The normative dimension and legal meaning of endangered and recovery in the U.S. Endangered Species Act.

PubMed

Vucetich, John A; Nelson, Michael P; Phillips, Michael K

2006-10-01

The ethical, legal, and social significance of the U.S. Endangered Species Act of 1973 (ESA) is widely appreciated. Much of the significance of the act arises from the legal definitions that the act provides for the terms threatened species and endangered species. The meanings of these terms are important because they give legal meaning to the concept of a recovered species. Unfortunately, the meanings of these terms are often misapprehended and rarely subjected to formal analysis. We analyzed the legal meaning of recovered species and illustrate key points with details from "recovery" efforts for the gray wolf (Canis lupus). We focused on interpreting the phrase "significant portion of its range," which is part of the legal definition of endangered species. We argue that recovery and endangerment entail a fundamentally normative dimension (i.e., specifying conditions of endangerment) and a fundamentally scientific dimension (i.e., determining whether a species meets the conditions of endangerment). Specifying conditions for endangerment is largely normative because it judges risks of extinction to be either acceptable or unacceptable. Like many other laws that specify what is unacceptable, the ESA largely specifies the conditions that constitute unacceptable extinction risk. The ESA specifies unacceptable risks of extinction by defining endangered species in terms of the portion of a species' range over which a species is "in danger of extinction." Our analysis indicated that (1) legal recovery entails much more than the scientific notion of population viability, (2) most efforts to recover endangered species are grossly inadequate, and (3) many unlisted species meet the legal definition of an endangered or threatened species.

40 CFR Appendix B to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes

Code of Federal Regulations, 2010 CFR

2010-07-01

... Use Conditions Substitutes Application Substitute Decision Conditions Comments Electronics Cleaning w.... Electronics cleaning w/CFC-113 Dibromomethane Unacceptable High ODP; other alternatives exist. Electronics...

Improving Public Health through Innovations in Exposure Science

EPA Science Inventory

In the traditional risk assessment paradigm, exposure science is relegated to a supporting role, providing an exposure estimate for comparison with hazard-based guidance values to determine whether there may be an unacceptable risk to public health. More recently, exposure scien...

Transapical Implantation of a 2nd-Generation JenaValve Device in Patient with Extremely High Surgical Risk

PubMed Central

Mieres, Juan; Menéndez, Marcelo; Fernández-Pereira, Carlos; Rubio, Miguel; Rodríguez, Alfredo E.

2015-01-01

Transcatheter Aortic Valve Replacement (TAVR) is performed in patients who are poor surgical candidates. Many patients have inadequate femoral access, and alternative access sites have been used such as the transapical approach discussed in this paper. We present an elderly and fragile patient not suitable for surgery for unacceptable high risk, including poor ventricular function, previous myocardial infarction with percutaneous coronary intervention, pericardial effusion, and previous cardiac surgery with replacement of mechanical mitral valve. Transapical aortic valve replacement with a second-generation self-expanding JenaValve is performed. The JenaValve is a second-generation transapical TAVR valve consisting of a porcine root valve mounted on a low-profile nitinol stent. The valve is fully retrievable and repositionable. We discuss transapical access, implantation technique, and feasibility of valve implantation in this extremely high surgical risk patient. PMID:26346128

Transapical Implantation of a 2nd-Generation JenaValve Device in Patient with Extremely High Surgical Risk.

PubMed

Mieres, Juan; Menéndez, Marcelo; Fernández-Pereira, Carlos; Rubio, Miguel; Rodríguez, Alfredo E

2015-01-01

Transcatheter Aortic Valve Replacement (TAVR) is performed in patients who are poor surgical candidates. Many patients have inadequate femoral access, and alternative access sites have been used such as the transapical approach discussed in this paper. We present an elderly and fragile patient not suitable for surgery for unacceptable high risk, including poor ventricular function, previous myocardial infarction with percutaneous coronary intervention, pericardial effusion, and previous cardiac surgery with replacement of mechanical mitral valve. Transapical aortic valve replacement with a second-generation self-expanding JenaValve is performed. The JenaValve is a second-generation transapical TAVR valve consisting of a porcine root valve mounted on a low-profile nitinol stent. The valve is fully retrievable and repositionable. We discuss transapical access, implantation technique, and feasibility of valve implantation in this extremely high surgical risk patient.

24 CFR 1000.428 - For what reasons may HUD disapprove an application or approve an application for an amount less...

Code of Federal Regulations, 2011 CFR

2011-04-01

... following reasons: (a) HUD determines that the guarantee constitutes an unacceptable risk. Factors that will be considered in assessing financial risk shall include, but not be limited to, the following: (1...

24 CFR 1000.428 - For what reasons may HUD disapprove an application or approve an application for an amount less...

Code of Federal Regulations, 2010 CFR

2010-04-01

... following reasons: (a) HUD determines that the guarantee constitutes an unacceptable risk. Factors that will be considered in assessing financial risk shall include, but not be limited to, the following: (1...

Australian Defence Risk Management Framework: A Comparative Study

DTIC Science & Technology

2005-02-01

disadvantage or gain. There may be a range of possible outcomes associated with an event. Definition 1.3.3 Event An incident or situation, which occurs in a...prohibitive insurance costs. Sometimes, advantages may far outweigh disadvantages making risk more justifiable. The unacceptable risks are...objectives, work culture and risk management approaches. Globalisation and introduction of new technologies have significantly complicated the situation

The Aggregate Exposure Pathway (AEP): A conceptual framework for advancing exposure science research and applications

EPA Science Inventory

Historically, risk assessment has relied upon toxicological data to obtain hazard-based reference levels, which are subsequently compared to exposure estimates to determine whether an unacceptable risk to public health may exist. Recent advances in analytical methods, biomarker ...

Trade and food safety aspects for animal influenza viruses

USDA-ARS?s Scientific Manuscript database

The World Organization for Animal Health provides sanitary standards for international trade and emphasizes science-based risk assessment for safe trade of animals and animal products. The goal is to prevent unacceptable risks to animal and human health while avoiding unjustified or politically mot...

[Fast food promotes weight gain].

PubMed

Stender, Steen; Dyerberg, Jørn; Astrup, Arne V

2007-05-07

The total amounts of fat in a fast food menu consisting of French fries and fried Chicken Nuggets from McDonald's and KFC, respectively, bought in 35 different countries vary from 41 to 71 gram. In most countries the menu contained unacceptably high amounts of industrially-produced trans fat which contributes to an increased risk of ischaemic heart disease, weight gain, abdominal fat accumulation and type 2 diabetes. The quality of the ingredients in fast food ought to be better and the size of the portions smaller and less energy-dense so that frequent fast food meals do not increase the risk of obesity and diseases among customers.

40 CFR 164.133 - Emergency waiver of hearing.

Code of Federal Regulations, 2013 CFR

2013-07-01

... prevent an unacceptable risk: (i) To human health, or (ii) to fish or wildlife populations when such use would not pose a human health hazard; and (2) That there is no other feasible solution to such risk; and (3) That the time available to avert the risk to human health or fish and wildlife is insufficient to...

40 CFR 164.133 - Emergency waiver of hearing.

Code of Federal Regulations, 2012 CFR

2012-07-01

... prevent an unacceptable risk: (i) To human health, or (ii) to fish or wildlife populations when such use would not pose a human health hazard; and (2) That there is no other feasible solution to such risk; and (3) That the time available to avert the risk to human health or fish and wildlife is insufficient to...

40 CFR 164.133 - Emergency waiver of hearing.

Code of Federal Regulations, 2010 CFR

2010-07-01

... prevent an unacceptable risk: (i) To human health, or (ii) to fish or wildlife populations when such use would not pose a human health hazard; and (2) That there is no other feasible solution to such risk; and (3) That the time available to avert the risk to human health or fish and wildlife is insufficient to...

40 CFR 164.133 - Emergency waiver of hearing.

Code of Federal Regulations, 2014 CFR

2014-07-01

... prevent an unacceptable risk: (i) To human health, or (ii) to fish or wildlife populations when such use would not pose a human health hazard; and (2) That there is no other feasible solution to such risk; and (3) That the time available to avert the risk to human health or fish and wildlife is insufficient to...

40 CFR 164.133 - Emergency waiver of hearing.

Code of Federal Regulations, 2011 CFR

2011-07-01

... prevent an unacceptable risk: (i) To human health, or (ii) to fish or wildlife populations when such use would not pose a human health hazard; and (2) That there is no other feasible solution to such risk; and (3) That the time available to avert the risk to human health or fish and wildlife is insufficient to...

The relation of childhood trauma to suicide ideation in patients suffering from obsessive-compulsive disorder with lifetime suicide attempts.

PubMed

Khosravani, Vahid; Kamali, Zoleikha; Jamaati Ardakani, Razieh; Samimi Ardestani, Mehdi

2017-09-01

The aim of this study was to evaluate the relations of childhood trauma (CT) and obsessive-compulsive (OC) symptom dimensions to suicide ideation in patients with obsessive-compulsive disorder (OCD). Seventy OCD outpatients with lifetime suicide attempts and 60 controls were included. Participants completed the Scale for Suicide Ideation (SSI), the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). Among OCD patients, 97.1% had current suicide ideation. OCD patients revealed higher scores on CT, suicide ideation, depression and anxiety than controls. The CT history of sexual abuse (SA) and OC symptom dimension of unacceptable thoughts explained suicide ideation. It was concluded that SA and unacceptable thoughts may contribute to high suicidality and have important implications for the assessment and treatment of suicide risk in OCD patients with lifetime suicide attempts. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Superfund: Contaminated Sediments

EPA Pesticide Factsheets

Contaminated sediments are a significant environmental problem and contribute to the over 3,200 fish consumption advisories nationwide. The Superfund program cleans up sediment sites that present an unacceptable risk to human health or the environment.

Development of a pest risk analysis for Phytophthora ramorum for the European Union; the key deliverable from the EU-Funded project RAPRA

Treesearch

Claire Sansford; Alan Inman; Joan Webber

2010-01-01

Pest Risk Analysis (PRA) is an internationally recognized, structured process of determining whether plant pests and pathogens that are absent from a country or area could enter, establish, and cause an economic or environmental risk that is deemed unacceptable. PRA is also used to help identify phytosanitary measures to reduce risks to an acceptable level. United...

Occurrence of Organic Wastewater Contaminants, Pharmaceuticals, and Personal Care Products in Selected Water Supplies, Cape Cod, Massachusetts, June 2004

DTIC Science & Technology

2005-01-01

previously detected high nitrate concen- trations. (Phenol and d- limonene , detected in equipment blanks at unacceptably high concentrations, are not...both tables, were not counted twice. (Phenol and d- limonene , detected in equipment blanks at unaccept- ably high concentrations, are not included in...The surrogate recoveries (not included in table 2) for the PPCP method were 101 and 102 percent. Three compounds, d- limonene , phenol, and

Structural and Social Contexts of HIV Risk Among African Americans

PubMed Central

Cooper, Hannah L. F.; Osborne, Andrew H.

2009-01-01

HIV continues to be transmitted at unacceptably high rates among African Americans, and most HIV-prevention interventions have focused on behavioral change. To theorize additional approaches to HIV prevention among African Americans, we discuss how sexual networks and drug-injection networks are as important as behavior for HIV transmission. We also describe how higher-order social structures and processes, such as residential racial segregation and racialized policing, may help shape risk networks and behaviors. We then discuss 3 themes in African American culture—survival, propriety, and struggle—that also help shape networks and behaviors. Finally, we conclude with a discussion of how these perspectives might help reduce HIV transmission among African Americans. PMID:19372519

Cancer Risk Assessment in Welder's Under Different Exposure Scenarios.

PubMed

Barkhordari, Abolfazl; Zare Sakhvidi, Mohammad Javad; Zare Sakhvidi, Fariba; Halvani, Gholamhossein; Firoozichahak, Ali; Shirali, GholamAbbas

2014-05-01

Welders exposure to nickel and hexavalent chromium in welding fumes is associated with increase of cancer risk in welders. In this study we calculated cancer risk due to exposure to these compounds in welders. The role of exposure parameters in welders on derived incremental lifetime cancer risk were determined by stochastic modeling of cancer risk. Input parameters were determined by field investigation in Iranian welders in 2013 and literature review. The 90% upper band cancer risk due to hexavalent chromium and nickel exposure was in the range of 6.03E-03 to 2.12E-02 and 7.18E-03 to 2.61E-02 respectively. Scenario analysis showed that asthmatic and project welders are significantly at higher cancer risk in comparison with other welders (P<0.05). Shift duration was responsible for 37% and 33% of variances for hexavalent chromium and nickel respectively. Welders are at high and unacceptable risk of cancer. Control measures according to scenario analysis findings are advisable.

DESIGN CONSIDERATION INVOLVING ACTIVE SEDIMENT CAPS

EPA Science Inventory

When contaminated sediments pose unacceptable risks to human health and the environment, management activities such as removal, treatment, or isolation of contaminated sediments may be required. Various capping designs are being considered for isolating contaminated sediment are...

Microbiological safety of retail vacuum-packed and modified-atmosphere-packed cooked meats at end of shelf life.

PubMed

Sagoo, S K; Little, C L; Allen, G; Williamson, K; Grant, K A

2007-04-01

A study of retail modified-atmosphere-packed and vacuum-packed cooked ready-to-eat meats was undertaken from September through mid-November 2003 to determine the microbiological quality at the end of shelf life and to establish any risk factors in the production, storage, and display of this product. Examination of 2,981 samples using Microbiological Guidelines criteria revealed that 66% were of satisfactory or acceptable microbiology quality, 33% were of unsatisfactory quality mainly due to high aerobic colony counts and Enterobacteriaceae concentrations, and 1% were of unacceptable quality due to the presence of Listeria monocytogenes at 100 CFU/g or higher (27 samples; range of 10(2) to 106 CFU/g) and Campylobacter jejuni (1 sample), indicating a risk to health. All samples at the end of the shelf life had satisfactory (<20 CFU/g) and/or acceptable (<102 CFU/g) levels of Staphylococcus aureus and Clostridium perfringens, four samples (<1%) had unsatisfactory levels of Escherichia coli (range of 102 to 106 CFU/g) and 5.5% of the samples contained L. monocytogenes at <20 CFU/g (4.8%) or between 20 and 100 CFU/g (0.7%). More samples of chicken (45%; 224 of 495 samples), beef (43%; 160 of 371 samples), and turkey (41%; 219 of 523 samples) were of unsatisfactory or unacceptable quality compared with ham (23%; 317 of 1,351 samples) or pork (32%; 67 of 206 samples). Twelve different L. monocytogenes typing characters (serotype-amplified fragment length polymorphism type-phage type) were evaluated for isolates recovered from samples of unacceptable quality, and the 1/2-IX-NT type was recovered from almost half (48%) of these samples. Salmonella was not detected in any samples examined. Risk factors identified for cooked meats that were microbiologically contaminated more frequently included vacuum packaging, packaging on retail premises, slicing, temperature not monitored in display units, and no hazard analysis system in place. Results from this study also suggest that the shelf life assigned to some modified-atmosphere-packed and vacuum-packed meats may not be appropriate.

Influence of season and type of restaurants on sashimi microbiota.

PubMed

Miguéis, S; Moura, A T; Saraiva, C; Esteves, A

2016-10-01

In recent years, an increase in the consumption of Japanese food in European countries has been verified, including in Portugal. These specialities made with raw fish, typical Japanese meals, have been prepared in typical and on non-typical restaurants, and represent a challenge to risk analysis on HACCP plans. The aim of this study was to evaluate the influence of the type of restaurant, season and type of fish used on sashimi microbiota. Sashimi samples (n = 114) were directly collected from 23 sushi restaurants and were classified as Winter and Summer Samples. They were also categorized according to the type of restaurant where they were obtained: as typical or non-typical. The samples were processed using international standards procedures. A middling seasonality influence was observed in microbiota using mesophilic aerobic bacteria, psychrotrophic microorganisms, Lactic acid bacteria, Pseudomonas spp., H 2 S positive bacteria, mould and Bacillus cereus counts parameters. During the Summer Season, samples classified as unacceptable or potentially Hazardous were observed. Non-typical restaurants had the most cases of Unacceptable/potentially hazardous samples 83.33%. These unacceptable results were obtained as a result of high values of pathogenic bacteria like Listeria monocytogenes and Staphylococcus aureus No significant differences were observed on microbiota counts from different fish species. The need to implement more accurate food safety systems was quite evident, especially in the warmer season, as well as in restaurants where other kinds of food, apart from Japanese meals, was prepared. © Crown copyright 2016.

Chemical and chemically-related considerations associated with sluicing tank C-106 waste to tank AY-102

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

Reynolds, D.A.

1997-04-04

New data on tank 241-C-106 were obtained from grab sampling and from compatibility testing of tank C-106 and tank AY-102 wastes. All chemistry-associated and other compatibility Information compiled in this report strongly suggests that the sluicing of the contents of tank C-106, in accord with appropriate controls, will pose no unacceptable risk to workers, public safety, or the environment. In addition, it is expected that the sluicing operation will successfully resolve the High-Heat Safety Issue for tank C-106.

Cryptococcal meningitis: epidemiology and therapeutic options

PubMed Central

Sloan, Derek J; Parris, Victoria

2014-01-01

Cryptococcal meningitis causes morbidity and mortality worldwide. The burden of disease is greatest in middle- and low-income countries with a high incidence of human immunodeficiency virus (HIV) infection. Patients taking immunosuppressive drugs and some immunocompetent hosts are also at risk. Treatment of cryptococcal meningitis consists of three phases: induction, consolidation, and maintenance. Effective induction therapy requires potent fungicidal drugs (amphotericin B and flucytosine), which are often unavailable in low-resource, high-endemicity settings. As a consequence, mortality is unacceptably high. Wider access to effective treatment is urgently required to improve outcomes. For human immunodeficiency virus-infected patients, judicious management of asymptomatic cryptococcal antigenemia and appropriately timed introduction of antiretroviral therapy are important. PMID:24872723

Overview of SNAP

EPA Pesticide Factsheets

Section 612(c) of the Clean Air Act (CAA) requires the Agency to publish a list of acceptable and unacceptable substitutes for ozone-depleting substances (ODS). The SNAP program does not require that substitutes be risk- free to be found acceptable.

DESIGN CONSIDERATION INVOLVING ACTIVE SEDIMENT CAPS (PRESENTATION)

EPA Science Inventory

When contaminated sediments pose unacceptable risks to human health and the environment, management activities such as removal, treatment, or isolation of contaminated sediments may be required. Various capping designs are being considered for isolating contaminated sediment are...

Guidelines for contingency planning NASA (National Aeronautics and Space Administration) ADP security risk reduction decision studies

NASA Technical Reports Server (NTRS)

Tompkins, F. G.

1984-01-01

Guidance is presented to NASA Computer Security Officials for determining the acceptability or unacceptability of ADP security risks based on the technical, operational and economic feasibility of potential safeguards. The risk management process is reviewed as a specialized application of the systems approach to problem solving and information systems analysis and design. Reporting the results of the risk reduction analysis to management is considered. Report formats for the risk reduction study are provided.

Validation of the CME Geomagnetic Forecast Alerts Under the COMESEP Alert System

NASA Astrophysics Data System (ADS)

Dumbović, Mateja; Srivastava, Nandita; Rao, Yamini K.; Vršnak, Bojan; Devos, Andy; Rodriguez, Luciano

2017-08-01

Under the European Union 7th Framework Programme (EU FP7) project Coronal Mass Ejections and Solar Energetic Particles (COMESEP, http://comesep.aeronomy.be), an automated space weather alert system has been developed to forecast solar energetic particles (SEP) and coronal mass ejection (CME) risk levels at Earth. The COMESEP alert system uses the automated detection tool called Computer Aided CME Tracking (CACTus) to detect potentially threatening CMEs, a drag-based model (DBM) to predict their arrival, and a CME geoeffectiveness tool (CGFT) to predict their geomagnetic impact. Whenever CACTus detects a halo or partial halo CME and issues an alert, the DBM calculates its arrival time at Earth and the CGFT calculates its geomagnetic risk level. The geomagnetic risk level is calculated based on an estimation of the CME arrival probability and its likely geoeffectiveness, as well as an estimate of the geomagnetic storm duration. We present the evaluation of the CME risk level forecast with the COMESEP alert system based on a study of geoeffective CMEs observed during 2014. The validation of the forecast tool is made by comparing the forecasts with observations. In addition, we test the success rate of the automatic forecasts (without human intervention) against the forecasts with human intervention using advanced versions of the DBM and CGFT (independent tools available at the Hvar Observatory website, http://oh.geof.unizg.hr). The results indicate that the success rate of the forecast in its current form is unacceptably low for a realistic operation system. Human intervention improves the forecast, but the false-alarm rate remains unacceptably high. We discuss these results and their implications for possible improvement of the COMESEP alert system.

Analysis of en route operational errors : probability of resolution and time-on-position.

DOT National Transportation Integrated Search

2012-02-01

The Federation Administrations Air Traffic Control Organization Safety Management System (SMS) is : designed to prevent the introduction of unacceptable safety risk into the National Airspace System. One of the : most important safety metrics used...

Risk management analysis for construction of Kutai Kartanegara bridge-East Kalimantan-Indonesia

NASA Astrophysics Data System (ADS)

Azis, Subandiyah

2017-11-01

Many sources of risk that may impede the achievement of the project objectives through either cost or quality and time, especially for bridges that have collapsed before, so when the implementation of possible hazard / high hazard so when should the possible hazard/high hazard be implemented The purpose of this research is to identify, to analyze risks by classifying the risks using the method of Risk Breakdown Structure (RBS) and managing the dominant risk of execution of the installation work to determine the handling of the steel frame in order to maximize the positive and minimize the incidence of adverse events. The results of this study indicate there are 15 sources of risks are identified, and there are 6 risk indicates the dominant risks. Mitigation performed on the dominant risks unacceptable i.e. Project factor that shows the delays in the arrival of materials due to locations, schedule of the arrival of materials should be tailored to the needs of the field and the amount of material that comes with the required field should also be evaluated. The result is expected to be a guideline for identifying risks and mitigation measures for further research. Subsequent researchers to pay attention on the security factor that implementation time does not affect the productivity of work in construction projects.

Risk management for the Space Exploration Initiative

NASA Technical Reports Server (NTRS)

Buchbinder, Ben

1993-01-01

Probabilistic Risk Assessment (PRA) is a quantitative engineering process that provides the analytic structure and decision-making framework for total programmatic risk management. Ideally, it is initiated in the conceptual design phase and used throughout the program life cycle. Although PRA was developed for assessment of safety, reliability, and availability risk, it has far greater application. Throughout the design phase, PRA can guide trade-off studies among system performance, safety, reliability, cost, and schedule. These studies are based on the assessment of the risk of meeting each parameter goal, with full consideration of the uncertainties. Quantitative trade-off studies are essential, but without full identification, propagation, and display of uncertainties, poor decisions may result. PRA also can focus attention on risk drivers in situations where risk is too high. For example, if safety risk is unacceptable, the PRA prioritizes the risk contributors to guide the use of resources for risk mitigation. PRA is used in the Space Exploration Initiative (SEI) Program. To meet the stringent requirements of the SEI mission, within strict budgetary constraints, the PRA structure supports informed and traceable decision-making. This paper briefly describes the SEI PRA process.

Large-scale retrospective evaluation of regulated liquid chromatography-mass spectrometry bioanalysis projects using different total error approaches.

PubMed

Tan, Aimin; Saffaj, Taoufiq; Musuku, Adrien; Awaiye, Kayode; Ihssane, Bouchaib; Jhilal, Fayçal; Sosse, Saad Alaoui; Trabelsi, Fethi

2015-03-01

The current approach in regulated LC-MS bioanalysis, which evaluates the precision and trueness of an assay separately, has long been criticized for inadequate balancing of lab-customer risks. Accordingly, different total error approaches have been proposed. The aims of this research were to evaluate the aforementioned risks in reality and the difference among four common total error approaches (β-expectation, β-content, uncertainty, and risk profile) through retrospective analysis of regulated LC-MS projects. Twenty-eight projects (14 validations and 14 productions) were randomly selected from two GLP bioanalytical laboratories, which represent a wide variety of assays. The results show that the risk of accepting unacceptable batches did exist with the current approach (9% and 4% of the evaluated QC levels failed for validation and production, respectively). The fact that the risk was not wide-spread was only because the precision and bias of modern LC-MS assays are usually much better than the minimum regulatory requirements. Despite minor differences in magnitude, very similar accuracy profiles and/or conclusions were obtained from the four different total error approaches. High correlation was even observed in the width of bias intervals. For example, the mean width of SFSTP's β-expectation is 1.10-fold (CV=7.6%) of that of Saffaj-Ihssane's uncertainty approach, while the latter is 1.13-fold (CV=6.0%) of that of Hoffman-Kringle's β-content approach. To conclude, the risk of accepting unacceptable batches was real with the current approach, suggesting that total error approaches should be used instead. Moreover, any of the four total error approaches may be used because of their overall similarity. Lastly, the difficulties/obstacles associated with the application of total error approaches in routine analysis and their desirable future improvements are discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

Risk assessment of debris flow in Yushu seismic area in China: a perspective for the reconstruction

NASA Astrophysics Data System (ADS)

Lan, H. X.; Li, L. P.; Zhang, Y. S.; Gao, X.; Liu, H. J.

2013-11-01

The 14 April 2010 Ms = 7.1 Yushu Earthquake (YE) had caused severe damage in the Jiegu township, the residential centre of Yushu Tibetan Autonomous Prefecture, Qinghai Province, China. In view of the fragile geological conditions after YE, risk assessment of secondary geohazards becomes an important concern for the reconstruction. A quantitative methodology was developed to assess the risk of debris flow by taking into account important intensity information. Debris flow scenarios were simulated with respect to rainfall events with 10, 50 and 100 yr returning period, respectively. The possible economic loss and fatalities caused by damage to buildings were assessed both in the settlement area and in the low hazard settlement area regarding the simulated debris flow events. Three modelled building types were adopted, i.e. hollow brick wood (HBW), hollow brick concrete (HBC) and reinforced concrete (RC) buildings. The results suggest that HBC structure achieves a good balance for the cost-benefit relationship compared with HBW and RC structures and thus could be an optimal choice for most of the new residential buildings in the Jiegu township. The low hazard boundary presents significant risk reduction efficiency in the 100 yr returning debris flow event. In addition, the societal risk for the settlement area is unacceptable when the 100 yr returning event occurs but reduces to ALARP (as low as reasonably practicable) level as the low hazard area is considered. Therefore, the low hazard area was highly recommended to be taken into account in the reconstruction. Yet, the societal risk might indeed approach an unacceptable level if one considers that YE has inevitably increased the occurrence frequency of debris flow. The quantitative results should be treated as a perspective for the reconstruction rather than precise numbers of future losses, owing to the complexity of the problem and the deficiency of data.

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

PubMed

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

2017-01-01

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

Cross-infection risks associated with current procedures for using high-speed dental handpieces.

PubMed Central

Lewis, D L; Boe, R K

1992-01-01

When a dye solution used to simulate patient material was either injected into high-speed dental handpiece (drill) waterlines or applied to the equipment externally, internal air turbine chambers became contaminated. These chambers served as a reservoir of the material, which was slowly dislodged by air expelled during subsequent handpiece operation and which was diluted by water spray used for cooling the drilling surface. Considering the fact that patient materials could reside in internal parts of the equipment that are not usually disinfected and that the material may be subsequently sprayed into cuts and abrasions in the oral cavity, the common approach to reprocessing handpieces (external wiping in combination with flushing) may pose unacceptably high risks to those individuals treated soon after infected patients. Therefore, unless reliable data on cross-infection frequencies are obtained and prove it unnecessary, heat-treating high-speed handpieces between each patient should be considered an essential component of standard procedures whenever universal precautions are practiced in dentistry. PMID:1537909

GEOCHEMICAL AND INTERFACIAL APPLICATIONS FOR ASSESSING ECOLOGICAL TOXICANT EXPOSURES

EPA Science Inventory

Numerous publications in the past several years have demonstrated that a significant fraction of our nation's waterbodies and associated underlying sediments contain sufficient quantities of contaminants such that they pose unacceptable risks to both wildlife and human health. I...

Project TENDR: Targeting Environmental Neuro-Developmental Risks The TENDR Consensus Statement

PubMed Central

Bennett, Deborah; Bellinger, David C.; Birnbaum, Linda S.; Bradman, Asa; Chen, Aimin; Cory-Slechta, Deborah A.; Engel, Stephanie M.; Fallin, M. Daniele; Halladay, Alycia; Hauser, Russ; Hertz-Picciotto, Irva; Kwiatkowski, Carol F.; Lanphear, Bruce P.; Marquez, Emily; Marty, Melanie; McPartland, Jennifer; Newschaffer, Craig J.; Payne-Sturges, Devon; Patisaul, Heather B.; Perera, Frederica P.; Ritz, Beate; Sass, Jennifer; Schantz, Susan L.; Webster, Thomas F.; Whyatt, Robin M.; Woodruff, Tracey J.; Zoeller, R. Thomas; Anderko, Laura; Campbell, Carla; Conry, Jeanne A.; DeNicola, Nathaniel; Gould, Robert M.; Hirtz, Deborah; Huffling, Katie; Landrigan, Philip J.; Lavin, Arthur; Miller, Mark; Mitchell, Mark A.; Rubin, Leslie; Schettler, Ted; Tran, Ho Luong; Acosta, Annie; Brody, Charlotte; Miller, Elise; Miller, Pamela; Swanson, Maureen; Witherspoon, Nsedu Obot

2016-01-01

Summary: Children in America today are at an unacceptably high risk of developing neurodevelopmental disorders that affect the brain and nervous system including autism, attention deficit hyperactivity disorder, intellectual disabilities, and other learning and behavioral disabilities. These are complex disorders with multiple causes—genetic, social, and environmental. The contribution of toxic chemicals to these disorders can be prevented. Approach: Leading scientific and medical experts, along with children’s health advocates, came together in 2015 under the auspices of Project TENDR: Targeting Environmental Neuro-Developmental Risks to issue a call to action to reduce widespread exposures to chemicals that interfere with fetal and children’s brain development. Based on the available scientific evidence, the TENDR authors have identified prime examples of toxic chemicals and pollutants that increase children’s risks for neurodevelopmental disorders. These include chemicals that are used extensively in consumer products and that have become widespread in the environment. Some are chemicals to which children and pregnant women are regularly exposed, and they are detected in the bodies of virtually all Americans in national surveys conducted by the U.S. Centers for Disease Control and Prevention. The vast majority of chemicals in industrial and consumer products undergo almost no testing for developmental neurotoxicity or other health effects. Conclusion: Based on these findings, we assert that the current system in the United States for evaluating scientific evidence and making health-based decisions about environmental chemicals is fundamentally broken. To help reduce the unacceptably high prevalence of neurodevelopmental disorders in our children, we must eliminate or significantly reduce exposures to chemicals that contribute to these conditions. We must adopt a new framework for assessing chemicals that have the potential to disrupt brain development and prevent the use of those that may pose a risk. This consensus statement lays the foundation for developing recommendations to monitor, assess, and reduce exposures to neurotoxic chemicals. These measures are urgently needed if we are to protect healthy brain development so that current and future generations can reach their fullest potential. PMID:27479987

[The application of two occupation health risk assessment models in a wooden furniture manufacturing industry].

PubMed

Wang, A H; Leng, P B; Bian, G L; Li, X H; Mao, G C; Zhang, M B

2016-10-20

Objective: To explore the applicability of 2 different models of occupational health risk assessment in wooden furniture manufacturing industry. Methods: American EPA inhalation risk model and ICMM model of occupational health risk assessment were conducted to assess occupational health risk in a small wooden furniture enterprises, respectively. Results: There was poor protective measure and equipment of occupational disease in the plant. The concentration of wood dust in the air of two workshops was over occupational exposure limit (OEL) , and the C TWA was 8.9 mg/m 3 and 3.6 mg/m 3 , respectively. According to EPA model, the workers who exposed to benzene in this plant had high risk (9.7×10 -6 ~34.3×10 -6 ) of leukemia, and who exposed to formaldehyde had high risk (11.4 × 10 -6 ) of squamous cell carcinoma. There were inconsistent evaluation results using the ICMM tools of standard-based matrix and calculated risk rating. There were very high risks to be attacked by rhinocarcinoma of the workers who exposed to wood dust for the tool of calculated risk rating, while high risk for the tool of standard-based matrix. For the workers who exposed to noise, risk of noise-induced deafness was unacceptable and medium risk using two tools, respectively. Conclusion: Both EPA model and ICMM model can appropriately predict and assessthe occupational health risk in wooden furniture manufactory, ICMM due to the relatively simple operation, easy evaluation parameters, assessment of occupational - disease - inductive factors comprehensively, and more suitable for wooden furniture production enterprise.

A Comparison of Spectacles Purchased Online and in UK Optometry Practice.

PubMed

Alderson, Alison J; Green, Alison; Whitaker, David; Scally, Andrew J; Elliott, David B

2016-10-01

To compare spectacles bought online with spectacles from optometry practices. Thirty-three participants consisting of single vision spectacle wearers with either a low (N = 12, mean age 34 ± 14 years) or high prescription (N = 11, mean age 28 ± 9 years) and 10 presbyopic participants (mean age 59 ± 4 years) wearing progressive addition lenses (PALs) purchased 154 pairs of spectacles online and 154 from UK optometry practices. The spectacles were compared via participant-reported preference, acceptability, and safety; the assessment of lens, frame, and fit quality; and the accuracy of the lens prescriptions to international standard ISO 21987:2009. Participants preferred the practice spectacles (median ranking 4th, IQR 1-6) more than online (6th, IQR 4-8; Mann-Whitney U = 7345, p < 0.001) and practice PALs (median ranking 2nd, IQR 1-4) were particularly preferred (online 6.5th, IQR 4-9, Mann-Whitney U = 455, p < 0.001). Of those deemed unacceptable and unsafe, significantly more were bought online (unacceptable: online 43/154 vs. practice 15/154, Fisher's exact p = 0.0001; unsafe: online 14/154 vs. practice 5/154, Fisher's exact p = 0.03). Participants preferred spectacles from optometry practice rather than those bought online, despite lens quality and prescription accuracy being similar. A greater number of online spectacles were deemed unsafe or unacceptable because of poor spectacle frame fit, poor cosmetic appearance, and inaccurate optical centration. This seems particularly pertinent to PAL lenses, which are known to increase falls risk. Recommendations are made to improve both forms of spectacle provision.

7 CFR 1753.1 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... unacceptable loan security risks to RUS. (4) The P&S or contract have been modified. (e) The requirements and... Telecommunications Loan Documents contain provisions regarding procurement of materials and equipment and... and procedures whenever using loan funds to purchase materials and equipment or perform construction...

7 CFR 1737.41 - Procedure for obtaining approval.

Code of Federal Regulations, 2010 CFR

2010-01-01

... RUS financing. (3) The proposed interim financing presents unacceptable loan security risks to RUS, or..., DEPARTMENT OF AGRICULTURE PRE-LOAN POLICIES AND PROCEDURES COMMON TO INSURED AND GUARANTEED TELECOMMUNICATIONS LOANS Interim Financing of Construction of Telephone Facilities § 1737.41 Procedure for obtaining...

The case against libertarian arguments for compulsory vaccination.

PubMed

Bernstein, Justin

2017-11-01

In a recent paper in this journal, Jason Brennan correctly notes that libertarians struggle to justify a policy of compulsory vaccination. The most straightforward argument that justifies compulsory vaccination is that such a policy promotes welfare. But libertarians cannot make this argument because they claim that the state is justified only in protecting negative rights, not in promoting welfare. I consider two representative libertarian attempts to justify compulsory vaccination, and I argue that such arguments are unsuccessful. They either fail to show that the state is justified in implementing the policy or overgeneralise. I suggest that Brennan's solution is especially well motivated insofar as it addresses the shortcomings of these arguments. Brennan argues that we violate the rights of others by participating in an activity that imposes an unacceptable collective risk of harm. Going unvaccinated is an activity that imposes an unacceptable collective risk of harm, and thus amounts to a rights violation. So, the state can implement a policy of compulsory vaccination I object, however, that Brennan's delineation of acceptable and unacceptable risk implicitly rests on classical liberal rather than libertarian principles; he justifies compulsory vaccination on the grounds that it promotes welfare. I also object that Brennan's argument would entail significant departures from libertarian institutional arrangements. This leaves libertarians with a choice: they can develop new arguments to demonstrate that their position is compatible with compulsory vaccination, or they can accept that their view entails the impermissibility of compulsory vaccination, and argue that this is not an unpalatable implication of their view. 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/.

A Framework to Evaluate Wildlife Feeding in Research, Wildlife Management, Tourism and Recreation.

PubMed

Dubois, Sara; Fraser, David

2013-10-11

Feeding of wildlife occurs in the context of research, wildlife management, tourism and in opportunistic ways. A review of examples shows that although feeding is often motivated by good intentions, it can lead to problems of public safety and conservation and be detrimental to the welfare of the animals. Examples from British Columbia illustrate the problems (nuisance animal activity, public safety risk) and consequences (culling, translocation) that often arise from uncontrolled feeding. Three features of wildlife feeding can be distinguished: the feasibility of control, the effects on conservation and the effects on animal welfare. An evaluative framework incorporating these three features was applied to examples of feeding from the literature. The cases of feeding for research and management purposes were generally found to be acceptable, while cases of feeding for tourism or opportunistic feeding were generally unacceptable. The framework should allow managers and policy-makers to distinguish acceptable from unacceptable forms of wildlife feeding as a basis for policy, public education and enforcement. Many harmful forms of wildlife feeding seem unlikely to change until they come to be seen as socially unacceptable.

Is it safe to perform endoscopic band ligation for the duodenum? A pilot study in ex vivo porcine models.

PubMed

Kakutani, Hiroshi; Sasaki, Shigemasa; Ueda, Kaoru; Takakura, Kazuki; Sumiyama, Kazuki; Imazu, Hiroo; Hino, Syoryoku; Kawamura, Muneo; Tajiri, Hisao

2013-04-01

In the digestive tract, endoscopic band ligation (EBL) has been routinely used for the treatment of variceal bleeding and superficial malignancies. In recent years, endoscopic treatments for duodenal varices, adenoma, and cancer have also actively incorporated EBL. Although there have been a number of reports on the risks associated with the use of EBL in the esophagus, stomach, and colon, few studies have focused on EBL in the duodenum. We performed EBL procedures to evaluate the risks associated with the use of EBL in the duodenum. Overall, EBLs were performed at nine sites in duodenum sampled from a pig immediately after sacrifice. Submucosal saline injections were placed in three of the nine studied sites. Regardless of saline injection, the full thickness of the duodenal wall was ligated in all attempts. Routine EBL is not recommended in the duodenum because the risk of perforation is unacceptably high.

Radiation risk and human space exploration.

PubMed

Schimmerling, W; Cucinotta, F A; Wilson, J W

2003-01-01

Radiation protection is essential to enable humans to live and work safely in space. Predictions about the nature and magnitude of the risks posed by space radiation are subject to very large uncertainties. Prudent use of worst-case scenarios may impose unacceptable constraints on shielding mass for spacecraft or habitats, tours of duty of crews on Space Station, and on the radius and duration of sorties on planetary surfaces. The NASA Space Radiation Health Program has been devised to develop the knowledge required to accurately predict and to efficiently manage radiation risk. The knowledge will be acquired by means of a peer-reviewed, largely ground-based and investigator-initiated, basic science research program. The NASA Strategic Plan to accomplish these objectives in a manner consistent with the high priority assigned to the protection and health maintenance of crews will be presented. Published by Elsevier Science Ltd on behalf of COSPAR.

Radiation risk and human space exploration

NASA Technical Reports Server (NTRS)

Schimmerling, W.; Cucinotta, F. A.; Wilson, J. W.

2003-01-01

Radiation protection is essential to enable humans to live and work safely in space. Predictions about the nature and magnitude of the risks posed by space radiation are subject to very large uncertainties. Prudent use of worst-case scenarios may impose unacceptable constraints on shielding mass for spacecraft or habitats, tours of duty of crews on Space Station, and on the radius and duration of sorties on planetary surfaces. The NASA Space Radiation Health Program has been devised to develop the knowledge required to accurately predict and to efficiently manage radiation risk. The knowledge will be acquired by means of a peer-reviewed, largely ground-based and investigator-initiated, basic science research program. The NASA Strategic Plan to accomplish these objectives in a manner consistent with the high priority assigned to the protection and health maintenance of crews will be presented. Published by Elsevier Science Ltd on behalf of COSPAR.

Estimating risk at a Superfund site using passive sampling devices as biological surrogates in human health risk models.

PubMed

Allan, Sarah E; Sower, Gregory J; Anderson, Kim A

2011-10-01

Passive sampling devices (PSDs) sequester the freely dissolved fraction of lipophilic contaminants, mimicking passive chemical uptake and accumulation by biomembranes and lipid tissues. Public Health Assessments that inform the public about health risks from exposure to contaminants through consumption of resident fish are generally based on tissue data, which can be difficult to obtain and requires destructive sampling. The purpose of this study is to apply PSD data in a Public Health Assessment to demonstrate that PSDs can be used as a biological surrogate to evaluate potential human health risks and elucidate spatio-temporal variations in risk. PSDs were used to measure polycyclic aromatic hydrocarbons (PAHs) in the Willamette River; upriver, downriver and within the Portland Harbor Superfund megasite for 3 years during wet and dry seasons. Based on an existing Public Health Assessment for this area, concentrations of PAHs in PSDs were substituted for fish tissue concentrations. PSD measured PAH concentrations captured the magnitude, range and variability of PAH concentrations reported for fish/shellfish from Portland Harbor. Using PSD results in place of fish data revealed an unacceptable risk level for cancer in all seasons but no unacceptable risk for non-cancer endpoints. Estimated cancer risk varied by several orders of magnitude based on season and location. Sites near coal tar contamination demonstrated the highest risk, particularly during the dry season and remediation activities. Incorporating PSD data into Public Health Assessments provides specific spatial and temporal contaminant exposure information that can assist public health professionals in evaluating human health risks. Copyright © 2011 Elsevier Ltd. All rights reserved.

Estimating risk at a Superfund site using passive sampling devices as biological surrogates in human health risk models

PubMed Central

Allan, Sarah E.; Sower, Gregory J.; Anderson, Kim A.

2013-01-01

Passive sampling devices (PSDs) sequester the freely dissolved fraction of lipophilic contaminants, mimicking passive chemical uptake and accumulation by biomembranes and lipid tissues. Public Health Assessments that inform the public about health risks from exposure to contaminants through consumption of resident fish are generally based on tissue data, which can be difficulties to obtain and requires destructive sampling. The purpose of this study is to apply PSD data in a Public Health Assessment to demonstrate that PSDs can be used as a biological surrogate to evaluate potential human health risks and elucidate spatio-temporal variations in risk. PSDs were used to measure polycyclic aromatic hydrocarbons (PAHs) in the Willamette River; upriver, downriver and within the Portland Harbor Superfund megasite for three years during wet and dry seasons. Based on an existing Public Health Assessment for this area, concentrations of PAHs in PSDs were substituted for fish tissue concentrations. PSD measured PAH concentrations captured the magnitude, range and variability of PAH concentrations reported for fish/shellfish from Portland Harbor. Using PSD results in place of fish data revealed an unacceptable risk level for cancer in all seasons but no unacceptable risk for non-cancer endpoints. Estimated cancer risk varied by several orders of magnitude based on season and location. Sites near coal tar contamination demonstrated the highest risk, particularly during the dry season and remediation activities. Incorporating PSD data into Public Health Assessments provides specific spatial and temporal contaminant exposure information that can assist public health professionals in evaluating human health risks. PMID:21741671

Role of adverse outcome pathways in developing computational models for regulatory toxicology

EPA Science Inventory

Regulatory toxicology for both human health and the environment increasingly is moving from a sole reliance on direct observation of apical toxicity outcomes in whole organism toxicity tests, to predictive approaches in which unacceptable outcomes and risk are inferred from mecha...

Brownfields and health risks--air dispersion modeling and health risk assessment at landfill redevelopment sites.

PubMed

Ofungwu, Joseph; Eget, Steven

2006-07-01

Redevelopment of landfill sites in the New Jersey-New York metropolitan area for recreational (golf courses), commercial, and even residential purposes seems to be gaining acceptance among municipal planners and developers. Landfill gas generation, which includes methane and potentially toxic nonmethane compounds usually continues long after closure of the landfill exercise phase. It is therefore prudent to evaluate potential health risks associated with exposure to gas emissions before redevelopment of the landfill sites as recreational, commercial, and, especially, residential properties. Unacceptably high health risks would call for risk management measures such as limiting the development to commercial/recreational rather than residential uses, stringent gas control mechanisms, interior air filtration, etc. A methodology is presented for applying existing models to estimate residual landfill hazardous compounds emissions and to quantify associated health risks. Besides the toxic gas constituents of landfill emissions, other risk-related issues concerning buried waste, landfill leachate, and explosive gases were qualitatively evaluated. Five contiguously located landfill sites in New Jersey intended for residential and recreational redevelopment were used to exemplify the approach.

The microbiological quality of ready-to-eat foods with added spices.

PubMed

Little, C L; Omotoye, R; Mitchell, R T

2003-03-01

A microbiological study of ready-to-eat foods with added spices or spice ingredients was undertaken to identify any risk factors in the production, storage and display of this product and to establish their effect on microbiological quality. Examination of 1946 ready-to-eat foods from sandwich bars, cafés, public houses, restaurants, specialist sandwich producers, bakers, delicatessens, market stalls and mobile vendors found that 1291 (66%) were of satisfactory/acceptable microbiological quality, 609 (32%) were of unsatisfactory quality, and 46 (2%) were of unacceptable quality. Unacceptable results were due to high levels of B. cereus and/or other Bacillus spp. (>/=10(5) cfu g(-1)). Unsatisfactory results were mostly due to high Aerobic Colony Counts (up to >/=10(7) cfu g(-1)), Enterobacteriaceae (>/=10(4) cfu g(-1)), Escherichia coli (>/=10(2) cfu g(-1)), and Bacillus spp (>/=10(4) cfu g(-1)). Examination of 750 spices and spice ingredients revealed that B. cereus were present in 142 (19%) samples, other Bacillus spp. in 399 (53%) samples, and Salmonella spp. (S. enteritidis PT 11) in one (<1%) sample. Approximately a third (222) of spice and spice ingredients examined contained high counts (>/=10(4) cfu g(-1)) of B. cereus and/or other Bacillus spp., and appeared to be associated with the corresponding ready-to-eat foods containing similar high counts of these organisms (P<0.0001). Acceptable microbiological quality of ready-to-eat foods to which spices or spice ingredients have been added was associated with premises that had management food hygiene training and hazard analysis in place. Poor microbiological quality was associated with preparation on the premises, premises type, little or no confidence in the food business management of food hygiene, and small premises as indicated by local authority inspectors' confidence in management and consumer at risk scores.

Assessing human health risks from pesticide use in conventional and innovative cropping systems with the BROWSE model.

PubMed

Lammoglia, Sabine-Karen; Kennedy, Marc C; Barriuso, Enrique; Alletto, Lionel; Justes, Eric; Munier-Jolain, Nicolas; Mamy, Laure

2017-08-01

Reducing the risks and impacts of pesticide use on human health and on the environment is one of the objectives of the European Commission Directive 2009/128/EC in the quest for a sustainable use of pesticides. This Directive, developed through European national plans such as Ecophyto plan in France, promotes the introduction of innovative cropping systems relying, for example, on integrated pest management. Risk assessment for human health of the overall pesticide use in these innovative systems is required before the introduction of those systems to avoid that an innovation becomes a new problem. The objectives of this work were to assess and to compare (1) the human exposure to pesticides used in conventional and innovative cropping systems designed to reduce pesticide needs, and (2) the corresponding risks for human health. Humans (operator and residents) exposure to pesticides and risks for human health were assessed for each pesticide with the BROWSE model. Then, a method was proposed to represent the overall risk due to all pesticides used in one system. This study considers 3 conventional and 9 associated innovative cropping systems, and 116 plant protection products containing 89 different active substances (i.e. pesticides). The modelling results obtained with BROWSE showed that innovative cropping systems such as low input or no herbicide systems would reduce the risk for human health in comparison to the corresponding conventional cropping systems. On the contrary, BROWSE showed that conservation tillage system would lead to unacceptable risks in the conditions of our study, because of a high number of pesticide applications, and especially of some herbicides. For residents, the dermal absorption was the main exposure route while ingestion was found to be negligible. For operators, inhalation was also a predominant route of exposure. In general, human exposure to pesticides and human health risks were found to be correlated to the treatment frequency index TFI (number of registered doses of pesticides used per hectare for one copping season), confirming the relationship between the reduction of pesticide use and the reduction of risks. Assessment with the BROWSE model helped to identify cropping systems with decreased risks from pesticides for human health and to propose some improvements to the cropping systems by identifying the pesticides that led to unacceptable risks. Copyright © 2017 Elsevier Ltd. All rights reserved.

Space Radiation Cancer Risks and Uncertainties for Mars Missions

NASA Technical Reports Server (NTRS)

Cucinotta, F. A.; Schimmerling, W.; Wilson, J. W.; Peterson, L. E.; Badhwar, G. D.; Saganti, P. B.; Dicello, J. F.

2001-01-01

Projecting cancer risks from exposure to space radiation is highly uncertain because of the absence of data for humans and because of the limited radiobiology data available for estimating late effects from the high-energy and charge (HZE) ions present in the galactic cosmic rays (GCR). Cancer risk projections involve many biological and physical factors, each of which has a differential range of uncertainty due to the lack of data and knowledge. We discuss an uncertainty assessment within the linear-additivity model using the approach of Monte Carlo sampling from subjective error distributions that represent the lack of knowledge in each factor to quantify the overall uncertainty in risk projections. Calculations are performed using the space radiation environment and transport codes for several Mars mission scenarios. This approach leads to estimates of the uncertainties in cancer risk projections of 400-600% for a Mars mission. The uncertainties in the quality factors are dominant. Using safety standards developed for low-Earth orbit, long-term space missions (>90 days) outside the Earth's magnetic field are currently unacceptable if the confidence levels in risk projections are considered. Because GCR exposures involve multiple particle or delta-ray tracks per cellular array, our results suggest that the shape of the dose response at low dose rates may be an additional uncertainty for estimating space radiation risks.

C-Band Airport Surface Communications System Engineering-Initial High-Level Safety Risk Assessment and Mitigation

NASA Technical Reports Server (NTRS)

Zelkin, Natalie; Henriksen, Stephen

2011-01-01

This document is being provided as part of ITT's NASA Glenn Research Center Aerospace Communication Systems Technical Support (ACSTS) contract: "New ATM Requirements--Future Communications, C-Band and L-Band Communications Standard Development." ITT has completed a safety hazard analysis providing a preliminary safety assessment for the proposed C-band (5091- to 5150-MHz) airport surface communication system. The assessment was performed following the guidelines outlined in the Federal Aviation Administration Safety Risk Management Guidance for System Acquisitions document. The safety analysis did not identify any hazards with an unacceptable risk, though a number of hazards with a medium risk were documented. This effort represents an initial high-level safety hazard analysis and notes the triggers for risk reassessment. A detailed safety hazards analysis is recommended as a follow-on activity to assess particular components of the C-band communication system after the profile is finalized and system rollout timing is determined. A security risk assessment has been performed by NASA as a parallel activity. While safety analysis is concerned with a prevention of accidental errors and failures, the security threat analysis focuses on deliberate attacks. Both processes identify the events that affect operation of the system; and from a safety perspective the security threats may present safety risks.

Quantitative microbiological risk assessment as a tool to obtain useful information for risk managers--specific application to Listeria monocytogenes and ready-to-eat meat products.

PubMed

Mataragas, M; Zwietering, M H; Skandamis, P N; Drosinos, E H

2010-07-31

The presence of Listeria monocytogenes in a sliced cooked, cured ham-like meat product was quantitatively assessed. Sliced cooked, cured meat products are considered as high risk products. These ready-to-eat, RTE, products (no special preparation, e.g. thermal treatment, before eating is required), support growth of pathogens (high initial pH=6.2-6.4 and water activity=0.98-0.99) and has a relatively long period of storage at chilled temperatures with a shelf life equal to 60 days based on manufacturer's instructions. Therefore, in case of post-process contamination, even with low number of cells, the microorganism is able to reach unacceptable levels at the time of consumption. The aim of this study was to conduct a Quantitative Microbiological Risk Assessment (QMRA) on the risk of L. monocytogenes presence in RTE meat products. This may help risk managers to make decisions and apply control measures with ultimate objective the food safety assurance. Examples are given to illustrate the development of practical risk management strategies based on the results obtained from the QMRA model specifically developed for this pathogen/food product combination. Copyright 2010 Elsevier B.V. All rights reserved.

Intelligent Real-Time Problem Solving

DTIC Science & Technology

1990-01-01

uncertainty, its preferences, and its attitude towards risk . 14 Control Theory This paradigm has culminated in a mature academic discipline that has produced a...systems offer the obvious advantages of evaluating against reality, but they are often cumbersome or even unavailable, may pose unacceptable risks , etc. In... return an answer. For the sorts of anytime algorithms wc are interested in, one can determine the expected utility of the answers returned by the

How Academic Psychiatry Can Better Prepare Students for Their Future Patients: Part I--The Failure to Recognize Depression and Risk for Suicide in Primary Care; Problem Identification, Responsibility, and Solutions

ERIC Educational Resources Information Center

Lake, C. Raymond

2008-01-01

The author, after a review of the relevant literature, found that depression and the risk for suicide remain unacceptably underrecognized in primary care (PC). The negative consequences are substantial for patients and their physicians. Suicide prevention in PC begins with the recognition of depression because suicide occurs largely during…

Dimensions of operational stress and forms of unacceptable risk taking with small arms and munitions.

