Reducing sedentary time in adults at risk of type 2 diabetes: process evaluation of the STAND (Sedentary Time ANd Diabetes RCT

Directory of Open Access Journals (Sweden)

Stuart J. H. Biddle

2017-01-01

Full Text Available Abstract Background Reducing sedentary behaviour may have important health implications. This study evaluated the potential enablers and barriers for outcomes of a randomised controlled trial (RCT designed to evaluate a pragmatic education based intervention designed to reduce sedentary (sitting behaviour in young adults at high risk of type 2 diabetes. Methods Data were collected from participants in the intervention group immediately after an educational workshop addressing sedentary time and diabetes risk (n = 71, through phone interviews 6 weeks (n = 45 after the workshop, and at the conclusion of the 12-month trial (n = 10. The two education session facilitators were also interviewed about the intervention. Results The RCT showed no difference in sedentary time at 12 months between intervention and control arms. The lack of behaviour change appeared not to be attributed to the workshops, which were well led and very favourably received according to feedback. However, factors contributing to this lack of behaviour change include lack of perceived health risk from baseline measures feedback; the preference to adopt physically active behaviours rather than to sit less; certain barriers to sitting less; motivational drift after the 3-month follow-up measurements where participants had no contact for a further 9 months; and, for some, unreliability of the self-monitoring tool. Conclusions The workshop was well led and well received by the attendees but future interventions need to consider more contact with participants, discuss any specific benefits around simply standing to reduce sitting time, address the barriers to sitting less, and provide a more user-friendly and reliable self-monitoring tool. Trial registration Current controlled trials ISRCTN08434554 , MRC project 91409. Registered retrospectively on 22 February 2011.

AN EVALUATION OF RISK MANAGEMENT STRATEGIES FOR DAIRY FARMS

OpenAIRE

Bosch, Darrell J.; Johnson, Christian J.

1992-01-01

Variability in feed prices and crop yields are important sources of risk to dairy farmers. A simulation model of a representative dairy farm was used to evaluate crop insurance and hedging as risk management strategies. These strategies lowered expected net returns but also reduced risk. The preferred set of strategies at lower levels of risk aversion included hedging and crop insurance, although a base scenario in which no risk management strategies were employed was also efficient. The pref...

Using detection and deterrence to reduce insider risk

Energy Technology Data Exchange (ETDEWEB)

Eggers, R F; Carlson, R L; Udell, C J

1988-06-01

This paper addresses a new concept of interaction between adversary detection and deterrence. It provides an initial evaluation of the effects of these variables on the risk of theft of special nuclear material by an insider adversary and can be extended to the sabotage threat. A steady-state risk equation is used. Exercises with this equation show that deterrence, resulting from the prospect of detection, has a greater ability to reduce the risk than the detection exercise itself. This is true for all cases except those in which the probability of detection is 1. Cases were developed for three different types of adversaries that can be distinguished from one another by the level of detection they are willing to tolerate before they are deterred from attempting a theft. By considering the effects of detection, deterrence, and adversary type, the ground work is laid for designing cost-effective insider threat-protection systems. 2 refs., 6 figs.

Evaluation of the Effectiveness of Tai Chi versus Brisk Walking in Reducing Cardiovascular Risk Factors: Protocol for a Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

Aileen W. K. Chan

2016-07-01

Full Text Available Physical inactivity is one of the major modifiable lifestyle risk factors for cardiovascular disease (CVD. This protocol aims to evaluate the effectiveness of Tai Chi versus brisk walking in reducing CVD risk factors. This is a randomized controlled trial with three arms, namely, Tai Chi group, walking group, and control group. The Tai Chi group will receive Tai Chi training, which consists of two 60-min sessions each week for three months, and self-practice for 30 min every day. The walking group will perform brisk walking for 30 min every day. The control group will receive their usual care. 246 subjects with CVD risk factors will be recruited from two outpatient clinics. The primary outcome is blood pressure. Secondary outcomes include fasting blood for lipid profile, sugar and glycated haemoglobin (HbA1c; body mass index, waist circumference, body fat percentage; perceived stress level and quality of life. Data collections will be conducted at baseline, 3-month, 6-month and 9-month. Generalized estimating equations model will be used to compare the changes in outcomes across time between groups. It is expected that both the Tai Chi and walking groups could maintain better health and have improved quality of life, and that Tai Chi will be more effective than brisk walking in reducing CVD risk factors.

Policies for Reducing Coastal Risk on the East and Gulf Coasts

Science.gov (United States)

Glickson, D.; Johnson, S.

2014-12-01

Hurricane- and coastal storm-related economic losses have increased substantially over the past century, largely due to expanding population and development in susceptible coastal areas. Concurrent with this growth, the federal government has assumed an increasing proportion of the financial responsibility associated with U.S. coastal storms, which may discourage state and local governments from taking appropriate actions to reduce risk and enhance resilience. Strategies to manage coastal storm risks fall into two categories: reducing the probability of flooding or wave impact (such as seawalls, storm surge barriers, beach nourishment, dune building, restoration/expansion of oyster reefs, salt marshes, and mangroves) and reducing the number or vulnerability of people or structures (such as relocation, land-use planning, and elevating or floodproofing buildings). Over the past century, most coastal risk management programs have emphasized coastal armoring, while doing little to decrease development in harm's way. This National Research Council report calls for the development of a national vision for managing coastal risks that includes a long-term view, regional solutions, and recognition of all benefits. A national coastal risk assessment is needed to identify high priority areas. Benefit-cost analysis provides a reasonable framework to evaluate national investments in coastal risk reduction, if constrained by other important environmental, social, and life-safety factors. Extensive collaboration and additional policy changes will be necessary to move from a nation that is primarily reactive to coastal disasters to one that invests wisely in coastal risk reduction and builds resilience among coastal communities.

Evaluation of Jump into Action: A Program to Reduce the Risk of Non-Insulin Dependent Diabetes Mellitus in School Children on the Texas-Mexico Border.

Science.gov (United States)

Holcomb, J. David; Lira, Juanita; Kingery, Paul M.; Smith, D. W.; Lane, Dorothy; Goodway, Jackie

1998-01-01

Evaluated Jump into Action, a non-insulin dependent diabetes mellitus (NIDDM)-prevention program that encouraged students to eat well and exercise regularly to reduce NIDDM risks. Surveys of predominantly Hispanic fifth graders and their teachers at Texas-Mexico border schools indicated that the program increased NIDDM-prevention knowledge and…

The 'polypill' to reduce cardiovascular risk

DEFF Research Database (Denmark)

Patel, Vinod; Pedersen, Oluf; Morrissey, John

2004-01-01

This article considers data from the Steno-2 multifactorial intervention study in type 2 diabetes to which are applied the United Kingdom Prospective Diabetes Study (UKPDS) risk engine. Mathematical analyses support the use of a 'polypill' to reduce cardiovascular risk in type 2 diabetes. It is s...

Benefits from reducing risk of death

Energy Technology Data Exchange (ETDEWEB)

Krupnick, A

1994-07-01

Of the categories of benefits to individuals, reductions in the risk of premature mortality are of central. concern to the public and environmental policy makers. These benefits can include those from reductions in own- risk, for example, an individual's valuation of reducing his or her own mortality risks; reductions in risk to an individual's family, friends, or co-workers (i.e., of people known to the individual); and reductions in risks to unknown individuals. The last type would be an example of altruistic value. The overall goal is to measure the welfare change from a change in the current and/or future probability of dying. The willingness to pay (WTP) reflects the amount of income taken from a person that would leave him or her indifferent to a decrease in risk, whenever it occurs. When this value is divided by the risk change, the resulting value is called the 'value of a statistical life'. Another relevant measure appearing in the literature is the value of life-years saved. A final issue concerns the type of premature mortality risks one is valuing when environmental pollution is at issue. While most effort has gone into estimating the welfare effects of a change in current probability of death of healthy workers on the job, this is more relevant for characterizing the benefits of reducing accidental death risks than death from environmental causes. Exposure to pollutants raises risks of developing cancer, chronic heart, respiratory, and other diseases that raise mortality risks in the future. Such exposure also may raise current death risks for the very old and the sick. But, surely the pollution effect that is analogous to occupational health risks-pollution exposures high enough to raise current risks of death for the healthy, prime-age person-is insignificant in the United States.

Benefits from reducing risk of death

International Nuclear Information System (INIS)

Krupnick, A.

1994-01-01

Of the categories of benefits to individuals, reductions in the risk of premature mortality are of central. concern to the public and environmental policy makers. These benefits can include those from reductions in own- risk, for example, an individual's valuation of reducing his or her own mortality risks; reductions in risk to an individual's family, friends, or co-workers (i.e., of people known to the individual); and reductions in risks to unknown individuals. The last type would be an example of altruistic value. The overall goal is to measure the welfare change from a change in the current and/or future probability of dying. The willingness to pay (WTP) reflects the amount of income taken from a person that would leave him or her indifferent to a decrease in risk, whenever it occurs. When this value is divided by the risk change, the resulting value is called the 'value of a statistical life'. Another relevant measure appearing in the literature is the value of life-years saved. A final issue concerns the type of premature mortality risks one is valuing when environmental pollution is at issue. While most effort has gone into estimating the welfare effects of a change in current probability of death of healthy workers on the job, this is more relevant for characterizing the benefits of reducing accidental death risks than death from environmental causes. Exposure to pollutants raises risks of developing cancer, chronic heart, respiratory, and other diseases that raise mortality risks in the future. Such exposure also may raise current death risks for the very old and the sick. But, surely the pollution effect that is analogous to occupational health risks-pollution exposures high enough to raise current risks of death for the healthy, prime-age person-is insignificant in the United States

The interplay between gait, falls and cognition: can cognitive therapy reduce fall risk?

Science.gov (United States)

Segev-Jacubovski, Orit; Herman, Talia; Yogev-Seligmann, Galit; Mirelman, Anat; Giladi, Nir; Hausdorff, Jeffrey M

2011-01-01

In this article, we briefly summarize the incidence and significant consequences of falls among older adults, the insufficient effectiveness of commonly used multifactorial interventions and the evidence linking falls and cognitive function. Recent pharmacologic and nonpharmacologic studies that evaluated the effects of cognitive therapy on fall risk are reviewed. The results of this article illustrate the potential utility of multiple, diverse forms of cognitive therapy for reducing fall risk. The article also indicates that large-scale, randomized controlled trials are warranted and that additional research is needed to better understand the pathophysiologic mechanisms underlying the interplay between human mobility, fall risk and cognitive function. Nonetheless, we suggest that multimodality interventions that combine motor and cognitive therapy should, eventually, be incorporated into clinical practice to enable older adults and patients to move safer and with a reduced fall risk. PMID:21721921

Meta-analyses on behavioral interventions to reduce the risk of transmission of HIV.

Science.gov (United States)

Vergidis, Paschalis I; Falagas, Matthew E

2009-06-01

Different behavioral interventions have found to be efficacious in reducing high-risk sexual activity. Interventions have been evaluated in both original research and meta-analytic reviews. Most of the studies have shown that interventions are efficacious among different study populations. In adolescents, both in- and out-of-the classroom interventions showed a decrease in the risk of unprotected sex. In African Americans, greater efficacy was found for interventions including peer education. For Latinos, effect was larger in interventions with segmentation in the same gender. Geographic and social isolation are barriers in approaching MSM. For IDUs, interventions provided within a treatment program have an impact on risk reduction above that produced by drug treatment alone. Finally, people diagnosed with HIV tend to reduce their sexual risk behavior. However, adherence to safe sex practices for life can be challenging. Relentless efforts for implementation of behavioral interventions to decrease high-risk behavior are necessary to decrease HIV transmission.

Relationship Between Perceived Risk of Falling and Adoption of Precautions to Reduce Fall Risk.

Science.gov (United States)

Blalock, Susan J; Gildner, Paula L; Jones, Jennifer L; Bowling, James M; Casteel, Carri H

2016-06-01

To better understand the relationship between perceived risk of falling and awareness and adoption of four specific precautions that older adults have taken to reduce this risk. Cross-sectional. Data were collected in in-person interviews conducted in the homes of study participants. Interviews conducted between March 2011 and September 2013 and lasted an average of 60-90 minutes. A stratified sampling strategy designed to enroll an equal number of homebound and nonhomebound participants was used. All participants (N = 164) were recruited from central North Carolina. Participants were asked about 1-year fall history, perceived risk of falling, restriction of activities because of fear of falling, awareness of four recommended fall prevention behaviors (exercise, annual medication review, bathroom grab bars, safe footwear), and current practice of these behaviors. In bivariate analyses, individuals who were aware of two behaviors recommended to reduce the risk of falling (exercise, use of safe footwear) and had adopted these behaviors perceived their risk of falling as lower than individuals who were aware of the recommended behaviors but had not adopted them. Moreover, in multivariate analyses, individuals who did not know that exercise is recommended to reduce the risk of falling perceived their risk of falling as lower than those who were aware of this recommendation and had adopted it. Individuals were least likely to be aware that medication reviews and exercise are recommended to reduce fall risk. Awareness of behaviors recommended to reduce fall risk appears necessary for adoption of these behaviors to reduce perceived risk. Fall-prevention campaigns should emphasize behaviors where awareness is low. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Functional neural correlates of reduced physiological falls risk

Directory of Open Access Journals (Sweden)

Hsu Chun

2011-08-01

Full Text Available Abstract Background It is currently unclear whether the function of brain regions associated with executive cognitive processing are independently associated with reduced physiological falls risk. If these are related, it would suggest that the development of interventions targeted at improving executive neurocognitive function would be an effective new approach for reducing physiological falls risk in seniors. Methods We performed a secondary analysis of 73 community-dwelling senior women aged 65 to 75 years old who participated in a 12-month randomized controlled trial of resistance training. Functional MRI data were acquired while participants performed a modified Eriksen Flanker Task - a task of selective attention and conflict resolution. Brain volumes were obtained using MRI. Falls risk was assessed using the Physiological Profile Assessment (PPA. Results After accounting for baseline age, experimental group, baseline PPA score, and total baseline white matter brain volume, baseline activation in the left frontal orbital cortex extending towards the insula was negatively associated with reduced physiological falls risk over the 12-month period. In contrast, baseline activation in the paracingulate gyrus extending towards the anterior cingulate gyrus was positively associated with reduced physiological falls risk. Conclusions Baseline activation levels of brain regions underlying response inhibition and selective attention were independently associated with reduced physiological falls risk. This suggests that falls prevention strategies may be facilitated by incorporating intervention components - such as aerobic exercise - that are specifically designed to induce neurocognitive plasticity. Trial Registration ClinicalTrials.gov Identifier: NCT00426881

Does Metformin Reduce Cancer Risks? Methodologic Considerations.

Science.gov (United States)

Golozar, Asieh; Liu, Shuiqing; Lin, Joeseph A; Peairs, Kimberly; Yeh, Hsin-Chieh

2016-01-01

The substantial burden of cancer and diabetes and the association between the two conditions has been a motivation for researchers to look for targeted strategies that can simultaneously affect both diseases and reduce their overlapping burden. In the absence of randomized clinical trials, researchers have taken advantage of the availability and richness of administrative databases and electronic medical records to investigate the effects of drugs on cancer risk among diabetic individuals. The majority of these studies suggest that metformin could potentially reduce cancer risk. However, the validity of this purported reduction in cancer risk is limited by several methodological flaws either in the study design or in the analysis. Whether metformin use decreases cancer risk relies heavily on the availability of valid data sources with complete information on confounders, accurate assessment of drug use, appropriate study design, and robust analytical techniques. The majority of the observational studies assessing the association between metformin and cancer risk suffer from methodological shortcomings and efforts to address these issues have been incomplete. Future investigations on the association between metformin and cancer risk should clearly address the methodological issues due to confounding by indication, prevalent user bias, and time-related biases. Although the proposed strategies do not guarantee a bias-free estimate for the association between metformin and cancer, they will reduce synthesis of and reporting of erroneous results.

Using Tai Chi to Reduce Fall Risk Factors Among Older Adults: An Evaluation of a Community-Based Implementation.

Science.gov (United States)

Gallant, Mary P; Tartaglia, Meaghan; Hardman, Susan; Burke, Kara

2017-04-01

This study aimed to evaluate a community-based implementation of an evidence-based fall prevention program, in which 131 individuals participated in Tai Chi: Moving for Better Balance. Self-report and functional performance assessments included demographics, health and fall history, the Activities-Specific Balance Scale, the Timed Up and Go test, and the Functional Reach test. Pre-post scores were compared with the Wilcoxon signed rank test. The mostly female participants were 73 years old, on average. At baseline, 18% reported being afraid or very afraid of falling, and 18% had fallen in the past 6 months. At follow-up, there was significant improvement in Timed Up and Go ( p older adults, and can effectively reduce fall risk when implemented in community settings.

EPA'S strategy to reduce risk of radon

International Nuclear Information System (INIS)

Page, S.

1993-01-01

The Indoor Radon Abatement Act of 1988 (IRAA) directed EPA to undertake a variety of activities to address the growing public concern over dangers posed by exposure to indoor radon. Among other requirements, the law directed the Agency to study radon levels, evaluate mitigation methods, establish proficiency programs, assist states with program development, develop training centers, and provide public information. EPA has developed and implemented programs to address each of the key provisions of this statute. This paper presents EPA's broad national strategy to reduce radon risks. It combines and reinforces EPA's basic foundation, including its guiding policies and cooperative partnerships, with an overall management approach and focus for the future. The paper starts with an overview that introduces the strategy's four key elements: underlying policies and scientific principles, a decentralized system of states and other partners for targeting the public, multiple strategies for achieving radon risk reduction, and a strong focus on five key program priorities. This paper then discusses each of these elements in more detail and describes how they interact to guide future efforts and directions of the Agency

Increase plant safety and reduce cost by implementing risk-informed in-service inspection programs

International Nuclear Information System (INIS)

Billington, A.; Monette, P.

2001-01-01

The idea behind the program is that it is possible to 'inspect less, but inspect better'. In other words, the risk-informed In-Service Inspection (ISI) process is used to improve the effectiveness of examination of piping components, i.e. concentrate inspection resources and enhance inspection strategies on high safety significant locations, and reduce inspection requirements on others. The Westinghouse Owners Group (WOG) risk-informed ISI process has already been applied for full scope (Millstone 3, Surry 1) and limited scope (Beznau, Ringhals 4, Asco, Turkey Point 3). By examining the high safety significant piping segments for the different fluid piping systems, the total piping core damage frequency is reduced. In addition, more than 80% of the risk associated with potential pressure boundary failures is addressed with the WOG risk-informed ISI process, while typically less that 50% of this same risk is addressed by the current inspection programs. The risk-informed ISI processes are used to improve the effectiveness of inspecting safety-significant piping components, to reduce inspection requirements on other piping components, to evaluate improvements to plant availability and enhanced safety measures, including reduction of personnel radiation exposure, and to reduce overall Operation and Maintenance (O and M) costs while maintaining regulatory compliance. A description of the process as well as benefits from past projects is presented, since the methodology is applicable for WWER plant design. (author)

Increase plant safety and reduce cost by implementing risk-informed In-Service Inspection programs

International Nuclear Information System (INIS)

Billington, A.; Monette, P.; Doumont, C.

2000-01-01

The idea behind the program is that it is possible to 'inspect less, but inspect better'. In other words, the risk-informed In-Service Inspection (ISI) process is used to improve the effectiveness of examination of piping components, i.e. concentrate inspection resources and enhance inspection strategies on high safety significant locations, and reduce inspection requirements on others. The Westinghouse Owners Group (WOG) risk-informed ISI process has already been applied for full scope (Millstone 3, Surry 1) and limited scope (Beznau, Ringhals 4, Asco, Turkey Point 3). By examining the high safety significant piping segments for the different fluid piping systems, the total piping core damage frequency is reduced. In addition, more than 80% of the risk associated with potential pressure boundary failures is addressed with the WOG risk-informed ISI process, while typically less than 50% of this same risk is addressed by the current inspection programs. The risk-informed ISI processes are used: to improve the effectiveness of inspecting safety-significant piping components; to reduce inspection requirements on other piping components; to evaluate improvements to plant availability and enhanced safety measures, including reduction of personnel radiation exposure; and to reduce overall Operation and Maintenance (O and M) costs while maintaining regulatory compliance. A description of the process as well as benefits of past projects is presented, since the methodology is applicable for VVER plant design. (author)

Perceptions of Risk of Developing Skin Cancer for Diverse Audiences: Enhancing Relevance of Sun Protection to Reduce the Risk.

Science.gov (United States)

Robinson, June K; Friedewald, John; Gordon, Elisa J

2016-03-01

Sixty-five percent of kidney transplant recipients (KTRs) develop squamous cell carcinoma (SCC). Perceptions of risk of developing skin cancer, amelioration of this risk with sun protection, and having choices among sun protection strategies may enhance sun protection use by KTRS, who are at greater risk than the general population. Thirty KTRs stratified among non-Hispanic Whites, non-Hispanic Blacks, and Hispanic/Latinos evaluated three versions of the interactive, web-based, electronic sun protection program and suggested refinements. The sequence of content presentation prepared the participant to accept the credibility, accuracy, and relevance of the message. Beginning with informing participants that using sun protection reduces the chance of developing skin cancer made the information credible to KTRs. Showing skin cancer on all skin types and patient testimonials enhanced participants' awareness of their susceptibility to develop skin cancer and primed patients to receive their personal risk of developing skin cancer. Coupling presentation of knowledge about the benefits of sun protection in reducing the risk of developing skin cancer with the personal risk of getting the disease was essential to KTRs believing that they could influence their health outcome.

Sustainability Risk Evaluation for Large-Scale Hydropower Projects with Hybrid Uncertainty

Directory of Open Access Journals (Sweden)

Weiyao Tang

2018-01-01

Full Text Available As large-scale hydropower projects are influenced by many factors, risk evaluations are complex. This paper considers a hydropower project as a complex system from the perspective of sustainability risk, and divides it into three subsystems: the natural environment subsystem, the eco-environment subsystem and the socioeconomic subsystem. Risk-related factors and quantitative dimensions of each subsystem are comprehensively analyzed considering uncertainty of some quantitative dimensions solved by hybrid uncertainty methods, including fuzzy (e.g., the national health degree, the national happiness degree, the protection of cultural heritage, random (e.g., underground water levels, river width, and fuzzy random uncertainty (e.g., runoff volumes, precipitation. By calculating the sustainability risk-related degree in each of the risk-related factors, a sustainable risk-evaluation model is built. Based on the calculation results, the critical sustainability risk-related factors are identified and targeted to reduce the losses caused by sustainability risk factors of the hydropower project. A case study at the under-construction Baihetan hydropower station is presented to demonstrate the viability of the risk-evaluation model and to provide a reference for the sustainable risk evaluation of other large-scale hydropower projects.

Reducing cancer risk in rural communities through supermarket interventions.

Science.gov (United States)

McCool, Barent N; Lyford, Conrad P; Hensarling, Natalie; Pence, Barbara; McCool, Audrey C; Thapa, Janani; Belasco, Eric; Carter, Tyra M

2013-09-01

Cancer risk is high, and prevention efforts are often minimal in rural communities. Feasible means of encouraging lifestyles that will reduce cancer risk for residents of rural communities are needed. This project developed and tested a model that could be feasibly adopted by rural communities to reduce cancer risk. This model focuses on incorporating multi-faceted cancer risk education in the local supermarket. As the supermarket functions both as the primary food source and an information source in small rural communities, the supermarket focus encourages the development of a community environment supportive of lifestyles that should reduce residents' risk for cancer. The actions taken to implement the model and the challenges that communities would have in implementing the model are identified.

Nutritional strategies to reduce falls risk in older people.

Science.gov (United States)

Nash, Louise; Bergin, Nick

2018-03-23

A literature review found an association between increased falls risk and malnutrition, sarcopenia, vitamin D deficiency and dehydration. Strategies to identify, prevent and treat these conditions can help to reduce falls risk in at-risk groups such as frail, older people. Nurses can reduce falls risk in older people by raising awareness of risk factors and embedding nutritional strategies in local falls reduction strategies. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Does retirement reduce the risk of myocardial infarction?

DEFF Research Database (Denmark)

Olesen, Kasper; Rugulies, Reiner; Rod, Naja Hulvej

2014-01-01

BACKGROUND: Recent studies have suggested that retirement may have beneficial effects on health outcomes. In this study we examined whether the risk of myocardial infarction (MI) was reduced following retirement in a Danish population sample. METHODS: Participants were 617 511 Danish workers, born...... of 1.11 (95% confidence interval: 1.06, 1.16) when comparing retirees with active workers of the same age. CONCLUSIONS: This study does not support the hypothesis that retirement reduces risk of MI. On the contrary, we find that retirement is associated with a modestly increased risk of MI....

Reducing Environmental Risks by Information Disclosure: Evidence in Residential Lead Paint Disclosure Rule

Science.gov (United States)

Bae, Hyunhoe

2012-01-01

Recently, there has been a surge in environmental regulations that require information disclosure. However, existing empirical evidence is limited to certain applications and has yet to generalize the effectiveness of this approach as a policy strategy to reduce environmental risks. This study evaluates the disclosure rule of the residential lead…

Reducing the Risk of Type 2 Diabetes in Nonselected Outpatients With Schizophrenia

DEFF Research Database (Denmark)

Hjorth, Peter; Espensen, Caroline H; Madsen, Nikolaj J

2018-01-01

maintaining such a lifestyle because of factors related to their illness, such as cognitive disturbances, negative and positive symptoms, and side effects of psychotropic medications. OBJECTIVE: To measure and reduce risk factors for type 2 diabetes in patients with schizophrenia and examine characteristics...... and reduction in their risk factors for type 2 diabetes. The clinical intervention incorporated individual guidance, group sessions, and treatment as usual. RESULTS: Patients newly diagnosed with schizophrenia were found to have high consumption of soft drinks and low physical activity at their index evaluation......: The study found that positive outcomes were associated with female sex and a longer duration of illness. Negative outcomes with worsening of risk factors were associated with being newly diagnosed with schizophrenia and male sex. It was possible to produce improvements in some risk factors through...

Acid-reducing vagotomy is associated with reduced risk of subsequent ischemic heart disease in complicated peptic ulcer: An Asian population study.

Science.gov (United States)

Wu, Shih-Chi; Fang, Chu-Wen; Chen, William Tzu-Liang; Muo, Chih-Hsin

2016-12-01

Persistent exacerbation of a peptic ulcer may lead to a complicated peptic ulcer (perforation or/and bleeding). The management of complicated peptic ulcers has shifted from acid-reducing vagotomy, drainage, and gastrectomy to simple local suture or non-operative (endoscopic/angiographic) hemostasis. We were interested in the long-term effects of this trend change. In this study, complicated peptic ulcer patients who received acid-reducing vagotomy were compared with those who received simple suture/hemostasis to determine the risk of ischemic heart disease (IHD).This retrospective cohort study analyzed 335,680 peptic ulcer patients recorded from 2000 to 2006 versus 335,680 age-, sex-, comorbidity-, and index-year matched comparisons. Patients with Helicobacter pylori (HP) infection were excluded. In order to identify the effect of vagus nerve severance, patients who received gastrectomy or antrectomy were also excluded. The incidence of IHD in both cohorts, and in the complicated peptic ulcer patients who received acid-reducing vagotomy versus those who received simple suture or hemostasis was evaluated.The overall incidence of IHD was higher in patients with peptic ulcer than those without peptic ulcer (17.00 vs 12.06 per 1000 person-years), with an adjusted hazard ratio (aHR) of 1.46 based on multivariable Cox proportional hazards regression analysis controlling for age, sex, Charlson's comorbidity index, and death (competing risk). While comparing peptic ulcer patients with acid-reducing vagotomy to those with simple suture/hemostasis or those without surgical treatment, the aHR (0.58) was the lowest in the acid-reducing vagotomy group.Patients with peptic ulcer have an elevated risk of IHD. However, complicated peptic ulcer patients who received acid-reducing vagotomy were associated with reduced risk of developing IHD.

Breastfeeding Reduces Childhood Obesity Risks.

Science.gov (United States)

Wang, Liang; Collins, Candice; Ratliff, Melanie; Xie, Bin; Wang, Youfa

2017-06-01

The present study examined the effects of breastfeeding and its duration on the development of childhood obesity from 24 months through grade 6. U.S. longitudinal data collected from 1234 children were analyzed using logistic regression models and generalized estimating equation (GEE). Child height and weight were measured six times at ages of 24 months, 36 months, 54 months, grade 1, grade 3, and grade 6. During the early 1990s, prevalence of breastfeeding was low in the United States, 60% and 48% at 1 and 6 months, respectively. Nonsmoking, white, married mothers with both parents in the household, and with income above the poverty line, were more likely to breastfeed at 1 month of age of their babies. Obesity rate of the children increased with age from 24 months to grade 6. Logistic regression showed that breastfeeding at month 1 was associated with 53% (odds ratio [OR]: 0.47, 95% confidence interval [CI]: 0.30-0.73) and 47% (OR: 0.53, 95% CI: 0.36-0.78) decreased risks for childhood obesity at grades 1 and 6, respectively. GEE analysis showed that breastfeeding at 1 month reduced risk for childhood obesity by 36% (95% CI: 0.47-0.88) from ages 24 months through grade 6. Regarding breastfeeding duration, more than 6 months (vs. never) was associated with a decreased risk for childhood obesity by 42% (OR: 0.58, 95% CI: 0.36-0.94). Breastfeeding at 1 month and more than 6 months reduced the risk of childhood obesity. Rate of breastfeeding was low in the United States in the 1990s, which may have had long-term implications on children.

Specifying the ovarian cancer risk threshold of 'premenopausal risk-reducing salpingo-oophorectomy' for ovarian cancer prevention: a cost-effectiveness analysis.

Science.gov (United States)

Manchanda, Ranjit; Legood, Rosa; Antoniou, Antonis C; Gordeev, Vladimir S; Menon, Usha

2016-09-01

Risk-reducing salpingo-oophorectomy (RRSO) is the most effective intervention to prevent ovarian cancer (OC). It is only available to high-risk women with >10% lifetime OC risk. This threshold has not been formally tested for cost-effectiveness. To specify the OC risk thresholds for RRSO being cost-effective for preventing OC in premenopausal women. The costs as well as effects of surgical prevention ('RRSO') were compared over a lifetime with 'no RRSO' using a decision analysis model. RRSO was undertaken in premenopausal women >40 years. The model was evaluated at lifetime OC risk levels: 2%, 4%, 5%, 6%, 8% and 10%. Costs and outcomes are discounted at 3.5%. Uncertainty in the model was assessed using both deterministic sensitivity analysis and probabilistic sensitivity analysis (PSA). Outcomes included in the analyses were OC, breast cancer (BC) and additional deaths from coronary heart disease. Total costs and effects were estimated in terms of quality-adjusted life-years (QALYs); incidence of OC and BC; as well as incremental cost-effectiveness ratio (ICER). Published literature, Nurses Health Study, British National Formulary, Cancer Research UK, National Institute for Health and Care Excellence guidelines and National Health Service reference costs. The time horizon is lifetime and perspective: payer. Premenopausal RRSO is cost-effective at 4% OC risk (life expectancy gained=42.7 days, ICER=£19 536/QALY) with benefits largely driven by reduction in BC risk. RRSO remains cost-effective at >8.2% OC risk without hormone replacement therapy (ICER=£29 071/QALY, life expectancy gained=21.8 days) or 6%if BC risk reduction=0 (ICER=£27 212/QALY, life expectancy gained=35.3 days). Sensitivity analysis indicated results are not impacted much by costs of surgical prevention or treatment of OC/ BC or cardiovascular disease. However, results were sensitive to RRSO utility scores. Additionally, 37%, 61%, 74%, 84%, 96% and 99.5% simulations on PSA are cost

Cerebrospinal fluid leakage during transsphenoidal surgery: postoperative external lumbar drainage reduces the risk for meningitis

NARCIS (Netherlands)

van Aken, M. O.; Feelders, R. A.; de Marie, S.; van de Berge, J. H.; Dallenga, A. H. G.; Delwel, E. J.; Poublon, R. M. L.; Romijn, J. A.; van der Lely, A. J.; Lamberts, S. W. J.; de Herder, W. W.

2004-01-01

Postoperative meningitis is a well known complication of transsphenoidal surgery (TSS). The objective of this study was to evaluate whether postoperative external cerobrospinal fluid (CSF) drainage in case of intraoperative CSF-leakage, reduces the risk of postoperative meningitis. We

Risk estimation and evaluation

Energy Technology Data Exchange (ETDEWEB)

Ferguson, R A.D.

1982-10-01

Risk assessment involves subjectivity, which makes objective decision making difficult in the nuclear power debate. The author reviews the process and uncertainties of estimating risks as well as the potential for misinterpretation and misuse. Risk data from a variety of aspects cannot be summed because the significance of different risks is not comparable. A method for including political, social, moral, psychological, and economic factors, environmental impacts, catastrophes, and benefits in the evaluation process could involve a broad base of lay and technical consultants, who would explain and argue their evaluation positions. 15 references. (DCK)

Acceptability of mobile health interventions to reduce inactivity-related health risk in central Pennsylvania adults

Directory of Open Access Journals (Sweden)

Chih-Hsiang Yang

2015-01-01

Full Text Available Insufficient physical activity and excessive sedentary behavior elevate health risk. Mobile applications (apps provide one mode for delivering interventions to modify these behaviors and reduce health risk. The purpose of this study was to characterize the need for and acceptability of health behavior interventions among rural adults and evaluate the interest in and the value of app-based interventions in this population. Central Pennsylvania adults with smartphones (N = 258 completed a brief web survey in October–November 2012. Most adults report one or both inactivity-related behavioral risk factors, would use a free app to modify those risk behaviors, and would pay a small amount for that app. Low-cost, efficacious apps to increase physical activity or reduce sedentary behavior should be promoted in public health practice. User experience should be at the forefront of this process to increase value and minimize burden in the service of long-term engagement, behavior change, and health risk reduction.

RISK ANALYSIS AND EVALUATION FOR CRITICAL LOGISTICAL INFRASTRUCTURE

Directory of Open Access Journals (Sweden)

Sascha Düerkop

2016-12-01

Full Text Available Logistical infrastructure builds the backbone of an economy. Without an effective logistical infrastructure in place, the supply for both enterprises and consumers might not be met. But even a high-quality logistical infrastructure can be threatened by risks. Thus, it is important to identify, analyse, and evaluate risks for logistical infrastructure that might threaten logistical processes. Only if those risks are known and their impact estimated, decision makers can implement counteractive measures to reduce risks. In this article, we develop a network-based approach that allows for the evaluation of risks and their consequences onto the logistical network. We will demonstrate the relevance of this approach by applying it to the logistics network of the central German state of Hesse. Even though transport data is extensively tracked and recorded nowadays, typical daily risks, like accidents on a motorway, and extraordinary risks, like a bridge at risk to collapse, terrorist attacks or climate-related catastrophes, are not systematically anticipated. Several studies unveiled recently that the overall impact for an economy of possible failures of single nodes and/or edges in a network are not calculated, and particularly critical edges are not identified in advance. We address this information gap by a method that helps to identify and quantify risks in a given network. To reach this objective, we define a mathematical optimization model that quantifies the current “risk-related costs” of the overall network and quantify the risk by investigating the change of the overall costs in the case a risk is realized.

Pest risk assessment of Monilinia fructicola for the EU territory and identification and evaluation of risk management options

DEFF Research Database (Denmark)

Baker, R.; Candresse, T.; Dormannsné Simon, E.

2011-01-01

The EFSA Panel on Plant Health has delivered a pest risk assessment on the risk posed by Monilinia fructicola to the EU territory and has identified risk management options and evaluated their effectiveness in reducing the risk to plant health posed by this organism. The Panel has also analysed...... the effectiveness of the special requirements presently listed in Annex IV, Part A, Section I of Council Directive 2000/29/EC, in reducing the risk of introduction of this pest into the EU territory. The Panel concluded that the main pathways for entry into the EU territory are plant material for propagation...... of the risk assessment area. Cultural practices and control measures currently applied and competition with other Monilinia species cannot prevent the establishment of M. fructicola. The probability of spread is very likely because of the multiple ways of dispersal of the pest. The overall impact...

Reducing cardiovascular risk : protecting the kidney

NARCIS (Netherlands)

Dobre, Daniela; Lambers Heerspink, Hiddo J.; de Zeeuw, Dick

2009-01-01

Progressive decline of renal function in chronic kidney disease (CKD), measured by a reduced glomerular filtration rate or albuminuria, is linked to an increased risk of cardiovascular (CV) disease. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), most

Business risks, functions, methods of assessment and ways to reduce risk

Directory of Open Access Journals (Sweden)

A.V. Mihalchuk

2015-06-01

Full Text Available For successful existence in a market economy entrepreneur have to take bold actions, and this increases the risk. The article describes the concept of entrepreneurship and business risk, positive and negative aspects of functions of risk in business. Therefore, it is necessary to assess the risk properly and be able to manage it to achieve the most effective results in the market. In market conditions the problem of assessing and accounting market becomes independent theoretical and practical significance as an important component of the theory and practice of management. Risk - a key element of business activities. Development of risk situations can lead to both the occurrence of adverse effects (losses, lost profits, and positive results for a company in the form of increased profit. This article describes: the concept of entrepreneurship, risk and business risks, characteristic of positive and negative aspects of risk functions in business, methods of assessment and risk reduction, shows formulae and examples you can use to assess risk in an enterprise. Analyzing already established methods of risk assessment a number of rules were proposed in order to reduce business risk.

Evaluations and utilizations of risk importances

International Nuclear Information System (INIS)

Vesely, W.E.; Davis, T.C.

1985-08-01

This report presents approaches for utilizing Probabilistic Risk Analyses (PRA's) to determine risk importances. Risk importances are determined for design features, plant operations, and other factors that can affect risk. PRA's can be used to identify the importances of risk contributors or proposed changes to designs or operations. The objective of this report is to serve as a handbook and guide in evaluating and applying risk importances. The utilization of both qualitative risk importances and quantitative risk importances is described in this report. Qualitative risk importances are based on the logic models in the PRA, while quantitative risk importances are based on the quantitative results of the PRA. Both types of importances are among the most robust and meaningful information a PRA can provide. A wide variety of risk importance evaluations are described including evaluations of the importances of design changes, testing, maintenance, degrading environments, and aging. Specific utilizations are described in inspection and in reliability assurance programs, however the general approaches have widespread applicability. The role of personal computers and decision support programs in applying risk importance evaluations is also described

The efficiency of asset management strategies to reduce urban flood risk.

Science.gov (United States)

ten Veldhuis, J A E; Clemens, F H L R

2011-01-01

In this study, three asset management strategies were compared with respect to their efficiency to reduce flood risk. Data from call centres at two municipalities were used to quantify urban flood risks associated with three causes of urban flooding: gully pot blockage, sewer pipe blockage and sewer overloading. The efficiency of three flood reduction strategies was assessed based on their effect on the causes contributing to flood risk. The sensitivity of the results to uncertainty in the data source, citizens' calls, was analysed through incorporation of uncertainty ranges taken from customer complaint literature. Based on the available data it could be shown that increasing gully pot blockage is the most efficient action to reduce flood risk, given data uncertainty. If differences between cause incidences are large, as in the presented case study, call data are sufficient to decide how flood risk can be most efficiently reduced. According to the results of this analysis, enlargement of sewer pipes is not an efficient strategy to reduce flood risk, because flood risk associated with sewer overloading is small compared to other failure mechanisms.

Reducing drinking water supply chemical contamination: risks from underground storage tanks.

Science.gov (United States)

Enander, Richard T; Hanumara, R Choudary; Kobayashi, Hisanori; Gagnon, Ronald N; Park, Eugene; Vallot, Christopher; Genovesi, Richard

2012-12-01

Drinking water supplies are at risk of contamination from a variety of physical, chemical, and biological sources. Ranked among these threats are hazardous material releases from leaking or improperly managed underground storage tanks located at municipal, commercial, and industrial facilities. To reduce human health and environmental risks associated with the subsurface storage of hazardous materials, government agencies have taken a variety of legislative and regulatory actions--which date back more than 25 years and include the establishment of rigorous equipment/technology/operational requirements and facility-by-facility inspection and enforcement programs. Given a history of more than 470,000 underground storage tank releases nationwide, the U.S. Environmental Protection Agency continues to report that 7,300 new leaks were found in federal fiscal year 2008, while nearly 103,000 old leaks remain to be cleaned up. In this article, we report on an alternate evidence-based intervention approach for reducing potential releases from the storage of petroleum products (gasoline, diesel, kerosene, heating/fuel oil, and waste oil) in underground tanks at commercial facilities located in Rhode Island. The objective of this study was to evaluate whether a new regulatory model can be used as a cost-effective alternative to traditional facility-by-facility inspection and enforcement programs for underground storage tanks. We conclude that the alternative model, using an emphasis on technical assistance tools, can produce measurable improvements in compliance performance, is a cost-effective adjunct to traditional facility-by-facility inspection and enforcement programs, and has the potential to allow regulatory agencies to decrease their frequency of inspections among low risk facilities without sacrificing compliance performance or increasing public health risks. © 2012 Society for Risk Analysis.

Contract Design: Risk Management and Evaluation.

Science.gov (United States)

Mühlbacher, Axel C; Amelung, Volker E; Juhnke, Christin

2018-01-12

Effective risk adjustment is an aspect that is more and more given weight on the background of competitive health insurance systems and vital healthcare systems. The risk structure of the providers plays a vital role in Pay for Performance. A prerequisite for optimal incentive-based service models is a (partial) dependence of the agent's returns on the provider's gain level. Integrated care systems as well as accountable care organisations (ACOs) in the US and similar concepts in other countries are advocated as an effective method of improving the performance of healthcare systems. These systems outline a payment and care delivery model that intends to tie provider reimbursements to predefined quality metrics. By this the total costs of care shall be reduced. Little is known about the contractual design and the main challenges of delegating "accountability" to these new kinds of organisations and/or contracts. The costs of market utilisation are highly relevant for the conception of healthcare contracts; furthermore information asymmetries and contract-specific investments are an obstacle to the efficient operation of ACOs. A comprehensive literature review on methods of designing contracts in Integrated Care was conducted. The research question in this article focuses on how reimbursement strategies, evaluation of measures and methods of risk adjustment can best be integrated in healthcare contracting. Each integrated care contract includes challenges for both payers and providers without having sufficient empirical data on both sides. These challenges are clinical, administrative or financial nature. Risk adjusted contracts ensure that the reimbursement roughly matches the true costs resulting from the morbidity of a population. If reimbursement of care provider corresponds to the actual expenses for an individual/population the problem of risk selection is greatly reduced. The currently used methods of risk adjustment have widely differing model and forecast

Reduced risk of axillary lymphatic spread in triple-negative breast cancer

DEFF Research Database (Denmark)

Holm-Rasmussen, Emil Villiam; Jensen, Maj-Britt; Balslev, Eva

2015-01-01

We examined the association between the hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status of women with primary breast cancer and the risk of axillary lymph node (ALN) involvement at the time of diagnosis. Information on 20,009 women diagnosed with primary breast...... cancer between 2008 and 2012 was retrieved from the Danish Breast Cancer Cooperative Group database. The associations between clinical and pathological variables and ALN involvement at the time of diagnosis were evaluated in univariate and multivariate regression analyses, as well as the significance......-negative breast cancer (TNBC) patients showed a significantly reduced risk of ALN involvement at the time of diagnosis compared to patients with HR-positive/HER2-negative tumors (OR 0.55; 95 % CI 0.49-0.62; P

Evaluation of test intervals strategies with a risk monitor

International Nuclear Information System (INIS)

Soerman, J.

2005-01-01

The Swedish nuclear power utility Oskarshamn Power Group (OKG), is investigating how the use of a risk monitor can facilitate and improve risk-informed decision-making at their nuclear power plants. The intent is to evaluate if risk-informed decision-making can be accepted. A pilot project was initiated and carried out in 2004. The project included investigating if a risk monitor can be used for optimising test intervals for diesel- and gas turbine generators with regard to risk level. The Oskarhamn 2 (O2), PSA Level 1 model was converted into a risk monitor using RiskSpectrum RiskWatcher (RSRW) software. The converted PSA model included the complete PSA model for the power operation mode. RSRW then performs a complete requantification for every analysis. Time dependent reliability data are taken into account, i.e. a shorter test interval will increases the components availability (possibility to e.g. start on demand). The converted O2 model was then used to investigate whether it would be possible to balance longer test intervals for diesel generators, gas turbine generators and high pressure injection system with shorter test intervals for the low pressure injection system, while maintaining a low risk level at the plant. The results show that a new mixture of test intervals can be implemented with only marginally changes in the risk calculated with the risk monitor model. The results indicate that the total number of test activities for the systems included in the pilot study could be reduced by 20% with a maintained level of risk. A risk monitor taking into account the impact from test intervals in availability calculations for components is well suited for evaluation of test interval strategies. It also enables the analyst to evaluate the risk level over a period of time including the impact the actual status of the plant may have on the risk level. (author)

Reducing risk of spinal haematoma from spinal and epidural pain procedures.

Science.gov (United States)

Breivik, Harald; Norum, Hilde; Fenger-Eriksen, Christian; Alahuhta, Seppo; Vigfússon, Gísli; Thomas, Owain; Lagerkranser, Michael

2018-04-25

Central neuraxial blocks (CNB: epidural, spinal and their combinations) and other spinal pain procedures can cause serious harm to the spinal cord in patients on antihaemostatic drugs or who have other risk-factors for bleeding in the spinal canal. The purpose of this narrative review is to provide a practise advisory on how to reduce risk of spinal cord injury from spinal haematoma (SH) during CNBs and other spinal pain procedures. Scandinavian guidelines from 2010 are part of the background for this practise advisory. We searched recent guidelines, PubMed (MEDLINE), SCOPUS and EMBASE for new and relevant randomised controlled trials (RCT), case-reports and original articles concerning benefits of neuraxial blocks, risks of SH due to anti-haemostatic drugs, patient-related risk factors, especially renal impairment with delayed excretion of antihaemostatic drugs, and specific risk factors related to the neuraxial pain procedures. Epidural and spinal analgesic techniques, as well as their combination provide superior analgesia and reduce the risk of postoperative and obstetric morbidity and mortality. Spinal pain procedure can be highly effective for cancer patients, less so for chronic non-cancer patients. We did not identify any RCT with SH as outcome. We evaluated risks and recommend precautions for SH when patients are treated with antiplatelet, anticoagulant, or fibrinolytic drugs, when patients' comorbidities may increase risks, and when procedure-specific risk factors are present. Inserting and withdrawing epidural catheters appear to have similar risks for initiating a SH. Invasive neuraxial pain procedures, e.g. spinal cord stimulation, have higher risks of bleeding than traditional neuraxial blocks. We recommend robust monitoring routines and treatment protocol to ensure early diagnosis and effective treatment of SH should this rare but potentially serious complication occur. When neuraxial analgesia is considered for a patient on anti

Risk-reducing mastectomy for the prevention of primary breast cancer.

Science.gov (United States)

Carbine, Nora E; Lostumbo, Liz; Wallace, Judi; Ko, Henry

2018-04-05

Recent progress in understanding the genetic basis of breast cancer and widely publicized reports of celebrities undergoing risk-reducing mastectomy (RRM) have increased interest in RRM as a method of preventing breast cancer. This is an update of a Cochrane Review first published in 2004 and previously updated in 2006 and 2010. (i) To determine whether risk-reducing mastectomy reduces death rates from any cause in women who have never had breast cancer and in women who have a history of breast cancer in one breast, and (ii) to examine the effect of risk-reducing mastectomy on other endpoints, including breast cancer incidence, breast cancer mortality, disease-free survival, physical morbidity, and psychosocial outcomes. For this Review update, we searched Cochrane Breast Cancer's Specialized Register, MEDLINE, Embase and the WHO International Clinical Trials Registry Platform (ICTRP) on 9 July 2016. We included studies in English. Participants included women at risk for breast cancer in at least one breast. Interventions included all types of mastectomy performed for the purpose of preventing breast cancer. At least two review authors independently abstracted data from each report. We summarized data descriptively; quantitative meta-analysis was not feasible due to heterogeneity of study designs and insufficient reporting. We analyzed data separately for bilateral risk-reducing mastectomy (BRRM) and contralateral risk-reducing mastectomy (CRRM). Four review authors assessed the methodological quality to determine whether or not the methods used sufficiently minimized selection bias, performance bias, detection bias, and attrition bias. All 61 included studies were observational studies with some methodological limitations; randomized trials were absent. The studies presented data on 15,077 women with a wide range of risk factors for breast cancer, who underwent RRM.Twenty-one BRRM studies looking at the incidence of breast cancer or disease-specific mortality, or

A Risk Assessment Model for Reduced Aircraft Separation: A Quantitative Method to Evaluate the Safety of Free Flight

Science.gov (United States)

Cassell, Rick; Smith, Alex; Connors, Mary; Wojciech, Jack; Rosekind, Mark R. (Technical Monitor)

1996-01-01

As new technologies and procedures are introduced into the National Airspace System, whether they are intended to improve efficiency, capacity, or safety level, the quantification of potential changes in safety levels is of vital concern. Applications of technology can improve safety levels and allow the reduction of separation standards. An excellent example is the Precision Runway Monitor (PRM). By taking advantage of the surveillance and display advances of PRM, airports can run instrument parallel approaches to runways separated by 3400 feet with the same level of safety as parallel approaches to runways separated by 4300 feet using the standard technology. Despite a wealth of information from flight operations and testing programs, there is no readily quantifiable relationship between numerical safety levels and the separation standards that apply to aircraft on final approach. This paper presents a modeling approach to quantify the risk associated with reducing separation on final approach. Reducing aircraft separation, both laterally and longitudinally, has been the goal of several aviation R&D programs over the past several years. Many of these programs have focused on technological solutions to improve navigation accuracy, surveillance accuracy, aircraft situational awareness, controller situational awareness, and other technical and operational factors that are vital to maintaining flight safety. The risk assessment model relates different types of potential aircraft accidents and incidents and their contribution to overall accident risk. The framework links accident risks to a hierarchy of failsafe mechanisms characterized by procedures and interventions. The model will be used to assess the overall level of safety associated with reducing separation standards and the introduction of new technology and procedures, as envisaged under the Free Flight concept. The model framework can be applied to various aircraft scenarios, including parallel and in

[Strategies for reducing risks in smoking: opportunity or threat].

Science.gov (United States)

Córdoba, Rodrigo; Nerín, Isabel

2009-12-01

The smoking control policies recommended by the World Health Organisation have achieved a slight decrease in smoking prevalence in the developed countries, although associated mortality is still very high. The use of tobacco products other than cigarettes and even medicinal nicotine (known as nicotine replacement therapy (NRT)) has been proposed as a risk reduction strategy. Among the tobacco products with less individual risk than cigarettes would be any type of tobacco without smoke (smokeless) with a low content in nitrosamines and modified cigarettes; both forms included under the PREP (Potentially Reduced Exposure Products) concept. The idea would be to promote these products among those who cannot quit smoking or wish to reduce their risk without giving up nicotine intake. The possible effects of risk reduction strategies, including PREP, on the decreased prevalence and morbidity and mortality are reviewed, and the possible implications that this measure could have in our country are analysed. Tobacco control measures in Spain are recent and still insufficient. Therefore, the current priority in Spain is the development of policies of control that have shown to more than effective. The marketing and advertising of new tobacco products, even with reduced potential risk, seems more a serious threat than an opportunity for the development of smoking control policies.

Reducing the Risk of Methadone Overdose

Centers for Disease Control (CDC) Podcasts

2012-07-03

This podcast is based on the July 2012 CDC Vital Signs report. Approximately 14 people die every day of overdoses related to methadone. Listen to learn how to reduce your risk of an overdose.  Created: 7/3/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/3/2012.

Judging risk behaviour and risk preference: the role of the evaluative connotation of risk terms.

NARCIS (Netherlands)

van Schie, E.C.M.; van der Pligt, J.; van Baaren, K.

1993-01-01

Two experiments investigated the impact of the evaluative connotation of risk terms on the judgment of risk behavior and on risk preference. Exp 1 focused on the evaluation congruence of the risk terms with a general risk norm and with Ss' individual risk preference, and its effects on the extremity

Communication in reducing facility siting risk

International Nuclear Information System (INIS)

Bisconti, A.S.

1992-01-01

Today, social considerations are as important as technical ones in siting new nuclear facilities. Siting any industrial facility has become extremely difficult in this era of not in my backyard (NIMBY). Even if NIMBY does not arise locally, well-organized national opposition groups can be counted on to step in to fan the flames, especially when the industrial facility has to do with anything nuclear. It is now generally recognized that the greatest risk of failure for new nuclear facilities is not technical but social. Applying lessons gained from past experience and social science research can help reduce that risk. From these lessons, six principles for public interaction and communication stand out: (1) create goodwill now; (2) involve the community early; (3) establish the need; (4) communicate controls, not risk; (5) avoid jargon; (6) understand your public

USING THE DELPHI TECHNIQUE TO DEVELOP EFFECTIVENESS INDICATORS FOR SOCIAL MARKETING COMMUNICATION TO REDUCE HEALTH-RISK BEHAVIORS AMONG YOUTH.

