. III. Data OMB Control Number: 0660-0038. Form Number(s): None. Type of Review: Regular submission...

Neurocognitive impairment and suicide risk among prison inmates.

PubMed

Vadini, Francesco; Calella, Giulio; Pieri, Alessandro; Ricci, Elena; Fulcheri, Mario; Verrocchio, Maria Cristina; De Risio, Alfredo; Sciacca, Antonina; Santilli, Francesca; Parruti, Giustino

2018-01-01

Worldwide, prisoners are at high risk of suicide. Reducing the number of suicides in jails and prisons is an international priority. Several risk factors for suicide attempts, such as historical, prison-related, psychosocial and clinical factors, have been found in prisoners. We assessed whether demographic, conviction-related and neuro-behavioral variables might be associated with current suicide risk and lifetime suicide attempts in two large central Italy prisons. On a preliminary sample of 254 detainees within an ongoing project, we assessed whether demographic, conviction-related, psychiatric, cognitive variables and illness comorbidity might be associated with current suicide risk and lifetime suicide attempts in two large central Italy prisons. Psychiatric disorders and suicide risk was evaluated using the Mini International Neuropsychiatric Interview. We also have identified the detainees with clear-cut previous suicide attempts. The cognitive function was assessed with a brief neuropsychological battery including trail making A, trail making B, Digit Span, and Symbol Digit test. Impulsivity was assessed with the Barratt Impulsiveness Scale. Cumulative illness was evaluated with Charlson Comorbidity Index. Impairment in global cognitive function was the strongest predictor of both high suicide risk and lifetime suicide attempts (both p < 0.001), independently of psychiatric disorders, psychopharmacological treatment, detention status, conviction time, substance use disorder, impulsivity, and illness comorbidity. Limitation LIMITATION: Cross-sectional study design and relatively small sample size. Cognitive deficits may improve our understanding of the suicidal vulnerability and should be systematically included in the assessment of suicide risk, as potential predictors of suicidal acts and targets of preventive interventions. Copyright © 2017 Elsevier B.V. All rights reserved.

75 FR 32440 - Catalog of Federal Domestic Assistance (CFDA) Number: 84.215J

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-08

... DEPARTMENT OF EDUCATION Full-Service Community Schools Catalog of Federal Domestic Assistance (CFDA) Number: 84.215J AGENCY: Office of Innovation and Improvement, Department of Education. ACTION... Education announces priorities, requirements, definitions, and selection criteria for the Full-Service...

Using a Delphi process to define priorities for prison health research in Canada.

PubMed

Kouyoumdjian, Fiona G; Schuler, Andrée; McIsaac, Kathryn E; Pivnick, Lucie; Matheson, Flora I; Brown, Glenn; Kiefer, Lori; Silva, Diego; Hwang, Stephen W

2016-01-14

A large number of Canadians spend time in correctional facilities each year, and they are likely to have poor health compared to the general population. Relatively little health research has been conducted in Canada with a focus on people who experience detention or incarceration. We aimed to conduct a Delphi process with key stakeholders to define priorities for research in prison health in Canada for the next 10 years. We conducted a Delphi process using an online survey with two rounds in 2014 and 2015. We invited key stakeholders in prison health research in Canada to participate, which we defined as persons who had published research on prison health in Canada since 1994 and persons in the investigators' professional networks. We invited 143 persons to participate in the first round and 59 participated. We invited 137 persons to participate in the second round and 67 participated. Participants suggested topics in the first round, and these topics were collated by investigators. We measured the level of agreement among participants that each collated topic was a priority for prison health research in Canada for the next 10 years, and defined priorities based on the level of agreement. In the first round, participants suggested 71 topics. In the second round, consensus was achieved that a large number of suggested topics were research priorities. Top priorities were diversion and alternatives to incarceration, social and community re-integration, creating healthy environments in prisons, healthcare in custody, continuity of healthcare, substance use disorders and the health of Aboriginal persons in custody. Generated in an inclusive and systematic process, these findings should inform future research efforts to improve the health and healthcare of people who experience detention and incarceration in Canada. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Women and Parasitic Diseases

MedlinePlus

... Z Index Laboratory Diagnostic Assistance Parasitic Disease and Malaria Strategic Priorities: 2015—2020 About our Division Get ... human immunodeficiency virus (HIV) infection. Pregnant women in malaria-endemic countries are at increased risk for adverse ...