PubMed

Ben-Shalom, Uzi

2015-01-01

Accidents with small arms and munitions during deployment is a significant safety concern for leaders and safety specialists in combat units. Operational stress may lead to forms of unacceptable risk taking with small arms that may underlie some of these accidents. The present research studied the correlation between two dimensions of operational stress, two forms of risk taking with small arms among combat unit soldiers and possible mediators. The dimensions of operational threat, negative affect and personality profile from the EPQ-R-S were predictors; "exaggerated preparedness" and "risky games with small arms and munitions" were dependent variables; safety climate of the platoon served as a mediator variable. The participants were 461 compulsory service combat soldiers in 31 companies. This field study was conducted during period of top security alert. The results reveal that perceived threat is indeed correlated with exaggerated operational preparedness whereas general emotional state was correlated with risky games with small arms. Safety climate mediated only the correlation between general emotional state and risky games with small arms and munitions. Preparedness and risky games were predicted by the interaction of Psychoticism and the Lie Scale from the EPQ-R-S. The results may enhance the efforts in reducing risk taking and prevention of accidents with small arms and munitions during and following deployment.

Senescence sweetening of chip and fry processing potatoes

USDA-ARS?s Scientific Manuscript database

Potato storage makes the crop available over an extended time period, but increases financial risk to growers and end users. Senescence sweetening limits storage duration for chip and fry processing potatoes because it results in an unacceptable accumulation of reducing sugars that result in dark-co...

Virus engineering: Fighting HIV at its own game

NASA Astrophysics Data System (ADS)

Lin, Shixian; Chen, Peng R.

2014-07-01

Live-attenuated viruses used in vaccines can regain their virulence, which for deadly viruses such as HIV is an unacceptable risk. Now, attenuated HIV-1 viruses, which include mutations that genetically encode unnatural amino acids and prevent them from replicating in normal cells, have been constructed.

33 CFR 150.910 - What installations, structures, or activities are prohibited in a safety zone?

Code of Federal Regulations, 2010 CFR

2010-07-01

... incompatible with or that present an unacceptable risk to safety of the deepwater port's operations or activity are allowed in the safety zone of a deepwater port. ... Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS...

Integrated Environmental Risk Assessment and Whole-Process Management System in Chemical Industry Parks

PubMed Central

Shao, Chaofeng; Yang, Juan; Tian, Xiaogang; Ju, Meiting; Huang, Lei

2013-01-01

Chemical industry parks in China are considered high-risk areas because they present numerous risks that can damage the environment, such as pollution incidents. In order to identify the environmental risks and the principal risk factors in these areas, we have developed a simple physical model of a regional environmental risk field (ERF) using existing dispersal patterns and migration models. The regional ERF zoning was also conducted and a reference value for diagnostic methods was developed to determine risk-acceptable, risk-warning, and risk-mitigation zones, which can provide a risk source layout for chemical industry parks. In accordance with the environmental risk control requirements, this study focused on the three stages of control and management of environmental risk and established an environmental risk management system including risk source identification and assessment, environmental safety planning, early risk warning, emergency management, assessment of environmental effects, and environmental remediation of pollution accidents. By using this model, the environmental risks in Tianjin Binhai New Area, the largest chemical industry park in China, were assessed and the environmental risk zoning map was drawn, which suggested the existence of many unacceptable environmental risks in this area. Thus, relevant suggestions have been proposed from the perspective of the adjustment of risk source layout, intensified management of environmental risk control and so on. PMID:23603866

Integrated environmental risk assessment and whole-process management system in chemical industry parks.

PubMed

Shao, Chaofeng; Yang, Juan; Tian, Xiaogang; Ju, Meiting; Huang, Lei

2013-04-19

Chemical industry parks in China are considered high-risk areas because they present numerous risks that can damage the environment, such as pollution incidents. In order to identify the environmental risks and the principal risk factors in these areas, we have developed a simple physical model of a regional environmental risk field (ERF) using existing dispersal patterns and migration models. The regional ERF zoning was also conducted and a reference value for diagnostic methods was developed to determine risk-acceptable, risk-warning, and risk-mitigation zones, which can provide a risk source layout for chemical industry parks. In accordance with the environmental risk control requirements, this study focused on the three stages of control and management of environmental risk and established an environmental risk management system including risk source identification and assessment, environmental safety planning, early risk warning, emergency management, assessment of environmental effects, and environmental remediation of pollution accidents. By using this model, the environmental risks in Tianjin Binhai New Area, the largest chemical industry park in China, were assessed and the environmental risk zoning map was drawn, which suggested the existence of many unacceptable environmental risks in this area. Thus, relevant suggestions have been proposed from the perspective of the adjustment of risk source layout, intensified management of environmental risk control and so on.

Corrected Panel-Reactive Antibody Positivity Rates for Hypersensitized Patients in Turkish Population With Calculated Panel-Reactive Antibody Software.

PubMed

Karadeniz, S T; Akgul, S U; Ogret, Y; Ciftci, H S; Bayraktar, A; Bakkaloglu, H; Caliskan, Y; Yelekci, K; Turkmen, A; Aydin, A E; Oguz, F S; Carin, M; Aydin, F

2017-04-01

High rates of panel-reactive antibody (PRA) may decrease the chance of kidney transplantation and may result in long waiting periods before transplantation. The calculated PRA (cPRA) is performed based on unacceptable HLA antigens. These antigens are identified by a program that was created based on the antibodies that developed against the HLA antigens circulating in serum and on the risk of binding of these antibodies to antigens. The antigen profile of the population and antigen frequencies can be measured, and more realistic cPRA positivity rates may be obtained using this method. We developed a program based on the HLA antigens of 494 blood donors in 2 European Federation for Immunogenetics-accredited Tissue Typing Laboratories in Turkey. Next-generation sequencing-based tissue typing (HLA-A, -B, -C, -DR, -DQ, 4 digits) of the samples was performed. The PRA screening test was performed on 380 patients who were waiting for organ transplant from a cadaver in Istanbul Faculty of Medicine. The single antigen bead assay testing was performed to identify the antibody profiles on 48 hypersensitized patients. The PRA testing results using the current methods were 44.6% ± 18.5%, and the cPRA rate was 86.2% ± 5.1%. The mean PRA positivity of the sensitized patients using the current methods was 44.6%; however, the rate was 86.2% using the cPRA. cPRA shows the rate of the rejected donors according to all unacceptable antigens. The need for a list of unacceptable antigens in place of the PRA positivity rate is a real change in the sensitization-dependent calculation as cPRA positivity rate. In principal, implementation of cPRA will encourage many centers and laboratories to adopt a standard measurement of sensitization in Turkey. It will increase the chances of better donor match, particularly for hypersensitized patients, by the creation of an unacceptable mismatch program using cPRA software. Copyright © 2017 Elsevier Inc. All rights reserved.

Preventing Continuous Positive Airway Pressure Failure: Evidence-Based and Physiologically Sound Practices from Delivery Room to the Neonatal Intensive Care Unit.

PubMed

Wright, Clyde J; Sherlock, Laurie G; Sahni, Rakesh; Polin, Richard A

2018-06-01

Routine use of continuous positive airway pressure (CPAP) to support preterm infants with respiratory distress is an evidenced-based strategy to decrease incidence of bronchopulmonary dysplasia. However, rates of CPAP failure remain unacceptably high in very premature neonates, who are at high risk for developing bronchopulmonary dysplasia. Using the GRADE framework to assess the quality of available evidence, this article reviews strategies aimed at decreasing CPAP failure, starting with delivery room interventions and followed through to system-based efforts in the neonatal intensive care unit. Despite best efforts, some very premature neonates fail CPAP. Also reviewed are predictors of CPAP failure in this vulnerable population. Copyright © 2018 Elsevier Inc. All rights reserved.

A Comparison of Spectacles Purchased Online and in UK Optometry Practice

PubMed Central

Alderson, Alison J.; Green, Alison; Whitaker, David; Scally, Andrew J.; Elliott, David B.

2016-01-01

ABSTRACT Purpose To compare spectacles bought online with spectacles from optometry practices. Methods Thirty-three participants consisting of single vision spectacle wearers with either a low (N = 12, mean age 34 ± 14 years) or high prescription (N = 11, mean age 28 ± 9 years) and 10 presbyopic participants (mean age 59 ± 4 years) wearing progressive addition lenses (PALs) purchased 154 pairs of spectacles online and 154 from UK optometry practices. The spectacles were compared via participant-reported preference, acceptability, and safety; the assessment of lens, frame, and fit quality; and the accuracy of the lens prescriptions to international standard ISO 21987:2009. Results Participants preferred the practice spectacles (median ranking 4th, IQR 1–6) more than online (6th, IQR 4–8; Mann-Whitney U = 7345, p < 0.001) and practice PALs (median ranking 2nd, IQR 1–4) were particularly preferred (online 6.5th, IQR 4–9, Mann-Whitney U = 455, p < 0.001). Of those deemed unacceptable and unsafe, significantly more were bought online (unacceptable: online 43/154 vs. practice 15/154, Fisher’s exact p = 0.0001; unsafe: online 14/154 vs. practice 5/154, Fisher’s exact p = 0.03). Conclusions Participants preferred spectacles from optometry practice rather than those bought online, despite lens quality and prescription accuracy being similar. A greater number of online spectacles were deemed unsafe or unacceptable because of poor spectacle frame fit, poor cosmetic appearance, and inaccurate optical centration. This seems particularly pertinent to PAL lenses, which are known to increase falls risk. Recommendations are made to improve both forms of spectacle provision. PMID:27536974

32 CFR 211.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... a fee interest in real property on which a proposed project is planned to be located. Military... ensure that a project does not create an unacceptable risk to the national security of the United States. Proposed project. A proposed project is the project as described in the application submitted to the...

32 CFR 211.3 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Requester. A developer of a renewable energy development or other energy project or a state or local...) Mitigation. Actions taken by either or both the DoD or the applicant to ensure that a project does not create an unacceptable risk to the national security of the United States. (i) Proposed project. A proposed...

32 CFR 211.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Requester. A developer of a renewable energy development or other energy project or a state or local...) Mitigation. Actions taken by either or both the DoD or the applicant to ensure that a project does not create an unacceptable risk to the national security of the United States. (i) Proposed project. A proposed...

32 CFR 211.10 - Reporting determinations to Congress.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Reporting determinations to Congress. 211.10 Section 211.10 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE... unacceptable risk pursuant to § 211.6, the senior officer shall submit to the congressional defense committees...

32 CFR 211.9 - Mitigation Options.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 2 2013-07-01 2013-07-01 false Mitigation Options. 211.9 Section 211.9 National... MISSION COMPATIBILITY EVALUATION PROCESS Project Evaluation Procedures § 211.9 Mitigation Options. (a) In discussing mitigation to avoid an unacceptable risk to the national security of the United States, the DoD...

32 CFR 211.9 - Mitigation options.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Mitigation options. 211.9 Section 211.9 National... MISSION COMPATIBILITY EVALUATION PROCESS Project Evaluation Procedures § 211.9 Mitigation options. (a) In discussing mitigation to avoid an unacceptable risk to the national security of the United States, the DoD...

32 CFR 211.9 - Mitigation Options.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 2 2012-07-01 2012-07-01 false Mitigation Options. 211.9 Section 211.9 National... MISSION COMPATIBILITY EVALUATION PROCESS Project Evaluation Procedures § 211.9 Mitigation Options. (a) In discussing mitigation to avoid an unacceptable risk to the national security of the United States, the DoD...

Anaerobic Biodegradation of Ethylene Dibromide and 1,2-Dichloroethane in the Presence of Fuel Hydrocarbons

EPA Science Inventory

Field evidence from underground storage tank sites where leaded gasoline leaked indicates the lead scavengers 1,2- dibromoethane (ethylene dibromide, or EDB) and 1,2- dichloroethane (1,2-DCA) may be present in groundwater at levels that pose unacceptable risk. These compounds are...

LINKING GREAT WATERSHEDS AND RIVERS TO FORECAST THE IMPACT OF CONTAMINANT STRESSORS ON LARGE RECEIVING WATERS

EPA Science Inventory

Contaminated sediments are pervasive within the waters of the nation. A number of contaminants are bioaccumulative and are an unacceptable risk to the ecosystem, including humans. Many sites having contaminated sediments are contained within state 305(b) and 303(d) listings and w...

Cultural factors constraining the introduction of family planning among the Kassena-Nankana of northern Ghana.

PubMed

Adongo, P B; Phillips, J F; Kajihara, B; Fayorsey, C; Debpuur, C; Binka, F N

1997-12-01

This study presents a focus group investigation of reasons why women in a rural, Sahelian community are reluctant to adopt family planning even when convenient services are made freely available. First, women opting to practice contraception must do so at considerable risk of social ostracism or familial conflict. Implementing individual preference is something that must be done without the support of others. Second, few women view personal decisions about contraceptives as theirs to make. Women and children are the property of the corporate family-kin and community militate against reproductive control. Third, although children are highly valued for a variety of economic, social, and cultural reasons, mortality risks remain extremely high. Low fertility imposes the unacceptable risk that a woman will have no surviving children at the end of her reproductive life. Taken together, these findings attest to the inadequacy of service strategies focused on the contribution of distribution, individual agency, or personal choice. Outreach should also build a sense of community legitimacy for the program, collective health action, and traditional leadership support for family planning behavior.

Health risk equations and risk assessment of airborne benzene homologues exposure to drivers and passengers in taxi cabins.

PubMed

Chen, Xiaokai; Feng, Lili; Luo, Huilong; Cheng, Heming

2016-03-01

Interior air environment and health problems of vehicles have attracted increasing attention, and benzene homologues (BHs) including benzene, toluene, ethylbenzene, xylenes, and styrene are primary hazardous gases in vehicular cabins. The BHs impact on the health of passengers and drivers in 38 taxis is assessed, and health risk equations of in-car BHs to different drivers and passengers are induced. The health risk of in-car BHs for male drivers is the highest among all different receptors and is 1.04, 6.67, and 6.94 times more than ones for female drivers, male passengers, and female passengers, respectively. In-car BHs could not lead to the non-cancer health risk to all passengers and drivers as for the maximal value of non-cancer indices is 0.41 and is less than the unacceptable value (1.00) of non-cancer health risk from USEPA. However, in-car BHs lead to cancer health risk to drivers as for the average value of cancer indices is 1.21E-04 which is 1.21 times more than the unacceptable value (1.00E-04) of cancer health risk from USEPA. Finally, for in-car airborne benzene concentration (X, μg/m(3)) to male drivers, female drivers, male passengers, and female passengers, the cancer health risk equations are Y = 1.48E-06X, Y = 1.42E-06X, Y = 2.22E-07X, and Y = 2.13E-07X, respectively, and the non-cancer health risk equations are Y = 1.70E-03X, Y = 1.63E-03X, Y = 2.55E-04X, and Y = 2.45E-04X, respectively.

5 CFR 432.105 - Proposing and taking action based on unacceptable performance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... unacceptable performance. 432.105 Section 432.105 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERFORMANCE BASED REDUCTION IN GRADE AND REMOVAL ACTIONS § 432.105 Proposing and taking action based on unacceptable performance. (a) Proposing action based on unacceptable performance...

Evolving paradigms for desensitization in managing broadly HLA sensitized transplant candidates.

PubMed

Reinsmoen, Nancy L; Lai, Chi-Hung; Vo, Ashley; Jordan, Stanley C

2012-04-01

The broadly human leukocyte antigen (HLA) sensitized patient awaiting organ transplantation remains a persistent and significant problem for transplant medicine. Sensitization occurs as a consequence of exposure to HLA antigens through pregnancy, blood and platelet transfusions, and previous transplants. Early experience with desensitization protocols coupled with improved diagnostics for donor-specific antibodies (DSAs) and renal pathology have greatly improved transplant rates and outcomes for patients once considered un-transplantable or at high risk for poor outcomes. More recent advances have occurred through implementation of a national allocation system requiring the entering of unacceptable antigens that reduces the rate of crossmatch positivity. Current desensitization therapies include high-dose intravenous immunoglobulin (IVIG), plasma exchange (PLEX) with low-dose IVIG, and IVIG combined with rituximab. Developing therapies include proteasome inhibitors aimed at plasma cells and modifiers of complement-mediated injury. Here we discuss the important advancements in desensitization including defining the risk for antibody-mediated rejection prior to transplantation and the evolution of therapies aimed at reducing the impact of antibody injury on allografts.

19 CFR 122.187 - Revocation or suspension of access.

Code of Federal Regulations, 2010 CFR

2010-04-01

... that continued access might pose an unacceptable risk to public health, interest or safety, national security, aviation safety, the revenue, or the security of the area. In this case the port director will... health, safety, or security is involved and, in such a case, a final notice of revocation or suspension...

Techniques for Promoting Intellectual Self Confidence among At-Risk Science Students in Rural and Small Schools.

ERIC Educational Resources Information Center

Prather, J. Preston

Most students enter their first formal science courses with intelligently conceived and sophisticated concepts of science. Some of these may be compatible with the principles of modern science, but others may be incorrect, inadequate, outdated, or otherwise unacceptable. Conceptual frameworks based on intuitive misperceptions, naive inferences,…

40 CFR Appendix M to Subpart G - Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004

Code of Federal Regulations, 2010 CFR

2010-07-01

... —Rigid polyurethane slabstock and other foams —Polystyrene extruded insulation boardstock and billet...—Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004 Foam Blowing—Unacceptable Substitutes End-use Substitute Decision Comments All foam end-uses: HCFC-141b Unacceptable...

40 CFR Appendix M to Subpart G - Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004

Code of Federal Regulations, 2012 CFR

2012-07-01

... —Rigid polyurethane slabstock and other foams —Polystyrene extruded insulation boardstock and billet...—Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004 Foam Blowing—Unacceptable Substitutes End-use Substitute Decision Comments All foam end-uses: HCFC-141b Unacceptable...

40 CFR Appendix M to Subpart G - Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004

Code of Federal Regulations, 2011 CFR

2011-07-01

... —Rigid polyurethane slabstock and other foams —Polystyrene extruded insulation boardstock and billet...—Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004 Foam Blowing—Unacceptable Substitutes End-use Substitute Decision Comments All foam end-uses: HCFC-141b Unacceptable...

[Analysis of changes in characteristics of arterial hypertension occupational risk in workers of nonferrous metallurgy].

PubMed

Vlasova, E M; Shliapnikov, D M; Lebedeva, T M

2015-01-01

The article covers changes in occupational cardiovascular risk for workers of nonferrous,metallurgy. Findings are that exposure to noise up to 94 dB with length of service increases possible atherosclerosis and metabolic syndrome. With 5 years of service, risk of the predicted conditions increases by 40.5%. When occupational exposure lasts over 5 years, risk of arterial hypertension increases. A group of workers without exposure to occupational factors appeared to have no connection between length of service and metabolic syndrome and arterial hypertension. Risk evolution modelling proved that risk of functional disorders in nonferrous metallurgy workers becomes unacceptable after 5 years of service (cardiovascular disorders are critical).

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

Doll, D.C.; Ringenberg, Q.S.; Yarbro, J.W.

Although cancer during pregnancy is infrequent, its management is difficult for patients, their families, and their physicians. When termination of the pregnancy is unacceptable, decisions regarding the use of irradiation and chemotherapy are complicated by the well-known high risks of abortion and fetal malformation. This risk is concentrated in the first trimester and varies with the choice of chemotherapeutic agents or combinations of agents. There is only minimal evidence of increased risk of malformation or abortion in the second or third trimester. Recent progress in cancer therapy has made cure a reasonable goal, and for some malignant neoplasms, cure ismore » still possible even when initial therapy is modified or delayed. When cure is a reasonable goal, curative therapy should not be compromised by modification or delay. When treatment for cure or significant palliation is not possible, however, the goal should shift to protection of the fetus from damage by the injudicious use of teratogenic cancer therapy. This report will review the available data that may assist in these difficult decisions. 114 references.« less

Comprehensive risk reduction in patients with atrial fibrillation: emerging diagnostic and therapeutic options—a report from the 3rd Atrial Fibrillation Competence NETwork/European Heart Rhythm Association consensus conference

PubMed Central

Kirchhof, Paulus; Lip, Gregory Y.H.; Van Gelder, Isabelle C.; Bax, Jeroen; Hylek, Elaine; Kaab, Stefan; Schotten, Ulrich; Wegscheider, Karl; Boriani, Giuseppe; Brandes, Axel; Ezekowitz, Michael; Diener, Hans; Haegeli, Laurent; Heidbuchel, Hein; Lane, Deirdre; Mont, Luis; Willems, Stephan; Dorian, Paul; Aunes-Jansson, Maria; Blomstrom-Lundqvist, Carina; Borentain, Maria; Breitenstein, Stefanie; Brueckmann, Martina; Cater, Nilo; Clemens, Andreas; Dobrev, Dobromir; Dubner, Sergio; Edvardsson, Nils G.; Friberg, Leif; Goette, Andreas; Gulizia, Michele; Hatala, Robert; Horwood, Jenny; Szumowski, Lukas; Kappenberger, Lukas; Kautzner, Josef; Leute, Angelika; Lobban, Trudie; Meyer, Ralf; Millerhagen, Jay; Morgan, John; Muenzel, Felix; Nabauer, Michael; Baertels, Christoph; Oeff, Michael; Paar, Dieter; Polifka, Juergen; Ravens, Ursula; Rosin, Ludger; Stegink, W.; Steinbeck, Gerhard; Vardas, Panos; Vincent, Alphons; Walter, Maureen; Breithardt, Günter; Camm, A. John

2012-01-01

While management of atrial fibrillation (AF) patients is improved by guideline-conform application of anticoagulant therapy, rate control, rhythm control, and therapy of accompanying heart disease, the morbidity and mortality associated with AF remain unacceptably high. This paper describes the proceedings of the 3rd Atrial Fibrillation NETwork (AFNET)/European Heart Rhythm Association (EHRA) consensus conference that convened over 60 scientists and representatives from industry to jointly discuss emerging therapeutic and diagnostic improvements to achieve better management of AF patients. The paper covers four chapters: (i) risk factors and risk markers for AF; (ii) pathophysiological classification of AF; (iii) relevance of monitored AF duration for AF-related outcomes; and (iv) perspectives and needs for implementing better antithrombotic therapy. Relevant published literature for each section is covered, and suggestions for the improvement of management in each area are put forward. Combined, the propositions formulate a perspective to implement comprehensive management in AF. PMID:21791573

Risk factors for stillbirth in developing countries: a systematic review of the literature.

PubMed

Di Mario, Simona; Say, Lale; Lincetto, Ornella

2007-07-01

To identify risk factors for stillbirth in developing countries and to measure their impact by calculating the population attributable fraction (PAF) for each risk factor. Systematic review of published studies on risk factors for stillbirth within 3 broadly defined categories: infections, other clinical conditions, and context-dependent conditions such as socioeconomic status, maternal literacy, and receipt of antenatal care. Where statistically significant associations were found between a risk factor and occurrence of stillbirth, the PAF (the proportion of cases occurring in the total population that would be avoided if the exposure was removed) was calculated. A total of 33 studies, conducted in 31 developing countries, were included in the review. The definition of stillbirth varied widely in these studies. Risk factors for stillbirth having a PAF higher than 50% were maternal syphilis, chorioamnionitis, maternal malnutrition, lack of antenatal care, and maternal socioeconomic disadvantage. Maternal syphilis prevention, screening and treatment together with other interventions targeting universal use of antenatal care (that includes screening for syphilis) and improving the socioeconomic conditions including nutritional status of the mother, could effectively contribute towards reducing the unacceptably high burden due to stillbirth in developing countries.

The Costs of Depression

PubMed Central

Kessler, Ronald C.

2011-01-01

Brief summary Data are reviewed on the societal costs of major depressive disorder (MDD). Early-onset MDD is found to predict difficulties in subsequent role transitions, including low educational attainment, high risk of teen child-bearing, marital disruption, and unstable employment. Among people with specific social and productive roles, MDD is found to predict significant decrements in role functioning (e.g., low marital quality, low work performance, low earnings). MDD is also associated with elevated risk of onset, persistence, and severity of a wide range of chronic physical disorders as well as with increased early mortality due to an even wider range of physical disorders and to suicide. Although effectiveness trials show that expanded MDD treatment can reverse many of these adverse effects, only a minority of people with MDD receives treatment and the quality of treatment is unacceptably low among the majority of those in treatment. PMID:22370487

48 CFR 52.215-1 - Instructions to Offerors-Competitive Acquisition.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., if the last day falls on a Saturday, Sunday, or legal holiday, then the period shall include the next... Government's control prior to the time set for receipt of offers; or (3) It is the only proposal received. (B... balance poses an unacceptable risk to the Government. (9) If a cost realism analysis is performed, cost...

"We Risk Failing to Invest in the Day after Tomorrow"

ERIC Educational Resources Information Center

Stanistreet, Paul

2009-01-01

More than 500 people from across the country attended the Campaigning Alliance for Lifelong Learning's February lobby of Parliament. They made sure their voices were heard, lobbying their MPs and ensuring politicians from all parties got the message that the loss of over a million adult learning places is unacceptable. This article describes the…

Fuel processor temperature monitoring and control

DOEpatents

Keskula, Donald H.; Doan, Tien M.; Clingerman, Bruce J.

2002-01-01

In one embodiment, the method of the invention monitors one or more of the following conditions: a relatively low temperature value of the gas stream; a relatively high temperature value of the gas stream; and a rate-of-change of monitored temperature. In a preferred embodiment, the rate of temperature change is monitored to prevent the occurrence of an unacceptably high or low temperature condition. Here, at least two temperatures of the recirculating gas stream are monitored over a period of time. The rate-of-change of temperature versus time is determined. Then the monitored rate-of-change of temperature is compared to a preselected rate-of-change of value. The monitoring of rate-of-change of temperature provides proactive means for preventing occurrence of an unacceptably high temperature in the catalytic reactor.

Variation of free asparagine concentration and association with quality parameters for hard red spring wheat grown in North Dakota

USDA-ARS?s Scientific Manuscript database

Free asparagine in wheat is known to be a precursor for the formation of acrylamide which is unacceptable to consumers due to its potential risks to human health. This research was performed to determine variation of free asparagine concentration (FAC) in hard red spring (HRS) wheat grown in North ...

48 CFR 552.270-1 - Instructions to Offerors-Acquisition of Leasehold Interests in Real Property.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... However, if the last day falls on a Saturday, Sunday, or legal holiday, then the period shall include the... received at the activity designated for receipt of offers and was under the Government's control prior to... Contracting Officer determines that the lack of balance poses an unacceptable risk to the Government. (7) The...

A coupled physical and economic model of the response of coastal real estate to climate risk

NASA Astrophysics Data System (ADS)

McNamara, Dylan E.; Keeler, Andrew

2013-06-01

Barring an unprecedented large-scale effort to raise island elevation, barrier-island communities common along the US East Coast are likely to eventually face inundation of the existing built environment on a timescale that depends on uncertain climatic forcing. Between the present and when a combination of sea-level rise and erosion renders these areas uninhabitable, communities must choose levels of defensive expenditures to reduce risks and individual residents must assess whether and when risk levels are unacceptably high to justify investment in housing. We model the dynamics of coastal adaptation as the interplay of underlying climatic risks, collective actions to mitigate those risks, and individual risk assessments based on beliefs in model predictions and processing of past climate events. Efforts linking physical and behavioural models to explore shoreline dynamics have not yet brought together this set of essential factors. We couple a barrier-island model with an agent-based model of real-estate markets to show that, relative to people with low belief in model predictions about climate change, informed property owners invest heavily in defensive expenditures in the near term and then abandon coastal real estate at some critical risk threshold that presages a period of significant price volatility.

40 CFR Appendix E to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2011 CFR

2011-07-01

... Refrigeration and Air-Conditioning Sector Unacceptable Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses MT-31 Unacceptable Chemical contained in this blend presents...

40 CFR Appendix F to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2010 CFR

2010-07-01

... Refrigeration and Air-Conditioning Sector UnacceptabLe Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses Hexafluoropropylene (HFP) and all HFP-containing blends Unacceptable...

40 CFR Appendix E to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2013 CFR

2013-07-01

... Refrigeration and Air-Conditioning Sector Unacceptable Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses MT-31 Unacceptable Chemical contained in this blend presents...

40 CFR Appendix E to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2012 CFR

2012-07-01

... Refrigeration and Air-Conditioning Sector Unacceptable Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses MT-31 Unacceptable Chemical contained in this blend presents...

40 CFR Appendix E to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2010 CFR

2010-07-01

... Refrigeration and Air-Conditioning Sector Unacceptable Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses MT-31 Unacceptable Chemical contained in this blend presents...

40 CFR Appendix F to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2012 CFR

2012-07-01

... Refrigeration and Air-Conditioning Sector UnacceptabLe Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses Hexafluoropropylene (HFP) and all HFP-containing blends Unacceptable...

40 CFR Appendix F to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2013 CFR

2013-07-01

... Refrigeration and Air-Conditioning Sector UnacceptabLe Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses Hexafluoropropylene (HFP) and all HFP-containing blends Unacceptable...

40 CFR Appendix F to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2011 CFR

2011-07-01

... Refrigeration and Air-Conditioning Sector UnacceptabLe Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses Hexafluoropropylene (HFP) and all HFP-containing blends Unacceptable...

40 CFR Appendix E to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2014 CFR

2014-07-01

... Refrigeration and Air-Conditioning Sector Unacceptable Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses MT-31 Unacceptable Chemical contained in this blend presents...

40 CFR Appendix F to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2014 CFR

2014-07-01

... Refrigeration and Air-Conditioning Sector UnacceptabLe Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses Hexafluoropropylene (HFP) and all HFP-containing blends Unacceptable...

A proposed framework for consistent regulation of public exposures to radionuclides and other carcinogens

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

Kocher, D.C.; Hoffman, F.O.

1991-12-31

This paper discusses a proposed framework for consistent regulation of carcinogenic risks to the public based on establishing de manifestis (i.e., unacceptable) and de minimis (i.e., trivial) lifetime risks from exposure to any carcinogens at levels of about 10{sup {minus}1}--10{sup {minus}3} and 10{sup {minus}4}--10{sup {minus}6}, respectively, and reduction of risks above de minimis levels as low as reasonably achievable (ALARA). We then discuss certain differences in the way risks from exposure to radionuclides and other carcinogens currently are regulated or assessed which would need to be considered in implementing the proposed regulatory framework for all carcinogens.

A proposed framework for consistent regulation of public exposures to radionuclides and other carcinogens

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

Kocher, D.C.; Hoffman, F.O.

1991-01-01

This paper discusses a proposed framework for consistent regulation of carcinogenic risks to the public based on establishing de manifestis (i.e., unacceptable) and de minimis (i.e., trivial) lifetime risks from exposure to any carcinogens at levels of about 10{sup {minus}1}--10{sup {minus}3} and 10{sup {minus}4}--10{sup {minus}6}, respectively, and reduction of risks above de minimis levels as low as reasonably achievable (ALARA). We then discuss certain differences in the way risks from exposure to radionuclides and other carcinogens currently are regulated or assessed which would need to be considered in implementing the proposed regulatory framework for all carcinogens.

Microbiological examination of cold ready-to-eat sliced meats from catering establishments in the United Kingdom.

PubMed

Gillespie, I; Little, C; Mitchell, R

2000-03-01

A microbiological study of cold, ready-to-eat sliced meats from 2579 catering establishments (public houses, hotels, cafés, restaurants, residential homes and other catering premises) found that 2587 of 3494 samples (74%) were of acceptable quality, 892 (26%) were of unsatisfactory quality and 15 (<1%) were of unacceptable quality. Unacceptable results were due to high levels of Escherichia coli, Staphylococcus aureus, Listeria species and/or Clostridium perfringens. Unsatisfactory results were mostly due to high Aerobic Plate Counts. The microbiological quality of cold, ready-to-eat meats was associated with meat type, premises type, management training, hygienic practices, meat supplier and length of storage. The relationship between food hygiene training and microbiological quality is discussed.

Superfund record of decision (EPA Region 1): Tansitor Electronics, Inc., Bennington, VT, September 29, 1995

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

NONE

1996-03-01

This Decision Document presents the selected remedial action for the Tansitor Electronics, Inc. Superfund Site in Bennington, Vermont. This ROD sets forth the selected remedy for the Tansitor Electronics, Inc. Superfund Site, which includes management of migration components to obtain a comprehensive remedy. This ROD does not include any source control component because EPA`s risk assessment concluded that the surface and subsurface soils did not present an unacceptable risk either under current conditions or under a potential future residential scenario.

Aspiration in children and adolescents with neurogenic dysphagia: comparison of clinical judgment and fiberoptic endoscopic evaluation of swallowing.

PubMed

Beer, Sabrina; Hartlieb, Till; Müller, Arnd; Granel, Michael; Staudt, Martin

2014-12-01

A total of 30 children and adolescents with dysphagia due to various chronic neurological disorders were assessed for their risk of aspiration. This assessment was performed clinically by experienced speech and swallowing therapists, and verified thereafter by fiberoptic endoscopy. We found the clinical judgment to be correct in only 70% (for aspiration of saliva), 55% (of puree), and 67% (of thin liquids). We conclude that, because of this unacceptably high error rate of clinical assessment, a fiberoptic evaluation of swallowing is a necessary diagnostic step both for the planning of therapy and for the development of feeding strategies in children and adolescents with neurogenic dysphagia. Georg Thieme Verlag KG Stuttgart · New York.

19 CFR 152.108 - Unacceptable bases of appraisement.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 2 2013-04-01 2013-04-01 false Unacceptable bases of appraisement. 152.108 Section 152.108 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY... Merchandise § 152.108 Unacceptable bases of appraisement. For the purposes of this subpart, imported...

19 CFR 152.108 - Unacceptable bases of appraisement.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 2 2011-04-01 2011-04-01 false Unacceptable bases of appraisement. 152.108 Section 152.108 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY... Merchandise § 152.108 Unacceptable bases of appraisement. For the purposes of this subpart, imported...

19 CFR 152.108 - Unacceptable bases of appraisement.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 2 2012-04-01 2012-04-01 false Unacceptable bases of appraisement. 152.108 Section 152.108 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY... Merchandise § 152.108 Unacceptable bases of appraisement. For the purposes of this subpart, imported...

19 CFR 152.108 - Unacceptable bases of appraisement.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Unacceptable bases of appraisement. 152.108 Section 152.108 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY... Merchandise § 152.108 Unacceptable bases of appraisement. For the purposes of this subpart, imported...

The characteristics of unacceptable/taboo thoughts in obsessive-compulsive disorder.

PubMed

Brakoulias, Vlasios; Starcevic, Vladan; Berle, David; Milicevic, Denise; Moses, Karen; Hannan, Anthony; Sammut, Peter; Martin, Andrew

2013-10-01

In the quest to unravel the heterogeneity of obsessive-compulsive disorder (OCD), an increasing number of factor analytic studies are recognising unacceptable/taboo thoughts as one of the symptom dimensions of OCD. This study aims to examine the characteristics associated with unacceptable/taboo thoughts. Using the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist (YBOCS-SC) with 154 individuals with OCD, obsessive-compulsive symptoms were subjected to principal components analysis. The characteristics associated with the resulting symptom dimensions were then assessed using logistic and linear regression techniques. Unacceptable/taboo thoughts comprised of sexual, religious and impulsive aggressive obsessions, and mental rituals. Higher scores on an unacceptable/taboo thoughts symptom dimension were predicted by higher Y-BOCS obsession subscores, Y-BOCS time preoccupied by obsessions scores, Y-BOCS distress due to obsessions scores, importance of control of thought ratings, male gender, and having had treatment prior to entering into the study. Unacceptable/taboo thoughts were also predicted by greater levels of hostility, and a past history of non-alcohol substance dependence. An unacceptable/taboo thought symptom dimension of OCD is supported by a unique set of associated characteristics that should be considered in the assessment and treatment of individuals with these symptoms. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Silicosis among gold miners: exposure--response analyses and risk assessment.

PubMed

Steenland, K; Brown, D

1995-10-01

This study sought to estimate the risk of silicosis by cumulative exposure-years in a cohort of miners exposed to silica, as well as the lifetime risk of silicosis under the current Occupational Safety and Health Administration (OSHA) standard (0.09 mg/m3). In a cohort study of 3330 gold miners who worked at least 1 year underground from 1940 to 1965 (average 9 years) and were exposed to a median silica level of 0.05 mg/m3 (0.15 mg/m3 for those hired before 1930), 170 cases of silicosis were determined from either death certificates or two cross-sectional radiographic surveys. The risk of silicosis was less than 1% with a cumulative exposure under 0.5 mg/m3-years, increasing to 68% to 84% for the highest cumulative exposure category of more than 4 mg/m3-years. Cumulative exposure was the best predictor of disease, followed by duration of exposure and average exposure. After adjustment for competing risks of death, a 45-year exposure under the current OSHA standard would lead to a lifetime risk of silicosis of 35% to 47%. Almost 2 million US workers are currently exposed to silica. Our results add to a small but increasing body of literature that suggests that the current OSHA silica exposure level is unacceptably high.

Risk and protective factors associated with adolescent girls' substance use: Data from a nationwide Facebook sample.

PubMed

Schwinn, Traci M; Schinke, Steven P; Hopkins, Jessica; Thom, Bridgette

2016-01-01

Despite overall reductions in teenage substance use, adolescent girls' rates of substance use remain unacceptably high. This article examines whether girls' substance use is associated with general risk and protective factors (goal setting, problem solving, refusal skills, peer use, and self-efficacy) and gender-specific risk and protective factors (communication style, coping skills, self-esteem, body image, perceived stress, anxiety, and depression). Cross-sectional data were collected in 2013 via online surveys from a nationwide sample of adolescent girls (N = 788), aged 13 and 14 years, who were recruited through Facebook. In multivariate analyses, controlling for correlates of adolescent substance use, 11 of the 13 general and gender-specific risk and protective factors were consistently associated with past-month alcohol, cigarette, and other drug use in the expected direction; past-month marijuana use was associated with 8 of the 13 factors. Refusal skills, peer use, coping, and depressive mood were most consistently and strongly associated with substance use. Substance abuse prevention programs targeting adolescent girls should focus on such general risk and protective factors as problem solving, refusal skills, peer influences, and self-efficacy, as well as such gender-specific risk and protective factors as communication style, coping, self-esteem, body image, perceived stress, and mood management.

Sabotage at Nuclear Power Plants

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

Purvis, James W.

1999-07-21

Recently there has been a noted worldwide increase in violent actions including attempted sabotage at nuclear power plants. Several organizations, such as the International Atomic Energy Agency and the US Nuclear Regulatory Commission, have guidelines, recommendations, and formal threat- and risk-assessment processes for the protection of nuclear assets. Other examples are the former Defense Special Weapons Agency, which used a risk-assessment model to evaluate force-protection security requirements for terrorist incidents at DOD military bases. The US DOE uses a graded approach to protect its assets based on risk and vulnerability assessments. The Federal Aviation Administration and Federal Bureau of Investigationmore » conduct joint threat and vulnerability assessments on high-risk US airports. Several private companies under contract to government agencies use formal risk-assessment models and methods to identify security requirements. The purpose of this paper is to survey these methods and present an overview of all potential types of sabotage at nuclear power plants. The paper discusses emerging threats and current methods of choice for sabotage--especially vehicle bombs and chemical attacks. Potential consequences of sabotage acts, including economic and political; not just those that may result in unacceptable radiological exposure to the public, are also discussed. Applicability of risk-assessment methods and mitigation techniques are also presented.« less

What becomes of nuclear risk assessment in light of radiation hormesis?

PubMed

Cuttler, Jerry M

2006-08-25

A nuclear probabilistic risk or safety assessment (PRA or PSA) is a scientific calculation that uses assumptions and models to determine the likelihood of plant or fuel repository failures and the corresponding releases of radioactivity. Estimated radiation doses to the surrounding population are linked inappropriately to risks of cancer death and congenital malformations. Even though PRAs use very pessimistic assumptions, they demonstrate that nuclear power plants and fuel repositories are very safe compared with the health risks of other generating options or other risks that people readily accept. Because of the frightening negative images and the exaggerated safety and health concerns that are communicated, many people judge nuclear risks to be unacceptable and do not favour nuclear plants. Large-scale tests and experience with nuclear accidents demonstrate that even severe accidents expose the public to only low doses of radiation, and a century of research has demonstrated that such exposures are beneficial to health. A scientific basis for this phenomenon now exists. PRAs are valuable tools for improving plant designs, but if nuclear power is to play a significant role in meeting future energy needs, we must communicate its many real benefits and dispel the negative images formed by unscientific extrapolations of harmful effects at high doses.

The Evidence in Hand: Report of the Task Force on the Artifact in Library Collections. Optimizing Collections and Services for Scholarly Use.

ERIC Educational Resources Information Center

Nichols, Stephen G.; Smith, Abby

This report discusses the ways in which artifacts and their physical frailties affect their research value--originality, faithfulness, fixity, and stability--over time and how libraries can minimize the risk of unacceptable loss of that value. It investigates the specific issues around selected media, such as paper-based printed matter, moving…

In Situ Wetland Restoration Demonstration

DTIC Science & Technology

2014-07-01

Program (ESTCP) has funded the Naval Facilities Engineering and Expeditionary Warfare Center (NAVFAC EXWC) and its DoD partners: U.S. Army Public Health ...Command Engineering Service Center [NAVFAC ESC]) and its DoD partners U.S. Army Public Health Command, Naval Facilities Engineering Command Atlantic...made that unacceptable risks to human health or the environment may be present in portions of the Canal Creek system. Innovative technologies

Eliminating the Rhetoric: An Evaluation of the Halt Phase Strategy

DTIC Science & Technology

1999-06-01

Halt operations can demonstrate to the enemy leadership that continued aggression equals unacceptable risk because air superiority can be exploited...lesson can be drawn. The presence of ground forces demonstrates commitment and leadership . Powerful ground combat forces represent the strongest... leadership far more than technology will determine who wins and who loses." 10 The Fallacy of Technological Determinism Another main theme in critiques of

Injury risk and a tackle ban in youth Rugby Union: reviewing the evidence and searching for targeted, effective interventions. A critical review.

PubMed

Tucker, Ross; Raftery, Martin; Verhagen, Evert

2016-08-01

It has recently been proposed that the tackle, an integral part of Rugby Union, be banned in school rugby, as a means to reduce the risk of injury. This proposal held that harmful contact should be removed in response to what was termed an unacceptably high-injury risk. Such a ban would represent a significant intervention that could change the nature of Rugby Union. As such, the basis and rationale for such a ban is worthy of critical evaluation. This review aims to describe the research on which such a ban is proposed. It does so through an assessment (identification), estimation (understanding of the magnitude and occurrence) and evaluation (determining acceptability) of the risk before decisions can be made about implementing any risk mitigation strategies. The body of literature describing injury risk, particularly among youths, is indeed thin and fraught with methodological differences that makes definitive conclusions impossible. We describe these, and their implications, arguing that the complete ban on the tackle may be unnecessary in young children, in whom injury risk may not be as high as is often argued, but also that it may have detrimental consequences. Finally, we propose alternative strategies and research questions which must be pursued to effectively reduce risk without creating unintended consequences or changing the nature of the sport. 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/

Assignment of C1q-binding HLA antibodies as unacceptable HLA antigens avoids positive CDC-crossmatches prior to transplantation of deceased donor organs.

PubMed

Juhl, David; Marget, Matthias; Hallensleben, Michael; Görg, Siegfried; Ziemann, Malte

2017-03-01

Soon, a virtual crossmatch shall replace the complement-dependent cytotoxicity (CDC) allocation crossmatch in the Eurotransplant region. To prevent positive CDC-crossmatches in the recipient centre, careful definition of unacceptable antigens is necessary. For highly sensitized patients, this is difficult by CDC alone. Assignment of all antibodies detected by sensitive assays, however, could prevent organ allocation. To assess the usefulness of the Luminex C1q-assay to prevent positive CDC-crossmatches, all CDC-crossmatches performed prior to deceased kidney transplantation in a 16-month-period were reviewed. Sera causing positive crossmatches were investigated by the C1q-assay. 31 out of 1432 crossmatches (2.2%) were positive. Sera involved in 26 positive crossmatches were available. C1q-binding donor-specific antibodies were detected in 19 sera (73.1%). The other sera were from recipients without any HLA antibodies detectable by CDC or common solid phase assays. Three patients had known Non-HLA antibodies causing positive CDC-results. Four crossmatches were only weak positive. Therefore, avoidance of donors with HLA antigens against whom C1q-binding antibodies were detected would have prevented all positive crossmatches due to HLA antibodies. Provided that all HLA specificities against which antibodies are detected by the Luminex C1q-assay are considered as unacceptable antigens, CDC-crossmatches prior to transplantation might safely be omitted in many patients. They should be maintained in highly immunized patients, however, for whom assignment of all C1q-positive antibodies as unacceptable antigens could lead to a significant delay or even prevention of transplantation. Copyright © 2017 Elsevier B.V. All rights reserved.

Lead in the blood of children living close to industrial point sources in Bulgaria and Poland

NASA Astrophysics Data System (ADS)

Willeke-Wetstein, C.; Bainova, A.; Georgieva, R.; Huzior-Balajewicz, A.; Bacon, J. R.

2003-05-01

ln Eastern European countries some industrial point sources are still suspected to have unacceptable emission rates of lead that pose a major health risk in particular to children. An interdisciplinary research project under the auspices of the EU had the aims (I) to monitor the current contamination of two industrial zones in Bulgaria and Poland, (2) to relate the Pb levels in ecological strata to the internal exposure of children, (3) to develop public health strategies in order to reduce the health risk by heavy metals. The human monitoring of Pb in Poland did not show increased health risks for the children living in an industrial zone close to Krakow. Bulgarian children, however, exceeded the WHO limit of 100 μg lead per litre blood by over one hundred percent (240 μg/1). Samples of soil, fodder and livestock organs showed elevated concentrations of lead. Recent literature results are compared with the findings in Bulgaria and Poland. The sources of the high internal exposure of children are discussed. Public health strategies to prevent mental dysfunction in Bulgarian children at risk include awareness building and social masures.

21 CFR 1305.25 - Unaccepted and defective electronic orders.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Unaccepted and defective electronic orders. 1305... SCHEDULE I AND II CONTROLLED SUBSTANCES Electronic Orders § 1305.25 Unaccepted and defective electronic orders. (a) No electronic order may be filled if: (1) The required data fields have not been completed...

21 CFR 1305.25 - Unaccepted and defective electronic orders.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 9 2014-04-01 2014-04-01 false Unaccepted and defective electronic orders. 1305... SCHEDULE I AND II CONTROLLED SUBSTANCES Electronic Orders § 1305.25 Unaccepted and defective electronic orders. (a) No electronic order may be filled if: (1) The required data fields have not been completed...

The Effect of Distinguished Educators on Academic Gain of Louisiana Academically Unacceptable Schools

ERIC Educational Resources Information Center

Scroggins, Ruby C.

2012-01-01

The purpose of this study was to examine the degree of academic growth of Academically Unacceptable schools in Louisiana which have been assigned a Distinguished Educator. Distinguished Educators are external change agents who are placed in Academically Unacceptable schools in Louisiana. The data were generated from the Louisiana Department of…

Plant photonics: application of optical coherence tomography to monitor defects and rots in onion

NASA Astrophysics Data System (ADS)

Meglinski, I. V.; Buranachai, C.; Terry, L. A.

2010-04-01

The incidence of physiological and/or pathological defects in many fresh produce types is still unacceptably high and accounts for a large proportion of waste. With increasing interest in food security their remains strong demand in developing reliable and cost effective technologies for non-destructive screening of internal defects and rots, these being deemed unacceptable by consumers. It is well recognized that the internal defects and structure of turbid scattering media can be effectively visualized by using optical coherence tomography (OCT). In the present study, the high spatial resolution and advantages of OCT have been demonstrated for imaging the skins and outer laminae (concentric tissue layers) of intact whole onion bulbs with a view to non-invasively visualizing potential incidence/severity of internal defects.

Assessment of credit risk based on fuzzy relations

NASA Astrophysics Data System (ADS)

Tsabadze, Teimuraz

2017-06-01

The purpose of this paper is to develop a new approach for an assessment of the credit risk to corporate borrowers. There are different models for borrowers' risk assessment. These models are divided into two groups: statistical and theoretical. When assessing the credit risk for corporate borrowers, statistical model is unacceptable due to the lack of sufficiently large history of defaults. At the same time, we cannot use some theoretical models due to the lack of stock exchange. In those cases, when studying a particular borrower given that statistical base does not exist, the decision-making process is always of expert nature. The paper describes a new approach that may be used in group decision-making. An example of the application of the proposed approach is given.

Children's exposure to harmful elements in toys and low-cost jewelry: characterizing risks and developing a comprehensive approach.

PubMed

Guney, Mert; Zagury, Gerald J

2014-04-30

Contamination problem in jewelry and toys and children's exposure possibility have been previously demonstrated. For this study, risk from oral exposure has been characterized for highly contaminated metallic toys and jewelry ((MJ), n=16) considering three scenarios. Total and bioaccessible concentrations of Cd, Cu, Ni, and Pb were high in selected MJ. First scenario (ingestion of parts or pieces) caused unacceptable risk for eight items for Cd, Ni, and/or Pb (hazard index (HI)>1, up to 75, 5.8, and 43, respectively). HI for ingestion of scraped-off material scenario was always <1. Finally, saliva mobilization scenario caused HI>1 in three samples (two for Cd, one for Ni). Risk characterization identified different potentially hazardous items compared to United States, Canadian, and European Union approaches. A comprehensive approach was also developed to deal with complexity and drawbacks caused by various toy/jewelry definitions, test methods, exposure scenarios, and elements considered in different regulatory approaches. It includes bioaccessible limits for eight priority elements (As, Cd, Cr, Cu, Hg, Ni, Pb, and Sb). Research is recommended on metals bioaccessibility determination in toys/jewelry, in vitro bioaccessibility test development, estimation of material ingestion rates and frequency, presence of hexavalent Cr and organic Sn, and assessment of prolonged exposure to MJ. Copyright © 2014 Elsevier B.V. All rights reserved.

40 CFR Appendix M to Subpart G of... - Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004

Code of Federal Regulations, 2014 CFR

2014-07-01

... refrigeration, and sandwich panels —Rigid polyurethane slabstock and other foams —Polystyrene extruded... 29, 2004 Foam Blowing—Unacceptable Substitutes End-use Substitute Decision Comments All foam end-uses: HCFC-141b Unacceptable Alternatives exist with lower or zero = ODP. —Rigid polyurethane and...

40 CFR Appendix M to Subpart G of... - Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004

Code of Federal Regulations, 2013 CFR

2013-07-01

... refrigeration, and sandwich panels —Rigid polyurethane slabstock and other foams —Polystyrene extruded... 29, 2004 Foam Blowing—Unacceptable Substitutes End-use Substitute Decision Comments All foam end-uses: HCFC-141b Unacceptable Alternatives exist with lower or zero = ODP. —Rigid polyurethane and...

Infection risk and intrauterine devices.

PubMed

Martínez, Francisca; López-Arregui, Eduardo

2009-01-01

For most women, intrauterine contraceptive devices (IUCD) are a safe option. Upper genital tract infections (pelvic inflammatory disease, PID) occur when pathogenic microorganisms ascend from the cervix and invade the endometrium and the fallopian tubes, causing an inflammatory reaction. Evidence-based recommendations regarding intrauterine contraception and risk of infection were presented at the Congress of the European Society of Contraception, in Prague, 2008: A clinical history (including sexual history) should be taken as part of the routine assessment for intrauterine contraception to identify women at high risk of sexually transmitted infections (STI); if appropriate a test should be offered; if symptoms or signs are present, appropriate diagnostic tests should be done, results awaited, necessary treatment completed, and IUCD insertion postponed until resolution. Prophylactic antibiotics are not recommended (evidence level II-3). STI screening is not routinely recommended. PID among IUCD users is most strongly related to the insertion process and to the background risk of STI (evidence level II-2). Conditions which represent an unacceptable health risk if an IUCD is inserted (WHO Medical Eligibility Criteria, MEC, Categories 3-4) are current PID, current purulent cervicitis, chlamydial or gonorrheal infection. For continuation as well as initiation, WHO MEC categories 3-4 are allotted to women with known pelvic tuberculosis, puerperal sepsis and septic abortion.

Assisted reproduction professionals' awareness and attitudes towards their own IVF cycles.

PubMed

Bonetti, T C S; Melamed, R M M; Braga, D P A F; Madaschi, C; Iaconelli, A; Pasqualotto, F F; Borges, E

2008-12-01

Professionals involved in assisted reproductive technologies (ART) have in-depth awareness and knowledge of the risks of multiple pregnancies at the conclusion of in vitro fertilization (IVF) treatment. The aim of the study was to investigate ART professionals' attitudes towards the awareness of the risk of infertility, as well as the decision-making process in IVF issues. Seventy ART professionals answered a questionnaire covering demographic data, infertility awareness and attitudes towards IVF. Approximately half (50.8%) of the participants thought that they were not at risk of infertility. However, if they received a diagnosis of infertility, none would accept childlessness and almost all would undergo IVF. In an IVF cycle, the number of high-quality embryos transferred would be around three, but if treatment was extended to a third cycle, a higher percentage of participants would elect to transfer four or more embryos. All participants would prefer to undergo IVF and accept the risk of multiple pregnancy than remaining childless. It was found that less than a third of ART professionals considered triplets to be an unacceptable complication of IVF. Diagnosis of infertility affects all participants psychosocially, supporting the idea that the emotional aspects of wanting a biological child, and decision making about whether to undertake ART, outweigh the medical position regarding the risks and benefits of IVF.

Risk assessment of soils contaminated by mercury mining, Northern Spain.

PubMed

Ordóñez, A; Alvarez, R; Charlesworth, S; De Miguel, E; Loredo, J

2011-01-01

Analytical results of soil samples taken in three different mercury mining sites in Northern Spain are studied to assess the potential adverse health effects of the exposure to trace elements associated with the mining process. Doses contacted through ingestion and inhalation and the dose absorbed through the skin were calculated using USEPA's exposure parameters and the US Department of Energy's toxicity values. The results of the risk assessment indicate that the highest risk is associated with ingestion of soil particles and that the trace element of major concern is arsenic, the exposure to which results in a high cancer risk value for all the sites ranging from 3.3 × 10(-5) to 3.6 × 10(-3), well above the 1 × 10(-5) probability level deemed unacceptable by most regulatory agencies. Regarding non-cancer effects, exposure to polluted soils yields an aggregate hazard index above the threshold value of 1 for all three sites, with As and Hg as the main contributors. Risk assessment has proven to be a very useful tool to identify the contaminants and exposure pathways of most concern in the soils from metal mining sites, as well as to categorize them in terms of action priority to ensure fitness for use.

