WorldWideScience

Sample records for facility risk screening

  1. Screening Level Risk Assessment for the New Waste Calcining Facility

    Energy Technology Data Exchange (ETDEWEB)

    M. L. Abbott; K. N. Keck; R. E. Schindler; R. L. VanHorn; N. L. Hampton; M. B. Heiser

    1999-05-01

    This screening level risk assessment evaluates potential adverse human health and ecological impacts resulting from continued operations of the calciner at the New Waste Calcining Facility (NWCF) at the Idaho Nuclear Technology and Engineering Center (INTEC), Idaho National Engineering and Environmental Laboratory (INEEL). The assessment was conducted in accordance with the Environmental Protection Agency (EPA) report, Guidance for Performing Screening Level Risk Analyses at Combustion Facilities Burning Hazardous Waste. This screening guidance is intended to give a conservative estimate of the potential risks to determine whether a more refined assessment is warranted. The NWCF uses a fluidized-bed combustor to solidify (calcine) liquid radioactive mixed waste from the INTEC Tank Farm facility. Calciner off volatilized metal species, trace organic compounds, and low-levels of radionuclides. Conservative stack emission rates were calculated based on maximum waste solution feed samples, conservative assumptions for off gas partitioning of metals and organics, stack gas sampling for mercury, and conservative measurements of contaminant removal (decontamination factors) in the off gas treatment system. Stack emissions were modeled using the ISC3 air dispersion model to predict maximum particulate and vapor air concentrations and ground deposition rates. Results demonstrate that NWCF emissions calculated from best-available process knowledge would result in maximum onsite and offsite health and ecological impacts that are less then EPA-established criteria for operation of a combustion facility.

  2. Impact of Breast Density Legislation on Breast Cancer Risk Assessment and Supplemental Screening: A Survey of 110 Radiology Facilities.

    Science.gov (United States)

    Nayak, Lina; Miyake, Kanae K; Leung, Jessica W T; Price, Elissa R; Liu, Yueyi I; Joe, Bonnie N; Sickles, Edward A; Thomas, William R; Lipson, Jafi A; Daniel, Bruce L; Hargreaves, Jonathan; Brenner, R James; Bassett, Lawrence W; Ojeda-Fournier, Haydee; Lindfors, Karen K; Feig, Stephen A; Ikeda, Debra M

    2016-09-01

    Breast density notification laws, passed in 19 states as of October 2014, mandate that patients be informed of their breast density. The purpose of this study is to assess the impact of this legislation on radiology practices, including performance of breast cancer risk assessment and supplemental screening studies. A 20-question anonymous web-based survey was emailed to radiologists in the Society of Breast Imaging between August 2013 and March 2014. Statistical analysis was performed using Fisher's exact test. Around 121 radiologists from 110 facilities in 34 USA states and 1 Canadian site responded. About 50% (55/110) of facilities had breast density legislation, 36% of facilities (39/109) performed breast cancer risk assessment (one facility did not respond). Risk assessment was performed as a new task in response to density legislation in 40% (6/15) of facilities in states with notification laws. However, there was no significant difference in performing risk assessment between facilities in states with a law and those without (p facilities in states with laws implemented handheld whole breast ultrasound (WBUS), automated WBUS, and tomosynthesis, respectively. The ratio of facilities offering handheld WBUS was significantly higher in states with a law than in states without (p facilities are offering supplemental screening with WBUS and tomosynthesis, and many are performing formal risk assessment for determining patient management.

  3. Health risks for the population living in the vicinity of an Integrated Waste Management Facility: Screening environmental pollutants

    Energy Technology Data Exchange (ETDEWEB)

    Domingo, José L., E-mail: joseluis.domingo@urv.cat [Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Rovira, Joaquim [Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Departament d' Enginyeria Quimica, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Catalonia (Spain); Vilavert, Lolita; Nadal, Martí [Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Figueras, María J. [Microbiology Unit, School of Medicine, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Schuhmacher, Marta [Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Departament d' Enginyeria Quimica, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Catalonia (Spain)

    2015-06-15

    We performed a screening investigation to assess the human health risks of the Integrated Waste Management Facility (IWMF: mechanical–biological treatment (MBT) plant plus municipal solid waste incinerator (MSWI); Ecoparc-3) of Barcelona (Spain). Air concentrations of pollutants potentially released by the MBT plant (VOCs and bioaerosols) and the MSWI (trace elements, PCDD/Fs and PCBs) were determined. Trace elements, PCDD/Fs and PCBs were also analyzed in soil samples. The concentrations of trace elements and bioaerosols were similar to those previously reported in other areas of similar characteristics, while formaldehyde was the predominant VOC. Interestingly, PCDD/F concentrations in soil and air were the highest ever reported near a MSWI in Catalonia, being maximum concentrations 10.8 ng WHO-TEQ/kg and 41.3 fg WHO-TEQ/m{sup 3}, respectively. In addition, there has not been any reduction in soils, even after the closure of a power plant located adjacently. Human health risks of PCDD/F exposure in the closest urban nucleus located downwind the MSWI are up to 10-times higher than those nearby other MSWIs in Catalonia. Although results must be considered as very preliminary, they are a serious warning for local authorities. We strongly recommend to conduct additional studies to confirm these findings and, if necessary, to implement measures to urgently mitigate the impact of the MSWI on the surrounding environment. We must also state the tremendous importance of an individual evaluation of MSWIs, rather than generalizing their environmental and health risks. - Highlights: • Health risks of an Integrated Waste Management Facility in Catalonia are assessed. • PCDD/F exposure near this facility is up to 10-times higher than that near others. • Environmental monitoring of incineration plants should be performed case-by-case. • Since results are very preliminary, confirmatory studies should be conducted.

  4. D & D screening risk evaluation guidance

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-09-01

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

  5. Risks of Cervical Cancer Screening

    Science.gov (United States)

    ... are at increased risk for HPV infections. Other risk factors for cervical cancer include: Giving birth to many children. Smoking cigarettes. Using oral contraceptives ("the Pill"). Having a weakened immune system . Cervical Cancer Screening ...

  6. Risks of Colorectal Cancer Screening

    Science.gov (United States)

    ... screening tests have different risks or harms. Screening tests may cause anxiety when you are thinking about or getting ready ... is cancer when there really isn't) can cause anxiety and is usually followed by more tests (such as biopsy ), which also have risks. The ...

  7. Dysphonia risk screening protocol

    Directory of Open Access Journals (Sweden)

    Katia Nemr

    2016-03-01

    Full Text Available OBJECTIVE: To propose and test the applicability of a dysphonia risk screening protocol with score calculation in individuals with and without dysphonia. METHOD: This descriptive cross-sectional study included 365 individuals (41 children, 142 adult women, 91 adult men and 91 seniors divided into a dysphonic group and a non-dysphonic group. The protocol consisted of 18 questions and a score was calculated using a 10-cm visual analog scale. The measured value on the visual analog scale was added to the overall score, along with other partial scores. Speech samples allowed for analysis/assessment of the overall degree of vocal deviation and initial definition of the respective groups and after six months, the separation of the groups was confirmed using an acoustic analysis. RESULTS: The mean total scores were different between the groups in all samples. Values ranged between 37.0 and 57.85 in the dysphonic group and between 12.95 and 19.28 in the non-dysphonic group, with overall means of 46.09 and 15.55, respectively. High sensitivity and specificity were demonstrated when discriminating between the groups with the following cut-off points: 22.50 (children, 29.25 (adult women, 22.75 (adult men, and 27.10 (seniors. CONCLUSION: The protocol demonstrated high sensitivity and specificity in differentiating groups of individuals with and without dysphonia in different sample groups and is thus an effective instrument for use in voice clinics.

  8. Integrated Disposal Facility Risk Assessment

    Energy Technology Data Exchange (ETDEWEB)

    MANN, F. M.

    2003-06-03

    An environmental risk assessment associated with the disposal of projected Immobilized Low-Activity Waste, solid wastes and failed or decommissioned melters in an Integrated Disposal Facility was performed. Based on the analyses all performance objectives associated with the groundwater, air, and intruder pathways were met.

  9. Osteoporosis screening and risk management

    OpenAIRE

    Wilkins, Consuelo H.

    2007-01-01

    Consuelo H WilkinsDepartment of Medicine, Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO, USAAbstract: Osteoporosis is common among older adults and results in costly osteoporotic fractures. Screening for this metabolic bone disorder is warranted in most older adults and clinicians must be diligent in identifying persons at risk. The evaluation should include an assessment of risk factors for falls, a bone density test, and consideratio...

  10. Risk Profiling May Improve Lung Cancer Screening

    Science.gov (United States)

    A new modeling study suggests that individualized, risk-based selection of ever-smokers for lung cancer screening may prevent more lung cancer deaths and improve the effectiveness and efficiency of screening compared with current screening recommendations

  11. Risks of Esophageal Cancer Screening

    Science.gov (United States)

    ... Esophageal Cancer Prevention Esophageal Cancer Screening Research Esophageal Cancer Screening (PDQ®)–Patient Version What is screening? Go to ... the esophagus and the stomach). Being overweight . Esophageal Cancer Screening Key Points Tests are used to screen for ...

  12. Creation of a small high-throughput screening facility.

    Science.gov (United States)

    Flak, Tod

    2009-01-01

    The creation of a high-throughput screening facility within an organization is a difficult task, requiring a substantial investment of time, money, and organizational effort. Major issues to consider include the selection of equipment, the establishment of data analysis methodologies, and the formation of a group having the necessary competencies. If done properly, it is possible to build a screening system in incremental steps, adding new pieces of equipment and data analysis modules as the need grows. Based upon our experience with the creation of a small screening service, we present some guidelines to consider in planning a screening facility.

  13. Osteoporosis screening and risk management

    Directory of Open Access Journals (Sweden)

    Consuelo H Wilkins

    2007-10-01

    Full Text Available Consuelo H WilkinsDepartment of Medicine, Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO, USAAbstract: Osteoporosis is common among older adults and results in costly osteoporotic fractures. Screening for this metabolic bone disorder is warranted in most older adults and clinicians must be diligent in identifying persons at risk. The evaluation should include an assessment of risk factors for falls, a bone density test, and consideration of possible secondary causes of osteoporosis. Several medications are available to improve bone density and decrease fractures. Adequate calcium and vitamin D intake (and treatment of vitamin D deficiency are paramount in the management of osteoporosis.Keywords: Osteoporosis, Fractures, Vitamin D

  14. [Cancer screening and risk communication].

    Science.gov (United States)

    Wegwarth, Odette

    2013-04-01

    In most psychological and medical research, patients are assumed to have difficulties with health statistics but clinicians not. However, studies indicate that most doctors have problems in understanding health statistics, including those of their own speciality. For example, only two out of 20 urologists knew the information relevant for a patient to make an informed decision about whether to take PSA screening for prostate cancer, just 14 out of 65 physicians in internal medicine understood that 5-year survival rates do not tell anything about screening's benefit, and merely 34 out of 160 gynecologists were able to interpret the meaning of a positive test result. This statistical illiteracy has a direct effect on patients understanding and interpretation of medical issues. Not rarely their own limited health literacy and their doctors' misinformation make them suffer through a time of emotional distress and unnecessary anxiety. The main reasons for doctors' statistical illiteracy are medical schools that ignore the importance of teaching risk communication. With little effort doctors could taught the simple techniques of risk communication, which would make most of their statistical confusion disappear.

  15. Risks of Lung Cancer Screening

    Science.gov (United States)

    ... Treatment Lung Cancer Prevention Lung Cancer Screening Research Lung Cancer Screening (PDQ®)–Patient Version What is screening? Go ... These are called diagnostic tests . General Information About Lung Cancer Key Points Lung cancer is a disease in ...

  16. Risks of Endometrial Cancer Screening

    Science.gov (United States)

    ... Transvaginal ultrasound Endometrial sampling Tests are used to screen for different types of cancer. Some screening tests ... endometrium by inserting a brush, curette , or thin, flexible tube through the cervix and into the uterus. ...

  17. Syphilis screening practices in blood transfusion facilities in Ghana

    DEFF Research Database (Denmark)

    Sarkodie, Francis; Hassall, Oliver; Owusu-Dabo, Ellis

    2016-01-01

    OBJECTIVES: The primary objective of this study was to compare laboratory practices for screening blood donors for syphilis at blood transfusion facilities in Ghana with the recommendations of the World Health Organization and the National Blood Service, Ghana (NBSG). The prevalence of syphilis...... of 58 (48%) transfusion facilities tested donors for syphilis, with an estimated 3.7% seroprevalence (95% confidence interval 3.6-3.8%). A total of 62782 out of 91386 (68.7%) donations were tested with assays that are not recommended. The estimated syphilis seroprevalence in voluntary donations was 2.......9%, compared to 4.0% in family donations (p=0.001). Only 6.9% of the health facilities were using standard operating procedures (SOPs). CONCLUSIONS: Despite international and national recommendations, more than half of the studied health facilities that provide blood transfusions in Ghana are not screening...

  18. Monitored retrievable storage facility site screening and evaluation report

    Energy Technology Data Exchange (ETDEWEB)

    none,

    1985-05-01

    The Nuclear Waste Policy Act of 1982 directs the Department of Energy to complete a detailed study of the need for and feasibility of, and to submit to the Congress a proposal for, the construction of one or more monitored retrievable storage facilities for high level radioactive waste and spent nuclear fuel.'' The Act directs that the proposal includes site specific designs. Further, the proposal is to include, for the first such facility, at least three alternative sites and at least five alternative combinations of such proposed site and facility designs...'' as well as a recommendation of the combination among the alternatives that the Secretary deems preferable.'' An MRS Site Screening Task Force has been formed to help identify and evaluated potential MRS facility sites within a preferred region and with the application of a siting process and criteria developed by the DOE. The activities of the task force presented in this report includes: site screening (Sections 3, 4, and 5), the MRS facilities which are to be sited are described; the criteria, process and outcome of the screening process is presented; and descriptions of the candidate MRS facility sites are given, and site evaluations (Sections 6 through 9) where the rational for the site evaluations are presented, along with each evaluation and findings of the Task Force.

  19. Uncertainties in risk assessment at USDOE facilities

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, L.D.; Holtzman, S.; Meinhold, A.F.; Morris, S.C.; Rowe, M.D.

    1994-01-01

    The United States Department of Energy (USDOE) has embarked on an ambitious program to remediate environmental contamination at its facilities. Decisions concerning cleanup goals, choices among cleanup technologies, and funding prioritization should be largely risk-based. Risk assessments will be used more extensively by the USDOE in the future. USDOE needs to develop and refine risk assessment methods and fund research to reduce major sources of uncertainty in risk assessments at USDOE facilities. The terms{open_quote} risk assessment{close_quote} and{open_quote} risk management{close_quote} are frequently confused. The National Research Council (1983) and the United States Environmental Protection Agency (USEPA, 1991a) described risk assessment as a scientific process that contributes to risk management. Risk assessment is the process of collecting, analyzing and integrating data and information to identify hazards, assess exposures and dose responses, and characterize risks. Risk characterization must include a clear presentation of {open_quotes}... the most significant data and uncertainties...{close_quotes} in an assessment. Significant data and uncertainties are {open_quotes}...those that define and explain the main risk conclusions{close_quotes}. Risk management integrates risk assessment information with other considerations, such as risk perceptions, socioeconomic and political factors, and statutes, to make and justify decisions. Risk assessments, as scientific processes, should be made independently of the other aspects of risk management (USEPA, 1991a), but current methods for assessing health risks are based on conservative regulatory principles, causing unnecessary public concern and misallocation of funds for remediation.

  20. Uncertainties in risk assessment at USDOE facilities

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, L.D.; Holtzman, S.; Meinhold, A.F.; Morris, S.C.; Rowe, M.D.

    1994-01-01

    The United States Department of Energy (USDOE) has embarked on an ambitious program to remediate environmental contamination at its facilities. Decisions concerning cleanup goals, choices among cleanup technologies, and funding prioritization should be largely risk-based. Risk assessments will be used more extensively by the USDOE in the future. USDOE needs to develop and refine risk assessment methods and fund research to reduce major sources of uncertainty in risk assessments at USDOE facilities. The terms{open_quote} risk assessment{close_quote} and{open_quote} risk management{close_quote} are frequently confused. The National Research Council (1983) and the United States Environmental Protection Agency (USEPA, 1991a) described risk assessment as a scientific process that contributes to risk management. Risk assessment is the process of collecting, analyzing and integrating data and information to identify hazards, assess exposures and dose responses, and characterize risks. Risk characterization must include a clear presentation of {open_quotes}... the most significant data and uncertainties...{close_quotes} in an assessment. Significant data and uncertainties are {open_quotes}...those that define and explain the main risk conclusions{close_quotes}. Risk management integrates risk assessment information with other considerations, such as risk perceptions, socioeconomic and political factors, and statutes, to make and justify decisions. Risk assessments, as scientific processes, should be made independently of the other aspects of risk management (USEPA, 1991a), but current methods for assessing health risks are based on conservative regulatory principles, causing unnecessary public concern and misallocation of funds for remediation.

  1. Syphilis screening practices in blood transfusion facilities in Ghana

    Directory of Open Access Journals (Sweden)

    Francis Sarkodie

    2016-02-01

    Conclusions: Despite international and national recommendations, more than half of the studied health facilities that provide blood transfusions in Ghana are not screening blood donations for syphilis. These data show a considerable mismatch between recommendations and practice, with serious consequences for blood safety and public health.

  2. Prenatal screening costs at a large military treatment facility.

    Science.gov (United States)

    Shiv, Erin; Sale, Taylor J; Simsiman, Amanda; Leininger, William M; Lutgendorf, Monica A

    2017-07-01

    Prenatal screening with cell-free DNA (cfDNA) offers improved detection of Down syndrome (T21) compared to conventional screening. These tests are expensive and have fewer detectable anomalies. Our objective was to investigate potential costs and test performance of screening algorithms when accounting for detectable aneuploidies. This is a cost analysis for a large military treatment facility. Using a theoretical delivery cohort and published performance data, universal screening with cfDNA was compared to sequential screening, comparing T21 to all detectable aneuploidies. Predicted test performance and costs were calculated. A cohort of 3000 deliveries was used. For T21, universal cfDNA is more expensive ($1,346,064) than sequential screening ($244,885), but has a lower false positive rate and avoids 101 invasive diagnostic tests. An additional case of T21 is detected with a marginal cost of $1,101,179. For all detectable aneuploidies, cfDNA is more expensive ($1,353,660) than sequential screening ($239,189), and 59 invasive diagnostic tests are avoided. Sequential screening detects an additional case of aneuploidy, with a cost savings of $1,114,471. Although cfDNA is superior in detecting T21 cases, sequential screening is superior when considering all aneuploidies detectable. The cost increase with universal cfDNA is significant, and is not justified with small improvements in the performance.

  3. Risk-Screening Environmental Indicators (RSEI)

    Data.gov (United States)

    U.S. Environmental Protection Agency — EPA’s Risk-Screening Environmental Indicators (RSEI) is a geographically-based model that helps policy makers and communities explore data on releases of toxic...

  4. Direct facile screening of recombinant DNA vector constructs.

    Science.gov (United States)

    Winnard, Paul T; Challa, Rushi; Bhujwalla, Zaver M; Raman, Venu

    2014-04-01

    Direct efficient facile screening of bacterial transformants with the goal of selecting, retrieving, and using recombinant DNA is exemplified by simple visual-based colorimetric inspections or fluorescent protein-based assays. We describe pRedScript, which introduces the constitutive expression of a very bright red fluorescent protein into transformants. On agar plates, red colonies are simply visualized in ambient white light in stark contrast to recombinant transformants that are white. In addition, the bright red fluorescence of the reporter protein can also be harnessed as a sensitive signal for screening bacterial promoters during the development of optimized fermentation conditions.

  5. Risks of Breast Cancer Screening

    Science.gov (United States)

    ... of dying from breast cancer. MRI (magnetic resonance imaging) in women with a high risk of breast ... a mammogram , the breast is placed between 2 plates that are pressed together. Pressing the breast helps ...

  6. Social Risk Screening for Pediatric Inpatients.

    Science.gov (United States)

    Pai, Nikhil; Kandasamy, Sharmilaa; Uleryk, Elizabeth; Maguire, Jonathon L

    2016-12-01

    This systematic review aims to identify existing social risk screening instruments applicable to hospitalized children (primary) and evaluate their content validity and methodological quality (secondary). Individual questions were abstracted and sorted by social risk theme. Content validity was evaluated by 13 hospital-based social workers. Methodological quality was assessed using the 108-item Consensus Based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. A total of 1070 citations were evaluated and 146 articles were reviewed, which identified 44 unique instruments. No instrument was applicable to social risk in hospitalized children. Sixty-one percent of instruments focused on a single social risk theme and only 18% of instruments covered more than 5 themes. The 2 instruments with the highest combination of social worker endorsement and COSMIN scores each addressed only 1 social risk theme relevant to hospitalized children. A broad, content valid and methodologically strong social risk screening instrument for hospitalized children was not identified.

  7. Monitored retrievable storage facility site screening and evaluation report

    Energy Technology Data Exchange (ETDEWEB)

    none,

    1985-05-01

    The Nuclear Waste Policy Act of 1982 directs the Department of Energy to complete a detailed study of the need for and feasibility of, and to submit to the Congress a proposal for, the construction of one or more monitored retrievable storage facilities for high level radioactive waste and spent nuclear fuel.'' The Act directs that the proposal includes site specific designs. Further, the proposal is to include, for the first such facility, at least three alternative sites and at least five alternative combinations of such proposed sites and facility designs{hor ellipsis}'' as well as a recommendation of the combination among the alternatives that the Secretary deems preferable.'' An MRS Site Screening Task Force has been formed to help identify and evaluate potential MRS facility sites within a preferred region and with the application of a siting process and criteria developed by the DOE. The activities of the Task Force presented in this report include: site evaluations (sections 10 through 12) where the rationale for the site evaluations are presented, along with each evaluation and findings of the Task Force. This in Volume 2 of a three volume document.

  8. Monitored Retrievable Storage facility site screening and evaluation report

    Energy Technology Data Exchange (ETDEWEB)

    none,

    1985-05-01

    The Nuclear Waste Policy Act of 1982 directs the Department of Energy to complete a detailed study of the need for and feasibility of, and to submit to the Congress a proposal for, the construction of one or more monitored retrievable storage facilities for high level radioactive waste and spent nuclear fuel.'' The Act directs that the proposal includes site specific designs. Further, the proposal is to include, for the first such facility, at least three alternative sites and at least five alternative combinations of such proposed sites and facility designs {hor ellipsis}'' as well as a recommendation of the combination among the alternatives that the Secretary deems preferable.'' An MRS Site Screening Task Force has been formed to help identify and evaluate potential MRS facility sites within a preferred region and with the application of a siting process and criteria developed by the DOE. The activities of the Task Force presented in this report, all site evaluations (sections 13 through 16) where the rationale for the site evaluations are presented, along with each evaluation and findings of the Task Force. This is Volume 3 of a three volume document. References are also included in this volume.

  9. Biotechnology System Facility: Risk Mitigation on Mir

    Science.gov (United States)

    Gonda, Steve R., III; Galloway, Steve R.

    2003-01-01

    NASA is working with its international partners to develop space vehicles and facilities that will give researchers the opportunity to conduct scientific investigations in space. As part of this activity, NASA's Biotechnology Cell Science Program (BCSP) at the Johnson Space Center (JSC) is developing a world-class biotechnology laboratory facility for the International Space Station (ISS). This report describes the BCSP, including the role of the BTS. We identify the purpose and objectives of the BTS and a detailed description of BTS facility design and operational concept, BTS facility and experiment-specific hardware, and scientific investigations conducted in the facility. We identify the objectives, methods, and results of risk mitigation investigations of the effects of microgravity and cosmic radiation on the BTS data acquisition and control system. These results may apply to many other space experiments that use commercial, terrestrial-based data acquisition technology. Another focal point is a description of the end-to-end process of integrating and operating biotechnology experiments on a variety of space vehicles. The identification of lessons learned that can be applied to future biotechnology experiments is an overall theme of the report. We include a brief summary of the science results, but this is not the focus of the report. The report provides some discussion on the successful 130-day tissue engineering experiment performed in BTS on Mir and describes a seminal gene array investigation that identified a set of unique genes that are activated in space.

  10. Risk assessment of tailings facility dam failure

    OpenAIRE

    Hadzi-Nikolova, Marija; Mirakovski, Dejan; Stefanova, Violeta

    2011-01-01

    This paper presents the consequences of tailings facility dam failure and therefore the needs for its risk assessment. Tailings are fine-grained wastes of the mining industry, output as slurries, due to mixing with water during mineral processing. Tailings dams vary a lot as it is affected by: tailings characteristics and mill output, site characteristics as: topography, hydrology, geology, groundwater, seismicity and available material and disposal methods. The talings which accumulat...

  11. Risk management activities at the DOE Class A reactor facilities

    Energy Technology Data Exchange (ETDEWEB)

    Sharp, D.A. [Westinghouse Savannah River Co., Aiken, SC (United States); Hill, D.J. [Argonne National Lab., IL (United States); Linn, M.A. [Oak Ridge National Lab., TN (United States); Atkinson, S.A. [EG and G Idaho, Inc., Idaho Falls, ID (United States); Hu, J.P. [Brookhaven National Lab., Upton, NY (United States)

    1993-12-31

    The probabilistic risk assessment (PRA) and risk management group of the Association for Excellence in Reactor Operation (AERO) develops risk management initiatives and standards to improve operation and increase safety of the DOE Class A reactor facilities. Principal risk management applications that have been implemented at each facility are reviewed. The status of a program to develop guidelines for risk management programs at reactor facilities is presented.

  12. Risk management activities at the DOE Class A reactor facilities

    Energy Technology Data Exchange (ETDEWEB)

    Sharp, D.A. (Westinghouse Savannah River Co., Aiken, SC (United States)); Hill, D.J. (Argonne National Lab., IL (United States)); Linn, M.A. (Oak Ridge National Lab., TN (United States)); Atkinson, S.A. (EG and G Idaho, Inc., Idaho Falls, ID (United States)); Hu, J.P. (Brookhaven National Lab., Upton, NY (United States))

    1993-01-01

    The probabilistic risk assessment (PRA) and risk management group of the Association for Excellence in Reactor Operation (AERO) develops risk management initiatives and standards to improve operation and increase safety of the DOE Class A reactor facilities. Principal risk management applications that have been implemented at each facility are reviewed. The status of a program to develop guidelines for risk management programs at reactor facilities is presented.

  13. Thermal Protection System Aerothermal Screening Tests in HYMETS Facility

    Science.gov (United States)

    Szalai, Christine E.; Beck, Robin A. S.; Gasch, Matthew J.; Alumni, Antonella I.; Chavez-Garcia, Jose F.; Splinter, Scott C.; Gragg, Jeffrey G.; Brewer, Amy

    2011-01-01

    The Entry, Descent, and Landing (EDL) Technology Development Project has been tasked to develop Thermal Protection System (TPS) materials for insertion into future Mars Entry Systems. A screening arc jet test of seven rigid ablative TPS material candidates was performed in the Hypersonic Materials Environmental Test System (HYMETS) facility at NASA Langley Research Center, in both an air and carbon dioxide test environment. Recession, mass loss, surface temperature, and backface thermal response were measured for each test specimen. All material candidates survived the Mars aerocapture relevant heating condition, and some materials showed a clear increase in recession rate in the carbon dioxide test environment. These test results supported subsequent down-selection of the most promising material candidates for further development.

  14. Tailored information about cancer risk and screening: a systematic review.

    NARCIS (Netherlands)

    Albada, A.; Ausems, M.G.E.M.; Bensing, J.M.; Dulmen, S. van

    2009-01-01

    OBJECTIVE: To study interventions that provide people with information about cancer risk and about screening that is tailored to their personal characteristics. We assess the tailoring characteristics, theory base and effects on risk perception, knowledge and screening behavior of these

  15. Cost Analysis of Universal Screening vs. Risk Factor-Based Screening for Methicillin-Resistant Staphylococcus aureus (MRSA)

    Science.gov (United States)

    Roth, Virginia R.; Longpre, Tara; Coyle, Doug; Suh, Kathryn N.; Taljaard, Monica; Ramotar, Karamchand; Forster, Alan

    2016-01-01

    Background The literature remains conflicted regarding the most effective way to screen for MRSA. This study was designed to assess costs associated with universal versus risk factor-based screening for the reduction of nosocomial MRSA transmission. Methods The study was conducted at The Ottawa Hospital, a large multi-centre tertiary care facility with approximately 47,000 admissions annually. From January 2006-December 2007, patients underwent risk factor-based screening for MRSA on admission. From January 2008 to August 2009 universal MRSA screening was implemented. A comparison of costs incurred during risk factor-based screening and universal screening was conducted. The model incorporated probabilities relating to the likelihood of being tested and the results of polymerase chain reaction (PCR) testing with associated effects in terms of MRSA bacteremia and true positive and negative test results. Inputted costs included laboratory testing, contact precautions and infection control, private room costs, housekeeping, and length of hospital stay. Deterministic sensitivity analyses were conducted. Results The risk factor-based MRSA screening program screened approximately 30% of admitted patients and cost the hospital over $780 000 annually. The universal screening program screened approximately 83% of admitted patients and cost over $1.94 million dollars, representing an excess cost of $1.16 million per year. The estimated additional cost per patient screened was $17.76. Conclusion This analysis demonstrated that a universal MRSA screening program was costly from a hospital perspective and was previously known to not be clinically effective at reducing MRSA transmission. These results may be useful to inform future model-based economic analyses of MRSA interventions. PMID:27462905

  16. Cost Analysis of Universal Screening vs. Risk Factor-Based Screening for Methicillin-Resistant Staphylococcus aureus (MRSA.

    Directory of Open Access Journals (Sweden)

    Virginia R Roth

    Full Text Available The literature remains conflicted regarding the most effective way to screen for MRSA. This study was designed to assess costs associated with universal versus risk factor-based screening for the reduction of nosocomial MRSA transmission.The study was conducted at The Ottawa Hospital, a large multi-centre tertiary care facility with approximately 47,000 admissions annually. From January 2006-December 2007, patients underwent risk factor-based screening for MRSA on admission. From January 2008 to August 2009 universal MRSA screening was implemented. A comparison of costs incurred during risk factor-based screening and universal screening was conducted. The model incorporated probabilities relating to the likelihood of being tested and the results of polymerase chain reaction (PCR testing with associated effects in terms of MRSA bacteremia and true positive and negative test results. Inputted costs included laboratory testing, contact precautions and infection control, private room costs, housekeeping, and length of hospital stay. Deterministic sensitivity analyses were conducted.The risk factor-based MRSA screening program screened approximately 30% of admitted patients and cost the hospital over $780 000 annually. The universal screening program screened approximately 83% of admitted patients and cost over $1.94 million dollars, representing an excess cost of $1.16 million per year. The estimated additional cost per patient screened was $17.76.This analysis demonstrated that a universal MRSA screening program was costly from a hospital perspective and was previously known to not be clinically effective at reducing MRSA transmission. These results may be useful to inform future model-based economic analyses of MRSA interventions.

  17. Wide Variations in Compliance with Tuberculosis Screening Guidelines and Tuberculosis Incidence between Antiretroviral Therapy Facilities - Cote d'Ivoire.

    Directory of Open Access Journals (Sweden)

    Andrew F Auld

    Full Text Available In Côte d'Ivoire, tuberculosis (TB is a common cause of death among HIV-infected antiretroviral therapy (ART enrollees. Ivorian guidelines recommend screening for TB and initiation of TB treatment before ART initiation. Compliance with these guidelines can help reduce TB-related mortality during ART and possibly nosocomial TB transmission.In a retrospective cohort study among 3,682 randomly selected adults (≥15 years old starting ART during 2004-2007 at 34 randomly selected facilities, documentation of TB screening completion, prevalence of active TB at ART initiation, and incidence of TB during ART were evaluated. At ART initiation, median age was 36 years, 67% were female, and median CD4 count was 135 cells/μL. Among all 3,682 enrollees, 73 (2% were on TB treatment at the time of referral to the ART facility. Among the 3,609 not on TB treatment, 1,263 (36% were documented to receive some TB screening before ART initiation; 21% were screened for cough, 21% for weight loss, 18% for fever, 18% for TB contacts, and 12% for night sweats. Among the 1,263 screened, 111 (11% were diagnosed with TB and started TB treatment before ART. No associations between patient characteristics and probability of being screened were noted. However, documentation of TB screening completion before ART varied widely by ART facility from 0-100%. TB incidence during ART was 3.0 per 100 person-years but varied widely by ART facility from 0/100 person-year to 13.1/100 person-years.Screening for TB before ART initiation was poorly documented. Facility-level variations in TB screening documentation suggest facility-level factors, such as investment in training programs, might determine documentation practices. Targeting under-performing ART facilities with improvement activities is needed. Variations among facilities in TB incidence warrant further research. These incidence variations could reflect differences between facilities in TB screening, diagnostic tests

  18. Optimal and acceptable technical facilities involving risks.

    Science.gov (United States)

    Rackwitz, Ruediger

    2004-06-01

    Economic cost-benefit optimization of technical facility requires suitable "life saving cost" and/or an appropriate acceptance criterion if human life and limb are at risk. Traditionally, acceptance criteria implicit in codes of practice, standards, or regulations for well-defined fields of application are calibrated against past and present practice. This is all but satisfying. It is unclear whether present rules are already optimal. Extrapolations into new fields of application are extremely difficult. Direct cost-benefit analysis is proposed as an alternative. Based on the recently proposed "life quality index" (LQI), a rational acceptance criterion and so-called life saving cost are derived. The classical life quality index is reviewed, modified, and imbedded in modern economics theory. The results are then applied to technical facilities. The relation between optimization and the LQI-based acceptance criterion is discussed. The relevant economics literature is reviewed with respect to discount rates applicable for long-term investments into risk reduction. They should be as low as possible according to a recent mathematical result. Modern economic growth theory decomposes the output growth rate into the rate of time preference of consumption and the rate of economical growth multiplied by the elasticity of marginal utility of consumption. It is found that the rate of time preference of consumption should be a little larger than the long-term population growth rate. The public benefit rate (output growth rate) on the other hand should be smaller than the sum of the population growth rate and the long-term growth rate of a national economy, which is around 2% for most industrial countries. Accordingly, the rate of time preference of consumption is about 1%, which is also intergenerationally acceptable from an ethical point of view. Given a certain output growth rate there is a corresponding maximum financial interest rate in order to maintain nonnegativity of

  19. Screensaver: an open source lab information management system (LIMS for high throughput screening facilities

    Directory of Open Access Journals (Sweden)

    Nale Jennifer

    2010-05-01

    Full Text Available Abstract Background Shared-usage high throughput screening (HTS facilities are becoming more common in academe as large-scale small molecule and genome-scale RNAi screening strategies are adopted for basic research purposes. These shared facilities require a unique informatics infrastructure that must not only provide access to and analysis of screening data, but must also manage the administrative and technical challenges associated with conducting numerous, interleaved screening efforts run by multiple independent research groups. Results We have developed Screensaver, a free, open source, web-based lab information management system (LIMS, to address the informatics needs of our small molecule and RNAi screening facility. Screensaver supports the storage and comparison of screening data sets, as well as the management of information about screens, screeners, libraries, and laboratory work requests. To our knowledge, Screensaver is one of the first applications to support the storage and analysis of data from both genome-scale RNAi screening projects and small molecule screening projects. Conclusions The informatics and administrative needs of an HTS facility may be best managed by a single, integrated, web-accessible application such as Screensaver. Screensaver has proven useful in meeting the requirements of the ICCB-Longwood/NSRB Screening Facility at Harvard Medical School, and has provided similar benefits to other HTS facilities.

  20. Screensaver: an open source lab information management system (LIMS) for high throughput screening facilities

    Science.gov (United States)

    2010-01-01

    Background Shared-usage high throughput screening (HTS) facilities are becoming more common in academe as large-scale small molecule and genome-scale RNAi screening strategies are adopted for basic research purposes. These shared facilities require a unique informatics infrastructure that must not only provide access to and analysis of screening data, but must also manage the administrative and technical challenges associated with conducting numerous, interleaved screening efforts run by multiple independent research groups. Results We have developed Screensaver, a free, open source, web-based lab information management system (LIMS), to address the informatics needs of our small molecule and RNAi screening facility. Screensaver supports the storage and comparison of screening data sets, as well as the management of information about screens, screeners, libraries, and laboratory work requests. To our knowledge, Screensaver is one of the first applications to support the storage and analysis of data from both genome-scale RNAi screening projects and small molecule screening projects. Conclusions The informatics and administrative needs of an HTS facility may be best managed by a single, integrated, web-accessible application such as Screensaver. Screensaver has proven useful in meeting the requirements of the ICCB-Longwood/NSRB Screening Facility at Harvard Medical School, and has provided similar benefits to other HTS facilities. PMID:20482787

  1. Targeted screening for colorectal cancer in high-risk individuals.

    Science.gov (United States)

    Wong, Martin C S; Wong, Sunny H; Ng, Siew C; Wu, Justin C Y; Chan, Francis K L; Sung, Joseph J Y

    2015-12-01

    The idea of targeted screening for colorectal cancer based on risk profiles originates from its benefits to improve detection yield and optimize screening efficiency. Clinically, it allows individuals to be more aware of their own risk and make informed decisions on screening choice. From a public health perspective, the implementation of risk stratification strategies may better justify utilization of colonoscopic resources, and facilitate resource-planning in the formulation of population-based screening programmes. There are several at-risk groups who should receive earlier screening, and colonoscopy is more preferred. This review summarizes the currently recommended CRC screening strategies among subjects with different risk factors, and introduces existing risk scoring systems. Additional genetic, epidemiological, and clinical parameters may be needed to enhance their performance to risk-stratify screening participants. Future research studies should refine these scoring systems, and explore the adaptability, feasibility, acceptability, and user-friendliness of their use in clinical practice among different population groups.

  2. A National Survey of Mental Health Screening and Assessment Practices in Juvenile Correctional Facilities

    Science.gov (United States)

    Swank, Jacqueline M.; Gagnon, Joseph C.

    2017-01-01

    Background: Mental health screening and assessment is crucial within juvenile correctional facilities (JC). However, limited information is available about the current screening and assessment procedures specifically within JC. Objective: The purpose of the current study was to obtain information about the mental health screening and assessment…

  3. Systematic screening for cardiovascular risk at pharmacies

    Science.gov (United States)

    Rohla, Miklos; Haberfeld, Heinz; Sinzinger, Helmut; Kritz, Harald; Tscharre, Maximilian; Freynhofer, Matthias K; Huber, Kurt; Weiss, Thomas W

    2016-01-01

    Background Early identification and treatment of cardiovascular risk factors (CVRFs) is essential to prevent excess morbidity, mortality and healthcare-related costs. We sought to investigate whether an active screening programme at pharmacies could identify a significant proportion of patients with previously undetected CVRFs. Methods and results Between April and July 2013, 184 pharmacies in Lower Austria enrolled a total of 6800 participants, in whom body mass index (BMI), blood pressure (BP), total cholesterol and blood glucose were measured. Mean age was 58±17 years and 67.8% were women. 21% of men and 16% of women had a BMI≥30 kg/m2. The crude prevalence of diabetes mellitus (DM) was 7%, hypercholesterolaemia was identified in 57%, and 44% had elevated BP. Among fasting individuals (n=1814), DM was found in 18%. In total, 30% were confronted with a CVRF they were previously unaware of, and pharmacists recommended 45% of all participants to actively consult a physician. A first-time diagnosis of a CVRF was most frequent in the age groups between 25 and 64 (32% of participants). Conclusions This pharmacy-based approach for cardiovascular risk screening found similar overall prevalences of CVRFs as reported by national surveys, but revealed underdiagnoses, particularly in lower age groups. A previously unknown CVRF was identified in every third individual, frequently prompting the pharmacists to recommend the consultation of a physician. An active screening approach at pharmacies might therefore serve as an effective alternative to the public preventive medical examination, particularly in younger age groups. PMID:27738518

  4. Challenges Associated With Managing Suicide Risk in Long-Term Care Facilities

    Science.gov (United States)

    O'Riley, Alisa; Nadorff, Michael R.; Conwell, Yeates; Edelstein, Barry

    2016-01-01

    Little information about suicidal ideation and behavior in long-term care (LTC) facilities is available. Nonetheless, the implementation of the Minimum Data Set 3.0 requires that LTC facilities screen their residents for suicide risk and have protocols in place to effectively manage residents’ responses. In this article, the authors briefly discuss the risk factors of suicide in the elderly and the problems that suicidal ideation and behavior pose in the LTC environment. The authors explain issues that arise when trying to manage suicide risk in the elderly LTC population with general, traditional approaches. These inherent issues make it difficult to develop an effective protocol for managing suicide risk in LTC facilities, leading the authors to propose their own framework for assessing and managing suicide risk in the LTC setting. PMID:27610048

  5. High-risk facilities. Emergency management in nuclear, chemical and hazardous waste facilities; Hochrisikoanlagen. Notfallschutz bei Kernkraft-, Chemie- und Sondermuellanlagen

    Energy Technology Data Exchange (ETDEWEB)

    Kloepfer, Michael (ed.) [Humboldt-Universitaet, Berlin (Germany)

    2012-07-01

    The book on emergency management in high-risk facilities covers the following topics: Change in the nuclear policy, risk management of high-risk facilities as a constitutional problem - emergency management in nuclear facilities, operational mechanisms of risk control in nuclear facilities, regulatory surveillance responsibilities for nuclear facilities, operational mechanism of the risk control in chemical plants, regulatory surveillance responsibilities for chemical facilities, operational mechanisms of the risk control in hazardous waste facilities, regulatory surveillance responsibilities for hazardous waste facilities, civil law consequences in case of accidents in high-risk facilities, criminal prosecution in case of accidents in high-risk facilities, safety margins as site risk for emission protection facilities, national emergency management - strategic emergency management structures, warning and self-protection of the public in case of CBRN hazards including aspects of the psych-social emergency management.

  6. Risks of Stomach (Gastric) Cancer Screening

    Science.gov (United States)

    ... Gastric Cancer Treatment Stomach Cancer Prevention Stomach Cancer Screening Research Stomach (Gastric) Cancer Screening (PDQ®)–Patient Version What is ... from the . There is no standard or routine screening test for stomach cancer. Several types of screening tests have been ...

  7. Who delivers where? The effect of obstetric risk on facility delivery in East Africa.

    Science.gov (United States)

    Virgo, Sandra; Gon, Giorgia; Cavallaro, Francesca L; Graham, Wendy; Woodd, Susannah

    2017-09-01

    Skilled attendance at birth is key for the survival of pregnant women. This study investigates whether women at increased risk of maternal and newborn complications in four East African countries are more likely to deliver in a health facility than those at lower risk. Demographic and Health Survey data for Kenya 2014, Rwanda 2014-15, Tanzania 2015-16 and Uganda 2011 were used to study women with a live birth in the three years preceding the survey. A three-level obstetric risk index was created using known risk factors. Generalised linear Poisson regression was used to investigate the association between obstetric risk and facility delivery. We analysed data from 13 119 women across the four countries of whom 42-45% were considered at medium risk and 12-17% at high risk, and the remainder were at low risk. In Rwanda, 93% of all women delivered in facilities but this was lower (59-66%) in the other three countries. There was no association between a woman's obstetric risk level and her place of delivery in any country; greater wealth and more education were, however, independently strongly associated with facility delivery. In four East African countries, women at higher obstetric risk were not more likely to deliver in a facility than those with lower risk. This calls for a renewed focus on antenatal risk screening and improved communication on birth planning to ensure women with an increased chance of maternal and newborn complications are supported to deliver in facilities with skilled care. © 2017 John Wiley & Sons Ltd.

  8. Desmin detection by facile prepared carbon quantum dots for early screening of colorectal cancer

    Science.gov (United States)

    Li, Chang-feng; Yan, Zhen-kun; Chen, Li-bo; Jin, Jing-peng; Li, Dan-dan

    2017-01-01

    Abstract Th aim of this study was to develop a new facile chemical method for early screening of colorectal cancer. The -C(O)OH groups modified Carbon Quantum Dots (CQDs) were prepared by an facile innovative route of acid attacking on carbon nanotubes (CNTs). The -C(O)OH groups were further transported into -C(O)Cl groups by SOCl2 treating. The obtained ClCQDs were conjugated onto the anti-Desmin, which were applied for testing the Desmin concentration in serum by using linearly fitted relationship with photoluminescence (PL) intensity. The obtained carbon quantum dots are quasispherical graphite nanocrystals with photoluminescence at about 455 nm. The Desmin with concentration of 1 ng/mL can lead to a decrease of PL intensity for anti-Desmin conjugated CQDs with good linearity. This assay had good specificity for Desmin with in interferential substances of immunoglobulin G (IgG), alpha fetoprotein (AFP), and carcinoembryoic antigen (CEA). A new facile acid attack method was developed to prepare ClCQDs, which could conjugate onto the anti-Desmin for detection of Desmin in serum with high sensitivity and specificity. As the detection limit is lower than 1 ng/ mL, this work provides a promising strategy for the evaluation of colorectal cancer risk with low cost and excellent sensing performance. PMID:28151847

  9. Selecting Universal Screening Measures to Identify Students at Risk Academically

    Science.gov (United States)

    Salinger, Rachel L.

    2016-01-01

    Universal screening measures can be used to identify students at risk academically due to learning disabilities or other difficulties. Research and legislation support the use of screening measures early in students' education to ensure they receive any supports necessary to bolster their academic achievement. When selecting a screening measure,…

  10. Selecting Universal Screening Measures to Identify Students at Risk Academically

    Science.gov (United States)

    Salinger, Rachel L.

    2016-01-01

    Universal screening measures can be used to identify students at risk academically due to learning disabilities or other difficulties. Research and legislation support the use of screening measures early in students' education to ensure they receive any supports necessary to bolster their academic achievement. When selecting a screening measure,…

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-02-01

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

  12. Lung cancer screening: identifying the high risk cohort

    OpenAIRE

    Marcus, Michael W.; Raji, Olaide Y; John K. Field

    2015-01-01

    Low dose computed tomography (LDCT) is a viable screening tool for early lung cancer detection and mortality reduction. In practice, the success of any lung cancer screening programme will depend on successful identification of individuals at high risk in order to maximise the benefit-harm ratio. Risk prediction models incorporating multiple risk factors have been recognised as a method of identifying individuals at high risk of developing lung cancer. Identification of individuals at high ri...

  13. Partially observable Markov decision processes for risk-based screening

    Science.gov (United States)

    Mrozack, Alex; Liao, Xuejun; Skatter, Sondre; Carin, Lawrence

    2016-05-01

    A long-term goal for checked baggage screening in airports has been to include passenger information, or at least a predetermined passenger risk level, in the screening process. One method for including that information could be treating the checked baggage screening process as a system-of-systems. This would allow for an optimized policy builder, such as one trained using the methodology of partially observable Markov decision processes (POMDP), to navigate the different sensors available for screening. In this paper we describe the necessary steps to tailor a POMDP for baggage screening, as well as results of simulations for specific screening scenarios.

  14. Tailored information about cancer risk and screening: a systematic review.

    NARCIS (Netherlands)

    Albada, A.; Ausems, M.G.E.M.; Bensing, J.M.; Dulmen, S. van

    2009-01-01

    OBJECTIVE: To study interventions that provide people with information about cancer risk and about screening that is tailored to their personal characteristics. We assess the tailoring characteristics, theory base and effects on risk perception, knowledge and screening behavior of these intervention

  15. Risk stratification in cervical cancer screening by complete screening history: Applying bioinformatics to a general screening population.

    Science.gov (United States)

    Baltzer, Nicholas; Sundström, Karin; Nygård, Jan F; Dillner, Joakim; Komorowski, Jan

    2017-07-01

    Women screened for cervical cancer in Sweden are currently treated under a one-size-fits-all programme, which has been successful in reducing the incidence of cervical cancer but does not use all of the participants' available medical information. This study aimed to use women's complete cervical screening histories to identify diagnostic patterns that may indicate an increased risk of developing cervical cancer. A nationwide case-control study was performed where cervical cancer screening data from 125,476 women with a maximum follow-up of 10 years were evaluated for patterns of SNOMED diagnoses. The cancer development risk was estimated for a number of different screening history patterns and expressed as Odds Ratios (OR), with a history of 4 benign cervical tests as reference, using logistic regression. The overall performance of the model was moderate (64% accuracy, 71% area under curve) with 61-62% of the study population showing no specific patterns associated with risk. However, predictions for high-risk groups as defined by screening history patterns were highly discriminatory with ORs ranging from 8 to 36. The model for computing risk performed consistently across different screening history lengths, and several patterns predicted cancer outcomes. The results show the presence of risk-increasing and risk-decreasing factors in the screening history. Thus it is feasible to identify subgroups based on their complete screening histories. Several high-risk subgroups identified might benefit from an increased screening density. Some low-risk subgroups identified could likely have a moderately reduced screening density without additional risk. © 2017 UICC.

  16. Targeted Cancer Screening in Average-Risk Individuals.

    Science.gov (United States)

    Marcus, Pamela M; Freedman, Andrew N; Khoury, Muin J

    2015-11-01

    Targeted cancer screening refers to use of disease risk information to identify those most likely to benefit from screening. Researchers have begun to explore the possibility of refining screening regimens for average-risk individuals using genetic and non-genetic risk factors and previous screening experience. Average-risk individuals are those not known to be at substantially elevated risk, including those without known inherited predisposition, without comorbidities known to increase cancer risk, and without previous diagnosis of cancer or pre-cancer. In this paper, we describe the goals of targeted cancer screening in average-risk individuals, present factors on which cancer screening has been targeted, discuss inclusion of targeting in screening guidelines issued by major U.S. professional organizations, and present evidence to support or question such inclusion. Screening guidelines for average-risk individuals currently target age; smoking (lung cancer only); and, in some instances, race; family history of cancer; and previous negative screening history (cervical cancer only). No guidelines include common genomic polymorphisms. RCTs suggest that targeting certain ages and smoking histories reduces disease-specific cancer mortality, although some guidelines extend ages and smoking histories based on statistical modeling. Guidelines that are based on modestly elevated disease risk typically have either no or little evidence of an ability to affect a mortality benefit. In time, targeted cancer screening is likely to include genetic factors and past screening experience as well as non-genetic factors other than age, smoking, and race, but it is of utmost importance that clinical implementation be evidence-based.

  17. The cumulative risk of false-positive screening results across screening centres in the Norwegian Breast Cancer Screening Program

    Energy Technology Data Exchange (ETDEWEB)

    Roman, M., E-mail: Marta.Roman@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Department of Women and Children’s Health, Oslo University Hospital, Oslo (Norway); Skaane, P., E-mail: PERSK@ous-hf.no [Department of Radiology, Oslo University Hospital Ullevaal, University of Oslo, Oslo (Norway); Hofvind, S., E-mail: Solveig.Hofvind@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Oslo and Akershus University College of Applied Sciences, Faculty of Health Science, Oslo (Norway)

    2014-09-15

    Highlights: • We found variation in early performance measures across screening centres. • Radiologists’ performance may play a key role in the variability. • Potential to improve the effectiveness of breast cancer screening programs. • Continuous surveillance of screening centres and radiologists is essential. - Abstract: Background: Recall for assessment in mammographic screening entails an inevitable number of false-positive screening results. This study aimed to investigate the variation in the cumulative risk of a false positive screening result and the positive predictive value across the screening centres in the Norwegian Breast Cancer Screening Program. Methods: We studied 618,636 women aged 50–69 years who underwent 2,090,575 screening exams (1996–2010. Recall rate, positive predictive value, rate of screen-detected cancer, and the cumulative risk of a false positive screening result, without and with invasive procedures across the screening centres were calculated. Generalized linear models were used to estimate the probability of a false positive screening result and to compute the cumulative false-positive risk for up to ten biennial screening examinations. Results: The cumulative risk of a false-positive screening exam varied from 10.7% (95% CI: 9.4–12.0%) to 41.5% (95% CI: 34.1–48.9%) across screening centres, with a highest to lowest ratio of 3.9 (95% CI: 3.7–4.0). The highest to lowest ratio for the cumulative risk of undergoing an invasive procedure with a benign outcome was 4.3 (95% CI: 4.0–4.6). The positive predictive value of recall varied between 12.0% (95% CI: 11.0–12.9%) and 19.9% (95% CI: 18.3–21.5%), with a highest to lowest ratio of 1.7 (95% CI: 1.5–1.9). Conclusions: A substantial variation in the performance measures across the screening centres in the Norwegian Breast Cancer Screening Program was identified, despite of similar administration, procedures, and quality assurance requirements. Differences in the

  18. Time perspective and perceived risk as related to mammography screening.

    Science.gov (United States)

    Griva, Fay; Anagnostopoulos, Fotios; Potamianos, Gregory

    2013-01-01

    The present study explored the relation of time perspective to perceived risk for breast cancer and mammography screening. Women free from breast cancer (N = 194), eligible for mammography screening in terms of age, completed the Zimbardo Time Perspective Inventory (Zimbardo & Boyd, 1999) and measures of perceived risk, attitude toward performing mammography screening, intention to get a mammogram, and mammography screening behavior. Hierarchical multiple regression analysis revealed that perceived risk of breast cancer (β= .18, p < .01) and intention to be screened (β = .35, p < .01) were significantly associated with mammography screening, after controlling for the effects of sociodemographic (e.g., age, education, and economic level) and health-related variables (e.g., family history of breast cancer and previous benign breast disease). Path analyses including the main psychological variables indicated that perceived risk was indirectly related to intention via attitude (β = .17, p < .01), and to mammography screening through attitude and intention (β = .06, p < .01). Attitude was indirectly related to mammography screening via intention (β = .20, p < .01). Also, a significant indirect association was observed between future orientation and mammography screening, via perceived risk (β = .10, p < .01). Theoretical implications of study findings and suggestions for future research on use of mammography are presented.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-09-01

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

  20. Prospective screening for deep vein thrombosis in high risk patients.

    Science.gov (United States)

    Barnes, R W

    1977-08-01

    In 257 patients undergoing total hip replacement, gastric bypass for morbid obesity, major abdominal surgery, and major leg amputation, Doppler ultrasonic screening revealed only five instances of deep vein thrombosis. The present study suggests that Doppler screening of high risk patients is a useful alternative to routine anticoagulant prophylaxis of venous thromboembolic disease.

  1. Screening-Level Ecological Risk Assessment Methods, Revision 3

    Energy Technology Data Exchange (ETDEWEB)

    Mirenda, Richard J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2012-08-16

    This document provides guidance for screening-level assessments of potential adverse impacts to ecological resources from release of environmental contaminants at the Los Alamos National Laboratory (LANL or the Laboratory). The methods presented are based on two objectives, namely: to provide a basis for reaching consensus with regulators, managers, and other interested parties on how to conduct screening-level ecological risk investigations at the Laboratory; and to provide guidance for ecological risk assessors under the Environmental Programs (EP) Directorate. This guidance promotes consistency, rigor, and defensibility in ecological screening investigations and in reporting those investigation results. The purpose of the screening assessment is to provide information to the risk managers so informed riskmanagement decisions can be made. This document provides examples of recommendations and possible risk-management strategies.

