Radiodosimetry and preventive measures in the event of a nuclear accident. Proceedings of an international symposium

International Nuclear Information System (INIS)

1996-08-01

An international symposium on Radiodosimetry and Preventive Measures in the Event of a Nuclear Accident was held in Cracow, Poland, from 26 to 28 May 1994. The symposium was organized by the Polish Society for Nuclear Medicine, and co-sponsored by the IAEA. Over 40 experts from Belarus, Latvia, Lithuania, Germany, Poland, the Russian Federation, Sweden and Switzerland participated. The aim of the Symposium was to review models of iodine kinetics used in the calculation of internal radiation doses to the thyroid after the Chernobyl accident, to discuss internal and external radiation dose to the thyroid in terms or risk of thyroid cancer, and to present data on the incidence rate of thyroid cancer in the selected iodine deficient area in Poland. A part of the symposium was dedicated to the physiological basis of iodine prophylaxis and emergency planning for a nuclear accident. Recommendations of the IAEA on preventive measures in the event of a nuclear accident were also addressed. These proceedings contain the full text of the eight invited papers presented at the symposium. Refs, figs, tabs

Addressing the Issue: Bullying and LGBTQ Youth

Directory of Open Access Journals (Sweden)

Kimberly Allen

2014-09-01

Full Text Available Each day, thousands of youth experience bullying and as many of 70% of all youth report having experienced bullying, either directly or indirectly (Cantor, 2005. For Gay, Lesbian, Bi-sexual, Transgender and Questioning (LGBTQ youth, the chances of experiencing bullying are much higher than for youth in the general population (Russell, Horn, Kosciw, & Saewyc, 2010. Although many youth serving organizations have begun to address the issue of bullying with bullying prevention programs, there is a deficit of information and a lack of inclusion of prevention efforts that specifically address LGBTQ youth. This article address the role of youth organizations in creating safe and inclusive environments for all youth, with specific attention paid to resources and strategies for inclusive environments for LGBTQ youth.

A digital pixel cell for address event representation image convolution processing

Science.gov (United States)

Camunas-Mesa, Luis; Acosta-Jimenez, Antonio; Serrano-Gotarredona, Teresa; Linares-Barranco, Bernabe

2005-06-01

Address Event Representation (AER) is an emergent neuromorphic interchip communication protocol that allows for real-time virtual massive connectivity between huge number of neurons located on different chips. By exploiting high speed digital communication circuits (with nano-seconds timings), synaptic neural connections can be time multiplexed, while neural activity signals (with mili-seconds timings) are sampled at low frequencies. Also, neurons generate events according to their information levels. Neurons with more information (activity, derivative of activities, contrast, motion, edges,...) generate more events per unit time, and access the interchip communication channel more frequently, while neurons with low activity consume less communication bandwidth. AER technology has been used and reported for the implementation of various type of image sensors or retinae: luminance with local agc, contrast retinae, motion retinae,... Also, there has been a proposal for realizing programmable kernel image convolution chips. Such convolution chips would contain an array of pixels that perform weighted addition of events. Once a pixel has added sufficient event contributions to reach a fixed threshold, the pixel fires an event, which is then routed out of the chip for further processing. Such convolution chips have been proposed to be implemented using pulsed current mode mixed analog and digital circuit techniques. In this paper we present a fully digital pixel implementation to perform the weighted additions and fire the events. This way, for a given technology, there is a fully digital implementation reference against which compare the mixed signal implementations. We have designed, implemented and tested a fully digital AER convolution pixel. This pixel will be used to implement a full AER convolution chip for programmable kernel image convolution processing.

A Quantitative Index to Support Recurrence Prevention Plans of Human-Related Events

Energy Technology Data Exchange (ETDEWEB)

Kim, Yochan; Park, Jinkyun; Jung, Wondea [KAERI, Daejeon (Korea, Republic of); Kim, Do Sam; Lee, Durk Hun [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

2015-05-15

In Korea, HuRAM+ (Human related event Root cause Analysis Method plus) was developed to scrutinize the causes of the human-related events. The information of the human-related events investigated by the HuRAM+ method has been also managed by a database management system, R-tracer. It is obvious that accumulating data of human error causes aims to support plans that reduce recurrences of similar events. However, in spite of the efforts for the development of the human error database, it was indicated that the database does not provide useful empirical basis for establishment of the recurrence prevention plans, because the framework to interpret the collected data and apply the insights from the data into the prevention plants has not been developed yet. In this paper, in order to support establishment of the recurrence prevention plans, a quantitative index, Human Error Repeat Interval (HERI), was proposed and its applications to human error prevention were introduced. In this paper, a quantitative index, the HERI was proposed and the statistics of HERIs were introduced. These estimations can be employed to evaluate effects of recurrence prevention plans to human errors. If a mean HERI score is low and the linear trend is not positive, it can be suspected that the recurrence prevention plans applied every human-related event has not been effectively propagated. For reducing repetitive error causes, the system design or operational culture can be reviewed. If there is a strong and negative trend, systematic investigation of the root causes behind these trends is required. Likewise, we expect that the HERI index will provide significant basis for establishing or adjusting prevention plans of human errors. The accurate estimation and application of HERI scores is expected to be done after accumulating more data. When a scatter plot of HERIs is fitted by two or more models, a statistical model selection method can be employed. Some criteria have been introduced by

A Quantitative Index to Support Recurrence Prevention Plans of Human-Related Events

International Nuclear Information System (INIS)

Kim, Yochan; Park, Jinkyun; Jung, Wondea; Kim, Do Sam; Lee, Durk Hun

2015-01-01

In Korea, HuRAM+ (Human related event Root cause Analysis Method plus) was developed to scrutinize the causes of the human-related events. The information of the human-related events investigated by the HuRAM+ method has been also managed by a database management system, R-tracer. It is obvious that accumulating data of human error causes aims to support plans that reduce recurrences of similar events. However, in spite of the efforts for the development of the human error database, it was indicated that the database does not provide useful empirical basis for establishment of the recurrence prevention plans, because the framework to interpret the collected data and apply the insights from the data into the prevention plants has not been developed yet. In this paper, in order to support establishment of the recurrence prevention plans, a quantitative index, Human Error Repeat Interval (HERI), was proposed and its applications to human error prevention were introduced. In this paper, a quantitative index, the HERI was proposed and the statistics of HERIs were introduced. These estimations can be employed to evaluate effects of recurrence prevention plans to human errors. If a mean HERI score is low and the linear trend is not positive, it can be suspected that the recurrence prevention plans applied every human-related event has not been effectively propagated. For reducing repetitive error causes, the system design or operational culture can be reviewed. If there is a strong and negative trend, systematic investigation of the root causes behind these trends is required. Likewise, we expect that the HERI index will provide significant basis for establishing or adjusting prevention plans of human errors. The accurate estimation and application of HERI scores is expected to be done after accumulating more data. When a scatter plot of HERIs is fitted by two or more models, a statistical model selection method can be employed. Some criteria have been introduced by

Reduced fatalism and increased prevention behavior after two high-profile lung cancer events.

Science.gov (United States)

Portnoy, David B; Leach, Corinne R; Kaufman, Annette R; Moser, Richard P; Alfano, Catherine M

2014-01-01

The positive impact of media coverage of high-profile cancer events on cancer prevention behaviors is well-established. However, less work has focused on potential adverse psychological reactions to such events, such as fatalism. Conducting 3 studies, the authors explored how the lung cancer death of Peter Jennings and diagnosis of Dana Reeve in 2005 related to fatalism. Analysis of a national media sample in Study 1 found that media coverage of these events often focused on reiterating the typical profile of those diagnosed with lung cancer; 38% of the media mentioned at least 1 known risk factor for lung cancer, most often smoking. Data from a nationally representative survey in Study 2 found that respondents reported lower lung cancer fatalism, after, compared with before, the events (OR = 0.16, 95% CI [0.03, 0.93]). A sustained increase in call volume to the national tobacco Quitline after these events was found in Study 3. These results suggest that there is a temporal association between high-profile cancer events, the subsequent media coverage, psychological outcomes, and cancer prevention behaviors. These results suggest that high-profile cancer events could be leveraged as an opportunity for large-scale public heath communication campaigns through the dissemination of cancer prevention messages and services.

Development, Implementation and Evaluation of an Educational Intervention to Prevent Low Speed Vehicle Run-Over Events: Lessons Learned

Directory of Open Access Journals (Sweden)

Bronwyn Griffin

2018-04-01

Full Text Available There is a growing body of literature regarding low speed vehicle runover (LSVRO events among children. To date, no literature exists on evaluation of interventions to address this serious childhood injury. Knowledge, attitudes, and behaviour regarding LSVROs were assessed via survey at a shopping centre (pre-intervention, then five months later (post-intervention, to investigate the effect of a population level educational intervention in Queensland, Australia. Participants’ knowledge regarding frequency of LSVRO events was poor. No participant demonstrated ‘adequate behaviour’ in relation to four safe driveway behaviours pre-intervention; this increased at post-intervention (p < 0.05. Most of the sample perceived other’s driveway behaviour as inadequate, and this reduced significantly (<0.05. Perceived effectiveness of LSVRO prevention strategies increased from pre- to post-intervention, but not significantly. TV was the greatest source of knowledge regarding LSVROs pre- and post-intervention. This study provides some evidence that the educational campaign and opportunistic media engagement were successful in increasing awareness and improving behaviour regarding LSVROs. While there are several limitations to this study, our experience reflects the ‘real-world’ challenges associated with implementing prevention strategies. We suggest a multi-faceted approach involving media (including social media, legislative changes, subsidies (for reversing cameras, and education to prevent LSVROs.

DEVS representation of dynamical systems - Event-based intelligent control. [Discrete Event System Specification

Science.gov (United States)

Zeigler, Bernard P.

1989-01-01

It is shown how systems can be advantageously represented as discrete-event models by using DEVS (discrete-event system specification), a set-theoretic formalism. Such DEVS models provide a basis for the design of event-based logic control. In this control paradigm, the controller expects to receive confirming sensor responses to its control commands within definite time windows determined by its DEVS model of the system under control. The event-based contral paradigm is applied in advanced robotic and intelligent automation, showing how classical process control can be readily interfaced with rule-based symbolic reasoning systems.

Incidence and preventability of adverse events requiring intensive care admission: a systematic review.

Science.gov (United States)

Vlayen, Annemie; Verelst, Sandra; Bekkering, Geertruida E; Schrooten, Ward; Hellings, Johan; Claes, Neree

2012-04-01

Adverse events are unintended patient injuries or complications that arise from health care management resulting in death, disability or prolonged hospital stay. Adverse events that require critical care are a considerable financial burden to the health care system, but also their global impact on patients and society is probably underestimated. The objectives of this systematic review were to synthesize the best available evidence regarding the estimates of the incidence and preventability of adverse events that necessitate intensive care admission, to determine the type and consequences [mortality, length of intensive care unit (ICU) stay and costs] of these adverse events. MEDLINE (from 1966 to present), EMBASE (from 1974 to present) and CENTRAL (version 1-2010) were searched for studies reporting on unplanned admissions on ICUs. Several other sources were searched for additional studies. Only quantitative studies that used chart review for the detection of adverse events requiring intensive care admission were considered for eligibility. For the purposes of this systematic review, ICUs were defined as specialized hospital facilities which provide continuous monitoring and intensive care for acutely ill patients. Studies that were published in the English, Dutch, German, French or Spanish language were eligible for inclusion. Two reviewers independently extracted data and assessed the methodological quality of the included studies. A total of 27 studies were reviewed. Meta-analysis of the data was not appropriate because of methodological and statistical heterogeneity between studies; therefore, results are presented in a descriptive way. The percentage of surgical and medical adverse events that required ICU admission ranged from 1.1% to 37.2%. ICU readmissions varied from 0% to 18.3%. Preventability of the adverse events varied from 17% to 76.5%. Preventable adverse events are further synthesized by type of event. Consequences of the adverse events included a

Methods for assessing the preventability of adverse drug events: a systematic review.

Science.gov (United States)

Hakkarainen, Katja Marja; Andersson Sundell, Karolina; Petzold, Max; Hägg, Staffan

2012-02-01

Preventable adverse drug events (ADEs) are common in both outpatient and inpatient settings. However, the proportion of preventable ADEs varies considerably in different studies, even when conducted in the same setting, and methods for assessing the preventability of ADEs are diverse. The aim of this article is to identify and systematically evaluate methods for assessing the preventability of ADEs. Seven databases (Cochrane, CINAHL, EMBASE, IPA, MEDLINE, PsycINFO and Web of Science) were searched in September 2010 utilizing the databases' index terms and other common terminology on preventable ADEs. No limits for the years of publication were set. Reference lists of included original articles and relevant review articles were also screened. After applying predetermined inclusion and exclusion criteria on 4161 unique citations, 142 (3.4%) original research articles were included in the review. One additional article was included from reference lists. Outcome measures of included studies had to include the frequency of ADEs and the assessment of their preventability. Studies were excluded if they focused on individuals with one specific type of treatment, medical condition, medical procedure or ADE. Measurement instruments for determining the preventability of ADEs in each article were extracted and unique instruments were compared. The process of assessing the preventability of ADEs was described based on reported actions taken to standardize and conduct the assessment, and on information about the reliability and validity of the assessment. Eighteen unique instruments for determining the preventability of ADEs were identified. They fell under the following four groups: (i) instruments using a definition of preventability only (n = 3); (ii) instruments with a definition of preventability and an assessment scale for determining preventability (n = 5); (iii) instruments with specific criteria for each preventability category (n = 3); and (iv) instruments

Blood Pressure Reduction and Secondary Stroke Prevention: A Systematic Review and Metaregression Analysis of Randomized Clinical Trials.

Science.gov (United States)

Katsanos, Aristeidis H; Filippatou, Angeliki; Manios, Efstathios; Deftereos, Spyridon; Parissis, John; Frogoudaki, Alexandra; Vrettou, Agathi-Rosa; Ikonomidis, Ignatios; Pikilidou, Maria; Kargiotis, Odysseas; Voumvourakis, Konstantinos; Alexandrov, Anne W; Alexandrov, Andrei V; Tsivgoulis, Georgios

2017-01-01

Current recommendations do not specifically address the optimal blood pressure (BP) reduction for secondary stroke prevention in patients with previous cerebrovascular events. We conducted a systematic review and metaregression analysis on the association of BP reduction with recurrent stroke and cardiovascular events using data from randomized controlled clinical trials of secondary stroke prevention. For all reported events during each eligible study period, we calculated the corresponding risk ratios to express the comparison of event occurrence risk between patients randomized to antihypertensive treatment and those randomized to placebo. On the basis of the reported BP values, we performed univariate metaregression analyses according to the achieved BP values under the random-effects model (Method of Moments) for those adverse events reported in ≥10 total subgroups of included randomized controlled clinical trials. In pairwise meta-analyses, antihypertensive treatment lowered the risk for recurrent stroke (risk ratio, 0.73; 95% confidence interval, 0.62-0.87; Psecondary stroke prevention. © 2016 American Heart Association, Inc.

Scoping review of health promotion and disease prevention interventions addressed to elderly people.

Science.gov (United States)

Duplaga, Mariusz; Grysztar, Marcin; Rodzinka, Marcin; Kopec, Agnieszka

2016-09-05

The ageing of modern societies remains one of the greatest challenges for health and social systems. To respond to this challenge, we need effective strategies assuring healthy active life for elderly people. Health promotion and related activities are perceived as a key intervention, which can improve wellbeing in later life. The main aim of this study is the identification and classification of such interventions addressed to older adults and elderly. Therefore, the strategy based on the scoping review as a feasible tool for exploring this domain, summarizing research findings and identifying gaps of evidence, was applied. The scoping review relies on the analysis of previous reviews of interventions aimed at older adults (55-64 years old) and elderly persons (65 years and above) assessed for their effectiveness in the framework of a systematic review and/or meta-analysis. The search strategy was based on the identification of interventions reported as health promotion, primary disease prevention, screening or social support. In the analysis, the reviews published from January 2000 to April 2015 were included. The search strategy yielded 334 systematic reviews and/or meta-analyses addressed to target groups of interest, 182 of them assessed interventions belonging to health promotion, 219 to primary prevention, 34 to screening and 35 to social support. The studies focused on elderly (65 years and above) made up 40.4 % of all retrieved reviews and those addressing population of 55 years and above accounted for 24.0 %. Interventions focused on health maintenance and improvement in elderly and older adults represent frequently combined health promotion and disease prevention actions. Many interventions of this type are not addressed exclusively to elderly populations and/or older adults but are designed for the general population. The most common types of interventions addressed to elderly and older adults in the area of health promotion include health

Prevention policies addressing packaging and packaging waste: Some emerging trends.

Science.gov (United States)

Tencati, Antonio; Pogutz, Stefano; Moda, Beatrice; Brambilla, Matteo; Cacia, Claudia

2016-10-01

Packaging waste is a major issue in several countries. Representing in industrialized countries around 30-35% of municipal solid waste yearly generated, this waste stream has steadily grown over the years even if, especially in Europe, specific recycling and recovery targets have been fixed. Therefore, an increasing attention starts to be devoted to prevention measures and interventions. Filling a gap in the current literature, this explorative paper is a first attempt to map the increasingly important phenomenon of prevention policies in the packaging sector. Through a theoretical sampling, 11 countries/states (7 in and 4 outside Europe) have been selected and analyzed by gathering and studying primary and secondary data. Results show evidence of three specific trends in packaging waste prevention policies: fostering the adoption of measures directed at improving packaging design and production through an extensive use of the life cycle assessment; raising the awareness of final consumers by increasing the accountability of firms; promoting collaborative efforts along the packaging supply chains. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Acetylsalicylic acid in primary prevention of cardiovascular events; literature study

NARCIS (Netherlands)

Bredie, S.J.H.; Wollersheim, H.C.H.; Verheugt, F.W.A.; Thien, Th.

2002-01-01

OBJECTIVE: To evaluate literature data on the use of acetylsalicylic acid (ASA) as a primary prevention measure for cardiovascular events. DESIGN: Literature search. METHOD: Using Medline, all randomised placebo-controlled trials of ASA published between 1985 and 1 May 2001, and which used

Visualising linked health data to explore health events around preventable hospitalisations in NSW Australia.

Science.gov (United States)

Falster, Michael O; Jorm, Louisa R; Leyland, Alastair H

2016-09-07

To explore patterns of health service use in the lead-up to, and following, admission for a 'preventable' hospitalisation. 266 950 participants in the 45 and Up Study, New South Wales (NSW) Australia Linked data on hospital admissions, general practitioner (GP) visits and other health events were used to create visual representations of health service use. For each participant, health events were plotted against time, with different events juxtaposed using different markers and panels of data. Various visualisations were explored by patient characteristics, and compared with a cohort of non-admitted participants matched on sociodemographic and health characteristics. Health events were displayed over calendar year and in the 90 days surrounding first preventable hospitalisation. The visualisations revealed patterns of clustering of GP consultations in the lead-up to, and following, preventable hospitalisation, with 14% of patients having a consultation on the day of admission and 27% in the prior week. There was a clustering of deaths and other hospitalisations following discharge, particularly for patients with a long length of stay, suggesting patients may have been in a state of health deterioration. Specialist consultations were primarily clustered during the period of hospitalisation. Rates of all health events were higher in patients admitted for a preventable hospitalisation than the matched non-admitted cohort. We did not find evidence of limited use of primary care services in the lead-up to a preventable hospitalisation, rather people with preventable hospitalisations tended to have high levels of engagement with multiple elements of the healthcare system. As such, preventable hospitalisations might be better used as a tool for identifying sicker patients for managed care programmes. Visualising longitudinal health data was found to be a powerful strategy for uncovering patterns of health service use, and such visualisations have potential to be more

Inter-ethnic Cooperation Revisited: Why mobile phones can help prevent discrete events of violence, using the Kenyan case study

Directory of Open Access Journals (Sweden)

Charles Patrick Martin-Shields

2013-11-01

Full Text Available This paper will critically explore why mobile phones have drawn so much interest from the conflict management community in Kenya, and develop a general set of factors to explain why mobile phones can have a positive effect on conflict prevention efforts generally. Focusing on theories of information asymmetry and security dilemmas, collective action problems, and the role of third party actors in conflict prevention, it aims to continue the discussion around Pierskalla and Hollenbach’s recent research on mobile phones and conflict risk. Given the successful, high profile uses of mobile phone-based violence prevention in Kenya I will identify a set of political and social factors that contribute to the success of crowdsourcing programs that use mobile phones, and explain what makes them transferable across cases for conflict prevention in other countries. The primary findings are that a population must prefer non-violence since technology is a magnifier of human intent, that the events of violence start and stop relative to specific events, the population knows to use their phones to share information about potential violence, and that there are third party actors involved in collecting and validating the crowdsourced data.

CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea.

Science.gov (United States)

McEvoy, R Doug; Antic, Nick A; Heeley, Emma; Luo, Yuanming; Ou, Qiong; Zhang, Xilong; Mediano, Olga; Chen, Rui; Drager, Luciano F; Liu, Zhihong; Chen, Guofang; Du, Baoliang; McArdle, Nigel; Mukherjee, Sutapa; Tripathi, Manjari; Billot, Laurent; Li, Qiang; Lorenzi-Filho, Geraldo; Barbe, Ferran; Redline, Susan; Wang, Jiguang; Arima, Hisatomi; Neal, Bruce; White, David P; Grunstein, Ron R; Zhong, Nanshan; Anderson, Craig S

2016-09-08

Obstructive sleep apnea is associated with an increased risk of cardiovascular events; whether treatment with continuous positive airway pressure (CPAP) prevents major cardiovascular events is uncertain. After a 1-week run-in period during which the participants used sham CPAP, we randomly assigned 2717 eligible adults between 45 and 75 years of age who had moderate-to-severe obstructive sleep apnea and coronary or cerebrovascular disease to receive CPAP treatment plus usual care (CPAP group) or usual care alone (usual-care group). The primary composite end point was death from cardiovascular causes, myocardial infarction, stroke, or hospitalization for unstable angina, heart failure, or transient ischemic attack. Secondary end points included other cardiovascular outcomes, health-related quality of life, snoring symptoms, daytime sleepiness, and mood. Most of the participants were men who had moderate-to-severe obstructive sleep apnea and minimal sleepiness. In the CPAP group, the mean duration of adherence to CPAP therapy was 3.3 hours per night, and the mean apnea-hypopnea index (the number of apnea or hypopnea events per hour of recording) decreased from 29.0 events per hour at baseline to 3.7 events per hour during follow-up. After a mean follow-up of 3.7 years, a primary end-point event had occurred in 229 participants in the CPAP group (17.0%) and in 207 participants in the usual-care group (15.4%) (hazard ratio with CPAP, 1.10; 95% confidence interval, 0.91 to 1.32; P=0.34). No significant effect on any individual or other composite cardiovascular end point was observed. CPAP significantly reduced snoring and daytime sleepiness and improved health-related quality of life and mood. Therapy with CPAP plus usual care, as compared with usual care alone, did not prevent cardiovascular events in patients with moderate-to-severe obstructive sleep apnea and established cardiovascular disease. (Funded by the National Health and Medical Research Council of Australia

Trend analysis of human error events and assessment of their proactive prevention measure at Rokkasho reprocessing plant

International Nuclear Information System (INIS)

Yamazaki, Satoru; Tanaka, Izumi; Wakabayashi, Toshio

2012-01-01

A trend analysis of human error events is important for preventing the recurrence of human error events. We propose a new method for identifying the common characteristics from results of trend analysis, such as the latent weakness of organization, and a management process for strategic error prevention. In this paper, we describe a trend analysis method for human error events that have been accumulated in the organization and the utilization of the results of trend analysis to prevent accidents proactively. Although the systematic analysis of human error events, the monitoring of their overall trend, and the utilization of the analyzed results have been examined for the plant operation, such information has never been utilized completely. Sharing information on human error events and analyzing their causes lead to the clarification of problems in the management and human factors. This new method was applied to the human error events that occurred in the Rokkasho reprocessing plant from 2010 October. Results revealed that the output of this method is effective in judging the error prevention plan and that the number of human error events is reduced to about 50% those observed in 2009 and 2010. (author)

Examination of Preventive Resources, Life Events, and Coping Strategies.

Science.gov (United States)

McCarthy, Christopher J.; Lambert, Richard G.; Beard, Michelle; Canipe, Kara

The Preventive Coping Resources Inventory (PRI) was developed to assess specific coping resources most useful for stress prevention and also applicable to education settings. Undergraduates (N=501) at a large, southwestern university completed the inventory and other measures of adjustment and coping. Exploratory factor analysis revealed five…

A flexible analog memory address list manager for PHENIX

International Nuclear Information System (INIS)

Ericson, M.N.; Musrock, M.S.; Britton, C.L. Jr.; Walker, J.W.; Wintenberg, A.L.; Young, G.R.; Allen, M.D.

1996-01-01

A programmable analog memory address list manager has been developed for use with all analog memory-based detector subsystems of PHENIX. The unit provides simultaneous read/write control, cell write-over protection for both a Level-1 trigger decision delay and digitization latency, and re-ordering of AMU addresses following conversion, at a beam crossing rate of 105 ns. Addresses are handled such that up to 5 Level-1 (LVL-1) events can be maintained in the AMU without write-over. Data tagging is implemented for handling overlapping and shared beam-event data packets. Full usage in all PHENIX analog memory-based detector subsystems is accomplished by the use of detector-specific programmable parameters--the number of data samples per valid LVL-1 trigger and the sample spacing. Architectural candidates for the system are discussed with emphasis on implementation implications. Details of the design are presented including application specifics, timing information, and test results from a full implementation using field programmable gate arrays (FPGAs)

Preventing Lone Wolf Terrorism: some CT Approaches Addressed

Directory of Open Access Journals (Sweden)

Edwin Bakker

2011-12-01

Full Text Available After a brief discussion of the epistemological and phenomenological difficulties associated with the concept of lone wolf terrorism, a number of possible counter-terrorist approaches are discussed. Lone operator terrorist acts should be considered ‘black swan’ occurrences that are almost impossible to categorize or systematize, let alone forecast. Thus, not the profile of the perpetrator, but the modus operandi offer clues for a better response to this particular threat. Furthermore, almost all lone operators do display a degree of commitment to, and identification with, extremist movements – providing leads for preventing new rounds of radicalization within this potential group of sympathizers or followers. With the apparent increase of Islamist lone wolf terrorism and fears for right-wing extremists wanting to follow the example of the Norwegian mass murderer A.B. Breivik, new questions need to be posed, addressing the role of virtual communities with which lone operators identify themselves. 

Screening DNA chip and event-specific multiplex PCR detection methods for biotech crops.

Science.gov (United States)

Lee, Seong-Hun

2014-11-01

There are about 80 biotech crop events that have been approved by safety assessment in Korea. They have been controlled by genetically modified organism (GMO) and living modified organism (LMO) labeling systems. The DNA-based detection method has been used as an efficient scientific management tool. Recently, the multiplex polymerase chain reaction (PCR) and DNA chip have been developed as simultaneous detection methods for several biotech crops' events. The event-specific multiplex PCR method was developed to detect five biotech maize events: MIR604, Event 3272, LY 038, MON 88017 and DAS-59122-7. The specificity was confirmed and the sensitivity was 0.5%. The screening DNA chip was developed from four endogenous genes of soybean, maize, cotton and canola respectively along with two regulatory elements and seven genes: P35S, tNOS, pat, bar, epsps1, epsps2, pmi, cry1Ac and cry3B. The specificity was confirmed and the sensitivity was 0.5% for four crops' 12 events: one soybean, six maize, three cotton and two canola events. The multiplex PCR and DNA chip can be available for screening, gene-specific and event-specific analysis of biotech crops as efficient detection methods by saving on workload and time. © 2014 Society of Chemical Industry. © 2014 Society of Chemical Industry.

A trend analysis of human error events for proactive prevention of accidents. Methodology development and effective utilization

International Nuclear Information System (INIS)

Hirotsu, Yuko; Ebisu, Mitsuhiro; Aikawa, Takeshi; Matsubara, Katsuyuki

2006-01-01

This paper described methods for analyzing human error events that has been accumulated in the individual plant and for utilizing the result to prevent accidents proactively. Firstly, a categorization framework of trigger action and causal factors of human error events were reexamined, and the procedure to analyze human error events was reviewed based on the framework. Secondly, a method for identifying the common characteristics of trigger action data and of causal factor data accumulated by analyzing human error events was clarified. In addition, to utilize the results of trend analysis effectively, methods to develop teaching material for safety education, to develop the checkpoints for the error prevention and to introduce an error management process for strategic error prevention were proposed. (author)

Life review based on remembering specific positive events in active aging.

Science.gov (United States)

Latorre, José M; Serrano, Juan P; Ricarte, Jorge; Bonete, Beatriz; Ros, Laura; Sitges, Esther

2015-02-01

The aim of this study is to evaluate the effectiveness of life review (LR) based on specific positive events in non-depressed older adults taking part in an active aging program. Fifty-five older adults were randomly assigned to an experimental group or an active control (AC) group. A six-session individual training of LR based on specific positive events was carried out with the experimental group. The AC group undertook a "media workshop" of six sessions focused on learning journalistic techniques. Pre-test and post-test measures included life satisfaction, depressive symptoms, experiencing the environment as rewarding, and autobiographical memory (AM) scales. LR intervention decreased depressive symptomatology, improved life satisfaction, and increased specific memories. The findings suggest that practice in AM for specific events is an effective component of LR that could be a useful tool in enhancing emotional well-being in active aging programs, thus reducing depressive symptoms. © The Author(s) 2014.

Cause analysis and preventives for human error events in Daya Bay NPP

International Nuclear Information System (INIS)

Huang Weigang; Zhang Li

1998-01-01

Daya Bay Nuclear Power Plant is put into commercial operation in 1994 Until 1996, there are 368 human error events in operating and maintenance area, occupying 39% of total events. These events occurred mainly in the processes of maintenance, test equipment isolation and system on-line, in particular in refuelling and maintenance. The author analyses root causes for human errorievents, which are mainly operator omission or error procedure deficiency; procedure not followed; lack of training; communication failures; work management inadequacy. The protective measures and treatment principle for human error events are also discussed, and several examples applying them are given. Finally, it is put forward that key to prevent human error event lies in the coordination and management, person in charge of work, and good work habits of staffs

Seamless prevention of adverse events from tattooing

DEFF Research Database (Denmark)

Serup, Jørgen

2015-01-01

The boom in tattooing has been paralleled by more frequent adverse events, which may be localised in the skin or systemic and manifested clinically or latent. Infections, allergic reactions from red-coloured tattoos and papulo-nodular reactions from black tattoos dominate. Mild complaints are very...... orchestration of a multi-targeted strategy. High-priority elements of this strategy shall facilitate a qualified 'go' or 'no go' decision by the customer before the tattoo is made and should involve informed consent, qualification of the tattooist and the parlour, including supplies of inks etc., and attention......, which needs attention and timely action to prevent additional cases and epidemic outbreaks, are part of this seamless strategy, along with optimised medical therapy and research....

Imperative of preventive measures addressing the life-cycle.

Science.gov (United States)

Yajnik, Chittaranjan S

2009-01-01

The epidemiological characteristics of chronic non-communicable diseases (NCD) are fast changing. The prevalence has risen to unprecedented levels, and the young and the underprivileged are increasingly affected. The classic view of the etiology of NCD consists of a genetic susceptibility which is precipitated by aging and modern lifestyle. In a virtual absence of any methods to tackle genetic susceptibility, the preventive approach has so far been focused on the control of lifestyle factors in those at high risk (old, and those with positive family history and elevated risk factors). Such an approach might help high risk individuals, but is unlikely to curtail the burgeoning epidemic of obesity and diabetes. Recent research has suggested that susceptibility to NCD originates in early life through non-genetic mechanisms (fetal programming). Tackling these may offer an exciting opportunity to control the NCD epidemic by influencing the susceptibility in a more durable manner than only controlling the lifestyle factors in adult life. The imperative is to address the life cycle rather than concentrate on the end stages. Copyright (c) 2009 S. Karger AG, Basel.

On constructing optimistic simulation algorithms for the discrete event system specification

International Nuclear Information System (INIS)

Nutaro, James J.

2008-01-01

This article describes a Time Warp simulation algorithm for discrete event models that are described in terms of the Discrete Event System Specification (DEVS). The article shows how the total state transition and total output function of a DEVS atomic model can be transformed into an event processing procedure for a logical process. A specific Time Warp algorithm is constructed around this logical process, and it is shown that the algorithm correctly simulates a DEVS coupled model that consists entirely of interacting atomic models. The simulation algorithm is presented abstractly; it is intended to provide a basis for implementing efficient and scalable parallel algorithms that correctly simulate DEVS models

Genetic risk, coronary heart disease events, and the clinical benefit of statin therapy: an analysis of primary and secondary prevention trials.

Science.gov (United States)

Mega, J L; Stitziel, N O; Smith, J G; Chasman, D I; Caulfield, M; Devlin, J J; Nordio, F; Hyde, C; Cannon, C P; Sacks, F; Poulter, N; Sever, P; Ridker, P M; Braunwald, E; Melander, O; Kathiresan, S; Sabatine, M S

2015-06-06

Genetic variants have been associated with the risk of coronary heart disease. In this study, we tested whether or not a composite of these variants could ascertain the risk of both incident and recurrent coronary heart disease events and identify those individuals who derive greater clinical benefit from statin therapy. A community-based cohort study (the Malmo Diet and Cancer Study) and four randomised controlled trials of both primary prevention (JUPITER and ASCOT) and secondary prevention (CARE and PROVE IT-TIMI 22) with statin therapy, comprising a total of 48,421 individuals and 3477 events, were included in these analyses. We studied the association of a genetic risk score based on 27 genetic variants with incident or recurrent coronary heart disease, adjusting for traditional clinical risk factors. We then investigated the relative and absolute risk reductions in coronary heart disease events with statin therapy stratified by genetic risk. We combined data from the different studies using a meta-analysis. When individuals were divided into low (quintile 1), intermediate (quintiles 2-4), and high (quintile 5) genetic risk categories, a significant gradient in risk for incident or recurrent coronary heart disease was shown. Compared with the low genetic risk category, the multivariable-adjusted hazard ratio for coronary heart disease for the intermediate genetic risk category was 1·34 (95% CI 1·22-1·47, pgenetic risk category was 1·72 (1·55-1·92, pgenetic risk categories. Similarly, we noted greater absolute risk reductions in those individuals in higher genetic risk categories (p=0·0101), resulting in a roughly threefold decrease in the number needed to treat to prevent one coronary heart disease event in the primary prevention trials. Specifically, in the primary prevention trials, the number needed to treat to prevent one such event in 10 years was 66 in people at low genetic risk, 42 in those at intermediate genetic risk, and 25 in those at high

Synergy of Two Highly Specific Biomolecular Recognition Events

DEFF Research Database (Denmark)

Ejlersen, Maria; Christensen, Niels Johan; Sørensen, Kasper K

2018-01-01

Two highly specific biomolecular recognition events, nucleic acid duplex hybridization and DNA-peptide recognition in the minor groove, were coalesced in a miniature ensemble for the first time by covalently attaching a natural AT-hook peptide motif to nucleic acid duplexes via a 2'-amino......-LNA scaffold. A combination of molecular dynamics simulations and ultraviolet thermal denaturation studies revealed high sequence-specific affinity of the peptide-oligonucleotide conjugates (POCs) when binding to complementary DNA strands, leveraging the bioinformation encrypted in the minor groove of DNA...

Zooming in on Life Events: Is Hedonic Adaptation Sensitive to the Temporal Distance from the Event?

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Uglanova, Ekaterina A.; Staudinger, Ursula M.

2013-01-01

This paper analyzed the effect of major positive and negative life events (marriage, divorce, birth of child, widowhood, and unemployment) on life satisfaction. For the first time, this study estimated the effects of life events not with a precision of 12 months but of 3 months. Specifically, two questions were addressed: (1) Does the precision of…

Design of a medical record review study on the incidence and preventability of adverse events requiring a higher level of care in Belgian hospitals

Directory of Open Access Journals (Sweden)

Vlayen Annemie

2012-08-01

Full Text Available Abstract Background Adverse events are unintended patient injuries that arise from healthcare management resulting in disability, prolonged hospital stay or death. Adverse events that require intensive care admission imply a considerable financial burden to the healthcare system. The epidemiology of adverse events in Belgian hospitals has never been assessed systematically. Findings A multistage retrospective review study of patients requiring a transfer to a higher level of care will be conducted in six hospitals in the province of Limburg. Patient records are reviewed starting from January 2012 by a clinical team consisting of a research nurse, a physician and a clinical pharmacist. Besides the incidence and the level of causation and preventability, also the type of adverse events and their consequences (patient harm, mortality and length of stay will be assessed. Moreover, the adequacy of the patient records and quality/usefulness of the method of medical record review will be evaluated. Discussion This paper describes the rationale for a retrospective review study of adverse events that necessitate a higher level of care. More specifically, we are particularly interested in increasing our understanding in the preventability and root causes of these events in order to implement improvement strategies. Attention is paid to the strengths and limitations of the study design.

Counting addressing method: Command addressable element and extinguishing module

Directory of Open Access Journals (Sweden)

Ristić Jovan D.

2009-01-01

Full Text Available The specific requirements that appear in addressable fire detection and alarm systems and the shortcomings of the existing addressing methods were discussed. A new method of addressing of detectors was proposed. The basic principles of addressing and responding of a called element are stated. Extinguishing module is specific subsystem in classic fire detection and alarm systems. Appearing of addressable fire detection and alarm systems didn't caused essential change in the concept of extinguishing module because of long calling period of such systems. Addressable fire security system based on counting addressing method reaches high calling rates and enables integrating of the extinguishing module in addressable system. Solutions for command addressable element and integrated extinguishing module are given in this paper. The counting addressing method was developed for specific requirements in fire detection and alarm systems, yet its speed and reliability justifies its use in the acquisition of data on slowly variable parameters under industrial conditions. .

Managing the Organizational and Cultural Precursors to Major Events — Recognising and Addressing Complexity

International Nuclear Information System (INIS)

Taylor, R. H.; Carhart, N.; May, J.; Wijk, L. G. A. van

2016-01-01

Research at the University of Bristol, Safety Systems Research Centre has drawn out the key organizational and cultural precursors leading to major events in several industries (nuclear, petrochemical, transport and major civil engineering projects). It has shown that these are strikingly similar. The research built on preliminary work reported to the IAEA in 2004. Organizational and cultural findings contributing to each event were assembled from the published reports for twelve events and grouped under eight generic headings. These were: 1. leadership issues; 2. ‘local’ operational attitudes and behaviours (operational ‘culture’); 3. the impact of the business environment (often commercial and budgetary pressures); 4. oversight and scrutiny; 5. competence and training (at all levels); 6. risk assessment and risk management (also at all levels); 7. organizational learning; 8. communication issues. From the findings, sets of ‘Expectations’ were then developed as statements of good practice, which if recognised and implemented, should enable organizations to build stronger defences against the occurrence of future events. To probe operational reality, these were reformulated and developed into sets of draft ‘penetrating’ questions which explore whether ‘reality aligns with expectation’. Initial work has been carried out to refine some of these expectations and question sets by working with industry and further work is planned. The questions can be used by both duty holders and regulators to assess the vulnerability of organizations (‘condition monitoring’). Examples will be given in the presentation and full paper. To enable organizations to address these often neglected factors, new tools are being developed that can be employed to address the risks systematically. This might be regarded as analogous to the use of systematic processes (e.g., fault and event trees) to assess risks arising from engineering and human factors-related issues. An

Drinking game play among first-year college student drinkers: an event-specific analysis of the risk for alcohol use and problems.

Science.gov (United States)

Ray, Anne E; Stapleton, Jerod L; Turrisi, Rob; Mun, Eun-Young

2014-09-01

College students who play drinking games (DGs) more frequently report higher levels of alcohol use and experience more alcohol-related harm. However, the extent to which they are at risk for increased consumption and harm as a result of DG play on a given event after accounting for their typical DG participation, and typical and event drinking, is unclear. We examined whether first-year students consumed more alcohol and were more likely to experience consequences on drinking occasions when they played DGs. Participants (n = 336) completed up to six web-based surveys following weekend drinking events in their first semester. Alcohol use, DG play, and consequences were reported for the Friday and Saturday prior to each survey. Typical DG tendencies were controlled in all models. Typical and event alcohol use were controlled in models predicting risk for consequences. Participants consumed more alcohol on DG versus non-DG events. All students were more likely to experience blackout drinking consequences when they played DGs. Women were more likely to experience social-interpersonal consequences when they played DGs. DG play is an event-specific risk factor for increased alcohol use among first-year students, regardless of individual DG play tendencies. Further, event DG play signals increased risk for blackout drinking consequences for all students, and social-interpersonal consequences for women, aside from the amount of alcohol consumed on those occasions as well as typical drinking behaviors. Prevention efforts to reduce high-risk drinking may be strengthened by highlighting both event- and person-specific risks of DG play.

Examining Wrong Eye Implant Adverse Events in the Veterans Health Administration With a Focus on Prevention: A Preliminary Report.

Science.gov (United States)

Neily, Julia; Chomsky, Amy; Orcutt, James; Paull, Douglas E; Mills, Peter D; Gilbert, Christina; Hemphill, Robin R; Gunnar, William

2018-03-01

The study goals were to examine wrong intraocular lens (IOL) implant adverse events in the Veterans Health Administration (VHA), identify root causes and contributing factors, and describe system changes that have been implemented to address this challenge. This study represents collaboration between the VHA's National Center for Patient Safety (NCPS) and the National Surgery Office (NSO). This report includes 45 wrong IOL implant surgery adverse events reported to established VHA NCPS and NSO databases between July 1, 2006, and June 31, 2014. There are approximately 50,000 eye implant procedures performed each year in the VHA. Wrong IOL implant surgery adverse events are reported by VHA facilities to the NCPS and the NSO. Two authors (A.C. and J.N.) coded the reports for event type (wrong lens or expired lens) and identified the primary contributing factor (coefficient κ = 0.837). A descriptive analysis was conducted, which included the reported yearly event rate. The main outcome measure was the reported wrong IOL implant surgery adverse events. There were 45 reported wrong IOL implant surgery adverse events. Between 2011 and June 30, 2014, there was a significant downward trend (P = 0.02, R = 99.7%) at a pace of -0.08 (per 10,000 cases) every year. The most frequently coded primary contributing factor was incomplete preprocedure time-out (n = 12) followed by failure to perform double check of preprocedural calculations based upon original data and implant read-back at the time the surgical eye implant was performed (n = 10). Preventing wrong IOL implant adverse events requires diligence beyond performance of the preprocedural time-out. In 2013, the VHA has modified policy to ensure double check of preprocedural calculations and implant read-back with positive impact. Continued analysis of contributing human factors and improved surgical team communication are warranted.

Vocal Imitation in Parrots Allows Addressing of Specific Individuals in a Dynamic Communication Network

DEFF Research Database (Denmark)

Balsby, T.J.S.; Momberg, J.V.; Dabelsteen, T.

2012-01-01

€“fronted conures live in fission-fusion flocks where they encounter many different individuals every day, and it is possible that their vocal imitation ability is a flexible means to address a specific individual within a flock. We tested this via playback to short-term captive wild conures. Test birds were placed...... together in pairs in outdoor aviaries to form simple flocks. To simulate imitation of a specific individual these pairs received playback of contact calls that primarily imitate one of the two birds. Overall, individuals that received simulated vocal imitations of its calls responded more frequently...... and faster than the other individual. This suggests that orange-fronted conures can use imitations of contact calls to address specific individuals of a flock. In the discussion we argue that the fission-fusion flock dynamics of many parrot species has been an important factor in evolving conures´ and other...

Optimising secondary prevention in the acute period following a TIA of ischaemic origin.

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Heron, Neil

2016-01-01

Transient ischaemic attacks (TIAs) are highly prevalent conditions, with at least 46 000 people per year in the UK having a TIA for the first time. TIAs are a warning that the patient is at risk of further vascular events and the 90-day risk of vascular events following a TIA, excluding events within the first week after diagnosis when the risk is highest, can be as high as 18%. Immediate assessment of patients with TIA, either at accident and emergency, general practice and/or TIA clinics, is therefore required to address secondary prevention and prevent further vascular events. This article addresses the need for optimising secondary prevention in the acute period following a TIA of ischaemic origin to reduce the risk of further vascular events as per recent Cochrane review advice and presents a novel project, Stroke Prevention Rehabilitation Intervention Trial of Exercise (SPRITE), to do this. One novel way to tackle vascular risk factors and promote secondary prevention in patients with TIA could be to adapt a cardiac rehabilitation programme for these patients. SPRITE, a feasibility and pilot study (ClinicalTrials.gov Identifier: NCT02712385) funded by the National Institute for Health Research, is attempting to adapt a home-based cardiac rehabilitation programme, 'The Healthy Brain Rehabilitation Manual', for use in the acute period following a TIA. The use of cardiac rehabilitation programmes post-TIA requires further research, particularly within the primary care setting.

Estimating the probability of rare events: addressing zero failure data.

Science.gov (United States)

Quigley, John; Revie, Matthew

2011-07-01

Traditional statistical procedures for estimating the probability of an event result in an estimate of zero when no events are realized. Alternative inferential procedures have been proposed for the situation where zero events have been realized but often these are ad hoc, relying on selecting methods dependent on the data that have been realized. Such data-dependent inference decisions violate fundamental statistical principles, resulting in estimation procedures whose benefits are difficult to assess. In this article, we propose estimating the probability of an event occurring through minimax inference on the probability that future samples of equal size realize no more events than that in the data on which the inference is based. Although motivated by inference on rare events, the method is not restricted to zero event data and closely approximates the maximum likelihood estimate (MLE) for nonzero data. The use of the minimax procedure provides a risk adverse inferential procedure where there are no events realized. A comparison is made with the MLE and regions of the underlying probability are identified where this approach is superior. Moreover, a comparison is made with three standard approaches to supporting inference where no event data are realized, which we argue are unduly pessimistic. We show that for situations of zero events the estimator can be simply approximated with 1/2.5n, where n is the number of trials. © 2011 Society for Risk Analysis.

DDT and Malaria Prevention: Addressing the Paradox

Science.gov (United States)

Bouwman, Hindrik; van den Berg, Henk; Kylin, Henrik

2011-01-01

Background The debate regarding dichlorodiphenyltrichloroethane (DDT) in malaria prevention and human health is polarized and can be classified into three positions: anti-DDT, centrist-DDT, pro-DDT. Objective We attempted to arrive at a synthesis by matching a series of questions on the use of DDT for indoor residual spraying (IRS) with literature and insights, and to identify options and opportunities. Discussion Overall, community health is significantly improved through all available malaria control measures, which include IRS with DDT. Is DDT “good”? Yes, because it has saved many lives. Is DDT safe as used in IRS? Recent publications have increasingly raised concerns about the health implications of DDT. Therefore, an unqualified statement that DDT used in IRS is safe is untenable. Are inhabitants and applicators exposed? Yes, and to high levels. Should DDT be used? The fact that DDT is “good” because it saves lives, and “not safe” because it has health and environmental consequences, raises ethical issues. The evidence of adverse human health effects due to DDT is mounting. However, under certain circumstances, malaria control using DDT cannot yet be halted. Therefore, the continued use of DDT poses a paradox recognized by a centrist-DDT position. At the very least, it is now time to invoke precaution. Precautionary actions could include use and exposure reduction. Conclusions There are situations where DDT will provide the best achievable health benefit, but maintaining that DDT is safe ignores the cumulative indications of many studies. In such situations, addressing the paradox from a centrist-DDT position and invoking precaution will help design choices for healthier lives. PMID:21245017

What evidence and support do state-level public health practitioners need to address obesity prevention.

Science.gov (United States)

Leeman, Jennifer; Teal, Randall; Jernigan, Jan; Reed, Jenica Huddleston; Farris, Rosanne; Ammerman, Alice

2014-01-01

Obesity has reached epidemic proportions. Public health practitioners are distinctly positioned to promote the environmental changes essential to addressing obesity. The Centers for Disease Control and Prevention (CDC) and other entities provide evidence and technical assistance to support this work, yet little is known about how practitioners use evidence and support as they intervene to prevent obesity. The study's purpose was to describe how practitioners and CDC project officers characterized the obesity prevention task, where practitioners accessed support and evidence, and what approaches to support and evidence they found most useful. APPROACH OR DESIGN: Mixed-methods, cross-sectional interviews, and survey. State-level public health obesity prevention programs. Public health practitioners and CDC project officers. We conducted 10 in-depth interviews with public health practitioners (n = 7) and project officers (n = 3) followed by an online survey completed by 62 practitioners (50% response rate). We applied content analysis to interview data and descriptive statistics to survey data. Practitioners characterized obesity prevention as uncertain and complex, involving interdependence among actors, multiple levels of activity, an excess of information, and a paucity of evidence. Survey findings provide further detail on the types of evidence and support practitioners used and valued. We recommend approaches to tailoring evidence and support to the needs of practitioners working on obesity prevention and other complex health problems.

Nurses' Perceptions of Implementing Fall Prevention Interventions to Mitigate Patient-Specific Fall Risk Factors.

Science.gov (United States)

Wilson, Deleise S; Montie, Mary; Conlon, Paul; Reynolds, Margaret; Ripley, Robert; Titler, Marita G

2016-08-01

Evidence-based (EB) fall prevention interventions to mitigate patient-specific fall risk factors are readily available but not routinely used in practice. Few studies have examined nurses' perceptions about both the use of these EB interventions and implementation strategies designed to promote their adoption. This article reports qualitative findings of nurses' perceptions about use of EB fall prevention interventions to mitigate patient-specific fall risks, and implementation strategies to promote use of these interventions. The findings revealed five major themes: before-study fall prevention practices, use of EB fall prevention interventions tailored to patient-specific fall risk factors, beneficial implementation strategies, overall impact on approach to fall prevention, and challenges These findings are useful to guide nurses' engagement and use of EB fall prevention practices tailored to patient-specific fall risk factors. © The Author(s) 2016.

Pressure ulcer prevention in patients with advanced illness.

Science.gov (United States)

White-Chu, E Foy; Reddy, Madhuri

2013-03-01

Pressure ulcers can be challenging to prevent, particularly in patients with advanced illnesses. This review summarizes the relevant literature since 2011. Through a MEDLINE and CINAHL database search from January 1, 2011 to June 1, 2012, a total of 14 abstracts were found addressing the prevention of pressure ulcers in persons with advanced illness. Search terms included pressure ulcer, prevention, and control. Advanced illness was defined as patients transitioning from curative to supportive and palliative care. Ten original studies and four review articles specifically addressed pressure ulcer prevention. There were four articles that specifically addressed patients with advanced illness. The studies varied in quality. One systematic review, one randomized controlled trial, three prospective trials, two retrospective trials, one cost-effectiveness analysis, one quality improvement project, one comparative descriptive design, and four review articles were found. The interventions for pressure ulcer prevention were risk assessment, repositioning, surface selection, nutritional support and maintenance of skin integrity with or without incontinence. The quality of pressure ulcer prevention studies in persons with advanced illness is poor. Increased number and higher quality studies are needed to further investigate this important topic for these fragile patients.

Lessons Learned From a Community–Academic Partnership Addressing Adolescent Pregnancy Prevention in Filipino American Families

Science.gov (United States)

Javier, Joyce R.; Chamberlain, Lisa J.; Rivera, Kahealani K.; Gonzalez, Sarah E.; Mendoza, Fernando S.; Huffman, Lynne C.

2014-01-01

Background Filipino Americans have more adolescent pregnancies than other Asian-Pacific Islanders (APIs). Few community–academic collaborations have addressed adolescent pregnancy prevention in this community. Objectives We sought to describe the lessons learned from and impact of a community-based teen pregnancy prevention program for Filipino Americans implemented by a Filipina pediatrics resident. Methods We formed a community–academic partnership between the Filipino Youth Coalition, a community-based organization (CBO) in San Jose, California, and the Stanford School of Medicine’s Pediatric Advocacy Program. We developed a culturally tailored parent–teen conference addressing adolescent pregnancy prevention in Filipino Americans. We qualitatively and quantitatively evaluated this intervention by collecting both pre- and post-conference data using a convenience sample design. Lessons Learned Engaging particular aspects of Filipino culture (i.e., religion and intergenerational differences) helped to make this community–academic partnership successful. For physicians-in-training who are conducting community-based participatory research (CBPR), project challenges may include difficulties in building and maintaining academic–community relationships, struggles to promote sustainability, and conflicting goals of “community insiders” and “academic outsiders.” Authors offer insights and implications for residents interested in practicing CBPR. Conclusion CBPR is a key tool for exploring health issues in understudied populations. CBPR experiences can provide meaningful educational opportunities for physicians-in-training and can build sustained capacity in CBOs. They can also help residents to develop analytic skills, directly affect the health of the communities they serve, and, for minority physicians, give back to the communities they call home. PMID:21169708

Preventable and mitigable adverse events in cancer care: Measuring risk and harm across the continuum.

Science.gov (United States)

Lipitz-Snyderman, Allison; Pfister, David; Classen, David; Atoria, Coral L; Killen, Aileen; Epstein, Andrew S; Anderson, Christopher; Fortier, Elizabeth; Weingart, Saul N

2017-12-01

Patient safety is a critical concern in clinical oncology, but the ability to measure adverse events (AEs) across cancer care is limited by a narrow focus on treatment-related toxicities. The objective of this study was to assess the nature and extent of AEs among cancer patients across inpatient and outpatient settings. This was a retrospective cohort study of 400 adult patients selected by stratified random sampling who had breast (n = 128), colorectal (n = 136), or lung cancer (n = 136) treated at a comprehensive cancer center in 2012. Candidate AEs, or injuries due to medical care, were identified by trained nurse reviewers over the course of 1 year from medical records and safety-reporting databases. Physicians determined the AE harm severity and the likelihood of preventability and harm mitigation. The 400-patient sample represented 133,358 days of follow-up. Three hundred four AEs were identified for an overall rate of 2.3 events per 1000 patient days (91.2 per 1000 inpatient days and 0.9 per 1000 outpatient days). Thirty-four percent of the patients had 1 or more AEs (95% confidence interval, 29%-39%), and 16% of the patients had 1 or more preventable or mitigable AEs (95% confidence interval, 13%-20%). The AE rate for patients with breast cancer was lower than the rate for patients with colorectal or lung cancer (P ≤ .001). The preventable or mitigable AE rate was 0.9 per 1000 patient days. Six percent of AEs and 4% of preventable AEs resulted in serious harm. Examples included lymphedema, abscess, and renal failure. A heavy burden of AEs, including preventable or mitigable events, has been identified. Future research should examine risk factors and improvement strategies for reducing their burden. Cancer 2017;123:4728-4736. © 2017 American Cancer Society. © 2017 American Cancer Society.

A flexible analog memory address list manager/controller for PHENIX

International Nuclear Information System (INIS)

Ericson, M.N.; Walker, J.W.; Britton, C.L.; Wintenberg, A.L.; Young, G.R.

1995-01-01

A programmable analog memory address list manager/controller has been developed for use with all analog memory-based detector subsystems of PHENIX. The unit provides simultaneous read/write control, cell write-over protection for both a Level-1 trigger decision delay and digitization latency, and re-ordering of AMU addresses following conversion, at a beam crossing rate of 112 ns. Addresses are handled such that up to 5 Level-1 events can be maintained in the AMU without write-over. Data tagging is implemented for handling overlapping and shared beam event data packets. Full usage in all PHENIX analog memory-based detector sub-systems is accomplished by the use of detector-specific programmable parameters -- the number of data samples per Level-1 trigger valid and the swnple spacing. Architectural candidates for the system are discussed with emphasis on implementation implications. Details of the design are presented including design simulations, timing information, and test results from a full implementation using programmable logic devices

Background Predictors and Event-Specific Characteristics of Sexual Aggression Incidents: The Roles of Alcohol and Other Factors.

Science.gov (United States)

Davis, Kelly Cue; Danube, Cinnamon L; Stappenbeck, Cynthia A; Norris, Jeanette; George, William H

2015-08-01

Sexual assault in the United States is an important public health concern. Using prospective longitudinal methods and responses from 217 community men, we examined whether background characteristics predicted subsequent sexual aggression (SA) perpetration during a 3-month follow-up period. We also examined event-specific characteristics of reported SA occurrences. Consistent with predictions, SA perpetration history, aggressive and impulsive personality traits, rape myth attitudes, and alcohol expectancies predicted SA (both non- and alcohol-involved) at follow-up. In addition, alcohol-involved assaults occurred more often with casual (vs. steady) partners but were more likely to involve condom use with casual (vs. steady) partners. Results suggest important avenues for future research and SA prevention efforts. © The Author(s) 2015.

[Description of contributing factors in adverse events related to patient safety and their preventability].

Science.gov (United States)

Guerra-García, María Mercedes; Campos-Rivas, Beatriz; Sanmarful-Schwarz, Alexandra; Vírseda-Sacristán, Alicia; Dorrego-López, M Aránzazu; Charle-Crespo, Ángeles

2017-11-25

To assess the extent of healthcare related adverse events (AEs), their effect on patients, and their seriousness. To analyse the factors leading to the development of AEs, their relationship with the damage caused, and their degree of preventability. Retrospective descriptive study. Porriño, Pontevedra, Spain, Primary Care Service, from January-2014 to April-2016. Reported AEs were entered into the Patient Safety Reporting and Learning System (SiNASP). The variables measured were: Near Incident (NI) an occurrence with no effect or harm on the patient; Adverse Event (AE) an occurrence that affects or harms a patient. The level of harm is classified as minimal, minor, moderate, critical, and catastrophic. Preventability was classified as little evidence of being preventable, 50% preventable, and sound evidence of being preventable. percentages and Chi-squared test for qualitative variables; P<.05 with SPSS.15. SiNASP. Ethical considerations: approved by the Research Ethics Committee (2016/344). There were 166 recorded AEs (50.6% in males, and 46.4% in women. The mean age was 60.80years). Almost two-thirds 62.7% of AEs affected the patient, with 45.8% causing minimal damage, while 2.4% caused critical damages. Healthcare professionals were a contributing factor in 71.7% of the AEs, with the trend showing that poor communication and lack of protocols were related to the damage caused. Degree of preventability: 96.4%. Most AEs affected the patient, and were related to medication, diagnostic tests, and laboratory errors. The level of harm was related to communication problems, lack of, or deficient, protocols and a poor safety culture. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Preparing for what might happen: An episodic specificity induction impacts the generation of alternative future events.