Risk stratification and management of acute pulmonary embolism.

PubMed

Becattini, Cecilia; Agnelli, Giancarlo

2016-12-02

The clinical management of patients with acute pulmonary embolism is rapidly changing over the years. The widening spectrum of clinical management strategies for these patients requires effective tools for risk stratification. Patients at low risk for death could be candidates for home treatment or early discharge. Clinical models with high negative predictive value have been validated that could be used to select patients at low risk for death. In a major study and in several meta-analyses, thrombolysis in hemodynamically stable patients was associated with unacceptably high risk for major bleeding complications or intracranial hemorrhage. Thus, the presence of shock or sustained hypotension continues to be the criterion for the selection of candidates for thrombolytic treatment. Interventional procedures for early revascularization should be reserved to selected patients until further evidence is available. No clinical advantage is expected with the insertion of a vena cava filter in the acute-phase management of patients with acute pulmonary embolism. Direct oral anticoagulants used in fixed doses without laboratory monitoring showed similar efficacy (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.70-1.12) and safety (OR, 0.89; 95% CI, 0.77-1.03) in comparison with conventional anticoagulation in patients with acute pulmonary embolism. Based on these results and on their practicality, direct oral anticoagulants are the agents of choice for the treatment of the majority of patients with acute pulmonary embolism. © 2016 by The American Society of Hematology. All rights reserved.

[Incidence of non-communicable diseases and health risks due to potable water quality].

PubMed

Skudarnov, S E; Kurkatov, S V

2011-01-01

Iron and fluorine concentrations and water mineralization and hardness, which exceeded the maximum allowable concentrations, were found to cause an increase in overall morbidity and morbidity from skeletal-and-muscular, urogenital, and digestive system involvement in the population of the Krasnoyarsk Region. A quantitative relationship were found between the concentrations of iron, the hardness and dry residue of water and the incidence rates of urogenital, skeletal-and-muscular and digestive diseases. The consumption of potable water contaminated with chloroform and methane tetrachloride presents unacceptable carcinogenic risks to the population of the Krasnoyarsk Region.

Robotic bees for crop pollination: Why drones cannot replace biodiversity.

PubMed

Potts, Simon G; Neumann, Peter; Vaissière, Bernard; Vereecken, Nicolas J

2018-06-14

The notion that robotic crop pollination will solve the decline in pollinators has gained wide popularity recently (Fig. 1), and in March 2018 Walmart filed a patent for autonomous robot bees. However, w present six arguments showing that this is a technically and economically inviable 'solution' at present and poses substantial ecological and moral risks: (1) despite recent advances, robotic pollination is far from being able to replace bees to pollinate crops efficiently; (2) using robots is very unlikely to be economically viable; (3) there would be unacceptably high environmental costs; (4) wider ecosystems would be damaged; (5) it would erode the values of biodiversity; and, (6) relying on robotic pollination could actually lead to major food insecurity. Copyright © 2018 Elsevier B.V. All rights reserved.

Atrazine reduces reproduction in fathead minnow (Pimephales promelas): raw data report

USGS Publications Warehouse

Tillitt, Donald E.; Papoulias, Diana M.; Whyte, Jeffrey J.; Richter, Catherine A.

2014-01-01

The herbicide, atrazine, routinely is observed in surface and groundwaters, particularly in the “corn belt” region, a high-use area of the United States. Atrazine has demonstrated effects on reproduction in mammals and amphibians, but the characterization of endocrine-related effects in fish has received only limited attention. Peak concentrations of atrazine in surface water of streams from these agricultural areas coincide with annual spawning events of native fishes. Consequently, there was an unacceptable level of uncertainty in our understanding of the risks associated with the periods of greatest atrazine exposure and greatest vulnerability of certain species of fishes. For this reason, a study of the effects of atrazine on fathead minnow reproduction was undertaken (Tillitt and others, 2010). This report provides the raw data from that study.

Accuracy Considerations in Sterile Compounding.

PubMed

Akers, Michael J

2017-01-01

Published information about the accuracy of filling and closing operations of sterile products is limited and guidelines on the topic are very general. This article highlights the basic principles in sterile-product filling of syringes and vials. Also covered in this article are descriptions of some of the available devices for filling containers, a brief discussion of the advances in vial and syringe filling, a discussion on the advantages and disadvantages of sterile product filling methods, and a discussion on possible problems encountered during filling operations. Because of the extremely high costs of some new drugs, especially biopharmaceuticals, compounding pharmacies may prefer to fill small batches to reduce the risk of unacceptable monetary losses in the event of a manufacturing deviation that results in batch rejection. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

21 CFR 1305.15 - Unaccepted and defective DEA Forms 222.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 9 2011-04-01 2011-04-01 false Unaccepted and defective DEA Forms 222. 1305.15... I AND II CONTROLLED SUBSTANCES DEA Form 222 § 1305.15 Unaccepted and defective DEA Forms 222. (a) A DEA Form 222 must not be filled if either of the following apply: (1) The order is not complete...

21 CFR 1305.15 - Unaccepted and defective DEA Forms 222.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Unaccepted and defective DEA Forms 222. 1305.15... I AND II CONTROLLED SUBSTANCES DEA Form 222 § 1305.15 Unaccepted and defective DEA Forms 222. (a) A DEA Form 222 must not be filled if either of the following apply: (1) The order is not complete...

Air and water cooled modulator

DOEpatents

Birx, Daniel L.; Arnold, Phillip A.; Ball, Don G.; Cook, Edward G.

1995-01-01

A compact high power magnetic compression apparatus and method for delivering high voltage pulses of short duration at a high repetition rate and high peak power output which does not require the use of environmentally unacceptable fluids such as chlorofluorocarbons either as a dielectric or as a coolant, and which discharges very little waste heat into the surrounding air. A first magnetic switch has cooling channels formed therethrough to facilitate the removal of excess heat. The first magnetic switch is mounted on a printed circuit board. A pulse transformer comprised of a plurality of discrete electrically insulated and magnetically coupled units is also mounted on said printed board and is electrically coupled to the first magnetic switch. The pulse transformer also has cooling means attached thereto for removing heat from the pulse transformer. A second magnetic switch also having cooling means for removing excess heat is electrically coupled to the pulse transformer. Thus, the present invention is able to provide high voltage pulses of short duration at a high repetition rate and high peak power output without the use of environmentally unacceptable fluids and without discharging significant waste heat into the surrounding air.

SDDOT : safety program

DOT National Transportation Integrated Search

2000-05-01

The current safety and loss control program for the South Dakota Department of Transportation is not reaching its full potential and does not adequately prevent accidents and injuries. The Department has experienced an unacceptably high number of acc...

Pedestrian traffic injuries among school children in Kawempe, Uganda.

PubMed

Nakitto, Mable T; Mutto, Milton; Howard, Andrew; Lett, Ronald

2008-09-01

Traffic injuries are an important problem in low income countries. In Uganda road traffic is the largest single cause of injury in Kampala; pedestrians, and children are most affected. Pedestrian injury affects school children in Uganda. To determine the overall risk of pedestrian traffic injury among school children in Kawempe, Uganda. A cohort was assembled at 35 primary schools and followed for 3 terms. Ten of the schools had participated in previous injury programs, others were systematically selected. Injuries were recorded by teachers using a questionnaire. Data collected included ID, school, age, grade, gender, incident date, vehicle type, and injury outcome. Demographic characteristics are described and cumulative incidences calculated. The cohort included 8,165 children (49% male) from 35 primary schools. The mean age was 9 years (Sd=2.78). Of the 35 schools, 92% were day; the others mixed day and boarding. 53 children (27 girls) were involved in a traffic incident. 25% of the injuries reported were serious and warranted care in a health facility. No deaths occurred. Forty % of incidents involved commercial motorcycles, 41% bicycles, 9% cars, 8% taxis, and 2% trucks. The cumulative incidence was 0.168% each term. Over the 3 terms of the year the cumulative incidence was 0.5 +/- 0.02. There were no gender differences in the cumulative incidence. Each school year about 1/2 % of Kawempe school children are involved in a traffic incident. Interventions are necessary to reduce the unacceptably high incidents of pedestrian traffic. Interventions to alleviate this situation including safer routes, teaching skills of road crossing to children as well as better regulation and road safety education to two wheelers could reduce the unacceptably high incidents of pedestrian traffic injury.

Evaluation of a modified cleaning procedure in the prevention of carbapenem-resistant Acinetobacter baumannii clonal spread in a burn intensive care unit using a high-sensitivity luminometer.

PubMed

Casini, B; Selvi, C; Cristina, M L; Totaro, M; Costa, A L; Valentini, P; Barnini, S; Baggiani, A; Tagliaferri, E; Privitera, G

2017-01-01

Enhanced environmental cleaning practices are among the most accepted measures for controlling the spread of carbapenem-resistant Acinetobacter baumannii (CR-Ab). To evaluate the impact of heightened cleaning on an ongoing CR-Ab outbreak in a burn intensive care unit (BICU) of an Italian teaching hospital, where chlorhexidine-60% isopropyl alcohol was applied as a complementary disinfectant on high-touch surfaces. Compliance with the microbial limit proposed for the BICU by AFNOR-NF-S90-351 (20 colony-forming units/100cm 2 ) was assessed by plate count, and compared with the results obtained with intracellular adenosine triphosphate (ATP) detection. Genotyping was performed using pulsed-field gel electrophoresis. During the standard cleaning regimen, three out of 23 samples (13%) gave results over the AFNOR limit and five (21.7%) showed unacceptable ATP levels with 100 relative light units/100cm 2 as the benchmark limit (sensibility 86.4%, specificity 92.2%). Following improvement of the cleaning procedure, only two samples out of 50 (4%) did not satisfy the microbiological criteria and seven (14%) exceeded the ATP limit. In a successive phase, eight of 30 samples collected showed unacceptable results (27%). Adding chlorhexidine-60% isopropyl alcohol as complementary disinfectant proved to be effective for reducing environmental microbial contamination, ATP levels and CR-Ab infection/colonization in patients admitted to the BICU. Real-time monitoring by ATP assay was useful for managing the cleaning schedule and reducing hospital infections, although the calculated values must be interpreted as cleanliness indicators rather than risk indicators. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Federal High School Graduation Rate Policies and the Impact on Kansas

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Arkansas

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Alabama

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Connecticut

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Oregon

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Georgia

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Missouri

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Colorado

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on New Jersey

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Florida

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Illinois

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Ohio

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on New York

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Massachusetts

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Arizona

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on California

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Montana

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Kentucky

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Louisiana

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Maryland

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Alaska

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Idaho

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Maine

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Hawaii

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Oklahoma

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on New Hampshire

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on North Dakota

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on North Carolina

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Delaware

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Mississippi

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Indiana

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on New Mexico

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Minnesota

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Nebraska

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Nevada

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Michigan

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Evaluation of a risk-based environmental hot spot delineation algorithm.

PubMed

Sinha, Parikhit; Lambert, Michael B; Schew, William A

2007-10-22

Following remedial investigations of hazardous waste sites, remedial strategies may be developed that target the removal of "hot spots," localized areas of elevated contamination. For a given exposure area, a hot spot may be defined as a sub-area that causes risks for the whole exposure area to be unacceptable. The converse of this statement may also apply: when a hot spot is removed from within an exposure area, risks for the exposure area may drop below unacceptable thresholds. The latter is the motivation for a risk-based approach to hot spot delineation, which was evaluated using Monte Carlo simulation. Random samples taken from a virtual site ("true site") were used to create an interpolated site. The latter was gridded and concentrations from the center of each grid box were used to calculate 95% upper confidence limits on the mean site contaminant concentration and corresponding hazard quotients for a potential receptor. Grid cells with the highest concentrations were removed and hazard quotients were recalculated until the site hazard quotient dropped below the threshold of 1. The grid cells removed in this way define the spatial extent of the hot spot. For each of the 100,000 Monte Carlo iterations, the delineated hot spot was compared to the hot spot in the "true site." On average, the algorithm was able to delineate hot spots that were collocated with and equal to or greater in size than the "true hot spot." When delineated hot spots were mapped onto the "true site," setting contaminant concentrations in the mapped area to zero, the hazard quotients for these "remediated true sites" were on average within 5% of the acceptable threshold of 1.

58th SOW Low-Dust Helicopter Landing Zone Final Environmental Assessment

DTIC Science & Technology

2012-11-01

Effects AQCR Air Quality Control Region BASH Bird/wildlife-Aircraft Strike Hazard CEQ Council on Environmental Quality CFR Code of Federal Regulations...force would continue to be applied to minimize risks to aircrews and the general population. No unacceptable hazards to military personnel, the public...and Final EA As a result of comments received on the Draft EA, Section 3.1.2, Global Climate Change, and Hazardous and Toxic Materials and Waste

United States Army Space Experiment 601

DTIC Science & Technology

1992-07-29

impossible to urinate except into a diaper . The LES is hot and humid, bulky and heavy, and is unacceptable for space flight. The risk versus comfort...that the DSP satellite solar panels -r::eived enough sunlight reflected from the Earth to completely power the spacecraft, making the CRU output voltage...that were excessively cloudy were excluded from the statistics (if > 90% of pixels in the sample had brightness values above the threshold). The solar

Challenges in global ballast water management.

PubMed

Endresen, Øyvind; Lee Behrens, Hanna; Brynestad, Sigrid; Bjørn Andersen, Aage; Skjong, Rolf

2004-04-01

Ballast water management is a complex issue raising the challenge of merging international regulations, ship's specific configurations along with ecological conservation. This complexity is illustrated in this paper by considering ballast water volume, discharge frequency, ship safety and operational issues aligned with regional characteristics to address ecological risk for selected routes. A re-estimation of ballast water volumes gives a global annual level of 3500 Mton. Global ballast water volume discharged into open sea originating from ballast water exchange operations is estimated to approximately 2800 Mton. Risk based decision support systems coupled to databases for different ports and invasive species characteristics and distributions can allow for differentiated treatment levels while maintaining low risk levels. On certain routes, the risk is estimated to be unacceptable and some kind of ballast water treatment or management should be applied.

Reduction of earthquake risk in the united states: Bridging the gap between research and practice

USGS Publications Warehouse

Hays, W.W.

1998-01-01

Continuing efforts under the auspices of the National Earthquake Hazards Reduction Program are under way to improve earthquake risk assessment and risk management in earthquake-prone regions of Alaska, California, Nevada, Washington, Oregon, Arizona, Utah, Wyoming, and Idaho, the New Madrid and Wabash Valley seismic zones in the central United States, the southeastern and northeastern United States, Puerto Rico, Virgin Islands, Guam, and Hawaii. Geologists, geophysicists, seismologists, architects, engineers, urban planners, emergency managers, health care specialists, and policymakers are having to work at the margins of their disciplines to bridge the gap between research and practice and to provide a social, technical, administrative, political, legal, and economic basis for changing public policies and professional practices in communities where the earthquake risk is unacceptable. ?? 1998 IEEE.

Fetal Alcohol Spectrum Disorders: Using Knowledge, Attitudes and Practice of Justice Professionals to Support their Educational Needs.

PubMed

Mutch, Raewyn C; Jones, Heather M; Bower, Carol; Watkins, Rochelle E

2016-01-01

People with Fetal Alcohol Spectrum Disorders (FASD) can be involved in high risk, socially unacceptable and harmful behaviours and are at high risk of engaging with the justice system. To obtain baseline data on Western Australian justice professionals' knowledge, attitudes and practice relating to FASD to inform the development of FASD resources. Cross sectional study using on-line survey methods, descriptive analysis of quantitative data and content analysis methods for qualitative data. 1873 people were invited to complete the survey. A total of 427 (23%) judicial officers, lawyers, corrective services personnel and police completed the survey. The majority had heard of Fetal Alcohol Syndrome (85%) but were less familiar with FASD (60%). Only 16% of respondents identified the key features of FASD as permanent and only 48.4% considered psychological difficulties as important. The majority of legal and judicial officers and approximately half the police officers considered that knowledge about FASD was very relevant to their work. There was widespread agreement of the need for more information and training about FASD to optimise outcomes for people with, or suspected of having a FASD, engaging with the justice system.

Endovascular treatment of thoracic disease: patient selection and a proposal of a risk score.

PubMed

Rodrigues Alves, Claudia Maria; da Fonseca, José Honório Palma; de Souza, José Augusto Marcondes; Camargo Carvalho, Antonio Carlos; Buffolo, Enio

2002-04-01

Although selection criteria and subgroup analysis are still in the early developmental stages, endovascular treatment of aortic disease has become an alternative to surgery for many patients. From November 1996 to November 1999, 49 patients were treated with a self-expandable endoprosthesis at our institution. Most patients had acute aortic dissections. Thirteen of these patients did not follow the anatomic selection protocol. We retrospectively analyzed these patients to compare our numerical risk score (which includes clinical and anatomic criteria) between groups with or without success and between groups that followed the anatomic protocol (P) or did not follow the anatomic protocol (E [exception]). Success rates were similar in groups P and E, although mortality rates were higher in group E. Patients from group E had longer procedures and required multiple stents more frequently. The proposed risk score was able to differentiate between groups with or without success, as well as between groups P and E. In order to reduce mortality and morbidity rates, careful selection criteria must be followed when treating patients endovascularly. Although it is time-consuming, using objective criteria can help select patients for endovascular treatment. We propose that patients with a risk score higher than 11 should only undergo percutaneous treatment when they have an unacceptably high surgical risk, and even so only after a detailed discussion of the risks.

Silicosis among gold miners: exposure--response analyses and risk assessment.

PubMed Central

Steenland, K; Brown, D

1995-01-01

OBJECTIVES. This study sought to estimate the risk of silicosis by cumulative exposure-years in a cohort of miners exposed to silica, as well as the lifetime risk of silicosis under the current Occupational Safety and Health Administration (OSHA) standard (0.09 mg/m3). METHODS. In a cohort study of 3330 gold miners who worked at least 1 year underground from 1940 to 1965 (average 9 years) and were exposed to a median silica level of 0.05 mg/m3 (0.15 mg/m3 for those hired before 1930), 170 cases of silicosis were determined from either death certificates or two cross-sectional radiographic surveys. RESULTS. The risk of silicosis was less than 1% with a cumulative exposure under 0.5 mg/m3-years, increasing to 68% to 84% for the highest cumulative exposure category of more than 4 mg/m3-years. Cumulative exposure was the best predictor of disease, followed by duration of exposure and average exposure. After adjustment for competing risks of death, a 45-year exposure under the current OSHA standard would lead to a lifetime risk of silicosis of 35% to 47%. CONCLUSIONS. Almost 2 million US workers are currently exposed to silica. Our results add to a small but increasing body of literature that suggests that the current OSHA silica exposure level is unacceptably high. PMID:7573620

A Comparison of Mission Statements of National Blue Ribbon Schools and Unacceptable Texas High Schools

ERIC Educational Resources Information Center

Perfetto, John Charles; Holland, Glenda; Davis, Rebecca; Fedynich, La Vonne

2013-01-01

This study was conducted to determine the themes present in the context of high schools, to determine any significant differences in themes for high and low performing high schools, and to determine if significant differences were present for the same sample of high schools based on school size. An analysis of the content of mission statements…

Federal Graduation Rate Policies and the Impact on Iowa

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

The Factorial Validity of the Piers-Harris Children's Self-Concept Scale for Each of Three Samples of Elementary, Junior High, and Senior High School Students in a Large Metropolitan School District

ERIC Educational Resources Information Center

Michael, William B.; And Others

1975-01-01

The scale yielded three major dimensions that were essentially invariant across the three samples: physical appearance, socially unacceptable (bad) behavior, and academic or school status. (Author/RC)

Socioeconomic Influences on the Educational and Career Paths of Kentucky High School Seniors.

ERIC Educational Resources Information Center

Rever, Philip R.; And Others

The report is a response to Kentucky Higher Education Assistance Authority's concern about limiting factors which constrain students' choices of paths to follow after leaving high school, specifically unacceptable factors that prohibit students (1) from pursuing postsecondary education and (2) from entering postsecondary institutions of their…

Junior High Student Responsibilities for Basic Skills.

ERIC Educational Resources Information Center

Parker, Charles C.

This paper advances the thesis that students should be trained to recognize acceptable and unacceptable performances in basic skill areas and should assume responsibility for attaining proficiency in these areas. Among the topics discussed are the value of having junior high school students check their own assignments, discover their errors, and…

Cardiometabolic diseases of civilization: history and maturation of an evolving global threat. An update and call to action.

PubMed

Kones, Richard; Rumana, Umme

2017-05-01

Despite striking extensions of lifespan, leading causes of death in most countries now constitute chronic, degenerative diseases which outpace the capacity of health systems. Cardiovascular disease is the most common cause of death in both developed and undeveloped countries. In America, nearly half of the adult population has at least one chronic disease, and polypharmacy is commonplace. Prevalence of ideal cardiovascular health has not meaningfully improved over the past two decades. The fall in cardiovascular deaths in Western countries, half due to a fall in risk factors and half due to improved treatments, have plateaued, and this reversal is due to the dual epidemics of obesity and diabetes type 2. High burdens of cardiovascular risk factors are also evident globally. Undeveloped nations bear the burdens of both infectious diseases and high childhood death rates. Unacceptable rates of morbidity and mortality arise from insufficient resources to improve sanitation, pure water, and hygiene, ultimately linked to poverty and disparities. Simultaneously, about 80% of cardiovascular deaths now occur in low- and middle-income nations. For these reasons, risk factors for noncommunicable diseases, including poverty, health illiteracy, and lack of adherence, must be targeted with unprecedented vigor worldwide. Key messages In developed and relatively wealthy countries, chronic "degenerative" diseases have attained crisis proportions that threaten to reverse health gains made within the past decades. Although poverty, disparities, and poor sanitation still cause unnecessary death and despair in developing nations, they are now also burdened with increasing cardiovascular mortality. Poor adherence and low levels of health literacy contribute to the high background levels of cardiovascular risk.

Targeting von Willebrand Factor in Ischaemic Stroke: Focus on Clinical Evidence.

PubMed

Buchtele, Nina; Schwameis, Michael; Gilbert, James C; Schörgenhofer, Christian; Jilma, Bernd

2018-06-01

Despite great efforts in stroke research, disability and recurrence rates in ischaemic stroke remain unacceptably high. To address this issue, one potential target for novel therapeutics is the glycoprotein von Willebrand factor (vWF), which increases in thrombogenicity especially under high shear rates as it bridges between vascular sub-endothelial collagen and platelets. The rationale for vWF as a potential target in stroke comes from four bodies of evidence. (1) Animal models which recapitulate the pathogenesis of stroke and validate the concept of targeting vWF for stroke prevention and the use of the vWF cleavage enzyme ADAMTS13 in acute stroke treatment. (2) Extensive epidemiologic data establishing the prognostic role of vWF in the clinical setting showing that high vWF levels are associated with an increased risk of first stroke, stroke recurrence or stroke-associated mortality. As such, vWF levels may be a suitable marker for further risk stratification to potentially fine-tune current risk prediction models which are mainly based on clinical and imaging data. (3) Genetic studies showing an association between vWF levels and stroke risk on genomic levels. Finally, (4) studies of patients with primary disorders of excess or deficiency of function in the vWF axis (e.g. thrombotic thrombocytopenic purpura and von Willebrand disease, respectively) which demonstrate the crucial role of vWF in atherothrombosis. Therapeutic inhibition of VWF by novel agents appears particularly promising for secondary prevention of stroke recurrence in specific sub-groups of patients such as those suffering from large artery atherosclerosis, as designated according to the TOAST classification. Schattauer GmbH Stuttgart.

Adolescent drivers: a developmental perspective on risk, proficiency, and safety.

PubMed

Keating, Daniel P; Halpern-Felsher, Bonnie L

2008-09-01

Despite considerable improvement in the rates of crashes, injuries, and fatalities among adolescent drivers, attributable in part to effective interventions such as graduated driver licensing, these rates and their associated health risks remain unacceptably high. To understand the sources of risky driving among teens, as well as to identify potential avenues for further advances in prevention, this article presents a review of the relevant features of contemporary research on adolescent development. Current research offers significant advances in the understanding of the sources of safe driving, proficient driving, and risky driving among adolescents. This multifaceted perspective--as opposed to simple categorization of good versus bad driving--provides new opportunities for using insights on adolescent development to enhance prevention. Drawing on recent work on adolescent physical, neural, and cognitive development, we argue for approaches to prevention that recognize both the strengths and the limitations of adolescent drivers, with particular attention to the acquisition of expertise, regulatory competence, and self-regulation in the context of perceived risk. This understanding of adolescent development spotlights the provision of appropriate and effective scaffolding, utilizing the contexts of importance to adolescents--parents, peers, and the broader culture of driving--to support safe driving and to manage the inherent risks in learning to do so.

OEM Emergency Prevention and Mitigation Information

EPA Pesticide Factsheets

The Office of Emergency Management maintains information relevant to preventing emergencies before they occur, and/or mitigating the effects of emergency when they do occur. A principal element of this data asset is the information managed by the System for Risk Management Plans (SRMP), which compiles risk management plans submitted by facilities in accordance with the Clean Air Act, Section 112(r). Affected facilities are to develop risk management programs which will prevent and minimize consequences of accidental releases of certain hazardous chemicals that could harm public health and the environment.Another component of this data asset are the results generated by the Priority Assessment Model (PAM), which analyzes information concerning low-level chronic emissions from facilities and sets priorities (low, medium, high) for proactive controls on releases that do not necessarily pose imminent threats, but which may under adverse circumstances create unacceptable health or ecological risks.Also included are inspection records compiled by the Oil Inspection Program. Under the Clean Water Act Section 311, EPA regulates oil storage that meets a specific regulatory threshold. Facilities that store oil and meet the regulatory threshold need to prepare and implement a Spill Prevention, Control, and Countermeasures (SPCC) Plan which needs to be reviewed and approved by a professional engineer. Additionally, facilities with larger oil storage capacity may have to pre

CT Scan Screening for Lung Cancer: Risk Factors for Nodules and Malignancy in a High-Risk Urban Cohort

PubMed Central

Greenberg, Alissa K.; Lu, Feng; Goldberg, Judith D.; Eylers, Ellen; Tsay, Jun-Chieh; Yie, Ting-An; Naidich, David; McGuinness, Georgeann; Pass, Harvey; Tchou-Wong, Kam-Meng; Addrizzo-Harris, Doreen; Chachoua, Abraham; Crawford, Bernard; Rom, William N.

2012-01-01

Background Low-dose computed tomography (CT) for lung cancer screening can reduce lung cancer mortality. The National Lung Screening Trial reported a 20% reduction in lung cancer mortality in high-risk smokers. However, CT scanning is extremely sensitive and detects non-calcified nodules (NCNs) in 24–50% of subjects, suggesting an unacceptably high false-positive rate. We hypothesized that by reviewing demographic, clinical and nodule characteristics, we could identify risk factors associated with the presence of nodules on screening CT, and with the probability that a NCN was malignant. Methods We performed a longitudinal lung cancer biomarker discovery trial (NYU LCBC) that included low-dose CT-screening of high-risk individuals over 50 years of age, with more than 20 pack-year smoking histories, living in an urban setting, and with a potential for asbestos exposure. We used case-control studies to identify risk factors associated with the presence of nodules (n = 625) versus no nodules (n = 557), and lung cancer patients (n = 30) versus benign nodules (n = 128). Results The NYU LCBC followed 1182 study subjects prospectively over a 10-year period. We found 52% to have NCNs >4 mm on their baseline screen. Most of the nodules were stable, and 9.7% of solid and 26.2% of sub-solid nodules resolved. We diagnosed 30 lung cancers, 26 stage I. Three patients had synchronous primary lung cancers or multifocal disease. Thus, there were 33 lung cancers: 10 incident, and 23 prevalent. A sub-group of the prevalent group were stable for a prolonged period prior to diagnosis. These were all stage I at diagnosis and 12/13 were adenocarcinomas. Conclusions NCNs are common among CT-screened high-risk subjects and can often be managed conservatively. Risk factors for malignancy included increasing age, size and number of nodules, reduced FEV1 and FVC, and increased pack-years smoking. A sub-group of screen-detected cancers are slow-growing and may contribute to over-diagnosis and lead-time biases. PMID:22768300

Secondary stroke prevention: challenges and solutions.

PubMed

Esenwa, Charles; Gutierrez, Jose

2015-01-01

Stroke is the leading cause of disability in the USA and a major cause of mortality worldwide. One out of four strokes is recurrent. Secondary stroke prevention starts with deciphering the most likely stroke mechanism. In general, one of the main goals in stroke reduction is to control vascular risk factors such as hypertension, diabetes, dyslipidemia, and smoking cessation. Changes in lifestyle like a healthy diet and aerobic exercise are also recommended strategies. In the case of cardioembolism due to atrial fibrillation, mechanical valves, or cardiac thrombus, anticoagulation is the mainstay of therapy. The role of anticoagulation is less evident in the case of bioprosthetic valves, patent foramen ovale, and dilated cardiomyopathy with low ejection fraction. Strokes due to larger artery atherosclerosis account for approximately a third of all strokes. In the case of symptomatic extracranial carotid stenosis, surgical intervention as close as possible in time to the index event seems highly beneficial. In the case of intracranial large artery atherosclerosis, the best medical therapy consists of antiplatelets, high-dose statins, aggressive controls of vascular risk factors, and lifestyle modifications, with no role for intracranial arterial stenting or angioplasty. For patients with small artery occlusion (ie, lacunar stroke), the therapy is similar to that used in patients with intracranial large artery atherosclerosis. Despite the constant new evidence on how to best treat patients who have suffered a stroke, the risk of stroke recurrence remains unacceptably high, thus evidencing the need for novel therapies.

TNT Degradation by Natural Microbial Assemblages at Frontal Boundaries Between Water Masses in Coastal Ecosystems (ER-2124)

DTIC Science & Technology

2017-06-20

that would pose an unacceptable ecological or human health risk. Recent work by our group and others has focused on determining energetic degradation...Eastern North Carolina, USA). J. Water Health 6:473-482. 59 Derrien, D., Plain, C., Courty, P.E., Gelhaye, L., Moerdijk-Poortvliet, T.C., Thomas, F...sediment enrichments. Biodegradation 24(2):179-190. Fenner, K., Canonica, S., Wackett, L.P., and M.Els ner. 2013. Evaluating pesticide

The Fourth Factor: The Case for Parity of Information as an Operational Factor With Space, Time & Force

DTIC Science & Technology

2008-10-31

problem is devoid of a factor, it incurs additional (and sometimes unacceptable) risk. Operational art exists in an area that inter mingles science ...Operational Art as defined in U.S. Joint Doctrine is an accepted process for use by operational commanders to visualize how to most efficiently and...effectively employ military capabilities to achieve a desired objective. Within Operational Art are three accepted factors in which all other

One Size Does Not Fit All: How Acquisition Fails the Joint Force Commander

DTIC Science & Technology

2010-04-02

Campaign Planning and Strategy . The contents of this paper reflect my own personal views and are not necessarily endorsed by the Joint Forces Staff...one-size-fits-all‖ approach has insidiously led to a flawed aircraft acquisition strategy that allows unacceptable risk to combat effectiveness in an...and 78% of the total US tactical aviation fleet. This ―one-size-fits-all‖ approach has insidiously led to a flawed aircraft acquisition strategy

Human germline genetic modification: scientific and bioethical perspectives.

PubMed

Smith, Kevin R; Chan, Sarah; Harris, John

2012-10-01

The latest mammalian genetic modification technology offers efficient and reliable targeting of genomic sequences, in the guise of designer genetic recombination tools. These and other improvements in genetic engineering technology suggest that human germline genetic modification (HGGM) will become a safe and effective prospect in the relatively near future. Several substantive ethical objections have been raised against HGGM including claims of unacceptably high levels of risk, damage to the status of future persons, and violations of justice and autonomy. This paper critically reviews the latest GM science and discusses the key ethical objections to HGGM. We conclude that major benefits are likely to accrue through the use of safe and effective HGGM and that it would thus be unethical to take a precautionary stance against HGGM. Copyright © 2012 IMSS. Published by Elsevier Inc. All rights reserved.

Combined-modality therapy for primary central nervous system lymphoma: Long-term data from a Phase II multicenter study (Trans-Tasman Radiation Oncology Group)

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

O'Brien, Peter C.; Roos, Daniel E.; Pratt, Gary

2006-02-01

Purpose: To assess, in a multicenter setting, the long-term outcomes of a brief course of high-dose methotrexate followed by radiotherapy for patients with primary central nervous system lymphoma (PCNSL). Methods and Materials: Forty-six patients were entered in a Phase II protocol consisting of methotrexate (1 g/m{sup 2} on Days 1 and 8), followed by whole-brain irradiation (45-50.4 Gy). The median follow-up time was 7 years, with a minimum follow-up of 5 years. Results: The 5-year survival estimate was 37% ({+-}14%, 95% confidence interval [CI]), with progression-free survival being 36% ({+-}15%, 95% CI), and median survival 36 months. Of the originalmore » 46 patients, 10 were alive, all without evidence of disease recurrence. A total of 11 patients have developed neurotoxicity, with the actuarial risk being 30% ({+-}18%, 95% CI) at 5 years but continuing to increase. For patients aged >60 years the risk of neurotoxicity at 7 years was 58% ({+-}30%, 95% CI). Conclusion: Combined-modality therapy, based on high-dose methotrexate, results in improved survival outcomes in PCNSL. The risk of neurotoxicity for patients aged >60 years is unacceptable with this regimen, although survival outcomes for patients aged >60 years were higher than in many other series.« less

Defining acceptable levels for ecological indicators: an approach for considering social values.

PubMed

Smyth, Robyn L; Watzin, Mary C; Manning, Robert E

2007-03-01

Ecological indicators can facilitate an adaptive management approach, but only if acceptable levels for those indicators have been defined so that the data collected can be interpreted. Because acceptable levels are an expression of the desired state of the ecosystem, the process of establishing acceptable levels should incorporate not just ecological understanding but also societal values. The goal of this research was to explore an approach for defining acceptable levels of ecological indicators that explicitly considers social perspectives and values. We used a set of eight indicators that were related to issues of concern in the Lake Champlain Basin. Our approach was based on normative theory. Using a stakeholder survey, we measured respondent normative evaluations of varying levels of our indicators. Aggregated social norm curves were used to determine the level at which indicator values shifted from acceptable to unacceptable conditions. For seven of the eight indicators, clear preferences were interpretable from these norm curves. For example, closures of public beaches because of bacterial contamination and days of intense algae bloom went from acceptable to unacceptable at 7-10 days in a summer season. Survey respondents also indicated that the number of fish caught from Lake Champlain that could be safely consumed each month was unacceptably low and the number of streams draining into the lake that were impaired by storm water was unacceptably high. If indicators that translate ecological conditions into social consequences are carefully selected, we believe the normative approach has considerable merit for defining acceptable levels of valued ecological system components.

Defining Acceptable Levels for Ecological Indicators: An Approach for Considering Social Values

NASA Astrophysics Data System (ADS)

Smyth, Robyn L.; Watzin, Mary C.; Manning, Robert E.

2007-03-01

Ecological indicators can facilitate an adaptive management approach, but only if acceptable levels for those indicators have been defined so that the data collected can be interpreted. Because acceptable levels are an expression of the desired state of the ecosystem, the process of establishing acceptable levels should incorporate not just ecological understanding but also societal values. The goal of this research was to explore an approach for defining acceptable levels of ecological indicators that explicitly considers social perspectives and values. We used a set of eight indicators that were related to issues of concern in the Lake Champlain Basin. Our approach was based on normative theory. Using a stakeholder survey, we measured respondent normative evaluations of varying levels of our indicators. Aggregated social norm curves were used to determine the level at which indicator values shifted from acceptable to unacceptable conditions. For seven of the eight indicators, clear preferences were interpretable from these norm curves. For example, closures of public beaches because of bacterial contamination and days of intense algae bloom went from acceptable to unacceptable at 7-10 days in a summer season. Survey respondents also indicated that the number of fish caught from Lake Champlain that could be safely consumed each month was unacceptably low and the number of streams draining into the lake that were impaired by storm water was unacceptably high. If indicators that translate ecological conditions into social consequences are carefully selected, we believe the normative approach has considerable merit for defining acceptable levels of valued ecological system components.

Air and water cooled modulator

DOEpatents

Birx, D.L.; Arnold, P.A.; Ball, D.G.; Cook, E.G.

1995-09-05

A compact high power magnetic compression apparatus and method are disclosed for delivering high voltage pulses of short duration at a high repetition rate and high peak power output which does not require the use of environmentally unacceptable fluids such as chlorofluorocarbons either as a dielectric or as a coolant, and which discharges very little waste heat into the surrounding air. A first magnetic switch has cooling channels formed therethrough to facilitate the removal of excess heat. The first magnetic switch is mounted on a printed circuit board. A pulse transformer comprised of a plurality of discrete electrically insulated and magnetically coupled units is also mounted on said printed board and is electrically coupled to the first magnetic switch. The pulse transformer also has cooling means attached thereto for removing heat from the pulse transformer. A second magnetic switch also having cooling means for removing excess heat is electrically coupled to the pulse transformer. Thus, the present invention is able to provide high voltage pulses of short duration at a high repetition rate and high peak power output without the use of environmentally unacceptable fluids and without discharging significant waste heat into the surrounding air. 9 figs.

European Consensus on Primary Prevention of Coronary Heart Disease.

PubMed

Assmann, G

1988-07-01

The European Consensus on Primary Prevention of Coronary Heart Disease has recommended that providing care for individuals at particular risk for coronary artery disease (CAD) requires case finding through medical examinations in primary care, hospital and employment health examination settings. Decisions concerning management of elevated lipid levels should be based on overall cardiovascular risk. The goal of reducing cholesterol levels through risk reduction can ultimately be accomplished only with the implementation of health education efforts directed toward all age groups and actions by government and supranational agencies, including adequate food labelling to identify fat content, selective taxation to encourage healthful habits and wider availability of exercise facilities. Only measures directed at the overall population can eventually reach the large proportion of individuals at mildly to moderately increased risk for CAD. The European Policy Statement on the Prevention of Coronary Heart Disease recognizes that the question of lipid elevation as a risk factor for CAD involves assessment, not only of cholesterol level alone, but also of triglycerides and the HDL cholesterol lipid fraction. Five specific categories of dyslipidemia have been identified, with individualized screening and treatment strategies advised for each. It is the consensus of the study group panel members that these procedures are both practical and feasible. They begin the necessary long term process to reduce the unacceptably high levels of morbidity and mortality due to CAD throughout the European community.

Metal uptake by homegrown vegetables - the relative importance in human health risk assessments at contaminated sites.

PubMed

Augustsson, Anna L M; Uddh-Söderberg, Terese E; Hogmalm, K Johan; Filipsson, Monika E M

2015-04-01

Risk assessments of contaminated land often involve the use of generic bioconcentration factors (BCFs), which express contaminant concentrations in edible plant parts as a function of the concentration in soil, in order to assess the risks associated with consumption of homegrown vegetables. This study aimed to quantify variability in BCFs and evaluate the implications of this variability for human exposure assessments, focusing on cadmium (Cd) and lead (Pb) in lettuce and potatoes sampled around 22 contaminated glassworks sites. In addition, risks associated with measured Cd and Pb concentrations in soil and vegetable samples were characterized and a probabilistic exposure assessment was conducted to estimate the likelihood of local residents exceeding tolerable daily intakes. The results show that concentrations in vegetables were only moderately elevated despite high concentrations in soil, and most samples complied with applicable foodstuff legislation. Still, the daily intake of Cd (but not Pb) was assessed to exceed toxicological thresholds for about a fifth of the study population. Bioconcentration factors were found to vary more than indicated by previous studies, but decreasing BCFs with increasing metal concentrations in the soil can explain why the calculated exposure is only moderately affected by the choice of BCF value when generic soil guideline values are exceeded and the risk may be unacceptable. Copyright © 2015 Elsevier Inc. All rights reserved.

A Framework to Evaluate Wildlife Feeding in Research, Wildlife Management, Tourism and Recreation

PubMed Central

Dubois, Sara; Fraser, David

2013-01-01

Simple Summary Human feeding of wildlife is a world-wide phenomenon with very diverse effects on conservation, animal welfare and public safety. From a review of the motivations, types and consequences of wildlife feeding, an evaluative framework is presented to assist policy-makers, educators and managers to make ethical- and biologically-based decisions about the appropriateness of feeding wildlife in the context of research, wildlife management, tourism and recreation. Abstract Feeding of wildlife occurs in the context of research, wildlife management, tourism and in opportunistic ways. A review of examples shows that although feeding is often motivated by good intentions, it can lead to problems of public safety and conservation and be detrimental to the welfare of the animals. Examples from British Columbia illustrate the problems (nuisance animal activity, public safety risk) and consequences (culling, translocation) that often arise from uncontrolled feeding. Three features of wildlife feeding can be distinguished: the feasibility of control, the effects on conservation and the effects on animal welfare. An evaluative framework incorporating these three features was applied to examples of feeding from the literature. The cases of feeding for research and management purposes were generally found to be acceptable, while cases of feeding for tourism or opportunistic feeding were generally unacceptable. The framework should allow managers and policy-makers to distinguish acceptable from unacceptable forms of wildlife feeding as a basis for policy, public education and enforcement. Many harmful forms of wildlife feeding seem unlikely to change until they come to be seen as socially unacceptable. PMID:26479747

40 CFR Appendix A to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes

Code of Federal Regulations, 2011 CFR

2011-07-01

... characteristic of concern for PFCs is that they have long atmospheric lifetimes and high global warming potentials. Although actual contributions to global warming depend upon the quantities of PFCs emitted, the... characteristic of concern for PFCs is that they have long atmospheric lifetimes and high global warming...

40 CFR Appendix A to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes

Code of Federal Regulations, 2014 CFR

2014-07-01

... characteristic of concern for PFCs is that they have long atmospheric lifetimes and high global warming potentials. Although actual contributions to global warming depend upon the quantities of PFCs emitted, the... for PFCs is that they have long atmospheric lifetimes and high global warming potentials. Although...

40 CFR Appendix A to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes

Code of Federal Regulations, 2012 CFR

2012-07-01

... characteristic of concern for PFCs is that they have long atmospheric lifetimes and high global warming potentials. Although actual contributions to global warming depend upon the quantities of PFCs emitted, the... characteristic of concern for PFCs is that they have long atmospheric lifetimes and high global warming...

40 CFR Appendix A to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes

Code of Federal Regulations, 2013 CFR

2013-07-01

... characteristic of concern for PFCs is that they have long atmospheric lifetimes and high global warming potentials. Although actual contributions to global warming depend upon the quantities of PFCs emitted, the... characteristic of concern for PFCs is that they have long atmospheric lifetimes and high global warming...

Solar thermal technologies benefits assessment: Objectives, methodologies and results for 1981

NASA Technical Reports Server (NTRS)

Gates, W. R.

1982-01-01

The economic and social benefits of developing cost competitive solar thermal technologies (STT) were assessed. The analysis was restricted to STT in electric applications for 16 high insolation/high energy price states. Three fuel price scenarios and three 1990 STT system costs were considered, reflecting uncertainty over fuel prices and STT cost projections. After considering the numerous benefits of introducing STT into the energy market, three primary benefits were identified and evaluated: (1) direct energy cost savings were estimated to range from zero to $50 billion; (2) oil imports may be reduced by up to 9 percent, improving national security; and (3) significant environmental benefits can be realized in air basins where electric power plant emissions create substantial air pollution problems. STT research and development was found to be unacceptably risky for private industry in the absence of federal support. The normal risks associated with investments in research and development are accentuated because the OPEC cartel can artificially manipulate oil prices and undercut the growth of alternative energy sources.

Solar thermal technology development: Estimated market size and energy cost savings. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

Gates, W. R.

1983-01-01

Estimated future energy cost savings associated with the development of cost-competitive solar thermal technologies (STT) are discussed. Analysis is restricted to STT in electric applications for 16 high-insolation/high-energy-price states. The fuel price scenarios and three 1990 STT system costs are considered, reflecting uncertainty over future fuel prices and STT cost projections. STT R&D is found to be unacceptably risky for private industry in the absence of federal support. Energy cost savings were projected to range from $0 to $10 billion (1990 values in 1981 dollars), dependng on the system cost and fuel price scenario. Normal R&D investment risks are accentuated because the Organization of Petroleum Exporting Countries (OPEC) cartel can artificially manipulate oil prices and undercut growth of alternative energy sources. Federal participation in STT R&D to help capture the potential benefits of developing cost-competitive STT was found to be in the national interest.

Solar thermal technology development: Estimated market size and energy cost savings. Volume 1: Executive summary

NASA Astrophysics Data System (ADS)

Gates, W. R.

1983-02-01

Estimated future energy cost savings associated with the development of cost-competitive solar thermal technologies (STT) are discussed. Analysis is restricted to STT in electric applications for 16 high-insolation/high-energy-price states. The fuel price scenarios and three 1990 STT system costs are considered, reflecting uncertainty over future fuel prices and STT cost projections. STT R&D is found to be unacceptably risky for private industry in the absence of federal support. Energy cost savings were projected to range from $0 to $10 billion (1990 values in 1981 dollars), dependng on the system cost and fuel price scenario. Normal R&D investment risks are accentuated because the Organization of Petroleum Exporting Countries (OPEC) cartel can artificially manipulate oil prices and undercut growth of alternative energy sources. Federal participation in STT R&D to help capture the potential benefits of developing cost-competitive STT was found to be in the national interest.

Solar thermal technologies benefits assessment: Objectives, methodologies and results for 1981

NASA Astrophysics Data System (ADS)

Gates, W. R.

1982-07-01

The economic and social benefits of developing cost competitive solar thermal technologies (STT) were assessed. The analysis was restricted to STT in electric applications for 16 high insolation/high energy price states. Three fuel price scenarios and three 1990 STT system costs were considered, reflecting uncertainty over fuel prices and STT cost projections. After considering the numerous benefits of introducing STT into the energy market, three primary benefits were identified and evaluated: (1) direct energy cost savings were estimated to range from zero to $50 billion; (2) oil imports may be reduced by up to 9 percent, improving national security; and (3) significant environmental benefits can be realized in air basins where electric power plant emissions create substantial air pollution problems. STT research and development was found to be unacceptably risky for private industry in the absence of federal support. The normal risks associated with investments in research and development are accentuated because the OPEC cartel can artificially manipulate oil prices and undercut the growth of alternative energy sources.

Placental malaria among HIV-infected and uninfected women receiving anti-folates in a high transmission area of Uganda

PubMed Central

2009-01-01

Background HIV infection increases the risk of placental malaria, which is associated with poor maternal and infant outcomes. Recommendations in Uganda are for HIV-infected pregnant women to receive daily trimethoprim-sulphamethoxazole (TS) and HIV-uninfected women to receive intermittent sulphadoxine-pyrimethamine (SP). TS decreases the risk of malaria in HIV-infected adults and children but has not been evaluated among pregnant women. Methods This was a cross sectional study comparing the prevalence of placental malaria between HIV-infected women prescribed TS and HIV-uninfected women prescribed intermittent preventive therapy with sulphadoxine-pyrimethamine (IPT-SP) in a high malaria transmission area in Uganda. Placental blood was evaluated for malaria using smear and PCR. Results Placentas were obtained from 150 HIV-infected women on TS and 336 HIV-uninfected women on IPT-SP. The proportion of HIV-infected and HIV-uninfected women with placental malaria was 19% vs. 26% for those positive by PCR and 6% vs. 9% for those positive by smear, respectively. Among all infants, smear+ placental malaria was most predictive of low birth weight (LBW). Primigravidae were at higher risk than multigravidae of having placental malaria among HIV-uninfected, but not HIV-infected, women. Adjusting for gravidity, age, and season at the time of delivery, HIV-infected women on TS were not at increased risk for placental malaria compared to HIV-uninfected women on IPT-SP, regardless of the definition used. Conclusion Prevalence of placental malaria was similar in HIV-infected women on TS and HIV-uninfected women on IPT-SP. Nonetheless, while nearly all of the women in this study were prescribed anti-folates, the overall risk of placental malaria and LBW was unacceptably high. The population attributable risk of placental malaria on LBW was substantial, suggesting that future interventions that further diminish the risk of placental malaria may have a considerable impact on the burden of LBW in this population. PMID:19912657

Multiple objective optimization in reliability demonstration test

DOE PAGES

Lu, Lu; Anderson-Cook, Christine Michaela; Li, Mingyang

2016-10-01

Reliability demonstration tests are usually performed in product design or validation processes to demonstrate whether a product meets specified requirements on reliability. For binomial demonstration tests, the zero-failure test has been most commonly used due to its simplicity and use of minimum sample size to achieve an acceptable consumer’s risk level. However, this test can often result in unacceptably high risk for producers as well as a low probability of passing the test even when the product has good reliability. This paper explicitly explores the interrelationship between multiple objectives that are commonly of interest when planning a demonstration test andmore » proposes structured decision-making procedures using a Pareto front approach for selecting an optimal test plan based on simultaneously balancing multiple criteria. Different strategies are suggested for scenarios with different user priorities and graphical tools are developed to help quantify the trade-offs between choices and to facilitate informed decision making. As a result, potential impacts of some subjective user inputs on the final decision are studied to offer insights and useful guidance for general applications.« less

Uterine Fibroid Embolisation – Potential Impact on Fertility and Pregnancy Outcome

PubMed Central

David, M.; Kröncke, T.

2013-01-01

The current standard therapy to treat myomas in women wishing to have children consists of minimally invasive surgical myomectomy. Uterine artery embolisation (UAE) has also been discussed as another minimally invasive treatment option to treat myomas. This review evaluates the literature of the past 10 years on fibroid embolisation and its impact on fertility and pregnancy. Potential problems associated with UAE such as radiation exposure of the ovaries, impairment of ovarian function and the impact on pregnancy and child birth are discussed in detail. Previously published reports of at least 337 pregnancies after UAE were evaluated. The review concludes that UAE to treat myomas can only be recommended in women with fertility problems due to myomas who refuse surgery or women with an unacceptably high surgical risk, because the evaluated case reports and studies show that UAE significantly increases the risk of spontaneous abortion; there is also evidence of pathologically increased levels for other obstetric outcome parameters. There are still very few prospective studies which provide sufficient evidence for a definitive statement on the impact of UAE therapy on fertility rates and pregnancy outcomes. PMID:26633901

The bioethics of enhancing human performance for spaceflight

PubMed Central

Gibson, T M

2006-01-01

There are many ways of enhancing human performance. For military aviation in general, and for spaceflight in particular, the most important tools are selection, training, equipment, pharmacology, and surgery. In the future, genetic manipulation may be feasible. For each of these tools, the specific modalities available range from the ethically acceptable to the ethically unacceptable. Even when someone consents to a particular procedure to enhance performance, the action may be ethically unacceptable to society as a whole and the burden of risk for the individual may be too great. In addition, there are several characteristics that define the quality and the acceptability of the consent. Each method of enhancing performance will be examined in the context of the principles of medical ethics in a western society: autonomy, non‐maleficence, beneficence, and justice. The aim is to draw the attention of aeromedical practitioners to the complexities of ethical dilemmas such as this particular one in order to help them to develop a morally justifiable code of practice that balances society's needs against individual ambitions and corporate goals. PMID:16507654

HiveScience: A Citizen Science Project for Beekeepers##

EPA Science Inventory

Over the past decade, beekeepers have been experiencing unacceptably high colony losses while the demand for insect-pollinated crops has tripled during the same time period. Underscoring the need to develop reliable methods for predicting colony health, the United States Departme...

New Bedford Harbor Long Term Monitoring Program

EPA Science Inventory

New Bedford Harbor (NBH), located in southeastern Massachusetts, was designated as a Superfund site in 1983 due to unacceptably high levels of sediment contamination by polychlorinated biphenyls (PCBs). Based on human health and environmental concerns, the decision was made to d...

Addressing Uncertainty in Fecal Indicator Bacteria Dark Inactivation Rates

EPA Science Inventory

Fecal contamination is a leading cause of surface water quality degradation. Roughly 20% of all total maximum daily load assessments approved by the United States Environmental Protection Agency since 1995, for example, address water bodies with unacceptably high fecal indicator...

THERMODYNAMIC REACTION CONSTANTS FOR MODELING AQUEOUS ENVIRONMENTAL MERCURY SPECIATION

EPA Science Inventory

Unacceptably high fish tissue mercury residues are responsible for the majority of fish consumption advisories issued in 48 states of the United States of America. Mercury also has emerged as a transboundary contaminant of global concern. Although monomethylmercury is generally...

Cluster-sample surveys and lot quality assurance sampling to evaluate yellow fever immunisation coverage following a national campaign, Bolivia, 2007.

PubMed

Pezzoli, Lorenzo; Pineda, Silvia; Halkyer, Percy; Crespo, Gladys; Andrews, Nick; Ronveaux, Olivier

2009-03-01

To estimate the yellow fever (YF) vaccine coverage for the endemic and non-endemic areas of Bolivia and to determine whether selected districts had acceptable levels of coverage (>70%). We conducted two surveys of 600 individuals (25 x 12 clusters) to estimate coverage in the endemic and non-endemic areas. We assessed 11 districts using lot quality assurance sampling (LQAS). The lot (district) sample was 35 individuals with six as decision value (alpha error 6% if true coverage 70%; beta error 6% if true coverage 90%). To increase feasibility, we divided the lots into five clusters of seven individuals; to investigate the effect of clustering, we calculated alpha and beta by conducting simulations where each cluster's true coverage was sampled from a normal distribution with a mean of 70% or 90% and standard deviations of 5% or 10%. Estimated coverage was 84.3% (95% CI: 78.9-89.7) in endemic areas, 86.8% (82.5-91.0) in non-endemic and 86.0% (82.8-89.1) nationally. LQAS showed that four lots had unacceptable coverage levels. In six lots, results were inconsistent with the estimated administrative coverage. The simulations suggested that the effect of clustering the lots is unlikely to have significantly increased the risk of making incorrect accept/reject decisions. Estimated YF coverage was high. Discrepancies between administrative coverage and LQAS results may be due to incorrect population data. Even allowing for clustering in LQAS, the statistical errors would remain low. Catch-up campaigns are recommended in districts with unacceptable coverage.