  2. An exploration of screening protocols for intimate partner violence in healthcare facilities: a qualitative study.

    Science.gov (United States)

    Williams, Jessica R; Halstead, Valerie; Salani, Deborah; Koermer, Natasha

    2017-08-01

    Explore different methods by which intimate partner violence screening practices are implemented in clinic and emergency settings and better understand barriers and facilitators. Healthcare visits provide an opportunity for providers to identify and provide assistance to victims of intimate partner violence. However, wide variation exists in the implementation of screening and response protocols. In addition, providers experience barriers and facilitators to intimate partner violence screening and response. A comprehensive understanding of these factors is necessary to improve the role that providers play in detection and intervention of intimate partner violence. Qualitative descriptive research design. Sixteen healthcare facilities were recruited from a large metropolitan area in the USA. Data were collected through semi-structured, in-depth interviews with individuals knowledgeable about intimate partner violence screening and response within their facility. Data were analysed using directive content analysis. Major themes and patterns concerning intimate partner violence screening and response were identified within the following areas: procedural characteristics, barriers, facilitators and additional needs. Patient-provider communication and operational/facility characteristics emerged as critical aspects that impact the successful implementation of intimate partner violence screening and response programmes. Differences were found between clinic and emergency settings stemming from variations in health delivery models. Results provide important information on how healthcare facilities implement intimate partner violence screening and response, suggestions for practice improvement and directions for future interventions. Additional guidance is needed to ensure intimate partner violence identification, and response procedures are effective and tailored to needs of patients, providers and the facility. Nurses are in a strategic position to play a pivotal role in

  3. Dietary screening tool identifies nutritional risk in older adults123

    Science.gov (United States)

    Miller, Paige E; Mitchell, Diane C; Hartman, Terryl J; Lawrence, Frank R; Sempos, Christopher T; Smiciklas-Wright, Helen

    2009-01-01

    Background: No rapid methods exist for screening overall dietary intakes in older adults. Objective: The purpose of this study was to develop and evaluate a scoring system for a diet screening tool to identify nutritional risk in community-dwelling older adults. Design: This cross-sectional study in older adults (n = 204) who reside in rural areas examined nutrition status by using an in-person interview, biochemical measures, and four 24-h recalls that included the use of dietary supplements. Results: The dietary screening tool was able to characterize 3 levels of nutritional risk: at risk, possible risk, and not at risk. Individuals classified as at nutritional risk had significantly lower indicators of diet quality (Healthy Eating Index and Mean Adequacy Ratio) and intakes of protein, most micronutrients, dietary fiber, fruit, and vegetables. The at-risk group had higher intakes of fats and oils and refined grains. The at-risk group also had the lowest serum vitamin B-12, folate, β-cryptoxanthin, lutein, and zeaxanthin concentrations. The not-at-nutritional-risk group had significantly higher lycopene and β-carotene and lower homocysteine and methylmalonic acid concentrations. Conclusion: The dietary screening tool is a simple and practical tool that can help to detect nutritional risk in older adults. PMID:19458013

  4. Risk-based prostate cancer screening

    NARCIS (Netherlands)

    X.D. Zhu (Xiaoye); P.C. Albertsen (Peter); G.L. Andriole (Gerald); M.J. Roobol-Bouts (Monique); F.H. Schröder (Fritz); A.J. Vickers (Andrew)

    2012-01-01

    textabstractContext: Widespread mass screening of prostate cancer (PCa) is not recommended because the balance between benefits and harms is still not well established. The achieved mortality reduction comes with considerable harm such as unnecessary biopsies, overdiagnoses, and overtreatment. There

  5. A Fisheries Evaluation of the Richland and Wapato Canal Fish Screening Facilities, Spring 1987 : Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Neitzel, Duane A.; Abernethy, C.Scott; Lusty, E.William; Wampler, Sally J.

    1988-02-01

    We evaluated the effectiveness of new fish screening facilities at the Richland and Wapato canals in south-central Washington State. The screen integrity tests at the Richland Screens indicated that 100% of fall chinook salmon fry (Oncorhynchus tshawytscha) released in front of the screens were prevented from entering the canal behind the screens. Our estimate is based on a 61% catch efficiency for control fish planted behind the screens. At the Wapato Canal, we estimated that between 3% and 4% of the test fish were either impinged on the screen surface and passed over the screens or passed through faulty screen seals. Our estimate is based over the screens or passed through faulty screen seals. Our estimate is based on a greater than 90% capture of control fish released in front of the screens. At the Wapato Screens, we estimated that 0.8% of steelhead smolts (Salmo gairdneri) and 1.4% of spring chinook salmon smolts released during low canal flow tests wee descaled. During full canal flow tests, 1.6% of the steelhead and 3.1% of the spring chinook salmon released were descaled. The fish return pipe at the Wapato Canal was tested: the estimate of descaled test fish wa not different from the estimate of descaled control fish. The time required for fish to exit from the Wapato Screen forebay varied with species and with canal flow. During low canal flows, 43.2% of steelhead and 61.6% of spring chinook salmon smolts released at the trash racks were captured in the fish return within 96 hr. 11 refs., 11 figs., 10 tabs.

  6. Colorectal Cancer Screening in Average Risk Populations: Evidence Summary

    Directory of Open Access Journals (Sweden)

    Jill Tinmouth

    2016-01-01

    Full Text Available Introduction. The objectives of this systematic review were to evaluate the evidence for different CRC screening tests and to determine the most appropriate ages of initiation and cessation for CRC screening and the most appropriate screening intervals for selected CRC screening tests in people at average risk for CRC. Methods. Electronic databases were searched for studies that addressed the research objectives. Meta-analyses were conducted with clinically homogenous trials. A working group reviewed the evidence to develop conclusions. Results. Thirty RCTs and 29 observational studies were included. Flexible sigmoidoscopy (FS prevented CRC and led to the largest reduction in CRC mortality with a smaller but significant reduction in CRC mortality with the use of guaiac fecal occult blood tests (gFOBTs. There was insufficient or low quality evidence to support the use of other screening tests, including colonoscopy, as well as changing the ages of initiation and cessation for CRC screening with gFOBTs in Ontario. Either annual or biennial screening using gFOBT reduces CRC-related mortality. Conclusion. The evidentiary base supports the use of FS or FOBT (either annual or biennial to screen patients at average risk for CRC. This work will guide the development of the provincial CRC screening program.

  7. Evaluation of Low and High Frequency Sound for Enhancing Fish Screening Facilities to Protect Outmigrating Salmonids.

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Robert P.; Neitzel, Duane A.; Mavros, William V.

    1998-02-01

    The need to provide passage and protective screens at irrigation diversions has always been a necessary part of the Columbia River Basin Fish and Wildlife Program (NPPC 1984, 1987, 1994). From 1985 through 1990, fish protection facilities in large irrigation diversions throughout the Columbia Basin, especially in the Yakima Basin, were updated. After 1990, fish protection efforts turned to installation of new facilities on unscreened diversions and to repair and upgrade of older facilities. The screening program also includes funds to monitor and evaluate the facilities. The screen evaluations indicate they are an effective means for protecting juvenile fish larger than 40 mm in length. As state and federal agencies change screening criteria to protect smaller fish (e.g., bull trout fry), the physical barrier may not always be effective. Screen mesh small enough to protect fish may be vulnerable to frequent plugging. Gap tolerances on side and bottom seals may be difficult to install and maintain. Physical barrier screens can be enhanced with behavioral barriers that cause fish to avoid a hazard. Behavioral barriers may consist of sound generator, strobe lights, bubble curtains, or electrical barriers. State of Oregon House Bill 3112 states that "Standards and criteria shall address the overall level of protection necessary at a given water diversion and shall not favor one technology or technique over another." Additionally, it goes on to say, "Screening device means a fish screen or behavior barrier." Other Northwest states, in particular Washington, have taken a comprehensive program to install barriers at all unscreened diversions by 1999. Protecting all fish at all water withdrawals will probably require both physical and behavioral barriers. The purpose of this study is to evaluate the effectiveness of using an underwater sound-generator as a behavioral barrier for possible use at fish diversion facilities. This study did not include engineering and economic

  8. Elite Athletes experiences with risk related to Cardiac Screening

    DEFF Research Database (Denmark)

    Christensen, Jonas Schmidt; Thing, Lone Friis

    Elite Athletes experiences with risks related to Cardiac Screening Jonas Schmidt Christensen1, Lone Friis Thing1 1University of Copenhagen - Department of Nutrition, Exercise and Sports (NEXS), Cardiac screening of elite athletes are recommended by both the American Heart Association & the European...... is dominated by studies with a clinical medical focus and studies of athlete’s perspectives on cardiac screening are consequently an absence. By using an interpretive sociological perspective (Denzin 2001) and qualitative research done with elite athletes of both gender this paper seeks to explore how elite...... athletes experience risks associated with cardiac screening. To make possible an analysis of how elite athletes come to an understanding of and position themselves in relation to the risk discourse (Lupton 2013) they are met by, the focus is on Foucault’s technologies of the self and a subjectivity...

  9. Human health risk characterization of petroleum coke calcining facility emissions.

    Science.gov (United States)

    Singh, Davinderjit; Johnson, Giffe T; Harbison, Raymond D

    2015-12-01

    Calcining processes including handling and storage of raw petroleum coke may result in Particulate Matter (PM) and gaseous emissions. Concerns have been raised over the potential association between particulate and aerosol pollution and adverse respiratory health effects including decrements in lung function. This risk characterization evaluated the exposure concentrations of ambient air pollutants including PM10 and gaseous pollutants from a petroleum coke calciner facility. The ambient air pollutant levels were collected through monitors installed at multiple locations in the vicinity of the facility. The measured and modeled particulate levels in ambient air from the calciner facility were compared to standards protective of public health. The results indicated that exposure levels were, on occasions at sites farther from the facility, higher than the public health limit of 150 μg/m(3) 24-h average for PM10. However, the carbon fraction demonstrated that the contribution from the calciner facility was de minimis. Exposure levels of the modeled SO2, CO, NOx and PM10 concentrations were also below public health air quality standards. These results demonstrate that emissions from calcining processes involving petroleum coke, at facilities that are well controlled, are below regulatory standards and are not expected to produce a public health risk.

  10. Nutrition for refugee children: risks, screening, and treatment.

    Science.gov (United States)

    Fabio, Mary

    2014-08-01

    Pediatric refugees are at an increased risk for growth and nutritional deficits. As more children are resettled to the United States, it is important to screen appropriately in order to identify any growth or nutritional issues. Resettled refugee children continue to be at risk for both over- and undernutrition, therefore culturally appropriate education and counseling should be provided to improve long-term health.

  11. Review of screening for pancreatic cancer in high risk individuals

    Institute of Scientific and Technical Information of China (English)

    Alina Stoita; Ian D Penman; David B Williams

    2011-01-01

    Pancreatic cancer is difficult to diagnose at an early stage and is associated with a very poor survival. Ten percent of pancreatic cancers result from genetic susceptibility and/or familial aggregation. Individuals from families with multiple affected first-degree relatives and those with a known cancer-causing genetic mutation have been shown to be at much higher risk of developing pancreatic cancer. Recent efforts have focused on detecting disease at an earlier stage to improve survival in these high-risk groups. This article reviews high-risk groups, screening methods, and current screening programs and their results.

  12. Review of screening for pancreatic cancer in high risk individuals.

    Science.gov (United States)

    Stoita, Alina; Penman, Ian D; Williams, David B

    2011-05-21

    Pancreatic cancer is difficult to diagnose at an early stage and is associated with a very poor survival. Ten percent of pancreatic cancers result from genetic susceptibility and/or familial aggregation. Individuals from families with multiple affected first-degree relatives and those with a known cancer-causing genetic mutation have been shown to be at much higher risk of developing pancreatic cancer. Recent efforts have focused on detecting disease at an earlier stage to improve survival in these high-risk groups. This article reviews high-risk groups, screening methods, and current screening programs and their results.

  13. The Sheffield RNAi Screening Facility (SRSF): portfolio growth and technology development.

    Science.gov (United States)

    Brown, Stephen

    2014-05-01

    The Sheffield RNAi Screening Facility (SRSF) (www.rnai.group.shef.ac.uk) was established in 2008 with Wellcome Trust and University of Sheffield funding, with the task to provide the first UK RNAi screening resource for academic groups interested in identifying genes required in a diverse range of biological processes using Drosophila cell culture. The SRSF has carried out a wide range of screens varying in sizes from bespoke small-scale libraries, targeting a few hundred genes, to high-throughput, genome-wide studies. The SRSF has grown and improved with a dedicated partnership of its academic customers based mainly in the UK. We are part of the UK Academics Functional Genomics Network, participating in organizing an annual meeting in London and are part of the University of Sheffield's D3N (www.d3n.org.uk), connecting academics, biotech and pharmaceutical companies with a multidisciplinary network in Drug Discovery and Development. Recently, the SRSF has been funded by the Yorkshire Cancer Research Fund to perform genome-wide RNAi screens using human cells as part of a core facility for regional Yorkshire Universities and screens are now underway. Overall the SRSF has carried out more than 40 screens from Drosophila and human cell culture experiments.

  14. An evaluation of systematic tuberculosis screening at private facilities in Karachi, Pakistan.

    Directory of Open Access Journals (Sweden)

    Jacob Creswell

    Full Text Available BACKGROUND: In Pakistan, like many Asian countries, a large proportion of healthcare is provided through the private sector. We evaluated a systematic screening strategy to identify people with tuberculosis in private facilities in Karachi and assessed the approaches' ability to diagnose patients earlier in their disease progression. METHODS AND FINDINGS: Lay workers at 89 private clinics and a large hospital outpatient department screened all attendees for tuberculosis using a mobile phone-based questionnaire during one year. The number needed to screen to detect a case of tuberculosis was calculated. To evaluate early diagnosis, we tested for differences in cough duration and smear grading by screening facility. 529,447 people were screened, 1,010 smear-positive tuberculosis cases were detected and 942 (93.3% started treatment, representing 58.7% of all smear-positive cases notified in the intervention area. The number needed to screen to detect a smear-positive case was 124 (prevalence 806/100,000 at the hospital and 763 (prevalence 131/100,000 at the clinics; however, ten times the number of individuals were screened in clinics. People with smear-positive TB detected at the hospital were less likely to report cough lasting 2-3 weeks (RR 0.66 95%CI [0.49-0.90] and more likely to report cough duration >3 weeks (RR 1.10 95%CI [1.03-1.18]. Smear-positive cases at the clinics were less likely to have a +3 grade (RR 0.76 95%CI [0.63-0.92] and more likely to have +1 smear grade (RR 1.24 95%CI [1.02-1.51]. CONCLUSIONS: Tuberculosis screening at private facilities is acceptable and can yield large numbers of previously undiagnosed cases. Screening at general practitioner clinics may find cases earlier than at hospitals although more people must be screened to identify a case of tuberculosis. Limitations include lack of culture testing, therefore underestimating true TB prevalence. Using more sensitive and specific screening and diagnostic tests such

  15. Universal Screening for Writing Risk in Kindergarten

    Science.gov (United States)

    Coker, David L., Jr.; Ritchey, Kristen D.

    2014-01-01

    Early identification of students at risk for writing disabilities is an important step in improving writing performance. Kindergarten students (n = 84) were administered a set of researcher-developed writing tasks (letter writing, sound spelling, word spelling, and sentence writing) and school-administered reading tasks ("Dynamic Indicators…

  16. Risk profiling and screening for colorectal cancer

    NARCIS (Netherlands)

    Stegeman, I.

    2013-01-01

    The studies included in this thesis address a number of topics concerning risk stratification and differentiation in health care. As health care costs are increasing and the urge for prevention is rising, differentiating in the provision of health care may be one of the options for sustaining the

  17. Italian risk factor-based screening for gestational diabetes.

    Science.gov (United States)

    Corrado, F; Pintaudi, B; Di Vieste, G; Interdonato, M L; Magliarditi, M; Santamaria, A; D'Anna, R; Di Benedetto, A

    2014-09-01

    There is a debate about whether universal or risk factors-based screening is most appropriate for gestational diabetes diagnosis. The aim of our retrospective study was to compare in our population the universal screening test recommended by the International Association of Diabetes in Pregnancy Study Group (IADPSG) panel and the American Diabetes Association (ADA) versus the selective screening proposed by the United Kingdom National Institute for Health and Clinical Excellence guidelines (NICE) but modified by the Italian National Institute of Health. From May 2010 to October 2011 all consecutive pregnant women were screened for gestational diabetes according to the IADPSG's panel criteria, while all the risk factors for each patient were registered. Of the 1015 pregnant women included in the study, 113 (11%) were diagnosed with gestational diabetes and 26 (23%) of them would not have been identified by the selective screening proposed by the Italian National Institute of Health. However, all the risk factors considered by the selective screening revealed a good predictive role except for maternal age ≥ 35 years (OR: 0.98). In the group without the risk factors considered, it was reported the predictive role for gestational diabetes of prepregnancy BMI and nulliparity. The selective risk factors-based screening proposed by the Italian National Institute of Health has detected 77% of gestational diabetes cases in our population, sparing the oral glucose tolerance test for more than 40% of pregnant women at the same time. More information on the clinical impact of this choice could be obtained by a strict analysis of treatment, perinatal outcome and follow-up of an adequate sample size of "missed" gestational diabetes.

  18. Screening of Geomechanical Risks for Malaysian Development Field

    Directory of Open Access Journals (Sweden)

    Syed Najmuddin Syed Muhammad Syafiq

    2017-01-01

    Full Text Available Deeper drilling and exploitation of difficult reservoir is the new trend in oil and gas industry. Geomechanics study has, therefore, become a new requirement particularly for oil and gas field development. However, a complete geomechanics study is limited with the number of experts, time consuming and not a straightforward task. Therefore, there is an urgent need of a quick geomechanics screening criterion to be used as a standard guideline to evaluate the high level geomechanical risks and suitable analysis can be recommended for the identified development fields. The aim of this paper is to propose a screening criterion for geomechanical risks study based on four key parameters, drilling, depletion, injection and storage and sand production. The screening approach is designed based on Risk Assessment Matrix (RAM risk screening where the likelihood is based on a set of scores developed to specific questions. The consequence for each failure scenarios is assessed based on educated estimation of the impact towards people, asset, environment and reputation. Recommendations for geomechanical study are made based on the severity of each failure category on the RAM risk matrix. Fourteen development fields in offshore Peninsular Malaysia, offshore Sarawak and offshore Sabah are selected for the assessment. Based on results, fields in offshore Sarawak and Sabah have higher potential for geomechacnical issues mainly because of their geological settings and formation characteristics. A set of geomechanical study is proposed for each individual field for prudent management of potential geomechanics risk associated with the depletion and EOR injection scheme planned for the fields.

  19. GeMSE: A new Low-Background Facility for Meteorite and Material Screening

    CERN Document Server

    von Sivers, M; Rosén, Å V; Schumann, M

    2015-01-01

    We are currently setting up a facility for low-background gamma-ray spectrometry based on a HPGe detector. It is dedicated to material screening for the XENON and DARWIN dark matter projects as well as to the characterization of meteorites. The detector will be installed in a medium depth ($\\sim$620 m.w.e.) underground laboratory in Switzerland with several layers of shielding and an active muon-veto. The GeMSE facility will be operational by fall 2015 with an expected background rate of $\\sim$250 counts/day (100-2700 keV).

  20. GeMSE: A new low-background facility for meteorite and material screening

    Science.gov (United States)

    Sivers, M. V.; Hofmann, B. A.; Rosén, Å. V.; Schumann, M.

    2015-08-01

    We are currently setting up a facility for low-background gamma-ray spectrometry based on a HPGe detector. It is dedicated to material screening for the XENON and DARWIN dark matter projects as well as to the characterization of meteorites. The detector will be installed in a medium depth (˜620 m.w.e.) underground laboratory in Switzerland with several layers of shielding and an active muon-veto. The GeMSE facility will be operational by fall 2015 with an expected background rate of ˜250 counts/day (100-2700 keV).

  1. Estimating radiation risk induced by CT screening for Korean population

    Science.gov (United States)

    Yang, Won Seok; Yang, Hye Jeong; Min, Byung In

    2017-02-01

    The purposes of this study are to estimate the radiation risks induced by chest/abdomen computed tomography (CT) screening for healthcare and to determine the cancer risk level of the Korean population compared to other populations. We used an ImPACT CT Patient Dosimetry Calculator to compute the organ effective dose induced by CT screening (chest, low-dose chest, abdomen/pelvis, and chest/abdomen/pelvis CT). A risk model was applied using principles based on the BEIR VII Report in order to estimate the lifetime attributable risk (LAR) using the Korean Life Table 2010. In addition, several countries including Hong Kong, the United States (U.S.), and the United Kingdom, were selected for comparison. Herein, each population exposed radiation dose of 100 mSv was classified according to country, gender and age. For each CT screening the total organ effective dose calculated by ImPACT was 6.2, 1.5, 5.2 and 11.4 mSv, respectively. In the case of Korean female LAR, it was similar to Hong Kong female but lower than those of U.S. and U.K. females, except for those in their twenties. The LAR of Korean males was the highest for all types of CT screening. However, the difference of the risk level was negligible because of the quite low value.

  2. Improved risk assessment by screening sperm parameters.

    Science.gov (United States)

    Plassmann, S; Urwyler, H

    2001-02-28

    The question of whether a 4 or 9 week premating treatment period is more suitable in studies for effects on fertility and early embryonic development, and the extent to which the screening of sperm parameters may contribute to the detection of effects, has been under discussion since the ICH guideline changed in 1994/1995. This study presents a comparison between 4 and 9 weeks treatment with known male reproductive toxicants with regard to sperm motility, count, morphology, abnormal movements and testicular and epididymal histopathology. Mating outcome was examined after 4 weeks treatment. Three compounds with different targets and mechanisms of action were chosen: two testicular toxicants, Pyridoxine and Adriamycin and the epididymal toxicant, alpha-Chlorohydrine. Sperm motility was reduced in males treated with Pyridoxine (markedly) and alpha-Chlorohydrine (slightly) after 4 weeks treatment and in males treated with Adriamycin after 9 weeks treatment. With Pyridoxine and Adriamycin, sperm count was significantly increased after 4 weeks. Histopathological examination after 4 weeks showed characteristic changes leading to marked testicular tubular atrophy at 8/9 weeks, which was confirmed by a significantly reduced sperm count at 8/9 weeks. With alpha-Chlorohydrine, sperm count was not affected and the results of the histopathological examination were equivocal. Changes in sperm morphology were observed after 4/9 weeks of treatment with Pyridoxine. Mating outcome after 4 weeks was markedly affected with both Pyridoxine and alpha-Chlorohydrine, but no effect was observed with Adriamycin. The results of this study indicate that the two testicular toxicants would have been detected as male reproductive toxicants in a 4-week general toxicity study with routine testicular histopathology and examination of sperm parameters, without the need for mating trials. For the epididymal toxicant, alpha-Chlorohydrine, there was slightly reduced sperm motility after 4 weeks

  3. National Ignition Facility Risk Management Plan, Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Brereton, S J

    2002-06-01

    The National Ignition Facility (NIF) Risk Management Plan (LLNL, 1997a) was originally prepared in 1997 in accordance with the Department of Energy (DOE) Life Cycle Asset Management Good Practice Guide (DOE, 1996a) and supported NIF Critical Decision 3, approval to initiate construction (DOE, 1997a). The plan was updated in 1998 to reflect realized risks such as the finding and successful clean up of polychlorinated biphenyl (PCB)-filled electrical capacitors at the NIF excavation during initial construction and the litigation of the Programmatic Environmental Impact Statement for Stockpile Stewardship (DOE, 1996b) by a group of non-governmental organizations led by the Natural Resources Defense Council. The current update of the Risk Management Plan brings it into compliance with the applicable DOE Orders and Standards and addresses new risks, such as assuring safety during the period when construction, special equipment installation, and commissioning are occurring simultaneously at the NIF site, and the extensive use of models to manage technical performance risk. The objectives of the updated plan are to: (1) Identify the risks to the completion of the Project in terms of meeting performance and regulatory requirements, ES&H, cost, and schedule; (2) Assess or the risks in terms of likelihood of occurrence and their impact potential relative to technical performance, ES&H, costs, and schedule; and (3) Address suitable risk mitigation measures for each identified risk.

  4. Access to Mammography Facilities and Detection of Breast Cancer by Screening Mammography: A GIS Approach.

    Science.gov (United States)

    Rahman, Selina; Price, James H; Dignan, Mark; Rahman, Saleh; Lindquist, Peter S; Jordan, Timothy R

    2009-01-01

    OBJECTIVES: The objective of the study was to examine the association between access to mammography facilities and utilization of screening mammography in an urban population. METHODS: Data on female breast cancer cases were obtained from an extensive mammography surveillance project. Distance to mammography facilities was measured by using GIS, which was followed by measuring geographical access to mammography facilities using Floating Catchment Area (FCA) method (considering all available facilities within an arbitrary radius from the woman's residence by using Arc GIS 9.0 software). RESULTS: Of 2,024 women, 91.4% were Caucasian; age ranged from 25 to 98 years; most (95%) were non-Hispanic in origin. Logistic regression found age, family history, hormone replacement therapy, physician recommendation, and breast cancer stage at diagnosis to be significant predictors of having had a previous mammogram. Women having higher access to mammography facilities were less likely to have had a previous mammogram compared to women who had low access, considering all the facilities within 10 miles (OR=0.41, CI=0.22-0.76), 30 miles (OR=0.52, CI=0.29-0.91) and 40 miles (OR=0.51, CI=0.28-0.92) radiuses. CONCLUSIONS: Physical distance to mammography facilities does not necessarily predict utilization of mammogram and greater access does not assure greater utilizations, due to constraints imposed by socio economic and cultural barriers. Future studies should focus on measuring access to mammography facilities capturing a broader dimension of access considering qualitative aspect of facilities, as well as other travel impedances.

  5. Performance of Parabolic and Diffusive OTR Screens at the CLIC Test Facility 3

    CERN Document Server

    Olvegaard, M; Bravin, E; Burger, S; Dabrowski, A; Lefevre, T; Welsch, C P

    2011-01-01

    At the CLIC Test Facility 3, OTR screens are commonly used in beam imaging systems for energy and energy spread characterization in dedicated spectrometer lines. In these lines the horizontal beam size is typically of the order of one centimeter. Already in 2005 a limitation was observed resulting from a strong dependence of the intensity of the light captured by the camera, on the position on the screen (vignetting). The severity of this effect increases with the electron energy, as the aperture of the optical system is finite and the OTR photons are emitted in a small cone of 1/γ angle. To mitigate this effect, different shapes and surface polishing of the screens were investigated. Parabolic and diffusive OTR radiators were tested in several spectrometer lines all along the CTF3 complex. The results are presented in this paper.

  6. A photoclickable peptide microarray platform for facile and rapid screening of 3-D tissue microenvironments.

    Science.gov (United States)

    Sharma, Sadhana; Floren, Michael; Ding, Yonghui; Stenmark, Kurt R; Tan, Wei; Bryant, Stephanie J

    2017-10-01

    Microarrays are powerful experimental tools for high-throughput screening of cellular behavior in multivariate microenvironments. Here, we present a new, facile and rapid screening method for probing cellular behavior in 3D tissue microenvironments. This method utilizes a photoclickable peptide microarray platform developed using electrospun fibrous poly(ethylene glycol) hydrogels and microarray contact printing. We investigated the utility of this platform with five different peptide motifs and ten cell types including stem, terminally differentiated, cancer or immune cells that were from either primary origin or cell lines and from different species. We validated the capabilities of this platform to screen arrays consisting of multiple peptide motifs and concentrations for selectivity to cellular adhesion and morphology. Moreover, this platform is amenable to controlled spatial presentation of peptides. We show that by leveraging the differential attachment affinities for two cell types to two different peptides, this platform can also be used to investigate cell-cell interactions through miniature co-culture peptide arrays. Our fibrous peptide microarray platform enables high-throughput screening of 3D tissue microenvironments in a facile and rapid manner to investigate cell-matrix interactions and cell-cell signaling and to identify optimal tissue microenvironments for cell-based therapies. Copyright © 2017. Published by Elsevier Ltd.

  7. Screening Women at High Risk for Cervical Cancer: Special Groups of Women Who Require More Frequent Screening.

    Science.gov (United States)

    Vegunta, Suneela; Files, Julia A; Wasson, Megan N

    2017-08-01

    The updated cervical cancer screening guidelines recommend that women at average risk who have negative screening results undergo cervical cytological testing every 3 to 5 years. These recommendations do not pertain to women at high risk for cervical cancer. This article reviews recommendations for cervical cancer screening in women at high risk. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  8. [Neonatal screening: risk factors and outcome in 4400 children].

    Science.gov (United States)

    Luppari, R; Arslan, E

    1996-12-01

    The aim of this study was to determine the incidence of neonatal deafness and how effective screening could be in a cohort of infants under the national health service in Mestre Venice. The criteria used in the screening of a population at risk were those established by the JCIH (1990). All the children born between September 1992 and August 1995 (4408 infants) were examined in an attempt to identify risk factors. The children presenting one or more risk factors and those admitted to neonatal intensive care for any reason were submitted to ABR testing. The results were considered negative if the wave V was perceived at an intensity 21 trisomia while it proved impossible to determine the cause of deafness in the remaining two. As indicated in other studies, application of a risk register makes it possible to identify congenital deafness in 50-60% of the cases. For this reason the authors consider mass screening through the use of oto-acoustic emissions to be quite useful.

  9. Validation of Spot screening device for amblyopia risk factors.

    Science.gov (United States)

    Garry, Glynnis A; Donahue, Sean P

    2014-10-01

    To validate the Spot Vision Screener, a handheld digital screening device that evaluates children for amblyopia risk factors as defined by 2013 criteria of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS), in the setting of a controlled pediatric ophthalmology clinic. During a 3-month period, children 2-9 years of age were screened using Spot in a pediatric ophthalmology clinic before receiving a gold standard eye examination. Gold standard examinations were evaluated using the 2013 AAPOS Vision Screening Committee guidelines and compared with results from Spot, which were evaluated using two different manufacturer referral criteria: v1.0.3 and v1.1.51. The specificity and sensitivity for each set of referral criteria to detect both amblyopia risk factors and amblyopia were calculated. A total of 233 children were included. Of these, 155 were successfully screened and analyzed according to two different referral criteria. Spot screeing revealed ambyopia risk factors in 109 patients; examination confirmed amblyopia in 64. Using the original manufacturer's criteria (v1.0.3), Spot was 89% sensitive and 71% specific in detecting amblyopia risk factors. The updated referral criteria (v1.1.51) were applied to the same 155 patients, and specificity improved to 88% (P amblyopia, whereas Spot-v1.1.51 was 89% sensitive and 53% specific for detecting amblyopia. The Spot-v1.0.3 had high sensitivity but overreferred for suspected myopia and strabismus; Spot-v1.1.51 maintained high sensitivity and improved specificity. The original referral criteria has a high sensitivity to detect amblyopia risk factors but low specificty; v1.1.51 criteria increases specificity with minimal impact on sensitivity. Copyright © 2014 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  10. Screening school-aged children for risk of stuttering.

    Science.gov (United States)

    Howell, Peter

    2013-06-01

    Howell and Davis's (2011) model that predicts whether stuttering in eight-year old children will persist or recover by teenage was adapted for screening school-aged children for risk of stuttering. Stuttering-severity scores were used to predict whether children belonged to fluent or stuttering groups. Predicted group assignments were compared for models in which severity measures were made with whole-word repetitions excluded or included. The best model for distinguishing children who stutter (CWS) from fluent children was validated across a wide range of ages. Stuttering-severity scores from CWS (222 for development, and 272 for validation, of the models) and fluent children (103 for development, and 25 for validation, of the models) were employed. Models were developed that predicted prognosis and screened CWS and fluent children. All these analyses were conducted both with whole-word repetitions excluded and included in the stuttering-severity scores. The model that screened fluent children from all CWS which excluded whole-word repetitions was validated for children across a range of ages. All models achieved around 80% specificity and sensitivity. Models in which whole-word repetitions were excluded were always better than those which included them. Validation of the screening for fluency with whole-word repetitions excluded classified 84.4% of fluent children, and 88.0% of CWS, correctly. Some of these children differed in age from those used to develop the model. Howell and Davis's risk factor model for predicting persistence/recovery can be extended to screen school-aged children for fluency. After reading this article, participants will be able to: (1) describe the difference between finding group differences and risk factor modeling in stuttering research; (2) summarize the strengths and weaknesses of stuttering severity instrument version three; (3) discuss how validation of diagnostic and screening models for fluency can be performed; (4) see how risk

  11. Breast Cancer Screening in the Precision Medicine Era: Risk-Based Screening in a Population-Based Trial.

    Science.gov (United States)

    Shieh, Yiwey; Eklund, Martin; Madlensky, Lisa; Sawyer, Sarah D; Thompson, Carlie K; Stover Fiscalini, Allison; Ziv, Elad; Van't Veer, Laura J; Esserman, Laura J; Tice, Jeffrey A

    2017-01-01

    Ongoing controversy over the optimal approach to breast cancer screening has led to discordant professional society recommendations, particularly in women age 40 to 49 years. One potential solution is risk-based screening, where decisions around the starting age, stopping age, frequency, and modality of screening are based on individual risk to maximize the early detection of aggressive cancers and minimize the harms of screening through optimal resource utilization. We present a novel approach to risk-based screening that integrates clinical risk factors, breast density, a polygenic risk score representing the cumulative effects of genetic variants, and sequencing for moderate- and high-penetrance germline mutations. We demonstrate how thresholds of absolute risk estimates generated by our prediction tools can be used to stratify women into different screening strategies (biennial mammography, annual mammography, annual mammography with adjunctive magnetic resonance imaging, defer screening at this time) while informing the starting age of screening for women age 40 to 49 years. Our risk thresholds and corresponding screening strategies are based on current evidence but need to be tested in clinical trials. The Women Informed to Screen Depending On Measures of risk (WISDOM) Study, a pragmatic, preference-tolerant randomized controlled trial of annual vs personalized screening, will study our proposed approach. WISDOM will evaluate the efficacy, safety, and acceptability of risk-based screening beginning in the fall of 2016. The adaptive design of this trial allows continued refinement of our risk thresholds as the trial progresses, and we discuss areas where we anticipate emerging evidence will impact our approach.

  12. Practice Bulletin No. 179 Summary: Breast Cancer Risk Assessment and Screening in Average-Risk Women.

    Science.gov (United States)

    2017-07-01

    Breast cancer is the most commonly diagnosed cancer in women in the United States and the second leading cause of cancer death in American women (1). Regular screening mammography starting at age 40 years reduces breast cancer mortality in average-risk women (2). Screening, however, also exposes women to harm through false-positive test results and overdiagnosis of biologically indolent lesions. Differences in balancing benefits and harms have led to differences among major guidelines about what age to start, what age to stop, and how frequently to recommend mammography screening in average-risk women (2-4).Breast cancer risk assessment is very important for identifying women who may benefit from more intensive breast cancer surveillance; however, there is no standardized approach to office-based breast cancer risk assessment in the United States. This can lead to missed opportunities to identify women at high risk of breast cancer and may result in applying average-risk screening recommendations to high-risk women. Risk assessment and identification of women at high risk allow for referral to health care providers with expertise in cancer genetics counseling and testing for breast cancer-related germline mutations (eg, BRCA), patient counseling about risk-reduction options, and cascade testing to identify family members who also may be at increased risk.The purpose of this Practice Bulletin is to discuss breast cancer risk assessment, review breast cancer screening guidelines in average-risk women, and outline some of the controversies surrounding breast cancer screening. It will present recommendations for using a framework of shared decision making to assist women in balancing their personal values regarding benefits and harms of screening at various ages and intervals to make personal screening choices from within a range of reasonable options. Recommendations for women at elevated risk and discussion of new technologies, such as tomosynthesis, are beyond the

  13. Practice Bulletin Number 179: Breast Cancer Risk Assessment and Screening in Average-Risk Women.

    Science.gov (United States)

    2017-07-01

    Breast cancer is the most commonly diagnosed cancer in women in the United States and the second leading cause of cancer death in American women (1). Regular screening mammography starting at age 40 years reduces breast cancer mortality in average-risk women (2). Screening, however, also exposes women to harm through false-positive test results and overdiagnosis of biologically indolent lesions. Differences in balancing benefits and harms have led to differences among major guidelines about what age to start, what age to stop, and how frequently to recommend mammography screening in average-risk women (2-4).Breast cancer risk assessment is very important for identifying women who may benefit from more intensive breast cancer surveillance; however, there is no standardized approach to office-based breast cancer risk assessment in the United States. This can lead to missed opportunities to identify women at high risk of breast cancer and may result in applying average-risk screening recommendations to high-risk women. Risk assessment and identification of women at high risk allow for referral to health care providers with expertise in cancer genetics counseling and testing for breast cancer-related germline mutations (eg, BRCA), patient counseling about risk-reduction options, and cascade testing to identify family members who also may be at increased risk.The purpose of this Practice Bulletin is to discuss breast cancer risk assessment, review breast cancer screening guidelines in average-risk women, and outline some of the controversies surrounding breast cancer screening. It will present recommendations for using a framework of shared decision making to assist women in balancing their personal values regarding benefits and harms of screening at various ages and intervals to make personal screening choices from within a range of reasonable options. Recommendations for women at elevated risk and discussion of new technologies, such as tomosynthesis, are beyond the

  14. Screening for risk of cardiovascular disease is not associated with mental distress: the Inter99 study

    DEFF Research Database (Denmark)

    Jørgensen, Torben; Ladelund, Steen; Borch-Johnsen, Knut;

    2009-01-01

    screening, immediately after screening, and one and 10 months after screening. The screening classified participants into high or low risk individuals. High risk individuals received personal lifestyle counselling and were randomized to either group-based counselling (A) or referred care (B). Multilevel....... The scores increased after 1 month, but were still significantly lower than before screening. After 10 months, low risk individuals and high risk individuals in group A still had significantly lower scores (except for depression) compared with pre-screening levels, whereas high risk individuals in group B...

  15. Risks of Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Screening

    Science.gov (United States)

    ... Screening Research Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Screening (PDQ®)–Patient Version What is screening? Go to ... ovarian cancer. Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Screening Key Points Tests are used to screen for ...

  16. ADHD GROUP RISK SCREENING BASED ON GAME BIOFEEDBACK

    Directory of Open Access Journals (Sweden)

    O. A. Jafarova

    2013-01-01

    Full Text Available To organize the systematic selection and formation of risk groups regarding attention disorder, the algorithm of screening diagnostics for primary school students was developed using game biofeedback based on     heart     rate     and     time     of    response    to     suddenly    appearing    stimuli (test     "Rally".    Proposedareclassificationrules for including the subjects into the risk group, the intermediate group, and the group with satisfactory test results.

  17. Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

    Science.gov (United States)

    ... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults ... on Screening for Peripheral Artery Disease (PAD) and Cardiovascular Disease (CVD) Risk Assessment with Ankle Brachial Index (ABI) ...

  18. Histidine-containing peptide catalysts developed by a facile library screening method.

    Science.gov (United States)

    Akagawa, Kengo; Sakai, Nobutaka; Kudo, Kazuaki

    2015-02-02

    Although peptide catalysts have a high potential for the use as organocatalysts, the optimization of peptide sequences is laborious and time-consuming. To address this issue, a facile screening method for finding efficient aminocatalysts from a peptide library has been developed. In the screening for the Michael addition of a malonate to an enal, a dye-labeled product is immobilized on resin-bound peptides through reductive amination to visualize active catalysts. This procedure allows for the monitoring of the reactivity of entire peptides without modifying the resin beads beforehand. Peptides containing histidine at an appropriate position were identified by this method. A novel function of the histidyl residue, which enhances the binding of a substrate to the catalyst by capturing an iminium intermediate, was indicated.

  19. Travel distance to screening facilities and completion of abnormal mammographic follow-up among disadvantaged women.

    Science.gov (United States)

    Khang, Leepao; Adams, Swann Arp; Steck, Susan E; Zhang, Jiajia; Xirasagar, Sudha; Daguise, Virginie G

    2017-01-01

    Although many studies have examined factors in predicting incomplete and delay in abnormal mammogram follow-up, few have used geospatial methods to examine these factors. Consequently, the purpose of this study was to examine the relationship between travel distance to health facilities and completion of abnormal mammogram follow-up among disadvantaged women in South Carolina. Women participating in South Carolina's Best Chance Network between 1996 and 2009 with abnormal mammogram were included in the study. Kaplan-Meier survival was used to describe the probability of work-up completion after abnormal mammogram among different distance categories, and Cox proportional hazards model was used to further assess the relationship between work-up completion and travel distance to the screening provider and mammography facility. Among 1,073 women, there was significant difference in time to completion of abnormal mammogram work-up by race; African American women had longer time to completion compared to European American women. Accounting for race, age, previous mammograms, income, and insurance status, women who lived closest to their diagnosing mammography facility were more likely to complete their work-up compared to those who lived the farthest (HR = 1.41; 95% CI = 1.00-1.80). Distance to the diagnosing mammography facility may play a role on the completion of abnormal mammogram work-up. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Ecotoxicological screen of Potential Release Site 50-006(d) of Operable Unit 1147 of Mortandad Canyon and relationship to the Radioactive Liquid Waste Treatment Facilities project

    Energy Technology Data Exchange (ETDEWEB)

    Gonzales, G.J.; Newell, P.G.

    1996-04-01

    Potential ecological risk associated with soil contaminants in Potential Release Site (PRS) 50-006(d) of Mortandad Canyon at the Los Alamos National Laboratory was assessed by performing an ecotoxicological risk screen. The PRS surrounds Outfall 051, which discharges treated effluent from the Radioactive Liquid Waste Treatment Facility. Discharge at the outfall is permitted under the Clean Water Act National Pollution Discharge Elimination System. Radionuclide discharge is regulated by US Department of Energy (DOE) Order 5400.5. Ecotoxicological Screening Action Levels (ESALSs) were computed for nonradionuclide constituents in the soil, and human risk SALs for radionuclides were used as ESALs. Within the PRS and beginning at Outfall 051, soil was sampled at three points along each of nine linear transects at 100-ft intervals. Soil samples from 3 depths for each sampling point were analyzed for the concentration of a total of 121 constituents. Only the results of the surface sampling are reported in this report.

  1. Quantitative risk analysis of oil storage facilities in seismic areas.

    Science.gov (United States)

    Fabbrocino, Giovanni; Iervolino, Iunio; Orlando, Francesca; Salzano, Ernesto

    2005-08-31

    Quantitative risk analysis (QRA) of industrial facilities has to take into account multiple hazards threatening critical equipment. Nevertheless, engineering procedures able to evaluate quantitatively the effect of seismic action are not well established. Indeed, relevant industrial accidents may be triggered by loss of containment following ground shaking or other relevant natural hazards, either directly or through cascade effects ('domino effects'). The issue of integrating structural seismic risk into quantitative probabilistic seismic risk analysis (QpsRA) is addressed in this paper by a representative study case regarding an oil storage plant with a number of atmospheric steel tanks containing flammable substances. Empirical seismic fragility curves and probit functions, properly defined both for building-like and non building-like industrial components, have been crossed with outcomes of probabilistic seismic hazard analysis (PSHA) for a test site located in south Italy. Once the seismic failure probabilities have been quantified, consequence analysis has been performed for those events which may be triggered by the loss of containment following seismic action. Results are combined by means of a specific developed code in terms of local risk contour plots, i.e. the contour line for the probability of fatal injures at any point (x, y) in the analysed area. Finally, a comparison with QRA obtained by considering only process-related top events is reported for reference.

  2. Adolescent suicide risk screening: the effect of communication about type of follow-up on adolescents' screening responses.

    Science.gov (United States)

    King, Cheryl A; Hill, Ryan M; Wynne, Henry A; Cunningham, Rebecca M

    2012-01-01

    This experimental study examined the effect of communication about type of screening follow-up (in-person follow-up vs. no in-person follow-up) on adolescents' responses to a self-report suicide risk screen. Participants were 245 adolescents (131 girls, 114 boys; ages 13-17; 80% White, 21.6% Black, 9.8% American Indian, 2.9% Asian) seeking medical emergency services. They were randomized to a screening follow-up condition. Screening measures assessed primary risk factors for suicidal behavior, including suicidal thoughts, depressive symptoms, alcohol use, and aggressive/delinquent behavior. There was no main effect of follow-up condition on adolescents' screening scores; however, significant interactions between follow-up condition and public assistance status were evident. Adolescents whose families received public assistance were less likely to report aggressive-delinquent behavior if assigned to in-person follow-up. Adolescents whose families did not receive public assistance reported significantly higher levels of suicidal ideation if assigned to in-person follow-up. Findings suggest that response biases impact some adolescents' responses to suicide risk screenings. Because national policy strongly recommends suicide risk screening in emergency settings, and because screening scores are used to make critical decisions regarding risk management and treatment recommendations, findings indicate the importance of improving the reliability and validity of suicide risk screening for adolescents.

  3. Current directions in screening-level ecological risk assessments

    Energy Technology Data Exchange (ETDEWEB)

    Carlsen, T M; Efroymson, R A

    2000-12-11

    Ecological risk assessment (ERA) is a tool used by many regulatory agencies to evaluate the impact to ecological receptors from changes in environmental conditions. Widespread use of ERAs began with the United States Environmental Protection Agency's Superfund program to assess the ecological impact from hazardous chemicals released to the environment. Many state hazardous chemical regulatory agencies have adopted the use of ERAs, and several state regulatory agencies are evaluating the use of ERAs to assess ecological impacts from releases of petroleum and gas-related products. Typical ERAs are toxicologically-based, use conservative assumptions with respect to ecological receptor exposure duration and frequency, often require complex modeling of transport and exposure and are very labor intensive. In an effort to streamline the ERA process, efforts are currently underway to develop default soil screening levels, to identify ecological screening criteria for excluding sites from formal risk assessment, and to create risk-based corrective action worksheets. This should help reduce the time spent on ERAs, at least for some sites. Work is also underway to incorporate bioavailability and spatial considerations into ERAs. By evaluating the spatial nature of contaminant releases with respect to the spatial context of the ecosystem under consideration, more realistic ERAs with respect to the actual impact to ecological receptors at the population, community or ecosystem scale should be possible. In addition, by considering the spatial context, it should be possible to develop mitigation and monitoring efforts to more appropriately address such sites within the context of an ecological framework.

  4. Is mammography screening history a predictor of future breast cancer risk?

    DEFF Research Database (Denmark)

    Andersen, Sune Bangsbøll; Törnberg, Sven; Kilpeläinen, Sini

    2015-01-01

    Inspired by the model by Walter and Day for risk of cervical cancer following negative screens, one might hypothesize that women in a mammography screening programme with a certain number of negative screens had a lower remaining breast cancer risk than that of women in general. We studied whether...... number of negative screens was a predictor for a low remaining breast cancer risk in women participating in the mammography screening programmes in Stockholm, Copenhagen and Funen. Data were collected from the mammography screening programmes in Stockholm, Sweden (1989-2012), Copenhagen, Denmark (1991...... was not a predictor of a low remaining breast cancer risk in women participating in the mammography screening programmes in Stockholm, Sweden, Copenhagen and Funen, Denmark. The history of previous negative screens is therefore not suitable for personalisation of mammography screening....

  5. Screening calculations for radioactive waste releases from non-nuclear facilities

    Energy Technology Data Exchange (ETDEWEB)

    Shulan Xu; Soederman, Ann-Louis

    2009-02-15

    A series of screening calculations have been performed to assess the potential radiological consequences of discharges of radioactive substances to the environment arising from waste from non-nuclear practices. Solid waste, as well as liquids that are not poured to the sewer, are incinerated and ashes from incineration and sludge from waste water treatment plants are disposed or reused at municipal disposal facilities. Airborne discharges refer to releases from an incineration facility and liquid discharges refer both to releases from hospitals and laboratories to the sewage system, as well as leakage from waste disposal facilities. The external exposure of workers is estimated both in the waste water treatment plant and at the disposal facility. The calculations follow the philosophy of the IAEA's safety guidance starting with a simple assessment based on very conservative assumptions which may be iteratively refined using progressively more complex models, with more realistic assumptions, as necessary. In the assessments of these types of disposal, with cautious assumptions, carried out in this report we conclude that the radiological impacts on representative individuals in the public are negligible in that they are small with respect to the target dose of 10 muSv/a. A Gaussian plume model was used to estimate the doses from airborne discharges from the incinerator and left a significant safety margin in the results considering the conservative assumptions in the calculations. For the sewage plant workers the realistic approach included a reduction in working hours and the shorter exposure time resulted in maximum doses around 10 muSv/a. The calculations for the waste disposal facility show that the doses are higher or in the range of the target dose. The excess for public exposure is mainly caused by H-3 and C-14. The assumption used in the calculation is that all of the radioactive substances sent to the incineration facility and waste water treatment

  6. Site specific risk assessment of an energy-from-waste thermal treatment facility in Durham Region, Ontario, Canada. Part A: Human health risk assessment.

    Science.gov (United States)

    Ollson, Christopher A; Knopper, Loren D; Whitfield Aslund, Melissa L; Jayasinghe, Ruwan

    2014-01-01

    The regions of Durham and York in Ontario, Canada have partnered to construct an energy-from-waste thermal treatment facility as part of a long term strategy for the management of their municipal solid waste. This paper presents the results of a comprehensive human health risk assessment for this facility. This assessment was based on extensive sampling of baseline environmental conditions (e.g., collection and analysis of air, soil, water, and biota samples) as well as detailed site specific modeling to predict facility-related emissions of 87 identified contaminants of potential concern. Emissions were estimated for both the approved initial operating design capacity of the facility (140,000 tonnes per year) and for the maximum design capacity (400,000 tonnes per year). For the 140,000 tonnes per year scenario, this assessment indicated that facility-related emissions are unlikely to cause adverse health risks to local residents, farmers, or other receptors (e.g., recreational users). For the 400,000 tonnes per year scenarios, slightly elevated risks were noted with respect to inhalation (hydrogen chloride) and infant consumption of breast milk (dioxins and furans), but only during predicted 'upset conditions' (i.e. facility start-up, shutdown, and loss of air pollution control) that represent unusual and/or transient occurrences. However, current provincial regulations require that additional environmental screening would be mandatory prior to expansion of the facility beyond the initial approved capacity (140,000 tonnes per year). Therefore, the potential risks due to upset conditions for the 400,000 tonnes per year scenario should be more closely investigated if future expansion is pursued.

  7. Environmental risk assessment for start-up of a new consolidated maintenance facility

    Energy Technology Data Exchange (ETDEWEB)

    Heubach, J.G.; Wise, J.A.

    1992-10-01

    This paper summarizes a case study of a risk assessment for a consolidated maintenance facility (CMF). An interdisciplinary team was formed to identify and evaluate showstopper'' risks which could delay or prevent ontime, safe, and economical operation of a CMF and to recommend ways to mitigate the risks. The risk assessment was constrained by time, information, incomplete plans and facilities, and a concomitant major transition in manufacturing process, organization, and technology. Working within these constraints, the team integrated convergent findings into estimates of high, medium, and low risks based on the subjective likelihood of occurrence and predicted consequences of potential hazard events. The team also made risk-reduction recommendations for facility detail design and production start-up. The findings and recommendations reported in this study focus on risks related to environmental design and workstation ergonomics. Findings from the risk assessment effort should aid other constrained risk assessments and applied research on similar facilities.

  8. Screening for markers of frailty and perceived risk of adverse outcomes using the Risk Instrument for Screening in the Community (RISC).

    LENUS (Irish Health Repository)

    O Caoimh, Rónán

    2014-09-19

    Functional decline and frailty are common in community dwelling older adults, increasing the risk of adverse outcomes. Given this, we investigated the prevalence of frailty-associated risk factors and their distribution according to the severity of perceived risk in a cohort of community dwelling older adults, using the Risk Instrument for Screening in the Community (RISC).

  9. Site specific risk assessment of an energy-from-waste/thermal treatment facility in Durham Region, Ontario, Canada. Part B: Ecological risk assessment.

    Science.gov (United States)

    Ollson, Christopher A; Whitfield Aslund, Melissa L; Knopper, Loren D; Dan, Tereza

    2014-01-01

    The regions of Durham and York in Ontario, Canada have partnered to construct an energy-from-waste (EFW) thermal treatment facility as part of a long term strategy for the management of their municipal solid waste. In this paper we present the results of a comprehensive ecological risk assessment (ERA) for this planned facility, based on baseline sampling and site specific modeling to predict facility-related emissions, which was subsequently accepted by regulatory authorities. Emissions were estimated for both the approved initial operating design capacity of the facility (140,000 tonnes per year) and the maximum design capacity (400,000 tonnes per year). In general, calculated ecological hazard quotients (EHQs) and screening ratios (SRs) for receptors did not exceed the benchmark value (1.0). The only exceedances noted were generally due to existing baseline media concentrations, which did not differ from those expected for similar unimpacted sites in Ontario. This suggests that these exceedances reflect conservative assumptions applied in the risk assessment rather than actual potential risk. However, under predicted upset conditions at 400,000 tonnes per year (i.e., facility start-up, shutdown, and loss of air pollution control), a potential unacceptable risk was estimated for freshwater receptors with respect to benzo(g,h,i)perylene (SR=1.1), which could not be attributed to baseline conditions. Although this slight exceedance reflects a conservative worst-case scenario (upset conditions coinciding with worst-case meteorological conditions), further investigation of potential ecological risk should be performed if this facility is expanded to the maximum operating capacity in the future.

  10. FEDS user`s guide: Facility energy screening. Release 2.10

    Energy Technology Data Exchange (ETDEWEB)

    Dirks, J.A.

    1995-01-01

    The Facility Energy Decision Screening (FEDS) Model is under development at Pacific Northwest Laboratory (PNL) for the US DOE Federal Energy Management Program (DOE-FEMP) and the US Army Construction Engineering REsearch Laboratory (USA-CERL). FEDS is a multi-level energy analysis software system designed to provide a comprehensive approach to fuel-neutral, technology-independent, integrated (energy) resource planning and acquisition. The FEDS system includes Level-1, which is a top-down, first-pass energy systems analysis and energy resource acquisition decision software model for buildings and facilities, and the Level-2 software model, which allows specific engineering inputs and provides detailed output. The basic intent of the model is to provide an installation with the information necessary to determine the minimum life-cycle cost (LCC) configuration of the installation`s energy generation and consumption infrastructure. The model has no fuel or technology bias; it simply selects the technologies that will provide an equivalent or superior level of service (e.g., heating, cooling, illumination) at the minimum LCC.

  11. Fabrication of dielectrophoretic microfluidic chips using a facile screen-printing technique for microparticle trapping

    Science.gov (United States)

    Wee, Wei Hong; Li, Zedong; Hu, Jie; Adib Kadri, Nahrizul; Xu, Feng; Li, Fei; Pingguan-Murphy, Belinda

    2015-10-01

    Trapping of microparticles finds wide applications in numerous fields. Microfluidic chips based on a dielectrophoresis (DEP) technique hold several advantages for trapping microparticles, such as fast result processing, a small amount of sample required, high spatial resolution, and high accuracy of target selection. There is an unmet need to develop DEP microfluidic chips on different substrates for different applications in a low cost, facile, and rapid way. This study develops a new facile method based on a screen-printing technique for fabrication of electrodes of DEP chips on three types of substrates (i.e. polymethyl-methacrylate (PMMA), poly(ethylene terephthalate) and A4 paper). The fabricated PMMA-based DEP microfluidic chip was selected as an example and successfully used to trap and align polystyrene microparticles in a suspension and cardiac fibroblasts in a cell culture solution. The developed electrode fabrication method is compatible with different kinds of DEP substrates, which could expand the future application field of DEP microfluidic chips, including new forms of point-of care diagnostics and trapping circulating tumor cells.

  12. A suicide risk screening scale for HIV- infected persons in the ...

    African Journals Online (AJOL)

    To construct a brief suicide risk screening scale (SRSS) as a self-administered instrument to screen for .... be inadequate for measuring suicidality in ... describes your attitude for the past week, including now, write 'T' in the block provided.

  13. Statistical Methods for Estimating the Cumulative Risk of Screening Mammography Outcomes

    NARCIS (Netherlands)

    Hubbard, R.A.; Ripping, T.M.; Chubak, J.; Broeders, M.J.; Miglioretti, D.L.