Science.gov (United States)

Jing, Helen G; Madore, Kevin P; Schacter, Daniel L

2017-12-01

A critical adaptive feature of future thinking involves the ability to generate alternative versions of possible future events. However, little is known about the nature of the processes that support this ability. Here we examined whether an episodic specificity induction - brief training in recollecting details of a recent experience that selectively impacts tasks that draw on episodic retrieval - (1) boosts alternative event generation and (2) changes one's initial perceptions of negative future events. In Experiment 1, an episodic specificity induction significantly increased the number of alternative positive outcomes that participants generated to a series of standardized negative events, compared with a control induction not focused on episodic specificity. We also observed larger decreases in the perceived plausibility and negativity of the original events in the specificity condition, where participants generated more alternative outcomes, relative to the control condition. In Experiment 2, we replicated and extended these findings using a series of personalized negative events. Our findings support the idea that episodic memory processes are involved in generating alternative outcomes to anticipated future events, and that boosting the number of alternative outcomes is related to subsequent changes in the perceived plausibility and valence of the original events, which may have implications for psychological well-being. Published by Elsevier B.V.

Event-specific qualitative and quantitative detection of five genetically modified rice events using a single standard reference molecule.

Science.gov (United States)

Kim, Jae-Hwan; Park, Saet-Byul; Roh, Hyo-Jeong; Shin, Min-Ki; Moon, Gui-Im; Hong, Jin-Hwan; Kim, Hae-Yeong

2017-07-01

One novel standard reference plasmid, namely pUC-RICE5, was constructed as a positive control and calibrator for event-specific qualitative and quantitative detection of genetically modified (GM) rice (Bt63, Kemingdao1, Kefeng6, Kefeng8, and LLRice62). pUC-RICE5 contained fragments of a rice-specific endogenous reference gene (sucrose phosphate synthase) as well as the five GM rice events. An existing qualitative PCR assay approach was modified using pUC-RICE5 to create a quantitative method with limits of detection correlating to approximately 1-10 copies of rice haploid genomes. In this quantitative PCR assay, the square regression coefficients ranged from 0.993 to 1.000. The standard deviation and relative standard deviation values for repeatability ranged from 0.02 to 0.22 and 0.10% to 0.67%, respectively. The Ministry of Food and Drug Safety (Korea) validated the method and the results suggest it could be used routinely to identify five GM rice events. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Latino Migrant Worker HIV Prevention Program

Science.gov (United States)

Sánchez, Jesús; Silva-Suarez, Georgina; Serna, Claudia A.; De La Rosa, Mario

2017-01-01

There is limited information on the impact of the HIV/AIDS epidemic on Latino migrant workers (LMWs), although available data indicate that this community is being disproportionally affected. The need for prevention programs that address the specific needs of LMWs is becoming well recognized. HIV prevention interventions that train and employ community health workers are a culturally appropriate way to address the issues of community trust and capacity building in this community. This article describes the Latino Migrant Worker HIV Prevention Program and its efforts to train and engage community health workers in the prevention of HIV among LMWs in South Florida. PMID:22367261

Content addressable memories in scientific instruments

International Nuclear Information System (INIS)

Lotto, I. de; Golinelli, S.

1975-01-01

The content-addressable-memory feature of a new system designed in these laboratories for non-destructive testing of nuclear reactor pressure vessels based on acoustic emission analysis is presented. The content addressable memory is divided into two parts: the first selects the most frequent events among incoming ones (FES: Frequent Event Selection memory), the second stores the frequent events singled out (FEM: Frequent Event Memory). The statistical behaviour of FES is analyzed, and experimental results are compared with theoretical ones; the model presented proved to be a useful tool in dimensioning the instrument store capacity. (Auth.)

Specific neural basis of Chinese idioms processing: an event-related functional MRI study

International Nuclear Information System (INIS)

Chen Shaoqi; Zhang Yanzhen; Xiao Zhuangwei; Zhang Xuexin

2007-01-01

Objective: To address the neural basis of Chinese idioms processing with different kinds of stimuli using an event-related fMRI design. Methods: Sixteen native Chinese speakers were asked to perform a semantic decision task during fMRI scanning. Three kinds of stimuli were used: Real idioms (Real-idiom condition); Literally plausible phrases (Pseudo-idiom condition, the last character of a real idiom was replaced by a character with similar meaning); Literally implausible strings (Non-idiom condition, the last character of a real idiom was replaced by a character with unrelated meaning). Reaction time and correct rate were recorded at the same time. Results: The error rate was 2.6%, 5.2% and 0.9% (F=3.51, P 0.05) for real idioms, pseudo-idioms and wrong idioms, respectively. Similar neural network was activated in all of the three conditions. However, the right hippocampus was only activated in the real idiom condition, and significant activations were found in anterior portion of left inferior frontal gyms (BA47) in real-and pseudo-idiom conditions, but not in non-idiom condition. Conclusion: The right hippocampus plays a specific role in the particular wording of the Chinese idioms. And the left anterior inferior frontal gyms (BA47) may be engaged in the semantic processing of Chinese idioms. The results support the notion that there were specific neural bases for Chinese idioms processing. (authors)

Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma

DEFF Research Database (Denmark)

Jacobsen, L; Niggemann, B; Dreborg, S

2007-01-01

BACKGROUND: 3-year subcutaneous specific immunotherapy (SIT) in children with seasonal allergic rhinoconjunctivitis reduced the risk of developing asthma during treatment and 2 years after discontinuation of SIT (5-year follow-up) indicating long-term preventive effect of SIT. OBJECTIVE: We......: Specific immunotherapy has long-term clinical effects and the potential of preventing development of asthma in children with allergic rhino conjunctivitis up to 7 years after treatment termination....

Distribution of Estimated 10-Year Risk of Recurrent Vascular Events and Residual Risk in a Secondary Prevention Population

NARCIS (Netherlands)

Kaasenbrood, Lotte; Boekholdt, S. Matthijs; van der Graaf, Yolanda; Ray, Kausik K.; Peters, Ron J. G.; Kastelein, John J. P.; Amarenco, Pierre; LaRosa, John C.; Cramer, Maarten J. M.; Westerink, Jan; Kappelle, L. Jaap; de Borst, Gert J.; Visseren, Frank L. J.

2016-01-01

Among patients with clinically manifest vascular disease, the risk of recurrent vascular events is likely to vary. We assessed the distribution of estimated 10-year risk of recurrent vascular events in a secondary prevention population. We also estimated the potential risk reduction and residual

Distribution of Estimated 10-Year Risk of Recurrent Vascular Events and Residual Risk in a Secondary Prevention Population

NARCIS (Netherlands)

Kaasenbrood, Lotte; Boekholdt, S. Matthijs; Van Der Graaf, Yolanda; Ray, Kausik K.; Peters, Ron J G; Kastelein, John J P; Amarenco, Pierre; Larosa, John C.; Cramer, Maarten J M; Westerink, Jan; Kappelle, L. Jaap; De Borst, Gert J.; Visseren, Frank L J

2016-01-01

Background: Among patients with clinically manifest vascular disease, the risk of recurrent vascular events is likely to vary. We assessed the distribution of estimated 10-year risk of recurrent vascular events in a secondary prevention population. We also estimated the potential risk reduction and

Addressing Adolescent Substance Abuse: An Evaluation of Washington's Prevention and Intervention Services Program. 2001-03 Final Report.

Science.gov (United States)

Deck, Dennis D.

2004-01-01

To directly address the state of Washington's concerns regarding student alcohol and other drug use, in 1989 the state Legislature passed the Omnibus Alcohol and Controlled Substances Act (ESSHB 1793). One part of this act called for the creation of a school-based alcohol and other dug abuse prevention and early intervention program. The Office of…

Events at blood collection area due to nonconforming blood bags and plateletpheresis kits: need for timely corrective and preventive actions.

Science.gov (United States)

Verma, Anupam; Sachan, Deepti; Elhence, Priti; Pandey, Hem; Dubey, Anju

2012-07-01

Good blood banking practice requires that every effort should be made to detect any deviation or defect in blood bank products and to identify any potential risk to blood donor or recipient(s). We report the findings of an exercise that provide an insight into why feedback from the user side is crucial. Various events involving blood bags and plateletpheresis kits and the corresponding appropriate actions instituted for remedial measures were recorded. These scattered events were recorded for 6 months following the use of a new batch of improved blood bags with add-on features. Several events related to plateletpheresis kits from three different manufacturers were also recorded for 1 year. The affected blood bags were utilized with no untoward incident. The complaint was closed following satisfactory response from the blood bag manufacturing company that acted in a timely manner in addressing the root causes of the problems. However, corrective and preventive actions (CAPA) could not be implemented for plateletpheresis kits. The rate of undesirable events was higher with plateletpheresis kits as compared with whole blood bags (1.75% vs. 0.06%). As defects or deviations that trigger the need for CAPA can stem from numerous sources, it is important to clearly identify and document the problems and level of risk so that appropriate investigations can be instituted and remedial actions can be taken in a timely manner. This study demonstrates the usefulness of a quality initiative to collate and analyze blood product faults in conjunction with blood product manufacturers. © 2012 American Association of Blood Banks.

Predictors of Prevention Failure in College Students Participating in Two Indicated Depression Prevention Programs

Science.gov (United States)

Blanco, Vanessa; Rohde, Paul; Vázquez, Fernando L.; Otero, Patricia

2014-01-01

The purpose of this study was to identify subgroups of university students with the highest likelihood of remaining at elevated levels of depressive symptoms six months following the receipt of a depressive prevention intervention on the basis of known risk factors and participation in one of two depression prevention programs. Data from a randomized controlled trial evaluating depression prevention among 133 college students with elevated depressive symptoms were analyzed. Participants were randomized to a cognitive-behavioral or relaxation training group preventive intervention. Classification tree analysis showed that older age was the strongest risk factor for persistently elevated depression. Additional risk factors were: (1) for younger students, fewer daily pleasant activities; (2) for those with higher level of pleasant activities, higher level of stressful events; and (3) for those with higher level of stressful events, lower assertiveness. Results offer directions for prevention foci, identify specific subgroups of college students to target for depression prevention efforts, and suggest that research aim to help older, non-traditional students or graduating students manage the transition from college to the work force. PMID:24714056

Lightning and severe thunderstorms in event management.

Science.gov (United States)

Walsh, Katie M

2012-01-01

There are a few national position stands/guidelines that address environmental conditions in athletics, yet they do not govern all outdoor sports. Extreme heat and cold, lightning, and severe wind can all be fatal, yet the majority of outdoor sports have no published guidelines addressing these conditions in relation to activity. Available research on extreme heat and cold conditions in athletics provides prevention strategies, to include acclimatization. Lightning and severe wind are two environmental conditions to which humans cannot accommodate, and they both can be deadly. There are strong positions on extreme heat/cold and lightning safety in athletics, but none affiliated with severe winds. Medical personnel involved in planning large outdoor sporting events must know of the presence of nationally published weather-related documents and apply them to their event. In addition, research needs to be expanded in the realm of establishing guidelines for safety to participants and spectators in severe wind conditions.

Addressing the Needs of Preschool Children in the Context of Disasters and Terrorism: Assessment, Prevention, and Intervention.

Science.gov (United States)

Wolmer, Leo; Hamiel, Daniel; Pardo-Aviv, Lee; Laor, Nathaniel

2017-07-01

The goal of this paper is to review the research literature regarding the needs of preschoolers in the context of disasters and terrorism with the aim of understanding the existing methods for assessment, prevention, and intervention to provide recommendations and point out required research and development. We differentiate between screening tools that provide initial evaluation and assessment tools for diagnosing preschooler children's pathology and review possible interventions that address the preschool child's needs before, during, and after the incident itself. We also emphasize the lack of dissemination and research of prevention programs and mass interventions for preschoolers. Programs for community mass prevention and intervention for preschoolers should be developed and evaluated and interventions should be adapted for individual and group delivery. Moreover, the increase in the number of children refugees requires cultural adaptations of assessment measures and interventions.

Selection of low-risk design guidelines for energetic events

International Nuclear Information System (INIS)

Ferguson, D.; Marchaterre, J.; Graham, J.

1982-01-01

This paper recommends the establishment of specific design guidelines for protection against potential, but low-probability, energetic events. These guidelines recognize the plant protective features incorporated to prevent such events, as well as the inherent capability of the plant to accommodate a certain level of energy release. Further, their application is recommended within the context of necessary standardized and agreed-upon acceptance criteria which are less restrictive than ASME code requirements. The paper provides the background upon which the selection of the design is made, including the characterization of energetic events dependent on various core-design parameters, and including the necessity of a low-risk design balanced between prevention of accidents and the mitigation of consequences

Domain 2: Sport Safety and Injury Prevention

Science.gov (United States)

Gurchiek, Larry; Mokha, Monique Butcher

2004-01-01

Most coaches recognize the importance of creating a safe environment and preventing injuries of their athletes. Domain 2 is dedicated to this important aspect of coaching, and outlines specific areas within safety and injury prevention that coaches should address. Domain 2 sets the standards for facility, equipment, and environmental safety…

Monitoring adverse events in hospitals: how safe are hospitals for patients?

NARCIS (Netherlands)

Baines, R.J.

2018-01-01

This thesis aims to assess trends in adverse event and preventable adverse event rates in hospitals in the Netherlands through the time period 2004 –2012. Furthermore patient safety for specific care processes and patient groups are assessed. Patient safety has been high on the international agenda

Primary prevention of psychiatric illness in special populations.

Science.gov (United States)

Sajatovic, Martha; Sanders, Renata; Alexeenko, Lada; Madhusoodanan, Subramoniam

2010-11-01

Some populations appear to be particularly vulnerable to the development of psychiatric symptomatology related to life events and biologic or social/cultural factors. Such groups include individuals who have experienced traumatic events, military personnel, individuals with serious medical conditions, postpartum women, and immigrants. This study reviews the literature regarding primary prevention of psychiatric disorders in special populations and identifies a variety of universal, selective, and indicated prevention measures aimed at minimizing the psychiatric sequelae in these groups. The authors reviewed the literature regarding the prevention of psychiatric symptoms in trauma/abuse victims, individuals in the military, oncology patients, patients with diabetes, pregnant/postpartum women, and immigrants. The literature on primary prevention of psychiatric illness in the special populations identified is rather limited. Universal prevention may be beneficial in some instances through public awareness campaigns and disaster planning. In other instances, more specific and intensive interventions for individuals at high risk of psychiatric illness may improve outcomes, for example, crisis counseling for those who have experienced severe trauma. Primary prevention of psychiatric illness may be an attainable goal via implementation of specific universal, selected, and indicated primary prevention measures in special populations.

Incidence of hypocalcemia in patients receiving denosumab for prevention of skeletal-related events in bone metastasis.

Science.gov (United States)

Yerram, Prakirthi; Kansagra, Shraddha; Abdelghany, Osama

2017-04-01

Background Denosumab therapy is commonly used for the prevention of skeletal-related events in patients with bone metastasis. However, a common side effect of denosumab is hypocalcemia. Objective The aim of the study is to determine the incidence of hypocalcemia in patients receiving denosumab for prevention of skeletal-related events in bone metastasis and evaluate risk factors for developing hypocalcemia. Methods This was a retrospective medication use evaluation reviewing the incidence of hypocalcemia in patients receiving outpatient denosumab for prevention of skeletal-related events at Yale-New Haven Hospital. Additionally, various risk factors were reviewed to determine their risk of developing hypocalcemia. Results As per Common Terminology Criteria for Adverse Events v4.03, of the 106 patients included in the study population, 37 (35%) patients had an incidence of hypocalcemia within 30 days of denosumab administration. Fourteen patients (13.2%) had an incidence of grade 1, 13 patients (12.3%) had an incidence of grade 2 hypocalcemia, and 7 patients (6.6%) had an incidence of grade 3 hypocalcemia. Grade 4 hypocalcemia occurred in three (2.8%) patients. Calcium supplementation did not decrease the risk of developing hypocalcemia. Patients who had one or more episodes of acute kidney insufficiency were at a higher risk of developing hypocalcemia (odds ratio = 7.5 (95% confidence interval = 1.8-36.3), p = 0.001). Conclusion This study found that the overall incidence of hypocalcemia and severe hypocalcemia was higher than reported in clinical trials. Additionally, calcium supplementation did not have an effect on incidence of hypocalcemia, while patients who experienced acute kidney insufficiency while on denosumab had a higher likelihood of developing hypocalcemia.

Preventable coronary heart disease events from control of cardiovascular risk factors in US adults with diabetes (projections from utilizing the UKPDS risk engine).

Science.gov (United States)

Wong, Nathan D; Patao, Christopher; Malik, Shaista; Iloeje, Uchenna

2014-04-15

Type 2 diabetes mellitus (T2DM) carries significant risks for coronary heart disease (CHD). We examined the potential US population impact of single and composite risk factor control. Among US adults with diagnosed T2DM aged≥30 years in the National Health and Nutrition Examination Survey 2007 to 2012, we assessed CHD events preventable using the United Kingdom Prospective Diabetes Study CHD risk engine. We examined in all those not at goal the impact of statistical control of smoking, glycated hemoglobin, systolic blood pressure, and total and high-density lipoprotein cholesterol, according to the predefined criteria setting risk factors at different levels of control representing (1) "All to Goal," (2) at "Nominal Control," or (3) at "Aggressive Control." Preventable CHD events represented the difference between the number of events estimated from the control of these risk factors versus current levels of the risk factors. Of 606 men (representing 6.2 million) and 603 women (6.3 million) with DM and no previous CHD, 1.3 million men and 0.7 million women would develop a CHD event within 10 years if left uncontrolled. Controlling all risk factors to goal was projected to prevent 35% and 45% of CHD events in men and women, respectively. Nominal risk factor control was projected to prevent 36% and 38% and aggressive control 51% and 61% of CHD events, respectively. In conclusion, a significant proportion of CHD events in adults with T2DM could be prevented from composite control of risk factors often not at goal. Copyright © 2014 Elsevier Inc. All rights reserved.

Core Competencies for Injury and Violence Prevention

Science.gov (United States)

Stephens-Stidham, Shelli; Peek-Asa, Corinne; Bou-Saada, Ingrid; Hunter, Wanda; Lindemer, Kristen; Runyan, Carol

2009-01-01

Efforts to reduce the burden of injury and violence require a workforce that is knowledgeable and skilled in prevention. However, there has been no systematic process to ensure that professionals possess the necessary competencies. To address this deficiency, we developed a set of core competencies for public health practitioners in injury and violence prevention programs. The core competencies address domains including public health significance, data, the design and implementation of prevention activities, evaluation, program management, communication, stimulating change, and continuing education. Specific learning objectives establish goals for training in each domain. The competencies assist in efforts to reduce the burden of injury and violence and can provide benchmarks against which to assess progress in professional capacity for injury and violence prevention. PMID:19197083

Infusing Oral Health Care into Nursing Curriculum: Addressing Preventive Health in Aging and Disability

Directory of Open Access Journals (Sweden)

Joan Earle Hahn

2012-01-01

Full Text Available Access to oral health care is essential for promoting and maintaining overall health and well-being, yet oral health disparities exist among vulnerable and underserved populations. While nurses make up the largest portion of the health care work force, educational preparation to address oral health needs of elders and persons with disabilities is limited across nursing curricula. This descriptive study reports on the interdisciplinary development, implementation, and testing of an oral health module that was included and infused into a graduate nursing curriculum in a three-phase plan. Phase 1 includes evaluation of a lecture presented to eight gerontological nurse practitioner (GNP students. Phase 2 includes evaluation of GNP students’ perceptions of learning, skills, and confidence following a one-time 8-hour practicum infused into 80 required practicum hours. The evaluation data show promise in preparing nurse practitioner students to assess and address preventive oral health needs of persons aging with disabilities such that further infusion and inclusion in a course for nurse practitioners across five specialties will implemented and tested in Phase 3.

Infusing Oral Health Care into Nursing Curriculum: Addressing Preventive Health in Aging and Disability

Science.gov (United States)

Hahn, Joan Earle; FitzGerald, Leah; Markham, Young Kee; Glassman, Paul; Guenther, Nancy

2012-01-01

Access to oral health care is essential for promoting and maintaining overall health and well-being, yet oral health disparities exist among vulnerable and underserved populations. While nurses make up the largest portion of the health care work force, educational preparation to address oral health needs of elders and persons with disabilities is limited across nursing curricula. This descriptive study reports on the interdisciplinary development, implementation, and testing of an oral health module that was included and infused into a graduate nursing curriculum in a three-phase plan. Phase 1 includes evaluation of a lecture presented to eight gerontological nurse practitioner (GNP) students. Phase 2 includes evaluation of GNP students' perceptions of learning, skills, and confidence following a one-time 8-hour practicum infused into 80 required practicum hours. The evaluation data show promise in preparing nurse practitioner students to assess and address preventive oral health needs of persons aging with disabilities such that further infusion and inclusion in a course for nurse practitioners across five specialties will implemented and tested in Phase 3. PMID:22619708

Management and prevention of chronic obstructive pulmonary disease exacerbations: a state of the art review

Directory of Open Access Journals (Sweden)

Wedzicha Jadwiga A

2009-08-01

Full Text Available Abstract Exacerbations of chronic obstructive pulmonary disease (COPD are important events in the natural history of this prevalent and devastating condition. This review provides a concise, state of the art summary on prevention and management of exacerbations. Considerable new data underpins evidence in support of many preventative interventions, pharmacological and non-pharmacological, that are now available. Challenges remain in developing new approaches, and delivering those that already exist to the right patient at the right time. Management of an exacerbation remains stepwise according to clinical severity, but there is now additional focus on addressing comorbidities and taking the opportunity at acute events to optimise preventative strategies for the future. Ultimately, exacerbations are heterogeneous events in a heterogeneous disease, and an individualised approach is paramount.

Comparison Elements on STG DICE cell for Content-Addressable Memory and Simulation of Single-Event Transients

Directory of Open Access Journals (Sweden)

V. Ya. Stenin

2017-06-01

Full Text Available Comparison elements on base the STG DICE cell and the logical element “Exclusive OR” for a content-addressable memory were designed and simulated. The comparison element contains two identical joint groups of transistors that are spaced on the chip by the distance of four micrometers, so the loss of data in STG DICE cell practically excluded. On the characteristics of the new 65-nm CMOS comparison element, we predict the hardness of these item to single event rate (SER more to hundred times compared to elements on 6-transistors cells and the standard DICE cell with distances 0.5-0.6 μm between mutually sensitive nodes.

Quantitative tools for addressing hospital readmissions

Directory of Open Access Journals (Sweden)

Lagoe Ronald J

2012-11-01

Full Text Available Abstract Background Increased interest in health care cost containment is focusing attention on reduction of hospital readmissions. Major payors have already developed financial penalties for providers that generate excess readmissions. This subject has benefitted from the development of resources such as the Potentially Preventable Readmissions software. This process has encouraged hospitals to renew efforts to improve these outcomes. The aim of this study was to describe quantitative tools such as definitions, risk estimation, and tracking of patients for reducing hospital readmissions. Findings This study employed the Potentially Preventable Readmissions software to develop quantitative tools for addressing hospital readmissions. These tools included two definitions of readmissions that support identification and management of patients. They also included analytical approaches for estimation of the risk of readmission for individual patients by age, discharge status of the initial admission, and severity of illness. They also included patient specific spreadsheets for tracking of target populations and for evaluation of the impact of interventions. Conclusions The study demonstrated that quantitative tools including the development of definitions of readmissions, estimation of the risk of readmission, and patient specific spreadsheets could contribute to the improvement of patient outcomes in hospitals.

The selection of low-risk design guidelines for energetic events

International Nuclear Information System (INIS)

Fergusson, Donald; Marchaterre, John; Graham, John

1982-01-01

This paper recommends the establishment of specific design guidelines for protection against potential, but low probability, energetic events. These guidelines recognize the plant protective features incorporated to prevents such events, as well as the inherent capability of the plant to accommodate a certain level of energy release. Further, their application is recommended within the context of necessary standardized and agreed upon acceptance criteria which are less restrictive than ASME code requirements. The paper provides the background upon which the selection of the design is made, including the characterization of energetic events dependent on various core-design parameters, and including the necessity of a low-risk design balanced between prevention of accidents and the mitigation of consequences

Suicide Risk Protocols: Addressing the Needs of High Risk Youths Identified through Suicide Prevention Efforts and in Clinical Settings

Science.gov (United States)

Heilbron, Nicole; Goldston, David; Walrath, Christine; Rodi, Michael; McKeon, Richard

2013-01-01

Several agencies have emphasized the importance of establishing clear protocols or procedures to address the needs of youths who are identified as suicidal through suicide prevention programs or in emergency department settings. What constitutes optimal guidelines for developing and implementing such protocols, however, is unclear. At the request…

The preventing recurrent vascular events and neurological worsening through intensive organized case-management (PREVENTION trial protocol [clinicaltrials.gov identifier: NCT00931788

Directory of Open Access Journals (Sweden)

Tsuyuki Ross

2010-04-01

Full Text Available Abstract Background Survivors of transient ischemic attack (TIA or stroke are at high risk for recurrent vascular events and aggressive treatment of vascular risk factors can reduce this risk. However, vascular risk factors, especially hypertension and high cholesterol, are not managed optimally even in those patients seen in specialized clinics. This gap between the evidence for secondary prevention of stroke and the clinical reality leads to suboptimal patient outcomes. In this study, we will be testing a pharmacist case manager for delivery of stroke prevention services. We hypothesize this new structure will improve processes of care which in turn should lead to improved outcomes. Methods We will conduct a prospective, randomized, controlled open-label with blinded ascertainment of outcomes (PROBE trial. Treatment allocation will be concealed from the study personnel, and all outcomes will be collected in an independent and blinded manner by observers who have not been involved in the patient's clinical care or trial participation and who are masked to baseline measurements. Patients will be randomized to control or a pharmacist case manager treating vascular risk factors to guideline-recommended target levels. Eligible patients will include all adult patients seen at stroke prevention clinics in Edmonton, Alberta after an ischemic stroke or TIA who have uncontrolled hypertension (defined as systolic blood pressure (BP > 140 mm Hg or dyslipidemia (fasting LDL-cholesterol > 2.00 mmol/L and who are not cognitively impaired or institutionalized. The primary outcome will be the proportion of subjects who attain 'optimal BP and lipid control'(defined as systolic BP Conclusions Nearly one-quarter of those who survive a TIA or minor stroke suffer another vascular event within a year. If our intervention improves the provision of secondary prevention therapies in these patients, the clinical (and financial implications will be enormous.

Prevention of adverse events of interferon γ gene therapy by gene delivery of interferon γ-heparin-binding domain fusion protein in mice

Directory of Open Access Journals (Sweden)

Mitsuru Ando

2014-01-01

Full Text Available Sustained gene delivery of interferon (IFN γ can be an effective treatment, but our previous study showed high levels of IFNγ-induced adverse events, including the loss of body weight. These unwanted events could be reduced by target-specific delivery of IFNγ after in vivo gene transfer. To achieve this, we selected the heparin-binding domain (HBD of extracellular superoxide dismutase as a molecule to anchor IFNγ to the cell surface. We designed three IFNγ derivatives, IFNγ-HBD1, IFNγ-HBD2, and IFNγ-HBD3, each of which had 1, 2, or 3 HBDs, respectively. Each plasmid-encoding fusion proteins was delivered to the liver, a model target in this study, by hydrodynamic tail vein injection. The serum concentration of IFNγ-HBD2 and IFNγ-HBD3 after gene delivery was lower than that of IFNγ or IFNγ-HBD1. Gene delivery of IFNγ-HBD2, but not of IFNγ-HBD3, effectively increased the mRNA expression of IFNγ-inducible genes in the liver, suggesting liver-specific distribution of IFNγ-HBD2. Gene delivery of IFNγ-HBD2-suppressed tumor growth in the liver as efficiently as that of IFNγ with much less symptoms of adverse effects. These results indicate that the adverse events of IFNγ gene transfer can be prevented by gene delivery of IFNγ-HBD2, a fusion protein with high cell surface affinity.

Equipment and physical plant changes in response to the Fukushima event

International Nuclear Information System (INIS)

Newman, G.

2013-01-01

The Fukushima event led the international nuclear industry and regulatory bodies to challenge the ability of existing nuclear power plants to prevent and mitigate the effects of a severe external event leading to a total loss of AC power and resultant loss of cooling. Canadian Nuclear Industry's immediate response was to provide a high level of assurance that the existing plant is in a high state of readiness to deal with design basis and beyond design basis events, verify the capability of the existing plant to deal with beyond design basis events (equipment, procedures, staff qualification, external support agreements, etc), verify capability to mitigate station black out events, verify capability to cope with internal and external floods and address vulnerabilities to seismically induced damage to mitigation equipment.

Event Coverage Detection and Event Source Determination in Underwater Wireless Sensor Networks

Directory of Open Access Journals (Sweden)

Zhangbing Zhou

2015-12-01

Full Text Available With the advent of the Internet of Underwater Things, smart things are deployed in the ocean space and establish underwater wireless sensor networks for the monitoring of vast and dynamic underwater environments. When events are found to have possibly occurred, accurate event coverage should be detected, and potential event sources should be determined for the enactment of prompt and proper responses. To address this challenge, a technique that detects event coverage and determines event sources is developed in this article. Specifically, the occurrence of possible events corresponds to a set of neighboring sensor nodes whose sensory data may deviate from a normal sensing range in a collective fashion. An appropriate sensor node is selected as the relay node for gathering and routing sensory data to sink node(s. When sensory data are collected at sink node(s, the event coverage is detected and represented as a weighted graph, where the vertices in this graph correspond to sensor nodes and the weight specified upon the edges reflects the extent of sensory data deviating from a normal sensing range. Event sources are determined, which correspond to the barycenters in this graph. The results of the experiments show that our technique is more energy efficient, especially when the network topology is relatively steady.

Initiating Events for Multi-Reactor Plant Sites

Energy Technology Data Exchange (ETDEWEB)

Muhlheim, Michael David [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Flanagan, George F. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Poore, III, Willis P. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2014-09-01

Inherent in the design of modular reactors is the increased likelihood of events that initiate at a single reactor affecting another reactor. Because of the increased level of interactions between reactors, it is apparent that the Probabilistic Risk Assessments (PRAs) for modular reactor designs need to specifically address the increased interactions and dependencies.

Comparison of the New Adult Ventilator-Associated Event Criteria to the Centers for Disease Control and Prevention Pediatric Ventilator-Associated Pneumonia Definition (PNU2) in a Population of Pediatric Traumatic Brain Injury Patients.

Science.gov (United States)

Cirulis, Meghan M; Hamele, Mitchell T; Stockmann, Chris R; Bennett, Tellen D; Bratton, Susan L

2016-02-01

The new Centers for Disease Control and Prevention paradigm for ventilator-associated events is intended to simplify surveillance of infectious and noninfectious complications of mechanical ventilation in adults. We assessed the ventilator-associated events algorithm in pediatric patients. A retrospective observational cohort study. This single-center study took place in a PICU at an urban academic medical facility. Pediatric (ages 0-18 yr old) trauma patients with moderate-to-severe traumatic brain injury ventilated for greater than or equal to 2 days. We assessed for pediatric ventilator-associated pneumonia (as defined by current Centers for Disease Control and Prevention PNU2 guidelines), adult ventilator-associated events, and an experimental ventilator-associated events definition modified for pediatric patients. We compared ventilator-associated events to ventilator-associated pneumonia to calculate the test characteristics. Thirty-nine of 119 patients (33%) developed ventilator-associated pneumonia. Sensitivity of the adult ventilator-associated condition definition was 23% (95% CI, 11-39%), which increased to 56% (95% CI, 40-72%) using the modified pediatric ventilator-associated pneumonia criterion. Specificity reached 100% for both original and modified pediatric probable ventilator-associated pneumonia using ventilator-associated events criteria. Children who developed ventilator-associated pneumonia or ventilator-associated condition had similar baseline characteristics: age, mechanism of injury, injury severity scores, and use of an intracranial pressure monitor. Diagnosis of ventilator-associated pneumonia and ventilator-associated condition portended similarly unfavorable outcomes: longer median duration of ventilation, ICU and hospital length of stay, and more discharges to rehabilitation, home health, or nursing care compared with patients with no pulmonary complication. Both current and modified ventilator-associated events criteria have poor

How study patients who receive fluo pyrimidines to prevent ischemic events

International Nuclear Information System (INIS)

Saldombide, L.

2010-01-01

Introduction: Ischemic heart disease is the main cause of death in Uruguay and cancer is the second. The pillar of the systemic treatment of colorectal cancer are fluo pyrimidines and cause acute ischemic events in 3-8% of t rated patients. The 5 fluorouracil is the third anticancer drug most used Objective: Due to the high incidence of the two diseases and the risk of death caused by the ischemic treatment complications, the literature is analyzed to define how to study patients who receive fluo pyrimidines as a medium of preventing the same. Development: fluo pyrimidines cardio-toxicity can occur by myocardial toxicity, vasospasm, dihydropyrimidine dehydrogenase deficiency, autoimmune phenomena, platelet hyper aggregability, etc. The clinic is varied and underestimated: angina, abnormal ST silent and reversible, arrhythmias, heart failure, hypertension and heart failure. It is the most common complication with continuous infusion of 5 Fu and its equivalent capecitabine with bolus f lou pyrimidines. It is common that ischemic heart disease prioritises the risk increase of complications, but their absence does not exist. Without ischemic heart disease it is difficult to prevent ischemic events, however proposes that the older higher risk. Results: No uniform guidelines is advised: detailed history, determine if risk factors such as smoking, hypertension, diabetes and dyslipidemia and They are present electrocardiogram and cardiac evaluation. Warn the patient about angina l pain as early symptom and monitor symptoms during chemotherapy including cardio-vascular hypotension. Discontinue the medication and perform classic anti-angina l symptoms and / or signs of ischemia. Not reintroduce unless it is the only therapeutic option, since mortality may exceed

Criticality prevention specifications thorium--uranium-233 separations in the Purex Plant

International Nuclear Information System (INIS)

Matheison, W.E.; Oberg, G.C.; Ritter, G.L.

1970-01-01

The specifications in this document define the limits or restrictions required to maintain an acceptably low probability of the occurrence of a nuclear chain reaction in the Purex Plant while processing irradiated thoria targets. These criticality prevention specifications do not stipulate the system, procedures, or mechanisms to permit operation within the limits or restrictions

Pathophysiogenesis of Mesial Temporal Lobe Epilepsy: Is Prevention of Damage Antiepileptogenic?

Science.gov (United States)

Curia, G.; Lucchi, C.; Vinet, J.; Gualtieri, F.; Marinelli, C.; Torsello, A.; Costantino, L.; Biagini*,, G.

2014-01-01

Temporal lobe epilepsy (TLE) is frequently associated with hippocampal sclerosis, possibly caused by a primary brain injury that occurred a long time before the appearance of neurological symptoms. This type of epilepsy is characterized by refractoriness to drug treatment, so to require surgical resection of mesial temporal regions involved in seizure onset. Even this last therapeutic approach may fail in giving relief to patients. Although prevention of hippocampal damage and epileptogenesis after a primary event could be a key innovative approach to TLE, the lack of clear data on the pathophysiological mechanisms leading to TLE does not allow any rational therapy. Here we address the current knowledge on mechanisms supposed to be involved in epileptogenesis, as well as on the possible innovative treatments that may lead to a preventive approach. Besides loss of principal neurons and of specific interneurons, network rearrangement caused by axonal sprouting and neurogenesis are well known phenomena that are integrated by changes in receptor and channel functioning and modifications in other cellular components. In particular, a growing body of evidence from the study of animal models suggests that disruption of vascular and astrocytic components of the blood-brain barrier takes place in injured brain regions such as the hippocampus and piriform cortex. These events may be counteracted by drugs able to prevent damage to the vascular component, as in the case of the growth hormone secretagogue ghrelin and its analogues. A thoroughly investigation on these new pharmacological tools may lead to design effective preventive therapies. PMID:24251566

Unsupervised behaviour-specific dictionary learning for abnormal event detection

DEFF Research Database (Denmark)

Ren, Huamin; Liu, Weifeng; Olsen, Søren Ingvor

2015-01-01

the training data is only a small proportion of the surveillance data. Therefore, we propose behavior-specific dictionaries (BSD) through unsupervised learning, pursuing atoms from the same type of behavior to represent one behavior dictionary. To further improve the dictionary by introducing information from...... potential infrequent normal patterns, we refine the dictionary by searching ‘missed atoms’ that have compact coefficients. Experimental results show that our BSD algorithm outperforms state-of-the-art dictionaries in abnormal event detection on the public UCSD dataset. Moreover, BSD has less false alarms...

Top event prevention in complex systems

International Nuclear Information System (INIS)

Youngblood, R.W.; Worrell, R.B.

1995-01-01

A key step in formulating a regulatory basis for licensing complex and potentially hazardous facilities is identification of a collection of design elements that is necessary and sufficient to achieve the desired level of protection of the public, the workers, and the environment. Here, such a collection of design elements will be called a ''prevention set.'' At the design stage, identifying a prevention set helps to determine what elements to include in the final design. Separately, a prevention-set argument could be used to limit the scope of regulatory oversight to a subset of design elements. This step can be taken during initial review of a design, or later as part of an effort to justify relief from regulatory requirements that are burdensome but provide little risk reduction. This paper presents a systematic approach to the problem of optimally choosing a prevention set

Play it forward! A community-based participatory research approach to childhood obesity prevention.

Science.gov (United States)

Berge, Jerica M; Jin, Seok Won; Hanson, Carrie; Doty, Jennifer; Jagaraj, Kimberly; Braaten, Kent; Doherty, William J

2016-03-01

To date there has been limited success with childhood obesity prevention interventions. This may be due in part, to the challenge of reaching and engaging parents in interventions. The current study used a community-based participatory research (CBPR) approach to engage parents in cocreating and pilot testing a childhood obesity prevention intervention. Because CBPR approaches to childhood obesity prevention are new, this study aims to detail the creation, including the formation of the citizen action group (CAG), and implementation of a childhood obesity prevention intervention using CBPR methods. A CBPR approach was used to recruit community members to partner with university researchers in the CAG (n = 12) to create and implement the Play It Forward! childhood obesity intervention. The intervention creation and implementation took 2 years. During Year 1 (2011-2012), the CAG carried out a community needs and resources assessment and designed a community-based and family focused childhood obesity prevention intervention. During Year 2 (2012-2013), the CAG implemented the intervention and conducted an evaluation. Families (n = 50; 25 experimental/25 control group) with children ages 6-12 years participated in Play It Forward! Feasibility and process evaluation data suggested that the intervention was highly feasible and participants in both the CAG and intervention were highly satisfied. Specifically, over half of the families attended 75% of the Play It Forward! events and 33% of families attended all the events. Equal collaboration between parents and academic researchers to address childhood obesity may be a promising approach that merits further testing. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Semantic Complex Event Processing over End-to-End Data Flows

Energy Technology Data Exchange (ETDEWEB)

Zhou, Qunzhi [University of Southern California; Simmhan, Yogesh; Prasanna, Viktor K.

2012-04-01

Emerging Complex Event Processing (CEP) applications in cyber physical systems like SmartPower Grids present novel challenges for end-to-end analysis over events, flowing from heterogeneous information sources to persistent knowledge repositories. CEP for these applications must support two distinctive features - easy specification patterns over diverse information streams, and integrated pattern detection over realtime and historical events. Existing work on CEP has been limited to relational query patterns, and engines that match events arriving after the query has been registered. We propose SCEPter, a semantic complex event processing framework which uniformly processes queries over continuous and archived events. SCEPteris built around an existing CEP engine with innovative support for semantic event pattern specification and allows their seamless detection over past, present and future events. Specifically, we describe a unified semantic query model that can operate over data flowing through event streams to event repositories. Compile-time and runtime semantic patterns are distinguished and addressed separately for efficiency. Query rewriting is examined and analyzed in the context of temporal boundaries that exist between event streams and their repository to avoid duplicate or missing results. The design and prototype implementation of SCEPterare analyzed using latency and throughput metrics for scenarios from the Smart Grid domain.

DDT and Malaria Prevention: Addressing the Paradox

NARCIS (Netherlands)

Bouwman, H.; Berg, van den H.; Kylin, H.

2011-01-01

Background: The debate regarding dichlorodiphenyltrichloroethane (DDT) in malaria prevention and human health is polarized and can be classified into three positions: anti-DDT, centrist-DDT, pro-DDT. Objective: We attempted to arrive at a synthesis by matching a series of questions on the use of DDT

Prevention of acute malnutrition

DEFF Research Database (Denmark)

de Pee, Saskia; Grais, Rebecca; Fenn, Bridget

2015-01-01

of cash or food, enables households to better meet the food, health, and other needs of household members and may increase resilience; water, sanitation, and hygiene (WASH) and health interventions help prevent and address illness and hence reduce wasting risk. The contributions of specific interventions...... "best possible" treatment, can provide evidence about what works, to what extent, at what cost, and under which circumstances. Programs should address the most important causes in given contexts, be feasible to implement at scale, and assess implementation, coverage, and outcomes....

Cardiac events in football and strategies for first-responder treatment on the field.

Science.gov (United States)

Schmied, Christian; Drezner, Jonathan; Kramer, Efraim; Dvorak, Jiri

2013-12-01

The incidence and outcomes of sudden cardiac arrest (SCA) and global strategies for prevention of sudden cardiac death (SCD) in football are not known. The aim of this study was to estimate the occurrence of cardiac events in football and to investigate the preventive measures taken among the Fédération International de Football Association (FIFA) member associations internationally. A questionnaire was sent to the member associations of FIFA. The first section addressed the previous events of SCA, SCD or unexplained sports-related sudden death within the last 10 years. Further questions focused on football player medical screening strategies and SCA resuscitation response protocols on the field. 126 of 170 questionnaires were returned (response rate 74.1%), and 103 questionnaires (60.6%) were completed sufficiently to include in further analysis. Overall, 107 cases of SCA/SCD and 5 unexplained football-associated sudden deaths were reported. These events occurred in 52 of 103 responding associations (50.5%). 23 of 112 (20.5%) footballers survived. 12 of 22 (54.5%) players treated with an available automated external defibrillators (AED) on the pitch survived. A national registry to monitor cardiac events was established in only 18.4% of the associations. Most associations (85.4%) provide regular cardiac screening for their national teams while 75% screen teams of the national leagues. An AED is available at all official matches in 68% of associations. National registries to accurately measure SCA/SCD in football are rare and greatly needed. Deficiencies in emergency preparations, undersupply of AEDs on the field during matches, and variability in resuscitation response protocols and training of team-staff members should be addressed to effectively prevent SCD in football.

An Address Event Representation-Based Processing System for a Biped Robot

Directory of Open Access Journals (Sweden)

Uziel Jaramillo-Avila

2016-02-01

Full Text Available In recent years, several important advances have been made in the fields of both biologically inspired sensorial processing and locomotion systems, such as Address Event Representation-based cameras (or Dynamic Vision Sensors and in human-like robot locomotion, e.g., the walking of a biped robot. However, making these fields merge properly is not an easy task. In this regard, Neuromorphic Engineering is a fast-growing research field, the main goal of which is the biologically inspired design of hybrid hardware systems in order to mimic neural architectures and to process information in the manner of the brain. However, few robotic applications exist to illustrate them. The main goal of this work is to demonstrate, by creating a closed-loop system using only bio-inspired techniques, how such applications can work properly. We present an algorithm using Spiking Neural Networks (SNN for a biped robot equipped with a Dynamic Vision Sensor, which is designed to follow a line drawn on the floor. This is a commonly used method for demonstrating control techniques. Most of them are fairly simple to implement without very sophisticated components; however, it can still serve as a good test in more elaborate circumstances. In addition, the locomotion system proposed is able to coordinately control the six DOFs of a biped robot in switching between basic forms of movement. The latter has been implemented as a FPGA-based neuromorphic system. Numerical tests and hardware validation are presented.

Prevention of suicide among adolescents and young people: reflecting on the experience of Western models

Directory of Open Access Journals (Sweden)

I.B. Bovina

2013-07-01

Full Text Available We analyze various preventive and proactive suicide programs, which operate in a number of Western countries. We consider various measures implemented under the auspices of the WHO, as well as in the framework of the European Alliance Against Depression. Following J. Henden, wediscuss three types of suicide prevention: primary, secondary and tertiary. Primary prevention covers the population as a whole – suicide prevention is to promote the value of health and life. This type of prevention is addressed to a wide audience, including teenagers and young adults groups. Secondary prevention is aimed at those who have attempted to commit suicide, because the presence of attempts is a significant feature that allows to predict next attempts. Tertiary prevention is addressed to suicider’s close circle, it aims at help the suicider’s relatives to survive this event, use the appropriate ways of coping with the tragic situation.

Can Cell to Cell Thermal Runaway Propagation be Prevented in a Li-ion Battery Module?

Science.gov (United States)

Jeevarajan, Judith; Lopez, Carlos; Orieukwu, Josephat

2014-01-01

Increasing cell spacing decreased adjacent cell damage center dotElectrically connected adjacent cells drained more than physically adjacent cells center dotRadiant barrier prevents propagation when fully installed between BP cells center dotBP cells vent rapidly and expel contents at 100% SOC -Slower vent with flame/smoke at 50% -Thermal runaway event typically occurs at 160 degC center dotLG cells vent but do not expel contents -Thermal runaway event typically occurs at 200 degC center dotSKC LFP modules did not propagate; fuses on negative terminal of cell may provide a benefit in reducing cell to cell damage propagation. New requirement in NASA-Battery Safety Requirements document: JSC 20793 Rev C 5.1.5.1 Requirements - Thermal Runaway Propagation a. For battery designs greater than a 80-Wh energy employing high specific energy cells (greater than 80 watt-hours/kg, for example, lithium-ion chemistries) with catastrophic failure modes, the battery shall be evaluated to ascertain the severity of a worst-case single-cell thermal runaway event and the propensity of the design to demonstrate cell-to-cell propagation in the intended application and environment. NASA has traditionally addressed the threat of thermal runaway incidents in its battery deployments through comprehensive prevention protocols. This prevention-centered approach has included extensive screening for manufacturing defects, as well as robust battery management controls that prevent abuse-induced runaway even in the face of multiple system failures. This focused strategy has made the likelihood of occurrence of such an event highly improbable. b. The evaluation shall include all necessary analysis and test to quantify the severity (consequence) of the event in the intended application and environment as well as to identify design modifications to the battery or the system that could appreciably reduce that severity. In addition to prevention protocols, programs developing battery designs with

A simple strategy for fall events detection

KAUST Repository

Harrou, Fouzi

2017-01-20

The paper concerns the detection of fall events based on human silhouette shape variations. The detection of fall events is addressed from the statistical point of view as an anomaly detection problem. Specifically, the paper investigates the multivariate exponentially weighted moving average (MEWMA) control chart to detect fall events. Towards this end, a set of ratios for five partial occupancy areas of the human body for each frame are collected and used as the input data to MEWMA chart. The MEWMA fall detection scheme has been successfully applied to two publicly available fall detection databases, the UR fall detection dataset (URFD) and the fall detection dataset (FDD). The monitoring strategy developed was able to provide early alert mechanisms in the event of fall situations.

Primary Prevention of Cardiovascular Disease

Directory of Open Access Journals (Sweden)

Danny J. Eapen, MD

2016-09-01

Full Text Available Cardiovascular disease (CVD is the leading cause of death worldwide. This article focuses on current guidelines for the primary prevention of CVD and addresses management of key risk factors. Dietary modification, weight loss, exercise, and tobacco use cessation are specific areas where focused efforts can successfully reduce CVD risk on both an individual and a societal level. Specific areas requiring management include dyslipidemia, hypertension, physical activity, diabetes, aspirin use, and alcohol intake. These preventive efforts have major public health implications. As the global population continues to grow, health care expenditures will also rise, with the potential to eventually overwhelm the health care system. Therefore it is imperative to apply our collective efforts on CVD prevention to improve the cardiovascular health of individuals, communities, and nations.

Y-90 microsphere therapy: prevention of adverse events.

Science.gov (United States)

Schultz, Cheryl C; Campbell, Janice; Bakalyar, Donovan; Beauvais, Michele; Feng, Wenzheng; Savin, Michael

2009-08-01

Thirty-three (33) events that were inconsistent with intended treatment for 471 Y-90 microsphere deliveries were analyzed from 2001 to 2007. Each occurrence was categorized, based on root-cause analysis, as a device/product defect and/or operator error event. Events were further categorized, if there was an adverse outcome, as spill/leak, termination, recatheterization, dose deviation, and/or a regulatory medical event. Of 264 Y-90 Therasphere (MDS Nordion, Ottawa, Ontario, Canada) treatments, 15 events were reported (5.7%). Of 207 Y-90 SIR-Spheres (Sirtex, Wilmington, MA) treatments, 18 events were reported (8.7%). Twenty-five (25) of 33 events (76%) were device/product defects: 73% for Therasphere (11 of 15) and 78% for SIR-Spheres (14 of 18). There were 31 adverse outcomes associated with 33 events: 15 were leaks and/or spills, 9 resulted in termination of the dose administration, 3 resulted in recatheterization for dose compensation, 2 were dose deviations (doses differing from the prescribed between 10% and 20%), and 2 were reported as regulatory medical events. Fifty-five (55) corrective actions were taken: 39 (71%) were related to the manufacturer and 16 (29%) were hospital based. This process of analyzing each event and measuring our outcomes has been effective at minimizing adverse events and improving patient safety.

Common-Cause Failure Analysis in Event Assessment

International Nuclear Information System (INIS)

Rasmuson, D.M.; Kelly, D.L.

2008-01-01

This paper reviews the basic concepts of modeling common-cause failures (CCFs) in reliability and risk studies and then applies these concepts to the treatment of CCF in event assessment. The cases of a failed component (with and without shared CCF potential) and a component being unavailable due to preventive maintenance or testing are addressed. The treatment of two related failure modes (e.g. failure to start and failure to run) is a new feature of this paper, as is the treatment of asymmetry within a common-cause component group

The incidence, root-causes, and outcomes of adverse events in surgical units: implication for potential prevention strategies

Directory of Open Access Journals (Sweden)

Groenewegen Peter P

2011-05-01

Full Text Available Abstract Background We need to know the scale and underlying causes of surgical adverse events (AEs in order to improve the safety of care in surgical units. However, there is little recent data. Previous record review studies that reported on surgical AEs in detail are now more than ten years old. Since then surgical technology and quality assurance have changed rapidly. The objective of this study was to provide more recent data on the incidence, consequences, preventability, causes and potential strategies to prevent AEs among hospitalized patients in surgical units. Methods A structured record review study of 7,926 patient records was carried out by trained nurses and medical specialist reviewers in 21 Dutch hospitals. The aim was to determine the presence of AEs during hospitalizations in 2004 and to consider how far they could be prevented. Of all AEs, the consequences, responsible medical specialty, causes and potential prevention strategies were identified. Surgical AEs were defined as AEs attributable to surgical treatment and care processes and were selected for analysis in detail. Results Surgical AEs occurred in 3.6% of hospital admissions and represented 65% of all AEs. Forty-one percent of the surgical AEs was considered to be preventable. The consequences of surgical AEs were more severe than for other types of AEs, resulting in more permanent disability, extra treatment, prolonged hospital stay, unplanned readmissions and extra outpatient visits. Almost 40% of the surgical AEs were infections, 23% bleeding, and 22% injury by mechanical, physical or chemical cause. Human factors were involved in the causation of 65% of surgical AEs and were considered to be preventable through quality assurance and training. Conclusions Surgical AEs occur more often than other types of AEs, are more often preventable and their consequences are more severe. Therefore, surgical AEs have a major impact on the burden of AEs during hospitalizations

HY-Specific Induced Regulatory T Cells Display High Specificity and Efficacy in the Prevention of Acute Graft-versus-Host Disease.

Science.gov (United States)

Li, Jun; Heinrichs, Jessica; Haarberg, Kelley; Semple, Kenrick; Veerapathran, Anandharaman; Liu, Chen; Anasetti, Claudio; Yu, Xue-Zhong

2015-07-15

Naturally derived regulatory T cells (Tregs) may prevent graft-versus-host disease (GVHD) while preserving graft-versus-leukemia (GVL) activity. However, clinical application of naturally derived regulatory T cells has been severely hampered by their scarce availability and nonselectivity. To overcome these limitations, we took alternative approaches to generate Ag-specific induced Tregs (iTregs) and tested their efficacy and selectivity in the prevention of GVHD in preclinical models of bone marrow transplantation. We selected HY as a target Ag because it is a naturally processed, ubiquitously expressed minor histocompatibility Ag (miHAg) with a proven role in GVHD and GVL effect. We generated HY-specific iTregs (HY-iTregs) from resting CD4 T cells derived from TCR transgenic mice, in which CD4 cells specifically recognize HY peptide. We found that HY-iTregs were highly effective in preventing GVHD in male (HY(+)) but not female (HY(-)) recipients using MHC II-mismatched, parent→F1, and miHAg-mismatched murine bone marrow transplantation models. Interestingly, the expression of target Ag (HY) on the hematopoietic or nonhematopoietic compartment alone was sufficient for iTregs to prevent GVHD. Furthermore, treatment with HY-iTregs still preserved the GVL effect even against pre-established leukemia. We found that HY-iTregs were more stable in male than in female recipients. Furthermore, HY-iTregs expanded extensively in male but not female recipients, which in turn significantly reduced donor effector T cell expansion, activation, and migration into GVHD target organs, resulting in effective prevention of GVHD. This study demonstrates that iTregs specific for HY miHAgs are highly effective in controlling GVHD in an Ag-dependent manner while sparing the GVL effect. Copyright © 2015 by The American Association of Immunologists, Inc.

Effect of a ward-based pharmacy team on preventable adverse drug events in surgical patients (SUREPILL study)

NARCIS (Netherlands)

de Boer, M.; Boeker, E. B.; Ramrattan, M. A.; Kiewiet, J. J. S.; Ram, K.; Gombert-Handoko, K. B.; van Lent-Evers, N. A. E. M.; Kuks, P. F. M.; Mulder, W. M. C.; Breslau, P. J.; Oostenbroek, R. J.; Dijkgraaf, M. G. W.; Lie-A-Huen, L.; Boermeester, M. A.

2015-01-01

Surgical patients are at risk of adverse drug events (ADEs) causing morbidity and mortality. Much harm is preventable. Ward-based pharmacy interventions to reduce medication-related harm have not been evaluated in surgical patients. This multicentre prospective clinical trial evaluated a

Defense-in-depth approach against a beyond design basis event

Energy Technology Data Exchange (ETDEWEB)

Hoang, H., E-mail: Hoa.hoang@ge.com [GE Hitachi Nuclear Energy, 1989 Little Orchard St., 95125 San Jose, California (United States)

2013-10-15

The US industry, with the approval of the Nuclear Regulatory Commission, is promoting an approach to add diverse and flexible mitigation strategies, or Flex, that will increase the defense-in-depth capability for the nuclear power plants in the event of beyond design basis event, such as at the Fukushima Dai-ichi station. The objective of Flex is to establish and indefinite coping capability to prevent damage to the fuel in the core and spent fuel pool, and to maintain the containment function by utilizing installed equipment, on-site portable equipment and pre-staged off-site resources. This capability will address both an extended loss of all Ac power and a loss of ultimate heat sink which could arise following a design basis event with additional failures, and conditions from a beyond design basis event. (author)

Defense-in-depth approach against a beyond design basis event

International Nuclear Information System (INIS)

Hoang, H.

2013-10-01

The US industry, with the approval of the Nuclear Regulatory Commission, is promoting an approach to add diverse and flexible mitigation strategies, or Flex, that will increase the defense-in-depth capability for the nuclear power plants in the event of beyond design basis event, such as at the Fukushima Dai-ichi station. The objective of Flex is to establish and indefinite coping capability to prevent damage to the fuel in the core and spent fuel pool, and to maintain the containment function by utilizing installed equipment, on-site portable equipment and pre-staged off-site resources. This capability will address both an extended loss of all Ac power and a loss of ultimate heat sink which could arise following a design basis event with additional failures, and conditions from a beyond design basis event. (author)

Associations among Life Events, Empathic Concern, and Adolescents' Prosocial and Aggressive Behaviors Toward Specific Targets.

Science.gov (United States)

Davis, Alexandra N; Luce, Haley; Davalos, Natasha

2018-05-25

The goal of the present study was to examine the links between life events and adolescents' social behaviors (prosocial and aggressive behaviors) toward specific targets and to examine how empathic concern may play a role in these associations. The study examined two hypotheses: both the mediating role of empathic concern and the moderating role of empathic concern. The sample included 311 high school students from the Midwest (M age = 16.10 years; age range = 14-19 years; 58.7% girls; 82.7% White, 13.6% Latino). The results demonstrated support for the moderation model as well as complex links between life events and prosocial and aggressive behaviors toward specific targets. The discussion focuses on the role of empathic concern in understanding how life events are ultimately associated with adolescents' social development.

An Entry Point for Formal Methods: Specification and Analysis of Event Logs

Directory of Open Access Journals (Sweden)

Howard Barringer

2010-03-01

Full Text Available Formal specification languages have long languished, due to the grave scalability problems faced by complete verification methods. Runtime verification promises to use formal specifications to automate part of the more scalable art of testing, but has not been widely applied to real systems, and often falters due to the cost and complexity of instrumentation for online monitoring. In this paper we discuss work in progress to apply an event-based specification system to the logging mechanism of the Mars Science Laboratory mission at JPL. By focusing on log analysis, we exploit the "instrumentation" already implemented and required for communicating with the spacecraft. We argue that this work both shows a practical method for using formal specifications in testing and opens interesting research avenues, including a challenging specification learning problem.

Can histologic transformation of follicular lymphoma be predicted and prevented?

Science.gov (United States)

Kridel, Robert; Sehn, Laurie H; Gascoyne, Randy D

2017-07-20

Transformation to aggressive lymphoma is a critical event in the clinical course of follicular lymphoma (FL) patients. Yet, it is a challenge to reliably predict transformation at the time of diagnosis. Understanding the risk of transformation would be useful for guiding and monitoring patients, as well as for evaluating novel treatment strategies that could potentially prevent transformation. Herein, we review the contribution of clinical, pathological, and genetic risk factors to transformation. Patients with multiple clinical high-risk factors are at elevated risk of transformation but we are currently lacking a prognostic index that would specifically address transformation rather than disease progression or overall survival. From the biological standpoint, multiple studies have correlated individual biomarkers with transformation. However, accurate prediction of this event is currently hampered by our limited knowledge of the evolutionary pathways leading to transformation, as well as the scarcity of comprehensive, large-scale studies that assess both the genomic landscape of alterations within tumor cells and the composition of the microenvironment. Liquid biopsies hold great promise for achieving precision medicine. Indeed, mutations detected within circulating tumor DNA may be a better reflection of the inherent intratumoral heterogeneity than the biopsy of a single site. Last, we will assess whether evidence exists in the literature that transformation might be prevented altogether, based on the choice of therapy for FL. © 2017 by The American Society of Hematology.