Flank wears Simulation by using back propagation neural network when cutting hardened H-13 steel in CNC End Milling

NASA Astrophysics Data System (ADS)

Hazza, Muataz Hazza F. Al; Adesta, Erry Y. T.; Riza, Muhammad

2013-12-01

High speed milling has many advantages such as higher removal rate and high productivity. However, higher cutting speed increase the flank wear rate and thus reducing the cutting tool life. Therefore estimating and predicting the flank wear length in early stages reduces the risk of unaccepted tooling cost. This research presents a neural network model for predicting and simulating the flank wear in the CNC end milling process. A set of sparse experimental data for finish end milling on AISI H13 at hardness of 48 HRC have been conducted to measure the flank wear length. Then the measured data have been used to train the developed neural network model. Artificial neural network (ANN) was applied to predict the flank wear length. The neural network contains twenty hidden layer with feed forward back propagation hierarchical. The neural network has been designed with MATLAB Neural Network Toolbox. The results show a high correlation between the predicted and the observed flank wear which indicates the validity of the models.

Bacterial Pneumonia in Patients with Cancer: Novel Risk Factors and Management.

PubMed

Wong, Justin L; Evans, Scott E

2017-06-01

Bacterial pneumonias exact unacceptable morbidity on patients with cancer. Although the risk is often most pronounced among patients with treatment-induced cytopenias, the numerous contributors to life-threatening pneumonias in cancer populations range from derangements of lung architecture and swallow function to complex immune defects associated with cytotoxic therapies and graft-versus-host disease. These structural and immunologic abnormalities often make the diagnosis of pneumonia challenging in patients with cancer and impact the composition and duration of therapy. This article addresses host factors that contribute to pneumonia susceptibility, summarizes diagnostic recommendations, and reviews current guidelines for management of bacterial pneumonia in patients with cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

STREAM RESTORATION STRATEGIES FOR REDUCING RIVER NITROGEN LOADS

EPA Science Inventory

Despite decades of work implementing agricultural and urban best management practices to reduce the movement of excess nitrogen (N) from the land to aquatic ecosystems, the amount of N moving down streams and rivers remains unacceptably high in many watersheds. During this same ...

Failure analysis of blistered gold plating on spot welded electrical relays

NASA Technical Reports Server (NTRS)

Sokolowski, Witold; O'Donnell, Tim

1989-01-01

Gold-plated stainless-steel sideplates, part of a JPL Galileo spacecraft electronic-relay assembly, exhibited blistering after resistance spot welding. Unacceptable relays had heavy nonuniform gold electrodeposited layers with thicknesses 4.5-11.5 microns. SEM and metallographic investigations indicated much higher heat input generated during the resistance spot welding in unacceptable relays. The attributes of acceptable welded relays are contrasted with unacceptable relays; the possible mechanism of laminar formation of polymeric material in the gold plating is discussed; and some recommendations are provided to prevent similar problems.

Genomic approach to therapeutic target validation identifies a glucose-lowering GLP1R variant protective for coronary heart disease

PubMed Central

Scott, Robert A.; Freitag, Daniel F.; Li, Li; Chu, Audrey Y.; Surendran, Praveen; Young, Robin; Grarup, Niels; Stancáková, Alena; Chen, Yuning; V.Varga, Tibor; Yaghootkar, Hanieh; Luan, Jian'an; Zhao, Jing Hua; Willems, Sara M.; Wessel, Jennifer; Wang, Shuai; Maruthur, Nisa; Michailidou, Kyriaki; Pirie, Ailith; van der Lee, Sven J.; Gillson, Christopher; Olama, Ali Amin Al; Amouyel, Philippe; Arriola, Larraitz; Arveiler, Dominique; Aviles-Olmos, Iciar; Balkau, Beverley; Barricarte, Aurelio; Barroso, Inês; Garcia, Sara Benlloch; Bis, Joshua C.; Blankenberg, Stefan; Boehnke, Michael; Boeing, Heiner; Boerwinkle, Eric; Borecki, Ingrid B.; Bork-Jensen, Jette; Bowden, Sarah; Caldas, Carlos; Caslake, Muriel; Cupples, L. Adrienne; Cruchaga, Carlos; Czajkowski, Jacek; den Hoed, Marcel; Dunn, Janet A.; Earl, Helena M.; Ehret, Georg B.; Ferrannini, Ele; Ferrieres, Jean; Foltynie, Thomas; Ford, Ian; Forouhi, Nita G.; Gianfagna, Francesco; Gonzalez, Carlos; Grioni, Sara; Hiller, Louise; Jansson, Jan-Håkan; Jørgensen, Marit E.; Jukema, J. Wouter; Kaaks, Rudolf; Kee, Frank; Kerrison, Nicola D.; Key, Timothy J.; Kontto, Jukka; Kote-Jarai, Zsofia; Kraja, Aldi T.; Kuulasmaa, Kari; Kuusisto, Johanna; Linneberg, Allan; Liu, Chunyu; Marenne, Gaëlle; Mohlke, Karen L.; Morris, Andrew P.; Muir, Kenneth; Müller-Nurasyid, Martina; Munroe, Patricia B.; Navarro, Carmen; Nielsen, Sune F.; Nilsson, Peter M.; Nordestgaard, Børge G.; Packard, Chris J.; Palli, Domenico; Panico, Salvatore; Peloso, Gina M.; Perola, Markus; Peters, Annette; Poole, Christopher J.; Quirós, J. Ramón; Rolandsson, Olov; Sacerdote, Carlotta; Salomaa, Veikko; Sánchez, María-José; Sattar, Naveed; Sharp, Stephen J.; Sims, Rebecca; Slimani, Nadia; Smith, Jennifer A.; Thompson, Deborah J.; Trompet, Stella; Tumino, Rosario; van der A, Daphne L.; van der Schouw, Yvonne T.; Virtamo, Jarmo; Walker, Mark; Walter, Klaudia; Abraham, Jean E.; Amundadottir, Laufey T.; Aponte, Jennifer L.; Butterworth, Adam S.; Dupuis, Josée; Easton, Douglas F.; Eeles, Rosalind A.; Erdmann, Jeanette; Franks, Paul W.; Frayling, Timothy M.; Hansen, Torben; Howson, Joanna M. M.; Jørgensen, Torben; Kooner, Jaspal; Laakso, Markku; Langenberg, Claudia; McCarthy, Mark I.; Pankow, James S.; Pedersen, Oluf; Riboli, Elio; Rotter, Jerome I.; Saleheen, Danish; Samani, Nilesh J.; Schunkert, Heribert; Vollenweider, Peter; O'Rahilly, Stephen; Deloukas, Panos; Danesh, John; Goodarzi, Mark O.; Kathiresan, Sekar; Meigs, James B.; Ehm, Margaret G.; Wareham, Nicholas J.; Waterworth, Dawn M.

2016-01-01

Regulatory authorities have indicated that new drugs to treat type 2 diabetes (T2D) should not be associated with an unacceptable increase in cardiovascular risk. Human genetics may be able to inform development of antidiabetic therapies by predicting cardiovascular and other health endpoints. We therefore investigated the association of variants in 6 genes that encode drug targets for obesity or T2D with a range of metabolic traits in up to 11,806 individuals by targeted exome sequencing, and follow-up in 39,979 individuals by targeted genotyping, with additional in silico follow up in consortia. We used these data to first compare associations of variants in genes encoding drug targets with the effects of pharmacological manipulation of those targets in clinical trials. We then tested the association those variants with disease outcomes, including coronary heart disease, to predict cardiovascular safety of these agents. A low-frequency missense variant (Ala316Thr;rs10305492) in the gene encoding glucagon-like peptide-1 receptor (GLP1R), the target of GLP1R agonists, was associated with lower fasting glucose and lower T2D risk, consistent with GLP1R agonist therapies. The minor allele was also associated with protection against heart disease, thus providing evidence that GLP1R agonists are not likely to be associated with an unacceptable increase in cardiovascular risk. Our results provide an encouraging signal that these agents may be associated with benefit, a question currently being addressed in randomised controlled trials. Genetic variants associated with metabolic traits and multiple disease outcomes can be used to validate therapeutic targets at an early stage in the drug development process. PMID:27252175

An overview of safety assessment, regulation, and control of hazardous material use at NREL

NASA Astrophysics Data System (ADS)

Nelson, B. P.; Crandall, R. S.; Moskowitz, P. D.; Fthenakis, V. M.

1992-12-01

This paper summarizes the methodology we use to ensure the safe use of hazardous materials at the National Renewable Energy Laboratory (NREL). First, we analyze the processes and the materials used in those processes to identify the hazards presented. Then we study federal, state, and local regulations and apply the relevant requirements to our operations. When necessary, we generate internal safety documents to consolidate this information. We design research operations and support systems to conform to these requirements. Before we construct the systems, we perform a semiquantitative risk analysis on likely accident scenarios. All scenarios presenting an unacceptable risk require system or procedural modifications to reduce the risk. Following these modifications, we repeat the risk analysis to ensure that the respective accident scenarios present an acceptable risk. Once all risks are acceptable, we conduct an operational readiness review (ORR). A management-appointed panel performs the ORR ensuring compliance with all relevant requirements. After successful completion of the ORR, operations can begin.

Why risk is not variance: an expository note.

PubMed

Cox, Louis Anthony Tony

2008-08-01

Variance (or standard deviation) of return is widely used as a measure of risk in financial investment risk analysis applications, where mean-variance analysis is applied to calculate efficient frontiers and undominated portfolios. Why, then, do health, safety, and environmental (HS&E) and reliability engineering risk analysts insist on defining risk more flexibly, as being determined by probabilities and consequences, rather than simply by variances? This note suggests an answer by providing a simple proof that mean-variance decision making violates the principle that a rational decisionmaker should prefer higher to lower probabilities of receiving a fixed gain, all else being equal. Indeed, simply hypothesizing a continuous increasing indifference curve for mean-variance combinations at the origin is enough to imply that a decisionmaker must find unacceptable some prospects that offer a positive probability of gain and zero probability of loss. Unlike some previous analyses of limitations of variance as a risk metric, this expository note uses only simple mathematics and does not require the additional framework of von Neumann Morgenstern utility theory.

Preemptive mechanical ventilation can block progressive acute lung injury.

PubMed

Sadowitz, Benjamin; Jain, Sumeet; Kollisch-Singule, Michaela; Satalin, Joshua; Andrews, Penny; Habashi, Nader; Gatto, Louis A; Nieman, Gary

2016-02-04

Mortality from acute respiratory distress syndrome (ARDS) remains unacceptable, approaching 45% in certain high-risk patient populations. Treating fulminant ARDS is currently relegated to supportive care measures only. Thus, the best treatment for ARDS may lie with preventing this syndrome from ever occurring. Clinical studies were examined to determine why ARDS has remained resistant to treatment over the past several decades. In addition, both basic science and clinical studies were examined to determine the impact that early, protective mechanical ventilation may have on preventing the development of ARDS in at-risk patients. Fulminant ARDS is highly resistant to both pharmacologic treatment and methods of mechanical ventilation. However, ARDS is a progressive disease with an early treatment window that can be exploited. In particular, protective mechanical ventilation initiated before the onset of lung injury can prevent the progression to ARDS. Airway pressure release ventilation (APRV) is a novel mechanical ventilation strategy for delivering a protective breath that has been shown to block progressive acute lung injury (ALI) and prevent ALI from progressing to ARDS. ARDS mortality currently remains as high as 45% in some studies. As ARDS is a progressive disease, the key to treatment lies with preventing the disease from ever occurring while it remains subclinical. Early protective mechanical ventilation with APRV appears to offer substantial benefit in this regard and may be the prophylactic treatment of choice for preventing ARDS.

Preemptive mechanical ventilation can block progressive acute lung injury

PubMed Central

Sadowitz, Benjamin; Jain, Sumeet; Kollisch-Singule, Michaela; Satalin, Joshua; Andrews, Penny; Habashi, Nader; Gatto, Louis A; Nieman, Gary

2016-01-01

Mortality from acute respiratory distress syndrome (ARDS) remains unacceptable, approaching 45% in certain high-risk patient populations. Treating fulminant ARDS is currently relegated to supportive care measures only. Thus, the best treatment for ARDS may lie with preventing this syndrome from ever occurring. Clinical studies were examined to determine why ARDS has remained resistant to treatment over the past several decades. In addition, both basic science and clinical studies were examined to determine the impact that early, protective mechanical ventilation may have on preventing the development of ARDS in at-risk patients. Fulminant ARDS is highly resistant to both pharmacologic treatment and methods of mechanical ventilation. However, ARDS is a progressive disease with an early treatment window that can be exploited. In particular, protective mechanical ventilation initiated before the onset of lung injury can prevent the progression to ARDS. Airway pressure release ventilation (APRV) is a novel mechanical ventilation strategy for delivering a protective breath that has been shown to block progressive acute lung injury (ALI) and prevent ALI from progressing to ARDS. ARDS mortality currently remains as high as 45% in some studies. As ARDS is a progressive disease, the key to treatment lies with preventing the disease from ever occurring while it remains subclinical. Early protective mechanical ventilation with APRV appears to offer substantial benefit in this regard and may be the prophylactic treatment of choice for preventing ARDS. PMID:26855896

Identifying and Reducing Remaining Stocks of Rinderpest Virus

PubMed Central

Visser, Dawid; Evans, Brian; Vallat, Bernard

2015-01-01

In 2011, the world was declared free from rinderpest, one of the most feared and devastating infectious diseases of animals. Rinderpest is the second infectious disease, after smallpox, to have been eradicated. However, potentially infectious rinderpest virus material remains widely disseminated among research and diagnostic facilities across the world and poses a risk for disease recurrence should it be released. Member Countries of the World Organisation for Animal Health and the Food and Agricultural Organization of the United Nations are committed to destroying remaining stocks of infectious material or ensuring that it is stored under international supervision in a limited number of approved facilities. To facilitate this commitment and maintain global freedom from rinderpest, World Organisation for Animal Health Member Countries must report annually on rinderpest material held in their countries. The first official surveys, conducted during 2013–2015, revealed that rinderpest material was stored in an unacceptably high number of facilities and countries. PMID:26584400

Patterns of sexual behaviour among secondary school students in Swaziland, southern Africa.

PubMed

Buseh, Aaron G

2004-07-01

Among the many sub-Saharan African countries hardest hit by HIV/AIDS is the Kingdom of Swaziland. In an effort to reduce the spread of HIV, young people are an important group to reach with prevention messages. However, before developing such programmes, it is essential to understand young people's sexual risk behaviours. Students (n=941) from four coeducational secondary schools in Swaziland participated in a cross-sectional survey of sexual behaviours. Results indicate that considerable proportions of young people in this study were sexually experienced, irrespective of gender. Findings also suggest unacceptable high levels of sexual coercion, irrespective of age or gender. While boys may be less likely than girls to experience sexual coercion, being a male in this setting was not a protective factor. No significant differences were found on these variables in relation to location of the schools (rural vs. urban). Implications for developing and implementing HIV prevention programmes are suggested.

Modification of potato steroidal glycoalkaloids with silencing RNA constructs

USDA-ARS?s Scientific Manuscript database

Steroidal glycoalkaloids (SGAs), while found in many solanaceous plants, can accumulate to unacceptably high levels in potatoes. The two primary SGAs that occur in potatoes are the tri-glycosylated alkaloids, a-solanine and a-chaconine. The first glycosylation steps in their biosynthetic pathways ...

Decomposition-Based Failure Mode Identification Method for Risk-Free Design of Large Systems

NASA Technical Reports Server (NTRS)

Tumer, Irem Y.; Stone, Robert B.; Roberts, Rory A.; Clancy, Daniel (Technical Monitor)

2002-01-01

When designing products, it is crucial to assure failure and risk-free operation in the intended operating environment. Failures are typically studied and eliminated as much as possible during the early stages of design. The few failures that go undetected result in unacceptable damage and losses in high-risk applications where public safety is of concern. Published NASA and NTSB accident reports point to a variety of components identified as sources of failures in the reported cases. In previous work, data from these reports were processed and placed in matrix form for all the system components and failure modes encountered, and then manipulated using matrix methods to determine similarities between the different components and failure modes. In this paper, these matrices are represented in the form of a linear combination of failures modes, mathematically formed using Principal Components Analysis (PCA) decomposition. The PCA decomposition results in a low-dimensionality representation of all failure modes and components of interest, represented in a transformed coordinate system. Such a representation opens the way for efficient pattern analysis and prediction of failure modes with highest potential risks on the final product, rather than making decisions based on the large space of component and failure mode data. The mathematics of the proposed method are explained first using a simple example problem. The method is then applied to component failure data gathered from helicopter, accident reports to demonstrate its potential.

Metal uptake by homegrown vegetables – The relative importance in human health risk assessments at contaminated sites

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

Augustsson, Anna L.M., E-mail: anna.augustsson@lnu.se; Uddh-Söderberg, Terese E.; Hogmalm, K. Johan

Risk assessments of contaminated land often involve the use of generic bioconcentration factors (BCFs), which express contaminant concentrations in edible plant parts as a function of the concentration in soil, in order to assess the risks associated with consumption of homegrown vegetables. This study aimed to quantify variability in BCFs and evaluate the implications of this variability for human exposure assessments, focusing on cadmium (Cd) and lead (Pb) in lettuce and potatoes sampled around 22 contaminated glassworks sites. In addition, risks associated with measured Cd and Pb concentrations in soil and vegetable samples were characterized and a probabilistic exposure assessmentmore » was conducted to estimate the likelihood of local residents exceeding tolerable daily intakes. The results show that concentrations in vegetables were only moderately elevated despite high concentrations in soil, and most samples complied with applicable foodstuff legislation. Still, the daily intake of Cd (but not Pb) was assessed to exceed toxicological thresholds for about a fifth of the study population. Bioconcentration factors were found to vary more than indicated by previous studies, but decreasing BCFs with increasing metal concentrations in the soil can explain why the calculated exposure is only moderately affected by the choice of BCF value when generic soil guideline values are exceeded and the risk may be unacceptable. - Highlights: • Uptake of Cd and Pb by lettuce and potatoes increased with soil contamination. • Consumption of homegrown vegetables may lead to a daily Cd intake above TDIs. • The variability in the calculated BCFs is high when compared to previous studies. • Exposure assessments are most sensitive to the choice of BCFs at low contamination.« less

Mineral metabolism, mortality, and morbidity in maintenance hemodialysis.

PubMed

Block, Geoffrey A; Klassen, Preston S; Lazarus, J Michael; Ofsthun, Norma; Lowrie, Edmund G; Chertow, Glenn M

2004-08-01

Mortality rates in ESRD are unacceptably high. Disorders of mineral metabolism (hyperphosphatemia, hypercalcemia, and secondary hyperparathyroidism) are potentially modifiable. For determining associations among disorders of mineral metabolism, mortality, and morbidity in hemodialysis patients, data on 40,538 hemodialysis patients with at least one determination of serum phosphorus and calcium during the last 3 mo of 1997 were analyzed. Unadjusted, case mix-adjusted, and multivariable-adjusted relative risks of death were calculated for categories of serum phosphorus, calcium, calcium x phosphorus product, and intact parathyroid hormone (PTH) using proportional hazards regression. Also determined was whether disorders of mineral metabolism were associated with all-cause, cardiovascular, infection-related, fracture-related, and vascular access-related hospitalization. After adjustment for case mix and laboratory variables, serum phosphorus concentrations >5.0 mg/dl were associated with an increased relative risk of death (1.07, 1.25, 1.43, 1.67, and 2.02 for serum phosphorus 5.0 to 6.0, 6.0 to 7.0, 7.0 to 8.0, 8.0 to 9.0, and >/=9.0 mg/dl). Higher adjusted serum calcium concentrations were also associated with an increased risk of death, even when examined within narrow ranges of serum phosphorus. Moderate to severe hyperparathyroidism (PTH concentrations >/=600 pg/ml) was associated with an increase in the relative risk of death, whereas more modest increases in PTH were not. When examined collectively, the population attributable risk percentage for disorders of mineral metabolism was 17.5%, owing largely to the high prevalence of hyperphosphatemia. Hyperphosphatemia and hyperparathyroidism were significantly associated with all-cause, cardiovascular, and fracture-related hospitalization. Disorders of mineral metabolism are independently associated with mortality and morbidity associated with cardiovascular disease and fracture in hemodialysis patients.

Assessment of variations in control of asthma over time.

PubMed

Combescure, C; Chanez, P; Saint-Pierre, P; Daurès, J P; Proudhon, H; Godard, P

2003-08-01

Control and severity of asthma are two different but complementary concepts. The severity of asthma could influence the control over time. The aim of this study was to demonstrate this relationship. A total 365 patients with persistent asthma (severity) were enrolled and followed-up prospectively. Data were analysed using a continuous time homogeneous Markov model of the natural history of asthma. Control of asthma was defined according to three health states which were qualified: optimal, suboptimal and unacceptable control (states 1, 2 and 3). Transition forces (denoted lambda(ij) from state i to state j) and transition probabilities between control states were assessed and the results stratified by asthma severity were compared. Models were validated by comparing expected and observed numbers of patients in the different states. Transition probabilities stabilised between 100-250 days and more rapidly in patients with mild-to-moderate asthma. Patients with mild-to-moderate asthma in suboptimal or unacceptable control had a high probability of transition directly to optimal control. Patients with severe asthma had a tendency to remain in unacceptable control. A Markov model is a useful tool to model the control of asthma over time. Severity modified clearly the health states. It could be used to compare the performance of different approaches to asthma management.

Monitoring late-onset toxicities in phase I trials using predicted risks

PubMed Central

Bekele, B. Nebiyou; Ji, Yuan; Shen, Yu; Thall, Peter F.

2008-01-01

Late-onset (LO) toxicities are a serious concern in many phase I trials. Since most dose-limiting toxicities occur soon after therapy begins, most dose-finding methods use a binary indicator of toxicity occurring within a short initial time period. If an agent causes LO toxicities, however, an undesirably large number of patients may be treated at toxic doses before any toxicities are observed. A method addressing this problem is the time-to-event continual reassessment method (TITE-CRM, Cheung and Chappell, 2000). We propose a Bayesian dose-finding method similar to the TITE-CRM in which doses are chosen using time-to-toxicity data. The new aspect of our method is a set of rules, based on predictive probabilities, that temporarily suspend accrual if the risk of toxicity at prospective doses for future patients is unacceptably high. If additional follow-up data reduce the predicted risk of toxicity to an acceptable level, then accrual is restarted, and this process may be repeated several times during the trial. A simulation study shows that the proposed method provides a greater degree of safety than the TITE-CRM, while still reliably choosing the preferred dose. This advantage increases with accrual rate, but the price of this additional safety is that the trial takes longer to complete on average. PMID:18084008

Variation among conventional cultivars could be used as a criterion for environmental safety assessment of Bt rice on nontarget arthropods

NASA Astrophysics Data System (ADS)

Wang, Fang; Dang, Cong; Chang, Xuefei; Tian, Junce; Lu, Zengbin; Chen, Yang; Ye, Gongyin

2017-02-01

The current difficulty facing risk evaluations of Bacillus thuringiensis (Bt) crops on nontarget arthropods (NTAs) is the lack of criteria for determining what represents unacceptable risk. In this study, we investigated the biological parameters in the laboratory and field population abundance of Nilaparvata lugens (Hemiptera: Delphacidae) on two Bt rice lines and the non-Bt parent, together with 14 other conventional rice cultivars. Significant difference were found in nymphal duration and fecundity of N. lugens fed on Bt rice KMD2, as well as field population density on 12 October, compared with non-Bt parent. However, compared with the variation among conventional rice cultivars, the variation of each parameter between Bt rice and the non-Bt parent was much smaller, which can be easily seen from low-high bar graphs and also the coefficient of variation value (C.V). The variation among conventional cultivars is proposed to be used as a criterion for the safety assessment of Bt rice on NTAs, particularly when statistically significant differences in several parameters are found between Bt rice and its non-Bt parent. Coefficient of variation is suggested as a promising parameter for ecological risk judgement of IRGM rice on NTAs.

The ``Nuclear Renaissance'' and the Spread of Nuclear Weapons

NASA Astrophysics Data System (ADS)

Lyman, Edwin S.

2007-05-01

As interest grows around the world in nuclear power as an energy source that could help control greenhouse gas emissions, some have proclaimed the arrival of a ``nuclear renaissance.'' But can the increased risks of more nuclear power be managed? The political crisis surrounding Iran's pursuit of uranium enrichment has exposed weaknesses in the nuclear nonproliferation regime. Also, al Qaeda's declared interest in weapons of mass destruction raises the concern that terrorists could acquire nuclear weapons by stealing materials from poorly secured facilities. Growth of nuclear energy would require the construction of many additional uranium enrichment plants. And the generation of more spent nuclear fuel without a credible waste disposal strategy would increase political support for reprocessing, which separates large quantities of weapon-usable plutonium from spent fuel. There is little evidence that the various institutional arrangements and technical schemes proposed to mitigate the security risks of a major nuclear expansion would be effective. This talk will focus on the measures necessary to allow large-scale global growth of nuclear power without resulting in an unacceptably high risk of nuclear proliferation and nuclear terrorism, and will discuss the feasibility of such measures. To cite this abstract, use the following reference: http://meetings.aps.org/link/BAPS.2007.OSS07.E1.2

New Era of Lipid-Lowering Drugs

PubMed Central

Rye, Kerry-Anne

2016-01-01

There are several established lipid-modifying agents, including statins, fibrates, niacin, and ezetimibe, that have been shown in randomized clinical outcome trials to reduce the risk of having an atherosclerotic cardiovascular event. However, in many people, the risk of having an event remains unacceptably high despite treatment with these established agents. This has stimulated the search for new therapies designed to reduce residual cardiovascular risk. New approaches that target atherogenic lipoproteins include: 1) inhibition of proprotein convertase subtilisin/kexin type 9 to increase removal of atherogenic lipoproteins from plasma; 2) inhibition of the synthesis of apolipoprotein (apo) B, the main protein component of atherogenic lipoproteins; 3) inhibition of microsomal triglyceride transfer protein to block the formation of atherogenic lipoproteins; 4) inhibition of adenosine triphosphate citrate lyase to inhibit the synthesis of cholesterol; 5) inhibition of the synthesis of lipoprotein(a), a factor known to cause atherosclerosis; 6) inhibition of apoC-III to reduce triglyceride-rich lipoproteins and to enhance high-density lipoprotein (HDL) functionality; and 7) inhibition of cholesteryl ester transfer protein, which not only reduces the concentration of atherogenic lipoproteins but also increases the level and function of the potentially antiatherogenic HDL fraction. Other new therapies that specifically target HDLs include infusions of reconstituted HDLs, HDL delipidation, and infusions of apoA-I mimetic peptides that mimic some of the functions of HDLs. This review describes the scientific basis and rationale for developing these new therapies and provides a brief summary of established therapies. PMID:26983688

47 CFR 22.878 - Obligation to abate unacceptable interference.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... 22.878 Section 22.878 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.878 Obligation to abate unacceptable interference. This section applies only to commercial...

Developing cold-chipping potato varieties by silencing the vacuolar invertase gene

USDA-ARS?s Scientific Manuscript database

Accumulation of reducing sugars during cold storage is a persistent and costly problem for the potato processing industry. High temperature processing of potato tubers with elevated amounts of reducing sugars results in potato chips, fries and other products that are unacceptable to consumers becaus...

Seed coat darkening in Cowpea bean

USDA-ARS?s Scientific Manuscript database

Seed coat of cowpea bean (Vigna unguiculata L. Walp) slowly browns to a darker color during storage. High temperature and humidity during storage might contribute to this color change. Variation in browning rate among seeds in a lot leads to a mixture of seed colors creating an unacceptable product...

The feminine ideal and transactional sex: Navigating respectability and risk in Swaziland

PubMed Central

Fielding-Miller, Rebecca; Dunkle, Kristin L; Jama-Shai, Nwabisa; Windle, Michael; Hadley, Craig; Cooper, Hannah LF

2016-01-01

Women who engage in transactional sex are not only at increased risk of HIV and intimate partner violence, but also face social risks including gossip and ostracism. These social and physical risks may be dependent on both what a woman expects and needs from her partner and how her community perceives the relationship. Gender theory suggests that some of these social risks may hinge on whether or not a woman’s relationship threatens dominant masculinity. We conducted a qualitative study in Swaziland from September 2013 to October 2014 to explore transactional sex and respectable femininity through the lens of hegemonic gender theory. Using cultural consensus modeling, we identified cultural models of transactional sex and conducted 16 in-depth interviews with model key informants and 3 focus group discussions, for a total of 41 participants. We identified 4 main models of transactional relationships: One typified by marriage and high social respectability, a second in which women aspire towards marriage, a third particular to University students, and a fourth “sugar daddy” model. Women in all models expected and received significant financial support from their male partners. However, women in less respectable relationships risked social censure and stigma if they were discovered, in part because aspects of their relationship threatened hegemonic masculinity. Conversely, women who received male support in respectable relationships had to carefully select HIV risk reduction strategies that did not threaten their relationship and associated social status. Research and programming efforts typically focus only on the less socially respectable forms of transactional sex. This risks reinforcing stigma for women in relationships that are already considered socially unacceptable while ignoring the unique HIV risks faced by women in more respectable relationships. PMID:27107148

The feminine ideal and transactional sex: Navigating respectability and risk in Swaziland.

PubMed

Fielding-Miller, Rebecca; Dunkle, Kristin L; Jama-Shai, Nwabisa; Windle, Michael; Hadley, Craig; Cooper, Hannah L F

2016-06-01

Women who engage in transactional sex are not only at increased risk of HIV and intimate partner violence, but also face social risks including gossip and ostracism. These social and physical risks may be dependent on both what a woman expects and needs from her partner and how her community perceives the relationship. Gender theory suggests that some of these social risks may hinge on whether or not a woman's relationship threatens dominant masculinity. We conducted a qualitative study in Swaziland from September 2013 to October 2014 to explore transactional sex and respectable femininity through the lens of hegemonic gender theory. Using cultural consensus modeling, we identified cultural models of transactional sex and conducted 16 in-depth interviews with model key informants and 3 focus group discussions, for a total of 41 participants. We identified 4 main models of transactional relationships: One typified by marriage and high social respectability, a second in which women aspire towards marriage, a third particular to University students, and a fourth "sugar daddy" model. Women in all models expected and received significant financial support from their male partners. However, women in less respectable relationships risked social censure and stigma if they were discovered, in part because aspects of their relationship threatened hegemonic masculinity. Conversely, women who received male support in respectable relationships had to carefully select HIV risk reduction strategies that did not threaten their relationship and associated social status. Research and programming efforts typically focus only on the less socially respectable forms of transactional sex. This risks reinforcing stigma for women in relationships that are already considered socially unacceptable while ignoring the unique HIV risks faced by women in more respectable relationships. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Ethical behavioral standards of medical students on examinations and studies].

PubMed

Tolkin, Lior; Glick, Shimon

2007-06-01

In recent years the medical literature has reflected an increasing interest in the medical ethics of physicians and medical students. Studies have shown that cheating in medical school is frequent enough to cause concern, that there is a positive correlation between students' ethical attitude and their ethical behavior and between cheating in school and cheating in patient care. This study aims to examine student attitudes towards cheating, their self-reported behavior, analyze cultural and sub-cultural differences, and to reach practical conclusions that might be incorporated into the teaching of ethics in medical schools. Anonymous questionnaires were distributed to 193 first and second year students of the Israeli and American programs at Ben-Gurion University. The questionnaire consisted of fifty three multiple choice questions. The students were asked to state their opinion on various cheating practices at medical school and dishonesty in patient care, to estimate how they would resolve various ethical dilemmas and to provide some demographic information. The results were analyzed using SPSS. T-tests, Chi-Square tests, one-way analysis of variance, and Pearson and Spearman's coefficients, all used as appropriate. Completed questionnaires were returned by 141 students (73%). The majority of the students regard cheating in an exam (93%) or on a final paper (85%) to be morally unacceptable behavior. Copying during an exam is regarded as more morally unacceptable than copying a homework exercise. The majority of the students consider faking a patient's laboratory results to be morally unacceptable behavior (98%). American students regard copying a homework exercise, reconstructing exam questions for the benefit of next year students and giving answers to a fellow student during an exam to be more morally unacceptable in comparison to the Israeli students. Married students consider cheating to be more morally unacceptable than unmarried students. A positive correlation was found between religiosity and the position that cheating is a morally negative practice. There is a positive correlation between cheating in high school and the position that cheating is morally acceptable. In addition, the more often a student cheated in high school the more that student claims that he or she would cheat if they were sure that they would not be caught. Amongst Israeli students, there was a correlation between the view that the faculty did not treat them well, and the position that cheating is morally acceptable, No correlation was found between cheating and gender, age, birth country of parents, army service, or type of high school. Students' attitude toward cheating is significantly determined by the cultural and sub-cultural characteristics of each student's background. Ethical discussions in which an ethical code would be formed, moral dilemmas analyzed and cultural differences addressed, may help improve the ethical behavior of students in medical school, and thus improve their ethical practice in patient care.

Improving the decision-making process for nonprescription drugs: a framework for benefit-risk assessment.

PubMed

Brass, E P; Lofstedt, R; Renn, O

2011-12-01

Nonprescription drugs pose unique challenges to regulators. The fact that the barriers to access are lower for nonprescription drugs as compared with prescription drugs may permit additional consumers to obtain effective drugs. However, the use of these drugs by consumers in the absence of supervision by a health-care professional may result in unacceptable rates of misuse and suboptimal clinical outcomes. A value-tree method is proposed that defines important benefit and risk domains relevant to nonprescription drugs. This value tree can be used to comprehensively identify product-specific attributes in each domain and can also support formal benefit-risk assessment using a variety of tools. This is illustrated here, using a modification of the International Risk Governance Council (IRGC) framework, a flexible tool previously applied in a number of fields, which systematizes an approach to issue review, early alignment of stakeholders, evaluation, and risk mitigation/management. The proposed approach has the potential to provide structured, transparent tools for regulatory decision making for nonprescription drugs.

Risk analysis using AS/NZS 4360:2004, Bow-Tie diagram and ALARP on construction projects of Banyumanik Hospital

NASA Astrophysics Data System (ADS)

Sari, Diana Puspita; Pujotomo, Darminto; Wardani, Nadira Kusuma

2017-11-01

The Determination of risk is an uncertain event. Risks can have negative or positive impacts on project objectives. A project was defined as a series of activities and tasks that have a purpose, specifications, and limits of cost. Banyumanik Hospital Development Project is one of the construction projects in Semarang which have experienced some problems. The first problem is project delays on building stake. The second problem is delay of material supply. Finally, the problem that occurs is less management attention to health safety as evidenced by the unavailability of PPE for the workers. These problems will pose a risk to be a very important risk management performed by contractors at the Banyumanik Hospital Development Project to reduce the impact that would be caused by the risk borne by the provider of construction services. This research aim to risk identification, risk assessment and risk mitigation. Project risk management begins with the identification of risks based on the project life cycle. The risk assessment carried out by AS I NZS 4360: 2004 to the impacts of cost, time and quality. The results obtained from the method of AS I NZS 4360: 2004 is the risk that requires the handling of mitigation. Mitigated risk is the risk that had significant and high level. There are four risks that require risk mitigation with Bow-Tie diagrams which is work accidents, contract delays, material delays and design changes. Bow-Tie diagram method is a method for identifying causal and preventive action and recovery of a risk. Results obtained from Bow-Tie diagram method is a preventive action and recovery. This action is used as input to the ALARP method. ALARP method is used to determine the priority of the strategy proposed in the category broadly acceptable, tolerable, and unacceptable.

Clinical Outcome Metrics for Optimization of Robust Training

NASA Technical Reports Server (NTRS)

Ebert, D.; Byrne, V. E.; McGuire, K. M.; Hurst, V. W., IV; Kerstman, E. L.; Cole, R. W.; Sargsyan, A. E.; Garcia, K. M,; Foy, M. H.; Dulchavsky, S. A.;

Prioritizing Medical Resources for Exploration Missions

NASA Technical Reports Server (NTRS)

Shah, R. V.; Kerstman, E. L.

2015-01-01

Long duration missions beyond low Earth orbit introduce new constraints to the medical system. Factors such as the inability to evacuate to Earth in a timely manner, communication delay, limitations in available medical equipment, and the clinical background of the crew will all have an impact on the assessment and treatment of medical conditions. The Exploration Medical Capability (ExMC) Element of NASAs Human Research Program seeks to improve the way the element derives its mitigation strategies for the risk of "Unacceptable Health and Mission Outcomes Due to Limitation of In-flight Medical Capabilities."

Obstetric fistula: what about gender power?

PubMed

Roush, Karen; Kurth, Ann; Hutchinson, M Katherine; Van Devanter, Nancy

2012-01-01

Despite over 40 years of research there has been little progress in the prevention of obstetric fistula and women continue to suffer in unacceptable numbers. Gender power imbalance has consistently been shown to have serious implications for women's reproductive health and is known to persist in regions where obstetric fistula occurs. Yet, there is limited research about the role gender power imbalance plays in childbirth practices that put women at risk for obstetric fistula. This information is vital for developing effective maternal health interventions in regions affected by obstetric fistula.

Interim Land Use Control Implementation Plan

NASA Technical Reports Server (NTRS)

Applegate, Joseph L.

2014-01-01

This Interim Land Use Control Implementation Plan (LUCIP) has been prepared to inform current and potential future users of the Kennedy Space Center (KSC) Contractors Road Heavy Equipment (CRHE) Area (SWMU 055; "the Site") of institutional controls that have been implemented at the Site1. Although there are no current unacceptable risks to human health or the environment associated with the CRHE Area, an interim institutional land use control (LUC) is necessary to prevent human health exposure to volatile organic compound (VOC)-affected groundwater at the Site. Controls will include periodic inspection, condition certification, and agency notification.

[Novel technologies in the food and agriculture industry].

PubMed

de Vogel, P

1992-11-01

Product innovation obtained by means of new processes or novel raw materials or ingredients is not a recent event. The consumer today has access to a large array of products from which he may compose a nutritionally balanced diet with no inherent questions regarding food safety or wholesomeness. The controversial opinions of the consumer with regard to certain new technologies applied to food should not be confounded with the possible existence of a related unacceptable risk of the corresponding products. Scientific knowledge, from which such technologies are the result, provides a solid basis for the establishment of food safety. The principle of risk assessment should be applied by the manufacturer whenever innovative technologies are introduced in the creation of new food products.

Towards a better pesticide policy for the European Union.

PubMed

Storck, Veronika; Karpouzas, Dimitrios G; Martin-Laurent, Fabrice

2017-01-01

This opinion article aims to foster the debate about pesticide legislation in the European Union (EU). Numerous formerly authorized and widely used pesticides are now banned in the EU because unexpected and unacceptable risks emerged after their initial introduction to the market. Throughout this time lapse, environmental quality and human health have been threatened by the use of these compounds. These hazards could have been prevented by a more responsive pesticide regulatory framework. This article provides detailed insights into the pros and cons of pesticides, and points out weaknesses of the current pesticide environmental risk assessment procedures. Possibilities for improving the robustness and reliability of the pesticide regulatory framework are discussed. Copyright © 2016 Elsevier B.V. All rights reserved.

[Security of the medicinal therapy: Cartography of risks a priori within service of orthopaedic surgery].

PubMed

Razurel, A; Bertrand, É; Deranlot, J; Benhamou, F; Tritz, T; Le Mercier, F; Hardy, P

2015-11-01

Security and quality of the Medicinal Therapy are one of the most important objectives of the April 6th, 2011 order. The objective is to realize this study of the risks incurred by patients related to management and security of medicinal therapy in order to establish a plan to reduce the risks of drug's dispensation. The method of the Preliminary Risk Analysis (PRA) has been implemented by a multidisciplinary group in a hospital service of orthopaedic surgery. The study focused on the dispensation phase of medicinal circuit. This analysis revealed 148 scenarii, 35 were criticality unacceptable. Fifty-four initial risk control actions were proposed and their stress levels to put them in place were evaluated. The main measures of risk management are: training, information, communication, computerization, automation, dual control, updating the documentation system, drug reconciliation and respect for Best Practices Hospitallers (BPH). Risk management requires a significant human and financial investment as well as, material resources and multidisciplinary expertise in order to offer the best solutions. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

75 FR 3255 - Petitions for Modification

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-20

..., located in Barbour County, West Virginia. Regulation Affected: 30 CFR 75.1700 (Oil and gas wells... the immediate return. If mine air flows into the lateral as expected, or if gas inflow is acceptably... borehole plugging. If gas inflow from the well is unacceptably high (1.0% methane by volume, or higher, as...

Improving the Processing Quality of Existing Cultivars by Suppressing the Vacuolar Acid Invertase Gene

USDA-ARS?s Scientific Manuscript database

Storing potato tubers at low temperatures is highly advantageous in that it prevents sprouting, minimizes disease losses and increases the marketing window. Unfortunately, cold storage of existing cultivars causes an unacceptable accumulation of reducing sugars, a phenomenon referred to as cold-indu...

Predictive Modeling of Microbial Indicators for Timely Beach Notifications and Advisories at Marine Beaches

EPA Science Inventory

Marine beaches are occasionally contaminated by unacceptably high levels of fecal indicator bacteria (FIB) that exceed EPA water quality criteria. Here we describe application of a recent version of the software package Virtual Beach tool (VB 3.0.6) to build and evaluate multiple...

A Schoolwide Discipline Plan That Empowers Teachers and Gives Principals Time for Instructional Leadership.

ERIC Educational Resources Information Center

Borelli, Jan

1997-01-01

A high school principal explains her strategy for turning around a disorderly, gang-ridden middle school. Her discipline plan's success hinged on developing schoolwide expectations for behavior, developing positive consequences, compiling a list of unacceptable behaviors, and empowering teachers to administer consequences, including contacting…

The Effect of Empowerment and Self-Determination on Health Outcomes

ERIC Educational Resources Information Center

Garces-Ozanne, Arlene; Kalu, Edna Ikechi; Audas, Richard

2016-01-01

There remains a persistent gap in health outcomes between wealthy and poor countries. Basic measures such as life expectancy and infant and under-five mortality remain divergent, with preventable deaths being unacceptably high, despite significant efforts to reduce these disparities. We examine the impact of empowerment, measured by Freedom…

Implementation and Impact of the Check & Connect Mentoring Program

ERIC Educational Resources Information Center

Heppen, Jessica; O'Cummings, Mindee; Poland, Lindsay; Zeiser, Krissy; Mills, Nicholas

2015-01-01

High school graduation rates remain unacceptably low in the U.S., especially among disadvantaged youth (Chapman, Laird, Ifill, & KelalRamani, 2011; Stillwell, 2010), with troubling implications for future earnings and employment status (Bureau of Labor Statistics, 2012). Check & Connect (C&C) is an individualized program that pairs…

Western Australian High School Students' Attitudes towards Biotechnology Processes

ERIC Educational Resources Information Center

Dawson, Vaille; Schibeci, Renato

2003-01-01

This study reports on the attitudes towards biotechnology of 905, 15-16 year-old students from 11 Western Australian schools. Students were asked to read 15 statements about biotechnology processes and to draw a line to separate what they considered "acceptable" statements from those they considered "unacceptable". Overall, the…

40 CFR 231.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING SECTION 404(c) PROCEDURES...) Unacceptable adverse effect means impact on an aquatic or wetland ecosystem which is likely to result in... unacceptability of such impacts, consideration should be given to the relevant portions of the section 404(b)(1...

40 CFR 231.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING SECTION 404(c) PROCEDURES...) Unacceptable adverse effect means impact on an aquatic or wetland ecosystem which is likely to result in... unacceptability of such impacts, consideration should be given to the relevant portions of the section 404(b)(1...

Accounting for the economic risk caused by variation in disease severity in fungicide dose decisions, exemplified for Mycosphaerella graminicola on winter wheat.

PubMed

Te Beest, D E; Paveley, N D; Shaw, M W; van den Bosch, F

2013-07-01

A method is presented to calculate economic optimum fungicide doses accounting for the risk aversion of growers responding to variability in disease severity between crops. Simple dose-response and disease-yield loss functions are used to estimate net disease-related costs (fungicide cost plus disease-induced yield loss) as a function of dose and untreated severity. With fairly general assumptions about the shapes of the probability distribution of disease severity and the other functions involved, we show that a choice of fungicide dose which minimizes net costs, on average, across seasons results in occasional large net costs caused by inadequate control in high disease seasons. This may be unacceptable to a grower with limited capital. A risk-averse grower can choose to reduce the size and frequency of such losses by applying a higher dose as insurance. For example, a grower may decide to accept "high-loss" years 1 year in 10 or 1 year in 20 (i.e., specifying a proportion of years in which disease severity and net costs will be above a specified level). Our analysis shows that taking into account disease severity variation and risk aversion will usually increase the dose applied by an economically rational grower. The analysis is illustrated with data on Septoria tritici leaf blotch of wheat caused by Mycosphaerella graminicola. Observations from untreated field plots at sites across England over 3 years were used to estimate the probability distribution of disease severities at mid-grain filling. In the absence of a fully reliable disease forecasting scheme, reducing the frequency of high-loss years requires substantially higher doses to be applied to all crops. Disease-resistant cultivars reduce both the optimal dose at all levels of risk and the disease-related costs at all doses.

Percutaneous edge-to-edge mitral valve repair in high-surgical-risk patients: do we hit the target?

PubMed

Van den Branden, Ben J L; Swaans, Martin J; Post, Martijn C; Rensing, Benno J W M; Eefting, Frank D; Jaarsma, Wybren; Van der Heyden, Jan A S

2012-01-01

This study sought to assess the feasibility and safety of percutaneous edge-to-edge mitral valve (MV) repair in patients with an unacceptably high operative risk. MV repair for mitral regurgitation (MR) can be accomplished by use of a clip that approximates the free edges of the mitral leaflets. All patients were declined for surgery because of a high logistic EuroSCORE (>20%) or the presence of other specific surgical risk factors. Transthoracic echocardiography was performed before and 6 months after the procedure. Differences in New York Heart Association (NYHA) functional class, quality of life (QoL) using the Minnesota questionnaire, and 6-min walk test (6-MWT) distances were reported. Fifty-five procedures were performed in 52 patients (69.2% male, age 73.2 ± 10.1 years, logistic EuroSCORE 27.1 ± 17.0%). In 3 patients, partial clip detachment occurred; a second clip was placed successfully. One patient experienced cardiac tamponade. Two patients developed inguinal bleeding, of whom 1 needed surgery. Six patients (11.5%) died during 6-month follow-up (5 patients as a result of progressive heart failure and 1 noncardiac death). The MR grade before repair was ≥3 in 100%; after 6 months, a reduction in MR grade to ≤2 was present in 79% of the patients. Left ventricular (LV) end-diastolic diameter, LV ejection fraction, and systolic pulmonary artery pressure improved significantly. Accompanied improvements in NYHA functional class, QoL index, 6-MWT distances, and log N-terminal pro-B-type natriuretic peptide were observed. In a high-risk population, MR reduction can be achieved by percutaneous edge-to-edge valve repair, resulting in LV remodeling with improvement of functional capacity after 6 months. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

40 CFR Appendix G to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the March 3, 1999...

Code of Federal Regulations, 2010 CFR

2010-07-01

.... Refrigerants Unacceptable Substitutes End-use Substitute Decision Comments CFC-12, R-502, and HCFC-22 Household... gas emissions from direct release of refrigerant to the atmosphere. [64 FR 10378, Mar. 3, 1999] ...

40 CFR Appendix G to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the March 3, 1999...

Code of Federal Regulations, 2011 CFR

2011-07-01

.... Refrigerants Unacceptable Substitutes End-use Substitute Decision Comments CFC-12, R-502, and HCFC-22 Household... gas emissions from direct release of refrigerant to the atmosphere. [64 FR 10378, Mar. 3, 1999] ...

Measuring Attitudes toward Acceptable and Unacceptable Parenting Practices

ERIC Educational Resources Information Center

Budd, Karen S.; Behling, Steven; Li, Yan; Parikshak, Sangeeta; Gershenson, Rachel A.; Feuer, Rachel; Danko, Christina M.

2012-01-01

This study investigated the properties of a new rating instrument, the Parenting Questionnaire (PQ), designed to measure attitudes about acceptable and unacceptable parenting practices. In Study 1, subject matter experts representing culturally diverse psychologists, parents, and college students were consulted to identify 110 items receiving high…

Donation after cardiac death liver transplantation: Graft quality evaluation based on pretransplant liver biopsy.

PubMed

Xia, Weiliang; Ke, Qinghong; Wang, Ye; Feng, Xiaowen; Guo, Haijun; Wang, Weilin; Zhang, Min; Shen, Yan; Wu, Jian; Xu, Xiao; Yan, Sheng; Zheng, Shusen

2015-06-01

Donation after cardiac death (DCD) liver grafts are associated with inferior clinical outcomes and high discard rates because of poor graft quality. We investigated the predictive value of DCD liver biopsy for the pretransplant graft quality evaluation. DCD liver transplants that took place between October 2010 and April 2014 were included (n = 127). Histological features of graft biopsy samples were analyzed to assess risk factors for graft survival. Macrovesicular steatosis ≥ 20% [hazard ratio (HR) = 2.973; P = 0.045] and sinusoidal neutrophilic infiltrate (HR = 6.969; P = 0.005) were confirmed as independent risk factors for graft survival; hepatocellular swelling, vacuolation, and necrosis failed to show prognostic value. Additionally, a donor serum total bilirubin level ≥ 34.2 μmol/L was also associated with a lower probability of graft survival. Our analysis indicates that macrovesicular steatosis ≥ 20% and sinusoidal neutrophilic infiltrate are novel and useful histological markers for DCD liver grafts with unacceptable quality. This finding can be used by transplant surgeons to improve DCD liver acceptance protocols. © 2015 American Association for the Study of Liver Diseases.

Calculation of the age of the first infection for skin sores and scabies in five remote communities in northern Australia.

PubMed

Lydeamore, M J; Campbell, P T; Cuningham, W; Andrews, R M; Kearns, T; Clucas, D; Gundjirryirr Dhurrkay, R; Carapetis, J; Tong, S Y C; McCaw, J M; McVernon, J

2018-05-08

Prevalence of skin sores and scabies in remote Australian Aboriginal communities remains unacceptably high, with Group A Streptococcus (GAS) the dominant pathogen. We aim to better understand the drivers of GAS transmission using mathematical models. To estimate the force of infection, we quantified the age of first skin sores and scabies infection by pooling historical data from three studies conducted across five remote Aboriginal communities for children born between 2001 and 2005. We estimated the age of the first infection using the Kaplan-Meier estimator; parametric exponential mixture model; and Cox proportional hazards. For skin sores, the mean age of the first infection was approximately 10 months and the median was 7 months, with some heterogeneity in median observed by the community. For scabies, the mean age of the first infection was approximately 9 months and the median was 8 months, with significant heterogeneity by the community and an enhanced risk for children born between October and December. The young age of the first infection with skin sores and scabies reflects the high disease burden in these communities.

Centaur: A Mobile Dexterous Humanoid for Surface Operations

NASA Technical Reports Server (NTRS)

Rehnmark, Fredrik; Ambrose, Robert O.; Goza, S. Michael; Junkin, Lucien; Neuhaus, Peter D.; Pratt, Jerry E.

2005-01-01

Future human and robotic planetary expeditions could benefit greatly from expanded Extra-Vehicular Activity (EVA) capabilities supporting a broad range of multiple, concurrent surface operations. Risky, expensive and complex, conventional EVAs are restricted in both duration and scope by consumables and available manpower, creating a resource management problem. A mobile, highly dexterous Extra-Vehicular Robotic (EVR) system called Centaur is proposed to cost-effectively augment human astronauts on surface excursions. The Centaur design combines a highly capable wheeled mobility platform with an anthropomorphic upper body mounted on a three degree-of-freedom waist. Able to use many ordinary handheld tools, the robot could conserve EVA hours by relieving humans of many routine inspection and maintenance chores and assisting them in more complex tasks, such as repairing other robots. As an astronaut surrogate, Centaur could take risks unacceptable to humans, respond more quickly to EVA emergencies and work much longer shifts. Though originally conceived as a system for planetary surface exploration, the Centaur concept could easily be adapted for terrestrial military applications such as de-Gig, surveillance and other hazardous duties.

Solar thermal technology development: Estimated market size and energy cost savings. Volume 2: Assumptions, methodology and results

NASA Astrophysics Data System (ADS)

Gates, W. R.

1983-02-01

Estimated future energy cost savings associated with the development of cost-competitive solar thermal technologies (STT) are discussed. Analysis is restricted to STT in electric applications for 16 high-insolation/high-energy-price states. Three fuel price scenarios and three 1990 STT system costs are considered, reflecting uncertainty over future fuel prices and STT cost projections. Solar thermal technology research and development (R&D) is found to be unacceptably risky for private industry in the absence of federal support. Energy cost savings were projected to range from $0 to $10 billion (1990 values in 1981 dollars), depending on the system cost and fuel price scenario. Normal R&D investment risks are accentuated because the Organization of Petroleum Exporting Countries (OPEC) cartel can artificially manipulate oil prices and undercut growth of alternative energy sources. Federal participation in STT R&D to help capture the potential benefits of developing cost-competitive STT was found to be in the national interest. Analysis is also provided regarding two federal incentives currently in use: The Federal Business Energy Tax Credit and direct R&D funding.

Solar thermal technology development: Estimated market size and energy cost savings. Volume 2: Assumptions, methodology and results

NASA Technical Reports Server (NTRS)

Gates, W. R.