    2016-01-01

    BACKGROUND: This study illustrates alternative statistical methods for estimating cumulative risk of screening mammography outcomes in longitudinal studies. METHODS: Data from the US Breast Cancer Surveillance Consortium (BCSC) and the Nijmegen Breast Cancer Screening Program in the Netherlands were

  14. Which screening method is appropriate for older cancer patients at risk for malnutrition?

    Science.gov (United States)

    Isenring, Elizabeth; Elia, Marinos

    2015-04-01

    The risk for malnutrition increases with age and presence of cancer, and it is particularly common in older cancer patients. A range of simple and validated nutrition screening tools can be used to identify malnutrition risk in cancer patients (e.g., Malnutrition Screening Tool, Mini Nutritional Assessment Short Form Revised, Nutrition Risk Screening, and the Malnutrition Universal Screening Tool). Unintentional weight loss and current body mass index are common components of screening tools. Patients with cancer should be screened at diagnosis, on admission to hospitals or care homes, and during follow-up at outpatient or general practitioner clinics, at regular intervals depending on clinical status. Nutritional assessment is a comprehensive assessment of dietary intake, anthropometrics, and physical examination often conducted by dietitians or geriatricians after simple screening has identified at-risk patients. The result of nutritional screening, assessment and the associated care plans should be documented, and communicated, within and between care settings for best patient outcomes.

  15. Development of a facile method for high throughput screening with reporter gene assays.

    Science.gov (United States)

    Goetz, A S; Andrews, J L; Littleton, T R; Ignar, D M

    2000-10-01

    This report describes a facile methodology for high throughput screening with stable mammalian cell reporter gene assays. We have adapted a 96-well adherent cell method to an assay in which cells propagated in suspension are dispensed into 96- or 384-well plates containing test compounds in 100% DMSO. The validation of a stable CHO cell line that expresses 6xCRE-luciferase for use as a reporter gene host cell line is described. The reporter gene, when expressed in this particular CHO cell line, appears to respond specifically to modulation of cAMP levels, thus the cell line is appropriate for screening and pharmacological analysis of Galpha(s)- and Galpha(i)-coupled seven-transmembrane receptors. The development of the new suspension cell assay in both 96- and 384-well formats was performed using a derivative of the CHO host reporter cell line that was stably transfected with human melanocortin-1 receptor. The response of this cell line to NDP-alpha-melanocyte-stimulating hormone and forskolin was nearly identical between the adherent and suspension methods. The new method offers improvements in cost, throughput, cell culture effort, compound stability, accuracy of compound delivery, and hands-on time. The 384-well assay can be performed at high capacity in any laboratory without the use of expensive automation systems such that a single person can screen 100 plates per day with 3.5-4 h hands-on time. Although the system has been validated using Galpha(s)-coupled receptor-mediated activation of a cAMP response element, the method can be applied to other types of targets and/or transcriptional response elements.

  16. [Nutritional risk screening and nutrition assessment for gastrointestinal cancer patients].

    Science.gov (United States)

    Du, Yan-ping; Li, Ling-ling; He, Qing; Li, Yun; Song, Hu; Lin, Yi-jia; Peng, Jun-sheng

    2012-05-01

    To investigate the nutritional status, and provide evidence for nutritional treatment option. A total of 452 patients with gastrointestinal cancer were selected, including 156 gastric cancer,117 colon cancer, and 180 rectal cancer. The nutritional risk screening 2002(NRS2002) was applied to grade the nutritional risk. A multi-frequency bioelectrical impedance analysis was used to measure the patients' body composition. Albumin (Alb), prealbumin(PA), transferring(Tf), retinol binding protein(RBP), red blood cell(RBC), hemoglobin (Hb), haematocrit(Hct) were measured after fasting. The rate of patients with NRS2002 score more than 3 was 70.5%(110/156) for gastric cancer, 53.8%(63/117) for colon cancer, and 46.7%(86/180) for rectal cancer. The score for impaired nutritional status more than 1 for gastric cancer was higher than that for colorectal cancer(Pgastric cancer(Pobesity degree, fat content, fat percentage, and arm circumference were lower in gastric cancer patients as compared to colorectal cancer patients(Pgastric cancer patients(Pgastric cancer and colon cancer(Pgastric cancer are prone to fat loss and therefore have a higher nutritional risk and malnutrition than those with colorectal cancer. Combination of body composition analysis and laboratory examination may achieve comprehensive evaluation of the nutritional status of patients, and provide the evidence of nutritional therapy by being combined with NRS2002 score.

  17. The Risk of Noise-Induced Hearing Loss During Simulated Dives in Canadian Forces Hyperbaric Facilities

    Science.gov (United States)

    2012-10-01

    The risk of noise-induced hearing loss during simulated dives in Canadian Forces hyperbaric facilities Sharon M...2012-084 October 2012 The risk of noise-induced hearing loss during simulated dives in Canadian Forces hyperbaric ...transferred into the dive chamber of a hyperbaric facility. The mechanism is audible and sufficiently high in level in adjacent areas to warrant the

  18. Analysis of the formation, expression, and economic impacts of risk perceptions associated with nuclear facilities

    Energy Technology Data Exchange (ETDEWEB)

    Allison, T.; Hunter, S.; Calzonetti, F.J.

    1992-10-01

    This report investigates how communities hosting nuclear facilities form and express perceptions of risk and how these risk perceptions affect local economic development. Information was collected from site visits and interviews with plant personnel, officials of local and state agencies, and community activists in the hosting communities. Six commercial nuclear fuel production facilities and five nuclear facilities operated for the US Department of Energy by private contractors were chosen for analysis. The results presented in the report indicate that the nature of risk perceptions depends on a number of factors. These factors are (1) level of communication by plant officials within the local community, (2) track record of the facility. operator, (3) process through which community and state officials receive information and form opinions, (4) level of economic links each plant has with the local community, and (15) physical characteristics of the facility itself. This report finds that in the communities studied, adverse ask perceptions have not affected business location decisions, employment levels in the local community, tourism, or agricultural development. On the basis of case-study findings, this report recommends that nuclear facility siting programs take the following observations into account when addressing perceptions of risk. First, the quality of a facility`s participation with community activists, interest groups, and state agencies helps to determine the level of perceived risk within a community. Second, the development of strong economic links between nuclear facilities and their host communities will produce a higher level of acceptance of the nuclear facilities.

  19. Velocity Measurements at Six Fish Screening Facilities in the Yakima River Basin, Washington, Summer 1988 : Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Abernethy, C. Scott; Neitzel, Duane A.; Lusty, E. William

    1989-11-01

    The Bonneville Power Administration (BPA), the United States Bureau of Reclamation (USSR), and the Washington State Department of Ecology (WDOE) are funding the construction and evaluation of fish passage facilities and fish protection facilities at irrigation and hydroelectric diversions in the Yakima River Basin, Washington State. The program provides offsite enhancement to compensate for fish and wildlife losses caused by hydroelectric development throughout the Columbia River Basin, and addresses natural propagation of salmon to help mitigate the impact of irrigation in the Yakima River Basin. This report evaluates the flow characteristics of the screening facilities. Studies consisted of velocity measurements taken in front of the rotary drum screens and within the fish bypass systems during peak flows. Measurements of approach velocity and sweep velocity were emphasized in these studies; however, vertical velocity was also measured. 5 refs., 18 figs., 15 tabs.

  20. HEROICA: an underground facility for the fast screening of germanium detectors

    Science.gov (United States)

    Andreotti, E.; Garfagnini, A.; Maneschg, W.; Barros, N.; Benato, G.; Brugnera, R.; Costa, F.; Falkenstein, R.; Guthikonda, K. K.; Hegai, A.; Hemmer, S.; Hult, M.; Jänner, K.; Kihm, T.; Lehnert, B.; Liao, H.; Lubashevskiy, A.; Lutter, G.; Marissens, G.; Modenese, L.; Pandola, L.; Reissfelder, M.; Sada, C.; Salathe, M.; Schmitt, C.; Schulz, O.; Schwingenheuer, B.; Turcato, M.; Ur, C.; von Sturm, K.; Wagner, V.; Westermann, J.

    2013-06-01

    HEROICA (Hades Experimental Research Of Intrinsic Crystal Appliances) is an infrastructure to characterize germanium detectors and has been designed and constructed at the HADES Underground Research Laboratory, located in Mol (Belgium). Thanks to the 223 m overburden of clay and sand, the muon flux is lowered by four orders of magnitude. This natural shield minimizes the exposure of radio-pure germanium material to cosmic radiation resulting in a significant suppression of cosmogenic activation in the germanium detectors. The project has been strongly motivated by a special production of germanium detectors for the GERDA experiment. GERDA, currently collecting data at the Laboratori Nazionali del Gran Sasso of INFN, is searching for the neutrinoless double beta decay of 76Ge. In the near future, GERDA will increase its mass and sensitivity by adding new Broad Energy Germanium (BEGe) detectors. The production of the BEGe detectors is done at Canberra in Olen (Belgium), located about 30 km from the underground test site. Therefore, HADES is used both for storage of the crystals over night, during diode production, and for the characterization measurements. A full quality control chain has been setup and tested on the first seven prototype detectors delivered by the manufacturer at the beginning of 2012. The screening capabilities demonstrate that the installed setup fulfills a fast and complete set of measurements on the diodes and it can be seen as a general test facility for the fast screening of high purity germanium detectors. The results are of major importance for a future massive production and characterization chain of germanium diodes foreseen for a possible next generation 1-tonne double beta decay experiment with 76Ge.

  1. RCRA Facility Investigation/Remedial Investigation Report with Baseline Risk Assessment for the Fire Department Hose Training Facility (904-113G)

    Energy Technology Data Exchange (ETDEWEB)

    Palmer, E. [Westinghouse Savannah River Company, AIKEN, SC (United States)

    1997-04-01

    This report documents the Resource Conservation and Recovery Act (RCRA) Facility Investigation/Remedial Investigation/Baseline Risk Assessment (RFI/RI/BRA) for the Fire Department Hose Training Facility (FDTF) (904-113G).

  2. Support for Emergency Department Screening for Intimate Partner Violence Depends on Perceived Risk

    Science.gov (United States)

    Witting, Michael D.; Furuno, Jon P.; Hirshon, Jon Mark; Krugman, Scott D.; Perisse, Andre R. S.; Limcangco, Rhona

    2006-01-01

    Emergency department (ED) screening for intimate partner violence (IPV) faces logistic difficulties and has uncertain efficacy. We surveyed 146 ED visitors and 108 ED care providers to compare their support for ED IPV screening in three hypothetical scenarios of varying IPV risk. Visitor support for screening was 5 times higher for the high-risk…

  3. Predicting the risk of a false-positive test for women following a mammography screening programme

    DEFF Research Database (Denmark)

    Njor, Sisse Helle; Olsen, Anne Helene; Schwartz, Walter

    2007-01-01

    OBJECTIVES: The objectives of this study was to provide a simple estimate of the cumulative risk of a false-positive test for women participating in mammography screening. To test the method, we used data from two well-established, organized mammography screening programmes offering biennial...... be calculated in a simple way relatively early after the start of a mammography screening programme....

  4. Analyses in support of risk-informed natural gas vehicle maintenance facility codes and standards :

    Energy Technology Data Exchange (ETDEWEB)

    Ekoto, Isaac W.; Blaylock, Myra L.; LaFleur, Angela Christine; LaChance, Jeffrey L.; Horne, Douglas B.

    2014-03-01

    Safety standards development for maintenance facilities of liquid and compressed gas fueled large-scale vehicles is required to ensure proper facility design and operation envelopes. Standard development organizations are utilizing risk-informed concepts to develop natural gas vehicle (NGV) codes and standards so that maintenance facilities meet acceptable risk levels. The present report summarizes Phase I work for existing NGV repair facility code requirements and highlights inconsistencies that need quantitative analysis into their effectiveness. A Hazardous and Operability study was performed to identify key scenarios of interest. Finally, scenario analyses were performed using detailed simulations and modeling to estimate the overpressure hazards from HAZOP defined scenarios. The results from Phase I will be used to identify significant risk contributors at NGV maintenance facilities, and are expected to form the basis for follow-on quantitative risk analysis work to address specific code requirements and identify effective accident prevention and mitigation strategies.

  5. Teenage cervical screening in a high risk American population

    Directory of Open Access Journals (Sweden)

    Songlin Zhang

    2011-01-01

    Full Text Available Background: The new 2009 ACOG guideline for cervical cytology screening changed the starting age to 21 years regardless of the age of onset of sexual intercourse. However, many recent studies have shown a dramatic increase in the incidence of cervical epithelial abnormalities among adolescents within the past two decades. Materials and Methods: For this study, the reports of 156,342 cervical cytology were available of which 12,226 (7.8% were from teenagers. A total of 192 teenagers with high grade intraepithelial lesion (HSIL cervical cytology were identified. The ages ranged from 13 to 19 years with a mean of 17.7 years and a median of 18 years. Among them, 31.3% were pregnant, 12.0% were postpartum, and 13.5% were on oral contraceptive. Ninety-eight had prior cervical cytology. Results: The teenagers had statistically significant higher detection rates of overall abnormal cervical cytology (23.6% vs. 6.6%, P = 0, with 15.4% vs. 3.2% (P = 0 of low grade intraepithelial lesion (LSIL and 1.8% vs. 1.0% (P = 2.56 Χ 10 -13 of HSIL compared to women ≥20 years. The teenage group had the highest abnormal cytology among all age groups. The LSIL/HSIL ratio was 8.5:1 for teenagers and 3.1:1 for women ≥20 years. A total of 131 teenagers had cervical biopsies within 12 months of the HSIL cytology, with diagnoses of 39 CIN 3, 1 VAIN 3, 15 CIN 2, 62 CIN 1, and 14 had a negative histology (CIN 0. Only in 19 of these 39 women, the CIN 2/3 lesion proved to be persistent. Conclusion: We conclude that cytology screening of high risk teenagers is effective in detecting CIN 2/3 lesions. Moreover, treatment and careful follow-up can be realized.

  6. Risk management technique for liquefied natural gas facilities

    Science.gov (United States)

    Fedor, O. H.; Parsons, W. N.

    1975-01-01

    Checklists have been compiled for planning, design, construction, startup and debugging, and operation of liquefied natural gas facilities. Lists include references to pertinent safety regulations. Methods described are applicable to handling of other hazardous materials.

  7. Development of TUA-WELLNESS screening tool for screening risk of mild cognitive impairment among community-dwelling older adults.

    Science.gov (United States)

    Vanoh, Divya; Shahar, Suzana; Rosdinom, Razali; Din, Normah Che; Yahya, Hanis Mastura; Omar, Azahadi

    2016-01-01

    Focus on screening for cognitive impairment has to be given particular importance because of the rising older adult population. Thus, this study aimed to develop and assess a brief screening tool consisting of ten items that can be self-administered by community dwelling older adults (TUA-WELLNESS). A total of 1,993 noninstitutionalized respondents aged 60 years and above were selected for this study. The dependent variable was mild cognitive impairment (MCI) assessed using neuropsychological test batteries. The items for the screening tool comprised a wide range of factors that were chosen mainly from the analysis of ordinal logistic regression (OLR) and based on past literature. A suitable cut-off point was developed using receiver operating characteristic analysis. A total of ten items were included in the screening tool. From the ten items, eight were found to be significant by ordinal logistic regression and the remaining two items were part of the tool because they showed strong association with cognitive impairment in previous studies. The area under curve (AUC), sensitivity, and specificity for cut-off 11 were 0.84%, 83.3%, and 73.4%, respectively. TUA-WELLNESS screening tool has been used to screen for major risk factors of MCI among Malaysian older adults. This tool is only suitable for basic MCI risk screening purpose and should not be used for diagnostic purpose.

  8. Barriers and strategies for identifying and managing risk factors of cardiovascular diseases in levels of preventing, screening, and treating

    Directory of Open Access Journals (Sweden)

    Saber Azami Aghdash

    2015-11-01

    Full Text Available Introduction: Cardiovascular diseases (CVD are of the main causes of mortality in the world and impose a heavy economic, social, and health burden on society. Therefore, the objective of this study was to determine the barriers and strategies for identifying and managing risk factors of CVD in levels of preventing, screening, and treating. Methods: During present qualitative study with phenomenological approach, 60 subjects of cardiologists, nurses, patients, and their relatives were selected based on purposive sampling from educational-medical cardiothoracic subspecialty centers. Data were collected using an open-ended questionnaire and was extracted and analyzed with content analysis method. Results: Barriers were divided into three groups of individual barriers (low awareness, delay in referring for treatment and screening, incorrect beliefs, and not caring about health, socio-economic barriers (high costs, lack of resources, mental and psychological pressures, and health care barriers (non-alignment of doctors, being therapy-oriented, managerial and planning weaknesses, and lack of health care facilities. The most important presenting strategies are: providing public educations, improving family physician program, reduction of costs, cooperation of patients, and using functional indices to evaluate and improve the quality of services. Conclusion: Low awareness of people, high costs of services, lack of health care facilities, socio-cultural problems of people, and delay in referring of people, for treatment and screening are of the most important barriers of proper identifying and managing risk factors of CVD. Strategies provided in this study to overcome these barriers could be used.

  9. Screening Mammography: Patient Perceptions and Preferences Regarding Communication of Estimated Breast Cancer Risk.

    Science.gov (United States)

    Amornsiripanitch, Nita; Mangano, Mark; Niell, Bethany L

    2017-05-01

    Many models exist to estimate a woman's risk of development of breast cancer. At screening mammography, many imaging centers collect data required for these models to identify women who may benefit from supplemental screening and referral for cancer risk assessment. The purpose of this study was to discern perceptions and preferences of screening mammography patients regarding communication of estimated breast cancer risk. An anonymous survey was distributed to screening and surveillance mammography patients between April and June 2015. Survey questions were designed to assess patient preferences regarding the receipt and complexity of risk estimate communication, including hypothetical scenarios with and without > 20% estimated risk of breast cancer. The McNemar test and the Wilcoxon signed rank test were used with p ≤ 0.05 considered statistically significant. The survey was distributed to 1061 screening and surveillance mammography patients, and 503 patients responded (response rate, 47%). Although 86% (431/503) of patients expressed interest in learning their estimated risk, only 8% (38/503) had undergone formal risk assessment. The preferred method (241 respondents [26%]) of communication of risk 20%, patients preferred oral communication and were 10-fold as likely to choose only oral communication (p 20%, patients preferred to learn their estimated risk in great detail (69% and 85%), although women were significantly more likely to choose greater detail for risk > 20% (p < 0.00001). Screening mammography patients expressed interest in learning their estimated risk of breast cancer regardless of their level of hypothetical risk.

  10. Cervical cancer risk factors and feasibility of visual inspection with acetic acid screening in Sudan

    DEFF Research Database (Denmark)

    Ibrahim, Ahmed; Rasch, Vibeke; Pukkala, Eero;

    2011-01-01

    To assess the risk factors of cervical cancer and the feasibility and acceptability of a visual inspection with acetic acid (VIA) screening method in a primary health center in Khartoum, Sudan.......To assess the risk factors of cervical cancer and the feasibility and acceptability of a visual inspection with acetic acid (VIA) screening method in a primary health center in Khartoum, Sudan....

  11. Screening for gestational diabetes mellitus by a model based on risk indicators: a prospective study

    DEFF Research Database (Denmark)

    Jensen, Dorte; Mølsted-Pedersen, Lars; Beck-Nielsen, Henning;

    2003-01-01

    This study was performed to prospectively evaluate a screening model for gestational diabetes mellitus on the basis of clinical risk indicators.......This study was performed to prospectively evaluate a screening model for gestational diabetes mellitus on the basis of clinical risk indicators....

  12. Incremental Risks of Transporting NARM to the LLW Disposal Facility at Hanford

    Energy Technology Data Exchange (ETDEWEB)

    Weiner, R.F.

    1999-02-23

    This study models the incremental radiological risk of transporting NARM to the Hanford commercial LLW facility, both for incident-free transportation and for possible transportation accidents, compared with the radiological risk of transporting LLW to that facility. Transportation routes are modeled using HIGHWAY 3.1 and risks are modeled using RADTRAN 4. Both annual population doses and risks, and annual average individual doses and risks are reported. Three routes to the Hanford site were modeled from Albany, OR, from Coeur d'Alene, ID (called the Spokane route), and from Seattle, WA. Conservative estimates are used in the RADTRAN inputs, and RADTRAN itself is conservative.

  13. Assessment of screening practices for gestational hyperglycaemia in public health facilities: a descriptive study in Bangalore, India

    Directory of Open Access Journals (Sweden)

    Giridhara R. Babu

    2015-03-01

    Full Text Available Background. Screening and timely treatment of gestational hyperglycaemia (GH is proved to be beneficial and improves maternal and foetal health outcomes. To understand screening practices, we explored the knowledge and perceptions of doctors working in public health facilities in Bangalore, India. We also studied participation factors by examining whether undergoing glucose estimation tests affects morning sickness in pregnant women. Design and Methods. We aimed to understand the screening practices and knowledge of doctors. A semi-structured questionnaire was self-administered by the 50 participant doctors, selected from the sampling frame comprising of all the doctors working in public health facilities. We included 105 pregnant women for baseline assessment, in whom a well-structured questionnaire was used. Results. We reported that gestational diabetes mellitus (GDM screening was done in nearly all the health centres (96%. However, only 12% of the doctors could provide all components of GDM diagnosis and management correctly and 46% would diagnose by using a random blood glucose test. A majority (92% of the doctors had poor knowledge (68% about the cut-off values of glucose tests. More than 80% of pregnant women experienced some discomfort mostly due to rapid ingestion glucose in short span of time. Conclusions. Our study established that screening for GH is done in most public health facilities. Nonetheless, knowledge of doctors on the glucose tests and their interpretation needs improvement. Re-orientation trainings of the doctors can improve their knowledge and thereby can efficiently screen for GH. Further, adequate planning prior to the tests can aid successful completion of them.

  14. Tailoring breast cancer screening intervals by breast density and risk for women aged 50 years or older: Collaborative modeling of screening outcomes

    NARCIS (Netherlands)

    A. Trentham-Dietz (Amy); K. Kerlikowske (Karla); N.K. Stout (Natasha); D.L. Miglioretti (Diana); C.B. Schechter (Clyde); M.A. Ergun (Mehmet Ali); J.J. Van Den Broek (Jeroen J.); O. Alagoz (Oguzhan); B.L. Sprague (Brian L.); N.T. van Ravesteyn (Nicolien); A.M. Near (Aimee); R. Gangnon (Ronald); Hampton, J.M. (John M.); Chandler, Y. (Young); H.J. de Koning (Harry); J.S. Mandelblatt (Jeanne); A.N.A. Tosteson (Anna N.A.)

    2016-01-01

    textabstractBackground: Biennial screening is generally recommended for average-risk women aged 50 to 74 years, but tailored screening may provide greater benefits. Objective: To estimate outcomes for various screening intervals after age 50 years based on breast density and risk for breast cancer.

  15. Risk factors for colonization due to carbapenem-resistant Enterobacteriaceae among patients exposed to long-term acute care and acute care facilities.

    Science.gov (United States)

    Bhargava, Ashish; Hayakawa, Kayoko; Silverman, Ethan; Haider, Samran; Alluri, Krishna Chaitanya; Datla, Satya; Diviti, Sreelatha; Kuchipudi, Vamsi; Muppavarapu, Kalyan Srinivas; Lephart, Paul R; Marchaim, Dror; Kaye, Keith S

    2014-04-01

    This study aimed to identify risk factors associated with carbapenem-resistant Enterobacteriaceae (CRE) colonization among patients screened with rectal cultures upon admission to a hospital or long-term acute care (LTAC) center and to compare risk factors among patients who were screen positive for CRE at the time of hospital admission with those screen positive prior to LTAC admission. A retrospective nested matched case-control study was conducted from June 2009 to December 2011. Patients with recent LTAC exposure were screened for CRE carriage at the time of hospital admission, and patients admitted to a regional LTAC facility were screened prior to LTAC admission. Cases were patients with a positive CRE screening culture, and controls (matched in a 3∶1 ratio to cases) were patients with negative screening cultures. Nine hundred five cultures were performed on 679 patients. Forty-eight (7.1%) cases were matched to 144 controls. One hundred fifty-eight patients were screened upon hospital admission and 521 prior to LTAC admission. Independent predictors for CRE colonization included Charlson's score greater than 3 (odds ratio [OR], 4.85 [95% confidence interval (CI), 1.64-14.41]), immunosuppression (OR, 3.92 [95% CI, 1.08-1.28]), presence of indwelling devices (OR, 5.21 [95% CI, 1.09-2.96]), and prior antimicrobial exposures (OR, 3.89 [95% CI, 0.71-21.47]). Risk factors among patients screened upon hospital admission were similar to the entire cohort. Among patients screened prior to LTAC admission, the characteristics of the CRE-colonized and noncolonized patients were similar. These results can be used to identify patients at increased risk for CRE colonization and to help target active surveillance programs in healthcare settings.

  16. Towards meaningful stakeholder comprehension of sour gas facility risk assessments

    Energy Technology Data Exchange (ETDEWEB)

    McAuley, C.; Hrudey, S.E. [Alberta Univ., Edmonton, AB (Canada). Dept. of Public Health Sciences

    2006-01-15

    This study addressed public concerns in Alberta regarding the development of sour gas projects that are in close proximity to established populations. In particular, it focused on the reasoning of different perspectives of risk assessment between proponents of a sour gas development and the stakeholders affected. The main issues reviewed in this study were the toxicity of hydrogen sulphide and the toxic load models; the specifics of risk assessment and the risk estimation associated with pipeline failures; hazard distances associated with various end-points and set-back distances; the uncertainty that a pipeline failure will occur somewhere; a comparison of other risk scenarios where there are unknown exposure populations; risk management and risk issue management for pipeline failures; the evaluation of risk communication and validation of risk reduction measures and the issue of which risks could provide a useful basis for comparison in discussion about risk acceptability. It was noted that although zero risk is impossible, it was suggested that a better communication and understanding of the health affects of hydrogen sulphide and the toxic load concept in both public and regulatory forums would reduce uncertainty in health risk estimates associated with sour gas pipeline failures. 36 refs., 3 tabs.

  17. Ground-Truthing Validation to Assess the Effect of Facility Locational Error on Cumulative Impacts Screening Tools

    OpenAIRE

    Sadd, J. L.; Hall, E. S.; Pastor, M.; Morello-Frosch, R. A.; D. Lowe-Liang; Hayes, J.; Swanson, C

    2015-01-01

    Researchers and government regulators have developed numerous tools to screen areas and populations for cumulative impacts and vulnerability to environmental hazards and risk. These tools all rely on secondary data maintained by government agencies as part of the regulatory and permitting process. Stakeholders interested in cumulative impacts screening results have consistently questioned the accuracy and completeness of some of these datasets. In this study, three cumulative impacts screenin...

  18. R2 TRI facilities with 1999-2011 risk related estimates throughout the census blockgroup

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset delineates the distribution of estimate risk from the TRI facilities for 1999 - 2011 throughout the census blockgroup of the region using Office of...

  19. Editorial: risk scoring for colon cancer screening: validated, but still not ready for prime time.

    Science.gov (United States)

    Lin, Otto S

    2011-06-01

    Risk stratification for colorectal cancer screening would allow us to use less expensive screening tests, such as sigmoidoscopy with or without fecal blood testing, on lower risk individuals, and reserve colonoscopy for those at higher risk. In this issue, Levitzky et al. validates a risk score that was previously developed by Imperiale et al., finding similar results among three ethnic groups. Risk scoring would detect 82-87% of proximal advanced neoplasia while decreasing colonoscopy use by 33-46%. However, before risk scoring is ready for widespread use, sigmoidoscopy access and performance issues need to be addressed, and we must be comfortable with missing some proximal neoplasms.

  20. Which part of a short, global risk assessment, the Risk Instrument for Screening in the Community, predicts adverse healthcare outcomes?

    LENUS (Irish Health Repository)

    O’Caoimh, Rónán

    2015-01-01

    The Risk Instrument for Screening in the Community (RISC) is a short, global risk assessment to identify community-dwelling older adults’ one-year risk of institutionalisation, hospitalisation, and death. We investigated the contribution that the three components of the RISC (\

  1. Primary care physicians' cancer screening recommendation practices and perceptions of cancer risk of Asian Americans.

    Science.gov (United States)

    Kwon, Harry T; Ma, Grace X; Gold, Robert S; Atkinson, Nancy L; Wang, Min Qi

    2013-01-01

    Asian Americans experience disproportionate incidence and mortality rates of certain cancers, compared to other racial/ethnic groups. Primary care physicians are a critical source for cancer screening recommendations and play a significant role in increasing cancer screening of their patients. This study assessed primary care physicians' perceptions of cancer risk in Asians and screening recommendation practices. Primary care physicians practicing in New Jersey and New York City (n=100) completed a 30-question survey on medical practice characteristics, Asian patient communication, cancer screening guidelines, and Asian cancer risk. Liver cancer and stomach cancer were perceived as higher cancer risks among Asian Americans than among the general population, and breast and prostate cancer were perceived as lower risks. Physicians are integral public health liaisons who can be both influential and resourceful toward educating Asian Americans about specific cancer awareness and screening information.

  2. Hazard screening of chemical releases and environmental equity analysis of populations proximate to toxic release inventory facilities in Oregon.

    Science.gov (United States)

    Neumann, C M; Forman, D L; Rothlein, J E

    1998-04-01

    A comprehensive approach using hazard screening, demographic analysis, and a geographic information system (GIS) for mapping is employed to address environmental equity issues in Oregon. A media-specific chronic toxicity index [or chronic index (CI)] was used to compare environmental chemical releases reported in the EPA's Toxic Chemical Release Inventory (TRI) database. In 1992, 254 facilities reportedly released more than 40 million pounds of toxic chemicals directly into the environment on-site or transferred them to sewage treatment plants or other off-site facilities for disposal and recycling. For each reported on-site TRI chemical release, a CI based on oral toxicity factors and total mass was calculated. CIs were aggregated on a media-, facility-, and chemical-specific basis. Glycol ethers, nickel, trichloroethylene, chloroform, and manganese were ranked as the top five chemicals released statewide based on total CI. In contrast, based on total mass, methanol, nickel, ammonia, acetone, and toluene were identified as the top five TRI chemicals released in Oregon. TRI facility rankings were related to the demographics and household income of surrounding neighborhoods using bivariate GIS mapping and statistical analysis. TRI facilities were disproportionately located in racial and ethnic minority neighborhoods. They were also located in areas with lower incomes compared to those in the surrounding county. No relationship was observed between the hazard ranking of the TRI facilities overall and socioeconomic characteristics of the community in which they were located.

  3. Assessment and Screening of the Risk Factors in Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    Jaspinder Kaur

    2014-07-01

    Full Text Available Metabolic syndrome (MetS is chronic inflammatory epidemic state contributing to total and cardiovascular mortality. The current study planned to assess and screen risk factors for MetS and its components. A cross-sectional study conducted to assess age, gender, social status, employment, education, family history, physical activity, dietary habits, alcohol, sleep, body mass index and stress as determinants of MetS. The results were analyzed by Chi Square test with statistical significance of p value <0.05. The frequency of MetS was 17.38% as per modified National Cholesterol Education Program–Adult Treatment Panel III criteria. Females (57.38%, age >50 years (86.90%; p < 0.05, middle socioeconomic status (70.50%, illiteracy (39.35%, and unemployment (81.97%; p < 0.05 were found contributing though to different extents. Subjects with a sedentary lifestyle (72.14%, positive family history (42.63%, omnivore diet (47.55%, stress (78.69%; p < 0.05, insomnia (29.51% and increased BMI (83.62%; p < 0.001 had shown predisposition to MetS. However, the protective role of alcohol (38.28%, an active lifestyle (36.21%, vegetarian diet (62.07% and adequate sleep (73.11% was observed. A significant hypertension (98.37%; p < 0.001, dyslipidemia (77.05%; p < 0.001, dysglycemia (75.41%; p < 0.001 and obesity (59.02%; p < 0.001 was reported in MetS. Common concerns of female gender, increasing age and BMI, sedentary lifestyle, stress and positive family history should be considered for early identification and appropriate intervention to fight the growing MetS epidemic.

  4. Cancer risk factors and screening in First Nations in Ontario

    Directory of Open Access Journals (Sweden)

    Maegan V. Mazereeuw

    2017-06-01

    Full Text Available Introduction: A lack of identifiers in health administrative databases limits our understanding of the cancer burden in First Nations. This study compares cancer risk factors and screening between First Nations in Ontario (on and off reserve and non-Aboriginal Ontarians using two unique health surveys. Methods: We measured age-standardized prevalence estimates using the First Nations Regional Health Survey (RHS Phase 2, 2008/10 (for First Nations on reserve and the Canadian Community Health Survey (CCHS, 2007–2013 (for First Nations off reserve and non-Aboriginal Ontarians. We used prevalence rate ratios (RR and Pearson’s chisquare tests for differences in proportions to compare estimates between First Nations (on and off reserve and non-Aboriginal Ontarians. Results: A higher proportion of First Nation men, women and adolescents on reserve smoked (RR = 1.97, 2.78 and 7.21 respectively and were obese (RR = 1.73, 2.33 and 3.29 respectively compared to their non-Aboriginal counterparts. Similar patterns were observed for First Nations off reserve. Frequent binge drinking was also more prevalent among First Nation men and women living on reserve (RR = 1.28 and 2.22, respectively and off reserve (RR = 1.70 and 1.45, respectively than non-Aboriginal Ontarians. First Nation men and women on reserve were about half as likely to consume fruit at least twice per day and vegetables at least twice per day compared to non-Aboriginal men and women (RR = 0.53 and 0.54, respectively. Pap test uptake was similar across all groups, while First Nation women on reserve were less likely to have had a mammogram in the last five years than non-Aboriginal women (RR = 0.85. Conclusion: First Nations, especially those living on reserve, have an increased risk for cancer and other chronic diseases compared to non-Aboriginal Ontarians. These results provide evidence to support policies and programs to reduce the future burden of cancer and other chronic diseases in

  5. Development of TUA-WELLNESS screening tool for screening risk of mild cognitive impairment among community-dwelling older adults

    Directory of Open Access Journals (Sweden)

    Vanoh D

    2016-05-01

    Full Text Available Divya Vanoh,1 Suzana Shahar,1 Razali Rosdinom,2 Normah Che Din,3 Hanis Mastura Yahya,4 Azahadi Omar5 1Dietetic Programme, Centre of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; 2Department of Psychiatry, University Kebangsaan Medical Centre, Kuala Lumpur, Malaysia; 3Health Psychology Programme, 4Nutrition Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; 5Institute of Public Health, Ministry of Health, Kuala Lumpur, Malaysia Background and aim: Focus on screening for cognitive impairment has to be given particular importance because of the rising older adult population. Thus, this study aimed to develop and assess a brief screening tool consisting of ten items that can be self-administered by community dwelling older adults (TUA-WELLNESS. Methodology: A total of 1,993 noninstitutionalized respondents aged 60 years and above were selected for this study. The dependent variable was mild cognitive impairment (MCI assessed using neuropsychological test batteries. The items for the screening tool comprised a wide range of factors that were chosen mainly from the analysis of ordinal logistic regression (OLR and based on past literature. A suitable cut-off point was developed using receiver operating characteristic analysis. Results: A total of ten items were included in the screening tool. From the ten items, eight were found to be significant by ordinal logistic regression and the remaining two items were part of the tool because they showed strong association with cognitive impairment in previous studies. The area under curve (AUC, sensitivity, and specificity for cut-off 11 were 0.84%, 83.3%, and 73.4%, respectively. Conclusion: TUA-WELLNESS screening tool has been used to screen for major risk factors of MCI among Malaysian older adults. This tool is only suitable for basic MCI risk screening purpose and should not be used for diagnostic

  6. Home screening for sexually transmitted diseases in high-risk young women: randomised controlled trial

    DEFF Research Database (Denmark)

    Cook, Robert L; Østergaard, Lars; Hillier, Sharon L

    2007-01-01

    OBJECTIVE: Home screening tests could eliminate several barriers to testing sexually transmitted diseases (STDs). AIM: To determine whether offering repeated home screening tests would increase the rate of testing for chlamydia and gonorrhoea in a high-risk sample of young women. METHODS: In this......OBJECTIVE: Home screening tests could eliminate several barriers to testing sexually transmitted diseases (STDs). AIM: To determine whether offering repeated home screening tests would increase the rate of testing for chlamydia and gonorrhoea in a high-risk sample of young women. METHODS...

  7. Results of the Randomized Danish Lung Cancer Screening Trial with Focus on High-Risk Profiling

    DEFF Research Database (Denmark)

    M. W. Wille, Mathilde; Dirksen, Asger; Ashraf, Haseem;

    2016-01-01

    RATIONALE: As of April 2015, participants in the Danish Lung Cancer Screening Trial had been followed for at least 5 years since their last screening. OBJECTIVES: Mortality, causes of death, and lung cancer findings are reported to explore the effect of computed tomography (CT) screening. METHODS...... fewer deaths in the screening group. CONCLUSIONS: No statistically significant effects of CT screening on lung cancer mortality were found, but the results of post hoc high-risk subgroup analyses showed nonsignificant trends that seem to be in good agreement with the results of the National Lung...

  8. Economic impacts of noxious facilities: Incorporating the effects of risk aversion

    Energy Technology Data Exchange (ETDEWEB)

    Nieves, L.A.

    1993-09-01

    Developing new sites for noxious facilities has become a complex process with many potential pitfalls. In addition to the need to negotiate conditions acceptable to the host community, siting success may depend on the facility proposer`s ability to identify a candidate site that not only meets technical requirements, but that is located in a community or region whose population is not highly averse to the risks associated with the type of facility being proposed. Success may also depend on the proposer accurately assessing potential impacts of the facility and offering an equitable compensation package to the people affected by it. Facility impact assessments, as typically performed, include only the effects of changes in population, employment and economic activity associated with facility construction and operation. Because of their scope, such assessments usually show a short-run, net economic benefit for the host region, making the intensely negative public reaction to some types and locations of facilities seem unreasonable. The impact component excluded from these assessments is the long-run economic effect of public perceptions of facility risk and nuisance characteristics. Recent developments in psychological and economic measurement techniques have opened the possibility of correcting this flaw by incorporating public perceptions in projections of economic impacts from noxious facilities.

  9. Lung cancer screening: review and performance comparison under different risk scenarios.

    Science.gov (United States)

    Tota, Joseph E; Ramanakumar, Agnihotram V; Franco, Eduardo L

    2014-02-01

    Lung cancer is currently one of the most common malignant diseases and is responsible for substantial mortality worldwide. Compared with never smokers, former smokers remain at relatively high risk for lung cancer, accounting for approximately half of all newly diagnosed cases in the US. Screening offers former smokers the best opportunity to reduce their risk of advanced stage lung cancer and there is now evidence that annual screening using low-dose computed tomography (LDCT) is effective in preventing mortality. Studies are being conducted to evaluate whether the benefits of LDCT screening outweigh its costs and potential harms and to determine the most appropriate workup for patients with screen-detected lung nodules. Program efficiency would be optimized by targeting high-risk current smokers, but low uptake among this group is a concern. Former smokers may be invited for screening; however, if fewer long-term current smokers and more former smokers with long quit duration elect to attend, this could have very adverse effects on cost and screening test parameters. To illustrate this point, we present three possible screening scenarios with lung cancer prevalence ranging from between 0.62 and 5.0 %. In summary, cost-effectiveness of lung cancer screening may be improved if linked to successful smoking cessation programs and if better approaches are developed to reach very high-risk patients, e.g., long-term current smokers or others based on more accurate risk prediction models.

  10. Screening for Chlamydia trachomatis in Low-Risk Obstetric Patients

    Directory of Open Access Journals (Sweden)

    Robert K. Gribble

    1994-01-01

    Full Text Available Objective: The purpose of this study was to evaluate the prevalence of Chlamydia trachomatis in our rural obstetric population and assess the appropriateness of selective vs. universal prenatal screening.

  11. Screening for gestational diabetes mellitus by a model based on risk indicators

    DEFF Research Database (Denmark)

    Jensen, Dorte Møller; Mølsted-Pedersen, Lars; Beck-Nielsen, Henning

    2003-01-01

    OBJECTIVE: This study was performed to prospectively evaluate a screening model for gestational diabetes mellitus on the basis of clinical risk indicators. STUDY DESIGN: In a prospective multicenter study with 5235 consecutive pregnant women, diagnostic testing with a 2-hour 75-g oral glucose...... was comparable with universal screening by fasting glucose or a 1-hour 50-g glucose challenge test. Both screening and diagnostic testing could be avoided in two thirds of all pregnant women....

  12. Colorectal cancer screening in high-risk groups is increasing, although current smokers fall behind.

    Science.gov (United States)

    Oluyemi, Aminat O; Welch, Amy R; Yoo, Lisa J; Lehman, Erik B; McGarrity, Thomas J; Chuang, Cynthia H

    2014-07-15

    There is limited information about colorectal cancer (CRC) screening trends in high-risk groups, including the black, obese, diabetic, and smoking populations. For this study, the authors evaluated national CRC screening trends in these high-risk groups to provide insights into whether screening resources are being appropriately used. This was a nationally representative, population-based study using the Behavioral Risk Factor Surveillance System from the Centers for Disease Control. Data analysis was performed using bivariate analyses with weighted logistic regression. In the general population, CRC screening increased significantly from 59% to 65% during the years 2006 to 2010. The screening prevalence in non-Hispanic blacks was 58% in 2006 and 65% in 2010. Among obese individuals, the prevalence of up-to-date CRC screening increased significantly from 59% in 2006 to 66% in 2010. Screening prevalence in individuals with diabetes was 63% in 2006 and 69% in 2010. The CRC screening prevalence in current smokers was 45% in 2006 and 50% in 2010. The odds of CRC screening in the non-Hispanic black population, the obese population, and the diabetic population were higher than in non-Hispanic whites, normal weight individuals, and the population without diabetes, respectively. Current smokers had significantly lower odds of CRC screening than never-smokers in the years studied (2006: odds ratio [OR], 0.71; 95% confidence interval [CI], 0.66-0.76; 2008: OR, 0.67; 95% CI, 0.63-0.71; 2010: OR, 0.69; 95% CI, 0.66-0.73). The prevalence of CRC screening in high-risk groups is trending upward. Despite this, current smokers have significantly lower odds of CRC screening compared with the general population. © 2014 American Cancer Society.

  13. Perspectives of colorectal cancer risk and screening among Dominicans and Puerto Ricans: stigma and misperceptions.

    Science.gov (United States)

    Goldman, Roberta E; Diaz, Joseph A; Kim, Ivone

    2009-11-01

    Colorectal cancer is the second most common cancer among Latinos, but a lower percentage of Latinos are screened than Whites and Blacks. Along with recognized economic barriers, differences in knowledge and perceptions might impede colorectal screening among Latinos. We conducted 147 individual, qualitative interviews with Dominicans and Puerto Ricans in the northeastern United States to explore their explanatory models for colorectal cancer and screening barriers. Many participants had not previously heard of colorectal cancer. The most commonly mentioned cause of colorectal cancer was anal sex. Also considered risks were "bad food," digestion leading to constipation, and strained bowel movements. Screening barriers included stigma, misperceptions, embarrassment, and machismo. Progress toward increasing colorectal cancer screening requires normalization of this screening among Latinos. Higher patient familiarity, along with improved physician counseling and referral, might contribute to reducing stigma and other barriers, and to enhancing knowledge and Latino community support of colorectal cancer screening.

  14. Familial risk and colorectal cancer screening health beliefs and attitudes in an insured population.

    Science.gov (United States)

    Palmer, Richard C; Emmons, Karen M; Fletcher, Robert H; Lobb, Rebecca; Miroshnik, Irina; Kemp, James Alan; Bauer, Mark

    2007-11-01

    To examine the relationship between health beliefs and attitudes toward colorectal cancer screening, strength of family history risk, and being appropriately screened for colorectal cancer. In February 2004, 7000 randomly selected members of a multi-specialty group practice located in Boston, MA were mailed a brief survey that was used to ascertain colorectal cancer family history. A follow-up survey that contained questions representing selected constructs of the Health Belief Model, Theory of Planned Behavior, and healthcare experiences was then mailed to all 355 individuals who reported a family history in the initial survey and 710 randomly selected participants with no colorectal cancer family history. Participants who were appropriately screened had higher mean scores for perceived cancer risk, subjective norms, and perceived benefits and lower scores for perceived barriers. Multivariate findings indicate that having high perceptions of risk for colorectal cancer was a significant correlate of being screened appropriately among individuals with a strong family history. For those at greatest colorectal cancer risk due to family history, ensuring that these individuals understand their personal risk might lead to increased colorectal cancer screening participation. Future intervention research is warranted to examine if raising perceptions of risk can increase screening behaviors in individuals with colorectal cancer risk due to family history.

  15. Cardiovascular risk factors and incident albuminuria in screen-detected type 2 diabetes

    DEFF Research Database (Denmark)

    Webb, D R; Zaccardi, F; Davies, M J

    2016-01-01

    BACKGROUND: It is unclear whether cardiovascular risk factor modification influences the development of renal disease in people with type 2 diabetes identified through screening. We determined predictors of albuminuria five years after a diagnosis of screen-detected diabetes within the ADDITION-E...

  16. Risk of breast cancer after false-positive results in mammographic screening

    DEFF Research Database (Denmark)

    Roman, Marta; Castells, Xavier; Hofvind, Solveig

    2016-01-01

    Women with false-positive results are commonly referred back to routine screening. Questions remain regarding their long-term outcome of breast cancer. We assessed the risk of screen-detected breast cancer in women with false-positive results. We conducted a joint analysis using individual level ...

  17. Attitudes towards Lung Cancer Screening in an Australian High-Risk Population

    Directory of Open Access Journals (Sweden)

    Alexandra E. Flynn

    2013-01-01

    Full Text Available Objectives. To determine whether persons at high risk of lung cancer would participate in lung cancer screening test if available in Australia and to elicit general attitudes towards cancer screening and factors that might affect participation in a screening program. Methods. We developed a 20-item written questionnaire, based on two published telephone interview scripts, addressing attitudes towards cancer screening, perceived risk of lung cancer, and willingness to be screened for lung cancer and to undertake surgery if lung cancer were detected. The questionnaire was given to 102 current and former smokers attending the respiratory clinic and pulmonary rehabilitation programmes. Results. We gained 90 eligible responses (M:F, 69:21. Mean [SD] age was 63 [11] and smoking history was 32 [21] pack years. 95% of subjects would participate in a lung cancer screening test, and 91% of these would consider surgery if lung cancer was detected. 44% of subjects considered that they were at risk of lung cancer. This was lower in ex-smokers than in current smokers. Conclusions. There is high willingness for lung cancer screening and surgical treatment. There is underrecognition of risk among ex-smokers. This misperception could be a barrier to a successful screening or case-finding programme in Australia.

  18. Reaching Graduate Students at Risk for Suicidal Behavior through the Interactive Screening Program

    Science.gov (United States)

    Moffitt, Lauren B.; Garcia-Williams, Amanda; Berg, John P.; Calderon, Michelle E.; Haas, Ann P.; Kaslow, Nadine J.

    2014-01-01

    Suicidal behavior is a significant concern among graduate students. Because many suicidal graduate students do not access mental health services, programs to connect them to resources are essential. This article describes the Interactive Screening Program (ISP), an anonymous, Web-based tool for screening and engaging at-risk graduate school…

  19. The feasibility of screening for suicidal risk with the Hypomania Checklist and Mood Disorder Questionnaire

    Institute of Scientific and Technical Information of China (English)

    刘艳红

    2014-01-01

    Objective To evaluate the feasibility of screening for suicidal risk with the Hypomania Checklist(HCL-32)and Mood Disorder Questionnaire(MDQ)among patients of bipolar disorder or depression.Methods This was the re-analysis of data from Bipolar Screening Investigation Project.1 487 consecutive subjects with bipolar disorder or

  20. Comparative analysis of three screening instruments for autism spectrum disorder in toddlers at high risk.

    NARCIS (Netherlands)

    Oosterling, I.J.; Swinkels, S.H.N.; Gaag, R.J. van der; Visser, J.C.; Dietz, C.; Buitelaar, J.K.

    2009-01-01

    Several instruments have been developed to screen for autism spectrum disorders (ASD) in high-risk populations. However, few studies compare different instruments in one sample. Data were gathered from the Early Screening of Autistic Traits Questionnaire, Social Communication Questionnaire, Communic

  1. The development and validation of the Indigenous Risk Impact Screen (IRIS): a 13-item screening instrument for alcohol and drug and mental health risk.

    Science.gov (United States)

    Schlesinger, Carla M; Ober, Coralie; McCarthy, Molly M; Watson, Joanne D; Seinen, Anita

    2007-03-01

    The study aimed to assess the psychometric properties of the Indigenous Risk Impact Screen (IRIS) as a screening instrument for determining (i) the presence of alcohol and drug and mental health risk in Indigenous adult Australians and (ii) the cut-off scores that discriminate most effectively between the presence and absence of risk. A cross-sectional survey was used in clinical and non-clinical Indigenous and non-Indigenous services across Queensland Australia. A total of 175 Aboriginal and Torres Strait Islander people from urban, rural, regional and remote locations in Queensland took part in the study. Measures included the Indigenous Risk Impact Screen (IRIS), the Severity of Dependence Scale (SDS), the Alcohol Use Disorders Identification Test (AUDIT) and the Leeds Dependence Questionnaire (LDQ). Additional Mental Health measures included the Depression Anxiety and Stress Scale (DASS-21) and the Self-Report Questionnaire (SRQ). Principle axis factoring analysis of the IRIS revealed two factors corresponding with (i) alcohol and drug and (ii) mental health. The IRIS alcohol and drug and mental health subscales demonstrated good convergent validity with other well-established screening instruments and both subscales showed high internal consistency. A receiver operating characteristics (ROC) curve analysis was used to generate cut-offs for the two subscales and t-tests validated the utility of these cut-offs for determining risky levels of drinking. The study validated statistically the utility of the IRIS as a screen for alcohol and drug and mental health risk. The instrument is therefore recommended as a brief screening instrument for Aboriginal and Torres Strait Islander people.

  2. Validity of the malnutrition screening tool for older adults at high risk of hospital readmission.

    Science.gov (United States)

    Wu, Min-Lin; Courtney, Mary D; Shortridge-Baggett, Lillie M; Finlayson, Kathleen; Isenring, Elisabeth A

    2012-06-01

    Malnutrition is a serious problem in older adults, particularly for those at risk of hospital readmission. The essential step in managing malnutrition is early identification using a valid nutrition screening tool. The purpose of this study was to validate the Malnutrition Screening Tool (MST) in older adults at high risk of hospital readmission. Two RNs administered the MST to identify malnutrition risk and compared it with the comprehensive Subjective Global Assessment (SGA) to assess nutritional status for patients 65 and older who had at least one risk factor for hospital readmission. The MST demonstrates substantial sensitivity, specificity, and agreement with the SGA. These findings indicate that nursing staff can use the MST as a valid tool for routine screening and rescreening to identify patients at risk of malnutrition. Use of the MST may prevent hospital-acquired malnutrition in acute hospitalized older adults at high risk of readmission.

  3. Cost-benefit analysis of esophageal cancer endoscopic screening in high-risk areas of China

    Institute of Scientific and Technical Information of China (English)

    Juan Yang; Wen-Qiang Wei; Jin Niu; Zhi-Cai Liu; Chun-Xia Yang; You-Lin Qiao

    2012-01-01

    AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer (EC) in high-risk areas of China.METHODS:Markov model-based analyses were conducted to compare the net present values (NPVs) and the benefit-cost ratios (BCRs) of 12 EC endoscopic screening strategies.Strategies varied according to the targeted screening age,screening frequencies,and follow-up intervals.Model parameters were collected from population-based studies in China,published literatures,and surveillance data.RESULTS:Compared with non-screening outcomes,all strategies with hypothetical 100 000 subjects saved life years.Among five dominant strategies determined by the incremental cost-effectiveness analysis,screening once at age 50 years incurred the lowest NPV (international dollar-I$55 million) and BCR (2.52).Screening six times between 40-70 years at a 5-year interval [i.e.,six times(40)f-strategy] yielded the highest NPV (I$99 million) and BCR (3.06).Compared with six times(40)fstrategy,screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV,but the same BCR.CONCLUSION:EC endoscopic screening is cost-beneficial in high-risk areas of China.Policy-makers should consider the cost-benefit,population acceptance,and local economic status when choosing suitable screening strategies.

  4. Screening for Suicide Risk in Adolescents, Adults, and Older Adults in Primary Care

    Science.gov (United States)

    Understanding Task Force Recommendations Screening for Suicide Risk in Adolescents, Adults, and Older Adults in Primary Care The U.S. Preventive Services Task Force (Task Force) has issued a final ...

  5. Climate risk screening tools and their application: A guide to the guidance

    Energy Technology Data Exchange (ETDEWEB)

    Traerup, S.; Olhoff, A.

    2011-07-01

    Climate risk screening is an integral part of efforts to ascertain current and future vulnerabilities and risks related to climate change. It is a prerequisite for identifying and designing adaptation measures, and an important element in the process of integrating, or mainstreaming, climate change adaptation into development project, planning and policy processes. There is an increasing demand and attention among national stakeholders in developing countries to take into account potential implications of climate variability and change for planning and prioritizing of development strategies and activities. Subsequently, there is a need for user friendly guidance on climate risk screening tools and their potentials for application that targets developing country stakeholders. This need is amplified by the sheer volume of climate change mainstreaming guidance documents and risk screening and assessment tools available and currently under development. Against this background, this paper sets out to provide potential users in developing countries, including project and programme developers and managers, with an informational entry point to climate risk screening tools. The emphasis in this report is on providing: 1) An overview of available climate risk screening and assessment tools along with indications of the tools available and relevant for specific purposes and contexts (Section 3). 2) Examples of application of climate risk screening and assessment tools along with links to further information (Section 4). Before turning to the respective sections on available climate risk screening tools and examples of their application, a delimitation of the tools included in this paper is included in Section 2. This section also provides a brief overview of how climate screening and related tools fit into decision making steps at various planning and decision making levels in conjunction with an outline of overall considerations to make when choosing a tool. The paper is

  6. Type of hormone therapy and risk of misclassification at mammography screening

    DEFF Research Database (Denmark)

    Njor, Sisse H; Hallas, Jesper; Schwartz, Walter;

    2011-01-01

    Current users of hormone therapy (HT) are known to have a lower accuracy of mammography screening than do never users. We studied whether the risk of misclassification depends on type of hormone, administration, regimen, and dose of the therapy.......Current users of hormone therapy (HT) are known to have a lower accuracy of mammography screening than do never users. We studied whether the risk of misclassification depends on type of hormone, administration, regimen, and dose of the therapy....

  7. Evaluation of an inpatient fall risk screening tool to identify the most critical fall risk factors in inpatients.

    Science.gov (United States)

    Hou, Wen-Hsuan; Kang, Chun-Mei; Ho, Mu-Hsing; Kuo, Jessie Ming-Chuan; Chen, Hsiao-Lien; Chang, Wen-Yin

    2017-03-01

    To evaluate the accuracy of the inpatient fall risk screening tool and to identify the most critical fall risk factors in inpatients. Variations exist in several screening tools applied in acute care hospitals for examining risk factors for falls and identifying high-risk inpatients. Secondary data analysis. A subset of inpatient data for the period from June 2011-June 2014 was extracted from the nursing information system and adverse event reporting system of an 818-bed teaching medical centre in Taipei. Data were analysed using descriptive statistics, receiver operating characteristic curve analysis and logistic regression analysis. During the study period, 205 fallers and 37,232 nonfallers were identified. The results revealed that the inpatient fall risk screening tool (cut-off point of ≥3) had a low sensitivity level (60%), satisfactory specificity (87%), a positive predictive value of 2·0% and a negative predictive value of 99%. The receiver operating characteristic curve analysis revealed an area under the curve of 0·805 (sensitivity, 71·8%; specificity, 78%). To increase the sensitivity values, the Youden index suggests at least 1·5 points to be the most suitable cut-off point for the inpatient fall risk screening tool. Multivariate logistic regression analysis revealed a considerably increased fall risk in patients with impaired balance and impaired elimination. The fall risk factor was also significantly associated with days of hospital stay and with admission to surgical wards. The findings can raise awareness about the two most critical risk factors for falls among future clinical nurses and other healthcare professionals and thus facilitate the development of fall prevention interventions. This study highlights the needs for redefining the cut-off points of the inpatient fall risk screening tool to effectively identify inpatients at a high risk of falls. Furthermore, inpatients with impaired balance and impaired elimination should be closely

  8. Risk of upper extremity biomechanical overload in automotive facility.

    Science.gov (United States)

    Sancini, Angela; Capozzella, Assunta; Caciar, Tiziana; Tomei, Francesco; Nardone, Nadia; Scala, Barbara; Fiaschetti, Maria; Cetica, Carlotta; Scimitto, Lara; Gioffrrè, PierAgostino; Sinibaldi, Federica; Di Pastena, Claudia; Corbosiero, Paola; Schifano, Maria Pia; Tomei, Gianfranco; Ciarrocca, Manuela

    2013-01-01

    To assess the risk factors for upper extremity-work-related musculoskeletal disorders (UE-WMSD) on 13 production lines in an airbag factory using the threshold limit values-American conference of industrial hygienists- hand activity level (TLV-ACGIH-HAL) method and introduce the ergonomic improvement to reduce the repetitiveness and the peak force (Pf). Professional exposure level on 13 production lines in a automobile factory was measured using the TLV-ACGIH-HAL method and a further risk was assessed according to the ergonomic improvement. The first assessment of 9 production lines showed that the professional exposure level was above the TLV or HAL limit. The second assessment showed that the professional exposure level was below the AL limit on all production lines except 1, in which the professional exposure level was between TLV and HAL. The assessment of UE-WMSD-related risk can identify the riskiest emplacements and evaluate the reduction of risk in professional exposure through interventions of structural- organizational type. Copyright © 2013 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  9. Sequential screening for psychosocial and behavioural risk during pregnancy in a population of urban African Americans.