Site-Specific Antioxidative Therapy for Prevention of Atherosclerosis and Cardiovascular Disease

Directory of Open Access Journals (Sweden)

Hajime Otani

2013-01-01

Full Text Available Oxidative stress has been implicated in pathophysiology of aging and age-associated disease. Antioxidative medicine has become a practice for prevention of atherosclerosis. However, limited success in preventing cardiovascular disease (CVD in individuals with atherosclerosis using general antioxidants has prompted us to develop a novel antioxidative strategy to prevent atherosclerosis. Reducing visceral adipose tissue by calorie restriction (CR and regular endurance exercise represents a causative therapy for ameliorating oxidative stress. Some of the recently emerging drugs used for the treatment of CVD may be assigned as site-specific antioxidants. CR and exercise mimetic agents are the choice for individuals who are difficult to continue CR and exercise. Better understanding of molecular and cellular biology of redox signaling will pave the way for more effective antioxidative medicine for prevention of CVD and prolongation of healthy life span.

Prevention of Contrast-Induced AKI: A Review of Published Trials and the Design of the Prevention of Serious Adverse Events following Angiography (PRESERVE) Trial

Science.gov (United States)

Gallagher, Martin; Kaufman, James; Cass, Alan; Parikh, Chirag R.; Chertow, Glenn M.; Shunk, Kendrick A.; McCullough, Peter A.; Fine, Michael J.; Mor, Maria K.; Lew, Robert A.; Huang, Grant D.; Conner, Todd A.; Brophy, Mary T.; Lee, Joanne; Soliva, Susan; Palevsky, Paul M.

2013-01-01

Summary Contrast-induced AKI (CI-AKI) is a common condition associated with serious, adverse outcomes. CI-AKI may be preventable because its risk factors are well characterized and the timing of renal insult is commonly known in advance. Intravenous (IV) fluids and N-acetylcysteine (NAC) are two of the most widely studied preventive measures for CI-AKI. Despite a multitude of clinical trials and meta-analyses, the most effective type of IV fluid (sodium bicarbonate versus sodium chloride) and the benefit of NAC remain unclear. Careful review of published trials of these interventions reveals design limitations that contributed to their inconclusive findings. Such design limitations include the enrollment of small numbers of patients, increasing the risk for type I and type II statistical errors; the use of surrogate primary endpoints defined by small increments in serum creatinine, which are associated with, but not necessarily causally related to serious, adverse, patient-centered outcomes; and the inclusion of low-risk patients with intact baseline kidney function, yielding low event rates and reduced generalizability to a higher-risk population. The Prevention of Serious Adverse Events following Angiography (PRESERVE) trial is a randomized, double-blind, multicenter trial that will enroll 8680 high-risk patients undergoing coronary or noncoronary angiography to compare the effectiveness of IV isotonic sodium bicarbonate versus IV isotonic sodium chloride and oral NAC versus oral placebo for the prevention of serious, adverse outcomes associated with CI-AKI. This article discusses key methodological issues of past trials investigating IV fluids and NAC and how they informed the design of the PRESERVE trial. PMID:23660180

Cost-Effectiveness Comparison of Breast Cancer Screening and Vascular Event Primary Prevention with Aspirin in Wales

Science.gov (United States)

Morgan, Gareth

2011-01-01

Aim: For the first time, this article presents a cost-effectiveness comparison of a breast cancer screening programme with a possible health education programme with aspirin for vascular event primary prevention. Background: Breast cancer screening is a well established part of cancer control programmes yet recent evidence on this intervention has…

Recurring events - Volume 2

International Nuclear Information System (INIS)

2003-04-01

known, thus the actions taken were not effective in preventing recurrence of an event, - The contributing factors or causes of the event were not taken into account in defining the actions to be taken. Several good practices were identified to prevent recurring events. These practices are part of related guides provided by national and international bodies. Some of these are: - NPPs should analyse recurring events in-depth, in order to identify root causes and contributing factors to prevent further recurrence. The specific factors that failed to prevent recurrence should be investigated and identified (that is, why prior operating experience was not effectively applied). - For minor events, trend analyses should be performed to monitor the frequency of component failures (which may be unavoidable) or the frequency of minor human performance problems (which may indicate weaknesses in error prevention processes and programs). - Analysis of external operating experiences from other NPPs should be strengthened to broaden the basis for preventive measures; - Actions taken after events should be assessed regarding their effectiveness in preventing recurrence of similar events. Subsequent to the workshop, a more detailed search of reports of operating experience, including IRS and other reports from national sources, resulted in the determination of a number of recurring categories: - Loss of RHR at mid-loop (in the 1999 report also); - BWR instability (in the 1999 report also); - PWR vessel corrosion due to boric acid effects; - Hydrogen detonation in BWR piping; - Steam Generator Tube Rupture; - Multiple valve failures in ECCS; - Service Water Failure due to Marine Biofouling (in the 1999 report also); - System Level Failures with Human Factors Considerations; - Strainer Clogging (sources of emergency injection or recirculation). Five conclusions were established on the basis of the workshop and the recurring event analysis: Conclusion 1: Recurring events continue to be

Characteristics of workplace violence prevention training and violent events among home health and hospice care providers.

Science.gov (United States)

Vladutiu, Catherine J; Casteel, Carri; Nocera, Maryalice; Harrison, Robert; Peek-Asa, Corinne

2016-01-01

In the rapidly growing home health and hospice industry, little is known about workplace violence prevention (WVP) training and violent events. We examined the characteristics of WVP training and estimated violent event rates among 191 home health and hospice care providers from six agencies in California. Training characteristics were identified from the Occupational Safety and Health Administration guidelines. Rates were estimated as the number of violent events divided by the total number of home visit hours. Between 2008 and 2009, 66.5% (n = 127) of providers reported receiving WVP training when newly hired or as recurrent training. On average, providers rated the quality of their training as 5.7 (1 = poor to 10 = excellent). Among all providers, there was an overall rate of 17.1 violent events per 1,000 visit-hours. Efforts to increase the number of home health care workers who receive WVP training and to improve training quality are needed. © 2015 Wiley Periodicals, Inc.

Dissemination of a highly virulent pathogen: tracking the early events that define infection.

Directory of Open Access Journals (Sweden)

Rodrigo J Gonzalez

2015-01-01

Full Text Available The series of events that occurs immediately after pathogen entrance into the body is largely speculative. Key aspects of these events are pathogen dissemination and pathogen interactions with the immune response as the invader moves into deeper tissues. We sought to define major events that occur early during infection of a highly virulent pathogen. To this end, we tracked early dissemination of Yersinia pestis, a highly pathogenic bacterium that causes bubonic plague in mammals. Specifically, we addressed two fundamental questions: (1 do the bacteria encounter barriers in disseminating to draining lymph nodes (LN, and (2 what mechanism does this nonmotile bacterium use to reach the LN compartment, as the prevailing model predicts trafficking in association with host cells. Infection was followed through microscopy imaging in addition to assessing bacterial population dynamics during dissemination from the skin. We found and characterized an unexpected bottleneck that severely restricts bacterial dissemination to LNs. The bacteria that do not pass through this bottleneck are confined to the skin, where large numbers of neutrophils arrive and efficiently control bacterial proliferation. Notably, bottleneck formation is route dependent, as it is abrogated after subcutaneous inoculation. Using a combination of approaches, including microscopy imaging, we tested the prevailing model of bacterial dissemination from the skin into LNs and found no evidence of involvement of migrating phagocytes in dissemination. Thus, early stages of infection are defined by a bottleneck that restricts bacterial dissemination and by neutrophil-dependent control of bacterial proliferation in the skin. Furthermore, and as opposed to current models, our data indicate an intracellular stage is not required by Y. pestis to disseminate from the skin to draining LNs. Because our findings address events that occur during early encounters of pathogen with the immune response

WANO Activities Related to Identifying and Reducing the Likelihood for Recurring Events

International Nuclear Information System (INIS)

Llewellyn, Michael

2003-01-01

similar issues, or similar aspects or precursors to more serious events, have recently occurred at several member NPPs. These issues are identified through analysis of event reports filed with WANO by a team of operating experience personnel based in the WANO Paris Centre offices. SOERs are written in a manner that clearly identifies the issue, describes examples of the issue from various power plant reports, and provides recommendations that each WANO-member NPP is expected to implement at their plant. WANO analysis has identified recurring events in areas of 'Severe Weather' and 'Emergency Power Reliability', and has SOERs in production for those subject areas. WANO typically issues one or two SOERs every year. Significant Event Reports (SERs) are written by WANO when a single, highly significant event with important learning points occurs at a member NPP. SERs address single event occurrences; whereas SOERs address issues evident in a series of events. During production of an SER, WANO reviews and analyses possible aspects of the event that may be recurrent to a prior event at that NPP or at another NPP in the industry. Therefore, even though an SER addresses a single event, some aspects of event recurrence are examined. Where possible, WANO tries to determine why previous operating experience was not effectively used to, prevent recurrence of the event. (author)

Catalogue of requirements for a plant-specific safety inspection of German nuclear power plants taking into account the Fukushima-I (Japan) events; Anforderungskatalog fuer anlagenbezogene Ueberpruefungen deutscher Kernkraftwerke unter Beruecksichtigung der Ereignisse in Fukushima-I (Japan)

Energy Technology Data Exchange (ETDEWEB)

NONE

2011-03-30

The catalogue of requirements for a plant-specific safety inspection of German nuclear power plants taking into account the Fukushima-I (Japan) events worked out by the German RSK (reactor safety commission) includes the following inspection topics: natural events like earth quakes, floods, weather-based consequences and possible superposition; civilization-based events like airplane crash, gas release, reactor accident consequences for neighboring units, terroristic impacts, external attacks on computer-based control systems. Further event-independent assumptions have to be considered: station blackout, long-term emergency power supply requirement, failure of auxiliary cooling water supply, efficacy of preventive measures, aggravating boundary conditions for the performance of emergency measures.

Prevention of atherosclerosis by specific AT1-receptor blockade with candesartan cilexetil

Directory of Open Access Journals (Sweden)

Vasilios Papademetriou

2001-03-01

Full Text Available Several studies indicate that blockade of the renin-angiotensin-aldosterone system (RAAS can prevent atherosclerosis and vascular events, but the precise mechanisms involved are still unclear. In this study, we investigated the effect of the AT 1-receptor blocker, candesartan, in the prevention of atherosclerosis in Watanabe heritable hyperlipidaemic (WHHL rabbits and also the effect of AT1-receptor blockade in the uptake of oxidised LDL by macrophage cell cultures. In the first set of experiments, 12 WHHL rabbits were randomly assigned to three groups: placebo, atenolol 5 mg/kg daily or candesartan 2 mg/kg daily for six months. Compared with controls and atenolol-treated rabbits, candesartan treatment resulted in a significant 50—60% reduction of atherosclerotic plaque formation and a 66% reduction in cholesterol accumulation in the thoracic aorta.Studies in macrophage cultures indicated that candesartan prevented uptake of oxidised LDL-(oxLDL-cholesterol by cultured macrophages. Candesartan inhibited the uptake of oxLDL in a dose-dependent manner, reaching a maximum inhibition of 70% at concentrations of 5.6 µg/ml. Further studies in other animal models and well-designed trials in humans are warranted to further explore the role of AT1-receptor blockade in the prevention of atherosclerosis.

B Plant Complex pollution prevention plan. Revision 1

International Nuclear Information System (INIS)

Beam, T.G.

1994-01-01

The US Department of Energy (DOE) has directed Westinghouse Hanford Company (WHC) to develop an effective strategy to minimize the generation of hazardous, radioactive, and mixed wastes at Hanford in compliance with state and federal regulations. WHC has formalized a pollution prevention program composed of management policies, management requirements and procedures. This plan addresses pollution prevention for B Plant Complex. A pollution prevention team is in place and has been assigned responsibility for implementing the plan. This plan includes actions and goals for reducing volume and toxicity of waste generated, as well as a basis for evaluation of progress. Descriptions of waste streams, current specific goals, general pollution prevention methods, and specific accomplishments are in the appendices of this plan

Alcohol prevention at sporting events: study protocol for a quasi-experimental control group study

Directory of Open Access Journals (Sweden)

Natalie Durbeej

2016-06-01

Full Text Available Abstract Background Alcohol intoxication and overserving of alcohol at sporting events are of great concern, given the relationships between alcohol consumption, public disturbances, and violence. During recent years this matter has been on the agenda for Swedish policymakers, authorities and key stakeholders, with demands that actions be taken. There is promising potential for utilizing an environmental approach to alcohol prevention as a strategy to reduce the level of alcohol intoxication among spectators at sporting events. Examples of prevention strategies may be community mobilization, Responsible Beverage Service training, policy work, and improved controls and sanctions. This paper describes the design of a quasi-experimental control group study to examine the effects of a multi-component community-based alcohol intervention at matches in the Swedish Premier Football League. Methods A baseline assessment was conducted during 2015 and at least two follow-up assessments will be conducted in 2016 and 2017. The two largest cities in Sweden are included in the study, with Stockholm as the intervention area and Gothenburg as the control area. The setting is Licensed Premises (LP inside and outside Swedish football arenas, in addition to arena entrances. Spectators are randomly selected and invited to participate in the study by providing a breath alcohol sample as a proxy for Blood Alcohol Concentration (BAC. Actors are hired and trained by an expert panel to act out a standardized scene of severe pseudo-intoxication. Four types of cross-sectional data are generated: (i BAC levels among ≥ 4 200 spectators, frequency of alcohol service to pseudo-intoxicated patrons attempting to purchase alcohol at LP (ii outside the arenas (≥200 attempts and (iii inside the arenas (≥ 200 attempts, and (iv frequency of security staff interventions towards pseudo-intoxicated patrons attempting to enter the arenas (≥ 200 attempts. Discussion There

Calcium Channel Blockers in Secondary Cardiovascular Prevention and Risk of Acute Events: Real-World Evidence from Nested Case-Control Studies on Italian Hypertensive Elderly.

Science.gov (United States)

Bettiol, Alessandra; Lucenteforte, Ersilia; Vannacci, Alfredo; Lombardi, Niccolò; Onder, Graziano; Agabiti, Nera; Vitale, Cristiana; Trifirò, Gianluca; Corrao, Giovanni; Roberto, Giuseppe; Mugelli, Alessandro; Chinellato, Alessandro

2017-12-01

Antihypertensive treatment with calcium channel blockers (CCBs) is consolidated in clinical practice; however, different studies observed increased risks of acute events for short-acting CCBs. This study aimed to provide real-world evidence on risks of acute cardiovascular (CV) events, hospitalizations and mortality among users of different CCB classes in secondary CV prevention. Three case-control studies were nested in a cohort of Italian elderly hypertensive CV-compromised CCBs users. Cases were subjects with CV events (n = 25,204), all-cause hospitalizations (n = 19,237), or all-cause mortality (n = 17,996) during the follow-up. Up to four controls were matched for each case. Current or past exposition to CCBs at index date was defined based on molecule, formulation and daily doses of the last CCB delivery. The odds ratio (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression models. Compared to past users, current CCB users had significant reductions in risks of CV events [OR 0.88 (95% CI: 0.84-0.91)], hospitalization [0.90 (0.88-0.93)] and mortality [0.48 (0.47-0.49)]. Current users of long-acting dihydropyridines (DHPs) had the lowest risk [OR 0.87 (0.84-0.90), 0.86 (0.83-0.90), 0.55 (0.54-0.56) for acute CV events, hospitalizations and mortality], whereas current users of short-acting CCBs had an increased risk of acute CV events [OR 1.77 (1.13-2.78) for short-acting DHPs; 1.19 (1.07-1.31) for short-acting non-DHPs] and hospitalizations [OR 1.84 (0.96-3.51) and 1.23 (1.08-1.42)]. The already-existing warning on short-acting CCBs should be potentiated, addressing clinicians towards the choice of long-acting formulations.

Enter your email-address: how German internet users manage their email addresses

NARCIS (Netherlands)

Utz, S.

2004-01-01

Writing E-mail is the most popular Internet activity. Meanwhile, many people have more than one E-mail address. The question how people manage their E-mail addresses, more specifically, whether they use them deliberately for different purposes, is the central question of this paper. E-mail addresses

Getting sports injury prevention on to public health agendas - addressing the shortfalls in current information sources.

Science.gov (United States)

Finch, Caroline F

2012-01-01

Public health policy is a successful population-level strategy for injury prevention but it is yet to be widely applied to the sports sector. Such policy is generally coordinated by government health departments concerned with the allocation of limited resources to health service delivery and preventive programs for addressing large community health issues. Prioritisation of sports injury prevention (SIP) requires high-quality evidence about the size of the problem and its public health burden; identification of at-risk vulnerable groups; confirmed effective prevention solutions; evidence of intervention cost-effectiveness; and quantification of both financial and policy implications of inaction. This paper argues that the major reason for a lack of sports injury policy by government departments for health or sport to date is a lack of relevant information available for policy makers to make their decisions. Key information gaps evident in Australia are used to highlight this problem. SIP policy does not yet rank highly because, relative to other health/injury issues, there is very little hard evidence to support: claims for its priority ranking, the existence of solutions that can be implemented and which will work, and potential cost-savings to government agencies. Moreover, policy action needs to be integrated across government portfolios, including sport, health and others. Until sports medicine research generates high-quality population-level information of direct relevance and importance to policy makers, especially intervention costing and implementation cost-benefit estimates, and fully engage in policy-informing partnerships, SIP will continue to be left off the public health agenda.

A Few Examples of ISPs Addressing Specific Reactor Safety Problems

International Nuclear Information System (INIS)

Reocreux, M.

2008-01-01

Four International Standard Problems which were related to safety reactor problems are briefly discussed. ISP-20 (Steam Generator Tube Rupture in DOEL 2) is a unique ISP as it is based on a real incident which occurred in a commercial Power Plant. This ISP clearly illustrated the special problems of an ISP based on a real plant, namely limited access to precise plant data, some lack in the detailed knowledge of sensor behaviour, etc. ISP-26 (ROSA IV-LSTF small break test) was an open ISP. A qualitatively good prediction of the measured events was obtained even if some modelling deficiencies were identified. ISP-27 (BETHSY Exp. 9.1 B) was a blind ISP. All important trends observed during the test were qualitatively calculated by most computer codes. However, some deficiencies in calculating some variables were evident. ISP-33 (PACTEL Natural Circulation) was an exercise with a test facility modelled on the basis of a Russian VVER 440 and with participations from Eastern and Western organisations. ISP-33 was a double-blind exercise. The simulation of some variables caused some problems although they were in principle not too complicated. Post-test calculations demonstrated significant improvements. For all the four ISPs, the influence of the code user was evident and caused some scatter in the results. A specific study was performed in ISP-26 to clarify from where those user effects were coming. The reactor safety problems related to those ISPs are detailed and the specific contribution of the ISPs to bring solutions is discussed.

Prevention and mitigation of steam-generator water-hammer events in PWR plants

International Nuclear Information System (INIS)

Han, J.T.; Anderson, N.

1982-11-01

Water hammer in nuclear power plants is an unresolved safety issue under study at the NRC (USI A-1). One of the identified safety concerns is steam generator water hammer (SGWH) in pressurized-water reactor (PWR) plants. This report presents a summary of: (1) the causes of SGWH; (2) various fixes employed to prevent or mitigate SGWH; and (3) the nature and status of modifications that have been made at each operating PWR plant. The NRC staff considers that the issue of SGWH in top feedring designs has been technically resolved. This report does not address technical findings relevant to water hammer in preheat type steam generators. 10 figures, 2 tables

Challenges and Strategies for Prevention of Multidrug-Resistant Organism Transmission in Nursing Homes.

Science.gov (United States)

Dumyati, Ghinwa; Stone, Nimalie D; Nace, David A; Crnich, Christopher J; Jump, Robin L P

2017-04-01

Nursing home residents are at high risk for colonization and infection with bacterial pathogens that are multidrug-resistant organisms (MDROs). We discuss challenges and potential solutions to support implementing effective infection prevention and control practices in nursing homes. Challenges include a paucity of evidence that addresses MDRO transmission during the care of nursing home residents, limited staff resources in nursing homes, insufficient infection prevention education in nursing homes, and perceptions by nursing home staff that isolation and contact precautions negatively influence the well being of their residents. A small number of studies provide evidence that specifically address these challenges. Their outcomes support a paradigm shift that moves infection prevention and control practices away from a pathogen-specific approach and toward one that focuses on resident risk factors.

MDEP Design-Specific Common Position CP-APR1400WG-01. Common position addressing Fukushima Daiichi nuclear power plant accident

International Nuclear Information System (INIS)

2016-05-01

The MDEP APR1400 Working Group (APR1400WG) members consist of members from Republic of Korea, United Arab Emirates, and the United States. A main objectives of MDEP is to encourage convergence of code, standard and safety goals with exploring the opportunities for harmonization of regulatory practice and cooperation on safety review of APR-1400 specific designs. This common position addressing is aimed at sharing knowledge, information and experience on safety improvement related to lessons learned from the Fukushima Daiichi NPP Accident or Fukushima Daiichi NPP Accident-related issues amongst APR-1400 WG member states to achieve the MEDP goal. Because not all of these Regulators have completed the regulatory review of their APR1400 applications yet, this paper identifies common preliminary approaches to address potential safety improvements for APR1400 plants, as well as common general expectations for new nuclear power plants, as related to lessons learned from the Fukushima Daiichi NPP Accident or Fukushima Daiichi NPP Accident-related issues. While some asymmetry exists among those of three Regulators in terms of design, regulatory practice and licensing milestone sharing information and common understanding on post-Fukushima Daiichi NPP Accident enhancement would be promote resilient design for countering beyond design extreme external event like Fukushima Daiichi NPP nuclear disaster. This common position paper aims at identifying characteristics of post-Fukushima Daiichi NPP Accident enhancements putting in place by each country and setting common position to achieve balanced and harmonized APR-1400 design. After the safety reviews of the APR1400 design applications that are currently in review are completed, the regulators will update this paper to reflect their safety conclusions regarding the APR1400 design and how the design could be enhanced to address Fukushima Daiichi NPP Accident-related issues. The common preliminary approaches are organised into

Can preventable adverse events be predicted among hospitalized older patients? The development and validation of a predictive model.

NARCIS (Netherlands)

Steeg, L. van de; Langelaan, M.; Wagner, C.

2014-01-01

Objective: To develop and validate a predictive model for preventable adverse events (AEs) in hospitalized older patients, using clinically important risk factors that are readily available on admission. Design: Data from two retrospective patient record review studies on AEs were used. Risk factors

Sun protection behavior and knowledge of patients attending laser clinic to prevent adverse events of laser: A Cross-sectional, Single Center, Tertiary Care Study.

Science.gov (United States)

Tempark, Therdpong; Lueangarun, Suparuj; Chatproedprai, Susheera; Panchaprateep, Ratchathorn; Pongprutthipan, Marisa; Wananukul, Siriwan

2018-06-08

Limited data of sun protection knowledge in laser treatment patients exists therefore, preventative information should be provided by dermatologists to minimize harmful effects. To assess sun protection knowledge-behavior and knowledge to prevent adverse events from laser therapy among patients who visited a laser clinic at a tertiary university hospital in Bangkok, Thailand. This is a self-reported questionnaire, cross-sectional survey. All participants from the Laser Clinic in KCMH were recruited into the study. A Total of 385 patients were enrolled into the study; 80.5% female participants. Patients who never received laser treatment significantly lacked proper sun protection knowledge to prevent adverse events of lasers when compared to those who previous received laser treatments regarding the application of sunscreen after laser treatment (56.6% vs 17.4%, p protection in the post laser area (41.9% vs 20.4%, p knowledge of sun protection to prevent adverse events were significantly different among the group of educational levels and previous history of laser treatment. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Event Investigation

International Nuclear Information System (INIS)

Korosec, D.

2000-01-01

The events in the nuclear industry are investigated from the license point of view and from the regulatory side too. It is well known the importance of the event investigation. One of the main goals of such investigation is to prevent the circumstances leading to the event and the consequences of the event. The protection of the nuclear workers against nuclear hazard, and the protection of general public against dangerous effects of an event could be achieved by systematic approach to the event investigation. Both, the nuclear safety regulatory body and the licensee shall ensure that operational significant events are investigated in a systematic and technically sound manner to gather information pertaining to the probable causes of the event. One of the results should be appropriate feedback regarding the lessons of the experience to the regulatory body, nuclear industry and general public. In the present paper a general description of systematic approach to the event investigation is presented. The systematic approach to the event investigation works best where cooperation is present among the different divisions of the nuclear facility or regulatory body. By involving management and supervisors the safety office can usually improve their efforts in the whole process. The end result shall be a program which serves to prevent events and reduce the time and efforts solving the root cause which initiated each event. Selection of the proper method for the investigation and an adequate review of the findings and conclusions lead to the higher level of the overall nuclear safety. (author)

NASA Electronic Parts and Packaging Field Programmable Gate Array Single Event Effects Test Guideline Update

Science.gov (United States)

Berg, Melanie D.; LaBel, Kenneth A.

2018-01-01

The following are updated or new subjects added to the FPGA SEE Test Guidelines manual: academic versus mission specific device evaluation, single event latch-up (SEL) test and analysis, SEE response visibility enhancement during radiation testing, mitigation evaluation (embedded and user-implemented), unreliable design and its affects to SEE Data, testing flushable architectures versus non-flushable architectures, intellectual property core (IP Core) test and evaluation (addresses embedded and user-inserted), heavy-ion energy and linear energy transfer (LET) selection, proton versus heavy-ion testing, fault injection, mean fluence to failure analysis, and mission specific system-level single event upset (SEU) response prediction. Most sections within the guidelines manual provide information regarding best practices for test structure and test system development. The scope of this manual addresses academic versus mission specific device evaluation and visibility enhancement in IP Core testing.

Incorporating Primary and Secondary Prevention Approaches To Address Childhood Obesity Prevention and Treatment in a Low-Income, Ethnically Diverse Population: Study Design and Demographic Data from the Texas Childhood Obesity Research Demonstration (TX CORD) Study

Science.gov (United States)

Butte, Nancy F.; Barlow, Sarah; Vandewater, Elizabeth A.; Sharma, Shreela V.; Huang, Terry; Finkelstein, Eric; Pont, Stephen; Sacher, Paul; Byrd-Williams, Courtney; Oluyomi, Abiodun O.; Durand, Casey; Li, Linlin; Kelder, Steven H.

2015-01-01

Abstract Background: There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demonstration (TX CORD) project, which addresses child obesity among low-income, ethnically diverse overweight and obese children, ages 2–12 years; a two-tiered systems-oriented approach is hypothesized to reduce BMI z-scores, compared to primary prevention alone. Methods: Our study aims are to: (1) implement and evaluate a primary obesity prevention program; (2) implement and evaluate efficacy of a 12-month family-centered secondary obesity prevention program embedded within primary prevention; and (3) quantify the incremental cost-effectiveness of the secondary prevention program. Baseline demographic and behavioral data for the primary prevention community areas are presented. Results: Baseline data from preschool centers, elementary schools, and clinics indicate that most demographic variables are similar between intervention and comparison communities. Most families are low income (≤$25,000) and Hispanic/Latino (73.3–83.8%). The majority of parents were born outside of the United States. Child obesity rates exceed national values, ranging from 19.0% in preschool to 35.2% in fifth-grade children. Most parents report that their children consume sugary beverages, have a television in the bedroom, and do not consume adequate amounts of fruits and vegetables. Conclusions: Interventions to address childhood obesity are warranted in low-income, ethnically diverse communities. Integrating primary and secondary approaches is anticipated to provide sufficient exposure that will lead to significant decreases in childhood obesity. PMID:25555188

Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population: study design and demographic data from the Texas Childhood Obesity Research Demonstration (TX CORD) study.

Science.gov (United States)

Hoelscher, Deanna M; Butte, Nancy F; Barlow, Sarah; Vandewater, Elizabeth A; Sharma, Shreela V; Huang, Terry; Finkelstein, Eric; Pont, Stephen; Sacher, Paul; Byrd-Williams, Courtney; Oluyomi, Abiodun O; Durand, Casey; Li, Linlin; Kelder, Steven H

2015-02-01

There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demonstration (TX CORD) project, which addresses child obesity among low-income, ethnically diverse overweight and obese children, ages 2-12 years; a two-tiered systems-oriented approach is hypothesized to reduce BMI z-scores, compared to primary prevention alone. Our study aims are to: (1) implement and evaluate a primary obesity prevention program; (2) implement and evaluate efficacy of a 12-month family-centered secondary obesity prevention program embedded within primary prevention; and (3) quantify the incremental cost-effectiveness of the secondary prevention program. Baseline demographic and behavioral data for the primary prevention community areas are presented. Baseline data from preschool centers, elementary schools, and clinics indicate that most demographic variables are similar between intervention and comparison communities. Most families are low income (≤$25,000) and Hispanic/Latino (73.3-83.8%). The majority of parents were born outside of the United States. Child obesity rates exceed national values, ranging from 19.0% in preschool to 35.2% in fifth-grade children. Most parents report that their children consume sugary beverages, have a television in the bedroom, and do not consume adequate amounts of fruits and vegetables. Interventions to address childhood obesity are warranted in low-income, ethnically diverse communities. Integrating primary and secondary approaches is anticipated to provide sufficient exposure that will lead to significant decreases in childhood obesity.

Surrogate decision makers' perspectives on preventable breakdowns in care among critically ill patients: A qualitative study.

Science.gov (United States)

Fisher, Kimberly A; Ahmad, Sumera; Jackson, Madeline; Mazor, Kathleen M

2016-10-01

To describe surrogate decision makers' (SDMs) perspectives on preventable breakdowns in care among critically ill patients. We screened 70 SDMs of critically ill patients for those who identified a preventable breakdown in care, defined as an event where the SDM believes something "went wrong", that could have been prevented, and resulted in harm. In-depth interviews were conducted with SDMs who identified an eligible event. 32 of 70 participants (46%) identified at least one preventable breakdown in care, with a total of 75 discrete events. Types of breakdowns involved medical care (n=52), communication (n=59), and both (n=40). Four additional breakdowns were related to problems with SDM bedside access to the patient. Adverse consequences of breakdowns included physical harm, need for additional medical care, emotional distress, pain, suffering, loss of trust, life disruption, impaired decision making, and financial expense. 28 of 32 SDMs raised their concerns with clinicians, yet only 25% were satisfactorily addressed. SDMs of critically ill patients frequently identify preventable breakdowns in care which result in harm. An in-depth understanding of the types of events SDMs find problematic and the associated harms is an important step towards improving the safety and patient-centeredness of healthcare. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Event-governed and verbally-governed behavior.

Science.gov (United States)

Vargas, E A

1988-01-01

A NUMBER OF STATEMENTS PRESCRIBE BEHAVIOR: apothegms, maxims, proverbs, instructions, and so on. These differing guides to conduct present varieties of the dictionary definition of "rules." The term "rules" thus defines a category of language usage. Such a term, and its derivative, "rule-governed," does not address a controlling relation in the analysis of verbal behavior. The prevailing confounding of a category of language with a category of verbal behavior appears related to a lack of understanding as to what distinguishes verbal behavior from other behavior. Verbal behavior is a behavior-behavior relation in which events are contacted through the mediation of another organism's behavior specifically shaped for such mediation by a verbal community. It contrasts with behavior that contacts events directly, and shaped directly by the features of those events. Thus we may distinguish between two large classes of behavior by whether it is behavior controlled by events, or behavior controlled verbally. However, the functional controls operative with both classes of behavior do not differ.

Health Belief Model and Labelling Theory in the Analysis of Preventive Behaviors to Address Biopsychosocial Impacts of Sexual Violence Among Street Children in YOGYAKARTA

OpenAIRE

Intan Noor Khalifah; Argyo Demartoto; Harsono Salimo

2017-01-01

Background: Street children are at high risk of sexual violence. Necessary measures should be undertaken to address deleterious biopsychosocial impacts of sexual violence. This study aimed to analyze the preventive behaviors to address biopsychosocial impacts of sexual violence among street children in Yogyakarta using Health Belief Model and Labelling Theory.Subjects and Method: This study was qualitative descriptive with phenomenology approach. The key informants for this study included Hea...

Experience of a national campaign for hand trauma prevention in France.

Science.gov (United States)

Bellemere, P; Guimberteau, J C

2013-12-01

In France, hand injuries are the number one cause of all accidents referred to our hospital casualty departments. Their human and economic consequences are very serious. Two thirds of these accidents arise during everyday living activities and a third of them happen at work. The specific prevention of hand injuries in each of these domains has not been sufficiently developed. The authors present the national prevention campaign recently set up by the FESUM. The campaign took place in the form of events held in different towns in France. Each event, lasting from a minimum of 2 days to 10 days maximum, included press conferences, prevention workshops specific to hand injuries, theatrical animation for youngsters, conferences for the general public, meetings in industrial or training college environments, photography and video exhibitions, and the publication of pamphlets and posters. These manifestations were carried out in partnership with the association APAVC and the voluntary involvement of surgeons from the FESUM hand centres in each town visited. Over a period of 2 years, 22 large or medium-sized towns were able to hold these campaign events. By this means, thousands of people - adults, schoolchildren or young, professional apprentices - were made aware of hand injuries and how to prevent them. We were able to reinforce the broadcasting of simple prevention messages launched by the campaign, particularly with regard to wearing gloves for all manual activities, with the help of heavy local, regional and national media coverage. This campaign was the first widespread action of its kind, aimed specifically at the prevention of hand injuries. Furthermore, it was a way of strengthening the credibility of the FESUM hand emergency centres with the health authorities and to promote the services available to patients. © Georg Thieme Verlag KG Stuttgart · New York.

Waste Form Features, Events, and Processes

International Nuclear Information System (INIS)

R. Schreiner

2004-01-01

The purpose of this report is to evaluate and document the inclusion or exclusion of the waste form features, events and processes (FEPs) with respect to modeling used to support the Total System Performance Assessment for License Application (TSPA-LA). A screening decision, either Included or Excluded, is given for each FEP along with the technical bases for screening decisions. This information is required by the Nuclear Regulatory Commission (NRC) in 10 CFR 63.114 (d, e, and f) [DIRS 156605]. The FEPs addressed in this report deal with the issues related to the degradation and potential failure of the waste form and the migration of the waste form colloids. For included FEPs, this analysis summarizes the implementation of the FEP in TSPA-LA, (i.e., how the FEP is included). For excluded FEPs, this analysis provides the technical bases for exclusion from TSPA-LA (i.e., why the FEP is excluded). This revision addresses the TSPA-LA FEP list (DTN: MO0407SEPFEPLA.000 [DIRS 170760]). The primary purpose of this report is to identify and document the analyses and resolution of the features, events, and processes (FEPs) associated with the waste form performance in the repository. Forty FEPs were identified that are associated with the waste form performance. This report has been prepared to document the screening methodology used in the process of FEP inclusion and exclusion. The analyses documented in this report are for the license application (LA) base case design (BSC 2004 [DIRS 168489]). In this design, a drip shield is placed over the waste package and no backfill is placed over the drip shield (BSC 2004 [DIRS 168489]). Each FEP may include one or more specific issues that are collectively described by a FEP name and a FEP description. The FEP description may encompass a single feature, process or event, or a few closely related or coupled processes if the entire FEP can be addressed by a single specific screening argument or TSPA-LA disposition. The FEPs are

Waste Form Features, Events, and Processes

Energy Technology Data Exchange (ETDEWEB)

R. Schreiner

2004-10-27

The purpose of this report is to evaluate and document the inclusion or exclusion of the waste form features, events and processes (FEPs) with respect to modeling used to support the Total System Performance Assessment for License Application (TSPA-LA). A screening decision, either Included or Excluded, is given for each FEP along with the technical bases for screening decisions. This information is required by the Nuclear Regulatory Commission (NRC) in 10 CFR 63.114 (d, e, and f) [DIRS 156605]. The FEPs addressed in this report deal with the issues related to the degradation and potential failure of the waste form and the migration of the waste form colloids. For included FEPs, this analysis summarizes the implementation of the FEP in TSPA-LA, (i.e., how the FEP is included). For excluded FEPs, this analysis provides the technical bases for exclusion from TSPA-LA (i.e., why the FEP is excluded). This revision addresses the TSPA-LA FEP list (DTN: MO0407SEPFEPLA.000 [DIRS 170760]). The primary purpose of this report is to identify and document the analyses and resolution of the features, events, and processes (FEPs) associated with the waste form performance in the repository. Forty FEPs were identified that are associated with the waste form performance. This report has been prepared to document the screening methodology used in the process of FEP inclusion and exclusion. The analyses documented in this report are for the license application (LA) base case design (BSC 2004 [DIRS 168489]). In this design, a drip shield is placed over the waste package and no backfill is placed over the drip shield (BSC 2004 [DIRS 168489]). Each FEP may include one or more specific issues that are collectively described by a FEP name and a FEP description. The FEP description may encompass a single feature, process or event, or a few closely related or coupled processes if the entire FEP can be addressed by a single specific screening argument or TSPA-LA disposition. The FEPs are

Modeling of preventive maintenance changes influence upon flight safety indexes

Directory of Open Access Journals (Sweden)

А.В. Гончаренко

2004-03-01

Full Text Available  It is considered a simplified model of connection between the catastrophic events flow frequency and both preventive maintenance changes periodicity and diagnosis depth of aviation equipment. It is deduced specific formulas for computing the changes and diagnostics parameters influence upon the values of both the catastrophic events flow frequency and technical-economical control factor criterion of flight safety levels.

Envelope conformational changes induced by human immunodeficiency virus type 1 attachment inhibitors prevent CD4 binding and downstream entry events.

Science.gov (United States)

Ho, Hsu-Tso; Fan, Li; Nowicka-Sans, Beata; McAuliffe, Brian; Li, Chang-Ben; Yamanaka, Gregory; Zhou, Nannan; Fang, Hua; Dicker, Ira; Dalterio, Richard; Gong, Yi-Fei; Wang, Tao; Yin, Zhiwei; Ueda, Yasutsugu; Matiskella, John; Kadow, John; Clapham, Paul; Robinson, James; Colonno, Richard; Lin, Pin-Fang

2006-04-01

BMS-488043 is a small-molecule human immunodeficiency virus type 1 (HIV-1) CD4 attachment inhibitor with demonstrated clinical efficacy. The compound inhibits soluble CD4 (sCD4) binding to the 11 distinct HIV envelope gp120 proteins surveyed. Binding of BMS-488043 and that of sCD4 to gp120 are mutually exclusive, since increased concentrations of one can completely block the binding of the other without affecting the maximal gp120 binding capacity. Similarly, BMS-488043 inhibited virion envelope trimers from binding to sCD4-immunoglobulin G (IgG), with decreasing inhibition as the sCD4-IgG concentration increased, and BMS-488043 blocked the sCD4-induced exposure of the gp41 groove in virions. In both virion binding assays, BMS-488043 was active only when added prior to sCD4. Collectively, these results indicate that obstruction of gp120-sCD4 interactions is the primary inhibition mechanism of this compound and that compound interaction with envelope must precede CD4 binding. By three independent approaches, BMS-488043 was further shown to induce conformational changes within gp120 in both the CD4 and CCR5 binding regions. These changes likely prevent gp120-CD4 interactions and downstream entry events. However, BMS-488043 could only partially inhibit CD4 binding to an HIV variant containing a specific envelope truncation and altered gp120 conformation, despite effectively inhibiting the pseudotyped virus infection. Taken together, BMS-488043 inhibits viral entry primarily through altering the envelope conformation and preventing CD4 binding, and other downstream entry events could also be inhibited as a result of these induced conformational changes.

Preventing disasters: public health vulnerability reduction as a sustainable adaptation to climate change.

Science.gov (United States)

Keim, Mark E

2011-06-01

Global warming could increase the number and severity of extreme weather events. These events are often known to result in public health disasters, but we can lessen the effects of these disasters. By addressing the factors that cause changes in climate, we can mitigate the effects of climate change. By addressing the factors that make society vulnerable to the effects of climate, we can adapt to climate change. To adapt to climate change, a comprehensive approach to disaster risk reduction has been proposed. By reducing human vulnerability to disasters, we can lessen--and at times even prevent--their impact. Human vulnerability is a complex phenomenon that comprises social, economic, health, and cultural factors. Because public health is uniquely placed at the community level, it has the opportunity to lessen human vulnerability to climate-related disasters. At the national and international level, a supportive policy environment can enable local adaptation to disaster events. The purpose of this article is to introduce the basic concept of disaster risk reduction so that it can be applied to preventing and mitigating the negative effects of climate change and to examine the role of community-focused public health as a means for lessening human vulnerability and, as a result, the overall risk of climate-related disasters.

Guidelines for prevention in psychology.

Science.gov (United States)

2014-04-01

The effectiveness of prevention to enhance human functioning and reduce psychological distress has been demonstrated. From infancy through adulthood, access to preventive services and interventions is important to improve the quality of life and human functioning and reduce illness and premature death. The importance of prevention is consistent with the Patient Protection and Affordable Care Act of 2010. Even with the increased focus on prevention, psychology training programs rarely require specific courses on prevention. In particular, conceptualizations about best practices in prevention, particularly at the environmental level, are lacking. Therefore, psychologists engaged in prevention can benefit from a set of guidelines that address and inform prevention practices. Accordingly, the Guidelines for Prevention in Psychology are intended to "inform psychologists, the public, and other interested parties regarding desirable professional practices" in prevention. The Prevention Guidelines are recommended based on their potential benefits to the public and the professional practice of psychology. They support prevention as an important area of practice, research, and training for psychologists. The Guidelines give increased attention to prevention within APA, encouraging psychologists to become involved with preventive activities relevant to their area of practice. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Specific plasma oxylipins increase the odds of cardiovascular and cerebrovascular events in patients with peripheral artery disease.

Science.gov (United States)

Caligiuri, Stephanie P B; Aukema, Harold M; Ravandi, Amir; Lavallée, Renée; Guzman, Randy; Pierce, Grant N

2017-08-01

Oxylipins and fatty acids may be novel therapeutic targets for cardiovascular disease. The objective was to determine if plasma oxylipins or fatty acids can influence the odds of cardiovascular/cerebrovascular events. In 98 patients (25 female, 73 male) with peripheral artery disease, the prevalence of transient ischemic attacks, cerebrovascular accidents, stable angina, and acute coronary syndrome was n = 16, 10, 16, and 24, respectively. Risk factors such as being male, diagnosed hypertension, diabetes mellitus, and hyperlipidemia were not associated with events. Plasma fatty acids and oxylipins were analyzed with gas chromatography and HPLC-MS/MS, respectively. None of 24 fatty acids quantified were associated with events. In contrast, 39 plasma oxylipins were quantified, and 8 were significantly associated with events. These 8 oxylipins are known regulators of vascular tone. For example, every 1 unit increase in Thromboxane B 2 /Prostaglandin F 1 α and every 1 nmol/L increase in plasma 16-hydroxyeicosatetraenoic acid, thromboxane B2, or 11,12-dihydroxyeicosatrienoic acid (DiHETrE) increased the odds of having had ≥2 events versus no event (p < 0.05). The greatest predictor was plasma 8,9-DiHETrE, which increased the odds of acute coronary syndrome by 92-fold. In conclusion, specific oxylipins were highly associated with clinical events and may represent specific biomarkers and (or) therapeutic targets of cardiovascular disease.

Ultrafast hydrogen exchange reveals specific structural events during the initial stages of folding of cytochrome c.

Science.gov (United States)

Fazelinia, Hossein; Xu, Ming; Cheng, Hong; Roder, Heinrich

2014-01-15

Many proteins undergo a sharp decrease in chain dimensions during early stages of folding, prior to the rate-limiting step in folding. However, it remains unclear whether compact states are the result of specific folding events or a general hydrophobic collapse of the poly peptide chain driven by the change in solvent conditions. To address this fundamental question, we extended the temporal resolution of NMR-detected H/D exchange labeling experiments into the microsecond regime by adopting a microfluidics approach. By observing the competition between H/D exchange and folding as a function of labeling pH, coupled with direct measurement of exchange rates in the unfolded state, we were able to monitor hydrogen-bond formation for over 50 individual backbone NH groups within the initial 140 microseconds of folding of horse cytochrome c. Clusters of solvent-shielded amide protons were observed in two α-helical segments in the C-terminal half of the protein, while the N-terminal helix remained largely unstructured, suggesting that proximity in the primary structure is a major factor in promoting helix formation and association at early stages of folding, while the entropically more costly long-range contacts between the N- and C-terminal helices are established only during later stages. Our findings clearly indicate that the initial chain condensation in cytochrome c is driven by specific interactions among a subset of α-helical segments rather than a general hydrophobic collapse.

Establishment and application of event-specific polymerase chain reaction methods for two genetically modified soybean events, A2704-12 and A5547-127.

Science.gov (United States)

Li, Xiang; Pan, Liangwen; Li, Junyi; Zhang, Qigang; Zhang, Shuya; Lv, Rong; Yang, Litao

2011-12-28

For implementation of the issued regulations and labeling policies for genetically modified organism (GMO) supervision, the polymerase chain reaction (PCR) method has been widely used due to its high specificity and sensitivity. In particular, use of the event-specific PCR method based on the flanking sequence of transgenes has become the primary trend. In this study, both qualitative and quantitative PCR methods were established on the basis of the 5' flanking sequence of transgenic soybean A2704-12 and the 3' flanking sequence of transgenic soybean A5547-127, respectively. In qualitative PCR assays, the limits of detection (LODs) were 10 copies of haploid soybean genomic DNA for both A2704-12 and A5547-127. In quantitative real-time PCR assays, the LODs were 5 copies of haploid soybean genomic DNA for both A2704-12 and A5547-127, and the limits of quantification (LOQs) were 10 copies for both. Low bias and acceptable SD and RSD values were also achieved in quantification of four blind samples using the developed real-time PCR assays. In addition, the developed PCR assays for the two transgenic soybean events were used for routine analysis of soybean samples imported to Shanghai in a 6 month period from October 2010 to March 2011. A total of 27 lots of soybean from the United States and Argentina were analyzed: 8 lots from the Unites States were found to have the GM soybean A2704-12 event, and the GM contents were <1.5% in all eight analyzed lots. On the contrary, no GM soybean A5547-127 content was found in any of the eight lots. These results demonstrated that the established event-specific qualitative and quantitative PCR methods could be used effectively in routine identification and quantification of GM soybeans A2704-12 and A5547-127 and their derived products.

The threat of nuclear terrorism: Assessment and preventive action

International Nuclear Information System (INIS)

Nilsson, A.

2001-01-01

In the light of the events of 11 September, the General Conference requested the IAEA Director General to review thoroughly the activities and programmes of the Agency with a view to strengthening the Agency's work relevant to preventing acts of terrorism involving nuclear materials and other radioactive materials. That review is ongoing and the results will be presented in March to the Board of Governors, including proposals for revisions and updates on relevant programmes. It is underlined that preventing nuclear terrorism requires cooperation between States and with international organizations. The problem must be addressed in a comprehensive manner. The international community should therefore strive for strong, comprehensive, internationally accepted security systems

Universal preventive interventions for children in the context of disasters and terrorism.

Science.gov (United States)

Pfefferbaum, Betty; Varma, Vandana; Nitiéma, Pascal; Newman, Elana

2014-04-01

This review addresses universal disaster and terrorism services and preventive interventions delivered to children before and after an event. The article describes the organization and structure of services used to meet the needs of children in the general population (practice applications), examines screening and intervention approaches (tools for practice), and suggests future directions for the field. A literature search identified 17 empirical studies that were analyzed to examine the timing and setting of intervention delivery, providers, conditions addressed and outcomes, and intervention approaches and components. Copyright © 2014 Elsevier Inc. All rights reserved.

Prevention and control of rabies in an age of global travel: a review of travel- and trade-associated rabies events--United States, 1986-2012.

Science.gov (United States)

Lankau, E W; Cohen, N J; Jentes, E S; Adams, L E; Bell, T R; Blanton, J D; Buttke, D; Galland, G G; Maxted, A M; Tack, D M; Waterman, S H; Rupprecht, C E; Marano, N

2014-08-01

Rabies prevention and control efforts have been successful in reducing or eliminating virus circulation regionally through vaccination of specific reservoir populations. A notable example of this success is the elimination of canine rabies virus variant from the United States and many other countries. However, increased international travel and trade can pose risks for rapid, long-distance movements of ill or infected persons or animals. Such travel and trade can result in human exposures to rabies virus during travel or transit and could contribute to the re-introduction of canine rabies variant or transmission of other viral variants among animal host populations. We present a review of travel- and trade-associated rabies events that highlight international public health obligations and collaborative opportunities for rabies prevention and control in an age of global travel. Rabies is a fatal disease that warrants proactive coordination among international public health and travel industry partners (such as travel agents, tour companies and airlines) to protect human lives and to prevent the movement of viral variants among host populations. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

[Fatal incidents by crowd crush during mass events. (Un)preventable phenomenon?].

Science.gov (United States)

Wagner, U; Fälker, A; Wenzel, V

2013-01-01

Crowd crushes with dozens or even hundreds of casualties have occurred several times at the Hajj in Saudi Arabia and also in soccer stadiums in Western Europe. As fatal accidents after human stampedes during mass events occur very rarely and are usually accompanied by many years of criminal court proceedings in order to identify underlying responsible mechanisms and culprits, it is very difficult to draw conclusions and formulate precautions from an emergency medical point of view. This study analyzed a fatal crowd crush which occurred on 4 December 1999 following the "Air & Style" snowboard contest with approximately 22,000 people attending in the Bergisel stadium in Innsbruck, Austria. Firstly, focused interviews were conducted with professional rescuers, police and physicians and secondly publicly available court records dealing with this incident in the district court of Innsbruck, Austria were analyzed. During the snowboard contest 87 emergency medical technicians, 6 emergency physicians, 1 leading emergency physician, 21 policemen and 140 security personnel were present. Following the accident additionally some 100 emergency medical technicians, 36 emergency medical service vehicles and 4 physician-staffed emergency medical service vehicles responded to the scene. The deadly crowd crush resulting in 6 fatalities, 4 patients still in a vegetative state and 38 injured, was due to a severe crowd accumulation at one stadium exit, which was not recognized and dispersed in time. Construction of the exit in line with darkness, steep slope and slippery surface contributed adversely to this dangerous situation, although panic did not occur at any time. Unfortunately, there is no patent remedy to completely prevent fatal accidents by a crowd crush at mass events. If planning is initiated early, sufficient material and personnel reserves are kept in reserve and despite conflicting interests of the organizers, the host community, security, police and emergency medical

Features, Events, and Processes: Disruptive Events

International Nuclear Information System (INIS)

P. Sanchez

2004-01-01

The purpose of this analysis report is to evaluate and document the inclusion or exclusion of the disruptive events features, events, and processes (FEPs) with respect to modeling used to support the total system performance assessment for license application (TSPA-LA). A screening decision, either ''Included'' or ''Excluded,'' is given for each FEP, along with the technical basis for screening decisions. This information is required by the U.S. Nuclear Regulatory Commission (NRC) at 10 CFR 63.114 (d), (e), and (f) [DIRS 156605]. The FEPs addressed in this report deal with both seismic and igneous disruptive events, such as fault displacements through the repository and an igneous intrusion into the repository. For included FEPs, this analysis summarizes the implementation of the FEP in TSPA-LA (i.e., how the FEP is included). For excluded FEPs, this analysis provides the technical basis for exclusion from TSPA-LA (i.e., why the FEP is excluded). Previous versions of this report were developed to support the total system performance assessments (TSPA) for various prior repository designs. This revision addresses the repository design for the license application (LA)

Features, Events, and Processes: Disruptive Events

Energy Technology Data Exchange (ETDEWEB)

P. Sanchez

2004-11-08

The purpose of this analysis report is to evaluate and document the inclusion or exclusion of the disruptive events features, events, and processes (FEPs) with respect to modeling used to support the total system performance assessment for license application (TSPA-LA). A screening decision, either ''Included'' or ''Excluded,'' is given for each FEP, along with the technical basis for screening decisions. This information is required by the U.S. Nuclear Regulatory Commission (NRC) at 10 CFR 63.114 (d), (e), and (f) [DIRS 156605]. The FEPs addressed in this report deal with both seismic and igneous disruptive events, such as fault displacements through the repository and an igneous intrusion into the repository. For included FEPs, this analysis summarizes the implementation of the FEP in TSPA-LA (i.e., how the FEP is included). For excluded FEPs, this analysis provides the technical basis for exclusion from TSPA-LA (i.e., why the FEP is excluded). Previous versions of this report were developed to support the total system performance assessments (TSPA) for various prior repository designs. This revision addresses the repository design for the license application (LA).

Developing and testing an intervention to prevent homelessness among individuals discharged from psychiatric wards to shelters and 'No Fixed Address'.

Science.gov (United States)

Forchuk, C; MacClure, S K; Van Beers, M; Smith, C; Csiernik, R; Hoch, J; Jensen, E

2008-09-01

Shelter data in a recent study revealed discharges from psychiatric facilities to shelters or the street occurred at least 194 times in 2002 in London, Ontario, Canada. This problem must be addressed to reduce the disastrous effects of such discharge, including re-hospitalization and prolonged homelessness. An intervention was developed and tested to prevent homelessness associated with discharge directly to no fixed address. A total of 14 participants at-risk of being discharged without housing were enrolled, with half randomized into the intervention group. The intervention group was provided with immediate assistance in accessing housing and assistance in paying their first and last month's rent. The control group received usual care. Data was collected from participants prior to discharge, at 31 and 6-months post-discharge. All the individuals in the intervention group maintained housing after 3 and 6 months. All but one individual in the control group remained homeless after 3 and 6 months. The exception joined the sex trade to avoid homelessness. The results of this pilot were so dramatic that randomizing to the control group was discontinued. Discussions are underway to routinely implement the intervention. Systemic improvements can prevent homelessness for individuals being discharged from psychiatric wards.

SENTINEL EVENTS

Directory of Open Access Journals (Sweden)

Andrej Robida

2004-09-01

the surveyed persons agreed to disclosure of the event to a patient but this was the case in less than half of the occasions.Conclusions. The small number of reports of sentinel events, late or incomplete reporting of conducted analyses of root causes and plans for future prevention of these events and survey data showed the state of culture in the majority of hospitals. Fear of reporting and therefore, hiding of errors or ascribing errors to the »usual« complications of a disease or procedures, the reaction of leadership to quickly find a culprit for the event, disregarding a serious approach to analyze the event and taking measures for their future prevention leads to the culture of silence. Root cause analysis of the events showed that the reason frequently lies in systems and processes and not in individuals. Health care will never be without risks for patients. However, with an open approach without the blaming and shaming of individuals, implementation of reporting the events in hospitals and other health care facilities with clear goals of patient safety, standardization of equipment, materials, and processes and education on patient safety many sentinel events and medical errors could and should be prevented.

Investigation of Lab Fire Prevention Management System of Combining Root Cause Analysis and Analytic Hierarchy Process with Event Tree Analysis

Directory of Open Access Journals (Sweden)

Cheng-Chan Shih

2016-01-01

Full Text Available This paper proposed a new approach, combining root cause analysis (RCA, analytic hierarchy process (AHP, and event tree analysis (ETA in a loop to systematically evaluate various laboratory safety prevention strategies. First, 139 fire accidents were reviewed to identify the root causes and draw out prevention strategies. Most fires were caused due to runaway reactions, operation error and equipment failure, and flammable material release. These mostly occurred in working places of no prompt fire protection. We also used AHP to evaluate the priority of these strategies and found that chemical fire prevention strategy is the most important control element, and strengthening maintenance and safety inspection intensity is the most important action. Also together with our surveys results, we proposed that equipment design is also critical for fire prevention. Therefore a technical improvement was propounded: installing fire detector, automatic sprinkler, and manual extinguisher in the lab hood as proactive fire protections. ETA was then used as a tool to evaluate laboratory fire risks. The results indicated that the total risk of a fire occurring decreases from 0.0351 to 0.0042 without/with equipment taking actions. Establishing such system can make Environment, Health and Safety (EH&S office not only analyze and prioritize fire prevention policies more practically, but also demonstrate how effective protective equipment improvement can achieve and the probabilities of the initiating event developing into a serious accident or controlled by the existing safety system.

Chopsticks Don't Make It Culturally Competent: Addressing Larger Issues for HIV Prevention among Gay, Bisexual, and Queer Asian Pacific Islander Men

Science.gov (United States)

Han, Chong-suk

2009-01-01

According to the Centers for Disease Control and Prevention, men who have sex with men account for the largest proportion of cumulative AIDS cases among Asian Pacific Islanders. Yet little is known about the factors that need to be addressed in developing culturally competent intervention strategies for members of this group. This article explores…

Small Business Procurement Event

Science.gov (United States)

2014-08-13

Small Business Procurement Event 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK...NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Department of the Navy,Office of Small Business Programs,720 Kennon...distribution unlimited 13. SUPPLEMENTARY NOTES NDIA 27th Navy Gold Coast Small Business Procurement Event, 12-13 Aug 2014, San Diego, CA. 14. ABSTRACT

Using a web-based game to prevent posttraumatic stress in children following medical events: design of a randomized controlled trial.