1983-01-01

Estimated future energy cost savings associated with the development of cost-competitive solar thermal technologies (STT) are discussed. Analysis is restricted to STT in electric applications for 16 high-insolation/high-energy-price states. Three fuel price scenarios and three 1990 STT system costs are considered, reflecting uncertainty over future fuel prices and STT cost projections. Solar thermal technology research and development (R&D) is found to be unacceptably risky for private industry in the absence of federal support. Energy cost savings were projected to range from $0 to $10 billion (1990 values in 1981 dollars), depending on the system cost and fuel price scenario. Normal R&D investment risks are accentuated because the Organization of Petroleum Exporting Countries (OPEC) cartel can artificially manipulate oil prices and undercut growth of alternative energy sources. Federal participation in STT R&D to help capture the potential benefits of developing cost-competitive STT was found to be in the national interest. Analysis is also provided regarding two federal incentives currently in use: The Federal Business Energy Tax Credit and direct R&D funding.

Toward optimizing patient-specific IMRT QA techniques in the accurate detection of dosimetrically acceptable and unacceptable patient plans

PubMed Central

McKenzie, Elizabeth M.; Balter, Peter A.; Stingo, Francesco C.; Jones, Jimmy; Followill, David S.; Kry, Stephen F.

2014-01-01

Purpose: The authors investigated the performance of several patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) dosimeters in terms of their ability to correctly identify dosimetrically acceptable and unacceptable IMRT patient plans, as determined by an in-house-designed multiple ion chamber phantom used as the gold standard. A further goal was to examine optimal threshold criteria that were consistent and based on the same criteria among the various dosimeters. Methods: The authors used receiver operating characteristic (ROC) curves to determine the sensitivity and specificity of (1) a 2D diode array undergoing anterior irradiation with field-by-field evaluation, (2) a 2D diode array undergoing anterior irradiation with composite evaluation, (3) a 2D diode array using planned irradiation angles with composite evaluation, (4) a helical diode array, (5) radiographic film, and (6) an ion chamber. This was done with a variety of evaluation criteria for a set of 15 dosimetrically unacceptable and 9 acceptable clinical IMRT patient plans, where acceptability was defined on the basis of multiple ion chamber measurements using independent ion chambers and a phantom. The area under the curve (AUC) on the ROC curves was used to compare dosimeter performance across all thresholds. Optimal threshold values were obtained from the ROC curves while incorporating considerations for cost and prevalence of unacceptable plans. Results: Using common clinical acceptance thresholds, most devices performed very poorly in terms of identifying unacceptable plans. Grouping the detector performance based on AUC showed two significantly different groups. The ion chamber, radiographic film, helical diode array, and anterior-delivered composite 2D diode array were in the better-performing group, whereas the anterior-delivered field-by-field and planned gantry angle delivery using the 2D diode array performed less well. Additionally, based on the AUCs, there was no significant difference in the performance of any device between gamma criteria of 2%/2 mm, 3%/3 mm, and 5%/3 mm. Finally, optimal cutoffs (e.g., percent of pixels passing gamma) were determined for each device and while clinical practice commonly uses a threshold of 90% of pixels passing for most cases, these results showed variability in the optimal cutoff among devices. Conclusions: IMRT QA devices have differences in their ability to accurately detect dosimetrically acceptable and unacceptable plans. Field-by-field analysis with a MapCheck device and use of the MapCheck with a MapPhan phantom while delivering at planned rotational gantry angles resulted in a significantly poorer ability to accurately sort acceptable and unacceptable plans compared with the other techniques examined. Patient-specific IMRT QA techniques in general should be thoroughly evaluated for their ability to correctly differentiate acceptable and unacceptable plans. Additionally, optimal agreement thresholds should be identified and used as common clinical thresholds typically worked very poorly to identify unacceptable plans. PMID:25471949

Toward optimizing patient-specific IMRT QA techniques in the accurate detection of dosimetrically acceptable and unacceptable patient plans.

PubMed

McKenzie, Elizabeth M; Balter, Peter A; Stingo, Francesco C; Jones, Jimmy; Followill, David S; Kry, Stephen F

2014-12-01

The authors investigated the performance of several patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) dosimeters in terms of their ability to correctly identify dosimetrically acceptable and unacceptable IMRT patient plans, as determined by an in-house-designed multiple ion chamber phantom used as the gold standard. A further goal was to examine optimal threshold criteria that were consistent and based on the same criteria among the various dosimeters. The authors used receiver operating characteristic (ROC) curves to determine the sensitivity and specificity of (1) a 2D diode array undergoing anterior irradiation with field-by-field evaluation, (2) a 2D diode array undergoing anterior irradiation with composite evaluation, (3) a 2D diode array using planned irradiation angles with composite evaluation, (4) a helical diode array, (5) radiographic film, and (6) an ion chamber. This was done with a variety of evaluation criteria for a set of 15 dosimetrically unacceptable and 9 acceptable clinical IMRT patient plans, where acceptability was defined on the basis of multiple ion chamber measurements using independent ion chambers and a phantom. The area under the curve (AUC) on the ROC curves was used to compare dosimeter performance across all thresholds. Optimal threshold values were obtained from the ROC curves while incorporating considerations for cost and prevalence of unacceptable plans. Using common clinical acceptance thresholds, most devices performed very poorly in terms of identifying unacceptable plans. Grouping the detector performance based on AUC showed two significantly different groups. The ion chamber, radiographic film, helical diode array, and anterior-delivered composite 2D diode array were in the better-performing group, whereas the anterior-delivered field-by-field and planned gantry angle delivery using the 2D diode array performed less well. Additionally, based on the AUCs, there was no significant difference in the performance of any device between gamma criteria of 2%/2 mm, 3%/3 mm, and 5%/3 mm. Finally, optimal cutoffs (e.g., percent of pixels passing gamma) were determined for each device and while clinical practice commonly uses a threshold of 90% of pixels passing for most cases, these results showed variability in the optimal cutoff among devices. IMRT QA devices have differences in their ability to accurately detect dosimetrically acceptable and unacceptable plans. Field-by-field analysis with a MapCheck device and use of the MapCheck with a MapPhan phantom while delivering at planned rotational gantry angles resulted in a significantly poorer ability to accurately sort acceptable and unacceptable plans compared with the other techniques examined. Patient-specific IMRT QA techniques in general should be thoroughly evaluated for their ability to correctly differentiate acceptable and unacceptable plans. Additionally, optimal agreement thresholds should be identified and used as common clinical thresholds typically worked very poorly to identify unacceptable plans.

47 CFR 22.877 - Unacceptable interference to Part 90 non-cellular 800 MHz licensees from commercial aviation air...

Code of Federal Regulations, 2010 CFR

2010-10-01

...-cellular 800 MHz licensees from commercial aviation air-ground systems. 22.877 Section 22.877 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.877 Unacceptable interference...

Independent Review of U.S. and Russian Probabilistic Risk Assessments for the International Space Station Mini Research Module #2 Micrometeoroid and Orbital Debris Risk

NASA Technical Reports Server (NTRS)

Squire, Michael D.

2011-01-01

The Mini-Research Module-2 (MRM-2), a Russian module on the International Space Station, does not meet its requirements for micrometeoroid and orbital debris probability of no penetration (PNP). To document this condition, the primary Russian Federal Space Agency ISS contractor, S.P. Korolev Rocket and Space Corporation-Energia (RSC-E), submitted an ISS non-compliance report (NCR) which was presented at the 5R Stage Operations Readiness Review (SORR) in October 2009. In the NCR, RSC-E argued for waiving the PNP requirement based on several factors, one of which was the risk of catastrophic failure was acceptably low at 1 in 11,100. However, NASA independently performed an assessment of the catastrophic risk resulting in a value of 1 in 1380 and believed that the risk at that level was unacceptable. The NASA Engineering and Safety Center was requested to evaluate the two competing catastrophic risk values and determine which was more accurate. This document contains the outcome of the assessment.

Mechanical Ventilation as a Therapeutic Tool to Reduce ARDS Incidence.

PubMed

Nieman, Gary F; Gatto, Louis A; Bates, Jason H T; Habashi, Nader M

2015-12-01

Trauma, hemorrhagic shock, or sepsis can incite systemic inflammatory response syndrome, which can result in early acute lung injury (EALI). As EALI advances, improperly set mechanical ventilation (MV) can amplify early injury into a secondary ventilator-induced lung injury that invariably develops into overt ARDS. Once established, ARDS is refractory to most therapeutic strategies, which have not been able to lower ARDS mortality below the current unacceptably high 40%. Low tidal volume ventilation is one of the few treatments shown to have a moderate positive impact on ARDS survival, presumably by reducing ventilator-induced lung injury. Thus, there is a compelling case to be made that the focus of ARDS management should switch from treatment once this syndrome has become established to the application of preventative measures while patients are still in the EALI stage. Indeed, studies have shown that ARDS incidence is markedly reduced when conventional MV is applied preemptively using a combination of low tidal volume and positive end-expiratory pressure in both patients in the ICU and in surgical patients at high risk for developing ARDS. Furthermore, there is evidence from animal models and high-risk trauma patients that superior prevention of ARDS can be achieved using preemptive airway pressure release ventilation with a very brief duration of pressure release. Preventing rather than treating ARDS may be the way forward in dealing with this recalcitrant condition and would represent a paradigm shift in the way that MV is currently practiced.

Effects of sevoflurane anaesthesia on recovery in children: a comparison with halothane.

PubMed

Lapin, S L; Auden, S M; Goldsmith, L J; Reynolds, A M

1999-01-01

We prospectively studied one hundred ASA physical status I-II children, ages six months to six years, undergoing myringotomy surgery. Children were randomly assigned to one of four anaesthetic groups receiving either halothane or sevoflurane for anaesthesia and oral midazolam premedication or no premedication. We found that children anaesthetized with sevoflurane had significantly faster recovery times and discharge home times than those who received halothane. Patients given oral midazolam premedication had significantly longer recovery times, but no delay in discharge home compared with those not premedicated. However, children anaesthetized with sevoflurane and no premedication had an unacceptably high incidence (67%) of postoperative agitation. The use of oral midazolam preoperatively did decrease the amount of postoperative agitation seen with sevoflurane. We conclude that although sevoflurane does shorten recovery times, the degree of associated postoperative agitation makes it unacceptable as a sole anaesthetic for myringotomy surgery.

Pulse compression using a tapered microstructure optical fiber.

PubMed

Hu, Jonathan; Marks, Brian S; Menyuk, Curtis R; Kim, Jinchae; Carruthers, Thomas F; Wright, Barbara M; Taunay, Thierry F; Friebele, E J

2006-05-01

We calculate the pulse compression in a tapered microstructure optical fiber with four layers of holes. We show that the primary limitation on pulse compression is the loss due to mode leakage. As a fiber's diameter decreases due to the tapering, so does the air-hole diameter, and at a sufficiently small diameter the guided mode loss becomes unacceptably high. For the four-layer geometry we considered, a compression factor of 10 can be achieved by a pulse with an initial FWHM duration of 3 ps in a tapered fiber that is 28 m long. We find that there is little difference in the pulse compression between a linear taper profile and a Gaussian taper profile. More layers of air-holes allows the pitch to decrease considerably before losses become unacceptable, but only a moderate increase in the degree of pulse compression is obtained.

Successful Sequential Liver and Hematopoietic Stem Cell Transplantation in a Child With CD40 Ligand Deficiency and Cryptosporidium-Induced Liver Cirrhosis.

PubMed

Quarello, Paola; Tandoi, Francesco; Carraro, Francesca; Vassallo, Elena; Pinon, Michele; Romagnoli, Renato; David, Ezio; Dell Olio, Dominic; Salizzoni, Mauro; Fagioli, Franca; Calvo, Pier Luigi

2018-05-01

Hematopoietic stem cell transplantation (HSCT) is curative in patients with primary immunodeficiencies. However, pre-HSCT conditioning entails unacceptably high risks if the liver is compromised. The presence of a recurrent opportunistic infection affecting the biliary tree and determining liver cirrhosis with portal hypertension posed particular decisional difficulties in a 7-year-old child with X-linked CD40-ligand deficiency. We aim at adding to the scanty experience available on such rare cases, as successful management with sequential liver transplantation (LT) and HSCT has been reported in detail only in 1 young adult to date. A closely sequential strategy, with a surgical complication-free LT, followed by reduced-intensity conditioning, allowed HSCT to be performed only one month after LT, preventing Cryptosporidium parvum recolonization of the liver graft. Combined sequential LT and HSCT resolved the cirrhotic evolution and corrected the immunodeficiency so that the infection responsible for the progressive sclerosing cholangitis did not recur. Hopefully, this report of the successful resolution of a potentially fatal combination of immunodeficiency and chronic opportunistic infection with end-stage organ damage in a child will encourage others to adapt a sequential transplant approach to this highly complex pathology. However, caution is to be exercised to carefully balance the risks intrinsic to transplant surgery and immunosuppression in primary immunodeficiencies.

Denver's Public Schools: Reforms, Challenges, and the Future

ERIC Educational Resources Information Center

Bray, Judy; Medler, Alex

2009-01-01

Denver is currently in the national education spotlight, largely because of its willingness to try a unique combination of major education reforms not seen in other large urban school districts. While many observers hold these reforms in high regard, a steep road lies ahead. Current student results are unacceptable by all measures. The time is…

Identification of Childhood Disability in Jamaica: The Ten Question Screen.

ERIC Educational Resources Information Center

Thorburn, Marigold; And Others

1992-01-01

This study evaluated use of the Ten Question Screen (TQ) to identify disability in a 2-stage population-based survey of 5,478 children aged 2-9 years in Clarendon, Jamaica. Findings indicated varied sensitivity by different subgroups (age, gender, and disability) and an unacceptably high false positive rate. (Author/DB)

The Relationship Between Repetition Priming and Skill Acquisition

DTIC Science & Technology

1993-01-01

hours of cognitive testing. Given that most measures were of response latency, it neemed unacceptable to include subjects with high error rates indicative...U Leaf Crude Oil Paper Bug Spray Hair Sea Water Plastic Shampoo Rock Blood Cement Ink IF the word is Food, THEN check if its Solid or Liquid LF its

"Getting a Job": Vocationalism, Identity Formation, and Critical Ethnographic Inquiry

ERIC Educational Resources Information Center

Down, Barry; Smyth, John

2012-01-01

This article examines the highly disputed policy nexus around what on the surface appears to be the helpful field of vocational education and training. Despite the promises of vocational education and training to deliver individual labour market success and global competitiveness, the reality is that it serves to residualise unacceptably large…

Why We Test Students for Drugs

ERIC Educational Resources Information Center

Brady, Lisa A.

2008-01-01

Today, there is a collective national awareness that an unacceptable number of teens are involved in the use of dangerous drugs such as methamphetamine, ecstasy, and heroin, and they have access to high-grade marijuana. Alcohol use, even more pervasive, results in risky sexual behaviors, automobile accidents, and even death. To the dismay of many…

The Importance of Tooth Decay Prevention in Children under Three

ERIC Educational Resources Information Center

Milgrom, Peter; Huebner, Colleen; Chi, Donald

2010-01-01

Tooth decay and tooth loss was once the norm but public health interventions have led to major improvements for most people. Nevertheless, not all children have benefited. Dental disease in young children is unacceptably high. Tooth decay is preventable. Early childhood educators are often the first to notice the problem. Professional…

A Critical Review of the Massachusetts Next Generation Science and Technology/Engineering Standards. Policy Brief

ERIC Educational Resources Information Center

Metzenberg, Stan

2015-01-01

Stan Metzenberg offers a critical analysis of the draft "Massachusetts Science and Technology/Engineering Standards," which are for pre-Kindergarten to Grade 8 and introductory high school courses. Metzenberg claims that the document reveals significant, unacceptable gaps in science content, as well as some notable errors and…

Application of a hazard and operability study method to hazard evaluation of a chemical unit of the power station.

PubMed

Habibi, E; Zare, M; Barkhordari, A; Mirmohammadi, Sj; Halvani, Ghh

2008-12-28

The aim of this study was to identify the hazards, evaluate their risk factors and determine the measure for promotion of the process and reduction of accidents in the chemical unit of the power station. In this case and qualitative study, HAZOP technique was used to recognize the hazards and problems of operations on the chemical section at power station. Totally, 126 deviations were documented with various causes and consequences. Ranking and evaluation of identified risks indicate that the majority of deviations were categorized as "acceptable" and less than half of that were "unacceptable". The highest calculated risk level (1B) related to both the interruption of acid entry to the discharge pumps and an increased density of the acid. About 27% of the deviations had the lowest risk level (4B). The identification of hazards by HAZOP indicates that it could, systemically, assess and criticize the process of consumption or production of acid and alkali in the chemical unit of power plant.

Parameters. US Army War College Quarterly. Volume 25. Number 1. Spring 1995,

DTIC Science & Technology

1995-01-01

major reason the fratricide rate remains so high is that imperfect human skills and judgment needed to employ weapon systems quickly degrade under...and rehearsals before the Desert Storm ground campaign, the residual rate of fratricide remained unacceptably high. Nor are the high rates at our combat...California State University, Fullerton. He is the editor and an author of The Search For Strategy: Politics and Strategic Vision. Spring 1995 31 Haiti, Peru

The Risks to Patient Privacy from Publishing Data from Clinical Anesthesia Studies.

PubMed

O'Neill, Liam; Dexter, Franklin; Zhang, Nan

2016-06-01

In this article, we consider the privacy implications of posting data from small, randomized trials, observational studies, or case series in anesthesia from a few (e.g., 1-3) hospitals. Prior to publishing such data as supplemental digital content, the authors remove attributes that could be used to re-identify individuals, a process known as "anonymization." Posting health information that has been properly "de-identified" is assumed to pose no risks to patient privacy. Yet, computer scientists have demonstrated that this assumption is flawed. We consider various realistic scenarios of how the publication of such data could lead to breaches of patient privacy. Several examples of successful privacy attacks are reviewed, as well as the methods used. We survey the latest models and methods from computer science for protecting health information and their application to posting data from small anesthesia studies. To illustrate the vulnerability of such published data, we calculate the "population uniqueness" for patients undergoing one or more surgical procedures using data from the State of Texas. For a patient selected uniformly at random, the probability that an adversary could match this patient's record to a unique record in the state external database was 42.8% (SE < 0.1%). Despite the 42.8% being an unacceptably high level of risk, it underestimates the risk for patients from smaller states or provinces. We propose an editorial policy that greatly reduces the likelihood of a privacy breach, while supporting the goal of transparency of the research process.

Reducing Transaction Costs for Energy Efficiency Investments and Analysis of Economic Risk Associated With Building Performance Uncertainties: Small Buildings and Small Portfolios Program

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

Langner, R.; Hendron, B.; Bonnema, E.

2014-08-01

The small buildings and small portfolios (SBSP) sector face a number of barriers that inhibit SBSP owners from adopting energy efficiency solutions. This pilot project focused on overcoming two of the largest barriers to financing energy efficiency in small buildings: disproportionately high transaction costs and unknown or unacceptable risk. Solutions to these barriers can often be at odds, because inexpensive turnkey solutions are often not sufficiently tailored to the unique circumstances of each building, reducing confidence that the expected energy savings will be achieved. To address these barriers, NREL worked with two innovative, forward-thinking lead partners, Michigan Saves and Energi,more » to develop technical solutions that provide a quick and easy process to encourage energy efficiency investments while managing risk. The pilot project was broken into two stages: the first stage focused on reducing transaction costs, and the second stage focused on reducing performance risk. In the first stage, NREL worked with the non-profit organization, Michigan Saves, to analyze the effects of 8 energy efficiency measures (EEMs) on 81 different baseline small office building models in Holland, Michigan (climate zone 5A). The results of this analysis (totaling over 30,000 cases) are summarized in a simple spreadsheet tool that enables users to easily sort through the results and find appropriate small office EEM packages that meet a particular energy savings threshold and are likely to be cost-effective.« less

47 CFR 22.877 - Unacceptable interference to part 90 non-cellular 800 MHz licensees from commercial aviation air...

Code of Federal Regulations, 2014 CFR

2014-10-01

...-cellular 800 MHz licensees from commercial aviation air-ground systems. 22.877 Section 22.877...-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.877 Unacceptable interference to part 90 non-cellular 800 MHz licensees from commercial aviation air-ground systems. The definition...

47 CFR 22.877 - Unacceptable interference to Part 90 non-cellular 800 MHz licensees from commercial aviation air...

Code of Federal Regulations, 2012 CFR

2012-10-01

...-cellular 800 MHz licensees from commercial aviation air-ground systems. 22.877 Section 22.877...-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.877 Unacceptable interference to Part 90 non-cellular 800 MHz licensees from commercial aviation air-ground systems. The definition...

47 CFR 22.877 - Unacceptable interference to Part 90 non-cellular 800 MHz licensees from commercial aviation air...

Code of Federal Regulations, 2011 CFR

2011-10-01

...-cellular 800 MHz licensees from commercial aviation air-ground systems. 22.877 Section 22.877...-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.877 Unacceptable interference to Part 90 non-cellular 800 MHz licensees from commercial aviation air-ground systems. The definition...

47 CFR 22.877 - Unacceptable interference to Part 90 non-cellular 800 MHz licensees from commercial aviation air...

Code of Federal Regulations, 2013 CFR

2013-10-01

...-cellular 800 MHz licensees from commercial aviation air-ground systems. 22.877 Section 22.877...-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.877 Unacceptable interference to Part 90 non-cellular 800 MHz licensees from commercial aviation air-ground systems. The definition...

30 CFR 250.136 - How will MMS determine if my operating performance is unacceptable?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false How will MMS determine if my operating performance is unacceptable? 250.136 Section 250.136 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT...) Accidents and their nature; (b) Pollution events, environmental damages and their nature; (c) Incidents of...

Pre-Crisis Intervention Strategies for Reducing Unacceptable Behaviors by Exceptional Students in a Public Elementary School.

ERIC Educational Resources Information Center

Levine-Brown, Linda S.

This report describes the implementation of a data-based program to reduce unacceptable student behaviors and decrease the number of administrative interventions with 21 students with severe emotional disturbances. A computerized database was developed to track classroom and transportation discipline infractions. Students met monthly to review…

Managing ethical performance in organizations: insights from the corporate world.

PubMed

Soule, Edward

2007-03-01

Medical organizations can learn at least three lessons from the recent spate of corporate scandals and the regulatory response they triggered. One is the importance of identifying and eliminating those conflicts of interest that pose unacceptable risks to an organization's reputation or to an industry's public profile. Second, although disclosing a risk attendant to a conflict of interest is of crucial importance, disclosures are not automatic absolutions, regardless of how full and complete they may be. Third, an organization's ethical performance is first and foremost a function of its culture. If there were any doubt, the likes of Enron Corporation and WorldCom confirmed that formal controls and legal sanctions are no substitute for the importance that members of an organization accord to playing by the rules and working with integrity.

Teens and seat belt use: What makes them click?

PubMed

Shults, Ruth A; Haegerich, Tamara M; Bhat, Geeta; Zhang, Xinjian

2016-06-01

Motor vehicle crashes kill more adolescents in the United States than any other cause, and often the teen is not wearing a seat belt. Using data from the 2011 Youth Risk Behavior Surveys from 38 states, we examined teens' self-reported seat belt use while riding as a passenger and identified individual characteristics and environmental factors associated with always wearing a seat belt. Only 51% of high school students living in 38 states reported always wearing a seat belt when riding as a passenger; prevalence varied from 32% in South Dakota to 65% in Delaware. Seat belt use was 11 percentage points lower in states with secondary enforcement seat belt laws compared to states with primary enforcement laws. Racial/ethnic minorities, teens living in states with secondary enforcement seat belt laws, and those engaged in substance use were least likely to always wear their seat belts. The likelihood of always being belted declined steadily as the number of substance use behaviors increased. Seat belt use among teens in the United States remains unacceptably low. Results suggest that environmental influences can compound individual risk factors, contributing to even lower seat belt use among some subgroups. This study provides the most comprehensive state-level estimates to date of seat belt use among U.S. teens. This information can be useful when considering policy options to increase seat belt use and for targeting injury prevention interventions to high-risk teens. States can best increase teen seat belt use by making evidence-informed decisions about state policy options and prevention strategies. Published by Elsevier Ltd.

Vasectomy as a reversible form of contraception for select patients.

PubMed

Samplaski, Mary K; Daniel, Ariande; Jarvi, Keith

2014-04-01

To provide an effective form of birth control, men may choose a reversible or permanent form of contraception. Vasectomy is presently offered as a permanent option for male contraception. We have had patients who were interested in vasectomy and reversal as a temporary birth control option. The purpose of this paper is to determine if vasectomy should be offered for selected couples as a temporary form of contraception and under which circumstances. A literature review was conducted to determine the available reversible contraceptive options, risks, failure rates and contraindications to each, and the risks and success rates of vasectomy and vasectomy reversal. Reversible contraceptives include hormonally based methods for women, non-hormonal anatomic barrier devices and spermatocidal agents. Hormone based therapies may be contraindicated in women with cardiovascular disease, hypertension, and some cancers. Non-hormonal contraceptives are generally less effective and may be unacceptable for some couples due to higher failure rates, difficulty of use and lack of acceptance. Both vasectomy and vasectomy reversal are low risk procedures. Reversal may be performed with a high degree of success, particularly with a short obstructive interval (97% patency if performed < 3 years following vasectomy). While vasectomy should be considered a permanent form of sterilization for most couples, there are select couples, unable or unwilling to use other forms of birth control, who would benefit from an informed discussion about using a vasectomy as a reversible form of contraception.

Verification of Dose Distribution in Carbon Ion Radiation Therapy for Stage I Lung Cancer

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

Irie, Daisuke; Saitoh, Jun-ichi, E-mail: junsaito@gunma-u.ac.jp; Shirai, Katsuyuki

Purpose: To evaluate robustness of dose distribution of carbon-ion radiation therapy (C-ion RT) in non-small cell lung cancer (NSCLC) and to identify factors affecting the dose distribution by simulated dose distribution. Methods and Materials: Eighty irradiation fields for delivery of C-ion RT were analyzed in 20 patients with stage I NSCLC. Computed tomography images were obtained twice before treatment initiation. Simulated dose distribution was reconstructed on computed tomography for confirmation under the same settings as actual treatment with respiratory gating and bony structure matching. Dose-volume histogram parameters, such as %D95 (percentage of D95 relative to the prescribed dose), were calculated.more » Patients with any field for which the %D95 of gross tumor volume (GTV) was below 90% were classified as unacceptable for treatment, and the optimal target margin for such cases was examined. Results: Five patients with a total of 8 fields (10% of total number of fields analyzed) were classified as unacceptable according to %D95 of GTV, although most patients showed no remarkable change in the dose-volume histogram parameters. Receiver operating characteristic curve analysis showed that tumor displacement and change in water-equivalent pathlength were significant predictive factors of unacceptable cases (P<.001 and P=.002, respectively). The main cause of degradation of the dose distribution was tumor displacement in 7 of the 8 unacceptable fields. A 6-mm planning target volume margin ensured a GTV %D95 of >90%, except in 1 extremely unacceptable field. Conclusions: According to this simulation analysis of C-ion RT for stage I NSCLC, a few fields were reported as unacceptable and required resetting of body position and reconfirmation. In addition, tumor displacement and change in water-equivalent pathlength (bone shift and/or chest wall thickness) were identified as factors influencing the robustness of dose distribution. Such uncertainties should be regarded in planning.« less

Tobacco control environment: cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries

PubMed Central

Corsi, Daniel J; Gilmore, Anna B; Kruger, Annamarie; Igumbor, Ehimario; Chifamba, Jephat; Yang, Wang; Wei, Li; Iqbal, Romaina; Mony, Prem; Gupta, Rajeev; Vijayakumar, Krishnapillai; Mohan, V; Kumar, Rajesh; Rahman, Omar; Yusoff, Khalid; Ismail, Noorhassim; Zatonska, Katarzyna; Altuntas, Yuksel; Rosengren, Annika; Bahonar, Ahmad; Yusufali, AfzalHussein; Dagenais, Gilles; Lear, Scott; Diaz, Rafael; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Lanas, Fernando; Rangarajan, Sumathy; Teo, Koon; McKee, Martin; Yusuf, Salim

2017-01-01

Objectives This study examines in a cross-sectional study ‘the tobacco control environment’ including tobacco policy implementation and its association with quit ratio. Setting 545 communities from 17 high-income, upper-middle, low-middle and low-income countries (HIC, UMIC, LMIC, LIC) involved in the Environmental Profile of a Community's Health (EPOCH) study from 2009 to 2014. Participants Community audits and surveys of adults (35–70 years, n=12 953). Primary and secondary outcome measures Summary scores of tobacco policy implementation (cost and availability of cigarettes, tobacco advertising, antismoking signage), social unacceptability and knowledge were associated with quit ratios (former vs ever smokers) using multilevel logistic regression models. Results Average tobacco control policy score was greater in communities from HIC. Overall 56.1% (306/545) of communities had >2 outlets selling cigarettes and in 28.6% (154/539) there was access to cheap cigarettes (<5cents/cigarette) (3.2% (3/93) in HIC, 0% UMIC, 52.6% (90/171) LMIC and 40.4% (61/151) in LIC). Effective bans (no tobacco advertisements) were in 63.0% (341/541) of communities (81.7% HIC, 52.8% UMIC, 65.1% LMIC and 57.6% LIC). In 70.4% (379/538) of communities, >80% of participants disapproved youth smoking (95.7% HIC, 57.6% UMIC, 76.3% LMIC and 58.9% LIC). The average knowledge score was >80% in 48.4% of communities (94.6% HIC, 53.6% UMIC, 31.8% LMIC and 35.1% LIC). Summary scores of policy implementation, social unacceptability and knowledge were positively and significantly associated with quit ratio and the associations varied by gender, for example, communities in the highest quintile of the combined scores had 5.0 times the quit ratio in men (Odds ratio (OR) 5·0, 95% CI 3.4 to 7.4) and 4.1 times the quit ratio in women (OR 4.1, 95% CI 2.4 to 7.1). Conclusions This study suggests that more focus is needed on ensuring the tobacco control policy is actually implemented, particularly in LMICs. The gender-related differences in associations of policy, social unacceptability and knowledge suggest that different strategies to promoting quitting may need to be implemented in men compared to women. PMID:28363924

Shuttle Flight Operations Contract Generator Maintenance Facility Land Use Control Implementation Plan (LUCIP)

NASA Technical Reports Server (NTRS)

Applegate, Joseph L.

2014-01-01

This Land Use Control Implementation Plan (LUCIP) has been prepared to inform current and potential future users of the Kennedy Space Center (KSC) Shuttle Flight Operations Contract Generator Maintenance Facility (SFOC; SWMU 081; "the Site") of institutional controls that have been implemented at the Site1. Although there are no current unacceptable risks to human health or the environment associated with the SFOC, an institutional land use control (LUC) is necessary to prevent human health exposure to antimony-affected groundwater at the Site. Controls will include periodic inspection, condition certification, and agency notification.

Land Use Control Implementation Plan

NASA Technical Reports Server (NTRS)

Starr, Andrew Scott

2015-01-01

This Land Use Control Implementation Plan (LUCIP) has been prepared to inform current and potential future users of Building M7-505 of institutional controls that have been implemented at the site. Although there are no current unacceptable risks to human health or the environment associated with Building M7-505, institutional land use controls (LUCs) are necessary to prohibit the use of groundwater from the site. LUCs are also necessary to prevent access to soil under electrical equipment in the northwest portion of the site. Controls necessary to prevent human exposure will include periodic inspection, condition certification, and agency notification.

Potential use of CD40 ligand for immunotherapy of childhood B-cell precursor acute lymphoblastic leukaemia.

PubMed

D'Amico, Giovanna; Marin, Virna; Biondi, Andrea; Bonamino, Martin Hernán

2004-09-01

Around 20% of children affected by B-cell precursor acute lymphoblastic leukaemia (BCP-ALL) still experience a recurrence of the disease after diagnosis, despite a significant improvement in the cure rate (80%). Moreover, standard therapies have high and often unacceptable acute and chronic organ toxicity, with an increased risk for secondary malignancies. Therefore, new strategies are needed to improve overall survival and decrease treatment-associated morbidity. Recent in-vitro and in-vivo studies have demonstrated that CD40 engagement improves tumour immunogenicity and, consequently, generates a strong antitumour immune response. The CD40-CD40 ligand (CD40L) system is of pivotal importance in the immune response via interactions between T cells and antigen-presenting cells. The general aim of this chapter is to review the feasibility of developing cellular strategies to increase childhood BCP-ALL immunogenicity, and the potential use of CD40L as a new strategy to induce an antileukaemia immune response in BCP-ALL.

The management of gastric volvulus in elderly patients.

PubMed

Zuiki, Toru; Hosoya, Yoshinori; Lefor, Alan Kawarai; Tanaka, Hiroyuki; Komatsubara, Toshihide; Miyahara, Yuzo; Sanada, Yukihiro; Ohki, Jun; Sekiguchi, Chuji; Sata, Naohiro

2016-01-01

Gastric volvulus is torsion of the stomach and requires immediate treatment. The optimal treatment strategy for patients with gastric volvulus is not established, because of significant variations in the cause and clinical course of this condition. We describe our experience with six elderly patients with gastric volvulus caused by different conditions using various approaches. This includes two patients managed with endoscopic reduction, followed by endoscopic or laparoscopic gastropexy. Endoscopy is a necessary first step to determine the optimal treatment strategy, and endoscopic reduction is often effective. The indications for surgical repair of gastric volvulus depend on the patient's overall condition, and several options are available. In some elderly patients with severe comorbidities, major surgery may have an unacceptably high risk. We propose a novel treatment strategy for gastric volvulus in the elderly and a review of the literature. Early endoscopy is necessary in patients with gastric volvulus. Endoscopic or laparoscopic gastropexy may be adequate therapy in selected elderly patients. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Identification of potential recovery facilities for designing a reverse supply chain network using physical programming

NASA Astrophysics Data System (ADS)

Pochampally, Kishore K.; Gupta, Surendra M.; Kamarthi, Sagar V.

2004-02-01

Although there are many quantitative models in the literature to design a reverse supply chain, every model assumes that all the recovery facilities that are engaged in the supply chain have enough potential to efficiently re-process the incoming used products. Motivated by the risk of re-processing used products in facilities of insufficient potentiality, this paper proposes a method to identify potential facilities in a set of candidate recovery facilities operating in a region where a reverse supply chain is to be established. In this paper, the problem is solved using a newly developed method called physical programming. The most significant advantage of using physical programming is that it allows a decision maker to express his preferences for values of criteria (for comparing the alternatives), not in the traditional form of weights but in terms of ranges of different degrees of desirability, such as ideal range, desirable range, highly desirable range, undesirable range, and unacceptable range. A numerical example is considered to illustrate the proposed method.

A comparison of spacecraft penetration hazards due to meteoroids and manmade earth-orbiting objects

NASA Technical Reports Server (NTRS)

Brooks, D. R.

1976-01-01

The ability of a typical double-walled spacecraft structure to protect against penetration by high-velocity incident objects is reviewed. The hazards presented by meteoroids are compared to the current and potential hazards due to manmade orbiting objects. It is shown that the nature of the meteoroid number-mass relationship makes adequate protection for large space facilities a conceptually straightforward structural problem. The present level of manmade orbiting objects (an estimated 10,000 in early 1975) does not pose an unacceptable risk to manned space operations proposed for the near future, but it does produce penetration probabilities in the range of 1-10 percent for a 100-m diameter sphere in orbit for 1,000 days. The number-size distribution of manmade objects is such that adequate protection is difficult to achieve for large permanent space facilities, to the extent that future restrictions on such facilities may result if the growth of orbiting objects continues at its historical rate.

When the heart rules the head: ischaemic stroke and intracerebral haemorrhage complicating infective endocarditis.

PubMed

Jiad, Estabrak; Gill, Sumanjit K; Krutikov, Maria; Turner, David; Parkinson, Michael H; Curtis, Carmel; Werring, David J

2017-01-01

Sir William Osler meticulously described the clinical manifestations of infective endocarditis in 1885, concluding that: 'few diseases present greater difficulties in the way of diagnosis … which in many cases are practically insurmountable'. Even with modern investigation techniques, diagnosing infective endocarditis can be hugely challenging, yet is critically important in patients presenting with stroke (both cerebral infarction and intracranial haemorrhage), its commonest neurological complication. In ischaemic stroke, intravenous thrombolysis carries an unacceptably high risk of intracranial haemorrhage, while in intracerebral haemorrhage, mycotic aneurysms require urgent treatment to avoid rebleeding, and in all cases, prompt treatment with antibiotics and valve surgery may be life-saving. Here, we describe typical presentations of ischaemic stroke and intracerebral haemorrhage caused by infective endocarditis. We review the diagnostic challenges, the importance of rapid diagnosis, treatment options and controversies. 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/.

On the use of UAVs at active volcanoes: a case study from Volcan de Fuego, Guatemala

NASA Astrophysics Data System (ADS)

Watson, M.; Chigna, G.; Wood, K.; Richardson, T.; Liu, E.; Schellenberg, B.; Thomas, H.; Naismith, A.

2017-12-01

Volcan de Fuego, Guatemala, is one of Central America's most active systems. More than one hundred thousand people live within ten kilometres of the summit, many of them in profound poverty. Both the summit region and the volcano's steep sided valleys present significant access challenges, mostly associated with unacceptably high risk. Unmanned aerial vehicles (UAVs) offer the opportunity to observe, map and quantify emissions of tephra, gas, lava and heat flux and, using structure from motion algorithms, model dynamic topography. During recent campaigns, the team have completed observations of changes in the summit morphology immediately prior a paroxysmal eruption, mapped the key drainage systems after the fifth of May 2017 eruption and sampled the plume for tephra and gases using a range of onboard instruments. I will present the group's findings within a broader context of hazard mitigation and physical volcanology, and discuss the future of UAVs in volcano monitoring and research.

Evaluation of Final Radiological Conditions at Areas of the Niagara Falls Storage Site Remediated under the Formerly Utilized Sites Remedial Action Program -12184

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

Clayton, Christopher; Kothari, Vijendra; Starr, Ken

2012-02-26

The U. S. Department of Energy (DOE) methods and protocols allow evaluation of remediation and final site conditions to determine if remediated sites remain protective. Two case studies are presented that involve the Niagara Falls Storage Site (NFSS) and associated vicinity properties (VPs), which are being remediated under the Formerly Utilized Sites Remedial Action Program (FUSRAP). These properties are a part of the former Lake Ontario Ordnance Works (LOOW). In response to stakeholders concerns about whether certain remediated NFSS VPs were putting them at risk, DOE met with stakeholders and agreed to evaluate protectiveness. Documentation in the DOE records collectionmore » adequately described assessed and final radiological conditions at the completed VPs. All FUSRAP wastes at the completed sites were cleaned up to meet DOE guidelines for unrestricted use. DOE compiled the results of the investigation in a report that was released for public comment. In conducting the review of site conditions, DOE found that stakeholders were also concerned about waste from the Separations Process Research Unit (SPRU) at the Knolls Atomic Power Laboratory (KAPL) that was handled at LOOW. DOE agreed to determine if SPRU waste remained at that needed to be remediated. DOE reviewed records of waste characterization, historical handling locations and methods, and assessment and remediation data. DOE concluded that the SPRU waste was remediated on the LOOW to levels that pose no unacceptable risk and allow unrestricted use and unlimited exposure. This work confirms the following points as tenets of an effective long-term surveillance and maintenance (LTS&M) program: Stakeholder interaction must be open and transparent, and DOE must respond promptly to stakeholder concerns. DOE, as the long-term custodian, must collect and preserve site records in order to demonstrate that remediated sites pose no unacceptable risk. DOE must continue to maintain constructive relationships with the U.S. Army Corps of Engineers and state and federal regulators.« less

Effects of competing news media frames of weight on antifat stigma, beliefs about weight and support for obesity-related public policies.

PubMed

Frederick, D A; Saguy, A C; Sandhu, G; Mann, T

2016-03-01

In the popular news media, public health officials routinely emphasize the health risks of obesity and portray weight as under personal control. These messages may increase support for policies designed to reduce rates of obesity, but can also increase antifat stigma. Less often, the media cover 'Health at Every Size' or 'Fat Rights' perspectives that may have the opposite effects. We investigated how exposure to different 'fat frames' shifts attitudes about weight and support for obesity policies. Across four experiments (n=2187), people read constructed news articles framing fatness as negative (unhealthy, controllable, acceptable to stigmatize) or positive (healthy, uncontrollable, unacceptable to stigmatize). Compared with people who read fat-positive frames, people who read fat-negative frames expressed more: belief in the health risks of being fat (d=0.95-1.22), belief weight is controllable (d=0.38-0.55), support for charging obese people more for health insurance (d=0.26-0.77), antifat prejudice (in three out of four experiments, d=0.28-0.39), willingness to discriminate against fat people (d=0.39-0.71) and less willingness to celebrate body size diversity (d=0.37-0.64). They were also less willing to say that women at the lower end of the obese range could be healthy at their weights. Effects on support for public policies, however, were generally small and/or nonsignificant. Compared with a control condition, exposure to fat-positive frames generally shifted attitudes more than fat-negative frames. In experiment 4, adding a message about the unacceptability of weight-based discrimination to unhealthy/controllable news articles only reduced antifat stigma on one of three measures compared with articles adding a discrimination-acceptable message. Exposure to different news frames of fat can shift beliefs about weight-related health risks and weight-based stigma. Shifting policy attitudes, however, is more challenging.

The risk of musculoskeletal disorders for workers due to repetitive movements during tomato harvesting.

PubMed

Cecchini, M; Colantoni, A; Massantini, R; Monarca, D

2010-04-01

Tomatoes are the most common crop in Italy. The production cycle requires operations in the field and factory that can cause musculoskeletal disorders due to the repetitive movements of the upper limbs of the workers employed in the sorting phase. This research aims to evaluate these risks using the OCRA (occupational repetitive actions) index method This method is based firstly on the calculation of a maximum number of recommended actions, related to the way the operation is performed, and secondly on a comparison of the number of actions effectively carried out by the upper limb with the recommended calculated value. The results of the risk evaluation for workers who manually sort tomatoes during harvest showed a risk for the workers, with an exposure index greater than 20; the OCRA index defines an index higher than 3.5 as unacceptable. The present trend of replacing manual sorting onboard a vehicle with optical sorters seems to be appropriate to reduce the risk of work-related musculoskeletal disorders (WMSDs) and is supported from both a financial point of view and as a quality control measure.

Fuel cell flooding detection and correction

DOEpatents

DiPierno Bosco, Andrew; Fronk, Matthew Howard

2000-08-15

Method and apparatus for monitoring an H.sub.2 -O.sub.2 PEM fuel cells to detect and correct flooding. The pressure drop across a given H.sub.2 or O.sub.2 flow field is monitored and compared to predetermined thresholds of unacceptability. If the pressure drop exists a threshold of unacceptability corrective measures are automatically initiated.

47 CFR 22.970 - Unacceptable interference to part 90 non-cellular 800 MHz licensees from cellular radiotelephone...

Code of Federal Regulations, 2011 CFR

2011-10-01

...-cellular 800 MHz licensees from cellular radiotelephone or part 90-800 MHz cellular systems. 22.970 Section... MOBILE SERVICES Cellular Radiotelephone Service § 22.970 Unacceptable interference to part 90 non-cellular 800 MHz licensees from cellular radiotelephone or part 90-800 MHz cellular systems. (a) Definition...

The Perfect Place to Work? Australian Academic Libraries and Unacceptable Behaviour

ERIC Educational Resources Information Center

Moorcroft, Heather

2009-01-01

Despite the stereotype of libraries as peaceful retreats, unacceptable behaviour is a reality that desk staff have to deal with. This paper outlines the results of two surveys conducted at Charles Darwin University Library to investigate the extent to which this is a problem in Australian academic libraries. The first survey went to CAUL (Council…

47 CFR 22.970 - Unacceptable interference to part 90 non-cellular 800 MHz licensees from cellular radiotelephone...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 22.970 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.970 Unacceptable interference to part 90 non... −104 dBm or higher, as measured at the R.F. input of the receiver of a mobile unit; or (B) A median...

Toxicity of six insecticides to predatory mite Amblyseius cucumeris (Oudemans) (Acari: Phytoseiidae) in- and off-field.

PubMed

Cheng, Shenhang; Lin, Ronghua; Zhang, Nan; Yuan, Shankui; Zhou, Xinxin; Huang, Jian; Ren, Xiaodong; Wang, Shoushan; Jiang, Hui; Yu, Caihong

2018-06-22

Amblyseius cucumeris (Oudemans) is a beneficial non-target arthropod (NTA) and a key predator of tetranychid mites in integrated pest management (IPM) programs across China. Evaluating the toxic effects of insecticides on such predatory mites is essential for the success and development of IPM. We tested six insecticides to determine the risk of neonicotinoid insecticide toxicity to predatory mites, using the 'open glass plate method' and adult female A. cucumeris in a "worst case laboratory exposure" scenario. A 48-h toxicity test was performed using the hazard quotient (HQ) approach to evaluate the risk of each insecticide. The LR 50 values (application rate that caused 50% mortality) of acetamiprid, thiamethoxam, imidacloprid, and dinotefuran were 76.4, 104.5, 84.9, and 224.6 g active ingredient (a.i.) ha -1 , respectively, with in-field HQ values of 0.40, 1.28, 0.49, and 0.82, respectively. The HQ values were lower than the trigger value of 2, and were consistent with off-field values. The risks of the four neonicotinoid insecticides to adult female A. cucumeris were acceptable in two exposure scenarios in field and off field. The 48-h LR 50 values for bifenthrin and malathion were 0.008 and 0.062 g. a.i. ha -1 , respectively, which were much lower than the recommended field application rates. The HQ values were much higher than the trigger values for both in- and off-field, indicating that the risks of these two insecticides were unacceptable. Bifenthrin and malathion posed an extremely high risk to the test species, and their use should be restricted to reduce risks to the field with augmentative releases of A. cucumeris. Copyright © 2018 Elsevier Inc. All rights reserved.

Science-based decision making in a high-risk energy production environment

NASA Astrophysics Data System (ADS)

Weiser, D. A.

2016-12-01

Energy production practices that may induce earthquakes require decisions about acceptable risk before projects begin. How much ground shaking, structural damage, infrastructure damage, or delay of geothermal power and other operations is tolerable? I review a few mitigation strategies as well as existing protocol in several U.S. states. Timely and accurate scientific information can assist in determining the costs and benefits of altering production parameters. These issues can also be addressed with probability estimates of adverse effects ("costs"), frequency of earthquakes of different sizes, and associated impacts of different magnitude earthquakes. When risk management decisions based on robust science are well-communicated to stakeholders, mitigation efforts benefit. Effective communications elements include a) the risks and benefits of different actions (e.g. using a traffic light protocol); b) the factors to consider when determining acceptable risk; and c) the probability of different magnitude events. I present a case example for The Geysers geothermal field in California, to discuss locally "acceptable" and "unacceptable" earthquakes and share nearby communities' responses to smaller and larger magnitude earthquakes. I use the USGS's "Did You Feel It?" data archive to sample how often felt events occur, and how many of those are above acceptable magnitudes (to both local residents and operators). Using this information, I develop a science-based decision-making framework, in the case of potentially risky earthquakes, for lessening seismic risk and other negative consequences. This includes assessing future earthquake probabilities based on past earthquake records. One of my goals is to help characterize uncertainties in a way that they can be managed; to this end, I present simple and accessible approaches that can be used in the decision making process.

The Budget of the United States Government. Department of Defense Extract for Fiscal Year 1985

DTIC Science & Technology

1984-02-01

with real GNP rising over 6% and industrial production by 16%. Unemployment, though still unacceptably high , has declined by a record 2l/z...the administration will focus its legislative effort on three of those proposals, in modified form: cost-of-living adjustment (COLA) reform, a high 5...computer matching, adjusted payment schedules, contractor and grantee performance incentives, and a streamlined field structure. All of these efforts

Intercomparison of CO 2 measurements

NASA Astrophysics Data System (ADS)

Poisson, A.; Culkin, F.; Ridout, P.

1990-10-01

Seawater samples, of four different salinities, were analysed for total alkalinity, total CO 2, pH and pCO 2 by up to 12 laboratories. The results showthat although most laboratories are capable of high precision in these determinations, there is an unacceptably high disagreement between their analyses of the same samples. For global programmes involving studies of the CO 2 system in seawater, it is strongly recommended that standard reference materials be made widely available.

Shooting for Stars: Cross-Sector Lessons for Retaining High-Performing Educators. Building an Opportunity Culture for America's Teachers

ERIC Educational Resources Information Center

Ableidinger, Joe; Kowal, Julie

2010-01-01

As the United States continues to grapple with unacceptable education results, "a great teacher for every student" has risen to a national imperative. In response, many districts have increased retention efforts through teacher induction programs, professional development, mentoring, and other strategies. But education actually has lower…

Connecting Caring and Action through Responsive Teaching: How One Team Accomplished Success in a Struggling Middle School

ERIC Educational Resources Information Center

Strahan, David B.; Layell, Krystal

2006-01-01

In "Turning Points 2000," Jackson and Davis noted that "changes in middle grades practices have least often occurred where they are needed most: in high-poverty urban and rural communities where unacceptably poor student achievement is rampant". Even so, in many struggling schools, some teams have achieved success. Their…

Collection Development "Dog Care & Training": The Well-Behaved Dog

ERIC Educational Resources Information Center

Alpi, Kristine M.; Sherman, Barbara L.

2008-01-01

Dogs are indeed people's best friends. A majority of owners report that their dog is a "member of the family," and that acceptable canine behavior and optimal care are high priorities for them. The human-animal bond, the close connection between people and their pets, is forged by positive interactions, but unacceptable canine behaviors that…

Challenging Traditional Assumptions of High School Science through the Physics and Everyday Thinking Curriculum™

ERIC Educational Resources Information Center

Ross, Michael J.

2013-01-01

Science education in the U.S. has failed for over a century to bring the experience of scientific induction to classrooms, from elementary science to undergraduate courses. The achievement of American students on international comparisons of science proficiency is unacceptable, and the disparities between groups underrepresented in STEM and others…

Making Training More Cognitively Effective: Making Videos Interactive

ERIC Educational Resources Information Center

Cherrett, Tom; Wills, Gary; Price, Joe; Maynard, Sarah; Dror, Itiel E.

2009-01-01

The cost of health and safety (H&S) failures to the UK industry is currently estimated at up to 6.5 billion British Pounds per annum, with the construction sector suffering unacceptably high levels of work-related incidents. Better H&S education across all skill levels in the industry is seen as an integral part of any solution.…

EPA publishes notice to extend comment period to close 6/16/16 on proposal to list new substitutes and prohibit certain high-GWP HFCs as alternatives under SNAP

EPA Pesticide Factsheets

Proposed New Listings of Substitutes; Changes of Listing Status; and Reinterpretation of Unacceptability for Closed Cell Foam Products Under the Significant New Alternatives Policy Program; and Revision of Clean Air Act Section 608 Venting Prohibition for

Synchronous Half-Wave Rectifier

NASA Technical Reports Server (NTRS)

Rippel, Wally E.

1989-01-01

Synchronous rectifying circuit behaves like diode having unusually low voltage drop during forward-voltage half cycles. Circuit particularly useful in power supplies with potentials of 5 Vdc or less, where normal forward-voltage drops in ordinary diodes unacceptably large. Fabricated as monolithic assembly or as hybrid. Synchronous half-wave rectifier includes active circuits to attain low forward voltage drop and high rectification efficiency.

[FMEA applied to the radiotherapy patient care process].

PubMed

Meyrieux, C; Garcia, R; Pourel, N; Mège, A; Bodez, V

2012-10-01

Failure modes and effects analysis (FMEA), is a risk analysis method used at the Radiotherapy Department of Institute Sainte-Catherine as part of a strategy seeking to continuously improve the quality and security of treatments. The method comprises several steps: definition of main processes; for each of them, description for every step of prescription, treatment preparation, treatment application; identification of the possible risks, their consequences, their origins; research of existing safety elements which may avoid these risks; grading of risks to assign a criticality score resulting in a numerical organisation of the risks. Finally, the impact of proposed corrective actions was then estimated by a new grading round. For each process studied, a detailed map of the risks was obtained, facilitating the identification of priority actions to be undertaken. For example, we obtain five steps in patient treatment planning with an unacceptable level of risk, 62 a level of moderate risk and 31 an acceptable level of risk. The FMEA method, used in the industrial domain and applied here to health care, is an effective tool for the management of risks in patient care. However, the time and training requirements necessary to implement this method should not be underestimated. Copyright © 2012 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

47 CFR 90.672 - Unacceptable interference to non-cellular 800 MHz licensees from 800 MHz cellular systems or part...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Unacceptable interference to non-cellular 800 MHz licensees from 800 MHz cellular systems or part 22 Cellular Radiotelephone systems, and within the 900 MHz Business/Industrial Land Transportation Pool. 90.672 Section 90.672 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY...

Relating (Un)acceptability to Interpretation. Experimental Investigations on Negation

PubMed Central

Etxeberria, Urtzi; Tubau, Susagna; Deprez, Viviane; Borràs-Comes, Joan; Espinal, M. Teresa

2018-01-01

Although contemporary linguistic studies routinely use unacceptable sentences to determine the boundary of what falls outside the scope of grammar, investigations far more rarely take into consideration the possible interpretations of such sentences, perhaps because these interpretations are commonly prejudged as irrelevant or unreliable across speakers. In this paper we provide the results of two experiments in which participants had to make parallel acceptability and interpretation judgments of sentences presenting various types of negative dependencies in Basque and in two varieties of Spanish (Castilian Spanish and Basque Country Spanish). Our results show that acceptable sentences are uniformly assigned a single negation reading in the two languages. However, while unacceptable sentences consistently convey single negation in Basque, they are interpreted at chance in both varieties of Spanish. These results confirm that judgment data that distinguish between acceptable and unacceptable negative utterances can inform us not only about an adult’s grammar of his/her particular language but also about interesting cross-linguistic differences. We conclude that the acceptability and interpretation of (un)grammatical negative sentences can serve linguistic theory construction by helping to disentangle basic assumptions about the nature of various negative dependencies. PMID:29456515

Microbiological quality of take-away cooked rice and chicken sandwiches: effectiveness of food hygiene training of the management.