    Science.gov (United States)

    Kiely, M; Gantz, M G; El-Khorazaty, M N; El-Mohandes, A A E

    2013-10-01

    Screening for psychosocial and behavioural risks, such as depression, intimate partner violence, and smoking, during pregnancy is considered to be state of the art in prenatal care. This prospective longitudinal analysis examines the added benefit of repeated screening, compared with a single screening, in identifying such risks during pregnancy. Data were collected as part of a randomised controlled trial to address intimate partner violence, depression, smoking, and environmental tobacco smoke exposure in African American women. Prenatal care sites in the District of Columbia serving mainly women of minority background. A cohort of 1044 African American pregnant women in the District of Columbia. Mothers were classified by their initial response (acknowledgement of risks), and these data were updated during pregnancy. Risks were considered new if they were not previously reported. Standard hypothesis tests and logistic regression were used to predict the acknowledgment of any new risk(s) during pregnancy. New risks: psychosocial variables to understand what factors might help identify the acknowledgement of additional risk(s). Repeated screening identified more mothers acknowledging risk over time. Reported smoking increased by 11%, environmental tobacco smoke exposure increased by 19%, intimate partner violence increased by 9%, and depression increased by 20%. The psychosocial variables collected at the baseline that were entered into the logistic regression model included relationship status, education, Medicaid, illicit drug use, and alcohol use during pregnancy. Among these, only education less than high school was associated with the acknowledgement of new risk in the bivariate analyses, and significantly predicted the identification of new risks (OR 1.39, 95% CI 1.01-1.90). It is difficult to predict early on who will acknowledge new risks over the course of pregnancy, and thus all women should be screened repeatedly to allow for the identification of risks

  10. Mass or high-risk screening for abdominal aortic aneurysm

    DEFF Research Database (Denmark)

    Lindholt, Jes Sanddal; Henneberg, E W; Fasting, H

    1997-01-01

    Abdominal aortic aneurysm (AAA) is known to be associated with various diseases, especially hypertension, acute myocardial infarction (AMI), chronic obstructive airway disease (COAD), and intermittent claudication. These associations have led to a debate about whether screening of older men for AAA...

  11. Mass or high-risk screening for abdominal aortic aneurysm

    DEFF Research Database (Denmark)

    Lindholt, Jes Sanddal; Henneberg, E W; Fasting, H

    1997-01-01

    Abdominal aortic aneurysm (AAA) is known to be associated with various diseases, especially hypertension, acute myocardial infarction (AMI), chronic obstructive airway disease (COAD), and intermittent claudication. These associations have led to a debate about whether screening of older men for AAA...

  12. Geographic access to family planning facilities and the risk of unintended and teenage pregnancy.

    Science.gov (United States)

    Goodman, David C; Klerman, Lorraine V; Johnson, Kay A; Chang, Chiang-Hua; Marth, Nancy

    2007-03-01

    This study tested the hypotheses that greater geographic access to family planning facilities is associated with lower rates of unintended and teenage pregnancies. State Pregnancy Risk Assessment Monitoring System (PRAMS) and natality files in four states were used to locate unintended and teenage births, respectively. Geographic availability was measured by cohort travel time to the nearest family planning facility, the presence of a family planning facility in a ZIP area, and the supply of primary care physicians and obstetric-gynecologists. 83% of the PRAMS cohort and 80% of teenagers lived within 15 min or less of a facility and virtually none lived more than 30 min. Adjusted odds ratios did not demonstrate a statistically significant trend to a higher risk of unintended pregnancies with longer travel time. Similarly there was no association with unintended pregnancy and the presence of a family planning facility within the ZIP area of maternal residence, or with the supply of physicians capable of providing family planning services. Both crude and adjusted relative rates of teenage pregnancies were significantly lower with further distance from family planning sites and with the absence of a facility in the ZIP area of residence. In adjusted models, the supply of obstetricians-gynecologists and primary care physicians was not significantly associated with decreased teen pregnancies. This study found no relationship between greater geographic availability of family planning facilities and a risk of unintended pregnancies. Greater geographic availability of family planning services was associated with a higher risk of teenage pregnancy, although these results may be confounded by facilities locating in areas with greater family planning needs.

  13. Patients' Experiences of Nurse-Led Screening for Cardiovascular Risk in Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Frølund, Jannie Christina; Primdahl, Jette

    2015-01-01

    are screened for CVD. Such information is important in order to organize and further develop screening programmes for CVD in patients with RA. The aim of the present study was to explore RA patients' experiences of participation in nurse-led screening for CVD and to identify key issues for the future......BACKGROUND: Patients with rheumatoid arthritis (RA) have increased morbidity and mortality due to cardiovascular disease (CVD). Screening for cardiovascular risk is recommended by the European League Against Rheumatism (EULAR). There is a lack of evidence of the experiences of RA patients who...... organization of screening programmes. METHODS: Three qualitative focus group interviews were carried out with 14 outpatients diagnosed with RA. The participants were stratified into groups, depending on whether they had a low-to-moderate or high ten-year risk of cardiovascular death according to the European...

  14. A comparative study of worker and general public risks from nuclear facility operation using MACCS2

    Energy Technology Data Exchange (ETDEWEB)

    East, J.M.; O`Kula, K.R.

    1994-10-01

    Over the last five years, the US Department of Energy (DOE) has attempted to establish quantitative risk indices as minimum acceptance criteria for assurance of safe operation of its nuclear facilities. The risk indices serve as aiming points or targets to include consideration of all aspects of operation including normal conditions as well as abnormal, design basis events, and beyond-design basis events. Although initial focus of the application of these safety targets had been on DOE`s reactors, more recent assessments have also considered non-reactor facilities including those encompassing storage and nuclear processing activities. Regardless of the facility`s primary function, accident progression, event tree/fault tree logic models, and probabilistic (dose) consequence assessment model must be implemented to yield a fully integrated analysis of facility operation. The primary tool for probabilistic consequence assessment in the US is the MELCOR Accident Consequence Code System (MACCS). In this study, two version of MACCS are applied to representative source terms developed in the safety analysis associated with a waste processing facility at the Westinghouse Savannah River Company`s (WSRC`s) Savannah River Site (SRS). The MACCS versions are used to estimate population dose and subsequent health effects to workers and the general public from the SRS referenced facility operation. When combined with the frequency of occurrence evaluation, the margin of compliance with the safety targets may be quantified.

  15. DVT prophylaxis after TKA: routine anticoagulation vs risk screening approach - a randomized study.

    Science.gov (United States)

    Kulshrestha, Vikas; Kumar, Santhosh

    2013-12-01

    The American College of Chest Physicians (ACCP) recommended routine anticoagulation for thromboprophylaxis in patients undergoing lower limb arthroplasty. We compared results of routine anticoagulation Vs risk stratified approach for Deep Venous Thrombosis (DVT) prophylaxis after TKA in terms of symptomatic DVT and wound complications. Nine hundred TKAs done in 673 patients were randomized after DVT risk screening to routine anticoagulation (n = 450) or to risk stratification (n = 450) and selective anticoagulation. 194 patients in the risk screening group received only Aspirin. Primary outcome was symptomatic DVT and wound complication. This randomized study showed that the symptomatic DVT rates after TKA were similar whether patients were routinely anticoagulated or selectively anticoagulated after risk screening. However there was a significantly higher incidence of wound complications (P < 0.014) after routine anticoagulation.

  16. Results of the Randomized Danish Lung Cancer Screening Trial with Focus on High-Risk Profiling.

    Science.gov (United States)

    Wille, Mathilde M W; Dirksen, Asger; Ashraf, Haseem; Saghir, Zaigham; Bach, Karen S; Brodersen, John; Clementsen, Paul F; Hansen, Hanne; Larsen, Klaus R; Mortensen, Jann; Rasmussen, Jakob F; Seersholm, Niels; Skov, Birgit G; Thomsen, Laura H; Tønnesen, Philip; Pedersen, Jesper H

    2016-03-01

    As of April 2015, participants in the Danish Lung Cancer Screening Trial had been followed for at least 5 years since their last screening. Mortality, causes of death, and lung cancer findings are reported to explore the effect of computed tomography (CT) screening. A total of 4,104 participants aged 50-70 years at the time of inclusion and with a minimum 20 pack-years of smoking were randomized to have five annual low-dose CT scans (study group) or no screening (control group). Follow-up information regarding date and cause of death, lung cancer diagnosis, cancer stage, and histology was obtained from national registries. No differences between the two groups in lung cancer mortality (hazard ratio, 1.03; 95% confidence interval, 0.66-1.6; P = 0.888) or all-cause mortality (hazard ratio, 1.02; 95% confidence interval, 0.82-1.27; P = 0.867) were observed. More cancers were found in the screening group than in the no-screening group (100 vs. 53, respectively; P risk of death due to lung cancer, with nonsignificantly fewer deaths in the screening group. No statistically significant effects of CT screening on lung cancer mortality were found, but the results of post hoc high-risk subgroup analyses showed nonsignificant trends that seem to be in good agreement with the results of the National Lung Screening Trial. Clinical trial registered with www.clinicaltrials.gov (NCT00496977).

  17. A model for patient-direct screening and referral for familial cancer risk.

    Science.gov (United States)

    Niendorf, Kristin B; Geller, Melissa A; Vogel, Rachel Isaksson; Church, Timothy R; Leininger, Anna; Bakke, Angela; Madoff, Robert D

    2016-10-01

    Patients at increased familial risk of cancer are sub-optimally identified and referred for genetic counseling. We describe a systematic model for information collection, screening and referral for hereditary cancer risk. Individuals from three different clinical and research populations were screened for hereditary cancer risk using a two-tier process: a 7-item screener followed by review of family history by a genetic counselor and application of published criteria. A total of 869 subjects participated in the study; 769 in this high risk population had increased familial cancer risk based on the screening questionnaire. Of these eligible participants, 500 (65.0 %) provided family histories and 332 (66.4 %) of these were found to be at high risk of a hereditary cancer syndrome, 102 (20.4 %) at moderate familial cancer risk, and 66 (13.2 %) at average risk. Three months following receipt of the risk result letter, nearly all respondents found the process at least somewhat helpful (98.4 %). All participants identified as high-risk were mailed a letter recommending genetic counseling and were provided appointment tools. After 1 year, only 13 (7.3 %) of 179 high risk respondents reported pursuit of recommended genetic counseling. Participants were willing to provide family history information for the purposes of risk assessment; however, few patients pursued recommended genetic services. This suggests that cancer family history registries are feasible and viable but that further research is needed to increase the uptake of genetic counseling.

  18. Identifying Relationships between High-Risk Sexual Behaviors and Screening Positive for Chlamydia and Gonorrhea in School-Wide Screening Events

    Science.gov (United States)

    Salerno, Jennifer; Darling-Fisher, Cindy; Hawkins, Nicole M.; Fraker, Elizabeth

    2013-01-01

    Background: This article describes a school-wide sexually transmitted infection (STI) screening to identify adolescent high-risk sexual behaviors, STI history/incidence, and presence of chlamydia and gonorrhea, and examines relationships between high-risk behaviors and screening positive for chlamydia and gonorrhea in an alternative high school…

  19. Teenage cervical screening in a high risk American population

    OpenAIRE

    Songlin Zhang; Jaiyeola Thomas; Joel Thibodeaux; Ami Bhalodia; Fleurette Abreo

    2011-01-01

    Background: The new 2009 ACOG guideline for cervical cytology screening changed the starting age to 21 years regardless of the age of onset of sexual intercourse. However, many recent studies have shown a dramatic increase in the incidence of cervical epithelial abnormalities among adolescents within the past two decades. Materials and Methods: For this study, the reports of 156,342 cervical cytology were available of which 12,226 (7.8%) were from teenagers. A total of 192 teenagers with high...

  20. [Screening for breast cancer on basis of individual risk assessment for women ineligible for the national population screening program].

    Science.gov (United States)

    van Asperen, C J; de Bock, G H; van der Horst, F; de Koning, H J; Rutgers, E J

    2001-01-20

    For healthy women, without malignancies in their personal histories, a positive family history for breast cancer is the single indication for individual breast surveillance outside the population screening. Management of women is based on individual risk assessment. A cumulative risk of 20% and more, as a result of a positive family history, will in practice be an indication for breast surveillance. This threshold is not evidence-based yet, nor are data available on the benefits of this surveillance efficacy. When a personal cumulative risk of more than 30% exists to develop breast cancer, a consultation with a clinical geneticist involved in a family cancer clinic should be offered. Surveillance of women with a high-risk cumulative risk should preferably be included in a prospective study design. Only in this way will data about compliance and the estimates of different ways of surveillance become available. There is no convincing evidence that population screening for women aged 40-49 years does lead to important mortality reduction in combination with a good balance between pros and cons for the women involved. Women in the age category 50-75 years, with breast cancer in their personal histories, who are not followed anymore, should be informed by their specialist about participating (again) in the population breast screening. There is no evidence of mortality reduction as a result of breast self-examination nor of palpation performed by a physician. However, awareness of the own body can be useful for early recognition of breast abnormalities; it may reduce the delay between the first recognizable symptom and the subsequently initiated therapy.

  1. Correlations between risk factors for hearing impairment and TEOAE screening test outcome in neonates at risk for hearing loss.

    Science.gov (United States)

    Ratyńska, J; Grzanka, A; Mueller-Malesińska, M; Skarzyński, H; Hatzopoulos, S

    2001-01-01

    The aim of the study was to find the correlation between specific risk factors for hearing impairment as well as between risk factors and TEOAE screening results in neonates at risk for hearing impairment. Seventy-one newborns at risk for hearing impairment have been included in the study. Strong correlations between specific risk factors were found. Investigation of the relationship between specific risk factors and TEOAE signal-to-noise ratio (SNR) showed that in children with genetic risk factors, TORCH (toxoplasmosis, rubella, CMV, herpes virus, others) infections and in those treated with ototoxic drugs, the values of SNRs were significantly lower than in children at risk who did not present those factors. In case of hyperbilirubinaemic children the values of SNR were significantly higher than in the controls. In our opinion these relationships may be partially explained by the positive predictive values of these risk factors, but other intrinsic factors may also be involved.

  2. Screening for coronary heart disease risk factors in retail pharmacies in Sheffield, 1992.

    Science.gov (United States)

    Allison, C; Page, H; George, S

    1994-01-01

    OBJECTIVE--To investigate the current and likely future provision of screening services for risk factors for coronary heart disease in retail pharmacies in Sheffield. DESIGN--This was a questionnaire survey asking about screening tests currently offered, price charged per test, likely future provision of screening tests, the action respondents would take upon finding an abnormal test result, whether the pharmacy was owner-run, franchised, or part of a commercial chain, and inviting open comments from respondents. SETTING--All retail pharmacy premises on the Sheffield Family Health Services Authority list. RESULTS--Seventy seven responses were obtained to 102 questionnaires distributed. Only nine of these currently offered any screening test other than pregnancy testing, although 37 indicated that they might offer tests in the future. Thirty nine were not offering screening and had no plans to do so. Pharmacies offering or likely to offer screening tests were mainly owner-run. All pharmacists who replied to the question asking about their action upon finding abnormal result (33) reported that they would advise the patient to see a doctor. The most frequent comments made by pharmacists were about the commercial viability of screening in pharmacies and the lack of space available to ensure patient privacy and confidentiality during screening. CONCLUSIONS--Screening in retail pharmacies would probably be a commercial failure unless doctors were able to contract for screening services from pharmacies. Evidence from this study and others, however, leads us to question the desirability of this option. PMID:8189175

  3. The effectiveness of screening for diabetes and cardiovascular disease risk factors in a community pharmacy setting.

    Science.gov (United States)

    Willis, Andrew; Rivers, Peter; Gray, Laura J; Davies, Melanie; Khunti, Kamlesh

    2014-01-01

    Risk factors for cardiovascular disease including diabetes have seen a large rise in prevalence in recent years. This has prompted interest in prevention through the identifying individuals at risk of both diabetes and cardiovascular disease and has seen increased investment in screening interventions taking place in primary care. Community pharmacies have become increasingly involved in the provision of such interventions and this systematic review and meta-analysis aims to gather and analyse the existing literature assessing community pharmacy based screening for risk factors for diabetes and those with a high cardiovascular disease risk. We conducted systematic searches of electronic databases using MeSH and free text terms from 1950 to March 2012. For our analysis two outcomes were assessed. They were the percentage of those screened who were referred for further assessment by primary care and the uptake of this referral. Sixteen studies fulfilled our inclusion criteria comprising 108,414 participants screened. There was significant heterogeneity for all included outcomes. Consequently we have not presented summary statistics and present forest plots with I2 and p values to describe heterogeneity. We found that all included studies suffered from high rates of attrition between pharmacy screening and follow up. We have also identified a strong trend towards higher rates for referral in more recent studies. Our results show that pharmacies are feasible sites for screening for diabetes and those at risk of cardiovascular disease. A significant number of previously unknown cases of cardiovascular disease risk factors such as hypertension, hypercholesterolemia and diabetes are identified, however a significant number of referred participants at high risk do not attend their practitioner for follow up. Research priorities should include methods of increasing uptake to follow up testing and early intervention, to maximise the efficacy of screening interventions based

  4. The effectiveness of screening for diabetes and cardiovascular disease risk factors in a community pharmacy setting.

    Directory of Open Access Journals (Sweden)

    Andrew Willis

    Full Text Available Risk factors for cardiovascular disease including diabetes have seen a large rise in prevalence in recent years. This has prompted interest in prevention through the identifying individuals at risk of both diabetes and cardiovascular disease and has seen increased investment in screening interventions taking place in primary care. Community pharmacies have become increasingly involved in the provision of such interventions and this systematic review and meta-analysis aims to gather and analyse the existing literature assessing community pharmacy based screening for risk factors for diabetes and those with a high cardiovascular disease risk.We conducted systematic searches of electronic databases using MeSH and free text terms from 1950 to March 2012. For our analysis two outcomes were assessed. They were the percentage of those screened who were referred for further assessment by primary care and the uptake of this referral.Sixteen studies fulfilled our inclusion criteria comprising 108,414 participants screened. There was significant heterogeneity for all included outcomes. Consequently we have not presented summary statistics and present forest plots with I2 and p values to describe heterogeneity. We found that all included studies suffered from high rates of attrition between pharmacy screening and follow up. We have also identified a strong trend towards higher rates for referral in more recent studies.Our results show that pharmacies are feasible sites for screening for diabetes and those at risk of cardiovascular disease. A significant number of previously unknown cases of cardiovascular disease risk factors such as hypertension, hypercholesterolemia and diabetes are identified, however a significant number of referred participants at high risk do not attend their practitioner for follow up. Research priorities should include methods of increasing uptake to follow up testing and early intervention, to maximise the efficacy of screening

  5. Noninvasive Screening for Risk Factors of Type 2 Diabetes in Young, Rural, Caucasian Children

    Science.gov (United States)

    Peterson, Sharon; Sheffer, Sarah; Long Roth, Sara; Bennett, Paul A.; Lloyd, Les

    2010-01-01

    School nurses play an important role in identifying students who are at risk for Type 2 diabetes mellitus (T2DM). Few studies have screened Caucasian students, and none have targeted rural, low-income, elementary children. The five noninvasive risk factors used for this study were family history, high body mass index (BMI) for age/sex,…

  6. Awareness of endometrial cancer risk and compliance with screening in hereditary nonpolyposis colorectal cancer

    DEFF Research Database (Denmark)

    Ketabi, Zohreh; Mosgaard, Berit J; Gerdes, Anne-Marie;

    2012-01-01

    Women with hereditary nonpolyposis colorectal cancer (HNPCC) have a 40-60% lifetime risk for endometrial cancer. Guidelines in Denmark recommend gynecologic screening for female members of families with HNPCC. We estimated the knowledge of endometrial cancer risk and identified possible predictor...

  7. Urinary tract cancer and hereditary nonpolyposis colorectal cancer : Risks and screening options

    NARCIS (Netherlands)

    Sijmons, RH; Kiemeney, LALM; Witjes, JA; Vasen, HFA

    Purpose: We investigate the risk of the different types of urinary tract cancer in hereditary nonpolyposis colorectal cancer families and review screening options. Materials and Methods: We retrospectively calculated the relative and cumulative risks of developing urinary tract cancer by comparing

  8. Imaging the risks - risking the image: Social impact assessment of the final disposal facility

    Energy Technology Data Exchange (ETDEWEB)

    Avolahti, J.; Vira, J. [Posiva Oy, Helsinki (Finland)

    1999-12-01

    Preparations for the final disposal of spent nuclear fuel in Finland started about twenty years ago. At present the work is carried out by Posiva Oy, which in 1996 took over the programme managed earlier by Teollisuuden Voima Oy, one of the country's nuclear power companies. From 1996 on the preparations have been made for all the spent fuel from Finnish nuclear power stations. The site for the final disposal facility will be selected among four alternatives by the end of 2000 and - assuming that the technical approach proposed by Posiva is accepted by the Government and the Parliament - the construction of the repository will start in the 2010s. The disposal operations are planned to be started in 2020. The alternative four sites have gone through a systematic site selection process based on geologic siting criteria and on environmental and cultural considerations. One of the objectives of the process was to avoid inhabited areas, agricultural fields, valuable groundwater or preservation areas as well as areas which might draw interest as regards the potential for ore deposits. The idea was that the field investigations and later the possible disposal facility should not cause any harm to local people. Two of the candidate sites are at present nuclear power plant sites situated at the coast, the two other candidates are inland sites with no nuclear activities. The geologic siting investigations were started in 1987. Interim assessments of the results so far have been made in 1992 and 1996 and a final report of all the investigations will be published before the end of 2000. The present view is that all four candidates are geologically suitable for siting the repository. Posiva's EIA for the final disposal of spent fuel in Finland is nearing completion. A considerable effort was made to involve local groups and individuals in the assessment process. Yet the participation remained limited and consisted mainly of active opponents of the project and of those

  9. Colorectal cancer screening for average-risk North Americans: an economic evaluation.

    Directory of Open Access Journals (Sweden)

    Steven J Heitman

    Full Text Available BACKGROUND: Colorectal cancer (CRC fulfills the World Health Organization criteria for mass screening, but screening uptake is low in most countries. CRC screening is resource intensive, and it is unclear if an optimal strategy exists. The objective of this study was to perform an economic evaluation of CRC screening in average risk North American individuals considering all relevant screening modalities and current CRC treatment costs. METHODS AND FINDINGS: An incremental cost-utility analysis using a Markov model was performed comparing guaiac-based fecal occult blood test (FOBT or fecal immunochemical test (FIT annually, fecal DNA every 3 years, flexible sigmoidoscopy or computed tomographic colonography every 5 years, and colonoscopy every 10 years. All strategies were also compared to a no screening natural history arm. Given that different FIT assays and collection methods have been previously tested, three distinct FIT testing strategies were considered, on the basis of studies that have reported "low," "mid," and "high" test performance characteristics for detecting adenomas and CRC. Adenoma and CRC prevalence rates were based on a recent systematic review whereas screening adherence, test performance, and CRC treatment costs were based on publicly available data. The outcome measures included lifetime costs, number of cancers, cancer-related deaths, quality-adjusted life-years gained, and incremental cost-utility ratios. Sensitivity and scenario analyses were performed. Annual FIT, assuming mid-range testing characteristics, was more effective and less costly compared to all strategies (including no screening except FIT-high. Among the lifetimes of 100,000 average-risk patients, the number of cancers could be reduced from 4,857 to 1,393 [corrected] and the number of CRC deaths from 1,782 [corrected] to 457, while saving CAN$68 per person. Although screening patients with FIT became more expensive than a strategy of no screening when the

  10. A nutritional risk screening model for patients with liver cirrhosis established using discriminant analysis

    Directory of Open Access Journals (Sweden)

    ZHU Binghua

    2017-06-01

    Full Text Available ObjectiveTo establish a nutritional risk screening model for patients with liver cirrhosis using discriminant analysis. MethodsThe clinical data of 273 patients with liver cirrhosis who were admitted to Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from August 2015 to March 2016 were collected. Body height, body weight, upper arm circumference, triceps skinfold thickness, subscapular skinfold thickness, and hand grip strength were measured and recorded, and then body mass index (BMI and upper arm muscle circumference were calculated. Laboratory markers including liver function parameters, renal function parameters, and vitamins were measured. The patients were asked to complete Nutritional Risk Screening 2002 and Malnutrition Universal Screening Tool (MUST, and a self-developed nutritional risk screening pathway was used for nutritional risk classification. Observation scales of the four diagnostic methods in traditional Chinese medicine were used to collect patients′ symptoms and signs. Continuous data were expressed as mean±SD (x±s; an analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. Discriminant analysis was used for model establishment, and cross validation was used for model verification. ResultsThe nutritional risk screening pathway for patients with liver cirrhosis was used for the screening of respondents, and there were 49 patients (17.95% in non-risk group, 49 (17.95% in possible-risk group, and 175 (64.10% in risk group. The distance criterion function was used to establish the nutritional risk screening model for patients with liver cirrhosis: D1=-11.885+0.310×BMI+0150×MAC+0.005×P-Alb-0.001×Vit B12+0.103×Vit D-0.89×ascites-0.404×weakness-0.560×hypochondriac pain+0035×dysphoria with feverish sensation (note: if a patient has ascites, weakness, hypochondriac pain

  11. Hearing screenings on children under three years at risk of hearing impairment.

    Directory of Open Access Journals (Sweden)

    Marcelino Lizano Rabelo

    2011-09-01

    Full Text Available This article presents the results of newborn hearing screenings on infants under three years at risk of hearing impairment at Paediatric Hospital of Sancti Spíritus¸on from 2008 to 2010. All children at risk of hearing impairment were tested by an auditory brainstem response (ABR for the positive diagnosis of hearing impairment. Results: Over the period, 398 infants were screened, among whom 36 (8,98% were diagnosed as deaf or hard of hearing. twenty seven children (6,8% had a sensorineural hearing impairment, The most important risk factors for sensorineural hearing loss were: severe birth asphyxia; mechanic ventilation, and antibiotics.Conclusion: Our hearing screening on infants at risk allowed 36 children diagnosed as hearing impairment, all of then received early management.

  12. Evaluation of coronary artery calcium screening strategies focused on risk categories: the Dallas Heart Study.

    Science.gov (United States)

    Patel, Mahesh J; de Lemos, James A; McGuire, Darren K; See, Raphael; Lindsey, Jason B; Murphy, Sabina A; Grundy, Scott M; Khera, Amit

    2009-06-01

    A strategy using coronary artery calcium (CAC) screening to refine coronary heart disease risk assessment in moderately high risk (MHR) subjects (10-year risk 10%-20%) has been suggested. The potential impact of this strategy is unknown. Coronary artery calcium screening strategies focused on MHR subjects were modeled in 2,610 subjects aged 30 to 65 years undergoing Framingham risk scoring and CAC assessment in the Dallas Heart Study. The proportions of subjects eligible for imaging and reclassified from MHR to high risk (HR) (10-year risk >20%) based upon CAC scores were determined. Only 1.0% of women and 15.4% of men were at MHR by Framingham risk scoring and thus eligible for imaging, and MHR to HR using a CAC threshold > or = 400. Coronary artery calcium imaging targeting MHR subjects was also relatively inefficient (>100 women, 14.3 men scanned per subject reclassified). Restricting to an older age range (45-65 years) or expanding the MHR group to 6% to 20% risk had virtually no impact on risk assessment in women. In a secondary analysis, a proposed imaging strategy targeting promotion of subjects from lower risk to MHR was more efficient and had greater yield than current recommendations targeting promotion from MHR to HR. Coronary artery calcium screening strategies focused on MHR subjects will have a negligible impact on risk assessment in women and a modest impact in men. Further studies are needed to optimize the use of CAC screening as an adjunct to coronary heart disease risk assessment, especially for women and those at seemingly lower risk.

  13. Malnutrition risk in hospitalized children: use of 3 screening tools in a large European population.

    Science.gov (United States)

    Chourdakis, Michael; Hecht, Christina; Gerasimidis, Konstantinos; Joosten, Koen Fm; Karagiozoglou-Lampoudi, Thomais; Koetse, Harma A; Ksiazyk, Janusz; Lazea, Cecilia; Shamir, Raanan; Szajewska, Hania; Koletzko, Berthold; Hulst, Jessie M

    2016-05-01

    Several malnutrition screening tools have been advocated for use in pediatric inpatients. We evaluated how 3 popular pediatric nutrition screening tools [i.e., the Pediatric Yorkhill Malnutrition Score (PYMS), the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and the Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONGKIDS)] compared with and were related to anthropometric measures, body composition, and clinical variables in patients who were admitted to tertiary hospitals across Europe. The 3 screening tools were applied in 2567 inpatients at 14 hospitals across 12 European countries. The classification of patients into different nutritional risk groups was compared between tools and related to anthropometric measures and clinical variables [e.g., length of hospital stay (LOS) and infection rates]. A similar rate of completion of the screening tools for each tool was achieved (PYMS: 86%; STAMP: 84%; and STRONGKIDS: 81%). Risk classification differed markedly by tool, with an overall agreement of 41% between tools. Children categorized as high risk (PYMS: 25%; STAMP: 23%; and STRONGKIDS: 10%) had a longer LOS than that of children at low risk (1.4, 1.4, and 1.8 d longer, respectively; P malnutrition risk varied across the pediatric tools used. A considerable portion of children with subnormal anthropometric measures were not identified with all of the tools. The data obtained do not allow recommending the use of any of these screening tools for clinical practice. This study was registered at clinicaltrials.gov as NCT01132742. © 2016 American Society for Nutrition.

  14. Guidance Manual for Conducting Screening Level Ecological Risk Assessments at the INEL

    Energy Technology Data Exchange (ETDEWEB)

    R. L. VanHorn; N. L. Hampton; R. C. Morris

    1995-06-01

    This document presents reference material for conducting screening level ecological risk assessments (SLERAs)for the waste area groups (WAGs) at the Idaho National Engineering Laboratory. Included in this document are discussions of the objectives of and processes for conducting SLERAs. The Environmental Protection Agency ecological risk assessment framework is closely followed. Guidance for site characterization, stressor characterization, ecological effects, pathways of contaminant migration, the conceptual site model, assessment endpoints, measurement endpoints, analysis guidance, and risk characterization are included.

  15. Acid mine drainage risks - A modeling approach to siting mine facilities in Northern Minnesota USA

    Science.gov (United States)

    Myers, Tom

    2016-02-01

    Most watershed-scale planning for mine-caused contamination concerns remediation of past problems while future planning relies heavily on engineering controls. As an alternative, a watershed scale groundwater fate and transport model for the Rainy Headwaters, a northeastern Minnesota watershed, has been developed to examine the risks of leaks or spills to a pristine downstream watershed. The model shows that the risk depends on the location and whether the source of the leak is on the surface or from deeper underground facilities. Underground sources cause loads that last longer but arrive at rivers after a longer travel time and have lower concentrations due to dilution and attenuation. Surface contaminant sources could cause much more short-term damage to the resource. Because groundwater dominates baseflow, mine contaminant seepage would cause the most damage during low flow periods. Groundwater flow and transport modeling is a useful tool for decreasing the risk to downgradient sources by aiding in the placement of mine facilities. Although mines are located based on the minerals, advance planning and analysis could avoid siting mine facilities where failure or leaks would cause too much natural resource damage. Watershed scale transport modeling could help locate the facilities or decide in advance that the mine should not be constructed due to the risk to downstream resources.

  16. Hospital readmission from post-acute care facilities: risk factors, timing, and outcomes

    Science.gov (United States)

    Burke, Robert E.; Whitfield, Emily A.; Hittle, David; Min, Sung-joon; Levy, Cari; Prochazka, Allan V.; Coleman, Eric A.; Schwartz, Robert; Ginde, Adit A.

    2016-01-01

    Objectives Hospital discharges to post-acute care (PAC) facilities have increased rapidly. This increase may lead to more hospital readmissions from PAC facilities, which are common and poorly understood. We sought to determine the risk factors and timing for hospital readmission from PAC facilities and evaluate the impact of readmission on patient outcomes. Design Retrospective analysis of Medicare Current Beneficiary Survey (MCBS) from 2003–2009. Setting The MCBS is a nationally-representative survey of beneficiaries matched with claims data. Participants Community-dwelling beneficiaries who were hospitalized and discharged to a PAC facility for rehabilitation. Intervention/Exposure Potential readmission risk factors included patient demographics, health utilization, active medical conditions at time of PAC admission, and PAC characteristics. Measurements Hospital readmission during the PAC stay, return to community residence, and all-cause mortality. Results Of 3246 acute hospitalizations followed by PAC facility stays, 739 (22.8%) included at least 1 hospital readmission. The strongest risk factors for readmission included impaired functional status (HR 4.78, 95% CI 3.21–7.10), markers of increased acuity such as need for intravenous medications in PAC (1.63, 1.39–1.92), and for-profit PAC ownership (1.43, 1.21–1.69). Readmitted patients had a higher mortality rate at both 30 days (18.9 vs. 8.6%, p<0.001) and 100 days (39.9 vs. 14.5%, p<0.001) even after adjusting for age, comorbidities, and prior health care utilization (30 days: OR 2.01, 95% CI 1.60–2.54; 100 days: OR 3.79, 95% CI 3.13–4.59). Conclusions Hospital readmission from PAC facilities is common and associated with a high mortality rate. Readmission risk factors may signify inadequate transitional care processes or a mismatch between patient needs and PAC resources. PMID:26715357

  17. Does a risk questionnaire add anything to a colorectal screening project? Report of a 3-year screening experience.

    Science.gov (United States)

    Niv, Y

    1992-07-01

    A questionnaire to detect persons at high risk for colorectal cancer was used in conjunction with fecal occult blood tests in a 3-year screening program in Northern Israel. Screening was offered to 2,590 persons over 40 years of age and accepted by 1,797 (compliance of 69.4%). In the subsequent 2 years, occult blood testing (Hemoccult II) was offered to those who had had negative tests (compliance rate of 99.6% and 100%). Six hundred and thirty persons (35.1%) had risk factors according to the questionnaire, and 195 of them underwent colonoscopy, with a predictive value of 15.9% for a neoplastic lesion. The Hemoccult II test was positive in 71 participants (4.0%) of whom 67 were investigated with a similar predictive value for neoplastic lesion (16.4%). In the second and third annual screening, the fecal occult blood test was positive in 29 (2.6%) and 27 (2.5%), and had a two and three times higher predictive value for neoplastic lesions, respectively. This was accompanied by a decrease in the cost of discovery. In all three stages, an adenomatous polyp was found in 48, and cancer in 10 participants (2.6% and 0.5% of the 1,797 original participants). Although a questionnaire may be fruitful in colorectal cancer screening, the higher number of participants subjected to further examinations makes this approach very expensive. The annual stool examination for occult blood has a higher predictive value for colonic neoplasm and a lower cost than a one stage, broader population based, study.

  18. Evaluation of the lung cancer risks at which to screen ever- and never-smokers: screening rules applied to the PLCO and NLST cohorts.

    Directory of Open Access Journals (Sweden)

    Martin C Tammemägi

    2014-12-01

    Full Text Available BACKGROUND: Lung cancer risks at which individuals should be screened with computed tomography (CT for lung cancer are undecided. This study's objectives are to identify a risk threshold for selecting individuals for screening, to compare its efficiency with the U.S. Preventive Services Task Force (USPSTF criteria for identifying screenees, and to determine whether never-smokers should be screened. Lung cancer risks are compared between smokers aged 55-64 and ≥ 65-80 y. METHODS AND FINDINGS: Applying the PLCO(m2012 model, a model based on 6-y lung cancer incidence, we identified the risk threshold above which National Lung Screening Trial (NLST, n = 53,452 CT arm lung cancer mortality rates were consistently lower than rates in the chest X-ray (CXR arm. We evaluated the USPSTF and PLCO(m2012 risk criteria in intervention arm (CXR smokers (n = 37,327 of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO. The numbers of smokers selected for screening, and the sensitivities, specificities, and positive predictive values (PPVs for identifying lung cancers were assessed. A modified model (PLCOall2014 evaluated risks in never-smokers. At PLCO(m2012 risk ≥ 0.0151, the 65th percentile of risk, the NLST CT arm mortality rates are consistently below the CXR arm's rates. The number needed to screen to prevent one lung cancer death in the 65th to 100th percentile risk group is 255 (95% CI 143 to 1,184, and in the 30th to 15 y, 8.5% had PLCO(m2012 risk ≥ 0.0151. None of 65,711 PLCO never-smokers had PLCO(m2012 risk ≥ 0.0151. Risks and lung cancers were significantly greater in PLCO smokers aged ≥ 65-80 y than in those aged 55-64 y. This study omitted cost-effectiveness analysis. CONCLUSIONS: The USPSTF criteria for CT screening include some low-risk individuals and exclude some high-risk individuals. Use of the PLCO(m2012 risk ≥ 0.0151 criterion can improve screening efficiency. Currently, never-smokers should not be screened

  19. Identification of effective screening strategies for cardiovascular disease prevention in a developing country: using cardiovascular risk-estimation and risk-reduction tools for policy recommendations.

    Science.gov (United States)

    Selvarajah, Sharmini; Haniff, Jamaiyah; Kaur, Gurpreet; Guat Hiong, Tee; Bujang, Adam; Chee Cheong, Kee; Bots, Michiel L

    2013-02-25

    Recent increases in cardiovascular risk-factor prevalences have led to new national policy recommendations of universal screening for primary prevention of cardiovascular disease in Malaysia. This study assessed whether the current national policy recommendation of universal screening was optimal, by comparing the effectiveness and impact of various cardiovascular screening strategies. Data from a national population based survey of 24 270 participants aged 30 to 74 was used. Five screening strategies were modelled for the overall population and by gender; universal and targeted screening (four age cut-off points). Screening strategies were assessed based on the ability to detect high cardiovascular risk populations (effectiveness), incremental effectiveness, impact on cardiovascular event prevention and cost of screening. 26.7% (95% confidence limits 25.7, 27.7) were at high cardiovascular risk, men 34.7% (33.6, 35.8) and women 18.9% (17.8, 20). Universal screening identified all those at high-risk and resulted in one high-risk individual detected for every 3.7 people screened, with an estimated cost of USD60. However, universal screening resulted in screening an additional 7169 persons, with an incremental cost of USD115,033 for detection of one additional high-risk individual in comparison to targeted screening of those aged ≥35 years. The cost, incremental cost and impact of detection of high-risk individuals were more for women than men for all screening strategies. The impact of screening women aged ≥45 years was similar to universal screening in men. Targeted gender- and age-specific screening strategies would ensure more optimal utilisation of scarce resources compared to the current policy recommendations of universal screening.

  20. Screening for TB by sputum culture in high-risk groups in Copenhagen, Denmark

    DEFF Research Database (Denmark)

    Jensen, Sidse Graff; Wrona Olsen, Nete; Seersholm, Niels;

    2015-01-01

    INTRODUCTION: Evidence on screening high-risk groups for TB by mobile X-ray in low-incidence countries is building, but knowledge on other possible screening methods is limited. In this retrospective study we report results from a community based programme screening for TB by spot sputum culture....... METHODS: On seven occasions, from September 2012 through June 2014, we offered TB screening to all persons present at 11 locations where socially marginalised people gather in Copenhagen. Spot sputum samples from participants were examined by smear microscopy and culture. Genotype, nucleic acid......-positive and seven (19.4%) were smear-positive. Twelve out of 21 (57.1%) cases tested were nucleic acid amplification test positive. Twenty-eight (77.8%) had chest X-ray suggestive of TB. All patients with TB started treatment, 30 (83.3%) had a successful outcome. DISCUSSION: Screening for TB by spot sputum culture...

  1. Self-reported screen time and cardiometabolic risk in obese Dutch adolescents.

    Directory of Open Access Journals (Sweden)

    Teatske M Altenburg

    Full Text Available BACKGROUND: It is not clear whether the association between sedentary time and cardiometabolic risk exists among obese adolescents. We examined the association between screen time (TV and computer time and cardiometabolic risk in obese Dutch adolescents. METHODS AND FINDINGS: For the current cross-sectional study, baseline data of 125 Dutch overweight and obese adolescents (12-18 years participating in the Go4it study were included. Self-reported screen time (Activity Questionnaire for Adolescents and Adults and clustered and individual cardiometabolic risk (i.e. body composition, systolic and diastolic blood pressure, low-density (LDL-C, high-density (HDL-C and total cholesterol (TC, triglycerides, glucose and insulin were assessed in all participants. Multiple linear regression analyses were used to assess the association between screen time and cardiometabolic risk, adjusting for age, gender, pubertal stage, ethnicity and moderate-to-vigorous physical activity. We found no significant relationship between self-reported total screen time and clustered cardiometabolic risk or individual risk factors in overweight and obese adolescents. Unexpectedly, self-reported computer time, but not TV time, was slightly but significantly inversely associated with TC (B = -0.002; CI = [-0.003;-0.000] and LDL-C (B = -0.002; CI = [-0.001;0.000]. CONCLUSIONS: In obese adolescents we could not confirm the hypothesised positive association between screen time and cardiometabolic risk. Future studies should consider computer use as a separate class of screen behaviour, thereby also discriminating between active video gaming and other computer activities.

  2. Screening-Level Risk Assessment for Styrene-Acrylonitrile (SAN) Trimer Detected in Soil and Groundwater

    OpenAIRE

    Kirman, C. R.; Gargas, M L; Collins, J. J.; Rowlands, J. C.

    2012-01-01

    A screening-level risk assessment was conducted for styrene-acrylonitrile (SAN) Trimer detected at the Reich Farm Superfund site in Toms River, NJ. Consistent with a screening-level approach, on-site and off-site exposure scenarios were evaluated using assumptions that are expected to overestimate actual exposures and hazards at the site. Environmental sampling data collected for soil and groundwater were used to estimate exposure point concentrations. Several exposure scenarios were evaluate...

  3. A Screening Tool for Assessing Alcohol Use Risk among Medically Vulnerable Youth.

    Directory of Open Access Journals (Sweden)

    Sharon Levy

    Full Text Available In an effort to reduce barriers to screening for alcohol use in pediatric primary care, the National Institute on Alcoholism and Alcohol Abuse (NIAAA developed a two-question Youth Alcohol Screening Tool derived from population-based survey data. It is unknown whether this screening tool, designed for use with general populations, accurately identifies risk among youth with chronic medical conditions (YCMC. This growing population, which comprises nearly one in four youth in the US, faces a unique constellation of drinking-related risks.To validate the NIAAA Youth Alcohol Screening Tool in a population of YCMC, we performed a cross-sectional validation study with a sample of 388 youth ages 9-18 years presenting for routine subspecialty care at a large children's hospital for type 1 diabetes, persistent asthma, cystic fibrosis, inflammatory bowel disease, or juvenile idiopathic arthritis. Participants self-administered the NIAAA Youth Alcohol Screening Tool and the Diagnostic Interview Schedule for Children as a criterion standard measure of alcohol use disorders (AUD. Receiver operating curve analysis was used to determine cut points for identifying youth at moderate and highest risk for an AUD.Nearly one third of participants (n = 118; 30.4% reported alcohol use in the past year; 86.4% (106 of past year drinkers did not endorse any AUD criteria, 6.8% (n = 8 of drinkers endorsed a single criterion, and 6.8% of drinkers met criteria for an AUD. Using the NIAAA tool, optimal cut points found to identify youth at moderate and highest risk for an AUD were ≥ 6 and ≥12 drinking days in the past year, respectively.The NIAAA Youth Alcohol Screening Tool is highly efficient for detecting alcohol use and discriminating disordered use among YCMC. This brief screen appears feasible for use in specialty care to ascertain alcohol-related risk that may impact adversely on health status and disease management.

  4. Modelling the cumulative risk of a false-positive screening test.

    Science.gov (United States)

    Hubbard, Rebecca A; Miglioretti, Diana L; Smith, Robert A

    2010-10-01

    The goal of a screening test is to reduce morbidity and mortality through the early detection of disease; but the benefits of screening must be weighed against potential harms, such as false-positive (FP) results, which may lead to increased healthcare costs, patient anxiety, and other adverse outcomes associated with diagnostic follow-up procedures. Accurate estimation of the cumulative risk of an FP test after multiple screening rounds is important for program evaluation and goal setting, as well as informing individuals undergoing screening what they should expect from testing over time. Estimation of the cumulative FP risk is complicated by the existence of censoring and possible dependence of the censoring time on the event history. Current statistical methods for estimating the cumulative FP risk from censored data follow two distinct approaches, either conditioning on the number of screening tests observed or marginalizing over this random variable. We review these current methods, identify their limitations and possibly unrealistic assumptions, and propose simple extensions to address some of these limitations. We discuss areas where additional extensions may be useful. We illustrate methods for estimating the cumulative FP recall risk of screening mammography and investigate the appropriateness of modelling assumptions using 13 years of data collected by the Breast Cancer Surveillance Consortium (BCSC). In the BCSC data we found evidence of violations of modelling assumptions of both classes of statistical methods. The estimated risk of an FP recall after 10 screening mammograms varied between 58% and 77% depending on the approach used, with an estimate of 63% based on what we feel are the most reasonable modelling assumptions.

  5. Uncertain Futures: Individual Risk and Social Context in Decision-Making in Cancer Screening.

    Science.gov (United States)

    Lee, Simon J Craddock

    2010-04-01

    A core logic of cancer control and prevention, like much in public health, turns on the notion of decision-making under conditions of uncertainty. Population-level data are increasingly used to develop risk profiles, or estimates, that clinicians and the consumer public may use to guide individual decisions about cancer screening. Individual risk perception forms a piece of a larger social economy of decision-making and choice that makes population screening possible. Individual decision-making depends on accessing and interpreting available clinical information, filtered through the lens of personal values and both cognitive and affective behavioral processes. That process is also mediated by changing social roles and interpersonal relationships. This paper begins to elucidate the influence of this "social context" within the complexity of cancer screening. Reflecting on current work in risk and health, I consider how ethnographic narrative methods can enrich this model.

  6. Towards personalized screening: Cumulative risk of breast cancer screening outcomes in women with and without a first-degree relative with a history of breast cancer.

    Science.gov (United States)

    Ripping, Theodora Maria; Hubbard, Rebecca A; Otten, Johannes D M; den Heeten, Gerard J; Verbeek, André L M; Broeders, Mireille J M

    2016-04-01

    Several reviews have estimated the balance of benefits and harms of mammographic screening in the general population. The balance may, however, differ between individuals with and without family history. Therefore, our aim is to assess the cumulative risk of screening outcomes; screen-detected breast cancer, interval cancer, and false-positive results, in women screenees aged 50-75 and 40-75, with and without a first-degree relative with a history of breast cancer at the start of screening. Data on screening attendance, recall and breast cancer detection were collected for each woman living in Nijmegen (The Netherlands) since 1975. We used a discrete time survival model to calculate the cumulative probability of each major screening outcome over 19 screening rounds. Women with a family history of breast cancer had a higher risk of all screening outcomes. For women screened from age 50-75, the cumulative risk of screen-detected breast cancer, interval cancer and false-positive results were 9.0, 4.4 and 11.1% for women with a family history and 6.3, 2.7 and 7.3% for women without a family history, respectively. The results for women 40-75 followed the same pattern for women screened 50-75 for cancer outcomes, but were almost doubled for false-positive results. To conclude, women with a first-degree relative with a history of breast cancer are more likely to experience benefits and harms of screening than women without a family history. To complete the balance and provide risk-based screening recommendations, the breast cancer mortality reduction and overdiagnosis should be estimated for family history subgroups.

  7. Perceptions of cervical cancer risk and screening among transmasculine individuals: patient and provider perspectives.

    Science.gov (United States)

    Agénor, Madina; Peitzmeier, Sarah M; Bernstein, Ida M; McDowell, Michal; Alizaga, Natalie M; Reisner, Sari L; Pardee, Dana J; Potter, Jennifer

    2016-10-01

    Transmasculine people (individuals assigned a female sex at birth who identify as male or masculine) are at risk of cervical cancer. Despite low rates of Pap test use in this population, research examining the determinants of cervical cancer screening among transmasculine individuals is scarce. We conducted in-depth interviews and focus groups with 49 participants (32 transmasculine patients and 17 healthcare providers) in order to examine transmasculine individuals' and healthcare providers' perceptions of cervical cancer risk and screening among individuals on the transmasculine continuum. Overall, patients believed that transmasculine individuals should receive regular Pap tests, especially in the event of gynaecological concerns. While healthcare providers' views varied, many perceived transmasculine individuals to be at low risk of cervical cancer. Contrary to existing screening guidelines, several providers believed that transmasculine individuals who did not engage in penile-vaginal intercourse with cisgender men, expressed discomfort about Pap testing or intended to obtain a hysterectomy might not need to be screened regularly or at all. Our findings underscore the importance of educating patients and providers about cervical cancer risk among transmasculine individuals and establishing evidence-based guidelines for cervical cancer screening in this underserved population.

  8. Alcohol consumption and rates of cancer screening: Is cancer risk overestimated?

    Science.gov (United States)

    Mu, Lin; Mukamal, Kenneth J

    2016-02-01

    Alcohol consumption in moderation has been associated with incident breast and colorectal cancer. Whether these associations may be overestimated by more intensive screening among moderate consumers is unknown. This study examines the associations of alcohol consumption with cancer screening. In six iterations (2002-2012) of the Behavioral Risk Factor Surveillance System, a telephone survey of US adults conducted by the Centers for Disease Control and Prevention, participants reported their alcohol use and recent screening for several cancers. We assessed whether alcohol use was associated with breast, cervical, and colorectal cancer screening after sample-weighted adjustment for sociodemographic and healthcare utilization factors. Among 2,191,483 survey respondents, 80.5 % (weighted prevalence) of eligible individuals reported having an up-to-date mammogram, 87.7 % having a Pap test, and 56.8 % having a colonoscopy/sigmoidoscopy. For all breast, cervical, and colorectal cancers, moderate consumers were more likely to report screening (84.7, 91.2, 61.1 %) than non-consumers, even after multivariate adjustment (adjusted prevalence ratios 1.04, 1.04, 1.07; p cancer screening. In the USA, moderate consumers consistently report a greater likelihood of breast, cervical, and colorectal cancer screening than do non-consumers. Given the likelihood of overdiagnosis, further study of alcohol consumption and cancer should include cancer-specific mortality, which is less sensitive to differences in screening and detection.

  9. Review of screening for pancreatic cancer in high risk individuals

    OpenAIRE

    Stoita, Alina; Penman, Ian D; Williams, David B.

    2011-01-01

    Pancreatic cancer is difficult to diagnose at an early stage and is associated with a very poor survival. Ten percent of pancreatic cancers result from genetic susceptibility and/or familial aggregation. Individuals from families with multiple affected first-degree relatives and those with a known cancer-causing genetic mutation have been shown to be at much higher risk of developing pancreatic cancer. Recent efforts have focused on detecting disease at an earlier stage to improve survival in...

  10. Using liver enzymes as screening tests to predict mortality risk.

    Science.gov (United States)

    Fulks, Michael; Stout, Robert L; Dolan, Vera F

    2008-01-01

    Determine the relationship between liver function test results (GGT, alkaline phosphatase, AST, and ALT) and all-cause mortality in life insurance applicants. By use of the Social Security Master Death File, mortality was examined in 1,905,664 insurance applicants for whom blood samples were submitted to the Clinical Reference Laboratory. There were 50,174 deaths observed in this study population. Results were stratified by 3 age/sex groups: females, age <60; males, age <60; and all, age 60+. Liver function test values were grouped using percentiles of their distribution in these 3 age/sex groups, as well as ranges of actual values. Using the risk of the middle 50% of the population by distribution as a reference, relative mortality observed for GGT and alkaline phosphatase was linear with a steep slope from very low to relatively high values. Relative mortality was increased at lower values for both AST and ALT. ALT did not predict mortality for values above the middle 50% of its distribution. GGT and alkaline phosphatase are significant predictors of mortality risk for all values. ALT is still useful for triggering further testing for hepatitis, but AST should be used instead to assess mortality risk linked with transaminases.

  11. Tailoring Breast Cancer Screening Intervals by Breast Density and Risk for Women Aged 50 Years or Older: Collaborative Modeling of Screening Outcomes.

    Science.gov (United States)

    Trentham-Dietz, Amy; Kerlikowske, Karla; Stout, Natasha K; Miglioretti, Diana L; Schechter, Clyde B; Ergun, Mehmet Ali; van den Broek, Jeroen J; Alagoz, Oguzhan; Sprague, Brian L; van Ravesteyn, Nicolien T; Near, Aimee M; Gangnon, Ronald E; Hampton, John M; Chandler, Young; de Koning, Harry J; Mandelblatt, Jeanne S; Tosteson, Anna N A

    2016-11-15

    Biennial screening is generally recommended for average-risk women aged 50 to 74 years, but tailored screening may provide greater benefits. To estimate outcomes for various screening intervals after age 50 years based on breast density and risk for breast cancer. Collaborative simulation modeling using national incidence, breast density, and screening performance data. United States. Women aged 50 years or older with various combinations of breast density and relative risk (RR) of 1.0, 1.3, 2.0, or 4.0. Annual, biennial, or triennial digital mammography screening from ages 50 to 74 years (vs. no screening) and ages 65 to 74 years (vs. biennial digital mammography from ages 50 to 64 years). Lifetime breast cancer deaths, life expectancy and quality-adjusted life-years (QALYs), false-positive mammograms, benign biopsy results, overdiagnosis, cost-effectiveness, and ratio of false-positive results to breast cancer deaths averted. Screening benefits and overdiagnosis increase with breast density and RR. False-positive mammograms and benign results on biopsy decrease with increasing risk. Among women with fatty breasts or scattered fibroglandular density and an RR of 1.0 or 1.3, breast cancer deaths averted were similar for triennial versus biennial screening for both age groups (50 to 74 years, median of 3.4 to 5.1 vs. 4.1 to 6.5 deaths averted; 65 to 74 years, median of 1.5 to 2.1 vs. 1.8 to 2.6 deaths averted). Breast cancer deaths averted increased with annual versus biennial screening for women aged 50 to 74 years at all levels of breast density and an RR of 4.0, and those aged 65 to 74 years with heterogeneously or extremely dense breasts and an RR of 4.0. However, harms were almost 2-fold higher. Triennial screening for the average-risk subgroup and annual screening for the highest-risk subgroup cost less than $100 000 per QALY gained. Models did not consider women younger than 50 years, those with an RR less than 1, or other imaging methods. Average-risk women

  12. A comparative study of worker and general public risks from nuclear facility operation using MACCS2

    Energy Technology Data Exchange (ETDEWEB)

    East, J.M.; O`Kula, K.R. [Westinghouse Savannah River Co., Aiken, SC (United States)

    1995-12-31

    Over the last five years, the US Department of Energy (DOE) has attempted to establish quantitative risk indices as minimum acceptance criteria for assurance of safe operation of its nuclear facilities. The risk indices serve as aiming points or targets to include consideration of all aspects of operation including normal conditions as well as abnormal, design basis events, and beyond-design basis events. Although initial focus of the application of these safety targets had been on DOE`s reactors, more recent assessments have also considered non-reactor facilities including those encompassing storage and nuclear processing activities. Regardless of the facility`s primary function, accident progression, event tree/fault tree logic models, and probabilistic (dose) consequence assessment model must be implemented to yield a fully integrated analysis of facility operation. The primary tool for probabilistic consequence assessment in the U.S. is the MELCOR Accident Consequence Code System (MACCS). In this study, two version of MACCS are applied to representative source terms developed in the safety analysis associated with a waste processing facility at the Westinghouse Savannah River Company`s (WSRC`s) Savannah River Site (SRS). The MACCS versions are used to estimate population dose and subsequent health effects to workers and the general public from the SRS referenced facility operation. When combined with the frequency of occurrence evaluation, the margin of compliance with the safety targets may be quantified. Additionally, numerical evaluation of the safety targets with the two code versions will serve as an indicator of the impact of the enhancements made to MACCS relative to earlier baseline software.