The Application of Failure Modes and Effects Analysis Methodology to Intrathecal Drug Delivery for Pain Management

PubMed Central

Patel, Teresa; Fisher, Stanley P.

2016-01-01

Objective This study aimed to utilize failure modes and effects analysis (FMEA) to transform clinical insights into a risk mitigation plan for intrathecal (IT) drug delivery in pain management. Methods The FMEA methodology, which has been used for quality improvement, was adapted to assess risks (i.e., failure modes) associated with IT therapy. Ten experienced pain physicians scored 37 failure modes in the following categories: patient selection for therapy initiation (efficacy and safety concerns), patient safety during IT therapy, and product selection for IT therapy. Participants assigned severity, probability, and detection scores for each failure mode, from which a risk priority number (RPN) was calculated. Failure modes with the highest RPNs (i.e., most problematic) were discussed, and strategies were proposed to mitigate risks. Results Strategic discussions focused on 17 failure modes with the most severe outcomes, the highest probabilities of occurrence, and the most challenging detection. The topic of the highest‐ranked failure mode (RPN = 144) was manufactured monotherapy versus compounded combination products. Addressing failure modes associated with appropriate patient and product selection was predicted to be clinically important for the success of IT therapy. Conclusions The methodology of FMEA offers a systematic approach to prioritizing risks in a complex environment such as IT therapy. Unmet needs and information gaps are highlighted through the process. Risk mitigation and strategic planning to prevent and manage critical failure modes can contribute to therapeutic success. PMID:27477689

A Currency for Offsetting Energy Development Impacts: Horse-Trading Sage-Grouse on the Open Market

PubMed Central

Doherty, Kevin E.; Naugle, David E.; Evans, Jeffrey S.

2010-01-01

Background Biodiversity offsets provide a mechanism to compensate for unavoidable damages from new energy development as the U.S. increases its domestic production. Proponents argue that offsets provide a partial solution for funding conservation while opponents contend the practice is flawed because offsets are negotiated without the science necessary to backup resulting decisions. Missing in negotiations is a biologically-based currency for estimating sufficiency of offsets and a framework for applying proceeds to maximize conservation benefits. Methodology/Principal Findings Here we quantify a common currency for offsets for greater sage-grouse (Centrocercus urophasianus) by estimating number of impacted birds at 4 levels of development commonly permitted. Impacts were indiscernible at 1–12 wells per 32.2 km2. Above this threshold lek losses were 2–5 times greater inside than outside of development and bird abundance at remaining leks declined by −32 to −77%. Findings reiterated the importance of time-lags as evidenced by greater impacts 4 years after initial development. Clustering well locations enabled a few small leks to remain active inside of developments. Conclusions/Significance Documented impacts relative to development intensity can be used to forecast biological trade-offs of newly proposed or ongoing developments, and when drilling is approved, anticipated bird declines form the biological currency for negotiating offsets. Monetary costs for offsets will be determined by true conservation cost to mitigate risks such as sagebrush tillage to other populations of equal or greater number. If this information is blended with landscape level conservation planning, the mitigation hierarchy can be improved by steering planned developments away from conservation priorities, ensuring compensatory mitigation projects deliver a higher return for conservation that equate to an equal number of birds in the highest priority areas, provide on-site mitigation recommendations, and provide a biologically based cost for mitigating unavoidable impacts. PMID:20442770

Mortuary operations in the aftermath of the 2009 Victorian bushfires.