PubMed

Little, C L; Barnes, J; Mitchell, R T

2002-12-01

During August 2001 a microbiological study of ready-to-eat cooked rice from take-aways and of chicken sandwiches made on the premises from sandwich bars was undertaken. The intention was to identify risk factors in the production, storage and handling of cooked rice and sandwiches, and to establish their effect on microbiological quality. Examination of cooked rice revealed that the majority of samples (87%; 442 of 508) were of satisfactory/acceptable microbiological quality; 50 (10%) were unsatisfactory, and 16 (3%) were of unacceptable quality due to Bacillus cereus and/or other Bacillus spp in excess of 10(5) cfu/g. The microbiological quality of cooked rice was associated with cuisine type (p < 0.00001), rice type (p < 0.01), cooking (p < 0.01), serving methods (p < 0.00001), and management food hygiene training (p < 0.01). Examination of chicken sandwiches found that most (75%; 335 of 449) were of satisfactory/acceptable microbiological quality and 114 (25%) were unsatisfactory. Acceptable microbiological quality of sandwiches was associated with sandwich bars that had hazard analysis in place (p < 0.05). Smaller businesses, as indicated by Local Authority Inspectors' Consumer at Risk scores, were more likely to have samples classified as unsatisfactory or unacceptable compared to larger businesses (p < 0.001). The majority (90%) of premises had hand-washing facilities accessible and available for use, although only over half (55%) were correctly used as judged by the sampling officer. Where the manager of the premises had received some form of food hygiene training, food safety procedures such as the hazard analysis system were more likely to be in place (p < 0.0001).

Risk analysis of earth return options for the Mars rover/sample return mission

NASA Technical Reports Server (NTRS)

1988-01-01

Four options for return of a Mars surface sample to Earth were studied to estimate the risk of mission failure and the risk of a sample container breach that might result in the release of Martian life forms, should such exist, in the Earth's biosphere. The probabilities calculated refer only to the time period from the last midcourse correction burn to possession of the sample on Earth. Two extreme views characterize this subject. In one view, there is no life on Mars, therefore there is no significant risk and no serious effort is required to deal with back contamination. In the other view, public safety overrides any desire to return Martian samples, and any risk of damaging contamination greater than zero is unacceptable. Zero risk requires great expense to achieve and may prevent the mission as currently envisioned from taking place. The major conclusion is that risk of sample container breach can be reduced to a very low number within the framework of the mission as now envisioned, but significant expense and effort, above that currently planned is needed. There are benefits to the public that warrant some risk. Martian life, if it exists, will be a major discovery. If it does not, there is no risk.

Cerebral oxygenation and hemodynamic changes during infant cardiac surgery: measurements by near infrared spectroscopy

NASA Astrophysics Data System (ADS)

du Plessis, Adre J.; Volpe, Joseph J.

1996-10-01

Despite dramatic advances in the survival rate among infants undergoing cardiac surgery for congenital heart disease, the incidence of brain injury suffered by survivors remains unacceptably high. This is largely due to our limited understanding of the complex changes in cerebral oxygen utilization and supply occurring during the intraoperative period as a result of hypothermia, neuroactive drugs, and profound circulatory changes. Current techniques for monitoring the adequacy of cerebral oxygen supply and utilization during hypothermic cardiac surgery are inadequate to address this complex problem and consequently to identify the infant at risk for such brain injury. Furthermore, this inability to detect imminent hypoxic- ischemic brain injury is likely to become all the more conspicuous as new neuroprotective strategies, capable of salvaging 'insulated' neuronal tissue form cell death, enter the clinical arena. Near infrared spectroscopy is a relatively new, noninvasive, and portable technique capable of interrogating the oxygenation and hemodynamics of tissue in vivo. These characteristics of the technique have generated enormous interest among clinicians in the ability of near infrared spectroscopy to elucidate the mechanisms of intraoperative brain injury and ultimately to identify infants oat risk for such injury. This paper reviews the experience with this technique to date during infant cardiac surgery.

Bezlotoxumab for the prevention of Clostridium difficile recurrence.

PubMed

Couture-Cossette, Antoine; Carignan, Alex; Ilangumaran, Subburaj; Valiquette, Louis

2017-11-01

Clostridium difficile infection is a major economic and clinical burden, due to its high frequency of recurrence. Currently recommended treatments are not efficient for prevention and may contribute to the risk of recurrent infection. In recent years, research has focused on strategies to lessen this risk. Bezlotoxumab is a monoclonal antibody that prevents recurrences of C. difficile infection through the antagonism of toxin B. Areas covered: In this review, the authors discuss the burden of C. difficile infection and its recurrences, the mechanisms underlying the recurrences, and current C. difficile treatments. They subsequently analyze the strategic therapeutic rationale for bezlotoxumab use, as well as the supporting clinical evidence. Expert opinion: Bezlotoxumab is an attractive solution for reducing the unacceptable level of recurrence that occurs with the currently recommended C. difficile treatments and other alternative therapies under consideration. Even though bezlotoxumab has not been tested in large-scale trials exclusively in cases of already established recurrent C.difficile infection (rCDI), it has an advantage over current treatments in that it does not interfere with the patient's gut flora while directly neutralizing the key virulence factor. Although cost remains an important factor against its widespread use, simpler administration, fewer side-effects, and better social acceptability justify its consideration for treating rCDI.

Fibroblast Growth Factor-23: A Novel Biomarker for Cardiovascular Disease in Chronic Kidney Disease Patients.

PubMed

Papagianni, Aikaterini

2017-09-01

Fibroblast Growth Factor (FGF)-23 increase is considered one of the earliest biochemical abnormalities in chronic kidney disease-mineral bone disorder (CKD-MBD). Furthermore, accumulating data have provided evidence of a link between increased FGF-23 levels and cardiovascular morbidity and mortality in CKD patients as well as in several other populations including cardiology patients and general population. The cellular and molecular mechanisms underlying the deleterious effect of FGF-23 on the cardiovascular system are not yet completely defined and are the focus of intense research. However, animal and human studies have demonstrated important actions of FGF-23 in the heart and vessels through which could promote the development of cardiovascular complications in uremia. Moreover, significant interactions have been reported between FGF-23 and other well recognized cardiovascular risk factors such as renin-angiotensin system and inflammation which could account, at least in part, for the observed associations between FGF-23 and adverse clinical outcomes. Further studies are needed to clarify the mechanisms responsible for the pleiotropic actions of FGF-23 and moreover to identify whether it is a modifiable risk factor and a potential target of therapeutic interventions which could probably help to reduce the unacceptably high cardiovascular morbidity and mortality of CKD patients.

Self-Arrangement of Fleeting Student Pairs: A Web 2.0 Approach for Peer Tutoring

ERIC Educational Resources Information Center

Westera, Wim; de Bakker, Gijs; Wagemans, Leo

2009-01-01

This article presents a Web 2.0 approach for the arrangement of peer tutoring in online learning. In online learning environments, the learners' expectations of obtaining frequent, one-to-one support from their teachers tend to increase the teachers' workloads to unacceptably high levels. To address this problem of workload a self-organised peer…

Policy Responses to the Recent Poor Performance of the U.S. Labor Market

ERIC Educational Resources Information Center

Haveman, Robert; Heinrich, Carolyn; Smeeding, Timothy

2012-01-01

Since the onset of the Great Recession, the U.S. labor market has been reeling. Public concern has largely focused on the unemployment rate, which rose to double digits and has since been stalled at just over 9 percent. This rate is unacceptably high, and macroeconomic policy efforts have been unsuccessful in bringing it down. The overall…

The Preschool Nap as a Protective Factor in the Fight against Childhood Obesity: An Exploratory Study

ERIC Educational Resources Information Center

Kihm, Holly Spencer; Rolling, Peggy

2014-01-01

Although the prevalence of childhood obesity has not increased in recent years, it remains unacceptably high and warrants continued study. The purpose of this study was to explore the potential relationship between weight status and length of sleep (both daytime and nighttime) among preschool children. Special attention was given to the role…

When Will Our Values Finally Result in the Creation of New Pathways for Change--Change that We Can Believe In?

ERIC Educational Resources Information Center

Rusch, Frank R.; Wolfe, Pamela

2008-01-01

Despite efforts over the past several decades to improve the delivery of transition services for youth with disabilities, outcomes continue to be unacceptably dismal for most youth, including high rates of unemployment, residential independence, and financial dependence, concurrent with low rates of enrollment in college or other postsecondary…

Citation Help in Databases: The More Things Change, the More They Stay the Same

ERIC Educational Resources Information Center

Van Ullen, Mary; Kessler, Jane

2012-01-01

In 2005, the authors reviewed citation help in databases and found an error rate of 4.4 errors per citation. This article describes a follow-up study that revealed a modest improvement in the error rate to 3.4 errors per citation, still unacceptably high. The most problematic area was retrieval statements. The authors conclude that librarians…

Do Ethical Judgments Depend on the Type of Response Scale? Comparing Acceptability versus Unacceptability Judgments in the Case of Life-Ending Procedures

ERIC Educational Resources Information Center

Sastre, Maria Teresa Munoz; Gonzalez, Charlene; Lhermitte, Astrid; Sorum, Paul C.; Mullet, Etienne

2010-01-01

Using Functional Measurement (Anderson, 2008), Frileux, Lelievre, Munoz Sastre, Mullet, and Sorum (2003) examined the joint impact of several key factors on lay people's judgments of the acceptability of physicians' interventions to end patients' lives. The level of acceptability was high, and the information integration rule that best described…

Aspirations to Achievement: Men of Color and Community Colleges. A Special Report from the Center for Community College Student Engagement

ERIC Educational Resources Information Center

Center for Community College Student Engagement, 2014

2014-01-01

Consistently and unmistakably, data show a persistent gap separating Latinos and Black males from other student groups on measures of academic progress and college completion. These gaps exist across higher education. They are undeniable and unacceptable. Men of color have high aspirations when they begin higher education. Why are these…

40 CFR Appendix G to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the March 3, 1999...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Restrictions and Unacceptable Substitutes Listed in the March 3, 1999, Final rule, Effective April 2, 1999. G Appendix G to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. G Appendix G to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix G to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the March 3, 1999...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Restrictions and Unacceptable Substitutes Listed in the March 3, 1999, Final rule, Effective April 2, 1999. G Appendix G to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. G Appendix G to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix G to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the March 3, 1999...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Restrictions and Unacceptable Substitutes Listed in the March 3, 1999, Final rule, Effective April 2, 1999. G Appendix G to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. G Appendix G to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix K to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the July 22, 2002...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Restrictions and Unacceptable Substitutes Listed in the July 22, 2002, Final Rule, Effective August 21, 2002 K Appendix K to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. K Appendix K to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix K to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the July 22, 2002...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Restrictions and Unacceptable Substitutes Listed in the July 22, 2002, Final Rule, Effective August 21, 2002 K Appendix K to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. K Appendix K to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix K to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the July 22, 2002...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Restrictions and Unacceptable Substitutes Listed in the July 22, 2002, Final Rule, Effective August 21, 2002 K Appendix K to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. K Appendix K to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix K to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the July 22, 2002...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Restrictions and Unacceptable Substitutes Listed in the July 22, 2002, Final Rule, Effective August 21, 2002 K Appendix K to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. K Appendix K to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix K to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the July 22, 2002...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Restrictions and Unacceptable Substitutes Listed in the July 22, 2002, Final Rule, Effective August 21, 2002 K Appendix K to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. K Appendix K to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix C to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the May 22, 1996...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Restrictions and Unacceptable Substitutes Listed in the May 22, 1996 Final Rule, Effective June 21, 1996 C Appendix C to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. C Appendix C to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix C to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the May 22, 1996...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Restrictions and Unacceptable Substitutes Listed in the May 22, 1996 Final Rule, Effective June 21, 1996 C Appendix C to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. C Appendix C to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix C to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the May 22, 1996...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Restrictions and Unacceptable Substitutes Listed in the May 22, 1996 Final Rule, Effective June 21, 1996 C Appendix C to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. C Appendix C to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

Real-Time Pretreatment Review Limits Unacceptable Deviations on a Cooperative Group Radiation Therapy Technique Trial: Quality Assurance Results of RTOG 0933

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

Gondi, Vinai, E-mail: vgondi@chicagocancer.org; University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin; Cui, Yunfeng

2015-03-01

Purpose: RTOG 0933 was a phase II trial of hippocampal avoidance during whole brain radiation therapy for patients with brain metastases. The results demonstrated improvement in short-term memory decline, as compared with historical control individuals, and preservation of quality of life. Integral to the conduct of this trial were quality assurance processes inclusive of pre-enrollment credentialing and pretreatment centralized review of enrolled patients. Methods and Materials: Before enrolling patients, all treating physicians and sites were required to successfully complete a “dry-run” credentialing test. The treating physicians were credentialed based on accuracy of magnetic resonance imaging–computed tomography image fusion and hippocampal andmore » normal tissue contouring, and the sites were credentialed based on protocol-specified dosimetric criteria. Using the same criteria, pretreatment centralized review of enrolled patients was conducted. Physicians enrolling 3 consecutive patients without unacceptable deviations were permitted to enroll further patients without pretreatment review, although their cases were reviewed after treatment. Results: In all, 113 physicians and 84 sites were credentialed. Eight physicians (6.8%) failed hippocampal contouring on the first attempt; 3 were approved on the second attempt. Eight sites (9.5%) failed intensity modulated radiation therapy planning on the first attempt; all were approved on the second attempt. One hundred thirteen patients were enrolled in RTOG 0933; 100 were analyzable. Eighty-seven cases were reviewed before treatment; 5 (5.7%) violated the eligibility criteria, and 21 (24%) had unacceptable deviations. With feedback, 18 cases were approved on the second attempt and 2 cases on the third attempt. One patient was treated off protocol. Twenty-two cases were reviewed after treatment; 1 (4.5%) violated the eligibility criteria, and 5 (23%) had unacceptable deviations. Conclusions: Although >95% of the cases passed the pre-enrollment credentialing, the pretreatment centralized review disqualified 5.7% of reviewed cases, prevented unacceptable deviations in 24% of reviewed cases, and limited the final unacceptable deviation rate to 5%. Thus, pretreatment review is deemed necessary in future hippocampal avoidance trials and is potentially useful in other similarly challenging radiation therapy technique trials.« less

Selecting Statistical Procedures for Quality Control Planning Based on Risk Management.

PubMed

Yago, Martín; Alcover, Silvia

2016-07-01

According to the traditional approach to statistical QC planning, the performance of QC procedures is assessed in terms of its probability of rejecting an analytical run that contains critical size errors (PEDC). Recently, the maximum expected increase in the number of unacceptable patient results reported during the presence of an undetected out-of-control error condition [Max E(NUF)], has been proposed as an alternative QC performance measure because it is more related to the current introduction of risk management concepts for QC planning in the clinical laboratory. We used a statistical model to investigate the relationship between PEDC and Max E(NUF) for simple QC procedures widely used in clinical laboratories and to construct charts relating Max E(NUF) with the capability of the analytical process that allow for QC planning based on the risk of harm to a patient due to the report of erroneous results. A QC procedure shows nearly the same Max E(NUF) value when used for controlling analytical processes with the same capability, and there is a close relationship between PEDC and Max E(NUF) for simple QC procedures; therefore, the value of PEDC can be estimated from the value of Max E(NUF) and vice versa. QC procedures selected by their high PEDC value are also characterized by a low value for Max E(NUF). The PEDC value can be used for estimating the probability of patient harm, allowing for the selection of appropriate QC procedures in QC planning based on risk management. © 2016 American Association for Clinical Chemistry.

Perceptions of ecological risk associated with mountain pine beetle (Dendroctonus ponderosae) infestations in Banff and Kootenay National Parks of Canada.

PubMed

McFarlane, Bonita L; Watson, David O T; Witson, David O T

2008-02-01

Western Canada is experiencing an unprecedented outbreak of the mountain pine beetle (MPB). The MPB has the potential to impact some of Canada's national parks by affecting park ecosystems and the visitor experience. Controls have been initiated in some parks to lessen the impacts and to prevent the beetle from spreading beyond park boundaries. We examine the perception of ecological risk associated with MPB in two of Canada's national parks, the factors affecting perceptions of risk, and the influence of risk judgments on support for controlling MPB outbreaks in national parks. Data were collected using two studies of park visitors: a mail survey in 2003 and an onsite survey in 2005. The MPB was rated as posing a greater risk to the health and productivity of park ecosystems than anthropogenic hazards and other natural disturbance agents. Visitors who were familiar with MPB rated the ecological and visitor experience impacts as negative, unacceptable, and eliciting negative emotion. Knowledge and residency were the most consistent predictors of risk judgments. Of knowledge, risk, and demographic variables, only sex and risk to ecosystem domains influenced support for controlling the MPB in national parks. Implications for managing MPB in national parks, visitor education, and ecological integrity are discussed.

Enteropathogenic Bacteria Contamination of Unchlorinated Drinking Water in Korea, 2010

PubMed Central

Lee, Si Won; Lee, Do Kyung; An, Hyang Mi; Cha, Min Kyeong; Kim, Kyung Jae

2011-01-01

Objectives The purpose of this study was to assess the microbiological quality of unchlorinated drinking water in Korea, 2010. One hundred and eighty unchlorinated drinking water samples were collected from various sites in Seoul and Gyeonggi province. Methods To investigate bacterial presence, the pour plate method was used with cultures grown on selective media for total bacteria, total coliforms, and Staphylococcus spp., respectively. Results In the 180 total bacteria investigation, 72 samples from Seoul and 33 samples from Gyeonggi province were of an unacceptable quality (>102 CFU/mL). Of all the samples tested, total coliforms were detected in 28 samples (15.6%) and Staphylococcus spp. in 12 samples (6.7%). Most of the coliform isolates exhibited high-level resistance to cefazolin (88.2%), cefonicid (64.7%) and ceftazidime (20.6%). In addition, Staphylococcus spp. isolates exhibited high-level resistance to mupirocin (42%). Species of Pseudomonas, Acinetobacter, Cupriavidus, Hafnia, Rahnella, Serratia, and Yersinia were isolated from the water samples. Conclusions The results of this study suggest that consumption of unchlorinated drinking water could represent a notable risk to the health of consumers. As such, there is need for continuous monitoring of these water sources and to establish standards. PMID:22216417

The development of biomarkers to reduce attrition rate in drug discovery focused on oncology and central nervous system.

PubMed

Safavi, Maliheh; Sabourian, Reyhaneh; Abdollahi, Mohammad

2016-10-01

The task of discovery and development of novel therapeutic agents remains an expensive, uncertain, time-consuming, competitive, and inefficient enterprise. Due to a steady increase in the cost and time of drug development and the considerable amount of resources required, a predictive tool is needed for assessing the safety and efficacy of a new chemical entity. This study is focused on the high attrition rate in discovery and development of oncology and central nervous system (CNS) medicines, because the failure rate of these medicines is higher than others. Some approaches valuable in reducing attrition rates are proposed and the judicious use of biomarkers is discussed. Unlike the significant progress made in identifying and characterizing novel mechanisms of disease processes and targeted therapies, the process of novel drug development is associated with an unacceptably high attrition rate. The application of clinically qualified predictive biomarkers holds great promise for further development of therapeutic targets, improved survival, and ultimately personalized medicine sets for patients. Decisions such as candidate selection, development risks, dose ranging, early proof of concept/principle, and patient stratification are based on the measurements of biologically and/or clinically validated biomarkers.

Air pollution and vulnerability: solving the puzzle of prioritization.

PubMed

Wright, Caradee Y; Diab, Roseanne

2011-01-01

While ambient air pollution levels in excess of prescribed health standards are generally unacceptable, the exceedance is even more serious in areas where people reside. Vulnerability caused by poverty, disease, lack of education, and poor living conditions exacerbates the problem. Air quality management plans identify prioritized strategies for improved air quality independent of consideration of vulnerability. A population exposure and vulnerability risk prioritization framework comprising five themes (air pollution sources; air pollution levels; air pollution potential; community awareness, observations, perceptions, and actions; and vulnerability factors) was proposed and applied to the eThekwini Municipality (Durban, South Africa). Data were scored according to predetermined risk threshold values to ascertain at-risk communities. While those urban wards located in a known air pollution hotspot had the highest air pollution levels, a periurban ward with moderate exposure levels was most vulnerable. This framework will prove invaluable for the development of focused interventions to reduce vulnerability and air pollution-associated adverse health impacts.

How academic psychiatry can better prepare students for their future patients. Part I: the failure to recognize depression and risk for suicide in primary care; problem identification, responsibility, and solutions.

PubMed

Lake, C Raymond

2008-01-01

The author, after a review of the relevant literature, found that depression and the risk for suicide remain unacceptably underrecognized in primary care (PC). The negative consequences are substantial for patients and their physicians. Suicide prevention in PC begins with the recognition of depression because suicide occurs largely during depression. In this article (Part I), the author suggests causes, responsibilities, and solutions for that failure. He also addresses the role of academic psychiatry's traditional curriculum. The comprehensive, initial diagnostic interview that is typically taught to medical students in psychiatry may decrease recognition in PC care because of the time required to complete it. In Part II, the author offers guidelines to develop a weekly interview course with an instrument targeting abbreviated diagnostic screening for only the most critical psychiatric problems such as depression and the risk for suicide.

The optimisation of occupational potential exposures - preliminary considerations

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

Crouail, P.; Guimaraes, L.

1995-03-01

One of the major innovation brought about the ICRP 60 recommendations and emphasized by the ICRP 64 publication, is the introduction of the concept of potential exposures into the system of radiological protection. Potential exposures are characterized by {open_quotes}probability of occurrence lesser than unity{close_quotes} and {open_quotes}radiological risks exceeding normal levels{close_quotes} where normal must be interpreted as not exceeding the planned routine exposures. It is then necessary to develop consensual methods to look for and choose the optimum scenarios (i.e. those for which probability of events and possible consequences have been reduced as low as reasonably achievable). Moreover, the boundaries formore » the unacceptable levels of risks for workers should be defined, as well as reasonable risk indicators. The aim of this paper is to discuss the actual changes in the field of occupational radiological protection, induced by the potential exposure concept with particular emphasize on the optimization of protection.« less

Availability and Quality of Emergency Obstetric and Newborn Care in Bangladesh

PubMed Central

Wichaidit, Wit; Alam, Mahbub-Ul; Halder, Amal K.; Unicomb, Leanne; Hamer, Davidson H.; Ram, Pavani K.

2016-01-01

Bangladesh's maternal mortality and neonatal mortality remain unacceptably high. We assessed the availability and quality of emergency obstetric care (EmOC) and emergency newborn care (EmNC) services at health facilities in Bangladesh. We randomly sampled 50 rural villages and 50 urban neighborhoods throughout Bangladesh and interviewed the director of eight and nine health facilities nearest to each sampled area. We categorized health facilities into different quality levels (high, moderate, low, and substandard) based on staffing, availability of a phone or ambulance, and signal functions (six categories for EmOC and four categories for EmNC). We interviewed the directors of 875 health facilities. Approximately 28% of health facilities did not have a skilled birth attendant on call 24 hours per day. The least commonly performed EmOC signal function was administration of anticonvulsants (67%). The quality of EmOC services was high in 33% and moderate in 52% of the health facilities. The least common EmNC signal function was kangaroo mother care (7%). The quality of EmNC was high in 2% and moderate in 33% of the health facilities. Approximately one-third of health facilities lack 24-hour availability of skilled birth attendants, increasing the risk of peripartum complications. Most health facilities offered moderate to high quality services for EmOC and low to substandard quality for EmNC. PMID:27273640

Complications of hematopoietic stem transplantation: Fungal infections.

PubMed

Omrani, Ali S; Almaghrabi, Reem S

2017-12-01

Patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) are at increased risk of invasive fungal infections, especially during the early neutropenic phase and severe graft-versus-host disease. Mold-active prophylaxis should be limited to the highest risk groups. Empiric antifungal therapy for HSCT with persistent febrile neutropenia is associated with unacceptable response rates, unnecessary antifungal therapy, increased risk of toxicity, and inflated costs. Empiric therapy should not be a substitute for detailed work up to identify the cause of fever in such patients. The improved diagnostic performance of serum biomarkers such as galactomannan and β-D-glucan, as well as polymerase chain reaction assays has allowed the development of diagnostic-driven antifungal therapy strategies for high risk patients. Diagnostic-driven approaches have resulted in reduced unnecessary antifungal exposure, improved diagnosis of invasive fungal disease, and reduced costs without increased risk of mortality. The appropriateness of diagnostic-driven antifungal strategy for individual HSCT centers depends on the availability and turnaround times for diagnostics, multidisciplinary expertise, and the local epidemiology of invasive fungal infections. Echinocandins are the treatment of choice for invasive candidiasis in most HSCT recipients. Fluconazole may be used for the treatment of invasive candidiasis in hemodynamically stable patients with no prior azole exposure. The primary treatment of choice for invasive aspergillosis is voriconazole. Alternatives include isavuconazole and lipid formulations of amphotericin. Currently available evidence does not support routine primary combination antifungal therapy for invasive aspergillosis. However, combination salvage antifungal therapy may be considered in selected patients. Therapeutic drug monitoring is recommended for the majority of HSCT recipients on itraconazole, posaconazole, or voriconazole. Copyright © 2017 King Faisal Specialist Hospital & Research Centre. Published by Elsevier B.V. All rights reserved.

Determinants of domestic violence against women in Ghana.

PubMed

Owusu Adjah, Ebenezer S; Agbemafle, Isaac

2016-05-02

The prevalence of domestic violence remains unacceptably high with numerous consequences ranging from psychological to maternal and neonatal mortality and morbidity outcomes in pregnant women. The aim of this study was to identify factors that increased the likelihood of an event of domestic violence as reported by ever married Ghanaian women. Data from the 2008 Ghana Demographic and Health Survey (GDHS) was analysed using a multivariate logistic model and risk factors were obtained using the forward selection procedure. Of the 1524 ever married women in this study, 33.6 % had ever experienced domestic violence. The risk of ever experiencing domestic violence was 35 % for women who reside in urban areas. Risk of domestic violence was 41 % higher for women whose husbands ever experienced their father beating their mother. Women whose mother ever beat their father were three times more likely to experience domestic violence as compared to women whose mother did not beat their father. The risk of ever experiencing domestic violence was 48 % less likely for women whose husbands had higher than secondary education as compared to women whose husbands never had any formal education. Women whose husbands drink alcohol were 2.5 times more likely to experience domestic violence as compared to women whose husbands do not drink alcohol. Place of residence, alcohol use by husband and family history of violence do increase a woman's risk of ever experiencing domestic violence. Higher than secondary education acted as a protective buffer against domestic violence. Domestic violence against women is still persistent and greater efforts should be channelled into curtailing it by using a multi-stakeholder approach and enforcing stricter punishments to perpetrators.

Health risk assessment of instant noodles commonly consumed in Port Harcourt, Nigeria.

PubMed

Charles, Iniobong A; Ogbolosingha, Atieme J; Afia, Inimfon U

2018-01-01

The current study investigated the levels of some heavy metals [lead (Pb), arsenic (As), nickel (Ni), mercury (Hg), copper (Cu), cadmium (Cd), aluminum (Al), and chromium (Cr)] and polycyclic aromatic hydrocarbons (PAHs) in six brands of instant noodles (CFN, GFC, NGP, GAA, CUN, and FCS) commonly consumed in Port Harcourt, Nigeria. Risks of consumption of contaminated noodles were also assessed. Heavy metal content and PAHs were determined using flame atomic absorption spectrophotometer and gas chromatography, respectively. Concentrations of heavy metals as Pb, Ni, Cu, Al, and Cr were detected while As, Hg, and Cd were not detected in noodles. High average concentrations (mean ± SD mg/kg) of Pb were observed in brands CFN (3.163 ± 0.21) and GFC (1.022 ± 0.08) which were significantly higher (P ≤ 0.05) than in NGP (0.043 ± 0.15) and GAA (0.276 ± 0.18), although all were above WHO permissible limits (0.025 mg/kg). Target Hazard Quotient and Hazard Index for Pb were > 1 in brands CFN and GFC indicating unacceptable risk. Results of PAHs showed brands had total PAHs (mg/kg) in the order CFN > CUN > GAA > NGP > FCS > GFC. Although carcinogenic risks associated with these noodles are within permissible range, consumption of CFN and GFC could pose greater health risk to consumers. Long-term consumption of brands CUN, CFN, and GAA may have higher probability of carcinogenesis among consumers. We therefore recommend more diligent regulatory policies and monitoring by relevant government agencies (WHO, NAFDAC, CPC, and SON) to ensure wholesome noodles get to consumers.

Characterising the individual health risk in infants exposed to organochlorine pesticides via breast milk by applying appropriate margins of safety derived from estimated daily intakes.

PubMed

Hernik, A; Góralczyk, K; Struciński, P; Czaja, K; Korcz, W; Minorczyk, M; Lyczewska, M; Ludwicki, J K

2014-01-01

Milk secretion being an important way of elimination of organochlorine pesticides (OCPs) poses a concern due to potential risk for breastfed infants. This study aims to provide a tool for assessing such risks to infants exposed to OCPs (through accumulation in the mother's body), using calculated individual margins of safety (MoS). Selected OCPs included; p,p'-DDT, p,p'-DDD, p,p'-DDE, β-HCH, γ-HCH and HCB which were analysed in 28 samples of maternal milk. The highest intakes were recorded for p,p'-DDE (at 2.90 μg kg(-1)bw d(-1)) whilst the lowest was for γ-HCH, (at 0.019 μg kg(-1)bwd(-1)). For the risk characterisation purposes MoSs were calculated for the compounds for which toxicological reference values (e.g. ADI, TDI) were adopted. The MoS for average ∑DDT concentrations was found to be relatively low (2.82) somewhat similar to that for HCB at 7.08, and for γ-HCH, the MoS was substantially higher at 263.1. This, however does not take into account the extremely high individual concentrations. Thus, it was decided to calculate estimated daily intake (EDI) values based on OCP levels in individual milk samples. MoS levels of <1 (meaning unacceptable risk) were noted both for HCB in one sample as well as for ∑DDT in 3 samples indicating likely threats to infant's health. The lowest MoS noted for γ-HCH equalled to 60.6, indicating that this compound was not a threat to the health of any of the breastfed infants from the study group. Copyright © 2013. Published by Elsevier Ltd.

Seismic performance assessment of base-isolated safety-related nuclear structures

USGS Publications Warehouse

Huang, Y.-N.; Whittaker, A.S.; Luco, N.

2010-01-01

Seismic or base isolation is a proven technology for reducing the effects of earthquake shaking on buildings, bridges and infrastructure. The benefit of base isolation has been presented in terms of reduced accelerations and drifts on superstructure components but never quantified in terms of either a percentage reduction in seismic loss (or percentage increase in safety) or the probability of an unacceptable performance. Herein, we quantify the benefits of base isolation in terms of increased safety (or smaller loss) by comparing the safety of a sample conventional and base-isolated nuclear power plant (NPP) located in the Eastern U.S. Scenario- and time-based assessments are performed using a new methodology. Three base isolation systems are considered, namely, (1) Friction Pendulum??? bearings, (2) lead-rubber bearings and (3) low-damping rubber bearings together with linear viscous dampers. Unacceptable performance is defined by the failure of key secondary systems because these systems represent much of the investment in a new build power plant and ensure the safe operation of the plant. For the scenario-based assessments, the probability of unacceptable performance is computed for an earthquake with a magnitude of 5.3 at a distance 7.5 km from the plant. For the time-based assessments, the annual frequency of unacceptable performance is computed considering all potential earthquakes that may occur. For both assessments, the implementation of base isolation reduces the probability of unacceptable performance by approximately four orders of magnitude for the same NPP superstructure and secondary systems. The increase in NPP construction cost associated with the installation of seismic isolators can be offset by substantially reducing the required seismic strength of secondary components and systems and potentially eliminating the need to seismically qualify many secondary components and systems. ?? 2010 John Wiley & Sons, Ltd.

Does intake of trace elements through urban gardening in Copenhagen pose a risk to human health?

PubMed

Warming, Marlies; Hansen, Mette G; Holm, Peter E; Magid, Jakob; Hansen, Thomas H; Trapp, Stefan

2015-07-01

This study investigates the potential health risk from urban gardening. The concentrations of the trace elements arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), lead (Pb), nickel (Ni), and zinc (Zn) in five common garden crops from three garden sites in Copenhagen were measured. Concentrations (mg/kg dw) of As were 0.002-0.21, Cd 0.03-0.25, Cr < 0.09-0.38, Cu 1.8-8.7, Ni < 0.23-0.62, Pb 0.05-1.56, and Zn 10-86. Generally, elemental concentrations in the crops do not reflect soil concentrations, nor exceed legal standards for Cd and Pb in food. Hazard quotients (HQs) were calculated from soil ingestion, vegetable consumption, measured trace element concentrations and tolerable intake levels. The HQs for As, Cd, Cr, Cu, Ni, and Zn do not indicate a health risk through urban gardening in Copenhagen. Exposure to Pb contaminated sites may lead to unacceptable risk not caused by vegetable consumption but by unintentional soil ingestion. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

PubMed

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

2008-11-01

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

Uveitis in juvenile idiopathic arthritis.

PubMed

Heiligenhaus, Arnd; Minden, Kirsten; Föll, Dirk; Pleyer, Uwe

2015-02-06

Juvenile idiopathic arthritis (JIA) is the most common systemic disease causing uveitis in childhood, with a prevalence of 10 per 100 000 persons. JIA often takes a severe inflammatory course, and its complications often endanger vision. This review is based on pertinent articles retrieved by a selective literature search up to 18 August 2014 and on the current interdisciplinary S2k guideline on the diagnostic evaluation and anti-inflammatory treatment of juvenile idiopathic uveitis. Uveitis arises in roughly 1 in 10 patients with JIA. Regular eye check-ups should be performed starting as soon as JIA is diagnosed. 75-80% of patients are girls; antinuclear antibodies are found in 70-90%. The risk to vision is higher if JIA begins in the preschool years. As for treatment, only a single, small-scale randomized controlled trial (RCT) and a small number of prospective trials have been published to date. Topical corticosteroids should be given as the initial treatment. Systemic immunosuppression is needed if irritation persists despite topical corticosteroids, if new complications arise, or if the topical steroids have to be given in excessively high doses or have unacceptable side effects. If the therapeutic effect remains inadequate, conventional and biological immune modulators can be given as add-on (escalation) therapy. Treatment lowers the risk of uveitis and its complications and thereby improves the prognosis for good visual function. Severely affected patients should be treated in competence centers to optimize their long-term outcome. Multidisciplinary, individualized treatment is needed because of the chronic course of active inflammation and the ensuing high risk of complications that can endanger vision. Future improvements in therapy will be aided by prospective, population-based registries and by basic research on biomarkers for the prediction of disease onset, prognosis, tissue damage, and therapeutic response.

ARV-based HIV prevention for women - where we are in 2014.

PubMed

Mastro, Timothy D; Sista, Nirupama; Abdool-Karim, Quarraisha

2014-01-01

Women continue to be at special risk for HIV acquisition due to a complex mix of biological, behavioural, structural, cultural and social factors, with unacceptable rates of new infection. Scientific advances over the past decade have highlighted the use of antiretroviral (ARV) drugs as pre-exposure prophylaxis (PrEP) to prevent HIV acquisition (sexually, parenterally and vertically) and ARV treatment (ART) for HIV-positive patients to prevent onward transmission (treatment as prevention - TasP). This paper reviews the evidence base for PrEP and TasP, describes new products in development and the need to translate research findings into programmes with impact at the population level.

Novel Antipsychotics in the Treatment of Behavioral Disturbances and Psychoses Associated With Neurodegenerative Disorders

PubMed Central

Masand, Prakash S.

2000-01-01

Behavioral disturbances and psychosis are common features of neurodegenerative disorders and may be drug induced, intrinsic to the underlying pathology, or both. These disturbances, including psychotic and mood symptoms, apathy, aggression and other behavioral symptoms, and superimposed delirium, cause a great amount of disability to the patient and stress on the caregiver. Conventional neuroleptics have been shown to be effective in the treatment of these symptoms, but unacceptable side effects may occur. However, the novel antipsychotics, with their lower risk of inducing extrapyramidal symptoms, have shown promise in the treatment of behavioral disturbances and psychosis associated with neurodegenerative disorders. PMID:15014653

Contamination source apportionment and health risk assessment of heavy metals in soil around municipal solid waste incinerator: A case study in North China.

PubMed

Ma, Wenchao; Tai, Lingyu; Qiao, Zhi; Zhong, Lei; Wang, Zhen; Fu, Kaixuan; Chen, Guanyi

2018-08-01

Few studies have comprehensively taken into account the source apportionment and human health risk of soil heavy metals in the vicinity of municipal solid waste incinerator (MSWI) in high population density area. In this study, 8 elements (Cr, Pb, Cu, Ni, Zn, Cd, Hg, and As) in fly ash, soil samples from different functional areas and vegetables collected surrounding the MSWI in North China were determined. The single pollution index, integrated Nemerow pollution index, principal component analysis (PCA), absolute principle component score-multiple linear regression (APCS-MLR) model and dose-response model were used in this study. The results showed that the soils around the MSWI were moderately polluted by Cu, Pb, Zn, and Hg, and heavily polluted by As and Cd. MSWI had a significant influence on the distribution of soil heavy metals in different distances from MSWI. The source apportionment results showed that MSWI, natural source, industrial discharges and coal combustion were the four major potential sources for heavy metals in the soils, with the contributions of 36.08%, 29.57%, 10.07%, and 4.55%, respectively. MSWI had a major impact on Zn, Cu, Pb, Cd, and Hg contamination in soil. The non-carcinogenic risk and carcinogenic risk posed by soil heavy metals surrounding the MSWI were unacceptable. The soil heavy metals concentrations and health risks in different functional areas were distinct. MSWI was the predominate source of non-carcinogenic risk with the average contribution rate of 36.99% and carcinogenic risk to adult male, adult female and children with 4.23×10 -4 , 4.57×10 -4 , and 1.41×10 -4 respectively, implying that the impact of MSWI on human health was apparent. This study provided a new insight for the source apportionment and health risk assessment of soil heavy metals in the vicinity of MSWI. Copyright © 2018. Published by Elsevier B.V.

An evaluation of flight path management automation in transport category aircraft

NASA Technical Reports Server (NTRS)

Chandra, D.; Bussolari, S. R.

1991-01-01

A desk-top simulation of a Boeing 757/767 Electronic Flight Instrumentation System (EFIS) and Control Display Unit (CDU) was used in an experiment to compare three modes of communication for the clearance amendment process: standard voice procedures, a textual delivery method, and a graphical delivery method. Eight qualified Boeing 757/767 pilots served as subjects. Each flew nine landing scenarios with three amendments given in each scenario. Both acceptable and unacceptable clearance amendments were presented in order to assess situational awareness. Times for comprehension and execution of the amendment were recorded along with workload ratings, responses to unacceptable amendments, and subjective impressions. The graphical mode was found to be superior in terms of the time measures and subjective ratings. No difference was found between the modes in the ability to detect unacceptable clearances.

Adjuvant Sunitinib in High-Risk Renal-Cell Carcinoma after Nephrectomy.

PubMed

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

2016-12-08

Sunitinib, a vascular endothelial growth factor pathway inhibitor, is an effective treatment for metastatic renal-cell carcinoma. We sought to determine the efficacy and safety of sunitinib in patients with locoregional renal-cell carcinoma at high risk for tumor recurrence after nephrectomy. In this randomized, double-blind, phase 3 trial, we assigned 615 patients with locoregional, high-risk clear-cell renal-cell carcinoma to receive either sunitinib (50 mg per day) or placebo on a 4-weeks-on, 2-weeks-off schedule for 1 year or until disease recurrence, unacceptable toxicity, or consent withdrawal. The primary end point was disease-free survival, according to blinded independent central review. Secondary end points included investigator-assessed disease-free survival, overall survival, and safety. The median duration of disease-free survival was 6.8 years (95% confidence interval [CI], 5.8 to not reached) in the sunitinib group and 5.6 years (95% CI, 3.8 to 6.6) in the placebo group (hazard ratio, 0.76; 95% CI, 0.59 to 0.98; P=0.03). Overall survival data were not mature at the time of data cutoff. Dose reductions because of adverse events were more frequent in the sunitinib group than in the placebo group (34.3% vs. 2%), as were dose interruptions (46.4% vs. 13.2%) and discontinuations (28.1% vs. 5.6%). Grade 3 or 4 adverse events were more frequent in the sunitinib group (48.4% for grade 3 events and 12.1% for grade 4 events) than in the placebo group (15.8% and 3.6%, respectively). There was a similar incidence of serious adverse events in the two groups (21.9% for sunitinib vs. 17.1% for placebo); no deaths were attributed to toxic effects. Among patients with locoregional clear-cell renal-cell carcinoma at high risk for tumor recurrence after nephrectomy, the median duration of disease-free survival was significantly longer in the sunitinib group than in the placebo group, at a cost of a higher rate of toxic events. (Funded by Pfizer; S-TRAC ClinicalTrials.gov number, NCT00375674 .).

Tobacco control environment: cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries.

PubMed

Chow, Clara K; Corsi, Daniel J; Gilmore, Anna B; Kruger, Annamarie; Igumbor, Ehimario; Chifamba, Jephat; Yang, Wang; Wei, Li; Iqbal, Romaina; Mony, Prem; Gupta, Rajeev; Vijayakumar, Krishnapillai; Mohan, V; Kumar, Rajesh; Rahman, Omar; Yusoff, Khalid; Ismail, Noorhassim; Zatonska, Katarzyna; Altuntas, Yuksel; Rosengren, Annika; Bahonar, Ahmad; Yusufali, AfzalHussein; Dagenais, Gilles; Lear, Scott; Diaz, Rafael; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Lanas, Fernando; Rangarajan, Sumathy; Teo, Koon; McKee, Martin; Yusuf, Salim

2017-03-31

This study examines in a cross-sectional study 'the tobacco control environment' including tobacco policy implementation and its association with quit ratio. 545 communities from 17 high-income, upper-middle, low-middle and low-income countries (HIC, UMIC, LMIC, LIC) involved in the Environmental Profile of a Community's Health (EPOCH) study from 2009 to 2014. Community audits and surveys of adults (35-70 years, n=12 953). Summary scores of tobacco policy implementation (cost and availability of cigarettes, tobacco advertising, antismoking signage), social unacceptability and knowledge were associated with quit ratios (former vs ever smokers) using multilevel logistic regression models. Average tobacco control policy score was greater in communities from HIC. Overall 56.1% (306/545) of communities had >2 outlets selling cigarettes and in 28.6% (154/539) there was access to cheap cigarettes (<5cents/cigarette) (3.2% (3/93) in HIC, 0% UMIC, 52.6% (90/171) LMIC and 40.4% (61/151) in LIC). Effective bans (no tobacco advertisements) were in 63.0% (341/541) of communities (81.7% HIC, 52.8% UMIC, 65.1% LMIC and 57.6% LIC). In 70.4% (379/538) of communities, >80% of participants disapproved youth smoking (95.7% HIC, 57.6% UMIC, 76.3% LMIC and 58.9% LIC). The average knowledge score was >80% in 48.4% of communities (94.6% HIC, 53.6% UMIC, 31.8% LMIC and 35.1% LIC). Summary scores of policy implementation, social unacceptability and knowledge were positively and significantly associated with quit ratio and the associations varied by gender, for example, communities in the highest quintile of the combined scores had 5.0 times the quit ratio in men (Odds ratio (OR) 5·0, 95% CI 3.4 to 7.4) and 4.1 times the quit ratio in women (OR 4.1, 95% CI 2.4 to 7.1). This study suggests that more focus is needed on ensuring the tobacco control policy is actually implemented, particularly in LMICs. The gender-related differences in associations of policy, social unacceptability and knowledge suggest that different strategies to promoting quitting may need to be implemented in men compared to women. 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/.

Bias due to Preanalytical Dilution of Rodent Serum for Biochemical Analysis on the Siemens Dimension Xpand Plus

PubMed Central

Johns, Jennifer L.; Moorhead, Kaitlin A.; Hu, Jing; Moorhead, Roberta C.

2018-01-01

Clinical pathology testing of rodents is often challenging due to insufficient sample volume. One solution in clinical veterinary and exploratory research environments is dilution of samples prior to analysis. However, published information on the impact of preanalytical sample dilution on rodent biochemical data is incomplete. The objective of this study was to evaluate the effects of preanalytical sample dilution on biochemical analysis of mouse and rat serum samples utilizing the Siemens Dimension Xpand Plus. Rats were obtained from end of study research projects. Mice were obtained from sentinel testing programs. For both, whole blood was collected via terminal cardiocentesis into empty tubes and serum was harvested. Biochemical parameters were measured on fresh and thawed frozen samples run straight and at dilution factors 2–10. Dilutions were performed manually, utilizing either ultrapure water or enzyme diluent per manufacturer recommendations. All diluted samples were generated directly from the undiluted sample. Preanalytical dilution caused clinically unacceptable bias in most analytes at dilution factors four and above. Dilution-induced bias in total calcium, creatinine, total bilirubin, and uric acid was considered unacceptable with any degree of dilution, based on the more conservative of two definitions of acceptability. Dilution often caused electrolyte values to fall below assay range precluding evaluation of bias. Dilution-induced bias occurred in most biochemical parameters to varying degrees and may render dilution unacceptable in the exploratory research and clinical veterinary environments. Additionally, differences between results obtained at different dilution factors may confound statistical comparisons in research settings. Comparison of data obtained at a single dilution factor is highly recommended. PMID:29497614

Microbiological study of ready-to-eat salad vegetables from retail establishments uncovers a national outbreak of salmonellosis.

PubMed

Sagoo, S K; Little, C L; Ward, L; Gillespie, I A; Mitchell, R T

2003-03-01

The increasing availability of bagged prepared salad vegetables reflects consumer demand for fresh, healthy, convenient, and additive-free foods that are safe and nutritious. During May and June 2001 a study of retail bagged prepared ready-to-eat salad vegetables was undertaken to determine the microbiological quality of these vegetables. Examination of the salad vegetables revealed that the vast majority (3,826 of 3,852 samples; 99.3%) were of satisfactory or acceptable microbiological quality according to Public Health Laboratory Service microbiological guidelines, while 20 (0.5%) samples were of unsatisfactory microbiological quality. Unsatisfactory quality was due to Escherichia coli and Listeria spp. (not Listeria monocytogenes) levels in excess of 10(2) CFU/g. However, six (0.2%) samples were of unacceptable microbiological quality because of the presence of Salmonella (Salmonella Newport PT33 [one sample], Salmonella Umbilo [three samples], and Salmonella Durban [one sample]) or because of a L. monocytogenes level of 660 CFU/g, which indicates a health risk. In each case, the retailer involved and the UK Food Standards Agency were immediately informed, and full investigations were undertaken. Nineteen cases of Salmonella Newport PT33 infection were subsequently identified throughout England and Wales. The outbreak strain of Salmonella Newport PT33 isolated from the salad and from humans had a unique plasmid profile. Campylobacter spp. and E. coli O157 were not detected in any of the samples examined. The presence of Salmonella, as well as high levels of L. monocytogenes, is unacceptable. However, minimally processed cut and packaged salad is exposed to a range of conditions during growth, harvest, preparation, and distribution, and it is possible that these conditions may increase the potential for microbial contamination, highlighting the necessity for the implementation of good hygiene practices from farm to fork to prevent contamination and/or bacterial growth in these salad products.

Policy-Led Comparative Environmental Risk Assessment of Genetically Modified Crops: Testing for Increased Risk Rather Than Profiling Phenotypes Leads to Predictable and Transparent Decision-Making

PubMed Central

Raybould, Alan; Macdonald, Phil

2018-01-01

We describe two contrasting methods of comparative environmental risk assessment for genetically modified (GM) crops. Both are science-based, in the sense that they use science to help make decisions, but they differ in the relationship between science and policy. Policy-led comparative risk assessment begins by defining what would be regarded as unacceptable changes when the use a particular GM crop replaces an accepted use of another crop. Hypotheses that these changes will not occur are tested using existing or new data, and corroboration or falsification of the hypotheses is used to inform decision-making. Science-led comparative risk assessment, on the other hand, tends to test null hypotheses of no difference between a GM crop and a comparator. The variables that are compared may have little or no relevance to any previously stated policy objective and hence decision-making tends to be ad hoc in response to possibly spurious statistical significance. We argue that policy-led comparative risk assessment is the far more effective method. With this in mind, we caution that phenotypic profiling of GM crops, particularly with omics methods, is potentially detrimental to risk assessment. PMID:29755975

One State's Systems Change Efforts to Reduce Child Care Expulsion: Taking the Pyramid Model to Scale

ERIC Educational Resources Information Center

Vinh, Megan; Strain, Phil; Davidon, Sarah; Smith, Barbara J.

2016-01-01

This article describes the efforts funded by the state of Colorado to address unacceptably high rates of expulsion from child care. Based on the results of a 2006 survey, the state of Colorado launched two complementary policy initiatives in 2009 to impact expulsion rates and to improve the use of evidence-based practices related to challenging…

Hyperthermia in the treatment of cancer: A review of the radiobiological basis

NASA Technical Reports Server (NTRS)

Baker, D. G.

1978-01-01

Temperatures in the range 41.5 C to 43.5 C tend to be more damaging to malignant than nonmalignant cells. Where local hyperthermia (41.5 C to 43.5 C) is combined with ionizing radiation, a significant therapeutic ratio may be realized. Total body hyperthermia, alone or combined with other therapeutic modalities, can provide palliation for some systemic malignancies but may not be as effective as local hyperthermia for treating local disease. The influence of hyperthermia on immune mechanisms and the risk of metastatic spread of potential tumor growth stimulation need further investigation. Among other questions needing elucidation before hyperthermia can be considered a standard treatment modality are the time-dose (for heating) relationships to produce an optimal therapeutic ratio and whether the late sequela of combined heat and ionizing radiation may result in an unacceptable risk of patient morbidity.

Biological and nonbiological complex drugs for multiple sclerosis in Latin America: regulations and risk management.

PubMed

Carrá, Adriana; Macías Islas, Miguel Angel; Tarulla, Adriana; Bichuetti, Denis Bernardi; Finkelsztejn, Alessandro; Fragoso, Yara Dadalti; Árcega-Revilla, Raul; Cárcamo Rodríguez, Claudia; Durán, Juan Carlos; Bonitto, Juan García; León, Rosalba; Oehninger Gatti, Carlos; Orozco, Geraldine; Vizcarra Escobar, Darwin

2015-06-01

Biological drugs and nonbiological complex drugs with expired patents are followed by biosimilars and follow-on drugs that are supposedly similar and comparable with the reference product in terms of quality, safety and efficacy. Unlike simple molecules that can be copied and reproduced, biosimilars and follow-on complex drugs are heterogeneous and need specific regulations from health and pharmacovigilance agencies. A panel of 14 Latin American experts on multiple sclerosis from nine different countries met to discuss the recommendations regarding biosimilars and follow-on complex drugs for treating multiple sclerosis. Specific measures relating to manufacturing, therapeutic equivalence assessment and pharmacovigilance reports need to be implemented before commercialization. Physical, chemical, biological and immunogenic characterizations of the new product need to be available before clinical trials start. The new product must maintain the same immunogenicity as the original. Automatic substitution of biological and complex drugs poses unacceptable risks to the patient.

Milan Army Ammunition Plant remedial investigation report: Volume 1. Final report 89-91

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

Okusu, N.; Hall, H.; Orndorff, A.

1991-12-09

A Remedial Investigation at the Milan Army Ammunition Plant, TN, was conducted for the US Army Toxic and Hazardous Materials Agency, under the terms of an Interagency Agreement with the State of Tennessee and the US Environmental Protection Agency. The study focused on the CERCLA site and selected RCRA regulated units identified by previous studies as potential sources of contamination. A broad range of chemicals including metals, explosives, and other organic compounds were found in source areas and in groundwater. The results of a risk assessment indicate that unacceptable levels of human health risks potentially exist. Conceptual models of sitemore » and unit characteristics were formulated to explain major findings, and areas not contributing to the problem were identified. For many source areas, major unknowns exist regarding hydrology, extent of contamination, and current and future impacts to groundwater quality.« less

Response of Ambulatory Human Subjects to Artificial Gravity (Short Radius Centrifugation)

NASA Technical Reports Server (NTRS)

Paloski, William H.; Arya, Maneesh; Newby, Nathaniel; Tucker, Jon-Michael; Jarchow, Thomas; Young, Laurence

2006-01-01

Prolonged exposure to microgravity results in significant adaptive changes, including cardiovascular deconditioning, muscle atrophy, bone loss, and sensorimotor reorganization, that place individuals at risk for performing physical activities after return to a gravitational environment. Planned missions to Mars include unprecedented hypogravity exposures that would likely result in unacceptable risks to crews. Artificial gravity (AG) paradigms may offer multisystem protection from the untoward effects of adaptation to the microgravity of space or the hypogravity of planetary surfaces. While the most effective AG designs would employ a rotating spacecraft, perceived issues may preclude their use. The questions of whether and how intermittent AG produced by a short radius centrifuge (SRC) could be employed have therefore sprung to the forefront of operational research. In preparing for a series of intermittent AG trials in subjects deconditioned by bed rest, we have examined the responses of several healthy, ambulatory subjects to SRC exposures.

On the duality of resilience and privacy†.

PubMed

Crowcroft, Jon

2015-03-08

Protecting information has long been an important problem. We would like to protect ourselves from the risk of loss: think of the library of Alexandria; and from unauthorized access: consider the very business of the 'Scandal Sheets', going back centuries. This has never been more true than today when vast quantities of data (dare one say lesser quantities of information) are stored on computer systems, and routinely moved around the Internet, at almost no cost. Computer and communication systems are both fragile and vulnerable, and so the risk of catastrophic loss or theft is potentially much higher. A single keystroke can delete a public database, or expose a private dataset to the world. In this paper, I consider the problems of providing resilience against loss, and against unacceptable access as a dual . Here, we see that two apparently different solutions to different technical problems may be transformed into one another, and hence give better insight into both problems.

Federal Farmworker Housing Standards and Regulations, Their Promise and Limitations, and Implications for Farmworker Health.