Science.gov (United States)

Marsac, Meghan L; Kohser, Kristen L; Winston, Flaura K; Kenardy, Justin; March, Sonja; Kassam-Adams, Nancy

2013-01-01

Medical events including acute illness and injury are among the most common potentially traumatic experiences for children. Despite the scope of the problem, only limited resources are available for prevention of posttraumatic stress symptoms (PTSS) after pediatric medical events. Web-based programs provide a low-cost, accessible means to reach a wide range of families and show promise in related areas of child mental health. To describe the design of a randomized controlled trial that will evaluate feasibility and estimate preliminary efficacy of Coping Coach, a web-based preventive intervention to prevent or reduce PTSS after acute pediatric medical events. Seventy children and their parents will be randomly assigned to either an intervention or a waitlist control condition. Inclusion criteria require that children are aged 8-12 years, have experienced a medical event, have access to Internet and telephone, and have sufficient competency in the English language to complete measures and understand the intervention. Participants will complete baseline measures and will then be randomized to the intervention or waitlist control condition. Children in the intervention condition will complete module 1 (Feelings Identification) in the hospital and will be instructed on how to complete modules 2 (Appraisals) and 3 (Avoidance) online. Follow-up assessments will be conducted via telephone at 6, 12, and 18 weeks after the baseline assessment. Following the 12-week assessment, children in the waitlist control condition will receive instructions for completing the intervention. Primary study outcomes include data on intervention feasibility and outcomes (child appraisals, coping, PTSS and health-related quality of life). Results will provide data on the feasibility of the implementation of the Coping Coach intervention and study procedures as well as estimations of efficacy to determine sample size for a larger study. Potential strengths and limitations of this design are

Using a web-based game to prevent posttraumatic stress in children following medical events: design of a randomized controlled trial

Directory of Open Access Journals (Sweden)

Nancy Kassam-Adams

2013-07-01

Full Text Available Background: Medical events including acute illness and injury are among the most common potentially traumatic experiences for children. Despite the scope of the problem, only limited resources are available for prevention of posttraumatic stress symptoms (PTSS after pediatric medical events. Web-based programs provide a low-cost, accessible means to reach a wide range of families and show promise in related areas of child mental health. Objectives: To describe the design of a randomized controlled trial that will evaluate feasibility and estimate preliminary efficacy of Coping Coach, a web-based preventive intervention to prevent or reduce PTSS after acute pediatric medical events. Method: Seventy children and their parents will be randomly assigned to either an intervention or a waitlist control condition. Inclusion criteria require that children are aged 8–12 years, have experienced a medical event, have access to Internet and telephone, and have sufficient competency in the English language to complete measures and understand the intervention. Participants will complete baseline measures and will then be randomized to the intervention or waitlist control condition. Children in the intervention condition will complete module 1 (Feelings Identification in the hospital and will be instructed on how to complete modules 2 (Appraisals and 3 (Avoidance online. Follow-up assessments will be conducted via telephone at 6, 12, and 18 weeks after the baseline assessment. Following the 12-week assessment, children in the waitlist control condition will receive instructions for completing the intervention. Results: Primary study outcomes include data on intervention feasibility and outcomes (child appraisals, coping, PTSS and health-related quality of life. Discussion: Results will provide data on the feasibility of the implementation of the Coping Coach intervention and study procedures as well as estimations of efficacy to determine sample size for a

Identify alternative splicing events based on position-specific evolutionary conservation.

Directory of Open Access Journals (Sweden)

Liang Chen

Full Text Available The evolution of eukaryotes is accompanied by the increased complexity of alternative splicing which greatly expands genome information. One of the greatest challenges in the post-genome era is a complete revelation of human transcriptome with consideration of alternative splicing. Here, we introduce a comparative genomics approach to systemically identify alternative splicing events based on the differential evolutionary conservation between exons and introns and the high-quality annotation of the ENCODE regions. Specifically, we focus on exons that are included in some transcripts but are completely spliced out for others and we call them conditional exons. First, we characterize distinguishing features among conditional exons, constitutive exons and introns. One of the most important features is the position-specific conservation score. There are dramatic differences in conservation scores between conditional exons and constitutive exons. More importantly, the differences are position-specific. For flanking intronic regions, the differences between conditional exons and constitutive exons are also position-specific. Using the Random Forests algorithm, we can classify conditional exons with high specificities (97% for the identification of conditional exons from intron regions and 95% for the classification of known exons and fair sensitivities (64% and 32% respectively. We applied the method to the human genome and identified 39,640 introns that actually contain conditional exons and classified 8,813 conditional exons from the current RefSeq exon list. Among those, 31,673 introns containing conditional exons and 5,294 conditional exons classified from known exons cannot be inferred from RefSeq, UCSC or Ensembl annotations. Some of these de novo predictions were experimentally verified.

Martian crustal dichotomy: product of accretion and not a specific event?

International Nuclear Information System (INIS)

Frey, H.; Schultz, R.A.; Maxwell, T.A.

1987-01-01

Attempts to explain the fundamental crustal dichotomy on Mars range from purely endogenic to extreme exogenic processes, but to date no satisfactory theory has evolved. What is accepted is: (1) the dichotomy is an ancient feature of the Martian crust, and (2) the boundary between the cratered highlands and northern plains which marks the dichotomy in parts of Mars has undergone significant and variable modification during the observable parts of Martian history. Some ascribe it to a single mega-impact event, essentially an instantaneous rearrangement of the crustal structures (topography and lithospheric thickness). Others prefer an internal mechanism: a period of vigorous convection subcrustally erodes the northern one third of Mars, causing foundering and isostatic lowering of that part of Mars. The evidence for each theory is reviewed, with the conclusion that there is little to recommend either. An alternative is suggested: the formation of the crustal dichotomy on Mars was not a specific tectonic event but a byproduct of the accretionary process and therefore a primordial characteristic of the Martian crust, predating the oldest recognizable landforms

Plan to Prevent and Respond to Sexual Assault of Military Men

Science.gov (United States)

2016-10-01

Kenyon, S. (1996). "Honey, we don’t do men": Gender stereotypes and the provision of services to sexually assaulted males . Journal of Interpersonal... males is limited. The Department is now working to increase research-informed, gender -specific prevention techniques that address male specific...needs of male survivors. The Department will conduct further evaluation of gender -specific needs to determine if additional gender -specific training or

The Acute Risks of Exercise in Apparently Healthy Adults and Relevance for Prevention of Cardiovascular Events.

Science.gov (United States)

Goodman, Jack M; Burr, Jamie F; Banks, Laura; Thomas, Scott G

2016-04-01

Increased physical activity (PA) is associated with improved quality of life and reductions in cardiovascular (CV) morbidity and all-cause mortality in the general population in a dose-response manner. However, PA acutely increases the risk of adverse CV event or sudden cardiac death (SCD) above levels expected at rest. We review the likelihood of adverse CV events related to exercise in apparently healthy adults and strategies for prevention, and contextualize our understanding of the long-term risk reduction conferred from PA. A systematic review of the literature was performed using electronic databases; additional hand-picked relevant articles from reference lists and additional sources were included after the search. The incidence of adverse CV events in adults is extremely low during and immediately after PA of varying types and intensities and is significantly lower in those with long-standing PA experience. The risk of SCD and nonfatal events during and immediately after PA remains extremely low (well below 0.01 per 10,000 participant hours); increasing age and PA intensity are associated with greater risk. In most cases of exercise-related SCD, occult CV disease is present and SCD is typically the first clinical event. Exercise acutely increases the risk of adverse CV events, with greater risk associated with vigorous intensity. The risks of an adverse CV event during and immediately after exercise are outweighed by the health benefits of vigorous exercise performed regularly. A key challenge remains the identification of occult structural heart disease and inheritable conditions that increase the chances of lethal arrhythmias during exercise. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Human active X-specific DNA methylation events showing stability across time and tissues

Science.gov (United States)

Joo, Jihoon Eric; Novakovic, Boris; Cruickshank, Mark; Doyle, Lex W; Craig, Jeffrey M; Saffery, Richard

2014-01-01

The phenomenon of X chromosome inactivation in female mammals is well characterised and remains the archetypal example of dosage compensation via monoallelic expression. The temporal series of events that culminates in inactive X-specific gene silencing by DNA methylation has revealed a ‘patchwork' of gene inactivation along the chromosome, with approximately 15% of genes escaping. Such genes are therefore potentially subject to sex-specific imbalance between males and females. Aside from XIST, the non-coding RNA on the X chromosome destined to be inactivated, very little is known about the extent of loci that may be selectively silenced on the active X chromosome (Xa). Using longitudinal array-based DNA methylation profiling of two human tissues, we have identified specific and widespread active X-specific DNA methylation showing stability over time and across tissues of disparate origin. Our panel of X-chromosome loci subject to methylation on Xa reflects a potentially novel mechanism for controlling female-specific X inactivation and sex-specific dimorphisms in humans. Further work is needed to investigate these phenomena. PMID:24713664

A methodology for nuclear power plant operational events evaluation

International Nuclear Information System (INIS)

Araujo, Jeferson

2015-01-01

Operational events are normal occurrences in industrial plants and in nuclear power plants. The evaluation of operational events gains importance when it comes specifically to nuclear power plants due to the proportions that the impact and the consequences of these events may cause to the installation itself, their workers, the external area of the nuclear installation, the environment and to the public in general. These consequences, for the operation of these facilities can range from very little, until the consequences that lead to accidents and can cause significant impacts. Operational events may be associated or have influence in many fields of knowledge, such as operation, maintenance, engineering, Radiological Protection, physical protection, chemistry, Human or Organizational Factors and external events, among others. The accident at the Fukushima Daichi nuclear power plant, shows the importance of exhausting all the studies concerning operational events in order to improve the operational safety of nuclear plants, considering all the causes and possible consequences. In this context, the evaluation of operational events discipline emerges as an important and relevant tool to contribute to the maintenance and/or improvement of the operational safety of nuclear installations. Not without reason the nuclear industry actively participates in programs of exchange of operational experience, where relevant events are thoroughly evaluated and discussed in specific forums, such as power plant operators, regulators and/or joint technical meetings, always with the purpose to prevent, minimize or mitigate its consequences. Any evaluation of operational events passes necessarily by an in-depth study of the circumstances of the event, culminating with the identification of your cause and proposition of corrective actions to prevent recurrence of similar events. Additionally, the events should not be studied individually, but evaluated within a temporal context in order

A methodology for nuclear power plant operational events evaluation

Energy Technology Data Exchange (ETDEWEB)

Araujo, Jeferson, E-mail: jeferson@cnen.gov.br [Comissao Nacional de Energia Nuclear (CGRC/CNEN), Rio de janeiro, RJ (Brazil). Coordenacao Geral de Reatores e do Ciclo de Combustivel; Costa, Sergio Dias, E-mail: sergiodiascosta@hotmail.com [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

2015-07-01

Operational events are normal occurrences in industrial plants and in nuclear power plants. The evaluation of operational events gains importance when it comes specifically to nuclear power plants due to the proportions that the impact and the consequences of these events may cause to the installation itself, their workers, the external area of the nuclear installation, the environment and to the public in general. These consequences, for the operation of these facilities can range from very little, until the consequences that lead to accidents and can cause significant impacts. Operational events may be associated or have influence in many fields of knowledge, such as operation, maintenance, engineering, Radiological Protection, physical protection, chemistry, Human or Organizational Factors and external events, among others. The accident at the Fukushima Daichi nuclear power plant, shows the importance of exhausting all the studies concerning operational events in order to improve the operational safety of nuclear plants, considering all the causes and possible consequences. In this context, the evaluation of operational events discipline emerges as an important and relevant tool to contribute to the maintenance and/or improvement of the operational safety of nuclear installations. Not without reason the nuclear industry actively participates in programs of exchange of operational experience, where relevant events are thoroughly evaluated and discussed in specific forums, such as power plant operators, regulators and/or joint technical meetings, always with the purpose to prevent, minimize or mitigate its consequences. Any evaluation of operational events passes necessarily by an in-depth study of the circumstances of the event, culminating with the identification of your cause and proposition of corrective actions to prevent recurrence of similar events. Additionally, the events should not be studied individually, but evaluated within a temporal context in order

ENGAGING STUDENTS THROUGH EVENT MARKETING: AN EXAMPLE OF UNIVERSITY ENTREPRENEURSHIP EVENT

Directory of Open Access Journals (Sweden)

Alev KOÇAK ALAN

2017-12-01

Full Text Available Despite the growing importance of event marketing, this study investigated the impact of entrepreneurship event on university students which was hosting by one of the leading university in Turkey. Three different assets of event image (event inventiveness, event appropriateness, event adequacy were proposed to influence students’ satisfaction and revisit intentions. Research conducted to 468 students which participate in the entrepreneurship event for two days. For the analyses structural equation modeling technique was used. It was found that (i the dimensions of event image (inventiveness, appropriateness, and adequacy have an impact on students’ satisfaction and (ii students’ satisfaction was a main driver of their revisit intention. Results, future researches and managerial implications were addressed.

Spatiotemporal Features for Asynchronous Event-based Data

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Xavier eLagorce

2015-02-01

Full Text Available Bio-inspired asynchronous event-based vision sensors are currently introducing a paradigm shift in visual information processing. These new sensors rely on a stimulus-driven principle of light acquisition similar to biological retinas. They are event-driven and fully asynchronous, thereby reducing redundancy and encoding exact times of input signal changes, leading to a very precise temporal resolution. Approaches for higher-level computer vision often rely on the realiable detection of features in visual frames, but similar definitions of features for the novel dynamic and event-based visual input representation of silicon retinas have so far been lacking. This article addresses the problem of learning and recognizing features for event-based vision sensors, which capture properties of truly spatiotemporal volumes of sparse visual event information. A novel computational architecture for learning and encoding spatiotemporal features is introduced based on a set of predictive recurrent reservoir networks, competing via winner-take-all selection. Features are learned in an unsupervised manner from real-world input recorded with event-based vision sensors. It is shown that the networks in the architecture learn distinct and task-specific dynamic visual features, and can predict their trajectories over time.

Rates of medical errors and preventable adverse events among hospitalized children following implementation of a resident handoff bundle.

Science.gov (United States)

Starmer, Amy J; Sectish, Theodore C; Simon, Dennis W; Keohane, Carol; McSweeney, Maireade E; Chung, Erica Y; Yoon, Catherine S; Lipsitz, Stuart R; Wassner, Ari J; Harper, Marvin B; Landrigan, Christopher P

2013-12-04

Handoff miscommunications are a leading cause of medical errors. Studies comprehensively assessing handoff improvement programs are lacking. To determine whether introduction of a multifaceted handoff program was associated with reduced rates of medical errors and preventable adverse events, fewer omissions of key data in written handoffs, improved verbal handoffs, and changes in resident-physician workflow. Prospective intervention study of 1255 patient admissions (642 before and 613 after the intervention) involving 84 resident physicians (42 before and 42 after the intervention) from July-September 2009 and November 2009-January 2010 on 2 inpatient units at Boston Children's Hospital. Resident handoff bundle, consisting of standardized communication and handoff training, a verbal mnemonic, and a new team handoff structure. On one unit, a computerized handoff tool linked to the electronic medical record was introduced. The primary outcomes were the rates of medical errors and preventable adverse events measured by daily systematic surveillance. The secondary outcomes were omissions in the printed handoff document and resident time-motion activity. Medical errors decreased from 33.8 per 100 admissions (95% CI, 27.3-40.3) to 18.3 per 100 admissions (95% CI, 14.7-21.9; P < .001), and preventable adverse events decreased from 3.3 per 100 admissions (95% CI, 1.7-4.8) to 1.5 (95% CI, 0.51-2.4) per 100 admissions (P = .04) following the intervention. There were fewer omissions of key handoff elements on printed handoff documents, especially on the unit that received the computerized handoff tool (significant reductions of omissions in 11 of 14 categories with computerized tool; significant reductions in 2 of 14 categories without computerized tool). Physicians spent a greater percentage of time in a 24-hour period at the patient bedside after the intervention (8.3%; 95% CI 7.1%-9.8%) vs 10.6% (95% CI, 9.2%-12.2%; P = .03). The average duration of verbal

NASA Electronic Parts and Packaging (NEPP) Field Programmable Gate Array (FPGA) Single Event Effects (SEE) Test Guideline Update

Science.gov (United States)

Berg, Melanie D.; LaBel, Kenneth A.

2018-01-01

The following are updated or new subjects added to the FPGA SEE Test Guidelines manual: academic versus mission specific device evaluation, single event latch-up (SEL) test and analysis, SEE response visibility enhancement during radiation testing, mitigation evaluation (embedded and user-implemented), unreliable design and its affects to SEE Data, testing flushable architectures versus non-flushable architectures, intellectual property core (IP Core) test and evaluation (addresses embedded and user-inserted), heavy-ion energy and linear energy transfer (LET) selection, proton versus heavy-ion testing, fault injection, mean fluence to failure analysis, and mission specific system-level single event upset (SEU) response prediction. Most sections within the guidelines manual provide information regarding best practices for test structure and test system development. The scope of this manual addresses academic versus mission specific device evaluation and visibility enhancement in IP Core testing.

Addressing knowledge gaps in molecular, sero-surveillance and monitoring approaches on Zika epidemics and other arbovirus co-infections: A structured review

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Ernest Tambo

2017-05-01

Full Text Available Globalization, with consequent increased travel and trade, rapid urbanization and growing weather variation events due to climate change has contributed to the recent unprecedented Zika virus (ZIKV pandemic. This has emphasized the pressing need for local, national, regional and global community collaborative proactiveness, leadership and financial investment resilience in research and development. This paper addresses the potential knowledge gaps and impact of early detection and monitoring approaches on ZIKV epidemics and related arboviral infections steered towards effective prevention and smart response strategies. We advocate for the development and validation of robust field and point of care diagnostic tools that are more sensitive, specific and cost effective for use in ZIKV epidemics and routine pathophysiology surveillance and monitoring systems as an imperative avenue in understanding Zika-related and other arbovirus trends and apply genomic and proteomic characterisation approaches in guiding annotation efforts in order to design and implement public health burden mitigation and adaptation strategies.

Stress: Specific Life Events in the Teaching Profession.

Science.gov (United States)

Martray, Carl R.; Adams, Ronald D.

This study examined the greatest stressors in teaching situations that affect teachers, and how these events vary for groups of elementary, middle, and secondary school teachers. The list of possibly stressful situations was taken from the Teaching Events Stress Inventory (TESI), developed by Cichon and Koff in 1978. Data were collected from…

The shared and specific relationships between exposure to potentially traumatic events and transdiagnostic dimensions of psychopathology.

Science.gov (United States)

Sunderland, Matthew; Carragher, Natacha; Chapman, Cath; Mills, Katherine; Teesson, Maree; Lockwood, Emma; Forbes, David; Slade, Tim

2016-03-01

The experience of traumatic events has been linked to the development of psychopathology. Changing perspectives on psychopathology have resulted in the hypothesis that broad dimensional constructs account for the majority of variance across putatively distinct disorders. As such, traumatic events may be associated with several disorders due to their relationship with these broad dimensions rather than any direct disorder-specific relationship. The current study used data from 8871 Australians to test this hypothesis. Two broad dimensions accounted for the majority of relationships between traumatic events and mental and substance use disorders. Direct relationships remained between post-traumatic stress disorder and six categories of traumatic events in the total population and between drug dependence and accidents/disasters for males only. These results have strong implications for how psychopathology is conceptualized and offer some evidence that traumatic events are associated with an increased likelihood of experiencing psychopathology in general. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Latino Migrant Worker HIV Prevention Program: building a community partnership through a community health worker training program.

Science.gov (United States)

Sánchez, Jesús; Silva-Suarez, Georgina; Serna, Claudia A; De La Rosa, Mario

2012-01-01

There is limited information on the impact of the HIV/AIDS epidemic on Latino migrant workers (LMWs), although available data indicate that this community is being disproportionally affected. The need for prevention programs that address the specific needs of LMWs is becoming well recognized. HIV prevention interventions that train and employ community health workers are a culturally appropriate way to address the issues of community trust and capacity building in this community. This article describes the Latino Migrant Worker HIV Prevention Program and its efforts to train and engage community health workers in the prevention of HIV among LMWs in South Florida.

Automated Testing Techniques for Event-Driven and Dynamically Typed Software Applications

DEFF Research Database (Denmark)

Adamsen, Christoffer Quist

techniques to address each of the challenges. We present a new methodology that extends the error detection capabilities of existing, manually written Android test suites. In the context of JavaScript web applications, we present practical race detectors for detecting AJAX and initialization races......, and a technique that can prevent event race errors by restricting the nondeterminism. Finally, we present a notion of test completeness for dynamic languages, along with a hybrid static/dynamic analysis framework that approximates test completeness, and demonstrate the usefulness of test completeness facts...

The specifics of opiate abuse in women as a basis of prevention programs and treatment

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Raketić Diana

2013-01-01

Full Text Available The aim of this research is to determine the specifics of opiate addiction in women in our environment, so as to create a specific plan of action in preventing and treatment opiate addiction in women based on the conducted description and results analysis. The sample consists of 32 examinees. Sociodempgraphic questionnaire and widely applied ASI structured interview (McLellan, Cacciola, 1982 were used. The results are in accordance with foreign research. 62.5% of opiate addicted women live with someone who is a drug addict, either as a family member or a partner. 40.6% of the examinees were physically abused, 21.9% were sexually abused as well, and 43.7% were positive for HCV. Positive criminal status and doing illegal business were present in 56% of the examinees. 56.3% of the examinees reported depression, while 84.4% are anxious. 65.6% are unemployed. Research results indicate some significant specifics of opiate addiction in women, with regard to which valuable recommendations for prevention and treatment can be made in our environment. Prevention and treatment must be multidisciplinary with the emphasis on the preserved capacities and the development of positive behavior in opiate addicted women.

Social Determinants and Teen Pregnancy Prevention: Exploring the Role of Nontraditional Partnerships.

Science.gov (United States)

Fuller, Taleria R; White, Carla P; Chu, Jocelyn; Dean, Deborah; Clemmons, Naomi; Chaparro, Carmen; Thames, Jessica L; Henderson, Anitra Belle; King, Pebbles

2018-01-01

Addressing the social determinants of health (SDOH) that influence teen pregnancy is paramount to eliminating disparities and achieving health equity. Expanding prevention efforts from purely individual behavior change to improving the social, political, economic, and built environments in which people live, learn, work, and play may better equip vulnerable youth to adopt and sustain healthy decisions. In 2010, the Centers for Disease Control and Prevention in partnership with the Office of Adolescent Health funded state- and community-based organizations to develop and implement the Teen Pregnancy Prevention Community-Wide Initiative. This effort approached teen pregnancy from an SDOH perspective, by identifying contextual factors that influence teen pregnancy and other adverse sexual health outcomes among vulnerable youth. Strategies included, but were not limited to, conducting a root cause analysis and establishing nontraditional partnerships to address determinants identified by community members. This article describes the value of an SDOH approach for achieving health equity, explains the integration of such an approach into community-level teen pregnancy prevention activities, and highlights two project partners' efforts to establish and nurture nontraditional partnerships to address specific SDOH.

Safety barriers on oil and gas platforms. Means to prevent hydrocarbon releases

Energy Technology Data Exchange (ETDEWEB)

Sklet, Snorre

2005-12-15

The main objective of the PhD project has been to develop concepts and methods that can be used to define, illustrate, analyse, and improve safety barriers in the operational phase of offshore oil and gas production platforms. The main contributions of this thesis are; Clarification of the term safety barrier with respect to definitions, classification, and relevant attributes for analysis of barrier performance Development and discussion of a representative set of hydrocarbon release scenarios Development and testing of a new method, BORA-Release, for qualitative and quantitative risk analysis of hydrocarbon releases Safety barriers are defined as physical and/or non-physical means planned to prevent, control, or mitigate undesired events or accidents. The means may range from a single technical unit or human actions, to a complex socio-technical system. It is useful to distinguish between barrier functions and barrier systems. Barrier functions describe the purpose of safety barriers or what the safety barriers shall do in order to prevent, control, or mitigate undesired events or accidents. Barrier systems describe how a barrier function is realized or executed. If the barrier system is functioning, the barrier function is performed. If a barrier function is performed successfully, it should have a direct and significant effect on the occurrence and/or consequences of an undesired event or accident. It is recommended to address the following attributes to characterize the performance of safety barriers; a) functionality/effectiveness, b) reliability/ availability, c) response time, d) robustness, and e) triggering event or condition. For some types of barriers, not all the attributes are relevant or necessary in order to describe the barrier performance. The presented hydrocarbon release scenarios include initiating events, barrier functions introduced to prevent hydrocarbon releases, and barrier systems realizing the barrier functions. Both technical and human

Intensified secondary prevention intending a reduction of recurrent events in TIA and minor stroke patients (INSPiRE-TMS: a protocol for a randomised controlled trial

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Leistner Stefanie

2013-01-01

Full Text Available Abstract Background Patients with recent stroke or TIA are at high risk for new vascular events. Several evidence based strategies in secondary prevention of stroke are available but frequently underused. Support programs with multifactorial risk factor modifications after stroke or TIA have not been investigated in large-scale prospective controlled trials so far. INSPiRE-TMS is a prospective, multi-center, randomized open intervention trial for intensified secondary prevention after minor stroke and TIA. Methods/design Patients with acute TIA or minor stroke admitted to the participating stroke centers are screened and recruited during in-hospital stay. Patients are randomised in a 1:1 ratio to intervention (support program and control (usual care arms. Inclusion of 2.082 patients is planned. The support program includes cardiovascular risk factor measurement and feedback, monitoring of medication adherence, coaching in lifestyle modifications, and active involvement of relatives. Standardized motivational interviewing is used to assess and enhance patients’ motivation. Primary objective is a reduction of new major vascular events defined as nonfatal stroke and myocardial infarction or vascular death. Recruitment time is planned for 3.5 years, follow up time is at least 2 years for every patient resulting in a total study time of 5 years (first patient in to last patient out. Discussion Given the high risk for vascular re-events in acute stroke and the available effective strategies in secondary prevention, the INSPIRE-TMS support program has the potential to lead to a relevant reduction of recurrent events and a prolongation of the event-free survival time. The trial will provide the basis for the decision whether an intensified secondary prevention program after stroke should be implemented into regular care. A cost-effectiveness evaluation will be performed. Trial registration clinicaltrials.gov: 01586702

Transformation of follicular lymphoma - Why does it happen and can it be prevented?

Science.gov (United States)

Link, Brian K

2018-03-01

Follicular lymphoma is a clinical disease with a multitude of presentations and behaviors. Although infrequent, transformation of follicular lymphoma to a more aggressive behaving subtype - prototypically diffuse large B-cell lymphoma - confers a substantially adverse prognosis. There is no consensus for optimal management after transformation is recognized. Historically considered a distinct clinical event, this review highlights the multiple subclinical transformational events that either variably or cumulatively result in clinical recognition of transformed follicular lymphoma. Known and suspected events include genetic and epigenetic perturbations, metabolomic changes, and alterations in the microenvironment. This diverse spectrum of pathways leads to heterogeneous clinical presentations and outcomes of transformed follicular lymphoma. Current options for prevention of transformation are limited to known strategies of managing follicular lymphoma before the transformation is recognized. Although most retrospectively analyzed studies suggest an association of lower transformation rates with early systemic therapy, specific components of therapy such as anti-CD20 antibodies, anthracyclines, or purine analogues are less strongly associated with "preventative' value. Thus, the goal of preventing transformation is of limited value among all factors that go into decisions on early management of follicular lymphoma. Future opportunities to prevent clinical evidence of transformation will benefit from early detection of markers of subclinical transformation and development of therapies to specifically target the biology implied by those markers. Copyright © 2017. Published by Elsevier Ltd.

Overview of plant specific source terms and their impact on risk

International Nuclear Information System (INIS)

Desaedeleer, G.

2004-01-01

Probabilistic risk assesment and safety assessment focuses on systems and measures to prevent core meltdown, and it integrates many aspects of design and operation. It provides mapping of initiating event, frequencies onto plant damage state and through plant systems analysis, utilizes fault tree and event tree logic models, may include 'external event' analysis such as fire, flood, wind, seismic events. Percent contribution of sequences to the core damage frequency are shown for the following plants, taken as examples ZION, EDISON, OCONEE 3, SEABROOK, SIZEWELL B, MILLSTONE 3, RINGHALS 2. The presentation includes comparison of the following initiating event frequencies: loss of off-site power; small LOCA; large LOCA, steam generator tube rupture; loss of feedwater; turbine trip; reactor trip. Consequence analysis deals with: dispersion and depletion of radioactivity in the atmosphere, health effects, factors in the off-site emergency plan analyzed with codes that address the weather conditions; provision of mapping of source terms; risk diagram for early fatalities and for latent cancer fatalities

Modelling of risk events with uncertain likelihoods and impacts in large infrastructure projects

DEFF Research Database (Denmark)

Schjær-Jacobsen, Hans

2010-01-01

to prevent future budget overruns. One of the central ideas is to introduce improved risk management processes and the present paper addresses this particular issue. A relevant cost function in terms of unit prices and quantities is developed and an event impact matrix with uncertain impacts from independent......This paper presents contributions to the mathematical core of risk and uncertainty management in compliance with the principles of New Budgeting laid out in 2008 by the Danish Ministry of Transport to be used in large infrastructure projects. Basically, the new principles are proposed in order...... uncertain risk events is used to calculate the total uncertain risk budget. Cost impacts from the individual risk events on the individual project activities are kept precisely track of in order to comply with the requirements of New Budgeting. Additionally, uncertain likelihoods for the occurrence of risk...

Systemic and Disease-Specific Risk Factors in Vascular Dementia: Diagnosis and Prevention

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Efraim Jaul

2017-10-01

Full Text Available In order to prevent the onset of vascular dementia (VaD in aging individuals, it is critical to detect clinically relevant vascular and systemic pathophysiological changes to signal the onset of its preceding prodromal stages. Identifying behavioral and neurobiological markers that are highly sensitive to VaD classification vs. other dementias is likely to assist in developing novel preventive treatment strategies that could delay the onset of disruptive psychomotor symptoms, decrease hospitalizations, and increase the quality of life in clinically-high-risk aging individuals. In light of empirical diagnostic and clinical findings associated with VaD pathophysiology, the current investigation will suggest a few clinically-validated biomarker measures of prodromal VaD cognitive impairments that are correlated with vascular symptomology, and VaD endophenotypes in non-demented aging people. In prodromal VaD individuals, distinguishing VaD from other dementias (e.g., Alzheimer's disease could facilitate specific early preventive interventions that significantly delay more severe cognitive deterioration or indirectly suppress the onset of dementia with vascular etiology. Importantly, the authors conclude that primary prevention strategies should examine aging individuals by employing comprehensive geriatric assessment approach, taking into account their medical history, and longitudinally noting their vascular, systemic, cognitive, behavioral, and clinical functional status. Secondary prevention strategies may include monitoring chronic medication as well as promoting programs that facilitate social interaction and every-day activities.

Event-based user classification in Weibo media.

Science.gov (United States)

Guo, Liang; Wang, Wendong; Cheng, Shiduan; Que, Xirong

2014-01-01

Weibo media, known as the real-time microblogging services, has attracted massive attention and support from social network users. Weibo platform offers an opportunity for people to access information and changes the way people acquire and disseminate information significantly. Meanwhile, it enables people to respond to the social events in a more convenient way. Much of the information in Weibo media is related to some events. Users who post different contents, and exert different behavior or attitude may lead to different contribution to the specific event. Therefore, classifying the large amount of uncategorized social circles generated in Weibo media automatically from the perspective of events has been a promising task. Under this circumstance, in order to effectively organize and manage the huge amounts of users, thereby further managing their contents, we address the task of user classification in a more granular, event-based approach in this paper. By analyzing real data collected from Sina Weibo, we investigate the Weibo properties and utilize both content information and social network information to classify the numerous users into four primary groups: celebrities, organizations/media accounts, grassroots stars, and ordinary individuals. The experiments results show that our method identifies the user categories accurately.

The Latino Migrant Worker HIV Prevention Program: Building a Community Partnership Through a Community Health Worker Training Program

OpenAIRE

Sánchez, Jesús; Silva-Suarez, Georgina; Serna, Claudia A.; De La Rosa, Mario

2012-01-01

There is limited information on the impact of the HIV/AIDS epidemic on Latino migrant workers (LMWs), although available data indicate that this community is being disproportionally affected. The need for prevention programs that address the specific needs of LMWs is becoming well recognized. HIV prevention interventions that train and employ community health workers are a culturally appropriate way to address the issues of community trust and capacity building in this community. This article...

Analyzing the Messages of the State of the Union Address

Science.gov (United States)

Kissling, Mark T.; Martell, Christopher C.

2014-01-01

In the era of smartphones and 24-hour news networks, the State of the Union address is a major event. All national media outlets--in print, on television, on the Internet--report on the address, some almost exclusively in the days leading up to and after the speech. In this article, considering their experiences teaching about the address, and…

Hospital deaths and adverse events in Brazil

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Pavão Ana Luiza B

2011-09-01

Full Text Available Abstract Background Adverse events are considered a major international problem related to the performance of health systems. Evaluating the occurrence of adverse events involves, as any other outcome measure, determining the extent to which the observed differences can be attributed to the patient's risk factors or to variations in the treatment process, and this in turn highlights the importance of measuring differences in the severity of the cases. The current study aims to evaluate the association between deaths and adverse events, adjusted according to patient risk factors. Methods The study is based on a random sample of 1103 patient charts from hospitalizations in the year 2003 in 3 teaching hospitals in the state of Rio de Janeiro, Brazil. The methodology involved a retrospective review of patient charts in two stages - screening phase and evaluation phase. Logistic regression was used to evaluate the relationship between hospital deaths and adverse events. Results The overall mortality rate was 8.5%, while the rate related to the occurrence of an adverse event was 2.9% (32/1103 and that related to preventable adverse events was 2.3% (25/1103. Among the 94 deaths analyzed, 34% were related to cases involving adverse events, and 26.6% of deaths occurred in cases whose adverse events were considered preventable. The models tested showed good discriminatory capacity. The unadjusted odds ratio (OR 11.43 and the odds ratio adjusted for patient risk factors (OR 8.23 between death and preventable adverse event were high. Conclusions Despite discussions in the literature regarding the limitations of evaluating preventable adverse events based on peer review, the results presented here emphasize that adverse events are not only prevalent, but are associated with serious harm and even death. These results also highlight the importance of risk adjustment and multivariate models in the study of adverse events.

The risk of a safety-critical event associated with mobile device use in specific driving contexts.

Science.gov (United States)

Fitch, Gregory M; Hanowski, Richard J; Guo, Feng

2015-01-01

We explored drivers' mobile device use and its associated risk of a safety-critical event (SCE) in specific driving contexts. Our premise was that the SCE risk associated with mobile device use increases when the driving task becomes demanding. Data from naturalistic driving studies involving commercial motor vehicle drivers and light vehicle drivers were partitioned into subsets representative of specific driving contexts. The subsets were generated using data set attributes that included level of service and relation to junction. These attributes were selected based on exogenous factors known to alter driving task demands. The subsets were analyzed using a case-cohort approach, which was selected to complement previous investigations of mobile device SCE risk using naturalistic driving data. Both commercial motor vehicle and light vehicle drivers varied as to how much they conversed on a mobile device but did not vary their engagement in visual-manual subtasks. Furthermore, commercial motor vehicle drivers conversed less frequently as the driving task demands increased, whereas light vehicle drivers did not. The risk of an SCE associated with mobile device use was dependent on the subtask performed and the driving context. Only visual-manual subtasks were associated with an increased SCE risk, whereas conversing was associated with a decreased risk in some driving contexts. Drivers' engagement in mobile device subtasks varies by driving context. The SCE risk associated with mobile device use is dependent on the types of subtasks performed and the driving context. The findings of this exploratory study can be applied to the design of driver-vehicle interfaces that mitigate distraction by preventing visual-manual subtasks while driving.

ENGINEERED BARRIER SYSTEM FEATURES, EVENTS AND PROCESSES

International Nuclear Information System (INIS)

Jaros, W.

2005-01-01

The purpose of this report is to evaluate and document the inclusion or exclusion of engineered barrier system (EBS) features, events, and processes (FEPs) with respect to models and analyses used to support the total system performance assessment for the license application (TSPA-LA). A screening decision, either Included or Excluded, is given for each FEP along with the technical basis for exclusion screening decisions. This information is required by the U.S. Nuclear Regulatory Commission (NRC) at 10 CFR 63.114 (d, e, and f) [DIRS 173273]. The FEPs addressed in this report deal with those features, events, and processes relevant to the EBS focusing mainly on those components and conditions exterior to the waste package and within the rock mass surrounding emplacement drifts. The components of the EBS are the drip shield, waste package, waste form, cladding, emplacement pallet, emplacement drift excavated opening (also referred to as drift opening in this report), and invert. FEPs specific to the waste package, cladding, and drip shield are addressed in separate FEP reports: for example, ''Screening of Features, Events, and Processes in Drip Shield and Waste Package Degradation'' (BSC 2005 [DIRS 174995]), ''Clad Degradation--FEPs Screening Arguments (BSC 2004 [DIRS 170019]), and Waste-Form Features, Events, and Processes'' (BSC 2004 [DIRS 170020]). For included FEPs, this report summarizes the implementation of the FEP in the TSPA-LA (i.e., how the FEP is included). For excluded FEPs, this analysis provides the technical basis for exclusion from TSPA-LA (i.e., why the FEP is excluded). This report also documents changes to the EBS FEPs list that have occurred since the previous versions of this report. These changes have resulted due to a reevaluation of the FEPs for TSPA-LA as identified in Section 1.2 of this report and described in more detail in Section 6.1.1. This revision addresses updates in Yucca Mountain Project (YMP) administrative procedures as they

Clinical contributions to addressing the social determinants of health.

Science.gov (United States)

Patel, Kiran C R; Spilsbury, Peter; Shukla, Rashmi

2010-04-01

The drive to address social determinants of health is gaining momentum. Appreciating that health outcomes are only partly affected by healthcare, clinicians and clinical communities can play a significant role in this crusade by action at local, regional, national and global levels. A concerted and systematic focus on integrating and industrialising upstream interventions at every healthcare encounter is essential to prevent future illness, thus enabling a paradigm shift in the healthcare service from being one of illness management to health preservation. The evidence base demonstrates the cost efficacy of upstream interventions. The challenge is how this evidence is utilised to implement these interventions in everyday healthcare. Today, with a global economic crisis and challenged public sector funding, the need to address prevention has never been more pressing. Clinical engagement at all levels, from the front line to the boardroom is vital. Clinicians must address access, communication, strategy and commissioning to fulfil a professional responsibility to become and remain the corporate memory of a health service focused on preventing illness while simultaneously delivering cost-effective healthcare.

Addressing the Federal-State-Local Interface Issues During a Catastrophic Event Such as an Anthrax Attack

Energy Technology Data Exchange (ETDEWEB)

Stein, Steven L.; Lesperance, Ann M.; Upton, Jaki F.

2010-02-01

On October 9, 2008, federal, state and local policy makers, emergency managers, and medical and public health officials convened in Seattle, Washington, for a workshop on Addressing the Federal-State-Local Interface Issues During a Catastrophic Event Such as an Anthrax Attack. The day-long symposium was aimed at generating a dialogue about recovery and restoration through a discussion of the associated challenges that impact entire communities, including people, infrastructure, and critical systems. The Principal Federal Official (PFO) provided an overview of the role of the PFO in a catastrophic event. A high-level summary of an anthrax scenario was presented. The remainder of the day was focused on interactive discussions among federal, state and local emergency management experts in the areas of: • Decision-making, prioritization, and command and control • Public health/medical services • Community resiliency and continuity of government. Key topics and issues that resulted from discussions included: • Local representation in the Joint Field Office (JFO) • JFO transition to the Long-Term Recovery Office • Process for prioritization of needs • Process for regional coordination • Prioritization - process and federal/military intervention • Allocation of limited resources • Re-entry decision and consistency • Importance of maintaining a healthy hospital system • Need for a process to establish a consensus on when it is safe to re-enter. This needs to be across all jurisdictions including the military. • Insurance coverage for both private businesses and individuals • Interaction between the government and industry. The symposium was sponsored by the Interagency Biological Restoration Demonstration, a collaborative regional program jointly funded by the U.S. Department of Homeland Security and the U.S. Department of Defense. To aid the program’s efforts and inform the development of blueprint for recovery from a biological incident

Preventive psychiatry in clinical practice

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Mamta Sood

2017-01-01

Full Text Available In the last two and a half decades, there have been series of global burden of disease studies which have highlighted significant disability attributable to mental and behavioral disorders with a huge treatment gap. Integration of the preventive strategies in the clinical practice has the potential to reduce the disability due to mental illnesses. The patients come to the clinic with an intention to get treated and investigated for the symptoms they have. At this point, they may also be amenable to the advice related to prevention. Therefore, the clinical encounter can be seen as an opportunity to implement preventive strategies. Preventive efforts in clinical practice must be guided by knowledge about the epidemiological data related to specific mental illnesses and about the evidence-based preventive strategies available for specific mental illnesses. These should be directed toward all those persons (patients, caregivers accompanying and at home, teachers, employers, etc. who are present and also toward those who are not present during the clinical encounter and must be age, gender, and culture sensitive. Sociodemographic characteristics of a person seeking relief from a problem in the clinical encounter help in directing the preventive efforts. The preventive efforts are also driven by the fact that the patient has the first episode or established or treatment refractory mental illness and the short or long duration of illness. For prevention-minded clinical practice, it helps to have a template so that the assessments and interventions relevant for prevention can be carried out as per that scheme; it also helps in orienting the practicing mental health professionals. While making various assessments, making a list of the likely issues to be addressed by preventive efforts during clinical encounter ( first and subsequent is also helpful.

Specific Depletion of Ly6Chi Inflammatory Monocytes Prevents Immunopathology in Experimental Cerebral Malaria

Science.gov (United States)

Kuepper, Janina M.; Biswas, Aindrila; Djie-Maletz, Andrea; Limmer, Andreas; van Rooijen, Nico; Mack, Matthias; Hoerauf, Achim; Dunay, Ildiko Rita

2015-01-01

Plasmodium berghei ANKA (PbA) infection of C57BL/6 mice leads to experimental cerebral malaria (ECM) that is commonly associated with serious T cell mediated damage. In other parasitic infection models, inflammatory monocytes have been shown to regulate Th1 responses but their role in ECM remains poorly defined, whereas neutrophils are reported to contribute to ECM immune pathology. Making use of the recent development of specific monoclonal antibodies (mAb), we depleted in vivo Ly6Chi inflammatory monocytes (by anti-CCR2), Ly6G+ neutrophils (by anti-Ly6G) or both cell types (by anti-Gr1) during infection with Ovalbumin-transgenic PbA parasites (PbTg). Notably, the application of anti-Gr1 or anti-CCR2 but not anti-Ly6G antibodies into PbTg-infected mice prevented ECM development. In addition, depletion of Ly6Chi inflammatory monocytes but not neutrophils led to decreased IFNγ levels and IFNγ+CD8+ T effector cells in the brain. Importantly, anti-CCR2 mAb injection did not prevent the generation of PbTg-specific T cell responses in the periphery, whereas anti-Gr1 mAb injection strongly diminished T cell frequencies and CTL responses. In conclusion, the specific depletion of Ly6Chi inflammatory monocytes attenuated brain inflammation and immune cell recruitment to the CNS, which prevented ECM following Plasmodium infection, pointing out a substantial role of Ly6C+ monocytes in ECM inflammatory processes. PMID:25884830

Short-term memory for event duration: modality specificity and goal dependency.

Science.gov (United States)

Takahashi, Kohske; Watanabe, Katsumi

2012-11-01

Time perception is involved in various cognitive functions. This study investigated the characteristics of short-term memory for event duration by examining how the length of the retention period affects inter- and intramodal duration judgment. On each trial, a sample stimulus was followed by a comparison stimulus, after a variable delay period (0.5-5 s). The sample and comparison stimuli were presented in the visual or auditory modality. The participants determined whether the comparison stimulus was longer or shorter than the sample stimulus. The distortion pattern of subjective duration during the delay period depended on the sensory modality of the comparison stimulus but was not affected by that of the sample stimulus. When the comparison stimulus was visually presented, the retained duration of the sample stimulus was shortened as the delay period increased. Contrarily, when the comparison stimulus was presented in the auditory modality, the delay period had little to no effect on the retained duration. Furthermore, whenever the participants did not know the sensory modality of the comparison stimulus beforehand, the effect of the delay period disappeared. These results suggest that the memory process for event duration is specific to sensory modality and that its performance is determined depending on the sensory modality in which the retained duration will be used subsequently.

IDC Re-Engineering Phase 2 System Specification Document Version 1.5

Energy Technology Data Exchange (ETDEWEB)

Satpathi, Meara Allena [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Burns, John F. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Harris, James M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2017-01-01

This document contains the system specifications derived to satisfy the system requirements found in the IDC System Requirements Document for the IDC Re-Engineering Phase 2 project. This System Specification Document (SSD) defines waveform data processing requirements for the International Data Centre (IDC) of the Comprehensive Nuclear Test Ban Treaty Organization (CTBTO). The routine processing includes characterization of events with the objective of screening out events considered to be consistent with natural phenomena or non-nuclear, man-made phenomena. This document does not address requirements concerning acquisition, processing and analysis of radionuclide data but does include requirements for the dissemination of radionuclide data and products.

OAE: The Ontology of Adverse Events.

Science.gov (United States)

He, Yongqun; Sarntivijai, Sirarat; Lin, Yu; Xiang, Zuoshuang; Guo, Abra; Zhang, Shelley; Jagannathan, Desikan; Toldo, Luca; Tao, Cui; Smith, Barry

2014-01-01

A medical intervention is a medical procedure or application intended to relieve or prevent illness or injury. Examples of medical interventions include vaccination and drug administration. After a medical intervention, adverse events (AEs) may occur which lie outside the intended consequences of the intervention. The representation and analysis of AEs are critical to the improvement of public health. The Ontology of Adverse Events (OAE), previously named Adverse Event Ontology (AEO), is a community-driven ontology developed to standardize and integrate data relating to AEs arising subsequent to medical interventions, as well as to support computer-assisted reasoning. OAE has over 3,000 terms with unique identifiers, including terms imported from existing ontologies and more than 1,800 OAE-specific terms. In OAE, the term 'adverse event' denotes a pathological bodily process in a patient that occurs after a medical intervention. Causal adverse events are defined by OAE as those events that are causal consequences of a medical intervention. OAE represents various adverse events based on patient anatomic regions and clinical outcomes, including symptoms, signs, and abnormal processes. OAE has been used in the analysis of several different sorts of vaccine and drug adverse event data. For example, using the data extracted from the Vaccine Adverse Event Reporting System (VAERS), OAE was used to analyse vaccine adverse events associated with the administrations of different types of influenza vaccines. OAE has also been used to represent and classify the vaccine adverse events cited in package inserts of FDA-licensed human vaccines in the USA. OAE is a biomedical ontology that logically defines and classifies various adverse events occurring after medical interventions. OAE has successfully been applied in several adverse event studies. The OAE ontological framework provides a platform for systematic representation and analysis of adverse events and of the factors (e

Waste minimization and pollution prevention awareness plan

International Nuclear Information System (INIS)

1991-01-01

The purpose of this plan is to document the Lawrence Livermore National Laboratory (LLNL) Waste Minimization and Pollution Prevention Awareness Program. The plan specifies those activities and methods that are or will be employed to reduce the quantity and toxicity of wastes generated at the site. The intent of this plan is to respond to and comply with (DOE's) policy and guidelines concerning the need for pollution prevention. The Plan is composed of a LLNL Waste Minimization and Pollution Prevention Awareness Program Plan and, as attachments, Program- and Department-specific waste minimization plans. This format reflects the fact that waste minimization is considered a line management responsibility and is to be addressed by each of the Programs and Departments. 14 refs

Waste minimization and pollution prevention awareness plan

Energy Technology Data Exchange (ETDEWEB)

1991-05-31

The purpose of this plan is to document the Lawrence Livermore National Laboratory (LLNL) Waste Minimization and Pollution Prevention Awareness Program. The plan specifies those activities and methods that are or will be employed to reduce the quantity and toxicity of wastes generated at the site. The intent of this plan is to respond to and comply with (DOE's) policy and guidelines concerning the need for pollution prevention. The Plan is composed of a LLNL Waste Minimization and Pollution Prevention Awareness Program Plan and, as attachments, Program- and Department-specific waste minimization plans. This format reflects the fact that waste minimization is considered a line management responsibility and is to be addressed by each of the Programs and Departments. 14 refs.

Weight Gain Prevention among Midlife Women: A Randomized Controlled Trial to Address Needs Related to the Physical and Social Environment

Directory of Open Access Journals (Sweden)

Courtney D. Perry

2016-05-01

Full Text Available Women tend to gain weight at midlife (40–60 years increasing risk of obesity-related chronic diseases. Within specific eating occasions, needs related to the physical and social environment may result in less healthy eating behavior, which can lead to weight gain over time. The purpose of this study was to determine if a dietitian-delivered nutrition counseling intervention tailored to eating occasion needs could improve diet and prevent weight gain among midlife women over two years. A randomized controlled trial was conducted with healthy midlife women (n = 354 in one U.S. metropolitan area. The intervention group (n = 185 received ten hours of individual nutrition counseling from dietitians over six months, while women in a control group (n = 169 received no counseling. Measured height, weight and waist circumference, and dietary intakes were collected at baseline and every six months over two years. Mixed linear models were used to test for intervention effect on change in outcome variables over time. Dietary intakes of fruit, reduced/low-fat dairy foods and refined grains were significantly improved over time in the intervention compared to control group. However, the intervention had no effect on weight over time (p = 0.48. Nutrition counseling tailored to address eating occasion needs improved self-reported diet but did not significantly affect weight change.

Veterinary public health capacity-building in India: a grim reflection of the developing world's underpreparedness to address zoonotic risks.

Science.gov (United States)

Kakkar, Manish; Abbas, Syed Shahid; Kumar, Ashok; Hussain, Mohammad Akhtar; Sharma, Kavya; Bhatt, Purvi Mehta; Zodpey, Sanjay

2013-01-01

Veterinary public health (VPH) is ideally suited to promote convergence between human, animal and environmental sectors. Recent zoonotic and emerging infectious disease events have given rise to increasing calls for efforts to build global VPH capacities. However, even with their greater vulnerability to such events, including their economic and livelihood impacts, the response from low-and middle-income countries such as India has been suboptimal, thereby elevating global health risks. Addressing risks effectively at the human-animal interface in these countries will require a clear vision, consistent policies, strategic approach and sustained political commitment to reform and refine the current VPH capacity-building efforts. Only then can the discipline serve its goal of disease prevention, poverty alleviation and support for sustainable livelihoods through improvements in human and animal health.

MDEP Design-Specific Common Position CP-EPRWG-02. Common position addressing Fukushima Daiichi-related issues

International Nuclear Information System (INIS)

2015-10-01

A severe accident involving several units took place in Japan at Fukushima Daiichi nuclear power plant (NPP) in March 2011. The immediate cause of the accident was an earthquake followed by a tsunami coupled with inadequate provisions against the consequences of such events in the design. Opportunities to improve protection against a realistic design basis tsunami were not taken. As a consequence of the tsunami, safety equipment and the related safety functions were lost at the plant, leading to core damage in three units and subsequently to large radioactive releases (INES 7). Several studies have already been performed to better understand the accident progression and detailed technical studies are still in progress in Japan and elsewhere. In the meantime, on-going studies on the behaviour of NPPs in very severe situations, similar to Fukushima Daiichi, seek to identify potential vulnerabilities in plant design and operation; to suggest reasonably practicable upgrades; or to recommend enhanced regulatory requirements and guidance to address such situations. Likewise, agencies around the world that are responsible for regulating the design, construction and operation of EPR plants are engaged in similar activities. The MDEP EPR Working Group (EPRWG) members consist of members from the United States, the United Kingdom, France, Finland, China, India and Sweden. Because not all of these countries have completed the regulatory review of their EPR applications yet, this paper identifies common preliminary approaches to address potential safety improvements for EPR plants, as well as common general expectations for new nuclear power plants, as related to lessons learned from the Fukushima Daiichi accident or Fukushima Daiichi-related issues. After the safety reviews of the EPR design applications that are currently in review are completed, the regulators will update this paper to reflect their safety conclusions regarding the EPR design and how the design could be

Development of an event-specific hydrolysis probe quantitative real-time polymerase chain reaction assay for Embrapa 5.1 genetically modified common bean (Phaseolus vulgaris).

Science.gov (United States)

Treml, Diana; Venturelli, Gustavo L; Brod, Fábio C A; Faria, Josias C; Arisi, Ana C M

2014-12-10

A genetically modified (GM) common bean event, namely Embrapa 5.1, resistant to the bean golden mosaic virus (BGMV), was approved for commercialization in Brazil. Brazilian regulation for genetically modified organism (GMO) labeling requires that any food containing more than 1% GMO be labeled. The event-specific polymerase chain reaction (PCR) method has been the primary trend for GMO identification and quantitation because of its high specificity based on the flanking sequence. This work reports the development of an event-specific assay, named FGM, for Embrapa 5.1 detection and quantitation by use of SYBR Green or hydrolysis probe. The FGM assay specificity was tested for Embrapa 2.3 event (a noncommercial GM common bean also resistant to BGMV), 46 non-GM common bean varieties, and other crop species including maize, GM maize, soybean, and GM soybean. The FGM assay showed high specificity to detect the Embrapa 5.1 event. Standard curves for the FGM assay presented a mean efficiency of 95% and a limit of detection (LOD) of 100 genome copies in the presence of background DNA. The primers and probe developed are suitable for the detection and quantitation of Embrapa 5.1.

Preventing burnout among general practitioners: is there a possible route?

DEFF Research Database (Denmark)

Nielsen, Helena G.; Tulinius, C.

2009-01-01

Stress and burnout among general practitioners (GPs) is a serious problem. Some authors suggest supervision groups or Balint groups as a means of preventing burnout and others address how to treat the condition. This paper reports a case study of a supervision group for Danish GPs which, as well...... as training reflective practice, focuses specifically on the prevention of burnout. The concept of compassion fatigue is extended to cover the circumstances reported by some practitioners in supervision Udgivelsesdato: 2009/9...

Memory for media: investigation of false memories for negatively and positively charged public events.

Science.gov (United States)

Porter, Stephen; Taylor, Kristian; Ten Brinke, Leanne

2008-01-01

Despite a large body of false memory research, little has addressed the potential influence of an event's emotional content on susceptibility to false recollections. The Paradoxical Negative Emotion (PNE) hypothesis predicts that negative emotion generally facilitates memory but also heightens susceptibility to false memories. Participants were asked whether they could recall 20 "widely publicised" public events (half fictitious) ranging in emotional valence, with or without visual cues. Participants recalled a greater number of true negative events (M=3.31/5) than true positive (M=2.61/5) events. Nearly everyone (95%) came to recall at least one false event (M=2.15 false events recalled). Further, more than twice as many participants recalled any false negative (90%) compared to false positive (41.7%) events. Negative events, in general, were associated with more detailed memories and false negative event memories were more detailed than false positive event memories. Higher dissociation scores were associated with false recollections of negative events, specifically.

LAN attack detection using Discrete Event Systems.

Science.gov (United States)

Hubballi, Neminath; Biswas, Santosh; Roopa, S; Ratti, Ritesh; Nandi, Sukumar

2011-01-01

Address Resolution Protocol (ARP) is used for determining the link layer or Medium Access Control (MAC) address of a network host, given its Internet Layer (IP) or Network Layer address. ARP is a stateless protocol and any IP-MAC pairing sent by a host is accepted without verification. This weakness in the ARP may be exploited by malicious hosts in a Local Area Network (LAN) by spoofing IP-MAC pairs. Several schemes have been proposed in the literature to circumvent these attacks; however, these techniques either make IP-MAC pairing static, modify the existing ARP, patch operating systems of all the hosts etc. In this paper we propose a Discrete Event System (DES) approach for Intrusion Detection System (IDS) for LAN specific attacks which do not require any extra constraint like static IP-MAC, changing the ARP etc. A DES model is built for the LAN under both a normal and compromised (i.e., spoofed request/response) situation based on the sequences of ARP related packets. Sequences of ARP events in normal and spoofed scenarios are similar thereby rendering the same DES models for both the cases. To create different ARP events under normal and spoofed conditions the proposed technique uses active ARP probing. However, this probing adds extra ARP traffic in the LAN. Following that a DES detector is built to determine from observed ARP related events, whether the LAN is operating under a normal or compromised situation. The scheme also minimizes extra ARP traffic by probing the source IP-MAC pair of only those ARP packets which are yet to be determined as genuine/spoofed by the detector. Also, spoofed IP-MAC pairs determined by the detector are stored in tables to detect other LAN attacks triggered by spoofing namely, man-in-the-middle (MiTM), denial of service etc. The scheme is successfully validated in a test bed. Copyright © 2010 ISA. Published by Elsevier Ltd. All rights reserved.

Analysis of operation events for HFETR emergency diesel generator set

International Nuclear Information System (INIS)

Li Zhiqiang; Ji Xifang; Deng Hong

2015-01-01

By the statistic analysis of the historical failure data of the emergency diesel generator set, the specific mode, the attribute, and the direct and root origin for each failure are reviewed and summarized. Considering the current status of the emergency diesel generator set, the preventive measures and solutions in terms of operation, handling and maintenance are proposed, and the potential events for the emergency diesel generator set are analyzed. (authors)

New oral anticoagulants: their advantages and disadvantages compared with vitamin K antagonists in the prevention and treatment of patients with thromboembolic events.

Science.gov (United States)

Mekaj, Ymer H; Mekaj, Agon Y; Duci, Shkelzen B; Miftari, Ermira I

2015-01-01

Despite the discovery and application of many parenteral (unfractionated and low-molecular-weight heparins) and oral anticoagulant vitamin K antagonist (VKA) drugs, the prevention and treatment of venous and arterial thrombotic phenomena remain major medical challenges. Furthermore, VKAs are the only oral anticoagulants used during the past 60 years. The main objective of this study is to present recent data on non-vitamin K antagonist oral anticoagulants (NOACs) and to analyze their advantages and disadvantages compared with those of VKAs based on a large number of recent studies. NOACs are novel direct-acting medications that are selective for one specific coagulation factor, either thrombin (IIa) or activated factor X (Xa). Several NOACs, such as dabigatran (a direct inhibitor of FIIa) and rivaroxaban, apixaban and edoxaban (direct inhibitors of factor Xa), have been used for at least 5 years but possibly 10 years. Unlike traditional VKAs, which prevent the coagulation process by suppressing the synthesis of vitamin K-dependent factors, NOACs directly inhibit key proteases (factors IIa and Xa). The important indications of these drugs are the prevention and treatment of deep vein thrombosis and pulmonary embolisms, and the prevention of atherothrombotic events in the heart and brain of patients with acute coronary syndrome and atrial fibrillation. They are not fixed, and dose-various strengths are available. Most studies have reported that more advantages than disadvantages for NOACs when compared with VKAs, with the most important advantages of NOACs including safety issues (ie, a lower incidence of major bleeding), convenience of use, minor drug and food interactions, a wide therapeutic window, and no need for laboratory monitoring. Nonetheless, there are some conditions for which VKAs remain the drug of choice. Based on the available data, we can conclude that NOACs have greater advantages and fewer disadvantages compared with VKAs. New studies are required

Design a Learning-Oriented Fall Event Reporting System Based on Kirkpatrick Model.