PubMed

Leditschke, Jodie; Collett, Sarsha; Ellen, Rebecca

2011-02-25

On the day of the 2009 Victorian bushfires the Victorian Institute of Forensic Medicine activated its emergency plan. Within 48 h a temporary body storage facility was constructed adjacent to the existing mortuary. This temporary facility had the capacity to store up to 300 deceased persons. Pathologists, anthropologists, odontologists, police and mortuary assistants responded from all around Australia, New Zealand and Indonesia. The existing forensic mortuary and staff were divided into two areas: DVI (disaster victim identification) and "routine operations". A high priority for the mortuary was to ensure the casework of the "routine" deceased persons (those cases which were not related to the bushfires) was handled concurrently and in a timely manner. On admission each set of victim remains was given both a Coroner's case number in addition to the DVI number allocated at the scene. The case was CT scanned, examined by a pathologist, an anthropologist, and odontologist and in some instances a fingerprint expert. Where possible a DNA sample was taken. All processes, samples, labels and paperwork underwent a quality assurance check prior to the case completion. Regular audits were conducted. All of post mortem examinations were completed within 20 days of admission. Occupational health and safety issues of the staff were a high priority; this included correct manual handling, infection control and psychological debriefings. During the operation it was found that some remains were contaminated with asbestos. Procedures were set in place to manage these cases individually and each was isolated to reduce the risk of exposure by staff to asbestos. This overall mortuary operation identified a number of significant challenges, in particular the management of multiple parts of human remains for one individual. A new procedure was developed to ensure that all human remains, where possible, were reconciled with identified deceased persons prior to the release to the funeral director. It also highlighted the need to have well documented plans in place including plans for temporary mortuary facilities. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Setting priorities for safe motherhood interventions in resource-scarce settings.

PubMed

Prata, Ndola; Sreenivas, Amita; Greig, Fiona; Walsh, Julia; Potts, Malcolm

2010-01-01

Guide policy-makers in prioritizing safe motherhood interventions. Three models (LOW, MED, HIGH) were constructed based on 34 sub-Saharan African countries to assess the relative cost-effectiveness of available safe motherhood interventions. Cost and effectiveness data were compiled and inserted into the WHO Mother Baby Package Costing Spreadsheet. For each model we assessed the percentage in maternal mortality reduction after implementing all interventions, and optimal combinations of interventions given restricted budgets of US$ 0.50, US$ 1.00, US$ 1.50 per capital maternal health expenditures respectively for LOW, MED, and HIGH models. The most cost-effective interventions were family planning and safe abortion (fpsa), antenatal care including misoprostol distribution for postpartum hemorrhage prevention at home deliveries (anc-miso), followed by sepsis treatment (sepsis) and facility-based postpartum hemorrhage management (pph). The combination of interventions that avert the greatest number of maternal deaths should be prioritized and expanded to cover the greatest number of women at risk. Those which save the most number of lives in each model are 'fpsa, anc-miso' and 'fpsa, sepsis, safe delivery' for LOW; 'fpsa, anc-miso' and 'fpsa, sepsis, safe delivery' for MED; and 'fpsa, anc-miso, sepsis, eclampsia treatment, safe delivery' for HIGH settings. Safe motherhood interventions save a significant number of newborn lives.

2013 Workplace and Equal Opportunity Survey of Active Duty Members: Administration, Datasets, and Codebook

DTIC Science & Technology

2016-05-01

and Kroeger (2002) provide details on sampling and weighting. Following the summary of the survey methodology is a description of the survey analysis... description of priority, for the ADDRESS file). At any given time, the current address used corresponded to the address number with the highest priority...types of address updates provided by the postal service. They are detailed below; each includes a description of the processing steps. 1. Postal Non

Priorities for research in miscarriage: a priority setting partnership between people affected by miscarriage and professionals following the James Lind Alliance methodology.