  13. Household sanitation facilities and women's risk of non-partner sexual violence in India.

    Science.gov (United States)

    Jadhav, Apoorva; Weitzman, Abigail; Smith-Greenaway, Emily

    2016-11-08

    Globally, one in ten individuals practice open defecation. Despite media speculation that it increases women's risk of sexual violence, little empirical evidence supports the claims. We investigate the relationship between household sanitation facilities and women's risk of non-partner sexual violence (NPSV) in India, where nearly half of the population lives without a pit or toilet. We use the most recent NPSV data, from the National Family Health Survey-III, to estimate logistic regression models of the effects of household sanitation facilities (toilet, pit, or none) on NPSV in the last year among women who have resided in their current home for one year or more. These effects are estimated net of other socioeconomic factors, compared to effects of household sanitation facilities on child diarrhea, and, as a falsification test, compared to effects of household sanitation facilities on intimate partner sexual violence (IPSV) in the last year. Net of their socioeconomic status, women who use open defecation are twice as likely to face NPSV as women with a household toilet. This is twice the association between open defecation and child diarrhea. The results of our falsification test indicate that open defecation is not correlated with IPSV, thus disconfirming a simultaneous selection of women into open defecation and sexual violence. Our findings provide empirical evidence that lacking household sanitation is associated with higher risk of NPSV.

  14. Psychological consequences of screening for cardiovascular risk factors in an un-selected general population

    DEFF Research Database (Denmark)

    Løkkegaard, Thomas; Andersen, John S; Jacobsen, Rikke K

    2015-01-01

    screening in healthy adults leads to mental distress in the study population, independent of participation. Methods: The Inter99 study (1999 – 2006) was a randomised intervention in the general population, aiming to prevent IHD by a healthier lifestyle. We included the whole study population, independent......Background: Concerns that general health checks, including screening for risk factors to ischemic heart disease (IHD),have negative psychological consequences seem widely unfounded; however, previous studies are only based on selfreports from participants. Aim: To investigate if risk factor...

  15. College students' knowledge of risk and screening recommendations for breast, cervical, and testicular cancers.

    Science.gov (United States)

    Daley, Christine Makosky

    2007-01-01

    There is a gap in the literature regarding the knowledge of college students about breast, cervical, and testicular cancers. I surveyed 3362 college students were surveyed about their knowledge of risk factors and screening recommendations for these 3 cancers during the 2002-2003 school year at a large public university in the Northeast. Students knew approximately 50% of the information about risk factors and screening recommendations for these 3 cancers. CONCLUSIONS. Based on these results, college students appear to have limited knowledge about breast, cervical, and testicular cancers and need education about them.

  16. Screening older adults at risk of falling with the Tinetti balance scale.

    Science.gov (United States)

    Raîche, M; Hébert, R; Prince, F; Corriveau, H

    2000-09-16

    In a prospective study of 225 community dwelling people 75 years and older, we tested the validity of the Tinetti balance scale to predict individuals who will fall at least once during the following year. A score of 36 or less identified 7 of 10 fallers with 70% sensitivity and 52% specificity. With this cut-off score, 53% of the individuals were screened positive and presented a two-fold risk of falling. These characteristics support the use of this test to screen older people at risk of falling in order to include them in a preventive intervention.

  17. How does HPV vaccination status relate to risk perceptions and intention to participate in cervical screening?

    DEFF Research Database (Denmark)

    Hestbech, Mie Sara; Gyrd-Hansen, Dorte; Kragstrup, Jakob

    2016-01-01

    while having the lowest perception of risk (in two different pre-specified dichotomisations). HPV vaccinated women perceived the vaccine effect to be larger than unvaccinated women did: adjusted OR of 0.31 (95 % CI: 0.18–0.51) and 0.37 (95 % CI: 0.25–0.53) for being HPV vaccinated while having...... the lowest perception of vaccine effect (in two different pre-specified dichotomisations). There were no associations between perceived cervical cancer risk and intention to participate in screening. Conclusions: HPV vaccinated women more often than unvaccinated women intended to participate in screening...

  18. Cervical Cancer Screening Barriers and Risk Factor Knowledge Among Uninsured Women.

    Science.gov (United States)

    Akinlotan, Marvellous; Bolin, Jane N; Helduser, Janet; Ojinnaka, Chinedum; Lichorad, Anna; McClellan, David

    2017-08-01

    A steady decline in cervical cancer incidence and mortality in the United States has been attributed to increased uptake of cervical cancer screening tests such as Papanicolau (Pap) tests. However, disparities in Pap test compliance exist, and may be due in part to perceived barriers or lack of knowledge about risk factors for cervical cancer. This study aimed to assess correlates of cervical cancer risk factor knowledge and examine socio-demographic predictors of self-reported barriers to screening among a group of low-income uninsured women. Survey and procedure data from 433 women, who received grant-funded cervical cancer screenings over a span of 33 months, were examined for this project. Data included demographics, knowledge of risk factors, and agreement on potential barriers to screening. Descriptive analysis showed significant correlation between educational attainment and knowledge of risk factors (r = 0.1381, P < 0.01). Multivariate analyses revealed that compared to Whites, Hispanics had increased odds of identifying fear of finding cancer (OR 1.56, 95% CI 1.00-2.43), language barriers (OR 4.72, 95% CI 2.62-8.50), and male physicians (OR 2.16, 95% CI 1.32-3.55) as barriers. Hispanics (OR 1.99, 95% CI 1.16-3.44) and Blacks (OR 2.06, 95% CI 1.15-3.68) had a two-fold increase in odds of agreeing that lack of knowledge was a barrier. Identified barriers varied with age, marital status and previous screening. Programs aimed at conducting free or subsidized screenings for medically underserved women should include culturally relevant education and patient care in order to reduce barriers and improve screening compliance for safety-net populations.

  19. Strategies for screening for pancreatic adenocarcinoma in high-risk patients.

    Science.gov (United States)

    Canto, Marcia Irene

    2007-08-01

    Identification of high-risk individuals, genetic counseling, and informed consent are important components of a screening program for familial pancreatic cancer. Screening high-risk individuals with imaging tests, such endoscopic ultrasound (EUS) and computed tomography (CT), can lead to the detection and treatment of predominantly asymptomatic early pancreatic neoplasms, as well as extra-pancreatic tumors. These pancreatic neoplasms consist of resectable, mostly branch-type non-invasive intraductal papillary mucinous neoplasms (IPMNs). EUS can visualize these very early IPMNs as focal duct ectasias or cysts. EUS features of chronic pancreatitis are highly prevalent in high-risk individuals and these directly correlate with multifocal lobulocentric parenchymal atrophy due to multifocal pancreatic intraepithelial neoplasia (PanIN). No one molecular marker is ready for "prime time" screening of high-risk individuals. Translational studies are underway to discover novel biomarkers for IPMNs, PanIN-3 lesions, or microinvasive adenocarcinoma, which are likely to be cured by timely intervention. Long-term, multi-prospective studies are needed to determine if screening for early pancreatic neoplasia and timely intervention results in decreased pancreatic cancer incidence and mortality in high-risk individuals.

  20. CT scan screening for lung cancer: risk factors for nodules and malignancy in a high-risk urban cohort.

    Directory of Open Access Journals (Sweden)

    Alissa K Greenberg

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

  1. Prevalence of major risk factors and use of screening tests for cancer in the United States.

    Science.gov (United States)

    Fedewa, Stacey A; Sauer, Ann Goding; Siegel, Rebecca L; Jemal, Ahmedin

    2015-04-01

    Much of the suffering and death from cancer could be prevented by more systematic efforts to reduce tobacco use, improve diet, increase physical activity, reduce obesity, and expand the use of established screening tests. Monitoring the prevalence of cancer risk factors and screening is important to measure progress and strengthen cancer prevention and early detection efforts. In this review article, we provide recent prevalence estimates for several cancer risk factors, including tobacco, obesity, physical activity, nutrition, ultraviolet radiation exposure as well as human papillomavirus and hepatitis B vaccination coverage and cancer screening prevalence in the United States. In 2013, cigarette smoking prevalence was 17.8% among adults nationally, but ranged from 10.3% in Utah to 27.3% in West Virginia. In addition, 15.7% of U.S. high school students were current smokers. In 2011-2012, obesity prevalence was high among both adults (34.9%) and adolescents (20.5%), but has leveled off since 2002. About 20.2% of high school girls were users of indoor tanning devices, compared with 5.3% of boys. In 2013, cancer screening prevalence ranged from 58.6% for colorectal cancer to 80.8% for cervical cancer and remains low among the uninsured, particularly for colorectal cancer screening where only 21.9% of eligible adults received recommended colorectal cancer screening. ©2015 American Association for Cancer Research.

  2. Pressure ulcer is associated with malnutrition as assessed by Nutritional Risk Screening (NRS 2002) in a mixed hospital population.

    Science.gov (United States)

    Alhaug, Johanne; Gay, Caryl L; Henriksen, Christine; Lerdal, Anners

    2017-01-01

    Background and aim: Pressure ulcers (PUs) and malnutrition represent a significant health problem for hospital inpatients. Satisfactory nutritional status is crucial for proper wound healing. Risk of malnutrition can be identified using standardized screening tools, such as the Nutritional Risk Screening (NRS) 2002. Objective: The objective of this study was to examine whether nutritional status based on the NRS 2002 is associated with PU in hospital inpatients. Design: The data for this cross-sectional analysis were based on 10 screening days between September 2012 and May 2014. All adult inpatients admitted to a medical or surgical ward on the screening days were evaluated for eligibility. Nursing students and ward nurses conducted the NRS 2002 initial screening and skin examinations for PU classification (Stages I-IV). A registered clinical dietician conducted all NRS 2002 final screenings. Results: The sample consisted of 651 patients, with mean age 62.9 years. Skin examinations indicated an 8% PU prevalence. Factors associated with PUs included age ≥ 70 years, low body mass index (BMI) and hospitalization in the medical department. Based on the initial screening, 48% were at 'Low risk' for malnutrition and 52% were at 'Possible risk'. After final screening, 34% of the sample was identified as 'At risk' for malnutrition. Patients identified at 'Possible risk' by the initial screening or 'At risk' by the final screening were more likely than patients at 'Low risk' to have a PU (OR = 2.58 and 2.55, respectively). Each of the three initial screening items was significantly associated PU, with 'Is BMINutritional risk using the NRS 2002 is associated with the presence of PU in a mixed hospital population. The final screening had a slightly stronger association with PU compared to the initial screening.

  3. Environmental Protection Agency (EPA) Facility Registry Service (FRS) Emergency Response (ER) Risk Management Plan (RMP) Facilities - Oil and Hazardous Materials

    Data.gov (United States)

    Department of Homeland Security — The purpose of this web feature service is to provide users with access to integrated facility information from FRS, limited to the subset of facilities that link to...

  4. Screening for hypertension among older adults: A primary care "High Risk" approach

    Directory of Open Access Journals (Sweden)

    John Jacob

    2010-01-01

    Full Text Available Background: Recommendations for early detection and management of elevated blood pressure through opportunistic clinic-based screening may be inadequate for the rural population in India as access to health facilities is limited. Materials and Methods: Sixteen Health Aides (trained primary care workers were trained to measure blood pressure using a standardized training procedure. Six of those assessed competent in initial evaluation were allotted a stratified random sample of about 150 persons each, 50 years or over, in the village under their care to measure blood pressures during their regular scheduled visits. Results: 14/16 of the health aides (83% met the stipulated criteria for the simulation study using a module from British Hypertension Society. In the field survey of 920 individuals where 20% of the population was evaluated by a blinded investigator, the weighted Kappa for agreement, using normal, pre-hypertension and hypertension as categories, ranged between 62% and 89%. Only 75/286 (25% of those detected to be hypertensive knew their status prior to the study. All those detected with hypertension were referred to a physician at a referral facility. 70% of those referred were evaluated at the referral facility and 64% of them initiated on treatment for hypertension within 3 months. Conclusion: Using primary care workers to screen for hypertension through the model suggested here will ensure that the population over 50 years of age will be screened once every 2 years without burdening the worker. This screening process will enable the health system to identify and cater to needs of this vulnerable population.

  5. Risk screening, emergency care, and lay concepts of complications during pregnancy in Chiapas, Mexico.

    Science.gov (United States)

    Tinoco-Ojanguren, Rolando; Glantz, Namino M; Martinez-Hernandez, Imelda; Ovando-Meza, Ismael

    2008-03-01

    Maternal morbidity and mortality are widespread in Chiapas, Mexico's southernmost state, as in many developing regions. Globally, the utility of three approaches to addressing such problems has been debated: (a) obstetric risk screening (i.e. screening women for risk during pregnancy and channeling those at risk to preventive care); (b) emergency obstetric care (i.e. identifying complications during pregnancy or birth and providing prompt effective treatment); and (c) combined risk screening and emergency care. Unaddressed to date in peer-reviewed journals are the lay perceptions of complications and risk that precede and incite the quest for obstetric care in Mexico. High incidence of maternal mortality in Chiapas, exacerbated by the predominantly rural, highly indigenous, geographically dispersed, and economically marginalized nature of the state's southern Border Region, prompted us to conduct 45 open-ended interviews with a convenience sample of women and their close relative/s, including indigenous and non-indigenous informants in urban and rural areas of four municipalities in this region. Interviews suggest that none of the three approaches is effective in this context, and we detail reasons why each approach has fallen short. Specific obstacles identified include that (1) many women do not access adequate prenatal screening care on a regular basis; (2) emergency obstetric care in this region is severely circumscribed; and (3) lay notions of pregnancy-related risk and complications contrast with official clinical criteria, such that neither clinical nor extra-clinical prenatal monitoring encompasses the entire range of physical and social risk factors and danger signs. Findings reported here center on a rich description of the latter: lay versus clinical criteria for risk of antepartum complication.

  6. Screening high-risk children for asthma through a community intervention.

    Science.gov (United States)

    Sheikh, Shahid I; Pitts, Judy; Ryan-Wenger, Nancy A; McCoy, Karen S; Hayes, Don

    2015-10-01

    Many children, particularly those from inner city neighborhoods, have undiagnosed asthma. This study was done to evaluate the effectiveness of an asthma screening, referral and follow-up intervention in an inner city community setting in early identification of children at risk for undiagnosed asthma. A descriptive longitudinal cohort design was used to assess children at baseline and at a 2-year follow-up. Parents of children in a private day school and a church Sunday school (N = 103) completed a validated Asthma Screening Tool at both time periods. Children with asthma and at risk for asthma were referred to a primary care provider (PCP). At baseline, screening of 103 children, ages 3-17 years (mean=7.7 ± 2.9), were categorized as known asthma diagnosis (n = 22), at-risk for undiagnosed asthma (n = 52) and not at-risk for asthma (n = 29). Sixty-two (60.2%) parents responded to the 2-year follow-up. Referral to PCP was kept by 61.5% from the known asthma group and by 24% of children at-risk for asthma. At 2-year follow-up, among not at-risk group, no one converted to at risk status, but majority of children among known asthma group continued to have uncontrolled asthma symptoms, and very few received daily preventive asthma medications. The asthma screening, referral and follow-up intervention for inner city children in a community setting was successful in early identification of patients at-risk for asthma. More education for PCPs on guidelines for diagnosis and management of asthma is needed to decrease childhood asthma morbidity.

  7. Toward a simple risk assessment screening tool for HCV infection in Egypt.

    Science.gov (United States)

    El-Ghitany, Engy M; Farghaly, Azza G; Abdel Wahab, Moataza M; Farag, Shehata; Abd El-Wahab, Ekram W

    2016-10-01

    Asymptomatic patients with HCV infection identified through screening program could benefit not only from treatment but also from other interventions such as counseling to maintain health and avoid risk behaviors. This might prevent the spread of infection and result in significant public health benefits. However, mass screening would quickly deplete resources. This work aims to develop a brief HCV risk assessment questionnaire that inquires initially about a wide range of risk factors found to be potentially associated with HCV infection in order to identify the few most significant questions that could be quickly used to facilitate cost-effective HCV case-finding in the general population in Egypt. An exhaustive literature search was done to include all reported HCV risk factors that were pooled in a 65 item questionnaire. After an initial pilot study, a case-control study was performed that included 1,024 cases and 1,046 controls. In a multivariable model, a list of independent risk factors were found to be significant predictors for being HCV seropositive among two age strata (45 years) for each gender. A simplified model that assigned values of the odds ratio as a weight for each factor present predicted HCV infection with high diagnostic accuracy. Attaining the defined cut-off value of the total risk score enhances the effectiveness of screening. HCV risk factors in the Egyptian population vary by age and gender. An accurate prediction screening tool can be used to identify those at high risk who may benefit most from HCV serologic testing. These results are to be further validated in a large scale cross-sectional study to assess the wider use of this tool. J. Med. Virol. 88:1767-1775, 2016. © 2016 Wiley Periodicals, Inc.

  8. Breast cancer screening in an era of personalized regimens: a conceptual model and National Cancer Institute initiative for risk-based and preference-based approaches at a population level.

    Science.gov (United States)

    Onega, Tracy; Beaber, Elisabeth F; Sprague, Brian L; Barlow, William E; Haas, Jennifer S; Tosteson, Anna N A; D Schnall, Mitchell; Armstrong, Katrina; Schapira, Marilyn M; Geller, Berta; Weaver, Donald L; Conant, Emily F

    2014-10-01

    Breast cancer screening holds a prominent place in public health, health care delivery, policy, and women's health care decisions. Several factors are driving shifts in how population-based breast cancer screening is approached, including advanced imaging technologies, health system performance measures, health care reform, concern for "overdiagnosis," and improved understanding of risk. Maximizing benefits while minimizing the harms of screening requires moving from a "1-size-fits-all" guideline paradigm to more personalized strategies. A refined conceptual model for breast cancer screening is needed to align women's risks and preferences with screening regimens. A conceptual model of personalized breast cancer screening is presented herein that emphasizes key domains and transitions throughout the screening process, as well as multilevel perspectives. The key domains of screening awareness, detection, diagnosis, and treatment and survivorship are conceptualized to function at the level of the patient, provider, facility, health care system, and population/policy arena. Personalized breast cancer screening can be assessed across these domains with both process and outcome measures. Identifying, evaluating, and monitoring process measures in screening is a focus of a National Cancer Institute initiative entitled PROSPR (Population-based Research Optimizing Screening through Personalized Regimens), which will provide generalizable evidence for a risk-based model of breast cancer screening, The model presented builds on prior breast cancer screening models and may serve to identify new measures to optimize benefits-to-harms tradeoffs in population-based screening, which is a timely goal in the era of health care reform. © 2014 American Cancer Society.

  9. Risk modeling and screening for BRCA1 mutations among Filipino breast cancer patients

    CERN Document Server

    Nato, A Q J

    2003-01-01

    Breast cancer susceptibility gene, type 1(BRCA1) has been thought to be responsible for approx 45% of families with multiple breast carcinomas and for approx 80% of breast and ovarian cancer families. In this study, we investigated 34 familial Filipino breast cancer (BC) patients to: (a) estimate breast cancer risks and BRCA1/2 mutation carrier probabilities using risk assessment and prior probability models, respectively; (b) screen for putative polymorphisms at selected smaller exons of BRCA1 by single-strand conformation polymorphism (SSCP) analysis; (c) screen for truncated mutations at BRCA1 exon 11 by radioactive protein truncation test (PTT); and (d) estimate posterior probabilities upon incorporation of screening results. SSCP analysis revealed 8 unique putative polymorphisms. Low prevalence of unique putative polymorphisms at exon 2, 5, 17, and 22 may indicate probable mutations. Contrastingly, high prevalence of unique putative polymorphisms at exons 13, 15, and 16 may suggest true polymorphisms whi...

  10. Colorectal cancer screening of high-risk populations: A national survey of physicians

    Directory of Open Access Journals (Sweden)

    White Pascale M

    2012-01-01

    Full Text Available Abstract Background The incidence of colorectal cancer can be decreased by appropriate use of screening modalities. Patients with a family history of colon cancer and of African-American ethnicity are known to be at higher risk of developing colorectal cancer. We aimed to determine if there is a lack of physician knowledge for colorectal cancer screening guidelines based on family history and ethnicity. Between February and April 2009 an anonymous web-based survey was administered to a random sample selected from a national list of 25,000 internists, family physicians and gastroenterologists. A stratified sampling strategy was used to include practitioners from states with high as well as low CRC incidence. All data analyses were performed following data collection in 2009. Results The average knowledge score was 37 ± 18% among the 512 respondents. Gastroenterologists averaged higher scores compared to internists, and family physicians, p = 0.001. Only 28% of physicians correctly identified the screening initiation point for African-Americans while only 12% of physicians correctly identified the screening initiation point and interval for a patient with a family history of CRC. The most commonly cited barriers to referring high-risk patients for CRC screening were "patient refusal" and "lack of insurance reimbursement." Conclusions There is a lack of knowledge amongst physicians of the screening guidelines for high-risk populations, based on family history and ethnicity. Educational programs to improve physician knowledge and to reduce perceived barriers to CRC screening are warranted to address health disparities in colorectal cancer.

  11. Psychometric Evaluation of a Brief Parent- and Teacher-Rated Screen for Children at Risk of Conduct Disorder

    Science.gov (United States)

    Duncombe, Melissa E.; Havighurst, Sophie S.; Holland, Kerry A.; Frankling, Emma J.

    2012-01-01

    This study examined the psychometric properties of the Conduct Problems Risk Screen (CPRS), a seven-item screen derived from DSM-IV-TR criteria that can be completed by parents or teachers. The sample consisted of 4,752 Australian five- to nine-year-old primary school children. The results showed the parent and teacher screens had very good…

  12. Study on the screening program and risk factors of carotid artery stenosis with coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    李庆祥

    2013-01-01

    Objective The purpose of this research project was to evaluate the relationship and risk factors between coronary artery disease and carotid artery stenosis (CAS) ,screened by duplex ultra-sonography.Methods 1339 patients with coronary artery disease were enrolled into this

  13. Screening for Emotional and Behavioral Risk among Students with Limited English Proficiency

    Science.gov (United States)

    Dowdy, Erin; Dever, Bridget V.; DiStefano, Christine; Chin, Jenna K.

    2011-01-01

    Students with limited English proficiency (LEP) make up one of the fastest growing segments of the student population; however, LEP status is often related to poor academic and behavioral outcomes. Teacher-reported behavioral rating scales can be informative measurements to screen and identify students at risk for behavioral and emotional…

  14. Glaucoma screening during regular optician visits : can the population at risk of developing glaucoma be reached?

    NARCIS (Netherlands)

    Stoutenbeek, R.; Jansonius, N. M.

    2006-01-01

    Aim: To determine the percentage of the population at risk of developing glaucoma, which can potentially be reached by conducting glaucoma screening during regular optician visits. Methods: 1200 inhabitants aged > 40 years were randomly selected from Dutch community population databases. A questionn

  15. How to screen obese children at risk for type 2 diabetes mellitus?

    NARCIS (Netherlands)

    van der Aa, Marloes P; Fazeli Farsani, Soulmaz; Kromwijk, Lisa A J; de Boer, Anthonius; Knibbe, Catherijne A J; van der Vorst, Marja M J

    2014-01-01

    BACKGROUND: Recommended screening to identify children at risk for diabetes and its precursors impaired glucose tolerance (IGT) and insulin resistance (IR) is fasted plasma glucose (FPG). This study evaluates the added value of fasted plasma insulin (FPI). METHODS: This study analyzed routinely coll

  16. Patient doses and radiation risks in film-screen mammography in Finland

    Energy Technology Data Exchange (ETDEWEB)

    Servomaa, A.; Parviainen, T.; Komppa, T. [Finnish Centre for Radiation and Nuclear Safety (STUK), Helsinki (Finland)

    1995-12-31

    Screen-film mamography is the most sensitive method for the early detection of breast cancer. Breast doses in mamography should be measured for several reasons, especially for the evaluation of patient risk in a screening programme, but also for the assessment and comparison of imaging techniques and equipment performance. In this study, the factors affecting patient doses were assessed by making performance and patient dose measurements; about 50 mammographic units used for screening were included in the study. The lifetime risk as a function of age at exposure was calculated using the average glandular dose, the relative risk model shown in the BEIR V report, and the breast cancer mortality in Finland. The mean surface dose of a 4.5 cm thick phantom was 6.3 mGy, and the mean glandular dose 1.0 mGy. Analysis of the surface dose with respect to film optical density, relative speed of film processing, sensitivity of image receptors, and antiscatter grid showed that the mean surface dose could be decreased by more than 50%. For the screened age group of 50 to 59 years, the risk of exposure-induced death (REID) of breast cancer is about 1.4 x 10{sup -6} mSv{sup -1}, and the average loss of life expectancy due to the radiation-induced breast cancer deaths (LLE/REID) is about 9.5 years. (Author).

  17. Risk of cancer radioinduced by mammographic screening; Risco de cancer radioinduzido em rastreamento mamografico

    Energy Technology Data Exchange (ETDEWEB)

    Correa, Rosangela da Silveira, E-mail: rcorrea@cnen.gov.br [Centro Regional de Ciencias Nucleares do Centro-Oeste (CRCN-CO/CNEN-GO), Goiania, GO (Brazil); Peixoto, Joao Emilio, E-mail: joao.e.peixoto@uol.com.br [Instituto Nacional de Cancer (INCA), Rio de Janeiro, RJ (Brazil); Ferreira, Rubemar de Souza, E-mail: josilto@cnen.gov.br [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil); Freitas-Junior, Ruffo, E-mail: ruffojr@terra.com.br [Universidade Federal de Goiania (UEG), Goiania, GO (Brazil). Hospital das Clinicas. Programa de Mastologia

    2013-07-01

    This work aims to estimate the risk benefit of mammography, in terms of the number of lives saved/number of lives lost, in the female population of the State of Goias, Brazil, depending on the age range indicated for screening and the type of technology available.

  18. Screening method to assess the risk of explosive spalling on fire exposed concrete

    DEFF Research Database (Denmark)

    Sørensen, Lars Schiøtt

    2003-01-01

    At the Technical University of Denmark (BYG.DTU)a new test set-up is under development to screen various concretes to assess their risk of explosive spalling. The test exposes a standard cylinder to compressive ring stresses together with rapid heating of the cylinder end....

  19. Glaucoma screening during regular optician visits : can the population at risk of developing glaucoma be reached?

    NARCIS (Netherlands)

    Stoutenbeek, R.; Jansonius, N. M.

    2006-01-01

    Aim: To determine the percentage of the population at risk of developing glaucoma, which can potentially be reached by conducting glaucoma screening during regular optician visits. Methods: 1200 inhabitants aged > 40 years were randomly selected from Dutch community population databases. A questionn

  20. Glaucoma screening during regular optician visits : can the population at risk of developing glaucoma be reached?

    NARCIS (Netherlands)

    Stoutenbeek, R.; Jansonius, N. M.

    2006-01-01

    Aim: To determine the percentage of the population at risk of developing glaucoma, which can potentially be reached by conducting glaucoma screening during regular optician visits. Methods: 1200 inhabitants aged > 40 years were randomly selected from Dutch community population databases. A

  1. Five-Year Cervical (Pre)Cancer Risk of Women Screened by HPV and Cytology Testing.

    Science.gov (United States)

    Uijterwaal, Margot H; Polman, Nicole J; Van Kemenade, Folkert J; Van Den Haselkamp, Sander; Witte, Birgit I; Rijkaart, Dorien; Berkhof, Johannes; Snijders, Peter J F; Meijer, Chris J L M

    2015-06-01

    Primary human papillomavirus (HPV)-based cervical screening will be introduced in the Netherlands in 2016. We assessed the 5-year cervical (pre)cancer risk of women with different combinations of HPV and cytology test results. Special attention was paid to risks for cervical intraepithelial neoplasia grade 3 and 2 or more (CIN3+/2+) of HPV-positive women with a negative triage test, because this determines the safety of a 5-year screening interval for HPV-positive, triage test-negative women. In addition, age-related effects were studied. A total of 25,553 women were screened by HPV testing and cytology in a screening setting. Women were managed on the presence of HPV and/or abnormal cytology. Five-year cumulative incidences for CIN3+/2+ were calculated. Five-year CIN3+(2+) risk was 10.0% (17.7%) among HPV-positive women. When stratified by cytology, the CIN3+(CIN2+) risk was 7.9% (12.9%) for women with normal cytology and 22.2% (45.3%) for women with equivocal or mildly abnormal (i.e., BMD) cytology. For HPV-negative women, the 5-year CIN3+(2+) risk was 0.09% (0.21%). Additional triage of HPV-positive women with normal cytology by repeat cytology at 12 months showed a 5-year CIN3+(2+) risk of 4.1% (7.0%). HPV-non 16/18-positive women with normal cytology at baseline had comparable risks of 3.5% (7.9%). HPV-non 16/18-positive women with normal baseline cytology and normal repeat cytology had a 5-year CIN3+ risk of 0.42%. No age-related effects were detected. In conclusion, HPV-positive women with normal cytology and a negative triage test, either repeat cytology after 12 months or baseline HPV 16/18 genotyping, develop a non-negligible CIN3+ risk over 5 years. Therefore, extension of the screening interval over 5 years only seems possible for HPV screen-negative women. ©2015 American Association for Cancer Research.

  2. Race, region and risk: An examination of minority proximity to noxious facilities

    Energy Technology Data Exchange (ETDEWEB)

    Nieves, A.L. [Wheaton Coll., IL (United States)]|[Argonne National Lab., IL (United States); Nieves, L.A. [Argonne National Lab., IL (United States)

    1996-04-01

    The past decade has given rise to terms like environmental racism, eco-racism, and environmental inequities to characterize a disproportional distribution of environmental disamenities among minority communities. Much of the literature supports the contention that racial and ethnic minorities and low-income groups bear a disproportionate burden of risk from hazardous activities and substances in the environment. This study expands the scope of prior studies by employing county-level data for the entire nation and including a broad range of facility types associated with environmental disamenities. In addition, it addresses the issue of the distribution of noxious facilities among white and non-white populations in an attempt to determine the relative exposure to risk among different racial and ethnic groups. In addition, the authors also explore the relative importance of nonurban versus urban residence.

  3. Accident Management & Risk-Based Compliance With 40 CFR 68 for Chemical Process Facilities

    Energy Technology Data Exchange (ETDEWEB)

    O`Kula, K.R. [Westinghouse Savannah River Company, AIKEN, SC (United States); Taylor, R.P. Jr.; Ashbaugh, S.G. [Innovative Technology Solutions, Albuquerque, NM (United States)

    1995-08-23

    A risk-based logic model is suggested as an appropriate basis for better predicting accident progression and ensuing source terms to the environment from process upset conditions in complex chemical process facilities. Under emergency conditions, decision-makers may use the Accident Progression Event Tree approach to identify the best countermeasure for minimizing deleterious consequences to receptor groups before the atmospheric release has initiated. It is concluded that the chemical process industry may use this methodology as a supplemental information provider to better comply with the Environmental Protection Agency`s proposed 40 CFR 68 Risk Management Program rule. An illustration using a benzene-nitric acid potential interaction demonstrates the value of the logic process. The identification of worst-case releases and planning for emergency response are improved through these methods, at minimum. It also provides a systematic basis for prioritizing facility modifications to correct vulnerabilities.

  4. Data Sources for the Model-based Small Area Estimates of Cancer Risk Factors and Screening Behaviors - Small Area Estimates

    Science.gov (United States)

    The model-based estimates of important cancer risk factors and screening behaviors are obtained by combining the responses to the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS).

  5. The STRONGkids nutritional risk screening tool can be used by paediatric nurses to identify hospitalised children at risk.

    Science.gov (United States)

    Moeeni, Vesal; Walls, Tony; Day, Andrew S

    2014-12-01

    Hospitalised children have higher rates of undernutrition. Early detection of at-risk patients could lead to prompt preventative or corrective interventions. Several nutritional risk screening tools are available for screening hospitalised children including the STRONGkids tool. This study was designed to assess the usefulness of STRONGkids when applied by nurses rather than a paediatrician. The STRONGkids questionnaire was simplified to enhance clarity with nursing staff. Trained nursing staff were asked to apply the tool to children, aged 1 month to 17 years, admitted to the Christchurch Hospital, New Zealand. Each patient was also assessed by a paediatrician. In addition, the current nutritional state of each patient was defined by measuring their weight and height. Of the 162 children enrolled, 11.7% were undernourished and 13% overnourished. STRONGkids recognised 84% of undernourished children when the tool was applied by nurses and 90% when the tool was applied by a paediatrician, indicating substantial agreement (kappa = 0.65). A minor simplification to the questionnaire improved its utility. STRONGkids successfully recognised at-risk children, when applied by either nurses or a paediatrician. It was suitable and feasible for nursing staff to use it to screen for children at risk of nutritional deterioration. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  6. Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania

    OpenAIRE

    Kizito Kuchibanda; Mayo, Aloyce W.

    2015-01-01

    The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interv...

  7. Is Noncycloplegic Photorefraction Applicable for Screening Refractive Amblyopia Risk Factors?

    Directory of Open Access Journals (Sweden)

    Zhale Rajavi

    2012-01-01

    Full Text Available Purpose: To compare the accuracy of noncycloplegic photorefraction (NCP with that of cycloplegic refraction (CR for detecting refractive amblyopia risk factors (RARFs and to determine cutoff points. Methods: In this diagnostic test study, right eyes of 185 children (aged 1 to 14 years first underwent NCP using the PlusoptiX SO4 photoscreener followed by CR. Based on CR results, hyperopia (≥ +3.5 D, myopia (≥ -3 D, astigmatism (≥ 1.5 D, and anisometropia (≥ 1.5 D were set as diagnostic criteria based on AAPOS guidelines. The difference in the detection of RARFs by the two methods was the main outcome measure. Results: RARFs were present in 57 (30.8% and 52 (28.1% of cases by CR and NCP, respectively, with an 89.7% agreement. In contrast to myopia and astigmatism, mean spherical power in hyperopic eyes was significantly different based on the two methods (P < 0.001, being higher with CR (+5.96 ± 2.13 D as compared to NCP (+2.37 ± 1.36 D. Considering CR as the gold standard, specificities for NCP exceeded 93% and sensitivities were also acceptable (≥ 83% for myopia and astigmatism. Nevertheless, sensitivity of NCP for detecting hyperopia was only 45.4%. Using a cutoff point of +1.87 D, instead of +3.5 D, for hyperopia, sensitivity of NCP was increased to 81.8% with specificity of 84%. Conclusion: NCP is a relatively accurate method for detecting RARFs in myopia and astigmatism. Using an alternative cutoff point in this study, NCP may be considered an acceptable device for detecting hyperopia as well.

  8. Fuzzy-based risk prioritization for a hydrogen refueling facility in Malaysia

    Institute of Scientific and Technical Information of China (English)

    Hue-yee CHONG; Mahidzal DAHARI; Hwa-jen YAP; Ying-tai LOONG

    2013-01-01

    Hydrogen is starting to be mentioned as an alternative fuel to replace the fossil fuel in future transportation applications due to its characteristics of zero greenhouse gas emission and high energy efficiency.Before hydrogen fuel and its facilities can be introduced to the public,relevant safety issues and its hazards must be assessed in order to avoid any chance of injury or loss.While a traditional risk assessment has difficulty in prioritizing the risk of failure modes,this paper proposes a new fuzzy-based risk evaluation technique which uses fuzzy value to prioritize the risk of various scenarios.In this study,the final risk of each failure modes was prioritized by using the MATLAB fuzzy logic tool box with a combination of two assessments.The first assessment was concerned with the criteria which affected the actual probability of occurrence.This assessment considered the availability of the standard that was applied to prevent the likelihood of the scenario occurring.On the other hand,the second assessment was focused on evaluating the consequence of the failure by taking into account the availability of detection and the complexity of the failure rather than only the severity of the scenarios.A total of 87 failure scenarios were identified using failure modes and effect analysis(FMEA)procedures on hydrogen refueling station models.Fuzzy-based assessments were performed through risk prioritizing various failure scenarios with a fuzzy value(0 to 1)and risk level(low,medium,and high)while a traditional risk assessment approach presented the risks only in forms of level(low,medium,and/or high).Availability of the fuzzy value enabled further prioritizing on the risk results that fell in the same level of risk.This study concluded that fuzzy-based risk evaluation is able to further prioritize the decisions when compared with a traditional risk assessment method.

  9. Risk Factors for Birth Asphyxia in an Urban Health Facility in Cameroon

    OpenAIRE

    Chiabi, Andreas; Nguefack, Seraphin; Evelyne MAH; NODEM, Sostenne; Mbuagbaw, Lawrence; Mbonda, Elie; TCHOKOTEU, Pierre-Fernand; Anderson DOH

    2013-01-01

    How to Cite This Article: Chiabi A, Nguefack S, Mah E, Nodem S, Mbuagbaw L, Mbonda E, Tchokoteu PF, Doh A. Risk Factors for Birth Asphyxia in an Urban Health Facility in Cameroon. Iran J Child Neurol. 2013 Summer; 7(3):46-54.ObjectiveThe World Health Organization (WHO) estimates that 4 million children are born with asphyxia every year, of which 1 million die and an equal number survive with severe neurologic sequelae. The purpose of this study was to identify the risk factors of birth asphyx...

  10. Risk communication considerations to facilitate the screening of mass populations for potential contamination with radioactive material.

    Science.gov (United States)

    Emery, R J; Sprau, D D; Morecook, R C

    2008-11-01

    Experience gained during a field training exercise with a Medical Reserve Corps unit on the screening of large groups of individuals for possible contamination with radioactive material revealed that while exercise participants were generally attentive to the proper use of protective equipment and detectors, they tended to overlook important basic risk communications aspects. For example, drill participants did not actively communicate with the persons waiting in line for screening, a step which would provide re-assurance, possibly minimize apprehension, and would clarify expectations. When questioned on this issue of risk communication, drill participants were often able to craft ad hoc messages, but the messages were inconsistent and likely would not have significantly helped diminish anxiety and maintain crowd control. Similar difficulties were encountered regarding messaging for persons determined to be contaminated, those departing the screening center, and those to be delivered to the media. Based on these experiences, the need for a suggested list of risk communication points was identified. To address this need, a set of risk communication templates were developed that focused on the issues likely to be encountered in a mass screening event. The points include issues such as the importance of remaining calm, steps for minimizing possible intake or uptake, considerations for those exhibiting acute injuries, expected screening wait times, the process to be followed and the information to be collected, the process to be undertaken for those exhibiting contamination, and symptoms to watch for after departure. Drill participants indicated in follow-up discussions that such pre-established risk communication templates would serve to enhance their ability to assist in times of emergency and noted the potential broader applicably of the approach for use in responses for other disasters types as well.

  11. Screening for Fall Risks in the Emergency Department: A Novel Nursing-Driven Program

    Directory of Open Access Journals (Sweden)

    Jill M. Huded

    2015-12-01

    Full Text Available Introduction: Seniors represent the fasting growing population in the U.S., accounting for 20.3 million visits to emergency departments (EDs annually. The ED visit can provide an opportunity for identifying seniors at high risk of falls. We sought to incorporate the Timed Up & Go Test (TUGT, a commonly used falls screening tool, into the ED encounter to identify seniors at high fall risk and prompt interventions through a geriatric nurse liaison (GNL model. Methods: Patients aged 65 and older presenting to an urban ED were evaluated by a team of ED nurses trained in care coordination and geriatric assessment skills. They performed fall risk screening with the TUGT. Patients with abnormal TUGT results could then be referred to physical therapy (PT, social work or home health as determined by the GNL. Results: Gait assessment with the TUGT was performed on 443 elderly patients between 4/1/13 and 5/31/14. A prior fall was reported in 37% of patients in the previous six months. Of those screened with the TUGT, 368 patients experienced a positive result. Interventions for positive results included ED-based PT (n=63, 17.1%, outpatient PT referrals (n=56, 12.2% and social work consultation (n=162, 44%. Conclusion: The ED visit may provide an opportunity for older adults to be screened for fall risk. Our results show ED nurses can conduct the TUGT, a validated and time efficient screen, and place appropriate referrals based on assessment results. Identifying and intervening on high fall risk patients who visit the ED has the potential to improve the trajectory of functional decline in our elderly population.

  12. A facile inhibitor screening of SARS coronavirus N protein using nanoparticle-based RNA oligonucleotide

    Directory of Open Access Journals (Sweden)

    Roh C

    2012-05-01

    Full Text Available Changhyun RohDivision of Biotechnology, Advanced Radiation Technology Institute (ARTI, Korea Atomic Energy Research Institute (KAERI, Jeongeup, Republic of KoreaAbstract: Hundreds of million people worldwide have been infected with severe acute respiratory syndrome (SARS, and the rate of global death from SARS has remarkably increased. Hence, the development of efficient drug treatments for the biological effects of SARS is highly needed. We have previously shown that quantum dots (QDs-conjugated RNA oligonucleotide is sensitive to the specific recognition of the SARS-associated coronavirus (SARS-CoV nucleocapsid (N protein. In this study, we found that a designed biochip could analyze inhibitors of the SARS-CoV N protein using nanoparticle-based RNA oligonucleotide. Among the polyphenolic compounds examined, (--catechin gallate and (--gallocatechin gallate demonstrated a remarkable inhibition activity on SARS-CoV N protein. (--catechin gallate and (--gallocatechin gallate attenuated the binding affinity in a concentrated manner as evidenced by QDs-conjugated RNA oligonucleotide on a designed biochip. At a concentration of 0.05 µg mL–1, (--catechin gallate and (--gallocatechin gallate showed more than 40% inhibition activity on a nanoparticle-based RNA oligonucleotide biochip system.Keywords: SARS, RNA oligonucleotide, quantum dots, inhibitor, screening

  13. Identification and Prioritization of Analysis Cases for Marine and Hydrokinetic Energy Risk Screening

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, Richard M.; Unwin, Stephen D.; Van Cleve, Frances B.

    2010-06-16

    In this report we describe the development of the Environmental Risk Evaluation System (ERES), a risk-informed analytical process for estimating the environmental risks associated with the construction and operation of marine and hydrokinetic energy generation projects. The development process consists of two main phases of analysis. In the first phase, preliminary risk analyses will take the form of screening studies in which key environmental impacts and the uncertainties that create risk are identified, leading to a better-focused characterization of the relevant environmental effects. Existence of critical data gaps will suggest areas in which specific modeling and/or data collection activities should take place. In the second phase, more detailed quantitative risk analyses will be conducted, with residual uncertainties providing the basis for recommending risk mitigation and monitoring activities. We also describe the process used for selecting three cases for fiscal year 2010 risk screening analysis using the ERES. A case is defined as a specific technology deployed in a particular location involving certain environmental receptors specific to that location. The three cases selected satisfy a number of desirable criteria: 1) they correspond to real projects whose deployment is likely to take place in the foreseeable future; 2) the technology developers are willing to share technology and project-related data; 3) the projects represent a diversity of technology-site-receptor characteristics; 4) the projects are of national interest, and 5) environmental effects data may be available for the projects.

  14. Citizen perceptions of information flow around a nuclear facility: A study in risk communication

    Energy Technology Data Exchange (ETDEWEB)

    Price, M.O. [Delgado Community Coll., New Orleans, LA (United States)

    1997-08-01

    Responses of focus group members from the region around a Nuclear Facility provide the data for this qualitative study concerning citizen perceptions of available site information. Analyses of three of the focus group discussion questions and the answers they elicited showed a dominant perception among participants of insufficient easily available information about the site. These respondents also indicated that most of them obtain site information through mass media and hearsay, that many lack trust in the information they have and would trust only an independent entity to provide accurate information. A new area in communication studies, variously called environmental risk communication, risk communication and health risk communication, continues to evolve among those working in various allied disciplines, some far removed from communication. As science attempts to solve environmental problems caused by technological advances, this field acquires numerous practitioners. Some of these risk communication experts may however, be overlooking basic and necessary components of effective communication, because their expertise is in another discipline. One result of this can be communication breakdown in which those involved, assume that meaning is shared, when in fact the opposite is true. This paper seeks to clarify a necessary ingredient of effective interpersonal risk communication, using data obtained from citizens living around one of the nation`s nuclear facilities as an example.

  15. Risk perception and public acceptance toward a highly protested Waste-to-Energy facility.

    Science.gov (United States)

    Ren, Xiangyu; Che, Yue; Yang, Kai; Tao, Yun

    2016-02-01

    The application of Waste-to-Energy treatment in Municipal Solid Waste faces strong protest by local communities, especially in cities with high population densities. This study introduces insight into the public awareness, acceptance and risk perception toward Waste-to-Energy through a structured questionnaire survey around a Waste-to-Energy facility in Shanghai, China. The Dichotomous-Choice contingent valuation method was applied to study the willingness to accept of residents as an indicator of risk perception and tolerance. The factors influencing risk perception and the protest response choice were analyzed. The geographical distributions of the acceptance of Waste-to-Energy facility and protest response were explored using geographical information systems. The findings of the research indicated an encouraging vision of promoting Waste-to-Energy, considering its benefits of renewable energy and the conservation of land. A high percentage of protest willingness to accept (50.94%) was highlighted with the effect of income, opinion about Waste-to-Energy, gender and perceived impact. The fuzzy classification among people with different opinions on compensation (valid 0, positive or protest willingness to accept) revealed the existing yet rejected demand of compensation among protesters. Geographical distribution in the public attitude can also be observed. Finally significant statistical relation between knowledge and risk perception indicates the need of risk communication, as well as involving public into whole management process. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Community health workers, social support and cervical cancer screening among high-risk groups in rural Mexico.

    Science.gov (United States)

    Elliott, Patrick F; Belinson, Suzanne E; Ottolenghi, Emma; Smyth, Kathleen; Belinson, Jerome L

    2013-11-01

    Rural Mexico has a low screening prevalence and high burden of cervical cancer. One strategy to increase screening coverage utilizes community health workers (CHWs) to recruit high-risk women and address barriers. We conducted a systematic cross-sectional survey of 196 women residing in Chiapas, Mexico who were recruited by either CHWs or traditional means for screening. This analysis compares 110 rural women's risk factors, attitudes and knowledge of cervical cancer and socioeconomic factors stratified by type of recruitment. Women who were informed of screening by CHWs were more likely to be of high risk sub-groups and report higher scores of social support but were also more likely to endorse difficulty with access and fatalistic attitudes about cancer. Utilizing CWHs results in increased screening among high-risk women and increased social support for screening among rural women, addressing a significant barrier, but may have limited effects on other barriers.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  18. A semiparametric censoring bias model for estimating the cumulative risk of a false-positive screening test under dependent censoring.

    Science.gov (United States)

    Hubbard, Rebecca A; Miglioretti, Diana L

    2013-03-01

    False-positive test results are among the most common harms of screening tests and may lead to more invasive and expensive diagnostic testing procedures. Estimating the cumulative risk of a false-positive screening test result after repeat screening rounds is, therefore, important for evaluating potential screening regimens. Existing estimators of the cumulative false-positive risk are limited by strong assumptions about censoring mechanisms and parametric assumptions about variation in risk across screening rounds. To address these limitations, we propose a semiparametric censoring bias model for cumulative false-positive risk that allows for dependent censoring without specifying a fixed functional form for variation in risk across screening rounds. Simulation studies demonstrated that the censoring bias model performs similarly to existing models under independent censoring and can largely eliminate bias under dependent censoring. We used the existing and newly proposed models to estimate the cumulative false-positive risk and variation in risk as a function of baseline age and family history of breast cancer after 10 years of annual screening mammography using data from the Breast Cancer Surveillance Consortium. Ignoring potential dependent censoring in this context leads to underestimation of the cumulative risk of false-positive results. Models that provide accurate estimates under dependent censoring are critical for providing appropriate information for evaluating screening tests.

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

    NARCIS (Netherlands)

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

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

  20. Consensus Recommendations for Advancing Breast Cancer: Risk Identification and Screening in Ethnically Diverse Younger Women

    Directory of Open Access Journals (Sweden)

    Alexander Stojadinovic, Thomas A Summers, John Eberhardt, Albert Cerussi, Warren Grundfest, Charles M. Peterson, Michael Brazaitis, Elizabeth Krupinski, Harold Freeman

    2011-01-01

    Full Text Available A need exists for a breast cancer risk identification paradigm that utilizes relevant demographic, clinical, and other readily obtainable patient-specific data in order to provide individualized cancer risk assessment, direct screening efforts, and detect breast cancer at an early disease stage in historically underserved populations, such as younger women (under age 40 and minority populations, who represent a disproportionate number of military beneficiaries. Recognizing this unique need for military beneficiaries, a consensus panel was convened by the USA TATRC to review available evidence for individualized breast cancer risk assessment and screening in young (< 40, ethnically diverse women with an overall goal of improving care for military beneficiaries. In the process of review and discussion, it was determined to publish our findings as the panel believes that our recommendations have the potential to reduce health disparities in risk assessment, health promotion, disease prevention, and early cancer detection within and in other underserved populations outside of the military. This paper aims to provide clinicians with an overview of the clinical factors, evidence and recommendations that are being used to advance risk assessment and screening for breast cancer in the military.

  1. Ovarian Cancer Screening Pilot Trial In High Risk Women — EDRN Public Portal

    Science.gov (United States)

    BACKGROUND: No proven ovarian cancer (OC) screening strategy exists for women who are at increased risk for the disease. A risk of ovarian cancer algorithm (ROCA) using serial CA125 values have previously shown greater positive predictive value (PPV) and sensitivity than a single CA125 in screening women at general population risk. We hypothesized that using ROCA would yield a reasonable PPV for ovarian cancer screening in a cohort at increased risk. METHODS: Between 7/2001 and 9/2006, 25 sites (14 CGN, 3 ovarian SPOREs, 1 EDRN, 7 others) prospectively enrolled patients. Inclusion criteria included: among self, 1st degree and 2nd degree relatives in same lineage either (i) BRCA 1/2 mutation, or (ii) two of OC or early onset (age 1% to ultrasound (US) and risk > 10% additionally to a gynecologic oncologist. Objectives included PPV for study indicated surgery, sensitivity, and compliance. Sample size was chosen to observe 8 OC endpoints with a power of 80% to rule out PPV < or = 10% if the true PPV = 20%.

  2. Mitigating threat and risk in nuclear facilities through convergence of security systems

    Energy Technology Data Exchange (ETDEWEB)

    Flynn, Daniel John [Florida Institute of Technology (United States)

    2010-07-01

    The advancement of sensor and subsystems integration, facility network infrastructures, and situational awareness platforms now enable an integrated view of a comprehensive security solution on a single screen. A Radar Video Surveillance (RVS) system converges these aspects of security systems into a Geographic Information System (GIS) view, which conveys overall security status and reacts to potential threats. An overhead GIS view of the facility is populated with security sensors, including perimeter security sensors, CCTV cameras, access control equipment, radar sensors, and life safety equipment. The status and location of these sensors is displayed on the map, as well as the data from these sensors, such as intruder locations and live CCTV images. The software automatically directs PTZ cameras to the current location of a potential incident, displays that image, records it, and initiates an alarm and an automated response. This paper describes the concept of comprehensive security convergence, including sensor integration, situational awareness, automation of responses and notification, and the challenges and opportunities in providing true convergence as well as the benefits this approach delivers in a nuclear facility. (authors)

  3. A historical application of social amplification of risk model: Economic impacts of risk events at nuclear weapons facilities?

    Energy Technology Data Exchange (ETDEWEB)

    Metz, W.C.

    1996-12-31

    Public perceptions of risk have proven to be a critical barrier to the federal government`s extensive, decade-long, technical and scientific effort to site facilities for the interim storage and permanent disposal of high-level radioactive waste (HLW). The negative imagery, fear, and anxiety that are linked to ``nuclear`` and ``radioactive`` technologies, activities, and facilities by the public originate from the personal realities and experiences of individuals and the information they receive. These perceptions continue to be a perplexing problem for those responsible for making decisions about federal nuclear waste management policies and programs. The problem of understanding and addressing public perceptions is made even more difficult because there are decidedly different opinions about HLW held by the public and nuclear industry and radiation health experts.

  4. Screening Risk Assessment for Possible Radionuclides in the Amchitka Marine Environment

    Energy Technology Data Exchange (ETDEWEB)

    NNSA/NV

    2002-10-31

    As part of its environmental stewardship program the U.S. Department of Energy (DOE) is reevaluating three sites where underground nuclear tests were conducted in the deep subsurface of Amchitka Island, Alaska. The tests (i.e., Long Shot, Milrow, and Cannikin) were conducted in 1965, 1969, and 1971, respectively. Extensive investigations were conducted on these tests and their effect on the environment. Evaluations at the time of testing indicated limited release of radionuclides and absence of risk related to the testing; however, these are being reevaluated under the current DOE environmental stewardship program. A screening risk assessment of potential radionuclide release into the marine environment is an important part of this reevaluation. The risk assessment is one of three interrelated activities: a groundwater model and this screening risk assessment, both of which guide the decisions in the third activity, the site closure plan. Thus, the overall objective of the work is to understand, and subsequently manage, any risk to humans and the environment through a closure and long-term stewardship plan. The objective of this screening risk assessment is to predict whether possible releases of radionuclides at the ocean floor would represent potential risks to Native Alaskans by consumption of marine subsistence species. In addition, risks were predicted for consumers of commercial catches of marine organisms. These risks were calculated beginning with estimates of possible radionuclide release at the seafloor (from a groundwater modeling study), into the seawater, through possible uptake by marine organisms, and finally possible consumption by humans. The risk assessment model has 11 elements, progressing from potential release at the seafloor through water and food chains to human intake. Data for each of these elements were systematically found and synthesized from many sources, and represent the best available knowledge. Whenever precise data were lacking

  5. Evolution and Innovations of the National Neonatal and High Risk Screening Program in Costa Rica

    Directory of Open Access Journals (Sweden)

    Carlos de Céspedes

    2004-09-01

    Full Text Available We present the evolution, organization and results of the National Neonatal and High Risk Screening Program in Costa Rica (PNT. This program has been working uninterruptedly for more than fourteen years. Costa Rica currently has a literacy rate of 95%. To August 2004 the rate of infant mortality was 9.74 per 1000 births and to 2003, life expectancy was 76.3 years for men and 81.1 years for women. The control of infectious and parasitic diseases, as well as of severe malnutrition, has given room to a prevalence of chronic diseases with a pathology profile similar to that of a developed country. The clinical observation, mainly starting from early 70s, of a growing number of patients with mental retardation and other disabilities caused by congenital hypothyroidism and hereditary metabolic diseases that could have been prevented in many cases with an early diagnosis and opportune treatment, led us to the decision to implement a systematically massive neonatal screening for these diseases. The presence of a single Public System of Social Security in Costa Rica, which currently includes from primary health care up to the hospitals of tertiary attention, with a single Children’s Hospital for the whole country, as well as communication facilities, are factors that offered, in principle, favorable conditions for this effort, even for a developing country. To September 2004, 835,217 children have been screened. There is a coverage of 95.1% of the newborns in the country. Also to this date, 259 children with congenital hypothyroidism, 18 with phenylketonuria, 20 with the maple syrup disease, 30 with congenital adrenal hyperplasia and 10 with galactosemia have been detected, confirmed and treated, for a total of 337 children that were spared of mental retardation, other disabilities and even death. Massive neonatal screening for organic acidemias recently started in June of 2004. Cystic fibrosis is under a pilot study and the screening for

  6. Regional differences in self-reported screening, prevalence and management of cardiovascular risk factors in Switzerland.