PubMed

Moss Joyner, Ann; George, Lance; Hall, Mary Lee; Jacobs, Ilene J; Kissam, E D; Latin, Shelley; Parnell, Allan; Ruiz, Virginia; Shadbeh, Nargess; Tobacman, Janet

2015-11-01

The housing available to most farmworkers is substandard and unacceptable in 21st-century America. The federal government established minimal occupational safety and health standards applicable to migrant farmworker labor camps decades ago, and some states have statutory schemes and regulations that set standards for farm labor camps and employee housing. Many of these federal and state regulations no longer reflect current employment and housing trends, and enforcement success varies greatly. These regulations implicitly recognize the connection between housing conditions and health, but do not effectively address that connection. This review describes the current state of farmworker housing, discusses laws and regulations pertaining to such housing, and highlights the literature on health risks associated with inadequate housing. We propose specific recommendations to strengthen enforcement and reduce the risks of substandard housing for the health of farmworkers and their families. © The Author(s) 2015.

Environmental Health

NASA Technical Reports Server (NTRS)

Pierson, Duane; James, John; Russo, Dane; Limero, Thomas; Beck, Steve; Groves, Theron

1999-01-01

The Environmental Health activity for the Extended Duration Orbiter Medical Project (EDOMP) was formed to develop an overall strategy for safeguarding crew members from potential airborne hazards anticipated on missions of extended duration. These efforts were necessary because of major modifications to the air revitalization system of the U.S. Space Shuttle and an increased potential for environmental health risks associated with longer space flights. Degradation of air quality in the Shuttle during a space flight mission has the potential to affect the performance of the crew not only during piloting, landing, or egress, but also during space flight. It was anticipated that the risk of significant deterioration in air quality would increase with extended mission lengths and could result from: (1) a major chemical contamination incident, such as a thermodegradation event or toxic leak, (2) continual accumulation of volatile organic compounds to unacceptable levels, (3) excessive levels of airborne particles, (4) excessive levels of microorganisms, or (5) accumulation of airborne pathogens.

Developing a Comprehensive Risk Assessment Framework for Geological Storage CO 2

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

Duncan, Ian

2014-08-31

The operational risks for CCS projects include: risks of capturing, compressing, transporting and injecting CO₂; risks of well blowouts; risk that CO 2 will leak into shallow aquifers and contaminate potable water; and risk that sequestered CO 2 will leak into the atmosphere. This report examines these risks by using information on the risks associated with analogue activities such as CO 2 based enhanced oil recovery (CO 2-EOR), natural gas storage and acid gas disposal. We have developed a new analysis of pipeline risk based on Bayesian statistical analysis. Bayesian theory probabilities may describe states of partial knowledge, even perhapsmore » those related to non-repeatable events. The Bayesian approach enables both utilizing existing data and at the same time having the capability to adsorb new information thus to lower uncertainty in our understanding of complex systems. Incident rates for both natural gas and CO 2 pipelines have been widely used in papers and reports on risk of CO 2 pipelines as proxies for the individual risk created by such pipelines. Published risk studies of CO 2 pipelines suggest that the individual risk associated with CO2 pipelines is between 10 -3 and 10 -4, which reflects risk levels approaching those of mountain climbing, which many would find unacceptably high. This report concludes, based on a careful analysis of natural gas pipeline failures, suggests that the individual risk of CO 2 pipelines is likely in the range of 10-6 to 10-7, a risk range considered in the acceptable to negligible range in most countries. If, as is commonly thought, pipelines represent the highest risk component of CCS outside of the capture plant, then this conclusion suggests that most (if not all) previous quantitative- risk assessments of components of CCS may be orders of magnitude to high. The potential lethality of unexpected CO 2 releases from pipelines or wells are arguably the highest risk aspects of CO 2 enhanced oil recovery (CO2-EOR), carbon capture, and storage (CCS). Assertions in the CCS literature, that CO 2 levels of 10% for ten minutes, or 20 to 30% for a few minutes are lethal to humans, are not supported by the available evidence. The results of published experiments with animals exposed to CO 2, from mice to monkeys, at both normal and depleted oxygen levels, suggest that lethal levels of CO 2 toxicity are in the range 50 to 60%. These experiments demonstrate that CO 2 does not kill by asphyxia, but rather is toxic at high concentrations. It is concluded that quantitative risk assessments of CCS have overestimated the risk of fatalities by using values of lethality a factor two to six lower than the values estimated in this paper. In many dispersion models of CO 2 releases from pipelines, no fatalities would be predicted if appropriate levels of lethality for CO 2 had been used in the analysis.« less

PATIENT-SPECIFIC AND SURGERY-SPECIFIC FACTORS THAT AFFECT RETURN TO SPORT AFTER ACL RECONSTRUCTION

PubMed Central

Lynch, Andrew; Rabuck, Stephen; Lynch, Brittany; Davin, Sarah; Irrgang, James

2016-01-01

Context Anterior cruciate ligament (ACL) reconstruction is frequently performed to allow individuals to return to their pre-injury levels of sports participation, however, return to pre-injury level of sport is poor and re-injury rates are unacceptably high. Re-injury is likely associated with the timeframe and guidelines for return to sport (RTS). It is imperative for clinicians to recognize risk factors for re-injury and to ensure that modifiable risk factors are addressed prior to RTS. The purpose of this commentary is to summarize the current literature on the outcomes following return to sport after ACL reconstruction and to outline the biologic and patient-specific factors that should be considered when counseling an athlete on their progression through rehabilitation. Evidence Acquisition A comprehensive literature search was performed to identify RTS criteria and RTS rates after ACL reconstruction with consideration paid to graft healing, anatomic reconstruction, and risk factors for re-injury and revision. Results were screened for relevant original research articles and review articles, from which results were summarized. Study Design Clinical Review of the Literature Results Variable RTS rates are presented in the literature due to variable definitions of RTS ranging from a high threshold (return to competition) to low threshold (physician clearance for return to play). Re-injury and contralateral injury rates are greater than the risk for primary ACL injury, which may be related to insufficient RTS guidelines based on time from surgery, which do not allow for proper healing or resolution of post-operative impairments and elimination of risk factors associated with both primary and secondary ACL injuries. Conclusions RTS rates to pre-injury level of activity after ACLR are poor and the risk for graft injury or contralateral injury requiring an additional surgery is substantial. Resolving impairments while eliminating movement patterns associated with injury and allowing sufficient time for graft healing likely gives the athlete the best chance to RTS without further injury. Additional research is needed to identify objective imaging and functional testing criteria to improve clinical decision making for RTS after ACLR. Level of Evidence Level 5 PMID:27104060

Computer modelling as a tool for the exposure assessment of operators using faulty agricultural pesticide spraying equipment.

PubMed

Bańkowski, Robert; Wiadrowska, Bozena; Beresińska, Martyna; Ludwicki, Jan K; Noworyta-Głowacka, Justyna; Godyń, Artur; Doruchowski, Grzegorz; Hołownicki, Ryszard

2013-01-01

Faulty but still operating agricultural pesticide sprayers may pose an unacceptable health risk for operators. The computerized models designed to calculate exposure and risk for pesticide sprayers used as an aid in the evaluation and further authorisation of plant protection products may be applied also to assess a health risk for operators when faulty sprayers are used. To evaluate the impact of different exposure scenarios on the health risk for the operators using faulty agricultural spraying equipment by means of computer modelling. The exposure modelling was performed for 15 pesticides (5 insecticides, 7 fungicides and 3 herbicides). The critical parameter, i.e. toxicological end-point, on which the risk assessment was based was the no observable adverse effect level (NOAEL). This enabled risk to be estimated under various exposure conditions such as pesticide concentration in the plant protection product and type of the sprayed crop as well as the number of treatments. Computer modelling was based on the UK POEM model including determination of the acceptable operator exposure level (AOEL). Thus the degree of operator exposure could be defined during pesticide treatment whether or not personal protection equipment had been employed by individuals. Data used for computer modelling was obtained from simulated, pesticide substitute treatments using variously damaged knapsack sprayers. These substitute preparations consisted of markers that allowed computer simulations to be made, analogous to real-life exposure situations, in a dose dependent fashion. Exposures were estimated according to operator dosimetry exposure under 'field' conditions for low level, medium and high target field crops. The exposure modelling in the high target field crops demonstrated exceedance of the AOEL in all simulated treatment cases (100%) using damaged sprayers irrespective of the type of damage or if individual protective measures had been adopted or not. For low level and medium field crops exceedances ranged between 40 - 80% cases. The computer modelling may be considered as an practical tool for the hazard assessment when the faulty agricultural sprayers are used. It also may be applied for programming the quality checks and maintenance systems of this equipment.

Risk factors for tuberculosis treatment failure, default, or relapse and outcomes of retreatment in Morocco

PubMed Central

2011-01-01

Background Patients with tuberculosis require retreatment if they fail or default from initial treatment or if they relapse following initial treatment success. Outcomes among patients receiving a standard World Health Organization Category II retreatment regimen are suboptimal, resulting in increased risk of morbidity, drug resistance, and transmission.. In this study, we evaluated the risk factors for initial treatment failure, default, or early relapse leading to the need for tuberculosis retreatment in Morocco. We also assessed retreatment outcomes and drug susceptibility testing use for retreatment patients in urban centers in Morocco, where tuberculosis incidence is stubbornly high. Methods Patients with smear- or culture-positive pulmonary tuberculosis presenting for retreatment were identified using clinic registries in nine urban public clinics in Morocco. Demographic and outcomes data were collected from clinical charts and reference laboratories. To identify factors that had put these individuals at risk for failure, default, or early relapse in the first place, initial treatment records were also abstracted (if retreatment began within two years of initial treatment), and patient characteristics were compared with controls who successfully completed initial treatment without early relapse. Results 291 patients presenting for retreatment were included; 93% received a standard Category II regimen. Retreatment was successful in 74% of relapse patients, 48% of failure patients, and 41% of default patients. 25% of retreatment patients defaulted, higher than previous estimates. Retreatment failure was most common among patients who had failed initial treatment (24%), and default from retreatment was most frequent among patients with initial treatment default (57%). Drug susceptibility testing was performed in only 10% of retreatment patients. Independent risk factors for failure, default, or early relapse after initial treatment included male gender (aOR = 2.29, 95% CI 1.10-4.77), positive sputum smear after 3 months of treatment (OR 7.14, 95% CI 4.04-13.2), and hospitalization (OR 2.09, 95% CI 1.01-4.34). Higher weight at treatment initiation was protective. Male sex, substance use, missed doses, and hospitalization appeared to be risk factors for default, but subgroup analyses were limited by small numbers. Conclusions Outcomes of retreatment with a Category II regimen are suboptimal and vary by subgroup. Default among patients receiving tuberculosis retreatment is unacceptably high in urban areas in Morocco, and patients who fail initial tuberculosis treatment are at especially high risk of retreatment failure. Strategies to address risk factors for initial treatment default and to identify patients at risk for failure (including expanded use of drug susceptibility testing) are important given suboptimal retreatment outcomes in these groups. PMID:21356062

Risk factors for tuberculosis treatment failure, default, or relapse and outcomes of retreatment in Morocco.

PubMed

Dooley, Kelly E; Lahlou, Ouafae; Ghali, Iraqi; Knudsen, Janine; Elmessaoudi, My Driss; Cherkaoui, Imad; El Aouad, Rajae

2011-02-28

Patients with tuberculosis require retreatment if they fail or default from initial treatment or if they relapse following initial treatment success. Outcomes among patients receiving a standard World Health Organization Category II retreatment regimen are suboptimal, resulting in increased risk of morbidity, drug resistance, and transmission.. In this study, we evaluated the risk factors for initial treatment failure, default, or early relapse leading to the need for tuberculosis retreatment in Morocco. We also assessed retreatment outcomes and drug susceptibility testing use for retreatment patients in urban centers in Morocco, where tuberculosis incidence is stubbornly high. Patients with smear- or culture-positive pulmonary tuberculosis presenting for retreatment were identified using clinic registries in nine urban public clinics in Morocco. Demographic and outcomes data were collected from clinical charts and reference laboratories. To identify factors that had put these individuals at risk for failure, default, or early relapse in the first place, initial treatment records were also abstracted (if retreatment began within two years of initial treatment), and patient characteristics were compared with controls who successfully completed initial treatment without early relapse. 291 patients presenting for retreatment were included; 93% received a standard Category II regimen. Retreatment was successful in 74% of relapse patients, 48% of failure patients, and 41% of default patients. 25% of retreatment patients defaulted, higher than previous estimates. Retreatment failure was most common among patients who had failed initial treatment (24%), and default from retreatment was most frequent among patients with initial treatment default (57%). Drug susceptibility testing was performed in only 10% of retreatment patients. Independent risk factors for failure, default, or early relapse after initial treatment included male gender (aOR = 2.29, 95% CI 1.10-4.77), positive sputum smear after 3 months of treatment (OR 7.14, 95% CI 4.04-13.2), and hospitalization (OR 2.09, 95% CI 1.01-4.34). Higher weight at treatment initiation was protective. Male sex, substance use, missed doses, and hospitalization appeared to be risk factors for default, but subgroup analyses were limited by small numbers. Outcomes of retreatment with a Category II regimen are suboptimal and vary by subgroup. Default among patients receiving tuberculosis retreatment is unacceptably high in urban areas in Morocco, and patients who fail initial tuberculosis treatment are at especially high risk of retreatment failure. Strategies to address risk factors for initial treatment default and to identify patients at risk for failure (including expanded use of drug susceptibility testing) are important given suboptimal retreatment outcomes in these groups.

Exposure Estimation and Interpretation of Occupational Risk: Enhanced Information for the Occupational Risk Manager

PubMed Central

Waters, Martha; McKernan, Lauralynn; Maier, Andrew; Jayjock, Michael; Schaeffer, Val; Brosseau, Lisa

2015-01-01

The fundamental goal of this article is to describe, define, and analyze the components of the risk characterization process for occupational exposures. Current methods are described for the probabilistic characterization of exposure, including newer techniques that have increasing applications for assessing data from occupational exposure scenarios. In addition, since the probability of health effects reflects variability in the exposure estimate as well as the dose-response curve—the integrated considerations of variability surrounding both components of the risk characterization provide greater information to the occupational hygienist. Probabilistic tools provide a more informed view of exposure as compared to use of discrete point estimates for these inputs to the risk characterization process. Active use of such tools for exposure and risk assessment will lead to a scientifically supported worker health protection program. Understanding the bases for an occupational risk assessment, focusing on important sources of variability and uncertainty enables characterizing occupational risk in terms of a probability, rather than a binary decision of acceptable risk or unacceptable risk. A critical review of existing methods highlights several conclusions: (1) exposure estimates and the dose-response are impacted by both variability and uncertainty and a well-developed risk characterization reflects and communicates this consideration; (2) occupational risk is probabilistic in nature and most accurately considered as a distribution, not a point estimate; and (3) occupational hygienists have a variety of tools available to incorporate concepts of risk characterization into occupational health and practice. PMID:26302336

Pollution characteristics and health risk assessment of heavy metals in the vegetable bases of northwest China.

PubMed

Sawut, Rukeya; Kasim, Nijat; Maihemuti, Balati; Hu, Li; Abliz, Abdugheni; Abdujappar, Abdusalam; Kurban, Miradil

2018-06-17

The objective of this study was to investigate heavy metal contamination in four major vegetable bases and determine the health risks of residents in the vicinity of the highly urbanized city Urumqi in Xinjiang, China. In this paper, we determined the contents of six heavy metals (i.e., As, Zn, Cd, Cr, Hg, and Pb) in surface soil and groundwater to evaluate the levels of heavy metal pollution and human health risks using the pollution index (PI), the Nemerow integrated pollution index (NIPI), the ecological risk factor (E i r ), risk index (RI) and the health risk assessment model. The results showed that (1) The PI, NIPI, the ecological risk factor and risk index indicated that Cd and Hg were the primary pollutants in Sishihu village. These indices suggested moderate to slightly heavy potential ecological risks. In Anningqu town, Hg and Cd led to high levels of pollution and posed slightly heavy potential ecological risks. In Qinggedahu village, it was concluded that the metals Zn, Cr, Cd, Hg, and Pb caused moderate to heavy pollution. In Liushihu village, the pollution trends in the area were low. The results of the pollution level of the irrigation well water (i.e., groundwater) indicated that the well water was considerably safer than the soil, but Cr posed a slight pollution risk. (2) The non-carcinogenic risks for adults based on the HI values of these four vegetable bases were <1. However, when considering the non-carcinogenic risks for children, the HI values were larger than 1 in all areas, indicating the local children have a higher potential non-carcinogenic risk. In addition, CR (Carcinogenic risk) from dermal contact with the vegetables bases did not pose a high risk for residents. However, for adults, the carcinogenic risk posed by Arsenic (As) through trough inhalation was the primary pathway of exposure in three of the vegetable bases, generally in the order of Qinggedahu village > Sishihu village > Anningqu town. For children, the carcinogenic risks posed by As through trough inhalation and ingestion were the main exposure pathways. From the TCR results, it can be seen that in Sishihu village, Anningqu town, and Qinggedahu village, the TCR values for adults and children were >1 × 10 -4 (unitless), and this degree of carcinogenic risk is unacceptable. (3) The identification of risk sources determined the main pollution sources affecting the vegetable bases were human activities and natural sources. Anthropogenic activities were most often related to traffic pollution sources and agricultural pollution sources, such as the irrational use of pesticides and fertilizers and stock farming. The results are important for designing remediation scenarios to control the spread of contamination as well as for serving as a reference point for soil environmental protection efforts in this region. Copyright © 2018 Elsevier B.V. All rights reserved.

Can Internet information on vertebroplasty be a reliable means of patient self-education?

PubMed

Sullivan, T Barrett; Anderson, Joshua T; Ahn, Uri M; Ahn, Nicholas U

2014-05-01

Studies of the quality and accuracy of health and medical information available on the Internet have shown that many sources provide inadequate information. However, to our knowledge, there are no published studies analyzing the quality of information available online regarding vertebroplasty. Because this has been a high-volume procedure with highly debated efficacy, it is critical that patients receive complete, accurate, and well-balanced information before deciding a treatment course. Additionally, few studies have evaluated the merit of academic site authorship or site certification on information quality, but some studies have used measurements of quality that are based primarily on subjective criteria or information accuracy rather than information completeness. The purposes of our study were (1) to evaluate and analyze the information on vertebroplasty available to the general public through the Internet; (2) to see if sites sponsored by academic institutions offered a higher quality of information; and (3) to determine whether quality of information varied according to site approval by a certification body. Three search engines were used to identify 105 web sites (35 per engine) offering information regarding vertebroplasty. Sites were evaluated for authorship/sponsorship, content, and references cited. Information quality was rated as "excellent," "high," "moderate," "low," or "unacceptable." Sites also were evaluated for contact information to set up an appointment. Data were analyzed as a complete set, then compared between authorship types, and finally evaluated by certification status. Academic sites were compared with other authorship groups and certified sites were compared with noncertified sites using Student's t-test. Appropriate indications were referenced in 74% of sites, whereas only 45% discussed a contraindication to the procedure. Benefits were expressed by 100% of sites, but risks were outlined in only 53% (p < 0.001). Ninety-nine percent of sites provided step-by-step descriptions of the procedure, and 44% of sites also included images. Alternative treatments were mentioned by 51% of sites. Twenty-seven percent of sites referenced peer-reviewed literature, 41% offered experiential or noncited data based on American populations, and 7% offered analogous data from international populations. Thirty percent of sites provided contact information for patient appointment scheduling. Seven percent of sites were classified as excellent quality, 6% as high quality, 11% as moderate quality, 19% as poor quality, and 57% as unacceptable. Sixteen percent of sites were sponsored by academic institutions, 62% by private groups, 8% by biomedical device companies, and 14% were sponsored otherwise. Academic sites reported fewer risks of the procedure than private sites or other sites (p = 0.05 and p = 0.04), but reported more risks than industry sites (p = 0.007). Academic sites were more likely than sites classified as other to offer contact information for patient appointment scheduling (p = 0.004). Nine percent of sites evaluated were Health on the Net Foundation (HONCode) certified. No association with improved information quality was observed in these sites relative to noncertified sites (all p > 0.05). Internet information regarding vertebroplasty is not only inadequate for proper patient education, but also potentially misleading as sites are more likely to present benefits of the procedure than risks. Although academic sites might be expected to offer higher-quality information than private, industry, or other sites, our data would suggest that they do not. HONCode certification cannot be used reliably as a means of qualifying website information quality. Academic sites should be expected to set a high standard and alter their Internet presence with adequate information distribution. Certification bodies also should alter their standards to necessitate provision of complete information in addition to emphasizing accurate information. Treating physicians may want to counsel their patients regarding the limitations of information present on the Internet and the pitfalls of current certification systems. Level IV, economic and decision analyses. See the Instructions for Authors for a complete description of levels of evidence.

Azithromycin to prevent post-discharge morbidity and mortality in Kenyan children: a protocol for a randomised, double-blind, placebo-controlled trial (the Toto Bora trial)

PubMed Central

Singa, Benson O; John-Stewart, Grace C; Richardson, Barbra A; Brander, Rebecca L; McGrath, Christine J; Tickell, Kirkby D; Amondi, Mary; Rwigi, Doreen; Babigumira, Joseph B; Kariuki, Sam; Nduati, Ruth; Walson, Judd L

2017-01-01

Introduction Child mortality due to infectious diseases remains unacceptably high in much of sub-Saharan Africa. Children who are hospitalised represent an accessible population at particularly high risk of death, both during and following hospitalisation. Hospital discharge may be a critical time point at which targeted use of antibiotics could reduce morbidity and mortality in high-risk children. Methods and analysis In this randomised, double-blind, placebo-controlled trial (Toto Bora Trial), 1400 children aged 1–59 months discharged from hospitals in Western Kenya, in Kisii and Homa Bay, will be randomised to either a 5-day course of azithromycin or placebo to determine whether a short course of azithromycin reduces rates of rehospitalisation and/or death in the subsequent 6-month period. The primary analysis will be modified intention-to-treat and will compare the rates of rehospitalisation or death in children treated with azithromycin or placebo using Cox proportional hazard regression. The trial will also evaluate the effect of a short course of azithromycin on enteric and nasopharyngeal infections and cause-specific morbidities. We will also identify risk factors for postdischarge morbidity and mortality and subpopulations most likely to benefit from postdischarge antibiotic use. Antibiotic resistance in Escherichia coli and Streptococcus pneumoniae among enrolled children and their primary caregivers will also be assessed, and cost-effectiveness analyses will be performed to inform policy decisions. Ethics and dissemination Study procedures were reviewed and approved by the institutional review boards of the Kenya Medical Research Institute, the University of Washington and the Kenyan Pharmacy and Poisons Board. The study is being externally monitored, and a data safety and monitoring committee has been assembled to monitor patient safety and to evaluate the efficacy of the intervention. The results of this trial will be published in peer-reviewed scientific journals and presented at relevant academic conferences and to key stakeholders. Trial registration number NCT02414399. PMID:29289941

[Analysis the relationship between the found ways and first diagnosis age for large vestibular aqueduct children].

PubMed

Yang, Yali; Huang, Lihui; Cheng, Xiaohua; Fu, Xinxing; Liu, Jiaxing; Ni, Tingting

2014-11-01

To explore the found ways and first diagnosis age of children with large vestibular aqueduct, and their relations with hearing loss. Medical histories of 122 cases of children diagnosed with large vestibular aqueduct by HRCT or MRI had been collected from January 2009 to April 2014 in our hospital children's hearing diagnosis center clinic. Found ways comprise of accepting universal newborn hearing screening (UNHS) group and unaccepting UNHS group. Accepting UNHS children were divided into two ears unpassing group, single ear unpassing group and passing group. The patients in unaccepting UNHS group were divided into not sensitive to sounds, speech stunting, sudden hearing loss, and other group. Analysis the relationship between the found ways and first diagnosis age and their relations with hearing loss. There are 84 cases (68.85%) accepting UNHS, the average age of first diagnosis was (17.24 ± 17.08) months; 37 cases (31.15%) are not accepting UNHS. The average age of first diagnosis was (30.92 ± 18.21) months. The average first diagnosis age of accepting UNHS group was more earlier than the unaccepting UNHS group. The difference was statistically signif- icant (P < 0.01). There were 57 cases (67.85%) whose two ears not pass UNHS; 15 cases (17.86%) single ear not pass; namely the referral rate was 85.71%; 12 cases (14.29%) pass the test. The first diagnosis age of passing UNHS group was more later than two ears unpassing group (P < 0.001). In the unaccepting UNHS group, the average first diagnosis age of not sensitive to sounds group (19.69 ± 11.16 months) was more earlier than words dysplasia group (37.13 ± 15.62 months) and sudden hearing loss group (47.40 ± 24.70 months) (P < 0.01). The difference in the degree of hearing loss between accepting UNHS and unaccepting UNHS group had no statistical significance (P > 0.05). In unaccepting UNHS group ,the average first diagnosis age of the mild-to-moderate hearing loss group was later than the very severe hearing loss group (P < 0.01). Most of large vestibular aqueduct children can be found and receive diagnosis early by UNHS. But part of these patients with late-onset or progressive hearing loss, especially these with mild-to-moderate hearing loss cannot be found early, which should arouse our attention.

Investigation of Flow Conditioners for Compact Jet Engine Simulator Rig Noise Reduction

NASA Technical Reports Server (NTRS)

Doty, Michael J.; Haskin, Henry H.

2011-01-01

The design requirements for two new Compact Jet Engine Simulator (CJES) units for upcoming wind tunnel testing lead to the distinct possibility of rig noise contamination. The acoustic and aerodynamic properties of several flow conditioner devices are investigated over a range of operating conditions relevant to the CJES units to mitigate the risk of rig noise. An impinging jet broadband noise source is placed in the upstream plenum of the test facility permitting measurements of not only flow conditioner self-noise, but also noise attenuation characteristics. Several perforated plate and honeycomb samples of high porosity show minimal self-noise but also minimal attenuation capability. Conversely, low porosity perforated plate and sintered wire mesh conditioners exhibit noticeable attenuation but also unacceptable self-noise. One fine wire mesh sample (DP450661) shows minimal selfnoise and reasonable attenuation, particularly when combined in series with a 15.6 percent open area (POA) perforated plate upstream. This configuration is the preferred flow conditioner system for the CJES, providing up to 20 dB of broadband attenuation capability with minimal self-noise.

An investigation of acoustic noise requirements for the Space Station centrifuge facility

NASA Technical Reports Server (NTRS)

Castellano, Timothy

1994-01-01

Acoustic noise emissions from the Space Station Freedom (SSF) centrifuge facility hardware represent a potential technical and programmatic risk to the project. The SSF program requires that no payload exceed a Noise Criterion 40 (NC-40) noise contour in any octave band between 63 Hz and 8 kHz as measured 2 feet from the equipment item. Past experience with life science experiment hardware indicates that this requirement will be difficult to meet. The crew has found noise levels on Spacelab flights to be unacceptably high. Many past Ames Spacelab life science payloads have required waivers because of excessive noise. The objectives of this study were (1) to develop an understanding of acoustic measurement theory, instruments, and technique, and (2) to characterize the noise emission of analogous Facility components and previously flown flight hardware. Test results from existing hardware were reviewed and analyzed. Measurements of the spectral and intensity characteristics of fans and other rotating machinery were performed. The literature was reviewed and contacts were made with NASA and industry organizations concerned with or performing research on noise control.

Transient probabilities for queues with applications to hospital waiting list management.

PubMed

Joy, Mark; Jones, Simon

2005-08-01

In this paper we study queuing systems within the NHS. Recently imposed government performance targets lead NHS executives to investigate and instigate alternative management strategies, thereby imposing structural changes on the queues. Under such circumstances, it is most unlikely that such systems are in equilibrium. It is crucial, in our opinion, to recognise this state of affairs in order to make a balanced assessment of the role of queue management in the modern NHS. From a mathematical perspective it should be emphasised that measures of the state of a queue based upon the assumption of statistical equilibrium (a pervasive methodology in the study of queues) are simply wrong in the above scenario. To base strategic decisions around such ideas is therefore highly questionable and it is one of the purposes of this paper to offer alternatives: we present some (recent) research whose results generate performance measures and measures of risk, for example, of waiting-times growing unacceptably large; we emphasise that these results concern the transient behaviour of the queueing model-there is no asssumption of statistical equilibrium. We also demonstrate that our results are computationally tractable.

Questionnaire for low back pain in the garment industry workers

PubMed Central

Bindra, Supreet; Sinha, A. G. K.; Benjamin, A. I.

2013-01-01

Low back pain affects up to 90% of the world's population at some point in their lives. Until date no questionnaire has been designed for back pain in the garment industry workers. Therefore, the objective of this study is to design a questionnaire to determine the prevalence, risk factors, impact, health care service utilization and back pain features in the garment industry workers and gain preliminary experience of its use. The content validity and reliability of the questionnaire was established. Items showing acceptable internal consistency and moderate to high test re-test reliability were retained in the questionnaire. Items showing unacceptable internal consistency, low test re-test reliability or poor differentiation were reworded, redrafted and re-tested on the workers. It took 20 min to complete one interview schedule. Environmental factors such as the absence of the garment industry owner/supervisor or co-workers at the time of the interview and interview during leisure hours need to be standardized. Thus, final questionnaire is ready for use after necessary amendments and will be used on the larger sample size in the main study. PMID:24421591

Questionnaire for low back pain in the garment industry workers.

PubMed

Bindra, Supreet; Sinha, A G K; Benjamin, A I

2013-05-01

Low back pain affects up to 90% of the world's population at some point in their lives. Until date no questionnaire has been designed for back pain in the garment industry workers. Therefore, the objective of this study is to design a questionnaire to determine the prevalence, risk factors, impact, health care service utilization and back pain features in the garment industry workers and gain preliminary experience of its use. The content validity and reliability of the questionnaire was established. Items showing acceptable internal consistency and moderate to high test re-test reliability were retained in the questionnaire. Items showing unacceptable internal consistency, low test re-test reliability or poor differentiation were reworded, redrafted and re-tested on the workers. It took 20 min to complete one interview schedule. Environmental factors such as the absence of the garment industry owner/supervisor or co-workers at the time of the interview and interview during leisure hours need to be standardized. Thus, final questionnaire is ready for use after necessary amendments and will be used on the larger sample size in the main study.

A proposal to reduce the risk of transmission of human papilloma virus via transvaginal ultrasound.

PubMed

Combs, C Andrew; Fishman, Alan

2016-07-01

Three steps must be followed to prevent the transmission of infection via a contaminated transvaginal ultrasound probe: cleaning the probe after every use, high-level disinfection, and covering the probe with a single-use barrier during the examination. There may be critical flaws in at least 2 of these steps as they are currently practiced. First, 2 widely used disinfectants, glutaraldehyde and orthophthalaldehyde, have recently been found to be ineffective at neutralizing human papilloma virus type 16 and type 18. Second, commercial ultrasound probe covers have an unacceptable rate of leakage (8-81%) compared to condoms (0.9-2%). We recommend the use of a sonicated hydrogen peroxide disinfectant system rather than aldehyde-type disinfectants. We recommend that the probe be covered with a condom rather than a commercial probe cover during transvaginal ultrasound examination. Combined with probe cleaning, these 2 steps are estimated to result in an 800 million- to 250 billion-fold reduction in human papilloma virus viral load, which should translate to greatly enhanced patient safety. Copyright © 2016 Elsevier Inc. All rights reserved.

Obesity prevention in children.

PubMed

Moreno, Luis A; Bel-Serrat, Silvia; Santaliestra-Pasías, Alba M; Rodríguez, Gerardo

2013-01-01

The prevalence of childhood overweight and obesity continues to be unacceptably high and of public health concern in Europe. During childhood and adolescence, environmental factors are the main drivers of obesity development. Obesity is caused by a chronic energy imbalance involving both dietary intake and physical activity patterns. Several risk factors are influencing obesity development, even starting in the prenatal period. From birth, along life, mainly diet and physical activity/inactivity are the most important drivers on top of genetic susceptibility. The first years of life can therefore be crucial to start preventive interventions that can have an impact on lifestyle and on later overweight and obesity. Schools are an attractive and popular setting for implementing interventions for children. Interventions including a community component are considered to be the most effective. Obesity control will require policy interventions to improve the environments that promote poor dietary intake and physical inactivity rather than individually focused interventions. More solid institutional and health policies are needed together with more effective interventions to obtain evident changes for the prevention of excess adiposity among children. Copyright © 2013 S. Karger AG, Basel.

Prevention and treatment of the chronic thromboembolic pulmonary hypertension.

PubMed

Pesavento, Raffaele; Prandoni, Paolo

2018-04-01

Chronic thromboembolic pulmonary hypertension (CTEPH) is an uncommon and late complication of pulmonary embolism resulting from misguided remodelling of residual pulmonary thromboembolic material and small-vessel arteriopathy. CTEPH is the only form of pulmonary hypertension (PH) potentially curable by pulmonary endarterectomy (PEA). Unfortunately, several patients have either an unacceptable risk-benefit ratio for undergoing the surgical intervention or develop persistent PH after PEA. Novel medical and endovascular therapies can be considered for them. The soluble guanylate cyclase stimulator riociguat is recommended for the treatment of patients with inoperable disease or with recurrent/persistent PH after PEA. Other drugs developed for the treatment of other forms of PH, as prostanoids, phosphodiesterase-5 inhibitors and endothelin receptor antagonists have been used in the treatment of CTEPH, with limited benefit. Balloon pulmonary angioplasty is a novel and promising technique and is progressively emerging from the pioneering phase. Highly specialized training level and complex protocols of postoperative care are mandatory to consolidate the technical success of the surgical and endovascular intervention. Copyright © 2018 Elsevier Ltd. All rights reserved.

Performing a preliminary hazard analysis applied to administration of injectable drugs to infants.

PubMed

Hfaiedh, Nadia; Kabiche, Sofiane; Delescluse, Catherine; Balde, Issa-Bella; Merlin, Sophie; Carret, Sandra; de Pontual, Loïc; Fontan, Jean-Eudes; Schlatter, Joël

2017-08-01

Errors in hospitals during the preparation and administration of intravenous drugs to infants and children have been reported to a rate of 13% to 84%. This study aimed to investigate the potential for hazardous events that may lead to an accident for preparation and administration of drug injection in a pediatric department and to describe a reduction plan of risks. The preliminary hazard analysis (PHA) method was implemented by a multidisciplinary working group over a period of 5 months (April-August 2014) in infants aged from 28 days to 2 years. The group identified required hazard controls and follow-up actions to reduce the error risk. To analyze the results, the STATCART APR software was used. During the analysis, 34 hazardous situations were identified, among 17 were quoted very critical and drawn 69 risk scenarios. After follow-up actions, the scenarios with unacceptable risk declined from 17.4% to 0%, and these with acceptable under control from 46.4% to 43.5%. The PHA can be used as an aid in the prioritization of corrective actions and the implementation of control measures to reduce risk. The PHA is a complement of the a posteriori risk management already exists. © 2017 John Wiley & Sons, Ltd.

L-Band Digital Aeronautical Communications System Engineering - Initial Safety and Security Risk Assessment and Mitigation

NASA Technical Reports Server (NTRS)

Zelkin, Natalie; Henriksen, Stephen

2011-01-01

This document is being provided as part of ITT's NASA Glenn Research Center Aerospace Communication Systems Technical Support (ACSTS) contract NNC05CA85C, Task 7: "New ATM Requirements--Future Communications, C-Band and L-Band Communications Standard Development." ITT has completed a safety hazard analysis providing a preliminary safety assessment for the proposed L-band (960 to 1164 MHz) terrestrial en route communications system. The assessment was performed following the guidelines outlined in the Federal Aviation Administration Safety Risk Management Guidance for System Acquisitions document. The safety analysis did not identify any hazards with an unacceptable risk, though a number of hazards with a medium risk were documented. This effort represents a preliminary safety hazard analysis and notes the triggers for risk reassessment. A detailed safety hazards analysis is recommended as a follow-on activity to assess particular components of the L-band communication system after the technology is chosen and system rollout timing is determined. The security risk analysis resulted in identifying main security threats to the proposed system as well as noting additional threats recommended for a future security analysis conducted at a later stage in the system development process. The document discusses various security controls, including those suggested in the COCR Version 2.0.

Test and Evaluation Master Plan (TEMP) for the Navy Occupational Health Information Management System (NOHIMS). Appendix A through Appendix U.

DTIC Science & Technology

1985-04-24

reliability/ downtime/ communication lines/ man-machine interface/ other: 2. A noticeable (to the user) failure happens about and that number has been...improving/ steady/ getting.worse. 3. The number of failures /errors for NOHIMS is acceptable/ somewhat acceptable/ somewhat unacceptable/ unacceptable...somewhat fast/ somewhat slow/ slow. 7. When a NWHIMS failure occurs, it affects the day-to-day provision of medical care because work procedures must

Beliefs about Emotions, Depression, Anxiety and Fatigue: A Mediational Analysis.

PubMed

Sydenham, Mia; Beardwood, Jennifer; Rimes, Katharine A

2017-01-01

Beliefs that it is unacceptable to experience or express negative emotions have been found to be associated with various clinical problems. It is unclear how such beliefs, which could be viewed as a form of unhelpful perfectionism about emotions, may contribute to symptomatology. This study investigated two hypotheses: a) greater endorsement of beliefs about the unacceptability of negative emotions will be associated with greater emotional avoidance and lower levels of support-seeking and self-compassion; b) these beliefs about emotions will be associated with higher levels of symptoms of depression, anxiety and fatigue and that this relationship will be mediated by social support-seeking, emotional avoidance and self-compassion. Online questionnaires were completed by 451 community participants. Mediational analyses were undertaken to investigate emotional avoidance, social support-seeking and self-compassion as mediators of the relationship between beliefs about emotions and symptoms of depression, anxiety and fatigue. Beliefs about the unacceptability of negative emotions were significantly associated with more emotional avoidance and less self-compassion and support-seeking. The relationships between beliefs about emotions and depression, anxiety and fatigue were significantly mediated by self-compassion and emotional avoidance but not social support-seeking. Future research should investigate whether interventions that pay particular attention to emotional avoidance and self-compassion, such as mindfulness-based therapy or modified forms of CBT, may be beneficial in reducing distress and fatigue associated with beliefs about the unacceptability of negative emotions.

The attitudes of dental students towards socially acceptable and unacceptable group working practices.

PubMed

Sisson, K; Newton, J

2007-08-01

To explore the attitudes of undergraduate dental students towards academically unacceptable behaviour. Three sets of vignettes were designed exploring; attitudes towards sharing essays which students present as their own work (set 1), attitudes towards purchasing an essay from a commercial website (set 2), and attitudes towards working in a group (set 3). Eighty-nine dental students read the vignettes, then indicated whether they felt the student depicted should engage in the behaviour, and whether any assessment of the work would be a fair assessment of the student's ability. In addition for the group working vignette, respondents were asked to indicate whether in that situation they would speak to the tutor about their own contribution to the group product. Twenty-one respondents (24%) reported that students should share essays, 11 (12%) felt that the essay would be a fair assessment; 13 (15%) felt that students should buy commercially produced essays, five (6%) felt it would be a fair assessment. For the vignettes involving group work, 31 (35%) respondents felt that group-based assessments were fair, 65 (73%) of respondents felt it unlikely that they would speak to the tutor about their individual contribution. A disturbing proportion of dental students report that cheating is acceptable, the majority feel that unacceptable academic practices are not a fair indication of students' ability. The respondents reported that they were unlikely to report the unacceptable working practices of fellow students.

Pediatric nurses' differentiations between acceptable and unacceptable parent discipline behaviors: a Q-study.

PubMed

Ho, Grace W K; Gross, Deborah A

2015-01-01

Nurses are mandated to report suspected cases of child maltreatment. However, it is unclear how nurses decide what constitutes child abuse or evidence for reporting. It is crucial to examine how nurses define various forms of child maltreatment, including child abuse and its differentiation from physical discipline, to enhance our services to families with young children. The present study examined pediatric nurses' views on acceptable versus unacceptable discipline behaviors to better understand parent behaviors that nurses are likely to deem reportable to child protective services. Using Q methodology, a convenience sample of 48 pediatric nurses from one urban medical center sorted 71 statements related to the behavior or outcome of punishing a child via the Internet application FlashQ. The statements were sorted on a predefined continuum ranging from "Most Unacceptable" to "Most Acceptable." By-person factor analysis was used to uncover groups of nurses with similar sorts and to generate a unique sort that represented the viewpoint of nurses in that group. Two distinct viewpoints were uncovered. Although there was consensus on what constitutes most acceptable and most unacceptable parent behaviors, nurses varied on their endorsement of using physical force as a form of discipline, suggesting a potential for discrepant tendencies to identify and report child abuse. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Beyond Maastricht IV: are standard empiric triple therapies for Helicobacter pylori still useful in a South-European country?

PubMed

Almeida, Nuno; Donato, Maria Manuel; Romãozinho, José Manuel; Luxo, Cristina; Cardoso, Olga; Cipriano, Maria Augusta; Marinho, Carol; Fernandes, Alexandra; Calhau, Carlos; Sofia, Carlos

2015-02-15

Empiric triple treatments for Helicobacter pylori (H. pylori) are increasingly unsuccessful. We evaluated factors associated with failure of these treatments in the central region of Portugal. This single-center, prospective study included 154 patients with positive (13)C-urea breath test (UBT). Patients with no previous H. pylori treatments (Group A, n = 103) received pantoprazole 40 mg 2×/day, amoxicillin 1000 mg 12/12 h and clarithromycin (CLARI) 500 mg 12/12 h, for 14 days. Patients with previous failed treatments (Group B, n = 51) and no history of levofloxacin (LVX) consumption were prescribed pantoprazole 40 mg 2×/day, amoxicillin 1000 mg 12/12 h and LVX 250 mg 12/12 h, for 10 days. H. pylori eradication was assessed by UBT 6-10 weeks after treatment. Compliance and adverse events were assessed by verbal and written questionnaires. Risk factors for eradication failure were determined by multivariate analysis. Intention-to-treat and per-protocol eradication rates were Group A: 68.9% (95% CI: 59.4-77.1%) and 68.8% (95% CI: 58.9-77.2%); Group B: 52.9% (95% CI: 39.5-66%) and 55.1% (95% CI: 41.3-68.2%), with 43.7% of Group A and 31.4% of Group B reporting adverse events. Main risk factors for failure were H. pylori resistance to CLARI and LVX in Groups A and B, respectively. Another independent risk factor in Group A was history of frequent infections (OR = 4.24; 95% CI 1.04-17.24). For patients with no H. pylori resistance to CLARI, a history of frequent infections (OR = 4.76; 95% CI 1.24-18.27) and active tobacco consumption (OR = 5.25; 95% CI 1.22-22.69) were also associated with eradication failure. Empiric first and second-line triple treatments have unacceptable eradication rates in the central region of Portugal and cannot be used, according to Maastricht recommendations. Even for cases with no H. pylori resistance to the used antibiotics, results were unacceptable and, at least for CLARI, are influenced by history of frequent infections and tobacco consumption.

MRI-Guided Laser Interstitial Thermal Therapy for Epilepsy.

PubMed

North, Robert Y; Raskin, Jeffrey S; Curry, Daniel J

2017-10-01

MRI-guided laser interstitial thermal therapy for epilepsy (LITT-E) has become an established, minimally invasive alternative to traditional epilepsy surgery. LITT-E is particularly valuable in cases in which open surgery poses unacceptably high morbidity or patient preference precludes craniotomy. Here we present a focused review of technical details and application of LITT to both focal and generalized epilepsy. Copyright © 2017 Elsevier Inc. All rights reserved.

Comments on Economides and Ehlig-Economides,"Sequestering carbon dioxide in a closed underground volume," SPE 124430, October 2009

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

Oldenburg, Curt; Pruess, Karsten; Birkholzer, Jens

The paper examines the pressure increase resulting from injection of CO2 into a 1D radial system with closed boundaries. The finding is that unacceptably high pressures are obtained when only 1% or less of the pore volume is occupied by injected CO2. These results are used to make the general conclusion that large-scale CCS is not feasible.

Cardiac output and systemic vascular resistance: Clinical assessment compared with a noninvasive objective measurement in children with shock.

PubMed

Razavi, Asma; Newth, Christopher J L; Khemani, Robinder G; Beltramo, Fernando; Ross, Patrick A

2017-06-01

To evaluate physician assessment of cardiac output and systemic vascular resistance in patients with shock compared with an ultrasonic cardiac output monitor (USCOM). To explore potential changes in therapy decisions if USCOM data were available using physician intervention answers. Double-blinded, prospective, observational study in a tertiary hospital pediatric intensive care unit. Forty children (<18years) admitted with shock, requiring ongoing volume resuscitation or inotropic support. Two to 3 physicians clinically assessed cardiac output and systemic vascular resistance, categorizing them as high, normal, or low. An investigator simultaneously measured cardiac index (CI) and systemic vascular resistance index (SVRI) with USCOM categorized as high, normal, or low. Overall agreement between physician and USCOM for CI (48.5% [κ = 0.18]) and SVRI (45.9% [κ = 0.16]) was poor. Interobserver agreement was also poor for CI (58.7% [κ = 0.33]) and SVRI (52.3% [κ = 0.28]). Comparing theoretical physician interventions to "acceptable" or "unacceptable" clinical interventions, based on USCOM measurement, 56 (21%) physician interventions were found to be "unacceptable." There is poor agreement between physician-assessed CI and SVRI and USCOM, with significant interobserver variability among physicians. Objective measurement of CI and SVRI may reduce variability and improve diagnostic accuracy. Copyright © 2016 Elsevier Inc. All rights reserved.

Consistent high clinical pregnancy rates and low ovarian hyperstimulation syndrome rates in high-risk patients after GnRH agonist triggering and modified luteal support: a retrospective multicentre study.

PubMed

Iliodromiti, Stamatina; Blockeel, Christophe; Tremellen, Kelton P; Fleming, Richard; Tournaye, Herman; Humaidan, Peter; Nelson, Scott M

2013-09-01

Are clinical pregnancy rates satisfactory and the incidence of OHSS low after GnRH agonist trigger and modified intensive luteal support in patients with a high risk of ovarian hyperstimulation syndrome (OHSS)? GnRH agonist trigger combined with 1500 IU hCG at the time of oocyte retrieval and subsequent estradiol and progesterone replacement in OHSS high-risk patients can facilitate fresh embryo transfer with high clinical pregnancy rates and a low risk of severe OHSS. Conventional luteal support packages are inadequate to facilitate a fresh transfer after a GnRH agonist trigger. A low dose of hCG (1500 IU) after oocyte aspiration can be used to replace the actions of early luteal LH to sustain implantation and the function of the early corpus luteum, although the level of risk of severe OHSS with this strategy is unclear. This international multicentre retrospective case study, including 275 women at high risk of OHSS, was undertaken during the period January 2011-December 2012. Women were identified as at high risk of OHSS, based on IVF response, ovarian reserve characteristics and previous history of having had treatment, in three clinical IVF centres in UK, Belgium and Australia. All three centres used a GnRH agonist trigger followed by one bolus of 1500 IU hCG 1h after oocyte retrieval. Moreover, the luteal phase was supported with daily vaginal progesterone and twice daily estradiol valerate. A total of 275 autologous cycles with fresh transfer were undertaken in a cohort of high-risk women as defined by baseline characteristics [median (interquartile range)]: age 31.6 (29-35) years, antral follicle count median 25 (18-34) and anti-Müllerian hormone median 49.1 pmol/l (35.2-69.3). At the end of stimulation, the peak estradiol median of 12 000 pmol/l (9400-15 914) and the mean oocyte yield of 17.8 ± 8.4 confirmed a high response. The overall clinical pregnancy rate was 41.8% per cycle started, with only two cases of severe OHSS reported (0.72%). No significant differences in clinical pregnancy rates between centres were identified. This is a retrospective study and future randomized controlled trials will be able to compare whether these outcomes can be improved upon by either segmentation of the stimulation cycle and embryo transfer or alternative aggressive luteal support strategies. In women who are undergoing ovarian stimulation and who develop an excessive ovarian response, the use of a GnRH agonist trigger combined with modified luteal support can provide the opportunity to proceed to fresh embryo transfer with adequate clinical pregnancy rates. However, this procedure will not completely eliminate the risk of OHSS and for women with an extreme ovarian response or with significant comorbidity, where the possibility of severe OHSS is unacceptable, we recommend GnRH agonist trigger followed by a freeze-all policy to completely avoid OHSS.

Drug desensitization in the management of hypersensitivity reactions to monoclonal antibodies and chemotherapy.

PubMed

Mezzano, Veronica; Giavina-Bianchi, Pedro; Picard, Matthieu; Caiado, Joana; Castells, Mariana

2014-04-01

Hypersensitivity reactions to monoclonal antibodies and chemotherapy, which may vary in severity from mild to life-threatening, can lead to their discontinuation and replacement by alternative agents that are often less effective, more toxic, and/or more expensive. Drug desensitization has emerged as the best treatment modality capable of allowing re-introduction of the hypersensitivity reaction-inducing medication in highly sensitized patients in need of first line therapies. In recent years, the availability of new anti-neoplastic drugs and therapeutic monoclonal antibodies has increased, as has the potential for hypersensitivity reactions. Development of desensitization protocols for these new medications requires a careful assessment of the potential risks and benefits. The purposes of this review are to provide an overview of the presentation of hypersensitivity reactions amenable to desensitization and to increase awareness of the indications for and outcomes of desensitization protocols. Rapid drug desensitization has proven to be a safe and effective way of administering first line therapy to patients with hypersensitivity reactions, providing an extremely powerful treatment modality for patients for whom alternative drugs are deemed unacceptable. Rapid drug desensitization protocols should be administered only by highly trained allergists and nurses who have experience in determining which reactions are amenable to desensitization, and can identify high risk patients and provide them with appropriate care. Efforts should be made to increase awareness of the remarkable safety and efficacy of rapid drug desensitization among non-allergists, especially in the fields of oncology and rheumatology, so as to favor its universal application. Development of desensitization units to provide state-of-the-art care is possible only through coordinated teamwork.

Specification Section 01065S ES&H for Service Contracts

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

Kirsch, Greg C.

2014-07-01

Section Includes: Requirements and guidelines in performance of work concerning protection of environment and property, and the safety and health of Contractors, Sandia National Laboratories (SNL) and Department of Energy (DOE) employees, visitors to SNL, and members of the public. This Section is applicable only to Service Contracts that do not involve construction or construction-like activities. Construction and construction-like activities are covered by Section 01065, Environment, Safety and Health (ES&H) for Construction Contracts. The entire ES&H program shall focus on safe-by-design intent, understanding the technical basis for the work, identifying and controlling energy sources, unacceptable consequences, risk assessments, and positivemore » verification.« less

Tooth Whitening: What We Now Know

PubMed Central

Carey, Clifton M.

2014-01-01

Declarative Title Current research about tooth whitening shows that it is safe and effective when manufacturer’s protocol is followed, yet there are risks of which the profession and users should be aware. This update provides a summary of current research and assessment of the safety and efficacy of tooth whitening regimens. Background Tooth whitening has become one of the most frequently requested dental procedures by the public. The public has come to demand whiter, more perfect smiles and in response many choices for tooth whitening have been made available. These include home-based products such as toothpastes, gels, and films, as well as in-office based systems where products containing highly concentrated bleaching agents are applied under professional supervision. The profession and public have been aware of certain risks related to tooth whitening such as increased tooth sensitivity and gingival irritation. New research has shown that there are other risks such as tooth surface roughening and softening, increased potential for demineralization, degradation of dental restorations, and unacceptable color change of dental restorations. The new research is also focused on optimizing whitening procedures to reduce tooth sensitivity and to increase the persistence of the whitening. Methods Current reports in the literature are reviewed that are related to the use of peroxide based whitening methods. These reports include in vitro studies for method optimization and mechanism as well as clinical studies on effects of various whitening regimens. Conclusions When manufacturer’s instructions are followed, hydrogen peroxide and carbamide peroxide based tooth whitening is safe and effective. Patients should be informed of the risks associated with tooth whitening and instructed on identification of adverse occurrences so that they may seek professional help asneeded. PMID:24929591

Sale of cigarettes to school children aged 14 and 15 years in New Zealand.

PubMed

Ford, D J; Scragg, R; Weir, J

1997-06-27

To determine the sources of cigarettes and extent of illegal sales to 14 and 15 year old children, and to examine associated risk factors in order to more effectively reduce tobacco access to children. Nationwide cross sectional survey of fourth form school children in New Zealand by means of an anonymous self administered questionnaire. Questionnaires from 14,097 fourteen and fifteen years olds were analysed, with over one third smokers. Twenty four percent of the whole group (3432) had bought cigarettes in the last year. Of smokers, 59.9% bought their own, with the great majority (68.9%) from dairies, particularly females. Ninety five percent said it was "easy" or "very easy" to buy cigarettes, and this was a major risk factor for this behaviour (relative risk (RR) = 2.01, 95% confidence interval (CI) 1.74, 2.32, RR = 2.54, CI 2.28, 2.83, respectively). Only 24.6% children had ever been refused cigarettes because of age and all points of sale were comparable in this respect. Heavy smokers and males were more likely to have been refused. While refusal was associated with a fourfold increase in the perception that it was difficult to buy cigarettes, there was only a minimal reduction in the risk of children buying their own cigarettes (RR = 0.95, CI 0.91, 1.00). We have shown that the illegal sale of cigarettes to children is unacceptably easy and accurately perceived as such by children who smoke. The active enforcement of existing or future legislation is essential, with prosecution of offending retailers, if we are to make any progress to reduce the high prevalence of smoking in New Zealand children.

Patient-reported immunosuppression nonadherence 6 to 24 months after liver transplant: association with pretransplant psychosocial factors and perceptions of health status change

PubMed Central

Rodrigue, James R.; Nelson, David R.; Hanto, Douglas W.; Reed, Alan I.; Curry, Michael P.