PubMed

Prior, Matthew; Bagness, Carmel; Brewin, Jane; Coomarasamy, Arri; Easthope, Lucy; Hepworth-Jones, Barbara; Hinshaw, Kim; O'Toole, Emily; Orford, Julie; Regan, Lesley; Raine-Fenning, Nick; Shakespeare, Judy; Small, Rachel; Thornton, Jim; Metcalf, Leanne

2017-08-23

To identify and prioritise important research questions for miscarriage. A priority setting partnership using prospective surveys and consensus meetings following methods advocated by the James Lind Alliance. UK. Women and those affected by miscarriage working alongside healthcare professionals. In the initial survey, 1093 participants (932 women who have experienced miscarriage, 8 partners, 17 family members, friends or colleagues, 104 healthcare professionals and eight charitable organisations) submitted 3279 questions. A review of existing literature identified a further 64. Non-questions were removed, and the remaining questions were categorised and summarised into 58 questions. In an interim electronic survey, 2122 respondents chose their top 10 priorities from the 58 summary questions. The 25 highest ranked in the survey were prioritised at a final face-to-face workshop. In summary, the top 10 priorities were ranked as follows: research into preventative treatment, emotional aspects in general, investigation, relevance of pre-existing medical conditions, emotional support as a treatment, importance of lifestyle factors, importance of genetic and chromosomal causes, preconception tests, investigation after different numbers of miscarriage and male causal factors. These results should be the focus of future miscarriage research. Presently, studies are being conducted to address the top priority; however, many other priorities, especially psychological and emotional support, are less well researched areas. We hope our results will encourage both researchers and funders to focus on these priorities. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

GCR and SPE Radiation Effects in Materials

NASA Technical Reports Server (NTRS)

Waller, Jess; Rojdev, Kristina; Nichols, Charles

2016-01-01

This Year 3 project provides risk reduction data to assess galactic cosmic ray (GCR) and solar particle event (SPE) space radiation damage in materials used in manned low-earth orbit, lunar, interplanetary, and Martian surface missions. Long duration (up to 50 years) space radiation damage is being quantified for materials used in inflatable structures (1st priority), and space suit and habitable composite materials (2nd priority). The data collected has relevance for nonmetallic materials (polymers and composites) used in NASA missions where long duration reliability is needed in continuous or intermittent space radiation fluxes.

Sexual Violence in America: Public Funding and Social Priority.

PubMed

Waechter, Randall; Ma, Van

2015-12-01

We compared lifetime risk, annual incidence, and annual economic burden of sexual violence with other major public health issues in the United States: cardiovascular disease, cancer, diabetes, and HIV/AIDS. With public funding data from 2013, we examined how much public funding is allocated to these public health issues as a proxy of the social priority of addressing each of them. Although sexual violence is as prevalent as and more costly than are these other major public health issues, it receives a fraction of the public funds that they receive.

Systematic reviews addressing identified health policy priorities in Eastern Mediterranean countries: a situational analysis.

PubMed

El-Jardali, Fadi; Akl, Elie A; Karroum, Lama Bou; Kdouh, Ola; Akik, Chaza; Fadlallah, Racha; Hammoud, Rawan