    Science.gov (United States)

    Marques-Vidal, Pedro; Paccaud, Fred

    2012-03-28

    In Switzerland, health policies are decided at the local level, but little is known regarding their impact on the screening and management of cardiovascular risk factors (CVRFs). We thus aimed at assessing geographical levels of CVRFs in Switzerland. Swiss Health Survey for 2007 (N = 17,879). Seven administrative regions were defined: West (Leman), West-Central (Mittelland), Zurich, South (Ticino), North-West, East and Central Switzerland. Obesity, smoking, hypertension, dyslipidemia and diabetes prevalence, treatment and screening within the last 12 months were assessed by interview. After multivariate adjustment for age, gender, educational level, marital status and Swiss citizenship, no significant differences were found between regions regarding prevalence of obesity or current smoking. Similarly, no differences were found regarding hypertension screening and prevalence. Two thirds of subjects who had been told they had high blood pressure were treated, the lowest treatment rates being found in East Switzerland: odds-ratio and [95% confidence interval] 0.65 [0.50-0.85]. Screening for hypercholesterolemia was more frequently reported in French (Leman) and Italian (Ticino) speaking regions. Four out of ten participants who had been told they had high cholesterol levels were treated and the lowest treatment rates were found in German-speaking regions. Screening for diabetes was higher in Ticino (1.24 [1.09 - 1.42]). Six out of ten participants who had been told they had diabetes were treated, the lowest treatment rates were found for German-speaking regions. In Switzerland, cardiovascular risk factor screening and management differ between regions and these differences cannot be accounted for by differences in populations' characteristics. Management of most cardiovascular risk factors could be improved.

  7. Regional differences in self-reported screening, prevalence and management of cardiovascular risk factors in Switzerland

    Directory of Open Access Journals (Sweden)

    Marques-Vidal Pedro

    2012-03-01

    Full Text Available Abstract Background In Switzerland, health policies are decided at the local level, but little is known regarding their impact on the screening and management of cardiovascular risk factors (CVRFs. We thus aimed at assessing geographical levels of CVRFs in Switzerland. Methods Swiss Health Survey for 2007 (N = 17,879. Seven administrative regions were defined: West (Leman, West-Central (Mittelland, Zurich, South (Ticino, North-West, East and Central Switzerland. Obesity, smoking, hypertension, dyslipidemia and diabetes prevalence, treatment and screening within the last 12 months were assessed by interview. Results After multivariate adjustment for age, gender, educational level, marital status and Swiss citizenship, no significant differences were found between regions regarding prevalence of obesity or current smoking. Similarly, no differences were found regarding hypertension screening and prevalence. Two thirds of subjects who had been told they had high blood pressure were treated, the lowest treatment rates being found in East Switzerland: odds-ratio and [95% confidence interval] 0.65 [0.50-0.85]. Screening for hypercholesterolemia was more frequently reported in French (Leman and Italian (Ticino speaking regions. Four out of ten participants who had been told they had high cholesterol levels were treated and the lowest treatment rates were found in German-speaking regions. Screening for diabetes was higher in Ticino (1.24 [1.09 - 1.42]. Six out of ten participants who had been told they had diabetes were treated, the lowest treatment rates were found for German-speaking regions. Conclusions In Switzerland, cardiovascular risk factor screening and management differ between regions and these differences cannot be accounted for by differences in populations' characteristics. Management of most cardiovascular risk factors could be improved.

  8. Public attitudes towards genomic risk profiling as a component of routine population screening.

    Science.gov (United States)

    Nicholls, S G; Wilson, B J; Craigie, S M; Etchegary, H; Castle, D; Carroll, J C; Potter, B K; Lemyre, L; Little, J

    2013-10-01

    Including low penetrance genomic variants in population-based screening might enable personalization of screening intensity and follow up. The application of genomics in this way requires formal evaluation. Even if clinically beneficial, uptake would still depend on the attitudes of target populations. We developed a deliberative workshop on two hypothetical applications (in colorectal cancer and newborn screening) in which we applied stepped, neutrally-framed, information sets. Data were collected using nonparticipant observation, free-text comments by individual participants, and a structured survey. Qualitative data were transcribed and analyzed using thematic content analysis. Eight workshops were conducted with 170 individuals (120 colorectal cancer screening and 50 newborn screening for type 1 diabetes). The use of information sets promoted informed deliberation. In both contexts, attitudes appeared to be heavily informed by assessments of the likely validity of the test results and its personal and health care utility. Perceived benefits included the potential for early intervention, prevention, and closer monitoring while concerns related to costs, education needs regarding the probabilistic nature of risk, the potential for worry, and control of access to personal genomic information. Differences between the colorectal cancer and newborn screening groups appeared to reflect different assessments of potential personal utility, particularly regarding prevention.

  9. Prevalence and risk factors for proteinuria: the National Kidney Foundation of Malaysia Lifecheck Health Screening programme.

    Science.gov (United States)

    Ong, Loke Meng; Punithavathi, Narayanan; Thurairatnam, Dharminy; Zainal, Hadzlinda; Beh, Mei Li; Morad, Zaki; Lee, Sharleen Ys; Bavanandan, Sunita; Kok, Lai Sun

    2013-08-01

    Treatment of chronic kidney disease (CKD) poses a huge burden to the healthcare system. To address the problem, the National Kidney Foundation of Malaysia embarked on a programme to screen for proteinuria and educate the public on CKD. The public was invited for health screening and the data collected over a 21 month period was analyzed. In total, 40400 adults from all the states in Malaysia were screened. The screening population had a mean age of 41 years, 30.1% had hypertension and 10.6% had diabetes. Proteinuria was detected in 1.4% and haematuria in 8.9% of the participants. Factors associated with the highest risk for proteinuria were the presence of diabetes (adjusted odds ratio (OR) 2.63 (95% confidence interval (CI) 2.16-3.21)), hypertension (OR 2.49 (95% CI 2.03-3.07)) and cardiac disease (OR 2.05 (95% CI 1.50-2.81)). Other risk factors identified were lower educational level, family history of kidney disease, hypercholesterolaemia, obesity and lack of regular exercise. Chinese had the lowest risk for proteinuria among the races (OR 0.71 (95% CI 0.57-0.87) compared with Malays). The combination of high blood glucose and high blood pressure (BP) substantially increased the risk for proteinuria (OR 38.1 for glucose ≥ 10 mmol/L and systolic BP ≥ 180 mm Hg and OR 47.9 for glucose ≥ 10 mmol/L and diastolic BP ≥ 110 mm Hg). The prevalence of proteinuria in Malaysia is similar to other countries. The major risk factors for proteinuria were diabetes, hypertension and cardiac disease. The presence of both high blood pressure and high blood glucose exert a synergistic effect in substantially increasing the risk for proteinuria. © 2013 The Authors. Nephrology © 2013 Asian Pacific Society of Nephrology.

  10. Patterns of nonmasslike enhancement at screening breast MR imaging of high-risk premenopausal women.

    Science.gov (United States)

    Giess, Catherine S; Raza, Sughra; Birdwell, Robyn L

    2013-01-01

    Current U.S. recommendations for breast cancer screening of women with at least a 20%-25% lifetime risk of developing breast cancer include contrast material-enhanced magnetic resonance (MR) imaging of the breasts. The cancer detection rate in high-risk women undergoing screening MR imaging is approximately 10 times higher than that in normal-risk women undergoing screening mammography. Many of these high-risk women commence MR imaging screening while they are premenopausal, when the breasts are most influenced by cyclical hormonal changes. Healthy premenopausal breast tissue enhances in a cyclical and variable manner. This enhancement is described as background enhancement. Typically, enhancement of normal breast tissue occurs in a symmetric and diffuse pattern, and there is little diagnostic difficulty in classifying it as normal background parenchymal enhancement. However, sometimes the pattern is more focal, asymmetric, or regional. It may then be described as nonmasslike enhancement, an observation associated with both benign and malignant breast pathologic conditions. A review of the morphologic features and internal enhancement patterns in normal but nondiffuse background enhancement and abnormal nonmasslike enhancement in high-risk premenopausal women can help improve interpretive specificity and decrease false-positive interpretations. MR imaging pitfalls and interpretation strategies for localized background enhancement and pathologic nonmasslike enhancement in this high-risk population are highlighted. In evaluating nonmasslike enhancement, the use of the Breast Imaging Reporting and Data System (BI-RADS) lexicon to perform careful analysis of morphologic features, along with an understanding of the role and limitations of kinetic information, will help balance early breast cancer detection against false-positive interpretation.

  11. Identifying high risk individuals for targeted lung cancer screening: Independent validation of the PLCOm2012 risk prediction tool.

    Science.gov (United States)

    Weber, Marianne; Yap, Sarsha; Goldsbury, David; Manners, David; Tammemagi, Martin; Marshall, Henry; Brims, Fraser; McWilliams, Annette; Fong, Kwun; Kang, Yoon Jung; Caruana, Michael; Banks, Emily; Canfell, Karen

    2017-07-15

    Lung cancer screening with computerised tomography holds promise, but optimising the balance of benefits and harms via selection of a high risk population is critical. PLCOm2012 is a logistic regression model based on U.S. data, incorporating sociodemographic and health factors, which predicts 6-year lung cancer risk among ever-smokers, and thus may better predict those who might benefit from screening than criteria based solely on age and smoking history. We aimed to validate the performance of PLCOm2012 in predicting lung cancer outcomes in a cohort of Australian smokers. Predicted risk of lung cancer was calculated using PLCOm2012 applied to baseline data from 95,882 ever-smokers aged ≥45 years in the 45 and Up Study (2006-2009). Predictions were compared to lung cancer outcomes captured to June 2014 via linkage to population-wide health databases; a total of 1,035 subsequent lung cancer diagnoses were identified. PLCOm2012 had good discrimination (area under the receiver-operating-characteristic-curve; AUC 0.80, 95%CI 0.78-0.81) and excellent calibration (mean and 90th percentiles of absolute risk difference between observed and predicted outcomes: 0.006 and 0.016, respectively). Sensitivity (69.4%, 95%CI, 65.6-73.0%) of the PLCOm2012 criteria in the 55-74 year age group for predicting lung cancers was greater than that using criteria based on ≥30 pack-years smoking and ≤15 years quit (57.3%, 53.3-61.3%; p cancer screening using PLCOm2012 might improve the balance of benefits versus harms, and cost-effectiveness of lung cancer screening. © 2017 UICC.

  12. A cost analysis of a pancreatic cancer screening protocol in high-risk populations.

    Science.gov (United States)

    Bruenderman, Elizabeth; Martin, Robert C G

    2015-09-01

    Pancreatic cancer is the 4th leading cause of cancer death in the United States. A screening protocol is needed to catch early-stage, resectable disease. This study suggests a protocol for high-risk individuals and assesses the cost in the context of the Affordable Care Act. Medicare and national average pricing were used for cost analysis of a protocol using magnetic resonance imaging/MRCP biannually in high-risk groups. Costs per year of life added" based on Medicare and national average costs, respectively, are as follows: $638.62 and $2,542.37 for Peutz-Jeghers syndrome, $945.33 and $3,763.44 for hereditary pancreatitis, $1,141.77 and $4,545.45 for familial pancreatic cancer and "p16-Leiden" mutations, and $356.42 and $1,418.92 for new-onset diabetes over age 50 with weight loss or smoking. A screening program using magnetic resonance imaging/MRCP is affordable in high-risk populations. The United States Preventive Services Task Force must re-evaluate its pancreatic cancer screening guidelines to make screening more cost-effective for the individual. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Development of the Falls Risk for Older People in the Community (FROP-Com) screening tool.

    Science.gov (United States)

    Russell, Melissa A; Hill, Keith D; Day, Lesley M; Blackberry, Irene; Gurrin, Lyle C; Dharmage, Shyamali C

    2009-01-01

    the aim of this study was to develop a brief screening tool for use in the emergency department (ED), to identify people who require further assessment and management. this prospective study included 344 community-dwelling older people presenting to an ED after a fall. After direct discharge participants had a home-based assessment performed that included the Falls Risk for Older People in the Community (FROP-Com), a comprehensive, yet simple, multifactorial falls risk assessment tool. They were then monitored for falls for 12 months. The items from the FROP-Com assessment tool predictive of falls in a multifactorial logistic regression were used to develop the FROP-Com screen. the items significantly predictive of falls and combined to form the FROP-Com screen were: falls in the previous 12 months, observation of the person's balance and the need for assistance to perform domestic activities of daily living. At the cut-off with the highest Youden index sensitivity was 67.1% (95% CI 59.9-74.3) and specificity was 66.7% (95% CI 59.8-73.6). the FROP-Com screen has a relatively good capacity to predict falls. It can be used in time-limited situations to classify those at high risk of falls who require more detailed assessment and management.

  14. Risk factors for hearing loss in infants under universal hearing screening program in Northern Thailand

    Directory of Open Access Journals (Sweden)

    Poonual W

    2015-12-01

    Full Text Available Watcharapol Poonual,1 Niramon Navacharoen,2 Jaran Kangsanarak,2 Sirianong Namwongprom3 1Clinical Epidemiology Program, 2Department of Otolaryngology, 3Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Objective: To define the risk factors for hearing loss in infants (aged 3 months under universal hearing screening program. Materials and methods: A total of 3,120 infants (aged 3 months who underwent hearing screening using a universal hearing screening program using automated otoacoustic emission test between November 1, 2010 and May 31, 2012 in Uttaradit Hospital, Buddhachinaraj Hospital, and Sawanpracharuk Hospital (tertiary hospitals located in Northern Thailand were included in this prospective cohort study. Results: Of the 3,120 infants, 135 (4.3% were confirmed to have hearing loss with the conventional otoacoustic emission test. Five of these 135 infants (3.7% with hearing loss showed test results consistent with auditory brainstem responses. From the univariable analysis, there were eleven potential risk factors associated with hearing deterioration. On multivariable analysis, the risk factors independently associated with hearing loss at 3 months were birth weight 1,500–2,500 g (risk ratio [RR] 1.6, 95% confidence interval [CI] 1.1–2.6, APGAR score <6 at 5 minutes (RR 2.2, 95% CI 1.1–4.4, craniofacial anomalies (RR 2.5, 95% CI 1.6–4.2, sepsis (RR 1.8, 95% CI 1.0–3.2, and ototoxic exposure (RR 4.1, 95% CI 1.9–8.6. Conclusion: This study concluded that low birth weight, APGAR score <6 at 5 minutes, craniofacial anomalies, sepsis, and ototoxic exposure are the risk factors for bilateral hearing loss in infants (aged 3 months and proper tests should be performed to identify these risk factors. As an outcome, under the present circumstances, it is suggested that infirmary/physicians/general practitioners/health action centers/polyclinics should carry out universal hearing screening in all

  15. MRI screening for breast cancer in women at high risk; is the Australian breast MRI screening access program addressing the needs of women at high risk of breast cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Schenberg, Tess [Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Mitchell, Gillian [Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria (Australia); Taylor, Donna [School of Surgery, University of Western Australia, Perth, Western Australia (Australia); Department of Radiology, Royal Perth Hospital, Perth, Western Australia (Australia); BreastScreen Western Australia, Adelaide Terrace, Perth, Western Australia (Australia); Saunders, Christobel [School of Surgery, University of Western Australia, Perth, Western Australia (Australia); Department of General Surgery, St John of God Hospital, Perth, Western Australia (Australia); Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia)

    2015-09-15

    Breast magnetic resonance imaging (MRI) screening of women under 50 years old at high familial risk of breast cancer was given interim funding by Medicare in 2009 on the basis that a review would be undertaken. An updated literature review has been undertaken by the Medical Services Advisory Committee but there has been no assessment of the quality of the screening or other screening outcomes. This review examines the evidence basis of breast MRI screening and how this fits within an Australian context with the purpose of informing future modifications to the provision of Medicare-funded breast MRI screening in Australia. Issues discussed will include selection of high-risk women, the options for MRI screening frequency and measuring the outcomes of screening.

  16. Can data science inform environmental justice and community risk screening for type 2 diabetes?

    Science.gov (United States)

    Davis, J Allen; Burgoon, Lyle D

    2015-01-01

    Having the ability to scan the entire country for potential "hotspots" with increased risk of developing chronic diseases due to various environmental, demographic, and genetic susceptibility factors may inform risk management decisions and enable better environmental public health policies. Develop an approach for community-level risk screening focused on identifying potential genetic susceptibility hotpots. Our approach combines analyses of phenotype-genotype data, genetic prevalence of single nucleotide polymorphisms, and census/geographic information to estimate census tract-level population attributable risks among various ethnicities and total population for the state of California. We estimate that the rs13266634 single nucleotide polymorphism, a type 2 diabetes susceptibility genotype, has a genetic prevalence of 56.3%, 47.4% and 37.0% in Mexican Mestizo, Caucasian, and Asian populations. Looking at the top quintile for total population attributable risk, 16 California counties have greater than 25% of their population living in hotspots of genetic susceptibility for developing type 2 diabetes due to this single genotypic susceptibility factor. This study identified counties in California where large portions of the population may bear additional type 2 diabetes risk due to increased genetic prevalence of a susceptibility genotype. This type of screening can easily be extended to include information on environmental contaminants of interest and other related diseases, and potentially enables the rapid identification of potential environmental justice communities. Other potential uses of this approach include problem formulation in support of risk assessments, land use planning, and prioritization of site cleanup and remediation actions.

  17. Deriving and validating a risk estimation tool for screening asymptomatic chlamydia and gonorrhea.

    Science.gov (United States)

    Falasinnu, Titilola; Gilbert, Mark; Gustafson, Paul; Shoveller, Jean

    2014-12-01

    There has been considerable interest in the development of innovative service delivery modules for prioritizing resources in sexual health delivery in response to dwindling fiscal resources and rising infection rates. This study aims to derive and validate a risk scoring algorithm to accurately identify asymptomatic patients at increased risk for chlamydia and/or gonorrhea infection. We examined the electronic records of patient visits at sexual health clinics in Vancouver, Canada. We derived risk scores from regression coefficients of multivariable logistic regression model using visits between 2000 and 2006. We evaluated the model's discrimination, calibration, and screening performance. Temporal validation was assessed in visits from 2007 to 2012. The prevalence of infection was 1.8% (n = 10,437) and 2.1% (n = 14,956) in the derivation and validation data sets, respectively. The final model included younger age, nonwhite ethnicity, multiple sexual partners, and previous infection and showed reasonable performance in the derivation (area under the receiver operating characteristic curve = 0.74; Hosmer-Lemeshow P = 0.91) and validation (area under the receiver operating characteristic curve = 0.64; Hosmer-Lemeshow P = 0.36) data sets. A risk score cutoff point of at least 6 detected 91% and 83% of cases by screening 68% and 68% of the derivation and validation populations, respectively. These findings support the use of the algorithm for individualized risk assessment and have important implications for reducing unnecessary screening and saving costs. Specifically, we anticipate that the algorithm has potential uses in alternative settings such as Internet-based testing contexts by facilitating personalized test recommendations, stimulating health care-seeking behavior, and aiding risk communication by increasing sexually transmitted infection risk perception through the creation of tailored risk messages to different groups.

  18. Screening for Type 2 Diabetes in a High-Risk Population : Effects of a Negative Screening Test After 4 Years Follow-up

    NARCIS (Netherlands)

    Willems, Julie I.; Otto, Suzie J.; Klijs, Bart; de Koning, Harry J.

    2014-01-01

    A negative diabetes screening test may unintentionally provide reassurance, resulting in reduced incentive to follow a healthy lifestyle. The purpose of this study is to assess negative test result effects on lifestyle and risk perception at 4 years follow-up. Risk perception and changes in smoking,

  19. Screening effects on thyroid cancer risk estimates for populations affected by the Chernobyl accident

    Energy Technology Data Exchange (ETDEWEB)

    Jacob, P.; Kaiser, J. C.; Vavilov, S.E.; Bogdanova, T.; Tronko, N. D.

    2004-07-01

    Simulation calculations are performed in order to explore the ecological bias in studies as they are performed with settlement specific data in the aftemath of the Chernobyl accident. Based on methods, that were developed by Lubin for exploring the ecologic bias due to smoking in indoor radon studies of lung cancer, the influence of the introduction of ultrasound devices and enhanced medical surveillance on the detection and reporting of thyroid cancer cases was investigated. Calculations were performed by simulating thyroid doses of one million children in a total of 744 settlements and assuming a linear dependence of the risk on dose and various scenarios of the screening. The dose distributions simulate the distributions similar to those used in previous ecologic studies of the thyroid cancer risk in Ukraine after the Chernobyl accident. The ecologic bias was defined as the ratio of risk coefficients derived from an ecological study to the corresponding risk factor in the underlying risl model. the ecologic bias was estimated for each of the screening scenarios. Analytical equations were derived that allow the exact numerical compuation of the bias which is determined by covariance terms between the increased detection and reporting on one side and thyroid dose values (individual and averaged for the settlements) on the other side. Nested in th epopulation data, a cohort study was simulated with 10 000 individuals and an average thyroid dose of 0.3 Gy. the present study underlines the different scopes of the ecologic and cohort study designs perfomed in the aftermed of the Chernobyl accident. Whereas the ecologic studies give an estimate of the excess thyroid cancer risks per unit dose under the conditions of a health care system as it is typical for the affected countries after the Chernobyl accident, the cohort study gives risk estimates within a well screened cohort. Due to the strong screening effects, excess absoulte risks in the ecological study cohort are

  20. Women's interest in a personal breast cancer risk assessment and lifestyle advice at NHS mammography screening

    Science.gov (United States)

    Wilkinson, L.; Valencia, A.

    2017-01-01

    Abstract Background Although mortality from breast cancer is declining, incidence continues to increase and is often detected at routine NHS screening. Most middle aged and older women in England attend for screening every 3 years. Assessing their personal breast cancer risk and providing preventative lifestyle advice could help to further reduce breast cancer incidence. Methods A cross-sectional, self-complete postal survey measured attendees' interest in having a personal risk assessment, expected impact on screening attendance, knowledge of associations between lifestyle and breast cancer and preferred ways of accessing preventative lifestyle advice. Results A total of 1803/4948 (36.4%) completed questionnaires were returned. Most participants (93.7%) expressed interest in a personal risk assessment and 95% (1713/1803) believed it would make no difference or encourage re-attendance. Two-thirds (1208/1803) associated lifestyle with breast cancer, but many were unaware of specific risks such as weight gain, obesity, alcohol consumption and physical inactivity. NHS sourced advice was expected to be more credible than other sources, and booklets, brief counselling or an interactive website were most preferred for accessing this. Conclusions Attendees appear to welcome an intervention that would facilitate more proactive clinical and lifestyle prevention and address critical research gaps in breast cancer prevention and early detection. PMID:26834190

  1. Screening in high-risk group of gestational diabetes mellitus with its maternal and fetal outcomes

    Directory of Open Access Journals (Sweden)

    Angadi Rajasab Nilofer

    2012-01-01

    Full Text Available Background: Gestational diabetes mellitus (GDM is a metabolic disorder defined as glucose intolerance with the onset or first recognition during pregnancy. Women with GDM are at increased risk for adverse obstetric and perinatal outcome. The complications associated with GDM can be prevented by early recognition, intense monitoring and proper treatment. Aims: The present study was done to screen the high-risk pregnancy group for GDM, to find the incidence of abnormal results on screening and to correlate the abnormal results with the maternal and fetal outcomes. The study was done in a tertiary care hospital and teaching institute. It was a prospective cohort study. Materials and Methods: Selective screening for GDM was done in 150 pregnant women with high-risk factors. Screening was done with 50 g glucose challenge test (GCT after 18 weeks, and if GCT was negative then the test was repeated after 28 weeks of pregnancy. The patients who were having an abnormal GCT were subjected to 100 g oral glucose tolerance test (OGTT. All GDM patients were followed up and treated with diet and/or insulin therapy till delivery to know maternal and fetal outcomes. The period of study was from April 2008 to March 2009. Results: 7.3% of study population was OGCT positive. 6% of the study population was OGTT positive. Age >25 years, obesity, family history of DM, and past history of GDM were the risk factors significantly associated with GDM. One newborn had hypoglycemia and one had hyperbilirubinemia. The fetal and maternal outcome in GDM patients was good in our study due to early diagnosis and intervention. Conclusion: Women with GDM are at an increased risk for adverse obstetric and perinatal outcome. The increased morbidity in GDM is preventable by meticulous antenatal care.

  2. Evaluation of otoacoustic emissions and auditory brainstem responses for hearing screening of high risk infants

    Directory of Open Access Journals (Sweden)

    Tania Nazir

    2016-01-01

    Full Text Available Aim: The objective of the present study is the assessment of otoacoustic emissions (OAEs and auditory brainstem responses (ABRs for hearing screening of high risk infants. Study Design: Prospective, hospital-based. Materials and Methods: Distortion product OAEs (DPOAEs and brainstem evoked response audiometry (BERA recordings were obtained for 30 controls and 100 infants with one or more high risk factors, in a sound treated room and the results were interpreted. ABR peak latencies, amplitudes, and waveform morphology in high risk infants were compared with those in control group. DPOAE as screening test was evaluated in terms of various parameters with BERA/ABR taken as gold standard. Results: Absolute latencies of Wave I and Wave V and interpeak latency of I-V were significantly prolonged in high risk group as compared to control group. The most common causes to contribute significantly for hearing impairment were found to be hyperbilirubinemia, birth asphyxia, meningitis/septicemia. DPOAE when compared with ABR taken as gold standard showed that sensitivity of the test was 87.7% (74.5%-94.9% and specificity was 74.5% (60.0%-85.2%. Positive predictive value was 76.7% (63.2%-86.6% and negative predictive value of the test was 86% (71.9%-94.3%. Positive likelihood ratio was 0.29 (0.18-0.46 and negative likelihood ratio was 6.08 (2.82-13.09. Conclusion : ABR/BERA, though highly reliable, is a tedious and time consuming test. DPOAE is a simple and rapid test with relatively higher acceptability but low sensitivity and specificity; therefore, limits its role as independent screening test. DPOAE-ABR test series is an effective way to screen all the high risk infants at the earliest.

  3. Postoperative risks associated with alcohol screening depend on documented drinking at the time of surgery

    DEFF Research Database (Denmark)

    Rubinsky, Anna D; Bishop, Michael J; Maynard, Charles

    2013-01-01

    Both AUDIT-C alcohol screening scores up to a year before surgery and clinical documentation of drinking over 2 drinks per day immediately prior to surgery ("documented drinking >2d/d") are associated with increased postoperative complications and health care utilization. The purpose of this stud...... was to evaluate whether documented drinking >2d/d contributed additional information about postoperative risk beyond past-year AUDIT-C screening results.......Both AUDIT-C alcohol screening scores up to a year before surgery and clinical documentation of drinking over 2 drinks per day immediately prior to surgery ("documented drinking >2d/d") are associated with increased postoperative complications and health care utilization. The purpose of this study...

  4. Massive Endoscopic Screening for Esophageal and Gastric Cancers in a High-Risk Area of China.

    Directory of Open Access Journals (Sweden)

    Xianzhi Zheng

    Full Text Available This study aims to describe the findings from a massive endoscopic screening program in a high-risk area of China and to evaluate the prognosis of patients diagnosed through endoscopic screening compared with those diagnosed at usual hospital visits because of illness.In 2006, an early detection and treatment program was initiated in Yangzhong county, China. Local residents aged 40-69 years were eligible for free endoscopic screening. Endoscopic examination was performed with Lugol's iodine staining, followed by biopsies. Patients diagnosed with esophageal or gastric cancer were referred for treatment and followed to assess their long-term survival status.From 2006 through 2012, we screened 12453 participants, including 5334 (42.8% men and 7119 (57.2% women. The average age was 52.8 ± 8.0 years. We detected 166 patients with upper digestive tract cancers, including 106 cancers in the esophagus (detection rate: 0.85% and 60 cancers in the stomach (detection rate: 0.48%. Of these patients, 98.11% with esophageal cancer and 100% with gastric cancer were defined as at the early stage. In the process of follow-up, 17 patients died from cancer-related causes, and the median survival time was greater than 85 months. The overall survival rates for 1, 3 and 5 years were 98.0%, 90.0% and 89.0%, respectively. A significant positive effect was observed for the long-term survival of patients diagnosed through massive endoscopic screening.In a high-risk population, massive endoscopic screening can identify early stage carcinoma of esophageal and gastric cancers and improve patients' prognosis through early detection and treatment.

  5. Acceptance of screening for Intimate Partner Violence, actual screening and satisfaction with care amongst female clients visiting a health facility in Kano, Nigeria

    Science.gov (United States)

    Lawoko, Stephen; Oluwatosin, Abimbola

    2011-01-01

    Abstract Background Healthcare providers have advocated for the screening and management of Intimate Partner Violence (IPV) against women and its consequences. Unfortunately, data from high income countries suggest that women may have varied preferences for being screened for IPV in healthcare. Although women's preference for screening in sub-Saharan countries has not been well researched, IPV remains an accepted societal norm in many of these countries, including Nigeria. Objective The objective of the study was to assess women's acceptance of screening for IPV in healthcare, the extent to which inquiry about IPV was carried out in healthcare and whether such inquiry impacted on satisfaction with care. Method Data on these variables were gathered through structured interviews from a sample of 507 women at a regional hospital in Kano, Nigeria. The study design was cross-sectional. Results The results found acceptance for screening in the sample to be high (76%), but few women (7%) had actually been probed about violence in their contact with care providers. Acceptance for screening was associated with being married and being employed. Actual screening was associated with ethnicity and religion, where ethnic and religious majorities were more likely to be screened. Finally, being screened for IPV seemed to improve satisfaction with care. Conclusion The findings demonstrate the need for adaptation of a screening protocol that is also sensitive to detect IPV amongst all ethnic and religious groups. The findings also have implications for further education of socio-economically disadvantaged women on the benefits of screening.

  6. Seismic risk analysis for the Atomics International Nuclear Materials Development Facility, Santa Susana California

    Energy Technology Data Exchange (ETDEWEB)

    1978-12-29

    This report presents the results of a detailed seismic risk analysis of the Nuclear Materials Development Facility (NMDF) operated by Atomics International at Santa Susana, California. The historical seismic record was established after a review of available literature, consultation with operators of local seismic arrays and examination of appropriate seismic data bases including the USGS, California Institute of Technology and NEIS data bases. The resulting seismic record, covering the period 1969 to 1977, was used to identify all possible sources of seismicity that could affect the site. The best estimate curve indicates that the facility will experience 30% g with a return period of 55 years and 60% g with a return period of 750 years.

  7. Efficacy of screening immune system function in at-risk newborns.

    Science.gov (United States)

    Pavlovski, Christopher J

    2014-01-01

    This paper explores the introduction of a screening test to highlight impaired immune system status for newborn infants and its efficacy as a preventative clinical measure. Moreover, it is suggested that screening of the infantile immune system has the potential to highlight susceptibility to a range of infant and childhood diseases, bestowing an opportunity to introduce early intervention to reduce the incidence of these diseases. Development of the neonatal immune system is an important health issue, implicated in many childhood problems such as allergies, infection, and autoimmunity. The neonate has a limited immune system and ability to combat bacteria. Depleted levels of the tripeptide reduced glutathione (GSH) have been linked to numerous conditions and its intracellular level is acknowledged as an indicator of immune system function. Introduction of an immune system screening programme for infants is formally reviewed and assessed. Several benefits are reported in the treatment of impaired immune systems, a trial screening programme is proposed for at-risk infants to gather further evidence as to its efficacy. Infants at risk of impaired immune system function include cystic fibrosis, premature infants, and low birth weight infants. The interventions include breastfeeding, milk banks, and appropriate formula to support the immune system.

  8. Facile fabrication of CdSe/CdS quantum dots and their application on the screening of colorectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cao, Hongfeng; Dong, Quanjin, E-mail: qjdong1508@163.com [Zhejiang Provincial People’s Hospital, Department of Colorectal Surgery (China); Hu, Li [Nanjing University of Science and Technology, School of Environmental and Biological Engineering (China); Tu, Shiliang; Chai, Rui; Dai, Qiaoqiong [Zhejiang Provincial People’s Hospital, Department of Colorectal Surgery (China)

    2015-11-15

    In this paper, a facile aqueous route to water-soluble CdSe/CdS quantum dots (QDs) under mild conditions has been developed. The samples were characterized by means of transmission electron microscopy, energy-dispersive X-ray spectroscopy, and photoluminescence (PL) spectroscopy. The PL property of the QDs can be controlled by adjusting the reaction time. The CdSe/CdS QDs after 48-h reaction with size of 5 nm have the strongest PL intensity located at 553 nm, and the highest quantum yield of 19.9 %. The obtained QDs were applied for the colorectal cancer screening. The QDs could be conjugated with antibody of aldo-keto reductase family 1, member B10 (AKR1B10) for the detection of AKR1B10. The AKR1B10 in PBS/5 % serum solution with concentration of 1 ng/mL could be well calibrated, and the limit of detection could be lower than 0.05 ng/mL.

  9. Breast Cancer Risk Assessment at the Time of Screening Mammography: Perceptions and Clinical Management Outcomes for Women at High Risk.

    Science.gov (United States)

    Morman, Nichole A; Byrne, Lindsey; Collins, Christy; Reynolds, Kelly; Bell, Jeffrey G

    2017-08-01

    The purpose of this study was to evaluate the utility of a breast cancer risk assessment (BCRA) at the time of screening mammogram. Women whose BCRA indicated a high risk for cancer received a letter with instructions for breast health care and genetic counseling if appropriate. After 6 months this group received surveys to evaluate their risk perception and their recall of, and compliance with, recommendations. We also explored the impact of other variables such as a recommendation for genetic counseling and physician communication with the women. After the BCRA, the majority of high risk women reported no change in their perceived risk of cancer. A woman's perceived risk of cancer after a BCRA was significantly associated with her recall of recommendations for breast health care, but not with compliance. A recommendation for genetic counseling was not significantly related to women's perceived risk of cancer after the BCRA. Ten percent of women who should have obtained genetic counseling actually completed an appointment. Women who discussed their BCRA results with their physicians were more compliant with a six month breast exam with a doctor (53% vs 17%, p = 0.018). Overall, women felt that the BCRA was helpful and did not cause undue stress or anxiety. Although the cohort's compliance with recommendations was suboptimal, physicians' interactions with their patients may have a positive influence on their compliance.

  10. Psychosis risk screening in different populations using the Prodromal Questionnaire: A systematic review.

    Science.gov (United States)

    Savill, Mark; D'Ambrosio, Jennifer; Cannon, Tyrone D; Loewy, Rachel L

    2017-08-06

    Diagnosing individuals at ultra high risk (UHR) for psychosis can improve early access to treatment, and a two-stage model utilizing self-report screening followed by a clinical interview can be accurate and efficient. However, it is currently unclear which screening cut-offs to adopt with different populations. A systematic review of diagnostic accuracy studies evaluating the Prodromal Questionnaire (PQ) as a preliminary screener for UHR and psychosis was conducted to examine screening effectiveness in different contexts. MedLine, PsycInfo, SCOPUS and ProQuest Dissertations and Abstracts databases were electronically searched, along with a review screen and citation search of key papers. Findings were summarized in a narrative synthesis. In total, 14 diagnostic accuracy studies and 45 studies using the PQ as a screening tool for UHR and psychosis were included. In all settings, the 3 different versions of the PQ were all found to accurately identify UHR and full psychosis. Higher cut-off points were required in non-help-seeking samples, relative to general help-seeking populations, which in turn were higher than those needed in samples highly enriched with UHR participants. The findings support the use of the PQ as a preliminary screening tool for UHR in different settings; however, higher thresholds in lower UHR-prevalence populations are necessary to minimize false positives. Including the distress criteria, rather than just number of symptoms, may improve screening effectiveness. Different thresholds may be appropriate in different contexts depending on the importance of sensitivity vs specificity. Protocol registration: CRD42016033004. © 2017 John Wiley & Sons Australia, Ltd.

  11. Rational choice(s)? Rethinking decision-making on breast cancer risk and screening mammography.

    Science.gov (United States)

    Vahabi, Mandana; Gastaldo, Denise

    2003-12-01

    Women who refrain from undergoing breast cancer screening are believed to be uninformed about risks and usually labeled as irrational. Our purpose in writing this paper is to challenge the traditional notion of rational behaviour, illustrating with qualitative data that people's rationality is influenced by their socio-cultural and political identities. We explore three major themes: (1) cultural explanations regarding intention to use screening mammography (2) (dis)trust in science and expert opinion, and (3) self-responsibility and self-surveillance in caring for one's body. Understanding that women rely on different risk discourses to make decisions about their health should aide researchers, health professionals, and the community in better understanding alternative ways of conceptualizing people's health-related behaviours when they do not coincide with health authorities recommendations.

  12. Selective screening of 650 high risk Iranian patients for detection of inborn error of metabolism

    Directory of Open Access Journals (Sweden)

    Narges Pishva

    2015-02-01

    Full Text Available Objective: Although metabolic diseases individually are rare ,but overall have an incidence of 1/2000 and can cause devastating and irreversible effect if not diagnosed early and treated promptly. selective screening is an acceptable method for detection of these multi presentation diseases.Method: using panel neonatal screening for detection of metabolic diseases in 650 high risk Iranian patients in Fars province. The following clinical features were used as inclusion criteria for investigation of the patients.Lethargy, poor feeding ,persistent vomiting, cholestasis, intractable seizure ,decreased level of consciousness ,persistent hypoglycemia, unexplained acid base disturbance and unexplained neonatal death.Result: Organic acidemia with 40 cases (42% was the most frequent disorder diagnosed in our high risk populations, followed by disorder of galactose metabolism(30%, 15 patient had classic galactosemia(GALT

  13. Selective screening of 650 high risk Iranian patients for detection of inborn error of metabolism

    Directory of Open Access Journals (Sweden)

    Narges Pishva

    2015-02-01

    Full Text Available Objective: Although metabolic diseases individually are rare ,but overall have an incidence of 1/2000 and can cause devastating and irreversible effect if not diagnosed early and treated promptly. selective screening is an acceptable method for detection of these multi presentation diseases. Method: using panel neonatal screening for detection of metabolic diseases in 650 high risk Iranian patients in Fars province. The following clinical features were used as inclusion criteria for investigation of the patients. Lethargy, poor feeding ,persistent vomiting, cholestasis, intractable seizure ,decreased level of consciousness ,persistent hypoglycemia, unexplained acid base disturbance and unexplained neonatal death. Result: Organic acidemia with 40 cases (42% was the most frequent disorder diagnosed in our high risk populations, followed by disorder of galactose metabolism(30%, 15 patient had classic galactosemia(GALT

  14. Risk factors for pancreatic adenocarcinoma: are we ready for screening and surveillance?

    Science.gov (United States)

    Brand, Randall; Mahr, Claudius

    2005-05-01

    Of all common malignancies, pancreatic cancer has the lowest survival rate. According to estimates by the American Cancer Society, in 2004, 31,860 Americans were diagnosed, and 31,270 died from this near universally lethal disease. Unfortunately, only a small minority of patients are diagnosed when the extent of disease is still localized and thus potentially curable. These dismal survival results could be improved by developing successful screening and prevention strategies. Routine screening is not currently suggested for pancreatic cancer; however, there may be a benefit in a select group of patients identified to be at high risk for developing this disease. It is recommended that surveillance be performed on these high-risk individuals in a research setting to allow for the development of a successful detection strategy.

  15. [Assessment of risk to neuro-psychomotor development: screening using the Test Denver II and identification of maternal risks].

    Science.gov (United States)

    da Cunha, Hilton Luiz; de Melo, Aurea Nogueira

    2005-01-01

    To identify a positive screening test for developmental delay in children by the Denver Test II and their risk factors. A sample of 398 children was studied at 0 the 12 months of age regarding their neurodevelopment. The Denver II Test was used. The children who failed in two or more items of the test were suspected of having neurodevelopment delay. A set of independent variables was: socioeconomic, reproductive and environmental, birth conditions children's care. Analyses were performed using chi-square test and multivariate techinique logistic regression. At of 0 - 12 months of age, 45,73% (182) of the total of 398 children failed in the screening test. After adjusting for possible confounding variables, failure was associated with family lower income children, gestacional age less than 38 weeks, socioeconomic status family, schooling of the mother, mother's age, use of drug. This study demonstrates: 1--The Denver Test permited screening the delays development; 2--Maternal risk factors may interfere in the child's neurodevelopmental.

  16. Risk-based investment trade-off related to building facility management

    Energy Technology Data Exchange (ETDEWEB)

    Taillandier, F. [Departement TIDS, Centre Scientifique et Technique du Batiment, 06904 Sophia Antipolis (France); Laboratoire Optimisation de la conception et Ingenierie de l' environnement, Polytech' Savoie, Universite de Savoie, 73376 Le Bourget du lac (France)], E-mail: franck.taillandier@univ-savoie.fr; Sauce, G. [Laboratoire Optimisation de la conception et Ingenierie de l' environnement, Polytech' Savoie, Universite de Savoie, 73376 Le Bourget du lac (France); Bonetto, R. [Departement TIDS, Centre Scientifique et Technique du Batiment, 06904 Sophia Antipolis (France)

    2009-04-15

    Due to his or her profession, any building facility manager has to face many decision-making situations. One of the most important to be mentioned is the arbitration of a multi-year maintenance plan for buildings. Deciding between proposed maintenance actions, according to several constraints, so as to aim at satisfying corporate strategy is a complex choice. Risk approaches can be particularly effective because of their ability to handle complexity and uncertainties. The problem is then to be able to propose a method considering risks, adapted to the specific context of building facility management. Our method, regarded as a traditional approach, includes needed resources (i.e. costs) according to constraints (i.e. budget), but it also considers several risk domains (safety, technical preservation, client satisfaction, etc.), through the consequences (gain and loss). It proposes an ergonomic arbitration system based on filters following two complementary approaches: a selection of the fundamental actions and then an optimization of the plan (in a global view). The aim, for decision-makers, is to build their own solution by testing multiple angles of vision in simulation logic. This article presents the principles of the method, illustrated by an example of a real case conducted for a leading French company.

  17. Evaluation of a risk factor scoring model in screening for undiagnosed diabetes in China population

    Institute of Scientific and Technical Information of China (English)

    Jian-jun DONG; Neng-jun LOU; Jia-jun ZHAO; Zhong-wen ZHANG; Lu-lu QIU; Ying ZHOU; Lin LIAO

    2011-01-01

    Objective:To develop a risk scoring model for screening for undiagnosed type 2 diabetes in Chinese population.Methods:A total of 5348 subjects from two districts of Jinan City,Shandong Province,China were enrolled.Group A (2985) included individuals from east of the city and Group B (2363) from west of the city.Screening questionnaires and a standard oral glucose tolerance test (OGTr) were completed by all subjects.Based on the stepwise logistic regression analysis of Group A,variables were selected to establish the risk scoring model.The validity and effectiveness of this model were evaluated in Group B.Results:Based on stepwise logistic regression analysis performed with data of Group A,variables including age,body mass index (BMI),waist-to-hip ratio (WHR),systolic pressure,diastolic pressure,heart rate,family history of diabetes,and history of high glucose were accepted into the risk scoring model.The risk for having diabetes increased along with aggregate scores.When Youden index was closest to 1,the optimal cutoff value was set up at 51.At this point,the diabetes risk scoring model could identify diabetes patients with a sensitivity of 83.3% and a specificity of 66.5%,making the positive predictive value 12.83%and negative predictive value 98.53%.We compared our model with the Finnish and Danish model and concluded that our model has superior validity in Chinese population.Conclusions:Our diabetes risk scoring model has satisfactory sensitivity and specificity for identifying undiagnosed diabetes in our population,which might be a simple and practical tool suitable for massive diabetes screening.

  18. Nutritional Screening of Older Adults : Risk Factors for and Consequences of Malnutrition

    OpenAIRE

    2016-01-01

    Aims The overall aim of this thesis was to extend current knowledge about the prevalence of malnutrition, to identify possible risk factors for development of malnutrition, and to describe the consequences of malnutrition in relation to all-cause and cause-specific mortality among older adults admitted to hospital. Methods The prevalence of malnutrition was estimated in a cohort of 1771 older adults (≥65 years) who were admitted to a Swedish hospital during 2008–2009 (15 months) and screened ...

  19. Assessment of Breast Cancer Risk and Belief in Breast Cancer Screening Among the Primary Healthcare Nurses.

    Science.gov (United States)

    İz, Fatma Başalan; Tümer, Adile

    2016-09-01

    Breast cancer is the most frequently diagnosed cancer in women. Early detection of breast cancer is known to increase survival rates significantly after diagnosis. This research was carried out to determine the level of breast cancer risk among primary healthcare nurses and their belief in breast cancer screening. In this descriptive research, the data were collected in face-to-face interviews with the participants. The researchers contacted all primary healthcare nurses currently working in the province. The data collection tools included a questionnaire form on sociodemographic characteristics, breast cancer risk assessment form, and Champion's Health Belief Model Scale (CHBMS) for breast cancer screening. In data analysis, descriptive statistics, t test, and analysis of variance (ANOVA) were used. The mean age of nurses was 35 ± 3.6. The mean score for the breast cancer risk assessment form was calculated as 82.9 ± 18.7. The subscale scores for the CHBMS for breast cancer screening were as follows: susceptibility 7.3 ± 1.8, seriousness 19.5 ± 4.1, benefits of breast self-exam 15.5 ± 2.6, barriers to breast self-exam 15.1 ± 2.8, self-efficacy 40.3 ± 7.0, and motivation 19.5 ± 4.1. The risk of breast cancer was found to be low in the study group. The analysis of the subscale scores for the CHBMS for breast cancer screening revealed that nurses had a below-average susceptibility perception, a somewhat lower perception of seriousness, an above-average mean score for perceived benefits, a moderate barrier perception, a relatively high perceived self-efficacy, and motivation above average.

  20. Development of a screening MRI for infants at risk for abusive head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Flom, Lynda; Panigrahy, Ashok [Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Pittsburgh, PA (United States); Fromkin, Janet [University of Pittsburgh, Department of Pediatrics, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); Tyler-Kabara, Elizabeth [University of Pittsburgh, Department of Neurosurgery, Children' s Hospital of Pittsburgh of UPMC, McGowan Institute for Regenerative Medicine, Pittsburgh, PA (United States); Berger, Rachel P. [University of Pittsburgh, Department of Pediatrics, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); University of Pittsburgh, Safar Center for Resuscitation Research, Pittsburgh, PA (United States)

    2016-04-15

    Abusive head trauma (AHT) is an important cause of morbidity in infants. Identifying which well-appearing infants are at risk for AHT and need neuroimaging is challenging, and concern about radiation exposure limits the use of head CT. Availability of an MRI protocol that is highly sensitive for intracranial hemorrhage would allow for AHT screening of well-appearing infants without exposing them to radiation. To develop a screening MRI protocol to identify intracranial hemorrhage in well-appearing infants at risk for AHT. Infants enrolled in a parent study of well-appearing infants at increased risk for AHT were eligible for the current study if they underwent both head CT and conventional brain MRI. A derivation cohort of nine infants with AHT was used to identify sequences that provided the highest sensitivity for intracranial hemorrhage. A validation cohort of 78 infants including both controls with normal neuroimaging and cases with AHT was used to evaluate the accuracy of the selected sequences. Three pulse sequences - axial T2, axial gradient recalled echo (GRE) and coronal T1-W inversion recovery - were 100% sensitive for intracranial hemorrhage in the derivation cohort. The same sequences were 100% sensitive (25/25) and 83% specific (44/53) for intracranial hemorrhage in the validation cohort. A screening MRI protocol including axial T2, axial GRE and coronal T1-W inversion recovery sequences is highly sensitive for intracranial hemorrhage and may be useful as a screening tool to differentiate well-appearing infants at risk for AHT who should undergo head CT from those who can safely be discharged without head CT. Additional research is needed to evaluate the feasibility of this approach in clinical practice. (orig.)

  1. Screening for ovarian cancer in women with varying levels of risk, using annual tests, results in high recall for repeat screening tests

    Directory of Open Access Journals (Sweden)

    Nobbenhuis Marielle AE

    2011-11-01

    Full Text Available Abstract Background We assessed ovarian cancer screening outcomes in women with a positive family history of ovarian cancer divided into a low-, moderate- or high-risk group for development of ovarian cancer. Methods 545 women with a positive family history of ovarian cancer referred to the Ovarian Screening Service at the Royal Marsden Hospital, London from January 2000- December 2008 were included. They were stratified into three risk-groups according to family history (high-, moderate- and low-risk of developing ovarian cancer and offered annual serum CA 125 and transvaginal ultrasound screening. The high-risk group was offered genetic testing. Results The median age at entry was 44 years. The number of women in the high, moderate and low-risk groups was 397, 112, and 36, respectively. During 2266 women years of follow-up two ovarian cancer cases were found: one advanced stage at her fourth annual screening, and one early stage at prophylactic bilateral salpingo-oophorectomy (BSO. Prophylactic BSO was performed in 138 women (25.3%. Forty-three women had an abnormal CA125, resulting in 59 repeat tests. The re-call rate in the high, moderate and low-risk group was 14%, 3% and 6%. Equivocal transvaginal ultrasound results required 108 recalls in 71 women. The re-call rate in the high, moderate, and low-risk group was 25%, 6% and 17%. Conclusion No early stage ovarian cancer was picked up at annual screening and a significant number of re-calls for repeat screening tests was identified.

  2. Screening for celiac disease in average-risk and high-risk populations

    Science.gov (United States)

    Aggarwal, Saurabh; Lebwohl, Benjamin

    2012-01-01

    The prevalence of celiac disease is rising. As a result there is increasing interest in the associated mortality and morbidity of the disease. Screening of asymptomatic individuals in the general population is not currently recommended; instead, a strategy of case finding is the preferred approach, taking into account the myriad modes of presentation of celiac disease. Although a gluten-free diet is the treatment of choice in symptomatic patients with celiac disease, there is no consensus on whether institution of a gluten-free diet will improve the quality of life in asymptomatic screen-detected celiac disease patients. A review of the studies that have been performed on this subject is presented. Certain patient groups such as those with autoimmune diseases may be offered screening in the context of an informed discussion regarding the potential benefits, with the caveat that the data on this issue are sparse. Active case finding seems to be the most prudent option in most clinical situations. PMID:22282707

  3. Barriers to innovation: nurses' risk appraisal in using a new ethics screening and early intervention tool.

    Science.gov (United States)

    Pavlish, Carol L; Hellyer, Joan Henriksen; Brown-Saltzman, Katherine; Miers, Anne G; Squire, Karina

    2013-01-01

    We developed and assessed feasibility of an Ethics Screening and Early Intervention Tool that identifies at-risk clinical situations and prompts early actions to mitigate conflict and moral distress. Despite intensive care unit and oncology nurses' reports of tool benefits, they noted some risk to themselves when initiating follow-up actions. The riskiest actions were discussing ethical concerns with physicians, calling for ethics consultation, and initiating patient conversations. When discussing why initiating action was risky, participants revealed themes such as "being the troublemaker" and "questioning myself." To improve patient care and teamwork, all members of the health care team need to feel safe in raising ethics-related questions.

  4. Screening for gestational diabetes mellitus by a model based on risk indicators: a prospective study.

    Science.gov (United States)

    Jensen, Dorte M; Mølsted-Pedersen, Lars; Beck-Nielsen, Henning; Westergaard, Jes G; Ovesen, Per; Damm, Peter

    2003-11-01

    This study was performed to prospectively evaluate a screening model for gestational diabetes mellitus on the basis of clinical risk indicators. In a prospective multicenter study with 5235 consecutive pregnant women, diagnostic testing with a 2-hour 75-g oral glucose tolerance test was routinely performed in women with risk indicators and offered to women without risk indicators as part of the study. Forty-four percent of the women underwent testing, 43% declined participation, 6% did not speak Danish, and 7% could not be contacted. By extrapolation of the results from tested women to the whole group in question, a 2.4% prevalence of gestational diabetes mellitus was calculated. Sensitivity and specificity of the model was 80.6 (73.7-87.6) and 64.8 (63.5-66.1), respectively (95% CIs). Under ideal conditions, sensitivity of the model was comparable with universal screening by fasting glucose or a 1-hour 50-g glucose challenge test. Both screening and diagnostic testing could be avoided in two thirds of all pregnant women.

  5. Cost-effectiveness and harm-benefit analyses of risk-based screening strategies for breast cancer.

    Directory of Open Access Journals (Sweden)

    Ester Vilaprinyo

    Full Text Available The one-size-fits-all paradigm in organized screening of breast cancer is shifting towards a personalized approach. The present study has two objectives: 1 To perform an economic evaluation and to assess the harm-benefit ratios of screening strategies that vary in their intensity and interval ages based on breast cancer risk; and 2 To estimate the gain in terms of cost and harm reductions using risk-based screening with respect to the usual practice. We used a probabilistic model and input data from Spanish population registries and screening programs, as well as from clinical studies, to estimate the benefit, harm, and costs over time of 2,624 screening strategies, uniform or risk-based. We defined four risk groups, low, moderate-low, moderate-high and high, based on breast density, family history of breast cancer and personal history of breast biopsy. The risk-based strategies were obtained combining the exam periodicity (annual, biennial, triennial and quinquennial, the starting ages (40, 45 and 50 years and the ending ages (69 and 74 years in the four risk groups. Incremental cost-effectiveness and harm-benefit ratios were used to select the optimal strategies. Compared to risk-based strategies, the uniform ones result in a much lower benefit for a specific cost. Reductions close to 10% in costs and higher than 20% in false-positive results and overdiagnosed cases were obtained for risk-based strategies. Optimal screening is characterized by quinquennial or triennial periodicities for the low or moderate risk-groups and annual periodicity for the high-risk group. Risk-based strategies can reduce harm and costs. It is necessary to develop accurate measures of individual risk and to work on how to implement risk-based screening strategies.

  6. Cost-effectiveness and harm-benefit analyses of risk-based screening strategies for breast cancer.

    Science.gov (United States)

    Vilaprinyo, Ester; Forné, Carles; Carles, Misericordia; Sala, Maria; Pla, Roger; Castells, Xavier; Domingo, Laia; Rue, Montserrat

    2014-01-01

    The one-size-fits-all paradigm in organized screening of breast cancer is shifting towards a personalized approach. The present study has two objectives: 1) To perform an economic evaluation and to assess the harm-benefit ratios of screening strategies that vary in their intensity and interval ages based on breast cancer risk; and 2) To estimate the gain in terms of cost and harm reductions using risk-based screening with respect to the usual practice. We used a probabilistic model and input data from Spanish population registries and screening programs, as well as from clinical studies, to estimate the benefit, harm, and costs over time of 2,624 screening strategies, uniform or risk-based. We defined four risk groups, low, moderate-low, moderate-high and high, based on breast density, family history of breast cancer and personal history of breast biopsy. The risk-based strategies were obtained combining the exam periodicity (annual, biennial, triennial and quinquennial), the starting ages (40, 45 and 50 years) and the ending ages (69 and 74 years) in the four risk groups. Incremental cost-effectiveness and harm-benefit ratios were used to select the optimal strategies. Compared to risk-based strategies, the uniform ones result in a much lower benefit for a specific cost. Reductions close to 10% in costs and higher than 20% in false-positive results and overdiagnosed cases were obtained for risk-based strategies. Optimal screening is characterized by quinquennial or triennial periodicities for the low or moderate risk-groups and annual periodicity for the high-risk group. Risk-based strategies can reduce harm and costs. It is necessary to develop accurate measures of individual risk and to work on how to implement risk-based screening strategies.