Science.gov (United States)

Vantamay, Nottakrit

2015-09-01

This study aimed to develop effectiveness indicators for social marketing communication to reduce health-risk behaviors among Thai youth by using the Delphi technique. The Delphi technique is a research approach used to gain consensus through a series of two or more rounds of questionnaire surveys where information and results are fed back to panel members between each round and it has been extensively used to generate many indicators relevant to health behaviors. The Delphi technique was conducted in 3 rounds by consulting a panel of 15 experts in the field of social marketing communication for public health campaigns in Thailand. We found forty-nine effectiveness indicators in eight core components reached consensus. These components were: 1) attitude about health-risk behavior reduction, 2) subjective norms, 3) perceived behavioral control, 4) intention to reduce health-risk behaviors, 5) practices for reducing health-risk behaviors, 6) knowledge about the dangers and impact of health-risk behaviors, 7) campaign brand equity, and 8) communication networks. These effectiveness indicators could be applied by health promotion organizations for evaluating the effectiveness of social marketing communication to effectively reduce health-risk behaviors among youth.

High level waste (HLW) steam reducing station evaluation

International Nuclear Information System (INIS)

Gannon, R.E.

1993-01-01

Existing pressure equipment in High Level Waste does not have a documented technical baseline. Based on preliminary reviews, the existing equipment seems to be based on system required capacity instead of system capability. A planned approach to establish a technical baseline began September 1992 and used the Works Management System preventive maintenance schedule. Several issues with relief valves being undersized on steam reducing stations created a need to determine the risk of maintaining the steam in service. An Action Plan was developed to evaluate relief valves that did not have technical baselines and provided a path forward for continued operation. Based on Action Plan WER-HLE-931042, the steam systems will remain in service while the designs are being developed and implemented

Quality Risk Evaluation of the Food Supply Chain Using a Fuzzy Comprehensive Evaluation Model and Failure Mode, Effects, and Criticality Analysis

Directory of Open Access Journals (Sweden)

Libiao Bai

2018-01-01

Full Text Available Evaluating the quality risk level in the food supply chain can reduce quality information asymmetry and food quality incidents and promote nationally integrated regulations for food quality. In order to evaluate it, a quality risk evaluation indicator system for the food supply chain is constructed based on an extensive literature review in this paper. Furthermore, a mathematical model based on the fuzzy comprehensive evaluation model (FCEM and failure mode, effects, and criticality analysis (FMECA for evaluating the quality risk level in the food supply chain is developed. A computational experiment aimed at verifying the effectiveness and feasibility of this proposed model is conducted on the basis of a questionnaire survey. The results suggest that this model can be used as a general guideline to assess the quality risk level in the food supply chain and achieve the most important objective of providing a reference for the public and private sectors when making decisions on food quality management.

Reducing the Risks for Contrast-Induced Nephropathy

International Nuclear Information System (INIS)

Stacul, Fulvio

2005-01-01

Contrast-induced nephropathy (CIN) is one of the most serious adverse events associated with the use of contrast media (CM). Patients who develop this complication can have increased morbidity, higher rates of mortality, lengthy hospital stays, and poor long-term outcomes. Although CIN cannot be eliminated, the chances of developing this condition can be reduced by using appropriate prevention strategies. An important first step to reduce the chance of CIN is to identify risk factors associated with this condition. Patients with a previously elevated serum creatinine level, especially when secondary to diabetic nephropathy, are at great risk for developing CIN. Other patient-related risk factors include concurrent use of nephrotoxic medications, dehydration, congestive heart failure, age greater than 70 years, and probably the presence of diabetes mellitus even if serum creatinine is normal. Adequate hydration is widely accepted as an important prophylactic measure for preventing CIN, but the optimal hydration regimen is still debatable. The risk of CIN increases with greater doses of CM, as well as with the type of CM used. A high-osmolar CM poses a greater risk of CIN than does a low-osmolar CM and, as recent but limited data suggest, the use of an iso-osmolar CM is less nephrotoxic than a low-osmolar CM in patients with renal impairment following intra-arterial procedures, although this finding needs to be verified in future clinical studies. Pharmacologic agents such as calcium channel blockers, dopamine, atrial natriuretic peptide, fenoldopam, prostaglandin E1, and endothelin receptor antagonist have not been proven effective against CIN development. Controversies still exist on the possible effectiveness of theophylline and N-acetylcysteine. Simple strategies for the prevention of CIN in at-risk patients are reviewed and unproven interventions are discussed

Contract Design: Risk Management and Evaluation

Directory of Open Access Journals (Sweden)

Axel C. Mühlbacher

2018-01-01

Full Text Available Introduction: Effective risk adjustment is an aspect that is more and more given weight on the background of competitive health insurance systems and vital healthcare systems. The risk structure of the providers plays a vital role in Pay for Performance. A prerequisite for optimal incentive-based service models is a (partial dependence of the agent’s returns on the provider’s gain level. Integrated care systems as well as accountable care organisations (ACOs in the US and similar concepts in other countries are advocated as an effective method of improving the performance of healthcare systems. These systems outline a payment and care delivery model that intends to tie provider reimbursements to predefined quality metrics. By this the total costs of care shall be reduced.  Methods: Little is known about the contractual design and the main challenges of delegating “accountability” to these new kinds of organisations and/or contracts. The costs of market utilisation are highly relevant for the conception of healthcare contracts; furthermore information asymmetries and contract-specific investments are an obstacle to the efficient operation of ACOs. A comprehensive literature review on methods of designing contracts in Integrated Care was conducted. The research question in this article focuses on how reimbursement strategies, evaluation of measures and methods of risk adjustment can best be integrated in healthcare contracting.  Results: Each integrated care contract includes challenges for both payers and providers without having sufficient empirical data on both sides. These challenges are clinical, administrative or financial nature. Risk adjusted contracts ensure that the reimbursement roughly matches the true costs resulting from the morbidity of a population. If reimbursement of care provider corresponds to the actual expenses for an individual/population the problem of risk selection is greatly reduced. The currently used methods

Reducing the harms associated with risk assessments

International Nuclear Information System (INIS)

Montague, Peter

2004-01-01

Risk assessments are the intellectual products of dedicated public health and environmental professionals. Like many other products, risk assessments carry with them the potential for both good and harm. This paper briefly examines some of the harms to which risk assessments have contributed, and then suggests that the legal 'duty to warn' doctrine offers a logical and practical way to reduce some of these harms. The paper suggests concepts that could be incorporated into warnings accompanying every formal risk assessment as routine 'boiler plate' addenda, just as other potentially harmful products, such as lawn mowers and cook stoves, are accompanied by warnings. Finally, the paper briefly examines the 'Code of Ethics and Standards of Practice for Environmental Professionals' (promulgated by the National Association of Environmental Professionals) and shows that the suggested warnings are consistent with recommended practices for environmental professionals

Mitigating flood exposure: Reducing disaster risk and trauma signature.

Science.gov (United States)

Shultz, James M; McLean, Andrew; Herberman Mash, Holly B; Rosen, Alexa; Kelly, Fiona; Solo-Gabriele, Helena M; Youngs, Georgia A; Jensen, Jessica; Bernal, Oscar; Neria, Yuval

2013-01-01

Introduction. In 2011, following heavy winter snowfall, two cities bordering two rivers in North Dakota, USA faced major flood threats. Flooding was foreseeable and predictable although the extent of risk was uncertain. One community, Fargo, situated in a shallow river basin, successfully mitigated and prevented flooding. For the other community, Minot, located in a deep river valley, prevention was not possible and downtown businesses and one-quarter of the homes were inundated, in the city's worst flood on record. We aimed at contrasting the respective hazards, vulnerabilities, stressors, psychological risk factors, psychosocial consequences, and disaster risk reduction strategies under conditions where flood prevention was, and was not, possible. Methods . We applied the "trauma signature analysis" (TSIG) approach to compare the hazard profiles, identify salient disaster stressors, document the key components of disaster risk reduction response, and examine indicators of community resilience. Results . Two demographically-comparable communities, Fargo and Minot, faced challenging river flood threats and exhibited effective coordination across community sectors. We examined the implementation of disaster risk reduction strategies in situations where coordinated citizen action was able to prevent disaster impact (hazard avoidance) compared to the more common scenario when unpreventable disaster strikes, causing destruction, harm, and distress. Across a range of indicators, it is clear that successful mitigation diminishes both physical and psychological impact, thereby reducing the trauma signature of the event. Conclusion . In contrast to experience of historic flooding in Minot, the city of Fargo succeeded in reducing the trauma signature by way of reducing risk through mitigation.

Gastric Bypass Surgery Produces a Durable Reduction in Cardiovascular Disease Risk Factors and Reduces the Long-Term Risks of Congestive Heart Failure.

Science.gov (United States)

Benotti, Peter N; Wood, G Craig; Carey, David J; Mehra, Vishal C; Mirshahi, Tooraj; Lent, Michelle R; Petrick, Anthony T; Still, Christopher; Gerhard, Glenn S; Hirsch, Annemarie G

2017-05-23

Obesity and its association with reduced life expectancy are well established, with cardiovascular disease as one of the major causes of fatality. Metabolic surgery is a powerful intervention for severe obesity, resulting in improvement in comorbid diseases and in cardiovascular risk factors. This study investigates the relationship between metabolic surgery and long-term cardiovascular events. A cohort of Roux-en-Y gastric bypass surgery (RYGB) patients was tightly matched by age, body mass index, sex, Framingham Risk Score, smoking history, use of antihypertension medication, diabetes mellitus status, and calendar year with a concurrent cohort of nonoperated control patients. The primary study end points of major cardiovascular events (myocardial infarction, stroke, and congestive heart failure) were evaluated using Cox regression. Secondary end points of longitudinal cardiovascular risk factors were evaluated using repeated-measures regression. The RYGB and matched controls (N=1724 in each cohort) were followed for up to 12 years after surgery (overall median of 6.3 years). Kaplan-Meier analysis revealed a statistically significant reduction in incident major composite cardiovascular events ( P =0.017) and congestive heart failure (0.0077) for the RYGB cohort. Adjusted Cox regression models confirmed the reductions in severe composite cardiovascular events in the RYGB cohort (hazard ratio=0.58, 95% CI=0.42-0.82). Improvements of cardiovascular risk factors (eg, 10-year cardiovascular risk score, total cholesterol, high-density lipoprotein, systolic blood pressure, and diabetes mellitus) were observed within the RYGB cohort after surgery. Gastric bypass is associated with a reduced risk of major cardiovascular events and the development of congestive heart failure. © 2017 The Authors and Geisinger Clinic. Published on behalf of the American Heart Association, Inc., by Wiley.

Risk informed inservice inspection evaluation of the ComEd nuclear plants

International Nuclear Information System (INIS)

Fleming, K.N.; Hutchinson, J.J.

2000-01-01

In November, 1999 Commonwealth Edison Company began the largest scope project yet performed to implement risk informed in-service inspection programs for piping systems. A contractor team led by ERIN Engineering and Research was selected to perform full scope risk informed evaluations on ten reactor units at five sites including 3 BWR and 2 PWR stations. This risk informed evaluation has applied a number of advancements to RISI technology in key areas including risk quantification of inspection program changes, element selection, treatment of multiple damage mechanisms at a given location, and in streamlining an approach to RISI initially developed by EPRI. The scope of the evaluation covered more than 18,000 ASME Class 1 and 2 welds not counting those that will continue to be inspected as part of augmented programs for flow accelerated corrosion, stress corrosion cracking, and service water systems. When the current ASME Section XI based exams are replaced by the risk informed program, while some new inspection locations will be added, substantial cost savings and person-rem exposures are projected from the elimination of most of the current exams. ComEd expects to recover its investment in the RISI evaluation for each of the 10 reactor units in 1 to 2 refueling outages, from the cost savings of reduced inspections. At the same time, the risk of a severe accident due to pipe ruptures is not expected to exhibit significant changes. (author)

Programme for reducing the risk factors due to prenatal exposure

International Nuclear Information System (INIS)

Arranz, L.; Ferrer, N.; Sastre, J.M.

2001-01-01

When a patient is not aware of her pregnancy, the foetus/embryo may be inadvertently irradiated during a diagnostic exploration or therapeutic intervention. The radiosensitivity of the foetus/embryo changes during the different periods of gestation. For this reason there are different risk factors for each moment at which the patient may suffer irradiation. In the past 7 years, the Department of Radiophysics and Radiation Protection has been consulted 75 times for this reason, to evaluate the dose received in the uterus. Since the establishment of a programme to avoid inadvertent irradiation of the foetus/embryo, these consultations have been reduced. This programme is based on informing the patients and on training the medical staff. (author)

Reducing risks, protecting people. A harmonized approach

International Nuclear Information System (INIS)

Foster, R.B.

2000-01-01

Risk training, education and communication usually refer to the responsibilities of those who generate risk (e.g. operators of nuclear power plants) towards those who are exposed to the risk (e.g. employees working in the plants and those living in the vicinity). In this context training, education and communication are intended to transfer information from risk professionals to a largely uninformed audience, with a view to improving standards or providing reassurance. However, with the growth of media such as the Internet those to whom such training, education and communication have traditionally been directed are now much better informed. In addition, increasing prosperity affects expectations and prompts questions, not only about the adequacy of the control measures intended to address specific hazards, but also about whether the hazardous activity is justified at all. Within the UK (and Europe) this is very evident for nuclear power, other applications of ionizing radiation, and in other areas such as genetically modified food. In consequence regulators of hazardous activities face considerable new challenges. Of course, regulators still have to formulate standards, communicate them to those responsible for risk reduction and see that the necessary controls are in place. But in addition regulators also have to be able to answer questions such as: - why is this hazardous activity (e.g. a nuclear power plant) allowed at all? - what level of risk is unacceptable? - is the approach to risk reduction sufficiently precautionary? - why shouldn't the risk be reduced further? - why are the risks from certain activities (e.g. those from ionizing radiation) controlled to much lower levels than those from other work activities? - how are decisions made, what criteria are applied and how are the stake holders involves? All this does not make life easy for regulators! The full paper will describe how the Health and Safety Executive (HSE) has responded to these challenges by

Managing Risk, Reducing Vulnerability and Enhancing Productivity ...

International Development Research Centre (IDRC) Digital Library (Canada)

Managing Risk, Reducing Vulnerability and Enhancing Productivity under a Changing Climate. The countries of the Greater Horn of Africa are particularly vulnerable to drought, exacerbated by widespread poverty and dependence on rainfed agriculture. Even with normal rainfall, the region does not produce enough food to ...

A risk-based evaluation of LMFBR containment response under core disruptive accident conditions

International Nuclear Information System (INIS)

Hartung, J.; Berk, S.

1978-01-01

Probabilistic risk methodology is utilized to evaluate the failure modes and effects of LMFBR containment systems under Core Disruptive Accident (CDA) conditions. First, the potential causes of LMFBR containment failure under CDA conditions are discussed and categorized. Then, a simple scoping-type risk assessment of a reference design is presented to help place these potential causes of failure in perspective. The highest risk containment failure modes are identified for the reference design, and several design and research and development options which appear capable of reducing these risks are discussed. The degree to which large LMFBR containment systems must mitigate the consequences of CDA's to achieve a level of risk (for LMFBR's) comparable to the already very low risk of contemporary LWR's is explored. Based on the results of this evaluation, several suggestions are offered concerning CDA-related design goals and research and development priorities for large LMFBR's. (author)

Reducing Risk for the Next Generation Nuclear Plant

Energy Technology Data Exchange (ETDEWEB)

John M. Beck II; Harold J. Heydt; Emmanuel O. Opare; Kyle B. Oswald

2010-07-01

The Next Generation Nuclear Plant (NGNP) Project, managed by the Idaho National Laboratory (INL), is directed by the Energy Policy Act of 2005, to research, develop, design, construct, and operate a prototype forth generation nuclear reactor to meet the needs of the 21st Century. As with all large projects developing and deploying new technologies, the NGNP has numerous risks that need to be identified, tracked, mitigated, and reduced in order for successful project completion. A Risk Management Plan (RMP) was created to outline the process the INL is using to manage the risks and reduction strategies for the NGNP Project. Integral to the RMP is the development and use of a Risk Management System (RMS). The RMS is a tool that supports management and monitoring of the project risks. The RMS does not only contain a risk register, but other functionality that allows decision makers, engineering staff, and technology researchers to review and monitor the risks as the project matures.

Reducing Risk for the Next Generation Nuclear Plant

International Nuclear Information System (INIS)

Beck, John M. II; Heydt, Harold J.; Opare, Emmanuel O.; Oswald, Kyle B.

2010-01-01

The Next Generation Nuclear Plant (NGNP) Project, managed by the Idaho National Laboratory (INL), is directed by the Energy Policy Act of 2005, to research, develop, design, construct, and operate a prototype forth generation nuclear reactor to meet the needs of the 21st Century. As with all large projects developing and deploying new technologies, the NGNP has numerous risks that need to be identified, tracked, mitigated, and reduced in order for successful project completion. A Risk Management Plan (RMP) was created to outline the process the INL is using to manage the risks and reduction strategies for the NGNP Project. Integral to the RMP is the development and use of a Risk Management System (RMS). The RMS is a tool that supports management and monitoring of the project risks. The RMS does not only contain a risk register, but other functionality that allows decision makers, engineering staff, and technology researchers to review and monitor the risks as the project matures.

A Universal Rig for Supporting Large Hammer Drills: Reduced Injury Risk and Improved Productivity.

Science.gov (United States)

Rempel, David; Barr, Alan

2015-10-01

Drilling holes into concrete with heavy hammer and rock drills is one of the most physically demanding tasks performed in commercial construction and poses risks for musculoskeletal disorders, noise induced hearing loss, hand arm vibration syndrome and silicosis. The aim of this study was to (1) use a participatory process to develop a rig to support pneumatic rock drills or large electric hammer drills in order to reduce the health risks and (2) evaluate the usability of the rig. Seven prototype rigs for supporting large hammer drills were developed and modified with feedback from commercial contractors and construction workers. The final design was evaluated by laborers and electricians (N=29) who performed their usual concrete drilling with the usual method and the new rig. Subjective regional fatigue was significantly less in the neck, shoulders, hands and arms, and lower back) when using the universal rig compared to the usual manual method. Usability ratings for the rig were significantly better than the usual method on stability, control, drilling, accuracy, and vibration. Drilling time was reduced by approximately 50% with the rig. Commercial construction contractors, laborers and electricians who use large hammer drills for drilling many holes should consider using such a rig to prevent musculoskeletal disorders, fatigue, and silicosis.

Reducing risk and accelerating delivery of a neutron source for fusion materials research

Energy Technology Data Exchange (ETDEWEB)

Surrey, E., E-mail: Elizabeth.Surrey@ccfe.ac.uk [EURATOM/CCFE, Abingdon OX14 3DB (United Kingdom); Porton, M. [EURATOM/CCFE, Abingdon OX14 3DB (United Kingdom); Davenne, T.; Findlay, D.; Letchford, A.; Thomason, J. [STFC Rutherford Appleton Laboratory, Harwell OX11 0QX (United Kingdom); Roberts, S.G.; Marrow, J.; Seryi, A. [University of Oxford, Oxford OX1 3DP (United Kingdom); Connolly, B. [University of Birmingham, Edgbaston B15 2TT (United Kingdom); Owen, H. [University of Manchester, Manchester M13 9PL (United Kingdom)

2014-04-15

Highlights: • Proposed neutron source for fusion materials – FAFNIR – n(d,C) stripping source. • Near term technology, reduces risk compared with IFMIF, timely data production. • Technical, economic and programme needs assessed, compatible with EU Roadmap proposals. • Safety case impacts regulatory role for source, now mainly stakeholder insurance. - Abstract: The materials engineering database relevant to fusion irradiation is poorly populated and it has long been recognized that a fusion spectrum neutron source will be required, the facility IFMIF being the present proposal. Re-evaluation of the regulatory approach for the EU proposed DEMO device shows that the purpose of the source can be changed from lifetime equivalent irradiation exposure to data generation at lower levels of exposure by adopting a defence in depth strategy and regular component surveillance. This reduces the specification of the source with respect to IFMIF allowing lower risk technology solutions to be considered. A description of such a source, the Facility for Fusion Neutron Irradiation Research, FAFNIR, is presented here along with project timescales and costs.

A Proposed Set of Metrics to Reduce Patient Safety Risk From Within the Anatomic Pathology Laboratory.

Science.gov (United States)

Banks, Peter; Brown, Richard; Laslowski, Alex; Daniels, Yvonne; Branton, Phil; Carpenter, John; Zarbo, Richard; Forsyth, Ramses; Liu, Yan-Hui; Kohl, Shane; Diebold, Joachim; Masuda, Shinobu; Plummer, Tim; Dennis, Eslie

2017-05-01

Anatomic pathology laboratory workflow consists of 3 major specimen handling processes. Among the workflow are preanalytic, analytic, and postanalytic phases that contain multistep subprocesses with great impact on patient care. A worldwide representation of experts came together to create a system of metrics, as a basis for laboratories worldwide, to help them evaluate and improve specimen handling to reduce patient safety risk. Members of the Initiative for Anatomic Pathology Laboratory Patient Safety (IAPLPS) pooled their extensive expertise to generate a list of metrics highlighting processes with high and low risk for adverse patient outcomes. : Our group developed a universal, comprehensive list of 47 metrics for patient specimen handling in the anatomic pathology laboratory. Steps within the specimen workflow sequence are categorized as high or low risk. In general, steps associated with the potential for specimen misidentification correspond to the high-risk grouping and merit greater focus within quality management systems. Primarily workflow measures related to operational efficiency can be considered low risk. Our group intends to advance the widespread use of these metrics in anatomic pathology laboratories to reduce patient safety risk and improve patient care with development of best practices and interlaboratory error reporting programs. © American Society for Clinical Pathology 2017.

Ethical and affective evaluation of environmental risks

International Nuclear Information System (INIS)

Bohm, G.; Pfister, H.R.

1998-01-01

Full text of publication follows: the present paper will be concerned with environmental risk perception, with special emphasis on those environmental risks that pertain to global change phenomena, such as climate change and ozone depletion. Two determinants of risk judgments are investigated that seem particularly relevant to environmental risks: ethical and affective evaluations. It is assumed that the focus of risk evaluation can be on one of two aspects: a) on an evaluation of potential losses, or b) on ethical considerations. We assume that both, potential loss and violation of ethical principles elicit emotional evaluations, but that these two judgmental aspects are associated with different specific emotions. Following cognitive emotion theories, we distinguish loss-based emotions, such as worry and fear, from ethical emotions, e.g., guilt and anger. A study is presented that investigates the role of ethical and affective evaluations in risk judgments. Various environmental risks were presented to subjects, e.g., air pollution, ozone depletion, climate change and destruction of ecological balance. For each environmental risk, subjects indicated in free-response format as well as on rating scales the extent to which ethical principles were violated, and the intensity of both loss-based and ethical emotions. The correlational structure of the emotion ratings confirms the distinction between loss-based and ethical emotions. Risk judgments co-vary with the strength of ethical evaluation and with the intensity of loss-based emotions, but are independent of ethical emotions. The implications of these findings for the risk appraisal process are discussed. (authors)

Evaluating Grayware Characteristics and Risks

Directory of Open Access Journals (Sweden)

Zhongqiang Chen

2011-01-01

Full Text Available Grayware encyclopedias collect known species to provide information for incident analysis, however, the lack of categorization and generalization capability renders them ineffective in the development of defense strategies against clustered strains. A grayware categorization framework is therefore proposed here to not only classify grayware according to diverse taxonomic features but also facilitate evaluations on grayware risk to cyberspace. Armed with Support Vector Machines, the framework builds learning models based on training data extracted automatically from grayware encyclopedias and visualizes categorization results with Self-Organizing Maps. The features used in learning models are selected with information gain and the high dimensionality of feature space is reduced by word stemming and stopword removal process. The grayware categorizations on diversified features reveal that grayware typically attempts to improve its penetration rate by resorting to multiple installation mechanisms and reduced code footprints. The framework also shows that grayware evades detection by attacking victims' security applications and resists being removed by enhancing its clotting capability with infected hosts. Our analysis further points out that species in categories Spyware and Adware continue to dominate the grayware landscape and impose extremely critical threats to the Internet ecosystem.

Modelling the ability of source control measures to reduce inundation risk in a community-scale urban drainage system

Science.gov (United States)

Mei, Chao; Liu, Jiahong; Wang, Hao; Shao, Weiwei; Xia, Lin; Xiang, Chenyao; Zhou, Jinjun

2018-06-01

Urban inundation is a serious challenge that increasingly confronts the residents of many cities, as well as policymakers, in the context of rapid urbanization and climate change worldwide. In recent years, source control measures (SCMs) such as green roofs, permeable pavements, rain gardens, and vegetative swales have been implemented to address flood inundation in urban settings, and proven to be cost-effective and sustainable. In order to investigate the ability of SCMs on reducing inundation in a community-scale urban drainage system, a dynamic rainfall-runoff model of a community-scale urban drainage system was developed based on SWMM. SCMs implementing scenarios were modelled under six design rainstorm events with return period ranging from 2 to 100 years, and inundation risks of the drainage system were evaluated before and after the proposed implementation of SCMs, with a risk-evaluation method based on SWMM and analytic hierarchy process (AHP). Results show that, SCMs implementation resulting in significantly reduction of hydrological indexes that related to inundation risks, range of reduction rates of average flow, peak flow, and total flooded volume of the drainage system were 28.1-72.1, 19.0-69.2, and 33.9-56.0 %, respectively, under six rainfall events with return periods ranging from 2 to 100 years. Corresponding, the inundation risks of the drainage system were significantly reduced after SCMs implementation, the risk values falling below 0.2 when the rainfall return period was less than 10 years. Simulation results confirm the effectiveness of SCMs on mitigating inundation, and quantified the potential of SCMs on reducing inundation risks in the urban drainage system, which provided scientific references for implementing SCMs for inundation control of the study area.

Risk factors associated with reduced work productivity among people with chronic knee pain.

Science.gov (United States)

Agaliotis, M; Fransen, M; Bridgett, L; Nairn, L; Votrubec, M; Jan, S; Heard, R; Mackey, M

2013-09-01

To determine the burden and risk factors associated with reduced work productivity among people with chronic knee pain. A longitudinal study, nested within a randomised controlled trial (RCT) evaluating the long-term effects of dietary supplements, was conducted among people with chronic knee pain in paid employment (n = 360). Participants recorded days off work (absenteeism) and reduced productivity while at work (presenteeism) for seven days every two months over a 12-month period in a study specific diary. Examined risk factors included knee pain severity, occupational group, radiographic disease severity, physical activity, body mass index (BMI), health-related quality of life (SF-12) and co-morbidity. Over the 12-month follow up period, 50 (14%) participants reported one or more days off work due to knee problems, while 283 (79%) reported reduced productivity while at work (presenteeism absenteeism was having an SF-12 Mental Component Summary (MCS) score labour (OR: 2.23 [1.09-4.59]) or manual labour (OR: 6.40 [1.44-28.35]) or a high maximum knee pain (4-6 out of 10) (OR: 2.29 [1.17-4.46]). This longitudinal study found that among this cohort of people with chronic knee pain, the burden of reduced work productivity is mainly attributable to presenteeism rather absenteeism. This study demonstrated that effective strategies to increase work productivity should focus on reducing knee pain or physical disability especially among workers in manual or semi-manual labour. © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Issues in Value-at-Risk Modeling and Evaluation

NARCIS (Netherlands)

J. Daníelsson (Jón); C.G. de Vries (Casper); B.N. Jorgensen (Bjørn); P.F. Christoffersen (Peter); F.X. Diebold (Francis); T. Schuermann (Til); J.A. Lopez (Jose); B. Hirtle (Beverly)

1998-01-01

textabstractDiscusses the issues in value-at-risk modeling and evaluation. Value of value at risk; Horizon problems and extreme events in financial risk management; Methods of evaluating value-at-risk estimates.

Meta-analysis: Does garlic intake reduce risk of gastric cancer?

Science.gov (United States)

Kodali, R T; Eslick, Guy D

2015-01-01

In the past 2 decades, various epidemiological studies investigated whether garlic can positively modify the risk of gastric cancer. Garlic contains numerous sulfide compounds, including diallyl trisulfide, which have anticarcinogenic properties. We conducted a meta-analysis to determine if garlic intake reduces the risk of gastric cancer. An electronic search of MEDLINE, PubMed, and EMBASE to June 2014 was completed. There were 14 case control studies, 2 randomized controlled studies, and 1 cohort study that fulfilled our inclusion criteria. We used a random effects model to calculate pooled odds ratios (OR) and 95% confidence intervals (CIs) for risk of gastric cancer with garlic consumption. Meta-analysis of a total of 8,621 cases and 14,889 controls was conducted. Significant variability in duration of garlic intake and reference categories for amount of intake was noted. High, low, and any garlic intake were all associated with reduced risk of gastric cancer. High intake had the most significant risk reduction, OR = 0.49 (95% CI: 0.38-0.62). Heterogeneity was low (I² = 30.85, P = 0.17). A more modest risk reduction was associated with low intake, OR = 0.75 (95% CI: 0.58-0.97). Half of the studies did not separate garlic intake into high or low amounts, intake was only noted as consumption vs. non-consumption. Any amount of consumption still showed a risk reduction similar to low intake, OR = 0.77 (95% CI: 0.60-1.00). Low and any amount of consumption showed moderate heterogeneity (58% and 45%, respectively). Garlic intake appears to be associated with reduced risk of gastric cancer. Further high quality studies are required to confirm this finding and to assess the amount of garlic that needs to be consumed for protective effect.

Addressing the issue of falls off playground equipment: an empirically-based intervention to reduce fall-risk behaviors on playgrounds.

Science.gov (United States)

Morrongiello, Barbara A; Matheis, Shawn

2007-08-01

The present study evaluated the impact of an intervention to reduce fall-risk behaviors on playgrounds among children 6-11 years of age. Children completed posters indicating risky playground behaviors they would and would not do. In the intervention group, video and audio presentations were used to expose children to injury occurrences so that injury vulnerability was communicated in a fear-evoking way. In the control group, children only completed the pre- and post-intervention measures. Significant decreases in intentions to risk-take were obtained in the intervention, but not the control group. Effectiveness did not vary with children's age or sex, but was greater for those scoring high in sensation-seeking. A fear-appeals approach proved successful to reduce intended fall-risk behaviors, particularly for children high in sensation-seeking whose risk-taking is motivated by affect arousal.

Reducing sequence risk using trend following and the CAPE ratio

OpenAIRE

Clare, A.; Thomas, S.; Smith, P. N.; Seaton, J.

2017-01-01

The risk of experiencing bad investment outcomes at the wrong time, or sequence risk, is a poorly understood, but crucial aspect of the risk faced by investors, in particular those in the decumulation phase of their savings journey, typically over the period of retirement financed by a defined contributions pension scheme. Using US equity return data from 1872-2014 we show how this risk can be significantly reduced by applying trend-following investment strategies. We also demonstrate that kn...

Cities at risk: status of Italian planning system in reducing seismic and hydrogeological risks

Directory of Open Access Journals (Sweden)

Grazia Di Giovanni

2016-03-01

Full Text Available Italy and its urban systems are under high seismic and hydrogeological risks. The awareness about the role of human activities in the genesis of disasters is achieved in the scientific debate, as well as the role of urban and regional planning in reducing risks. The paper reviews the state of Italian major cities referred to hydrogeological and seismic risk by: 1 extrapolating data and maps about seismic hazard and landslide risk concerning cities with more than 50.000 inhabitants and metropolitan contexts, and 2 outlining how risk reduction is framed in Italian planning system (at national and regional levels. The analyses of available data and the review of the normative framework highlight the existing gaps in addressing risk reduction: nevertheless a wide knowledge about natural risks afflicting Italian territory and an articulated regulatory framework, the available data about risks are not exhaustive, and risk reduction policies and multidisciplinary pro-active approaches are only partially fostered and applied.

Reduced risk of UC in families affected by appendicitis

DEFF Research Database (Denmark)

Nyboe Andersen, Nynne; Gørtz, Sanne; Frisch, Morten

2017-01-01

OBJECTIVE: The possible aetiological link between appendicitis and UC remains unclear. In order to investigate the hereditary component of the association, we studied the risk of UC in family members of individuals with appendicitis. DESIGN: A cohort of 7.1 million individuals was established...... million person-years of follow-up between 1977 and 2011, a total of 190 004 cohort members developed appendicitis and 45 202 developed UC. Individuals having a first-degree relative with appendicitis before age 20 years had significantly reduced risk of UC (RR 0.90; 95% CI 0.86 to 0.95); this association...... was stronger in individuals with a family predisposition to UC (RR 0.66; 95% CI 0.51 to 0.83). CONCLUSIONS: Individuals with a first-degree relative diagnosed with appendicitis before age 20 years are at reduced risk of UC, particularly when there is a family predisposition to UC. Our findings question...

Indirect risk effects reduce feeding efficiency of ducks during spring.

Science.gov (United States)

Behney, Adam C; O'Shaughnessy, Ryan; Eichholz, Michael W; Stafford, Joshua D

2018-01-01

Indirect risk effects of predators on prey behavior can have more of an impact on prey populations than direct consumptive effects. Predation risk can elicit more vigilance behavior in prey, reducing the amount of time available for other activities, such as foraging, which could potentially reduce foraging efficiency. Understanding the conditions associated with predation risk and the specific effects predation risk have on prey behavior is important because it has direct influences on the profitability of food items found under various conditions and states of the forager. The goals of this study were to assess how ducks perceived predation risk in various habitat types and how strongly perceived risk versus energetic demand affected foraging behavior. We manipulated food abundance in different wetland types in Illinois, USA to reduce confounding between food abundance and vegetation structure. We conducted focal-animal behavioral samples on five duck species in treatment and control plots and used generalized linear mixed-effects models to compare the effects of vegetation structure versus other factors on the intensity with which ducks fed and the duration of feeding stints. Mallards fed more intensively and, along with blue-winged teal, used longer feeding stints in open habitats, consistent with the hypothesis that limited visibility was perceived to have a greater predation risk than unlimited visibility. The species temporally nearest to nesting, wood ducks, were willing to take more risks for a greater food reward, consistent with an increase in a marginal value of energy as they approached nesting. Our results indicate that some duck species value energy differently based on the surrounding vegetation structure and density. Furthermore, increases in the marginal value of energy can be more influential than perceived risk in shaping foraging behavior patterns. Based on these findings, we conclude that the value of various food items is not solely

Cigarette smoking risk-reducing beliefs: Findings from the United States Health Information National Trends Survey.

Science.gov (United States)

Kaufman, Annette R; Coa, Kisha I; Nguyen, Anh B

2017-09-01

Cigarette smoking risk-reducing beliefs are ideas that certain health promoting behaviors (e.g., exercise) may mitigate the risks associated with smoking. The objective of this study was to describe smoking risk-reducing beliefs and the belief that quitting can reduce the harmful effects of smoking among the U.S. adult population and the associations between these beliefs, current smoking status, and sociodemographics. Data were from the Health Information National Trends Survey 4 (HINTS 4) Cycles 3 and 4 (2013-2014; N=6862). Descriptive analyses were conducted to examine bivariate associations among the quit smoking belief, smoking risk-reducing beliefs, and covariates. Weighted ordinal logistic regression models examined the adjusted associations between smoking status and sociodemographics, with quit smoking belief and risk-reducing beliefs. Eighty-two percent of the population reported that quitting cigarette smoking can help reduce the harmful effects of smoking a lot: former smokers and individuals with higher educational attainment were more likely to endorse this belief than never smokers and those with lower educational attainment. Many people endorsed smoking risk-reducing beliefs about exercise (79.3%), fruits and vegetables (71.8%), vitamins (67.2%), and sleep (68.5%). Former smokers were less likely to subscribe to these beliefs than never smokers. Vulnerable populations who may be most at risk of smoking attributable morbidity and mortality were more likely to endorse risk-reducing beliefs. Future studies are needed to better understand how risk-reducing beliefs are formed and if modifying these beliefs may help to reduce cigarette smoking in the U.S. Published by Elsevier Inc.

How do women at increased breast cancer risk perceive and decide between risks of cancer and risk-reducing treatments? A synthesis of qualitative research.

Science.gov (United States)

Fielden, Hannah G; Brown, Stephen L; Saini, Pooja; Beesley, Helen; Salmon, Peter

2017-09-01

Risk-reducing procedures can be offered to people at increased cancer risk, but many procedures can have iatrogenic effects. People therefore need to weigh risks associated with both cancer and the risk-reduction procedure in their decisions. By reviewing relevant literature on breast cancer (BC) risk reduction, we aimed to understand how women at relatively high risk of BC perceive their risk and how their risk perceptions influence their decisions about risk reduction. Synthesis of 15 qualitative studies obtained from systematic searches of SCOPUS, Web of Knowledge, PsychINFO, and Medline electronic databases (inception-June 2015). Women did not think about risk probabilistically. Instead, they allocated themselves to broad risk categories, typically influenced by their own or familial experiences of BC. In deciding about risk-reduction procedures, some women reported weighing the risks and benefits, but papers did not describe how they did so. For many women, however, an overriding wish to reduce intense worry about BC led them to choose aggressive risk-reducing procedures without such deliberation. Reasoning that categorisation is a fundamental aspect of risk perception, we argue that patients can be encouraged to develop more nuanced and accurate categorisations of their own risk through their interactions with clinicians. Empirically-based ethical reflection is required to determine whether and when it is appropriate to provide risk-reduction procedures to alleviate worry. © 2016 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa

Science.gov (United States)

Haghighat, Roxanna; Cluver, Lucie

2017-01-01

Background Evidence on sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa is urgently needed. This systematic review synthesizes the extant research on prevalence, factors associated with, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa. Methods Studies were located through electronic databases, grey literature, reference harvesting, and contact with researchers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Quantitative studies that reported on HIV-positive participants (10–24 year olds), included data on at least one of eight outcomes (early sexual debut, inconsistent condom use, older partner, transactional sex, multiple sexual partners, sex while intoxicated, sexually transmitted infections, and pregnancy), and were conducted in sub-Saharan Africa were included. Two authors piloted all processes, screened studies, extracted data independently, and resolved any discrepancies. Due to variance in reported rates and factors associated with sexual risk-taking, meta-analyses were not conducted. Results 610 potentially relevant titles/abstracts resulted in the full text review of 251 records. Forty-two records (n = 35 studies) reported one or multiple sexual practices for 13,536 HIV-positive adolescents/youth from 13 sub-Saharan African countries. Seventeen cross-sectional studies reported on individual, relationship, family, structural, and HIV-related factors associated with sexual risk-taking. However, the majority of the findings were inconsistent across studies, and most studies scored HIV-positive status and accessing HIV support groups were associated with reduced sexual risk-taking. Of the four intervention studies (three RCTs), three evaluated group-based interventions, and one evaluated an individual-focused combination intervention. Three of the interventions were effective at reducing sexual risk-taking, with one

An Interactive Website to Reduce Sexual Risk Behavior: Process Evaluation of TeensTalkHealth.

Science.gov (United States)

Brady, Sonya S; Sieving, Renee E; Terveen, Loren G; Rosser, B R Simon; Kodet, Amy J; Rothberg, Vienna D

2015-09-02

Different theoretical frameworks support the use of interactive websites to promote sexual health. Although several Web-based interventions have been developed to address sexual risk taking among young people, no evaluated interventions have attempted to foster behavior change through moderated interaction among a virtual network of adolescents (who remain anonymous to one another) and health professionals. The objective was to conduct a summative process evaluation of TeensTalkHealth, an interactive sexual health website designed to promote condom use and other healthy decision making in the context of romantic and sexual relationships. Evaluation data were obtained from 147 adolescents who participated in a feasibility and acceptability study. Video vignettes, teen-friendly articles, and other content served as conversation catalysts between adolescents and health educators on message boards. Adolescents' perceptions that the website encouraged condom use across a variety of relationship situations were very high. Almost 60% (54/92, 59%) of intervention participants completed two-thirds or more of requested tasks across the 4-month intervention. Adolescents reported high levels of comfort, perceived privacy, ease of website access and use, and perceived credibility of health educators. Potential strategies to enhance engagement and completion of intervention tasks during future implementations of TeensTalkHealth are discussed, including tailoring of content, periodic website chats with health educators and anonymous peers, and greater incorporation of features from popular social networking websites. TeensTalkHealth is a feasible, acceptable, and promising approach to complement and enhance existing services for youth.

Using the Design for Demise Philosophy to Reduce Casualty Risk Due to Reentering Spacecraft

Science.gov (United States)

Kelley, R. L.

2012-01-01

Recently the reentry of a number of vehicles has garnered public attention due to their risk of human casualty due to fragments surviving reentry. In order to minimize this risk for their vehicles, a number of NASA programs have actively sought to minimize the number of components likely to survive reentry at the end of their spacecraft's life in order to meet and/or exceed NASA safety standards for controlled and uncontrolled reentering vehicles. This philosophy, referred to as "Design for Demise" or D4D, has steadily been adopted, to at least some degree, by numerous programs. The result is that many programs are requesting evaluations of components at the early stages of vehicle design, as they strive to find ways to reduce the number surviving components while ensuring that the components meet the performance requirements of their mission. This paper will discuss some of the methods that have been employed to ensure that the consequences of the vehicle s end-of-life are considered at the beginning of the design process. In addition this paper will discuss the technical challenges overcome, as well as some of the more creative solutions which have been utilized to reduce casualty risk.

Risk effectiveness evaluation of surveillance testing

International Nuclear Information System (INIS)

Kim, I.S.; Samanta, P.K.; Martorell, S.; Vesely, W.E.

1991-01-01

To address the concerns about nuclear power plant surveillance tests, i.e., their adverse safety impact due to negative effects and too burdensome requirements, it is necessary to evaluate the safety significance or risk effectiveness of such tests explicitly considering both negative and positive effects. This paper defines the negative effects of surveillance testing from a risk perspective, and then presents a methodology to quantify the negative risk impact, i.e., the risk penalty or risk increase caused by the test. The method focuses on two important kinds of negative effects, namely, test-caused transients and test-caused equipment degradations. The concepts and quantitative methods for the risk evaluation can be used in the decision-making process to establish the safety significance of the tests and to screen the plant-specific surveillance test requirements. 6 refs., 2 figs., 2 tabs

Medical interventional procedures--reducing the radiation risks

International Nuclear Information System (INIS)

Cousins, C.; Sharp, C.

2004-01-01

Over the last 40 years, the number of percutaneous interventional procedures using radiation has increased significantly, with many secondary care clinicians using fluoroscopically guided techniques. Many procedures can deliver high radiation doses to patients and staff, with the potential to cause immediate and delayed radiation effects. The challenge for interventionists is to maximize benefit, whilst minimizing radiation risk to patients and staff. Non-radiologist clinicians are often inadequately trained in radiation safety and radiobiology. However, clinical governance and legislation now requires a more rigorous approach to protecting patients and staff. Protection can be ensured, and risks can be controlled, by appropriate design, procurement and commissioning of equipment; quality assurance; and optimal operational technique, backed by audit. Interventionists need knowledge and skills to reduce the risks. Appropriate training should include awareness of the potential for radiation injury, equipment operational parameters, doses measurement and recording methods and dose reduction techniques. Clinical governance requires informed consent, appropriate patient counselling and follow-up

Medical interventional procedures--reducing the radiation risks

Energy Technology Data Exchange (ETDEWEB)

Cousins, C. E-mail: claire.cousins@addenbrookes.nhs.uk; Sharp, C

2004-06-01

Over the last 40 years, the number of percutaneous interventional procedures using radiation has increased significantly, with many secondary care clinicians using fluoroscopically guided techniques. Many procedures can deliver high radiation doses to patients and staff, with the potential to cause immediate and delayed radiation effects. The challenge for interventionists is to maximize benefit, whilst minimizing radiation risk to patients and staff. Non-radiologist clinicians are often inadequately trained in radiation safety and radiobiology. However, clinical governance and legislation now requires a more rigorous approach to protecting patients and staff. Protection can be ensured, and risks can be controlled, by appropriate design, procurement and commissioning of equipment; quality assurance; and optimal operational technique, backed by audit. Interventionists need knowledge and skills to reduce the risks. Appropriate training should include awareness of the potential for radiation injury, equipment operational parameters, doses measurement and recording methods and dose reduction techniques. Clinical governance requires informed consent, appropriate patient counselling and follow-up.

Technology Evaluation for Environmental Risk Mitigation Compendium

Science.gov (United States)

Meinhold, A.; Greene, B.; Dussich, J.; Sorkin, A.; Olsen, W.

2017-01-01

The Technology Evaluation for Environmental Risk Mitigation (TEERM) Principal Center and its predecessor organization the Acquisition Pollution Prevention Program (AP2) supported the National Aeronautics and Space Administration (NASA) in identifying technology solutions to risks and costs to NASA programs driven by environmental regulations and requirements. TEERM researched the commercial and government marketplace to locate viable and available technologies that met NASAs needs. TEERM focused on addressing environmentally-driven risks of direct concern to NASA programs and facilities, including hazardous materials in NASA operations and materials that became obsolescent because of environmental regulations. TEERM projects aimed to reduce cost; ensure the health and safety of people, assets, and the environment; promote efficiency; and minimize duplication. Major TEERM and AP2 projects focused on waste minimization and hazardous waste treatment, recycling, corrosion prevention and control, solvent and ozone depleting substances substitution, and aqueous based cleaners. In 2017, NASA made the decision to terminate the TEERM Principal Center. This Compendium Report documents TEERM and AP2 project successes. The Compendium Report traces the evolution of TEERM based on evolving risks and requirements for NASA and its relationship to the Space Shuttle Program, the United States Department of Defense, the European Space Agency, and other public and private stakeholders. This Compendium Report also documents project details from Project Summaries and Joint Test Plans and describes project stakeholders and collaborative effort results.

Does participative leadership reduce the onset of mobbing risk among nurse working teams?

Science.gov (United States)

Bortoluzzi, Guido; Caporale, Loretta; Palese, Alvisa

2014-07-01

To evaluate the advancement of knowledge on the impact of an empowering leadership style on the risk of mobbing behaviour among nurse working teams. The secondary aim was to evaluate, along with leadership style, the contribution of other organisational- and individual-related mobbing predictors. The style of leadership in reducing the onset of mobbing risk in nurse working teams still remains a matter of discussion. Nurse working teams are particularly affected by mobbing and studies exploring individual and organisational inhibiting/modulating factors are needed. An empirical study involving 175 nurses of various public hospital corporations in northern Italy. Data were collected via structured and anonymous questionnaires and analysed through a logistic regression. Organisational, individual and participative leadership variables explained 33.5% (P leadership enacted by nursing managers and the nursing shortage as perceived by clinical nurses. Results confirmed that the contribution made by a participative leadership style in attenuating the onset of mobbing risk in working teams was significant. A participative leadership style adopted by the nurse manager allows for the reduction of tensions in nurse working teams. However, mobbing remains a multifaceted phenomenon that is difficult to capture in its entirety and the leadership style cannot be considered as a panacea for resolving this problem in nurse working teams. © 2013 John Wiley & Sons Ltd.

Reducing health risk assigned to organic emissions from a chemical weapons incinerator.

Science.gov (United States)

Laman, David M; Weiler, B Douglas; Skeen, Rodney S

2013-03-01

Organic emissions from a chemical weapons incinerator have been characterized with an improved set of analytical methods to reduce the human health risk assigned to operations of the facility. A gas chromatography/mass selective detection method with substantially reduced detection limits has been used in conjunction with scanning electron microscopy/energy dispersive X-ray spectrometry and Fourier transform infrared microscopy to improve the speciation of semi-volatile and non-volatile organics emitted from the incinerator. The reduced detection limits have allowed a significant reduction in the assumed polycyclic aromatic hydrocarbon (PAH) and aminobiphenyl (ABP) emission rates used as inputs to the human health risk assessment for the incinerator. A mean factor of 17 decrease in assigned human health risk is realized for six common local exposure scenarios as a result of the reduced PAH and ABP detection limits.

Physical therapies for improving balance and reducing falls risk in osteoarthritis of the knee: a systematic review.

Science.gov (United States)

Mat, Sumaiyah; Tan, Maw Pin; Kamaruzzaman, Shahrul Bahyah; Ng, Chin Teck

2015-01-01

osteoarthritis (OA) of knee has been reported as a risk factor for falls and reduced balance in the elderly. This systematic review evaluated the effectiveness of physical therapies in improving balance and reducing falls risk among patients with knee OA. a computerised search was performed to identify relevant studies up to November 2013. Two investigators identified eligible studies and extracted data independently. The quality of the included studies was assessed by the PeDro score. a total of 15 randomised controlled trials involving 1482 patients were identified. The mean PeDro score was 7. The pooled standardised mean difference in balance outcome for strength training = 0.3346 (95% CI: 0.3207-0.60, P = 0.01 falls risk outcomes in, strength training, Tai chi and aerobics also showed a significant reduction in reduced risk of falls significantly with pooled result 0.55 (95% CI: 0.41-0.68, P balance and falls risk in older individuals with knee OA, while water-based exercises and light treatment did not significantly improve balance outcomes. Strength training, Tai Chi and aerobics exercises can therefore be recommended as falls prevention strategies for individuals with OA. However, a large randomised controlled study using actual falls outcomes is recommended to determine the appropriate dosage and to measure the potential benefits in falls reduction. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Risk-reducing Salpingo-Oophorectomy in Women at Higher Risk of Ovarian and Breast Cancer: A Single Institution Prospective Series.

Science.gov (United States)

Ricciardi, Enzo; Tomao, Federica; Aletti, Giovanni; Bazzurini, Luca; Bocciolone, Luca; Boveri, Sara; Landoni, Fabio; Lapresa, Maria Teresa; Maruccio, Matteo; Parma, Gabriella; Peccatori, Fedro; Petrella, Maria Cristina; Zanagnolo, Vanna; Colombo, Nicoletta; Maggioni, Angelo

2017-09-01

Occult cancers' reported rates vary from 2-12% and serous tubal intraepithelial carcinomas (STICs) have been identified in 3-12% of the prophylactically removed tubes of women carrying a BRCA mutation. The aim of this study was to evaluate the incidence of tubal minor epithelial atypia (STIL), STIC, and occult invasive cancer and to evaluate the cancer-specific mortality in a prospective series of women at higher risk of ovarian and breast cancer undergoing risk-reducing salpingo-oophorectomy (RRSO) n a tertiary cancer center. A series of RRSO specimens (including endometrial biopsy) from women carrying a BRCA mutation, BRCA-unknown and BRCA-negative were collected between January 1998 and April 2016 at the Division of Gynecology at the European Institute of Oncology. Inclusion criteria were: asymptomatic women who had a negative gynecologic screening within 3 months prior to RRSO. Exclusion criteria were: women with ovarian/tubal cancer prior to RRSO. A total of 411 women underwent RRSO. Median age at RRSO was 47.0 years (range=32-70 years); 75.2% had a history of breast cancer. Fifteen women were diagnosed with an occult cancer (7 STIC, 4 invasive cancers, 2 breast cancers metastatic to the adnexa, 2 endometrial cancer) (3.6%). Sixteen showed a STIL (3.9%). When excluding cases with preoperative positive markers, the occult invasive cancer rate drops to 1.5%. Our study, covering an 18-year period, shows a substantial low risk of occult cancer among a high-risk population of women undergoing RRSO. Our data still support the indication for RRSO in higher-risk patients. An endometrial biopsy should also be routinely obtained as it raises the chances of detecting occult endometrial cancers that may be otherwise missed. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Reduced cancer risk in vegetarians: an analysis of recent reports.

Science.gov (United States)

Lanou, Amy Joy; Svenson, Barbara

2010-12-20

This report reviews current evidence regarding the relationship between vegetarian eating patterns and cancer risk. Although plant-based diets including vegetarian and vegan diets are generally considered to be cancer protective, very few studies have directly addressed this question. Most large prospective observational studies show that vegetarian diets are at least modestly cancer protective (10%-12% reduction in overall cancer risk) although results for specific cancers are less clear. No long-term randomized clinical trials have been conducted to address this relationship. However, a broad body of evidence links specific plant foods such as fruits and vegetables, plant constituents such as fiber, antioxidants and other phytochemicals, and achieving and maintaining a healthy weight to reduced risk of cancer diagnosis and recurrence. Also, research links the consumption of meat, especially red and processed meats, to increased risk of several types of cancer. Vegetarian and vegan diets increase beneficial plant foods and plant constituents, eliminate the intake of red and processed meat, and aid in achieving and maintaining a healthy weight. The direct and indirect evidence taken together suggests that vegetarian diets are a useful strategy for reducing risk of cancer.