2014-01-01

Context Knowing the prevalence and risk factors of immunosuppression nonadherence after liver transplant may help guide intervention development. Objective To examine whether sociodemographic and psychosocial variables before liver transplant are predictive of nonadherence after liver transplant. Design Structured telephone interviews were used to collect self-report immunosuppression adherence and health status information. Medical record reviews were then completed to retrospectively examine the relationship between immunosuppression adherence and pretransplant variables, including sociodemographic and medical characteristics and the presence or absence of 6 hypothesized psychosocial risk factors. Setting and Participants A nonprobability sample of 236 adults 6 to 24 months after liver transplant at 2 centers completed structured telephone interviews. Main Outcome Measure Immunosuppressant medication nonadherence, categorized as missed-dose and altered-dose “adherent” or “nonadherent” during the past 6 months; immunosuppression medication holidays. Results Eighty-two patients (35%) were missed-dose nonadherent and 34 patients (14%) were altered-dose nonadherent. Seventy-one patients (30%) reported 1 or more 24-hour immunosuppression holidays in the past 6 months. Missed-dose nonadherence was predicted by male sex (odds ratio, 2.46; P = .01), longer time since liver transplant (odds ratio, 1.08; P = .01), pretransplant mood disorder (odds ratio, 2.52; P = .004), and pretransplant social support instability (odds ratio, 2.25; P = .03). Altered-dose nonadherence was predicted by pretransplant mood disorder (odds ratio, 2.15; P = .04) and pretransplant social support instability (odds ratio, 1.89; P = .03). Conclusion Rates of immunosuppressant nonadherence and drug holidays in the first 2 years after liver transplant are unacceptably high. Pretransplant mood disorder and social support instability increase the risk of nonadherence, and interventions should target these modifiable risk factors. PMID:24311395

Predictors of hip fracture mortality at a general hospital in South Brazil: an unacceptable surgical delay

PubMed Central

Ribeiro, Tiango Aguiar; Premaor, Melissa Orlandin; Larangeira, João Alberto; Brito, Luiz Giulian; Luft, Michel; Guterres, Leonardo Waihrich; Monticielo, Odirlei André

2014-01-01

OBJECTIVE: Hip fractures have been associated with increased mortality in the elderly. Several risk factors such as the time between the insult and the surgical repair have been associated with hip fracture mortality. Nevertheless, the risk of delayed surgical repair remains controversial. Few studies have examined this issue in Brazil. The aim of this study was to study the risk factors for death one year after hip fracture and in-hospital stay at a tertiary hospital in South Brazil. METHODS: A prospective cohort study was carried out from April 2005 to April 2011 at a tertiary university hospital at Santa Maria, Brazil. Subjects admitted for hip fracture who were 65 years of age or older were followed for one year. Information about fracture type, age, gender, clinical comorbidities, time to surgery, discharge, and American Society of Anesthesiologists score were recorded. Death was evaluated during the hospital stay and at one year. RESULTS: Four hundred and eighteen subjects were included in the final analysis. Of these, 4.3% died in-hospital and 15.3% were dead at one year. Time to surgery, American Society of Anesthesiologists score, Ischemic Heart Disease, and in-hospital stay were associated with death at one year in the univariate analysis. The American Society of Anesthesiologists score and time to surgery were one-year mortality predictors in the final regression model. In-hospital death was associated with American Society of Anesthesiologists score and age. CONCLUSION: Time to surgery is worryingly high at the South Brazil tertiary public health center studied here. Surgical delay is a risk factor that has the potential to be modified to improve mortality. PMID:24714833

Prophylactic Nipple-Sparing Mastectomy and Direct-to-Implant Reconstruction of the Large and Ptotic Breast: Is Preshaping of the Challenging Breast a Key to Success?

PubMed

Gunnarsson, Gudjon L; Bille, Camilla; Reitsma, Laurens C; Wamberg, Peter; Thomsen, Jørn Bo

2017-09-01

Nipple-sparing mastectomy with simultaneous hammock technique direct-to-implant reconstruction is increasingly offered to patients opting for risk-reducing mastectomy. Despite this promising method, patients with macromastia and ptotic breasts remain a challenging group to treat satisfactorily and more often end up undergoing a difficult corrective procedure and experience an unacceptably high rate of failed reconstruction. The authors examined whether targeted preshaping mastopexy/reduction could prepare these patients for a successful nipple-sparing mastectomy/direct-to-implant reconstruction. Patients seeking risk-reducing nipple-sparing mastectomy/direct-to-implant reconstruction at the authors' institutions deemed unfit for a one-stage procedure based on their previous experience were offered a targeted two-stage, risk-reducing mastopexy/reduction followed by a delayed secondary nipple-sparing mastectomy and direct-to-implant reconstruction. Patients were followed up at 3 weeks and 6 or 12 months. Forty-four reconstructions were performed in 22 patients aged 43 years (range, 26 to 57 years). All 44 procedures were completed successfully without any failure or nipple-areola complex losses. Patients' median body mass index was 30 kg/m (range, 22 to 44 kg/m). Six patients were smokers and one had hypertension. Two patients underwent reoperation because of hematoma and fat necrosis. The authors' results demonstrate that a targeted preshaping mastopexy/reduction followed by nipple-sparing mastectomy/direct-to-implant reconstruction can be safely planned in women who opt for a risk-reducing mastectomy and can be performed successfully with a 3- to 4-month time span between operations. On the basis of these results and the superior cosmetic outcome, the two-stage approach has become the authors' standard of care in all such settings. Therapeutic, IV.

Effects of health care provider work hours and sleep deprivation on safety and performance.

PubMed

Lockley, Steven W; Barger, Laura K; Ayas, Najib T; Rothschild, Jeffrey M; Czeisler, Charles A; Landrigan, Christopher P

2007-11-01

There has been increasing interest in the impact of resident-physician and nurse work hours on patient safety. The evidence demonstrates that work schedules have a profound effect on providers' sleep and performance, as well as on their safety and that of their patients. Nurses working shifts greater than 12.5 hours are at significantly increased risk of experiencing decreased vigilance on the job, suffering an occupational injury, or making a medical error. Physicians-in-training working traditional > 24-hour on-call shifts are at greatly increased risk of experiencing an occupational sharps injury or a motor vehicle crash on the drive home from work and of making a serious or even fatal medical error. As compared to when working 16-hours shifts, on-call residents have twice as many attentional failures when working overnight and commit 36% more serious medical errors. They also report making 300% more fatigue-related medical errors that lead to a patient's death. The weight of evidence strongly suggests that extended-duration work shifts significantly increase fatigue and impair performance and safety. From the standpoint of both providers and patients, the hours routinely worked by health care providers in the United States are unsafe. To reduce the unacceptably high rate of preventable fatigue-related medical error and injuries among health care workers, the United States must establish and enforce safe work-hour limits.

Anaphylaxis, Intra-Abdominal Infections, Skin Lacerations, and Behavioral Emergencies: A Literature Review of Austere Analogs for a near Earth Asteroid Mission

NASA Technical Reports Server (NTRS)

Chough, Natacha G.; Watkins, Sharmi; Menon, Anil S.

2012-01-01

As space exploration is directed towards destinations beyond low-Earth orbit, the consequent new set of medical risks will drive requirements for new capabilities and more resources to ensure crew health. The Space Medicine Exploration Medical Conditions List (SMEMCL), developed by the Exploration Medical Capability element of the Human Research Program, addresses the risk of "unacceptable health and mission outcomes due to limitations of in-flight medical capabilities". It itemizes 85 evidence-based clinical requirements for eight different mission profiles and identifies conditions warranting further research and technology development. Each condition is given a clinical priority for each mission profile. Four conditions -- intra-abdominal infections, skin lacerations, anaphylaxis, and behavioral emergencies -- were selected as a starting point for analysis. A systematic literature review was performed to understand how these conditions are treated in austere, limited-resource, space-analog environments (i.e., high-altitude and mountain environments, submarines, military deployments, Antarctica, isolated wilderness environments, in-flight environments, and remote, resource-poor, rural environments). These environments serve as analogs to spaceflight because of their shared characteristics (limited medical resources, delay in communication, confined living quarters, difficulty with resupply, variable time to evacuation). Treatment of these four medical conditions in austere environments provides insight into medical equipment and training requirements for exploration-class missions.

Emerging Applications of Stem Cell and Regenerative Medicine to Sports Injuries

PubMed Central

Ajibade, David A.; Vance, Danica D.; Hare, Joshua M.; Kaplan, Lee D.; Lesniak, Bryson P.

2014-01-01

Background: The treatment of sports-related musculoskeletal injuries with stem cells has become more publicized because of recent reports of high-profile athletes undergoing stem cell procedures. There has been increased interest in defining the parameters of safety and efficacy and the indications for potential use of stem cells in clinical practice. Purpose: To review the role of regenerative medicine in the treatment of sports-related injuries. Study Design: Review. Method: Relevant studies were identified through a PubMed search combining the terms stem cells and cartilage, ligament, tendon, muscle, and bone from January 2000 to August 2013. Studies and works cited in these studies were also reviewed. Results: Treatment of sports-related injuries with stem cells shows potential for clinical efficacy from the data available from basic science and animal studies. Conclusion: Cell-based therapies and regenerative medicine offer safe and potentially efficacious treatment for sports-related musculoskeletal injuries. Basic science and preclinical studies that support the possibility of enhanced recovery from sports injuries using cell-based therapies are accumulating; however, more clinical evidence is necessary to define the indications and parameters for their use. Accordingly, exposing patients to cell-based therapies could confer an unacceptable risk profile with minimal or no benefit. Continued clinical testing with animal models and clinical trials is necessary to determine the relative risks and benefits as well as the indications and methodology of treatment. PMID:26535296

Predicting children's behaviour during dental treatment under oral sedation.

PubMed

Lourenço-Matharu, L; Papineni McIntosh, A; Lo, J W

2016-06-01

The primary aim of this study was to assess whether parents' own anxiety and their perception of their child's dental fear and child's general fear can predict preoperatively their child's behaviour during dental treatment under oral sedation. The secondary aim was to assess whether the child's age, gender and ASA classification grade are associated with a child's behaviour under oral sedation. Cross-sectional prospective study. The Corah's Dental Anxiety Scale (DAS), Children's Fear Survey Schedule Dental-Subscale (CFSS-DS) and Children's Fear Survey Schedule Short-Form (CFSS-SF) questionnaires were completed by parents of children undergoing dental treatment with oral midazolam. Behaviour was rated by a single clinician using the overall behaviour section of the Houpt-Scale and scores dichotomised into acceptable or unacceptable behaviour. Data were analysed using χ (2), t test and logistic regression analysis. In total 404 children (215 girls, 53 %) were included, with the mean age of 4.57 years, SD = 1.9. Behaviour was scored as acceptable in 336 (83 %) and unacceptable in 68 (17 %) children. The level of a child's dental fear, as perceived by their parent, was significantly associated with the behaviour outcome (p = 0.001). Logistic regression analysis revealed that if the parentally perceived child's dental fear (CFSS-DS) rating was high, the odds of the child exhibiting unacceptable behaviour under oral sedation was two times greater than if their parents scored them a low dental fear rating (OR 2.27, 95 % CI 1.33-3.88, p = 0.003). CFSS-DS may be used preoperatively to help predict behaviour outcome when children are treated under oral sedation and facilitate treatment planning.

[Sexual violence in Congo-Kinshasa: necessity of decriminalizing abortion].

PubMed

Kalonda, J C Omba

2012-01-01

The sexual violence's committed in the Democratic Republic of Congo (DRC) are from their scales and consequences on women, real public health, politico-legal, and socio-economical challenges. More than a million of women have been victims of sexual violence on a period of less than fifteen years. Systematic rapes of women were used as war weapon by different groups involved in the Congolese war. Sexual violence against women has impacted public health by spreading sexually transmissible diseases including HIV/AIDS, causing unwanted pregnancies, leading to the gynaecological complications of rape-related injuries, and inflicting psychological trauma on the victims. Despite high level of unwanted pregnancies observed, the Congolese law is very restrictive and interdict induced abortion. This paper presents three arguments which plead in favour of legalizing abortion in DRC: 1) a restrictive law on abortion forces women to use unsafe abortion and increase incidence of injuries and maternal mortality ; 2) DRC has ratified the universal Declaration of human rights, the African union charter, and has than to promote equality between sexes, in this is included women reproductive rights; 3) an unwanted birth is an additional financial charge for a woman, a factor increasing poverty and psychologically unacceptable in case of rape. From the politico-legal point of view, ending rape impunity and decriminalizing abortion are recommended. Decriminalizing abortion give women choice and save victims and pregnant women from risks related to the pregnancy, a childbirth, or an eventual unsafe abortion. These risks increase the maternal mortality already high in DRC (between 950 and 3000 for 100000 live births).

Influence of Lifestyle Factors on Risk of Dental Caries among Children Living in Urban China.

PubMed

Kanemoto, Taeko; Imai, Hiroki; Sakurai, Atsuo; Dong, Hongwei; Shi, Sizhen; Yakushiji, Masashi; Shintani, Seikou

2016-01-01

The prevalence of dental caries has been decreasing among kindergarten children in Shanghai, China, over recent years, although it still remains at an unacceptably high level. The purpose of this study was to identify which factors were important in providing oral health guidance and achieving further improvement in the oral health status of kindergarten children in urban China. A survey was conducted on dental caries in 128 Japanese and 368 Chinese kindergarten children and a questionnaire given to their parents/guardians on each child's lifestyle and dietary habits from birth to the present. Correlations between responses to each questionnaire item and the status of dental caries were statistically analyzed. The dft index score (p=0.0016), prevalence of dental caries (p=0.0002), and percentages of children with decayed (untreated caries-affected) teeth (p<0.0001) were significantly higher in the Chinese than in the Japanese children. Many differences were observed in lifestyle factors between the two groups. The percentage of parents failing to control the child's snacking habits between meals was higher in China, and weaning was significantly delayed in China compared with in Japan. These lifestyle factors were considered to be associated closely with the high risk of dental caries in Chinese kindergarten children. These findings indicate that oral health guidance for kindergarten children in Shanghai, China, should focus on control of dietary habits, including control of inter-meal snacking, and breastfeeding practices. The results of this study may help improve the status of dental caries among Chinese children.

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

Hattemer-Frey, H.A.; Brandt, E.J.; Travis, C.C.

Commercial genetic engineering is advancing into areas that require the small-scale introduction of genetically engineered microorganisms (GEMs) to better quantify variables that affect microorganism distribution and survival and to document potential long-term consequences. A recombinant DNA marker system, the lacZY marker, developed by the Monsanto Agricultural Co., enables the distribution and fate of marked fluorescent pseudomonad organisms to be monitored under actual field conditions. Critical evaluation of GEMs under field conditions is imperative if plant-beneficial effects are to be correlated with organism release. This paper evaluates the effectiveness of this marker system and its ability to facilitate the assessment ofmore » risks associated with deliberate environmental introductions of genetically engineered microorganisms. Results of prerelease contained growth chamber and field experiments demonstrated that: (1) the scientific risk assessment methodology adopted by Monsanto and approved by the U.S. Environmental Protection Agency was appropriate and comprehensive; (2) the deliberate introduction of a GEM did not pose unacceptable or unforeseen risks to human health or the environment; (3) the lacZY marker is an effective environmental tracking tool; and (4) regulatory oversight should reflect the expected risk and not be excessively burdensome for all GEMs.« less

Evaluation of triclosan in Minnesota lakes and rivers: Part I - ecological risk assessment.

PubMed

Lyndall, Jennifer; Barber, Timothy; Mahaney, Wendy; Bock, Michael; Capdevielle, Marie

2017-08-01

Triclosan, an antimicrobial compound found in consumer products, may be introduced into the aquatic environment via residual concentrations in municipal wastewater treatment effluent. We conducted an aquatic risk assessment that incorporated the available measured triclosan data from Minnesota lakes and rivers. Although only data reported from Minnesota were considered in the risk assessment, the developed toxicity benchmarks can be applied to other environments. The data were evaluated using a series of environmental fate models to ensure the data were internally consistent and to fill any data gaps. Triclosan was not detected in over 75% of the 567 surface water and sediment samples. Measured environmental data were used to model the predicted environmental exposures to triclosan in surface water, surface sediment, and biota tissues. Toxicity benchmarks based on fatty acid synthesis inhibition and narcosis were determined for aquatic organisms based, in part, on a species sensitivity distribution of chronic toxicity thresholds from the available literature. Predicted and measured environmental concentrations for surface water, sediment, and tissue were below the effects benchmarks, indicating that exposure to triclosan in Minnesota lakes and rivers would not pose an unacceptable risk to aquatic organisms. Copyright © 2017 Elsevier Inc. All rights reserved.

For love and money: the need to rethink benefits in HIV cure studies

PubMed Central

Largent, Emily

2017-01-01

HIV cure research holds great potential to eradicate HIV, but the benefit to early trial participants is likely to be small. Moreover, participation carries unknown and possibly significant risks to research participants. This is the risk:benefit ratio challenge of HIV cure research. Although it may be consensual and rational for individuals to participate in HIV cure research that requires a degree of self-sacrifice, I argue that altruistic research participants can be exploited when the benefits to them are unfair. Transactions of this kind should not be prohibited, as that would be unacceptably paternalistic and thwart socially valuable research. Nevertheless, we should not simply accept these transactions but must work to reduce or eliminate exploitation by enhancing the benefits so that research participants are better off by their own lights. Offering payment in HIV cure research is the optimal way to enhance benefits to research participants and to make the risk:benefit ratio more favourable. I argue for a payment-as-benefit model against the standard view, assumed in ethics and policy, that offers of payment are not legitimate benefits. PMID:27193021

Evolution of trends in risk management.

PubMed

Aziz, Farah; Khalil, Alizan; Hall, John C

2005-07-01

In the past, the detection and response to adverse clinical events were viewed as an inherent part of professionalism; and, if perceived problems were not sorted out at that level, the ultimate expression of dissatisfaction was litigation. There are now demands for the adoption of more transparent and effective processes for risk management. Reviews of surgical practice have highlighted the presence of unacceptable levels of avoidable adverse events. This is being resolved in two ways. First, attention is being directed to the extent that training and experience have on outcomes after surgery, and both appear to be important. Second, a greater appreciation of human factors engineering has promoted a greater involvement of surgeons in processes involving teamwork and non-technical skills. The community wants surgeons who are competent and health-care systems that minimize risk. In recent times attention has been focused on the turmoil associated with change; but, when events are viewed over a period of several decades, there has been considerable progress towards these ideals. Further advancement would be aided by removing the adversarial nature of malpractice systems that have failed to maintain standards.

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.

Smokeless tobacco addiction: a threat to the oral and systemic health of the child and adolescent.

PubMed

Christen, A G; McDonald, J L; Olson, B L; Christen, J A

1989-01-01

The use of smokeless tobacco (ST) within the United States has increased greatly in recent years, especially among adolescent boys and young men. Recent national data completed from several large scale studies indicate that 10-12 million Americans use some form of ST. Representing a significant systemic and oral health risk, ST usage can produce a wide range of negative effects on both soft and hard oral tissues. These oral conditions include bad breath, discolored teeth and restorative materials, excessive tooth surface wear (abrasion), decreased ability to taste and smell, gingival (gum) recession, advanced periodontal soft and hard tissue destruction, tooth loss, soft tissue erythema and leukoplakia. Long-term ST usage is directly correlated to an increased risk of cancer of the mouth, larynx, throat and esophagus. Much of the destruction of oral tissues is related to the localization of the tobacco quid; i.e., it is habitually held in only one spot in the mouth. Nicotine from ST can activate the sympathetic nervous system thereby significantly increasing heart rate, blood pressure, cardiac stroke volume and output and coronary blood flow. A common misconception is that ST is a 'safe' alternative to smoking cigarettes. Several recent Surgeon General's Reports list ST as being addictive. It is highly possible that ST users will 'graduate' to cigarettes if they eventually conclude that these products are socially unacceptable, inconvenient or out of vogue. Health professionals, educators, parents and schoolchildren need to be informed about the significant health risks associated with ST use.

Caregivers’ perspectives on decision making about lung transplantation in cystic fibrosis

PubMed Central

Dellon, Elisabeth P.; Shores, Mitchell D.; Nelson, Katherine I.; Wolfe, Joanne; Noah, Terry L.; Hanson, Laura C.

2013-01-01

Context Lung transplantation extends survival for some patients with advanced cystic fibrosis, but it is complicated, has many potential risks, and its outcomes are difficult to predict. No standards exist for informed decision making about transplantation. Objective To assess decision making from the perspective of caregivers of patients who faced the transplant decision before dying of cystic fibrosis or transplant complications. Design Semistructured interviews with descriptive and qualitative content analysis. Participants Twenty-eight caregivers of patients with cystic fibrosis who received care at our center and died between 1996 and 2006. Results Of 28 patients who considered lung transplantation, 19 (68%) received transplants, 6 (21%) died while waiting for transplant, and 3 (11%) declined transplant. Three caregivers (11%) thought that the patient did not fully understand the reason for transplant referral. Five (18%) thought that the patient did not fully understand potential risks. Ten (36%) thought that alternatives were not fully understood. The only alternatives to transplant identified, progressive illness and the possibility of earlier death without transplant, were unacceptable to most. Thirteen caregivers (46%) reported that the patient thought that declining transplant was not an option. Caregivers described the decision as “easy” for 19 (68%), often expressing a sentiment of “do or die.” Those who described the decision as “easy” recalled fewer elements of informed decision making. Conclusions From caregivers’ reports, patients with cystic fibrosis may not fully understand risks of and alternatives to lung transplantation. Because a strong desire to prolong life necessitates honest communication about potential outcomes, interventions are needed to facilitate high-quality decision making. PMID:20050454

Exposure assessment of carcass disposal options in the event of a notifiable exotic animal disease: application to avian influenza virus.

PubMed

Pollard, Simon J T; Hickman, Gordon A W; Irving, Phil; Hough, Rupert L; Gauntlett, Daniel M; Howson, Simon F; Hart, Alwyn; Gayford, Paul; Gent, Nick

2008-05-01

We present a generalized exposure assessment of 28 disposal options for poultry carcasses in the event of a highly pathogenic avian influenza (HPAI) outbreak. The analysis supports a hereto unverified disposal hierarchy for animal carcasses, placing waste processing (e.g., incineration and rendering) above controlled disposal (e.g., landfill), above uncontrolled disposal (e.g., burial on-farm). We illustrate that early stages of the disposal chain (on-farm) pose greater opportunities for exposure to hazardous agents than later stages, where agents are generally contained, wastes are treated, and residues are managed by regulated processes. In selecting carcass disposal options, practitioners are advised to consider the full range of hazards rather than focusing solely on the HPAI agent, and to give preference to technologies that (i) offer high destruction efficiencies for target pathogens; (ii) do not give rise to significant releases of other pathogenic organisms; and (iii) do not release unacceptable concentrations of toxic chemicals. The approach offers an exposure assessment perspective for carcass disposal, thus providing a risk-informed basis for contingency planning and operational intervention. The authors recognize that relevant legislation, public perception, available capacity, and cost also need to be considered when selecting disposal options in the event of HPAI.

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

PubMed

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

2013-08-09

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

Vaccine-derived polioviruses.

PubMed

Agol, Vadim I

2006-06-01

The Sabin oral poliovaccine (OPV) is extremely efficacious and safe, despite its inherent genetic instability. While reversion to nearly wild-type phenotype regularly occurs soon after the onset of OPV reproduction in the gastro-intestinal tract of vaccine recipients or their contacts, this is usually not a big problem, provided the vaccine is used either for mass vaccination or in populations with a relatively high level of anti-polio immunity. However, if these conditions are not met, the vaccine viruses are likely to be converted into highly transmissible agents with a nearly wild-type level of neurovirulence. Moreover, OPV viruses may persist and evolve even in adequately immunized populations. The current strategy for the "endgame" of poliovirus eradication envisions cessation of OPV usage shortly after the last isolation of a wild poliovirus. If implemented, this strategy would result in rapid growth of non-immune human populations at the time when OPV derivatives would very likely be persisting. Therefore, the planned cessation of OPV vaccination is associated with a very high, and in the author's opinion, unacceptable risk of polio outbreaks caused by OPV derivatives. The only currently available tool to curb such outbreaks is OPV, which should have been used at a global scale. Safe discontinuation of OPV vaccination will be possible only after an efficient new vaccine or an anti-poliovirus drug is available. To achieve this goal, stimulation of poliovirus research and elimination of organizational and financial obstacles preventing it are needed.

The Effect of Soil Properties on Metal Bioavailability: Field Scale Validation to Support Regulatory Acceptance

DTIC Science & Technology

2014-06-01

unacceptable levels of the toxic metal(loid)s arsenic (As), cadmium (Cd), chromium (Cr), and lead (Pb). With the exception of Pb contaminated soils, human...remediation and closure. Lead (Pb), arsenic (As), chromium (Cr), and cadmium (Cd) are toxic (i.e., capable of producing an unwanted, deleterious effect...lagoon are contaminated with high concentrations of lead , chromium, and cadmium . 14 Deseret Chemical Depot: The Deseret Chemical Depot is

p16 Is Superior to ProEx C in Identifying High-grade Squamous Intraepithelial Lesions (HSIL) of the Anal Can

PubMed Central

Bala, Rajeev; Pinsky, Benjamin A.; Beck, Andrew H.; Kong, Christina S.; Welton, Mark L.; Longacre, Teri A.

2016-01-01

Although the incidence of human papillomavirus (HPV)-associated anal neoplasia is increasing, interobserver and intraobserver reproducibility in the grading of biopsy specimens from this area remains unacceptably low. Attempts to produce a more reproducible grading scheme have led to the use of biomarkers for the detection of high-risk HPV (HR-HPV). We evaluated the performance of standard morphology and biomarkers p16, ProEx C, and Ki-67 in a set of 75 lesions [17 nondysplastic lesions, 23 low-grade squamous intraepithelial lesions (LSIL)/condyloma, 20 high-grade squamous intraepithelial lesions (HSIL), 15 invasive squamous cell carcinomas] from the anal and perianal region in 65 patients and correlated these findings with HPV subtype on the basis of a type-specific multiplex real-time polymerase chain reaction assay designed to detect HR-HPV. A subset of cases with amplifiable HPV DNA was also sequenced. HSIL was typically flat (15/20), and only a minority (4/20) had koilocytes. In contrast, only 1 LSIL was flat (1/23), and the remainder were exophytic. The majority of LSIL had areas of koilocytic change (20/23). HR-HPV DNA was detected in the majority (89%) of invasive carcinomas and HSIL biopsies, 86% and 97% of which were accurately labeled by strong and diffuse block-positive p16 and ProEx C, respectively. LSIL cases, however, only infrequently harbored HR-HPV (13%); most harbored low-risk HPV (LR-HPV) types 6 and 11. Within the LSIL group, p16 outperformed ProEx C, resulting in fewer false-positive cases (5% vs. 75%). Ki-67 was also increased in HR-HPV-positive lesions, although biopsies with increased inflammation and reactive changes also showed higher Ki-67 indices. These data suggest that strong and diffuse block-positive nuclear and cytoplasmic labeling with p16 is a highly specific biomarker for the presence of HR-HPV in anal biopsies and that this finding correlates with high-grade lesions. PMID:23552383

Risk assessment in the management of newly diagnosed classical Hodgkin lymphoma.

PubMed

Connors, Joseph M

2015-03-12

Treatment of Hodgkin lymphoma is associated with 2 major types of risk: that the treatment may fail to cure the disease or that the treatment will prove unacceptably toxic. Careful assessment of the amount of the lymphoma (tumor burden), its behavior (extent of invasion or specific organ compromise), and host related factors (age; coincident systemic infection; and organ dysfunction, especially hematopoietic, cardiac, or pulmonary) is essential to optimize outcome. Elaborately assembled prognostic scoring systems, such as the International Prognostic Factors Project score, have lost their accuracy and value as increasingly effective chemotherapy and supportive care have been developed. Identification of specific biomarkers derived from sophisticated exploration of Hodgkin lymphoma biology is bringing promise of further improvement in targeted therapy in which effectiveness is increased at the same time off-target toxicity is diminished. Parallel developments in functional imaging are providing additional potential to evaluate the efficacy of treatment while it is being delivered, allowing dynamic assessment of risk during chemotherapy and adaptation of the therapy in real time. Risk assessment in Hodgkin lymphoma is continuously evolving, promising ever greater precision and clinical relevance. This article explores the past usefulness and the emerging potential of risk assessment for this imminently curable malignancy. © 2015 by The American Society of Hematology.

Reliability and Confidence Interval Analysis of a CMC Turbine Stator Vane

NASA Technical Reports Server (NTRS)

Murthy, Pappu L. N.; Gyekenyesi, John P.; Mital, Subodh K.

2008-01-01

High temperature ceramic matrix composites (CMC) are being explored as viable candidate materials for hot section gas turbine components. These advanced composites can potentially lead to reduced weight, enable higher operating temperatures requiring less cooling and thus leading to increased engine efficiencies. However, these materials are brittle and show degradation with time at high operating temperatures due to creep as well as cyclic mechanical and thermal loads. In addition, these materials are heterogeneous in their make-up and various factors affect their properties in a specific design environment. Most of these advanced composites involve two- and three-dimensional fiber architectures and require a complex multi-step high temperature processing. Since there are uncertainties associated with each of these in addition to the variability in the constituent material properties, the observed behavior of composite materials exhibits scatter. Traditional material failure analyses employing a deterministic approach, where failure is assumed to occur when some allowable stress level or equivalent stress is exceeded, are not adequate for brittle material component design. Such phenomenological failure theories are reasonably successful when applied to ductile materials such as metals. Analysis of failure in structural components is governed by the observed scatter in strength, stiffness and loading conditions. In such situations, statistical design approaches must be used. Accounting for these phenomena requires a change in philosophy on the design engineer s part that leads to a reduced focus on the use of safety factors in favor of reliability analyses. The reliability approach demands that the design engineer must tolerate a finite risk of unacceptable performance. This risk of unacceptable performance is identified as a component's probability of failure (or alternatively, component reliability). The primary concern of the engineer is minimizing this risk in an economical manner. The methods to accurately determine the service life of an engine component with associated variability have become increasingly difficult. This results, in part, from the complex missions which are now routinely considered during the design process. These missions include large variations of multi-axial stresses and temperatures experienced by critical engine parts. There is a need for a convenient design tool that can accommodate various loading conditions induced by engine operating environments, and material data with their associated uncertainties to estimate the minimum predicted life of a structural component. A probabilistic composite micromechanics technique in combination with woven composite micromechanics, structural analysis and Fast Probability Integration (FPI) techniques has been used to evaluate the maximum stress and its probabilistic distribution in a CMC turbine stator vane. Furthermore, input variables causing scatter are identified and ranked based upon their sensitivity magnitude. Since the measured data for the ceramic matrix composite properties is very limited, obtaining a probabilistic distribution with their corresponding parameters is difficult. In case of limited data, confidence bounds are essential to quantify the uncertainty associated with the distribution. Usually 90 and 95% confidence intervals are computed for material properties. Failure properties are then computed with the confidence bounds. Best estimates and the confidence bounds on the best estimate of the cumulative probability function for R-S (strength - stress) are plotted. The methodologies and the results from these analyses will be discussed in the presentation.

Allergy and immunology in Africa: Challenges and unmet needs.

PubMed

El-Gamal, Yehia M; Hossny, Elham M; El-Sayed, Zeinab A; Reda, Shereen M

2017-11-01

The tremendous increase in allergy in the African continent cannot simply be explained by the change in public hygiene. There are many "prehygiene" communities with sewage-contaminated water supplies, helminth infestations, bare footedness, and poor housing, and still there is a high prevalence of allergic disease. Africans can be exposed to many risk factors facilitating severe asthma and wheezing, including airborne viruses, smoke, indoor dampness, cockroaches, and poor access to health care. Although the reporting on food allergy is inadequate to perform systematic reviews or meta-analyses, the available data suggest that food allergy is underdiagnosed. The rate of new HIV infections in high-prevalence settings in Africa remains unacceptably high. Although the annual number of new HIV infections in Sub-Saharan Africa has decreased lately, new HIV infections in the Middle East and North Africa region have increased; however, the current prevalence of 0.1% is still among the lowest globally. Africa is densely populated, and consanguineous mating is high in some areas of North and Sub-Saharan Africa. This allows for emergence of many autosomal recessive primary immunodeficiency diseases. There is urgent need for the establishment of primary immunodeficiency disease registries, stem cell transplantation facilities, and neonatal screening programs. To address these expanding problems and perform local cutting-edge research, Africans need to be empowered by motivated governments, dedicated funds, and compassionate scientific partnership. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Quality Assurance in Trichiasis Surgery: a methodology

PubMed Central

Buchan, John C; Limburg, Hans; Burton, Matthew J

2013-01-01

SUMMARY Trachoma remains a significant cause of blindness in many parts of the world. The major route to blindness involves upper lid entropion leading to trachomatous trichiasis (TT) which promotes progressive corneal opacification. The provision of surgery to correct TT in the populations most severely affected is a major challenge for the global effort to eliminate Trachoma blindness by the year 2020. Most attention has been paid to increasing the quantity of TT surgery performed, and large numbers of non-doctor operators have been trained to this end. Surgical audit by those performing TT surgery is not a routine part of any national trachoma control programme, and no effective mechanism exists for identifying surgeons experiencing poor outcomes. We propose a methodology for surgical audit at the level of the individual surgeon based on Lot Quality Assurance. A set number of patients operated on previously for upper eyelid TT are examined to detect the recurrence of TT. The number of recurrent cases found will lead to categorisation of the TT surgeon to either “high recurrence” or “low recurrence” with reasonable confidence. The threshold of unacceptability can be set by individual programmes according to previous local studies of recurrence rates or those from similar settings. Identification of surgeons delivering unacceptably high levels of recurrent TT will guide managers on the need for remedial intervention such as re-training. PMID:20881027

Enhancing prescription drug innovation and adoption.

PubMed

Alexander, G Caleb; O'Connor, Alec B; Stafford, Randall S

2011-06-21

The adoption and use of a new drug would ideally be guided by its innovation and cost-effectiveness. However, information about the relative efficacy and safety of a drug is typically incomplete even well after market entry, and various other forces create a marketplace in which most new drugs are little better than their older counterparts. Five proposed mechanisms are considered for promoting innovation and reducing the use of therapies ultimately found to offer poor value or have unacceptable risks. These changes range from increasing the evidence required for U.S. Food and Drug Administration approval to modifying the structure of drug reimbursement. Despite the challenges of policy implementation, the United States has a long history of successfully improving the societal value and safe use of prescription medicines.

Corporate Funding for Schools of Public Health: Confronting the Ethical and Economic Challenges.

PubMed

Bayer, Ronald; Sampat, Bhaven N

2016-04-01

We discuss the public and private sponsoring of university research and the issues it raises in a context of diminished federal funding. We consider research funding at schools of public health and why these schools have historically had weaker links to industry than have other academic units. We argue that the possibility of enhanced links with industry at schools of public health may raise specific concerns beyond those facing universities generally. Six issues should be considered before entering into these relationships: (1) the effects on research orientation, (2) unacceptability of some funders, (3) potential threats to objectivity and academic freedom, (4) effects on academic standards, (5) the effects on dissemination of knowledge, and (6) reputational risks.

[Babies with cranial deformity].

PubMed

Feijen, Michelle M W; Claessens, Edith A W M Habets; Dovens, Anke J Leenders; Vles, Johannes S; van der Hulst, Rene R W J

2009-01-01

Plagiocephaly was diagnosed in a baby aged 4 months and brachycephaly in a baby aged 5 months. Positional or deformational plagio- or brachycephaly is characterized by changes in shape and symmetry of the cranial vault. Treatment options are conservative and may include physiotherapy and helmet therapy. During the last two decades the incidence of positional plagiocephaly has increased in the Netherlands. This increase is due to the recommendation that babies be laid on their backs in order to reduce the risk of sudden infant death syndrome. We suggest the following: in cases of positional preference of the infant, referral to a physiotherapist is indicated. In cases of unacceptable deformity of the cranium at the age 5 months, moulding helmet therapy is a possible treatment option.

Comparing models of helper behavior to actual practice in telephone crisis intervention: a Silent Monitoring Study of Calls to the U.S. 1-800-SUICIDE Network.

PubMed

Mishara, Brian L; Chagnon, François; Daigle, Marc; Balan, Bogdan; Raymond, Sylvaine; Marcoux, Isabelle; Bardon, Cécile; Campbell, Julie K; Berman, Alan

2007-06-01

Models of telephone crisis intervention in suicide prevention and best practices were developed from a literature review and surveys of crisis centers. We monitored 2,611 calls to 14 centers using reliable behavioral ratings to compare actual interventions with the models. Active listening and collaborative problem-solving models describe help provided. Centers vary greatly in the nature of interventions and their quality according to predetermined criteria. Helpers do not systematically assess suicide risk. Some lives may have been saved but occasionally unacceptable responses occur. Recommendations include the need for quality assurance, development of standardized practices and research relating intervention processes to outcomes.

Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study.

PubMed

Riva-Cambrin, Jay; Kestle, John R W; Holubkov, Richard; Butler, Jerry; Kulkarni, Abhaya V; Drake, James; Whitehead, William E; Wellons, John C; Shannon, Chevis N; Tamber, Mandeep S; Limbrick, David D; Rozzelle, Curtis; Browd, Samuel R; Simon, Tamara D

2016-04-01

OBJECT The rate of CSF shunt failure remains unacceptably high. The Hydrocephalus Clinical Research Network (HCRN) conducted a comprehensive prospective observational study of hydrocephalus management, the aim of which was to isolate specific risk factors for shunt failure. METHODS The study followed all first-time shunt insertions in children younger than 19 years at 6 HCRN centers. The HCRN Investigator Committee selected, a priori, 21 variables to be examined, including clinical, radiographic, and shunt design variables. Shunt failure was defined as shunt revision, subsequent endoscopic third ventriculostomy, or shunt infection. Important a priori-defined risk factors as well as those significant in univariate analyses were then tested for independence using multivariate Cox proportional hazard modeling. RESULTS A total of 1036 children underwent initial CSF shunt placement between April 2008 and December 2011. Of these, 344 patients experienced shunt failure, including 265 malfunctions and 79 infections. The mean and median length of follow-up for the entire cohort was 400 days and 264 days, respectively. The Cox model found that age younger than 6 months at first shunt placement (HR 1.6 [95% CI 1.1-2.1]), a cardiac comorbidity (HR 1.4 [95% CI 1.0-2.1]), and endoscopic placement (HR 1.9 [95% CI 1.2-2.9]) were independently associated with reduced shunt survival. The following had no independent associations with shunt survival: etiology, payer, center, valve design, valve programmability, the use of ultrasound or stereotactic guidance, and surgeon experience and volume. CONCLUSIONS This is the largest prospective study reported on children with CSF shunts for hydrocephalus. It confirms that a young age and the use of the endoscope are risk factors for first shunt failure and that valve type has no impact. A new risk factor-an existing cardiac comorbidity-was also associated with shunt failure.

Overview of an Integrated Medical System for Exploration Missions

NASA Technical Reports Server (NTRS)

Watkins, Sharmila; Rubin, David

2013-01-01

The Exploration Medical Capability (ExMC) element of the NASA Human Research Program (HRP) is charged with addressing the risk of unacceptable health and mission outcomes due to limitations of inflight medical capabilities. The Exploration Medical System Demonstration (EMSD) is a project within the ExMC element aimed at reducing this risk by improving the medical capabilities available for exploration missions. The EMSD project will demonstrate, on the ground and on ISS, the integration of several components felt to be essential to the delivery of medical care during long ]duration missions outside of low Earth orbit. The components of the EMSD include the electronic medical record, assisted medical procedure software, medical consumables tracking technology and RFID ] tagged consumables, video conferencing capability, ultrasound device and probes (ground demonstration only), peripheral biosensors, and the software to allow communication among the various components (middleware). This presentation seeks to inform our international partners of the goals and objectives of the EMSD and to foster collaboration opportunities related to this and future projects.

Monitoring and exposure assessment of pesticide residues in cowpea (Vigna unguiculata L. Walp) from five provinces of southern China.

PubMed

Huan, Zhibo; Xu, Zhi; Luo, Jinhui; Xie, Defang

2016-11-01

Residues of 14 pesticides were determined in 150 cowpea samples collected in five southern Chinese provinces in 2013 and 2014.70% samples were detected one or more residues. 61.3% samples were illegal mainly because of detection of unauthorized pesticides. 14.0% samples contained more than three pesticides. Deterministic and probabilistic methods were used to assess the chronic and acute risk of pesticides in cowpea to eight subgroups of people. Deterministic assessment showed that the estimated short-term intakes (ESTIs) of carbofuran were 1199.4%-2621.9% of the acute reference doses (ARfD) while the rates were 985.9%-4114.7% using probabilistic assessment. Probabilistic assessment showed 4.2%-7.8% subjects may suffer from unacceptable acute risk from carbofuran contaminated cowpeas from the five provinces (especially children). But undue concern is not necessary, because all the estimations are based on conservative assumption. Copyright © 2016 Elsevier Inc. All rights reserved.

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

Metzler, D.; Gibb, J.P.; Glover, W.A.

Compliance with the mandate of the Uranium Mill Tailings Radiation Control Act (UMTRCA) at Uranium Mill Tailings Remedial Action (UMTRA) Project sites requires implementation of a groundwater remedial action plan that meets the requirements of Subpart B of the US Environmental Protection Agency`s proposed groundwater protection standards (40 CFR 192). The UMTRA Groundwater Project will ensure that unacceptable current risk or potential risk to the public health, safety and the environment resulting from the groundwater contamination attributable to the UMTRA sites, is mitigated in a timely and cost-efficient manner. For each UMTRA processing site and vicinity property where contamination exists,more » a groundwater remedial action plan must be developed that identifies hazardous constituents and establishes acceptable concentration limits for the hazardous constituents as either (a) alternate concentration limits (ACL), (b) maximum concentration limits (MCLs), (c) supplemental standards, or (d) background groundwater quality levels. Project optimization is a strategy that will aggressively work within the current regulatory framework using all available options to meet regulatory requirements. This strategy is outlined within.« less

Proceedings of the National Conference on Climate Change and Water Resources Management (1st) Held in Albuquerque, New Mexico on November 4-7, 1991

DTIC Science & Technology

1993-12-01

mean water temperatures are not much in excess of 25° C . From the global climate model predictions summarized in Figures 4 and 5, all the models suggest...that the mean diurnal water temperatures could exceed 25° C under high-summer conditions, with water temperatures rising to around 30’ C or more for some...allocation, C = 41,500 acre-feet, a 20 percent increase in the mean inflow produces what we consider a priori to be an unacceptably high flood

Cataract, cost: curious questions.

PubMed

Moran, D J

1999-02-01

An investigation of the pricing of implantable prosthetic devices in Australia reveals some alarming practices. A governmental mechanism exists to prop up the pricing of 7500 listed devices to levels that are unacceptably high by world standards. Private hospitals and doctors are able, legally, to profit by marking up the cost of these devices from the market price to this artificially inflated price. Even the open market prices of implantable prosthetic items, such as intra-ocular lenses, are high by international standards. In a time of budgetary constraint for health spending and rapidly increasing use of these devices, these issues urgently need to be addressed in Australia.

Nonproliferation Challenges in Space Defense Technology - PANEL

NASA Technical Reports Server (NTRS)

Houts, Michael G.

2016-01-01

The use of highly enriched uranium (HEU) almost always "helps" space fission systems. Nuclear Thermal Propulsion (NTP) and high power fission electric systems appear able to use < 20% enriched uranium with minimal / acceptable performance impacts. However, lower power, "entry level" systems may be needed for space fission technology to be developed and utilized. Low power (i.e. approx.1 kWe) fission systems may have an unacceptable performance penalty if LEU is used instead of HEU. Are there Ways to Support Non-Proliferation Objectives While Simultaneously Helping Enable the Development and Utilization of Modern Space Fission Power and Propulsion Systems?

Thermal Control Method for High-Current Wire Bundles by Injecting a Thermally Conductive Filler

NASA Technical Reports Server (NTRS)

Rodriguez-Ruiz, Juan; Rowles, Russell; Greer, Greg

2011-01-01

A procedure was developed to inject thermal filler material (a paste-like substance) inside the power wire bundle coming from solar arrays. This substance fills in voids between wires, which enhances the heat path and reduces wire temperature. This leads to a reduced amount of heat generated. This technique is especially helpful for current and future generation high-power spacecraft (1 kW or more), because the heat generated by the power wires is significant enough to cause unacceptable overheating to critical components that are in close contact with the bundle.

Damping Goes the Distance in Golf

NASA Technical Reports Server (NTRS)

2004-01-01

In the late 1980s, Dr. Benjamin Dolgin of NASA s Jet Propulsion Laboratory developed a concept for a high-damping graphite/viscoelastic material for the Strategic Defense Initiative (popularly referred to as "Star Wars"), as part of a space-based laser anti-missile program called "Asterix." Dolgin drummed up this concept with the intention of stabilizing weapons launch platforms in space, where there is no solid ground to firmly support these structures. Without the inclusion of high-damping material, the orbital platforms were said to vibrate for 20 minutes after force was applied - a rate deemed "unacceptable" by leaders of the Strategic Defense Initiative.

Fragmentation of DNA components by hyperthermal heavy ion (Ar+ and Xe+) impact in the condensed phase

NASA Astrophysics Data System (ADS)

Sarabipour, Sarvenaz; Sarvenaz Sarabipour, Ms; Michaud, Marc; Deng, Zongwu; Huels, Michael A.

The overriding environmental factor that presently limits human endeavors in space is exposure to heavy ion radiation. While knowledge of its damage to living tissue is essential for radiation protection and risk estimates for astronauts, very little data exists at the molecular level regarding the nascent DNA damage by the primary particle track, or by secondary species during subsequent reaction cascades. This persistent lack of a basic understanding of nascent damage induced by such low dose, high LET radiation, introduces unacceptable errors in radiation risk estimates (based mainly on extrapolation from high dose, low LET radiation), particularly for long term exposure. Mutagenic effects induced by heavy ion radiation to cells are largely due to DNA damage by secondary transient species, i.e. secondary ballistic ions, electrons and radicals generated along the ion tracks; the secondary ions have hyperthermal energies up to several 100 eV, which they will deposit within a few nm in the surrounding medium; thus their LET is very high, and yields lethal clustered DNA lesions. We present measurements of molecular damage induced in films of DNA components by ions with precisely such low energies (1-100 eV) and compare results to conventional electron impact measurements. Experiments are conducted in UHV using a mass selected low energy ion source, and a high-resolution quadrupole MS to monitor ion yields desorbing from molecular films. Among the major fragments, NH4 + is identified in the desorption mass spectra of irradiated films of Adenine, Guanine, Cytosine, indicating efficient deamination; in cells this results in pre-mutagenic lesions. Experiments with 5-amino-Uracil, and comparison to previous results on uracil and thymine show that deamination is a key step in the NH4 + fragment formation. For Adenine, we also observe formation of amine aducts in the films, viz. amination of Adenine, and global fragmentation in all ion impact mass spectra, attributed mainly to kinetic & potential ion scattering.[Funded by NSERC and the Canadian Space Agency].

Factors Associated With Revision Surgery After Internal Fixation of Hip Fractures.

PubMed

Sprague, Sheila; Schemitsch, Emil H; Swiontkowski, Marc; Della Rocca, Gregory J; Jeray, Kyle J; Liew, Susan; Slobogean, Gerard P; Bzovsky, Sofia; Heels-Ansdell, Diane; Zhou, Qi; Bhandari, Mohit

2018-05-01

Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (for every 5-point increase) (HR 1.19, 95% CI 1.02-1.39; P = 0.027), displaced fracture (HR 2.16, 95% CI 1.44-3.23; P < 0.001), unacceptable quality of implant placement (HR 2.70, 95% CI 1.59-4.55; P < 0.001), and smokers treated with cancellous screws versus smokers treated with a sliding hip screw (HR 2.94, 95% CI 1.35-6.25; P = 0.006). Additionally, for every 10-year decrease in age, participants experienced an average increased risk of 39% for hardware removal. Results of this study may inform future research by identifying high-risk patients who may be better treated with arthroplasty and may benefit from adjuncts to care (HR 1.39, 95% CI 1.05-1.85; P = 0.020). Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Excellent outcomes of liver transplantation using severely steatotic grafts from brain-dead donors.

PubMed

Wong, Tiffany C L; Fung, James Y Y; Chok, Kenneth S H; Cheung, Tan To; Chan, Albert C Y; Sharr, William W; Dai, Wing Chiu; Chan, See Ching; Lo, Chung Mau

2016-02-01

Liver grafts with macrovesicular steatosis of > 60% are considered unsuitable for deceased donor liver transplantation (DDLT) because of the unacceptably high risk of primary nonfunction (PNF) and graft loss. This study reports our experience in using such grafts from brain-dead donors. Prospectively collected data of DDLT recipient outcomes from 1991 to 2013 were retrospectively analyzed. Macrovesicular steatosis > 60% at postperfusion graft biopsy was defined as severe steatosis. In total, 373 patients underwent DDLT. Nineteen patients received severely steatotic grafts (ie, macrovesicular steatosis > 60%), and 354 patients had grafts with ≤ 60% steatosis (control group). Baseline demographics were comparable except that recipient age was older in the severe steatosis group (51 versus 55 years; P = 0.03). Median Model for End-Stage Liver Disease (MELD) score was 20 in the severe steatosis group and 22 in the control group. Cold ischemia time (CIT) was 384 minutes in the severe steatosis group and 397.5 minutes in the control group (P = 0.66). The 2 groups were similar in duration of stay in the hospital and in the intensive care unit. Risk of early allograft dysfunction (0/19 [0%] versus 1/354 [0.3%]; P>0.99) and 30-day mortality (0/19 [0%] versus 11/354 [3.1%]; P = 0.93) were also similar between groups. No patient developed PNF. The 1-year and 3-year overall survival rates in the severe steatosis group were both 94.7%. The corresponding rates in the control group were 91.8% and 85.8% (P = 0.55). The use of severely steatotic liver grafts from low-risk donors was safe, and excellent outcomes were achieved; however, these grafts should be used with caution, especially in patients with high MELD score. Keeping a short CIT was crucial for the successful use of such grafts in liver transplantation. © 2015 American Association for the Study of Liver Diseases.

Perineal hygiene in patients with pelvic fractures.

PubMed

Hossain, Mohammad A; Pearce, Rachel; Bircher, Martin D

2008-08-01

At the tertiary referral Orthopaedic Unit of St. Georges Hospital, it was noted that there was an unacceptably high number of soiled perinea in patients transferred from Base Hospitals. This not only exposed the patients to increased infection [Jepsen O. The effectiveness of preoperative skin preparations: an integrated review of the literature. AORN J 1993;58:477-82; and Nix D, Ermer-Seltun J. A review of perineal skin care protocols and skin barrier product use. Ostomy Wound Manage 2004;50:59-67] but was also undignified and unacceptable for them. We decided to audit the problem with a view to finding out why this was happening and to improve the situation. A 2-year study was carried out over three distinct phases (phase 1: February-June 2004, phase 2: July-November 2004, phase 3: February-November 2005). Observations of soiling were recorded in a questionnaire by the surgeon prior to surgery. Key system and clinical guidelines were implemented during the second phase, and the audit process was repeated. The percentage of clean perinea in phase 1 was 32%, phase 2 68% and phase 3 99.5% indicating a clear improvement in the overall system.

Prevalence and predictors of postoperative pain after ear, nose, and throat surgery.

PubMed

Sommer, Michael; Geurts, José W J M; Stessel, Bjorn; Kessels, Alfons G H; Peters, Madelon L; Patijn, Jacob; van Kleef, Maarten; Kremer, Bernd; Marcus, Marco A E

2009-02-01

To determine postoperative pain in different types of ear, nose, and throat (ENT) surgery and their psychological preoperative predictors. Prospective cohort study. Academic hospital. A total of 217 patients undergoing ENT surgery. All ENT, neck, and salivary gland surgery. Postoperative pain and predictors for postoperative pain. Fifty percent of the patients undergoing surgery on the oral, pharyngeal, and laryngeal region and on the neck and salivary gland region had a visual analog scale score higher than 40 mm on day 1. In the patients who underwent oropharyngeal region operations the VAS score remained high on all 4 days. A VAS pain score higher than 40 mm was found in less than 30% of patients after endoscopic procedures and less than 20% after ear and nose surgery. After bivariate analysis, 6 variables--age, sex, preoperative pain, expected pain, short-term fear, and pain catastrophizing--had a predictive value. Multivariate analysis showed only preoperative pain, pain catastrophizing, and anatomical site of operation as independent predictors. Differences exist in the prevalence of unacceptable postoperative pain between ENT operations performed on different anatomical sites. A limited set of variables can be used to predict the occurrence of unacceptable postoperative pain after ENT surgery.

An assessment of health risks associated with arsenic exposure via consumption of homegrown vegetables near contaminated glassworks sites.

PubMed

Uddh-Söderberg, Terese E; Gunnarsson, Sara J; Hogmalm, K Johan; Lindegård, M I Boel G; Augustsson, Anna L M

2015-12-01

The health risk posed by arsenic in vegetables grown in private gardens near 22 contaminated glassworks sites was investigated in this study. Firstly, vegetable (lettuce and potato) and soil samples were collected and arsenic concentrations measured to characterize the arsenic uptake in the selected crops. Secondly, a probabilistic exposure assessment was conducted to estimate the average daily intake (ADIveg), which was then evaluated against toxicological reference values by the calculation of hazard quotients (HQs) and cancer risks (CRs). The results show that elevated arsenic concentrations in residential garden soils are mirrored by elevated concentrations in vegetables, and that consumption of these vegetables alone may result in an unacceptable cancer risk; the calculated reasonable maximum exposure, for example, corresponded to a cancer incidence 20 times higher than the stated tolerance limit. However, the characterization of risk depends to a great extent on which toxicological reference value is used for comparison, as well as how the exposure is determined. Based on the assumptions made in the present study, the threshold levels for chronic non-carcinogenic or acute effects were not exceeded, but the cancer risks indicated highlight the need for further exposure studies, as dietary intake involves more than just homegrown vegetables and total exposure is a function of more than just one exposure pathway. In addition, glassworks sites--and contaminated sites in general--contain multiple contaminants, affecting the final and total risk. Copyright © 2015. Published by Elsevier B.V.