  7. Cervical cancer risk factors and feasibility of visual inspection with acetic acid screening in Sudan

    Directory of Open Access Journals (Sweden)

    Ibrahim A

    2011-04-01

    Full Text Available Ahmed Ibrahim1, Vibeke Rasch2, Eero Pukkala3, Arja R Aro11Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark; 2Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark; 3Institute for Statistical and Epidemiological Cancer Research, Finnish Cancer Registry, Helsinki, FinlandObjectives: To assess the risk factors of cervical cancer and the feasibility and acceptability of a visual inspection with acetic acid (VIA screening method in a primary health center in Khartoum, Sudan.Methods: A cross-sectional prospective pilot study of 100 asymptomatic women living in Khartoum State in Sudan was carried out from December 2008 to January 2009. The study was performed at the screening center in Khartoum. Six nurses and two physicians were trained by a gynecologic oncologist. The patients underwent a complete gynecological examination and filled in a questionnaire on risk factors and feasibility and acceptability. They were screened for cervical cancer by application of 3%–5% VIA. Women with a positive test were referred for colposcopy and treatment.Results: Sixteen percent of screened women were tested positive. Statistically significant associations were observed between being positive with VIA test and the following variables: uterine cervix laceration (odds ratio [OR] 18.6; 95% confidence interval [CI]: 4.64–74.8, assisted vaginal delivery (OR 13.2; 95% CI: 2.95–54.9, parity (OR 5.78; 95% CI: 1.41–23.7, female genital mutilation (OR 4.78; 95% CI: 1.13–20.1, and episiotomy (OR 5.25; 95% CI: 1.15–23.8. All these associations remained statistically significant after adjusting for age, educational level, employment, and potential confounding factors such as smoking, number of sexual partners, and use of contraceptive method. Furthermore, the VIA screening method was found to be feasible and acceptable to participants.Conclusion: This pilot study showed that women who have uterine

  8. Intake risk and dose evaluation methods for workers in radiochemistry labs of a medical cyclotron facility.

    Science.gov (United States)

    Calandrino, Riccardo; del Vecchio, Antonella; Savi, Annarita; Todde, Sergio; Belloli, Sara

    2009-10-01

    The aim of this paper is to evaluate the risks and doses for the internal contamination of the radiochemistry staff in a high workload medical cyclotron facility. The doses from internal contamination derive from the inhalation of radioactive gas leakage from the cells by personnel involved in the synthesis processes and are calculated from urine sample measurements. Various models are considered for the calculation of the effective committed dose from the analysis of these urine samples, and the results are compared with data obtained from local environmental measurement of the radioactivity released inside the lab.

  9. Long-Term Cardiovascular Risk in Heterozygous Familial Hypercholesterolemia Relatives Identified by Cascade Screening

    DEFF Research Database (Denmark)

    Kjærgaard, Kasper Aalbæk; Christiansen, Morten Krogh; Schmidt, Morten

    2017-01-01

    BACKGROUND: Heterozygous familial hypercholesterolemia increases the risk of adverse cardiovascular events. Whether affected relatives of probands are at increased risk remains unknown. We aimed to evaluate the long-term cardiovascular risk in heterozygous familial hypercholesterolemia relatives...... with a low-density lipoprotein receptor (LDLR) mutation who were all recommended statin therapy. METHODS AND RESULTS: Participants were identified by cascade screening at Aarhus University Hospital during 1992-1994. A comparison cohort from the Danish general population was matched 10:1 to relatives by birth...... statins during their follow-up period. Despite frequent use of lipid-lowering medication, the adjusted hazard ratio of the primary end point was 1.65 (95% confidence interval, 1.17-2.33) in mutation-carrying relatives compared with the general population cohort. The risk in non-mutation-carrying relatives...

  10. Surprisingly low compliance to local guidelines for risk factor based screening for gestational diabetes mellitus - A population-based study

    Directory of Open Access Journals (Sweden)

    Winkvist Anna

    2009-11-01

    Full Text Available Abstract Background Screening for gestational diabetes mellitus (GDM is routine during pregnancy in many countries in the world. The screening programs are either based on general screening offered to all pregnant women or risk factor based screening stipulated in local clinical guidelines. The aims of this study were to investigate: 1 the compliance with local guidelines of screening for GDM and 2 the outcomes of pregnancy and birth in relation to risk factors of GDM and whether or not exposed to oral glucose tolerance test (OGTT. Methods This study design was a population-based retrospective cross-sectional study of 822 women. A combination of questionnaire data and data collected from medical records was applied. Compliance to the local guidelines of risk factor based screening for GDM was examined and a comparison of outcomes of pregnancy and delivery in relation to risk factor groups for GDM was performed. Results Of the 822 participants, 257 (31.3% women fulfilled at least one criterion for being exposed to screening for GDM according to the local clinical guidelines. However, only 79 (30.7% of these women were actually exposed to OGTT and of those correctly exposed for screening, seven women were diagnosed with GDM. Women developing risk factors for GDM during pregnancy had a substantially increased risk of giving birth to an infant with macrosomia. Conclusion Surprisingly low compliance with the local clinical guidelines for screening for GDM during pregnancy was found. Furthermore, the prevalence of the risk factors of GDM in our study was almost doubled compared to previous Swedish studies. Pregnant women developing risk factors of GDM during pregnancy were found to be at substantially increased risk of giving birth to an infant with macrosomia. There is a need of actions improving compliance to the local guidelines.

  11. Cervical cancer screening practices, knowledge of screening and risk, and highly active antiretroviral therapy adherence among women living with human immunodeficiency virus in Lima, Peru.

    Science.gov (United States)

    Delgado, Jeanne R; Menacho, Luis; Segura, Eddy R; Roman, Fernando; Cabello, Robinson

    2017-03-01

    Cervical cancer (CC) is the leading cause of cancer death among Peruvian women. Awareness shown by women living with HIV (WLHIV) of their increased risk and Papanicoloau (Pap) smear frequency is understudied, particularly in Peru. We assessed the uptake of guidelines-based CC screening practices and its associations with two predictors, knowledge of CC screening and risk and highly active antiretroviral therapy (HAART) adherence, among WLHIV. Collected by self-administered questionnaires from 2014 to 2016, we analyzed the data of 71 WLHIV. Most WLHIV (77.5%, n = 55/71) were overdue to CC screening by not having a Pap smear within the prior 12 months. WLHIV who had on-time Pap smears had a higher median composite 'knowledge' score of 3.0 ([interquartile range] 1.5-4) compared to 2.0 (IQR 1-3) for overdue WLHIV. On-time and overdue WLHIV had the same median composite 'HAART adherence' score of 3.0 (IQR 2-4). Bivariate analysis found no association between knowledge nor adherence with on-time Pap smears. Although on-time WLHIV were more knowledgeable about CC screening and risk, overall CC screening uptake was poor. Larger studies of this population are needed to assess the educational, social, and structural barriers contributing to this low prevalence of screening.

  12. Acceptance of screening for Intimate Partner Violence, actual screening and satisfaction with care amongst female clients visiting a health facility in Kano, Nigeria

    OpenAIRE

    John, Ime A.; Stephen Lawoko; Abimbola Oluwatosin

    2011-01-01

    Background: Healthcare providers have advocated for the screening and management of Intimate Partner Violence (IPV) against women and its consequences. Unfortunately, data from high income countries suggest that women may have varied preferences for being screened for IPV in healthcare. Although women’s preference for screening in sub-Saharan countries has not been well researched, IPV remains an accepted societal norm in many of these countries, including Nigeria.Objective: The objective of ...

  13. The care of Filipino juvenile offenders in residential facilities evaluated using the risk-need-responsivity model.

    Science.gov (United States)

    Spruit, Anouk; Wissink, Inge B; Stams, Geert Jan J M

    2016-01-01

    According to the risk-need-responsivity model of offender, assessment and rehabilitation treatment should target specific factors that are related to re-offending. This study evaluates the residential care of Filipino juvenile offenders using the risk-need-responsivity model. Risk analyses and criminogenic needs assessments (parenting style, aggression, relationships with peers, empathy, and moral reasoning) have been conducted using data of 55 juvenile offenders in four residential facilities. The psychological care has been assessed using a checklist. Statistical analyses showed that juvenile offenders had a high risk of re-offending, high aggression, difficulties in making pro-social friends, and a delayed socio-moral development. The psychological programs in the residential facilities were evaluated to be poor. The availability of the psychological care in the facilities fitted poorly with the characteristics of the juvenile offenders and did not comply with the risk-need-responsivity model. Implications for research and practice are discussed.

  14. Risk analysis in support of improved safety at US department of energy hot cell facilities

    Energy Technology Data Exchange (ETDEWEB)

    Felder, F.A.; Golay, M.W. [Massachusetts Inst. of Tech., Cambridge, MA (United States). Dept. of Nuclear Engineering; Phillips, Jerold; Leahy, Timothy

    2000-07-01

    The US Department of Energy (US-DOE) manages diverse facilities ranging from laboratory complexes to nuclear reactors and waste repositories. It is self-regulating in the areas of radiological safety, occupational protection and environmental disturbances. In these areas the US-DOE has obtained mostly good results, but at high expense by using conservative and unsystematic approaches. In an effort to improve both safety and use of resources a project has been undertaken to understand better how to utilize risk assessment techniques to obtain improved safety outcomes and their regulation. The example of the Test Reactor Area Hot Cell (TRAHC) at the Idaho National Engineering and Environmental Laboratory (INEEL) is the subject of a simple probabilistic risk assessment (PRA) in the areas of radiological releases to the environment and of occupational hazards. To our knowledge this is the first attempt to utilize quantitative risk analyses for management of non-radiological occupational risks. Its purpose is to examine the feasibility of utilizing risk assessment as a technique to supplant the currently employed, less formal, hazard analysis as the basis for allocating safety-related resources. Problems of data and modeling adequacy have proven to be important; results to-date indicate areas where revised resource allocation should be considered. (author)

  15. Nutrition risk screening of ICU patients%ICU患儿营养风险筛查

    Institute of Scientific and Technical Information of China (English)

    龚玲

    2014-01-01

    ICU患儿的病情较重,进展迅速,因此恰当的营养支持对于ICU患儿病情的恢复是有利的.ICU患儿需要根据其本身的营养状况以及潜在的营养风险来制定恰当的营养支持计划.营养风险筛查不仅可以评估患儿的营养状况,更能预测其潜在的营养风险,从而指导患儿的营养支持治疗计划的制定,最终改善预后.寻找出适用于ICU患儿的全面、简便、快捷、易行的营养风险筛查工具,实施恰当的营养风险筛查对ICU患儿的生长发育以及疾病的预后均具有重要意义.%It's known that ICU patients is in critical condition and might deteriorate rapidly,so it's important for them to get appropriate nutritional support in order to recover.We must make proper nutrition treatment plan for patients according to their different nutritional condition and potential risk.Nutritional risk screening can not only assess the nutritional status of children,is more likely to predict its potential nutritional risk,to guide nutritional support treatment plan,and ultimately improve the prognosis.Looking out for comprehensive,simple,fast,and easy nutritional risk screening tools as soon as possible and appropriate nutrition risk screening is significantly for growth and development as well as prognosis of ICU patients.

  16. Pathophysiology, risk factors, and screening methods for prediabetes in women with polycystic ovary syndrome

    Directory of Open Access Journals (Sweden)

    Gourgari E

    2016-08-01

    Full Text Available Evgenia Gourgari,1 Elias Spanakis,2 Adrian Sandra Dobs3 1Division of Pediatric Endocrinology, Georgetown University School of Medicine, Washington, DC, 2Division of Endocrinology, University of Maryland School of Medicine, 3Department of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: Polycystic ovary syndrome (PCOS is a syndrome associated with insulin resistance (IR, obesity, infertility, and increased cardiometabolic risk. This is a descriptive review of several mechanisms that can explain the IR among women with PCOS, other risk factors for the development of diabetes, and the screening methods used for the detection of glucose intolerance in women with PCOS. Few mechanisms can explain IR in women with PCOS such as obesity, insulin receptor signaling defects, and inhibition of insulin-mediated glucose uptake in adipocytes. Women with PCOS have additional risk factors for the development of glucose intolerance such as family history of diabetes, use of oral contraceptives, anovulation, and age. The Androgen Society in 2007 and the Endocrine Society in 2013 recommended using oral glucose tolerance test as a screening tool for abnormal glucose tolerance in all women with PCOS. The approach to detection of glucose intolerance among women with PCOS varies among health care providers. Large prospective studies are still needed for the development of guidelines with strong evidence. When assessing risk of future diabetes in women with PCOS, it is important to take into account the method used for screening as well as other risk factors that these women might have. Keywords: IR, OGTT, obesity, hyperandrogenism, anovulation, BMI, insulin resistance, PCOS

  17. Seismic risk analysis for General Electric Plutonium Facility, Pleasanton, California. Final report, part II

    Energy Technology Data Exchange (ETDEWEB)

    1980-06-27

    This report is the second of a two part study addressing the seismic risk or hazard of the special nuclear materials (SNM) facility of the General Electric Vallecitos Nuclear Center at Pleasanton, California. The Part I companion to this report, dated July 31, 1978, presented the seismic hazard at the site that resulted from exposure to earthquakes on the Calaveras, Hayward, San Andreas and, additionally, from smaller unassociated earthquakes that could not be attributed to these specific faults. However, while this study was in progress, certain additional geologic information became available that could be interpreted in terms of the existance of a nearby fault. Although substantial geologic investigations were subsequently deployed, the existance of this postulated fault, called the Verona Fault, remained very controversial. The purpose of the Part II study was to assume the existance of such a capable fault and, under this assumption, to examine the loads that the fault could impose on the SNM facility. This report first reviews the geologic setting with a focus on specifying sufficient geologic parameters to characterize the postulated fault. The report next presents the methodology used to calculate the vibratory ground motion hazard. Because of the complexity of the fault geometry, a slightly different methodology is used here compared to the Part I report. This section ends with the results of the calculation applied to the SNM facility. Finally, the report presents the methodology and results of the rupture hazard calculation.

  18. Acceptance of screening for Intimate Partner Violence, actual screening and satisfaction with care amongst female clients visiting a health facility in Kano, Nigeria

    Directory of Open Access Journals (Sweden)

    Ime A. John

    2011-02-01

    Full Text Available Background: Healthcare providers have advocated for the screening and management of Intimate Partner Violence (IPV against women and its consequences. Unfortunately, data from high income countries suggest that women may have varied preferences for being screened for IPV in healthcare. Although women’s preference for screening in sub-Saharan countries has not been well researched, IPV remains an accepted societal norm in many of these countries, including Nigeria.Objective: The objective of the study was to assess women’s acceptance of screening for IPV in healthcare, the extent to which inquiry about IPV was carried out in healthcare and whether such inquiry impacted on satisfaction with care.Method: Data on these variables were gathered through structured interviews from a sample of 507 women at a regional hospital in Kano, Nigeria. The study design was cross-sectional.Results: The results found acceptance for screening in the sample to be high (76%, but few women (7% had actually been probed about violence in their contact with care providers. Acceptance for screening was associated with being married and being employed. Actual screening was associated with ethnicity and religion, where ethnic and religious majorities were more likely to be screened. Finally, being screened for IPV seemed to improve satisfaction with care.Conclusion: The findings demonstrate the need for adaptation of a screening protocol that is also sensitive to detect IPV amongst all ethnic and religious groups. The findings also have implications for further education of socio-economically disadvantaged women on the benefits of screening.

  19. Acceptance of screening for Intimate Partner Violence, actual screening and satisfaction with care amongst female clients visiting a health facility in Kano, Nigeria

    Directory of Open Access Journals (Sweden)

    Ime A. John

    2011-02-01

    Full Text Available Background: Healthcare providers have advocated for the screening and management of Intimate Partner Violence (IPV against women and its consequences. Unfortunately, data from high income countries suggest that women may have varied preferences for being screened for IPV in healthcare. Although women’s preference for screening in sub-Saharan countries has not been well researched, IPV remains an accepted societal norm in many of these countries, including Nigeria.Objective: The objective of the study was to assess women’s acceptance of screening for IPV in healthcare, the extent to which inquiry about IPV was carried out in healthcare and whether such inquiry impacted on satisfaction with care.Method: Data on these variables were gathered through structured interviews from a sample of 507 women at a regional hospital in Kano, Nigeria. The study design was cross-sectional.Results: The results found acceptance for screening in the sample to be high (76%, but few women (7% had actually been probed about violence in their contact with care providers. Acceptance for screening was associated with being married and being employed. Actual screening was associated with ethnicity and religion, where ethnic and religious majorities were more likely to be screened. Finally, being screened for IPV seemed to improve satisfaction with care.Conclusion: The findings demonstrate the need for adaptation of a screening protocol that is also sensitive to detect IPV amongst all ethnic and religious groups. The findings also have implications for further education of socio-economically disadvantaged women on the benefits of screening.

  20. Women’s perspectives and experiences on screening for osteoporosis (Risk-stratified Osteoporosis Strategy Evaluation, ROSE)

    DEFF Research Database (Denmark)

    Rothmann, Mette Juel; Huniche, Lotte; Ammentorp, Jette

    2014-01-01

    This study aimed to investigate women's perspectives and experiences with screening for osteoporosis. Focus groups and individual interviews were conducted. Three main themes emerged: knowledge about osteoporosis, psychological aspects of screening, and moral duty. Generally, screening was accepted...... due to life experiences, self-perceived risk, and the preventive nature of screening. PURPOSE: The risk-stratified osteoporosis strategy evaluation (ROSE) study is a randomized prospective population-based trial investigating the efficacy of a screening program to prevent fractures in women aged 65...... main themes: knowledge about osteoporosis, psychological aspects of screening, and moral duty. The women viewed the program in the context of their everyday life and life trajectories. Age, lifestyle, and knowledge about osteoporosis were important to how women ascribed meaning to the program, how...

  1. Colorectal cancer risk assessment and screening recommendation: a community survey of healthcare providers' practice from a patient perspective

    OpenAIRE

    Courtney Ryan J; Paul Christine L; Sanson-Fisher Robert W; Macrae Finlay A; Carey Mariko L; Attia John; McEvoy Mark

    2012-01-01

    Abstract Background Family history is a common risk factor for colorectal cancer (CRC), yet it is often underused to guide risk assessment and the provision of risk-appropriate CRC screening recommendation. The aim of this study was to identify from a patient perspective health care providers' current practice relating to: (i) assessment of family history of CRC; (ii) notification of "increased risk" to patients at "moderately/potentially high" familial risk; and (iii) recommendation that pat...

  2. Blood glucose screening rates among Minnesota adults with hypertension, Behavioral Risk Factor Surveillance System, 2011.

    Science.gov (United States)

    Kidney, Renée S M; Peacock, James M; Smith, Steven A

    2014-11-26

    Many US adults have multiple chronic conditions, and hypertension and diabetes are among the most common dyads. Diabetes and prediabetes prevalence are increasing, and both conditions negatively affect cardiovascular health. Early diagnosis and treatment of diabetes and prediabetes can benefit people with hypertension by preventing cardiovascular complications. We analyzed 2011 Minnesota Behavioral Risk Factor Surveillance System data to describe the proportion of adults with hypertension screened for diabetes according to US Preventive Services Task Force Recommendations for blood glucose testing. Covariates associated with lower odds of recent screening among adults without diabetes were determined using weighted logistic regression. Of Minnesota adults with self-reported hypertension, 19.6% had a diagnosis of diabetes and 10.7% had a diagnosis of prediabetes. Nearly one-third of adults with hypertension without diabetes had not received blood glucose screening in the past 3 years. Factors associated with greater odds of not being screened in multivariable models included being aged 18 to 44 years (adjusted odds ratio [AOR], 1.77; 95% confidence interval [CI], 1.23-2.55); being nonobese, with stronger effects for normal body mass index; having no check-up in the past 2 years (AOR, 2.49; 95% CI, 1.49-4.17); having hypertension treated with medication (AOR, 2.01; 95% CI, 1.49-2.71); and completing less than a college degree (AOR, 1.45; 95% CI, 1.14-1.84). Excluding respondents with prediabetes or those not receiving a check-up did not change the results. Failure to screen among providers and failure to understand the importance of screening among individuals with hypertension may mean missed opportunities for early detection, clinical management, and prevention of diabetes.

  3. Can data science inform environmental justice and community risk screening for type 2 diabetes?

    Directory of Open Access Journals (Sweden)

    J Allen Davis

    Full Text Available Having the ability to scan the entire country for potential "hotspots" with increased risk of developing chronic diseases due to various environmental, demographic, and genetic susceptibility factors may inform risk management decisions and enable better environmental public health policies.Develop an approach for community-level risk screening focused on identifying potential genetic susceptibility hotpots.Our approach combines analyses of phenotype-genotype data, genetic prevalence of single nucleotide polymorphisms, and census/geographic information to estimate census tract-level population attributable risks among various ethnicities and total population for the state of California.We estimate that the rs13266634 single nucleotide polymorphism, a type 2 diabetes susceptibility genotype, has a genetic prevalence of 56.3%, 47.4% and 37.0% in Mexican Mestizo, Caucasian, and Asian populations. Looking at the top quintile for total population attributable risk, 16 California counties have greater than 25% of their population living in hotspots of genetic susceptibility for developing type 2 diabetes due to this single genotypic susceptibility factor.This study identified counties in California where large portions of the population may bear additional type 2 diabetes risk due to increased genetic prevalence of a susceptibility genotype. This type of screening can easily be extended to include information on environmental contaminants of interest and other related diseases, and potentially enables the rapid identification of potential environmental justice communities. Other potential uses of this approach include problem formulation in support of risk assessments, land use planning, and prioritization of site cleanup and remediation actions.

  4. RNAi Screening Facility

    Data.gov (United States)

    Federal Laboratory Consortium — Small interfering RNA (siRNA) molecules are pieces of RNA that block the activity of genes through a natural process called RNA interference (RNAi). This process has...

  5. [Usefulness of human papillomavirus testing in anal intraepithelial neoplasia screening in a risk behaviour population].

    Science.gov (United States)

    Padilla-España, Laura; Repiso-Jiménez, Bosco; Fernández-Sánchez, Fernando; Frieyro-Elicegui, Marta; Fernández-Morano, Teresa; Pereda, Teresa; Rivas-Ruiz, Francisco; Redondo, Maximino; de-Troya Martín, Magdalena

    2014-11-01

    The incidence of intraepithelial anal neoplasia is increasing in certain risk behaviour groups, and human papillomavirus (HPV) infection is involved in its pathogenesis. The systematic use of anal cytology, and more recently HPV detection by hybrid capture and genotyping, have been introduced into screening programs in recent decades. A retrospective cohort study was carried out on individuals with risk behaviours of developing intraepithelial anal neoplasia and who attended Sexually Transmitted Infections clinics in the Dermatology area of the Hospital Costa del Sol from January 2010 to December 2012. The intraepithelial anal neoplasia screening was performed using anal cytology and HPV genotyping. Half (50%) of the study population were HIV positive. A high frequency of anal dysplasia and presence of HPV in cytology (82.1%) and genotype (79%) was found. A statistically significant association (P<.005) was obtained between the presence of high-risk HPV genotypes and the presence of high-grade dysplasia in the second directed cytology. HPV genotyping enabled 17 cases (22%) of severe dysplasia to be identified that were under-diagnosed in the first cytology. Cases of high-grade dysplasia can be under-diagnosed by a first anal cytology. Detection of HPV can supplement this procedure, leading to the identification of those patients most at risk of developing high-grade anal dysplasia. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  6. Risk of sports: do we need a pre-participation screening for competitive and leisure athletes?

    Science.gov (United States)

    Corrado, Domenico; Schmied, Christian; Basso, Cristina; Borjesson, Mats; Schiavon, Maurizio; Pelliccia, Antonio; Vanhees, Luc; Thiene, Gaetano

    2011-04-01

    Sudden cardiac arrest is most often the first clinical manifestation of an underlying cardiovascular disease and usually occurs in previously asymptomatic athletes. The risk benefit ratio of physical exercise differs between young competitive athletes and middle-age/senior individuals engaged in leisure-time sports activity. Competitive sports are associated with an increase in the risk of sudden cardiovascular death (SCD) in susceptible adolescents and young adults with underlying cardiovascular disorders. In middle-age/older individuals, physical activity can be regarded as a 'two-edged sword': vigorous exertion increases the incidence of acute coronary events in those who did not exercise regularly, whereas habitual physical activity reduces the overall risk of myocardial infarction and SCD. Although cardiovascular pre-participation evaluation offers the potential to identify athletes with life-threatening cardiovascular abnormalities before onset of symptoms and may reduce their risk of SCD, there is a significant debate among cardiologists about efficacy, impact of false-positive results and cost-effectiveness of routine screening. This review presents an appraisal of the available data and criticisms concerning screening programmes aimed to prevent SCD of either young competitive athletes or older individuals engaged in leisure-time sports activity.

  7. Reliability of the Tuck Jump Injury Risk Screening Assessment in Elite Male Youth Soccer Players.

    Science.gov (United States)

    Read, Paul J; Oliver, Jon L; de Ste Croix, Mark B A; Myer, Gregory D; Lloyd, Rhodri S

    2016-06-01

    Read, PJ, Oliver, JL, de Ste Croix, MBA, Myer, GD, and Lloyd, RS. Reliability of the tuck jump injury risk screening assessment in elite male youth soccer players. J Strength Cond Res 30(6): 1510-1516, 2016-Altered neuromuscular control has been suggested as a mechanism for injury in soccer players. Ligamentous injuries most often occur during dynamic movements, such as decelerations from jump-landing maneuvers where high-risk movement patterns are present. The assessment of kinematic variables during jump-landing tasks as part of a preparticipation screen is useful in the identification of injury risk. An example of a field-based screening tool is the repeated tuck jump assessment. The purpose of this study was to analyze the within-subject variation of the tuck jump screening assessment in elite male youth soccer players. Twenty-five pre-peak height velocity (PHV) and 25 post-PHV elite male youth soccer players from the academy of a professional English soccer club completed the assessment. A test-retest design was used to explore the within-subject intersession reliability. Technique was graded retrospectively against the 10-point criteria set out in the screening protocol using two-dimensional video cameras. The typical error range reported for tuck jump total score (0.90-1.01 in pre-PHV and post-PHV players respectively) was considered acceptable. When each criteria was analyzed individually, kappa coefficient determined that knee valgus was the only criterion to reach substantial agreement across the two test sessions for both groups. The results of this study suggest that although tuck jump total score may be reliably assessed in elite male youth soccer players, caution should be applied in solely interpreting the composite score due to the high within-subject variation in a number of the individual criteria. Knee valgus may be reliably used to screen elite youth male soccer players for this plyometric technique error and for test-retest comparison.

  8. Low-dose CT screening in an Asian population with diverse risk for lung cancer: A retrospective cohort study

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Chin A. [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of); Lee, Kyung Soo [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of); Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Shin, Myung-Hee; Cho, Yun Yung [Sungkyunkwan University School of Medicine, Department of Social and Preventive Medicine, Seoul (Korea, Republic of); Choi, Yoon-Ho [Sungkyunkwan University School of Medicine, Center for Health Promotion, Seoul (Korea, Republic of); Kwon, O. Jung [Sungkyunkwan University School of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Shin, Kyung Eun [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of); Kyung Hee University Hospital, Department of Diagnostic Radiology, Seoul (Korea, Republic of)

    2015-08-15

    To evaluate the performance of low-dose CT (LDCT) screening for lung cancer (LCA) detection in an Asian population with diverse risks for LCA. LCA screening was performed in 12,427 symptomless Asian subjects using either LDCT (5,771) or chest radiography (CXR) (6,656) in a non-trial setting. Subjects were divided into high-risk and non-high-risk groups. Data were collected on the number of patients with screening-detected LCAs and their survival in order to compare outcomes between LDCT and CXR screening with the stratification of risks considering age, sex and smoking status. In the non-high-risk group, a significant difference was observed for the detection of lung cancer (adjusted OR, 5.07; 95 % CI, 2.72-9.45) and survival (adjusted HR of LCA survival between LDCT vs. CXR group, 0.08; 95 % CI, 0.01-0.62). No difference in detection or survival of LCA was noticed in the high-risk group. LCAs in the non-high-risk group were predominantly adenocarcinomas (96 %), and more likely to be part-solid or non-solid compared with those in the high-risk group (p = 0.023). In the non-high-risk group, LDCT helps detect more LCAs and offers better survival than CXR screening, due to better detection of part solid or non-solid lung adenocarcinomas. (orig.)

  9. Facile Alkaline Lysis of Escherichia coli Cells in High-Throughput Mode for Screening Enzyme Mutants: Arylsulfatase as an Example.

    Science.gov (United States)

    Yuan, Mei; Yang, Xiaolan; Li, Yuwei; Liu, Hongbo; Pu, Jun; Zhan, Chang-Guo; Liao, Fei

    2016-06-01

    Facile alkaline lysis of Escherichia coli cells in high-throughput (HTP) mode for screening enzyme mutants was tested with Pseudomonas aeruginosa arylsulfatase (PAAS). The alkaline lysis buffer was 1.0 M Tris-HCl at pH 9.0 plus 0.1 % Tween-20 and 2.0 mM 4-aminobenzamidine, mixed with cell suspension at 8:1 to 12:1 ratio for continuous agitation of mixtures in 96-well plates under room temperature; enzymatic activity in lysates was measured with 96-well microplate. PAAS activity tolerated final 0.1 % Tween-20. Individual clones were amplified for 12 h in 0.50 mL TB medium with 48-well plates to enhance the repeatability of induced expression. During continuous agitation of the mixture of cells and the lysis buffer, PAAS activities in lysates were steady from 3 to 9 h and comparable to sonication treatment but better than freezing-thawing. Coefficients of variation of activities of PAAS/mutants in lysates after treatment for 7 h reached ∼22 %. The mutant M72Q had specific activity 2-fold of G138S. By HTP lysis of cells, M72Q was recognized as a positive mutant over G138S with the area under the curve of 0.873. Therefore, for enzymes tolerating concentrated alkaline buffers, the proposed alkaline lysis approach may be generally applicable for HTP lysis of host cells during directed evolution.

  10. Addressing risk factors, screening, and preventative treatment for diabetic retinopathy in developing countries: a review.

    Science.gov (United States)

    Lin, Stephanie; Ramulu, Pradeep; Lamoureux, Ecosse L; Sabanayagam, Charumathi

    2016-05-01

    The number of people with diabetic retinopathy (DR) has increased with the increasing prevalence of diabetes mellitus worldwide, especially in developing countries. In recent years, the successful implementation of public health programs in developed countries has been thought to contribute to decreases in blindness from DR. Developing countries, however, have not seen the same improvements, and their public health interventions still face significant challenges. In this review we describe the current state of public health approaches including risk factor control, screening and treatment techniques for DR in developing countries, and suggest recommendations. While the awareness of DR is variable, specific knowledge about DR is low, such that many patients have already experienced vision loss by the time they are screened. Attempts to improve rates of screening, in particular through non-mydriatic cameras and tele-screening, are ongoing and promising, although challenges include collaboration with healthcare systems and technology failures. Laser treatment is the most readily available, with anti-VEGF therapy and vitreo-retinal surgery increasingly sought after and provided. Recommendations include the use of 'targeted mydriasis' for fundus imaging to address high rates of ungradable images, increased communication with diabetes management services to improve patient retention and mobilization of access to DR treatments.

  11. Factors affecting sensitivity and specificity of screening mammography and MRI in women with an inherited risk for breast cancer.

    NARCIS (Netherlands)

    Kriege, M.; Brekelmans, C.T.; Obdeijn, I.M.; Boetes, C.; Zonderland, H.M.; Muller, S.H.; Kok, T.; Manoliu, R.A.; Besnard, A.P.; Tilanus-Linthorst, M.M.; Seynaeve, C.; Bartels, C.C.; Kaas, R.; Meijer, S.; Oosterwijk-Wakka, J.C.; Hoogerbrugge-van der Linden, N.; Tollenaar, R.A.E.M.; Rutgers, E.J.; Koning, H.J. de; Klijn, J.G.M.

    2006-01-01

    BACKGROUND: The MRISC study is a screening study, in which women with an increased risk of hereditary breast cancer are screened by a yearly mammography and MRI, and half-yearly clinical breast examination. The sensitivity found in this study was 40% for mammography and 71% for MRI and the specifici

  12. Factors affecting sensitivity and specificity of screening mammography and MRI in women with an inherited risk for breast cancer

    NARCIS (Netherlands)

    Kriege, Mieke; Brekelmans, Cecile T. M.; Obdeijn, Inge Marie; Boetes, Carla; Zonderland, Harmine M.; Muller, Sara H.; Kok, Theo; Manoliu, Radu A.; Besnard, A. Peter E.; Tilanus-Linthorst, Madeleine M. A.; Seynaeve, Caroline; Bartels, Carina C. M.; Kaas, Reini; Meijer, Siebren; Oosterwijk, Jan C.; Hoogerbrugge, Nicoline; Tollenaar, Rob A. E. M.; Rutgers, Emiel J. T.; de Koning, Harry J.; Klijn, Jan G. M.

    2006-01-01

    Background The MRISC study is a screening study, in which women with an increased risk of hereditary breast cancer are screened by a yearly mammography and MRI, and half-yearly clinical breast examination. The sensitivity found in this study was 40% for mammography and 71% for MRI and the specificit

  13. Diagnostic Validity of the Eppendorf Schizophrenia Inventory (ESI): A Self-Report Screen for Ultrahigh Risk and Acute Psychosis

    Science.gov (United States)

    Niessen, Maurice A. J.; Dingemans, Peter M. A. J.; van de Fliert, Reinaud; Becker, Hiske E.; Nieman, Dorien H.; Linszen, Don

    2010-01-01

    Providers of mental health services need tools to screen for acute psychosis and ultrahigh risk (UHR) for transition to psychosis in help-seeking individuals. In this study, the Eppendorf Schizophrenia Inventory (ESI) was examined as a screening tool and for its ability to correctly predict diagnostic group membership (e.g., help seeking, mild…

  14. Survival benefit in women with BRCA1 mutation or familial risk in the MRI screening study (MRISC)

    NARCIS (Netherlands)

    Saadatmand, Sepideh; Obdeijn, Inge-Marie; Rutgers, Emiel J.; Oosterwijk, Jan C.; Tollenaar, Rob A.; Woldringh, Gwendolyn H.; Bergers, Elisabeth; Verhoef, Cornelis; Heijnsdijk, Eveline A.; Hooning, Maartje J.; de Koning, Harry J.; Tilanus-Linthorst, Madeleine M.

    2015-01-01

    Adding MRI to annual mammography screening improves early breast cancer detection in women with familial risk or BRCA1/2 mutation, but breast cancer specific metastasis free survival (MFS) remains unknown. We compared MFS of patients from the largest prospective MRI Screening Study (MRISC) with 1:1

  15. Methods and outcomes of screening for pancreaticadenocarcinoma in high-risk individuals

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Pancreatic ductal adenocarcinoma (PDAC) is a lethalneoplasia, for which secondary prevention (i.e .,screening) is advisable for high-risk individuals with"familiar pancreatic cancer" and with other specificgenetic syndromes (Peutz-Jeghers, p16, BRCA2, PALBand mismatch repair gene mutation carriers). There islimited evidence regarding the accuracy of screeningtests, their acceptability, costs and availability, andagreement on whom to treat. Successful target ofscreening are small resectable PDAC, intraductalpapillary mucinous neoplasms with high-grade dysplasiaand advanced pancreatic intraepithelial neoplasia. Bothmagnetic resonance imaging (MRI) and endoscopicultrasound (EUS) are employed for screening, and theoverall yield for pre-malignant or malignant pancreaticlesions is of about 20% with EUS and 14% with MRI/magnetic resonance colangiopancreatography. EUSperforms better for solid and MRI for cystic lesions.However, only 2% of these detected lesions can beconsidered a successful target, and there are insufficientdata demonstrating that resection of benign or lowgrade lesions improves survival. Many patients in thepublished studies therefore seemed to have receivedan overtreatment by undergoing surgery. It is crucial tobetter stratify the risk of malignancy individually, and tobetter define optimal screening intervals and methodseither with computerized tools or molecular biomarkers,possibly in large multicentre studies. At the moment,screening should be carefully performed within researchprotocols at experienced centres, offering involvedindividuals medical and psychological advice.

  16. Cancerogenesis Risks between 64 and 320 Row Detector CT for Coronary CTA Screening

    Directory of Open Access Journals (Sweden)

    Atif N Khan

    2014-01-01

    Full Text Available Objectives: This study compares cancerogenesis risks posed by the 64 row detector and the 320 row detector computed tomography scanners used during coronary computed tomography angiography (CCTA following decennial screening guidelines. Material and Methods: Data of the radiation absorbed after CCTA by lung, thyroid, and female breast in patients between 50 and 70 years of age obtained from prior published literature for the 64 row CT scanner were compared with data from our study using 320 row detector CT scanner. Data from the 64 row and the 320 row detector CT scanners was used to determine lifetime attributable risks (LAR of cancer based on the biological effects of ionizing radiation (BEIR VII report. Results: The relative reduction of LAR (% for 50-, 60-, and 70-year-old patients undergoing scanning with the 320 row detector CT scanner was 30% lower for lung, and more than 50% lower for female breast when compared with results from 64 row detector CT scanner. The use of 320 row detector CT would result in a combined cumulative cancer incidence of less than 1/500 for breast in women and less than 1/1000 for lung in men; By comparison, this is much lower than other more common risk factors: 16-fold for lung cancer in persistent smokers, 2-fold for breast cancer with a first degree family member history of breast cancer, and 10-fold for thyroid cancer with a family member with thyroid cancer. Decennial screening would benefit at least 355,000 patients from sudden cardiac death each year, 94% of whom have significant coronary artery disease, with at least one stenosis >75%. LAR for thyroid cancer was negligible for both scanners. Conclusion: Lung and female breast LAR reductions with 320 row detector compared with 64 row detector CT are substantial, and the benefits would outweigh increased cancer risks with decennial screening in the age group of 50-70 years.

  17. Obesity is a risk factor for thyroid cancer in a large, ultrasonographically screened population.

    Science.gov (United States)

    Han, Ji Min; Kim, Tae Yong; Jeon, Min Ji; Yim, Ji Hye; Kim, Won Gu; Song, Dong Eun; Hong, Suck Joon; Bae, Sung Jin; Kim, Hong-Kyu; Shin, Myung-Hee; Shong, Young Kee; Kim, Won Bae

    2013-06-01

    Obesity is a well-known risk factor for many cancers, including those of the esophagus, colon, kidney, breast, and skin. However, there are few reports on the relationship between obesity and thyroid cancer. We conducted this study to determine whether obesity is a risk factor for thyroid cancer by systematically screening a selected population by ultrasonography. We obtained data from 15,068 subjects that underwent a routine health checkup from 2007 to 2008 at the Health Screening and Promotion Center of Asan Medical Center. Thyroid ultrasonography was included in the checkup, and suspicious nodules were examined by ultrasonography-guided aspiration. Those with a history of thyroid disease or family history of thyroid cancer were excluded from this study. In total, 15,068 subjects, 8491 men and 6577 women, were screened by thyroid ultrasonography. Fine-needle aspiration cytology was performed in 1427 of these patients based on the predefined criteria and thyroid cancer was diagnosed in 267 patients. The prevalence of thyroid cancer in women was associated with a high BMI (per 5 kg/m(2) increase) (odds ratios (OR)=1.63, 95% CI 1.24-2.10, Pcancer in men and a high BMI (OR=1.16, 95% CI 0.85-1.57, P=0.336). There was no association between age, fasting serum insulin, or basal TSH levels and thyroid cancer in either gender. Obesity was associated with a higher prevalence of thyroid cancer in women when evaluated in a routine health checkup setting. This association between risk factor and disease was unrelated to serum insulin and TSH levels. Additional studies are needed to understand the mechanism(s) behind the association of obesity with thyroid cancer risk.

  18. Evolution of the excess absolute risk (EAR) in the Valencian breast cancer screening programme

    Energy Technology Data Exchange (ETDEWEB)

    Ferrer, S.; Ramos, M.; Villaescusa, J. I.; Verdu, G.; Salas, M. D.; Cuevas, M. D.

    2004-07-01

    Breast cancer is one of the most frequent diseases in women, with a high incidence rate. The best fight against the breast cancer is the early detection by menas of mammograms in a screening programme. The Valencian Breast Cancer Screening Programme (VBCSP) started at 1992, and it is composed of twenty-two mammography units. The programme is targeted towards asympotomatic women dfrom 45 to 69 years old, but this screening has a negative influence in the studied woman, whatever the diagnosis was. By means of MCNP-4c2 Monte Carlo code, some conversion factors from air kerma air kerma to glandular dose have been developed. Different breast woamn models, according to the Valencian brest anathomy (taking into account the relation breast radius / breast compression thickness obtained from real samples, have been simulated in order to obtain the glandular breast dose values. Quality control parameters as ESAK values were also employed for developing the methods. The conversion factors give a simple and fast wasy to obtain the mean glandular dose from mammography exposition parameters. The glandular dose has been also calculated following the European Protocol on Dosimetry in order to compare the results of the new methodology. Four sample populations of 100 omen from each uunit of the VBCSP have been taken innnn order to estimate the mean glandular dose and the associated excess absolute risk (EAR). Once the doses for each woman from the samples are obtained and according to the age of them, the EAR value for each sample has been determinated following the UNSCEAR 2000 projection risk model, which takes into account the characteristics of the Valencian population and gives the EAR for radio-induced breast cancer. The results have been calculated and compared by means of the ASQRAD software, but with an older risk projection model, the UNSCEAR 1994. Once the four sample average EAR have been calculated, the evolution of the induced risk in the Valencian Breast Cancer

  19. Training General Practitioners to Detect Probable Mental Disorders in Young People During Health Risk Screening.

    Science.gov (United States)

    Ambresin, Anne-Emmanuelle; Otjes, Christiaan P; Patton, George C; Sawyer, Susan M; Thuraisingam, Sharmala; English, Dallas R; Haller, Dagmar M; Sanci, Lena A

    2017-09-01

    The purpose of the study is to investigate whether a training intervention increases general practitioners' (GPs) detection sensitivity for probable mental disorders in young people. Forty general practices were randomized to an intervention (29 GPs) or comparison arm (49 GPs). Intervention GPs participated in 9 hours of interactive training on youth-friendly care, psychosocial health risk screening, and responding to risk-taking behavior with motivational interviewing approaches, followed by practice visits assisting with integration of screening processes and tools. Youth aged 14-24 years attending GPs underwent a computer-assisted telephone interview about their consultation and psychosocial health risks. Having a "probable mental disorder" was defined as either scoring high on Kessler's scale of psychological distress (K10) or self-perceived mental illness. Other definitions tested were high K10; self-perceived mental illness; and high K10 and self-perceived mental illness. Psychosocial health risk screening rates, detection sensitivity, and other accuracy parameters (specificity, positive predictive value, and negative predictive value) were estimated. GPs' detection sensitivity improved after the intervention if having probable mental disorder was defined as high K10 score and self-perceived mental illness (odds ratio: 2.81; 95% confidence interval: 1.23-6.42). There was no significant difference in sensitivity of GPs' detection for our preferred definition, high K10 or self-perceived mental illness (.37 in both; odds ratio: .93; 95% confidence interval: .47-1.83), and detection accuracy was comparable (specificity: .84 vs. .87, positive predictive values: .54 vs. .60, and negative predictive values: .72 vs. .72). Improving recognition of mental disorder among young people attending primary care is likely to require a multifaceted approach targeting young people and GPs. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc

  20. Men's information-seeking behavior regarding cancer risk and screening: A meta-narrative systematic review.

    Science.gov (United States)

    Saab, Mohamad M; Reidy, Mary; Hegarty, Josephine; O'Mahony, Mairin; Murphy, Mike; Von Wagner, Christian; Drummond, Frances J

    2017-07-20

    Preventive strategies are known to reduce cancer risk and incidence and improve prognosis. Men seldom seek medical information about cancer prevention and risk reduction. The aim of this meta-narrative systematic review was to critically appraise evidence from qualitative, quantitative, and mixed-methods studies that explored men's information-seeking behaviors in relation to cancer prevention and risk reduction. MEDLINE, CINAHL Plus with Full Text, PsycINFO, PsycARTICLES, Psychology and Behavioral Sciences Collection, Education Full Text, and ERIC were systematically searched for studies published in English between January 1, 2006 and May 30, 2016. A total of 4117 titles were identified; of which, 31 studies were included (21 qualitative studies, 9 quantitative studies, and 1 mixed-methods study). The methodological quality of the studies was appraised by using different tools. Most studies focused on screening for prostate (n = 18) and colorectal cancer (n = 7). Most men were passive information-gatherers rather than active information-seekers. Key sources of information included the Internet for active information-seekers and health care professionals for passive information-gatherers. Barriers to information-seeking included information overload, embarrassment, and fear. Low literacy and health literacy levels were addressed in 3 studies and were identified as impediments to active information-seeking. Facilitators to information-seeking included family support, media, celebrity endorsements, and targeted information. Men's information-seeking behavior regarding cancer risk reduction, prevention, and screening is influenced by several factors. This necessitates targeted interventions aimed at raising awareness of cancer prevention and screening, while accounting for men's informational needs, preferred learning strategies, and literacy levels. Copyright © 2017 John Wiley & Sons, Ltd.

  1. Disparities in Osteoporosis Screening Between At-Risk African-American and White Women

    Science.gov (United States)

    Miller, Redonda G; Ashar, Bimal H; Cohen, Jennifer; Camp, Melissa; Coombs, Carmen; Johnson, Elizabeth; Schneyer, Christine R

    2005-01-01

    Background Despite a lower prevalence of osteoporosis in African-American women, they remain at risk and experience a greater mortality than white women after sustaining a hip fracture. Lack of recognition of risk factors may occur in African-American women, raising the possibility that disparities in screening practices may exist. Objective To determine whether there is a difference in physician screening for osteoporosis in postmenopausal, at-risk African-American and white women. Methods We conducted a retrospective chart review at an urban academic hospital and a suburban community hospital. Subjects included 205 African-American and white women, age ≥65 years and weight ≤127 pounds, who were seen in Internal Medicine clinics. The main outcome was dual-energy x-ray absorptiometry (DXA) scan referral. We investigated physician and patient factors associated with referral. Secondary outcomes included evidence of discussion of osteoporosis and prescription of medications to prevent osteoporosis. Results Significantly fewer African-American than white women were referred for a DXA scan (OR 0.39%, 95% confidence interval (CI): 0.22 to 0.68). Physicians were also less likely to mention consideration of osteoporosis in medical records (0.27, 0.15 to 0.48) and to recommend calcium and vitamin D supplementation for this population (0.21, 0.11 to 0.37). If referred, African-American women had comparable DXA completion rates when compared with white women. No physician characteristics were significantly associated with DXA referral patterns. Conclusions Our study found a significant disparity in the recommendation for osteoporosis screening for African-American versus white women of similar risk, as well as evidence of disparate osteoporosis prevention and treatment, confirming results of other studies. Future educational and research initiatives should target this inequality. PMID:16117754

  2. The accuracy of the functional movement screen to identify individuals with an elevated risk of musculoskeletal injury.

    Science.gov (United States)

    Krumrei, Kirk; Flanagan, Molly; Bruner, Josh; Durall, Chris

    2014-11-01

    Injuries are somewhat commonplace in highly active populations. One strategy for reducing injuries is to identify individuals with an elevated injury risk before participation so that remediative interventions can be provided. Preparticipation screenings have traditionally entailed strength and flexibility measures thought to be indicative of inflated injury risk. Some researchers, however, have suggested that functional movements/tasks should be assessed to help identify individuals with a high risk of future injury. One assessment tool used for this purpose is the Functional Movement Screen (FMS). The FMS generates a numeric score based on performance attributes during 7 dynamic tasks; this score is purported to reflect future injury risk. Expanding interest in the FMS has led researchers to investigate how accurately it can identify individuals with an increased risk of injury. Can the Functional Movement Screen accurately identify highly active individuals with an elevated risk of injury?

  3. [Screening of fall risk in frail, but still independently living senior citizens].

    Science.gov (United States)

    Anders, Jennifer; Dapp, Ulrike; Laub, Susann; von Renteln-Kruse, Wolfgang; Juhl, Katharina

    2006-08-01

    Mobility is one of the most important factors for well-being and autonomy in old age. Impairments in mobility, falls and fear of falling are, therefore, of prognostic value. Falls generally result from an interaction of multiple risk factors. However, older people are often not aware of the risks of falling. They neither recognize risk factors nor report these factors to their physicians. The aim of this study was to develop and to test a self-reported multidimensional screening instrument to evaluate risk factors of falling in community-dwelling older people. Therefore, we identified multiple risk factors of falls based on a systematic literature review and then developed a new questionnaire - the Senior Citizen Risk of Falling Check. Risk factors, i.e. cognitive disorders, that are closely associated with the demand of nursing care were not covered in this relatively healthy target group. We pretested this instrument and adapted it before its use in a pilot test in residents of a sheltered housing complex in Hamburg. A group of 117 residents (average age 82.9 years, range 68.2-98.2 years, 83.8% women), all without care needs (assessed by the German health and care insurance system) returned the Senior Citizen Risk of Falling Check. Within 2 weeks all 117 participants were interviewed by telephone to analyze the test-retest reliability of the instrument (Cohen's kappa). We administered 13 questions on visual and hearing deficits, neurological impairment, depressive mood, medication use, muscle weakness, gait and balance deficits, nutrition, and history of falls. On average, 6 risk factors were reported (range 0-12). Reductions in gait speed (64.1%) was most frequently mentioned. Of the participants, 30.8% fell at least once during the last year and 22.2% of these falls resulted in injuries (fractures, hematomas, laceration, pain). Cohen's kappa was good (2/13 questions) to excellent (10/13 questions) with one exception (balance question kappa=0.20). The study

  4. Stepwise Relationship Between Components of Metabolic Syndrome and Risk of Colorectal Adenoma in a Taiwanese Population Receiving Screening Colonoscopy

    Directory of Open Access Journals (Sweden)

    Nien-Chih Hu

    2011-02-01

    Conclusion: Subjects with metabolic syndrome have increased risk of developing colorectal adenoma. Screening colonoscopy for prevention of colorectal adenoma might be warranted when abdominal obesity or more than three components of MS are present.

  5. Effect of population screening for type 2 diabetes and cardiovascular risk factors on mortality rate and cardiovascular events

    DEFF Research Database (Denmark)

    Simmons, Rebecca K; Griffin, Simon J; Witte, Daniel R

    2017-01-01

    -based screening for type 2 diabetes and cardiovascular risk factors on mortality rates and cardiovascular events. METHODS: This register-based, non-randomised, controlled trial included men and women aged 40-69 years without known diabetes who were registered with a general practice in Denmark (n = 1......,912,392). Between 2001 and 2006, 153,107 individuals registered with 181 practices participating in the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION)-Denmark study were sent a diabetes risk score questionnaire. Individuals at moderate-to-high risk...... were invited to visit their GP for assessment of diabetes status and cardiovascular risk (screening group). The 1,759,285 individuals registered with all other general practices in Denmark constituted the retrospectively constructed no-screening (control) group. Outcomes were mortality rate...

  6. Cost-effectiveness and harm-benefit analyses of risk-based screening strategies for breast cancer

    National Research Council Canada - National Science Library

    Vilaprinyo, Ester; Forné, Carles; Carles, Misericordia; Sala, Maria; Pla, Roger; Castells, Xavier; Domingo, Laia; Rue, Montserrat

    2014-01-01

    .... The present study has two objectives: 1) To perform an economic evaluation and to assess the harm-benefit ratios of screening strategies that vary in their intensity and interval ages based on breast cancer risk; and 2...

  7. Cost-Effectiveness and Harm-Benefit Analyses of Risk-Based Screening Strategies for Breast Cancer: e86858

    National Research Council Canada - National Science Library

    Ester Vilaprinyo; Carles Forné; Misericordia Carles; Maria Sala; Roger Pla; Xavier Castells; Laia Domingo; Montserrat Rue; Study Group

    2014-01-01

    .... The present study has two objectives: 1) To perform an economic evaluation and to assess the harm-benefit ratios of screening strategies that vary in their intensity and interval ages based on breast cancer risk; and 2...

  8. Physical Activity, Screen-Based Sedentary Behavior, and Sleep Duration in Adolescents: Youth Risk Behavior Survey, 2011-2013

    National Research Council Canada - National Science Library

    Kim, Youngdeok; Umeda, Masataka; Lochbaum, Marc; Stegemeier, Steven

    2016-01-01

    This study examined the concurrent associations of physical activity and screen-based sedentary behavior with sleep duration among adolescents by using data from the national Youth Risk Behavior Survey 2011-2013...

  9. Screening system for drug-induced arrhythmogenic risk combining a patch clamp and heart simulator

    Science.gov (United States)

    Okada, Jun-ichi; Yoshinaga, Takashi; Kurokawa, Junko; Washio, Takumi; Furukawa, Tetsushi; Sawada, Kohei; Sugiura, Seiryo; Hisada, Toshiaki

    2015-01-01

    To save time and cost for drug discovery, a paradigm shift in cardiotoxicity testing is required. We introduce a novel screening system for drug-induced arrhythmogenic risk that combines in vitro pharmacological assays and a multiscale heart simulator. For 12 drugs reported to have varying cardiotoxicity risks, dose-inhibition curves were determined for six ion channels using automated patch clamp systems. By manipulating the channel models implemented in a heart simulator consisting of more than 20 million myocyte models, we simulated a standard electrocardiogram (ECG) under various doses of drugs. When the drug concentrations were increased from therapeutic levels, each drug induced a concentration-dependent characteristic type of ventricular arrhythmia, whereas no arrhythmias were observed at any dose with drugs known to be safe. We have shown that our system combining in vitro and in silico technologies can predict drug-induced arrhythmogenic risk reliably and efficiently. PMID:26601174

  10. Screening and risk evaluation for sudden cardiac death in ischaemic and non-ischaemic cardiomyopathy

    DEFF Research Database (Denmark)

    Proclemer, Alessandro; Lewalter, Thorsten; Bongiorni, Maria Grazia;

    2013-01-01

    The purpose of this EHRA survey was to examine the current clinical practice of screening and risk evaluation for sudden cardiac death in ischaemic and non-ischaemic cardiomyopathy with a focus on selection of candidates for implantable cardioverter-defibrillator (ICD) therapy, timing of ICD...... centres (32.2%), and in patients with permanent dialysis in 8 centres (33.3%). Signal-averaged electrocardiography and heart rate variability were never considered as risk stratification tools in 23 centres (74.2%). Implantation of a loop recorder was performed in patients with borderline indications...... on the clinical risk stratification and not on non-invasive and invasive diagnostic tests or implantable loop recorder use....

  11. Cancer Worry, Perceived Risk and Cancer Screening in First-Degree Relatives of Patients with Familial Gastric Cancer.

    Science.gov (United States)

    Li, Jenny; Hart, Tae L; Aronson, Melyssa; Crangle, Cassandra; Govindarajan, Anand

    2016-06-01

    Currently, there is a lack of evidence evaluating the psychological impact of cancer-related risk perception and worry in individuals at high risk for gastric cancer. We examined the relationships between perceived risk, cancer worry and screening behaviors among first-degree relatives (FDRs) of patients with familial gastric cancer. FDRs of patients diagnosed with familial gastric cancer with a non-informative genetic analysis were identified and contacted. Participants completed a telephone interview that assessed socio-demographic information, cancer risk perception, cancer worry, impact of worry on daily functioning, and screening behaviors. Twenty-five FDRs completed the telephone interview. Participants reported high levels of comparative and absolute cancer risk perception, with an average perceived lifetime risk of 54 %. On the other hand, cancer-related worry scores were low, with a significant minority (12 %) experiencing high levels of worry. Study participants exhibited high levels of confidence (median = 70 %) in the effectiveness of screening at detecting a curable cancer. Participants that had undergone screening in the past showed significantly lower levels of cancer-related worry compared to those that had never undergone screening. In conclusion, individuals at high-risk for gastric cancer perceived a very high personal risk of cancer, but reported low levels of cancer worry. This paradoxical result may be attributed to participants' high levels of confidence in the effectiveness of screening. These findings highlight the importance for clinicians to discuss realistic risk appraisals and expectations towards screening with unaffected members of families at risk for gastric cancer, in an effort to help mitigate anxiety and help with coping.