Regulatory risk assessments: Is there a need to reduce uncertainty and enhance robustness?

Science.gov (United States)

Snodin, D J

2015-12-01

A critical evaluation of several recent regulatory risk assessments has been undertaken. These relate to propyl paraben (as a food additive, cosmetic ingredient or pharmaceutical excipient), cobalt (in terms of a safety-based limit for pharmaceuticals) and the cancer Threshold of Toxicological Concern as applied to food contaminants and pharmaceutical impurities. In all cases, a number of concerns can be raised regarding the reliability of the current assessments, some examples being absence of data audits, use of single-dose and/or non-good laboratory practice studies to determine safety metrics, use of a biased data set and questionable methodology and lack of consistency with precedents and regulatory guidance. Drawing on these findings, a set of recommendations is provided to reduce uncertainty and improve the quality and robustness of future regulatory risk assessments. © The Author(s) 2015.

Reducing the risk of Legionnaires' disease associated with cooling towers

Energy Technology Data Exchange (ETDEWEB)

Freije, M.R. [HC Information Resources Inc., Carlsbad, CA (United States)

2008-08-15

To reduce the health and legal risks associated with Legionnaires' disease, facility managers should take steps to minimize Legionella bacteria in plumbing systems, open industrial equipment, water features, cooling towers, and other aerosolizing water systems. The risk of Legionnaires' disease associated with cooling towers can be reduced by controlling Legionella bacteria in cooling water and preventing transmission of the bacteria from towers to people. This paper presents nine reasonable ways to accomplish these goals. (orig.)

Can a Risk Factor Based Approach Safely Reduce Screening for Retinopathy of Prematurity?

Directory of Open Access Journals (Sweden)

K. M. Friddle

2017-01-01

Full Text Available Objective. Current American retinopathy of prematurity (ROP screening guidelines is imprecise for infants ≥ 30 weeks with birth weights between 1500 and 2000 g. Our objective was to evaluate a risk factor based approach for screening premature infants at low risk for severe ROP. Study Design. We performed a 13-year review from Intermountain Health Care (IHC data. All neonates born at ≤32 weeks were reviewed to determine ROP screening and/or development of severe ROP. Severe ROP was defined by stage ≥ 3 or need for laser therapy. Regression analysis was used to identify significant risk factors for severe ROP. Results. We identified 4607 neonates ≤ 32 weeks gestation. Following exclusion for death, with no retinal exam or incomplete data, 2791 (61% were included in the study. Overall, severe ROP occurred in 260 (9.3%, but only 11/1601 ≥ 29 weeks (0.7%. All infants with severe ROP ≥ 29 weeks had at least 2 identified ROP risk factors. Implementation of this risk based screening strategy to the IHC population over the timeline of this study would have eliminated screening in 21% (343/1601 of the screened population. Conclusions. Limiting ROP screening for infants ≥ 29 and ≤ 32 weeks to only those with clinical risk factors could significantly reduce screening exams while identifying all infants with severe ROP.

Credit Risk Evaluation : Modeling - Analysis - Management

OpenAIRE

Wehrspohn, Uwe

2002-01-01

An analysis and further development of the building blocks of modern credit risk management: -Definitions of default -Estimation of default probabilities -Exposures -Recovery Rates -Pricing -Concepts of portfolio dependence -Time horizons for risk calculations -Quantification of portfolio risk -Estimation of risk measures -Portfolio analysis and portfolio improvement -Evaluation and comparison of credit risk models -Analytic portfolio loss distributions The thesis contributes to the evaluatio...

Risk Stratification for Athletes and Adventurers in High-Altitude Environments: Recommendations for Preparticipation Evaluation.

Science.gov (United States)

Campbell, Aaron D; McIntosh, Scott E; Nyberg, Andy; Powell, Amy P; Schoene, Robert B; Hackett, Peter

2015-12-01

High-altitude athletes and adventurers face a number of environmental and medical risks. Clinicians often advise participants or guiding agencies before or during these experiences. Preparticipation evaluation (PPE) has the potential to reduce risk of high-altitude illnesses in athletes and adventurers. Specific conditions susceptible to high-altitude exacerbation also important to evaluate include cardiovascular and lung diseases. Recommendations by which to counsel individuals before participation in altitude sports and adventures are few and of limited focus. We reviewed the literature, collected expert opinion, and augmented principles of a traditional sport PPE to accommodate the high-altitude wilderness athlete/adventurer. We present our findings with specific recommendations on risk stratification during a PPE for the high-altitude athlete/adventurer. Copyright © 2015. Published by Elsevier Inc.

An Interactive Website to Reduce Sexual Risk Behavior: Process Evaluation of TeensTalkHealth

Science.gov (United States)

Sieving, Renee E; Terveen, Loren G; Rosser, BR Simon; Kodet, Amy J; Rothberg, Vienna D

2015-01-01

Background Different theoretical frameworks support the use of interactive websites to promote sexual health. Although several Web-based interventions have been developed to address sexual risk taking among young people, no evaluated interventions have attempted to foster behavior change through moderated interaction among a virtual network of adolescents (who remain anonymous to one another) and health professionals. Objective The objective was to conduct a summative process evaluation of TeensTalkHealth, an interactive sexual health website designed to promote condom use and other healthy decision making in the context of romantic and sexual relationships. Methods Evaluation data were obtained from 147 adolescents who participated in a feasibility and acceptability study. Video vignettes, teen-friendly articles, and other content served as conversation catalysts between adolescents and health educators on message boards. Results Adolescents’ perceptions that the website encouraged condom use across a variety of relationship situations were very high. Almost 60% (54/92, 59%) of intervention participants completed two-thirds or more of requested tasks across the 4-month intervention. Adolescents reported high levels of comfort, perceived privacy, ease of website access and use, and perceived credibility of health educators. Potential strategies to enhance engagement and completion of intervention tasks during future implementations of TeensTalkHealth are discussed, including tailoring of content, periodic website chats with health educators and anonymous peers, and greater incorporation of features from popular social networking websites. Conclusions TeensTalkHealth is a feasible, acceptable, and promising approach to complement and enhance existing services for youth. PMID:26336157

Reducing mortality risk by targeting specific air pollution sources: Suva, Fiji.

Science.gov (United States)

Isley, C F; Nelson, P F; Taylor, M P; Stelcer, E; Atanacio, A J; Cohen, D D; Mani, F S; Maata, M

2018-01-15

Health implications of air pollution vary dependent upon pollutant sources. This work determines the value, in terms of reduced mortality, of reducing ambient particulate matter (PM 2.5 : effective aerodynamic diameter 2.5μm or less) concentration due to different emission sources. Suva, a Pacific Island city with substantial input from combustion sources, is used as a case-study. Elemental concentration was determined, by ion beam analysis, for PM 2.5 samples from Suva, spanning one year. Sources of PM 2.5 have been quantified by positive matrix factorisation. A review of recent literature has been carried out to delineate the mortality risk associated with these sources. Risk factors have then been applied for Suva, to calculate the possible mortality reduction that may be achieved through reduction in pollutant levels. Higher risk ratios for black carbon and sulphur resulted in mortality predictions for PM 2.5 from fossil fuel combustion, road vehicle emissions and waste burning that surpass predictions for these sources based on health risk of PM 2.5 mass alone. Predicted mortality for Suva from fossil fuel smoke exceeds the national toll from road accidents in Fiji. The greatest benefit for Suva, in terms of reduced mortality, is likely to be accomplished by reducing emissions from fossil fuel combustion (diesel), vehicles and waste burning. Copyright © 2017. Published by Elsevier B.V.

Breast-feeding reduces the risk for childhood eczema.

Science.gov (United States)

Kull, Inger; Böhme, Maria; Wahlgren, Carl-Fredrik; Nordvall, Lennart; Pershagen, Göran; Wickman, Magnus

2005-09-01

The evidence for a preventive effect of breast-feeding on the development of eczema in childhood remains controversial. To investigate the effect of breast-feeding in various phenotypes of eczema to 4 years. A birth cohort of 4089 children made up the study base. Data on breast-feeding, allergic symptoms, and potential confounders were obtained from questionnaires when the children were 2 months and 1, 2, and 4 years old. At 4 years, blood specific IgE was analyzed. Children with symptoms of eczema and asthma during the period of breast-feeding were excluded in most analyses on risk assessment of eczema and asthma, respectively, to avoid disease-related modification of exposure. Exclusive breast-feeding for >or=4 months reduced the risk for eczema at the age of 4 years (odds ratio [OR], 0.78; 95% CI, 0.63--0.96) irrespective of combination with asthma, sensitization to common allergens, or parental allergic disease. This decreased risk was most evident for children with onset of eczema during the first 2 years persisting to 4 years (OR, 0.59; 95% CI, 0.45--0.77). Among children with early-onset eczema, irrespective of persistency, followed by late onset of asthma or early-onset asthma irrespective of persistency, followed by late-onset eczema to 4 years, a protective effect of breast-feeding was also seen (OR, 0.48; 95% CI, 0.30--0.76). Breast-feeding 4 months or more reduces the risk for eczema and onset of the allergy march to age 4.

THE IMPORTANCE OF EVALUATION OF RISK MANAGEMENT IN BUSINESS

Directory of Open Access Journals (Sweden)

SLOBODAN POPOVIĆ

2015-10-01

Full Text Available Economies with dominant private ownership and developed market institutions build their prosperity on a firm`s goal function in a form of maximization owner`s wealth. Financial situation of business organization is most important indicate that shows level of financial health. The creation of value for the owners imply two matters simultaneously competitive advantage and the evaluation of economic effects. Among economic activities, establishes the different types of addiction. In this work authors draw attention to two categories: the functional and stochastic. Case studies will be cash flows of investment and the contribution of the stochastic component of the risk of enterprise value. Methodological dominated analytical and descriptive methods. Management in the process of evaluation of investment seen what happens behind the projections of cash flows and estimates of available chances for possible modifications. The purpose of the discussion in this section refers to the warning that the application of the rules of net present values does not mean the completion of the management process at the moment of the decision on the selection of investments. In this study, we analyze the influence of stochastic risk in the creation of enterprise value, especially if the risk is managed improperly. In this connection, the starting hypothesis is that adequately compensate for risk has a positive effect on new investments and reduce the antagonism of shareholders and other creditors of the company.

Study Shows Aspirin Reduces Colorectal Cancer in Those at High Risk

Science.gov (United States)

Findings from the first large clinical trial of its kind indicate that taking high doses of aspirin daily for at least 2 years substantially reduces the risk of colorectal cancer among people at increased risk of the disease.

Comparison of human exposure pathways in an urban brownfield: reduced risk from paving roads.

Science.gov (United States)

James, Kyle; Farrell, Richard E; Siciliano, Steven D

2012-10-01

Risk assessments often do not quantify the risk associated with soil inhalation. This pathway generally makes a negligible contribution to the cumulative risk, because soil ingestion is typically the dominant exposure pathway. Conditions in northern or rural centers in Canada characterized by large areas of exposed soil, including unpaved roads, favor the resuspension of soil particles, making soil inhalation a relevant risk pathway. The authors determined and compared human exposure to metals and polycyclic aromatic hydrocarbons (PAHs) from soil ingestion and inhalation and analyzed the carcinogenic and noncarcinogenic risks before and after roads were paved in a northern community. To determine the inhalation exposure, three size fractions of airborne particulate matter were collected (total suspended particulates [TSP], particulate matter with an aerodynamic diameter less than 10 µm [PM10], and particulate matter with an aerodynamic diameter less than 2.5 µm [PM2.5]) before and after roads were paved. Road paving reduced the concentration of many airborne contaminants by 25 to 75%, thus reducing risk. For example, before paving, the carcinogenic risk associated with inhalation of Cr was 3.4 excess cancers per 100,000 people exposed, whereas after paving, this risk was reduced to 1.6 in 100,000. Paving roads reduced the concentrations of total suspended particulates (TSP; p roads is an effective method of reducing risk from the inhalation of soil particles. Copyright © 2012 SETAC.

Natural disturbance reduces disease risk in endangered rainforest frog populations.

Science.gov (United States)

Roznik, Elizabeth A; Sapsford, Sarah J; Pike, David A; Schwarzkopf, Lin; Alford, Ross A

2015-08-21

Natural disturbances can drive disease dynamics in animal populations by altering the microclimates experienced by hosts and their pathogens. Many pathogens are highly sensitive to temperature and moisture, and therefore small changes in habitat structure can alter the microclimate in ways that increase or decrease infection prevalence and intensity in host populations. Here we show that a reduction of rainforest canopy cover caused by a severe tropical cyclone decreased the risk of endangered rainforest frogs (Litoria rheocola) becoming infected by a fungal pathogen (Batrachochytrium dendrobatidis). Reductions in canopy cover increased the temperatures and rates of evaporative water loss in frog microhabitats, which reduced B. dendrobatidis infection risk in frogs by an average of 11-28% in cyclone-damaged areas, relative to unaffected areas. Natural disturbances to the rainforest canopy can therefore provide an immediate benefit to frogs by altering the microclimate in ways that reduce infection risk. This could increase host survival and reduce the probability of epidemic disease outbreaks. For amphibian populations under immediate threat from this pathogen, targeted manipulation of canopy cover could increase the availability of warmer, drier microclimates and therefore tip the balance from host extinction to coexistence.

Cereal fiber intake may reduce risk of gastric adenocarcinomas : The EPIC-EURGAST study

NARCIS (Netherlands)

Mendez, M. A.; Pera, Guillem; Aguclo, Antonio; Bueno-de-Mesquita, H. Bas; Palli, Domenico; Boeing, Heiner; Carneiro, Ftima; Berrino, Franco; Sacerdote, Carlotta; Tumino, Rosario; Panico, Salvatore; Berglund, Goeran; Manjer, Jonas; Johansson, Ingegerd; Stenling, Roger; Martinez, Carmen; Dorronsoro, Miren; Barricarte, Aurelio; Tormo, Maria J.; Quiros, Jose R.; Allen, Naomi; Key, Timothy J.; Bingham, Sheila; Linseisen, Jakob; Kaaks, Rudolf; Overvad, Kim; Jensen, Majken; Olsen, Anja; Tjonneland, Anne; Peeters, Petra H. M.; Numans, Mattijs E.; Ocke, Marga C.; Clavel-Chapelon, Francoise; Boutron-Ruault, Marie-Christine; Trichopoulou, Antonia; Lund, Eiliv; Slimani, Nadia; Jenab, Mazda; Ferrari, Pietro; Riboli, Elio; Gonzalez, Carlos A.

2007-01-01

Numerous case-control studies suggest dietary fiber may reduce risk of gastric cancer, but this has not been confirmed prospectively. A previous case-control study reported reduced risk of gastric cardia adenocarcinomas associated with cereal fiber, but not with fruit or vegetable fiber. To date,

The residual and direct effects of reduced-risk and conventional miticides on twospotted spider mites, Tetranychus urticae (Acari: Tetranychidae) and predatory mites (Acari: Phytoseiidae)

International Nuclear Information System (INIS)

Liburd, O.E.; White, J.C.; Rhodes, E.M.; Browdy, A.A.

2007-01-01

The residual effects of several reduced-risk and conventional miticides were evaluated in strawberries (Fragaria × ananassa Duchesne) on the twospotted spider mite (TSSM), Tetranychus urticae Koch (Acari: Tetranychidae) and on 2 predatory mites, Neoseiulus californicus McGregor and Phytoseiulus persimilis Athias-Henriot (Acari: Phytoseiidae). Experiments were conducted in the laboratory and greenhouse. The greenhouse experiments also tested the direct effects of the miticides on TSSM. The efficacy of conventional and reduced-risk miticides was evaluated on strawberry leaf discs and on whole plants for control of TSSM. Furthermore, the residual effects of these miticides were evaluated on whole strawberry plants against selective predatory mites. For TSSM, 5 treatments were evaluated: a conventional miticide; fenbutatin-oxide (Vendex[reg]) and 3 reduced-risk miticides; binfenazate (Acramite 50WP[reg]), activated garlic extract (Repel[reg]), sesame seed and castor oil (Wipeout[reg]), and a water-treated control. For predatory mites, the residual effects of only Acramite[reg] and Vendex[reg] were evaluated. Acramite[reg] was the most effective acaricide in reducing TSSM populations in both the laboratory and greenhouse experiments. Vendex[reg] and Wipeout[reg] were also effective in the laboratory, but did not cause significant reduction of TSSM in the greenhouse. Repel[reg] was the least effective of the 4 pesticides evaluated. Neither Acramite[reg] nor Vendex[reg] had a significant effect on either predatory mite species. However, there appeared to be more predatory mites on the Vendex[reg]-treated plants than on the Acramite[reg]-treated plants. There were significantly more predatory mites of both species on the cue plants, which were inoculated with TSSM versus the non-cue plants, which were not inoculated. (author) [es

Risk-based Regulatory Evaluation Program methodology

International Nuclear Information System (INIS)

DuCharme, A.R.; Sanders, G.A.; Carlson, D.D.; Asselin, S.V.

1987-01-01

The objectives of this DOE-supported Regulatory Evaluation Progrwam are to analyze and evaluate the safety importance and economic significance of existing regulatory guidance in order to assist in the improvement of the regulatory process for current generation and future design reactors. A risk-based cost-benefit methodology was developed to evaluate the safety benefit and cost of specific regulations or Standard Review Plan sections. Risk-based methods can be used in lieu of or in combination with deterministic methods in developing regulatory requirements and reaching regulatory decisions

Risk-reducing mastectomy and salpingo-oophorectomy in unaffected BRCA mutation carriers: uptake and timing

DEFF Research Database (Denmark)

Skytte, A-B; Gerdes, Anne-Marie Axø; Andersen, M K

2010-01-01

from 306 healthy BRCA carriers with no personal history of ovarian or breast cancer. We found a 10-year uptake of 75% for risk-reducing salpingo-oophorectomy and 50% for risk-reducing mastectomy by time to event analysis. Age and childbirth influenced this decision. The uptake rate has not changed......Once female carriers of a BRCA mutation are identified they have to make decisions on risk management. The aim of this study is to outline the uptake of risk-reducing surgery in the Danish population of BRCA mutation positive women and to search for factors affecting this decision. We analysed data...

Overcoming Learning Aversion in Evaluating and Managing Uncertain Risks.

Science.gov (United States)

Cox, Louis Anthony Tony

2015-10-01

Decision biases can distort cost-benefit evaluations of uncertain risks, leading to risk management policy decisions with predictably high retrospective regret. We argue that well-documented decision biases encourage learning aversion, or predictably suboptimal learning and premature decision making in the face of high uncertainty about the costs, risks, and benefits of proposed changes. Biases such as narrow framing, overconfidence, confirmation bias, optimism bias, ambiguity aversion, and hyperbolic discounting of the immediate costs and delayed benefits of learning, contribute to deficient individual and group learning, avoidance of information seeking, underestimation of the value of further information, and hence needlessly inaccurate risk-cost-benefit estimates and suboptimal risk management decisions. In practice, such biases can create predictable regret in selection of potential risk-reducing regulations. Low-regret learning strategies based on computational reinforcement learning models can potentially overcome some of these suboptimal decision processes by replacing aversion to uncertain probabilities with actions calculated to balance exploration (deliberate experimentation and uncertainty reduction) and exploitation (taking actions to maximize the sum of expected immediate reward, expected discounted future reward, and value of information). We discuss the proposed framework for understanding and overcoming learning aversion and for implementing low-regret learning strategies using regulation of air pollutants with uncertain health effects as an example. © 2015 Society for Risk Analysis.

Opportunities to reduce risk associated with nuclear logging techniques

International Nuclear Information System (INIS)

Wraight, P.D.; Robinson, E.; de Fleurieu, R.

1991-01-01

Nuclear logging provides petroleum exploration and production companies with data that are critical to their decisions and operations. Because this type data is so important, environmentally conscious well-logging and service companies are constantly reviewing the risks to people and environment associated with nuclear sources with the ALARA (as low as reasonably achievable) principle in mind. Opportunities to additionally reduce risks, which can be accomplished only with the active involvement of oil companies, are proposed in this paper

Guidance on methodology for evaluation of the effectiveness of options for reducing the risk of introduction and spread of organisms harmful to plant health in the EU territory

DEFF Research Database (Denmark)

Baker, R.; Candresse, T.; Dormannsné Simon, E.

2012-01-01

The European Food Safety Authority (EFSA) requested the Panel on Plant Health (PLH Panel) to provide guidance for the evaluation of the effectiveness of the options for plants and plant products for reducing the risk of introduction and spread of harmful organisms in the European Union territory...... and guidance documents for assessing a proposed RRO. In addition, the current document provides recommendations for assessing RROs, specifically: on experimental design; on the use of statistical methods including approaches for studying uncertainty; on the use of quantitative pathway analysis and spread...

Motivators and barriers of tamoxifen use as risk-reducing medication amongst women at increased breast cancer risk: a systematic literature review.

Science.gov (United States)

Meiser, B; Wong, W K T; Peate, M; Julian-Reynier, C; Kirk, J; Mitchell, G

2017-01-01

Selective estrogen receptor modulators, such as tamoxifen, reduce breast cancer risk by up to 50% in women at increased risk for breast cancer. Despite tamoxifen's well-established efficacy, many studies show that most women are not taking up tamoxifen. This systematic literature review aimed to identify the motivators and barriers to tamoxifen use 's amongst high-risk women. Using MEDLINE, PsycINFO, and Embase plus reviewing reference lists of relevant articles published between 1995 and 2016, 31 studies (published in 35 articles) were identified, which addressed high-risk women's decisions about risk-reducing medication to prevent breast cancer and were peer-reviewed primary clinical studies. A range of factors were identified as motivators of, and barriers to, tamoxifen uptake including: perceived risk, breast-cancer-related anxiety, health professional recommendation, perceived drug effectiveness, concerns about side-effects, knowledge and access to information about side-effects, beliefs about the role of risk-reducing medication, provision of a biomarker, preference for other forms of breast cancer risk reduction, previous treatment experience, concerns about randomization in clinical trial protocols and finally altruism. Results indicate that the decision for high-risk women regarding tamoxifen use or non-use as a risk-reducing medication is not straightforward. Support of women making this decision is essential and needs to encompass the full range of factors, both informational and psychological.

Prayer at midlife is associated with reduced risk of cognitive decline in Arabic women.

Science.gov (United States)

Inzelberg, Rivka; Afgin, Anne E; Massarwa, Magda; Schechtman, Edna; Israeli-Korn, Simon D; Strugatsky, Rosa; Abuful, Amin; Kravitz, Efrat; Farrer, Lindsay A; Friedland, Robert P

2013-03-01

Midlife habits may be important for the later development of Alzheimer's disease (AD). We estimated the contribution of midlife prayer to the development of cognitive decline. In a door-to-door survey, residents aged ≥65 years were systematically evaluated in Arabic including medical history, neurological, cognitive examination, and a midlife leisure-activities questionnaire. Praying was assessed by the number of monthly praying hours at midlife. Stepwise logistic regression models were used to evaluate the effect of prayer on the odds of mild cognitive impairment (MCI) and AD versus cognitively normal individuals. Of 935 individuals that were approached, 778 [normal controls (n=448), AD (n=92) and MCI (n=238)] were evaluated. A higher proportion of cognitively normal individuals engaged in prayer at midlife [(87%) versus MCI (71%) or AD (69%) (pprayer, the effect on cognitive decline could not be assessed in men. Among women, stepwise logistic regression adjusted for age and education, showed that prayer was significantly associated with reduced risk of MCI (p=0.027, OR=0.55, 95% CI 0.33-0.94), but not AD. Among individuals endorsing prayer activity, the amount of prayer was not associated with MCI or AD in either gender. Praying at midlife is associated with lower risk of mild cognitive impairment in women.

Investment risk evaluation techniques: use in energy-intensive industries and implications for ERDA's Industrial Conservation Program

Energy Technology Data Exchange (ETDEWEB)

None

1977-07-13

The trade-off between risk and rate-of-return in investment evaluations is crucial in assessing the commercial potential of future energy-conservation technologies. The focus of the Industrial Conservation Program at ERDA is to reduce the perceived risks of a given technology to the extent that the private sector will adopt the technology within the normal course of its business operations. These perceived risks may emanate from technical, institutional, or commercial uncertainties, or in many cases they may result merely from a company's or industry's lack of previous experience with a particular technology. Regardless of the source of the risk surrounding a project, the uncertainty it poses to the private sector will serve to inhibit decisions to invest. This study evaluates the treatment of risk in capital investments in certain energy-intensive industries which are the primary targets of ERDA's Industrial Conservation Program. These risks evaluation considerations were placed within a context that includes capital budgeting practices and procedures, organizational considerations, and basic rate-of-return evaluation procedures in the targeted energy-intensive industries (petroleum, chemicals, paper, textiles, cement, food processing, aluminum, steel, glass, and agriculture).

Evaluation of different hedging strategies for commodity price risks of industrial cogeneration plants

International Nuclear Information System (INIS)

Palzer, Andreas; Westner, Günther; Madlener, Reinhard

2013-01-01

In this paper, we design and evaluate eight different strategies for hedging commodity price risks of industrial cogeneration plants. Price developments are parameterized based on EEX data from 2008 to 2011. The probability distributions derived are used to determine the value-at-risk (VaR) of the individual strategies, which are in a final step combined in a mean-variance portfolio analysis for determining the most efficient hedging strategy. We find that the strategy adopted can have a marked influence on the remaining price risk. Quarter futures are found to be particularly well suited for reducing market price risk. In contrast, spot trading of CO 2 certificates is found to be preferable compared to forward market trading. Finally, portfolio optimization shows that a mix of various hedging strategies can further improve the profitability of a heat-based cogeneration plant. - Highlights: • Evaluation of commodity price risk hedging strategies for industrial cogeneration. • Value-at-risk analysis of eight different hedging strategies. • Mean-variance portfolio analysis for determining the optimal hedging strategy mix. • A mix of hedging strategies further improves profitability of heat-based CHP

Risk evaluation method for faults by engineering approach. (2) Application concept of margin analysis utilizing accident sequences

International Nuclear Information System (INIS)

Kamiya, Masanobu; Kanaida, Syuuji; Kamiya, Kouichi; Sato, Kunihiko; Kuroiwa, Katsuya

2016-01-01

The influence of the fault displacement on the facility should to be evaluated not only by the activity of the fault but also by obtaining risk information by considering scenarios including such as the frequency and the degree of the hazard, which should be an appropriate approach for nuclear safety. An applicable concept of margin analysis utilizing accident sequences for evaluating the influence of the fault displacement is proposed. By use of this analysis, we can evaluate of the safety functions and margin for core damage, verify the efficiency of equipment of portable type and make a decision to take additional measures to reduce the risk by using obtained risk information. (author)

Reducing risk where tectonic plates collide

Science.gov (United States)

Gomberg, Joan S.; Ludwig, Kristin A.

2017-06-19

Most of the world’s earthquakes, tsunamis, landslides, and volcanic eruptions are caused by the continuous motions of the many tectonic plates that make up the Earth’s outer shell. The most powerful of these natural hazards occur in subduction zones, where two plates collide and one is thrust beneath another. The U.S. Geological Survey’s (USGS) “Reducing Risk Where Tectonic Plates Collide—A USGS Plan to Advance Subduction Zone Science” is a blueprint for building the crucial scientific foundation needed to inform the policies and practices that can make our Nation more resilient to subduction zone-related hazards.

Obesity, physical activity and cancer risks: Results from the Cancer, Lifestyle and Evaluation of Risk Study (CLEAR).

Science.gov (United States)

Nunez, Carlos; Bauman, Adrian; Egger, Sam; Sitas, Freddy; Nair-Shalliker, Visalini

2017-04-01

Physical activity (PA) has been associated with lower risk of cardiovascular diseases, but the evidence linking PA with lower cancer risk is inconclusive. We examined the independent and interactive effects of PA and obesity using body mass index (BMI) as a proxy for obesity, on the risk of developing prostate (PC), postmenopausal breast (BC), colorectal (CRC), ovarian (OC) and uterine (UC) cancers. We estimated odds ratios (OR) and 95% confidence intervals (CI), adjusting for cancer specific confounders, in 6831 self-reported cancer cases and 1992 self-reported cancer-free controls from the Cancer Lifestyle and Evaluation of Risk Study, using unconditional logistic regression. For women, BMI was positively associated with UC risk; specifically, obese women (BMI≥30kg/m 2 ) had nearly twice the risk of developing UC compared to women with healthy-BMI-range (risk of developing any cancer type, CRC and PC. In particular, obese men had 37% (OR=1.37;CI:1.11-1.70), 113% (OR=2.13;CI:1.55-2.91) and 51% (OR=1.51;CI:1.17-1.94) higher risks of developing any cancer, CRC and PC respectively, when compared to men with healthy-BMI-range (BMIrisks of CRC, UC and BC. In particular, the highest level of PA (versus nil activity) was associated with reduced risks of CRC (OR=0.60;CI:0.44-0.84) and UC (OR=0.47;CI:0.27-0.80). Reduced risks of BC were associated with low (OR=0.66;CI:0.51-0.86) and moderate (OR=0.72;CI:0.57-0.91) levels of PA. There was no association between PA levels and cancer risks for men. We found no evidence of an interaction between BMI and PA in the CLEAR study. These findings suggest that PA and obesity are independent cancer risk factors. Copyright © 2017 Elsevier Ltd. All rights reserved.

What can individuals do to reduce personal health risks from air pollution?

Science.gov (United States)

Laumbach, Robert; Meng, Qingyu; Kipen, Howard

2015-01-01

In many areas of the world, concentrations of ambient air pollutants exceed levels associated with increased risk of acute and chronic health problems. While effective policies to reduce emissions at their sources are clearly preferable, some evidence supports the effectiveness of individual actions to reduce exposure and health risks. Personal exposure to ambient air pollution can be reduced on high air pollution days by staying indoors, reducing outdoor air infiltration to indoors, cleaning indoor air with air filters, and limiting physical exertion, especially outdoors and near air pollution sources. Limited evidence suggests that the use of respirators may be effective in some circumstances. Awareness of air pollution levels is facilitated by a growing number of public air quality alert systems. Avoiding exposure to air pollutants is especially important for susceptible individuals with chronic cardiovascular or pulmonary disease, children, and the elderly. Research on mechanisms underlying the adverse health effects of air pollution have suggested potential pharmaceutical or chemopreventive interventions, such as antioxidant or antithrombotic agents, but in the absence of data on health outcomes, no sound recommendations can be made for primary prevention. Health care providers and their patients should carefully consider individual circumstances related to outdoor and indoor air pollutant exposure levels and susceptibility to those air pollutants when deciding on a course of action to reduce personal exposure and health risks from ambient air pollutants. Careful consideration is especially warranted when interventions may have unintended negative consequences, such as when efforts to avoid exposure to air pollutants lead to reduced physical activity or when there is evidence that dietary supplements, such as antioxidants, have potential adverse health effects. These potential complications of partially effective personal interventions to reduce exposure or

Reducing health risk in family members of patients with type 2 diabetes: views of first degree relatives

Directory of Open Access Journals (Sweden)

O'Sullivan Bernadette

2009-12-01

Full Text Available Abstract Background Patients with type 2 diabetes can have an important role in discussing health risk within families. This study aimed to establish the acceptability to first degree relatives towards their relative with type 2 diabetes intervening as health promoters in their own families, using the Health Belief Model as a theoretical framework for evaluation. Methods Cross-sectional questionnaire design. Survey questionnaire for first degree relative (sibling or child mailed to a random sample of patients with type 2 diabetes registered with an urban hospital diabetes clinic (n = 607 eligible patients. Patients were asked to pass on questionnaires to one to two first degree relatives. Results Questionnaires were returned from 257 families (42% response rate with two responses provided by 107 families (a total of 364 questionnaires. The majority (94% of first degree relatives of patients with type 2 diabetes would like to be informed about reducing their risk. Half (48% of respondents reported being spoken to by a relative with type 2 diabetes about their risk of diabetes. Those spoken to were more likely to see themselves at risk of diabetes, to worry about developing diabetes and to view diabetes as a serious condition. Conclusions A role for patients with type 2 diabetes in discussing health risk in their family appears to be acceptable to many relatives. Discussion of risk and interventions to reduce health risk with their relatives should be encouraged in patients with type 2 diabetes.

Reducing health risk in family members of patients with type 2 diabetes: views of first degree relatives.

LENUS (Irish Health Repository)

Whitford, David L

2009-01-01

BACKGROUND: Patients with type 2 diabetes can have an important role in discussing health risk within families. This study aimed to establish the acceptability to first degree relatives towards their relative with type 2 diabetes intervening as health promoters in their own families, using the Health Belief Model as a theoretical framework for evaluation. METHODS: Cross-sectional questionnaire design. Survey questionnaire for first degree relative (sibling or child) mailed to a random sample of patients with type 2 diabetes registered with an urban hospital diabetes clinic (n = 607 eligible patients). Patients were asked to pass on questionnaires to one to two first degree relatives. RESULTS: Questionnaires were returned from 257 families (42% response rate) with two responses provided by 107 families (a total of 364 questionnaires). The majority (94%) of first degree relatives of patients with type 2 diabetes would like to be informed about reducing their risk. Half (48%) of respondents reported being spoken to by a relative with type 2 diabetes about their risk of diabetes. Those spoken to were more likely to see themselves at risk of diabetes, to worry about developing diabetes and to view diabetes as a serious condition. CONCLUSIONS: A role for patients with type 2 diabetes in discussing health risk in their family appears to be acceptable to many relatives. Discussion of risk and interventions to reduce health risk with their relatives should be encouraged in patients with type 2 diabetes.

Extreme Geohazards: Reducing the Disaster Risk and Increasing Resilience

Science.gov (United States)

Plag, Hans-Peter; Stein, Seth; Brocklebank, Sean; Jules-Plag, Shelley; Marsh, Stuart; Campus, Paola

2013-04-01

Extreme geohazards have the potential to escalate the global sustainability crisis and put us close to the boundaries of the safe operating space for humanity. Exposure of human assets to geohazards has increased dramatically in recent decades, and the sensitivity of the built environment and the embedded socio-economic fabric have changed. We are putting the urban environment, including megacities, in harm's way. Paradoxically, innovation during recent decades, in particular, urban innovation, has increased the disaster risk and coupled this risk to the sustainability crisis. Only more innovation can reduce disaster risk and lead us out of the sustainability crisis. Extreme geohazards (volcanic eruptions, earthquakes, tsunamis) that occurred regularly throughout the last few millennia mostly did not cause major disasters because population density was low and the built environment was not sprawling into hazardous areas to the same extent as today. Similar extreme events today would cause unparalleled damage on a global scale and could worsen the sustainability crisis. Simulation of these extreme hazards under present conditions can help to assess the disaster risk. The Geohazards Community of Practice of the Group on Earth Observations (GEO) with support from the European Science Foundation is preparing a white paper assessing the contemporary disaster risks associated with extreme geohazards and developing a vision for science and society to engage in deliberations addressing this risk (see http://www.geohazcop.org/projects/extgeowp). Risk awareness and monitoring is highly uneven across the world, and this creates two kinds of problems. Firstly, potential hazards are much more closely monitored in wealthy countries than in the developing world. But the largest hazards are global in nature, and it is critical to get as much forewarning as possible to develop an effective response. The disasters and near-misses of the past show that adherence to scientific

Risk Evaluation for CO{sub 2} Geosequestration in the Knox Supergroup

Energy Technology Data Exchange (ETDEWEB)

Leetaru, Hannes

2014-01-31

.e., persistently porous and permeable) injection depths within the overall formation. Less direct implications include the vertical position of the Potosi within the rock column and the absence of a laterally extensive shale caprock immediately overlying the Potosi. Based on modeling work done partly in association with this risk report, risks that should also be evaluated include the ability of available methods to predict and track the development of a CO{sub 2} plume as it migrates away from the injection point(s). The geologic and hydrodynamic uncertainties present risks that are compounded at the stage of acquiring necessary drilling and injection permits. It is anticipated that, in the future, a regional geologic study or CO{sub 2}-emitter request may identify a small specific area as a prospective CCS project site. At that point, the FEPs lists provided in this report should be evaluated by experts for their relative levels of risk. A procedure for this evaluation is provided. The higher-risk FEPs should then be used to write project-specific scenarios that may themselves be evaluated for risk. Then, actions to reduce and to manage risk can be described and undertaken. The FEPs lists provided as Appendix 2 should not be considered complete, as potentially the most important risks are ones that have not yet been thought of. But these lists are intended to include the most important risk elements pertinent to a Potosi-target CCS project, and they provide a good starting point for diligent risk identification, evaluation, and management.

Damage-reducing measures to manage flood risks in a changing climate

Science.gov (United States)

Kreibich, Heidi; Bubeck, Philip; Van Vliet, Mathijs; De Moel, Hans

2014-05-01

Damage due to floods has increased during the last few decades, and further increases are expected in several regions due to climate change and a growing vulnerability. To address the projected increase in flood risk, a combination of structural and non-structural flood risk mitigation measures is considered as a promising adaptation strategy. Such a combination takes into account that flood defence systems may fail, and prepare for unexpected crisis situations via land-use planning, building construction, evacuation and disaster response. Non-structural flood risk mitigation measures like shielding with water shutters or sand bags, building fortification or safeguarding of hazardous substances are often voluntary: they demand self-dependent action by the population at risk (Bubeck et al. 2012; 2013). It is believed that these measures are especially effective in areas with frequent flood events and low flood water levels, but some types of measures showed a significant damage-reducing effect also during extreme flood events, such as the Elbe River flood in August 2002 in Germany (Kreibich et al. 2005; 2011). Despite the growing importance of damage-reducing measures, information is still scarce about factors that motivate people to undertake such measures, the state of implementation of various non-structural measures in different countries and their damage reducing effects. Thus, we collected information and undertook an international review about this topic in the framework of the Dutch KfC project "Climate proof flood risk management". The contribution will present an overview about the available information on damage-reducing measures and draw conclusions for practical flood risk management in a changing climate. References: Bubeck, P., Botzen, W. J. W., Suu, L. T. T., Aerts, J. C. J. H. (2012): Do flood risk perceptions provide useful insights for flood risk management? Findings from central Vietnam. Journal of Flood Risk Management, 5, 4, 295-302 Bubeck, P

Reducing the Risk of Methadone Overdose PSA (:60)

Centers for Disease Control (CDC) Podcasts

2012-07-03

This 60 second PSA is based on the July 2012 CDC Vital Signs report. Approximately 14 people die every day of overdoses related to methadone. Listen to learn how to reduce your risk of an overdose.  Created: 7/3/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/3/2012.

Setting Priorities in Behavioral Interventions: An Application to Reducing Phishing Risk.

Science.gov (United States)

Canfield, Casey Inez; Fischhoff, Baruch

2018-04-01

Phishing risk is a growing area of concern for corporations, governments, and individuals. Given the evidence that users vary widely in their vulnerability to phishing attacks, we demonstrate an approach for assessing the benefits and costs of interventions that target the most vulnerable users. Our approach uses Monte Carlo simulation to (1) identify which users were most vulnerable, in signal detection theory terms; (2) assess the proportion of system-level risk attributable to the most vulnerable users; (3) estimate the monetary benefit and cost of behavioral interventions targeting different vulnerability levels; and (4) evaluate the sensitivity of these results to whether the attacks involve random or spear phishing. Using parameter estimates from previous research, we find that the most vulnerable users were less cautious and less able to distinguish between phishing and legitimate emails (positive response bias and low sensitivity, in signal detection theory terms). They also accounted for a large share of phishing risk for both random and spear phishing attacks. Under these conditions, our analysis estimates much greater net benefit for behavioral interventions that target these vulnerable users. Within the range of the model's assumptions, there was generally net benefit even for the least vulnerable users. However, the differences in the return on investment for interventions with users with different degrees of vulnerability indicate the importance of measuring that performance, and letting it guide interventions. This study suggests that interventions to reduce response bias, rather than to increase sensitivity, have greater net benefit. © 2017 Society for Risk Analysis.

Pharmacist intervention reduces gastropathy risk in patients using NSAIDs.

Science.gov (United States)

Ibañez-Cuevas, Victoria; Lopez-Briz, Eduardo; Guardiola-Chorro, M Teresa

2008-12-01

To establish a detection and intervention strategy in order to reduce the number of non-steroidal anti-inflammatory drug (NSAIDs) users at risk of gastropathy from receiving either inadequate or no gastroprotection. Community Pharmacies in Valencia, Spain. Prospective longitudinal intervention study without control group carried out by 79 Community Pharmacies. Patients over 18 who asked for any systemic NSAID were interviewed according to standard procedure. Pharmacist intervention was carried out when a patient at risk of serious NSAID-induced gastrointestinal complications due to inadequate or no gastric protection was identified. The doctor responsible was informed in order to then be able to assess the need to prescribe gastroprotection or change it if inadequate. In the case of over-the-counter (OTC) drugs, pharmacist intervention mainly involved replacing NSAIDs for safer medications. Firstly, the number of patients who had no prescribed gastroprotection or inadequate gastroprotection was determined. Pharmacist intervention then brought about changes in pharmacotherapy in this situation. Of the 6,965 patients who asked for NSAIDs during the study period, 3,054 (43.9%) presented NSAID gastropathy risk factors. 35.6% of the latter (1,089) were not prescribed gastroprotection or were prescribed inadequate gastroprotection. Pharmacist intervention was carried out in 1,075 of these cases. On 391 occasions such risk situations were reported to doctors, who accepted pharmacist intervention on 309 occasions (79.0%) and then either prescribed gastroprotection (77% of cases); changed it (13.9%); withdrew the NSAID (5.8%) or substituted it (3.2%). 235 Pharmacist interventions took place when dispensing OTC NSAIDs. Our strategy allowed us to identify a large number of patients who asked for NSAIDs in Community Pharmacies and who were at risk of NSAID gastropathy, as they received either inadequate gastroprotection or no gastroprotection whatsoever. Moreover, the

Sociocultural tailoring of a healthy lifestyle intervention to reduce cardiovascular disease and type 2 diabetes risk among Latinos.

Science.gov (United States)

Mudd-Martin, Gia; Martinez, Maria C; Rayens, Mary Kay; Gokun, Yevgeniya; Meininger, Janet C

2013-11-27

Suboptimal lifestyle factors in combination with genetic susceptibility contribute to cardiovascular disease and type 2 diabetes risk among Latinos. We describe a community-academic collaboration that developed and explored the feasibility of implementing a socioculturally tailored, healthy lifestyle intervention integrating genomics and family history education to reduce risk of cardiovascular disease and type 2 diabetes among Latinos. The community-based participatory research was conducted with communities in Kentucky, which has a rapidly growing Latino population. This growth underscores the need for socioculturally appropriate health resources. Su Corazon, Su Vida (Your Heart, Your Life) is a Spanish-language, healthy lifestyle educational program to reduce cardiovascular disease and type 2 diabetes risk among Latinos. Twenty natural leaders from an urban Latino community in Kentucky participated in sociocultural tailoring of the program and development of a genomics and family history module. The tailored program was presented to 22 participants to explore implementation feasibility and assess appropriateness for community use. Preintervention and postintervention assessments of genomic knowledge and lifestyle behaviors and qualitative postintervention evaluations were conducted. Postintervention improvements in health-promoting lifestyle choices and genomic knowledge specific to cardiovascular disease and type 2 diabetes suggested that the program may be effective in reducing risk. Feedback indicated the program was socioculturally acceptable and responsive to community needs. These findings indicated that a tailored healthy lifestyle program integrating genomics and family history education was socioculturally appropriate and may feasibly be implemented to reduce cardiovascular disease and type 2 diabetes risk in a Latino community with limited health care resources. The project highlights contributions of community-based processes in tailoring

Development, oviposition, and mortality of Neoseiulus fallacis (Acari: Phytoseiidae) in response to reduced-risk insecticides.

Science.gov (United States)

Villanueva, Raul T; Walgenbach, James F

2005-12-01

Eight reduced-risk insecticides (acetamiprid, thiamethoxam, imidacloprid, thiacloprid, methoxyfenozide, pyriproxyfen, indoxacarb, and spinosad) and three conventional insecticides (azinphosmethyl, fenpropathrin, and esfenvalerate) were tested against Neoseiulus fallacis (Garman) (Acari: Phytoseiidae), the most abundant predacious mite in North Carolina apple (Malus spp.) orchards. To assess the effect of insecticides on development and mortality of N. fallacis immatures, 12-h-old eggs were individually placed on bean leaf disks previously dipped in insecticide solutions. Tetranychus urticae Koch (Acari: Tetranychidae) females were added as a food source. None of the reduced-risk insecticides significantly affected immature N. fallacis compared with the control; however, the pyrethroids esfenvalerate and fenpropathrin were highly toxic to immatures. To evaluate the effect of insecticides on mortality and oviposition of adult N. fallacis, 7- to 8-d-old females were confined on insecticide-treated bean leaves with Malephora crocea (Aizoaceae) pollen added as a food source. Spinosad resulted in the highest mortality, whereas azinphosmethyl, acetamiprid, fenpropathrin, and imidacloprid were moderately toxic, and mortality from esfenvalerate, indoxacarb, thiacloprid, methoxyfenozide, pyriproxyfen, and thiamethoxam did not differ significantly from the control. Oviposition was affected in a similar manner, with the exception of acetamiprid that did not affect oviposition, and thiamethoxam that reduced oviposition.

Evaluating Personalized Feedback Intervention Framing with a Randomized Controlled Trial to Reduce Young Adult Alcohol-Related Sexual Risk Taking.

Science.gov (United States)

Lewis, Melissa A; Rhew, Isaac C; Fairlie, Anne M; Swanson, Alex; Anderson, Judyth; Kaysen, Debra

2018-03-06

The purpose of this study was to evaluate personalized feedback intervention (PFI) framing with two web-delivered PFIs aimed to reduce young adult alcohol-related risky sexual behavior (RSB). Combined PFIs typically use an additive approach whereby independent components on drinking and components on RSB are presented without the discussion of the influence of alcohol on RSB. In contrast, an integrated PFI highlights the RSB-alcohol connection by presenting integrated alcohol and RSB components that focus on the role of intoxication as a barrier to risk reduction in sexual situations. In a randomized controlled trial, 402 (53.98% female) sexually active young adults aged 18-25 were randomly assigned to a combined PFI, an integrated PFI, or attention control. All assessment and intervention procedures were web-based. At the 1-month follow-up, those randomly assigned to the integrated condition had a lower likelihood of having any casual sex partners compared to those in the control group. At the 6-month follow-up, the combined condition had a lower likelihood of having any casual sex partners compared to those in the control group. When examining alcohol-related RSB, at the 1-month follow-up, both interventions showed a lower likelihood of any drinking prior to sex compared to the control group. When examining alcohol-related sexual consequences, results showed a reduction in the non-zero count of consequences in the integrated condition compared to the control at the 1-month follow-up. For typical drinks per week, those in the combined condition showed a greater reduction in the non-zero count of drinks than those in the control condition at the 1-month follow-up. While there were no significant differences between the two interventions, the current findings highlight the utility of two efficacious web-based alcohol and RSB interventions among a national sample of at-risk young adults.

Risk analysis and evaluation of agricultural drought disaster in the major grain-producing areas, China

OpenAIRE

Zongtang Xie; Jiuping Xu; Yanfei Deng

2016-01-01

The analysis and evaluation of agricultural drought risk can assist in reducing regional disasters and agricultural drought losses. Because of the uncertainties and incomplete agricultural drought information, this paper employed an information diffusion technology and information matrix to identify a drought disaster risk distribution and to quantify the relationship between the annual drought-affected rate and the grain production losses in China's major grain-producing areas. From the asse...

Evaluating Fall Risk in People with Low Vision: A Case Series

OpenAIRE

Kierstyn Napier-Dovorany, OD; Victoria Graham, DPT

2013-01-01

Background: People with low vision have increased risk for falls and preventable health conditions due to sedentary lifestyle and reduced participation in social activities. This case series describes an interprofessional low vision, balance, and mobility evaluation of two patients referred to our low vision optometric clinic. Case Report: RM, an 82-year-old white female with diabetic retinopathy, and PC, a 55-year-old white female with retinopathy of prematurity, completed a comprehensive lo...

Risk management study for the Hanford Site facilities: Risk reduction cost comparison for the retired Hanford Site facilities

International Nuclear Information System (INIS)

Coles, G.A.; Egge, R.G.; Senger, E.; Shultz, M.W.; Taylor, W.E.

1994-02-01

This document provides a cost-comparison evaluation for implementing certain risk-reduction measures and their effect on the overall risk of the 100 and 200 Area retired, surplus facilities. The evaluation is based on conditions that existed at the time the risk evaluation team performed facility investigations, and does not acknowledge risk-reduction measures that occurred soon after risk identification. This evaluation is one part of an overall risk management study for these facilities. The retired facilities investigated for this evaluation are located in the 100 and 200 Areas of the 1450-km 2 Hanford Site. The Hanford Site is a semiarid tract of land in southeastern Washington State. The nearest population center is Richland, Washington, (population 32,000) 30 km southeast of the 200 Area. This cost-comparison evaluation (1) determines relative costs for reducing risk to acceptable levels; (2) compares the cost of reducing risk using different risk-reduction options; and (3) compares the cost of reducing risks at different facilities. The result is an identification of the cost effective risk-reduction measures. Supporting information required to develop costs of the various risk-reduction options also is included

Active fans and grizzly bears: Reducing risks for wilderness campers

Science.gov (United States)

Sakals, M. E.; Wilford, D. J.; Wellwood, D. W.; MacDougall, S. A.

2010-03-01

Active geomorphic fans experience debris flows, debris floods and/or floods (hydrogeomorphic processes) that can be hazards to humans. Grizzly bears ( Ursus arctos) can also be a hazard to humans. This paper presents the results of a cross-disciplinary study that analyzed both hydrogeomorphic and grizzly bear hazards to wilderness campers on geomorphic fans along a popular hiking trail in Kluane National Park and Reserve in southwestern Yukon Territory, Canada. Based on the results, a method is proposed to reduce the risks to campers associated with camping on fans. The method includes both landscape and site scales and is based on easily understood and readily available information regarding weather, vegetation, stream bank conditions, and bear ecology and behaviour. Educating wilderness campers and providing a method of decision-making to reduce risk supports Parks Canada's public safety program; a program based on the principle of user self-sufficiency. Reducing grizzly bear-human conflicts complements the efforts of Parks Canada to ensure a healthy grizzly bear population.

Screening Risk Evaluation methodology

International Nuclear Information System (INIS)

Hopper, K.M.

1994-01-01

The Screening Risk Evaluation (SRE) Guidance document is a set of guidelines provided for the uniform implementation of SREs performed on D ampersand D facilities. These guidelines are designed specifically for the completion of the second (semi-quantitative screening) phase of the D ampersand D Risk-Based Process. The SRE Guidance produces screening risk scores reflecting levels of risk through the use of risk ranking indices. Five types of possible risk are calculated from the SRE: current releases, worker exposures, future releases, physical hazards, and criticality. The Current Release Index (CRI) calculates the risk to human health and the environment from ongoing or probable releases within a one year time period. The Worker Exposure Index (WEI) calculates the risk to workers, occupants, and visitors in D ampersand D facilities of contaminant exposure. The Future Release Index (FRI) calculates the risk of future releases of contaminants, after one year, to human health and the environment. The Physical Hazards Index (PHI) calculates the risk-to human health due to factors other than that of contaminants. The index of Criticality is approached as a modifying factor to the entire SRE, due to the fact that criticality issues are strictly regulated under DOE. Screening risk results will be tabulated in matrix form and Total Risk will be calculated (weighted equation) to produce a score on which to base early action recommendations. Other recommendations from the screening risk scores will be made based either on individual index scores or from reweighted Total Risk calculations. All recommendations based on the SRE will be made based on a combination of screening risk scores, decision drivers, and other considerations, determined on a project by project basis. The SRE is the first and most important step in the overall D ampersand D project level decision making process

Reduced cancer risk in vegetarians: an analysis of recent reports

Directory of Open Access Journals (Sweden)

Amy Joy Lanou

2010-12-01

Full Text Available Amy Joy Lanou1, Barbara Svenson21Department of Health and Wellness, 2Ramsey Library, University of North Carolina Asheville, Asheville, NC, USAAbstract: This report reviews current evidence regarding the relationship between vegetarian eating patterns and cancer risk. Although plant-based diets including vegetarian and vegan diets are generally considered to be cancer protective, very few studies have directly addressed this question. Most large prospective observational studies show that vegetarian diets are at least modestly cancer protective (10%–12% reduction in overall cancer risk although results for specific cancers are less clear. No long-term randomized clinical trials have been conducted to address this relationship. However, a broad body of evidence links specific plant foods such as fruits and vegetables, plant constituents such as fiber, antioxidants and other phytochemicals, and achieving and maintaining a healthy weight to reduced risk of cancer diagnosis and recurrence. Also, research links the consumption of meat, especially red and processed meats, to increased risk of several types of cancer. Vegetarian and vegan diets increase beneficial plant foods and plant constituents, eliminate the intake of red and processed meat, and aid in achieving and maintaining a healthy weight. The direct and indirect evidence taken together suggests that vegetarian diets are a useful strategy for reducing risk of cancer.Keywords: diet, vegan, prevention

EVALUATING RISK-PREDICTION MODELS USING DATA FROM ELECTRONIC HEALTH RECORDS.