2014-08-20

Systematic reviews can offer policymakers and stakeholders concise, transparent, and relevant evidence pertaining to pressing policy priorities to help inform the decision-making process. The production and the use of systematic reviews are specifically limited in the Eastern Mediterranean region. The extent to which published systematic reviews address policy priorities in the region is still unknown. This situational analysis exercise aims at assessing the extent to which published systematic reviews address policy priorities identified by policymakers and stakeholders in Eastern Mediterranean region countries. It also provides an overview about the state of systematic review production in the region and identifies knowledge gaps. We conducted a systematic search of the Health System Evidence database to identify published systematic reviews on policy-relevant priorities pertaining to the following themes: human resources for health, health financing, the role of the non-state sector, and access to medicine. Priorities were identified from two priority-setting exercises conducted in the region. We described the distribution of these systematic reviews across themes, sub-themes, authors' affiliations, and countries where included primary studies were conducted. Out of the 1,045 systematic reviews identified in Health System Evidence on selected themes, a total of 200 systematic reviews (19.1%) addressed the priorities from the Eastern Mediterranean region. The theme with the largest number of systematic reviews included was human resources for health (115) followed by health financing (33), access to medicine (27), and role of the non-state sector (25). Authors based in the region produced only three systematic reviews addressing regional priorities (1.5%). Furthermore, no systematic review focused on the Eastern Mediterranean region. Primary studies from the region had limited contribution to systematic reviews; 17 systematic reviews (8.5%) included primary studies conducted in the region. There are still gaps in the production of systematic reviews addressing policymakers' and stakeholders' priorities in the Eastern Mediterranean region. Efforts should be directed towards better aligning systematic review production with policy needs and priorities. Study findings can inform the agendas of researchers, research institutions, and international funding agencies of priority areas where systematic reviews are required.

Systematic reviews addressing identified health policy priorities in Eastern Mediterranean countries: a situational analysis

PubMed Central

2014-01-01

Background Systematic reviews can offer policymakers and stakeholders concise, transparent, and relevant evidence pertaining to pressing policy priorities to help inform the decision-making process. The production and the use of systematic reviews are specifically limited in the Eastern Mediterranean region. The extent to which published systematic reviews address policy priorities in the region is still unknown. This situational analysis exercise aims at assessing the extent to which published systematic reviews address policy priorities identified by policymakers and stakeholders in Eastern Mediterranean region countries. It also provides an overview about the state of systematic review production in the region and identifies knowledge gaps. Methods We conducted a systematic search of the Health System Evidence database to identify published systematic reviews on policy-relevant priorities pertaining to the following themes: human resources for health, health financing, the role of the non-state sector, and access to medicine. Priorities were identified from two priority-setting exercises conducted in the region. We described the distribution of these systematic reviews across themes, sub-themes, authors’ affiliations, and countries where included primary studies were conducted. Results Out of the 1,045 systematic reviews identified in Health System Evidence on selected themes, a total of 200 systematic reviews (19.1%) addressed the priorities from the Eastern Mediterranean region. The theme with the largest number of systematic reviews included was human resources for health (115) followed by health financing (33), access to medicine (27), and role of the non-state sector (25). Authors based in the region produced only three systematic reviews addressing regional priorities (1.5%). Furthermore, no systematic review focused on the Eastern Mediterranean region. Primary studies from the region had limited contribution to systematic reviews; 17 systematic reviews (8.5%) included primary studies conducted in the region. Conclusions There are still gaps in the production of systematic reviews addressing policymakers’ and stakeholders’ priorities in the Eastern Mediterranean region. Efforts should be directed towards better aligning systematic review production with policy needs and priorities. Study findings can inform the agendas of researchers, research institutions, and international funding agencies of priority areas where systematic reviews are required. PMID:25139256

What Are the Risks of Vasectomy?

MedlinePlus

... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

Health assessment for Koppers Company, Inc. , National Priorities List (NPL) Site, Texarkana, Texas, Region 6. CERCLIS No. TXD980623904. Final report

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

Not Available

The Koppers Company, Inc. Site located in Texarkana, Texas is on the National Priorities List. The site is the former location of a wood treatment facility. The site is contaminated with numerous chemicals from the former wood treatment operations including polyaromatic hydrocarbons (PAH), phenolic compounds, polychlorinated dibenzofurans (PCDF). Previous remedial activity has included reseeding and the installation of sod in highly contaminated residential areas. The primary environmental pathways of potential concern are surface soils and ground water. Long-term exposures to contaminated soils in the residential area pose a potential health risk for ingestion and dermal absorption of soil contaminants. Groundmore » water beneath the site is contaminated and would pose a potential health risk if used for potable purposes.« less