Science.gov (United States)

Zhou, Sicheng; Kang, Hong; Gong, Yang

2017-01-01

Patient fall has been a severe problem in healthcare facilities around the world due to its prevalence and cost. Routine fall prevention training programs are not as effective as expected. Using event reporting systems is the trend for reducing patient safety events such as falls, although some limitations of the systems exist at current stage. We summarized these limitations through literature review, and developed an improved web-based fall event reporting system. The Kirkpatrick model, widely used in the business area for training program evaluation, has been integrated during the design of our system. Different from traditional event reporting systems that only collect and store the reports, our system automatically annotates and analyzes the reported events, and provides users with timely knowledge support specific to the reported event. The paper illustrates the design of our system and how its features are intended to reduce patient falls by learning from previous errors.

Dealing with School Violence: The Effect of School Violence Prevention Training on Teachers' Perceived Self-Efficacy in Dealing with Violent Events

Science.gov (United States)

Sela-Shayovitz, Revital

2009-01-01

This study deals with the relationship between school violence prevention training and teachers' perceived self-efficacy in handling violent events. Three indicators were used to examine teachers' self-efficacy: personal teaching efficacy (PTE), teachers' efficacy in the school as an organisation (TESO), and teachers' outcome efficacy (TOE). Data…

Knowledge engineering for adverse drug event prevention: on the design and development of a uniform, contextualized and sustainable knowledge-based framework.

Science.gov (United States)

Koutkias, Vassilis; Kilintzis, Vassilis; Stalidis, George; Lazou, Katerina; Niès, Julie; Durand-Texte, Ludovic; McNair, Peter; Beuscart, Régis; Maglaveras, Nicos

2012-06-01

The primary aim of this work was the development of a uniform, contextualized and sustainable knowledge-based framework to support adverse drug event (ADE) prevention via Clinical Decision Support Systems (CDSSs). In this regard, the employed methodology involved first the systematic analysis and formalization of the knowledge sources elaborated in the scope of this work, through which an application-specific knowledge model has been defined. The entire framework architecture has been then specified and implemented by adopting Computer Interpretable Guidelines (CIGs) as the knowledge engineering formalism for its construction. The framework integrates diverse and dynamic knowledge sources in the form of rule-based ADE signals, all under a uniform Knowledge Base (KB) structure, according to the defined knowledge model. Equally important, it employs the means to contextualize the encapsulated knowledge, in order to provide appropriate support considering the specific local environment (hospital, medical department, language, etc.), as well as the mechanisms for knowledge querying, inference, sharing, and management. In this paper, we present thoroughly the establishment of the proposed knowledge framework by presenting the employed methodology and the results obtained as regards implementation, performance and validation aspects that highlight its applicability and virtue in medication safety. Copyright © 2012 Elsevier Inc. All rights reserved.

Highly specific detection of genetic modification events using an enzyme-linked probe hybridization chip.

Science.gov (United States)

Zhang, M Z; Zhang, X F; Chen, X M; Chen, X; Wu, S; Xu, L L

2015-08-10

The enzyme-linked probe hybridization chip utilizes a method based on ligase-hybridizing probe chip technology, with the principle of using thio-primers for protection against enzyme digestion, and using lambda DNA exonuclease to cut multiple PCR products obtained from the sample being tested into single-strand chains for hybridization. The 5'-end amino-labeled probe was fixed onto the aldehyde chip, and hybridized with the single-stranded PCR product, followed by addition of a fluorescent-modified probe that was then enzymatically linked with the adjacent, substrate-bound probe in order to achieve highly specific, parallel, and high-throughput detection. Specificity and sensitivity testing demonstrated that enzyme-linked probe hybridization technology could be applied to the specific detection of eight genetic modification events at the same time, with a sensitivity reaching 0.1% and the achievement of accurate, efficient, and stable results.

PREVENTING CLICK EVENT HIJACKING BY USER INTENTION INFERENCE

Directory of Open Access Journals (Sweden)

Kailas Patil

2016-12-01

Full Text Available Web applications are getting more complex and dynamic. By exploiting layout and JavaScript features of a web page, attackers can create web page objects that hijack users’ clicks. Such objects look like normal web page objects, but users’ clicks on these objects lead to unexpected browser actions, such as visiting different URLs or sending out malicious requests. We call this type of attacks click event hijacking attacks. The Facebook Clickjacking attack is an example, which puts a transparent layer containing the victim web application on top of another web page that lures users to click. While users think they click on the underlying web page, they actually click in the victim web application, resulting in unauthorized actions to the web application. In this paper, we propose a solution to mitigate the problem of click event hijacking by inferring users’ intentions. Our solution ClickGuard ensures that the browser’s behavior after a click matches the user’s original intention. The proposed solution is implemented as a Mozilla Firefox extension and evaluated its effectiveness against click event hijacking attacks.

Cost-Effectiveness of High, Moderate and Low-Dose Statins in the Prevention of Vascular Events in the Brazilian Public Health System

International Nuclear Information System (INIS)

Ribeiro, Rodrigo Antonini; Duncan, Bruce Bartholow; Ziegelmann, Patricia Klarmann; Stella, Steffan Frosi; Vieira, Jose Luiz da Costa; Restelatto, Luciane Maria Fabian; Polanczyk, Carisi Anne

2015-01-01

Statins have proven efficacy in the reduction of cardiovascular events, but the financial impact of its widespread use can be substantial. To conduct a cost-effectiveness analysis of three statin dosing schemes in the Brazilian Unified National Health System (SUS) perspective. We developed a Markov model to evaluate the incremental cost-effectiveness ratios (ICERs) of low, intermediate and high intensity dose regimens in secondary and four primary scenarios (5%, 10%, 15% and 20% ten-year risk) of prevention of cardiovascular events. Regimens with expected low-density lipoprotein cholesterol reduction below 30% (e.g. simvastatin 10mg) were considered as low dose; between 30-40%, (atorvastatin 10mg, simvastatin 40mg), intermediate dose; and above 40% (atorvastatin 20-80mg, rosuvastatin 20mg), high-dose statins. Effectiveness data were obtained from a systematic review with 136,000 patients. National data were used to estimate utilities and costs (expressed as International Dollars - Int$). A willingness-to-pay (WTP) threshold equal to the Brazilian gross domestic product per capita (circa Int$11,770) was applied. Low dose was dominated by extension in the primary prevention scenarios. In the five scenarios, the ICER of intermediate dose was below Int$10,000 per QALY. The ICER of the high versus intermediate dose comparison was above Int$27,000 per QALY in all scenarios. In the cost-effectiveness acceptability curves, intermediate dose had a probability above 50% of being cost-effective with ICERs between Int$ 9,000-20,000 per QALY in all scenarios. Considering a reasonable WTP threshold, intermediate dose statin therapy is economically attractive, and should be a priority intervention in prevention of cardiovascular events in Brazil

Cost-Effectiveness of High, Moderate and Low-Dose Statins in the Prevention of Vascular Events in the Brazilian Public Health System

Energy Technology Data Exchange (ETDEWEB)

Ribeiro, Rodrigo Antonini, E-mail: rodrigo.ribeiro@htanalyze.com [Programa de Pós-Graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Duncan, Bruce Bartholow [Programa de Pós-Graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Programa de Pós-Graduação em Cardiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Ziegelmann, Patricia Klarmann [Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Departamento de Estatística da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Stella, Steffan Frosi [Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Programa de Pós-Graduação em Cardiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Vieira, Jose Luiz da Costa [Instituto de Cardiologia / Fundação Universitária de Cardiologia, Porto Alegre, RS (Brazil); Restelatto, Luciane Maria Fabian [Serviço de Medicina Interna do Hospital de Clínicas de Porto Alegre, Porto Alegre, RS (Brazil); Polanczyk, Carisi Anne [Programa de Pós-Graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Programa de Pós-Graduação em Cardiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil)

2015-01-15

Statins have proven efficacy in the reduction of cardiovascular events, but the financial impact of its widespread use can be substantial. To conduct a cost-effectiveness analysis of three statin dosing schemes in the Brazilian Unified National Health System (SUS) perspective. We developed a Markov model to evaluate the incremental cost-effectiveness ratios (ICERs) of low, intermediate and high intensity dose regimens in secondary and four primary scenarios (5%, 10%, 15% and 20% ten-year risk) of prevention of cardiovascular events. Regimens with expected low-density lipoprotein cholesterol reduction below 30% (e.g. simvastatin 10mg) were considered as low dose; between 30-40%, (atorvastatin 10mg, simvastatin 40mg), intermediate dose; and above 40% (atorvastatin 20-80mg, rosuvastatin 20mg), high-dose statins. Effectiveness data were obtained from a systematic review with 136,000 patients. National data were used to estimate utilities and costs (expressed as International Dollars - Int$). A willingness-to-pay (WTP) threshold equal to the Brazilian gross domestic product per capita (circa Int$11,770) was applied. Low dose was dominated by extension in the primary prevention scenarios. In the five scenarios, the ICER of intermediate dose was below Int$10,000 per QALY. The ICER of the high versus intermediate dose comparison was above Int$27,000 per QALY in all scenarios. In the cost-effectiveness acceptability curves, intermediate dose had a probability above 50% of being cost-effective with ICERs between Int$ 9,000-20,000 per QALY in all scenarios. Considering a reasonable WTP threshold, intermediate dose statin therapy is economically attractive, and should be a priority intervention in prevention of cardiovascular events in Brazil.

Efficacy of standard and intensive statin treatment for the secondary prevention of cardiovascular and cerebrovascular events in diabetes patients : A meta-analysis

NARCIS (Netherlands)

De Vries, Folgerdiena M.; Kolthof, Johan; Postma, Maarten J.; Denig, Petra; Hak, Eelko

2014-01-01

Aims: To estimate the efficacy of standard and intensive statin treatment in the secondary prevention of major cardiovascular and cerebrovascular events in diabetes patients. Methods: A systematic search was conducted in Medline over the years 1990 to September 2013. Randomized, double-blind,

Design and Rationale of the Intima-Medial Thickness Sub-Study of the PreventIon of CArdiovascular Events in iSchemic Stroke Patients with High Risk of Cerebral hemOrrhage (PICASSO-IMT) Study.

Science.gov (United States)

Seo, Woo-Keun; Kim, Yong Jae; Lee, Juneyoung; Kwon, Sun U

2017-09-01

Atherosclerosis is one of the main mechanisms of stroke and cardiovascular diseases and is associated with increased risk of recurrent stroke and cardiovascular events. Intima-medial thickness (IMT) is a well-known surrogate marker of atherosclerosis and has been used to predict stroke and cardiovascular events. However, the clinical significance of IMT and IMT change in stroke has not been investigated in well-designed studies. The PreventIon of CArdiovascular events in iSchemic Stroke patients with high risk of cerebral hemOrrhage-Intima-Media Thickness (PICASSO-IMT) sub-study is designed to investigate the effects of cilostazol, probucol, or both on IMT in patients with stroke. PICASSO-IMT is a prospective sub-study of the PICASSO study designed to measure IMT and plaque score at 1, 13, 25, 37, and 49 months after randomization. The primary outcome is the change in mean carotid IMT, which is defined as the mean of the far-wall IMTs of the right and left common carotid arteries, between baseline and 13 months after randomization. PICASSO-IMT will provide the largest IMT data set in a stroke population and will provide valuable information about the clinical significance of IMT in patients with ischemic stroke. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Event heap: a coordination infrastructure for dynamic heterogeneous application interactions in ubiquitous computing environments

Science.gov (United States)

Johanson, Bradley E.; Fox, Armando; Winograd, Terry A.; Hanrahan, Patrick M.

2010-04-20

An efficient and adaptive middleware infrastructure called the Event Heap system dynamically coordinates application interactions and communications in a ubiquitous computing environment, e.g., an interactive workspace, having heterogeneous software applications running on various machines and devices across different platforms. Applications exchange events via the Event Heap. Each event is characterized by a set of unordered, named fields. Events are routed by matching certain attributes in the fields. The source and target versions of each field are automatically set when an event is posted or used as a template. The Event Heap system implements a unique combination of features, both intrinsic to tuplespaces and specific to the Event Heap, including content based addressing, support for routing patterns, standard routing fields, limited data persistence, query persistence/registration, transparent communication, self-description, flexible typing, logical/physical centralization, portable client API, at most once per source first-in-first-out ordering, and modular restartability.

Development, optimization, and single laboratory validation of an event-specific real-time PCR method for the detection and quantification of Golden Rice 2 using a novel taxon-specific assay.

Science.gov (United States)

Jacchia, Sara; Nardini, Elena; Savini, Christian; Petrillo, Mauro; Angers-Loustau, Alexandre; Shim, Jung-Hyun; Trijatmiko, Kurniawan; Kreysa, Joachim; Mazzara, Marco

2015-02-18

In this study, we developed, optimized, and in-house validated a real-time PCR method for the event-specific detection and quantification of Golden Rice 2, a genetically modified rice with provitamin A in the grain. We optimized and evaluated the performance of the taxon (targeting rice Phospholipase D α2 gene)- and event (targeting the 3' insert-to-plant DNA junction)-specific assays that compose the method as independent modules, using haploid genome equivalents as unit of measurement. We verified the specificity of the two real-time PCR assays and determined their dynamic range, limit of quantification, limit of detection, and robustness. We also confirmed that the taxon-specific DNA sequence is present in single copy in the rice genome and verified its stability of amplification across 132 rice varieties. A relative quantification experiment evidenced the correct performance of the two assays when used in combination.

Event-Based User Classification in Weibo Media

Directory of Open Access Journals (Sweden)

Liang Guo

2014-01-01

Full Text Available Weibo media, known as the real-time microblogging services, has attracted massive attention and support from social network users. Weibo platform offers an opportunity for people to access information and changes the way people acquire and disseminate information significantly. Meanwhile, it enables people to respond to the social events in a more convenient way. Much of the information in Weibo media is related to some events. Users who post different contents, and exert different behavior or attitude may lead to different contribution to the specific event. Therefore, classifying the large amount of uncategorized social circles generated in Weibo media automatically from the perspective of events has been a promising task. Under this circumstance, in order to effectively organize and manage the huge amounts of users, thereby further managing their contents, we address the task of user classification in a more granular, event-based approach in this paper. By analyzing real data collected from Sina Weibo, we investigate the Weibo properties and utilize both content information and social network information to classify the numerous users into four primary groups: celebrities, organizations/media accounts, grassroots stars, and ordinary individuals. The experiments results show that our method identifies the user categories accurately.

[Adverse events management. Methods and results of a development project].

Science.gov (United States)

Rabøl, Louise Isager; Jensen, Elisabeth Brøgger; Hellebek, Annemarie H; Pedersen, Beth Lilja

2006-11-27

This article describes the methods and results of a project in the Copenhagen Hospital Corporation (H:S) on preventing adverse events. The aim of the project was to raise awareness about patients' safety, test a reporting system for adverse events, develop and test methods of analysis of events and propagate ideas about how to prevent adverse events. H:S developed an action plan and a reporting system for adverse events, founded an organization and developed an educational program on theories and methods of learning from adverse events for both leaders and employees. During the three-year period from 1 January 2002 to 31 December 2004, the H:S staff reported 6011 adverse events. In the same period, the organization completed 92 root cause analyses. More than half of these dealt with events that had been optional to report, the other half events that had been mandatory to report. The number of reports and the front-line staff's attitude towards reporting shows that the H:S succeeded in founding a safety culture. Future work should be centred on developing and testing methods that will prevent adverse events from happening. The objective is to suggest and complete preventive initiatives which will help increase patient safety.

Fatigue during treatment with antiepileptic drugs: A levetiracetam-specific adverse event?

Science.gov (United States)

Mula, Marco; von Oertzen, Tim J; Cock, Hannah R; Yogarajah, Mahinda; Lozsadi, Dora A; Agrawal, Niruj

2017-07-01

To examine the prevalence and clinical correlates of fatigue as an adverse event (AE) of antiepileptic drug (AED) treatment in patients with epilepsy. Data from 443 adult outpatients with epilepsy assessed with the Adverse Event Profile (AEP) and the Neurological Disorder Depression Inventory for Epilepsy (NDDIE) were analysed. Fatigue is reported by 36.6% of patients as always a problem during AED treatment. Fatigue is more likely to be reported by females (64.8% vs. 35.2%; Chi-Square=16.762; df=3; p=0.001) and during treatment with levetiracetam (42.3% vs. 33.2%; Chi-Square=11.462; df=3; p=0.009). The associations with the female gender and levetiracetam treatment were not mediated by depression, as identified with the NDDIE, and could not be simply explained by the large number of subjects on levetiracetam treatment, as analogous figures resulted from the analysis of a monotherapy subsample (41.7% vs. 30.3%; Chi-Square=11.547; df=3; p=0.009). One third of patients with epilepsy reports fatigue as a significant problem during AED treatment. Fatigue is more likely to be reported by females and seems to be specifically associated with LEV treatment. However, fatigue is not mediated by a negative effect of LEV on mood. Copyright © 2017 Elsevier Inc. All rights reserved.

Development and evaluation of event-specific quantitative PCR method for genetically modified soybean A2704-12.

Science.gov (United States)

Takabatake, Reona; Akiyama, Hiroshi; Sakata, Kozue; Onishi, Mari; Koiwa, Tomohiro; Futo, Satoshi; Minegishi, Yasutaka; Teshima, Reiko; Mano, Junichi; Furui, Satoshi; Kitta, Kazumi

2011-01-01

A novel real-time PCR-based analytical method was developed for the event-specific quantification of a genetically modified (GM) soybean event; A2704-12. During the plant transformation, DNA fragments derived from pUC19 plasmid were integrated in A2704-12, and the region was found to be A2704-12 specific. The pUC19-derived DNA sequences were used as primers for the specific detection of A2704-12. We first tried to construct a standard plasmid for A2704-12 quantification using pUC19. However, non-specific signals appeared with both qualitative and quantitative PCR analyses using the specific primers with pUC19 as a template, and we then constructed a plasmid using pBR322. The conversion factor (C(f)), which is required to calculate the amount of the genetically modified organism (GMO), was experimentally determined with two real-time PCR instruments, the Applied Biosystems 7900HT and the Applied Biosystems 7500. The determined C(f) values were both 0.98. The quantitative method was evaluated by means of blind tests in multi-laboratory trials using the two real-time PCR instruments. The limit of quantitation for the method was estimated to be 0.1%. The trueness and precision were evaluated as the bias and reproducibility of relative standard deviation (RSD(R)), and the determined bias and RSD(R) values for the method were each less than 20%. These results suggest that the developed method would be suitable for practical analyses for the detection and quantification of A2704-12.

Eating and weight/shape criticism as a specific life-event related to bulimia nervosa: a case control study.

Science.gov (United States)

Gonçalves, Sonia Ferreira; Machado, Bárbara César; Martins, Carla

2014-01-01

The present study aims to evaluate the occurrence of life events preceding the onset of eating problems in bulimia nervosa patients. A case-control design was used involving the comparison of 60 female subjects who meet DSM-IV criteria for bulimia nervosa with 60 healthy control subjects and 60 subjects with other psychiatric disorders. The RFI (Fairburn et al., 1998) subset of factors that represent exposure to life events in the 12 months immediately before the development of eating problems was used. Women with bulimia nervosa reported higher rates of major stress, criticism about eating, weight and shape and also a great number of antecedent life events during the year preceding the development of eating problems than the healthy control group. However, when compared with the general psychiatric control group only the exposure to critical comments about weight, shape, or eating emerged as a specific trigger for bulimia nervosa. Our findings support the fact that eating and shape/weight criticism in the year preceding the development of eating disturbance seems to be specifically related to bulimia nervosa.

Psychological aspects of idiopathic scoliosis: the specificity of the mother-daughter relationship

Directory of Open Access Journals (Sweden)

Galina V. Pyatakova

2016-12-01

Conclusion: General and specific characteristics of the mother-daughter relationship in families of adolescent girls with idiopathic scoliosis and families of healthy adolescent girls were revealed. In the context of complex surgical treatment, preventive measures are necessary to address psychological difficulties in adolescent patients with idiopathic scoliosis.

Effectiveness of HIV prevention for women: What is working?

OpenAIRE

Gil Llario, María Dolores; Ballester Arnal, Rafael; Giménez García, Cristina; Salmerón Sánchez, Pedro

2014-01-01

The HIV-AIDS remains a public health prob- lem which disproportionally affects women. However, prevention strategies have rarely considered their specific efficacy for them. For this reason, this study examines the differential effectiveness of six intervention elements based on socio-cognitive theories addressing young women. A controlled between-groups design examined the change in risk profile among 167 young Spanish women (mean age ...

Male Circumcision for HIV Prevention in South Africa: Addressing HIV and Gender Relations

OpenAIRE

Fischer-Nielsen, Sara; Møller, Sabrah

2011-01-01

The thesis scrutinizes how gender relations and women’s and men’s control of sexual health are influenced by the intervention of male circumcision for HIV prevention in South Africa. The analytical framework combines the theory of therapeutic citizenship, post-development theory and gender theory. We argue that the individual man’s choice to circumcise is being challenged by international HIV prevention methods emphasizing men’s responsibility in HIV prevention. In South Africa, current chang...

Patterns in neurosurgical adverse events: endovascular neurosurgery.

Science.gov (United States)

Wong, Judith M; Ziewacz, John E; Panchmatia, Jaykar R; Bader, Angela M; Pandey, Aditya S; Thompson, B Gregory; Frerichs, Kai; Gawande, Atul A

2012-11-01

As part of a project to devise evidence-based safety interventions for specialty surgery, the authors sought to review current evidence in endovascular neurosurgery concerning the frequency of adverse events in practice, their patterns, and current methods of reducing the occurrence of these events. This review represents part of a series of papers written to consolidate information about these events and preventive measures as part of an ongoing effort to ascertain the utility of devising system-wide policies and safety tools to improve neurosurgical practice. Based on a review of the literature, thromboembolic events appeared to be the most common adverse events in endovascular neurosurgery, with a reported incidence ranging from 2% to 61% depending on aneurysm rupture status and mode of detection of the event. Intraprocedural and periprocedural prevention and rescue regimens are advocated to minimize this risk; however, evidence on the optimal use of anticoagulant and antithrombotic agents is limited. Furthermore, it is unknown what proportion of eligible patients receive any prophylactic treatment. Groin-site hematoma is the most common access-related complication. Data from the cardiac literature indicate an overall incidence of 9% to 32%, but data specific to neuroendovascular therapy are scant. Manual compression, compression adjuncts, and closure devices are used with varying rates of success, but no standardized protocols have been tested on a broad scale. Contrast-induced nephropathy is one of the more common causes of hospital-acquired renal insufficiency, with an incidence of 30% in high-risk patients after contrast administration. Evidence from medical fields supports the use of various preventive strategies. Intraprocedural vessel rupture is infrequent, with the reported incidence ranging from 1% to 9%, but it is potentially devastating. Improvements in device technology combined with proper endovascular technique play an important role in reducing

Road Map to Address Cognitive Health

Centers for Disease Control (CDC) Podcasts

2014-06-09

In this podcast, CDC’s Dr. Lynda Anderson highlights the important roles that states and communities can play in addressing cognitive health as part of overall health.  Created: 6/9/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 6/9/2014.

Specific depletion of Ly6C(hi) inflammatory monocytes prevents immunopathology in experimental cerebral malaria.

Science.gov (United States)

Schumak, Beatrix; Klocke, Katrin; Kuepper, Janina M; Biswas, Aindrila; Djie-Maletz, Andrea; Limmer, Andreas; van Rooijen, Nico; Mack, Matthias; Hoerauf, Achim; Dunay, Ildiko Rita

2015-01-01

Plasmodium berghei ANKA (PbA) infection of C57BL/6 mice leads to experimental cerebral malaria (ECM) that is commonly associated with serious T cell mediated damage. In other parasitic infection models, inflammatory monocytes have been shown to regulate Th1 responses but their role in ECM remains poorly defined, whereas neutrophils are reported to contribute to ECM immune pathology. Making use of the recent development of specific monoclonal antibodies (mAb), we depleted in vivo Ly6C(hi) inflammatory monocytes (by anti-CCR2), Ly6G+ neutrophils (by anti-Ly6G) or both cell types (by anti-Gr1) during infection with Ovalbumin-transgenic PbA parasites (PbTg). Notably, the application of anti-Gr1 or anti-CCR2 but not anti-Ly6G antibodies into PbTg-infected mice prevented ECM development. In addition, depletion of Ly6C(hi) inflammatory monocytes but not neutrophils led to decreased IFNγ levels and IFNγ+CD8+ T effector cells in the brain. Importantly, anti-CCR2 mAb injection did not prevent the generation of PbTg-specific T cell responses in the periphery, whereas anti-Gr1 mAb injection strongly diminished T cell frequencies and CTL responses. In conclusion, the specific depletion of Ly6C(hi) inflammatory monocytes attenuated brain inflammation and immune cell recruitment to the CNS, which prevented ECM following Plasmodium infection, pointing out a substantial role of Ly6C+ monocytes in ECM inflammatory processes.

ENGINEERED BARRIER SYSTEM FEATURES, EVENTS AND PROCESSES

Energy Technology Data Exchange (ETDEWEB)

Jaros, W.

2005-08-30

The purpose of this report is to evaluate and document the inclusion or exclusion of engineered barrier system (EBS) features, events, and processes (FEPs) with respect to models and analyses used to support the total system performance assessment for the license application (TSPA-LA). A screening decision, either Included or Excluded, is given for each FEP along with the technical basis for exclusion screening decisions. This information is required by the U.S. Nuclear Regulatory Commission (NRC) at 10 CFR 63.114 (d, e, and f) [DIRS 173273]. The FEPs addressed in this report deal with those features, events, and processes relevant to the EBS focusing mainly on those components and conditions exterior to the waste package and within the rock mass surrounding emplacement drifts. The components of the EBS are the drip shield, waste package, waste form, cladding, emplacement pallet, emplacement drift excavated opening (also referred to as drift opening in this report), and invert. FEPs specific to the waste package, cladding, and drip shield are addressed in separate FEP reports: for example, ''Screening of Features, Events, and Processes in Drip Shield and Waste Package Degradation'' (BSC 2005 [DIRS 174995]), ''Clad Degradation--FEPs Screening Arguments (BSC 2004 [DIRS 170019]), and Waste-Form Features, Events, and Processes'' (BSC 2004 [DIRS 170020]). For included FEPs, this report summarizes the implementation of the FEP in the TSPA-LA (i.e., how the FEP is included). For excluded FEPs, this analysis provides the technical basis for exclusion from TSPA-LA (i.e., why the FEP is excluded). This report also documents changes to the EBS FEPs list that have occurred since the previous versions of this report. These changes have resulted due to a reevaluation of the FEPs for TSPA-LA as identified in Section 1.2 of this report and described in more detail in Section 6.1.1. This revision addresses updates in Yucca Mountain Project

The impact of different emotional states on the memory for what, where and when features of specific events.

Science.gov (United States)

Zlomuzica, Armin; Preusser, Friederike; Totzeck, Christina; Dere, Ekrem; Margraf, Jürgen

2016-02-01

Emotions can modulate the encoding and recollection of personal events. In the present study, we investigated the effects of different emotional states (pleasant, neutral or anxious) on episodic memory formation in a virtual reality (VR) setting. Emotional states were induced by pleasant, neutral or anxiety-inducing movie clips prior to the presentation of specific events in a VR scenario. Episodic memory performance of healthy participants in whom an anxious emotional state had been induced was inferior to those of the neutral and pleasant conditions. In the anxious condition, participants were particularly impaired regarding their memory for the location of events. A correlational analysis indicated that high levels of negative arousal were associated with poor memory for the temporal and spatial context of events. In contrast, high levels of happiness were associated with better memory for the spatial context of events. Our data provide evidence that emotional arousal can modulate memory for what happened, where and when. Copyright © 2015. Published by Elsevier B.V.

Economic optimization of a global strategy to address the pandemic threat.

Science.gov (United States)

Pike, Jamison; Bogich, Tiffany; Elwood, Sarah; Finnoff, David C; Daszak, Peter

2014-12-30

Emerging pandemics threaten global health and economies and are increasing in frequency. Globally coordinated strategies to combat pandemics, similar to current strategies that address climate change, are largely adaptive, in that they attempt to reduce the impact of a pathogen after it has emerged. However, like climate change, mitigation strategies have been developed that include programs to reduce the underlying drivers of pandemics, particularly animal-to-human disease transmission. Here, we use real options economic modeling of current globally coordinated adaptation strategies for pandemic prevention. We show that they would be optimally implemented within 27 y to reduce the annual rise of emerging infectious disease events by 50% at an estimated one-time cost of approximately $343.7 billion. We then analyze World Bank data on multilateral "One Health" pandemic mitigation programs. We find that, because most pandemics have animal origins, mitigation is a more cost-effective policy than business-as-usual adaptation programs, saving between $344.0.7 billion and $360.3 billion over the next 100 y if implemented today. We conclude that globally coordinated pandemic prevention policies need to be enacted urgently to be optimally effective and that strategies to mitigate pandemics by reducing the impact of their underlying drivers are likely to be more effective than business as usual.

Addressing Sexual Violence as Student Affairs Work

Science.gov (United States)

Landreman, Lisa M.; Williamsen, Kaaren M.

2018-01-01

In this chapter, we outline the challenges campuses face in addressing sexual violence and Title IX compliance. We argue that there are critical roles for student affairs professionals in Title IX work in developing effective campus sexual violence prevention and response strategies.

Software for security event management: Development and utilization

Directory of Open Access Journals (Sweden)

Aleksandr V. Kuznetcov

2017-11-01

Full Text Available We address the challenge to the information security coming from the lack of algorithmic machinery for managing the security events. We start with a mathematical formulation of the problem for a tabular processor by introducing an appropriate target function. Details of corresponding algorithm can be found by following the provided links. We describe our original software module that implements the algorithm for determining the registered security events. The module is based on the tabular processor certified by the Russian Federal Service for Technical and Export Control. We present a control sample for testing the developed module. The sample has the dimension 30x20 and contains 14 choices for threshold values of security events number. The results of the tests comply with the specified boundary conditions and demonstrate a nonlinear dependence of the objective function on the number of registered security events, as well as a nonlinear dependence of the percentage of the detected security event on the total initial number of security events to be registered at the event source. The performance of the module specifically, the central processing unit usage is found acceptable (not exceeding 33%, which allows one to use the software for typical automated workplaces equipped with appropriate tabular processors. Our approach is universal with respect to the application areas.

Addressing female genital mutilation in Europe: a scoping review of approaches to participation, prevention, protection, and provision of services.

Science.gov (United States)

Baillot, Helen; Murray, Nina; Connelly, Elaine; Howard, Natasha

2018-02-08

Public and policy attention to female genital mutilation (FGM) in diaspora communities has increased in Europe, but research remains limited and misinformation abounds. As a first step to addressing these issues, this study explored FGM prevention and response interventions in Europe, using a scoping literature review and key informant interviews. A scoping study design was selected, using Arksey and O'Malley's six-stage scoping framework to review identified sources. Key informant interviews were used to inform and add depth to literature findings. Findings were summarised thematically, guided by the Scottish Government's '4Ps' framework for tackling violence against women (i.e. participation, prevention, protection, providing services). Seventy literature sources, of 1095 screened, plus 16 individual and 3 group interview sources were included. Several countries have developed promising interventions supporting FGM resistance and recovery. However, gaps remain including community participation, professional knowledge and linkages, and evaluation of approaches. This scoping review is an initial attempt to describe available primary evidence on European initiatives responding to FGM. Further research is required to determine whether interventions are effective, while policy and practice development must be shaped and driven by the experiences, needs, and views of affected communities.

Cost-Effectiveness of High, Moderate and Low-Dose Statins in the Prevention of Vascular Events in the Brazilian Public Health System

Directory of Open Access Journals (Sweden)

Rodrigo Antonini Ribeiro

2015-01-01

Full Text Available Background: Statins have proven efficacy in the reduction of cardiovascular events, but the financial impact of its widespread use can be substantial. Objective: To conduct a cost-effectiveness analysis of three statin dosing schemes in the Brazilian Unified National Health System (SUS perspective. Methods: We developed a Markov model to evaluate the incremental cost-effectiveness ratios (ICERs of low, intermediate and high intensity dose regimens in secondary and four primary scenarios (5%, 10%, 15% and 20% ten-year risk of prevention of cardiovascular events. Regimens with expected low-density lipoprotein cholesterol reduction below 30% (e.g. simvastatin 10mg were considered as low dose; between 30-40%, (atorvastatin 10mg, simvastatin 40mg, intermediate dose; and above 40% (atorvastatin 20-80mg, rosuvastatin 20mg, high-dose statins. Effectiveness data were obtained from a systematic review with 136,000 patients. National data were used to estimate utilities and costs (expressed as International Dollars - Int$. A willingness-to-pay (WTP threshold equal to the Brazilian gross domestic product per capita (circa Int$11,770 was applied. Results: Low dose was dominated by extension in the primary prevention scenarios. In the five scenarios, the ICER of intermediate dose was below Int$10,000 per QALY. The ICER of the high versus intermediate dose comparison was above Int$27,000 per QALY in all scenarios. In the cost-effectiveness acceptability curves, intermediate dose had a probability above 50% of being cost-effective with ICERs between Int$ 9,000-20,000 per QALY in all scenarios. Conclusions: Considering a reasonable WTP threshold, intermediate dose statin therapy is economically attractive, and should be a priority intervention in prevention of cardiovascular events in Brazil.

15 CFR 291.4 - National industry-specific pollution prevention and environmental compliance resource centers.

Science.gov (United States)

2010-01-01

... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false National industry-specific pollution prevention and environmental compliance resource centers. 291.4 Section 291.4 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NIST EXTRAMURAL PROGRAM...

Preventing and Addressing Challenging Behavior: Common Questions and Practical Strategies

Science.gov (United States)

Hemmeter, Mary Louise; Ostrosky, Michaelene M.; Corso, Robert M.

2012-01-01

The purpose of this article is to offer preschool teachers strategies for preventing challenging behavior and supporting the development of social skills and emotional competencies. This article is framed in a question and answer format using questions from teachers who the authors have worked with in the past. These questions and strategies are…

Convocation address.

Science.gov (United States)

Swaminathan, M S

1998-07-01

This address delivered to the 40th convocation of the International Institute for Population Sciences in India in 1998 opens by noting that a shortage of jobs for youth is India's most urgent problem but that the problems that attend the increasing numbers of elderly also require serious attention. The address then notes that the Earth's population is growing at an unsustainable rate while economic inequities among countries are increasing, so that, while intellectual property is becoming the most important asset in developed countries, nutritional anemia among pregnant women causes their offspring to be unable to achieve their full intellectual potential from birth. Next, the address uses a discussion of the 18th-century work on population of the Marquis de Condorcet and of Thomas Malthus to lead into a consideration of estimated increased needs of countries like India and China to import food grains in the near future. Next, the progress of demographic transition in Indian states is covered and applied to Mahbub ul Haq's measure of human deprivation developed for and applied to the region of the South Asian Association for Regional Cooperation (India, Pakistan, Bangladesh, Nepal, Sri Lanka, Bhutan, and the Maldives). The address continues by reiterating some of the major recommendations forwarded by a government of India committee charged in 1995 with drafting a national population policy. Finally, the address suggests specific actions that could be important components of the Hunger-Free India Programme and concludes that all success rests on the successful implementation of appropriate population policies.

The development and implementation of theory-driven programs capable of addressing poverty-impacted children's health, mental health, and prevention needs: CHAMP and CHAMP+, evidence-informed, family-based interventions to address HIV risk and care.

Science.gov (United States)

McKernan McKay, Mary; Alicea, Stacey; Elwyn, Laura; McClain, Zachary R B; Parker, Gary; Small, Latoya A; Mellins, Claude Ann

2014-01-01

This article describes a program of prevention and intervention research conducted by the CHAMP (Collaborative HIV prevention and Adolescent Mental health Project; McKay & Paikoff, 2007 ) investigative team. CHAMP refers to a set of theory-driven, evidence-informed, collaboratively designed, family-based approaches meant to address the prevention, health, and mental health needs of poverty-impacted African American and Latino urban youth who are either at risk for HIV exposure or perinatally infected and at high risk for reinfection and possible transmission. CHAMP approaches are informed by theoretical frameworks that incorporate an understanding of the critical influences of multilevel contextual factors on youth risk taking and engagement in protective health behaviors. Highly influential theories include the triadic theory of influence, social action theory, and ecological developmental perspectives. CHAMP program delivery strategies were developed via a highly collaborative process drawing upon community-based participatory research methods in order to enhance cultural and contextual sensitivity of program content and format. The development and preliminary outcomes associated with a family-based intervention for a new population, perinatally HIV-infected youth and their adult caregivers, referred to as CHAMP+, is described to illustrate the integration of theory, existing evidence, and intensive input from consumers and healthcare providers.

Cost-effectiveness of aspirin treatment in the primary prevention of cardiovascular disease events in subgroups based on age, gender, and varying cardiovascular risk

NARCIS (Netherlands)

Greving, Jacoba P.; Buskens, Erik; Koffijberg, Hendrik; Algra, Ale

2008-01-01

BACKGROUND - Aspirin is effective for the primary prevention of cardiovascular events, but it remains unclear for which subgroups of individuals aspirin is beneficial. We assessed the cost-effectiveness of aspirin separately for men and women of different ages with various levels of cardiovascular

Cost-effectiveness of aspirin treatment in the primary prevention of cardiovascular disease events in subgroups based on age, gender, and varying cardiovascular risk

NARCIS (Netherlands)

Greving, J.P.; Buskens, E.; Koffijberg, H.; Algra, A.

2008-01-01

Background-Aspirin is effective for the primary prevention of cardiovascular events, but it remains unclear for which subgroups of individuals aspirin is beneficial. We assessed the cost-effectiveness of aspirin separately for men and women of different ages with various levels of cardiovascular

Addressing submarine geohazards through scientific drilling

Science.gov (United States)

Camerlenghi, A.

2009-04-01

eruptions, earthquakes and the associated tsunamis can lead to destruction of seafloor structures potentially capable of releasing hydrocarbon pollutants into Mediterranean waters, and damage to a dense telecommunication cables net that would cause severe economic loss. However, the most devastating effect would be that of earthquake or landslide-induced tsunamis. When compared to other basins, the Mediterranean has larger vulnerability due to its small dimensions, resulting in close proximity to tsunami sources and impact areas. Recent examples include the 1979 Nice airport submarine landslide and tsunami and the 2002 Stromboli volcano landslide and tsunami. Future international scientific drilling must include submarine geohazards among priority scientific objectives. The science advisory structure must be prepared to receive and evaluate proposal specifically addressing submarine geohazards. The implementing organizations need to be prepared for the technological needs of drilling proposals addressing geohazards. Among the most relevant: geotechnical sampling, down-hole logging at shallow depths below the seafloor, in situ geotechnical and physical measurements, capability of deployment of long-term in situ observatories. Pre-site surveys will often aim at the highest possible resolution, three dimensional imaging of the seafloor ant its sub-surface. Drilling for submarine geohazards is seen as an opportunity of multiplatform drilling, and for Mission Specific drilling in particular. Rather than turning the scientific investigation in a purely engineering exercise, proposals addressing submarine geohazards should offer an opportunity to scientists and engineers to work together to unravel the details of basic geological processes that may turn into catastrophic events.

Public Health Models for Preventing Child Maltreatment: Applications From the Field of Injury Prevention.

Science.gov (United States)

Scott, Debbie; Lonne, Bob; Higgins, Daryl

2016-10-01

Contemporary approaches to child protection are dominated by individualized forensically focused interventions that provide limited scope for more holistic preventative responses to children at risk and the provision of support to struggling families and communities. However, in many jurisdictions, it is frequently shown, often through public inquiries and program reviews, that investigatory and removal approaches are failing in critically important ways, particularly regarding reducing the inequities that underpin neglect and abuse. Consequently, there have been increasing calls for a public health model for the protection of children, although there is often a lack of clarity as to what exactly this should entail. Yet, there are opportunities to learn from public health approaches successfully used in the field of injury prevention. Specifically, we advocate for the use of Haddon's Matrix, which provides a detailed theoretical and practical framework for the application of a comprehensive and integrated public health model to guide intervention program design and responses to child protection risk factors. A broad overview of the application of Haddon's Matrix's principles and methods is provided with examples of program and intervention design. It is argued that this framework provides the range of interventions necessary to address the complex social and structural factors contributing to inequity and the maltreatment of children. It also provides the foundation for a holistic and integrated system of prevention and intervention to contribute to system-level change and address child maltreatment. © The Author(s) 2016.

Programmatic Considerations to Reduce the Risk of Adverse Renal Stone Events in Spaceflight

Science.gov (United States)

Antonsen, Erik; Pietrzyk, Robert

2017-01-01

Introduction: Microgravity exposure may alter the likelihood that astronauts will experience renal stones. The potential risk includes both acute and chronic health issues, with the potential for significant impact on mission objectives. Methods: To understand the role of the NASA's Human Research Program (HRP) research agenda in both preventing and addressing renal stones in spaceflight, current astronaut epidemiologic data and a summary of programmatic considerations are reviewed. Results: Although there has never been a symptomatic renal stone event in a U.S. crewmember during spaceflight, urine chemistry has been altered - likely due to induced changes in renal physiology as a result of exposure to microgravity. This may predispose astronauts to stone formation, leading the HRP to conduct and sponsor research to: 1) understand the risk of stone formation in space; 2) prevent stones from forming; and 3) address stones that may form by providing novel diagnostic and therapeutic approaches. Discussion: The development of a renal stone during spaceflight is a significant medical concern that requires the HRP to minimize this risk by providing the ability to prevent, diagnose, monitor and treat the condition during spaceflight. A discussion of the risk as NASA understands it is followed by an overview of the multiple mitigations currently under study, including novel ultrasound techniques for stone detection and manipulation, and how they may function as part of a larger exploration medical system.

The design of the SAFE or SORRY? study: a cluster randomised trial on the development and testing of an evidence based inpatient safety program for the prevention of adverse events

Directory of Open Access Journals (Sweden)

Koopmans Raymond TCM

2009-04-01

Full Text Available Abstract Background Patients in hospitals and nursing homes are at risk of the development of, often preventable, adverse events (AEs, which threaten patient safety. Guidelines for prevention of many types of AEs are available, however, compliance with these guidelines appears to be lacking. Besides general barriers that inhibit implementation, this non-compliance is associated with the large number of guidelines competing for attention. As implementation of a guideline is time-consuming, it is difficult for organisations to implement all available guidelines. Another problem is lack of feedback about performance using quality indicators of guideline based care and lack of a recognisable, unambiguous system for implementation. A program that allows organisations to implement multiple guidelines simultaneously may facilitate guideline use and thus improve patient safety. The aim of this study is to develop and test such an integral patient safety program that addresses several AEs simultaneously in hospitals and nursing homes. This paper reports the design of this study. Methods and design The patient safety program addresses three AEs: pressure ulcers, falls and urinary tract infections. It consists of bundles and outcome and process indicators based on the existing evidence based guidelines. In addition it includes a multifaceted tailored implementation strategy: education, patient involvement, and a computerized registration and feedback system. The patient safety program was tested in a cluster randomised trial on ten hospital wards and ten nursing home wards. The baseline period was three months followed by the implementation of the patient safety program for fourteen months. Subsequently the follow-up period was nine months. Primary outcome measure was the incidence of AEs on every ward. Secondary outcome measures were the utilization of preventive interventions and the knowledge of nurses regarding the three topics. Randomisation took

A Multifactorial Approach to Sport-Related Concussion Prevention and Education: Application of the Socioecological Framework.

Science.gov (United States)

Register-Mihalik, Johna; Baugh, Christine; Kroshus, Emily; Y Kerr, Zachary; Valovich McLeod, Tamara C

2017-03-01

To offer an overview of sport-related concussion (SRC) prevention and education strategies in the context of the socioecological framework (SEF). Athletic trainers (ATs) will understand the many factors that interact to influence SRC prevention and the implications of these interactions for effective SRC education. Concussion is a complex injury that is challenging to identify and manage, particularly when athletes fail to disclose symptoms to their health care providers. Education is 1 strategy for increasing disclosure. However, limited information addresses how ATs can integrate the many factors that may influence the effectiveness of SRC education into their specific settings. Public health models provide an example through the SEF, which highlights the interplay among various levels of society and sport that can facilitate SRC prevention strategies, including education. For ATs to develop appropriate SRC prevention strategies, a framework for application is needed. A growing body of information concerning SRC prevention indicates that knowledge alone is insufficient to change concussion-related behaviors. The SEF allows this information to be considered at levels such as policy and societal, community, interpersonal (relationships), and intrapersonal (athlete). The use of such a framework will facilitate more comprehensive SRC prevention efforts that can be applied in all athletic training practice settings. Clinical Applications: Athletic trainers can use this information as they plan SRC prevention strategies in their specific settings. This approach will aid in addressing the layers of complexity that exist when developing a concussion-management policy and plan.

Specific depletion of Ly6C(hi inflammatory monocytes prevents immunopathology in experimental cerebral malaria.

Directory of Open Access Journals (Sweden)

Beatrix Schumak

Full Text Available Plasmodium berghei ANKA (PbA infection of C57BL/6 mice leads to experimental cerebral malaria (ECM that is commonly associated with serious T cell mediated damage. In other parasitic infection models, inflammatory monocytes have been shown to regulate Th1 responses but their role in ECM remains poorly defined, whereas neutrophils are reported to contribute to ECM immune pathology. Making use of the recent development of specific monoclonal antibodies (mAb, we depleted in vivo Ly6C(hi inflammatory monocytes (by anti-CCR2, Ly6G+ neutrophils (by anti-Ly6G or both cell types (by anti-Gr1 during infection with Ovalbumin-transgenic PbA parasites (PbTg. Notably, the application of anti-Gr1 or anti-CCR2 but not anti-Ly6G antibodies into PbTg-infected mice prevented ECM development. In addition, depletion of Ly6C(hi inflammatory monocytes but not neutrophils led to decreased IFNγ levels and IFNγ+CD8+ T effector cells in the brain. Importantly, anti-CCR2 mAb injection did not prevent the generation of PbTg-specific T cell responses in the periphery, whereas anti-Gr1 mAb injection strongly diminished T cell frequencies and CTL responses. In conclusion, the specific depletion of Ly6C(hi inflammatory monocytes attenuated brain inflammation and immune cell recruitment to the CNS, which prevented ECM following Plasmodium infection, pointing out a substantial role of Ly6C+ monocytes in ECM inflammatory processes.

Event Boundaries in Memory and Cognition.

Science.gov (United States)

Radvansky, Gabriel A; Zacks, Jeffrey M

2017-10-01

Research on event cognition is rapidly developing and is revealing fundamental aspects of human cognition. In this paper, we review recent and current work that is driving this field forward. We first outline the Event Horizon Model, which broadly describes the impact of event boundaries on cognition and memory. Then, we address recent work on event segmentation, the role of event cognition in working memory and long-term memory, including event model updating, and long term retention. Throughout we also consider how event cognition varies across individuals and groups of people and consider the neural mechanisms involved.

A Review of Nutrition-Specific and Nutrition-Sensitive Approaches to Preventing Moderate Acute Malnutrition

International Nuclear Information System (INIS)

Mucha, Noreen; Jimenez, Michelle; Stone-Jimenez, Maryanne; Brown, Rebecca

2014-01-01

Full text: Recent literature reviews have demonstrated the limited efficacy of targeted supplementary feeding programmes aimed at both treating and preventing moderate acute malnutrition (MAM), with high rates of defaulting, low coverage and high associated costs. There is a growing interest in a) reviewing and improving protocols / tools for the management of acute malnutrition and b) increasing the quality and variety of products available for the treatment / prevention of moderate acute malnutrition. There is however, varying evidence on the impact of nutritional products aimed at preventing or treating acute malnutrition, or on the comparative efficacy of different products. Following several literature reviews and operational research with varying results, there is increasing consensus that MAM should be tackled not only through products, and that clearer guidance should be provided on broader preventive strategies, such as optimal infant and young child feeding (IYCF) and caregiving practices, optimal maternal nutrition, counselling, social protection, food security and livelihoods, and water, sanitation and hygiene (WASH). The CMAM Forum has commissioned Technical Briefs which aim to summarise current thinking and practice relating to preventive approaches to MAM, looking at the role of both nutrition-specific and nutrition-sensitive interventions. The work is being launched in January 2014 and results will be available for presentation at the IAEA MAM Symposium in May 2014. The briefs aim to provide: • An overview of approaches to preventing MAM across different sectors (e.g. agriculture, health, IYCF, social protection, water and sanitation) and in different contexts. • A review of current knowledge including: – Evidence from systematic and literature reviews. – Existing approaches and practice for prevention of MAM. – Current guidance on making programmatic choices relating to MAM prevention interventions and decision-making frameworks. �

Ionic liquids for addressing unmet needs in healthcare

Science.gov (United States)

Agatemor, Christian; Ibsen, Kelly N.; Tanner, Eden E. L.

2018-01-01

Abstract Advances in the field of ionic liquids have opened new applications beyond their traditional use as solvents into other fields especially healthcare. The broad chemical space, rich with structurally diverse ions, and coupled with the flexibility to form complementary ion pairs enables task‐specific optimization at the molecular level to design ionic liquids for envisioned functions. Consequently, ionic liquids now are tailored as innovative solutions to address many problems in medicine. To date, ionic liquids have been designed to promote dissolution of poorly soluble drugs and disrupt physiological barriers to transport drugs to targeted sites. Also, their antimicrobial activity has been demonstrated and could be exploited to prevent and treat infectious diseases. Metal‐containing ionic liquids have also been designed and offer unique features due to incorporation of metals. Here, we review application‐driven investigations of ionic liquids in medicine with respect to current status and future potential. PMID:29376130

Reducing the incidence of adverse events in anesthesia practice

OpenAIRE

BELAVIĆ, MATIJA; LONČARIĆ-KATUŠIN, MIRJANA; ŽUNIĆ, JOSIP

2013-01-01

Background and purpose: adverse event during anesthesia is defined as an event that may result in the development of complications and is caused by human error, failure of the apparatus, the selected anesthetic techniques and individual reaction of the patient. Timely detection of adverse events prevents complications and their analysis through the register of the same to the adoption of preventive and remedial measures. Materials and methods:The Department of Anesthesiology in General...

Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football

DEFF Research Database (Denmark)

Thorborg, Kristian; Krommes, Kasper Kühn; Esteve, Ernest

2017-01-01

Objective To investigate the effect of FIFA injury prevention programmes in football (FIFA 11 and FIFA 11+). Design Systematic review and meta-analysis. Eligibility criteria for selecting studies Randomised controlled trials comparing the FIFA injury prevention programmes with a control (no or sham...... intervention) among football players. Data sources MEDLINE via PubMed, EMBASE via OVID, CINAHL via Ebsco, Web of Science, SportDiscus and Cochrane Central Register of Controlled Trials, from 2004 to 14 March 2016. Results 6 cluster-randomised controlled trials had assessed the effect of FIFA injury prevention...... programmes compared with controls on the overall football injury incidence in recreational/subelite football. These studies included 2 specific exercise-based injury prevention programmes: FIFA 11 (2 studies) and FIFA 11+ (4 studies). The primary analysis showed a reduction in the overall injury risk ratio...

Probabilistic analysis of external events with focus on the Fukushima event

International Nuclear Information System (INIS)

Kollasko, Heiko; Jockenhoevel-Barttfeld, Mariana; Klapp, Ulrich

2014-01-01

External hazards are those natural or man-made hazards to a site and facilities that are originated externally to both the site and its processes, i.e. the duty holder may have very little or no control over the hazard. External hazards can have the potential of causing initiating events at the plant, typically transients like e.g., loss of offsite power. Simultaneously, external events may affect safety systems required to control the initiating event and, where applicable, also back-up systems implemented for risk-reduction. The plant safety may especially be threatened when loads from external hazards exceed the load assumptions considered in the design of safety-related systems, structures and components. Another potential threat is given by hazards inducing initiating events not considered in the safety demonstration otherwise. An example is loss of offsite power combined with prolonged plant isolation. Offsite support, e.g., delivery of diesel fuel oil, usually credited in the deterministic safety analysis may not be possible in this case. As the Fukushima events have shown, the biggest threat is likely given by hazards inducing both effects. Such hazards may well be dominant risk contributors even if their return period is very high. In order to identify relevant external hazards for a certain Nuclear Power Plant (NPP) location, a site specific screening analysis is performed, both for single events and for combinations of external events. As a result of the screening analysis, risk significant and therefore relevant (screened-in) single external events and combinations of them are identified for a site. The screened-in events are further considered in a detailed event tree analysis in the frame of the Probabilistic Safety Analysis (PSA) to calculate the core damage/large release frequency resulting from each relevant external event or from each relevant combination. Screening analyses of external events performed at AREVA are based on the approach provided

Clopidogrel plus aspirin versus aspirin alone for preventing cardiovascular events.

Science.gov (United States)

Squizzato, Alessandro; Bellesini, Marta; Takeda, Andrea; Middeldorp, Saskia; Donadini, Marco Paolo

2017-12-14

Aspirin is the prophylactic antiplatelet drug of choice for people with cardiovascular disease. Adding a second antiplatelet drug to aspirin may produce additional benefit for people at high risk and people with established cardiovascular disease. This is an update to a previously published review from 2011. To review the benefit and harm of adding clopidogrel to aspirin therapy for preventing cardiovascular events in people who have coronary disease, ischaemic cerebrovascular disease, peripheral arterial disease, or were at high risk of atherothrombotic disease, but did not have a coronary stent. We updated the searches of CENTRAL (2017, Issue 6), MEDLINE (Ovid, 1946 to 4 July 2017) and Embase (Ovid, 1947 to 3 July 2017) on 4 July 2017. We also searched ClinicalTrials.gov and the WHO ICTRP portal, and handsearched reference lists. We applied no language restrictions. We included all randomised controlled trials comparing over 30 days use of aspirin plus clopidogrel with aspirin plus placebo or aspirin alone in people with coronary disease, ischaemic cerebrovascular disease, peripheral arterial disease, or at high risk of atherothrombotic disease. We excluded studies including only people with coronary drug-eluting stent (DES) or non-DES, or both. We collected data on mortality from cardiovascular causes, all-cause mortality, fatal and non-fatal myocardial infarction, fatal and non-fatal ischaemic stroke, major and minor bleeding. The overall treatment effect was estimated by the pooled risk ratio (RR) with 95% confidence interval (CI), using a fixed-effect model (Mantel-Haenszel); we used a random-effects model in cases of moderate or severe heterogeneity (I 2 ≥ 30%). We assessed the quality of the evidence using the GRADE approach. We used GRADE profiler (GRADE Pro) to import data from Review Manager to create a 'Summary of findings' table. The search identified 13 studies in addition to the two studies in the previous version of our systematic review. Overall

Prevention of violence in prison - The role of health care professionals.

Science.gov (United States)

Pont, Jörg; Stöver, Heino; Gétaz, Laurent; Casillas, Alejandra; Wolff, Hans

2015-08-01

The World Health Organization (WHO) classifies violence prevention as a public health priority. In custodial settings, where violence is problematic, administrators and custodial officials are usually tasked with the duty of addressing this complicated issue-leaving health care professionals largely out of a discussion and problem-solving process that should ideally be multidisciplinary in approach. Health care professionals who care for prisoners are in a unique position to help identify and prevent violence, given their knowledge about health and violence, and because of the impartial position they must sustain in the prison environment in upholding professional ethics. Thus, health care professionals working in prisons should be charged with leading violence prevention efforts in custodial settings. In addition to screening for violence and detecting violent events upon prison admission, health care professionals in prison must work towards uniform in-house procedures for longitudinal and systemized medical recording/documentation of violence. These efforts will benefit the future planning, implementation, and evaluation of focused strategies for violence prevention in prisoner populations. Copyright © 2015. Published by Elsevier Ltd.

Joint Attributes and Event Analysis for Multimedia Event Detection.

Science.gov (United States)

Ma, Zhigang; Chang, Xiaojun; Xu, Zhongwen; Sebe, Nicu; Hauptmann, Alexander G

2017-06-15

Semantic attributes have been increasingly used the past few years for multimedia event detection (MED) with promising results. The motivation is that multimedia events generally consist of lower level components such as objects, scenes, and actions. By characterizing multimedia event videos with semantic attributes, one could exploit more informative cues for improved detection results. Much existing work obtains semantic attributes from images, which may be suboptimal for video analysis since these image-inferred attributes do not carry dynamic information that is essential for videos. To address this issue, we propose to learn semantic attributes from external videos using their semantic labels. We name them video attributes in this paper. In contrast with multimedia event videos, these external videos depict lower level contents such as objects, scenes, and actions. To harness video attributes, we propose an algorithm established on a correlation vector that correlates them to a target event. Consequently, we could incorporate video attributes latently as extra information into the event detector learnt from multimedia event videos in a joint framework. To validate our method, we perform experiments on the real-world large-scale TRECVID MED 2013 and 2014 data sets and compare our method with several state-of-the-art algorithms. The experiments show that our method is advantageous for MED.

Possible adverse events in children treated by manual therapy: a review

Directory of Open Access Journals (Sweden)

Humphreys B Kim

2010-06-01

patients undergoing manual therapy, particularly spinal manipulation report that mild to moderate adverse events are common and self limiting. However serious adverse events are rare and much less than for medication commonly prescribed for these problems. More high quality research specifically addressing adverse events and pediatric manual therapy is needed.

Multiloop Integral System Test (MIST): MIST Facility Functional Specification

International Nuclear Information System (INIS)

Habib, T.F.; Koksal, C.G.; Moskal, T.E.; Rush, G.C.; Gloudemans, J.R.