Science.gov (United States)

Wang, L E; Shaw, Pamela A; Mathelier, Hansie M; Kimmel, Stephen E; French, Benjamin

2016-03-01

The availability of data from electronic health records facilitates the development and evaluation of risk-prediction models, but estimation of prediction accuracy could be limited by outcome misclassification, which can arise if events are not captured. We evaluate the robustness of prediction accuracy summaries, obtained from receiver operating characteristic curves and risk-reclassification methods, if events are not captured (i.e., "false negatives"). We derive estimators for sensitivity and specificity if misclassification is independent of marker values. In simulation studies, we quantify the potential for bias in prediction accuracy summaries if misclassification depends on marker values. We compare the accuracy of alternative prognostic models for 30-day all-cause hospital readmission among 4548 patients discharged from the University of Pennsylvania Health System with a primary diagnosis of heart failure. Simulation studies indicate that if misclassification depends on marker values, then the estimated accuracy improvement is also biased, but the direction of the bias depends on the direction of the association between markers and the probability of misclassification. In our application, 29% of the 1143 readmitted patients were readmitted to a hospital elsewhere in Pennsylvania, which reduced prediction accuracy. Outcome misclassification can result in erroneous conclusions regarding the accuracy of risk-prediction models.

Reduced risk of breast cancer associated with recreational physical activity varies by HER2 status

International Nuclear Information System (INIS)

Ma, Huiyan; Xu, Xinxin; Ursin, Giske; Simon, Michael S; Marchbanks, Polly A; Malone, Kathleen E; Lu, Yani; McDonald, Jill A; Folger, Suzanne G; Weiss, Linda K; Sullivan-Halley, Jane; Deapen, Dennis M; Press, Michael F; Bernstein, Leslie

2015-01-01

Convincing epidemiologic evidence indicates that physical activity is inversely associated with breast cancer risk. Whether this association varies by the tumor protein expression status of the estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), or p53 is unclear. We evaluated the effects of recreational physical activity on risk of invasive breast cancer classified by the four biomarkers, fitting multivariable unconditional logistic regression models to data from 1195 case and 2012 control participants in the population-based Women’s Contraceptive and Reproductive Experiences Study. Self-reported recreational physical activity at different life periods was measured as average annual metabolic equivalents of energy expenditure [MET]-hours per week. Our biomarker-specific analyses showed that lifetime recreational physical activity was negatively associated with the risks of ER-positive (ER+) and of HER2-negative (HER2−) subtypes (both P trend ≤ 0.04), but not with other subtypes (all P trend > 0.10). Analyses using combinations of biomarkers indicated that risk of invasive breast cancer varied only by HER2 status. Risk of HER2–breast cancer decreased with increasing number of MET-hours of recreational physical activity in each specific life period examined, although some trend tests were only marginally statistically significant (all P trend ≤ 0.06). The test for homogeneity of trends (HER2– vs. HER2+) reached statistical significance only when evaluating physical activity during the first 10 years after menarche (P homogeneity = 0.03). Our data suggest that physical activity reduces risk of invasive breast cancers that lack HER2 overexpression, increasing our understanding of the biological mechanisms by which physical activity acts

HOW INTERNAL RISK - BASED AUDIT APPRAISES THE EVALUATION OF RISKS MANAGEMENT

Directory of Open Access Journals (Sweden)

N. Dorosh

2017-09-01

Full Text Available The article deals with the nature and function of the internal risk-based audit process approach to create patterns of risks and methods of evaluation. Deals with the relationship between the level of maturity of the risk of the company and the method of risk-based internal audit. it was emphasized that internal auditing provides an independent and objective opinion to an organization’s management as to whether its risks are being managed to acceptable levels.

Innovative Corporate Initiatives to Reduce Climate Risk: Lessons from East Asia

Directory of Open Access Journals (Sweden)

Edward B. Barbier

2017-12-01

Full Text Available Businesses, investors, and insurers are requiring better quantitative assessments of their exposure to climate risks and their impact on climate change. They are incorporating these assessments in their day-to-day management and long-term investment decisions. Already, there are efforts to develop international guidelines, common policies and legal frameworks for such assessments, as well as the desire to foster climate financing. We examine recent progress in East Asia and the rest of the world in setting targets, pricing policies, and other mechanisms to reduce climate risks. We develop a model that demonstrates how reduced climate risk management may lower the total cost of capital of firms, thus making them more attractive to investors. We discuss the additional policies needed to support improved climate risk management in investment decisions, private investments in climate science, technology and innovation (STI expansion, and more widespread adoption of climate financing and principles. Central banks, financial authorities, and governments can advance this objective by creating financial incentives to support investment decision-making. This would take into account factors such as improving climate performance, establishing better climate risk management and reporting requirements to foster green STI, and developing international guidelines and common policy and legal frameworks to support better climate risk management, assessments and reporting.

Effectiveness of a Reduced-Risk Insecticide Based Bed Bug Management Program in Low-Income Housing

Directory of Open Access Journals (Sweden)

Narinderpal Singh

2013-11-01

Full Text Available Bed bug (Cimex lectularius L. infestations are becoming increasingly common in low-income communities. Once they are introduced, elimination is very difficult. As part of the efforts to develop effective and safe bed bug management programs, we conducted a laboratory study evaluating the efficacy of a reduced-risk insecticide—Alpine aerosol (0.5% dinotefuran. We then conducted a field evaluation of a reduced-risk insecticide based integrated pest management (IPM program in low-income family apartments with young children. In laboratory evaluations, direct spray and 5 min exposure to dry Alpine aerosol residue caused 100.0 ± 0.0 and 91.7 ± 8.3% mortality to bed bug nymphs, respectively. Direct Alpine aerosol spray killed 91.3 ± 4.3% of the eggs. The IPM program included education, steam, bagging infested linens, placing intercepting devices under furniture legs and corners of rooms, applying Alpine aerosol and Alpine dust (0.25% dinotefuran, 95% diatomaceous earth dust, and regularly scheduled monitoring and re-treatment. Nine apartments ranging from 1–1,428 (median: 29 bed bugs based on visual inspection and Climbup interceptor counts were included. Over a 6-month period, an average 172 g insecticide (Alpine aerosol + Alpine dust was used in each apartment, a 96% reduction in pesticide usage compared to chemical only treatment reported in a similar environment. The IPM program resulted in an average of 96.8 ± 2.2% reduction in the number of bed bugs. However, elimination of bed bugs was only achieved in three lightly infested apartments (<30 bed bugs at the beginning. Elimination success was closely correlated with the level of bed bug populations.

At-Risk Youth Appearance and Job Performance Evaluation

Science.gov (United States)

Freeburg, Beth Winfrey; Workman, Jane E.

2008-01-01

The goal of this study was to identify the relationship of at-risk youth workplace appearance to other job performance criteria. Employers (n = 30; each employing from 1 to 17 youths) evaluated 178 at-risk high school youths who completed a paid summer employment experience. Appearance evaluations were significantly correlated with evaluations of…

School-Based Interventions to Reduce Obesity Risk in Children in High- and Middle-Income Countries.

Science.gov (United States)

Evans, Charlotte E L; Albar, Salwa Ali; Vargas-Garcia, Elisa J; Xu, Fei

2015-01-01

School-based interventions are relatively new and were first introduced in the United States in the 1990s. Early programs were mainly education based with many of the findings now embedded in school policy in the form of a healthy eating curriculum. More recent school programs have taken education outside the classroom and attempted to engage parents as well as teachers. Environmental changes such as improving the quality of foods available at lunchtime and at other times during the school day are now common. Reviews of evaluations of school-based programs have demonstrated that they are effective and successfully improve dietary quality such as increasing fruit and vegetable intake and decreasing sweet and savory snacks and sweetened drinks; not just in school but over the whole day and particularly in younger school children. School-based interventions are also effective at reducing obesity if components to increase physical activity and reduce sedentary behaviors are also targeted but not if only dietary behaviors are tackled. Most of the high-quality evaluation studies using randomized controlled trials have been carried out in high-income countries as they are costly to run. However, middle-income countries have benefitted from the information available from these evaluation studies and many are now starting to fund and evaluate school-based programs themselves, resulting in unique problems such as concomitant under- and overnutrition being addressed. Action for the future demands more focus on populations most at risk of poor dietary quality and obesity in order to reduce inequalities in health and on adolescents who have not benefited as much as younger children from school-based interventions. This will involve innovative solutions within schools as well as targeting the food environment outside schools such as reducing the density of fast-food outlets and marketing of sweet and savory snacks and drinks. © 2015 Elsevier Inc. All rights reserved.

The efficacy of methadone maintenance interventions in reducing illicit opiate use, HIV risk behavior and criminality: a meta-analysis.

Science.gov (United States)

Marsch, L A

1998-04-01

To provide empirically based evaluation data regarding the efficacy of psychopharmacological interventions in opiate substance abuse, the present study employed meta-analytic statistical procedures to determine the effectiveness of methadone hydrochloride as a pharmacotherapeutic agent. Empirical research findings from 11 studies investigating the effect of methadone maintenance treatment (MMT) on illicit opiate use, and eight and 24 studies investigating the effect of MMT on HIV risk behaviors and criminal activities, respectively, by individuals in such treatment were addressed. Results demonstrate a consistent, statistically significant relationship between MMT and the reduction of illicit opiate use, HIV risk behaviors and drug and property-related criminal behaviors. The effectiveness of MMT is most apparent in its ability to reduce drug-related criminal behaviors. MMT had a moderate effect in reducing illicit opiate use and drug and property-related criminal behaviors, and a small to moderate effect in reducing HIV risk behaviors. Results clarify discrepancies in the literature and are useful in predicting the outcomes of individuals in treatment. The treatment's effectiveness is evident among opiate-dependent individuals across a variety of contexts, cultural and ethnic groups, and study designs.

Reduced 25-hydroxyvitamin D and risk of Alzheimer's disease and vascular dementia

DEFF Research Database (Denmark)

Afzal, Shoaib; Bojesen, Stig E; Nordestgaard, Børge G

2014-01-01

BACKGROUND: Vitamin D deficiency has been implicated as a risk factor for dementia in several cross-sectional studies. We tested the hypothesis that reduced plasma 25-hydroxyvitamin D (25[OH]D) is associated with increased risk of Alzheimer's disease (AD) and vascular dementia in the general.......28 (95% CI, 1.00-1.64) for 25(OH)D less than 25 nmol/L vs. greater than or equal to 50 nmol/L, and 1.27 (95% CI, 1.01-1.60) for less than the 25th vs. more than the 50th seasonally adjusted 25(OH)D. CONCLUSIONS: We observed an association of reduced plasma 25(OH)D with increased risk of the combined end...

The role of mass media campaigns in reducing high-risk drinking among college students.

Science.gov (United States)

DeJong, William

2002-03-01

This article categorizes and describes current media campaigns to reduce college student drinking, reviews key principles of campaign design and outlines recommendations for future campaigns. The article describes three types of media campaigns on student drinking: information, social norms marketing, and advocacy. Key principles of campaign design are derived from work in commercial marketing, advertising, and public relations and from evaluations of past public health campaigns. Information campaigns on the dangers of high-risk drinking are common, but none has been rigorously evaluated. Quasi-experimental studies suggest that social norms marketing campaigns, which correct misperceptions of campus drinking norms, may be effective, but more rigorous research is needed. As of this writing, only one major media campaign has focused on policy advocacy to reduce college student drinking, but it is still being evaluated. Lessons for campaign design are organized as a series of steps for campaign development, implementation and assessment: launch a strategic planning process, select a strategic objective, select the target audience, develop a staged approach, define the key promise, avoid fear appeals, select the right message source, select a mix of media channels, maximize media exposure, conduct formative research, and conduct process and outcome evaluations. Future campaigns should integrate information, social norms marketing, and advocacy approaches to create a climate of support for institutional, community and policy changes that will alter the environment in which students make decisions about their alcohol consumption.

Modified risk evaluation method

International Nuclear Information System (INIS)

Udell, C.J.; Tilden, J.A.; Toyooka, R.T.

1993-08-01

The purpose of this paper is to provide a structured and cost-oriented process to determine risks associated with nuclear material and other security interests. Financial loss is a continuing concern for US Department of Energy contractors. In this paper risk is equated with uncertainty of cost impacts to material assets or human resources. The concept provides a method for assessing the effectiveness of an integrated protection system, which includes operations, safety, emergency preparedness, and safeguards and security. The concept is suitable for application to sabotage evaluations. The protection of assets is based on risk associated with cost impacts to assets and the potential for undesirable events. This will allow managers to establish protection priorities in terms of the cost and the potential for the event, given the current level of protection

Consumer Evaluations of Food Risk Management Quality in Europe

NARCIS (Netherlands)

Kleef, van E.; Houghton, J.R.; Krystallis, A.; Pfenning, U.; Rowe, G.; Dijk, van H.; Lans, van der I.A.; Frewer, L.J.

2007-01-01

In developing and implementing appropriate food risk management strategies, it is important to understand how consumers evaluate the quality of food risk management practices. The aim of this study is to model the underlying psychological factors influencing consumer evaluations of food risk

Reduced risk HTGR concept for industrial heat application

International Nuclear Information System (INIS)

Boardman, C.E.; Lipps, A.J.

1982-01-01

The industrial process heat market has been identified as major market for the High Temperature Gas-Cooled Reactor (HTGR), however, this market introduces stringent availability requirements on the reactor system relative to electric plants which feed a large existing grid. The characteristics and requirements of the industrial heat markets are summarized; the risks associated with serving this market with a single large HTGR will be discussed; and the modular concept, which has the potential to reduce both safety and investment risks, will be described. The reference modular concept described consists of several small, relatively benign nuclear heat sources linked together to supply heat energy to a balance-of-plant incorporating a process gas train/thermochemical pipe line system and a normal steam-electric plant

Risk management study for the Hanford Site facilities: Risk reduction cost comparison for the retired Hanford Site facilities. Volume 4

Energy Technology Data Exchange (ETDEWEB)

Coles, G.A.; Egge, R.G.; Senger, E.; Shultz, M.W.; Taylor, W.E.

1994-02-01

This document provides a cost-comparison evaluation for implementing certain risk-reduction measures and their effect on the overall risk of the 100 and 200 Area retired, surplus facilities. The evaluation is based on conditions that existed at the time the risk evaluation team performed facility investigations, and does not acknowledge risk-reduction measures that occurred soon after risk identification. This evaluation is one part of an overall risk management study for these facilities. The retired facilities investigated for this evaluation are located in the 100 and 200 Areas of the 1450-km{sup 2} Hanford Site. The Hanford Site is a semiarid tract of land in southeastern Washington State. The nearest population center is Richland, Washington, (population 32,000) 30 km southeast of the 200 Area. This cost-comparison evaluation (1) determines relative costs for reducing risk to acceptable levels; (2) compares the cost of reducing risk using different risk-reduction options; and (3) compares the cost of reducing risks at different facilities. The result is an identification of the cost effective risk-reduction measures. Supporting information required to develop costs of the various risk-reduction options also is included.

Multivariate market risk evaluation between Malaysian Islamic stock index and sectoral indices

Directory of Open Access Journals (Sweden)

Sew Lai Ng

2017-03-01

Full Text Available Without an efficient financial risk management, it may cause massive consequences to a financial institution as well as individual. Therefore, developing a methodology which gives precise estimates to reduce the exposure of risk to a minimum is of great importance. This paper uses an asymmetric BEKK-GARCH model to examine the return and volatility linkages between the FTSE Bursa Malaysia Emas Shariah (FBMS index and the sectoral indices under a normal market. The findings suggest that the FBMS plays a leading role in the mean return spillover effect. There is a strong evidence of significant transmission of past shocks, volatilities and leverage effects are observed on the current conditional variance-covariance in all the pair-wise models. These empirical results are helpful in quantifying the cross-market risk evaluation, risk minimizing weight and cross-market hedge ratio for strategizing appropriate portfolio selection.

Gasbuggy Site Assessment and Risk Evaluation

Energy Technology Data Exchange (ETDEWEB)

None

2011-03-01

This report describes the geologic and hydrologic conditions and evaluates potential health risks to workers in the natural gas industry in the vicinity of the Gasbuggy, New Mexico, site, where the U.S. Atomic Energy Commission detonated an underground nuclear device in 1967. The 29-kiloton detonation took place 4,240 feet below ground surface and was designed to evaluate the use of a nuclear detonation to enhance natural gas production from the Pictured Cliffs Formation in the San Juan Basin, Rio Arriba County, New Mexico, on land administered by Carson National Forest. A site-specific conceptual model was developed based on current understanding of the hydrologic and geologic environment. This conceptual model was used for establishing plausible contaminant exposure scenarios, which were then evaluated for human health risk potential. The most mobile and, therefore, the most probable contaminant that could result in human exposure is tritium. Natural gas production wells were identified as having the greatest potential for bringing detonation-derived contaminants (tritium) to the ground surface in the form of tritiated produced water. Three exposure scenarios addressing potential contamination from gas wells were considered in the risk evaluation: a gas well worker during gas-well-drilling operations, a gas well worker performing routine maintenance, and a residential exposure. The residential exposure scenario was evaluated only for comparison; permanent residences on national forest lands at the Gasbuggy site are prohibited

Reducing e-commerce risks using digital certificates

Directory of Open Access Journals (Sweden)

Piščević Miloš

2009-01-01

Full Text Available E-commerce means buying and selling goods and services across the Internet. Secured communication in e-commerce, across unsecured medium, such as the Internet, represents one of the major components in a domain of providing necessary security- critical demands, so the flow of information could go in a secure way. The Internet, as a global computer network must provide five major security services: confidentiality, data integrity, authentication, availability, and non-repudiation of information. Without guaranteeing aformentioned security goals, risks may be very high in e-commerce systems. A possible way to reduce these risks is to use digital certificates. Digital certificates provide a means of proving identity in electronic transactions, and from the point of view of computer communication they are irreplacable, but nevertheless they provide a good mechanism for implementing the major part of this security goal, and therefore, their usage in e-commerce is the major topic of this paper.

Evaluating emergency risk communications: a dialogue with the experts.

Science.gov (United States)

Thomas, Craig W; Vanderford, Marsha L; Crouse Quinn, Sandra

2008-10-01

Evaluating emergency risk communications is fraught with challenges since communication can be approached from both a systemic and programmatic level. Therefore, one must consider stakeholders' perspectives, effectiveness issues, standards of evidence and utility, and channels of influence (e.g., mass media and law enforcement). Evaluation issues related to timing, evaluation questions, methods, measures, and accountability are raised in this dialogue with emergency risk communication specialists. Besides the usual evaluation competencies, evaluators in this area need to understand and work collaboratively with stakeholders and be attuned to the dynamic contextual nature of emergency risk communications. Sample resources and measures are provided here to aid in this emerging and exciting field of evaluation.

A Healthy Dietary Pattern Reduces Lung Cancer Risk: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Sun, Yanlai; Li, Zhenxiang; Li, Jianning; Li, Zengjun; Han, Jianjun

2016-03-04

Diet and nutrients play an important role in cancer development and progress; a healthy dietary pattern has been found to be associated with several types of cancer. However, the association between a healthy eating pattern and lung cancer risk is still unclear. Therefore, we conducted a systematic review with meta-analysis to evaluate whether a healthy eating pattern might reduce lung cancer risk. We identified relevant studies from the PubMed and Embase databases up to October 2015, and the relative risks were extracted and combined by the fixed-effects model when no substantial heterogeneity was observed; otherwise, the random-effects model was employed. Subgroup and publication bias analyses were also performed. Finally, eight observational studies were included in the meta-analysis. The pooled relative risk of lung cancer for the highest vs. lowest category of healthy dietary pattern was 0.81 (95% confidence interval, CI: 0.75-0.86), and no significant heterogeneity was detected. The relative risks (RRs) for non-smokers, former smokers and current smokers were 0.89 (95% CI: 0.63-1.27), 0.74 (95% CI: 0.62-0.89) and 0.86 (95% CI: 0.79-0.93), respectively. The results remained stable in subgroup analyses by other confounders and sensitivity analysis. The results of our meta-analysis suggest that a healthy dietary pattern is associated with a lower lung cancer risk, and they provide more beneficial evidence for changing the diet pattern in the general population.

Reducing the health risks from radon in the UK overground workplace

International Nuclear Information System (INIS)

Denman, A.R.

2008-01-01

In response to the potential health risk from radon in workplaces in the United Kingdom (UK), the Ionising Radiations Regulations 1999 include the protection of workers from excessive radon levels. Under the Management of Health and Safety at Work Regulations 1999, employers are required to make risk assessments for potential hazards in the workplace. This is taken to apply to the risk from radon in premises in areas where over 1% of domestic housing properties have average annual radon levels over the Action Level. Whilst the UK Action Level in domestic housing has been set at 200 Bq·m -3 , the workplace limit is 400 Bq·m -3 . The Regulations require that this limit be compared to a 24-hour winter maximum, while in domestic properties the annual average radon level is compared to the Action Level. This paper discusses the application of the Regulations in the UK to ensure compliance and reduce risk from radon in the workplace, include use of short-term measurements, and the consideration of seasonal variation. Reduction of radon levels can be achieved by methods similar to those in domestic properties, but, in large buildings, several sump/pump systems may be required. Case studies have shown that the sump/pump system preferentially reduces radon levels at night, when workers are not usually present. Thus to achieve a significant health benefit the average radon level should be reduced below 325 Bq·m -3 . (author)

Evaluating risk management strategies in resource planning

International Nuclear Information System (INIS)

Andrews, C.J.

1995-01-01

This paper discusses the evaluation of risk management strategies as a part of integrated resource planning. Value- and scope-related uncertainties can be addressed during the process of planning, but uncertainties in the operating environment require technical analysis within planning models. Flexibility and robustness are two key classes of strategies for managing the risk posed by these uncertainties. This paper reviews standard capacity expansion planning models and shows that they are poorly equipped to compare risk management strategies. Those that acknowledge uncertainty are better at evaluating robustness than flexibility, which implies a bias against flexible options. Techniques are available to overcome this bias

Risk evaluation of uranium mining: a new kinetic approach

Energy Technology Data Exchange (ETDEWEB)

Scislewski, Alexandro [Brazilian Nuclear Energy Comission (CNEN), Avenida Santana, 680, Centro, Caetite-Bahia, 46400-000 (Brazil); Zuddas, Pierpaolo [Universite Pierre et Marie Curie, Paris-Sorbonne, ISTEP place Jussieu, Tour 56-55, case 116, F75252 Paris Cedex 05 (France)

2013-07-01

Release of uranium and associated heavy metals is the main environmental concern regarding exploitation and processing of U-ore. Increasing uranium mining activities potentially increase the risks linked to radiation exposure. As a tool to evaluate these risks, a geochemical inverse modeling approach was developed to estimate the water-mineral interaction in the presence of uranium. Our methodology is based on the estimation of dissolution rate and reactive surface area of the different minerals participating in the reaction by reconstructing the chemical evolution of the interacting fluids. We found that the reactive surface area of parent-rock minerals changes over several orders of magnitude during the investigated reaction time. We propose that the formation of coatings on dissolving mineral surfaces significantly reduces reactivity. Our results show that negatively charged uranium complexes decrease when alkalinity and rock buffer capacity is similarly lower, indicating that the dissolved carbonate is an important parameter impacting uranium mobility. (authors)

Risk evaluation of uranium mining: a new kinetic approach

International Nuclear Information System (INIS)

Scislewski, Alexandro; Zuddas, Pierpaolo

2013-01-01

Release of uranium and associated heavy metals is the main environmental concern regarding exploitation and processing of U-ore. Increasing uranium mining activities potentially increase the risks linked to radiation exposure. As a tool to evaluate these risks, a geochemical inverse modeling approach was developed to estimate the water-mineral interaction in the presence of uranium. Our methodology is based on the estimation of dissolution rate and reactive surface area of the different minerals participating in the reaction by reconstructing the chemical evolution of the interacting fluids. We found that the reactive surface area of parent-rock minerals changes over several orders of magnitude during the investigated reaction time. We propose that the formation of coatings on dissolving mineral surfaces significantly reduces reactivity. Our results show that negatively charged uranium complexes decrease when alkalinity and rock buffer capacity is similarly lower, indicating that the dissolved carbonate is an important parameter impacting uranium mobility. (authors)

A risk evaluation model and its application in online retailing trustfulness

Science.gov (United States)

Ye, Ruyi; Xu, Yingcheng

2017-08-01

Building a general model for risks evaluation in advance could improve the convenience, normality and comparability of the results of repeating risks evaluation in the case that the repeating risks evaluating are in the same area and for a similar purpose. One of the most convenient and common risks evaluation models is an index system including of several index, according weights and crediting method. One method to build a risk evaluation index system that guarantees the proportional relationship between the resulting credit and the expected risk loss is proposed and an application example is provided in online retailing in this article.

A European Commission software tool for radon risk calculation and evaluation of countermeasures

Energy Technology Data Exchange (ETDEWEB)

Degrange, J.P.; Levy, F.P. [CEPN, Fontenay-aux-Roses Cedex (France); Birchall, A.; Haylock, R.; Marsh, J.; Muirhead, C. [National Radiological Protection Board, Chilton (United Kingdom); Janssens, A. [European Commission, DG XI (Luxembourg)

2000-05-01

The effects of exposure to radon on workers and members of the public have been examined for many years. Recent advances have been made in evaluating the risk associated with radon exposure and in implementing remediation programmes in dwellings. However, decisions about whether to implement countermeasures to reduce radon exposures may benefit from an enhanced capability to evaluate and understand the associated health risk. In this context, the European Commission has launched a project to develop a user friendly software package based upon current information on radon epidemiology, radon dosimetry, demography, and countermeasure efficiency. The software has been designed to perform lung cancer risk calculations specific to European populations for various exposure profiles and to evaluate, in terms of risk reduction, the efficiency of various countermeasures in dwellings. This paper presents an overview of the general structure of the software and outlines its most important modelling approaches. The software is able to evaluate the risk of fatal lung cancer associated with individual or collective exposure to radon. The individual risk calculation module determines, for an individual of given age, sex and tobacco consumption, the excess risk for a given exposure (past or future exposure) time-profile, on the basis of demographic data (WHO, 1996 and 1998) specific to the selected population. The collective risk calculation module determines the excess risk for each occupant of a dwelling, for an exposure time-profile derived from data describing the dwelling, its occupancy, and the chosen countermeasures. These calculations may be done using one of two classical approaches: 1) The epidemiological approach in which the risk is obtained directly from the radon exposure data using a risk model (BEIR IV, 1988; BEIR VI, 1999) derived from epidemiological studies of uranium miners; 2) The dosimetric approach in which the risk is derived from the radon exposure data

A European Commission software tool for radon risk calculation and evaluation of countermeasures

International Nuclear Information System (INIS)

Degrange, J.P.; Levy, F.P.; Birchall, A.; Haylock, R.; Marsh, J.; Muirhead, C.; Janssens, A.

2000-01-01

The effects of exposure to radon on workers and members of the public have been examined for many years. Recent advances have been made in evaluating the risk associated with radon exposure and in implementing remediation programmes in dwellings. However, decisions about whether to implement countermeasures to reduce radon exposures may benefit from an enhanced capability to evaluate and understand the associated health risk. In this context, the European Commission has launched a project to develop a user friendly software package based upon current information on radon epidemiology, radon dosimetry, demography, and countermeasure efficiency. The software has been designed to perform lung cancer risk calculations specific to European populations for various exposure profiles and to evaluate, in terms of risk reduction, the efficiency of various countermeasures in dwellings. This paper presents an overview of the general structure of the software and outlines its most important modelling approaches. The software is able to evaluate the risk of fatal lung cancer associated with individual or collective exposure to radon. The individual risk calculation module determines, for an individual of given age, sex and tobacco consumption, the excess risk for a given exposure (past or future exposure) time-profile, on the basis of demographic data (WHO, 1996 and 1998) specific to the selected population. The collective risk calculation module determines the excess risk for each occupant of a dwelling, for an exposure time-profile derived from data describing the dwelling, its occupancy, and the chosen countermeasures. These calculations may be done using one of two classical approaches: 1) The epidemiological approach in which the risk is obtained directly from the radon exposure data using a risk model (BEIR IV, 1988; BEIR VI, 1999) derived from epidemiological studies of uranium miners; 2) The dosimetric approach in which the risk is derived from the radon exposure data

Preconceptional motivational interviewing interventions to reduce alcohol-exposed pregnancy risk.

Science.gov (United States)

Ingersoll, Karen S; Ceperich, Sherry D; Hettema, Jennifer E; Farrell-Carnahan, Leah; Penberthy, J Kim

2013-04-01

Alcohol exposed pregnancy (AEP) is a leading cause of preventable birth defects. While randomized controlled trials (RCTs) have shown that multi-session motivational interviewing-based interventions reduce AEP risk, a one-session intervention could facilitate broader implementation. The purposes of this study were to: (1) test a one-session motivational AEP prevention intervention for community women and (2) compare outcomes to previous RCTs. Participants at risk for AEP (N=217) were randomized to motivational interviewing+assessment feedback (EARLY), informational video, or informational brochure conditions. Outcomes were drinks per drinking day (DDD), ineffective contraception rate, and AEP risk at 3 and 6 months. All interventions were associated with decreased DDD, ineffective contraception rate, and AEP risk. Participants who received EARLY had larger absolute risk reductions in ineffective contraception and AEP risk, but not DDD. Effect sizes were compared to previous RCTs. The one-session EARLY intervention had less powerful effects than multi-session AEP prevention interventions among community women, but may provide a new option in a continuum of preventive care. Copyright © 2013 Elsevier Inc. All rights reserved.

Risk evaluation system for operational events and inspection findings

International Nuclear Information System (INIS)

Lopez G, A.; Godinez S, V.; Lopez M, R.

2010-10-01

The Mexican Nuclear Regulatory Commission has developed an adaptation of the US NRC Significance Determination Process (SDP) to evaluate the risk significance of operational events and inspection findings in Laguna Verde nuclear power plant. The Mexican Nuclear Regulatory Commission developed a plant specific flow chart for preliminary screening instead of the open questionnaire used by the US NRC-SDP, with the aim to improve the accuracy of the screening process. Also, the work sheets and support information tables required by the SDP were built up in an Excel application which allows to perform the risk evaluation in an automatic way, focusing the regulator staff efforts in the risk significance analysis instead of the risk calculation tasks. In order to construct this tool a simplified PRA model was developed and validated with the individual plant examination model. This paper shows the Mexican Nuclear Regulatory Commission process and some risk events evaluations performed using the Risk Evaluation System for Operational Events and Inspection Findings (SERHE, by its acronyms in Spanish). (Author)

Evaluation of the Prostate Cancer Prevention Trial Risk Calculator in a High-Risk Screening Population

Science.gov (United States)

Kaplan, David J.; Boorjian, Stephen A.; Ruth, Karen; Egleston, Brian L.; Chen, David Y.T.; Viterbo, Rosalia; Uzzo, Robert G.; Buyyounouski, Mark K.; Raysor, Susan; Giri, Veda N.

2009-01-01

Introduction Clinical factors in addition to PSA have been evaluated to improve risk assessment for prostate cancer. The Prostate Cancer Prevention Trial (PCPT) risk calculator provides an assessment of prostate cancer risk based on age, PSA, race, prior biopsy, and family history. This study evaluated the risk calculator in a screening cohort of young, racially diverse, high-risk men with a low baseline PSA enrolled in the Prostate Cancer Risk Assessment Program. Patients and Methods Eligibility for PRAP include men ages 35-69 who are African-American, have a family history of prostate cancer, or have a known BRCA1/2 mutation. PCPT risk scores were determined for PRAP participants, and were compared to observed prostate cancer rates. Results 624 participants were evaluated, including 382 (61.2%) African-American men and 375 (60%) men with a family history of prostate cancer. Median age was 49.0 years (range 34.0-69.0), and median PSA was 0.9 (range 0.1-27.2). PCPT risk score correlated with prostate cancer diagnosis, as the median baseline risk score in patients diagnosed with prostate cancer was 31.3%, versus 14.2% in patients not diagnosed with prostate cancer (p<0.0001). The PCPT calculator similarly stratified the risk of diagnosis of Gleason score ≥7 disease, as the median risk score was 36.2% in patients diagnosed with Gleason ≥7 prostate cancer versus 15.2% in all other participants (p<0.0001). Conclusion PCPT risk calculator score was found to stratify prostate cancer risk in a cohort of young, primarily African-American men with a low baseline PSA. These results support further evaluation of this predictive tool for prostate cancer risk assessment in high-risk men. PMID:19709072

Reducing The Risk Of Fires In Conveyor Transport

Science.gov (United States)

Cheremushkina, M. S.; Poddubniy, D. A.

2017-01-01

The paper deals with the actual problem of increasing the safety of operation of belt conveyors in mines. Was developed the control algorithm that meets the technical requirements of the mine belt conveyors, reduces the risk of fires of conveyors belt, and enables energy and resource savings taking into account random sort of traffic. The most effective method of decision such tasks is the construction of control systems with the use of variable speed drives for asynchronous motors. Was designed the mathematical model of the system "variable speed multiengine drive - conveyor - control system of conveyors", that takes into account the dynamic processes occurring in the elements of the transport system, provides an assessment of the energy efficiency of application the developed algorithms, which allows to reduce the dynamic overload in the belt to (15-20)%.

Reducing the risk from radioactive sources

International Nuclear Information System (INIS)

MacKenzie, C.

2006-01-01

Each year the IAEA receives reports of serious injuries or deaths due to misuse or accidents involving sealed radioactive sources. Sealed radioactive sources are used widely in medicine, industry, and agriculture - by doctors to treat cancer, by radiographers to check welds in pipelines, or by specialists to irradiate food to prevent it from spoiling, for example. If these sources are lost or improperly discarded, a serious accident may result. In addition, the security of sealed sources has become a growing concern, particularly the potential that such a source could be used as a radioactive dispersal device or 'dirty bomb'. Preventing the loss or theft of sealed radioactive sources reduces both the risk of accidents and the risk that such sources could become an instrument of misuse. In most countries, radioactive materials and activities that produce radiation are regulated. Those working with sealed radioactive sources are required not just to have proper credentials, but also the needed training and support to deal with unexpected circumstances that may arise when a source is used. Despite these measures, accidents involving sealed sources continue to be reported to the IAEA. Among its many activities to improve the safety and security of sealed sources, the IAEA has been investigating the root causes of major accidents since the 1980s and publishing the findings so that others can learn from them. This information needs to be in the hands of those whose actions and decisions can reduce accidents by preventing a lost source from making it's way into scrap metal. The IAEA has also developed an international catalogue of sealed radioactive sources, and provides assistance to countries to safely contain sources no longer in use. To raise awareness, a Sealed Radioactive Sources Toolkit was issued that focuses on the long-term issues in safely and securely managing radioactive sealed sources. The target audiences are government agencies, radioactive sealed source

A Healthy Dietary Pattern Reduces Lung Cancer Risk: A Systematic Review and Meta-Analysis

Directory of Open Access Journals (Sweden)

Yanlai Sun

2016-03-01

Full Text Available Background: Diet and nutrients play an important role in cancer development and progress; a healthy dietary pattern has been found to be associated with several types of cancer. However, the association between a healthy eating pattern and lung cancer risk is still unclear. Objective: Therefore, we conducted a systematic review with meta-analysis to evaluate whether a healthy eating pattern might reduce lung cancer risk. Methods: We identified relevant studies from the PubMed and Embase databases up to October 2015, and the relative risks were extracted and combined by the fixed-effects model when no substantial heterogeneity was observed; otherwise, the random-effects model was employed. Subgroup and publication bias analyses were also performed. Results: Finally, eight observational studies were included in the meta-analysis. The pooled relative risk of lung cancer for the highest vs. lowest category of healthy dietary pattern was 0.81 (95% confidence interval, CI: 0.75–0.86, and no significant heterogeneity was detected. The relative risks (RRs for non-smokers, former smokers and current smokers were 0.89 (95% CI: 0.63–1.27, 0.74 (95% CI: 0.62–0.89 and 0.86 (95% CI: 0.79–0.93, respectively. The results remained stable in subgroup analyses by other confounders and sensitivity analysis. Conclusions: The results of our meta-analysis suggest that a healthy dietary pattern is associated with a lower lung cancer risk, and they provide more beneficial evidence for changing the diet pattern in the general population.

Probabilistic risk assessment of earthquakes at the Rocky Flats Plant and subsequent upgrade to reduce risk

International Nuclear Information System (INIS)

Day, S.A.

1989-01-01

An analysis to determine the risk associated with earthquakes at the Rocky Flats Plant was performed. Seismic analyses and structural evaluations were used to postulate building and equipment damage and radiological releases to the environment from various magnitudes of earthquakes. Dispersion modeling and dose assessment to the public were then calculated. The frequency of occurrence of various magnitudes of earthquakes were determined from the Department of Energy natural Phenomena Hazards Modeling Project. Risk to the public was probabilistically assessed for each magnitude of earthquake and for overall seismic risk. Based on the results of this Probabilistic Risk Assessment and a cost/benefit analysis, seismic upgrades are being implemented for several plutonium-handling facilities for the purpose of risk reduction

Risk Evaluation of a UHV Power Transmission Construction Project Based on a Cloud Model and FCE Method for Sustainability

Directory of Open Access Journals (Sweden)

Huiru Zhao

2015-03-01

Full Text Available In order to achieve the sustainable development of energy, Ultra High Voltage (UHV power transmission construction projects are being established in China currently. Their high-tech nature, the massive amount of money involved, and the need for multi-agent collaboration as well as complex construction environments bring many challenges and risks. Risk management, therefore, is critical to reduce the risks and realize sustainable development of projects. Unfortunately, many traditional risk assessment methods may not perform well due to the great uncertainty and randomness inherent in UHV power construction projects. This paper, therefore, proposes a risk evaluation index system and a hybrid risk evaluation model to evaluate the risk of UHV projects and find out the key risk factors. This model based on a cloud model and fuzzy comprehensive evaluation (FCE method combines the superiority of the cloud model for reflecting randomness and discreteness with the advantages of the fuzzy comprehensive evaluation method in handling uncertain and vague issues. For the sake of proving our framework, an empirical study of “Zhejiang-Fuzhou” UHV power transmission construction project is presented. As key contributions, we find the risk of this project lies at a “middle” to “high” level and closer to a “middle” level; the “management risk” and “social risk” are identified as the most important risk factors requiring more attention; and some risk control recommendations are proposed. This article demonstrates the value of our approach in risk identification, which seeks to improve the risk control level and the sustainable development of UHV power transmission construction projects.

Safety evaluations by means of the method use of the risk matrix in radiotherapy treatments

International Nuclear Information System (INIS)

Sanchez, L.; Diaz, A.; Correa, T.; Gonzalez, Y.

2014-08-01

The quality of a radiotherapy treatment is linked to multidisciplinary factors that need to be taken into account in combined form whenever an evaluation of the safety is carried out. Knowing the accidents happened in this area, and to guarantee their prevention, the causes and sequences that could behave to them should be controlled, for what is necessary to make periodic evaluations of the same one. Our objective was to carry out the safety evaluation to the treatment process of a radiotherapy service and to identify the causes and consequences that can cause these accidental exposures, for patients, worker or people, from the equipment installation until the treatment completion. The method of Risk Matrices was used, by means the SEVRRA system carried out by the Comision Nacional de Seguridad Nuclear y Salvaguardias of Mexico; this system allows to carry out a combined analysis of the occurrence frequency of the event initiator, the probability of human errors or barrier failures and the graveness of the consequences, facilitating the identification of the associated risk to the radiotherapy procedures. The method establishes priorities for the risk administration and identifies the main causes that could cause accidental exposures; also allows preventing the accidents occurrence using risk criterions that take into account the probability and magnitude of the potential exposures. This method, although does not allow to quantify numerically the risk, makes possible to classify it in levels, what is enough to establish priorities, without carrying out risks analysis but precise but more expensive. As a result we obtained that for the Co 60 77% of the treatments, is realized with low or half risk and 23% with high risk; the work load that is elevated in our case, intervenes directly in 46 initiators, in second and third place, the non realization of a portal image in the first treatment section and in the weekly continuation, as a consequences reducer, but these

Hierarchic Analysis Method to Evaluate Rock Burst Risk

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Ming Ji

2015-01-01

Full Text Available In order to reasonably evaluate the risk of rock bursts in mines, the factors impacting rock bursts and the existing grading criterion on the risk of rock bursts were studied. By building a model of hierarchic analysis method, the natural factors, technology factors, and management factors that influence rock bursts were analyzed and researched, which determined the degree of each factor’s influence (i.e., weight and comprehensive index. Then the grade of rock burst risk was assessed. The results showed that the assessment level generated by the model accurately reflected the actual risk degree of rock bursts in mines. The model improved the maneuverability and practicability of existing evaluation criteria and also enhanced the accuracy and science of rock burst risk assessment.

Mobile Phone-Based Lifestyle Intervention for Reducing Overall Cardiovascular Disease Risk in Guangzhou, China: A Pilot Study

Directory of Open Access Journals (Sweden)

Zhiting Liu

2015-12-01

Full Text Available With the rapid and widespread adoption of mobile devices, mobile phones offer an opportunity to deliver cardiovascular disease (CVD interventions. This study evaluated the efficacy of a mobile phone-based lifestyle intervention aimed at reducing the overall CVD risk at a health management center in Guangzhou, China. We recruited 589 workers from eight work units. Based on a group-randomized design, work units were randomly assigned either to receive the mobile phone-based lifestyle interventions or usual care. The reduction in 10-year CVD risk at 1-year follow-up for the intervention group was not statistically significant (–1.05%, p = 0.096. However, the mean risk increased significantly by 1.77% (p = 0.047 for the control group. The difference of the changes between treatment arms in CVD risk was –2.83% (p = 0.001. In addition, there were statistically significant changes for the intervention group relative to the controls, from baseline to year 1, in systolic blood pressure (–5.55 vs. 6.89 mmHg; p < 0.001, diastolic blood pressure (–6.61 vs. 5.62 mmHg; p < 0.001, total cholesterol (–0.36 vs. –0.10 mmol/L; p = 0.005, fasting plasma glucose (–0.31 vs. 0.02 mmol/L; p < 0.001, BMI (–0.57 vs. 0.29 kg/m2; p < 0.001, and waist hip ratio (–0.02 vs. 0.01; p < 0.001. Mobile phone-based intervention may therefore be a potential solution for reducing CVD risk in China.

Risk evaluation of medical and industrial radiation devices

International Nuclear Information System (INIS)

Jones, E.D.; Cunningham, R.E.; Rathbun, P.A.

1994-03-01

In 1991, the NRC, Division of Industrial and Medical Nuclear Safety, began a program to evaluate the use of probabilistic risk assessment (PRA) in regulating medical devices. This program represents an initial step in an overall plant to evaluate the use of PRA in regulating the use of nuclear by-product materials. The NRC envisioned that the use of risk analysis techniques could assist staff in ensuring that the regulatory approach was standardized, understandable, and effective. Traditional methods of assessing risk in nuclear power plants may be inappropriate to use in assessing the use of by-product devices. The approaches used in assessing nuclear reactor risks are equipment-oriented. Secondary attention is paid to the human component, for the most part after critical system failure events have been identified. This paper describes the risk methodology developed by Lawrence Livermore National Laboratory (LLNL), initially intended to assess risks associated with the use of the Gamma Knife, a gamma stereotactic radiosurgical device. For relatively new medical devices such as the Gamma Knife, the challenge is to perform a risk analysis with very little quantitative data but with an important human factor component. The method described below provides a basic approach for identifying the most likely risk contributors and evaluating their relative importance. The risk analysis approach developed for the Gamma Knife and described in this paper should be applicable to a broader class of devices in which the human interaction with the device is a prominent factor. In this sense, the method could be a prototypical model of nuclear medical or industrial device risk analysis

Observational methods to assess the effectiveness of screening colonoscopy in reducing right colon cancer mortality risk: SCOLAR.

Science.gov (United States)

Goodman, Michael; Fletcher, Robert H; Doria-Rose, V Paul; Jensen, Christopher D; Zebrowski, Alexis M; Becerra, Tracy A; Quinn, Virginia P; Zauber, Ann G; Corley, Douglas A; Doubeni, Chyke A

2015-11-01

Screening colonoscopy's effectiveness in reducing risk of death from right colon cancers remains unclear. Methodological challenges of existing observational studies addressing this issue motivated the design of 'Effectiveness of Screening for Colorectal Cancer in Average-Risk Adults (SCOLAR)'. SCOLAR is a nested case-control study based on two large integrated health systems. This affords access to a large, well-defined historical cohort linked to integrated data on cancer outcomes, patient eligibility, test indications and important confounders. We found electronic data adequate for excluding ineligible patients (except family history), but not the detailed information needed for test indication assignment. The lessons of SCOLAR's design and implementation may be useful for future studies seeking to evaluate the effectiveness of screening tests in community settings.

Risk evaluation system for facility safeguards and security planning

International Nuclear Information System (INIS)

Udell, C.J.; Carlson, R.L.

1987-01-01

The Risk Evaluation System (RES) is an integrated approach to determining safeguards and security effectiveness and risk. RES combines the planning and technical analysis into a format that promotes an orderly development of protection strategies, planing assumptions, facility targets, vulnerability and risk determination, enhancement planning, and implementation. In addition, the RES computer database program enhances the capability of the analyst to perform a risk evaluation of the facility. The computer database is menu driven using data input screens and contains an algorithm for determining the probability of adversary defeat and risk. Also, base case and adjusted risk data records can be maintained and accessed easily

Risk evaluation system for facility safeguards and security planning

International Nuclear Information System (INIS)

Udell, C.J.; Carlson, R.L.

1987-01-01

The Risk Evaluation System (RES) is an integrated approach to determining safeguards and security effectiveness and risk. RES combines the planning and technical analysis into a format that promotes an orderly development of protection strategies, planning assumptions, facility targets, vulnerability and risk determination, enhancement planning, and implementation. In addition, the RES computer database program enhances the capability of the analyst to perform a risk evaluation of the facility. The computer database is menu driven using data input screens and contains an algorithm for determining the probability of adversary defeat and risk. Also, base case and adjusted risk data records can be maintained and accessed easily

Adherence to Mediterranean Diet Reduces Incident Frailty Risk: Systematic Review and Meta-Analysis.

Science.gov (United States)

Kojima, Gotaro; Avgerinou, Christina; Iliffe, Steve; Walters, Kate

2018-04-01

To conduct a systematic review of the literature on prospective cohort studies examining associations between adherence to a Mediterranean diet and incident frailty and to perform a meta-analysis to synthesize the pooled risk estimates. Systematic review and meta-analysis. Embase, MEDLINE, CINAHL, PsycINFO, and Cochrane Library were systematically searched on September 14, 2017. We reviewed references of included studies and relevant review papers and performed forward citation tracking for additional studies. Corresponding authors were contacted for additional data necessary for a meta-analysis. Community-dwelling older adults (mean age ≥60). Incident frailty risk according to adherence to a Mediterranean diet. Two reviewers independently screened the title, abstract, and full text to ascertain the eligibility of 125 studies that the systematic search of the literature identified, and four studies were included (5,789 older people with mean follow-up of 3.9 years). Two reviewers extracted data from the studies independently. All four studies provided adjusted odds ratios (ORs) of incident frailty risk according to three Mediterranean diet score (MDS) groups (0-3, 4-5, and 6-9). Greater adherence to a Mediterranean diet was associated with significantly lower incident frailty risk (pooled OR = 0.62, 95% CI = 0.47-0.82, P = .001 for MDS 4-5; pooled OR = 0.44, 95% CI = 0.31-0.64, P Mediterranean diet is associated with significantly lower risk of incident frailty in community-dwelling older people. Future studies should confirm these findings and evaluate whether adherence to a Mediterranean diet can reduce the risk of frailty, including in non-Mediterranean populations. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Use of screening techniques to reduce uncertainty in risk assessment at a former manufactured gas plant site

International Nuclear Information System (INIS)

Logan, C.M.; Walden, R.H.; Baker, S.R.; Pekar, Z.; LaKind, J.S.; MacFarlane, I.D.

1995-01-01

Preliminary analysis of risks from a former manufactured gas plant (MGP) site revealed six media associated with potential exposure pathways: soils, air, surface water, groundwater, estuarine sediments, and aquatic biota. Contaminants of concern (COCs) include polycyclic aromatic hydrocarbons, volatile organic hydrocarbons, metals, cyanide, and PCBs. Available chemical data, including site-specific measurements and existing data from other sources (e.g., agency monitoring programs, Chesapeake Bay Program), were evaluated for potential utility in risk assessment. Where sufficient data existed, risk calculations were performed using central tendency and reasonable maximum exposure estimates. Where site-specific data were not available, risks were estimated using conservatively high default assumptions for dose and/or exposure duration. Because of the large number of potential exposure pathways and COCs, a sensitivity analysis was conducted to determine which information most influences risk assessment outcome so that any additional data collection to reduce uncertainty can be cost-effectively targeted. The sensitivity analysis utilized two types of information: (1) the impact that uncertainty in risk input values has on output risk estimates, and (2) the potential improvement in key risk input values, and consequently output values, if better site-specific data were available. A decision matrix using both quantitative and qualitative information was developed to prioritize sampling strategies to minimize uncertainty in the final risk assessment

Novel J stents reduce the risk of embolic stroke in vitro

International Nuclear Information System (INIS)

Bartoli, Carlo R.; Spence, Paul A.; Giridharan, Guruprasad A.

2010-01-01

Two and a half million Americans with atrial fibrillation are at an elevated risk for embolic stroke. Warfarin therapy is standard treatment for high-risk patients, yet 40-65% of elderly patients do not receive anticoagulation therapy due to bleeding complications. To address this clinical need, we are evaluating a minimally invasive stent-based stroke prevention device to divert emboli from entering the arterial supply of the brain. The feasibility of a J-shaped stroke prevention device was tested in a mock circulatory loop. Sixteen sets of 100 simulated emboli (1-5 mm 3 ) were injected into the left atrium with and without J stents protecting the aortic arch vessels. To determine efficacy, emboli were trapped in filters in the aortic arch vessels and distal aorta for manual counting. J stents decreased the number of emboli that entered the brachiocephalic trunk by 93.7% (p<0.0001), left common carotid artery by 79.8% (p<0.0001), and left subclavian artery by 89.7% (p<0.0001). In a mock circulation, J stents positioned in the aortic arch vessels and oriented downstream of aortic flow significantly decreased the number of emboli that entered the aortic arch vessels. These results warrant further investigation to determine the safety and efficacy of this prophylactic intervention to reduce embolic events, and chronic large animal studies are underway. (orig.)

Novel J stents reduce the risk of embolic stroke in vitro

Energy Technology Data Exchange (ETDEWEB)

Bartoli, Carlo R. [University of Louisville, M.D./Ph.D. Program, Louisville, KY (United States); Spence, Paul A. [SCR Inc., Louisville, KY (United States); Giridharan, Guruprasad A. [Cardiovascular Innovation Institute, University of Louisville, Department of Bioengineering, Louisville, KY (United States)

2010-05-15

Two and a half million Americans with atrial fibrillation are at an elevated risk for embolic stroke. Warfarin therapy is standard treatment for high-risk patients, yet 40-65% of elderly patients do not receive anticoagulation therapy due to bleeding complications. To address this clinical need, we are evaluating a minimally invasive stent-based stroke prevention device to divert emboli from entering the arterial supply of the brain. The feasibility of a J-shaped stroke prevention device was tested in a mock circulatory loop. Sixteen sets of 100 simulated emboli (1-5 mm{sup 3}) were injected into the left atrium with and without J stents protecting the aortic arch vessels. To determine efficacy, emboli were trapped in filters in the aortic arch vessels and distal aorta for manual counting. J stents decreased the number of emboli that entered the brachiocephalic trunk by 93.7% (p<0.0001), left common carotid artery by 79.8% (p<0.0001), and left subclavian artery by 89.7% (p<0.0001). In a mock circulation, J stents positioned in the aortic arch vessels and oriented downstream of aortic flow significantly decreased the number of emboli that entered the aortic arch vessels. These results warrant further investigation to determine the safety and efficacy of this prophylactic intervention to reduce embolic events, and chronic large animal studies are underway. (orig.)

Reduced Order Model Implementation in the Risk-Informed Safety Margin Characterization Toolkit

International Nuclear Information System (INIS)

Mandelli, Diego; Smith, Curtis L.; Alfonsi, Andrea; Rabiti, Cristian; Cogliati, Joshua J.; Talbot, Paul W.; Rinaldi, Ivan; Maljovec, Dan; Wang, Bei; Pascucci, Valerio; Zhao, Haihua

2015-01-01

The RISMC project aims to develop new advanced simulation-based tools to perform Probabilistic Risk Analysis (PRA) for the existing fleet of U.S. nuclear power plants (NPPs). These tools numerically model not only the thermo-hydraulic behavior of the reactor primary and secondary systems but also external events temporal evolution and components/system ageing. Thus, this is not only a multi-physics problem but also a multi-scale problem (both spatial, µm-mm-m, and temporal, ms-s-minutes-years). As part of the RISMC PRA approach, a large amount of computationally expensive simulation runs are required. An important aspect is that even though computational power is regularly growing, the overall computational cost of a RISMC analysis may be not viable for certain cases. A solution that is being evaluated is the use of reduce order modeling techniques. During the FY2015, we investigated and applied reduced order modeling techniques to decrease the RICM analysis computational cost by decreasing the number of simulations runs to perform and employ surrogate models instead of the actual simulation codes. This report focuses on the use of reduced order modeling techniques that can be applied to any RISMC analysis to generate, analyze and visualize data. In particular, we focus on surrogate models that approximate the simulation results but in a much faster time (µs instead of hours/days). We apply reduced order and surrogate modeling techniques to several RISMC types of analyses using RAVEN and RELAP-7 and show the advantages that can be gained.

Reduced Order Model Implementation in the Risk-Informed Safety Margin Characterization Toolkit

Energy Technology Data Exchange (ETDEWEB)

Mandelli, Diego [Idaho National Lab. (INL), Idaho Falls, ID (United States); Smith, Curtis L. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Alfonsi, Andrea [Idaho National Lab. (INL), Idaho Falls, ID (United States); Rabiti, Cristian [Idaho National Lab. (INL), Idaho Falls, ID (United States); Cogliati, Joshua J. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Talbot, Paul W. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Rinaldi, Ivan [Idaho National Lab. (INL), Idaho Falls, ID (United States); Maljovec, Dan [Idaho National Lab. (INL), Idaho Falls, ID (United States); Wang, Bei [Idaho National Lab. (INL), Idaho Falls, ID (United States); Pascucci, Valerio [Idaho National Lab. (INL), Idaho Falls, ID (United States); Zhao, Haihua [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2015-09-01

The RISMC project aims to develop new advanced simulation-based tools to perform Probabilistic Risk Analysis (PRA) for the existing fleet of U.S. nuclear power plants (NPPs). These tools numerically model not only the thermo-hydraulic behavior of the reactor primary and secondary systems but also external events temporal evolution and components/system ageing. Thus, this is not only a multi-physics problem but also a multi-scale problem (both spatial, µm-mm-m, and temporal, ms-s-minutes-years). As part of the RISMC PRA approach, a large amount of computationally expensive simulation runs are required. An important aspect is that even though computational power is regularly growing, the overall computational cost of a RISMC analysis may be not viable for certain cases. A solution that is being evaluated is the use of reduce order modeling techniques. During the FY2015, we investigated and applied reduced order modeling techniques to decrease the RICM analysis computational cost by decreasing the number of simulations runs to perform and employ surrogate models instead of the actual simulation codes. This report focuses on the use of reduced order modeling techniques that can be applied to any RISMC analysis to generate, analyze and visualize data. In particular, we focus on surrogate models that approximate the simulation results but in a much faster time (µs instead of hours/days). We apply reduced order and surrogate modeling techniques to several RISMC types of analyses using RAVEN and RELAP-7 and show the advantages that can be gained.

Credit Risk Evaluation of Power Market Players with Random Forest

Science.gov (United States)

Umezawa, Yasushi; Mori, Hiroyuki

A new method is proposed for credit risk evaluation in a power market. The credit risk evaluation is to measure the bankruptcy risk of the company. The power system liberalization results in new environment that puts emphasis on the profit maximization and the risk minimization. There is a high probability that the electricity transaction causes a risk between companies. So, power market players are concerned with the risk minimization. As a management strategy, a risk index is requested to evaluate the worth of the business partner. This paper proposes a new method for evaluating the credit risk with Random Forest (RF) that makes ensemble learning for the decision tree. RF is one of efficient data mining technique in clustering data and extracting relationship between input and output data. In addition, the method of generating pseudo-measurements is proposed to improve the performance of RF. The proposed method is successfully applied to real financial data of energy utilities in the power market. A comparison is made between the proposed and the conventional methods.

A Patient Navigator Intervention to Reduce Hospital Readmissions among High-Risk Safety-Net Patients: A Randomized Controlled Trial.

Science.gov (United States)

Balaban, Richard B; Galbraith, Alison A; Burns, Marguerite E; Vialle-Valentin, Catherine E; Larochelle, Marc R; Ross-Degnan, Dennis

2015-07-01

Evidence-based interventions to reduce hospital readmissions may not generalize to resource-constrained safety-net hospitals. To determine if an intervention by patient navigators (PNs), hospital-based Community Health Workers, reduces readmissions among high risk, low socioeconomic status patients. Randomized controlled trial. General medicine inpatients having at least one of the following readmission risk factors: (1) age ≥60 years, (2) any in-network inpatient admission within the past 6 months, (3) length of stay ≥3 days, (4) admission diagnosis of heart failure, or (5) chronic obstructive pulmonary disease. The analytic sample included 585 intervention patients and 925 controls. PNs provided coaching and assistance in navigating the transition from hospital to home through hospital visits and weekly telephone outreach, supporting patients for 30 days post-discharge with discharge preparation, medication management, scheduling of follow-up appointments, communication with primary care, and symptom management. The primary outcome was in-network 30-day hospital readmissions. Secondary outcomes included rates of outpatient follow-up. We evaluated outcomes for the entire cohort and stratified by patient age >60 years (425 intervention/584 controls) and ≤60 years (160 intervention/341 controls). Overall, 30-day readmission rates did not differ between intervention and control patients. However, the two age groups demonstrated marked differences. Intervention patients >60 years showed a statistically significant adjusted absolute 4.1% decrease [95% CI: -8.0%, -0.2%] in readmission with an increase in 30-day outpatient follow-up. Intervention patients ≤60 years showed a statistically significant adjusted absolute 11.8% increase [95% CI: 4.4%, 19.0%] in readmission with no change in 30-day outpatient follow-up. A patient navigator intervention among high risk, safety-net patients decreased readmission among older patients while increasing readmissions

Reduced-risk insecticides for control of grape berry moth (Lepidoptera: Tortricidae) and conservation of natural enemies.

Science.gov (United States)

Jenkins, Paul E; Isaacs, Rufus

2007-06-01

A 3-yr field study was conducted at commercial grape (Vitis spp.) farms to evaluate insect management programs for control of the grape berry moth, Paralobesia viteana Clemens (Lepidoptera: Tortricidae) and conservation of natural enemies. At each farm, one vineyard received only reduced-risk insecticides for control of second and third generation P. viteana, whereas the comparison vineyard received conventional insecticides. Both vineyards received a conventional insecticide application for control of first generation P. viteana and other insect pests. Monitoring with pheromone traps showed no differences between programs in the total number of adult male moths trapped in vineyards, and oviposition by P. viteana was similar between the two programs in all 3 yr. During weekly samples of crop infestation, both programs had a similar percentage of clusters infested by P. viteana larvae. Berries infested by P. viteana were collected from vineyard borders during the second and third P. viteana generations and held under controlled conditions. In eight of the nine berry samples, survival of larvae was significantly lower in berries collected from vineyards managed under the reduced-risk insecticide program compared with the conventional program. Parasitism of P. citeana larvae in these samples was not consistently different between the two insecticide programs over 3 yr, and similar captures of natural enemies were found on yellow sticky traps in the two programs throughout the study. Our results indicate that integrated pest management programs incorporating reduced-risk insecticides for control of P. viteana can obtain similar or greater control of P. viteana compared with programs based solely on conventional insecticides, but they may not lead to measurable long-term increases in parasitism of P. viteana.

Psychosocial factors and uptake of risk-reducing salpingo-oophorectomy in women at high risk for ovarian cancer.

Science.gov (United States)

Meiser, Bettina; Price, Melanie A; Butow, Phyllis N; Karatas, Janan; Wilson, Judy; Heiniger, Louise; Baylock, Brandi; Charles, Margaret; McLachlan, Sue-Anne; Phillips, Kelly-Anne

2013-03-01

Bilateral risk-reducing salpingo-oophorectomy (RRSO) has been shown to significantly reduce the risk of ovarian cancer. This study assessed factors predicting uptake of RRSO. Women participating in a large multiple-case breast cancer family cohort study who were at increased risk for ovarian and fallopian tube cancer (i.e. BRCA1 or BRCA2 mutation carrier or family history including at least one first- or second-degree relative with ovarian or fallopian tube cancer), with no personal history of cancer and with at least one ovary in situ at cohort enrolment, were eligible for this study. Women who knew they did not carry the BRCA1 or BRCA2 mutation segregating in their family (true negatives) were excluded. Sociodemographic, biological and psychosocial factors, including cancer-specific anxiety, perceived ovarian cancer risk, optimism and social support, were assessed using self-administered questionnaires and interviews at cohort enrolment. RRSO uptake was self-reported every three years during systematic follow-up. Of 2,859 women, 571 were eligible. Mean age was 43.3 years; 62 women (10.9 %) had RRSO a median of two years after cohort entry. Factors predicting RRSO were: being parous (OR 3.3, p = 0.015); knowing one's mutation positive status (OR 2.9, p cancer (OR 2.5, p = 0.013). Psychological variables measured at cohort entry were not associated with RRSO. These results suggest that women at high risk for ovarian cancer make decisions about RRSO based on risk and individual socio-demographic characteristics, rather than in response to psychological factors such as anxiety.

Assessment of three risk evaluation systems for patients aged ≥70 in East China: performance of SinoSCORE, EuroSCORE II and the STS risk evaluation system.

Science.gov (United States)

Shan, Lingtong; Ge, Wen; Pu, Yiwei; Cheng, Hong; Cang, Zhengqiang; Zhang, Xing; Li, Qifan; Xu, Anyang; Wang, Qi; Gu, Chang; Zhang, Yangyang

2018-01-01

To assess and compare the predictive ability of three risk evaluation systems (SinoSCORE, EuroSCORE II and the STS risk evaluation system) in patients aged ≥70, and who underwent coronary artery bypass grafting (CABG) in East China. Three risk evaluation systems were applied to 1,946 consecutive patients who underwent isolated CABG from January 2004 to September 2016 in two hospitals. Patients were divided into two subsets according to their age: elderly group (age ≥70) with a younger group (age evaluation system were 0.78(0.64)%, 1.43(1.14)% and 0.78(0.77)%, respectively. SinoSCORE achieved the best discrimination (the area under the receiver operating characteristic curve (AUC) = 0.829), followed by the STS risk evaluation system (AUC = 0.790) and EuroSCORE II (AUC = 0.769) in the entire cohort. In the elderly group, the observed mortality rate was 4.82% while it was 1.38% in the younger group. SinoSCORE (AUC = .829) also achieved the best discrimination in the elderly group, followed by the STS risk evaluation system (AUC = .730) and EuroSCORE II (AUC = 0.640) while all three risk evaluation systems all had good performances in the younger group. SinoSCORE, EuroSCORE II and the STS risk evaluation system all achieved positive calibrations in the entire cohort and subsets. The performance of the three risk evaluation systems was not ideal in the entire cohort. In the elderly group, SinoSCORE appeared to achieve better predictive efficiency than EuroSCORE II and the STS risk evaluation system.

Designing and evaluating risk-based surveillance systems

DEFF Research Database (Denmark)

Willeberg, Preben; Nielsen, Liza Rosenbaum; Salman, Mo

2012-01-01

Risk-based surveillance systems reveal occurrence of disease or infection in a sample of population units, which are selected on the basis of risk factors for the condition under study. The purpose of such systems for supporting practical animal disease policy formulations and management decisions...... with prudent use of resources while maintaining acceptable system performance. High-risk category units are selected for testing by identification of the presence of specific high-risk factor(s), while disregarding other factors that might also influence the risk. On this basis we argue that the most...... applicable risk estimate for use in designing and evaluating a risk-based surveillance system would be a crude (unadjusted) relative risk, odds ratio or apparent prevalence. Risk estimates found in the published literature, however, are often the results of multivariable analyses implicitly adjusting...

Update on raloxifene: role in reducing the risk of invasive breast cancer in postmenopausal women

Directory of Open Access Journals (Sweden)

Vogel VG

2011-10-01

Full Text Available Victor G Vogel Cancer Institute, Geisinger Health System, Danville, PA, USA Abstract: Risk factors allow us to define women who are at increased lifetime risk for breast cancer, and the most important factor is age. Benign breast disease increases risk, and the most important histologies are atypical lobular or ductal hyperplasia and lobular carcinoma in situ. Family history of breast cancer among first-degree relatives (mother, sisters, daughters also increases risk. Quantitative measures of risk give accurate predictions of breast cancer incidence for groups of women but not for individual subjects. Multiple published, randomized controlled trials, which employed selective estrogen receptor (ER modulators (SERMs, have demonstrated consistent reductions of 35% or greater in the risk of ER-positive invasive and noninvasive breast cancer in postmenopausal women. Professional organizations in the US now recommend the use of SERMs to reduce the risk of breast cancer in high-risk, postmenopausal women. Raloxifene and tamoxifen reduce the risk of ER-positive invasive breast cancer with equal efficacy, but raloxifene is associated with a lower risk of thromboembolic disease, benign uterine conditions, and cataracts than tamoxifen in postmenopausal women. No evidence exists establishing whether a reduction in breast cancer risk from either agent translates into reduced breast cancer mortality. Overall quality of life is similar with raloxifene or tamoxifen, but the incidence of dyspareunia, weight gain, and musculoskeletal complaints is higher with raloxifene use, whereas vasomotor symptoms, bladder incontinence, gynecologic symptoms, and leg cramps were higher with tamoxifen use. Keywords: selective estrogen receptor modulators (SERMs, raloxifene, risk reduction, chemoprevention

Risk identification and evaluation of customer collaboration in product development

Directory of Open Access Journals (Sweden)

Xuefeng Zhang

2015-05-01

Full Text Available Purpose: The purpose of this paper is to identify risk factors that caused by customer collaboration in new product development systematically, and propose an approach to judge which risk factors are critical and catch substantial attention. Design/methodology/approach: This study identifies risk factors according to the results of case studies of enterprises in china. On this basis, an improved rough number approach is put forward to evaluate the importance of risk factors. Findings: Firstly, classify risk factors into three aspects. Then, present a risk factor set, which include thirty-seven risk factors. At last, determine which risk factors are critical by using an improved rough number approach. Originality/value: Considering there are few researches studying comprehensive risk factors of customer collaboration and assessing them, this paper explores a risk factor set of customer collaboration in product development stage, and proposes a novel approach, which can help to solve the problem of subjective, vague and lack of prior information of evaluation, to evaluate risk factors.

A quantitative risk assessment model to evaluate effective border control measures for rabies prevention

Science.gov (United States)

Weng, Hsin-Yi; Wu, Pei-I; Yang, Ping-Cheng; Tsai, Yi-Lun; Chang, Chao-Chin

2009-01-01

Border control is the primary method to prevent rabies emergence. This study developed a quantitative risk model incorporating stochastic processes to evaluate whether border control measures could efficiently prevent rabies introduction through importation of cats and dogs using Taiwan as an example. Both legal importation and illegal smuggling were investigated. The impacts of reduced quarantine and/or waiting period on the risk of rabies introduction were also evaluated. The results showed that Taiwan’s current animal importation policy could effectively prevent rabies introduction through legal importation of cats and dogs. The median risk of a rabid animal to penetrate current border control measures and enter Taiwan was 5.33 × 10−8 (95th percentile: 3.20 × 10−7). However, illegal smuggling may pose Taiwan to the great risk of rabies emergence. Reduction of quarantine and/or waiting period would affect the risk differently, depending on the applied assumptions, such as increased vaccination coverage, enforced custom checking, and/or change in number of legal importations. Although the changes in the estimated risk under the assumed alternatives were not substantial except for completely abolishing quarantine, the consequences of rabies introduction may yet be considered to be significant in a rabies-free area. Therefore, a comprehensive benefit-cost analysis needs to be conducted before recommending these alternative measures. PMID:19822125

Immediate Antiretroviral Therapy Reduces Risk of Infection-Related Cancer During Early HIV Infection

DEFF Research Database (Denmark)

Borges, Alvaro Humberto Diniz; Neuhaus, Jacqueline; Babiker, Abdel G

2016-01-01

BACKGROUND:  In the Strategic Timing of Antiretroviral Treatment (START) study, immediate combination antiretroviral therapy (cART) initiation reduced cancer risk by 64%. We hypothesized that risk reduction was higher for infection-related cancer and determined by differences in CD4 cell counts a...

Risk-reducing salpingectomy with delayed oophorectomy in BRCA1/2 mutation carriers: Patients' and professionals' perspectives

NARCIS (Netherlands)

Jong, M. de; Harmsen, M.G.; Hoogerbrugge, N.; Massuger, L.F.A.G.; Hermens, R.P.M.G.; Hullu, J.A. de

2015-01-01

OBJECTIVE: To identify influencing factors of BRCA1/2 mutation carriers and their professionals for risk-reducing salpingectomy (RRS) with delayed oophorectomy (RRO) as a substitute for risk-reducing salpingo-oophorectomy (RRSO) and for study participation on this concept. METHODS: A qualitative

Risk-benefit evaluation for large technological systems

International Nuclear Information System (INIS)

Okrent, D.

1979-01-01

The related topics of risk-benefit analysis, risk analysis, and risk-acceptance criteria (How safe is safe enough) are of growing importance. An interdisciplinary study on various aspects of these topics, including applications to nuclear power, was recently completed at the University of California, Los Angeles (UCLA), with the support of the National Science Foundation. In addition to more than 30 topical reports and various open-literature publications, a final report (UCLA-ENG-7777) to the study, titled ''A Generalized Evaluation Approach to Risk--Benefit for Large Technological Systems and Its Application to Nuclear Power'', was issued in early 1978. This article briefly summarizes portions of the final report dealing with general aspects of risk-benefit methodology, societal knowledge and perception of risk, and risk-acceptance criteria

Evaluation of allowed outage times (AOTS) from a risk and reliability standpoint

International Nuclear Information System (INIS)

Vesely, W.E.

1989-08-01

This report describes the basic risks associated with allowed outage times (AOTS), defines strategies for selecting the risks to be quantified, and describes how the risks can be quantified. This report provides a basis for risk-based approaches for regulatory and plant implementation. The AOT risk evaluations can be applied to proposed one-time AOT changes, or to permanent changes. The evaluations can also be used to quantify risks associated with present AOTs, and in establishing AOTs from a risk perspective. The report shows that the standard way of calculating AOT risks in probabilistic risk analyses (PRAs) generally is not sufficient when evaluating all the risks associated with an AOT in order to assess its acceptability. The PRA calculates an average AOT risk which includes the frequency at which the AOT is expected to occur. Other risks associated with an AOT include the single downtime risk, which is the risk incurred when (given) the AOT has occurred. The single downtime risk is generally the most applicable risk in determining the acceptability of the AOT. The single downtime risks are generally much larger than the PRA-averaged risk. For more comprehensive evaluations, both risks should be calculated. The report also describes other risks which can be considered, including personnel and economic risks. Finally, the report discusses the detailed evaluations which are involved in calculating AOT risks, including considerations of uncertainty. (author)

Conventional myelography - evaluation of risk and benefit

International Nuclear Information System (INIS)

Hentschel, F.

1989-01-01

While the benefit and methodic risk of conventional myelography (KMG) are known, a radiation risk of 0.04 to 0.9 annual radiation-induced cancers can be estimated for all inhabitants of the GDR, dependent on the investigated region and the technique used. An optimized technique can reduce the radiation burden to 50 or 25%. With comparable values of benefit and radiation risk spinal CT and KMG are not contradictory but complementary investigations. Alternative methods (MRT, US) must not be discussed from the standpoint of radiation burden, but according to their availability and their methodic limitations. (author)

Breastfeeding reduces the risk of obesity in childhood and adolescence

Directory of Open Access Journals (Sweden)

Eleni-Maria Papatesta

2013-06-01

Full Text Available Childhood obesity has increased dramatically over the last decades, representing one of the most serious public health hazards of the 21st century. Efforts must be made by healthcare professionals to prevent it, as it is associated with short- and long-term risks for physical and mental health and because of the increased possibility to persist during adulthood. From antiquity human breast milk was considered the ideal nourishment for the newborn. Breastfeeding is beneficial for the mother-child dyad. Among others, existing data suggest that it reduces the risk for childhood and adolescence obesity. The mechanisms for this are numerous and include the feeding behavior breastfeeding infants acquire, their growth rate, the ‘early protein hypothesis’, the role of leptin that is found in increased levels in human milk, the dietary choices the breastfed infants make during childhood and adolescence and finally the differences in their bowel flora. Meta-analyses provide sufficient evidence for this protective effect, with a dose-response effect as to the duration of breastfeeding. Healthcare professionals involved in the care of the mother-infant dyad must encourage and support mothers to breastfeed their infants for a long period of time, if obesity were to be prevented. Aim of this review is to provide an account of existing data on the association of breastfeeding and the reduced risk of obesity in childhood and adulthood.

Context dependency and consumer acceptance of risk reducing strategies - a choice experiment study on salmonella risks in pork

DEFF Research Database (Denmark)

Mørkbak, Morten Raun; Christensen, Tove; Gyrd-Hansen, Dorte

2012-01-01

The paper investigates to what extent context dependency is present, when consumers are introduced to different risk reducing technologies and how this will affect their preferences for reductions in food risks. In particular, choice experiments are used to elicit consumer preferences for reducin...... findings of bad news having greater effect than good news – now applied to context dependency of preferences for food safety technologies....

Reducing Youth Risk Behaviors Through Interactive Theater Intervention

Directory of Open Access Journals (Sweden)

Ryan J. Watson

2016-02-01

Full Text Available The reduction of risk behaviors in secondary schools is a key concern for parents, teachers, and school administrators. School is one of the primary contexts of socialization for young people; thus, the investment in school-based programs to reduce risk behaviors is essential. In this study, we report on youth who participated in an intervention designed to improve decision-making skills based on positive youth development approaches. We examine changes in decision-making skills before and after involvement in the Teen Interactive Theater Education (TITE program and retrospective self-assessment of change in knowledge, abilities, and beliefs as a result of participating in TITE (n = 127. Youth that reported increases in knowledge, abilities, and beliefs due to the intervention (n = 89 were more likely to think about the consequences of their decisions and list options before making a decision compared to their counterparts that reported less overall learning (n = 38. Implications for intervention research and stakeholders are discussed.

Workplace Interventions to Reduce Obesity and Cardiometabolic Risk.

Science.gov (United States)

Thorndike, Anne N

2011-02-01

The worksite is ideal for implementing interventions to reduce obesity and cardiometabolic risk factors. Although worksite health promotion is not new, employer-sponsored wellness programs have become more widespread due to the rising prevalence and high cost of obesity. Over the past two decades, employers and researchers focused efforts on individual-based programs to change employees' nutrition and exercise behaviors, but more recently, the worksite environment has been targeted. Overall, there is good evidence that individual-based worksite programs can produce modest weight loss, but the evidence for effects on other risk factors and on long-term health outcomes and costs is inconsistent. There is less evidence for the benefit of environmental-based interventions, and more data will be needed to establish conclusions about the benefits of these types of interventions. A major challenge for employers and researchers in the future will be to find the balance between effectiveness and economic viability of worksite wellness programs.

Reduced reward anticipation in youth at high-risk for unipolar depression: A preliminary study

Directory of Open Access Journals (Sweden)

Thomas M. Olino

2014-04-01

Full Text Available Offspring of depressed parents are at risk for depression and recent evidence suggests that reduced positive affect (PA may be a marker of risk. We investigated whether self-reports of PA and fMRI-measured striatal response to reward, a neural correlate of PA, are reduced in adolescent youth at high familial risk for depression (HR relative to youth at low familial risk for depression (LR. Functional magnetic resonance imaging assessments were conducted with 14 HR and 12 LR youth. All youth completed an ecological momentary assessment protocol to measure PA in natural settings and a self-report measure of depression symptomatology. Analyses found that HR youth demonstrated lower striatal response than LR youth during both reward anticipation and outcome. However, after controlling for youth self-reports of depression, HR youth demonstrated lower striatal response than LR youth only during reward anticipation. No significant differences were found between HR and LR youth on subjective ratings of PA or depressive symptoms. Results are consistent with previous findings that reduced reward response is a marker of risk for depression, particularly during reward anticipation, even in the absence of (or accounting for disrupted subjective mood. Further examinations of prospective associations between reward response and depression onset are needed.

Evaluation of the health risks to garment workers in the city of Xambrê-PR, Brazil.

Science.gov (United States)

Sant'Ana, Marco Antônio; Kovalechen, Fabrício

2012-01-01

This study evaluated the risks for cardiovascular disease and the life habits of garment industry workers in northwestern Paraná state, Brazil. The following parameters were assessed: body composition, cardiorespiratory fitness, eating habits and physical activities by garment industry workers. Cardiovascular risk was observed in some of the studied subjects, in the form of high BMI and reduced maximal oxygen uptake. The development of a workplace quality-of-life program is suggested, aiming to stimulate the development of physical activities to improve the cardiovascular conditioning of workers.

Realistic minimum accident source terms - Evaluation, application, and risk acceptance

International Nuclear Information System (INIS)

Angelo, P. L.

2009-01-01

The evaluation, application, and risk acceptance for realistic minimum accident source terms can represent a complex and arduous undertaking. This effort poses a very high impact to design, construction cost, operations and maintenance, and integrated safety over the expected facility lifetime. At the 2005 Nuclear Criticality Safety Division (NCSD) Meeting in Knoxville Tenn., two papers were presented mat summarized the Y-12 effort that reduced the number of criticality accident alarm system (CAAS) detectors originally designed for the new Highly Enriched Uranium Materials Facility (HEUMF) from 258 to an eventual as-built number of 60. Part of that effort relied on determining a realistic minimum accident source term specific to the facility. Since that time, the rationale for an alternate minimum accident has been strengthened by an evaluation process that incorporates realism. A recent update to the HEUMF CAAS technical basis highlights the concepts presented here. (authors)

Reducing Fall Risk with Combined Motor and Cognitive Training in Elderly Fallers

Directory of Open Access Journals (Sweden)

Francesco Barban

2017-02-01

Full Text Available Background. Falling is a major clinical problem in elderly people, demanding effective solutions. At present, the only effective intervention is motor training of balance and strength. Executive function-based training (EFt might be effective at preventing falls according to evidence showing a relationship between executive functions and gait abnormalities. The aim was to assess the effectiveness of a motor and a cognitive treatment developed within the EU co-funded project I-DONT-FALL. Methods. In a sample of 481 elderly people at risk of falls recruited in this multicenter randomised controlled trial, the effectiveness of a motor treatment (pure motor or mixed with EFt of 24 one-hour sessions delivered through an i-Walker with a non-motor treatment (pure EFt or control condition was evaluated. Similarly, a 24 one-hour session cognitive treatment (pure EFt or mixed with motor training, delivered through a touch-screen computer was compared with a non-cognitive treatment (pure motor or control condition. Results. Motor treatment, particularly when mixed with EFt, reduced significantly fear of falling (F(1,478 = 6.786, p = 0.009 although to a limited extent (ES −0.25 restricted to the period after intervention. Conclusions. This study suggests the effectiveness of motor treatment empowered by EFt in reducing fear of falling.

Reduced Risk of Importing Ebola Virus Disease because of Travel Restrictions in 2014: A Retrospective Epidemiological Modeling Study

Science.gov (United States)

Otsuki, Shiori

2016-01-01

Background An epidemic of Ebola virus disease (EVD) from 2013–16 posed a serious risk of global spread during its early growth phase. A post-epidemic evaluation of the effectiveness of travel restrictions has yet to be conducted. The present study aimed to estimate the effectiveness of travel restrictions in reducing the risk of importation from mid-August to September, 2014, using a simple hazard-based statistical model. Methodology/Principal Findings The hazard rate was modeled as an inverse function of the effective distance, an excellent predictor of disease spread, which was calculated from the airline transportation network. By analyzing datasets of the date of EVD case importation from the 15th of July to the 15th of September 2014, and assuming that the network structure changed from the 8th of August 2014 because of travel restrictions, parameters that characterized the hazard rate were estimated. The absolute risk reduction and relative risk reductions due to travel restrictions were estimated to be less than 1% and about 20%, respectively, for all models tested. Effectiveness estimates among African countries were greater than those for other countries outside Africa. Conclusions The travel restrictions were not effective enough to expect the prevention of global spread of Ebola virus disease. It is more efficient to control the spread of disease locally during an early phase of an epidemic than to attempt to control the epidemic at international borders. Capacity building for local containment and coordinated and expedited international cooperation are essential to reduce the risk of global transmission. PMID:27657544

Market Microstructure Effects on Firm Default Risk Evaluation

Directory of Open Access Journals (Sweden)

Flavia Barsotti

2016-07-01

Full Text Available Default probability is a fundamental variable determining the credit worthiness of a firm and equity volatility estimation plays a key role in its evaluation. Assuming a structural credit risk modeling approach, we study the impact of choosing different non parametric equity volatility estimators on default probability evaluation, when market microstructure noise is considered. A general stochastic volatility framework with jumps for the underlying asset dynamics is defined inside a Merton-like structural model. To estimate the volatility risk component of a firm we use high-frequency equity data: market microstructure noise is introduced as a direct effect of observing noisy high-frequency equity prices. A Monte Carlo simulation analysis is conducted to (i test the performance of alternative non-parametric equity volatility estimators in their capability of filtering out the microstructure noise and backing out the true unobservable asset volatility; (ii study the effects of different non-parametric estimation techniques on default probability evaluation. The impact of the non-parametric volatility estimators on risk evaluation is not negligible: a sensitivity analysis defined for alternative values of the leverage parameter and average jumps size reveals that the characteristics of the dataset are crucial to determine which is the proper estimator to consider from a credit risk perspective.

Design of Work Facilities for Reducing Musculoskeletal Disorders Risk in Paper Pallet Assembly Station

Science.gov (United States)

Mardi Safitri, Dian; Arfi Nabila, Zahra; Azmi, Nora

2018-03-01

Musculoskeletal Disorders (MSD) is one of the ergonomic risks due to manual activity, non-neutral posture and repetitive motion. The purpose of this study is to measure risk and implement ergonomic interventions to reduce the risk of MSD on the paper pallet assembly work station. Measurements to work posture are done by Ovako Working Posture Analysis (OWAS) methods and Rapid Entire Body Assessment (REBA) method, while the measurement of work repetitiveness was using Strain Index (SI) method. Assembly processes operators are identified has the highest risk level. OWAS score, Strain Index, and REBA values are 4, 20.25, and 11. Ergonomic improvements are needed to reduce that level of risk. Proposed improvements will be developed using the Quality Function Deployment (QFD) method applied with Axiomatic House of Quality (AHOQ) and Morphological Chart. As the result, risk level based on OWAS score & REBA score turn out from 4 & 11 to be 1 & 2. Biomechanics analysis of the operator also shows the decreasing values for L4-L5 moment, compression, joint shear, and joint moment strength.

Approved Risk Evaluation and Mitigation Strategies

Data.gov (United States)

U.S. Department of Health & Human Services — The Food and Drug Administration Amendments Act of 2007 gave FDA the authority to require a Risk Evaluation and Mitigation Strategy (REMS) from manufacturers to...

Evaluating and reducing a model of radiocaesium soil-plant uptake

Energy Technology Data Exchange (ETDEWEB)

Tarsitano, D.; Young, S.D. [School of Biosciences, University of Nottingham, University Park, Nottingham, NG7 2RD (United Kingdom); Crout, N.M.J., E-mail: neil.crout@nottingham.ac.u [School of Biosciences, University of Nottingham, University Park, Nottingham, NG7 2RD (United Kingdom)

2011-03-15

An existing model of radiocaesium transfer to grasses was extended to include wheat and barley and parameterised using data from a wide range of soils and contact times. The model structure was revised and evaluated using a subset of the available data which was not used for model parameterisation. The resulting model was then used as a basis for systematic model reduction to test the utility of the model components. This analysis suggested that the use of 4 model variables (relating to radiocaesium adsorption on organic matter and the pH sensitivity of soil solution potassium concentration) and 1 model input (pH) are not required. The results of this analysis were used to develop a reduced model which was further evaluated in terms of comparisons to observations. The reduced model had an improved empirical performance and fewer adjustable parameters and soil characteristic inputs. - Research highlights: {yields} A model of plant radiocesium uptake is evaluated and re-parameterised. {yields} The representation of time dependent changes in plant uptake is improved. {yields} Model reduction is applied to evaluate the model structure. {yields} A reduced model is identified which outperforms the previously reported model. {yields} The reduced model requires fewer soil specific inputs.

Risk-reducing surgery on the uterine adnexa: timing and type of surgical treatment, and pathology report.

Science.gov (United States)

Signorelli, Mauro; Bogani, Giorgio; Ditto, Antonino; Martinelli, Fabio; Chiappa, Valentina; Lopez, Carlos; Scaffa, Cono; Lorusso, Domenica; Raspagliesi, Francesco

2016-10-01

Inherited mutations in BRCA1 and BRCA2 increase significantly the risk of developing breast and ovarian cancers, and they have been associated with increased risks of developing other types of cancer. Although screening programs have been implemented in order to detect cancers at the early stage, they resulted ineffective. To date, risk-reducing bilateral salpingo-oophorectomy represents the only procedure allowing reducing the incidence of ovarian cancer and increasing survival among BRCA1 and -2 mutation carriers. In the present review we will discuss the advantages and disadvantages related to the execution of prophylactic surgery, thus underlying possible beneficial and detrimental effects of this kind of surgery in premenopausal women. Additionally, we will investigate further therapeutic strategies aimed to reduce the risk of developing ovarian cancer, without affected patients' hormonal status.

Review article Homebound instruction for students with chronic illness: reducing risk outside of the box

Directory of Open Access Journals (Sweden)

Steven R. Shaw

2014-05-01

Full Text Available Students with chronic illness are at risk for a host of academic and social problems. The risk is exacerbated when students are unable to attend school short term or long term due to medical problems. Educators may be able to reduce academic and social risk for students with chronic illness through effective homebound instruction. However, there remain many barriers to effective homebowund instruction. Effective interdisciplinary and community coordination, development of policies, teacher support, inclusion of families, and use of technology can be combined to overcome these barriers and create effective homebound programs and policies. The result is reduced risk for the large and vulnerable population of students with chronic illness.

Evaluation of commercially available seat suspensions to reduce whole body vibration exposures in mining heavy equipment vehicle operators.

Science.gov (United States)

Kim, Jeong Ho; Marin, Luz S; Dennerlein, Jack T

2018-09-01

As mining vehicle operators are exposed to high level of Whole body vibration (WBV) for prolonged periods of time, approaches to reduce this exposure are needed for the specific types of exposures in mining. Although various engineering controls (i.e. seat suspension systems) have been developed to address WBV, there has been lack of research to systematically evaluate these systems in reducing WBV exposures in mining heavy equipment vehicle settings. Therefore, this laboratory-based study evaluated the efficacy of different combinations of fore-aft (x-axis), lateral (y-axis), and vertical (z-axis) suspensions in reducing WBV exposures. The results showed that the active vertical suspension more effectively reduced the vertical vibration (∼50%; p's suspension (10%; p's suspension systems did not attenuate the corresponding axis vibration (p's > 0.06) and sometimes amplified the floor vibration, especially when the non-vertical vibration was predominant (p's suspensions to address non-vertical WBV exposures, especially because these non-vertical WBV exposures can increase risks for adverse health effects including musculoskeletal loading, discomfort, and impaired visual acuity. Copyright © 2018 Elsevier Ltd. All rights reserved.

Risk Evaluation for CO2 Geosequestration in the Knox Supergroup, Illinois Basin Final Report

Energy Technology Data Exchange (ETDEWEB)

Hnottavange-Telleen, Ken; Leetaru, Hannes

2014-09-30

porous and permeable) injection depths within the overall formation. Less direct implications include the vertical position of the Potosi within the rock column and the absence of a laterally extensive shale caprock immediately overlying the Potosi. Based on modeling work done partly in association with this risk report, risks that should also be evaluated include the ability of available methods to predict and track the development of a CO2 plume as it migrates away from the injection point(s). The geologic and hydrodynamic uncertainties present risks that are compounded at the stage of acquiring necessary drilling and injection permits. It is anticipated that, in the future, a regional geologic study or CO2-emitter request may identify a small specific area as a prospective CCS project site. At that point, the FEPs lists provided in this report should be evaluated by experts for their relative levels of risk. A procedure for this evaluation is provided. The higher-risk FEPs should then be used to write project-specific scenarios that may themselves be evaluated for risk. Then, actions to reduce and to manage risk can be described and undertaken. The FEPs lists provided as Appendix 2 should not be considered complete, as potentially the most important risks are ones that have not yet been thought of. But these lists are intended to include the most important risk elements pertinent to a Potosi-target CCS project, and they provide a good starting point for diligent risk identification, evaluation, and management.

POTENTIAL HEALTH RISK REDUCTION ARISING FROM REDUCED MERCURY EMISSIONS FROM COAL FIRED POWER PLANTS.

Energy Technology Data Exchange (ETDEWEB)

Sullivan, T. M.; Lipfert, F. W.; Morris, S. C.; Moskowitz, P. D.

2001-09-01

The U.S. Environmental Protection Agency (EPA) has announced plans to regulate mercury (Hg) emissions from coal-fired power plants. EPA has not prepared a quantitative assessment of the reduction in risk that could be achieved through reduction in coal plant emissions of Hg. To address this issue, Brookhaven National Laboratory (BNL) with support from the U.S. Department of Energy Office of Fossil Energy (DOE FE) prepared a quantitative assessment of the reduction in human health risk that could be achieved through reduction in coal plant emissions of Hg. The primary pathway for Hg exposure is through consumption of fish. The most susceptible population to Hg exposure is the fetus. Therefore the risk assessment focused on consumption of fish by women of child-bearing age. Dose response factors were generated from studies on loss of cognitive abilities (language skills, motor skills, etc.) by young children whose mothers consumed large amounts of fish with high Hg levels. Population risks were estimated for the general population in three regions of the country, (the Midwest, Northeast, and Southeast) that were identified by EPA as being heavily impacted by coal emissions. Three scenarios for reducing Hg emissions from coal plants were considered: (1) A base case using current conditions; (2) A 50% reduction; and, (3) A 90% reduction. These reductions in emissions were assumed to translate linearly into a reduction in fish Hg levels of 8.6% and 15.5%, respectively. Population risk estimates were also calculated for two subsistence fisher populations. These groups of people consume substantially more fish than the general public and, depending on location, the fish may contain higher Hg levels than average. Risk estimates for these groups were calculated for the three Hg levels used for the general population analyses. Analysis shows that the general population risks for exposure of the fetus to Hg are small. Estimated risks under current conditions (i.e., no

Fuzzy comprehensive evaluation-based disaster risk assessment of desertification in Horqin Sand Land, China.

Science.gov (United States)

Wang, Yongfang; Zhang, Jiquan; Guo, Enliang; Sun, Zhongyi

2015-02-03

Desertification is a typical disaster risk event in which human settlements and living environments are destroyed. Desertification Disaster Risk Assessment can control and prevent the occurrence and development of desertification disasters and reduce their adverse influence on human society. This study presents the methodology and procedure for risk assessment and zoning of desertification disasters in Horqin Sand Land. Based on natural disaster risk theory and the desertification disaster formation mechanism, the Desertification Disaster Risk Index (DDRI) combined hazard, exposure, vulnerability and restorability factors and was developed mainly by using multi-source data and the fuzzy comprehensive evaluation method. The results showed that high risk and middle risk areas account for 28% and 23% of the study area, respectively. They are distributed with an "S" type in the study area. Low risk and very low risk areas account for 21% and 10% of the study area, respectively. They are distributed in the west-central and southwestern parts. Very high risk areas account for 18% of the study area and are distributed in the northeastern parts. The results can be used to know the desertification disaster risk level. It has important theoretical and practical significance to prevention and control of desertification in Horqin Sand Land and even in Northern China.

Fuzzy Comprehensive Evaluation-Based Disaster Risk Assessment of Desertification in Horqin Sand Land, China

Directory of Open Access Journals (Sweden)

Yongfang Wang

2015-02-01

Full Text Available Desertification is a typical disaster risk event in which human settlements and living environments are destroyed. Desertification Disaster Risk Assessment can control and prevent the occurrence and development of desertification disasters and reduce their adverse influence on human society. This study presents the methodology and procedure for risk assessment and zoning of desertification disasters in Horqin Sand Land. Based on natural disaster risk theory and the desertification disaster formation mechanism, the Desertification Disaster Risk Index (DDRI combined hazard, exposure, vulnerability and restorability factors and was developed mainly by using multi-source data and the fuzzy comprehensive evaluation method. The results showed that high risk and middle risk areas account for 28% and 23% of the study area, respectively. They are distributed with an “S” type in the study area. Low risk and very low risk areas account for 21% and 10% of the study area, respectively. They are distributed in the west-central and southwestern parts. Very high risk areas account for 18% of the study area and are distributed in the northeastern parts. The results can be used to know the desertification disaster risk level. It has important theoretical and practical significance to prevention and control of desertification in Horqin Sand Land and even in Northern China.

Assessments and applications to enhance human reliability and reduce risk during less-than-full-power operations

International Nuclear Information System (INIS)

Hannaman, G.W.; Singh, A.

1992-01-01

Study of events, interviews with plant personnel, and applications of risk studies indicate that the risk of a potential accident during less-than-full-power (LTFP) operation is becoming a greater fraction of the risk as improvements are made to the full-power operations. Industry efforts have been increased to reduce risk and the cost of shutdown operations. These efforts consider the development and application of advanced tools to help utilities proactively identify issues and develop contingencies and interventions to enhance reliability and reduce risk of low-power operations at nuclear power plants. The role for human reliability assessments is to help improve utility outage planning to better achieve schedule and risk control objectives. Improvements are expected to include intervention tools to identify and reduce human error, definition of new instructional modules, and prioritization of risk reduction issues for operators. The Electric Power Research Institute is sponsoring a project to address the identification and quantification of factors that affect human reliability during LTFP operation of nuclear power plants. The results of this project are expected to promote the development of proactively applied interventions and contingencies for enhanced human reliability during shutdown operations

Reduced risk avoidance and altered neural correlates of feedback processing in patients with borderline personality disorder.

Science.gov (United States)

Endrass, Tanja; Schuermann, Beate; Roepke, Stefan; Kessler-Scheil, Sonia; Kathmann, Norbert

2016-09-30

Patients with borderline personality disorder (BPD) show deficits in reward-guided decision making and learning. The present study examined risk-taking behavior in combination with feedback processing. Eighteen BPD patients and 18 healthy controls performed a probabilistic two-choice gambling task, while an electroencephalogram was recorded. Options differed in risk, but were identical in expected value and outcome probability. The feedback-related negativity (FRN) and the feedback-related P300 were analyzed. Healthy controls preferred low-risk over high-risk options, whereas BPD patients chose both option with equal probability. FRN amplitudes were reduced in BPD, but effects of feedback valence and risk did not differ between groups. This suggests attenuated outcome processing in the anterior cingulate cortex, but intact reward prediction error signaling. Furthermore, the modulation of the feedback-related P300 with feedback valence and risk was smaller in BPD patients, and decreased P300 amplitudes were associated with increased behavioral risk-taking behavior. These findings could relate to the reduced ability of BPD patients to learn and adequately adjust their behavior based on feedback information, possibly due to reduced significance of negative feedback. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Priorities for technology development and policy to reduce the risk from radioactive materials

International Nuclear Information System (INIS)

Duggan, Ruth Ann

2010-01-01

The Standing Committee on International Security of Radioactive and Nuclear Materials in the Nonproliferation and Arms Control Division conducted its fourth annual workshop in February 2010 on Reducing the Risk from Radioactive and Nuclear Materials. This workshop examined new technologies in real-time tracking of radioactive materials, new risks and policy issues in transportation security, the best practices and challenges found in addressing illicit radioactive materials trafficking, industry leadership in reducing proliferation risk, and verification of the Nuclear Nonproliferation Treaty, Article VI. Technology gaps, policy gaps, and prioritization for addressing the identified gaps were discussed. Participants included academia, policy makers, radioactive materials users, physical security and safeguards specialists, and vendors of radioactive sources and transportation services. This paper summarizes the results of this workshop with the recommendations and calls to action for the Institute of Nuclear Materials Management (INMM) membership community.

Assessing the Risk of Occult Cancer and 30-day Morbidity in Women Undergoing Risk-reducing Surgery: A Prospective Experience.

Science.gov (United States)

Bogani, Giorgio; Tagliabue, Elena; Signorelli, Mauro; Chiappa, Valentina; Carcangiu, Maria Luisa; Paolini, Biagio; Casarin, Jvan; Scaffa, Cono; Gennaro, Massimiliano; Martinelli, Fabio; Borghi, Chiara; Ditto, Antonino; Lorusso, Domenica; Raspagliesi, Francesco

To investigate the incidence and predictive factors of 30-day surgery-related morbidity and occult precancerous and cancerous conditions for women undergoing risk-reducing surgery. A prospective study (Canadian Task Force classification II-1). A gynecologic oncology referral center. Breast-related cancer antigen (BRCA) mutation carriers and BRCAX patients (those with a significant family history of breast and ovarian cancer). Minimally invasive risk-reduction surgery. Overall, 85 women underwent risk-reducing surgery: 30 (35%) and 55 (65%) had hysterectomy plus bilateral salpingo-oophorectomy (BSO) and BSO alone, respectively. Overall, in 6 (7%) patients, the final pathology revealed unexpected cancer: 3 early-stage ovarian/fallopian tube cancers, 2 advanced-stage ovarian cancers (stage IIIA and IIIB), and 1 serous endometrial carcinoma. Additionally, 3 (3.6%) patients had incidental finding of serous tubal intraepithelial carcinoma. Four (4.7%) postoperative complications within 30 days from surgery were registered, including fever (n = 3) and postoperative ileus (n = 1); no severe (grade 3 or more) complications were observed. All complications were managed conservatively. The presence of occult cancer was the only factor predicting the development of postoperative complications (p = .02). Minimally invasive risk-reducing surgery is a safe and effective strategy to manage BRCA mutation carriers. Patients should benefit from an appropriate counseling about the high prevalence of undiagnosed cancers observed at the time of surgery. Copyright © 2017 AAGL. Published by Elsevier Inc. All rights reserved.

The determination of allowed outage time using the evaluation of transition risk

International Nuclear Information System (INIS)

Kang, D. I.; Kim, K. Y.; Jang, S. C.

2001-03-01

he objectives of this study are to propose a new evaluation method for transition risk and to determine the AOT using the new method. We review and compare the evaluation methods of transition risk which was previously studied. We also identify important assumptions used in previous studies for the evaluation of transition risk. We select general items required for the development of evaluation method for the transition risk. Based on the items selected, we propose a new evaluation method for transition risk. The new evaluation method for the transition risk is based on following assumptions; 1)For the same time span, the risk occurred from the failure to the completion of component repair during power operation is the same as the total risk including the risk occurred from power operation to specific shutdown/low power operation and the risk from specific shutdown/low power operation to power operation. 2)Shutdown operation and the repair of components are initiated just after the identification of the failure of components. The evaluation of the transition risk is performed to incorporate the characteristics of shutdown operation into Ulchin Units 3 and 4 Level 1 internal PSA for power operation. The application results of the new method to the HPSIS and the LPSIS for Ulchin Units 3 and 4 show that the AOT of HPSIS is properly determined and the AOT of LPSIS can be greatly increased. In this study, the main factors affecting the determination of AOT using the evaluation for transition risk are identified as the time of shutdown operation, the consideration of the change on common cause failure probability, and the risk of shutdown operation. It is expected that the evaluation method for the transition risk proposed in this study will be used for the determination of AOT and for the decision, in the case of the components unavailable, whether power operation is continuously performed or shutdown operation is initiated

Reduced reward anticipation in youth at high-risk for unipolar depression: a preliminary study.

Science.gov (United States)

Olino, Thomas M; McMakin, Dana L; Morgan, Judith K; Silk, Jennifer S; Birmaher, Boris; Axelson, David A; Williamson, Douglas E; Dahl, Ronald E; Ryan, Neal D; Forbes, Erika E

2014-04-01

Offspring of depressed parents are at risk for depression and recent evidence suggests that reduced positive affect (PA) may be a marker of risk. We investigated whether self-reports of PA and fMRI-measured striatal response to reward, a neural correlate of PA, are reduced in adolescent youth at high familial risk for depression (HR) relative to youth at low familial risk for depression (LR). Functional magnetic resonance imaging assessments were conducted with 14 HR and 12 LR youth. All youth completed an ecological momentary assessment protocol to measure PA in natural settings and a self-report measure of depression symptomatology. Analyses found that HR youth demonstrated lower striatal response than LR youth during both reward anticipation and outcome. However, after controlling for youth self-reports of depression, HR youth demonstrated lower striatal response than LR youth only during reward anticipation. No significant differences were found between HR and LR youth on subjective ratings of PA or depressive symptoms. Results are consistent with previous findings that reduced reward response is a marker of risk for depression, particularly during reward anticipation, even in the absence of (or accounting for) disrupted subjective mood. Further examinations of prospective associations between reward response and depression onset are needed. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Risk evaluation of accident management strategies

International Nuclear Information System (INIS)

Dingman, S.; Camp, A.

1992-01-01

The use of Probabilistic Risk Assessment (PRA) methods to evaluate accident management strategies in nuclear power plants discussed in this paper. The PRA framework allows an integrated evaluation to be performed to give the full implications of a particular strategy. The methodology is demonstrated for a particular accident management strategy, intentional depressurization of the reactor coolant system to avoid containment pressurization during the ejection of molten debris at vessel breach

Does Chocolate Intake During Pregnancy Reduce the Risks of Preeclampsia and Gestational Hypertension?

Science.gov (United States)

Saftlas, Audrey F.; Triche, Elizabeth W.; Beydoun, Hind; Bracken, Michael B.

2010-01-01

Purpose Chocolate consumption is associated with favorable levels of blood pressure and other cardiovascular disease risk markers. We analyzed a prospective cohort study to determine if regular chocolate intake during pregnancy is associated with reduced risks of preeclampsia and gestational hypertension (GH). Methods Subjects were recruited from 13 prenatal care practices in Connecticut (1988-1991). In-person interviews were administered at Chocolate consumption (servings/week) during the 1st and 3rd trimesters was ascertained at initial interview and immediately postpartum, respectively. Consumers of Chocolate intake was more frequent among normotensives (80.7%) than preeclamptics (62.5%) or GH women (75.8%), and associated with reduced odds of preeclampsia (1st trimester: aOR=0.55, 95% CI: 0.32-0.95; 3rd trimester: aOR=0.56, 95% CI: 0.32-0.97). Only 1st trimester intake was associated with reduced odds of GH (aOR=0.65, 95% CI: 0.45-0.87). Conclusions These findings provide additional evidence of the benefits of chocolate. Prospective studies are needed to confirm and delineate protective effects of chocolate intake on risk of preeclampsia. PMID:20609337

Replicating Reducing the Risk: 12-Month Impacts of a Cluster Randomized Controlled Trial

Science.gov (United States)

Blocklin, Michelle; Layzer, Jean; Price, Cristofer; Juras, Randall; Freiman, Lesley

2016-01-01

Objectives. To test the effectiveness of Reducing the Risk, an evidence-based sexual health curriculum designed to help prevent adolescent pregnancy and sexually transmitted infections, on youth sexual behavior and intermediate outcomes thought to lead to these behaviors. Methods. Classes within schools in St. Louis, Missouri; Austin, Texas; and San Diego, California; were randomly assigned to receive Reducing the Risk or “business as usual.” Youths completed Web-based surveys at baseline (preintervention, August 2012–January 2014) and 12 months later (August 2013–January 2015). Intent-to-treat analyses were conducted across sites; we tested for differences in impacts between sites and other subgroups. Results. The program had no overall impact on sexual behaviors. However, at 1 site, program participants were significantly less likely to have engaged in recent sexual intercourse than were control group members. There were positive overall impacts on intermediate outcomes (e.g., knowledge, attitudes). Conclusions. After 12 months, Reducing the Risk was unsuccessful at changing sexual behaviors. Other results were mixed, but promising evidence (e.g., behavioral impacts at 1 site, impacts on intermediate outcomes) suggests potential for more widespread behavioral impacts over a longer term. PMID:27689492

Overall strategy for risk evaluation and priority setting of risk regulations

International Nuclear Information System (INIS)

Hokstad, Per; Steiro, Trygve

2006-01-01

This paper presents the framework of an approach to support planning and priority setting for risk control. Such an approach could assist government/regulatory authorities in their allocation of resources among different sectors. The term risk will here be used in a very wide sense, and it will include, but not restrict to, the traditional HES (Health, Environment and Safety) concept. An overall classification of risk ('loss categories'), to be used across sectors and directorates is suggested. The risk evaluation includes a number of factors not accounted for in a standard risk assessment, but should be taken into account when authorities set priorities regarding risk control. Sociological, psychological and ethical perspectives are included, and the need for a discourse during the decision process is pinpointed. The paper also discusses the potential inclusion of cost benefit analyses in such an approach. The indicated approach is denoted Risk Across Sectors (RAS), and suggestions regarding the process to implement it are given. Such an implementation process will by itself increase the knowledge and competence of the involved parties

Reducing risks and increasing safety in everyday life: the role of the public

International Nuclear Information System (INIS)

Enander, A.