1991-04-01

The Multiloop Integral System Test (MIST) is part of a multiphase program started in 1983 to address small-break loss-of-coolant accidents (SBLOCAs) specific to Babcock and Wilcox designed plants. MIST is sponsored by the US Nuclear Regulatory Commission, the Babcock ampersand Wilcox Owners Group, the Electric Power Research Institute, and Babcock and Wilcox. The unique features of the Babcock and Wilcox design, specifically the hot leg U-bends and steam generators, prevented the use of existing integral system data or existing integral facilities to address the thermal-hydraulic SBLOCA questions. MIST was specifically designed and constructed for this program, and an existing facility -- the Once Through Integral System (OTIS) -- was also used. Data from MIST and OTIS are used to benchmark the adequacy of system codes, such as RELAP5 and TRAC, for predicting abnormal plant transients. The MIST Functional Specification documents as-built design features, dimensions, instrumentation, and test approach. It also presents the scaling basis for the facility and serves to define the scope of work for the facility design and construction. 13 refs., 112 figs., 38 tabs

Exercise for prevention of cardiovascular disease: Evidence-based recommendations

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Geevar Zachariah

2017-01-01

Full Text Available Sedentary lifestyle is one of the major risk factors for cardiovascular disease (CVD. In India, a large percentage of the people are physically inactive with fewer than 10% engaging in recreational physical activity. Physical activity has many beneficial effects on the risk factors for CVD. Apart from improving fitness level, it decreases myocardial oxygen demand and improves myocardial perfusion. There is an inverse association between physical activity and all-cause mortality. In primary prevention, physical inactivity is associated with a two-fold increase in the risk for coronary events. In secondary prevention, data confirm the existence of an inverse dose–response relationship between cardiovascular fitness and the all-cause mortality in large populations of cardiovascular patients. Guidelines from the American authorities as well as the European Society of Cardiology provide specific recommendations for exercise depending on the clinical setting (primary or secondary prevention of CVD and the patient-specific factors (the patient's physical activity level and the perceived CVD risk. The present review summarizes the clinical evidence regarding the role of exercise in CVD prevention and the exercise recommendations from the leading Cardiac societies.

Top event prevention analysis - a deterministic use of PRA

International Nuclear Information System (INIS)

Blanchard, D.P.; Worrell, R.B.

1995-01-01

Risk importance measures are popular for many applications of probabilistic analysis. Inherent in the derivation of risk importance measures are implicit assumptions that those using these numerical results should be aware of in their decision making. These assumptions and potential limitations include the following: (1) The risk importance measures are derived for a single event at a time and are therefore valid only if all other event probabilities are unchanged at their current values. (2) The results for which risk importance measures are derived may not be complete for reasons such as truncation

Quantification of risk considering external events on the change of allowed outage time and the preventive maintenance during power operation

Energy Technology Data Exchange (ETDEWEB)

Kang, D. J.; Kim, K. Y.; Yang, J. E

2001-03-01

In this study, for the major safety systems of Ulchin Units 3/4, we quantify the risk on the change of AOT and the PM during power operation to identify the effects on the results of external events PSA when nuclear power plant changes such as allowed outage time are requested. The systems for which the risks on the change of allowed outage time are quantified are High Pressure Safety Injection System (HPSIS), Containment Spray System (CSS), and Emergency Diesel Generator (EDG). The systems for which the risks on the PM during power operation are Low Pressure Safety Injection System (LPSIS), CSS, EDG, Essential Service Water System (ESWS). Following conclusions can be obtained through this study: 1)The increase of core damage frequency ({delta}CDF) on the change of AOT and the conditional core damage probability (CCDP) on the on-line PM of each system are differently quantified according to the cases of considering only internal events or only external events. . 2)It is expected that the quantification of risk including internal and external events is advantageous for the licensee of NPP if the regulatory acceptance criteria for the technical specification changes are relatively set up. However, it is expected to be disadvantageous for the licensee if the acceptance criteria are absolutely set up. 3)It is expected that the conduction on the quantification of only a fire event is sufficient when the quantification of external events PSA model is required for the plant changes of Korea Standard NPPs. 4)It is expected that the quantification of the increase of core damage frequency and the incremental conditional core damage probability on technical specification changes are not needed if the quantification results of those considering only internal events are below regulatory acceptance criteria and the external events PSA results are not greatly affected by the system availability. However, it is expected that the quantification of risk considering external events

Quantification of risk considering external events on the change of allowed outage time and the preventive maintenance during power operation

International Nuclear Information System (INIS)

Kang, D. J.; Kim, K. Y.; Yang, J. E.

2001-03-01

In this study, for the major safety systems of Ulchin Units 3/4, we quantify the risk on the change of AOT and the PM during power operation to identify the effects on the results of external events PSA when nuclear power plant changes such as allowed outage time are requested. The systems for which the risks on the change of allowed outage time are quantified are High Pressure Safety Injection System (HPSIS), Containment Spray System (CSS), and Emergency Diesel Generator (EDG). The systems for which the risks on the PM during power operation are Low Pressure Safety Injection System (LPSIS), CSS, EDG, Essential Service Water System (ESWS). Following conclusions can be obtained through this study: 1)The increase of core damage frequency (ΔCDF) on the change of AOT and the conditional core damage probability (CCDP) on the on-line PM of each system are differently quantified according to the cases of considering only internal events or only external events. . 2)It is expected that the quantification of risk including internal and external events is advantageous for the licensee of NPP if the regulatory acceptance criteria for the technical specification changes are relatively set up. However, it is expected to be disadvantageous for the licensee if the acceptance criteria are absolutely set up. 3)It is expected that the conduction on the quantification of only a fire event is sufficient when the quantification of external events PSA model is required for the plant changes of Korea Standard NPPs. 4)It is expected that the quantification of the increase of core damage frequency and the incremental conditional core damage probability on technical specification changes are not needed if the quantification results of those considering only internal events are below regulatory acceptance criteria and the external events PSA results are not greatly affected by the system availability. However, it is expected that the quantification of risk considering external events on

Purchase decision involvement: Event management segments and related event behavior

Science.gov (United States)

Rodney B. Warnick; David C. Bojanic

2012-01-01

The goal of this research was to examine the relationships between different levels of event purchase decision involvement (PDI) segments and their respective event behaviors (e.g., expenditures, travel behavior, event consumption and satisfaction). The specific purpose was to answer two major research questions: 1) Can PDI identify different levels or segments of...

Attachment avoidance, alexithymia, and gender: Examining their associations with distress disclosure tendencies and event-specific disclosure.

Science.gov (United States)

O'Loughlin, Julia I; Cox, Daniel W; Kahn, Jeffrey H; Wu, Amery D

2018-01-01

Distress disclosure has been linked with reduced psychological distress, increased wellbeing, and successful psychotherapeutic outcome. Because of the importance of distress disclosure, researchers have worked to develop and improve theoretical models of disclosure to facilitate counseling practices that reduce impediments to disclosure. Presently, we conducted a 2-part study to investigate distress disclosure's associations with attachment avoidance, gender, and alexithymia-3 constructs frequently linked with disclosure. In Part 1, we examined the extent to which attachment avoidance, alexithymia, and gender predicted general disclosure tendencies. In Part 2, we examined the extent to which attachment avoidance, alexithymia, and gender predicted event-specific disclosure. Participants were recruited from a crowdsourcing website (N = 178 in Part 1; N = 108 in Part 2). In Part 1, alexithymia partially mediated the association between attachment avoidance and disclosure tendencies, and the link between attachment avoidance and alexithymia was stronger for men than women. In Part 2, the association between distress intensity and event-specific disclosure was weaker for people with high levels of alexithymia. Implications for counseling theory and practice are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Concurrently examining unrealistic absolute and comparative optimism: Temporal shifts, individual-difference and event-specific correlates, and behavioural outcomes.

Science.gov (United States)

Ruthig, Joelle C; Gamblin, Bradlee W; Jones, Kelly; Vanderzanden, Karen; Kehn, Andre

2017-02-01

Researchers have spent considerable effort examining unrealistic absolute optimism and unrealistic comparative optimism, yet there is a lack of research exploring them concurrently. This longitudinal study repeatedly assessed unrealistic absolute and comparative optimism within a performance context over several months to identify the degree to which they shift as a function of proximity to performance and performance feedback, their associations with global individual difference and event-specific factors, and their link to subsequent behavioural outcomes. Results showed similar shifts in unrealistic absolute and comparative optimism based on proximity to performance and performance feedback. Moreover, increases in both types of unrealistic optimism were associated with better subsequent performance beyond the effect of prior performance. However, several differences were found between the two forms of unrealistic optimism in their associations with global individual difference factors and event-specific factors, highlighting the distinctiveness of the two constructs. © 2016 The British Psychological Society.

Developing a Web-Based Intervention to Prevent Drug Use among Adolescent Girls

Science.gov (United States)

Schwinn, Traci Marie; Hopkins, Jessica Elizabeth; Schinke, Steven Paul

2016-01-01

Objectives: Girls' rates of drug use have met up with and, in some instances, surpassed boys' rates. Although girls and boys share risk and protective factors associated with drug use, girls also have gender-specific risks. Interventions to prevent girls' drug use must be tailored to address the dynamics of female adolescence. Methods: One such…

The effectiveness of the cardiovascular disease prevention programme 'KardioPro' initiated by a German sickness fund: a time-to-event analysis of routine data.

Directory of Open Access Journals (Sweden)

Sabine Witt

Full Text Available Cardiovascular disease is the leading cause of morbidity and mortality in the developed world. To reduce this burden of disease, a German sickness fund ('Siemens-Betriebskrankenkasse', SBK initiated the prevention programme 'KardioPro' including primary (risk factor reduction and secondary (screening prevention and guideline-based treatment. The aim of this study was to assess the effectiveness of 'KardioPro' as it is implemented in the real world.The study is based on sickness fund routine data. The control group was selected from non-participants via propensity score matching. Study analysis was based on time-to-event analysis via Cox proportional hazards regression with the endpoint 'all-cause mortality, acute myocardial infarction (MI and ischemic stroke (1', 'all-cause mortality (2' and 'non-fatal acute MI and ischemic stroke (3'.A total of 26,202 insurants were included, 13,101 participants and 13,101 control subjects. 'KardioPro' enrollment was associated with risk reductions of 23.5% (95% confidence interval (CI 13.0-32.7% (1, 41.7% (95% CI 30.2-51.2% (2 and 3.5% (hazard ratio 0.965, 95% CI 0.811-1.148 (3. This corresponds to an absolute risk reduction of 0.29% (1, 0.31% (2 and 0.03% (3 per year.The prevention programme initiated by a German statutory sickness fund appears to be effective with regard to all-cause mortality. The non-significant reduction in non-fatal events might result from a shift from fatal to non-fatal events.

[Development and validation of event-specific quantitative PCR method for genetically modified maize LY038].

Science.gov (United States)

Mano, Junichi; Masubuchi, Tomoko; Hatano, Shuko; Futo, Satoshi; Koiwa, Tomohiro; Minegishi, Yasutaka; Noguchi, Akio; Kondo, Kazunari; Akiyama, Hiroshi; Teshima, Reiko; Kurashima, Takeyo; Takabatake, Reona; Kitta, Kazumi

2013-01-01

In this article, we report a novel real-time PCR-based analytical method for quantitation of the GM maize event LY038. We designed LY038-specific and maize endogenous reference DNA-specific PCR amplifications. After confirming the specificity and linearity of the LY038-specific PCR amplification, we determined the conversion factor required to calculate the weight-based content of GM organism (GMO) in a multilaboratory evaluation. Finally, in order to validate the developed method, an interlaboratory collaborative trial according to the internationally harmonized guidelines was performed with blind DNA samples containing LY038 at the mixing levels of 0, 0.5, 1.0, 5.0 and 10.0%. The precision of the method was evaluated as the RSD of reproducibility (RSDR), and the values obtained were all less than 25%. The limit of quantitation of the method was judged to be 0.5% based on the definition of ISO 24276 guideline. The results from the collaborative trial suggested that the developed quantitative method would be suitable for practical testing of LY038 maize.

Applying Machine Learning to Workers' Compensation Data to Identify Industry-Specific Ergonomic and Safety Prevention Priorities: Ohio, 2001 to 2011.

Science.gov (United States)

Meyers, Alysha R; Al-Tarawneh, Ibraheem S; Wurzelbacher, Steven J; Bushnell, P Timothy; Lampl, Michael P; Bell, Jennifer L; Bertke, Stephen J; Robins, David C; Tseng, Chih-Yu; Wei, Chia; Raudabaugh, Jill A; Schnorr, Teresa M

2018-01-01

This study leveraged a state workers' compensation claims database and machine learning techniques to target prevention efforts by injury causation and industry. Injury causation auto-coding methods were developed to code more than 1.2 million Ohio Bureau of Workers' Compensation claims for this study. Industry groups were ranked for soft-tissue musculoskeletal claims that may have been preventable with biomechanical ergonomic (ERGO) or slip/trip/fall (STF) interventions. On the basis of the average of claim count and rate ranks for more than 200 industry groups, Skilled Nursing Facilities (ERGO) and General Freight Trucking (STF) were the highest risk for lost-time claims (>7 days). This study created a third, major causation-specific U.S. occupational injury surveillance system. These findings are being used to focus prevention resources on specific occupational injury types in specific industry groups, especially in Ohio. Other state bureaus or insurers may use similar methods.

Advanced event reweighting using multivariate analysis

International Nuclear Information System (INIS)

Martschei, D; Feindt, M; Honc, S; Wagner-Kuhr, J

2012-01-01

Multivariate analysis (MVA) methods, especially discrimination techniques such as neural networks, are key ingredients in modern data analysis and play an important role in high energy physics. They are usually trained on simulated Monte Carlo (MC) samples to discriminate so called 'signal' from 'background' events and are then applied to data to select real events of signal type. We here address procedures that improve this work flow. This will be the enhancement of data / MC agreement by reweighting MC samples on a per event basis. Then training MVAs on real data using the sPlot technique will be discussed. Finally we will address the construction of MVAs whose discriminator is independent of a certain control variable, i.e. cuts on this variable will not change the discriminator shape.

Telmisartan to prevent recurrent stroke and cardiovascular events

NARCIS (Netherlands)

Yusuf, Salim; Diener, Hans-Christoph; Sacco, Ralph L.; Cotton, Daniel; Ounpuu, Stephanie; Lawton, William A.; Palesch, Yuko; Martin, Renee H.; Albers, Gregory W.; Bath, Philip; Bornstein, Natan; Chan, Bernard P. L.; Chen, Sien-Tsong; Cunha, Luis; Dahlof, Bjorn; de Keyser, Jacques; Donnan, Geoffrey A.; Estol, Conrado; Gorelick, Philip; Gu, Vivian; Hermansson, Karin; Hilbrich, Lutz; Kaste, Markku; Lu, Chuanzhen; Machnig, Thomas; Pais, Prem; Roberts, Robin; Skvortsova, Veronika; Teal, Philip; Toni, Danilo; VanderMaelen, Cam; Voigt, Thor; Weber, Michael; Yoon, Byung-Woo

2008-01-01

Background: Prolonged lowering of blood pressure after a stroke reduces the risk of recurrent stroke. In addition, inhibition of the renin-angiotensin system in high-risk patients reduces the rate of subsequent cardiovascular events, including stroke. However, the effect of lowering of blood

Benzodiazepine Use During Hospitalization: Automated Identification of Potential Medication Errors and Systematic Assessment of Preventable Adverse Events.

Directory of Open Access Journals (Sweden)

David Franklin Niedrig

Full Text Available Benzodiazepines and "Z-drug" GABA-receptor modulators (BDZ are among the most frequently used drugs in hospitals. Adverse drug events (ADE associated with BDZ can be the result of preventable medication errors (ME related to dosing, drug interactions and comorbidities. The present study evaluated inpatient use of BDZ and related ME and ADE.We conducted an observational study within a pharmacoepidemiological database derived from the clinical information system of a tertiary care hospital. We developed algorithms that identified dosing errors and interacting comedication for all administered BDZ. Associated ADE and risk factors were validated in medical records.Among 53,081 patients contributing 495,813 patient-days BDZ were administered to 25,626 patients (48.3% on 115,150 patient-days (23.2%. We identified 3,372 patient-days (2.9% with comedication that inhibits BDZ metabolism, and 1,197 (1.0% with lorazepam administration in severe renal impairment. After validation we classified 134, 56, 12, and 3 cases involving lorazepam, zolpidem, midazolam and triazolam, respectively, as clinically relevant ME. Among those there were 23 cases with associated adverse drug events, including severe CNS-depression, falls with subsequent injuries and severe dyspnea. Causality for BDZ was formally assessed as 'possible' or 'probable' in 20 of those cases. Four cases with ME and associated severe ADE required administration of the BDZ antagonist flumazenil.BDZ use was remarkably high in the studied setting, frequently involved potential ME related to dosing, co-medication and comorbidities, and rarely cases with associated ADE. We propose the implementation of automated ME screening and validation for the prevention of BDZ-related ADE.

A Mosque event

DEFF Research Database (Denmark)

Simonsen, Kirsten; Neergaard, Maja de; Koefoed, Lasse Martin

2017-01-01

and public imaginations attached to it. And they are connected to a specific event – the opening of the mosque. In the first part, a conceptual framework is presented bringing together literature on three notions: encounters, visibility and the event. Following this, the paper explores the opening event...

Economic optimization of a global strategy to address the pandemic threat

Science.gov (United States)

Pike, Jamison; Bogich, Tiffany; Elwood, Sarah; Finnoff, David C.; Daszak, Peter

2014-01-01

Emerging pandemics threaten global health and economies and are increasing in frequency. Globally coordinated strategies to combat pandemics, similar to current strategies that address climate change, are largely adaptive, in that they attempt to reduce the impact of a pathogen after it has emerged. However, like climate change, mitigation strategies have been developed that include programs to reduce the underlying drivers of pandemics, particularly animal-to-human disease transmission. Here, we use real options economic modeling of current globally coordinated adaptation strategies for pandemic prevention. We show that they would be optimally implemented within 27 y to reduce the annual rise of emerging infectious disease events by 50% at an estimated one-time cost of approximately $343.7 billion. We then analyze World Bank data on multilateral “One Health” pandemic mitigation programs. We find that, because most pandemics have animal origins, mitigation is a more cost-effective policy than business-as-usual adaptation programs, saving between $344.0.7 billion and $360.3 billion over the next 100 y if implemented today. We conclude that globally coordinated pandemic prevention policies need to be enacted urgently to be optimally effective and that strategies to mitigate pandemics by reducing the impact of their underlying drivers are likely to be more effective than business as usual. PMID:25512538

Common Running Overuse Injuries and Prevention

Directory of Open Access Journals (Sweden)

Žiga Kozinc

2017-09-01

Full Text Available Runners are particularly prone to developing overuse injuries. The most common running-related injuries include medial tibial stress syndrome, Achilles tendinopathy, plantar fasciitis, patellar tendinopathy, iliotibial band syndrome, tibial stress fractures, and patellofemoral pain syndrome. Two of the most significant risk factors appear to be injury history and weekly distance. Several trials have successfully identified biomechanical risk factors for specific injuries, with increased ground reaction forces, excessive foot pronation, hip internal rotation and hip adduction during stance phase being mentioned most often. However, evidence on interventions for lowering injury risk is limited, especially regarding exercise-based interventions. Biofeedback training for lowering ground reaction forces is one of the few methods proven to be effective. It seems that the best way to approach running injury prevention is through individualized treatment. Each athlete should be assessed separately and scanned for risk factors, which should be then addressed with specific exercises. This review provides an overview of most common running-related injuries, with a particular focus on risk factors, and emphasizes the problems encountered in preventing running-related injuries.

Why Do We Report Suicides and How Can We Facilitate Suicide Prevention Efforts?

Science.gov (United States)

Cheng, Qijin; Fu, King-wa; Caine, Eric; Yip, Paul S. F.

2014-01-01

Background The Hong Kong news media report suicide-related events more frequently and sensationally than Western countries. Little is known about Hong Kong media professionals’ experiences and thoughts about such reporting. Aims To understand Hong Kong media professionals’ experiences and perceptions of suicide reporting and whether the news media can be better engaged into suicide prevention. Method We conducted three focus groups of journalists from both the Cantonese and English language news media. Data were analyzed using grounded theory methods. Results We discerned three rationales from participants regarding their intense coverage of suicide-related events: (1) satisfying commercial competitiveness, (2) addressing social problems, and (3) responding to readers’ interests. The first rationale was a dominant and vigorous motivating factor, and often influenced suicide reporting among local Cantonese media. Media professionals recommended engagement strategies targeted at frontline journalists, media managers, and general media consumers. Conclusion We see potential to involve news media professionals in Hong Kong as working partners in suicide prevention. To succeed, this effort requires engagement in a proactive, consistent, and sustained fashion. PMID:24322824

How to Define the Content of a Job-Specific Worker's Health Surveillance for Hospital Physicians?

NARCIS (Netherlands)

Ruitenburg, Martijn M.; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

2016-01-01

Background: A job-specific Worker's Health Surveillance (WHS) for hospital physicians is a preventive occupational health strategy aiming at early detection of their diminished work-related health in order to improve or maintain physician's health and quality of care. This study addresses what steps

Telmisartan to prevent recurrent stroke and cardiovascular events

DEFF Research Database (Denmark)

Yusuf, Salim; Diener, Hans-Christoph; Sacco, Ralph L

2008-01-01

BACKGROUND: Prolonged lowering of blood pressure after a stroke reduces the risk of recurrent stroke. In addition, inhibition of the renin-angiotensin system in high-risk patients reduces the rate of subsequent cardiovascular events, including stroke. However, the effect of lowering of blood pres...

Grid collector: An event catalog with automated file management

International Nuclear Information System (INIS)

Wu, Kesheng; Zhang, Wei-Ming; Sim, Alexander; Gu, Junmin; Shoshani, Arie

2003-01-01

High Energy Nuclear Physics (HENP) experiments such as STAR at BNL and ATLAS at CERN produce large amounts of data that are stored as files on mass storage systems in computer centers. In these files, the basic unit of data is an event. Analysis is typically performed on a selected set of events. The files containing these events have to be located, copied from mass storage systems to disks before analysis, and removed when no longer needed. These file management tasks are tedious and time consuming. Typically, all events contained in the files are read into memory before a selection is made. Since the time to read the events dominate the overall execution time, reading the unwanted event needlessly increases the analysis time. The Grid Collector is a set of software modules that works together to address these two issues. It automates the file management tasks and provides ''direct'' access to the selected events for analyses. It is currently integrated with the STAR analysis framework. The users can select events based on tags, such as, ''production date between March 10 and 20, and the number of charged tracks > 100.'' The Grid Collector locates the files containing relevant events, transfers the files across the Grid if necessary, and delivers the events to the analysis code through the familiar iterators. There has been some research efforts to address the file management issues, the Grid Collector is unique in that it addresses the event access issue together with the file management issues. This makes it more useful to a large variety of users

Prevention of sudden cardiac death in young athletes: controversies and conundrums.

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Rowland, Thomas

2011-01-01

Strategies for preventing sudden cardiac death in young athletes are predicated on the assumption that: (1) these events reflect pre-existing, clinically silent heart disease, and (2) means for detecting these abnormalities on the pre-participation evaluation are both feasible and accurate. Recent controversy has surrounded both of these presumptions. Some evidence suggests that the myocardial hypertrophy accompanying sports training itself might serve as a substrate for fatal arrhythmias. As well, vigorous debate has arisen over the optimal content of the pre-participation evaluation, particularly regarding the inclusion of routine screening electrocardiograms. As the rarity of these fatal events does not lend itself to an experimental approach, such disagreements are not easily resolved. Consequently, it is expected that decisions regarding approaches to prevention of sudden death in athletes will be dictated largely by region-specific financial, political, and cultural factors. This chapter examines the aetiologies of sudden cardiac death in young athletes as well as the controversies surrounding the prevention of these tragedies. Copyright © 2011 S. Karger AG, Basel.

Associations between social media displays and event-specific alcohol consumption by college students.

Science.gov (United States)

Moreno, Megan A; Kacvinsky, Lauren; Pumper, Megan; Wachowski, Leah; Whitehill, Jennifer M

2013-12-01

The Mifflin Street Block Party is a yearly Wisconsin event known for high levels of alcohol consumption and previous negative outcomes. This study investigated displayed Mifflin references on Facebook and their association with alcohol consumption at the block party. Participants included first-year college students who were enrolled in a longitudinal study involving Facebook profile assessments and interviews. We identified a subset of participants who were interviewed within 28 days following the Mifflin St Block Party. Participants were categorized as "Mifflin Displayers" or "Non-displayers" based on Facebook profile content. Interviews included the timeline follow-back method to assess alcohol use in the past 28 days. Analysis included logistic and linear regression. Among the 66 participants included in this study, 45 (68.2%) were female and 38 (50%) were Mifflin Displayers on Facebook. Among the Mifflin Displayer participants, 18 (27.2%) displayed prior to Mifflin, 11 displayed the day of Mifflin (16.7%) and 19 (28.8%) displayed after. Some participants displayed in more than 1 time frame. A total of 40 (60.6%) reported alcohol use on the day of the Mifflin Street Block Party. The mean number of drinks reported on the day of Mifflin was 8.8 (SD = 6.1), with a range of 1 to 35. Displayed references to Mifflin on Facebook were positively associated with reporting alcohol use at Mifflin (OR = 20.9, 95% CI 5.6-78.8). Displaying Facebook references to Mifflin was associated with alcohol consumption on the day of the event. Future prevention efforts could consider creating Facebook advertisements with safety messages triggered by Mifflin displays.

Age-specific risks, severity, time course, and outcome of bleeding on long-term antiplatelet treatment after vascular events: a population-based cohort study.

Science.gov (United States)

Li, Linxin; Geraghty, Olivia C; Mehta, Ziyah; Rothwell, Peter M

2017-07-29

Lifelong antiplatelet treatment is recommended after ischaemic vascular events, on the basis of trials done mainly in patients younger than 75 years. Upper gastrointestinal bleeding is a serious complication, but had low case fatality in trials of aspirin and is not generally thought to cause long-term disability. Consequently, although co-prescription of proton-pump inhibitors (PPIs) reduces upper gastrointestinal bleeds by 70-90%, uptake is low and guidelines are conflicting. We aimed to assess the risk, time course, and outcomes of bleeding on antiplatelet treatment for secondary prevention in patients of all ages. We did a prospective population-based cohort study in patients with a first transient ischaemic attack, ischaemic stroke, or myocardial infarction treated with antiplatelet drugs (mainly aspirin based, without routine PPI use) after the event in the Oxford Vascular Study from 2002 to 2012, with follow-up until 2013. We determined type, severity, outcome (disability or death), and time course of bleeding requiring medical attention by face-to-face follow-up for 10 years. We estimated age-specific numbers needed to treat (NNT) to prevent upper gastrointestinal bleeding with routine PPI co-prescription on the basis of Kaplan-Meier risk estimates and relative risk reduction estimates from previous trials. 3166 patients (1582 [50%] aged ≥75 years) had 405 first bleeding events (n=218 gastrointestinal, n=45 intracranial, and n=142 other) during 13 509 patient-years of follow-up. Of the 314 patients (78%) with bleeds admitted to hospital, 117 (37%) were missed by administrative coding. Risk of non-major bleeding was unrelated to age, but major bleeding increased steeply with age (≥75 years hazard ratio [HR] 3·10, 95% CI 2·27-4·24; pbleeds (5·53, 2·65-11·54; pbleeds (≥75 years HR 4·13, 2·60-6·57; pbleeds were mostly disabling or fatal (45 [62%] of 73 patients vs 101 [47%] of 213 patients with recurrent ischaemic stroke), and outnumbered

Prevention interventions for human immunodeficiency virus in drug-using women with a history of partner violence.

Science.gov (United States)

Stockman, Jamila K; Ludwig-Barron, Natasha; Hoffman, Monica A; Ulibarri, Monica D; Dyer, Typhanye V Penniman

2012-01-01

The intersecting epidemics of human immunodeficiency virus (HIV) and partner violence disproportionately affect women who use drugs. Despite accumulating evidence throughout the world linking these epidemics, HIV prevention efforts focused on these synergistic issues as well as underlying determinants that contribute to the HIV risk environment (eg, housing instability, incarceration, policing practices, survival sex) are lacking. This article highlights selected behavior change theories and biomedical approaches that have been used or could be applied in HIV prevention interventions for drug-using women with histories of partner violence and in existing HIV prevention interventions for drug-using women that have been gender-focused while integrating histories of partner violence and/or relationship power dynamics. To date, there is a paucity of HIV prevention interventions designed for drug-using women (both in and outside of drug treatment programs) with histories of partner violence. Of the few that exist, they have been theory-driven, culture-specific, and address certain aspects of gender-based inequalities (eg, gender-specific norms, relationship power and control, partner violence through assessment of personal risk and safety planning). However, no single intervention has addressed all of these issues. Moreover, HIV prevention interventions for drug-using women with histories of partner violence are not widespread and do not address multiple components of the risk environment. Efficacious interventions should target individuals, men, couples, and social networks. There is also a critical need for the development of culturally tailored combination HIV prevention interventions that not only incorporate evidence-based behavioral and biomedical approaches (eg, microbicides, pre-exposure prophylaxis, female-initiated barrier methods) but also take into account the risk environment at the physical, social, economic and political levels. Ultimately, this approach

The Memory Is in the Details: Relations between Memory for the Specific Features of Events and Long-Term Recall during Infancy

Science.gov (United States)

Bauer, Patricia J.; Lukowski, Angela F.

2010-01-01

The second year of life is marked by pronounced changes in the length of time over which events are remembered. We tested whether the age-related differences are related to differences in memory for the specific features of events. In our study, 16- and 20-month-olds were tested for immediate and long-term recall of individual actions and temporal…

Estimated time spent on preventive services by primary care physicians

Directory of Open Access Journals (Sweden)

Gradison Margaret

2008-12-01

Full Text Available Abstract Background Delivery of preventive health services in primary care is lacking. One of the main barriers is lack of time. We estimated the amount of time primary care physicians spend on important preventive health services. Methods We analyzed a large dataset of primary care (family and internal medicine visits using the National Ambulatory Medical Care Survey (2001–4; analyses were conducted 2007–8. Multiple linear regression was used to estimate the amount of time spent delivering each preventive service, controlling for demographic covariates. Results Preventive visits were longer than chronic care visits (M = 22.4, SD = 11.8, M = 18.9, SD = 9.2, respectively. New patients required more time from physicians. Services on which physicians spent relatively more time were prostate specific antigen (PSA, cholesterol, Papanicolaou (Pap smear, mammography, exercise counseling, and blood pressure. Physicians spent less time than recommended on two "A" rated ("good evidence" services, tobacco cessation and Pap smear (in preventive visits, and one "B" rated ("at least fair evidence" service, nutrition counseling. Physicians spent substantial time on two services that have an "I" rating ("inconclusive evidence of effectiveness", PSA and exercise counseling. Conclusion Even with limited time, physicians address many of the "A" rated services adequately. However, they may be spending less time than recommended for important services, especially smoking cessation, Pap smear, and nutrition counseling. Future research is needed to understand how physicians decide how to allocate their time to address preventive health.

Risk analysis of brachytherapy events

International Nuclear Information System (INIS)

Buricova, P.; Zackova, H.; Hobzova, L.; Novotny, J.; Kindlova, A.

2005-01-01

For prevention radiological events it is necessary to identify hazardous situation and to analyse the nature of committed errors. Though the recommendation on the classification and prevention of radiological events: Radiological accidents has been prepared in the framework of Czech Society of Radiation Oncology, Biology and Physics and it was approved by Czech regulatory body (SONS) in 1999, only a few reports have been submitted up to now from brachytherapy practice. At the radiotherapy departments attention has been paid more likely to the problems of dominant teletherapy treatments. But in the two last decades the usage of brachytherapy methods has gradually increased because .nature of this treatment well as the possibilities of operating facility have been completely changed: new radionuclides of high activity are introduced and sophisticate afterloading systems controlled by computers are used. Consequently also the nature of errors, which can occurred in the clinical practice, has been changing. To determine the potentially hazardous parts of procedure the so-called 'process tree', which follows the flow of entire treatment process, has been created for most frequent type of applications. Marking the location of errors on the process tree indicates where failures occurred and accumulation of marks along branches show weak points in the process. Analysed data provide useful information to prevent medical events in brachytherapy .The results strength the requirements given in Recommendations of SONS and revealed the need for its amendment. They call especially for systematic registration of the events. (authors)

Social marketing to address attitudes and behaviours related to preventable injuries in British Columbia, Canada

Science.gov (United States)

Smith, Jennifer; Zheng, Xin; Lafreniere, Kevin; Pike, Ian

2018-01-01

Background Social marketing is a tool used in the domain of public health for prevention and public education. Because injury prevention is a priority public health issue in British Columbia, Canada, a 3-year consultation was undertaken to understand public attitudes towards preventable injuries and mount a province-wide social marketing campaign aimed at adults aged 25–55 years. Methods Public response to the campaign was assessed through an online survey administered to a regionally representative sample of adults within the target age group between 1 and 4 times per year on an ongoing basis since campaign launch. A linear regression model was applied to a subset of this data (n=5186 respondents) to test the association between exposure to the Preventable campaign and scores on perceived preventability of injuries as well as conscious forethought applied to injury-related behaviours. Results Campaign exposure was significant in both models (preventability: β=0.27, 95% CI 0.20 to 0.35; conscious thought: β=0.24, 95% CI 0.13 to 0.35), as was parental status (preventability: β=0.12, 95% CI 0.03 to 0.21; conscious thought: β=0.18, 95% CI 0.06 to 0.30). Exposure to the more recent campaign slogan was predictive of 0.47 higher score on conscious thought (95% CI 0.27 to 0.66). Discussion This study provides some evidence that the Preventable approach is having positive effect on attitudes and behaviours related to preventable injuries in the target population. Future work will seek to compare these data to other jurisdictions as the Preventable social marketing campaign expands to other parts of Canada. PMID:29549106

Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population

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There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demo...

Application of the Pareto principle to identify and address drug-therapy safety issues.

Science.gov (United States)

Müller, Fabian; Dormann, Harald; Pfistermeister, Barbara; Sonst, Anja; Patapovas, Andrius; Vogler, Renate; Hartmann, Nina; Plank-Kiegele, Bettina; Kirchner, Melanie; Bürkle, Thomas; Maas, Renke

2014-06-01

Adverse drug events (ADE) and medication errors (ME) are common causes of morbidity in patients presenting at emergency departments (ED). Recognition of ADE as being drug related and prevention of ME are key to enhancing pharmacotherapy safety in ED. We assessed the applicability of the Pareto principle (~80 % of effects result from 20 % of causes) to address locally relevant problems of drug therapy. In 752 cases consecutively admitted to the nontraumatic ED of a major regional hospital, ADE, ME, contributing drugs, preventability, and detection rates of ADE by ED staff were investigated. Symptoms, errors, and drugs were sorted by frequency in order to apply the Pareto principle. In total, 242 ADE were observed, and 148 (61.2 %) were assessed as preventable. ADE contributed to 110 inpatient hospitalizations. The ten most frequent symptoms were causally involved in 88 (80.0 %) inpatient hospitalizations. Only 45 (18.6 %) ADE were recognized as drug-related problems until discharge from the ED. A limited set of 33 drugs accounted for 184 (76.0 %) ADE; ME contributed to 57 ADE. Frequency-based listing of ADE, ME, and drugs involved allowed identification of the most relevant problems and development of easily to implement safety measures, such as wall and pocket charts. The Pareto principle provides a method for identifying the locally most relevant ADE, ME, and involved drugs. This permits subsequent development of interventions to increase patient safety in the ED admission process that best suit local needs.

Environmental evaluation of municipal waste prevention

International Nuclear Information System (INIS)

Gentil, Emmanuel C.; Gallo, Daniele; Christensen, Thomas H.

2011-01-01

Highlights: → Influence of prevention on waste management systems, excluding avoided production, is relatively minor. → Influence of prevention on overall supply chain, including avoided production is very significant. → Higher relative benefits of prevention are observed in waste management systems relying mainly on landfills. - Abstract: Waste prevention has been addressed in the literature in terms of the social and behavioural aspects, but very little quantitative assessment exists of the environmental benefits. Our study evaluates the environmental consequences of waste prevention on waste management systems and on the wider society, using life-cycle thinking. The partial prevention of unsolicited mail, beverage packaging and food waste is tested for a 'High-tech' waste management system relying on high energy and material recovery and for a 'Low-tech' waste management system with less recycling and relying on landfilling. Prevention of 13% of the waste mass entering the waste management system generates a reduction of loads and savings in the waste management system for the different impacts categories; 45% net reduction for nutrient enrichment and 12% reduction for global warming potential. When expanding our system and including avoided production incurred by the prevention measures, large savings are observed (15-fold improvement for nutrient enrichment and 2-fold for global warming potential). Prevention of food waste has the highest environmental impact saving. Prevention generates relatively higher overall relative benefit for 'Low-tech' systems depending on landfilling. The paper provides clear evidence of the environmental benefits of waste prevention and has specific relevance in climate change mitigation.

Derivation of Event-B Models from OWL Ontologies

Directory of Open Access Journals (Sweden)

Alkhammash Eman H.

2016-01-01

Full Text Available The derivation of formal specifications from large and complex requirements is a key challenge in systems engineering. In this paper we present an approach that aims to address this challenge by building formal models from OWL ontologies. An ontology is used in the field of knowledge representation to capture a clear view of the domain and to produce a concise and unambiguous set of domain requirements. We harness the power of ontologies to handle inconsistency of domain requirements and produce clear, concise and unambiguous set of domain requirements for Event-B modelling. The proposed approach works by generating Attempto Controlled English (ACE from the OWL ontology and then maps the ACE requirements to develop Event-B models. ACE is a subset of English that can be unambiguously translated into first-order logic. There is an injective mapping between OWL ontology and a subset of ACE. ACE is a suitable interlingua for producing the mapping between OWL and Event-B models for many reasons. Firstly, ACE is easy to learn and understand, it hides the math of OWL and would be natural to use by everybody. Secondly ACE has a parser that converts ACE texts into Discourse Representation Structures (DRS. Finally, ACE can be extended to target a richer syntactic subset of Event-B which ultimately would facilitate the translation of ACE requirements to Event-B.

Travellers and influenza: risks and prevention.

Science.gov (United States)

Goeijenbier, M; van Genderen, P; Ward, B J; Wilder-Smith, A; Steffen, R; Osterhaus, A D M E

2017-01-01

Influenza viruses are among the major causes of serious human respiratory tract infection worldwide. In line with the high disease burden attributable to influenza, these viruses play an important, but often neglected, role in travel medicine. Guidelines and recommendations regarding prevention and management of influenza in travellers are scarce. Of special interest for travel medicine are risk populations and also circumstances that facilitate influenza virus transmission and spread, like travel by airplane or cruise ship and mass gatherings. We conducted a PUBMED/MEDLINE search for a combination of the MeSH terms Influenza virus, travel, mass gathering, large scale events and cruise ship. In addition we gathered guidelines and recommendations from selected countries and regarding influenza prevention and management in travellers. By reviewing these search results in the light of published knowledge in the fields of influenza prevention and management, we present best practice advice for the prevention and management of influenza in travel medicine. Seasonal influenza is among the most prevalent infectious diseases in travellers. Known host-associated risk factors include extremes of age and being immune-compromised, while the most relevant environmental factors are associated with holiday cruises and mass gatherings. Pre-travel advice should address influenza and its prevention for travellers, whenever appropriate on the basis of the epidemiological situation concerned. Preventative measures should be strongly recommended for travellers at high-risk for developing complications. In addition, seasonal influenza vaccination should be considered for any traveller wishing to reduce the risk of incapacitation, particularly cruise ship crew and passengers, as well as those participating in mass gatherings. Besides advice concerning preventive measures and vaccination, advice on the use of antivirals may be considered for some travellers. © International Society of

Social marketing to address attitudes and behaviours related to preventable injuries in British Columbia, Canada.

Science.gov (United States)

Smith, Jennifer; Zheng, Xin; Lafreniere, Kevin; Pike, Ian

2018-06-01

Social marketing is a tool used in the domain of public health for prevention and public education. Because injury prevention is a priority public health issue in British Columbia, Canada, a 3-year consultation was undertaken to understand public attitudes towards preventable injuries and mount a province-wide social marketing campaign aimed at adults aged 25-55 years. Public response to the campaign was assessed through an online survey administered to a regionally representative sample of adults within the target age group between 1 and 4 times per year on an ongoing basis since campaign launch. A linear regression model was applied to a subset of this data (n=5186 respondents) to test the association between exposure to the Preventable campaign and scores on perceived preventability of injuries as well as conscious forethought applied to injury-related behaviours. Campaign exposure was significant in both models (preventability: β=0.27, 95% CI 0.20 to 0.35; conscious thought: β=0.24, 95% CI 0.13 to 0.35), as was parental status (preventability: β=0.12, 95% CI 0.03 to 0.21; conscious thought: β=0.18, 95% CI 0.06 to 0.30). Exposure to the more recent campaign slogan was predictive of 0.47 higher score on conscious thought (95% CI 0.27 to 0.66). This study provides some evidence that the Preventable approach is having positive effect on attitudes and behaviours related to preventable injuries in the target population. Future work will seek to compare these data to other jurisdictions as the Preventable social marketing campaign expands to other parts of Canada. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Waste Minimization and Pollution Prevention Awareness Plan

International Nuclear Information System (INIS)

1992-01-01

The purpose of this plan is to document the Lawrence Livermore National Laboratory (LLNL) Waste Minimization and Pollution Prevention Awareness Program. The plan specifies those activities and methods that are or will be employed to reduce the quantity and toxicity of wastes generated at the site. It is intended to satisfy Department of Energy (DOE) and other legal requirements that are discussed in Section C, below. The Pollution Prevention Awareness Program is included with the Waste Minimization Program as suggested by DOE Order 5400.1. The intent of this plan is to respond to and comply with the Department's policy and guidelines concerning the need for pollution prevention. The Plan is composed of a LLNL Waste Minimization and Pollution Prevention Awareness Program Plan and, as attachments, Directorate-, Program- and Department-specific waste minimization plans. This format reflects the fact that waste minimization is considered a line management responsibility and is to be addressed by each of the Directorates, Programs and Departments. Several Directorates have been reorganized, necessitating changes in the Directorate plans that were published in 1991

Stroke Prevention: Managing Modifiable Risk Factors

Directory of Open Access Journals (Sweden)

Silvia Di Legge

2012-01-01

Full Text Available Prevention plays a crucial role in counteracting morbidity and mortality related to ischemic stroke. It has been estimated that 50% of stroke are preventable through control of modifiable risk factors and lifestyle changes. Antihypertensive treatment is recommended for both prevention of recurrent stroke and other vascular events. The use of antiplatelets and statins has been shown to reduce the risk of recurrent stroke and other vascular events. Angiotensin-converting enzyme inhibitors (ACEIs and angiotensin II receptor blockers (ARBs are indicated in stroke prevention because they also promote vascular health. Effective secondary-prevention strategies for selected patients include carotid revascularization for high-grade carotid stenosis and vitamin K antagonist treatment for atrial fibrillation. The results of recent clinical trials investigating new anticoagulants (factor Xa inhibitors and direct thrombin inhibitors clearly indicate alternative strategies in stroke prevention for patients with atrial fibrillation. This paper describes the current landscape and developments in stroke prevention with special reference to medical treatment in secondary prevention of ischemic stroke.

A test of safety, violence prevention, and civility climate domain-specific relationships with relevant workplace hazards.

Science.gov (United States)

Gazica, Michele W; Spector, Paul E

2016-01-01

Safety climate, violence prevention climate, and civility climate were independently developed and linked to domain-specific workplace hazards, although all three were designed to promote the physical and psychological safety of workers. To test domain specificity between conceptually related workplace climates and relevant workplace hazards. Data were collected from 368 persons employed in various industries and descriptive statistics were calculated for all study variables. Correlational and relative weights analyses were used to test for domain specificity. The three climate domains were similarly predictive of most workplace hazards, regardless of domain specificity. This study suggests that the three climate domains share a common higher order construct that may predict relevant workplace hazards better than any of the scales alone.

HIV Prevention Among Transgender Populations: Knowledge Gaps and Evidence for Action.

Science.gov (United States)

Poteat, Tonia; Malik, Mannat; Scheim, Ayden; Elliott, Ayana

2017-08-01

The purpose of this review is to summarize the available evidence-based HIV prevention interventions tailored for transgender people. A limited number of evidence-based HIV prevention interventions have been tested with transgender populations. Most existing interventions target behavior change among transgender women, with only one HIV prevention program evaluated for transgender men. Studies addressing biomedical interventions for transgender women are ongoing. Few interventions address social and structural barriers to HIV prevention, such as stigma, discrimination, and poverty. Evidence-based multi-level interventions that address the structural, biomedical, and behavioral risks for HIV among transgender populations, including transgender men, are needed to address disparities in HIV prevalence. Future research should address not only pre-exposure prophylaxis uptake and condom use but also structural barriers that limit access to these prevention strategies.

Development and Evaluation of Event-Specific Quantitative PCR Method for Genetically Modified Soybean MON87701.

Science.gov (United States)

Tsukahara, Keita; Takabatake, Reona; Masubuchi, Tomoko; Futo, Satoshi; Minegishi, Yasutaka; Noguchi, Akio; Kondo, Kazunari; Nishimaki-Mogami, Tomoko; Kurashima, Takeyo; Mano, Junichi; Kitta, Kazumi

2016-01-01

A real-time PCR-based analytical method was developed for the event-specific quantification of a genetically modified (GM) soybean event, MON87701. First, a standard plasmid for MON87701 quantification was constructed. The conversion factor (C f ) required to calculate the amount of genetically modified organism (GMO) was experimentally determined for a real-time PCR instrument. The determined C f for the real-time PCR instrument was 1.24. For the evaluation of the developed method, a blind test was carried out in an inter-laboratory trial. The trueness and precision were evaluated as the bias and reproducibility of relative standard deviation (RSDr), respectively. The determined biases and the RSDr values were less than 30 and 13%, respectively, at all evaluated concentrations. The limit of quantitation of the method was 0.5%, and the developed method would thus be applicable for practical analyses for the detection and quantification of MON87701.

Direct oral anticoagulants versus warfarin for preventing stroke and systemic embolic events among atrial fibrillation patients with chronic kidney disease.

Science.gov (United States)

Kimachi, Miho; Furukawa, Toshi A; Kimachi, Kimihiko; Goto, Yoshihito; Fukuma, Shingo; Fukuhara, Shunichi

2017-11-06

Chronic kidney disease (CKD) is an independent risk factor for atrial fibrillation (AF), which is more prevalent among CKD patients than the general population. AF causes stroke or systemic embolism, leading to increased mortality. The conventional antithrombotic prophylaxis agent warfarin is often prescribed for the prevention of stroke, but risk of bleeding necessitates regular therapeutic monitoring. Recently developed direct oral anticoagulants (DOAC) are expected to be useful as alternatives to warfarin. To assess the efficacy and safety of DOAC including apixaban, dabigatran, edoxaban, and rivaroxaban versus warfarin among AF patients with CKD. We searched the Cochrane Kidney and Transplant Specialised Register (up to 1 August 2017) through contact with the Information Specialist using search terms relevant to this review. Studies in the Specialised Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal, and ClinicalTrials.gov. We included all randomised controlled trials (RCTs) which directly compared the efficacy and safety of direct oral anticoagulants (direct thrombin inhibitors or factor Xa inhibitors) with dose-adjusted warfarin for preventing stroke and systemic embolic events in non-valvular AF patients with CKD, defined as creatinine clearance (CrCl) or eGFR between 15 and 60 mL/min (CKD stage G3 and G4). Two review authors independently selected studies, assessed quality, and extracted data. We calculated the risk ratio (RR) and 95% confidence intervals (95% CI) for the association between anticoagulant therapy and all strokes and systemic embolic events as the primary efficacy outcome and major bleeding events as the primary safety outcome. Confidence in the evidence was assessing using GRADE. Our review included 12,545 AF participants with CKD from five studies. All participants were randomised to either DOAC (apixaban, dabigatran, edoxaban

MadEvent: automatic event generation with MadGraph

International Nuclear Information System (INIS)

Maltoni, Fabio; Stelzer, Tim

2003-01-01

We present a new multi-channel integration method and its implementation in the multi-purpose event generator MadEvent, which is based on MadGraph. Given a process, MadGraph automatically identifies all the relevant subprocesses, generates both the amplitudes and the mappings needed for an efficient integration over the phase space, and passes them to MadEvent. As a result, a process-specific, stand-alone code is produced that allows the user to calculate cross sections and produce unweighted events in a standard output format. Several examples are given for processes that are relevant for physics studies at present and forthcoming colliders. (author)

Grid collector: An event catalog with automated file management

Energy Technology Data Exchange (ETDEWEB)

Wu, Kesheng; Zhang, Wei-Ming; Sim, Alexander; Gu, Junmin; Shoshani, Arie

2003-10-17

High Energy Nuclear Physics (HENP) experiments such as STAR at BNL and ATLAS at CERN produce large amounts of data that are stored as files on mass storage systems in computer centers. In these files, the basic unit of data is an event. Analysis is typically performed on a selected set of events. The files containing these events have to be located, copied from mass storage systems to disks before analysis, and removed when no longer needed. These file management tasks are tedious and time consuming. Typically, all events contained in the files are read into memory before a selection is made. Since the time to read the events dominate the overall execution time, reading the unwanted event needlessly increases the analysis time. The Grid Collector is a set of software modules that works together to address these two issues. It automates the file management tasks and provides ''direct'' access to the selected events for analyses. It is currently integrated with the STAR analysis framework. The users can select events based on tags, such as, ''production date between March 10 and 20, and the number of charged tracks > 100.'' The Grid Collector locates the files containing relevant events, transfers the files across the Grid if necessary, and delivers the events to the analysis code through the familiar iterators. There has been some research efforts to address the file management issues, the Grid Collector is unique in that it addresses the event access issue together with the file management issues. This makes it more useful to a large variety of users.

Occupational Injury Prevention Research in NIOSH

Directory of Open Access Journals (Sweden)

Hongwei Hsiao

2010-12-01

Full Text Available This paper provided a brief summary of the current strategic goals, activities, and impacts of the NIOSH (National Institute for Occupational Safety and Health occupational injury research program. Three primary drivers (injury database, stakeholder input, and staff capacity were used to define NIOSH research focuses to maximize relevance and impact of the NIOSH injury-prevention-research program. Injury data, strategic goals, program activities, and research impacts were presented with a focus on prevention of four leading causes of workplace injury and death in the US: motor vehicle incidents, falls, workplace violence, and machine and industrial vehicle incidents. This paper showcased selected priority goals, activities, and impacts of the NIOSH injury prevention program. The NIOSH contribution to the overall decrease in fatalities and injuries is reinforced by decreases in specific goal areas. There were also many intermediate outcomes that are on a direct path to preventing injuries, such as new safety regulations and standards, safer technology and products, and improved worker safety training. The outcomes serve as an excellent foundation to stimulate further research and worldwide partnership to address global workplace injury problems.

A review of accidents, prevention and mitigation options related to hazardous gases

International Nuclear Information System (INIS)

Fthenakis, V.M.

1993-05-01

Statistics on industrial accidents are incomplete due to lack of specific criteria on what constitutes a release or accident. In this country, most major industrial accidents were related to explosions and fires of flammable materials, not to releases of chemicals into the environment. The EPA in a study of 6,928 accidental releases of toxic chemicals revealed that accidents at stationary facilities accounted for 75% of the total number of releases, and transportation accidents for the other 25%. About 7% of all reported accidents (468 cases) resulted in 138 deaths and 4,717 injuries ranging from temporary respiratory problems to critical injuries. In-plant accidents accounted for 65% of the casualties. The most efficient strategy to reduce hazards is to choose technologies which do not require the use of large quantities of hazardous gases. For new technologies this approach can be implemented early in development, before large financial resources and efforts are committed to specific options. Once specific materials and options have been selected, strategies to prevent accident initiating events need to be evaluated and implemented. The next step is to implement safety options which suppress a hazard when an accident initiating event occurs. Releases can be prevented or reduced with fail-safe equipment and valves, adequate warning systems and controls to reduce and interrupt gas leakage. If an accident occurs and safety systems fail to contain a hazardous gas release, then engineering control systems will be relied on to reduce/minimize environmental releases. As a final defensive barrier, the prevention of human exposure is needed if a hazardous gas is released, in spite of previous strategies. Prevention of consequences forms the final defensive barrier. Medical facilities close by that can accommodate victims of the worst accident can reduce the consequences of personnel exposure to hazardous gases

Assessing impact of blanket interventions for MAM prevention

International Nuclear Information System (INIS)

Grais, Rebecca F.; Isanaka, I; Langendorf, C; Roederer, T

2014-01-01

Full text: Blanket interventions for MAM prevention (Blanket supplementary feeding programming (BSFP)) provide a supplementary food ration often accompanied by a basic medical treatment and prevention package to a vulnerable population for a defined period in a defined geographic location. There is little strong evidence on the impact of BSFP on rates of malnutrition and mortality, and scare guidance on program monitoring and evaluation to improve the implementation of specific programs. Assessing the impact of BSFP has been fraught with difficulty. Their isolated impact is difficult, if not often impossible to disentangle from larger care and prevention packages, the objectives of BSFP may vary by context, implementing agency, time and geography. Various and often multiple co-morbidities among children in the targeted group complicate matters further with respect to impact assessment. This leads to difficulties in generalizing results from one context to another and the need for more complex metrics to guide operational decision-making. Ideally, impact or effectiveness of BSFP should be addressed in a research framework where appropriate and complete data is collected in order to address specific questions. The gold standard is the conduct of randomized studies including a control group. These studies have been scarce as they may be perceived as either rarely feasible or not ethical or both. However, as generating evidence on impact of BSFP is essential to provide operational guidance, these studies should be encouraged through a diversity of robust, yet creative and pragmatic, methodological approaches. As a case study, a series of studies conducted over the past decade are reviewed in the same location in Niger highlighting the lessons learned. (author)

Identification and prevention of antibody disulfide bond reduction during cell culture manufacturing.

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Trexler-Schmidt, Melody; Sargis, Sandy; Chiu, Jason; Sze-Khoo, Stefanie; Mun, Melissa; Kao, Yung-Hsiang; Laird, Michael W

2010-06-15

In the biopharmaceutical industry, therapeutic monoclonal antibodies are primarily produced in mammalian cell culture systems. During the scale-up of a monoclonal antibody production process, we observed excessive mechanical cell shear as well as significant reduction of the antibody's interchain disulfide bonds during harvest operations. This antibody reduction event was catastrophic as the product failed to meet the drug substance specifications and the bulk product was lost. Subsequent laboratory studies have demonstrated that cells subjected to mechanical shear release cellular enzymes that contribute to this antibody reduction phenomenon (manuscript submitted; Kao et al., 2009). Several methods to prevent this antibody reduction event were developed using a lab-scale model to reproduce the lysis and reduction events. These methods included modifications to the cell culture media with chemicals (e.g., cupric sulfate (CuSO(4))), pre- and post-harvest chemical additions to the cell culture fluid (CCF) (e.g., CuSO(4), EDTA, L-cystine), as well as lowering the pH and air sparging of the harvested CCF (HCCF). These methods were evaluated for their effectiveness in preventing disulfide bond reduction and their impact to product quality. Effective prevention methods, which yielded acceptable product quality were evaluated for their potential to be implemented at manufacturing-scale. The work described here identifies numerous effective reduction prevention measures from lab-scale studies; several of these methods were then successfully translated into manufacturing processes. 2010 Wiley Periodicals, Inc.

"What" and "where" was when? Memory for the temporal order of episodic events in children.

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Scarf, Damian; Boden, Hannah; Labuschagne, Lisa G; Gross, Julien; Hayne, Harlene

2017-12-01

In the past, researchers have shown that the individual components of episodic memory (i.e "what," "where," and "when") may emerge at different points in development. Specifically, while children as young as three can accurately report the "what" and "where" of an event, they struggle to accurately report when the event occurred. One explanation for children's difficulty in reporting when an event took place is a rudimentary understanding, and ability to use, temporal terms. In the current experiment, we employed a physical timeline to aid children's reporting of the order in which a series of episodic events occurred. Overall, while 4-, 5-, and 6-year olds performed above chance, 3-year olds did not. Our findings suggest that 3-year olds' limited ability to produce temporal terms may not be the rate-limiting step preventing them from identifying when events occurred in their recent past. © 2017 Wiley Periodicals, Inc.

PONTIAC (NT-proBNP selected prevention of cardiac events in a population of diabetic patients without a history of cardiac disease): a prospective randomized controlled trial.

Science.gov (United States)

Huelsmann, Martin; Neuhold, Stephanie; Resl, Michael; Strunk, Guido; Brath, Helmut; Francesconi, Claudia; Adlbrecht, Christopher; Prager, Rudolf; Luger, Anton; Pacher, Richard; Clodi, Martin

2013-10-08

The study sought to assess the primary preventive effect of neurohumoral therapy in high-risk diabetic patients selected by N-terminal pro-B-type natriuretic peptide (NT-proBNP). Few clinical trials have successfully demonstrated the prevention of cardiac events in patients with diabetes. One reason for this might be an inaccurate selection of patients. NT-proBNP has not been assessed in this context. A total of 300 patients with type 2 diabetes, elevated NT-proBNP (>125 pg/ml) but free of cardiac disease were randomized. The "control" group was cared for at 4 diabetes care units; the "intensified" group was additionally treated at a cardiac outpatient clinic for the up-titration of renin-angiotensin system (RAS) antagonists and beta-blockers. The primary endpoint was hospitalization/death due to cardiac disease after 2 years. At baseline, the mean age of the patients was 67.5 ± 9 years, duration of diabetes was 15 ± 12 years, 37% were male, HbA1c was 7 ± 1.1%, blood pressure was 151 ± 22 mm Hg, heart rate was 72 ± 11 beats/min, median NT-proBNP was 265.5 pg/ml (interquartile range: 180.8 to 401.8 pg/ml). After 12 months there was a significant difference between the number of patients treated with a RAS antagonist/beta-blocker and the dosage reached between groups (p titration of RAS antagonists and beta-blockers to maximum tolerated dosages is an effective and safe intervention for the primary prevention of cardiac events for diabetic patients pre-selected using NT-proBNP. (Nt-proBNP Guided Primary Prevention of CV Events in Diabetic Patients [PONTIAC]; NCT00562952). Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Principal scheme of preventive maintenance support system for nuclear power plants

International Nuclear Information System (INIS)

Nishiyama, Takuya; Terano, Takao; Yokoo, Takeshi; Shinohara, Yasushi

1985-01-01

It is of great importance to turn lessons learned from abnormal event experiences to advantage as well as taking apriori actions for prevention of abnormal events in nuclear power plants. From this point of view, a consultation system, named as Preventive Maintenance Support System (PMSS), which is to possess accumulated knowledges drawn from the past abnormal events in nuclear power plants infer occurrences, factors and developments of abnormal events and recommend preventive countermeasures on the basis of the knowledges, has been proposed. This report presents the principal scheme of PMSS. To begin with, following to the discussion of the purpose and use of PMSS, the fundamental functions PMSS should perform are specified. They are (1) event factors analyzation, (2) event prediction (event development estimation and analogous event estimation), (3) event significance evaluation and (4) preventive countermeasures presentation. In the next place, it is asserted that such a system should be constructed as a knowledge engineering one. Then, the R and D subjects and related schedule for PMSS are set up. (author)

Cost-effectiveness of denosumab versus zoledronic acid for preventing skeletal-related events in the Czech Republic.