1998-01-01

Full text of publication follows: in social science risk research more attention has been paid to examining how people in general perceive risks than to how they perceive possible measures to reduce risks and to increase their own safety. The latter area is, however, becoming increasingly important to understand, particularly in the light of current emphasis on individual responsibility in risk prevention and emergency preparedness. For example, in Sweden a major effort to increase safety awareness among the general public and to increase knowledge and skills in a number of safety-related areas is at present being planned. This effort is being undertaken as a cooperative effort between different authorities and institutions and is coordinated by the Swedish Rescue Services Agency. The intentions behind this and similar programmes raise a number of questions concerning how people view risks and safety measures in their own immediate environment. Knowledge of the factors affecting willingness to take precautions is important in the design of communication and information. The factors which are of significance may be risk-related and concern perceptions of personal risk, but may also be related to attitudes an beliefs concerning different precautionary measures, to perception of social norms and conventions as well as to personal experiences and values. This paper presents some data concerning views and actions among lay groups in relation to reducing risks and increasing safety. Factors affecting these views are discussed in the light of previous research and of empirical data from some recent studies. (author)

Risk management study for the retired Hanford Site facilities: Qualitative risk evaluation for the retired Hanford Site facilities

International Nuclear Information System (INIS)

Coles, G.A.; Shultz, M.V.; Taylor, W.E.

1993-09-01

This document provides a risk evaluation of the 100 and 200 Area retired, surplus facilities on the Hanford Site. Also included are the related data that were compiled by the risk evaluation team during investigations performed on the facilities. Results are the product of a major effort performed in fiscal year 1993 to produce qualitative information that characterizes certain risks associated with these facilities. The retired facilities investigated for this evaluation are located in the 100 and 200 Areas of the 1,450-km 2 (570-mi 2 ) Hanford Site. The Hanford Site is a semiarid tract of land in southeastern Washington State. The nearest population center is Richland, Washington, (population 32,000) 30-km (20 mi) southeast of the 200 Area. During walkdown investigations of these facilities, data on real and potential hazards that threatened human health or safety or created potential environmental release issues were identified by the risk evaluation team. Using these findings, the team categorized the identified hazards by facility and evaluated the risk associated with each hazard. The factors contributing to each risk, and the consequence and likelihood of harm associated with each hazard also are included in this evaluation

[Guidance of FDA risk evaluation and mitigation strategy and enlightenment to drug risk management of post-marketing Chinese medicine].

Science.gov (United States)

Li, Yuanyuan; Xie, Yanming

2011-10-01

The FDA risk evaluation and mitigation strategy (REMS) aims to drugs or biological products known or potential serious risk management. Analysis with the example of the content of the Onsolis REMS named FOCOS. Our country can be reference for the analysis of relevant experience and establish a scientific evaluation mechanism, strengthen the drug risk consciousness, promote the rational drug use, organic combined with the before-marketing and post-marketing evaluation of traditional Chinese medicine, and promote the evaluation of risk management of the drug development and improvement.

A Scalable Distribution Network Risk Evaluation Framework via Symbolic Dynamics

Science.gov (United States)

Yuan, Kai; Liu, Jian; Liu, Kaipei; Tan, Tianyuan

2015-01-01

Background Evaluations of electric power distribution network risks must address the problems of incomplete information and changing dynamics. A risk evaluation framework should be adaptable to a specific situation and an evolving understanding of risk. Methods This study investigates the use of symbolic dynamics to abstract raw data. After introducing symbolic dynamics operators, Kolmogorov-Sinai entropy and Kullback-Leibler relative entropy are used to quantitatively evaluate relationships between risk sub-factors and main factors. For layered risk indicators, where the factors are categorized into four main factors – device, structure, load and special operation – a merging algorithm using operators to calculate the risk factors is discussed. Finally, an example from the Sanya Power Company is given to demonstrate the feasibility of the proposed method. Conclusion Distribution networks are exposed and can be affected by many things. The topology and the operating mode of a distribution network are dynamic, so the faults and their consequences are probabilistic. PMID:25789859

Risk assessment analysis of the future technical unit dedicated to the evaluation and treatment of motor disabilities.

Science.gov (United States)

Grelier, S; Thetio, M; Quentin, V; Achache, V; Sanchez, N; Leroux, V; Durand, E; Pequignot, R

2011-03-01

The National Hospital of Saint Maurice (HNSM) for Physical Medicine and Rehabilitation aims at strengthening its position as a pivot rehabilitation and physical therapy center. The opening in 2011 of a new unit for the evaluation and treatment of motor disabilities meets this objective. This project includes several parts: clinical, financial, architectural, organizational, applied clinical research as well as dealing with medical equipments and information system. This study focuses on the risk assessment of this future technical unit. This study was conducted by a group of professionals working for the hospital. It started with the design of a functional model to better comprehend the system to be analyzed. Risk assessment consists in confronting this functional model to a list of dangers in order to determine the vulnerable areas of the system. Then the team designed some scenarios to identify the causes, securities barriers and consequences in order to rank the risks. The analysis targeted various dangers, e.g. political, strategic, financial, economical, marketing, clinical and operational. The team identified more than 70 risky scenarios. For 75% of them the criticality level was deemed initially tolerable and under control or unacceptable. The implementation of an action plan for reducing the level of risks before opening this technical unit brought the system down to an acceptable level at 66%. A year prior to opening this technical unit for the evaluation and treatment of motor disabilities, conducting this preliminary risk assessment, with its exhaustive and rigorous methodology, enabled the concerned professionals to work together around an action plan for reducing the risks. 2011 Elsevier Masson SAS. All rights reserved.

A guide to understanding and implementing risk evaluation and mitigation strategies in organ transplantation.

Science.gov (United States)

Gabardi, Steven; Tichy, Eric M

2013-03-01

To review the components of the Congressional mandate for risk evaluation and mitigation strategies (REMS) managed by the Food and Drug Administration and assess their impact on health care providers practicing within the organ transplant arena. A non-date-limited search of MEDLINE and EMBASE (January 2007-June 2012) was conducted by using the following search terms: risk evaluation and mitigation strategies, REMS, and organ transplant, including a query of the individual organs. Information from the Federal Register and the Food and Drug Administration was also evaluated. REMS are strategies implemented to manage known or potential risks associated with medications and to ensure ongoing pharmacovigilance throughout the life of a pharmaceutical product. Elements of REMS programs may consist of 3 levels: a medication guide, communication plan, and elements to assure safe use. A medication guide is used to help prevent serious adverse events, aid in patients' decision making, and enhance medication adherence. Communication plans help educate health care providers and encourage adherence with REMS. The elements to assure safe use is a restrictive process implemented when it is deemed necessary to ensure safe access for patients to products with known serious risks. In transplant medicine, REMS currently exist for belatacept (medication guide and communication plan) and the mycophenolic acid derivatives (medication guide and elements to assure safe use). REMS are another step in the evolution of the development and marketing of pharmaceutical agents. Use of REMS in solid-organ transplant is becoming common. Transplant clinicians must provide required patient education and become involved with other aspects of REMS implementation to reduce the serious risks of pharmaceuticals and to improve patients' outcomes.

Environmental risk evaluation to minimize impacts within the area affected by the Wenchuan earthquake

International Nuclear Information System (INIS)

Du, Pengfei; Chen, Jining; Chen, Chao; Liu, Yi; Liu, Jianguo; Wang, Hongtao; Zhang, Xiaojian

2012-01-01

Earthquakes can be devastating to built infrastructure and the natural environment, as evidenced by the March 2011, M = 9.0 earthquake, and subsequent tsunami, in Japan. As seen in the Japanese event, environmental damage caused by secondary disasters (tsunami, leakage from a nuclear reactor) can equal or exceed the impacts of the primary event. In order to develop an environmental assessment system to examine secondary disasters, a comprehensive environmental impact evaluation was conducted after the Wenchuan earthquake that occurred on 12 May 2008 in the Sichuan Province, China. This evaluation focused on several key environmental elements such as wastewater, drinking water, soil, solid waste, radiation, and ecosystem-level effects. As part of this assessment, an analysis of root causes and potential solutions was conducted for key issues such as population relocation and resettlement in temporary dwellings, recovery of environmental protection functions, industrial development strategies and production recovery. Methods for post-quake environmental assessment were developed, utilizing GIS-based techniques for spatial evaluation of primary and secondary disaster patterns. The goal of this exercise was the development of effective assessment methods that can be rapidly applied in a post-disaster situation to reduce and mitigate damage caused by secondary disasters, and facilitate the recovery of impaired environmental management structure and function. - Highlights: ► A comprehensive post-quake environmental risk evaluation system was developed. ► The research identifies potential long-term environmental risks in many aspects. ► The research analyzes potential solutions for many typical post-disaster issues. ► Effective assessment methods can be applied in a post-disaster situation to reduce damage caused by secondary disasters.

Environmental risk evaluation to minimize impacts within the area affected by the Wenchuan earthquake

Energy Technology Data Exchange (ETDEWEB)

Du, Pengfei, E-mail: dupf@tsinghua.edu.cn; Chen, Jining, E-mail: jchen1@tsinghua.edu.cn; Chen, Chao, E-mail: chen_water@tsinghua.edu.cn; Liu, Yi, E-mail: yi.liu@tsinghua.edu.cn; Liu, Jianguo, E-mail: jgliu@tsinghua.edu.cn; Wang, Hongtao, E-mail: htwang@tsinghua.edu.cn; Zhang, Xiaojian, E-mail: zhangxj@tsinghua.edu.cn

2012-03-01

Earthquakes can be devastating to built infrastructure and the natural environment, as evidenced by the March 2011, M = 9.0 earthquake, and subsequent tsunami, in Japan. As seen in the Japanese event, environmental damage caused by secondary disasters (tsunami, leakage from a nuclear reactor) can equal or exceed the impacts of the primary event. In order to develop an environmental assessment system to examine secondary disasters, a comprehensive environmental impact evaluation was conducted after the Wenchuan earthquake that occurred on 12 May 2008 in the Sichuan Province, China. This evaluation focused on several key environmental elements such as wastewater, drinking water, soil, solid waste, radiation, and ecosystem-level effects. As part of this assessment, an analysis of root causes and potential solutions was conducted for key issues such as population relocation and resettlement in temporary dwellings, recovery of environmental protection functions, industrial development strategies and production recovery. Methods for post-quake environmental assessment were developed, utilizing GIS-based techniques for spatial evaluation of primary and secondary disaster patterns. The goal of this exercise was the development of effective assessment methods that can be rapidly applied in a post-disaster situation to reduce and mitigate damage caused by secondary disasters, and facilitate the recovery of impaired environmental management structure and function. - Highlights: Black-Right-Pointing-Pointer A comprehensive post-quake environmental risk evaluation system was developed. Black-Right-Pointing-Pointer The research identifies potential long-term environmental risks in many aspects. Black-Right-Pointing-Pointer The research analyzes potential solutions for many typical post-disaster issues. Black-Right-Pointing-Pointer Effective assessment methods can be applied in a post-disaster situation to reduce damage caused by secondary disasters.

Streaming weekly soap opera video episodes to smartphones in a randomized controlled trial to reduce HIV risk in young urban African American/black women.

Science.gov (United States)

Jones, Rachel; Lacroix, Lorraine J

2012-07-01

Love, Sex, and Choices is a 12-episode soap opera video series created as an intervention to reduce HIV sex risk. The effect on women's HIV risk behavior was evaluated in a randomized controlled trial in 238 high risk, predominately African American young adult women in the urban Northeast. To facilitate on-demand access and privacy, the episodes were streamed to study-provided smartphones. Here, we discuss the development of a mobile platform to deliver the 12-weekly video episodes or weekly HIV risk reduction written messages to smartphones, including; the technical requirements, development, and evaluation. Popularity of the smartphone and use of the Internet for multimedia offer a new channel to address health disparities in traditionally underserved populations. This is the first study to report on streaming a serialized video-based intervention to a smartphone. The approach described here may provide useful insights in assessing advantages and disadvantages of smartphones to implement a video-based intervention.

Reducing drug–herb interaction risk with a computerized reminder system

Science.gov (United States)

Lin, Sheng-Shing; Tsai, Chiu-Lin; Tu, Ching-Yeh; Hsieh, Ching-Liang

2015-01-01

Background Traditional Chinese medicine (TCM) and Western medicine are both popular in Taiwan. Approximately 14.1% of Taiwanese residents use Western drugs and Chinese herbs concurrently; therefore, drug–herb interaction is critical to patient safety. This paper presents a new procedure for reducing the risk of drug interactions. Methods Hospital computer systems are modified to ensure that drug–herb interactions are automatically detected when a TCM practitioner is writing a prescription. A pop-up reminder appears, warning of interactions, and the practitioner may adjust doses, delete herbs, or leave the prescription unchanged. A pharmacist will receive interaction information through the system and provide health education to the patient. Results During the 2011–2013 study period, 256 patients received 891 herbal prescriptions with potential drug–herb interactions. Three of the 50 patients who concurrently used ginseng and antidiabetic drugs manifested hypoglycemia (fasting blood sugar level ≤70 mg/dL). Conclusion Drug–herb interactions can cause adverse reactions. A computerized reminder system can enable TCM practitioners to reduce the risk of drug–herb interactions. In addition, health education for patients is crucial in avoiding adverse reaction by the interactions. PMID:25733840

JCL roundtable: Risk evaluation and mitigation strategy.

Science.gov (United States)

Brown, W Virgil; Bramlet, Dean A; Ross, Joyce L; Underberg, James A

Many factors enter into the decision by the Food and Drug Administration (FDA) to approve a new drug for use by physicians and other health care providers in treating diseases. Initially, the FDA authority was restricted to issues of safety and only later did the documentation of efficacy become part of the review process required for approval. However, all drugs have the potential for causing harm at some dose level to all and at lower doses in certain patients with vulnerability to the particular pharmacology of the agent. As new drugs have been designed to manage disorders that are uncommon, but of significant consequence, they may have adverse effects that are acceptable only because they are so uniquely beneficial to these specific conditions. The risk of these adverse effects may be acceptable since the benefit can outweigh the harm in most patients and the adversity can be predicted and managed. The approval of this category of drugs has grown rapidly since definition of a mechanism of action to manage and modify the risk has been provided by a process known as known as Risk Evaluation and Mitigation Strategy or "REMS." In 2007, the Food and Drug Administration Amendments Act (FDAAA) allowed the FDA to require postmarketing studies and the authority to mandate the implementation of a REMS for drugs with efficacy but documented potential for harm. Two relatively new drugs useful in the management of severe elevations of low-density lipoprotein cholesterol have been approved under a requirement for a REMS. These are lomitapide, an inhibitor of microsomal triglyceride transfer protein and mipomersen, an antisense oligonucleotide which reduces the synthesis of apolipoprotein B. Copyright © 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Evaluation of AECB-1119, risk of energy production

International Nuclear Information System (INIS)

1978-01-01

The Inhaber report, 'Risk of Energy Production', is evaluated based on how the conclusions of the report match its objectives, the methodology used to reach the report's conclusions, and the presentation of the report. The authors recommend that a second volume containing the pertinent data used in the report should be published; and that total risks should be calculated ignoring material acquisition, construction and transportation risks, using the actual energy output of the various systems without imposing a backup energy supply, and comparing systems in such a way that death, injury and disease risks may be considered separately. They propose that the Atomic Energy Control Board should show how the report results relate to nuclear safety, and that the AECB should clarify the criteria for evaluating the small probability of a catastrophic nuclear accident. The response of the author of AECB--1119 is given in a separate section

7 CFR 319.59-3 - Articles prohibited importation pending risk evaluation.

Science.gov (United States)

2010-01-01

... 7 Agriculture 5 2010-01-01 2010-01-01 false Articles prohibited importation pending risk... Diseases § 319.59-3 Articles prohibited importation pending risk evaluation. The articles listed in...(b), pending the completion of an evaluation by APHIS of the potential pest risks associated with the...

Computerized counseling reduces HIV-1 viral load and sexual transmission risk: findings from a randomized controlled trial.

Science.gov (United States)

Kurth, Ann E; Spielberg, Freya; Cleland, Charles M; Lambdin, Barrot; Bangsberg, David R; Frick, Pamela A; Severynen, Anneleen O; Clausen, Marc; Norman, Robert G; Lockhart, David; Simoni, Jane M; Holmes, King K

2014-04-15

Evaluate a computerized intervention supporting antiretroviral therapy (ART) adherence and HIV transmission prevention. Longitudinal randomized controlled trial. An academic HIV clinic and a community-based organization in Seattle. In a total of 240 HIV-positive adults on ART, 209 completed 9-month follow-up (87% retention). Randomization to computerized counseling or assessment only, 4 sessions over 9 months. HIV-1 viral suppression, and self-reported ART adherence and transmission risks, compared using generalized estimating equations. Overall, intervention participants had reduced viral load: mean 0.17 log10 decline, versus 0.13 increase in controls, P = 0.053, and significant difference in ART adherence baseline to 9 months (P = 0.046). Their sexual transmission risk behaviors decreased (odds ratio = 0.55, P = 0.020), a reduction not seen among controls (odds ratio = 1.1, P = 0.664), and a significant difference in change (P = 0.040). Intervention effect was driven by those most in need; among those with detectable virus at baseline (>30 copies/mL, n = 89), intervention effect was mean 0.60 log10 viral load decline versus 0.15 increase in controls, P = 0.034. ART adherence at the final follow-up was 13 points higher among intervention participants versus controls, P = 0.038. Computerized counseling is promising for integrated ART adherence and safer sex, especially for individuals with problems in these areas. This is the first intervention to report improved ART adherence, viral suppression, and reduced secondary sexual transmission risk behavior.

Risk analysis and evaluation of agricultural drought disaster in the major grain-producing areas, China

Directory of Open Access Journals (Sweden)

Zongtang Xie

2016-09-01

Full Text Available The analysis and evaluation of agricultural drought risk can assist in reducing regional disasters and agricultural drought losses. Because of the uncertainties and incomplete agricultural drought information, this paper employed an information diffusion technology and information matrix to identify a drought disaster risk distribution and to quantify the relationship between the annual drought-affected rate and the grain production losses in China's major grain-producing areas. From the assessment results, provincial drought disaster risk spatial distribution maps for each major grain-producing area in China were obtained. These risk patterns showed that the probability of drought fell when the annual drought-covered rate and the annual drought-affected rate increased, and that the high risk areas were located primarily in China's northern and central provinces. These results can provide the basis for the development of effective drought mitigation strategies which would be able to inform possible drought situations and allow for easier decision-making on drought resistance strategies. The fuzzy relationship between the annual drought-affected rate and the drought-caused grain production losses provides vital information for the development of disaster compensation plans. Furthermore, the results of this study indicated that the proposed methods had superior detection stability and higher precision. We hope that by conducting such agricultural drought risk analysis, the results are able to provide the basis for the development of drought mitigation strategies to reduce future losses.

RISK EVALUATION OF PIN JIG WORK UNIT IN SHIPBUILDING BY USING FUZZY AHP METHOD

Directory of Open Access Journals (Sweden)

Murat Ozkok

2015-03-01

Full Text Available Shipbuilding industry includes many different industry branches in itself so various kind of work accidents occur. These work accidents often cause serious injuries and also deaths. It is a crucial thing to prevent or minimize these accidents. In order to reduce work accidents in shipyards, the most hazardous activities are needed to be determined and then, shipyard management must work on it in order to remove these hazard sources. In this study, pin jig work unit, where the curved parts are mounted on adjustable pin jigs, was considered. At first, the work activities and operations of pin jig work station were identified and they were classified as main and sub risk criterions. Then, pair comparison scales were built and these risk criterions were evaluated by experts who have been working for a shipyard located in Turkey. As a result of the evaluations of the experts, the risk weights of the activities carried out at pin jig work unit were defined by using fuzzy AHP method. Therefore, it is aimed for the shipyard management to take some precautions at pinjig work unit on the risky operations before failures happen.

Risk assessment and remedial policy evaluation using predictive modeling

International Nuclear Information System (INIS)

Linkov, L.; Schell, W.R.

1996-01-01

As a result of nuclear industry operation and accidents, large areas of natural ecosystems have been contaminated by radionuclides and toxic metals. Extensive societal pressure has been exerted to decrease the radiation dose to the population and to the environment. Thus, in making abatement and remediation policy decisions, not only economic costs but also human and environmental risk assessments are desired. This paper introduces a general framework for risk assessment and remedial policy evaluation using predictive modeling. Ecological risk assessment requires evaluation of the radionuclide distribution in ecosystems. The FORESTPATH model is used for predicting the radionuclide fate in forest compartments after deposition as well as for evaluating the efficiency of remedial policies. Time of intervention and radionuclide deposition profile was predicted as being crucial for the remediation efficiency. Risk assessment conducted for a critical group of forest users in Belarus shows that consumption of forest products (berries and mushrooms) leads to about 0.004% risk of a fatal cancer annually. Cost-benefit analysis for forest cleanup suggests that complete removal of organic layer is too expensive for application in Belarus and a better methodology is required. In conclusion, FORESTPATH modeling framework could have wide applications in environmental remediation of radionuclides and toxic metals as well as in dose reconstruction and, risk-assessment

Artistic occupations are associated with a reduced risk of Parkinson's disease.

Science.gov (United States)

Haaxma, Charlotte A; Borm, George F; van der Linden, Dimitri; Kappelle, Arnoud C; Bloem, Bastiaan R

2015-09-01

Parkinson's disease (PD) is preceded by a premotor phase of unknown duration. Dopaminergic degeneration during this phase may lead to subtle cognitive and behavioural changes, such as decreased novelty seeking. Consequently, premotor subjects might be most comfortable in jobs that do not require optimal dopamine levels, leading to an overrepresentation in structured and predictable occupations, or an underrepresentation in artistic occupations. In a case-control study, 750 men with PD (onset ≥40 years) and 1300 healthy men completed a validated questionnaire about their lifetime occupational status. Occupations were classified using the RIASEC model. Odds ratios (ORs) were calculated for the conventional and artistic categories, both for the most recent occupation before symptom onset, and for the very first occupation. Because farming has been associated with a PD risk, ORs were calculated separately for farming. A reduced risk of PD was found for men with an artistic occupation late in life (OR 0.14, 95% CI 0.04-0.53), while an artistic first occupation did not prevent PD (OR 0.72, CI 0.32-1.59). Conventional occupations showed no increased risk (recent: OR 1.07, CI 0.70-1.64; first: OR 1.14, CI 0.77-1.71). In support of previous reports, farming was associated with an increased risk of PD (recent: OR 2.6, CI 1.4-4.6; first: OR 2.7, CI 1.6-4.5). PD patients were older than controls, but various statistical corrections for age all lead to similar results. Artistic occupations late in life are associated with a reduced risk of subsequent PD, perhaps because this reflects a better preserved dopaminergic state. No initial occupation predicted PD, suggesting that the premotor phase starts later in life.

Algorithm of actions to identify and reduce risks in the production of milk and plant products

Directory of Open Access Journals (Sweden)

L. E. Glagoleva

2016-01-01

Full Text Available Foods with a new generation of functional and improved consumer properties, corresponds to the modern concepts of nutrition science and consumer needs. functional food production is a major global trend in food science and the subject of innovation. One of the important trends is the use of plant complexes and plant food systems. Using the plant complexes (PC and plant food systems (PFS provides a number of benefits: improved consumer properties of the product, do not need to change the process, it is possible to control directional rheological properties and consistency of the finished products, reduced the number of risk points in the production cycle. This paper describes the development of an algorithm of action to identify and mitigate risks in the production of milk and plant products. Also conducted a risk analysis, identified and assessed the risks in the process of production, installed capacity of available resources to reduce the level of risk. Established and submitted to the critical control points in production processes, as well as the critical limits for each critical control points, and the procedure for corrective action in case of violations of the past. During the study, measured changes in the quantitative and qualitative composition of microflora of semi-finished and Quantity of Mesophilic Aerobic and Facultative Anaerobic Microorganisms (QMAFAnM. To determine QMAFAnM samples were taken: 1 – cheesecakes (control, 2 – cheesecakes with RPS. Microbiological studies analyzed frozen-conjugated semi-finished products was determined within 90 days. It is clear from the data that the cottage cheese with semi-finished products have a lower RPM 11.7%. Analyzing the data, it is possible to conclude that the physico-chemical, organoleptic and microbiological indicators of products was developed to set standards on cheese semi-finished products. multilevel structure that characterizes the quality indicators has been developed and is

A neural network model for credit risk evaluation.

Science.gov (United States)

Khashman, Adnan

2009-08-01

Credit scoring is one of the key analytical techniques in credit risk evaluation which has been an active research area in financial risk management. This paper presents a credit risk evaluation system that uses a neural network model based on the back propagation learning algorithm. We train and implement the neural network to decide whether to approve or reject a credit application, using seven learning schemes and real world credit applications from the Australian credit approval datasets. A comparison of the system performance under the different learning schemes is provided, furthermore, we compare the performance of two neural networks; with one and two hidden layers following the ideal learning scheme. Experimental results suggest that neural networks can be effectively used in automatic processing of credit applications.

Risk variables in evaluation of transport projects

Science.gov (United States)

Vařbuchta, Petr; Kovářová, Hana; Hromádka, Vít; Vítková, Eva

2017-09-01

Depending on the constantly increasing demands on assessment of investment projects, especially assessment of large-scale projects in transport and important European projects with wide impacts, there is constantly increasing focus on risk management, whether to find mitigations, creating corrective measures or their implementation in assessment, especially in the context of Cost-Benefit analysis. To project assessment is often used implementation of certain risk variables, which can generate negative impacts of project outputs in framework of assess. Especially in case of transportation infrastructure projects is taken much emphasis on the influence of risk variables. However, currently in case of assessment of transportation projects is in Czech Republic used a few risk variables, which occur in the most projects. This leads to certain limitation in framework of impact assessment of risk variables. This papers aims to specify a new risk variables and process of applying them to already executed project assessment. Based on changes generated by new risk variables will be evaluated differences between original and adapted assessment.

Reducing the Risk: Unemployed Migrant Youth and Labour Market Programs. Overview.

Science.gov (United States)

Australian Inst. of Multicultural Affairs, Melbourne (Australia).

This booklet is an overview and summary of the publication "Reducing the Risk: Unemployed Migrant Youth and Labour Market Programs" which reviews programs and services for migrant and refugee youth in Australia. The unemployment rate for this group is higher than for their Australian-born peers, and their participation in governmental…

Risk-based cost-benefit analysis for evaluating microbial risk mitigation in a drinking water system.

Science.gov (United States)

Bergion, Viktor; Lindhe, Andreas; Sokolova, Ekaterina; Rosén, Lars

2018-04-01

Waterborne outbreaks of gastrointestinal diseases can cause large costs to society. Risk management needs to be holistic and transparent in order to reduce these risks in an effective manner. Microbial risk mitigation measures in a drinking water system were investigated using a novel approach combining probabilistic risk assessment and cost-benefit analysis. Lake Vomb in Sweden was used to exemplify and illustrate the risk-based decision model. Four mitigation alternatives were compared, where the first three alternatives, A1-A3, represented connecting 25, 50 and 75%, respectively, of on-site wastewater treatment systems in the catchment to the municipal wastewater treatment plant. The fourth alternative, A4, represented installing a UV-disinfection unit in the drinking water treatment plant. Quantitative microbial risk assessment was used to estimate the positive health effects in terms of quality adjusted life years (QALYs), resulting from the four mitigation alternatives. The health benefits were monetised using a unit cost per QALY. For each mitigation alternative, the net present value of health and environmental benefits and investment, maintenance and running costs was calculated. The results showed that only A4 can reduce the risk (probability of infection) below the World Health Organization guidelines of 10 -4 infections per person per year (looking at the 95th percentile). Furthermore, all alternatives resulted in a negative net present value. However, the net present value would be positive (looking at the 50 th percentile using a 1% discount rate) if non-monetised benefits (e.g. increased property value divided evenly over the studied time horizon and reduced microbial risks posed to animals), estimated at 800-1200 SEK (€100-150) per connected on-site wastewater treatment system per year, were included. This risk-based decision model creates a robust and transparent decision support tool. It is flexible enough to be tailored and applied to local

From risk analysis to risk control in land transport of dangerous materials. Contribution of quantitative evaluation

International Nuclear Information System (INIS)

Hubert, Ph.; Pages, P.

1985-03-01

The different approaches of risks and risk management system are described: statistics, potential risk, prevention, information and intervention. Quantitative evaluation is developed: data collection, purposes and methods. Two examples of application are given on risks associated to road transport of propane and of uranium hexafluoride. In conclusion level of risk and practical use of studies on risks are examined. 41 refs [fr

D & D screening risk evaluation guidance

Energy Technology Data Exchange (ETDEWEB)

Robers, S.K.; Golden, K.M.; Wollert, D.A.

1995-09-01

The Screening Risk Evaluation (SRE) guidance document is a set of guidelines provided for the uniform implementation of SREs performed on decontamination and decommissioning (D&D) facilities. Although this method has been developed for D&D facilities, it can be used for transition (EM-60) facilities as well. The SRE guidance produces screening risk scores reflecting levels of risk through the use of risk ranking indices. Five types of possible risk are calculated from the SRE: current releases, worker exposures, future releases, physical hazards, and criticality. The Current Release Index (CRI) calculates the current risk to human health and the environment, exterior to the building, from ongoing or probable releases within a one-year time period. The Worker Exposure Index (WEI) calculates the current risk to workers, occupants and visitors inside contaminated D&D facilities due to contaminant exposure. The Future Release Index (FRI) calculates the hypothetical risk of future releases of contaminants, after one year, to human health and the environment. The Physical Hazards Index (PHI) calculates the risks to human health due to factors other than that of contaminants. Criticality is approached as a modifying factor to the entire SRE, due to the fact that criticality issues are strictly regulated under DOE. Screening risk results will be tabulated in matrix form, and Total Risk will be calculated (weighted equation) to produce a score on which to base early action recommendations. Other recommendations from the screening risk scores will be made based either on individual index scores or from reweighted Total Risk calculations. All recommendations based on the SRE will be made based on a combination of screening risk scores, decision drivers, and other considerations, as determined on a project-by-project basis.

Does chocolate intake during pregnancy reduce the risks of preeclampsia and gestational hypertension?

Science.gov (United States)

Saftlas, Audrey F; Triche, Elizabeth W; Beydoun, Hind; Bracken, Michael B

2010-08-01

Chocolate consumption is associated with favorable levels of blood pressure and other cardiovascular disease risk markers. We analyzed a prospective cohort study to determine whether regular chocolate intake during pregnancy is associated with reduced risks of preeclampsia and gestational hypertension (GH). Subjects were recruited from 13 prenatal care practices in Connecticut (1988-1991). In-person interviews were administered at Chocolate consumption (servings/week) during the first and third trimesters was ascertained at initial interview and immediately postpartum, respectively. Consumers of less than 1 serving/week comprised the referent group. Adjusted odds ratios (aORs) were estimated by the use of logistic regression. Chocolate intake was more frequent among normotensive (80.7%) than preeclamptic (62.5%) or GH women (75.8%), and associated with reduced odds of preeclampsia (first trimester: aOR, 0.55; 95% confidence interval [95% CI], 0.32-0.95; third trimester: aOR, 0.56; 95% CI, 0.32-0.97). Only first trimester intake was associated with reduced odds of GH (aOR,0.65; 95% CI, 0.45-0.87). These findings provide additional evidence of the benefits of chocolate. Prospective studies are needed to confirm and delineate protective effects of chocolate intake on risk of preeclampsia. 2010 Elsevier Inc. All rights reserved.

Credit Risk Evaluation of Swedish SMEs : A Banking Sector Perspective

OpenAIRE

Hörstedt, Maria; Linjamaa, Johanna

2015-01-01

As a result from the latest financial crisis, the banking industry has undergone major modifications during the last years in order to limit banks’ risks. A vast majority of existing literature tends to focus upon credit risk evaluation methods and techniques mainly concerning quantitative measures and large companies. Thus, the lack of research regarding credit risk evaluation of SMEs is profound, especially considering Sweden. With the dominant market share of SMEs compared to large corpora...

Societal risk approach to safeguards design and evaluation

International Nuclear Information System (INIS)

Murphey, W.M.; Sherr, T.S.; Bennett, C.A.

1975-01-01

A comprehensive rationale for safeguards design and evaluation, and a framework for continuing systematic assessment of the system's effectiveness and efficient allocation of available safeguards resources for balanced protection, were developed. The societal risk approach employed considers the likelihood of successful destructive acts involving nuclear materials or facilities and the magnitude of the effects on society. The safeguards problem is described in terms of events affecting societal risk and adversary actions. Structure of the safeguards system and the evaluation of its adequacy are discussed. Adversary characteristics are also discussed

The use of current risk analysis tools evaluated towards preventing external domino accidents

NARCIS (Netherlands)

Reniers, Genserik L L; Dullaert, W.; Ale, B. J.M.; Soudan, K.

Risk analysis is an essential tool for company safety policy. Risk analysis consists of identifying and evaluating all possible risks. The efficiency of risk analysis tools depends on the rigueur of identifying and evaluating all possible risks. The diversity in risk analysis procedures is such that

A study of risk evaluation methodology selection for the external hazards

International Nuclear Information System (INIS)

Kuramoto, Takahiro; Yamaguchi, Akira; Narumiya, Yosiyuki

2014-01-01

Since the accident at Fukushima Daiichi Nuclear Power Plant caused by the Great East Japan Earthquake in March 2011, there has been growing demands for assessing the effects of external hazards, including natural events, such as earthquake and tsunami, and external human behaviors, and taking actions to address those external hazards. The newly established Japanese regulatory requirements claim design considerations associated with external hazards. The primary objective of the risk assessment for external hazards is to establish countermeasures against such hazards rather than grasping the risk figures. Therefore, applying detailed risk assessment methods, such as probabilistic risk assessment (PRA), to all the external hazards is not always the most appropriate. Risk assessment methods can vary in types including qualitative evaluation, hazard analysis (analyzing hazard frequencies or their influence), and margin assessment. To resolve these issues, a process has been established that enables us to identify the external hazards in a comprehensive and systematic manner, which have potential risks leading to core damage and to select an appropriate evaluation method according to the risks associated with each of the external hazards. This paper discusses the comprehensive and systematic identification process for the external hazards which have potential risks leading to core damage, and the approaches of selecting an appropriate evaluation method for each external hazard. This paper also describes some applications of specific risk evaluation methods. (author)

Perceptions of Risk of Developing Skin Cancer for Diverse Audiences: Enhancing Relevance of Sun Protection to Reduce the Risk

OpenAIRE

Robinson, June K.; Friedewald, John; Gordon, Elisa J.

2016-01-01

Sixty-five percent of kidney transplant recipients (KTRs) develop squamous cell carcinoma (SCC). Perceptions of risk of developing skin cancer, amelioration of this risk with sun protection, and having choices among sun protection strategies may enhance sun protection use by KTRS, who are at greater risk than the general population. Thirty KTRs stratified among non-Hispanic Whites, non-Hispanic Blacks, and Hispanic/Latinos evaluated three versions of the interactive, web-based, electronic sun...

HiRITER - An evaluation tool to reduce the adverse effect of inappropriate human actions in nuclear power plants

International Nuclear Information System (INIS)

Park, J.; Jung, W.; Kim, J.; Kim, S.; Heo, G.

2012-01-01

From end-users to regulatory bodies, it is widely recognized that human-induced events including inappropriate human actions are one of the most crucial sources degrading the overall safety of nuclear power plants (NPPs). This means that a systematic framework through which inappropriate human actions can be effectively identified is necessary to enhance the safety of NPPs. For this reason, HiRITER (High Risk Inducible Task Evaluator) has been developed, which is able to evaluate the effect of inappropriate human actions on risk as well as performance. To this end, HiRITER integrates three modules that have distinctive roles: human error prediction module that is able to determine the types of failure modes resulting from inappropriate human actions with the associated daily task, performance evaluation module that computes the loss of electric power due to the change of component configurations caused by human error and risk evaluation module that clarifies whether or not the propagation of human error can trigger an unexpected shutdown of NPPs. In addition, a couple of real events that had occurred in domestic NPPs are simulated in order to validate the feasibility of HiRITER. As a result, it is observed that the results of HiRITER are largely congruent with those of real events. Therefore, although a huge amount of additional effort is indispensable to enhance the overall accuracy of estimated results, it is expected that HiRITER could be a good starting point to reduce the adverse effect of inappropriate human actions in NPPs

Prometheus unbound - challenges of risk evaluation, risk classification, and risk management

Energy Technology Data Exchange (ETDEWEB)

Klinke, A.; Renn, O.

1999-11-01

For dealing with risks in a rational fashion, it is necessary to characterize risks and use the parameters of characterization as tools for designing appropriate actions. This reports suggests a set of criteria that one can use in evaluating risks. These criteria include: - Damage potential, i.e. the amount of damage that the hazard can cause; - probability of occurrence, i.e. the likelihood that a specific damage will occur; - incertitude, i.e., the remaining uncertainties that are not covered by the assessment of probabilities (subdivided in statistical uncertainties, genuine uncertainty, and ignorance); - ubiquity which defines the geographic dispersion of potential damages (intragenerational justice); - persistency which defines the temporal extension of potential damages (intergenerational justice); - irreversibility which describes the impossible restoration of the situation to the state before the damage occurred (possible restoration are e.g. reforestation and cleaning of water); - delay effects which characterize the time of latency between the initial event and the actual impact of damage. The time of latency could be of physical, chemical or biological nature; and - potential of mobilization which is understood as violation of individual, social or cultural interests and values generating social conflicts and psychological reactions by affected people. (orig.)

Evaluation of risk scores for risk stratification of acute coronary syndromes in the Myocardial Infarction National Audit Project (MINAP) database.

Science.gov (United States)

Gale, C P; Manda, S O M; Weston, C F; Birkhead, J S; Batin, P D; Hall, A S

2009-03-01

To compare the discriminative performance of the PURSUIT, GUSTO-1, GRACE, SRI and EMMACE risk models, assess their performance among risk supergroups and evaluate the EMMACE risk model over the wider spectrum of acute coronary syndrome (ACS). Observational study of a national registry. All acute hospitals in England and Wales. 100 686 cases of ACS between 2003 and 2005. Model performance (C-index) in predicting the likelihood of death over the time period for which they were designed. The C-index, or area under the receiver-operating curve, range 0-1, is a measure of the discriminative performance of a model. The C-indexes were: PURSUIT C-index 0.79 (95% confidence interval 0.78 to 0.80); GUSTO-1 0.80 (0.79 to 0.81); GRACE in-hospital 0.80 (0.80 to 0.81); GRACE 6-month 0.80 (0.79 to 0.80); SRI 0.79 (0.78 to 0.80); and EMMACE 0.78 (0.77 to 0.78). EMMACE maintained its ability to discriminate 30-day mortality throughout different ACS diagnoses. Recalibration of the model offered no notable improvement in performance over the original risk equation. For all models the discriminative performance was reduced in patients with diabetes, chronic renal failure or angina. The five ACS risk models maintained their discriminative performance in a large unselected English and Welsh ACS population, but performed less well in higher-risk supergroups. Simpler risk models had comparable performance to more complex risk models. The EMMACE risk score performed well across the wider spectrum of ACS diagnoses.

Evaluating the risk of osteoporosis through bone mass density

International Nuclear Information System (INIS)

Sayed, S.A.; Khaliq, A.

2017-01-01

Osteoporosis is a bone disorder, characterized by loss of bone mass density. Osteoporosis affects more than 30 percent of post-menopausal women. Osteoporosis is often associated with restricted body movement, pain and joint deformities. Early identification and early intervention can help in reducing these complications. The primary objective of this study was to estimate the burden of Osteoporosis in Urban setting of Sindh among women of different age groups and to access the effect of different protective measures that can reduce the risk of Osteoporosis. Method: In this study, 500 women's of 3 major cities of Sindh were approached by non-probability convenience sampling technique. Women bearing age 20 years or more were included. Women who fall under inclusion criteria were screened for BMD (Bone mineral density) test and were classified as Healthy, Osteopenic and Osteoporotic based on their T-score. The association of different protective measures and risk of osteoporosis was assessed by prevalence relative risk (PRR). Result: The result of this study indicate that the burden of Osteoporosis is very high among the women of Sindh, only 17.4 percent (84) women were found to have normal BMD score. The life style of majority of women was sedentary. The PRR calculated for Exposure to sunlight, regular exercise, and use of nutritional supplement was 12.5, 5.19 and 2.72 folds respectively. Conclusion: The results of study reveal that exposure to sunlight, regular physical exercise and use of nutritional supplements found to be effective in reducing the risk of osteoporosis among women of all age group. Health education and promotion toward osteoporosis prevention can significantly contribute in reducing the morbidity of osteoporosis. (author)

Evaluating The Risk Of Osteoporosis Through Bone Mass Density.

Science.gov (United States)

Sayed, Sayeeda Amber; Khaliq, Asif; Mahmood, Ashar

2016-01-01

Osteoporosis is a bone disorder, characterized by loss of bone mass density. Osteoporosis affects more than 30% of post-menopausal women. Osteoporosis is often associated with restricted body movement, pain and joint deformities. Early identification and early intervention can help in reducing these complications. The primary objective of this study was to estimate the burden of Osteoporosis in Urban setting of Sindh among women of different age groups and to access the effect of different protective measures that can reduce the risk of Osteoporosis. In this study, 500 women's of 3 major cities of Sindh were approached by non-probability convenience sampling technique. Women bearing age 20 years or more were included. Women who fall under inclusion criteria were screened for BMD (Bone mineral density) test and were classified as Healthy, Osteopenic and Osteoporotic based on their T-score. The association of different protective measures and risk of osteoporosis was assessed by prevalence relative risk (PRR). The result of this study indicate that the burden of Osteoporosis is very high among the women of Sindh, only 17.4% (84) women were found to have normal BMD score. The life style of majority of women was sedentary. The PRR calculated for Exposure to sunlight, regular exercise, and use of nutritional supplement was 12.5, 5.19 and 2.72 folds respectively. The results of study reveal that exposure to sunlight, regular physical exercise and use of nutritional supplements found to be effective in reducing the risk of osteoporosis among women of all age group. Health education and promotion toward osteoporosis prevention can significantly contribute in reducing the morbidity of osteoporosis.

Proposal of a risk-factor-based analytical approach for integrating occupational health and safety into project risk evaluation.

Science.gov (United States)

Badri, Adel; Nadeau, Sylvie; Gbodossou, André

2012-09-01

Excluding occupational health and safety (OHS) from project management is no longer acceptable. Numerous industrial accidents have exposed the ineffectiveness of conventional risk evaluation methods as well as negligence of risk factors having major impact on the health and safety of workers and nearby residents. Lack of reliable and complete evaluations from the beginning of a project generates bad decisions that could end up threatening the very existence of an organization. This article supports a systematic approach to the evaluation of OHS risks and proposes a new procedure based on the number of risk factors identified and their relative significance. A new concept called risk factor concentration along with weighting of risk factor categories as contributors to undesirable events are used in the analytical hierarchy process multi-criteria comparison model with Expert Choice(©) software. A case study is used to illustrate the various steps of the risk evaluation approach and the quick and simple integration of OHS at an early stage of a project. The approach allows continual reassessment of criteria over the course of the project or when new data are acquired. It was thus possible to differentiate the OHS risks from the risk of drop in quality in the case of the factory expansion project. Copyright © 2011 Elsevier Ltd. All rights reserved.

Reducing the risk of cyber threats in utilities through log management

Energy Technology Data Exchange (ETDEWEB)

Patnaik, A. [ArcSight, Cupertino, CA (United States)

2010-01-15

Electrical blackouts caused by terrorists hacking into targeted control systems have already occurred in Brazil. A patchwork of security tools is needed to reduce potential threats. The continuous collection and analysis of data is also needed to detect cyber threats. The real time correlation of logs across all systems, applications and users is needed to ensure the reliability and security of the power grid. Solutions must also integrate well with identity management sources in order to prevent remote access account hijacking. Effective log management can be used to detect threats and reduce the risk of power outages. 1 fig.

Balance training reduces falls risk in older individuals with type 2 diabetes.

Science.gov (United States)

Morrison, Steven; Colberg, Sheri R; Mariano, Mira; Parson, Henri K; Vinik, Arthur I

2010-04-01

This study assessed the effects of balance/strength training on falls risk and posture in older individuals with type 2 diabetes. Sixteen individuals with type 2 diabetes and 21 age-matched control subjects (aged 50-75 years) participated. Postural stability and falls risk was assessed before and after a 6-week exercise program. Diabetic individuals had significantly higher falls risk score compared with control subjects. The diabetic group also exhibited evidence of mild-to-moderate neuropathy, slower reaction times, and increased postural sway. Following exercise, the diabetic group showed significant improvements in leg strength, faster reaction times, decreased sway, and, consequently, reduced falls risk. Older individuals with diabetes had impaired balance, slower reactions, and consequently a higher falls risk than age-matched control subjects. However, all these variables improved after resistance/balance training. Together these results demonstrate that structured exercise has wide-spread positive effects on physiological function for older individuals with type 2 diabetes.

Communicating radon risk effectively: a mid-course evaluation. Interim report

International Nuclear Information System (INIS)

Smith, V.K.; Desvousges, W.H.; Fisher, A.; Johnson, F.R.

1987-07-01

A panel of 2300 homeowners was divided into subgroups to test the effectiveness of six alternative ways of explaining the risk from naturally occurring radon gas. The research design focused on two dimensions: qualitative vs. quantitative and directive vs. evaluative. These characteristics led to 4 experimental booklets, which were compared with EPA's Citizen's Guide and a one-page fact sheet. The evaluation examined how much people learned about radon; whether they could form risk perceptions consistent with their home's measured radon level; and whether they felt they had enough information to make a decision about mitigation. The fact sheet did not perform well on any of these evaluation criteria. None of the five booklets clearly was best for all 3 evaluation criteria; the report discusses the implications for designing an effective radon-risk communication program

Evaluation Method of Collision Risk by Using True Motion

Directory of Open Access Journals (Sweden)

Hayama Imazu

2017-03-01

Full Text Available It is necessary to develop a useful application to use big data like as AIS for safety and efficiency of ship operation. AIS is very useful system to collect targets information, but this information is not effective use yet. The evaluation method of collision risk is one of the cause disturb. Usually the collision risk of ship is evaluated by the value of the Closest Point of Approach (CPA which is related to a relative motion. So, it becomes difficult to find out a safety pass in a congested water. Here, Line of Predicted Collision (LOPC and Obstacle Zone by Target (OZT for evaluation of collision risk are introduced, these values are related to a true motion and it became visible of dangerous place, so it will make easy to find out a safety pass in a congested water.

A computer-assisted motivational social network intervention to reduce alcohol, drug and HIV risk behaviors among Housing First residents.

Science.gov (United States)

Kennedy, David P; Hunter, Sarah B; Chan Osilla, Karen; Maksabedian, Ervant; Golinelli, Daniela; Tucker, Joan S

2016-03-15

Individuals transitioning from homelessness to housing face challenges to reducing alcohol, drug and HIV risk behaviors. To aid in this transition, this study developed and will test a computer-assisted intervention that delivers personalized social network feedback by an intervention facilitator trained in motivational interviewing (MI). The intervention goal is to enhance motivation to reduce high risk alcohol and other drug (AOD) use and reduce HIV risk behaviors. In this Stage 1b pilot trial, 60 individuals that are transitioning from homelessness to housing will be randomly assigned to the intervention or control condition. The intervention condition consists of four biweekly social network sessions conducted using MI. AOD use and HIV risk behaviors will be monitored prior to and immediately following the intervention and compared to control participants' behaviors to explore whether the intervention was associated with any systematic changes in AOD use or HIV risk behaviors. Social network health interventions are an innovative approach for reducing future AOD use and HIV risk problems, but little is known about their feasibility, acceptability, and efficacy. The current study develops and pilot-tests a computer-assisted intervention that incorporates social network visualizations and MI techniques to reduce high risk AOD use and HIV behaviors among the formerly homeless. CLINICALTRIALS. NCT02140359.

Applied decision analysis and risk evaluation

International Nuclear Information System (INIS)

Ferse, W.; Kruber, S.

1995-01-01

During 1994 the workgroup 'Applied Decision Analysis and Risk Evaluation; continued the work on the knowledge based decision support system XUMA-GEFA for the evaluation of the hazard potential of contaminated sites. Additionally a new research direction was started which aims at the support of a later stage of the treatment of contaminated sites: The clean-up decision. For the support of decisions arising at this stage, the methods of decision analysis will be used. Computational aids for evaluation and decision support were implemented and a case study at a waste disposal site in Saxony which turns out to be a danger for the surrounding groundwater ressource was initiated. (orig.)

Reduced breath condensate pH in asymptomatic children with prior wheezing as a risk factor for asthma.

Science.gov (United States)

von Jagwitz, Marie; Pessler, Frank; Akmatov, Manas; Li, Jialiang; Range, Ursula; Vogelberg, Christian

2011-07-01

Early noninvasive detection of increased risk of asthma with exhaled breath condensate (EBC) pH measurement has not been applied to preschool children. We sought to evaluate the ability of EBC pH measurement to identify young asymptomatic children at risk of asthma using the combination of recurrent wheezing and atopic sensitization as a proxy for a high risk of asthma. pH values were measured in deaerated EBC from 191 children (median age, 4.4 years [interquartile range, 2.2 years]). Children were divided into one of 5 groups: asymptomatic children with recurrent wheezy bronchitis with (group 1, n = 34) or without (group 2, n = 64) allergic sensitization, acute wheezy bronchitis (group 3, n = 18), allergic rhinoconjunctivitis without recurrent wheezy bronchitis (group 4, n = 15), and healthy control subjects (group 5, n = 60). The Asthma Predictive Index score was calculated for groups 1 and 2. Statistical significance was evaluated with the appropriate nonparametric tests, and the discriminatory accuracy was evaluated with receiver operating characteristic analysis. Deaerated EBC pH values were significantly lower in groups 1 and 3 than in groups 2, 4, and 5 (median, 7.49 [interquartile range, 0.94] and 7.44 [interquartile range, 0.70] vs 7.93 [interquartile range, 0.23], 8.02 [interquartile range, 0.17], and 7.96 [interquartile range, 0.25], respectively; P < .001 and area under the receiver operating characteristic curve ≥0.80 in all comparisons). The area under the curve for the differentiation between groups 1 and 2 improved from 0.80 to 0.94 (sensitivity, 0.94; specificity, 0.84; positive predictive value, 0.76) when breath condensate pH values and Asthma Predictive Index scores were combined. A reduced deaerated EBC pH value might help identify young asymptomatic children at high risk of asthma. Copyright © 2011 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Evaluating the risks of clinical research: direct comparative analysis.

Science.gov (United States)

Rid, Annette; Abdoler, Emily; Roberson-Nay, Roxann; Pine, Daniel S; Wendler, David

2014-09-01

Many guidelines and regulations allow children and adolescents to be enrolled in research without the prospect of clinical benefit when it poses minimal risk. However, few systematic methods exist to determine when research risks are minimal. This situation has led to significant variation in minimal risk judgments, raising concern that some children are not being adequately protected. To address this concern, we describe a new method for implementing the widely endorsed "risks of daily life" standard for minimal risk. This standard defines research risks as minimal when they do not exceed the risks posed by daily life activities or routine examinations. This study employed a conceptual and normative analysis, and use of an illustrative example. Different risks are composed of the same basic elements: Type, likelihood, and magnitude of harm. Hence, one can compare the risks of research and the risks of daily life by comparing the respective basic elements with each other. We use this insight to develop a systematic method, direct comparative analysis, for implementing the "risks of daily life" standard for minimal risk. The method offers a way of evaluating research procedures that pose the same types of risk as daily life activities, such as the risk of experiencing anxiety, stress, or other psychological harm. We thus illustrate how direct comparative analysis can be applied in practice by using it to evaluate whether the anxiety induced by a respiratory CO2 challenge poses minimal or greater than minimal risks in children and adolescents. Direct comparative analysis is a systematic method for applying the "risks of daily life" standard for minimal risk to research procedures that pose the same types of risk as daily life activities. It thereby offers a method to protect children and adolescents in research, while ensuring that important studies are not blocked because of unwarranted concerns about research risks.

Distance factor on reducing scattered radiation risk during interventional fluoroscopy

International Nuclear Information System (INIS)

Husaini Salleh; Mohd Khalid Matori; Muhammad Jamal Mat Isa; Zainal Jamaluddin; Mohd Firdaus Abdul Rahman; Mohd Khairusalih Mohd Zin

2012-01-01

Interventional Radiology (IR) is subspecialty of diagnostic radiology where minimally invasive procedures are performed using an x-ray as a guidance. This procedure can deliver high radiation doses to patient and medical staff compared with other radiological method due to long screening time. The use of proper shielding, shorten the exposure time and keep the distance are the practices to reduce scattered radiation risks to staff involve in this procedure. This project is to study the distance factor on reducing the scattered radiation effect to the medical staff. It also may provide the useful information which can be use to establish the scattered radiation profile during the IR for the sake of radiation protection and safety to the medical staff involved. (author)

Cost-effectiveness of newborn circumcision in reducing lifetime HIV risk among U.S. males.

Directory of Open Access Journals (Sweden)

Stephanie L Sansom

Full Text Available BACKGROUND: HIV incidence was substantially lower among circumcised versus uncircumcised heterosexual African men in three clinical trials. Based on those findings, we modeled the potential effect of newborn male circumcision on a U.S. male's lifetime risk of HIV, including associated costs and quality-adjusted life-years saved. METHODOLOGY/PRINCIPAL FINDINGS: Given published estimates of U.S. males' lifetime HIV risk, we calculated the fraction of lifetime risk attributable to heterosexual behavior from 2005-2006 HIV surveillance data. We assumed 60% efficacy of circumcision in reducing heterosexually-acquired HIV over a lifetime, and varied efficacy in sensitivity analyses. We calculated differences in lifetime HIV risk, expected HIV treatment costs and quality-adjusted life years (QALYs among circumcised versus uncircumcised males. The main outcome measure was cost per HIV-related QALY saved. Circumcision reduced the lifetime HIV risk among all males by 15.7% in the base case analysis, ranging from 7.9% for white males to 20.9% for black males. Newborn circumcision was a cost-saving HIV prevention intervention for all, black and Hispanic males. The net cost of newborn circumcision per QALY saved was $87,792 for white males. Results were most sensitive to the discount rate, and circumcision efficacy and cost. CONCLUSIONS/SIGNIFICANCE: Newborn circumcision resulted in lower expected HIV-related treatment costs and a slight increase in QALYs. It reduced the 1.87% lifetime risk of HIV among all males by about 16%. The effect varied substantially by race and ethnicity. Racial and ethnic groups who could benefit the most from circumcision may have least access to it due to insurance coverage and state Medicaid policies, and these financial barriers should be addressed. More data on the long-term protective effect of circumcision on heterosexual males as well as on its efficacy in preventing HIV among MSM would be useful.

Risk assessment and risk management of mycotoxins.

Science.gov (United States)

2012-01-01

Risk assessment is the process of quantifying the magnitude and exposure, or probability, of a harmful effect to individuals or populations from certain agents or activities. Here, we summarize the four steps of risk assessment: hazard identification, dose-response assessment, exposure assessment, and risk characterization. Risk assessments using these principles have been conducted on the major mycotoxins (aflatoxins, fumonisins, ochratoxin A, deoxynivalenol, and zearalenone) by various regulatory agencies for the purpose of setting food safety guidelines. We critically evaluate the impact of these risk assessment parameters on the estimated global burden of the associated diseases as well as the impact of regulatory measures on food supply and international trade. Apart from the well-established risk posed by aflatoxins, many uncertainties still exist about risk assessments for the other major mycotoxins, often reflecting a lack of epidemiological data. Differences exist in the risk management strategies and in the ways different governments impose regulations and technologies to reduce levels of mycotoxins in the food-chain. Regulatory measures have very little impact on remote rural and subsistence farming communities in developing countries, in contrast to developed countries, where regulations are strictly enforced to reduce and/or remove mycotoxin contamination. However, in the absence of the relevant technologies or the necessary infrastructure, we highlight simple intervention practices to reduce mycotoxin contamination in the field and/or prevent mycotoxin formation during storage.

Conceptual Model of Offshore Wind Environmental Risk Evaluation System

Energy Technology Data Exchange (ETDEWEB)

Anderson, Richard M.; Copping, Andrea E.; Van Cleve, Frances B.; Unwin, Stephen D.; Hamilton, Erin L.

2010-06-01

In this report we describe the development of the Environmental Risk Evaluation System (ERES), a risk-informed analytical process for estimating the environmental risks associated with the construction and operation of offshore wind energy generation projects. The development of ERES for offshore wind is closely allied to a concurrent process undertaken to examine environmental effects of marine and hydrokinetic (MHK) energy generation, although specific risk-relevant attributes will differ between the MHK and offshore wind domains. During FY10, a conceptual design of ERES for offshore wind will be developed. The offshore wind ERES mockup described in this report will provide a preview of the functionality of a fully developed risk evaluation system that will use risk assessment techniques to determine priority stressors on aquatic organisms and environments from specific technology aspects, identify key uncertainties underlying high-risk issues, compile a wide-range of data types in an innovative and flexible data organizing scheme, and inform planning and decision processes with a transparent and technically robust decision-support tool. A fully functional version of ERES for offshore wind will be developed in a subsequent phase of the project.

Risk evaluation mitigation strategies: the evolution of risk management policy.

Science.gov (United States)

Hollingsworth, Kristen; Toscani, Michael

2013-04-01

The United States Food and Drug Administration (FDA) has the primary regulatory responsibility to ensure that medications are safe and effective both prior to drug approval and while the medication is being actively marketed by manufacturers. The responsibility for safe medications prior to marketing was signed into law in 1938 under the Federal Food, Drug, and Cosmetic Act; however, a significant risk management evolution has taken place since 1938. Additional federal rules, entitled the Food and Drug Administration Amendments Act, were established in 2007 and extended the government's oversight through the addition of a Risk Evaluation and Mitigation Strategy (REMS) for certain drugs. REMS is a mandated strategy to manage a known or potentially serious risk associated with a medication or biological product. Reasons for this extension of oversight were driven primarily by the FDA's movement to ensure that patients and providers are better informed of drug therapies and their specific benefits and risks prior to initiation. This article provides an historical perspective of the evolution of medication risk management policy and includes a review of REMS programs, an assessment of the positive and negative aspects of REMS, and provides suggestions for planning and measuring outcomes. In particular, this publication presents an overview of the evolution of the REMS program and its implications.

Hazard evaluation and risk management

International Nuclear Information System (INIS)

Fritzsche, A.F.

1986-01-01

The eigth chapter deals with the actual handling of hazards. The principal issue concerns man's behaviour towards hazards as an individual formerly and today; the evaluation of expected results of both a positive and a negative kind as determined by the individual's values which may differ and vary greatly from one individual to the next. The evaluation of benefit and hazard as well as the risk management resulting from decision-taking are political processes in the democratic state. Formal decision-taking tools play a major role in this process which concerns such central issues like who will participate; how the decision is arrived at; the participation of citizens; specialist knowledge and participation of the general public. (HSCH) [de

“Computerized Counseling Reduces HIV-1 Viral Load and Sexual Transmission Risk: Findings from a Randomized Controlled Trial”

Science.gov (United States)

KURTH, Ann E.; SPIELBERG, Freya; CLELAND, Charles M.; LAMBDIN, Barrot; BANGSBERG, David R.; FRICK, Pamela A.; SEVERYNEN, Anneleen O.; CLAUSEN, Marc; NORMAN, Robert G.; LOCKHART, David; SIMONI, Jane M.; HOLMES, King K.

2014-01-01

Objective Evaluate a computerized intervention supporting antiretroviral therapy (ART) adherence and HIV transmission prevention. Design Longitudinal RCT. Settings An academic HIV clinic and a community-based organization in Seattle. Subjects 240 HIV-positive adults on ART; 209 completed nine-month follow-up (87% retention). Intervention Randomization to computerized counseling or assessment-only, 4 sessions over 9 months. Main Outcome Measures HIV-1 viral suppression, and self-reported ART adherence, and transmission risks, compared using generalized estimating equations. Results Overall, intervention participants had reduced viral load (VL): mean 0.17 log10 decline, versus 0.13 increase in controls, p = 0.053, and significant difference in ART adherence baseline to 9 months (p = 0.046). Their sexual transmission risk behaviors decreased (OR = 0.55, p = 0.020), a reduction not seen among controls (OR = 1.1, p = 0.664), and a significant difference in change (p = 0.040). Intervention effect was driven by those most in need: among those with detectable virus at baseline (>30 copies/milliliter, n=89), intervention effect was mean 0.60 log10 VL decline versus 0.15 increase in controls, p=0.034. ART adherence at the final follow-up was 13 points higher among intervention participants versus controls, p = 0.038. Conclusions Computerized counseling is promising for integrated ART adherence and safer sex, especially for individuals with problems in these areas. This is the first intervention to report improved ART adherence, viral suppression, and reduced secondary sexual transmission risk behavior. PMID:24384803

RADON AND CARCINOGENIC RISK IN MOSCOW

Directory of Open Access Journals (Sweden)

S. M. Golovanev

2015-01-01

Full Text Available Objective: comparative evaluation of carcinogenic risk inMoscowfrom radon in indoor and atmospheric pollutants.Materials and methods: the lung cancer incidence in Moscow; radiation-hygienic passport of the territory; .U.S. EPA estimated average age at all and radon induced deaths, years of life lost; Report of UNSCEAR 2006 and WHO handbook on indoor radon, 2009. Trend analysis of incidence; evaluation of the excess relative risk; assessment of ratio radon-induced population risk and published values оf total population carcinogenic risk from chemical carcinogens.Results: it is shown that the 304 cases of lung cancer per year (1. 85 10-3 on average from 2006 to 2011 (21280diseases for 70 years in addition to background level induced by radon; the differences in average trends of all lungcancer incidence in the districts can exceed 25%.Conclusion. The potential of risk reduction by measures of mitigation radon concentration exceeds 5 times the cost efficiency to reduce emissions from vehicles and can reduce cancer incidence, on average 236 cases per year; population risk 16520 cases over 70 years or save not less than 2832 person-years of life per year. The annual effect of reducing losses from not-survival of 12 years as a result of radon-induced lung cancer deaths exceeds 14160000 dollars. The evaluating of the carcinogenic risk from radon in accordance with the definition of population risk increases the predictive evaluation of the effectiveness of preventive measures more than twice.

Adherence to the USDA Food Guide, DASH Eating Plan, and Mediterranean dietary pattern reduces risk of colorectal adenoma.

Science.gov (United States)

Dixon, L Beth; Subar, Amy F; Peters, Ulrike; Weissfeld, Joel L; Bresalier, Robert S; Risch, Adam; Schatzkin, Arthur; Hayes, Richard B

2007-11-01

The 2005 Dietary Guidelines for Americans include quantitative recommendations for 2 eating patterns, the USDA Food Guide and the Dietary Approaches to Stop Hypertension (DASH) Eating Plan, to promote optimal health and reduce disease risk. A Mediterranean dietary pattern has also been promoted for health benefits. Our objective was to determine whether adherence to the USDA Food Guide recommendations, the DASH Eating Plan, or a Mediterranean dietary pattern is associated with reduced risk of distal colorectal adenoma. In the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, men and women aged 55-74 y were screened for colorectal cancer by sigmoidoscopy at 10 centers in the U.S. After adjusting for potential confounders, men who most complied with the USDA Food Guide recommendations had a 26% reduced risk of colorectal adenoma compared with men who least complied with the recommendations (OR USDA score >or= 5 vs. dietary pattern. Women who most complied with the USDA Food Guide recommendations had an 18% reduced risk for colorectal adenoma, but subgroup analyses revealed protective associations only for current smokers (OR USDA score >or= 5 vs. or= 5 vs. dietary recommendations or a Mediterranean dietary pattern is associated with reduced risk of colorectal adenoma, especially in men.

Evaluation of risk management status for Croatian logistic operators

Directory of Open Access Journals (Sweden)

Diana BOŽIĆ

2010-01-01

Full Text Available Understanding organisational risks makes possible to control them and to change them into organisational strengths. Being known as “measure of uncertainty” in the business process, the risk is the uncertainty of achieving the organizational objectives. It may involve positive or negative consequences. There is a level of uncertainty in every supply chain while operating transportation and warehousing, positioning on the market, developing customer support, reducing cycle times or cutting costs. Therefore, the risk assessment should be one of the main tasks for any supply chain management team. It is required to develop formal risk assessment procedures, to identify the potential impacts to the supply chain operations and to develop a set of contingency plans to mitigate risks. This paper deals with supply chain risk assessment methodology, outlining the present risk management status of Croatian logistic operators.

Aspirin for Reducing Your Risk of Heart Attack and Stroke: Know the Facts

Science.gov (United States)

... the-Counter Medicines Safe Daily Use of Aspirin Aspirin for Reducing Your Risk of Heart Attack and ... any pharmacy, grocery or convenience store and buy aspirin without a prescription. The Drug Facts label on ...

Early growth characteristics and the risk of reduced lung function and asthma

DEFF Research Database (Denmark)

den Dekker, Herman T; Sonnenschein-van der Voort, Agnes M M; de Jongste, Johan C

2016-01-01

BACKGROUND: Children born preterm or with a small size for gestational age are at increased risk for childhood asthma. OBJECTIVE: We sought to assess the hypothesis that these associations are explained by reduced airway patency. METHODS: We used individual participant data of 24,938 children fro...

Reduced risk of UC in families affected by appendicitis: a Danish national cohort study.

Science.gov (United States)

Nyboe Andersen, Nynne; Gørtz, Sanne; Frisch, Morten; Jess, Tine

2017-08-01

The possible aetiological link between appendicitis and UC remains unclear. In order to investigate the hereditary component of the association, we studied the risk of UC in family members of individuals with appendicitis. A cohort of 7.1 million individuals was established by linkage of national registers in Denmark with data on kinship and diagnoses of appendicitis and UC. Poisson regression models were used to calculate first hospital contact rate ratios (RR) for UC with 95% CIs between individuals with or without relatives with a history of appendicitis. During 174 million person-years of follow-up between 1977 and 2011, a total of 190 004 cohort members developed appendicitis and 45 202 developed UC. Individuals having a first-degree relative with appendicitis before age 20 years had significantly reduced risk of UC (RR 0.90; 95% CI 0.86 to 0.95); this association was stronger in individuals with a family predisposition to UC (RR 0.66; 95% CI 0.51 to 0.83). Individuals with a first-degree relative diagnosed with appendicitis before age 20 years are at reduced risk of UC, particularly when there is a family predisposition to UC. Our findings question a previously hypothesised direct protective influence of appendicitis on inflammation of the large bowel. Rather, genetic or environmental factors linked to an increased risk of appendicitis while being protective against UC may explain the repeatedly reported reduced relative risk of UC in individuals with a history of appendicitis. 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/.

The Feasibility of Interventions to Reduce HIV Risk and Drug Use among Heterosexual Methamphetamine Users.

Science.gov (United States)

Corsi, Karen F; Lehman, Wayne E; Min, Sung-Joon; Lance, Shannon P; Speer, Nicole; Booth, Robert E; Shoptaw, Steve

2012-06-04

This paper reports on a feasibility study that examined contingency management among out-of-treatment, heterosexual methamphetamine users and the reduction of drug use and HIV risk. Fifty-eight meth users were recruited through street outreach in Denver from November 2006 through March 2007. The low sample size reflects that this was a pilot study to see if CM is feasible in an out-of-treatment, street-recruited population of meth users. Secondary aims were to examine if reductions and drug use and risk behavior could be found. Subjects were randomly assigned to contingency management (CM) or CM plus strengths-based case management (CM/SBCM), with follow-up at 4 and 8 months. Participants were primarily White (90%), 52% male and averaged 38 years old. Eighty-three percent attended at least one CM session, with 29% attending at least fifteen. All participants reduced meth use significantly at follow-up. Those who attended more sessions submitted more stimulant-free urines than those who attended fewer sessions. Participants assigned to CM/SBCM attended more sessions and earned more vouchers than clients in CM. Similarly, participants reported reduced needle-sharing and sex risk. Findings demonstrate that CM and SBCM may help meth users reduce drug use and HIV risk.

Evaluation of Odor-Reducing Commercial Products for Animal Waste

OpenAIRE

Shukla, Shuchi S.

1997-01-01

Six odor-reducing commercial products were tested for their efficacy in reducing odors from dairy and swine wastes. A sensory panel method was utilized for odor evaluations, in which the panel played an important part. Comparisons between products were made for agitated and unagitated conditions and effect of storage time (three weeks in which experiments were performed). Cotton pieces tied to the mouth of the sample jars were useful in absorbing the odors. Odor-treated jars were observed and...

Eliciting change in at-risk elders (ECARE): evaluation of an elder abuse intervention program.

Science.gov (United States)

Mariam, Lydia Morris; McClure, Regina; Robinson, J B; Yang, Janet A

2015-01-01

The current study evaluated the effectiveness of a community-based elder abuse intervention program that assists suspected victims of elder abuse and self-neglect through a partnership with local law enforcement. This program, Eliciting Change in At-Risk Elders, involves building alliances with the elder and family members, connecting the elder to supportive services that reduce risk of further abuse, and utilizing motivational interviewing-type skills to help elders overcome ambivalence regarding making difficult life changes. Risk factors of elder abuse decreased over the course of the intervention and nearly three-quarters of participants made progress on their treatment goal, advancing at least one of Prochaska and DiClemente's (1983) stages of change (precontemplation, contemplation, preparation, action, and maintenance). Forty-three percent of elders moved into the stages of action and maintenance regarding their goal. The usefulness of eliciting change via longer-term relationships with vulnerable elders in entrenched elder abuse situations is discussed.

Dynamic performances of the fallout radionuclides in the environment and related health risk evaluation

International Nuclear Information System (INIS)

Morisawa, Shinsuke

2003-01-01

The framework was developed for evaluating the cancer induction mortality risk due to the prolonged exposure to the fallout Sr-90 in the environment, which was released by the atmospheric nuclear detonation tests, through dietary intake by considering the effect of foods and feeds import to Japan. The risk evaluation framework presented was composed of three sub-models: the model foe evaluation of the global circulation of Sr-90, the model for evaluation of Sr-90 concentration in foods and dietary intake, and the model for the cancer induction mortality risk. The mortality risk by the radiation-induced leukemia was evaluated based on the NUREG/CR-4214 model. The model was applied on the reference Japanese for past half century to evaluate the historical variation of the health risks. The new framework is presented and discussed on their feasibility to apply on the health risk evaluation due to the low-level and prolonged exposure to radionuclides in the environment. The possibility to use some kind of bio-markers are discussed to evaluate the potential health risk in advance before the risk will be actually detected. (author)

Risk management study for the retired Hanford Site facilities: Qualitative risk evaluation for the retired Hanford Site facilities. Volume 3

Energy Technology Data Exchange (ETDEWEB)

Coles, G.A.; Shultz, M.V.; Taylor, W.E.

1993-09-01

This document provides a risk evaluation of the 100 and 200 Area retired, surplus facilities on the Hanford Site. Also included are the related data that were compiled by the risk evaluation team during investigations performed on the facilities. Results are the product of a major effort performed in fiscal year 1993 to produce qualitative information that characterizes certain risks associated with these facilities. The retired facilities investigated for this evaluation are located in the 100 and 200 Areas of the 1,450-km{sup 2} (570-mi{sup 2}) Hanford Site. The Hanford Site is a semiarid tract of land in southeastern Washington State. The nearest population center is Richland, Washington, (population 32,000) 30-km (20 mi) southeast of the 200 Area. During walkdown investigations of these facilities, data on real and potential hazards that threatened human health or safety or created potential environmental release issues were identified by the risk evaluation team. Using these findings, the team categorized the identified hazards by facility and evaluated the risk associated with each hazard. The factors contributing to each risk, and the consequence and likelihood of harm associated with each hazard also are included in this evaluation.

Evaluation of air pollution-related risks for Austrian mountain forests

International Nuclear Information System (INIS)

Smidt, Stefan; Herman, Friedl

2004-01-01

The present paper describes air pollution status and evaluation of risks related to effects of phytotoxic pollutants in the Austrian mountain forests. The results are based on Austrian networks (Forest Inventory, Forest Damage Monitoring System, Austrian Bioindicator Grid), the Austrian sample plots of the European networks of the UN-ECE (ICP Forests, Level I and Level II) and interdisciplinary research approaches. Based on the monitoring data and on modelling and mapping of Critical Thresholds, the evaluation of risk factors was possible. Cause-effect relationships between air pollution and tree responses were shown by tree-physiological measurements. Sulfur impact, proton and lead input, concentrations of nitrogen oxides, nitrogen input and ozone were evaluated. The risk was demonstrated at a regional and large-scale national level. Especially the increasing O 3 level and the accumulation of Pb with altitude present most serious risk for mountain forests. - Despite strong reduction of emissions in Europe, pollutants are still a potential stress factor, especially for sensitive mountain forest ecosystems in Austria

Preclinical Torsades-de-Pointes screens: advantages and limitations of surrogate and direct approaches in evaluating proarrhythmic risk.

Science.gov (United States)

Gintant, Gary A

2008-08-01

The successful development of novel drugs requires the ability to detect (and avoid) compounds that may provoke Torsades-de-Pointes (TdeP) arrhythmia while endorsing those compounds with minimal torsadogenic risk. As TdeP is a rare arrhythmia not readily observed during clinical or post-marketing studies, numerous preclinical models are employed to assess delayed or altered ventricular repolarization (surrogate markers linked to enhanced proarrhythmic risk). This review evaluates the advantages and limitations of selected preclinical models (ranging from the simplest cellular hERG current assay to the more complex in vitro perfused ventricular wedge and Langendorff heart preparations and in vivo chronic atrio-ventricular (AV)-node block model). Specific attention is paid to the utility of concentration-response relationships and "risk signatures" derived from these studies, with the intention of moving beyond predicting clinical QT prolongation and towards prediction of TdeP risk. While the more complex proarrhythmia models may be suited to addressing questionable or conflicting proarrhythmic signals obtained with simpler preclinical assays, further benchmarking of proarrhythmia models is required for their use in the robust evaluation of safety margins. In the future, these models may be able to reduce unwarranted attrition of evolving compounds while becoming pivotal in the balanced integrated risk assessment of advancing compounds.

Integration of industrial risk in regional policy management. Possibilities of evaluation

International Nuclear Information System (INIS)

Hubert, Philippe; Pages, Pierre

1990-02-01

Since the responsibility for risk management depends more and more on regional factors, evaluation methods and management regulations are not developed enough. This study start from the fact that an important methods exist for evaluation transport of dangerous materials in cities, risk analysis and emergency plans related to classified installations, management of quality of water, 'chronic' industrial risks at local and regional level, probabilistic estimation for industrial plants. The objective is in fact to show what risk analysis could bring to the municipality, the city or the region [fr

Risk evaluation for motor operated valves in an Inservice Testing Program at a PWR nuclear power plant in Taiwan

International Nuclear Information System (INIS)

Li, Y.C.; Chen, K.T.; Su, Y.L.; Ting, K.; Chien, F.T.; Li, G.D.; Huang, S.H.

2012-01-01

Safety related valves such as Motor Operated Valves (MOV), Air Operated Valves (AOV) or Check Valves (CV) play an important role in nuclear power plant. Functioning of these valves mainly aim at emergency reactivity control, post-accident residue heat removal, post-accident radioactivity removal and containment isolation when a design basis accident occurred. In order to maintain these valves under operable conditions, an Inservice Testing Program (IST) is defined for routine testing tasks based on the ASME Boiler and Pressure Vessel Code section XI code requirements. Risk based Inservice Testing Programs have been studied and developed extensively in the nuclear energy industry since the 1990s. Risk Based evaluations of IST can bring positive advantages to the licensee such as identifying the vulnerability of the system, reducing unnecessary testing burden, concentrating testing resources on the critical pass oriented valves and saving plant’s personnel dose exposure. This risk evaluation is incorporated with quantitative and qualitative analyses to the Motor Operated Valves under current Inservice Testing Program for PWR nuclear power plant in Taiwan. With the outcome of the risk classifications for the safety related MOVs through numerical or deterministic analyses, a risk based testing frequency relief is suggested to demonstrate the benefits received from the risk based Inservice Testing Program. The goal made of this study, it could be as a reference and cornerstone for the licensee to perform overall scope Risk-Informed Inservice Testing Program (RI-IST) evaluation by referring relevant methodologies established in this study.

Reducing the risk, managing safety.

Science.gov (United States)

Aldridge, Peter

2016-02-01

Fire safety in healthcare premises has always been a challenge to those that discharge this duty. Statutory compliance should be a matter of course, but in an ever increasingly challenged NHS, even this is not a given. While the NHS is driven by managing very complex risk to deliver cutting edge healthcare, providers cannot be risk averse. Which risk, however, takes priority? Here Peter Aldridge, fire and corporate services manager at Leeds Teaching Hospitals NHS Trust, and Secretary to the National Association of Healthcare Fire Officers (NAHFO)--which will this month and next jointly stage fire safety seminars with IHEEM; see page 8--considers the key issues, with input from a fire officer at a leading mental health and community Trust.

Maintenance evaluation using risk based criteria

International Nuclear Information System (INIS)

Torres Valle, A.

1996-01-01

The maintenance evaluation is currently performed by using economic and, in some case, technical equipment failure criteria, however this is done to a specific equipment level. In general, when statistics are used the analysis for maintenance optimization are made isolated and whit a post mortem character; The integration provided by mean of Probabilistic Safety assessment (PSA) together with the possibilities of its applications, allow for evaluation of maintenance on the basis of broader scope criteria in regard to those traditionally used. The evaluate maintenance using risk based criteria, is necessary to follow a dynamic and systematic approach, in studying the maintenance strategy, to allow for updating the initial probabilistic models, for including operational changes that often take place during operation of complex facilities. This paper proposes a dynamic evaluation system of maintenance task. The system is illustrated by means of a practical example

Mild traumatic brain injury is associated with reduced cortical thickness in those at risk for Alzheimer's disease.

Science.gov (United States)

Hayes, Jasmeet P; Logue, Mark W; Sadeh, Naomi; Spielberg, Jeffrey M; Verfaellie, Mieke; Hayes, Scott M; Reagan, Andrew; Salat, David H; Wolf, Erika J; McGlinchey, Regina E; Milberg, William P; Stone, Annjanette; Schichman, Steven A; Miller, Mark W

2017-03-01

Moderate-to-severe traumatic brain injury is one of the strongest environmental risk factors for the development of neurodegenerative diseases such as late-onset Alzheimer's disease, although it is unclear whether mild traumatic brain injury, or concussion, also confers risk. This study examined mild traumatic brain injury and genetic risk as predictors of reduced cortical thickness in brain regions previously associated with early Alzheimer's disease, and their relationship with episodic memory. Participants were 160 Iraq and Afghanistan War veterans between the ages of 19 and 58, many of whom carried mild traumatic brain injury and post-traumatic stress disorder diagnoses. Whole-genome polygenic risk scores for the development of Alzheimer's disease were calculated using summary statistics from the largest Alzheimer's disease genome-wide association study to date. Results showed that mild traumatic brain injury moderated the relationship between genetic risk for Alzheimer's disease and cortical thickness, such that individuals with mild traumatic brain injury and high genetic risk showed reduced cortical thickness in Alzheimer's disease-vulnerable regions. Among males with mild traumatic brain injury, high genetic risk for Alzheimer's disease was associated with cortical thinning as a function of time since injury. A moderated mediation analysis showed that mild traumatic brain injury and high genetic risk indirectly influenced episodic memory performance through cortical thickness, suggesting that cortical thinning in Alzheimer's disease-vulnerable brain regions is a mechanism for reduced memory performance. Finally, analyses that examined the apolipoprotein E4 allele, post-traumatic stress disorder, and genetic risk for schizophrenia and depression confirmed the specificity of the Alzheimer's disease polygenic risk finding. These results provide evidence that mild traumatic brain injury is associated with greater neurodegeneration and reduced memory performance

Risk Evaluation of Railway Coal Transportation Network Based on Multi Level Grey Evaluation Model

Science.gov (United States)

Niu, Wei; Wang, Xifu

2018-01-01

The railway transport mode is currently the most important way of coal transportation, and now China’s railway coal transportation network has become increasingly perfect, but there is still insufficient capacity, some lines close to saturation and other issues. In this paper, the theory and method of risk assessment, analytic hierarchy process and multi-level gray evaluation model are applied to the risk evaluation of coal railway transportation network in China. Based on the example analysis of Shanxi railway coal transportation network, to improve the internal structure and the competitiveness of the market.

Evaluating State Options for Reducing Medicaid Churning

Science.gov (United States)

Swartz, Katherine; Short, Pamela Farley; Graefe, Deborah R.; Uberoi, Namrata

2015-01-01

Medicaid churning - the constant exit and re-entry of beneficiaries as their eligibility changes - has long been a problem for both Medicaid administrators and recipients. Churning will continue under the Affordable Care Act, because despite new federal rules, Medicaid eligibility will continue to be based on current monthly income. We developed a longitudinal simulation model to evaluate four policy options for modifying or extending Medicaid eligibility to reduce churning. The simulations suggest that two options, extending Medicaid eligibility either to the end of a calendar year or for twelve months after enrollment, would be far more effective in reducing churning than the other options of a three-month extension or eligibility based on projected annual income. States should consider implementation of the option that best balances costs, including both administration and services, with improved health of Medicaid enrollees. PMID:26153313

Analysis, Evaluation and Measures to Reduce Environmental Risk within Watershed Areas of the Eastern Zauralye District Lakes

Science.gov (United States)

Rasskasova, N. S.; Bobylev, A. V.; Malaev, A. V.

2017-11-01

The authors have performed an analysis for the use of watershed areas of the lakes of the Eastern Zauralye district (the territory to the east of Ural) for national economic purposes. The analysis gave a possibility to assess the impact of watersheds depending on the applied technologies on the dump of various runoff into the reservoir waters. The watershed areas of all lakes have been found to be actively used as pastures, farmland and recreational resources. Some of the main sources of solid and liquid industrial waste are cattle farms and agricultural land using outdated equipment and technologies. The study of 26 km of the watershed line areas showed that pollutants (household garbage, fuels and lubricants) and organic substances (phosphorus and nitrogen) got into the waters of the reservoirs. The maximum runoff of solid and liquid waste into the waters of the lakes happens in summer which leads to increased concentrations of organic substances, an increase in productivity of alga and higher aquatic flora determining the degree of eutrophication and trophy in the reservoirs. The average annual trophic status of TSI lakes of the Eastern Zauralye district is 56 which corresponds to the typical phase of eutrophy. The reduced transparency of lakes is also the evidence of an increase in biological productivity of reservoirs, their eutrophication and, as a result, the water quality deterioration. The intensive eutrophication of reservoirs, in its turn, most significantly affects the concentration of the ammonium form of nitrogen, total phosphorus and total nitrogen, increase in pH and deterioration of oxygen condition. The authors have developed various activities to reduce a technogenic risk in the watershed areas of the lakes in the Eastern Zauralye district which can be applied to other areas using the analogy method.

Proposal of risk evaluation methodology for hazardous materials transportation

International Nuclear Information System (INIS)

Hartman, Luiz Carlos

2009-01-01

The increasing concern with the level of risk associated with the transportation of hazardous materials took some international institutions to pledge efforts in the evaluation of risk in regional level. Following this trend, the objective of this work was to analyze the most recent processes of analysis of risks from road transportation of hazardous materials. In the present work 21 methodologies of analysis of risks, developed by some authors and for diverse localities have been evaluated. Two of them, in special, have been reviewed and discussed: a method recently developed by the Swiss Federal Institute of Technology (Nicolet-Monnier and Gheorghe, 1996) and the strategy delineated by the Center for Chemical Process Safety CCPS (1995), taking into consideration the estimate of the individual and social risk. Also, the models of Harwood et al. (1990) and of Ramos (1997), adapted by Hartman (2003) have been applied to the reality of the roads of the state of Sao Paulo. The extension of these methodologies was explored, in order to find its advantages and disadvantages. As a study case the present work considered the ammonia transportation throughout two routes evaluating the reality of the roads of the state of Sao Paulo, including a significant parcel of evaluation in a densely populated area, getting the results using risk, at least, one of the methodologies mentioned above. The innovation proposed by this work was the research, the development and the introduction of two variables to the model considered by Harwood et al. (1990). These variables that influence in the value of the risk are: the age of the driver of truck and the zone of impact that is function type of product, period of the day where the transport was carried and the volume that has been transported. The aim of the proposed modifications is to let the value of the risk more sensible in relation to the type of the product carried and the age of the truck driver. The main related procedural stages

Improvement of endocytoscopic findings after per oral endoscopic myotomy (POEM) in esophageal achalasia; does POEM reduce the risk of developing esophageal carcinoma? Per oral endoscopic myotomy, endocytoscopy and carcinogenesis.

Science.gov (United States)

Minami, Hitomi; Yamaguchi, Naoyuki; Matsushima, Kayoko; Akazawa, Yuko; Ohnita, Ken; Takeshima, Fuminao; Nakayama, Toshiyuki; Hayashi, Tomayoshi; Inoue, Haruhiro; Nakao, Kazuhiko; Isomoto, Hajime

2013-01-30

Per oral endoscopic myotomy (POEM) has been reported to be a new therapeutic option for esophageal achalasia. The possibility that POEM could reduce the risk of developing esophageal squamous cell carcinoma was evaluated. This was a single-centre, retrospective study. Fifteen consecutive patients with esophageal achalasia who underwent POEM in our institution between August 2010 and January 2012 were enrolled. Ultra-high magnification with endocytoscopy was performed, and both histopathological and immunohistochemical evaluations for Ki-67 and p53 were assessed before and 3 months after POEM. POEM was successfully performed and effectively released the dysphagia symptom in all patients without severe complications. Subjective symptoms (mean Ekcardt score, before 7.4 vs. after 0.5, ptreatment of choice against achalasia and may reduce the risk of esophageal carcinogenesis. Endocytoscopy can be useful for the assessment of esophageal cellular proliferation.

Application of probabilistic risk assessment: Evaluating remedial alternatives at the Portland Harbor Superfund Site, Portland, Oregon, USA.

Science.gov (United States)

Ruffle, Betsy; Henderson, James; Murphy-Hagan, Clare; Kirkwood, Gemma; Wolf, Frederick; Edwards, Deborah A

2018-01-01

A probabilistic risk assessment (PRA) was performed to evaluate the range of potential baseline and postremedy health risks to fish consumers at the Portland Harbor Superfund Site (the "Site"). The analysis focused on risks of consuming fish resident to the Site containing polychlorinated biphenyls (PCBs), given that this exposure scenario and contaminant are the primary basis for US Environmental Protection Agency's (USEPA's) selected remedy per the January 2017 Record of Decision (ROD). The PRA used probability distributions fit to the same data sets used in the deterministic baseline human health risk assessment (BHHRA) as well as recent sediment and fish tissue data to evaluate the range and likelihood of current baseline cancer risks and noncancer hazards for anglers. Areas of elevated PCBs in sediment were identified on the basis of a geospatial evaluation of the surface sediment data, and the ranges of risks and hazards associated with pre- and postremedy conditions were calculated. The analysis showed that less active remediation (targeted to areas with the highest concentrations) compared to the remedial alternative selected by USEPA in the ROD can achieve USEPA's interim risk management benchmarks (cancer risk of 10 -4 and noncancer hazard index [HI] of 10) immediately postremediation for the vast majority of subsistence anglers that consume smallmouth bass (SMB) fillet tissue. In addition, the same targeted remedy achieves USEPA's long-term benchmarks (10 -5 and HI of 1) for the majority of recreational anglers. Additional sediment remediation would result in negligible additional risk reduction due to the influence of background. The PRA approach applied here provides a simple but adaptive framework for analysis of risks and remedial options focused on variability in exposures. It can be updated and refined with new data to evaluate and reduce uncertainty, improve understanding of the Site and target populations, and foster informed remedial decision

Non-animal approaches for toxicokinetics in risk evaluations of food chemicals.

Science.gov (United States)

Punt, Ans; Peijnenburg, Ad A C M; Hoogenboom, Ron L A P; Bouwmeester, Hans

2017-01-01

The objective of the present work was to review the availability and predictive value of non-animal toxicokinetic approaches and to evaluate their current use in European risk evaluations of food contaminants, additives and food contact materials, as well as pesticides and medicines. Results revealed little use of quantitative animal or human kinetic data in risk evaluations of food chemicals, compared with pesticides and medicines. Risk evaluations of medicines provided sufficient in vivo kinetic data from different species to evaluate the predictive value of animal kinetic data for humans. These data showed a relatively poor correlation between the in vivo bioavailability in rats and dogs versus that in humans. In contrast, in vitro (human) kinetic data have been demonstrated to provide adequate predictions of the fate of compounds in humans, using appropriate in vitro-in vivo scalers and by integration of in vitro kinetic data with in silico kinetic modelling. Even though in vitro kinetic data were found to be occasionally included within risk evaluations of food chemicals, particularly results from Caco-2 absorption experiments and in vitro data on gut-microbial conversions, only minor use of in vitro methods for metabolism and quantitative in vitro-in vivo extrapolation methods was identified. Yet, such quantitative predictions are essential in the development of alternatives to animal testing as well as to increase human relevance of toxicological risk evaluations. Future research should aim at further improving and validating quantitative alternative methods for kinetics, thereby increasing regulatory acceptance of non-animal kinetic data.

Literature Review on Modeling Cyber Networks and Evaluating Cyber Risks.

Energy Technology Data Exchange (ETDEWEB)

Kelic, Andjelka; Campbell, Philip L

2018-04-01

The National Infrastructure Simulations and Analysis Center (NISAC) conducted a literature review on modeling cyber networks and evaluating cyber risks. The literature review explores where modeling is used in the cyber regime and ways that consequence and risk are evaluated. The relevant literature clusters in three different spaces: network security, cyber-physical, and mission assurance. In all approaches, some form of modeling is utilized at varying levels of detail, while the ability to understand consequence varies, as do interpretations of risk. This document summarizes the different literature viewpoints and explores their applicability to securing enterprise networks.

Efficient improvement of nuclear power plant safety by reorganization of risk-informed safety importance evaluation methods for piping welded portions

Energy Technology Data Exchange (ETDEWEB)

Irie, Takashi; Hanafusa, Hidemitsu; Suyama, Takeshi [Institute of Nuclear Safety System, Inc., Mihama, Fukui (Japan); Morota, Hidetsugu; Kojima, Sigeo; Mizuno, Yoshinobu [Computer Software Development Co., Ltd., Tokyo (Japan)

2002-09-01

In this work, risk information was used to evaluate the safety importance of piping welded portions which were important for plant operation and maintenance of nuclear power plants. There are two types of risk-informed safety importance evaluation methods, namely the ASME method and the EPRI method. Since both methods have advantages and disadvantages, elements of each method were combined and reorganized. Considerations included whether the degradation mechanisms would be objectively evaluated and whether plant safety would be efficiently improved. The most objective and efficient method was as follows. Piping failure potential is quantitatively and objectively evaluated for failure with probabilistic fracture mechanics (PFM) and for other degradation mechanisms with empirical failure rates, and conditional core damage probability (CCDP) is calculated with PSA. This method reduces the inspected segment numbers to 1/4 of the deterministic method and increases the ratio of risk, which is covered by the inspected segments, to total risk from 80% of the deterministic method to 95%. Piping inspection numbers decreased for safety injection systems that were required the inspections by the deterministic method. Piping inspections were required for part of main feed water and main steam systems that were not required the inspections by the deterministic method. (author)

Occupational health and safety: Designing and building with MACBETH a value risk-matrix for evaluating health and safety risks

Science.gov (United States)

Lopes, D. F.; Oliveira, M. D.; Costa, C. A. Bana e.

2015-05-01

Risk matrices (RMs) are commonly used to evaluate health and safety risks. Nonetheless, they violate some theoretical principles that compromise their feasibility and use. This study describes how multiple criteria decision analysis methods have been used to improve the design and the deployment of RMs to evaluate health and safety risks at the Occupational Health and Safety Unit (OHSU) of the Regional Health Administration of Lisbon and Tagus Valley. ‘Value risk-matrices’ (VRMs) are built with the MACBETH approach in four modelling steps: a) structuring risk impacts, involving the construction of descriptors of impact that link risk events with health impacts and are informed by scientific evidence; b) generating a value measurement scale of risk impacts, by applying the MACBETH-Choquet procedure; c) building a system for eliciting subjective probabilities that makes use of a numerical probability scale that was constructed with MACBETH qualitative judgments on likelihood; d) and defining a classification colouring scheme for the VRM. A VRM built with OHSU members was implemented in a decision support system which will be used by OHSU members to evaluate health and safety risks and to identify risk mitigation actions.

Gasbuggy Site Assessment and Risk Evaluation

Energy Technology Data Exchange (ETDEWEB)

None

2011-03-01

The Gasbuggy site is in northern New Mexico in the San Juan Basin, Rio Arriba County (Figure 1-1). The Gasbuggy experiment was designed to evaluate the use of a nuclear detonation to enhance natural gas production from the Pictured Cliffs Formation, a tight, gas-bearing sandstone formation. The 29-kiloton-yield nuclear device was placed in a 17.5-inch wellbore at 4,240 feet (ft) below ground surface (bgs), approximately 40 ft below the Pictured Cliffs/Lewis shale contact, in an attempt to force the cavity/chimney formed by the detonation up into the Pictured Cliffs Sandstone. The test was conducted below the southwest quarter of Section 36, Township 29 North, Range 4 West, New Mexico Principal Meridian. The device was detonated on December 10, 1967, creating a 335-ft-high chimney above the detonation point and a cavity 160 ft in diameter. The gas produced from GB-ER (the emplacement and reentry well) during the post-detonation production tests was radioactive and diluted, primarily by carbon dioxide. After 2 years, the energy content of the gas had recovered to 80 percent of the value of gas in conventionally developed wells in the area. There is currently no technology capable of remediating deep underground nuclear detonation cavities and chimneys. Consequently, the U.S. Department of Energy (DOE) must continue to manage the Gasbuggy site to ensure that no inadvertent intrusion into the residual contamination occurs. DOE has complete control over the 1/4 section (160 acres) containing the shot cavity, and no drilling is permitted on that property. However, oil and gas leases are on the surrounding land. Therefore, the most likely route of intrusion and potential exposure would be through contaminated natural gas or contaminated water migrating into a producing natural gas well outside the immediate vicinity of ground zero. The purpose of this report is to describe the current site conditions and evaluate the potential health risks posed by the most plausible

Thyroid function, reduced kidney function and incident chronic kidney disease in a community-based population: the Atherosclerosis Risk in Communities study.

Science.gov (United States)

Schultheiss, Ulla T; Daya, Natalie; Grams, Morgan E; Seufert, Jochen; Steffes, Michael; Coresh, Josef; Selvin, Elizabeth; Köttgen, Anna

2017-11-01

Reduced kidney function is a common public health problem that increases risk for a wide variety of adverse outcomes, making the identification of potentially modifiable factors associated with the development of incident chronic kidney disease (CKD) important. Alterations in the hypothalamic-pituitary-thyroid axis have been linked to reduced kidney function, but the association of thyroid function with the development of incident CKD is largely uncharacterized. Concentrations of thyroid stimulating hormone (TSH), free thyroxine (FT4), triiodothyronine (T3) and thyroid peroxidase antibody (TPOAb) were quantified in 12 785 black and white participants of the ongoing community-based prospective Atherosclerosis Risk in Communities study. Thyroid markers and clinical categories of thyroid dysfunction (euthyroidism, combined subclinical and overt hypothyroidism, combined subclinical and overt hyperthyroidism) were also evaluated for their association with reduced kidney function (estimated glomerular filtration rate kidney function at study baseline. The clinical entities hypothyroidism and hyperthyroidism were also associated with higher odds of baseline reduced kidney function, but this was not significant. However, none of the markers of thyroid function nor different clinical categories of thyroid dysfunction (hypothyroidism, hyperthyroidism or TPOAb positivity) were associated with incident CKD in adjusted analyses. Elevated TSH, FT4 and reduced T3 concentrations were associated with reduced kidney function cross-sectionally. The lack of association with the development of incident CKD suggests that altered thyroid function in the general population is not causally related to CKD development, but screening for thyroidal status may be especially relevant in persons with reduced kidney function. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Support of the 'fallopian tube hypothesis' in a prospective series of risk-reducing salpingo-oophorectomy specimens

NARCIS (Netherlands)

Reitsma, Welmoed; de Bock, Geertruida H.; Oosterwijk, Jan C.; Bart, Joost; Hollema, Harry; Mourits, Marian J. E.

Objective: To determine the prevalence, localisation and type of occult (non) invasive cancer in risk-reducing salpingo-oophorectomy (RRSO) specimens in BRCA-mutation carriers and high-risk women from BRCA-negative families. Methods: A consecutive series of RRSO specimens of asymptomatic,

Simple risk stratification at admission to identify patients with reduced mortality from primary angioplasty

DEFF Research Database (Denmark)

Thune, Jens Jakob; Hoefsten, Dan Eik; Lindholm, Matias Greve

2005-01-01

BACKGROUND: Randomized trials comparing fibrinolysis with primary angioplasty for acute ST-elevation myocardial infarction have demonstrated a beneficial effect of primary angioplasty on the combined end point of death, reinfarction, and disabling stroke but not on all-cause death. Identifying...... a patient group with reduced mortality from an invasive strategy would be important for early triage. The Thrombolysis in Myocardial Infarction (TIMI) risk score is a simple validated integer score that makes it possible to identify high-risk patients on admission to hospital. We hypothesized that a high...... as high risk. There was a significant interaction between risk status and effect of primary angioplasty (P=0.008). In the low-risk group, there was no difference in mortality (primary angioplasty, 8.0%; fibrinolysis, 5.6%; P=0.11); in the high-risk group, there was a significant reduction in mortality...

A brief psychological intervention for mothers of children with food allergy can change risk perception and reduce anxiety: Outcomes of a randomized controlled trial.

Science.gov (United States)

Boyle, R J; Umasunthar, T; Smith, J G; Hanna, H; Procktor, A; Phillips, K; Pinto, C; Gore, C; Cox, H E; Warner, J O; Vickers, B; Hodes, M

2017-10-01

Mothers of children with food allergy have increased anxiety, which may be influenced by healthcare professionals' communication of risk. To evaluate a brief psychological intervention for reducing anxiety in mothers of children with food allergy. Two hundred mothers of children with food allergy were recruited from allergy clinics. A computer-generated randomization list was used to allocate participants to a single-session cognitive behavioural therapy intervention including a risk communication module, or standard care. Anxiety and risk perception were assessed at 6 weeks and 1 year. Primary outcome was state anxiety at 6 weeks. Secondary outcomes included state anxiety at 1 year, risk perception at 6 weeks and 1 year, and salivary cortisol response to a simulated anaphylaxis scenario at 1 year. We found no significant difference in the primary outcome state anxiety at 6 weeks, with mean 31.9 (SD 10.2) intervention, 34.0 (10.2) control; mean difference 2.1 (95% CI -0.9, 5.0; P=.17). There was significantly reduced state anxiety at 6 weeks in the intervention group, in the subgroup of participants with moderate/high anxiety at enrolment (103/200, 52%), with mean 33.0 (SD 9.3) intervention, 37.8 (SD 10.0) control; mean difference 4.8 (95% CI 0.9, 8.7; P=.016; Cohen's d effect size 0.50). The psychological intervention also reduced risk perception and salivary cortisol response (P=.032; effect size 0.36). We found evidence that a brief psychological intervention which incorporates accurate risk information may impact on anxiety, risk perception and physiological stress response in mothers of children with food allergy. © 2017 John Wiley & Sons Ltd.

Evaluation of risk effective STIs with specific application to diesels

International Nuclear Information System (INIS)

Vesely, W.E.; Samanta, P.K.; Ginzburg, T.

1987-01-01

From a risk standpoint, the objective of surveillance tests is to control the risk arising from failures which can occur while the component is on standby. At the same time, risks caused by the test from test-caused failures and test-caused degradations need also to be controlled. Risk-acceptable test intervals balance these risks in an attempt to achieve an acceptable low, overall risk. Risk and reliability approaches are presented which allow risk-acceptable test intervals to be determined for any component. To provide focus for the approaches, diesels are specifically evaluated, however, the approaches can be applied not only to diesels, but to any component with suitable data. Incorporation of the approaches in personal computer (PC) software is discussed, which can provide tools for the regulator or plant personnel for determining acceptable diesel test intervals for any plant specific or generic application. The FRANTIC III computer code was run to validate the approaches and to evaluate specific issues associated with determining risk effective test intervals for diesels. Using the approaches presented, diesel accident unavailability can be more effectively monitored and be controlled on a plant-specific or generic basis. Test intervals can be made more risk effective than they are now, producing more acceptable accident unavailabilities. The methods presented are one step toward performance-based technical specifications, which more directly control risks

Evaluating investments in renewable energy under policy risks

International Nuclear Information System (INIS)

Gatzert, Nadine; Vogl, Nikolai

2016-01-01

The considerable amount of required infrastructure and renewable energy investments expected in the forthcoming years also implies an increasingly relevant contribution of private and institutional investors. In this context, especially regulatory and policy risks have been shown to play a major role for investors when evaluating investments in renewable energy and should thus also be taken into account in risk assessment and when deriving risk-return profiles. In this paper, we provide a stochastic model framework to quantify policy risks associated with renewable energy investments (e.g. a retrospective reduction of a feed-in tariff), thereby also taking into account energy price risk, resource risk, and inflation risk. The model is illustrated by means of simulations and scenario analyses, and it makes use of expert estimates and fuzzy set theory for quantifying policy risks. Our numerical results for a portfolio of onshore wind farms in Germany and France show that policy risk can strongly impact risk-return profiles, and that cross-country diversification effects can considerably decrease the overall risk for investors. - Highlights: •Quantification of policy risks associated with renewable energy investments. •Results emphasize that policy risk has a major impact on risk and return. •Study of the cross-country diversification potential. •Cross-country diversification can considerably decrease the risk for an investor.

Questionnaire-based risk assessment system

International Nuclear Information System (INIS)

Sakajo, Satoko; Ohi, Tadashi

2004-01-01

In order to reduce human errors efficiently, it is important to evaluate error-likely tasks and improve them. There are a lot of evaluation methods, for example, experimental evaluation methods, investigations by the expert of human factors, checking guidelines, estimating human error probabilities, and so on. There are roughly two problems in those methods. (1) Qualitative evaluation methods do not evaluate how likely human errors will occur and do not estimate how effective the countermeasure is in reducing human error. (2) Most of the quantitative evaluation methods and detailed analysis methods require expert's judgment. We developed a questionnaire-based risk assessment method and its system. In this paper, we introduce the concept of the method, realization, and applications to a maintenance procedure of a nuclear power plant and an elevator. The feature of the method is that it is so simple and the inexpert can easily evaluate the risk of human error. Furthermore, because it is provided as an application service provider system, a lot of evaluators can use it simultaneously through internet and it is easy to collect and sum up the responses. We confirmed that it is useful to evaluate the risk of human error, analyze the problem, and estimate the effectiveness of countermeasures in advance through the applications. (author)

Risk evaluation: A cost-oriented approach

International Nuclear Information System (INIS)

Rogers, B.H.

1998-01-01

This method provides a structured and cost-oriented way to determine risks associated with loss and destruction of industrial security interests consisting of material assets and human resources. Loss and destruction are assumed to be adversary perpetrated, high-impact events in which the health and safety of people or high-value property is at risk. This concept provides a process for: (1) assessing effectiveness of all integrated protection system, which includes facility operations, safety, emergency and security systems, and (2) a qualitative prioritization scheme to determine the level of consequence relative to cost and subsequent risk. The method allows managers the flexibility to establish asset protection appropriate to programmatic requirements and priorities and to decide if funding is appropriate. The evaluation objectives are to: (1) provide for a systematic, qualitative tabletop process to estimate the potential for an undesirable event and its impact; and (2) identify ineffective protection and cost-effective solutions

Does long-term coffee intake reduce type 2 diabetes mellitus risk?