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Cristino, Joaquim; Finek, Jíndřich; Jandova, Petra; Kolek, Martin; Pásztor, Bálint; Giannopoulou, Christina; Qian, Yi; Brezina, Tomas; Lothgren, Mickael

2017-08-01

This study assessed the cost-effectiveness of the subcutaneous RANKL inhibitor, denosumab, vs the intravenous bisphosphonate, zoledronic acid, for the prevention of skeletal-related events (SREs) in patients with prostate cancer, breast cancer, and other solid tumors (OST) in the Czech Republic. A lifetime Markov model was developed to compare the effects of denosumab and zoledronic acid on costs (including drug costs and administration, patient management, SREs, and adverse events), quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios from a national payer perspective. Different discount rates, time horizons, SRE rates, distributions, and nature (asymptomatic vs all SREs), and the inclusion of treatment discontinuation were considered in scenario analyses. The robustness of the model was tested using deterministic and probabilistic sensitivity analyses. Across tumor types, denosumab was associated with fewer SREs, improved QALYs, and higher total costs over a lifetime. The incremental cost per QALY gained for denosumab vs zoledronic acid was 382,673 CZK for prostate cancer, 408,450 CZK for breast cancer, and 608,133 CZK for OST. Incremental costs per SRE avoided for the same tumor type were 54,007 CZK, 51,765 CZK, and 94,426 CZK, respectively. In scenario analyses, the results remained similar to baseline, when different discount rates and time horizons were considered. At a non-official willingness-to-pay threshold of 1.2 million CZK, the probabilities of denosumab being cost-effective vs zoledronic acid were 0.64, 0.67, and 0.49 for prostate cancer, breast cancer, and OST, respectively. The SRE rates used were obtained from clinical trials; studies suggest rates may be higher in clinical practice. Additional evidence on real-world SRE rates could further improve the accuracy of the modeling. Compared with zoledronic acid, denosumab provides a cost-effective treatment option for the prevention of SREs in patients with prostate cancer

Long-term secondary prevention of acute myocardial infarction (SEPAT) - guidelines adherence and outcome.

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Ergatoudes, Constantinos; Thunström, Erik; Rosengren, Annika; Björck, Lena; Bengtsson Boström, Kristina; Falk, Kristin; Fu, Michael

2016-11-17

A number of registry studies have reported suboptimal adherence to guidelines for cardiovascular prevention during the first year after acute myocardial infarction (AMI). However, only a few studies have addressed long-term secondary prevention after AMI. This study evaluates prevention guideline adherence and outcome of guideline-directed secondary prevention in patients surviving 2 years after AMI. Patients aged 18-85 years at the time of their index AMI were consecutively identified from hospital discharge records between July 2010 and December 2011 in Gothenburg, Sweden. All patients who agreed to participate in the study (16.2%) were invited for a structured interview, physical examinations and laboratory analysis 2 years after AMI. Guideline-directed secondary preventive goals were defined as optimally controlled blood pressure, serum cholesterol, glucose, regular physical activity, smoking cessation and pharmacological treatment. The mean age of the study cohort (n = 200) at the index AMI was 63.0 ± 9.7 years, 79% were men. Only 3.5% of the cohort achieved all six guideline-directed secondary preventive goals 2 years after infarction. LDL therapy was used by 97% of the patients, beta-blockers by 83.0%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers by 76.5% and statins by 88.5%. During follow-up, non-fatal adverse cardiovascular events (cardiac hospitalization, recurrent acute coronary syndrome, angina pectoris, new percutaneous coronary intervention, new onset of atrial fibrillation, post-infarct heart failure, pacemaker implantation, stroke/transient ischemic attack (TIA), cardiac surgery and cardiac arrest) occurred in 47% of the cohort and readmission due to cardiac causes in 30%. Our data showed the failure of secondary prevention in our daily clinical practice and high rate of non-fatal adverse cardiovascular events 2 years after AMI.

Characterization and specificity of probiotics to prevent salmonella infection in mice

Directory of Open Access Journals (Sweden)

Ana Andino

2014-08-01

Full Text Available Background: Probiotic strains of bacteria can prevent Salmonella from causing disease by preventing the pathogen from colonizing the intestines. Two strains of probiotics, Lactobacillus acidophilius and Pediococcus spp, that were obtained from poultry fecal samples have been shown to be efficacious in poultry. The objective of this study was to determine if these strains of probiotics could prevent salmonellosis in a mouse model. Methods: First, both strains of probiotics were evaluated for in vitro efficacy to inhibit the growth of and interfere with virulence gene regulation in Salmonella enterica. For in vivo efficacy, mice was used which models Typhoid illness. Mice were divided into 2 groups: Control and treatment, Lactobacillus and Pediococcus (LP; 108 Log CFU. Two experiments were conducted. In the first experiment, the mice were treated with LP in water for the first two days of the experiment and challenged with Salmonella at day three. In the second experiment, the LP treatment was given in the water for 10 days and challenge was performed on day 11. In both experiments, at day 20 post-challenge, all mice were sacrificed, intestinal tracts and organs removed and cultured for Salmonella. Results: The probiotic strains inhibited the growth of Salmonella and down-regulation of virulence genes was noted, but dependent on the strain of Salmonella being evaluated. For the in vivo experiment, the probiotics did not afford the mice protection from infection and increasing the length of time the probiotics were administered did not improve the efficacy of the probiotics. Conclusions: It appears that these strains of probiotic bacteria are effective against Salmonella in vitro. However, these isolates did not afford protection from Salmonella infection to mice which may be due to host specifity as these isolates were obtained from poultry

A prospective three-step intervention study to prevent medication errors in drug handling in paediatric care.

Science.gov (United States)

Niemann, Dorothee; Bertsche, Astrid; Meyrath, David; Koepf, Ellen D; Traiser, Carolin; Seebald, Katja; Schmitt, Claus P; Hoffmann, Georg F; Haefeli, Walter E; Bertsche, Thilo

2015-01-01

To prevent medication errors in drug handling in a paediatric ward. One in five preventable adverse drug events in hospitalised children is caused by medication errors. Errors in drug prescription have been studied frequently, but data regarding drug handling, including drug preparation and administration, are scarce. A three-step intervention study including monitoring procedure was used to detect and prevent medication errors in drug handling. After approval by the ethics committee, pharmacists monitored drug handling by nurses on an 18-bed paediatric ward in a university hospital prior to and following each intervention step. They also conducted a questionnaire survey aimed at identifying knowledge deficits. Each intervention step targeted different causes of errors. The handout mainly addressed knowledge deficits, the training course addressed errors caused by rule violations and slips, and the reference book addressed knowledge-, memory- and rule-based errors. The number of patients who were subjected to at least one medication error in drug handling decreased from 38/43 (88%) to 25/51 (49%) following the third intervention, and the overall frequency of errors decreased from 527 errors in 581 processes (91%) to 116/441 (26%). The issue of the handout reduced medication errors caused by knowledge deficits regarding, for instance, the correct 'volume of solvent for IV drugs' from 49-25%. Paediatric drug handling is prone to errors. A three-step intervention effectively decreased the high frequency of medication errors by addressing the diversity of their causes. Worldwide, nurses are in charge of drug handling, which constitutes an error-prone but often-neglected step in drug therapy. Detection and prevention of errors in daily routine is necessary for a safe and effective drug therapy. Our three-step intervention reduced errors and is suitable to be tested in other wards and settings. © 2014 John Wiley & Sons Ltd.

[Metabolic Syndrome as a marker of cardiovascular events in hypertensives in primary prevention].

Science.gov (United States)

Costa, José Antonio; Rodilla, Enrique; Cardona, Joaquín; González, Carmen; Pascual, José María

2012-07-07

The aim of this study was to assess the impact of metabolic syndrome (MS) as a predictor of cardiovascular events (CVE) in hypertensives in primary prevention. This retrospective study involved 2410 non-diabetic, hypertensive patients (52% women, 43% with MS), without previous CVE. The total follow-up was 13096 patient-years with a median of 4,5 years (IIQ; 2,2-7,3). Patients with metabolic syndrome did not have more risk of CVE (HR 1,19; CI 95%:0,89-1,58; p=0,292), 183 patients had a CVE, 88 in patients with MS (15,4; CI 95%:12,4-19,0 patients-years), and 95 in patients without MS (13,0; CI 95%:10,5-15,9 patients/years) (p=0,279). In a multivariate analysis corrected for other factors, only age (HR 1,08; CI 95%: 1,07-1,10; p=0,001), male gender (HR 1,77; CI 95%: 1,27-2,45; p=0,001), smoking (HR 2,95; CI 95%: 2,01-4,34; p=0,001) at the beginning, and values of systolic arterial pressure ≥160 mm Hg (HR 1,83; CI 95%: 1,17-2,89; p=0,009) and cholesterol-low density lipoproteins ≥160 mg/dl (HR 1,58; CI 95%: 1,05-2,38; p=0,029) during the follow-up, were associated with new CVE. In hypertensive non-diabetic patients in primary prevention the diagnosis of metabolic syndrome did not add any significant prediction about future CVE over the traditional risk factors. Systolic arterial pressure ≥160 mm Hg and cholesterol-low density lipoproteins ≥160 mg/dl, respectively, during the follow up were factors related to new CVE. Copyright © 2011 Elsevier España, S.L. All rights reserved.

Exploring the Masculine Identity in the Context of HIV Prevention in Chile.

Science.gov (United States)

Ferrer, Lilian; Cianelli, Rosina; Villegas, Natalia; Reed, Reiley; Bernales, Margarita; Repetto, Paula; Hufstader, Theodore; Lara, Loreto; Irarrázabal, Lisette; Peragallo-Montano, Nilda

2016-03-01

This study aims to describe human immunodeficiency virus (HIV)-related knowledge and beliefs, as well as understanding attitudes towards masculinity in the context of HIV prevention, held among Chilean men. This study reports the qualitative findings of a sequential qualitative-quantitative mixed methodology study: Bringing men into HIV Prevention in Chile, NIH R01 TW007674-03. Twenty in-depth interviews using a qualitative, descriptive approach to elicit information for the study were conducted among men residing in two communities of low socio-economic status in Santiago, Chile. Content analysis of interviews revealed three main themes regarding machismo and how it relates to HIV: sexuality and machismo, the changing nature of machismo, and violence against women. Addressing HIV and intimate partner violence through developing education programs tailored to meet the needs of Chilean men are needed to include men in HIV prevention efforts. Specifically, incorporating ideas of what men consider healthy masculinity and working to destigmatize men who have sex with men are important steps in addressing the negative aspects of machismo. © 2016 Sigma Theta Tau International.

A Youth Suicide Prevention Plan for Canada: A Systematic Review of Reviews.

Science.gov (United States)

Bennett, Kathryn; Rhodes, Anne E; Duda, Stephanie; Cheung, Amy H; Manassis, Katharina; Links, Paul; Mushquash, Christopher; Braunberger, Peter; Newton, Amanda S; Kutcher, Stanley; Bridge, Jeffrey A; Santos, Robert G; Manion, Ian G; Mclennan, John D; Bagnell, Alexa; Lipman, Ellen; Rice, Maureen; Szatmari, Peter

2015-06-01

We conducted an expedited knowledge synthesis (EKS) to facilitate evidence-informed decision making concerning youth suicide prevention, specifically school-based strategies and nonschool-based interventions designed to prevent repeat attempts. Systematic review of review methods were applied. Inclusion criteria were as follows: systematic review or meta-analysis; prevention in youth 0 to 24 years; peer-reviewed English literature. Review quality was determined with AMSTAR (a measurement tool to assess systematic reviews). Nominal group methods quantified consensus on recommendations derived from the findings. No included review addressing school-based prevention (n = 7) reported decreased suicide death rates based on randomized controlled trials (RCTs) or controlled cohort studies (CCSs), but reduced suicide attempts, suicidal ideation, and proxy measures of suicide risk were reported (based on RCTs and CCSs). Included reviews addressing prevention of repeat suicide attempts (n = 14) found the following: emergency department transition programs may reduce suicide deaths, hospitalizations, and treatment nonadherence (based on RCTs and CCSs); training primary care providers in depression treatment may reduce repeated attempts (based on one RCT); antidepressants may increase short-term suicide risk in some patients (based on RCTs and meta-analyses); this increase is offset by overall population-based reductions in suicide associated with antidepressant treatment of youth depression (based on observational studies); and prevention with psychosocial interventions requires further evaluation. No review addressed sex or gender differences systematically, Aboriginal youth as a special population, harm, or cost-effectiveness. Consensus on 6 recommendations ranged from 73% to 100%. Our EKS facilitates decision maker access to what is known about effective youth suicide prevention interventions. A national research-to-practice network that links researchers and decision

Statistical Considerations of Food Allergy Prevention Studies.

Science.gov (United States)

Bahnson, Henry T; du Toit, George; Lack, Gideon

Clinical studies to prevent the development of food allergy have recently helped reshape public policy recommendations on the early introduction of allergenic foods. These trials are also prompting new research, and it is therefore important to address the unique design and analysis challenges of prevention trials. We highlight statistical concepts and give recommendations that clinical researchers may wish to adopt when designing future study protocols and analysis plans for prevention studies. Topics include selecting a study sample, addressing internal and external validity, improving statistical power, choosing alpha and beta, analysis innovations to address dilution effects, and analysis methods to deal with poor compliance, dropout, and missing data. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Event-specific qualitative and quantitative PCR detection of the GMO carnation (Dianthus caryophyllus) variety Moonlite based upon the 5'-transgene integration sequence.

Science.gov (United States)

Li, P; Jia, J W; Jiang, L X; Zhu, H; Bai, L; Wang, J B; Tang, X M; Pan, A H

2012-04-27

To ensure the implementation of genetically modified organism (GMO)-labeling regulations, an event-specific detection method was developed based on the junction sequence of an exogenous integrant in the transgenic carnation variety Moonlite. The 5'-transgene integration sequence was isolated by thermal asymmetric interlaced PCR. Based upon the 5'-transgene integration sequence, the event-specific primers and TaqMan probe were designed to amplify the fragments, which spanned the exogenous DNA and carnation genomic DNA. Qualitative and quantitative PCR assays were developed employing the designed primers and probe. The detection limit of the qualitative PCR assay was 0.05% for Moonlite in 100 ng total carnation genomic DNA, corresponding to about 79 copies of the carnation haploid genome; the limit of detection and quantification of the quantitative PCR assay were estimated to be 38 and 190 copies of haploid carnation genomic DNA, respectively. Carnation samples with different contents of genetically modified components were quantified and the bias between the observed and true values of three samples were lower than the acceptance criterion (GMO detection method. These results indicated that these event-specific methods would be useful for the identification and quantification of the GMO carnation Moonlite.

Aspirin for primary prevention of cardiovascular events: meta-analysis of randomized controlled trials and subgroup analysis by sex and diabetes status.

Directory of Open Access Journals (Sweden)

Manling Xie

Full Text Available To evaluate the benefits and harms of aspirin for the primary prevention of CVD and determine whether the effects vary by sex and diabetes status.We searched Medline, Embase, and Cochrane databases for randomized controlled trials comparing the effects of aspirin with placebo or control in people with no pre-existing CVD. Two investigators independently extracted data and assessed the study quality. Analyses were performed using Stata version 12.Fourteen trials (107,686 participants were eligible. Aspirin was associated with reductions in major cardiovascular events (risk ratio, 0.90; 95% confidence interval, 0.85-0.95, myocardial infarction (0.86; 0.75-0.93, ischemic stroke (0.86; 0.75-0.98 and all-cause mortality (0.94; 0.89-0.99. There were also increases in hemorrhagic stroke (1.34; 1.01-1.79 and major bleeding (1.55; 1.35-1.78 with aspirin. The number needed to treat to prevent 1 major cardiovascular event over a mean follow-up of 6.8 years was 284. By comparison, the numbers needed to harm to cause 1 major bleeding is 299. In subgroup analyses, pooled results demonstrated a reduction in myocardial infarction among men (0.71; 0.59-0.85 and ischemic stroke among women (0.77; 0.63-0.93. Aspirin use was associated with a reduction (0.65; 0.51-0.82 in myocardial infarction among diabetic men. In meta-regression analyses, the results suggested that aspirin therapy might be associated with a decrease in stroke among diabetic women and a decrease in MI among diabetic men and risk reductions achieved with low doses (75 mg/day were as large as those obtained with higher doses (650 mg/day.The use of low-dose aspirin was beneficial for primary prevention of CVD and the decision regarding an aspirin regimen should be made on an individual patient basis. The effects of aspirin therapy varied by sex and diabetes status. A clear benefit of aspirin in the primary prevention of CVD in people with diabetes needs more trials.

Prescription-event monitoring: developments in signal detection.

Science.gov (United States)

Ferreira, Germano

2007-01-01

examined when comparing the 'strength of the signals' across drugs using PRR values. Further research will be required to address the sensitivity and specificity of the two ways of calculating PRR using data derived from drug cohorts.

Gender-Specific HIV Prevention with Urban Early-Adolescent Girls: Outcomes of the Keepin' It Safe Program

Science.gov (United States)

Di Noia, Jennifer; Schinke, Steven P.

2007-01-01

This study evaluates the efficacy of Keepin' It Safe, a theory-based, gender-specific, CD-ROM-mediated HIV prevention program for urban, early adolescent girls. Intervention effects were examined in a randomized, pretest-posttest wait-list control-group design. Changes in HIV/AIDS knowledge, protective attitudes, and skills for reducing HIV…

Extreme Events in Nature and Society

CERN Document Server

Albeverio, Sergio; Kantz, Holger

2006-01-01

Significant, and usually unwelcome, surprises, such as floods, financial crisis, epileptic seizures, or material rupture, are the topics of Extreme Events in Nature and Society. The book, authored by foremost experts in these fields, reveals unifying and distinguishing features of extreme events, including problems of understanding and modelling their origin, spatial and temporal extension, and potential impact. The chapters converge towards the difficult problem of anticipation: forecasting the event and proposing measures to moderate or prevent it. Extreme Events in Nature and Society will interest not only specialists, but also the general reader eager to learn how the multifaceted field of extreme events can be viewed as a coherent whole.

Teen pregnancy prevention: current perspectives.

Science.gov (United States)

Lavin, Claudia; Cox, Joanne E

2012-08-01

Teen pregnancy has been subject of public concern for many years. In the United States, despite nearly 2 decades of declining teen pregnancy and birth rates, the problem persists, with significant disparities present across racial groups and in state-specific rates. This review examines recent trends, pregnancy prevention initiatives and family planning policies that address the special needs of vulnerable youth. Unintended teen pregnancies impose potentially serious social and health burdens on teen parents and their children, as well as costs to society. Trends in teen pregnancy and birth rates show continued decline, but state and racial disparities have widened. Demographic factors and policy changes have contributed to these disparities. Research supports comprehensive pregnancy prevention initiatives that are multifaceted and promote consistent and correct use of effective methods of contraception for youth at risk of becoming pregnant. There is strong consensus that effective teen pregnancy prevention strategies should be multifaceted, focusing on delay of sexual activity especially in younger teens while promoting consistent and correct use of effective methods of contraception for those youth who are or plan to be sexually active. There is a need for further research to identify effective interventions for vulnerable populations.

The effect of social networks and social support on common mental disorders following specific life events.

Science.gov (United States)

Maulik, P K; Eaton, W W; Bradshaw, C P

2010-08-01

This study examined the association between life events and common mental disorders while accounting for social networks and social supports. Participants included 1920 adults in the Baltimore Epidemiologic Catchment Area Cohort who were interviewed in 1993-1996, of whom 1071 were re-interviewed in 2004-2005. Generalized estimating equations were used to analyze the data. Social support from friends, spouse or relatives was associated with significantly reduced odds of panic disorder and psychological distress, after experiencing specific life events. Social networks or social support had no significant stress-buffering effect. Social networks and social support had almost no direct or buffering effect on major depressive disorder, and no effect on generalized anxiety disorder and alcohol abuse or dependence disorder. The significant association between social support and psychological distress, rather than diagnosable mental disorders, highlights the importance of social support, especially when the severity of a mental health related problem is low.

Prevention of relapsing backache

Directory of Open Access Journals (Sweden)

Raspe, Heiner

2006-05-01

Full Text Available Background: The condition of non-specific back pain is characterized by high prevalence, non satisfactory therapeutic options and severe socioeconomic consequences. Therefore prevention seems an attractive option to downsize the problem. However, the construction of effective preventive measures is complicated by the obscure aetiology of the condition, the multidimensionality of risk and prognostic factors (bio psychosocial model! and the variability of its natural as well as clinical course. This led to the development of a wide variety of preventive measures: e. g. exercise programs, educational measures (including back school, ergonomic modification of the work environment, mechanical supports (e. g. back belts as well as multidisciplinary interventions. For two reasons the workplace seems to be a suitable setting for prevention. First, because a number of strong risk factors are associated with working conditions and second, because it allows addressing a large proportion of the adult population. Against this background the assessment at hand sets out to answer the following questions: What is the amount and methodological quality of the available scientific literature on the effectiveness of back pain prevention in the workplace environment? What are effective measures for the prevention of back pain and its consequences in the workplace environment and how effective are they? Is back pain prevention in the workplace environment cost-effective? Is there a need for more research? As primary outcomes for effectiveness the assessment will focus on time lost from work and the frequency and duration of episodes with back pain. The preventive measures assessed belong to the following categories: exercise programs, educational and information measures, multidimensional interventions, back belts, lifting teams and ergonomic interventions. Methods: The assessment is based on a systematic review of the published literature according to the

Hazards of Illicit Methamphetamine Production and Efforts at Reduction: Data from the Hazardous Substances Emergency Events Surveillance System

Science.gov (United States)

Melnikova, Natalia; Welles, Wanda Lizak; Wilburn, Rebecca E.; Rice, Nancy; Wu, Jennifer; Stanbury, Martha

2011-01-01

Objectives. Methamphetamine (meth) is a highly addictive drug of abuse that can easily be made in small illegal laboratories from household chemicals that are highly toxic and dangerous. Meth labs have been found in locations such as homes, outbuildings, motels, and cars. Its production endangers the “cook,” neighbors, responders, and the environment. This article describes surveillance data used to examine the emergence and public health impacts of illicit clandestine meth labs, as well as two states' efforts to thwart lab operations and prevent responder injuries. Methods. We analyzed data collected from 2001 to 2008 by 18 states participating in the Agency for Toxic Substances and Disease Registry's Hazardous Substances Emergency Events Surveillance (HSEES) Program to examine the occurrence and public health impacts of clandestine meth production. Results. HSEES data indicate that the majority of clandestine meth lab events occurred in residential areas. About 15% of meth lab events required evacuation. Nearly one-fourth of these events resulted in injuries, with 902 reported victims. Most victims (61%) were official responders, and one-third were members of the general public. Since 2004, with the implementation of local and federal laws and prevention activities, the number of meth lab events has declined. Increased education and training of first responders has led to decreased injuries among police officers, firefighters, and emergency medical personnel. Conclusions. HSEES data provided a good data source for monitoring the emergence of domestic clandestine meth production, the associated public health effects, and the results of state and federal efforts to promote actions to address the problem. PMID:21563719

Cardiovascular disease events and its predictors in women: Isfahan Cohort Study (ICS

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Masoumeh Sadeghi

2017-09-01

Conclusion: In ICS, HTN, diabetes mellitus and high triglyceride are strong predictors for CV events in Iranian women. As almost all strong risk markers of CVD events are preventable, health policy makers have to give urgent consideration to make preventive public health strategies.

Preventive Strategies against Bleeding due to Nonvitamin K Antagonist Oral Anticoagulants

Directory of Open Access Journals (Sweden)

Lessire Sarah

2014-01-01

Full Text Available Dabigatran etexilate (DE, rivaroxaban, and apixaban are nonvitamin K antagonist oral anticoagulants (NOACs that have been compared in clinical trials with existing anticoagulants (warfarin and enoxaparin in several indications for the prevention and treatment of thrombotic events. All NOACs presented bleeding events despite a careful selection and control of patients. Compared with warfarin, NOACs had a decreased risk of intracranial hemorrhage, and apixaban and DE (110 mg BID had a decreased risk of major bleeding from any site. Rivaroxaban and DE showed an increased risk of major gastrointestinal bleeding compared with warfarin. Developing strategies to minimize the risk of bleeding is essential, as major bleedings are reported in clinical practice and specific antidotes are currently not available. In this paper, the following preventive approaches are reviewed: improvement of appropriate prescription, identification of modifiable bleeding risk factors, tailoring NOAC’s dose, dealing with a missed dose as well as adhesion to switching, bridging and anesthetic procedures.

Communication strategies to address geohydrological risks: the POLARIS web initiative in Italy

Science.gov (United States)

Salvati, Paola; Pernice, Umberto; Bianchi, Cinzia; Marchesini, Ivan; Fiorucci, Federica; Guzzetti, Fausto

2016-06-01

Floods and landslides are common phenomena that cause serious damage and pose a severe threat to the population of Italy. The social and economic impact of floods and landslides in Italy is severe, and strategies to target the mitigation of the effects of these phenomena are needed. In the last few years, the scientific community has started to use web technology to communicate information on geohydrological hazards and the associated risks. However, the communication is often targeted at technical experts. In the attempt to communicate relevant information on geohydrological hazards with potential human consequences to a broader audience, we designed the POpoLazione A RISchio (POLARIS) website. POLARIS publishes accurate information on geohydrological risk to the population of Italy, including periodic reports on landslide and flood risk, analyses of specific damaging events and blog posts on landslide and flood events. By monitoring the access to POLARIS in the 21-month period between January 2014 and October 2015, we found that access increased during particularly damaging geohydrological events and immediately after the website was advertised by press releases. POLARIS demonstrates that the scientific community can implement suitable communication strategies that address different societal audiences, exploiting the role of mass media and social media. The strategies can help multiple audiences understand how risks can be reduced through appropriate measures and behaviours, contributing to increasing the resilience of the population to geohydrological risk.

A loss-of -RHR event under the various plant configurations in low power or shutdown conditions

International Nuclear Information System (INIS)

Seul, Kwang Won; Bang, Young Seok; Lee, Suk Ho; Kim, Hho Jung

1997-01-01

A present study addresses a loss-of-RHR event as an initiating event under specific low power of shutdown conditions. Two typical plant configurations, cold leg opening case with water-filled steam generators and pressurizer opening case with emptied steam generators, were evaluated using the RELAP5/MOD3.2 code. The calculation was compared with the experiment conducted at ROSA-IV/LSTF in Japan. As a result, the code was capable of simulating the system transient behavior following the event. Especially, thermal hydraulic transport processes including non-condensable gas behavior were reasonably predicted with an appropriate time step and CPU time. However, there were some code deficiencies such as too large system mass errors and severe flow oscillations in core region

Gender-Specific Combination HIV Prevention for Youth in High-Burden Settings: The MP3 Youth Observational Pilot Study Protocol.

Science.gov (United States)

Buttolph, Jasmine; Inwani, Irene; Agot, Kawango; Cleland, Charles M; Cherutich, Peter; Kiarie, James N; Osoti, Alfred; Celum, Connie L; Baeten, Jared M; Nduati, Ruth; Kinuthia, John; Hallett, Timothy B; Alsallaq, Ramzi; Kurth, Ann E

2017-03-08

Nearly three decades into the epidemic, sub-Saharan Africa (SSA) remains the region most heavily affected by human immunodeficiency virus (HIV), with nearly 70% of the 34 million people living with HIV globally residing in the region. In SSA, female and male youth (15 to 24 years) are at a disproportionately high risk of HIV infection compared to adults. As such, there is a need to target HIV prevention strategies to youth and to tailor them to a gender-specific context. This protocol describes the process for the multi-staged approach in the design of the MP3 Youth pilot study, a gender-specific, combination, HIV prevention intervention for youth in Kenya. The objective of this multi-method protocol is to outline a rigorous and replicable methodology for a gender-specific combination HIV prevention pilot study for youth in high-burden settings, illustrating the triangulated methods undertaken to ensure that age, sex, and context are integral in the design of the intervention. The mixed-methods, cross-sectional, longitudinal cohort pilot study protocol was developed by first conducting a systematic review of the literature, which shaped focus group discussions around prevention package and delivery options, and that also informed age- and sex- stratified mathematical modeling. The review, qualitative data, and mathematical modeling created a triangulated evidence base of interventions to be included in the pilot study protocol. To design the pilot study protocol, we convened an expert panel to select HIV prevention interventions effective for youth in SSA, which will be offered in a mobile health setting. The goal of the pilot study implementation and evaluation is to apply lessons learned to more effective HIV prevention evidence and programming. The combination HIV prevention package in this protocol includes (1) offering HIV testing and counseling for all youth; (2) voluntary medical circumcision and condoms for males; (3) pre-exposure prophylaxis (Pr

Injury prevention in Australian Indigenous communities.

Science.gov (United States)

Ivers, Rebecca; Clapham, Kathleen; Senserrick, Teresa; Lyford, Marilyn; Stevenson, Mark

2008-12-01

Injury prevention in Indigenous communities in Australia is a continuing national challenge, with Indigenous fatality rates due to injury three times higher than the general population. Suicide and transport are the leading causes of injury mortality, and assault, transport and falls the primary causes of injury morbidity. Addressing the complex range of injury problems in disadvantaged Indigenous communities requires considerable work in building or enhancing existing capacity of communities to address local safety issues. Poor data, lack of funding and absence of targeted programs are some of the issues that impede injury prevention activities. Traditional approaches to injury prevention can be used to highlight key areas of need, however adaptations are needed in keeping with Indigenous peoples' holistic approach to health, linked to land and linked to community in order to address the complex spiritual, emotional and social determinants of Indigenous injury.

Lack of evidence to favor specific preventive interventions in psychosis: a network meta‐analysis

Science.gov (United States)

Davies, Cathy; Cipriani, Andrea; Ioannidis, John P.A.; Radua, Joaquim; Stahl, Daniel; Provenzani, Umberto; McGuire, Philip; Fusar‐Poli, Paolo

2018-01-01

Preventing psychosis in patients at clinical high risk may be a promising avenue for pre‐emptively ameliorating outcomes of the most severe psychiatric disorder. However, information on how each preventive intervention fares against other currently available treatment options remains unavailable. The aim of the current study was to quantify the consistency and magnitude of effects of specific preventive interventions for psychosis, comparing different treatments in a network meta‐analysis. PsycINFO, Web of Science, Cochrane Central Register of Controlled Trials, and unpublished/grey literature were searched up to July 18, 2017, to identify randomized controlled trials conducted in individuals at clinical high risk for psychosis, comparing different types of intervention and reporting transition to psychosis. Two reviewers independently extracted data. Data were synthesized using network meta‐analyses. The primary outcome was transition to psychosis at different time points and the secondary outcome was treatment acceptability (dropout due to any cause). Effect sizes were reported as odds ratios and 95% confidence intervals (CIs). Sixteen studies (2,035 patients, 57% male, mean age 20.1 years) reported on risk of transition. The treatments tested were needs‐based interventions (NBI); omega‐3 + NBI; ziprasidone + NBI; olanzapine + NBI; aripiprazole + NBI; integrated psychological interventions; family therapy + NBI; D‐serine + NBI; cognitive behavioural therapy, French & Morrison protocol (CBT‐F) + NBI; CBT‐F + risperidone + NBI; and cognitive behavioural therapy, van der Gaag protocol (CBT‐V) + CBT‐F + NBI. The network meta‐analysis showed no evidence of significantly superior efficacy of any one intervention over the others at 6 and 12 months (insufficient data were available after 12 months). Similarly, there was no evidence for intervention differences in acceptability at either time point. Tests

Economic impact profiling of CBRN events: focusing on biological incidents.

Science.gov (United States)

Cavallini, Simona; Bisogni, Fabio; Mastroianni, Marco

2014-12-01

Chemical, biological, radiological and nuclear (CBRN) incidents, both caused accidentally by human error or natural/technological events and determined intentionally as criminal/malicious/terroristic acts, have consequences that could be differently characterized. In the last years many efforts to analyze the economic impact of terrorist threat have been carried out, while researches specifically concerning CBRN events have not been extensively undertaken. This paper in particular aims at proposing a methodological approach for studying macro-level economic impact profiles of biological incidents caused by weaponized and non-weaponized materials. The suggested approach investigates the economic consequences of biological incidents according to two main dimensions: type of large-scale effect and persistence of effect. Biological incident economic impacts are analyzed taking into account the persistence of effect during time as short-term impact (i.e. immediately after the incident), medium-term impact (i.e. by a month) and long-term impact (i.e. by years). The costs due to preventive countermeasure against biological threats (e.g. prevention, protection and preparedness expenses) are not taken into account. To this purpose, information on the key features of past biological incidents can be used as case studies to try to build impact profiles taking into account the proposed two main dimensions. Consequence management and effect mitigation of CBRN emergencies and disasters may benefit from an ex ante definition of the impact profiling related to this kind of incidents. The final goal of this paper is to define an approach to organize information on possible biological events according to their impact profile for supporting more effective and efficient first responders' prompt actions and policy makers' strategic decisions after the event occurrence.

Assessing traumatic event exposure: general issues and preliminary findings for the Stressful Life Events Screening Questionnaire.

Science.gov (United States)

Goodman, L A; Corcoran, C; Turner, K; Yuan, N; Green, B L

1998-07-01

This article reviews the psychometric properties of the Stressful Life Events Screening Questionnaire (SLESQ), a recently developed trauma history screening measure, and discusses the complexities involved in assessing trauma exposure. There are relatively few general measures of exposure to a variety of types of traumatic events, and most of those that exist have not been subjected to rigorous psychometric evaluation. The SLESQ showed good test-retest reliability, with a median kappa of .73, adequate convergent validity (with a lengthier interview) with a median kappa of .64, and good discrimination between Criterion A and non-Criterion A events. The discussion addresses some of the challenges of assessing traumatic event exposure along the dimensions of defining traumatic events, assessment methodologies, reporting consistency, and incident validation.

Could chiropractors screen for adverse drug events in the community? Survey of US chiropractors

Directory of Open Access Journals (Sweden)

Bero Lisa

2010-11-01

Full Text Available Abstract Background The "Put Prevention into Practice" campaign of the US Public Health Service (USPHS was launched with the dissemination of the Clinician's Handbook of Preventive Services that recommended standards of clinical care for various prevention activities, including preventive clinical strategies to reduce the risk of adverse drug events. We explored whether nonprescribing clinicians such as chiropractors may contribute to advancing drug safety initiatives by identifying potential adverse drug events in their chiropractic patients, and by bringing suspected adverse drug events to the attention of the prescribing clinicians. Methods Mail survey of US chiropractors about their detection of potential adverse drug events in their chiropractic patients. Results Over half of responding chiropractors (62% reported having identified a suspected adverse drug event occurring in one of their chiropractic patients. The severity of suspected drug-related events detected ranged from mild to severe. Conclusions Chiropractors or other nonprescribing clinicians may be in a position to detect potential adverse drug events in the community. These detection and reporting mechanisms should be standardized and policies related to clinical case management of suspected adverse drug events occurring in their patients should be developed.

Multistate event history analysis with frailty

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Govert Bijwaard

2014-05-01

Full Text Available Background: In survival analysis a large literature using frailty models, or models with unobserved heterogeneity, exists. In the growing literature and modelling on multistate models, this issue is only in its infant phase. Ignoring frailty can, however, produce incorrect results. Objective: This paper presents how frailties can be incorporated into multistate models, with an emphasis on semi-Markov multistate models with a mixed proportional hazard structure. Methods: First, the aspects of frailty modeling in univariate (proportional hazard, Cox and multivariate event history models are addressed. The implications of choosing shared or correlated frailty is highlighted. The relevant differences with recurrent events data are covered next. Multistate models are event history models that can have both multivariate and recurrent events. Incorporating frailty in multistate models, therefore, brings all the previously addressed issues together. Assuming a discrete frailty distribution allows for a very general correlation structure among the transition hazards in a multistate model. Although some estimation procedures are covered the emphasis is on conceptual issues. Results: The importance of multistate frailty modeling is illustrated with data on labour market and migration dynamics of recent immigrants to the Netherlands.

Practical Strategies for Preventing Adolescent Suicide

Science.gov (United States)

King, Keith

2006-01-01

A comprehensive approach to suicide prevention is needed to effectively address the problem of teen suicide. This article describes three levels of prevention (primary prevention, intervention, and postvention) and provides practical strategies that community, mental, and social health professionals can use within each level to help prevent…

Relationship between medication event rates and the Leapfrog computerized physician order entry evaluation tool.

Science.gov (United States)

Leung, Alexander A; Keohane, Carol; Lipsitz, Stuart; Zimlichman, Eyal; Amato, Mary; Simon, Steven R; Coffey, Michael; Kaufman, Nathan; Cadet, Bismarck; Schiff, Gordon; Seger, Diane L; Bates, David W

2013-06-01

The Leapfrog CPOE evaluation tool has been promoted as a means of monitoring computerized physician order entry (CPOE). We sought to determine the relationship between Leapfrog scores and the rates of preventable adverse drug events (ADE) and potential ADE. A cross-sectional study of 1000 adult admissions in five community hospitals from October 1, 2008 to September 30, 2010 was performed. Observed rates of preventable ADE and potential ADE were compared with scores reported by the Leapfrog CPOE evaluation tool. The primary outcome was the rate of preventable ADE and the secondary outcome was the composite rate of preventable ADE and potential ADE. Leapfrog performance scores were highly related to the primary outcome. A 43% relative reduction in the rate of preventable ADE was predicted for every 5% increase in Leapfrog scores (rate ratio 0.57; 95% CI 0.37 to 0.88). In absolute terms, four fewer preventable ADE per 100 admissions were predicted for every 5% increase in overall Leapfrog scores (rate difference -4.2; 95% CI -7.4 to -1.1). A statistically significant relationship between Leapfrog scores and the secondary outcome, however, was not detected. Our findings support the use of the Leapfrog tool as a means of evaluating and monitoring CPOE performance after implementation, as addressed by current certification standards. Scores from the Leapfrog CPOE evaluation tool closely relate to actual rates of preventable ADE. Leapfrog testing may alert providers to potential vulnerabilities and highlight areas for further improvement.

Re-inventing prevention? - An evaluation of tools for strengthening private preparedness for floods and heavy rains

Science.gov (United States)

Rohland, Stefanie; Pfurtscheller, Clemens; Seebauer, Sebastian

2016-04-01

Keywords: private preparedness, property protection, flood, heavy rains, Transtheoretical Model, evaluation of methods and tools Experiences in Europe and Austria from coping with numerous floods and heavy rain events in recent decades point to room for improvement in reducing damages and adverse effects. One of the emerging issues is private preparedness, which has only received punctual attention in Austria until now. Current activities to promote property protection are, however, not underpinned by a long-term strategy, thus minimizing their cumulative effect. While printed brochures and online information are widely available, innovative information services, tailored to and actively addressing specific target groups, are thin on the ground. This project reviews (national as well as international) established approaches, with a focus on German-speaking areas, checking their long-term effectiveness with the help of expert workshops and an empirical analysis of survey data. The Transtheoretical Model (Prochaska, 1977) serves as the analytical framework: We assign specific tools to distinct stages of behavioural change. People's openness to absorb risk information or their willingness to engage in private preparedness depend on an incremental process of considering, appraising, introducing and finally maintaining preventive actions. Based on this stage-specific perspective and the workshop results, gaps of intervention are identified to define best-practice examples and recommendations that can be realized within the prevailing legislative and organizational framework at national, regional and local level in Austria.

Addressable-Matrix Integrated-Circuit Test Structure

Science.gov (United States)

Sayah, Hoshyar R.; Buehler, Martin G.

1991-01-01

Method of quality control based on use of row- and column-addressable test structure speeds collection of data on widths of resistor lines and coverage of steps in integrated circuits. By use of straightforward mathematical model, line widths and step coverages deduced from measurements of electrical resistances in each of various combinations of lines, steps, and bridges addressable in test structure. Intended for use in evaluating processes and equipment used in manufacture of application-specific integrated circuits.

Scaling up liquid state machines to predict over address events from dynamic vision sensors.

Science.gov (United States)

Kaiser, Jacques; Stal, Rainer; Subramoney, Anand; Roennau, Arne; Dillmann, Rüdiger

2017-09-01

Short-term visual prediction is important both in biology and robotics. It allows us to anticipate upcoming states of the environment and therefore plan more efficiently. In theoretical neuroscience, liquid state machines have been proposed as a biologically inspired method to perform asynchronous prediction without a model. However, they have so far only been demonstrated in simulation or small scale pre-processed camera images. In this paper, we use a liquid state machine to predict over the whole  [Formula: see text]  event stream provided by a real dynamic vision sensor (DVS, or silicon retina). Thanks to the event-based nature of the DVS, the liquid is constantly fed with data when an object is in motion, fully embracing the asynchronicity of spiking neural networks. We propose a smooth continuous representation of the event stream for the short-term visual prediction task. Moreover, compared to previous works (2002 Neural Comput. 2525 282-93 and Burgsteiner H et al 2007 Appl. Intell. 26 99-109), we scale the input dimensionality that the liquid operates on by two order of magnitudes. We also expose the current limits of our method by running experiments in a challenging environment where multiple objects are in motion. This paper is a step towards integrating biologically inspired algorithms derived in theoretical neuroscience to real world robotic setups. We believe that liquid state machines could complement current prediction algorithms used in robotics, especially when dealing with asynchronous sensors.

CSI cardiac prevent 2015

OpenAIRE

S Ramakrishnan; Manisha Kaushik

2015-01-01

The CSI Cardiac Prevent 2015 was held at Hotel Taj Palace, New Delhi, on September 25-27, 2015. The major challenge was to create interest among cardiologists and physicians on preventive cardiology, a neglected area. The theme of the conference was "Innovations in Heart Disease Prevention.′′ This conference included "CSI at WHF Roadmap Workshop, Inauguration Ceremony, scientific program, plenary sessions, Nursing/Dietician track, Industry Exhibition, Social Events," Great India blood pressur...

Stream specificity and asymmetries in feature binding and content-addressable access in visual encoding and memory.

Science.gov (United States)

Huynh, Duong L; Tripathy, Srimant P; Bedell, Harold E; Ögmen, Haluk

2015-01-01

Human memory is content addressable-i.e., contents of the memory can be accessed using partial information about the bound features of a stored item. In this study, we used a cross-feature cuing technique to examine how the human visual system encodes, binds, and retains information about multiple stimulus features within a set of moving objects. We sought to characterize the roles of three different features (position, color, and direction of motion, the latter two of which are processed preferentially within the ventral and dorsal visual streams, respectively) in the construction and maintenance of object representations. We investigated the extent to which these features are bound together across the following processing stages: during stimulus encoding, sensory (iconic) memory, and visual short-term memory. Whereas all features examined here can serve as cues for addressing content, their effectiveness shows asymmetries and varies according to cue-report pairings and the stage of information processing and storage. Position-based indexing theories predict that position should be more effective as a cue compared to other features. While we found a privileged role for position as a cue at the stimulus-encoding stage, position was not the privileged cue at the sensory and visual short-term memory stages. Instead, the pattern that emerged from our findings is one that mirrors the parallel processing streams in the visual system. This stream-specific binding and cuing effectiveness manifests itself in all three stages of information processing examined here. Finally, we find that the Leaky Flask model proposed in our previous study is applicable to all three features.

Development and validation of an event-specific quantitative PCR method for genetically modified maize MIR162.

Science.gov (United States)

Takabatake, Reona; Masubuchi, Tomoko; Futo, Satoshi; Minegishi, Yasutaka; Noguchi, Akio; Kondo, Kazunari; Teshima, Reiko; Kurashima, Takeyo; Mano, Junichi; Kitta, Kazumi

2014-01-01

A novel real-time PCR-based analytical method was developed for the event-specific quantification of a genetically modified (GM) maize event, MIR162. We first prepared a standard plasmid for MIR162 quantification. The conversion factor (Cf) required to calculate the genetically modified organism (GMO) amount was empirically determined for two real-time PCR instruments, the Applied Biosystems 7900HT (ABI7900) and the Applied Biosystems 7500 (ABI7500) for which the determined Cf values were 0.697 and 0.635, respectively. To validate the developed method, a blind test was carried out in an interlaboratory study. The trueness and precision were evaluated as the bias and reproducibility of relative standard deviation (RSDr). The determined biases were less than 25% and the RSDr values were less than 20% at all evaluated concentrations. These results suggested that the limit of quantitation of the method was 0.5%, and that the developed method would thus be suitable for practical analyses for the detection and quantification of MIR162.

PRELIMINARY SELECTION OF MGR DESIGN BASIS EVENTS

International Nuclear Information System (INIS)

Kappes, J.A.

1999-01-01

The purpose of this analysis is to identify the preliminary design basis events (DBEs) for consideration in the design of the Monitored Geologic Repository (MGR). For external events and natural phenomena (e.g., earthquake), the objective is to identify those initiating events that the MGR will be designed to withstand. Design criteria will ensure that radiological release scenarios resulting from these initiating events are beyond design basis (i.e., have a scenario frequency less than once per million years). For internal (i.e., human-induced and random equipment failures) events, the objective is to identify credible event sequences that result in bounding radiological releases. These sequences will be used to establish the design basis criteria for MGR structures, systems, and components (SSCs) design basis criteria in order to prevent or mitigate radiological releases. The safety strategy presented in this analysis for preventing or mitigating DBEs is based on the preclosure safety strategy outlined in ''Strategy to Mitigate Preclosure Offsite Exposure'' (CRWMS M andO 1998f). DBE analysis is necessary to provide feedback and requirements to the design process, and also to demonstrate compliance with proposed 10 CFR 63 (Dyer 1999b) requirements. DBE analysis is also required to identify and classify the SSCs that are important to safety (ITS)

Regulatory approaches to obesity prevention: A systematic overview of current laws addressing diet-related risk factors in the European Union and the United States.

Science.gov (United States)

Sisnowski, Jana; Handsley, Elizabeth; Street, Jackie M

2015-06-01

High prevalence of overweight and obesity remains a significant international public health problem. Law has been identified as a tool for obesity prevention and selected high-profile measures have been reported. However, the nature and extent of enacted legislation internationally are unclear. This research provides an overview of regulatory approaches enacted in the United States, the European Union, and EU Member States since 2004. To this end, relevant databases of primary and secondary legislation were systematically searched to identify and explore laws addressing dietary risk factors for obesity. Across jurisdictions, current regulatory approaches to obesity prevention are limited in reach and scope. Target groups are rarely the general population, but instead sub-populations in government-supported settings. Consumer information provision is preferred over taxation and marketing restrictions other than the regulation of health and nutrition claims. In the EU in particular, product reformulation with industry consent has also emerged as a popular small-scale measure. While consistent and widespread use of law is lacking, governments have employed a range of regulatory measures in the name of obesity prevention, indicating that there is, in principle, political will. Results from this study may serve as a starting point for future research and policy development. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Operating experience feedback from safety significant events at research reactors

Energy Technology Data Exchange (ETDEWEB)

Shokr, A.M. [Atomic Energy Authority, Abouzabal (Egypt). Egypt Second Research Reactor; Rao, D. [Bhabha Atomic Research Centre, Mumbai (India)

2015-05-15

Operating experience feedback is an effective mechanism to provide lessons learned from the events and the associated corrective actions to prevent recurrence of events, resulting in improving safety in the nuclear installations. This paper analyzes the events of safety significance that have been occurred at research reactors and discusses the root causes and lessons learned from these events. Insights from literature on events at research reactors and feedback from events at nuclear power plants that are relevant to research reactors are also presented along with discussions. The results of the analysis showed the importance of communication of safety information and exchange of operating experience are vital to prevent reoccurrences of events. The analysis showed also the need for continued attention to human factors and training of operating personnel, and the need for establishing systematic ageing management programmes of reactor facilities, and programmes for safety management of handling of nuclear fuel, core components, and experimental devices.

Operating experience feedback from safety significant events at research reactors

International Nuclear Information System (INIS)

Shokr, A.M.

2015-01-01

Operating experience feedback is an effective mechanism to provide lessons learned from the events and the associated corrective actions to prevent recurrence of events, resulting in improving safety in the nuclear installations. This paper analyzes the events of safety significance that have been occurred at research reactors and discusses the root causes and lessons learned from these events. Insights from literature on events at research reactors and feedback from events at nuclear power plants that are relevant to research reactors are also presented along with discussions. The results of the analysis showed the importance of communication of safety information and exchange of operating experience are vital to prevent reoccurrences of events. The analysis showed also the need for continued attention to human factors and training of operating personnel, and the need for establishing systematic ageing management programmes of reactor facilities, and programmes for safety management of handling of nuclear fuel, core components, and experimental devices.

Prevention of choking among children.

Science.gov (United States)

2010-03-01

Choking is a leading cause of morbidity and mortality among children, especially those aged 3 years or younger. Food, coins, and toys are the primary causes of choking-related injury and death. Certain characteristics, including shape, size, and consistency, of certain toys and foods increase their potential to cause choking among children. Childhood choking hazards should be addressed through comprehensive and coordinated prevention activities. The US Consumer Product Safety Commission (CPSC) should increase efforts to ensure that toys that are sold in retail store bins, vending machines, or on the Internet have appropriate choking-hazard warnings; work with manufacturers to improve the effectiveness of recalls of products that pose a choking risk to children; and increase efforts to prevent the resale of these recalled products via online auction sites. Current gaps in choking-prevention standards for children's toys should be reevaluated and addressed, as appropriate, via revisions to the standards established under the Child Safety Protection Act, the Consumer Product Safety Improvement Act, or regulation by the CPSC. Prevention of food-related choking among children in the United States has been inadequately addressed at the federal level. The US Food and Drug Administration should establish a systematic, institutionalized process for examining and addressing the hazards of food-related choking. This process should include the establishment of the necessary surveillance, hazard evaluation, enforcement, and public education activities to prevent food-related choking among children. While maintaining its highly cooperative arrangements with the CPSC and the US Department of Agriculture, the Food and Drug Administration should have the authority to address choking-related risks of all food products, including meat products that fall under the jurisdiction of the US Department of Agriculture. The existing National Electronic Injury Surveillance System-All Injury

Introduction to the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infections.

Science.gov (United States)

Solomkin, Joseph S; Mazuski, John; Blanchard, Joan C; Itani, Kamal M F; Ricks, Philip; Dellinger, E Patchen; Allen, George; Kelz, Rachel; Reinke, Caroline E; Berríos-Torres, Sandra I

Surgical site infection (SSI) is a common type of health-care-associated infection (HAI) and adds considerably to the individual, social, and economic costs of surgical treatment. This document serves to introduce the updated Guideline for the Prevention of SSI from the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC). The Core section of the guideline addresses issues relevant to multiple surgical specialties and procedures. The second procedure-specific section focuses on a high-volume, high-burden procedure: Prosthetic joint arthroplasty. While many elements of the 1999 guideline remain current, others warrant updating to incorporate new knowledge and changes in the patient population, operative techniques, emerging pathogens, and guideline development methodology.

Prevention of suicide

Directory of Open Access Journals (Sweden)

Rajiv Gupta

2017-01-01

Full Text Available Suicide is a major public health problem in India, probably even bigger than in the West. Suicidal behavior is the best conceptualized as a multifaceted complex problem involving social factors and mental illnesses. Broadly, there are two approaches to suicide prevention; population preventive strategies and high-risk preventive strategies. Population preventive strategies include reducing availability of means for suicide, education of primary care physicians, influencing media portrayal of suicidal behavior, education of the public, telephone helplines, and addressing economic issues associated with suicidal behavior. High-risk preventive strategy includes identifying individuals with high risk of committing suicide, intensively treating mental illness if present, and providing psychosocial support. Thus, prevention requires a multipronged effort with collaboration from various sectors including mental health professionals, social justice department, and macroeconomic policy makers.

Integrated Initiating Event Performance Indicators

International Nuclear Information System (INIS)

S. A. Eide; Dale M. Rasmuson; Corwin L. Atwood

2005-01-01

The U.S. Nuclear Regulatory Commission Industry Trends Program (ITP) collects and analyses industry-wide data, assesses the safety significance of results, and communicates results to Congress and other stakeholders. This paper outlines potential enhancements in the ITP to comprehensively cover the Initiating Events Cornerstone of Safety. Future work will address other cornerstones of safety. The proposed Tier 1 activity involves collecting data on ten categories of risk-significant initiating events, trending the results, and comparing early performance with prediction limits (allowable numbers of events, above which NRC action may occur). Tier 1 results would be used to monitor industry performance at the level of individual categories of initiating events. The proposed Tier 2 activity involves integrating the information for individual categories of initiating events into a single risk-based indicator, termed the Baseline Risk Index for Initiating Events or BRIIE. The BRIIE would be evaluated yearly and compared against a threshold. BRIIE results would be reported to Congress on a yearly basis

Impact of Fall Prevention on Nurses and Care of Fall Risk Patients.

Science.gov (United States)

King, Barbara; Pecanac, Kristen; Krupp, Anna; Liebzeit, Daniel; Mahoney, Jane

2018-03-19

Falls are common events for hospitalized older adults, resulting in negative outcomes both for patients and hospitals. The Center for Medicare and Medicaid (CMS) has placed pressure on hospital administrators by identifying falls as a "never event", resulting in a zero falls goal for many hospitals. Staff nurses are responsible for providing direct care to patients and for meeting the hospital no falls goal. Little is known about the impact of "zero falls" on nurses, patients and the organization. A qualitative study, using Grounded Dimensional Analysis (GDA) was conducted to explore nurses' experiences with fall prevention in hospital settings and the impact of those experiences on how nurses provide care to fall risk patients. Twenty-seven registered nurses and certified nursing assistants participated in in-depth interviews. Open, axial and selective coding was used to analyze data. A conceptual model which illustrates the impact of intense messaging from nursing administration to prevent patient falls on nurses, actions nurses take to address the message and the consequences to nurses, older adult patients and to the organization was developed. Intense messaging from hospital administration to achieve zero falls resulted in nurses developing a fear of falls, protecting self and unit, and restricting fall risk patients as a way to stop messages and meet the hospital goal. Results of this study identify unintended consequences of fall prevention message on nurses and older adult patients. Further research is needed understand how nurse care for fall risk patients.

A Social Media mHealth Solution to Address the Needs of Dengue Prevention and Management in Sri Lanka.

Science.gov (United States)

Lwin, May O; Vijaykumar, Santosh; Rathnayake, Vajira Sampath; Lim, Gentatsu; Panchapakesan, Chitra; Foo, Schubert; Wijayamuni, Ruwan; Wimalaratne, Prasad; Fernando, Owen Noel Newton

2016-07-01

Sri Lanka has witnessed a series of dengue epidemics over the past five years, with the western province, home to the political capital of Colombo, bearing more than half of the dengue burden. Existing dengue monitoring prevention programs are exhausted as public health inspectors (PHIs) cope with increasing workloads and paper-based modes of surveillance and education, characterizing a reactive system unable to cope with the enormity of the problem. On the other hand, the unprecedented proliferation and affordability of mobile phones since 2009 and a supportive political climate have thus far remained unexploited for the use of mobile-based interventions for dengue management. To conduct a needs assessment of PHIs in Colombo with respect to their dengue-related tasks and develop a new mobile-based system to address these needs while strengthening existing systems. One-on-one in-depth interviews were conducted with 29 PHIs to a) gain a nuanced, in-depth understanding of the current state of surveillance practices, b) understand the logistical, technological and social challenges they confront, and c) identify opportunities for mobile-based interventions. Quantitative analysis included simple descriptive statistics while qualitative analysis comprised textual analysis of 209 pages of transcripts (or nearly 600 minutes of conversations) using grounded theory approaches. Current paper-based data collection practices for dengue surveillance involved a circuitous, time consuming process that could take between 7-10 days to officially report and record a single case. PHIs confronted challenges in terms of unreliable, standalone GIS devices, delays in registering mosquito breeding sites and lack of engagement from communities while delivering dengue education. These findings, in concert with a high motivation to use mobile-based systems, informed the development of Mo-Buzz, a mobile-based system that integrates three components - digitized surveillance, dynamic disease

Preventing Dropout in Secondary Schools. Educator's Practice Guide. What Works Clearinghouse. NCEE 2017-4028

Science.gov (United States)

Rumberger, Russell W.; Addis, Howard; Allensworth, Elaine; Balfanz, Robert; Bruch, Julie; Dillon, Erin; Duardo, Debra; Dynarski, Mark; Furgeson, Joshua; Jayanthi, Madhavi; Newman-Gonchar, Rebecca; Place, Kate; Tuttle, Christina

2017-01-01

The goal of this practice guide is to offer educators specific, evidence-based recommendations that address the challenges of preventing dropout in secondary schools. This guide synthesizes the best publicly available research and shares practices that are supported by evidence. It is intended to be practical and easy for teachers and school…

Home visitation programs: An untapped opportunity for the delivery of early childhood obesity prevention

Science.gov (United States)

Salvy, Sarah-Jeanne; de la Haye, Kayla; Galama, Titus; Goran, Michael I.

2016-01-01

Background Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: 1) short duration and low intensity; 2) late timing of implementation, when children are already overweight or obese; 3) intervention delivery limiting their accessibility and sustainability; and 4) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. Objective This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. Conclusion The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (1) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health due to socio-economic and structural conditions; (2) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (3) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. PMID:27911984

Home visitation programs: an untapped opportunity for the delivery of early childhood obesity prevention.

Science.gov (United States)

Salvy, S-J; de la Haye, K; Galama, T; Goran, M I

2017-02-01

Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: (i) short duration and low intensity; (ii) late timing of implementation, when children are already overweight or obese; (iii) intervention delivery limiting their accessibility and sustainability; and (iv) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (i) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health because of socio-economic and structural conditions; (ii) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (iii) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. © 2016 World Obesity Federation.

Prevention of corruption as administrative activity of authorities and the object of prosecutor’s observance

Directory of Open Access Journals (Sweden)

Timur L. Kozlov

2017-03-01

Full Text Available Objective to study corruption prevention as administrative activity of state and municipal authorities. Methods dialectical systematic formallegal analysis synthesis statistical and specific sociological methods. Results basing on the study of countercorruption legislation its implementation and acts of prosecutorial response the definition of the concept quotcorruption preventionquot was formulated which refers to administrative activities of state and municipal bodies and their officials aimed at the implementation of legislation on combating corruption. The feature of the preventive component of countercorruption legislation is that it brings together the complex of binding prohibitive and restrictive rules established for the prevention of corruption. Corruption prevention is implemented through a specific type of managerial administrative activity. The legality of this activity is provided by means of prosecutorial supervision over implementation of laws on corruption prevention. Scientific novelty for the first time in the article corruption prevention is viewed not as a criminological category but as an institution of administrative law characterized by the essential features of the state municipal control. Practical significance the main provisions and conclusions of the article can be used in research and lawenforcement activities in addressing issues related to combating corruption.