Directory of Open Access Journals (Sweden)

Pimentel Gustavo D

2009-09-01

Full Text Available Abstract This review reports the evidence for a relation between long-term coffee intake and risk of type 2 diabetes mellitus. Numerous epidemiological studies have evaluated this association and, at this moment, at least fourteen out of eighteen cohort studies revealed a substantially lower risk of type 2 diabetes mellitus with frequent coffee intake. Moderate coffee intake (≥4 cups of coffee/d of 150 mL or ≥400 mg of caffeine/d has generally been associated with a decrease in the risk of type 2 diabetes mellitus. Besides, results of most studies suggest a dose-response relation, with greater reductions in type 2 diabetes mellitus risk with higher levels of coffee consumption. Several mechanisms underlying this protective effect, as well as the coffee components responsible for this association are suggested. Despite positive findings, it is still premature to recommend an increase in coffee consumption as a public health strategy to prevent type 2 diabetes mellitus. More population-based surveys are necessary to clarify the long-term effects of decaffeinated and caffeinated coffee intake on the risk of type 2 diabetes mellitus.

Evaluation of Cardiovascular Risk Scores Applied to NASA's Astronant Corps

Science.gov (United States)

Jain, I.; Charvat, J. M.; VanBaalen, M.; Lee, L.; Wear, M. L.

2014-01-01

In an effort to improve cardiovascular disease (CVD) risk prediction, this analysis evaluates and compares the applicability of multiple CVD risk scores to the NASA Astronaut Corps which is extremely healthy at selection.

D ampersand D screening risk evaluation guidance

International Nuclear Information System (INIS)

Robers, S.K.; Golden, K.M.; Wollert, D.A.

1995-09-01

The Screening Risk Evaluation (SRE) guidance document is a set of guidelines provided for the uniform implementation of SREs performed on decontamination and decommissioning (D ampersand D) facilities. Although this method has been developed for D ampersand D facilities, it can be used for transition (EM-60) facilities as well. The SRE guidance produces screening risk scores reflecting levels of risk through the use of risk ranking indices. Five types of possible risk are calculated from the SRE: current releases, worker exposures, future releases, physical hazards, and criticality. The Current Release Index (CRI) calculates the current risk to human health and the environment, exterior to the building, from ongoing or probable releases within a one-year time period. The Worker Exposure Index (WEI) calculates the current risk to workers, occupants and visitors inside contaminated D ampersand D facilities due to contaminant exposure. The Future Release Index (FRI) calculates the hypothetical risk of future releases of contaminants, after one year, to human health and the environment. The Physical Hazards Index (PHI) calculates the risks to human health due to factors other than that of contaminants. Criticality is approached as a modifying factor to the entire SRE, due to the fact that criticality issues are strictly regulated under DOE. Screening risk results will be tabulated in matrix form, and Total Risk will be calculated (weighted equation) to produce a score on which to base early action recommendations. Other recommendations from the screening risk scores will be made based either on individual index scores or from reweighted Total Risk calculations. All recommendations based on the SRE will be made based on a combination of screening risk scores, decision drivers, and other considerations, as determined on a project-by-project basis

Towards successful physical stress reducing products: An evaluation of seven cases

NARCIS (Netherlands)

Looze, M.P. de; Urlings, I.J.M.; Vink, P.; Rhijn, J.W. van; Miedema, M.C.; Bronkhorst, R.E.; Grinten, M.P. van der

2001-01-01

Lifting, carrying, pushing and pulling at work are assumed to be related to increased risks of musculoskeletal injury, mainly in the low back and shoulder region. The implementation of products to reduce the physical load in heavy work is a well-known strategy to attack this problem. The success of

Pilot evaluation of an adolescent risk and injury prevention programme incorporating curriculum and school connectedness components.

Science.gov (United States)

Chapman, R L; Buckley, L; Sheehan, M; Shochet, I M

2013-08-01

School connectedness is an important protective factor for adolescent risk-taking behaviour. This study examined a pilot version of the Skills for Preventing Injury in Youth (SPIY) programme, combining teacher professional development (PD) for increasing school connectedness (connectedness component) with a risk and injury prevention curriculum for early adolescents (curriculum component). A process evaluation was conducted on the connectedness component, involving assessments of programme reach, participant receptiveness and initial use, and a preliminary impact evaluation was conducted on the combined connectedness and curriculum programme. The connectedness component was well received by teacher participants, who saw benefits for both themselves and their students. Classroom observation also showed that teachers who received PD made use of the programme strategies. Grade 8 students who participated in the SPIY programme were less likely to report violent behaviour at 6-month follow-up than were control students, and trends also suggested reduced transport injuries. The results of this research support the use of the combined SPIY connectedness and curriculum components in a large-scale effectiveness trial to assess the impact of the programme on students' connectedness, risk-taking and associated injuries.

SIMPLE DECISION RULES REDUCE REINJURY RISK AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

Science.gov (United States)

Grindem, Hege; Snyder-Mackler, Lynn; Moksnes, Håvard; Engebretsen, Lars; Risberg, May Arna

2016-01-01

Background Knee reinjury after anterior cruciate ligament (ACL) reconstruction is common and increases the risk of osteoarthritis. There is sparse evidence to guide return to sport (RTS) decisions in this population. Objectives To assess the relationship between knee reinjury after ACL reconstruction and 1) return to level I sports, 2) timing of return to sports, and 3) knee function prior to return. Methods 106 patients who participated in pivoting sports participated in this prospective two year cohort study. Sports participation and knee reinjury were recorded monthly. Knee function was assessed with the Knee Outcome Survey–Activities of Daily Living Scale, global rating scale of function, and quadriceps strength and hop test symmetry. Pass RTS criteria was defined as scores >90 on all tests, failure as failing any. Results Patients who returned to level I sports had 4.32 (p=0.048) higher reinjury rate than those who did not. The reinjury rate was significantly reduced by 51 % for each month RTS was delayed until 9 months after surgery, after which no further risk reduction was observed. 38.2 % of those who failed RTS criteria suffered reinjuries versus 5.6 % of those who passed (HR: 0.16, p=0.075). More symmetrical quadriceps strength prior to return significantly reduced the knee reinjury rate. Conclusion Returning to level I sports after ACL reconstruction leads to a more than 4-fold increase in reinjury rates over 2 years. Return to sport 9 months or later after surgery and more symmetrical quadriceps strength prior to return substantially reduces the reinjury rate. PMID:27162233

Reduce the risk of stock trading by using technical analysis in iran's ...

African Journals Online (AJOL)

Reduce the risk of stock trading by using technical analysis in iran's stock market. ... In this research, efficiency of 50 active companies of Tehran Stock ... With this observation, this research suggest forming a portfolio with zero cost by purchasing ... FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use ...

Evaluation on lifetime risk in reinforced concrete structure; RC kozo no lifetime risk no hyoka ni kansuru kisoteki kenkyu

Energy Technology Data Exchange (ETDEWEB)

Suzuki, M. [Public Works Research Institute, Tsukuba (Japan); Adachi, H. [Taisei Corp., Tokyo (Japan); Akakura, Y. [Ministry of Transport, Tokyo (Japan); Ibayashi, K.; Ozaka, Y. [Tohoku Gakuin Univ., Sendai (Japan)

1996-02-15

To evaluate the risk during longevity of reinforced concrete structure subjected to earthquake motions, called lifetime risk, damage and safety were estimated by means of the earthquake risk analysis and earthquake response analysis. For the earthquake risk analysis, historical earthquake data with relatively low accuracy were efficiently taken into account, to determine the annual mean generation probability against the earthquake motion strength in ten main cities. A new damage index with load hysteresis was defined as an anti-earthquake evaluation index where accumulative damage is taken into consideration. Assuming that the damage transits from `certain state` to `certain state` every time the earthquake motion generates at the noticeable place, damage transition matrix expressing transition probability was calculated by using the results of earthquake risk analysis and the accumulative damage index. The lifetime risk was calculated from the damage transition matrix and the earthquake motion generation probability, to evaluate the safety. 21 refs., 10 figs., 8 tabs.

Insulin use increases risk of asthma but metformin use reduces the risk in patients with diabetes in a Taiwanese population cohort.

Science.gov (United States)

Chen, Chiung-Zuei; Hsu, Chih-Hui; Li, Chung-Yi; Hsiue, Tzuen-Ren

2017-12-01

Recent reports have suggested that insulin promotes airway smooth muscle contraction and enhances airway hyperresponsiveness, which are cardinal features of asthma. In contrast, metformin can reduce both airway inflammatory and remodeling properties. However, these results are all from in vitro and animal studies. This study investigated whether diabetes and various antidiabetic agents associate with the risk of asthma. We used a retrospective population-based cohort study using Taiwan's National Health Insurance claim database from 2000 to 2010 and a Cox proportional hazards regression model to compare the incidence of asthma between patients with diabetes (n = 19,428) and a matched non-diabetic group (n = 38,856). We also used a case-control study nested from the above cohort including 1,982 incident cases of asthma and 1,982 age- and sex-matched controls. A time density sampling technique was used to assess the effects of various antidiabetic agents on the risk of asthma. The incidence of asthma was significantly higher in the diabetic cohort than that in the non-diabetic cohort after adjustment for age, sex, and obesity, with a hazard ratio of 1.30 (95% confidence interval [CI]: 1.24-1.38). Insulin was found to increase the risk of asthma among diabetic patients (odds ratio [OR] 2.23; 95% CI: 1.52-3.58). In contrast, the use of metformin correlated with a decreased risk of asthma (OR 0.75; 95% CI: 0.60-0.95). Individuals with diabetes are at an increased risk of asthma. Insulin may further increase the risk of asthma, but the risk could possibly be reduced by using metformin.

Evaluation of a visual risk communication tool: effects on knowledge and perception of blood transfusion risk.

Science.gov (United States)

Lee, D H; Mehta, M D

2003-06-01

Effective risk communication in transfusion medicine is important for health-care consumers, but understanding the numerical magnitude of risks can be difficult. The objective of this study was to determine the effect of a visual risk communication tool on the knowledge and perception of transfusion risk. Laypeople were randomly assigned to receive transfusion risk information with either a written or a visual presentation format for communicating and comparing the probabilities of transfusion risks relative to other hazards. Knowledge of transfusion risk was ascertained with a multiple-choice quiz and risk perception was ascertained by psychometric scaling and principal components analysis. Two-hundred subjects were recruited and randomly assigned. Risk communication with both written and visual presentation formats increased knowledge of transfusion risk and decreased the perceived dread and severity of transfusion risk. Neither format changed the perceived knowledge and control of transfusion risk, nor the perceived benefit of transfusion. No differences in knowledge or risk perception outcomes were detected between the groups randomly assigned to written or visual presentation formats. Risk communication that incorporates risk comparisons in either written or visual presentation formats can improve knowledge and reduce the perception of transfusion risk in laypeople.

Estimating the incremental net health benefit of requirements for cardiovascular risk evaluation for diabetes therapies.

Science.gov (United States)

Chawla, Anita J; Mytelka, Daniel S; McBride, Stephan D; Nellesen, Dave; Elkins, Benjamin R; Ball, Daniel E; Kalsekar, Anupama; Towse, Adrian; Garrison, Louis P

2014-03-01

To evaluate the advantages and disadvantages of pre-approval requirements for safety data to detect cardiovascular (CV) risk contained in the December 2008 U.S. Food and Drug Administration (FDA) guidance for developing type 2 diabetes drugs compared with the February 2008 FDA draft guidance from the perspective of diabetes population health. We applied the incremental net health benefit (INHB) framework to quantify the benefits and risks of investigational diabetes drugs using a common survival metric (life-years [LYs]). We constructed a decision analytic model for clinical program development consistent with the requirements of each guidance and simulated diabetes drugs, some of which had elevated CV risk. Assuming constant research budgets, we estimate the impact of increased trial size on drugs investigated. We aggregate treatment benefit and CV risks for each approved drug over a 35-year horizon under each guidance. The quantitative analysis suggests that the December 2008 guidance adversely impacts diabetes population health. INHB was -1.80 million LYs, attributable to delayed access to diabetes therapies (-0 .18 million LYs) and fewer drugs (-1.64 million LYs), but partially offset by reduced CV risk exposure (0.02 million LYs). Results were robust in sensitivity analyses. The health outcomes impact of all potential benefits and risks should be evaluated in a common survival measure, including health gain from avoided adverse events, lost health benefits from delayed or for gone efficacious products, and impact of alternative policy approaches. Quantitative analysis of the December 2008 FDA guidance for diabetes therapies indicates that negative impact on patient health will result. Copyright © 2014 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd.

Evaluation of the environmental impact of apple pest control strategies using pesticide risk indicators.

Science.gov (United States)

Ioriatti, Claudio; Agnello, Arthur M; Martini, Fabrizio; Kovach, Joseph

2011-10-01

Various pesticide risk indicators have been developed for estimating pesticide impact on human health and the environment. The present work applied a pesticide risk indicator to estimate change in pesticide risk in apple production between 2001 and 2009. The "Environmental Impact Quotient" was used, which evaluates potential impacts of pesticide active ingredients on farm workers, consumers, and nontarget organisms. A modified Environmental Impact Quotient was also tested, which accounts for all ingredients in the formulation presenting a health or environmental hazard, as identified in the Security Data Sheet. Irrespective of the rating system applied, an overall average improvement in environmental impact of apple protection strategies was indicated ranging from 23 to 24%. Hazard reduction was more significant when estimated per treatment, and was higher for acaricides and insecticides than for fungicides. Improvement appeared to be a consequence of using more selective and more effective active ingredients, applying alternative pest control techniques, compulsory periodic sprayer calibration, and wider use of dwarfing orchards. The modified Environmental Impact Quotient does not overcome all limitations regarding accuracy of pesticide risk indicators, but its ease of use in relying on official, easily accessible data, and the consistency of its results, makes it a good candidate for monitoring the success of reduced risk policies. Copyright © 2011 SETAC.

Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood

DEFF Research Database (Denmark)

Wolsk, Helene M; Chawes, Bo L; Litonjua, Augusto A

2017-01-01

BACKGROUND: We recently published two independent randomized controlled trials of vitamin D supplementation during pregnancy, both indicating a >20% reduced risk of asthma/recurrent wheeze in the offspring by 3 years of age. However, neither reached statistical significance. OBJECTIVE: To perform......) or placebo. All women also received a prenatal vitamin containing 400 IU/d vitamin D3. The primary outcome was asthma/recurrent wheeze from 0-3yrs. Secondary end-points were specific IgE, total IgE, eczema and lower respiratory tract infections (LRTI). We conducted random effects combined analyses...... of the treatment effect, individual patient data (IPD) meta-analyses, and analyses stratified by 25(OH)D level at study entry. RESULTS: The analysis showed a 25% reduced risk of asthma/recurrent wheeze at 0-3yrs: adjusted odds ratio (aOR) = 0.74 (95% CI, 0.57-0.96), p = 0.02. The effect was strongest among women...

Stochastic evaluation of tsunami inundation and quantitative estimating tsunami risk

International Nuclear Information System (INIS)

Fukutani, Yo; Anawat, Suppasri; Abe, Yoshi; Imamura, Fumihiko

2014-01-01

We performed a stochastic evaluation of tsunami inundation by using results of stochastic tsunami hazard assessment at the Soma port in the Tohoku coastal area. Eleven fault zones along the Japan trench were selected as earthquake faults generating tsunamis. The results show that estimated inundation area of return period about 1200 years had good agreement with that in the 2011 Tohoku earthquake. In addition, we evaluated quantitatively tsunami risk for four types of building; a reinforced concrete, a steel, a brick and a wood at the Soma port by combining the results of inundation assessment and tsunami fragility assessment. The results of quantitative estimating risk would reflect properly vulnerability of the buildings, that the wood building has high risk and the reinforced concrete building has low risk. (author)

User's guide to the repository intrusion risk evaluation code INTRUDE

International Nuclear Information System (INIS)

Nancarrow, D.J.; Thorne, M.C.

1986-05-01

The report, commissioned by the Department of the Environment as part of its radioactive waste management research programme, constitutes the user's guide to the repository intrusion risk evaluation code INTRUDE. It provides an explanation of the mathematical basis of the code, the database used and the operation of the code. INTRUDE is designed to facilitate the estimation of individual risks arising from the possibility of intrusion into shallow land burial facilities for radioactive wastes. It considers a comprehensive inventory of up to 65 long-lived radionuclides and produces risk estimates for up to 20 modes of intrusion and up to 50 times of evaluation. (author)

Multi Criteria Evaluation Module for RiskChanges Spatial Decision Support System

Science.gov (United States)

Olyazadeh, Roya; Jaboyedoff, Michel; van Westen, Cees; Bakker, Wim

2015-04-01

Multi-Criteria Evaluation (MCE) module is one of the five modules of RiskChanges spatial decision support system. RiskChanges web-based platform aims to analyze changes in hydro-meteorological risk and provides tools for selecting the best risk reduction alternative. It is developed under CHANGES framework (changes-itn.eu) and INCREO project (increo-fp7.eu). MCE tool helps decision makers and spatial planners to evaluate, sort and rank the decision alternatives. The users can choose among different indicators that are defined within the system using Risk and Cost Benefit analysis results besides they can add their own indicators. Subsequently the system standardizes and prioritizes them. Finally, the best decision alternative is selected by using the weighted sum model (WSM). The Application of this work is to facilitate the effect of MCE for analyzing changing risk over the time under different scenarios and future years by adopting a group decision making into practice and comparing the results by numeric and graphical view within the system. We believe that this study helps decision-makers to achieve the best solution by expressing their preferences for strategies under future scenarios. Keywords: Multi-Criteria Evaluation, Spatial Decision Support System, Weighted Sum Model, Natural Hazard Risk Management

Can we reduce the risk of disease heart in treatments of left breast? bated breath

International Nuclear Information System (INIS)

Fuentemilla Urio, N.; Lozares Cordero, S.; Otal Palacin, A.; Olasolo Alonso, J.; Pellejero Pellejero, S.; Martin Albina, M. L.; Maneru Camara, F.; Miquelez Alonso, S.; Rubio Arroniz, T.; Soto Prados, P.

2013-01-01

In studies related to breast cancer and mortality, there has been an increase in the mortality of patients with survival greater than 10 years treated with radiotherapy. Subsequent studies it appears that the main cause is heart disease. Therefore, that the heart started to consider organ of risk in the treatment of breast cancer with radiation therapy (adjuvant). Reducing the doses both heart and coronary arteries leads to a reduction in the risk of heart disease. Currently are introducing new techniques, to reduce the dose in heart and in the left anterior descending coronary artery such as new positions or techniques of Breath bated breath hold... (Author)

Risk-benefit evaluation of nuclear power plant siting

International Nuclear Information System (INIS)

Miettinen, J.; Savolainen, I.; Silvennoinen, P.

1976-01-01

An assessment scheme is described for the risk-benefit analyses of nuclear power versus conventional alternatives. Given the siting parameters for the proposed nuclear plant an economic comparison is made with the most advantageous competitive conventional production scenario. The economic benefit is determined from the differential discounted annual energy procurement cost as a function of the real interest rate and amortization time. The risk analysis encompasses the following factors: radiation risks in normal operation, reactor accident hazards and economic risks, atmospheric pollutants from the conventional power plants, and fuel transportation. The hazards are first considered in terms of probabilistic dose distributions. In the second stage risk components are converted to a compatible form where excess mortality is used as the risk indicator. Practical calculations are performed for the power production alternatives of Helsinki where district heat would be extracted from the nuclear power plant. At the real interest rate of 10% and amortization time of 20 yr the 1000 MW(e) nuclear option is found to be Pound9.1 m per yr more economic than the optimal conventional scenario. Simultaneously the nuclear alternative is estimated to reduce excess mortality by 2 to 5 fatal injuries annually. (author)

Risk factors for readmission to hospital in adult patients with heart failure and reduced ejection fraction

DEFF Research Database (Denmark)

Schjødt, Inge; Larsen, Palle; Johnsen, Søren Paaske

2017-01-01

REVIEW QUESTION/OBJECTIVE:: The objective of this systematic review is to identify and synthesize the best available evidence on risk factors associated with hospital readmission at different time points within the first year after heart failure (HF) hospitalization in patients suffering from HF...... with reduced ejection fraction (EF).More specifically, the question is: what are the risk factors for the prediction of hospital readmission within seven, 15, 30, 60, 90, 180 and 365 days of discharge in hospitalized patients with HF with reduced EF aged 18 years or older?...

A Pilot RCT of an Internet Intervention to Reduce the Risk of Alcohol-Exposed Pregnancy.

Science.gov (United States)

Ingersoll, Karen; Frederick, Christina; MacDonnell, Kirsten; Ritterband, Lee; Lord, Holly; Jones, Brogan; Truwit, Lauren

2018-06-01

Preventing alcohol-exposed pregnancies (AEPs) could reduce the incidence of fetal alcohol spectrum disorders. Previous face-to-face interventions significantly reduced risk for AEP, but a scalable intervention is needed to reach more women at risk. This study compared a 6 Core automated, interactive, and tailored Internet intervention, the Contraception and Alcohol Risk Reduction Internet Intervention (CARRII), to a static patient education (PE) website for its effect on AEP risk. Participants were recruited online to a pilot randomized clinical trial (RCT) with baseline, 9 weeks posttreatment, and 6-month (6-M) follow-up assessments. Seventy-one women completed online questionnaires and telephone interviews and were randomized to CARRII (n = 36) or PE (n = 35). Primary outcomes were rates of risky drinking, unprotected sex episodes, and AEP risk, collected from online prospective diaries. CARRII participants showed significant reductions in rate of unprotected sex from pretreatment (88.9%) to posttreatment (70.6%) (p < 0.04) and to 6-M follow-up (51.5%) (p = 0.001); rate of risky drinking from pretreatment (75.0%) to posttreatment (50.0%) (p < 0.02), but insignificant change from pretreatment to 6-M follow-up (57.6%) (p < 0.09); and rate of AEP risk from pretreatment (66.7%) to posttreatment (32.4%) (p = 0.001) and to 6-M follow-up (30.3%) (p = 0.005). PE participants demonstrated no significant changes on all 3 variables across all time points. Intent-to-treat group-by-time tests were not significant, but power was limited by missing diaries. Over 72% of CARRII participants completed all 6 Cores. Exploratory analyses suggest that higher program utilization is related to change. These data show that CARRII was acceptable, feasible, promising to reduce AEP risk, and merits further testing in a fully powered RCT. Copyright © 2018 by the Research Society on Alcoholism.

Diagnosis and Tests: Evaluating a Fall or Risk of Falling

Science.gov (United States)

... as a physical therapist, who can evaluate your fall risk. If your healthcare provider concludes that you are ... to check for things that can impact your fall risk, such as electrolyte balance and the possibility of ...

Reduced COPD Exacerbation Risk Correlates With Improved FEV1: A Meta-Regression Analysis.

Science.gov (United States)

Zider, Alexander D; Wang, Xiaoyan; Buhr, Russell G; Sirichana, Worawan; Barjaktarevic, Igor Z; Cooper, Christopher B

2017-09-01

The mechanism by which various classes of medication reduce COPD exacerbation risk remains unknown. We hypothesized a correlation between reduced exacerbation risk and improvement in airway patency as measured according to FEV 1 . By systematic review, COPD trials were identified that reported therapeutic changes in predose FEV 1 (dFEV 1 ) and occurrence of moderate to severe exacerbations. Using meta-regression analysis, a model was generated with dFEV 1 as the moderator variable and the absolute difference in exacerbation rate (RD), ratio of exacerbation rates (RRs), or hazard ratio (HR) as dependent variables. The analysis of RD and RR included 119,227 patients, and the HR analysis included 73,475 patients. For every 100-mL change in predose FEV 1 , the HR decreased by 21% (95% CI, 17-26; P < .001; R 2  = 0.85) and the absolute exacerbation rate decreased by 0.06 per patient per year (95% CI, 0.02-0.11; P = .009; R 2  = 0.05), which corresponded to an RR of 0.86 (95% CI, 0.81-0.91; P < .001; R 2  = 0.20). The relationship with exacerbation risk remained statistically significant across multiple subgroup analyses. A significant correlation between increased FEV 1 and lower COPD exacerbation risk suggests that airway patency is an important mechanism responsible for this effect. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Effect of Long-Term Consumption of Lactobacillus paracasei SD1 on Reducing Mutans streptococci and Caries Risk: A Randomized Placebo-Controlled Trial

Directory of Open Access Journals (Sweden)

Rawee Teanpaisan

2015-04-01

Full Text Available Background: A previous study revealed Lactobacillus paracasei SD1, a probiotic strain, could reduce mutans streptococci (MS. The aim of this study was to evaluate the long-term effects of L. paracasei SD1 on the colonization of MS, and whether caries lesions developed. Methods: After informed consent, 122 children were recruited and randomly assigned to the probiotic or control groups. The probiotic group received milk-powder containing L. paracasei SD1 and the control group received standard milk-powder once daily for six months. Salivary MS and lactobacilli were enumerated using differential culture at baseline and at three-month intervals for 12 months. The persistence of L. paracasei SD1 was investigated using AP-PCR for DNA-fingerprinting. Oral health was examined at baseline and at the end of the study according to WHO criteria. Results: The long-term consumption could prolong colonization of L. paracasei SD1. Significantly reduced MS counts and increased lactobacilli levels were found among children in the probiotic group. There were less caries lesions in the probiotic group at the end of the study. A significant reduction of the development of new caries lesions (4.5 times was observed in the high caries risk group but not in the low caries risk group. Conclusions: Results demonstrate that the long-term daily ingestion of the human-derived probiotic L. paracasei SD1 significantly reduces the number of MS and caries risk in the high caries group.

An approach to assessing risk in coalbed methane prospect evaluation

International Nuclear Information System (INIS)

Vanorsdale, C.R.

1991-01-01

The economic evaluation of drilling prospects requires assessing the degree of risk involved and its impact on reserve estimates. In developed areas, risk can be determined in a fairly straightforward manner. In remote wildcat areas, risk can almost never be adequately identified or quantified. Between these extremes lie complex reservoirs -- reservoirs to heterogeneous that each well drilled could exhibit production characteristics unlike those of its neighbors. This paper illustrates the use of a risk assessment methodology in a case study of Fruitland coal prospects in the San Juan Basin of New Mexico. This approach could be applied to coalbed methane prospects or any unconventional or highly heterogeneous reservoir with appropriate modification. The utility of this approach is made apparent in a graphical analysis that relates reserves, rate of return and payout time for managerial or financial presentation. This graphical technique and the underlying risk assessment were used to aid a conservative management team in evaluating participation in a multi-well coalbed project

Credit Risk Evaluation System: An Artificial Neural Network Approach

African Journals Online (AJOL)

On the other hand, this kind of bank's activity is connected with high risk as big amount of bad decisions may even cause bankruptcy. The key problem consists of distinguishing good (that surely repay) and bad (that likely default) credit applicants. Credit risk evaluation is an important and interesting management science ...

Offshore wind turbine risk quantification/evaluation under extreme environmental conditions

International Nuclear Information System (INIS)

Taflanidis, Alexandros A.; Loukogeorgaki, Eva; Angelides, Demos C.

2013-01-01

A simulation-based framework is discussed in this paper for quantification/evaluation of risk and development of automated risk assessment tools, focusing on applications to offshore wind turbines under extreme environmental conditions. The framework is founded on a probabilistic characterization of the uncertainty in the models for the excitation, the turbine and its performance. Risk is then quantified as the expected value of some risk consequence measure over the probability distributions considered for the uncertain model parameters. Stochastic simulation is proposed for the risk assessment, corresponding to the evaluation of some associated probabilistic integral quantifying risk, as it allows for the adoption of comprehensive computational models for describing the dynamic turbine behavior. For improvement of the computational efficiency, a surrogate modeling approach is introduced based on moving least squares response surface approximations. The assessment is also extended to a probabilistic sensitivity analysis that identifies the importance of each of the uncertain model parameters, i.e. risk factors, towards the total risk as well as towards each of the failure modes contributing to this risk. The versatility and computational efficiency of the advocated approaches is finally exploited to support the development of standalone risk assessment applets for automated implementation of the probabilistic risk quantification/assessment. -- Highlights: ► A simulation-based risk quantification/assessment framework is discussed. ► Focus is on offshore wind turbines under extreme environmental conditions. ► Approach is founded on probabilistic description of excitation/system model parameters. ► Surrogate modeling is adopted for improved computational efficiency. ► Standalone risk assessment applets for automated implementation are supported

Potential mediating pathways through which sports participation relates to reduced risk of suicidal ideation.

Science.gov (United States)

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

2010-09-01

Suicide ranks as the third leading cause of death for American youth. Researchers examining sport participation and suicidal behavior have regularly found inverse relationships. This study represents the first effort to test a model depicting potential mechanisms through which sport participation relates to reduced risk of suicidal ideation. The participants were 450 undergraduate students. Measures assessed participants' involvement in university-run sports and other activities; frequency of physical activity; and perceived social support, self-esteem, depression, hopelessness, loneliness, and suicidal ideation. Regression analyses confirmed a path model and tested for mediation effects. Vigorous activity mediated relationships between sport participation and self-esteem and depression; and self-esteem and depression mediated the relationship between vigorous activity and suicidal ideation. Social support mediated relationships between sport participation and depression, hopelessness, and loneliness; and each of these risk factors partially mediated the relationship between social support and suicidal ideation. However no variable fully mediated the relationship between sport participation and suicidal ideation. This study provides a foundation for research designed to examine pathways through which sport participation relates to reduced risk of suicidal behavior.

Research items regarding seismic residual risk evaluation

Energy Technology Data Exchange (ETDEWEB)

NONE

2013-08-15

After learning the Fukushima Dai-ichi NPP severe accidents in 2011, the government investigation committee proposed the effective use of probabilistic safety assessment (PSA), and now it is required to establish new safety rules reflecting the results of probabilistic risk assessment (PRA) and proposed severe accident measures. Since the Seismic Design Guide has been revised on September 19, 2006, JNES has been discussing seismic PRA (Levels 1-3) methods to review licensees' residual risk assessment while preparing seismic PRA models. Meanwhile, new safety standards for light water reactors are to be issued and enforced on July 2013, which require the residual risk of tsunami, in addition to earthquakes, should be lowered as much as possible. The Fukushima accidents raised the problems related to risk assessment, e.g. approaches based on multi-hazard (earthquake and tsunami), multi-unit, multi-site, and equipment's common cause failure. This fiscal year, while performing seismic and/or tsunami PRA to work on these problems, JNES picked up the equipment whose failure greatly contribute to core damage, surveyed accident management measures on those equipment as well as effectiveness to reduce core damage probability. (author)

BCG vaccination reduces risk of tuberculosis infection in vaccinated badgers and unvaccinated badger cubs.

Directory of Open Access Journals (Sweden)

Stephen P Carter

Full Text Available Wildlife is a global source of endemic and emerging infectious diseases. The control of tuberculosis (TB in cattle in Britain and Ireland is hindered by persistent infection in wild badgers (Meles meles. Vaccination with Bacillus Calmette-Guérin (BCG has been shown to reduce the severity and progression of experimentally induced TB in captive badgers. Analysis of data from a four-year clinical field study, conducted at the social group level, suggested a similar, direct protective effect of BCG in a wild badger population. Here we present new evidence from the same study identifying both a direct beneficial effect of vaccination in individual badgers and an indirect protective effect in unvaccinated cubs. We show that intramuscular injection of BCG reduced by 76% (Odds ratio = 0.24, 95% confidence interval (CI 0.11-0.52 the risk of free-living vaccinated individuals testing positive to a diagnostic test combination to detect progressive infection. A more sensitive panel of tests for the detection of infection per se identified a reduction of 54% (Odds ratio = 0.46, 95% CI 0.26-0.88 in the risk of a positive result following vaccination. In addition, we show the risk of unvaccinated badger cubs, but not adults, testing positive to an even more sensitive panel of diagnostic tests decreased significantly as the proportion of vaccinated individuals in their social group increased (Odds ratio = 0.08, 95% CI 0.01-0.76; P = 0.03. When more than a third of their social group had been vaccinated, the risk to unvaccinated cubs was reduced by 79% (Odds ratio = 0.21, 95% CI 0.05-0.81; P = 0.02.

Reducing cardiovascular risk factors in non-selected outpatients with schizophrenia.

Science.gov (United States)

Hansen, Mette Vinther; Hjorth, Peter; Kristiansen, Christina Blanner; Vandborg, Kirsten; Gustafsson, Lea Nørgaard; Munk-Jørgensen, Povl

2016-06-01

Cardiovascular diseases are the most common causes of premature death in patients with schizophrenia. We aimed at reducing cardiovascular risk factors in non-selected outpatients with schizophrenia using methods proven effective in short-term trials. Furthermore, we examined whether any baseline characteristics were associated with positive outcomes. All outpatients treated for schizophrenia at two Danish hospitals were included in this 1-year follow-up study. The patients were offered health interventions both individually and in groups. Weight, waist circumference, blood glucose, serum lipids, and information on smoking and alcohol were obtained. On average, small significant increases in body mass index (BMI) and waist circumferences were observed while small non-significant improvements in other cardiovascular risk factors were seen. Patients with high baseline BMI and patients with duration of treated illness beyond 2 years had significantly better intervention outcomes. Our results show that it was difficult to improve physical health in a group of non-selected patients with schizophrenia as part of routine care. The patients were not easily motivated to participate in the interventions, and it was difficult to monitor the recommended metabolic risk measures in the patient group. Future research should focus on simple strategies in health promotion that can be integrated into routine care. © The Author(s) 2016.

Newly developed integrated model to reduce risks in the electricity market

International Nuclear Information System (INIS)

Mo, Birger

2001-01-01

A new model which integrates hydro-scheduling and financial hedging has been developed in cooperation with Norsk Hydro. We believe the new tool will be useful for owners of hydropower plants that want to reduce risks in the power market. The model development started in 1997 and was financed by Norsk Hydro. As of 1998, the main financial contributor has been the Research Council of Norway through a project in the Strategic Institute Programme. (author)

Proactive information provision for reducing social construct risk of nuclear facility

International Nuclear Information System (INIS)

Kitamura, Masaharu; Takahashi, Makoto; Hashizume, Hidetoshi; Shiraishi, Natsuki; Yagi, Ekou

2006-01-01

Outlines of, and the empirical observations from, an action research project aiming at improvement of relationship between nuclear community and the public have been reported in this paper. Ultimate goal of the project is effective reduction of social construct risk of nuclear power plants. As an initial approach to the goal, a proactive information provision scheme has been designed based on the knowledge acquired during our previous attempt of public communication named repetitive dialogue forum. The information contents consistent with the actual need of local citizens has been derived from the previous experiences and provided in the present project. Although the project is in its incipient stage, the observations are informative enough to develop the project further to attain the ultimate purpose of reducing the social construct component of technological risk of nuclear facilities. (author)

Evaluating intergenerational risks: Probabillity adjusted rank-discounted utilitarianism

OpenAIRE

Asheim, Geir B.; Zuber, Stéphane

2015-01-01

Climate policies have stochastic consequences that involve a great number of generations. This calls for evaluating social risk (what kind of societies will future people be born into) rather than individual risk (what will happen to people during their own lifetimes). As a response we propose and axiomatize probability adjusted rank-discounted critical-level generalized utilitarianism (PARDCLU), through a key axiom that requires that the social welfare order both be ethical and satisfy first...

Risk evaluation and mitigation strategies: a focus on belatacept.

Science.gov (United States)

Sam, Teena; Gabardi, Steven; Tichy, Eric M

2013-03-01

To review the elements and components of the risk evaluation and mitigation strategies (REMS) for the costimulation blocker belatacept and associated implications for health care providers working with transplant recipients. The MEDLINE and EMBASE databases (January 1990 to March 2012) were searched by using risk evaluation and mitigation strategies, REMS, belatacept, and organ transplant as search terms (individual organs were also searched). Retrieved articles were supplemented with analysis of information obtained from the Federal Register, the Food and Drug Administration, and the manufacturer of belatacept. REMS are risk-management strategies implemented to ensure that a product's benefits outweigh its known safety risks. Although belatacept offers a novel strategy in maintenance immunosuppression and was associated with superior renal function compared with cyclosporine in phase 2 and 3 trials, belatacept is also associated with increased risk of posttransplant lymphoproliferative disorder and central nervous system infections. The Food and Drug Administration required development of a REMS program as part of belatacept's approval process to ensure safe and appropriate use of the medication and optimization of its risk-benefit profile. Elements of the belatacept REMS include a medication guide that must be dispensed with each infusion and a communication plan. In the management of a complex population of patients, it is essential that those who care for transplant recipients, and patients, recognize the implications of potential and known risks of belatacept. The REMS program aims to facilitate careful selection and education of patients and vigilant monitoring.

Credit risk evaluation based on social media.

Science.gov (United States)

Yang, Yang; Gu, Jing; Zhou, Zongfang

2016-07-01

Social media has been playing an increasingly important role in the sharing of individuals' opinions on many financial issues, including credit risk in investment decisions. This paper analyzes whether these opinions, which are transmitted through social media, can accurately predict enterprises' future credit risk. We consider financial statements oriented evaluation results based on logit and probit approaches as the benchmarks. We then conduct textual analysis to retrieve both posts and their corresponding commentaries published on two of the most popular social media platforms for financial investors in China. Professional advice from financial analysts is also investigated in this paper. We surprisingly find that the opinions extracted from both posts and commentaries surpass opinions of analysts in terms of credit risk prediction. Copyright © 2015 Elsevier Inc. All rights reserved.

An In Silico Approach for Evaluating a Fraction-Based, Risk Assessment Method for Total Petroleum Hydrocarbon Mixtures

Directory of Open Access Journals (Sweden)

Nina Ching Y. Wang

2012-01-01

Full Text Available Both the Massachusetts Department of Environmental Protection (MADEP and the Total Petroleum Hydrocarbon Criteria Working Group (TPHCWG developed fraction-based approaches for assessing human health risks posed by total petroleum hydrocarbon (TPH mixtures in the environment. Both organizations defined TPH fractions based on their expected environmental fate and by analytical chemical methods. They derived toxicity values for selected compounds within each fraction and used these as surrogates to assess hazard or risk of exposure to the whole fractions. Membership in a TPH fraction is generally defined by the number of carbon atoms in a compound and by a compound's equivalent carbon (EC number index, which can predict its environmental fate. Here, we systematically and objectively re-evaluate the assignment of TPH to specific fractions using comparative molecular field analysis and hierarchical clustering. The approach is transparent and reproducible, reducing inherent reliance on judgment when toxicity information is limited. Our evaluation of membership in these fractions is highly consistent (̃80% on average across various fractions with the empirical approach of MADEP and TPHCWG. Furthermore, the results support the general methodology of mixture risk assessment to assess both cancer and noncancer risk values after the application of fractionation.

Geographic exposure risk of variant Creutzfeldt-Jakob disease in US blood donors: a risk-ranking model to evaluate alternative donor-deferral policies.

Science.gov (United States)

Yang, Hong; Huang, Yin; Gregori, Luisa; Asher, David M; Bui, Travis; Forshee, Richard A; Anderson, Steven A

2017-04-01

Variant Creutzfeldt-Jakob disease (vCJD) has been transmitted by blood transfusion (TTvCJD). The US Food and Drug Administration (FDA) recommends deferring blood donors who resided in or traveled to 30 European countries where they may have been exposed to bovine spongiform encephalopathy (BSE) through beef consumption. Those recommendations warrant re-evaluation, because new cases of BSE and vCJD have markedly abated. The FDA developed a risk-ranking model to calculate the geographic vCJD risk using country-specific case rates and person-years of exposure of US blood donors. We used the reported country vCJD case rates, when available, or imputed vCJD case rates from reported BSE and UK beef exports during the risk period. We estimated the risk reduction and donor loss should the deferral be restricted to a few high-risk countries. We also estimated additional risk reduction by leukocyte reduction (LR) of red blood cells (RBCs). The United Kingdom, Ireland, and France had the greatest vCJD risk, contributing approximately 95% of the total risk. The model estimated that deferring US donors who spent extended periods of time in these three countries, combined with currently voluntary LR (95% of RBC units), would reduce the vCJD risk by 89.3%, a reduction similar to that achieved under the current policy (89.8%). Limiting deferrals to exposure in these three countries would potentially allow donations from an additional 100,000 donors who are currently deferred. Our analysis suggests that a deferral option focusing on the three highest risk countries would achieve a level of blood safety similar to that achieved by the current policy. © 2016 AABB.

Evaluating the Risk of Re-identification of Patients from Hospital Prescription Records.

Science.gov (United States)

Emam, Khaled El; Dankar, Fida K; Vaillancourt, Régis; Roffey, Tyson; Lysyk, Mary

2009-07-01

Pharmacies often provide prescription records to private research firms, on the assumption that these records are de-identified (i.e., identifying information has been removed). However, concerns have been expressed about the potential that patients can be re-identified from such records. Recently, a large private research firm requested prescription records from the Children's Hospital of Eastern Ontario (CHEO), as part of a larger effort to develop a database of hospital prescription records across Canada. To evaluate the ability to re-identify patients from CHEO'S prescription records and to determine ways to appropriately de-identify the data if the risk was too high. The risk of re-identification was assessed for 18 months' worth of prescription data. De-identification algorithms were developed to reduce the risk to an acceptable level while maintaining the quality of the data. The probability of patients being re-identified from the original variables and data set requested by the private research firm was deemed quite high. A new de-identified record layout was developed, which had an acceptable level of re-identification risk. The new approach involved replacing the admission and discharge dates with the quarter and year of admission and the length of stay in days, reporting the patient's age in weeks, and including only the first character of the patient's postal code. Additional requirements were included in the data-sharing agreement with the private research firm (e.g., audit requirements and a protocol for notification of a breach of privacy). Without a formal analysis of the risk of re-identification, assurances of data anonymity may not be accurate. A formal risk analysis at one hospital produced a clinically relevant data set that also protects patient privacy and allows the hospital pharmacy to explicitly manage the risks of breach of patient privacy.

Intake of Japanese and Chinese teas reduces risk of Parkinson's disease.

Science.gov (United States)

Tanaka, Keiko; Miyake, Yoshihiro; Fukushima, Wakaba; Sasaki, Satoshi; Kiyohara, Chikako; Tsuboi, Yoshio; Yamada, Tatsuo; Oeda, Tomoko; Miki, Takami; Kawamura, Nobutoshi; Sakae, Nobutaka; Fukuyama, Hidenao; Hirota, Yoshio; Nagai, Masaki

2011-07-01

Studies that have addressed the association between the intake of coffee or caffeine and Parkinson's disease (PD) were conducted mainly in Western countries. Little is known about this relationship in an Asian population. Therefore, we performed an assessment of the association of the intake of coffee, other caffeine-containing beverages, and caffeine with the risk of PD in Japan. The study involved 249 PD cases and 368 control subjects. Information on dietary factors was obtained through a self-administered diet history questionnaire. Adjustment was made for sex, age, region of residence, educational level, pack-years of smoking, body mass index, the dietary glycemic index, and intake of cholesterol, vitamin E, β-carotene, vitamin B(6,) alcohol, and iron. Intake of coffee, black tea, and Japanese and Chinese teas was significantly inversely associated with the risk of PD: the adjusted odds ratios in comparison of the highest with the lowest quartile were 0.52, 0.58, and 0.59, respectively (95% confidence intervals = 0.30-0.90, 0.35-0.97, and 0.35-0.995, respectively). A clear inverse dose-response relationship between total caffeine intake and PD risk was observed. We confirmed that the intake of coffee and caffeine reduced the risk of PD. Furthermore, this is the first study to show a significant inverse relationship between the intake of Japanese and Chinese teas and the risk of PD. Copyright © 2011 Elsevier Ltd. All rights reserved.

Reduced risk insecticides to control scale insects and protect natural enemies in the production and maintenance of urban landscape plants.

Science.gov (United States)

Frank, Steven D

2012-04-01

Armored scale insects are among the most difficult to manage and economically important arthropod pests in the production and maintenance of urban landscape plants. This is because of morphological traits that protect them from contact insecticides. I compared initial and season-long control of euonymus scale, Unaspis euonymi Comstock (Hemiptera: Diaspidae), by reduced-risk insecticides (insect growth regulators [IGRs], neonicotinoids, spirotetramat) to determine if they controlled scale as well as more toxic insecticides such as the organophosphate, acephate, and pyrethroid, bifenthrin. I also evaluated how these insecticides affected natural enemy abundance on experimental plants and survival when exposed to insecticide residue. All insecticides tested reduced first generation euonymus scale abundance. In 2009, reinfestation by second generation euonymus scale was highest on plants treated with acetamiprid and granular dinotefuran. In 2010, systemic neonicotinoids and spirotetramat prevented cottony cushion scale infestation 133 d after treatment whereas scale readily infested plants treated with bifenthrin and horticultural oil. Encarsia spp. and Cybocephalus spp. abundance was related to scale abundance. These natural enemies were generally less abundant than predicted by scale abundance on granular dinotefuran treated plants and more abundant on granular thiamethoxam treated plants. Bifenthrin residue killed 90-100% of O. insidiosus and E. citrina within 24 h. My results indicate that reduced risk insecticides can provide season-long scale control with less impact on natural enemies than conventional insecticides. This could have economic and environmental benefits by reducing the number of applications necessary to protect nursery and landscape plants from scale.

Polyurethane film dressings and ceramide 2-containing hydrocolloid dressing reduce the risk of pressure ulcer development in high-risk patients undergoing surgery: a matched case-control study

Directory of Open Access Journals (Sweden)

Kohta M

2015-02-01

Full Text Available Masushi Kohta,1 Kazumi Sakamoto,2 Tsunao Oh-i31Medical Engineering Laboratory, ALCARE Co, Ltd, Sumida-ku, Tokyo, 2Department of Nursing, 3Department of Dermatology, Tokyo Medical University Ibaraki Medical Center, Ami, Ibaraki, JapanBackground: Numerous clinical challenges regarding adhesive dressings have shown that using an adhesive dressing could minimize or prevent superficial skin loss in patients at risk of developing pressure ulcers. However, evidence that polyurethane film dressings and ceramide 2-containing hydrocolloid dressing can reduce the risk of pressure ulcer development in high-risk patients undergoing surgery is limited. Therefore, we assessed the effects of application of these dressings for reducing the risk of pressure ulcer development in these patients and identified other risk factors.Methods: A matched case-control study was conducted involving 254 patients at high risk for pressure ulcer development at one acute care hospital in Japan. No patients in this study had a pressure ulcer at the start of the study. Thirty-one patients developed a pressure ulcer during surgery, and these patients were defined as cases. Controls were randomly matched for sex and age (±4 years, from which 62 patients were selected. Medical records were obtained for preoperative factors, including age, sex, body mass index, diabetes mellitus, albumin, total protein, C-reactive protein, white cell count, red cell count, and hemoglobin, and for intraoperative factors, including dressing application, operation time, body position, and surgery type. The odds ratio (OR and 95% confidence interval (CI were determined to identify risk factors for pressure ulcer development in patients undergoing surgery.Results: By multiple logistic regression analysis, there was a significantly reduced risk of pressure ulcer development for patients who had dressing applications as compared with those without dressing applications (OR 0.063; 95% CI 0.012–0.343; P=0

5-Aminosalicylates reduce the risk of colorectal neoplasia in patients with ulcerative colitis: an updated meta-analysis.

Directory of Open Access Journals (Sweden)

Li-Na Zhao

Full Text Available BACKGROUND: Although the chemopreventive effect of 5-aminosalicylates on patients with ulcerative colitis has been extensively studied, the results remain controversial. This updated review included more recent studies and evaluated the effectiveness of 5-aminosalicylates use on colorectal neoplasia prevention in patients with ulcerative colitis. METHODS: Up to July 2013, we searched Medline, Embase, Web of Science, Cochrane CENTRAL, and SinoMed of China for all relevant observational studies (case-control and cohort about the effect of 5-aminosalicylates on the risk of colorectal neoplasia among patients with ulcerative colitis. The Newcastle-Ottawa Scale was used to assess the quality of studies. Adjusted odds ratios (ORs were extracted from each study. A random-effects model was used to generate pooled ORs and 95% confidence intervals (95%CI. Publication bias and heterogeneity were assessed. RESULTS: Seventeen studies containing 1,508 cases of colorectal neoplasia and a total of 20,193 subjects published from 1994 to 2012 were analyzed. 5-aminosalicylates use was associated with a reduced risk of colorectal neoplasia in patients with ulcerative colitis (OR 0.63; 95%CI 0.48-0.84. Pooled OR of a higher average daily dose of 5-aminosalicylates (sulfasalazine ≥ 2.0 g/d, mesalamine ≥ 1.2 g/d was 0.51 [0.35-0.75]. Pooled OR of 5-aminosalicylates use in patients with extensive ulcerative colitis was 1.00 [0.53-1.89]. CONCLUSION: Our pooled results indicated that 5-aminosalicylates use was associated with a reduced risk of colorectal neoplasia in patients with ulcerative colitis, especially in the cases with a higher average daily dose of 5-aminosalicylates use. However, the chemopreventive benefit of 5-aminosalicylates use in patients with extensive ulcerative colitis was limited.

Breast cancer screening in BRCA1 and BRCA2 mutation carriers after risk reducing salpingo-oophorectomy

NARCIS (Netherlands)

Fakkert, I.E.; Jansen, L.; Meijer, K.; Kok, Theo; Oosterwijk, J.C.; Mourits, M.J.E.; de Bock, G.H.

Breast cancer screening is offered to BRCA1 and BRCA2 mutation carriers from the age of 25 years because of their increased risk of breast cancer. As ovarian cancer screening is not effective, risk-reducing salpingho-oophorectomy (RRSO) is offered after child bearing age. RRSO before menopause

Millstone 3 risk evaluation report. An overall review and evaluation of the Millstone Unit 3 probabilistic safety study

International Nuclear Information System (INIS)

Kelly, G.; Barrett, R.; Buslik, A.

1986-06-01

In 1981, the US Nuclear Regulatory Commission (NRC) requested Northeast Utilities to perform a design-specific probabilistic safety study (PSS) for Millstone Nuclear Power Station, Unit No. 3 (Millstone 3). In 1983, Northeast Utilities submitted the Millstone 3 Probabilistic Safety Study for review by the NRC staff. The NRC staff prepared the Millstone 3 Risk Evaluation Report, which discusses the findings regarding the PSS. The PSS estimates that the mean annual core damage frequency due to internal and external events is 5 x 10 -5 and 2 x 10 -5 , respectively. The NRC staff's Risk Evaluation Report estimates that the mean annual core damage frequency is about 2 x 10 -4 for internal events and lies between 1 x 10 -5 and 2 x 10 -4 for external events. The NRC staff estimates that station blackout dominates internal and external event core damage frequencies. The staff recommends that Northeast Utilities perform an engineering analysis on upgrading the diesel generator lube oil cooler anchorage system and on adding a manually operated, AC-independent containment spray system. The staff also recommends that Northeast Utilities prepare two emergency procedures (loss of room cooling and relay chatter due to an earthquake) to help reduce uncertainties. (Subsequent to the completion of this document, Northeast Utilities and the NRC staff have continued a dialogue regarding station blackout from events other than earthquakes. Both Northeast Utilities and the staff have performed additional evaluations, which have drawn their results closer together. Final requirements, if any, for the prevention or mitigation of station blackout from events other than earthquakes have not yet been determined.) 26 refs., 16 tabs

Risk evaluation and monitoring in multiple sclerosis therapeutics.

Science.gov (United States)

Clanet, Michel C; Wolinsky, Jerry S; Ashton, Raymond J; Hartung, Hans-Peter; Reingold, Stephen C

2014-09-01

Risk for multiple sclerosis (MS) disease-modifying therapies (DMT) must be assessed on an ongoing basis. Early concerns regarding the first-approved DMTs for MS have been mitigated, but recently licensed therapies have been linked to possibly greater risks. The objective of this review is to discuss risk assessment in MS therapeutics based on an international workshop and comprehensive literature search and recommend strategies for risk assessment/monitoring. Assessment and perception of therapeutic risks vary between patients, doctors and regulators. Acceptability of risk depends on the magnitude of risk and the demonstrated clinical benefits of any agent. Safety signals must be distinguishable from chance occurrences in a clinical trial and in long-term use of medications. Post-marketing research is crucial for assessing longer-term safety in large patient cohorts. Reporting of adverse events is becoming more proactive, allowing more rapid identification of risks. Communication about therapeutic risks and their relationship to clinical benefit must involve patients in shared decision making. It is difficult to produce a general risk-assessment algorithm for all MS therapies. Specific algorithms are required for each DMT in every treated-patient population. New and evolving risks must be evaluated and communicated rapidly to allow patients and physicians to be well informed and able to share treatment decisions. © The Author(s) 2013.