Perceived Benefits and Challenges of Coordinated Approaches to Chronic Disease Prevention in State Health Departments

Science.gov (United States)

Sequeira, Sonia; Best, Leslie; Jones, Ellen; Baker, Elizabeth A.; Brownson, Ross C.

2014-01-01

Introduction Chronic disease prevention efforts have historically been funded categorically according to disease or risk factor. Federal agencies are now progressively starting to fund combined programs to address common risk. The purpose of this study was to inform transitions to coordinated chronic disease prevention by learning views on perceived benefits and challenges of a coordinated approach to funding. Methods A national survey on evidence-based public health was conducted from March through May 2013 among state health department employees working in chronic disease prevention (N = 865). Participants were asked to rank the top 3 benefits and top 3 challenges in coordinating chronic disease approaches from provided lists and could provide additional responses. Descriptive analyses, χ2 tests, and analysis of variance were conducted. Results The most common perceived benefits of coordinated approaches to chronic disease prevention were improved health outcomes, common risk factors better addressed, and reduced duplication of program efforts. The most common perceived challenges were funding restrictions, such as disease-specific performance measures; competing priorities; lack of communication across programs; funding might be reduced; agency not structured for program coordination; and loss of disease-specific partner support. Rankings of benefits and challenges were similar across states and participant roles; the perceived challenges “lack of communication across programs” (P = .02) and “funding might be reduced” differed by program area (P organizational support for coordinated approaches, and create benefits for organizational partners. PMID:24809362

Breaking the Rhythm of Depression: Cognitive Behavior Therapy and Relapse Prevention for Depression

Directory of Open Access Journals (Sweden)

Claudi L.H. Bockting

2010-12-01

Full Text Available A crucial part of the treatment of depression is the prevention of relapse and recurrence. Psychological interventions, especially cognitive behavior therapy (CBT are helpful in preventing relapse and recurrence in depression. The effectivity of four types of relapse prevention cognitive behavior therapy strategies will be addressed, i.e. acute prophylactic cognitive behavior therapy, continuation cognitive behavior therapy, sequential cognitive behavior therapy and cognitive behavior therapy in partial remission.Specific ingredients of three sequential cognitive behavior therapy programs (well-being cognitive therapy, preventive cognitive therapy, and mindfulness-based cognitive therapy will be discussed as applied after remission in patients that experienced previous depressive episodes. Sequential preventive cognitive behavior therapy after acute treatment may be an attractive alternative treatment for many patients who currently use antidepressants for years and years to prevent relapse and recurrence. This is an extremely challenging issue to research thoroughly. Future studies must rule out what intervention for whom is the best protection against relapse and recurrence in depression.

Method to Find Recovery Event Combinations in Probabilistic Safety Assessment

International Nuclear Information System (INIS)

Jung, Woo Sik; Riley, Jeff

2016-01-01

These research activities may develop mathematical methods, engineering analyses, and business processes. The research activities of the project covered by this scope are directed toward the specific issues of implementing the methods and strategies on a computational platform, identifying the features and enhancements to EPRI tools that would be necessary to realize significant improvements to the risk assessments performed by the end user. Fault tree analysis is extensively and successfully applied to the risk assessment of safety-critical systems such as nuclear, chemical and aerospace systems. The fault tree analysis is being used together with an event tree analysis in PSA of nuclear power plants. Fault tree solvers for a PSA are mostly based on the cutset-based algorithm. They generate minimal cut sets (MCSs) from a fault tree. The most popular fault tree solver in the PSA industry is FTREX. During the course of this project, certain technical issues (see Sections 2 to 5) have been identified that need to be addressed regarding how minimal cut sets are generated and quantified. The objective of this scope of the work was to develop new methods or techniques to address these technical limitations. By turning on all the cutset initiators (%1, %2, %3, %), all the possible minimal cut sets can be calculated easier than with the original fault tree. It is accomplished by the fact that the number of events in the minimal cut sets are significantly reduced by using cutset initiators instead of random failure events. And byy turning on a few chosen cutset initiators and turning off the other cutset initiators, minimal cut sets of the selected cutset initiator(s) can be easily calculated. As explained in the previous Sections, there is no way to calculate these minimal cut sets by turning off/on the random failure events in the original fault tree

Method to Find Recovery Event Combinations in Probabilistic Safety Assessment

Energy Technology Data Exchange (ETDEWEB)

Jung, Woo Sik [Sejong University, Seoul (Korea, Republic of); Riley, Jeff [Electric Power Research, Palo Alto (United States)

2016-05-15

These research activities may develop mathematical methods, engineering analyses, and business processes. The research activities of the project covered by this scope are directed toward the specific issues of implementing the methods and strategies on a computational platform, identifying the features and enhancements to EPRI tools that would be necessary to realize significant improvements to the risk assessments performed by the end user. Fault tree analysis is extensively and successfully applied to the risk assessment of safety-critical systems such as nuclear, chemical and aerospace systems. The fault tree analysis is being used together with an event tree analysis in PSA of nuclear power plants. Fault tree solvers for a PSA are mostly based on the cutset-based algorithm. They generate minimal cut sets (MCSs) from a fault tree. The most popular fault tree solver in the PSA industry is FTREX. During the course of this project, certain technical issues (see Sections 2 to 5) have been identified that need to be addressed regarding how minimal cut sets are generated and quantified. The objective of this scope of the work was to develop new methods or techniques to address these technical limitations. By turning on all the cutset initiators (%1, %2, %3, %), all the possible minimal cut sets can be calculated easier than with the original fault tree. It is accomplished by the fact that the number of events in the minimal cut sets are significantly reduced by using cutset initiators instead of random failure events. And byy turning on a few chosen cutset initiators and turning off the other cutset initiators, minimal cut sets of the selected cutset initiator(s) can be easily calculated. As explained in the previous Sections, there is no way to calculate these minimal cut sets by turning off/on the random failure events in the original fault tree.

Use and Perceived Benefits of Mobile Devices by Physicians in Preventing Adverse Drug Events in the Nursing Home

Science.gov (United States)

Handler, Steven M.; Boyce, Richard D.; Ligons, Frank; Perera, Subashan; Nace, David A.; Hochheiser, Harry

2015-01-01

Objective Although mobile devices equipped with drug reference software may help prevent adverse drug events (ADEs) in the nursing home (NH) by providing medication information at the point-of-care, little is known about their use and perceived benefits. The goal of this study was to conduct a survey of a nationally representative sample of NH physicians to quantify the use and perceived benefits of mobile devices in preventing ADEs in the NH setting. Design/Setting/Participants We surveyed physicians who attended the 2010 the AMDA Annual Symposium about their use of mobile devices and beliefs about the effectiveness of drug reference software in preventing ADEs. Results The overall net valid response rate was 70% (558/800) with 42% (236/558) using mobile devices to assist with prescribing in the NH. Physicians with ≤15 years clinical experience were 67% more likely to be mobile device users, compared to those with >15 years of clinical experience (odds ratio=1.68; 95% confidence interval=1.17-2.41; p=0.005). For those who used a mobile device to assist with prescribing, almost all (98%) reported performing an average of one or more drug look-ups per day, performed an average of 1-2 lookups per day for potential drug-drug interactions (DDIs), and most (88%) believed that drug reference software had helped to prevent at least one potential ADE in the preceding four-week period. Conclusions The proportion of NH physicians who use mobile devices with drug reference software, while significant, is lower than in other clinical environments. Our results suggest that NH physicians who use mobile devices equipped with drug reference software believe they are helpful for reducing ADEs. Further research is needed to better characterize the facilitators and barriers to adoption of the technology in the NH and its precise impact on NH ADEs. PMID:24094901

Enterocyte-specific epidermal growth factor prevents barrier dysfunction and improves mortality in murine peritonitis.

Science.gov (United States)

Clark, Jessica A; Gan, Heng; Samocha, Alexandr J; Fox, Amy C; Buchman, Timothy G; Coopersmith, Craig M

2009-09-01

Systemic administration of epidermal growth factor (EGF) decreases mortality in a murine model of septic peritonitis. Although EGF can have direct healing effects on the intestinal mucosa, it is unknown whether the benefits of systemic EGF in peritonitis are mediated through the intestine. Here, we demonstrate that enterocyte-specific overexpression of EGF is sufficient to prevent intestinal barrier dysfunction and improve survival in peritonitis. Transgenic FVB/N mice that overexpress EGF exclusively in enterocytes (IFABP-EGF) and wild-type (WT) mice were subjected to either sham laparotomy or cecal ligation and puncture (CLP). Intestinal permeability, expression of the tight junction proteins claudins-1, -2, -3, -4, -5, -7, and -8, occludin, and zonula occludens-1; villus length; intestinal epithelial proliferation; and epithelial apoptosis were evaluated. A separate cohort of mice was followed for survival. Peritonitis induced a threefold increase in intestinal permeability in WT mice. This was associated with increased claudin-2 expression and a change in subcellular localization. Permeability decreased to basal levels in IFABP-EGF septic mice, and claudin-2 expression and localization were similar to those of sham animals. Claudin-4 expression was decreased following CLP but was not different between WT septic mice and IFABP-EGF septic mice. Peritonitis-induced decreases in villus length and proliferation and increases in apoptosis seen in WT septic mice did not occur in IFABP-EGF septic mice. IFABP-EGF mice had improved 7-day mortality compared with WT septic mice (6% vs. 64%). Since enterocyte-specific overexpression of EGF is sufficient to prevent peritonitis-induced intestinal barrier dysfunction and confers a survival advantage, the protective effects of systemic EGF in septic peritonitis appear to be mediated in an intestine-specific fashion.

Aspiration pneumonia. Pathophysiological aspects, prevention and management. A review.

Science.gov (United States)

Petroianni, A; Ceccarelli, D; Conti, V; Terzano, C

2006-12-01

Aspiration pneumonias occur more frequently than reported and, in many cases, the disease is not recognised. In hospitalised and institutionalised patients with predisposing diseases prompt diagnosis of this complication and correct preventive measures can drastically reduce the worsening of clinical conditions and the deaths due to aspiration pneumonia. Normal airway structure, effective defence mechanisms, and preventive measures are decisive in reducing aspiration episodes. An increased aspiration risk for food, fluids, medications, or secretions may lead to the development of pneumonia. Pneumonia is the most common respiratory complication in all stroke deaths and in mechanical ventilation patients. In addition, the increased incidence of aspiration pneumonia with aging may be a consequence of impairment of swallowing and the cough reflex. Dysphagia, compromised consciousness, invasive procedures, anaesthesia, insufficient oral care, sleep disorders, and vomiting are all risk factors. Aspiration pneumonia includes different characteristic syndromes based on the amount (massive, acute, chronic) and physical character of the aspirated material (acid, infected, lipoid), needing a different therapeutic approach. Chronic patients education and correct health care practices are the keys for preventing the events of aspiration. In patients at risk a clinical and instrumental assessment of dysphagia should be evaluated. Management includes the removal of etiologic factors (drugs, tubes, mobilisation, oral hygiene), supportive care, and in bacterial pneumonias a specific antibiotic therapy for community-acquired or nosocomial events.

Socioeconomic inequality in the provision of specific preventive dental interventions among children in the UK: Children's Dental Health Survey 2003.

Science.gov (United States)

Shaban, R; Kassim, S; Sabbah, W

2017-06-09

Aim To assess socioeconomic inequality regarding specific preventive interventions (fissure sealants or any treatment to prevent caries) and dental visits among UK children.Method Data were from the Children's Dental Health Survey 2003, which included participants from England, Wales, Scotland, and Northern Ireland. The number of children in the analysis was 2,286. Variables were sex, age, area of residency (for example, England), mother's education, family social class, and deprivation level. Descriptive and regression analyses were performed.Results There were no significant socioeconomic differences in the use of preventive services. Deprivation and family social class (for example, intermediate and manual) were significantly associated with less regular dental visits (odd ratio 0.41, 95% CI [0.28, 0.63]; odd ratio 0.53, 95% CI [0.31, 0.89]; odd ratio 0.37, 95% CI [0.24, 0.58], respectively). Regular dental visits were associated with reporting preventive care for caries (odds ratio 2.25, 95% CI [1.45, 3.49]) and with the number of sealed tooth surfaces (rate ratio 1.73, 95% CI [1.16, 2.60]).Conclusion Despite apparent socioeconomic inequalities in regular dental visits, there was no significant inequality in using specific preventive interventions by children in the UK. This finding should be interpreted with caution considering the relatively small subsample included in this analysis.

Etiquette and Protocol: A Guide for Campus Events.

Science.gov (United States)

Harris, April L.

Intended for special events planners on college campuses, this book offers advice on matters of etiquette and protocol for campus events. Chapters cover the following topics: (1) invitations (e.g., the precedence of extending invitations, invitation components, formal invitations, types of invitations); (2) forms of address (with examples of…

Obesity intervention on the healthy lifestyle in childhood: results of the PRESTO (PrEvention STudy of Obesity Study

Directory of Open Access Journals (Sweden)

Sabine Dietrich

2008-03-01

Full Text Available

Background: Due to increasing problems with childhood and adolescent obesity in Austria PRESTO (PrEvention STudy of Obesity created a school based intervention program for promoting a healthy lifestyle in Austrian youth.

Methods: PRESTO was carried out by a multi-disciplinary team including a physician, a psychologist, a nutritionist and an exercise physiologist. The study was carried out in 12 first grade school classes in Austria (2002-2004, mainly in Vienna (N=260. The control group consisted of 231 subjects. Medical examinations were performed and the participantsf knowledge on good nutrition and dietary habits were collected. Twelve nutrition sessions, one hour per week in each class, were conducted. Teachers were advised to discuss health issues in their classes and specific exercise physiologists were informed about how to integrate appropriate exercises into their lessons.

Results: In comparison with control group, classes who performed PRESTO showed a significant knowledge of nutrition, consuming less unhealthy foods. These effects could be observed in the short term (14 weeks and at follow up (10 months. 24% subjects could be classified as being overweight (BMI .90.Perc..

Conclusions: School-oriented intervention programs/studies, like PRESTO, are a potential way to demonstrate positive effect on nutrition, physical activity and healthy behaviours in youth, especially if carried out on a long-term basis. Ultimately PRESTO has proven to be a suitable programme to be disseminated onto schools throughout Austria.

Analysis of operational events by ATHEANA framework for human factor modelling

International Nuclear Information System (INIS)

Bedreaga, Luminita; Constntinescu, Cristina; Doca, Cezar; Guzun, Basarab

2007-01-01

In the area of human reliability assessment, the experts recognise the fact that the current methods have not represented correctly the role of human in prevention, initiating and mitigating the accidents in nuclear power plants. The nature of this deficiency appears because the current methods used in modelling of human factor have not taken into account the human performance and reliability such as it has been observed in the operational events. ATHEANA - A Technique for Human Error ANAlysis - is a new methodology for human analysis that has included the specific data of operational events and also psychological models for human behaviour. This method has included new elements such as the unsafe action and error mechanisms. In this paper we present the application of ATHEANA framework in the analysis of operational events that appeared in different nuclear power plants during 1979-2002. The analysis of operational events has consisted of: - identification of the unsafe actions; - including the unsafe actions into a category, omission ar commission; - establishing the type of error corresponding to the unsafe action: slip, lapse, mistake and circumvention; - establishing the influence of performance by shaping the factors and some corrective actions. (authors)

Controlling spatio-temporal extreme events by decreasing the localized energy

International Nuclear Information System (INIS)

Du Lin; Xu Wei; Li Zhanguo; Zhou Bingchang

2011-01-01

The problem of controlling extreme events in spatially extended dynamical systems is investigated in this Letter. Based on observations of the system state, the control technique we proposed locally decreases the spatial energy of the amplitude in the vicinity of the highest burst, without needs of any knowledge or prediction of the system model. Considering the specific Complex Ginzburg-Landau equation, we provide theoretical analysis for designing the localized state feedback controller. More exactly, a simple control law by varying a damping parameter at control region is chose to achieve the control. Numerical simulations and statistic analysis demonstrate that extreme events can be efficiently suppressed by our strategy. In particular, the cost of the control and the tolerant time delay in applying the control is considered in detail. - Highlights: → We propose a local control scheme to suppress spatio-temporal extreme events. → The control is address by decreasing the spatial energy of the system locally. → The detail control law is to apply localized state feedback based on observations. → The cost of the control increases with the size of the control region exponentially. → The tolerant delay of the control is about 5-6 times of lifetime of extreme events.

The Yo me cuido® Program: Addressing Breast Cancer Screening and Prevention Among Hispanic Women.

Science.gov (United States)

Davis, Jenna L; Ramos, Roberto; Rivera-Colón, Venessa; Escobar, Myriam; Palencia, Jeannette; Grant, Cathy G; Green, B Lee

2015-09-01

Breast cancer is less likely to be diagnosed at the earliest stage in Hispanic/Latino (Hispanic) women compared to non-Hispanic White women, even after accounting for differences in age, socioeconomic status, and method of detection. Moffitt Cancer Center created a comprehensive health education program called Yo me cuido (®) (YMC) to address and reduce breast cancer disparities among Spanish- and English-speaking Hispanic women by providing breast cancer and healthy lifestyles awareness and education, and promoting breast cancer screenings, reminders, and referrals for women 40 years and older. The purpose of this paper is to showcase the innovative approaches and methods to cancer prevention and early detection of the YMC program, and to promote it as an effective tool for improving outcomes in community health education, outreach, and engagement activities with Hispanic populations. Key components of the program include educational workshops, mammogram referrals, and a multimedia campaign. The YMC program is unique because of its approaches in reaching the Hispanic population, such as delivering the program with compassionate services to empower participants to live a healthier lifestyle. Additionally, direct follow-up for mammography screenings is provided by program staff. From 2011 to 2013, YMC has educated 2,226 women and 165 men through 93 workshops. About 684 (52 %) women ages 40 and older have had a screening mammogram within their first year of participating in the program. The YMC program is an innovative cancer education and outreach program that has demonstrated a positive impact on the lives of the Hispanic community in the Tampa Bay region.

Study design of ASPirin in Reducing Events in the Elderly (ASPREE): a randomized, controlled trial.

Science.gov (United States)

2013-11-01

Cost-effective strategies to maintain healthy active lifestyle in aging populations are required to address the global burden of age-related diseases. ASPREE will examine whether the potential primary prevention benefits of low dose aspirin outweigh the risks in older healthy individuals. Our primary hypothesis is that daily oral 100 mg enteric-coated aspirin will extend a composite primary endpoint termed 'disability-free life' including onset of dementia, total mortality, or persistent disability in at least one of the Katz Activities of Daily Living in 19,000 healthy participants aged 65 years and above ('US minorities') and 70 years and above (non-'US minorities'). ASPREE is a double-blind, randomized, placebo-controlled trial of oral 100mg enteric-coated acetyl salicylic acid (ASA) or matching placebo being conducted in Australian and US community settings on individuals free of dementia, disability and cardiovascular disease (CVD) events. Secondary endpoints are all-cause and cause specific mortality, fatal and non-fatal cardiovascular events, fatal and non-fatal cancer (excluding non-melanoma skin cancer), dementia, mild cognitive impairment, depression, physical disability, and clinically significant bleeding. To 20 September 2013 14,383 participants have been recruited. Recruitment and study completion are anticipated in July 2014 and December 2018 respectively. In contrast to other aspirin trials that have largely focused on cardiovascular endpoints, ASPREE has a unique composite primary endpoint to better capture the overall risk and benefit of aspirin to extend healthy independent lifespan in older adults in the US and Australia. © 2013. Published by Elsevier Inc. All rights reserved.

Disclosure of Adverse Events in Pediatrics.

Science.gov (United States)

2016-12-01

Despite increasing attention to issues of patient safety, preventable adverse events (AEs) continue to occur, causing direct and consequential injuries to patients, families, and health care providers. Pediatricians generally agree that there is an ethical obligation to inform patients and families about preventable AEs and medical errors. Nonetheless, barriers, such as fear of liability, interfere with disclosure regarding preventable AEs. Changes to the legal system, improved communications skills, and carefully developed disclosure policies and programs can improve the quality and frequency of appropriate AE disclosure communications. Copyright © 2016 by the American Academy of Pediatrics.

Predicting the extreme 2015/16 El Nino event

CSIR Research Space (South Africa)

Mpheshea, LE

2015-09-01

Full Text Available A strong El Niño phenomenon is expected to develop during the austral summer. This study seeks to address the two main questions. 1) How strong will the 2016 event be? 2) With how much skill and confidence can a really strong event be predicted? A...

Cost-effectiveness of milk powder fortified with potassium to decrease blood pressure and prevent cardiovascular events among the adult population in China: a Markov model.

Science.gov (United States)

Dainelli, Livia; Xu, Tingting; Li, Min; Zimmermann, Diane; Fang, Hai; Wu, Yangfeng; Detzel, Patrick

2017-09-25

To model the long-term cost-effectiveness of consuming milk powder fortified with potassium to decrease systolic blood pressure (SBP) and prevent cardiovascular events. A best case scenario analysis using a Markov model was conducted. 8.67% of 50-79 year olds who regularly consume milk in China, including individuals with and without a prior diagnosis of hypertension. The model simulated the potential impact of a daily intake of two servings of milk powder fortified with potassium (+700 mg/day) vs the consumption of a milk powder without potassium fortification, assuming a market price equal to 0.99 international dollars (intl$; the consumption of a milk powder without potassium fortification, assuming a market price equal to intl$0.99 for the latter and to intl$1.12 for the first (+13.13%). Both deterministic and probabilistic sensitivity analyses were conducted to test the robustness of the results. Estimates of the incidence of cardiovascular events and subsequent mortality in China were derived from the literature as well as the effect of increasing potassium intake on blood pressure. The incremental cost-effectiveness ratio (ICER) was used to determine the cost-effectiveness of a milk powder fortified with potassium taking into consideration the direct medical costs associated with the cardiovascular events, loss of working days and health utilities impact. With an ICER equal to int$4711.56 per QALY (quality-adjusted life year) in the best case scenario and assuming 100% compliance, the daily consumption of a milk powder fortified with potassium shown to be a cost-effective approach to decrease SBP and reduce cardiovascular events in China. Healthcare savings due to prevention would amount to intl$8.41 billion. Sensitivity analyses showed the robustness of the results. Together with other preventive interventions, the consumption of a milk powder fortified with potassium could represent a cost-effective strategy to attenuate the rapid rise in

Civilian law: from occupational medicine to occupational event.

Science.gov (United States)

Mpotos, N; Watelet, J B

Civilian law:from occupational medicine to occupational event. Despite the growing importance of objective measurements, the health effects of many occupational risk factors are currently not fully quantified. Occupational noise, as a widespread risk factor, is illustrative in this regard; there is a strong body of evidence linking it to an important health outcome (hearing loss), but it is less decisively associated with others (such as psychological disorders). It is also distinct from environmental noise, and therefore falls under the responsibility of employers as well as individuals. Noise-induced hearing loss (NIHL) is, at present, incurable and irreversible. However, it is preventable, if effective and global hearing conservation programmes can be implemented. These programmes should not be isolated efforts, but should be integrated into the overall hazard prevention and control programme of the workplace. Belgian law encompasses a set of provisions for prevention and the protection of the health and safety of workers within the workplace, including aspects pertaining to the hygiene of the workplace and psychosocial aspects at work (stress, violence, bullying and sexual harassment, among others). In principle, combating environmental noise is fully addressed in this country. However, other levels of policy-making also play an important role in this regard. For example, the federal government is in charge of product standards, and therefore also of noise emission standards for products. The interpretation and enforcement of Belgian legislation on well-being at work converts European directives and international agreements on well-being at work into Belgian law.

What is the right way to talk about extreme events?

Science.gov (United States)

Sobel, A. H.

2013-12-01

Extreme weather events draw the attention of the public. By demonstrating the vulnerability of human society to climate, extreme events can cause nonscientists -government leaders as well as the broader population - to take the danger posed by anthropogenic global warming more seriously than they otherwise might. An extreme event that draws media attention can become a 'teachable moment'. But extreme events are difficult to talk about in a way that honors both the strengths and weaknesses of the underlying science. No single event can be attributed to climate change, and some types of events are not even clearly influenced by it (or not in any ways our science can yet demonstrate). Strong, media-friendly statements that closely connect specific events to climate - designed to make best use of the moment's teachability - can easily overstate the case. This will raise the hackles of one's colleagues, at a minimum, and at worst, may damage the credibility of the field more broadly. Yet talking too much about the uncertainties runs the risk of understating the basic truth that global warming is real and dangerous, and may lend inadvertent support to anti-scientific denialism. I will discuss this tension in the context of my own experiences in the media after 'Superstorm' Sandy. I will address arguments I have heard, from social scientists and media consultants, to the effect that climate scientists should adopt communications strategies that lead to stronger, more media-friendly statements, and learn to suppress the tendency, bred into us during our scientific training, to emphasize the uncertainties.

Efficacy of pectin solution for preventing gastro-esophageal reflux events in patients with percutaneous endoscopic gastrostomy.

Science.gov (United States)

Adachi, Kyoichi; Furuta, Kenji; Aimi, Masahito; Fukazawa, Kousuke; Shimura, Shino; Ohara, Shunji; Nakata, Shuji; Inoue, Yukiko; Ryuko, Kanji; Ishine, Junichi; Katoh, Kyoko; Hirata, Toshiaki; Ohhata, Shuzo; Katoh, Setsushi; Moriyama, Mika; Sumikawa, Masuko; Sanpei, Mari; Kinoshita, Yoshikazu

2012-05-01

The aim of this study was to determine the efficacy of pectin solution, which increases the viscosity of liquid nutrient, for prevention of gastro-esophageal reflux in comparison with half-solid nutrient. The subjects were 10 elderly patients undergoing percutaneous endoscopic gastrostomy feeding. Twenty-four-hour esophageal multichannel intraluminal impedance and pH testing was performed during intake of half-solid nutrient and a combination of pectin solution and liquid nutrient. During 4 h after delivery, there was no significant difference in the total number of gastro-esophageal reflux events between the feeding of the half-solid nutrient and the combination of pectin solution and liquid nutrient (5.7 ± 1.2 vs 5.3 ± 1.0/4 h). Acidic reflux after delivery of the half-solid nutrient was significantly more frequent than that after delivery of the combination of pectin solution and liquid nutrient (80.7% vs 60.4%, p = 0.018). The incidence of gastro-esophageal reflux reaching the upper portion of the esophagus tended to be higher during delivery of the half-solid nutrient than during delivery of the combination of pectin solution and liquid nutrient (47.4% vs 34.0%, p = 0.153). In conclusion, the usage of pectin solution combined with liquid nutrient is effective for preventing acidic gastro-esophageal reflux and gastro-esophageal reflux reaching the upper portion of the esophagus.

Analysis of medication-related malpractice claims: causes, preventability, and costs.

Science.gov (United States)

Rothschild, Jeffrey M; Federico, Frank A; Gandhi, Tejal K; Kaushal, Rainu; Williams, Deborah H; Bates, David W

2002-11-25

Adverse drug events (ADEs) may lead to serious injury and may result in malpractice claims. While ADEs resulting in claims are not representative of all ADEs, such data provide a useful resource for studying ADEs. Therefore, we conducted a review of medication-related malpractice claims to study their frequency, nature, and costs and to assess the human factor failures associated with preventable ADEs. We also assessed the potential benefits of proved effective ADE prevention strategies on ADE claims prevention. We conducted a retrospective analysis of a New England malpractice insurance company claims records from January 1, 1990, to December 31, 1999. Cases were electronically screened for possible ADEs and followed up by independent review of abstracts by 2 physician reviewers (T.K.G. and R.K.). Additional in-depth claims file reviews identified potential human factor failures associated with ADEs. Adverse drug events represented 6.3% (129/2040) of claims. Adverse drug events were judged preventable in 73% (n = 94) of the cases and were nearly evenly divided between outpatient and inpatient settings. The most frequently involved medication classes were antibiotics, antidepressants or antipsychotics, cardiovascular drugs, and anticoagulants. Among these ADEs, 46% were life threatening or fatal. System deficiencies and performance errors were the most frequent cause of preventable ADEs. The mean costs of defending malpractice claims due to ADEs were comparable for nonpreventable inpatient and outpatient ADEs and preventable outpatient ADEs (mean, $64,700-74,200), but costs were considerably greater for preventable inpatient ADEs (mean, $376,500). Adverse drug events associated with malpractice claims were often severe, costly, and preventable, and about half occurred in outpatients. Many interventions could potentially have prevented ADEs, with error proofing and process standardization covering the greatest proportion of events.

Application of declarative modeling approaches for external events

International Nuclear Information System (INIS)

Anoba, R.C.

2005-01-01

Probabilistic Safety Assessments (PSAs) are increasingly being used as a tool for supporting the acceptability of design, procurement, construction, operation, and maintenance activities at Nuclear Power Plants. Since the issuance of Generic Letter 88-20 and subsequent IPE/IPEEE assessments, the NRC has issued several Regulatory Guides such as RG 1.174 to describe the use of PSA in risk-informed regulation activities. Most PSA have the capability to address internal events including internal floods. As the more demands are being placed for using the PSA to support risk-informed applications, there has been a growing need to integrate other eternal events (Seismic, Fire, etc.) into the logic models. Most external events involve spatial dependencies and usually impact the logic models at the component level. Therefore, manual insertion of external events impacts into a complex integrated fault tree model may be too cumbersome for routine uses of the PSA. Within the past year, a declarative modeling approach has been developed to automate the injection of external events into the PSA. The intent of this paper is to introduce the concept of declarative modeling in the context of external event applications. A declarative modeling approach involves the definition of rules for injection of external event impacts into the fault tree logic. A software tool such as the EPRI's XInit program can be used to interpret the pre-defined rules and automatically inject external event elements into the PSA. The injection process can easily be repeated, as required, to address plant changes, sensitivity issues, changes in boundary conditions, etc. External event elements may include fire initiating events, seismic initiating events, seismic fragilities, fire-induced hot short events, special human failure events, etc. This approach has been applied at a number of US nuclear power plants including a nuclear power plant in Romania. (authors)

Addressing the need for a Clean Development Mechanism (CDM) specific project management strategy

CSIR Research Space (South Africa)

Lotz, M

2009-01-01

Full Text Available Clean Development Mechanism (CDM) projects have additional technical, financial and regulatory requirements that are not fully addressed by classic project management approaches. Research has been done on individual novel concepts of the CDM, like...

Prevention of hypertension in patients with pre-hypertension: protocol for the PREVER-prevention trial

Directory of Open Access Journals (Sweden)

Neto José

2011-03-01

Full Text Available Abstract Background Blood pressure (BP within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces the incidence of major cardiovascular events. In the absence of higher baseline risk, the use of BP agents reduces the incidence of hypertension. The PREVER-prevention trial aims to investigate the efficacy, safety and feasibility of a population-based intervention to prevent the incidence of hypertension and the development of target-organ damage. Methods This is a randomized, double-blind, placebo-controlled clinical trial, with participants aged 30 to 70 years, with pre-hypertension. The trial arms will be chlorthalidone 12.5 mg plus amiloride 2.5 mg or identical placebo. The primary outcomes will be the incidence of hypertension, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new sub-clinical atherosclerosis, and sudden death. The study will last 18 months. The sample size was calculated on the basis of an incidence of hypertension of 14% in the control group, a size effect of 40%, power of 85% and P alpha of 5%, resulting in 625 participants per group. The project was approved by the Ethics committee of each participating institution. Discussion The early use of blood pressure-lowering drugs, particularly diuretics, which act on the main mechanism of blood pressure rising with age, may prevent cardiovascular events and the incidence of hypertension in individuals with hypertension. If this intervention shows to be effective and safe

Internet and mobile technologies: addressing the mental health of trauma survivors in less resourced communities.

Science.gov (United States)

Ruzek, J I; Yeager, C M

2017-01-01

Internet and mobile technologies offer potentially critical ways of delivering mental health support in low-resource settings. Much evidence indicates an enormous negative impact of mental health problems in low- and middle-income countries (LMICs), and many of these problems are caused, or worsened, by exposure to wars, conflicts, natural and human-caused disasters, and other traumatic events. Though specific mental health treatments have been found to be efficacious and cost-effective for low-resource settings, most individuals living in these areas do not have access to them. Low-intensity task-sharing interventions will help, but there is a limit to the scalability and sustainability of human resources in these settings. To address the needs of trauma survivors, it will be important to develop and implement Internet and mobile technology resources to help reduce the scarcity, inequity, and inefficiency of current mental health services in LMICs. Mobile and Internet resources are experiencing a rapid growth in LMICs and can help address time, stigma, and cost barriers and connect those who have been socially isolated by traumatic events. This review discusses current research in technological interventions in low-resource settings and outlines key issues and future challenges and opportunities. Though formidable challenges exist for large-scale deployment of mobile and Internet mental health technologies, work to date indicates that these technologies are indeed feasible to develop, evaluate, and deliver to those in need of mental health services, and that they can be effective.

Managing hypercholesterolemia and preventing cardiovascular events in elderly and younger Chinese adults: focus on rosuvastatin.

Science.gov (United States)

Wang, Zhen; Ge, Junbo

2014-01-01

Coronary heart disease (CHD) is the leading cause of death worldwide. The efficacy and safety of statins in primary and secondary prevention of CHD is confirmed in several large studies, and rosuvastatin is the latest statin on market. We review the published literature on rosuvastatin in Chinese people. The pharmacokinetics of rosuvastatin in Chinese is somewhat different from that in Caucasians, but this does not influence the linear relationship between dosage and efficacy and with no drug accumulation. Rosuvastatin 5-20 mg/day is effective and safe in decreasing low-density lipoprotein cholesterol in both younger and elderly patients with hypercholesterolemia, even in very elderly patients. Rosuvastatin also shows anti-inflammatory and anti-atherosclerosis features, such as reducing carotid intima-media thickness and plaque area. Rosuvastatin can also improve the prognosis of Chinese CHD patients, such as in the case of acute myocardial infarction. Its adverse-event rate is low and comparable to other statins. In conclusion, rosuvastatin is effective and safe for younger or elderly Chinese patients.

Substance use by Egyptian youth: current patterns and potential avenues for prevention.

Science.gov (United States)

Loffredo, Christopher A; Boulos, Dina N K; Saleh, Doa'a A; Jillson, Irene A; Garas, Magdy; Loza, Nasser; Samuel, Philip; Shaker, Yousri Edward; Ostrowski, Mar-Jan; Amr, Sania

2015-04-01

Substance abuse in Egypt is a serious public health threat. Recent studies have demonstrated increases in the prevalence of the use of tobacco, illegal drugs, and over-the-counter drugs, particularly among youth. We conducted focus groups with a total of 40 male and female youth participants, ages 12-14 and 15-18, recruited from two different areas (Cairo and Alexandria) in 2012. We investigated their knowledge and perceptions regarding current substance use, its sources, and promoting and protecting factors, broadly addressing the use of tobacco products, illicit and prescription drugs, inhaled substances such as glue and solvents, and alcohol. Our findings suggest that: (1) youth in Egypt had access to and were actively using substances encountered in similar research worldwide, including tobacco, alcohol, illicit drugs, glue sniffing, and pharmaceutical agents; (2) smoking cigarettes and using hashish were the most common practices, and Tramadol was the most commonly used pharmaceutical drug; (3) peer pressure from friends stood out as the most common reason to start and continue using substances, followed by adverse life events and having a parent or family member who used substances; (4) strict parenting, religiosity, and having non-user friends were among the factors perceived by youth to prevent substance use or help them quit using substances; (5) most youths were aware of the adverse health effects of substance use. These findings will inform the design of quantitative surveys aimed at estimating the prevalence of specific behaviors related to substance use among youth and potential avenues for prevention.

Quantitative proteomic assessment of very early cellular signaling events

DEFF Research Database (Denmark)

Dengjel, Joern; Akimov, Vyacheslav; Olsen, Jesper V

2007-01-01

Technical limitations have prevented proteomic analyses of events occurring less than 30 s after signal initiation. We developed an automated, continuous quench-flow system allowing quantitative proteomic assessment of very early cellular signaling events (qPACE) with a time resolution of 1 s...

The effect of an active on-ward participation of hospital pharmacists in Internal Medicine teams on preventable Adverse Drug Events in elderly inpatients: protocol of the WINGS study (Ward-oriented pharmacy in newly admitted geriatric seniors)

NARCIS (Netherlands)

Klopotowska, J.E.; Wierenga, P.C.; de Rooij, S.E.; Stuijt, C.C.; Arisz, L.; Kuks, P.F.; Dijkgraaf, M.G.; Lie-A-Huen, L.; Smorenburg, S.M.

2011-01-01

The potential of clinical interventions, aiming at reduction of preventable Adverse Drug Events (preventable ADEs) during hospital stay, have been studied extensively. Clinical Pharmacy is a well-established and effective service, usually consisting of full-time on-ward participation of clinical

Negative Life Events, Social Support, and Self-Efficacy in Anxious Adolescents.

Science.gov (United States)

Raknes, Solfrid; Pallesen, Ståle; Bjaastad, Jon Fauskanger; Wergeland, Gro Janne; Hoffart, Asle; Dyregrov, Kari; Håland, Åshild Tellefsen; Haugland, Bente Storm Mowatt

2017-01-01

Purpose To examine the prevalence and correlates of anxiety in a community sample of adolescents. Knowing the prevalence and characteristics of anxious adolescents is valuable to improve anxiety prevention strategies and interventions. Design Cross-sectional data about anxiety were collected via a school survey from a community sample of Norwegian adolescents aged 12-17 ( N = 1719). Methods Based on scores from the Spence Children's Anxiety Scale, the adolescents were categorized as not anxious or anxious. Logistic regression analysis was performed to access the impact of each factor on the likelihood that participants would report an elevated level of anxiety. Results A total of 22% of the adolescents were categorized as anxious. Female gender, experienced negative life events, low social support, and low self-efficacy were associated with elevated level of anxiety. Conclusions The high prevalence of anxiety in adolescents demonstrates the importance of improved prevention interventions targeting anxious adolescents. We argue that addressing is the responsibility of not only the individual adolescents and their families but also schools, school health services, and policy makers. School-based interventions that increase social support and self-efficacy would probably be particularly beneficial for anxious adolescents.

Prevention of ischemic stroke in clinical practice: a role of internists and general practitioners.

Science.gov (United States)

Niewada, Maciej; Członkowska, Anna

2014-01-01

Stroke constitutes a substantial clinical and socio-economic burden. It is currently the third cause of death worldwide and results in mortality or disability in every third patient at the end of the first year following an acute cerebrovascular event. Although in-hospital mortality rates in stroke patients have decreased, prevention and cardiovascular risk control remain critical for improving the prognosis and reducing stroke burden worldwide. The definitions of stroke and transient ischemic attack (TIA) have been recently modified following the findings from neuroimaging and thrombolysis research. Both stroke and TIA are recurrent and preventable disorders. Both patients with stroke and those with TIA require prompt clinical workup, risk assessment, and appropriate management because the risk of recurrence, stroke, and coronary events is significant. The 5 most common cardiovascular risk factors (high blood pressure, smoking, abdominal obesity, diet, and lack of physical activity) are responsible for 80% of the cases. Stroke prevention involves lifestyle modification and specific treatment. Secondary prevention of ischemic stroke involves early treatment (antiplatelets and carotid interventions) and long-term management including lifestyle changes, antihypertensive therapy, antiplatelets, antithrombotic drugs in patients with atrial fibrillation, and the use of statins and other lipid-lowering drugs. Stroke patients are at risk of depression, dementia, epilepsy, and other complications that also require targeted treatment.

Cost-effectiveness of optimizing prevention in patients with coronary heart disease: the EUROASPIRE III health economics project.

Science.gov (United States)

De Smedt, Delphine; Kotseva, Kornelia; De Bacquer, Dirk; Wood, David; De Backer, Guy; Dallongeville, Jean; Seppo, Lehto; Pajak, Andrzej; Reiner, Zeljko; Vanuzzo, Diego; Georgiev, Borislav; Gotcheva, Nina; Annemans, Lieven

2012-11-01

The EUROASPIRE III survey indicated that the guidelines on cardiovascular disease prevention are poorly implemented in patients with established coronary heart disease (CHD). The purpose of this health economic project was to assess the potential clinical effectiveness and cost-effectiveness of optimizing cardiovascular prevention in eight EUROASPIRE III countries (Belgium, Bulgaria, Croatia, Finland, France, Italy, Poland, and the U.K.). METHODS AND RESULTS The individual risk for subsequent cardiovascular events was estimated, based on published Framingham equations. Based on the EUROASPIRE III data, the type of suboptimal prevention, if any, was identified for each individual, and the effects of optimized tailored prevention (smoking cessation, diet and exercise, better management of elevated blood pressure and/or LDL-cholesterol) were estimated. Costs of prevention and savings of avoided events were based on country-specific data. A willingness to pay threshold of €30,000/quality-adjusted life year (QALY) was used. The robustness of the results was validated by sensitivity analyses. Overall, the cost-effectiveness analyses for the eight countries showed mainly favourable results with an average incremental cost-effectiveness ratio (ICER) of €12,484 per QALY. Only in the minority of patients at the lowest risk for recurrent events, intensifying preventive therapy seems not cost-effective. Also, the single impact of intensified cholesterol control seems less cost-effective, possibly because their initial 2-year risk was already fairly low, hence the room for improvement is rather limited. These results underscore the societal value of optimizing prevention in most patients with established CHD, but also highlight the need for setting priorities towards patients more at risk and the need for more studies comparing intensified prevention with usual care in these patients.

The CBM first-level event selector

Energy Technology Data Exchange (ETDEWEB)

Cuveland, Jan de; Lindenstruth, Volker [Frankfurt Institute for Advanced Studies, Goethe University, Frankfurt (Germany)

2015-07-01

The CBM experiment currently under construction at GSI/FAIR is designed to study QCD predictions at high baryon densities. The CBM First-Level Event Selector (FLES) is the central event selection system of the experiment. Designed as a high-performance computer cluster, its task is an online analysis of the physics data including full event reconstruction at an incoming data rate exceeding 1 TByte/s. The CBM detector systems are free-running and self-triggered, delivering time-stamped data streams. As there is no inherent event separation, traditional approaches for global event building and event selection are not directly applicable. Instead of event building, the FLES combines the data from approximately 1000 input links to self-contained, overlapping processing intervals and distributes them to compute nodes. It employs a high-bandwidth InfiniBand network as well as dedicated custom FPGA input boards providing time-addressed access to buffered data. Subsequently, specialized event selection algorithms analyze these processing intervals in 4-D, identify events, and select those relevant for storage depending on the chosen CBM setup and selection scenario. This presentation outlines the design of the CBM First-level Event Selector and summarizes the results from first prototype systems.

Nutritional Science Meetings and Events | Division of Cancer Prevention

Science.gov (United States)

The Division of Cancer Prevention (DCP) conducts and supports research to determine a person's risk of cancer and to find ways to reduce the risk. This knowledge is critical to making progress against cancer because risk varies over the lifespan as genetic and epigenetic changes can transform healthy tissue into invasive cancer.

Prevention and Care Programs Addressing the Growing Prevalence of Diabetes in China.

Science.gov (United States)

Yin, Junmei; Kong, Alice P S; Chan, Juliana C N

2016-12-01

According to a 2010 national survey, 11 % of adults in China have diabetes, affecting 109.6 million individuals. The high prevalence of diabetes has been attributed to the aging of the population, the rapid adoption of energy-dense foods, and a reduction in physical activity. Collectively, these secular changes have created an obesogenic environment that can unmask diabetes in subjects with a genetic predisposition. The growing prevalence of maternal obesity, gestational diabetes, childhood obesity, and early-onset disease can lead to premature morbidity and mortality. Rising to meet these public health challenges, researchers in China have conducted randomized studies to demonstrate the benefits of lifestyle modification in preventing diabetes (the Da Qing Study), as well as that of team-based integrated care, using multiple strategies including peer support and information technology, in order to reduce hospitalizations, cardiovascular-renal complications, and premature deaths. With growing evidence supporting the benefits of these diabetes prevention and management programs, the next challenge is to use policies and systems to scale up the implementation of these programs through raising awareness, building capacity, and providing resources to reduce the human and socioeconomic burden of diabetes.

Adverse Life Events and Psychopathology and Prosocial Behavior in Late Adolescence: Testing the Timing, Specificity, Accumulation, Gradient, and Moderation of Contextual Risk

Science.gov (United States)

Flouri, Eirini; Kallis, Constantinos

2007-01-01

A study examines the role of contextual risk in psychopathology and prosocial behavior in adolescents. The results show that risk accumulation matters instead of specificity and that the number of adverse life events is nonmultiplicative with psychopathology.

Addressing vulnerabilities of female sex workers in an HIV prevention intervention in Mumbai and Thane: experiences from the Aastha project

Science.gov (United States)

Ranebennur, Virupax; Gaikwad, Sanjeevsingh; Ramesh, Sowmya; Bhende, Amrita

2014-01-01

Background It is important for targeted interventions to consider vulnerabilities of female sex workers (FSWs) such as poverty, work-related mobility, and literacy, for effective human immunodeficiency virus (HIV) prevention. This paper describes and examines the association of the Aastha HIV/sexually transmitted infection (STI) prevention project in Mumbai and Thane, India, on the relationship between vulnerability and behavioral outcomes. Materials and methods Data were drawn from the Behavioural Tracking Survey, a cross-sectional behavioral study conducted in 2010 with 2,431 FSWs recruited in Mumbai and Thane. The key independent measures used were program exposure and “vulnerability index”, a composite index of literacy, factors of dependence (alternative livelihood options, current debt, and children), and aspects of sex work (mobility and duration in sex work). Dependent measures included service uptake, self-confidence, self-identity, and individual agency. Logistic regression analysis was used to examine the study objectives. Results Of the analytical sample of 2,431 FSWs, 1,295 (53.3%) were categorized as highly vulnerable. Highly vulnerable FSWs who were associated with the Aastha program for more than a year were more likely to have accessed crisis-response services in the past 6 months (adjusted odds ratio [AOR] 2.2, 95% confidence interval [CI] 1.4–3.6; P<0.001), to have visited a clinic to get a checkup for STI symptoms (AOR 2.4, 95% CI 1.2–4.8; P<0.015), not to be ashamed to disclose identity as an FSW to health workers (AOR 2.1, 95% CI 1.2–3.5; P<0.008), and to be confident in supporting a fellow FSW in crisis (AOR 1.7, 95% CI 1.0–2.8, P<0.033) compared to those less vulnerable with similar exposure to the Aastha program. Conclusion It is critical for HIV/STI interventions to consider vulnerabilities of FSWs at project inception and address them with focused strategies, including a segmented service-delivery model and community

Continental-Scale Estimates of Runoff Using Future Climate Storm Events

Science.gov (United States)

Recent runoff events have had serious repercussions to both natural ecosystems and human infrastructure. Understanding how shifts in storm event intensities are expected to change runoff responses are valuable for local, regional, and landscape planning. To address this challenge...

Improving the delivery of preventive care services.

Science.gov (United States)

Hung, Dorothy Y

2007-05-01

Performance of preventive services is an important indicator of high-quality health care, but many recommended services are not regularly offered in primary care practices. Health risk assessments, counseling, and referral to community-based programs help address risk behaviors, many of which are leading causes of preventable death and disability in the United States. This study examined various influences on the delivery of preventive services designed to address smoking, excessive consumption of alcohol, unhealthy diets, and sedentary lifestyles. More than 300 health care providers in 52 practices nationwide have contributed data to this study. Staff participation in quality improvement enhanced work relationships and also diminished the effect of practice size on the performance of preventive care. The use of nurse practitioners, allied health professionals, clinician reminders, and patient registries were positively associated with care delivery.

Industrial pollution prevention handbook

International Nuclear Information System (INIS)

Freeman, H.M.

1995-01-01

This book presents the techniques, technologies, regulations, and strategies that define pollution prevention. The subject is addressed from many perspectives by prominent experts. In many ways pollution prevention, rather than being a specialty field itself, is actually a convergence of fields drawing upon knowledge in a wide variety of more typical fields of expertise. Individual chapters have been processed separately for inclusion in the appropriate data bases

Synchronous Parallel Emulation and Discrete Event Simulation System with Self-Contained Simulation Objects and Active Event Objects

Science.gov (United States)

Steinman, Jeffrey S. (Inventor)

1998-01-01

The present invention is embodied in a method of performing object-oriented simulation and a system having inter-connected processor nodes operating in parallel to simulate mutual interactions of a set of discrete simulation objects distributed among the nodes as a sequence of discrete events changing state variables of respective simulation objects so as to generate new event-defining messages addressed to respective ones of the nodes. The object-oriented simulation is performed at each one of the nodes by assigning passive self-contained simulation objects to each one of the nodes, responding to messages received at one node by generating corresponding active event objects having user-defined inherent capabilities and individual time stamps and corresponding to respective events affecting one of the passive self-contained simulation objects of the one node, restricting the respective passive self-contained simulation objects to only providing and receiving information from die respective active event objects, requesting information and changing variables within a passive self-contained simulation object by the active event object, and producing corresponding messages specifying events resulting therefrom by the active event objects.

Preventive Migraine Treatment

Science.gov (United States)

Silberstein, Stephen D.

2015-01-01

Purpose of Review: This article reviews the evidence base for the preventive treatment of migraine. Recent Findings: Evidence-based guidelines for the preventive treatment of migraine have recently been published by the American Academy of Neurology (AAN) and the Canadian Headache Society (CHS), providing valuable guidance for clinicians. Strong evidence exists to support the use of metoprolol, timolol, propranolol, divalproex sodium, sodium valproate, and topiramate for migraine prevention, according to the AAN. Based on best available evidence, adverse event profile, and expert consensus, topiramate, propranolol, nadolol, metoprolol, amitriptyline, gabapentin, candesartan, Petasites (butterbur), riboflavin, coenzyme Q10, and magnesium citrate received a strong recommendation for use from the CHS. Summary: Migraine preventive drug treatments are underutilized in clinical practice. Principles of preventive treatment are important to improve compliance, minimize side effects, and improve patient outcomes. Choice of preventive treatment of migraine should be based on the presence of comorbid and coexistent illness, patient preference, reproductive potential and planning, and best available evidence. PMID:26252585

Multi Agent System Based Wide Area Protection against Cascading Events

DEFF Research Database (Denmark)

Liu, Zhou; Chen, Zhe; Liu, Leo

2012-01-01

In this paper, a multi-agent system based wide area protection scheme is proposed in order to prevent long term voltage instability induced cascading events. The distributed relays and controllers work as a device agent which not only executes the normal function automatically but also can...... the effectiveness of proposed protection strategy. The simulation results indicate that the proposed multi agent control system can effectively coordinate the distributed relays and controllers to prevent the long term voltage instability induced cascading events....

Linking HIV-Negative Youth to Prevention Services in 12 U.S. Cities: Barriers and Facilitators to Implementing the HIV Prevention Continuum.

Science.gov (United States)

Doll, Mimi; Fortenberry, J Dennis; Roseland, Denise; McAuliff, Kathleen; Wilson, Craig M; Boyer, Cherrie B

2018-04-01

Linkage of HIV-negative youth to prevention services is increasingly important with the development of effective pre-exposure prophylaxis that complements behavioral and other prevention-focused interventions. However, effective infrastructure for delivery of prevention services does not exist, leaving many programs to address HIV prevention without data to guide program development/implementation. The objective of this study was to provide a qualitative description of barriers and facilitators of linkage to prevention services among high-risk, HIV-negative youth. Thematic analysis of structured interviews with staff implementing linkage to prevention services programs for youth aged 12-24 years. Twelve adolescent medicine HIV primary care programs as part of larger testing research program focused on young sexual minority men of color. The study included staff implementing linkage to prevention services programs along with community-based HIV testing programs. The main outcomes of the study were key barriers/facilitators to linkage to prevention services. Eight themes summarized perspectives on linkage to prevention services: (1) relationships with community partners, (2) trust between providers and youth, (3) youth capacity to navigate prevention services, (4) pre-exposure prophylaxis specific issues, (5) privacy issues, (6) gaps in health records preventing tailored services, (7) confidentiality of care for youth accessing services through parents'/caretakers' insurance, and (8) need for health-care institutions to keep pace with models that prioritize HIV prevention among at-risk youth. Themes are discussed in the context of factors that facilitated/challenged linkage to prevention services. Several evidence-based HIV prevention tools are available; infrastructures for coordinated service delivery to high-risk youth have not been developed. Implementation of such infrastructures requires attention to community-, provider-, and youth-related issues. Copyright �

Under-reporting of Adverse Events in the Biomedical Literature

Directory of Open Access Journals (Sweden)

Ronald N. Kostoff

2016-11-01

Full Text Available Purpose: To address the under-reporting of research results, with emphasis on the underreporting/distorted reporting of adverse events in the biomedical research literature. Design/methodology/approach: A four-step approach is used:(1 To identify the characteristics of literature that make it adequate to support policy; (2 to show how each of these characteristics becomes degraded to make inadequate literature; (3 to identify incentives to prevent inadequate literature; and (4 to show policy implications of inadequate literature. Findings: This review has provided reasons for, and examples of, adverse health effects of myriad substances (1 being under-reported in the premiere biomedical literature, or (2 entering this literature in distorted form. Since there is no way to gauge the extent of this under/distorted-reporting, the quality and credibility of the ‘premiere’ biomedical literature is unknown. Therefore, any types of meta-analyses or scientometric analyses of this literature will have unknown quality and credibility. The most sophisticated scientometric analysis cannot compensate for a highly flawed database. Research limitations: The main limitation is in identifying examples of under-reporting. There are many incentives for under-reporting and few dis-incentives. Practical implications: Almost all research publications, addressing causes of disease, treatments for disease, diagnoses for disease, scientometrics of disease and health issues, and other aspects of healthcare, build upon previous healthcare-related research published. Many researchers will not have laboratories or other capabilities to replicate or validate the published research, and depend almost completely on the integrity of this literature. If the literature is distorted, then future research can be misguided, and health policy recommendations can be ineffective or worse. Originality/value: This review has examined a much wider range of technical and nontechnical

Emotion processes in normal and abnormal development and preventive intervention.

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Izard, Carroll E; Fine, Sarah; Mostow, Allison; Trentacosta, Christopher; Campbell, Jan

2002-01-01

We present an analysis of the role of emotions in normal and abnormal development and preventive intervention. The conceptual framework stems from three tenets of differential emotions theory (DET). These principles concern the constructs of emotion utilization; intersystem connections among modular emotion systems, cognition, and action; and the organizational and motivational functions of discrete emotions. Particular emotions and patterns of emotions function differentially in different periods of development and in influencing the cognition and behavior associated with different forms of psychopathology. Established prevention programs have not emphasized the concept of emotion as motivation. It is even more critical that they have generally neglected the idea of modulating emotions, not simply to achieve self-regulation, but also to utilize their inherently adaptive functions as a means of facilitating the development of social competence and preventing psychopathology. The paper includes a brief description of a theory-based prevention program and suggestions for complementary targeted interventions to address specific externalizing and internalizing problems. In the final section, we describe ways in which emotion-centered preventions can provide excellent opportunities for research on the development of normal and abnormal behavior.

Contribution of hydrological data to the understanding of the spatio-temporal dynamics of F-specific RNA bacteriophages in river water during rainfall-runoff events.

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Fauvel, Blandine; Cauchie, Henry-Michel; Gantzer, Christophe; Ogorzaly, Leslie

2016-05-01

Heavy rainfall events were previously reported to bring large amounts of microorganisms in surface water, including viruses. However, little information is available on the origin and transport of viral particles in water during such rain events. In this study, an integrative approach combining microbiological and hydrological measurements was investigated to appreciate the dynamics and origins of F-specific RNA bacteriophage fluxes during two distinct rainfall-runoff events. A high frequency sampling (automatic sampler) was set up to monitor the F-specific RNA bacteriophages fluxes at a fine temporal scale during the whole course of the rainfall-runoff events. A total of 276 rainfall-runoff samples were collected and analysed using both infectivity and RT-qPCR assays. The results highlight an increase of 2.5 log10 and 1.8 log10 of infectious F-specific RNA bacteriophage fluxes in parallel of an increase of the water flow levels for both events. Faecal pollution was characterised as being mainly from anthropic origin with a significant flux of phage particles belonging to the genogroup II. At the temporal scale, two successive distinct waves of phage pollution were established and identified through the hydrological measurements. The first arrival of phages in the water column was likely to be linked to the resuspension of riverbed sediments that was responsible for a high input of genogroup II. Surface runoff contributed further to the second input of phages, and more particularly of genogroup I. In addition, an important contribution of infectious phage particles has been highlighted. These findings imply the existence of a close relationship between the risk for human health and the viral contamination of flood water. Copyright © 2016 Luxembourg institute of Science and Technology. Published by Elsevier Ltd.. All rights reserved.

Identification of canonical neural events during continuous gameplay of an 8-bit style video game.

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Cavanagh, James F; Castellanos, Joel

2016-06-01

Cognitive neuroscience suffers from a unique and pervasive problem of generalizability. Since neural findings are often interpreted in the context of a specific manipulation during a carefully controlled task, it is hard to transfer knowledge from one task to another. In this report we address problems of generalizability with two methodological advancements. First, we aimed to transcend status quo experimental procedures with a continuous, engaging task environment. To this end, we created a novel 8-bit style continuous space shooter video game that elicits a multitude of goal-oriented events, such as crashing into a wall or blowing up an enemy with a missile. Second, we aimed to objectively define the psychological significance of these events. To achieve this aim, we used pattern classification of EEG data to derive predictive weights from carefully controlled pre-game exemplar events (oddball target detection and gambling wins and losses) and transferred those weights to EEG activities during video game events. All major goal-oriented events (crashes into the wall, crashes into an enemy, missile hit on an enemy) had a significant between-task transfer bias towards oddball target weights in the time range of the canonical P3, indicating the presence of similar salience detection processes. Missile hits on an enemy were specifically identified as gambling wins, confirming the hypothesis that this goal-oriented event was appetitive. These findings suggest that it is possible to identify the contribution of canonical neural activities during otherwise ambiguous and uncontrolled task performance. Copyright © 2016 Elsevier Inc. All rights reserved.

Species-specific control of external superoxide levels by the coral holobiont during a natural bleaching event

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