  12. The Child Suicide Risk Assessment: A Screening Measure of Suicide Risk in Pre-Adolescents

    Science.gov (United States)

    Larzelere, Robert E.; Andersen, Jamie J.; Ringle, Jay L.; Jorgensen, Dan D.

    2004-01-01

    This study documents the initial reliability and validity of the Child Suicide Risk Assessment (CSRA) for children under the age of 13. The revised CSRA retained 18 of 20 original items based on item-specific psychometric data from 140 pre-adolescents in out-of-home treatment programs. The CSRA demonstrated adequate internal consistency (alpha =…

  13. The analysis of environmental risk for low- and intermediate-level radioactive waste vitrification facility of Korea

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Dae Seok; Lee, Kun Jai [KAIST, Taejon (Korea, Republic of); Cho, Chun Hyung; Lee, Kyung Ho; Maeng, Sung Jun; Lee, Myung Chan [Nuclear Environment Technology Institute, Taejon (Korea, Republic of)

    1999-07-01

    A vitrification facility for thetreatment of radioactive waste is under development by Korea Electric Power Corporation (KEPCO). The facility is designed to vitrify low- and intermediate- level radioactive waste (LILW) generated from the nuclear power plants in Korea. During the operation of the facility, radioactive nuclides and hazardous chemicals are to be released to the environment and residents near the facility can be exposed to those materials. A computer code, VERAS(vitrification Facility's Environmental Risk Assessment System) was developed, based on GENII (B. A. Napier, et al. 1988) to calculate both radioactive and non-radioactive chemical risks from the operation of the vitrification facility. Only atmospheric release was taken into consideration in the code where Gaussian plume model was applied. For the dose calculation, methodologies of ICRP 26 and 30 was used whereas risks caused by chemical elements are calculated in terms of cancer risk increase. Safety assessment was made on a sample case of the postulated vitrification plant using the VERAS. The results showed that the vitrification system was environmentally safe. (author). 6 refs., 8 tabs., 2 figs.

  14. Youth screen-time behaviour is associated with cardiovascular risk in young adulthood

    DEFF Research Database (Denmark)

    Grøntved, Anders; Ried-Larsen, Mathias; Møller, Niels Christian;

    2014-01-01

    = 435) followed for up to 12 years. Adiposity, blood pressure (BP), triglycerides, high-density lipoprotein (HDL), glucose, insulin, and self-reported TV viewing and computer use were obtained in adolescence and in young adulthood. A continuous metabolic syndrome z-score was calculated as the sum...... of standardized values of each risk factor (inverse of HDL). In multivariable-adjusted analyses, TV viewing and total screen time in adolescence were positively associated with adiposity, triglycerides, and metabolic syndrome z-score in young adulthood (p ... or decreased their viewing time. Insulin and metabolic syndrome z-scores were also higher among individuals who increased their TV viewing, computer use, or total screen time more than 2 hours/day compared with individuals who remained stable or decreased their viewing time (p

  15. Advantages and disadvantages of population screening for cancer and surveillance of at-risk groups.

    Science.gov (United States)

    Craanen, M E; Kuipers, E J

    2001-04-01

    Despite improvements in diagnostic and therapeutic modalities, the prognosis of patients with gastrointestinal malignancies has remained poor. In essence, this poor outcome is related to the majority of patients presenting at an already advanced stage of disease at the time of diagnosis. Unfortunately, however, mass screening and surveillance programmes aimed at early detection and treatment in the population at large are in most countries considered to be cost-ineffective. Moreover, even with regard to established risk groups, there is considerable debate over whether current surveillance strategies are beneficial to these patients in terms of a reduction in cancer-related mortality. This chapter addresses various aspects of screening and surveillance. In the first part, general issues are discussed, whereas the second part focuses particularly on disease entities frequently encountered in gastrointestinal practice. Copyright 2001 Harcourt Publishers Ltd.

  16. Prevalence of colorectal cancer screening among adults--Behavioral Risk Factor Surveillance System, United States, 2010.

    Science.gov (United States)

    Joseph, Djenaba A; King, Jessica B; Miller, Jacqueline W; Richardson, Lisa C

    2012-06-15

    Among cancers that affect both men and women, colorectal cancer is the second leading cause of cancer death. In 2007 (the most recent year for which data are available), >142,000 persons received a diagnosis for colorectal cancer and >53,000 persons died. Screening for colorectal cancer has been demonstrated to be effective in reducing the incidence of and mortality from the disease. In 2008, the U.S. Preventive Services Task Force (USPSTF) recommended that persons aged 50-75 years at average risk for colorectal cancer be screened by using one or more of the following methods: high-sensitivity fecal occult blood testing (FOBT) every year, sigmoidoscopy every 5 years with FOBT every 3 years, or colonoscopy every 10 years.

  17. Breast cancer risk after diagnosis by screening mammography of nonproliferative or proliferative benign breast disease: a study from a population-based screening program.

    Science.gov (United States)

    Castells, Xavier; Domingo, Laia; Corominas, Josep María; Torá-Rocamora, Isabel; Quintana, María Jesús; Baré, Marisa; Vidal, Carmen; Natal, Carmen; Sánchez, Mar; Saladié, Francina; Ferrer, Joana; Vernet, Mar; Servitja, Sonia; Rodríguez-Arana, Ana; Roman, Marta; Espinàs, Josep Alfons; Sala, María

    2015-01-01

    Benign breast disease increases the risk of breast cancer. This association has scarcely been evaluated in the context of breast cancer screening programs although it is a prevalent finding in mammography screening. We assessed the association of distinct categories of benign breast disease and subsequent risk of breast cancer, as well as the influence of a family history of breast cancer. A retrospective cohort study was conducted in 545,171 women aged 50-69 years biennially screened for breast cancer in Spain. The median of follow-up was 6.1 years. The age-adjusted rate ratio (RR) of breast cancer for women with benign breast disease, histologically classified into nonproliferative and proliferative disease with and without atypia, compared with women without benign breast disease was estimated by Poisson regression analysis. A stratified analysis by family history of breast cancer was performed in a subsample. All tests were two-sided. The age-adjusted RR of breast cancer after diagnosis of benign breast disease was 2.51 (95 % CI: 2.14-2.93) compared with women without benign breast disease. The risk was higher in women with proliferative disease with atypia (RR = 4.56, 95 % CI: 2.06-10.07) followed by those with proliferative disease without atypia (RR = 3.58; 95 % CI = 2.61-4.91). Women with nonproliferative disease and without a family history of breast cancer remained also at increased risk of cancer (OR = 2.23, 95 % CI: 1.86-2.68). An increased risk of breast cancer was observed among screening participants with proliferative or nonproliferative benign breast disease, regardless of a family history of breast cancer. This information may be useful to explore risk-based screening strategies.

  18. Renal-cell carcinoma risk estimates based on participants in the prostate, lung, colorectal, and ovarian cancer screening trial and national lung screening trial.

    Science.gov (United States)

    Lotan, Yair; Karam, Jose A; Shariat, Shahrokh F; Gupta, Amit; Roupret, Morgan; Bensalah, Karim; Margulis, Vitaly

    2016-04-01

    Current knowledge regarding risk of renal-cell carcinoma (RCC) is based on meta-analyses of case-control studies. The Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial and National Lung Screening Trial (NLST) provide robust prospective databases with clinical information and rates of cancer development. PLCO and NLST were used to identify risk factors for RCC. Data were extracted from PLCO and NLST to stratify risk of RCC by sex, race, age at inclusion, obesity, and smoking status. Incidence rates between groups were compared using the chi-square test. We excluded urothelial carcinomas. Overall, 701/154,118 and 190/53,242 RCCs were detected in PLCO and NLST, respectively. Incidence rates were higher in men (PLCO: 0.56 vs. 0.28/1000 person y, NLST: 0.73 vs. 0.35/1000 person y; both with P60 years, obesity, and intensity of smoking were associated with higher risk of developing RCC. In the NLST, sex and morbid obesity increased the risk for RCC but age, ethnicity, and smoking intensity were not predictors. There was no effect of screening for other cancers on detection of RCC. High-grade (grades ≥3) RCCs were diagnosed in 145 (20.7%) and 60 (31.6%) in the PLCO and NLST. In PLCO, age (60-64y), male sex, obesity, and current smokers with>50 pack years were at increased risk for high-grade RCC. In NLST, only male sex was an independent predictor of high-grade RCC. Age over 60 years, male sex, smoking intensity, and obesity affect the risk of RCC. Identification of a high-risk population may allow a pilot study of rational screening for RCC. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Targeted Echocardiographic Screening for Latent Rheumatic Heart Disease in Northern Uganda: Evaluating Familial Risk Following Identification of an Index Case.

    Directory of Open Access Journals (Sweden)

    Twalib Aliku

    2016-06-01

    Full Text Available Echocardiographic screening for detection of latent RHD has shown potential as a strategy to decrease the burden of disease. However, further research is needed to determine optimal implementation strategies. RHD results from a complex interplay between environment and host susceptibility. Family members share both and relatives of children with latent RHD may represent a high-risk group. The objective of this study was to use echocardiographic family screening to determine the relative risk of RHD among first-degree relatives of children with latent RHD compared to the risk in first-degree relatives of healthy peers.Previous school-based screening data were used to identify RHD positive children and RHD negative peers. All first-degree relatives ≥ 5 years were invited for echocardiography screening (2012 World Heart Federation Criteria. Sixty RHD positive cases (30 borderline/30 definite RHD and 67 RHD negative cases were recruited. A total of 455/667 (68% family members were screened. Definite RHD was more common in childhood siblings of RHD positive compared to RHD negative (p = 0.05. Children with any RHD were 4.5 times as likely to have a sibling with definite RHD, a risk that increased to 5.6 times when considering only cases with definite RHD. Mothers of RHD positive and RHD negative cases had an unexpectedly high rate of latent RHD (9.3%.Siblings of RHD positive cases with RHD are more likely to have definite RHD and the relative risk is highest if the index case has definite RHD. Future screening programs should consider implementation of sibling screening following detection of an RHD positive child. Larger screening studies of adults are needed, as data on prevalence of latent RHD outside of childhood are sparse. Future studies should prioritize implementation research to answer questions of how RHD screening can best be integrated into existing healthcare structures, ensuring practical and sustainable screening programs.

  20. Screening for hepatitis C in average and high-risk populations of Qatar using rapid point-of-care testing

    Science.gov (United States)

    Al Kaabi, Saad; John, Anil K; Al Dweik, Nazeeh; Ullah Wani, Hameed; Babu Thandassary, Ragesh; Derbala, Moutaz F; Al Ejji, Khalid; Sultan, Khaleel; Pasic, Fuad; Al Mohannadi, Munnera; Yacoub, Rafae; Butt, Mohd Tariq; Singh, Rajvir

    2015-01-01

    Background Screening for hepatitis C has been found to be beneficial in high-risk individuals and ‘baby boomers’. Objective Our aim was to screen for hepatitis C in average and high-risk individuals and compare the disease characteristics and response to treatment among the screened group (SG) and non-screened group (NSG). Method Community-based screening for hepatitis C was done in the average and high-risk populations of Qatar. Screening was done using rapid point-of-care testing. All patients with stage 1 fibrosis on liver biopsy were treated with pegylated interferon and ribavirin. Results In total, 13,704 people were screened and 272 (2%, 95% CI (1.8–2.2%) had positive antibodies to hepatitis C. During the same period, 237 non-screened patients (NSG) with hepatitis C were referred for treatment. Alanine and aspartate aminotransferases (ALT, AST) and overall fibrosis were significantly lower in the SG as compared with the NSG (p = 0.04, 0.04 and 0.01, respectively). The response to treatment was similar in the SG as compared with the NSG (sustained viral response 61.7 % versus 69.1%, p = 0.55). Average-risk patients had significantly lower ALT levels (p = 0.04) but had similar response to treatment as the high-risk individuals (sustained viral response 63.2 % versus 61%, p = 0.87). Conclusion Screening detects hepatitis C with lesser fibrosis but does not result in better response to pegylated interferon and ribavirin as compared with non-screened patients. PMID:26279845

  1. Rates of Delirium Diagnosis Do Not Improve with Emergency Risk Screening: Results of the Emergency Department Delirium Initiative Trial.

    Science.gov (United States)

    Arendts, Glenn; Love, Jennefer; Nagree, Yusuf; Bruce, David; Hare, Malcolm; Dey, Ian

    2017-08-01

    To determine whether a bundled risk screening and warning or action card system improves formal delirium diagnosis and person-centered outcomes in hospitalized older adults. Prospective trial with sequential introduction of screening and interventional processes. Two tertiary referral hospitals in Australia. Individuals aged 65 and older presenting to the emergency department (ED) and not requiring immediate resuscitation (N = 3,905). Formal ED delirium screening algorithm and use of a risk warning card with a recommended series of actions for the prevention and management of delirium during the subsequent admission MEASUREMENTS: Delirium diagnosis at hospital discharge, proportion discharged to new assisted living arrangements, in-hospital complications (use of sedation, falls, aspiration pneumonia, death), hospital length of stay. Participants with a positive risk screen were significantly more likely (relative risk = 6.0, 95% confidence interval = 4.9-7.3) to develop delirium, and the proportion of at-risk participants with a positive screen was constant across three study phases. Delirium detection rate in participants undergoing the final intervention (Phase 3) was 12.1% (a 2% absolute and 17% relative increase from the baseline rate) but this was not statistically significant (P = .29), and a similar relative increase was seen over time in participants not receiving the intervention CONCLUSION: A risk screening and warning or action card intervention in the ED did not significantly improve rates of delirium detection or other important outcomes. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  2. Universal screening for cardiovascular disease risk factors in adolescents to identify high-risk families: a population-based cross-sectional study.

    Science.gov (United States)

    Khoury, Michael; Manlhiot, Cedric; Gibson, Don; Chahal, Nita; Stearne, Karen; Dobbin, Stafford; McCrindle, Brian W

    2016-01-21

    Universal screening of children for dyslipidemia and other cardiovascular risk factors has been recommended. Given the clustering of cardiovascular risk factors within families, one benefit of screening adolescents may be to identify "at-risk" families in which adult members might also be at elevated risk and potentially benefit from medical evaluation. Cross-sectional study of grade 9 students evaluating adiposity, lipids and blood pressure. Data collected by Heart Niagara Inc. through the Healthy Heart Schools' Program. Parents completed questionnaires, evaluating family history of dyslipidemia, hypertension, diabetes and early cardiovascular disease events in parents and siblings (first-degree relatives), and grandparents (second-degree relatives). Associations between positive risk factor findings in adolescents and presence of a positive family history were assessed in logistic regression models. N = 4014 adolescents ages 14-15 years were screened; 3467 (86 %) provided family medical history. Amongst adolescents, 4.7 % had dyslipidemia, 9.5 % had obesity, and 3.5 % had elevated blood pressure. Central adiposity (waist-to-height ratio ≥0.5) in the adolescent was associated with increased odds of diabetes in first- (OR:2.0 (1.6-2.6), p identify increased odds of a positive family history. Presence of obesity and/or dyslipidemia in adolescents identified through a universal school-based screening program is associated with risk factor clustering within families. Universal pediatric cardiometabolic screening may be an effective entry into reverse cascade screening.

  3. Risk Factors and Screening for Trypanosoma cruzi Infection of Dutch Blood Donors.

    Directory of Open Access Journals (Sweden)

    Ed Slot

    Full Text Available Blood donors unaware of Trypanosoma cruzi infection may donate infectious blood. Risk factors and the presence of T. cruzi antibodies in at-risk Dutch blood donors were studied to assess whether specific blood safety measures are warranted in the Netherlands.Birth in a country endemic for Chagas disease (CEC, having a mother born in a CEC, or having resided for at least six continuous months in a CEC were considered risk factors for T. cruzi infection. From March through September 2013, risk factor questions were asked to all donors who volunteered to donate blood or blood components. Serum samples were collected from donors reporting one or more risk factors, and screened for IgG antibodies to T. cruzi by EIA.Risk factors for T. cruzi infection were reported by 1,426 of 227,278 donors (0.6%. Testing 1,333 at-risk donors, none (0.0%; 95%, CI 0.0-0.4% was seroreactive for IgG antibodies to T. cruzi. A total of 472 donors were born in a CEC; 553 donors reported their mother being born in a CEC; and 1,121 donors reported a long-term stay in a CEC. The vast majority of reported risk factors were related to Suriname and Brazil. Overall, the participants resided for 7,694 years in CECs, which equals 2.8 million overnight stays. Of those, 1.9 million nights were spent in Suriname.Asymptomatic T. cruzi infection appears to be extremely rare among Dutch blood donors. Blood safety interventions to mitigate the risk of T. cruzi transmission by transfusion would be highly cost-ineffective in the Netherlands, and are thus not required.

  4. Studies of benefit and risk resulting from the UK Breast Screening Programme

    CERN Document Server

    Beckett, J

    2000-01-01

    13% over the age range 35-79 years. This error range can be reduced to 1% when compressed breast thickness and age are used to estimate breast glandularity. At low breast thickness, little difference is found between composition dependent MGD-per-film estimates for women with augmented breasts and their non augmented counterparts. At high breast thickness however, the MGD's per film received by women with breast prostheses are considerably lower. In general, the BRR relating to the NHSBSP is favourable, even for subgroups of women who are thought to be at high risk or to obtain low benefit from the examination. The overall breast cancer mortality reduction for the NHSBSP at steady state was found to be in agreement with the Health of the Nation target of 25% in the age range 55-69 years. The use of mammography as a screening modality must be justified by comparison of the benefits and risks associated with the technique. The benefit risk ratio (BRR) associated with the National Health Service Breast Screening...

  5. The stroke offspring study: is parental stroke history of value in targeted risk factor screening?

    Science.gov (United States)

    Hart, Nigel D; Cupples, Margaret E; Wiggam, M Ivan; Patterson, Christopher C; Yarnell, John W G

    2011-01-01

    This study aimed to compare the prevalence of stroke risk factors among people with a parental history of stroke to those in a control group of individuals, of similar age, gender and social class, with no parental stroke history. Parental stroke increases an individual's risk of stroke, but little is known of the potential value of using this information in targeted screening for primary prevention in general practice. We sent questionnaires to 300 randomly selected individuals aged 40-65 years, in each of 11 different general practices in Northern Ireland. Among 1061 responses received within six weeks, 332 reported a parental history of stroke (31.3%). We matched respondents with (cases) and without (controls) a parental history of stroke on characteristics of age, gender and socioeconomic status. Matched pairs were invited to attend a consultation at which their diet and exercise habits were assessed using validated questionnaires and height, weight, blood pressure and serum lipids and glucose were measured. Matched data were available for 199 case-control pairs (398 individuals). Mean systolic and diastolic blood pressures were significantly higher in cases than in paired controls (systolic 146.3 versus 140.6 mmHg (P pressure has potential value in identifying people likely to benefit from primary prevention, but do not support the adoption of a targeted screening strategy for other commonly cited stroke risk factors.

  6. An oral health and function screening tool for nursing personnel of long-term care facilities to identify the need for dentist referral without preliminary training.

    Science.gov (United States)

    Tsukada, Shigemi; Ito, Kayoko; Stegaroiu, Roxana; Shibata, Satoko; Ohuchi, Akitsugu

    2017-06-01

    To develop and evaluate, with a dentist as gold standard, an oral health screening tool, the Oral Health Screening Tool for Nursing Personnel (OHSTNP), that assists long-term care facility nursing staff without preliminary training in identifying resident need for dentist referral. Using an OHSTNP adapted from previous screening tools (Chalmers, J Gerontol Nurs, 2004, 30, 5; Tsukada, J Jpn Soc Dent Hyg, 2012, 7, 43), one of four nurses, one of eight caregivers and a dentist with 15 years' experience screened the oral health/function of 57 long-term care facility residents. The OHSTNP included a question on the need and reasons for dentist referral. Tool reliability and validity were evaluated by determining inter-rater agreement (Cohen's kappa), sensitivity, specificity and accuracy. For dentist-nurse and dentist-caregiver pairs, kappa was statistically significant and sensitivity was high (≥0.67, nurses; ≥0.71, caregivers) for natural teeth, dentures and oral function-related categories. Specificity for all categories was ≥0.69. Screening by nurses and caregivers for need for referral had low sensitivity (0.05, 0.23), accuracy (0.25, 0.39) and kappa (-0.01, 0.08). However, if nursing staff had been instructed to request a dentist referral in case of alterations in natural teeth/dentures or severe alterations in any other category, the estimated values increased to a sensitivity of 0.86 and 0.91, an accuracy of 0.75 and 0.82 and a kappa of 0.26 and 0.47. OHSTNP was reliable and valid for screening natural teeth, denture conditions and oral functions. Supplementary guidelines improved estimates of OHSTNP sensitivity, accuracy and reliability for nurse/caregiver assessment of resident need for dentist referral. © 2017 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  7. Control de configuraciones peligrosas en instalaciones con riesgo asociado // Hazardous configurations control in risk related facilities

    Directory of Open Access Journals (Sweden)

    Antonio Torres - Valle

    2010-05-01

    Full Text Available ResumenEl control de configuraciones peligrosas en instalaciones con riesgo asociado es una aplicación delos Análisis Probabilistas de Seguridad (APS previos de las mismas. Una opción de mayor alcancees el uso de monitores de riesgo los que permiten la detección en tiempo real de talesconfiguraciones. Dada la complejidad de los APS y de los monitores de riesgo, esta tarea requiere depersonal experto. El documento presenta un método cualitativo de control de configuracionespeligrosas basado en matrices de dependencias. El algoritmo, informatizado en el códigoCONFIGURACION, puede ser aplicado sin necesidad de APS previos ni uso de monitores de riesgo.La sencillez del método justifica su extensión a instalaciones donde tales herramientas no se handesarrollado, permitiendo así la detección de las configuraciones peligrosas durante su explotación yelevando la seguridad de las plantas. Un sistema similar al descrito se utiliza como ayuda en laoperación de la central nuclear de Embalse. El artículo muestra el uso del método utilizando comobase un sistema de seguridad simplificado.Palabras claves: control de configuración, Análisis Probabilista de Seguridad (APS, matriz de___________________________________________________________________________AbstractThe hazardous configurations control in risk related facilities is an application of the previousProbabilistic Safety Analysis (PSA. A more complete option is the risk monitoring for the on-linedetection of these configurations. The expert personnel are required for this task take into account thecomplexity of the PSA and risk monitor. The paper presents a method of configuration control, basedon dependence matrixes. The algorithm is included in a computer code called CONFIGURACION, todetermine these situations in a qualitative way, without previous PSA results or using a Risk Monitor.The simplicity of the method warrants its application to facilities where these tools have not

  8. A semi-parametric censoring bias model for estimating the cumulative risk of a false-positive screening test under dependent censoring

    OpenAIRE

    Hubbard, Rebecca A.; Miglioretti, Diana L.

    2013-01-01

    False-positive test results are among the most common harms of screening tests and may lead to more invasive and expensive diagnostic testing procedures. Estimating the cumulative risk of a false-positive screening test result after repeat screening rounds is therefore important for evaluating potential screening regimens. Existing estimators of the cumulative false-positive risk are limited by strong assumptions about censoring mechanisms and parametric assumptions about variation in risk ac...

  9. Competing risks model in screening for preeclampsia by maternal characteristics and medical history.

    Science.gov (United States)

    Wright, David; Syngelaki, Argyro; Akolekar, Ranjit; Poon, Leona C; Nicolaides, Kypros H

    2015-07-01

    The purpose of this study was to develop a model for preeclampsia based on maternal demographic characteristics and medical history. This was a screening study of 120,492 singleton pregnancies at 11-13 weeks' gestation, including 2704 pregnancies (2.2%) that experienced preeclampsia. A survival-time model for the gestational age at delivery with preeclampsia was developed from variables of maternal characteristics and history. This approach assumes that, if the pregnancy was to continue indefinitely, all women would experience preeclampsia and that whether they do so or not before a specified gestational age depends on competition between delivery before or after development of preeclampsia. A 5-fold cross validation study was conducted to compare the performance of the new model with the National Institute for Health and Clinical Excellence (NICE) guidelines. In the new model, increased risk for preeclampsia, with a consequent shift in the Gaussian distribution of the gestational age at delivery with preeclampsia to the left, is provided by advancing maternal age, increasing weight, Afro-Caribbean and South Asian racial origin, medical history of chronic hypertension, diabetes mellitus and systemic lupus erythematosus or antiphospholipid syndrome, family history and personal history of preeclampsia, and conception by in vitro fertilization. The risk for preeclampsia decreases with increasing maternal height and in parous women with no previous preeclampsia; in the latter, the protective effect, which is related inversely to the interpregnancy interval, persists beyond 15 years. At a screen-positive rate of 11%, as defined by NICE, the new model predicted 40%, 48%, and 54% of cases of total preeclampsia and preeclampsia requiring delivery at preeclampsia. Such estimation of the a priori risk for preeclampsia is an essential first step in the use of Bayes theorem to combine maternal factors with biomarkers for the continuing development of more effective methods of

  10. Mammographic density and structural features can individually and jointly contribute to breast cancer risk assessment in mammography screening

    DEFF Research Database (Denmark)

    Winkel, Rikke Rass; von Euler-Chelpin, My; Nielsen, Mads;

    2016-01-01

    BACKGROUND: Mammographic density is a well-established risk factor for breast cancer. We investigated the association between three different methods of measuring density or parenchymal pattern/texture on digitized film-based mammograms, and examined to what extent textural features independently......-RADS alone). CONCLUSION: Our findings suggest that the (relative) amount of fibroglandular tissue (density) and mammographic structural features (texture/parenchymal pattern) jointly can improve risk segregation of screening women, using information already available from normal screening routine, in respect...... to future personalized screening strategies....

  11. The future role of genetic screening to detect newborns at risk of childhood-onset hearing loss

    Science.gov (United States)

    2013-01-01

    Objective: To explore the future potential of genetic screening to detect newborns at risk of childhood-onset hearing loss. Design: An expert led discussion of current and future developments in genetic technology and the knowledge base of genetic hearing loss to determine the viability of genetic screening and the implications for screening policy. Results and Discussion: Despite increasing pressure to adopt genetic technologies, a major barrier for genetic screening in hearing loss is the uncertain clinical significance of the identified mutations and their interactions. Only when a reliable estimate of the future risk of hearing loss can be made at a reasonable cost, will genetic screening become viable. Given the speed of technological advancement this may be within the next 10 years. Decision-makers should start to consider how genetic screening could augment current screening programmes as well as the associated data processing and storage requirements. Conclusion: In the interim, we suggest that decision makers consider the benefits of (1) genetically testing all newborns and children with hearing loss, to determine aetiology and to increase knowledge of the genetic causes of hearing loss, and (2) consider screening pregnant women for the m.1555A> G mutation to reduce the risk of aminoglycoside antibiotic-associated hearing loss. PMID:23131088

  12. EFEHR - the European Facilities for Earthquake Hazard and Risk: beyond the web-platform

    Science.gov (United States)

    Danciu, Laurentiu; Wiemer, Stefan; Haslinger, Florian; Kastli, Philipp; Giardini, Domenico

    2017-04-01

    European Facilities for Earthquake Hazard and Risk (EEFEHR) represents the sustainable community resource for seismic hazard and risk in Europe. The EFEHR web platform is the main gateway to access data, models and tools as well as provide expertise relevant for assessment of seismic hazard and risk. The main services (databases and web-platform) are hosted at ETH Zurich and operated by the Swiss Seismological Service (Schweizerischer Erdbebendienst SED). EFEHR web-portal (www.efehr.org) collects and displays (i) harmonized datasets necessary for hazard and risk modeling, e.g. seismic catalogues, fault compilations, site amplifications, vulnerabilities, inventories; (ii) extensive seismic hazard products, namely hazard curves, uniform hazard spectra and maps for national and regional assessments. (ii) standardized configuration files for re-computing the regional seismic hazard models; (iv) relevant documentation of harmonized datasets, models and web-services. Today, EFEHR distributes full output of the 2013 European Seismic Hazard Model, ESHM13, as developed within the SHARE project (http://www.share-eu.org/); the latest results of the 2014 Earthquake Model of the Middle East (EMME14), derived within the EMME Project (www.emme-gem.org); the 2001 Global Seismic Hazard Assessment Project (GSHAP) results and the 2015 updates of the Swiss Seismic Hazard. New datasets related to either seismic hazard or risk will be incorporated as they become available. We present the currents status of the EFEHR platform, with focus on the challenges, summaries of the up-to-date datasets, user experience and feedback, as well as the roadmap to future technological innovation beyond the web-platform development. We also show the new services foreseen to fully integrate with the seismological core services of European Plate Observing System (EPOS).

  13. Financial Risk Factor Analysis for Facility Gas Leakages of H2 and NG

    Directory of Open Access Journals (Sweden)

    In-Bok Lee

    2016-09-01

    Full Text Available Fuel cells may be the key to a more environmentally-friendly future because they emit low carbon dioxide per unit of energy supplied. However, little work has investigated the potential financial risks pertaining to fuel cell systems. Often used in the analysis of the safety of systems involving flammable or hazardous materials, risk factor analysis has recently been used to analyze the potential financial losses that may occur from industrial hazards. Therefore, this work undertakes a financial risk factor analysis to determine the costs of leakages of hydrogen and natural gas, which are used in fuel cell systems. Total leakage was calculated from an analysis of several leakage rates and modes. The impact of applying appropriate detection and prevention systems was also investigated. The findings were then used to analyze the consequences for various sections of the system and to calculate the overall cost based on facility outage or damage, and the cost of taking safety precautions. This provides a basis for comparison among proposed potential reactionary measures.

  14. Breast cancer genetic risk profile is differentially associated with interval and screen-detected breast cancers.

    Science.gov (United States)

    Li, J; Holm, J; Bergh, J; Eriksson, M; Darabi, H; Lindström, L S; Törnberg, S; Hall, P; Czene, K

    2015-03-01

    Polygenic risk profiles computed from multiple common susceptibility alleles for breast cancer have been shown to identify women at different levels of breast cancer risk. We evaluated whether this genetic risk stratification can also be applied to discriminate between screen-detected and interval cancers, which are usually associated with clinicopathological and survival differences. A 77 single-nucleotide polymorphism polygenic risk score (PRS) was constructed for breast cancer overall and by estrogen receptor (ER) status. PRS was inspected as a continuous (per standard deviation increment) variable in a case-only design. Modification of the PRS by mammographic density was evaluated by fitting an additional interaction term. PRS weighted by breast cancer overall estimates was found to be differentially associated with 1865 screen-detected and 782 interval cancers in the LIBRO-1 study {age-adjusted odds ratio (OR)perSD [95% confidence interval (CI)] 0.91 [0.83-0.99], P = 0.023}. The association was found to be more significant for PRS weighted by ER-positive breast cancer estimates [ORperSD = 0.90 (0.82-0.98), P = 0.011]. This result was corroborated by two independent studies [combined ORperSD = 0.87 (0.76-1.00), P = 0.058] with no evidence of heterogeneity. When enriched for 'true' interval cancers among nondense breasts, the difference in the association with PRS in screen-detected and interval cancers became more pronounced [ORperSD = 0.74 (0.62-0.89), P = 0.001], with a significant interaction effect between PRS and mammographic density (Pinteraction = 0.017). To our knowledge, this is the first report looking into the genetic differences between screen-detected and interval cancers. It is an affirmation that the two types of breast cancer may have unique underlying biology. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  15. The Identification of Seniors at Risk screening tool is useful for predicting acute readmissions

    DEFF Research Database (Denmark)

    Rosted, Elizabeth; Schultz, Martin; Dynesen, Helle;

    2014-01-01

    . Patients ≥ 65 years treated during a 14-day period were included. Their mean age was 78 years. Screening with the Identification of Seniors at Risk (ISAR) was performed (n = 198) by the Mobile Geriatric Team (MGT). The patients' medical journals were assessed retrospectively by the SG to determine any need...... for assessment and intervention. RESULTS: 53% of the admitted and 77% of the non-admitted patients would have benefitted from assessment by the MGT, and 22% would have benefitted from transfer directly to the Geriatric Unit. The readmitted patients and the patients who died during follow-up had a mean ISAR score...

  16. Evolution and Innovations of the National Neonatal and High Risk Screening Program in Costa Rica

    OpenAIRE

    de Céspedes, Carlos; Saborío, Manual; Trejos, Rafael; Abarca, Gabriela; Sánchez, Avelino; Rojas, Laura

    2014-01-01

    We present the evolution, organization and results of the National Neonatal and High Risk Screening Program in Costa Rica (PNT). This program has been working uninterruptedly for more than fourteen years. Costa Rica currently has a literacy rate of 95%. To August 2004 the rate of infant mortality was 9.74 per 1000 births and to 2003, life expectancy was 76.3 years for men and 81.1 years for women. The control of infectious and parasitic diseases, as well as of severe malnutrition, has given r...

  17. Risk Assessment of the Chopper Dipole Kicker Magnets for the MedAustron Facility

    CERN Document Server

    Kramer, T; Barnes, M J; Benedikt, M; Fowler, T

    2011-01-01

    The MedAustron facility, to be built in Wiener Neustadt (Austria), will provide protons and ions for both cancer therapy and research [1]. Different types of kicker magnets will be used in the accelerator complex, including fast beam chopper dipoles: these allow the beam to be switched on and off for routine operational reasons or in case of emergency. Main requirements for the beam chopper system are safety and reliability. A criticality analysis, to chart the probability of failure modes against the severity of their consequences of the fault, has been carried out for the chopper dipole system. This "Failure Mode, Effects, and Criticality Analysis" (FMECA), has been used to highlight failure modes with relatively high probability and severity of consequences: conservative ratings of critical components and appropriate redundancy, together with measurements and interlocks, have been used to reduce the probability and criticality of faults. This paper gives an overview of the Risk Assessment approach and pres...

  18. The utility and predictive value of combinations of low penetrance genes for screening and risk prediction of colorectal cancer.

    Science.gov (United States)

    Hawken, Steven J; Greenwood, Celia M T; Hudson, Thomas J; Kustra, Rafal; McLaughlin, John; Yang, Quanhe; Zanke, Brent W; Little, Julian

    2010-07-01

    Despite the fact that colorectal cancer (CRC) is a highly treatable form of cancer if detected early, a very low proportion of the eligible population undergoes screening for this form of cancer. Integrating a genomic screening profile as a component of existing screening programs for CRC could potentially improve the effectiveness of population screening by allowing the assignment of individuals to different types and intensities of screening and also by potentially increasing the uptake of existing screening programs. We evaluated the utility and predictive value of genomic profiling as applied to CRC, and as a potential component of a population-based cancer screening program. We generated simulated data representing a typical North American population including a variety of genetic profiles, with a range of relative risks and prevalences for individual risk genes. We then used these data to estimate parameters characterizing the predictive value of a logistic regression model built on genetic markers for CRC. Meta-analyses of genetic associations with CRC were used in building science to inform the simulation work, and to select genetic variants to include in logistic regression model-building using data from the ARCTIC study in Ontario, which included 1,200 CRC cases and a similar number of cancer-free population-based controls. Our simulations demonstrate that for reasonable assumptions involving modest relative risks for individual genetic variants, that substantial predictive power can be achieved when risk variants are common (e.g., prevalence > 20%) and data for enough risk variants are available (e.g., approximately 140-160). Pilot work in population data shows modest, but statistically significant predictive utility for a small collection of risk variants, smaller in effect than age and gender alone in predicting an individual's CRC risk. Further genotyping and many more samples will be required, and indeed the discovery of many more risk loci

  19. Risk stratification and detection of new colorectal neoplasms after colorectal cancer screening with faecal occult blood test

    DEFF Research Database (Denmark)

    Bjerrum, Andreas; Milter, Maya Christel; Andersen, Ole

    2015-01-01

    BACKGROUND: Limited data exist on adenoma surveillance as recommended in the European guidelines for quality assurance in colorectal cancer (CRC) screening and diagnosis after faecal occult blood test (FOBT) screening. OBJECTIVE: To assess the European guidelines for adenoma surveillance after CRC...... screening with FOBT. MATERIALS AND METHODS: This was a population-based cohort-study of 176 782 Danish individuals aged 50-74 years invited for CRC screening in 2005-2006. Adenoma patients were stratified into risk groups (low A, medium B, high C) in accordance with the European guidelines and followed up......-detected adenomas. During a median follow-up period of 72.7 months, detection of new advanced adenomas (B+C) was significantly higher in risk group C than group A (RR 2.25, 95% confidence interval: 1.13-4.48). Nine patients were diagnosed with CRC: one in risk group A, two in B and six in C. The detection rate...

  20. Developing risk-based screening guidelines for dioxin management at a Melbourne sewage treatment plant.

    Science.gov (United States)

    Gorman, J; Mival, K; Wright, J; Howell, M

    2003-01-01

    Dioxin is a generic term used to refer to the congeners of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs). The principal source of dioxin production is generally thought to be from unintended by-products of waste incineration, but dioxins are also naturally formed from volcanic activity and forest fires (WHO, 1998). Estimates of dioxin emissions in Australia suggest that approximately 75% of the total PCDD and PCDF emissions derive from prescribed burning and wild bushfires. Currently, no screening guidelines for dioxins within soils are available in Australia. This paper presents the general approach and results of a human health risk-based assessment performed by URS Australia in 2001 to develop site specific reference criteria for remediation of a former sewage plant in Melbourne. Risk-based soil remediation concentrations for dioxins at the sewage treatment plant site were developed using tolerable daily intake values of 4, 2 and 1 pg/kg/day. The potentially significant exposure pathways and processes for exposure to dioxins were identified and risk-based soil concentrations derived in accordance with the general method framework presented in the National Environmental Protection Measure (Assessment of Site Contamination). The derived dioxin reference criteria were used to develop an effective risk management program focussed on those conditions that present the greatest contribution to overall risk to human health.

  1. 6 CFR 27.200 - Information regarding security risk for a chemical facility.

    Science.gov (United States)

    2010-01-01

    ... information from chemical facilities that may reflect potential consequences of or vulnerabilities to a... chemical facility. 27.200 Section 27.200 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS Chemical Facility Security Program § 27.200 Information...

  2. Los Alamos neutron science user facility - control system risk mitigation & updates

    Energy Technology Data Exchange (ETDEWEB)

    Pieck, Martin [Los Alamos National Laboratory

    2011-01-05

    LANSCE User Facility is seeing continuing support and investments. The investment will sustain reliable facility operations well into the next decade. As a result, the LANSCE User Facility will continue to be a premier Neutron Science Facility at the Los Alamos National Laboratory.

  3. Situation of the companies of hygienic maintenance of facilities of risk of legionelosis in Madrid

    Directory of Open Access Journals (Sweden)

    Consuelo de Garrastazu Díaz

    2006-12-01

    Full Text Available The control of the hygienic maintenance of the facilities of legionelosis risk is verified through three types of performances: the notifications of cooling towers and evaporative condensers, the registry of the companies that make these treatments and the regulated formation of the personnel who makes these. In addition, by means of the sanitary inspection the correct operation of this mechanism of monitoring and control is verified.In relation to the companies that make the hygienic maintenance, it has been made a temporary analysis front to other companies of biocidas services, being stated that is basically that already they made biocide control services (companies DDD. In the Community of Madrid and as opposed to the criteria adopted by other communities, it is demanded that these companies count on warehouse own or subcontracted or that justify an adapted product management, so that it is always under the supervision off personnel specialized for his use. Also, it is demanded that this companies have a Technical Director, who takes responsibility of the procedures of performance and made treatments. In whatever to the accomplishment of treatments by part of companies registered in other communities, at the moment is not necessary registry of these in Madrid if they do not have social or industrial address, being able to make the maintenance if this activity is properly registered in the community where they are located.The Community of Madrid is accredited for the authorization of courses for personnel who conducts operations of hygienic maintenance of facilities of risk of Legionella, counting at the present with 26 courses authorized. The pursuit of these courses is made by means of the exigency of a previous notification to the edition celebration and the accomplishment of inspection and audit to the teaching institutions.

  4. Risk assessment and optimization (ALARA) analysis for the environmental remediation of Brookhaven National Laboratory`s hazardous waste management facility

    Energy Technology Data Exchange (ETDEWEB)

    Dionne, B.J.; Morris, S. III; Baum, J.W. [and others

    1998-03-01

    The Department of Energy`s (DOE) Office of Environment, Safety, and Health (EH) sought examples of risk-based approaches to environmental restoration to include in their guidance for DOE nuclear facilities. Extensive measurements of radiological contamination in soil and ground water have been made at Brookhaven National Laboratory`s Hazardous Waste Management Facility (HWMF) as part of a Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) remediation process. This provided an ideal opportunity for a case study. This report provides a risk assessment and an {open_quotes}As Low as Reasonably Achievable{close_quotes} (ALARA) analysis for use at other DOE nuclear facilities as an example of a risk-based decision technique.

  5. Risk assessment and optimization (ALARA) analysis for the environmental remediation of Brookhaven National Laboratory`s hazardous waste management facility

    Energy Technology Data Exchange (ETDEWEB)

    Dionne, B.J.; Morris, S.C. III; Baum, J.W. [and others

    1998-01-01

    The Department of Energy`s (DOE) Office of Environment, Safety, and Health (EH) sought examples of risk-based approaches to environmental restoration to include in their guidance for DOE nuclear facilities. Extensive measurements of radiological contamination in soil and ground water have been made at Brookhaven National Laboratory`s Hazardous Waste Management Facility (HWMF) as part of a Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) remediation process. This provided an ideal opportunity for a case study. This report provides a risk assessment and an {open_quotes}As Low as Reasonably Achievable{close_quotes} (ALARA) analysis for use at other DOE nuclear facilities as an example of a risk-based decision technique. This document contains the Appendices for the report.

  6. Lonely hearts don't get checked: On the role of social support in screening for cardiovascular risk.

    Science.gov (United States)

    Petrova, Dafina; Garcia-Retamero, Rocio; Catena, Andrés

    2015-12-01

    Regular cardiovascular risk screening can prevent cardiovascular disease through timely implementation of lifestyle changes or medication. However, few studies have investigated what factors promote regular screening for risk factors like hypertension and high blood cholesterol. The aim of this study was to investigate the relationship between social support and adherence to cardiovascular risk screening. We analyzed data from the Spanish National Health Survey-a cross-sectional representative survey conducted by the Spanish Ministry of Health in 2012 (N=21,007). Participants reported whether they had their blood pressure and cholesterol levels measured by a health professional in the previous 12 months. Social support (i.e., the perception that emotional and practical support was available when needed) was measured with a validated scale. Multiple logistic regressions were conducted adjusted for demographic and health-related factors. Compared to individuals who reported a lack of social support, individuals who perceived sufficient social support were on average twice more likely to report participation in blood pressure screening, OR=2.06, 95% CI [1.60, 2.66] and cholesterol screening, OR=2.85, 95% CI [1.99, 4.09]. These effects were uniform across different demographics and were replicated in a previous wave of the survey. Factors associated with worse screening adherence were low social class, being single or widowed, smoking, alcohol consumption, and no history of cardiovascular risk. Perceptions of social support are positively related to cardiovascular risk screening adherence. Future research should investigate what type of social support most effectively increases screening participation among high risk populations. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Preconception Screening for Gene Polymorphisms Associated with Thrombophilia and Hyperhomocysteinemia Risk in Healthy Young Women

    Directory of Open Access Journals (Sweden)

    Elena Yu. Glotova

    2013-09-01

    Full Text Available The frequency characteristics of the gene polymorphisms (FVL G1691A, FII G20210A, MTHFR C677T, MTHFR A1298C, MTRR A66G associated with thrombophilia, hyperhomocysteinemia risk and different perinatal or pregnancy complications were studied. This examination was conducted among 130 planned-pregnancy healthy young women aged between 19 and 29 years. A gene mutation analysis was performed using a real-time polymerase chain reaction (real-time PCR. Factor V Leiden (FVL G1691A and prothrombin gene (FII G20210A mutations were not identified in the women surveyed. The frequency of the occurrence of the heterozygous FVL 1691G/A genotype associated with the risk of thrombosis during pregnancy was very low in these women (0.8%. The frequency of the MTHFR (methylenetetrahydrofolate reductase 1298C/С mutant genotype was 11.5%, MTHFR 677T/Т – 5.4%, and MTRR (methionine synthase reductase 66G/G – 31.5%. A combination of the MTHFR 677TT/1298CC and MTHFR 677TТ/MTRR 66GG mutant genotypes, which significantly increased the risk of pregnancy loss and neural tube defects, were found to occur in 0.8% of the cases.We concluded that selective thrombophilia screening (FVL G1691A and FII G20210A based on prior personal and/or family history of venous thromboembolism was more cost-effective than a universal preconception screening in all planning pregnancy women. However, in order to decrease the risk of congenital anomalies and pregnancy complications associated with folate dependent homocysteine metabolism, preconception care should include folate supplementation

  8. Sex differences in prevalence and risk factors of asymptomatic cholelithiasis in Korean health screening examinee

    Science.gov (United States)

    Kim, Sung Bum; Kim, Kook Hyun; Kim, Tae Nyeun; Heo, Jun; Jung, Min Kyu; Cho, Chang Min; Lee, Yoon Suk; Cho, Kwang Bum; Lee, Dong Wook; Han, Ji Min; Kim, Ho Gak; Kim, Hyun Soo

    2017-01-01

    Abstract The aim of this study was to evaluate sex difference in the prevalence and risk factors for asymptomatic cholelithiasis in Korean health screening examinees. Examinees who underwent examination through health promotion center at 5 hospitals of Daegu-Gyeongbuk province in 2014 were analyzed retrospectively. All examinees were checked for height, weight, waist circumference, and blood pressure, and underwent laboratory tests and abdominal ultrasound. Diagnosis of cholelithiasis was made by ultrasound. Of the total of 30,544 examinees, mean age was 47.3 ± 10.9 years and male to female ratio was 1.4:1. Asymptomatic cholelithiasis was diagnosed in 1268 examinees with overall prevalence of 4.2%. In age below 40 years, females showed higher prevalence of asymptomatic cholelithiasis than males (2.7% vs. 1.9%, P = 0.020), whereas prevalence of asymptomatic cholelithiasis was higher in males than females older than 50 years (6.2% vs. 5.1%, P = 0.012). Multiple logistic regression analysis revealed age (≥50 years), obesity, and high blood pressure as risk factors for asymptomatic cholelithiasis in males and age, obesity, hypertriglyceridemia, and chronic hepatitis B infection in females (P < 0.05). Overall prevalence of asymptomatic cholelithiasis was 4.2% in Korean health screening examinees. Females showed higher prevalence of asymptomatic cholelithiasis than males younger than 40 years, whereas it was higher in males older than 50 years. Age and obesity were risk factors for asymptomatic cholelithiasis in both sexes. Males had additional risk factors of high blood pressure and females had hypertriglyceridemia and chronic hepatitis B infection. PMID:28353587

  9. Cerebral Vein Thrombosis:Screening of Acquired and Hereditary Thrombophilic Risk Factors

    Directory of Open Access Journals (Sweden)

    Sarraf Payam

    2009-10-01

    Full Text Available Cerebral vein thrombosis (CVT is an infrequent condition with a large variety of causes that can lead to serious disabilities. However, in 20% to 35% of cases, no cause is found. In this study we evaluated the hereditary (P & C Proteins, antithrombin, mutation of prothrombin G20210A and factor V Leiden, other risk factors (hyperhomocycteinemia, factor VIII, ACL-ab, APL-ab, and OCP and clinical manifestations among a population of Iranian patients with CVT. 18 women and 10 men aged 16 to 50 years with CVT were screened for inherited and acquired coagulation risk factors. No one had an abnormal ACL-ab, APL-ab or antithrombin III deficiency. One had prothrombin G20210A mutation (heterozygot (3.6%. Hyperhomocycteinemia was observed in 5 patients (17.9%. APC-R was decreased in 3 (10.7%. 2 had positive factor V Leiden mutation (heterozygot (7.1%. 17 had an increased of factor VIII (60.7. PS and PC deficiencies were each detected in two cases (7.1%. Conclusion: Our study suggests that screening for inherited thrombophilia may be an integral part in the diagnostic workup and duration of treatment in patients with CVT.

  10. SCREENING FOR UNDIAGNOSED DIABETIC SUBJECTS USING A SIMPLIFIED INDIAN DIABETES RISK SCORE [IDRS] IN KHAMMAM URBAN

    Directory of Open Access Journals (Sweden)

    Pothukuchi Madhavi

    2016-07-01

    Full Text Available BACKGROUND The rising prevalence of diabetes in developing countries is closely associated with industrialisation and socioeconomic development. The major determinants of diabetics in these countries are population growth, age structure, and urbanisation, prevalence of obesity because of increased intake of junk food, lack of physical activity, and stress among urban dwellers. Diabetes is increasingly concentrated in the urban areas. Hence, the present study was undertaken. METHODOLOGY A community based cross-sectional study was carried out in Raghunadhapalem, an urban area of Khammam with a total population of 1552. List of areas under Khammam (urban was obtained from Municipal Corporation and the present study area Raghunadhapalem, was chosen by simple random sampling technique. Duration of the study was 4 months. RESULTS Majority 232 (74.3% of study participants are at risk of developing Diabetes in future. Majority 291 (93.3% of the study participants do not have family history of diabetes. CONCLUSIONS IDRS is a simple, useful and cost-effective screening tool for diabetes in resource limited settings. By identifying the high & medium risk individuals using IDRS, we could make screening programs more cost effective.

  11. Methodology for the Model-based Small Area Estimates of Cancer Risk Factors and Screening Behaviors - Small Area Estimates

    Science.gov (United States)

    This model-based approach uses data from both the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS) to produce estimates of the prevalence rates of cancer risk factors and screening behaviors at the state, health service area, and county levels.

  12. [Study of risk factors of enterobiasis in schoolchildren and development of a prognostic table for primary screening].

    Science.gov (United States)

    Markin, A V; Terekhova, T V; Khromenkova, E P

    1996-01-01

    Risk factors for enterobiasis were qualitatively and quantitatively assessed by a questionnaire given to 277 health schoolchildren and 277 schoolchildren who suffered from enterobiasis. A prognostic table was developed for primary screening of risk groups. Preventive measures are recommended in the paper.

  13. High incidence of pseudotumours after hip resurfacing even in low risk patients; results from an intensified MRI screening protocol.

    NARCIS (Netherlands)

    Weegen, W. van der; Smolders, J.M.; Sijbesma, T.; Hoekstra, H.J.; Brakel, K.; Susante, J.L.C. van

    2013-01-01

    We intensified our screening protocol for the presence of pseudotumours in a consecutive series of patients with a hip resurfacing arthroplasty (HRA), to establish whether we should be alert to the presence of 'silent' pseudotumours. Patients categorised with high risk (11 hips) and low risk (10 hip

  14. A Comparison of Teacher Nomination and Screening to Identify Behavioral and Emotional Risk within a Sample of Underrepresented Students

    Science.gov (United States)

    Dowdy, Erin; Doane, Kymberly; Eklund, Katie; Dever, Bridget V.

    2013-01-01

    Early identification of behavioral and emotional risk has been identified as one strategy to help decrease rates of childhood behavioral and emotional problems. This study compares two methods for early identification (teacher nomination and universal screening) to determine how each strategy may differentially identify at-risk students. A sample…

  15. Incremental Validity Analyses of the Violence Risk Appraisal Guide and the Psychopathy Checklist: Screening Version in a Civil Psychiatric Sample

    Science.gov (United States)

    Edens, John F.; Skeem, Jennifer L.; Douglas, Kevin S.

    2006-01-01

    This study compares two instruments frequently used to assess risk for violence, the Violence Risk Appraisal Guide (VRAG) and the Psychopathy Checklist: Screening Version (PCL:SV), in a large sample of civil psychiatric patients. Despite a strong bivariate relationship with community violence, the VRAG could not improve on the predictive validity…

  16. Screening-level risk assessment for styrene-acrylonitrile (SAN) trimer detected in soil and groundwater.

    Science.gov (United States)

    Kirman, C R; Gargas, M L; Collins, J J; Rowlands, J C

    2012-01-01

    A screening-level risk assessment was conducted for styrene-acrylonitrile (SAN) Trimer detected at the Reich Farm Superfund site in Toms River, NJ. Consistent with a screening-level approach, on-site and off-site exposure scenarios were evaluated using assumptions that are expected to overestimate actual exposures and hazards at the site. Environmental sampling data collected for soil and groundwater were used to estimate exposure point concentrations. Several exposure scenarios were evaluated to assess potential on-site and off-site exposures, using parameter values for exposures to soil (oral, inhalation of particulates, and dermal contact) and groundwater (oral, dermal contact) to reflect central tendency exposure (CTE) and reasonable maximum exposure (RME) conditions. Three reference dose (RfD) values were derived for SAN Trimer for short-term, subchronic, and chronic exposures, based upon its effects on the liver in exposed rats. Benchmark (BMD) methods were used to assess the relationship between exposure and response, and to characterize appropriate points of departure (POD) for each RfD. An uncertainty factor of 300 was applied to each POD to yield RfD values of 0.1, 0.04, and 0.03 mg/kg-d for short-term, subchronic, and chronic exposures, respectively. Because a chronic cancer bioassay for SAN Trimer in rats (NTP 2011a) does not provide evidence of carcinogenicity, a cancer risk assessment is not appropriate for this chemical. Potential health hazards to human health were assessed using a hazard index (HI) approach, which considers the ratio of exposure dose (i.e., average daily dose, mg/kg-d) to toxicity dose (RfD, mg/kg-d) for each scenario. All CTE and RME HI values are well below 1 (where the average daily dose is equivalent to the RfD), indicating that there is no concern for potential noncancer effects in exposed populations even under the conservative assumptions of this screening-level assessment.

  17. On the advantage of screening kindergarten children for atherogenesis-related risk indicators.

    Science.gov (United States)

    Kupke, I R

    1985-01-01

    On the basis of our practical experience we can recommend screening of young children outside the clinic. Our methodology has proven to be appropriate for this purpose. Among young children, three groups are easily accessible: Newborns - since delivery occurs mostly in a clinic; infants up to one year - since these children are provided with basic medical care, and kindergarten children. According to our experience, kindergartens are favorable places for screening children because many children are together in one place. Children of this age can be easily motivated to cooperate during the examination, and since they stay in the kindergartens for a considerable period of the day, they only can be guided by nurses who can provide positive motivation for educational programs. As an additional advantage, the cooperation between nurses and parents, as well as positive influence on the parents, by the nurses might be taken into account. In this context, nurses must be regarded as key persons for strategies when considering life-style changes. Identifying children at risk at this early age could shorten the pathogenetic period and increase the chance for regression of the atherosclerotic disease process. Furthermore, children of this age are willing to learn and to change their habits. There is also a possibility that children may implant in their families experiences and information obtained in the kindergartens. Such parents might be more open to advice from kindergarten personnel, and thus also profit for themselves. An additional and valuable advantage of screening kindergarten children is the possibility of detecting first-degree relatives at risk before clinical manifestation of the disease, thereby having a good chance for successful intervention.

  18. Facile high-throughput forward chemical genetic screening by in situ monitoring of glucuronidase-based reporter gene expression in Arabidopsis thaliana

    Directory of Open Access Journals (Sweden)

    Vivek eHalder

    2015-01-01

    Full Text Available The use of biologically active small molecules to perturb biological functions holds enormous potential for investigating complex signaling networks. However, in contrast to animal systems, the search for and application of chemical tools for basic discovery in the plant sciences, generally referred to as ‘chemical genetics’, has only recently gained momentum. In addition to cultured cells, the well-characterized, small-sized model plant Arabidopsis thaliana is suitable for cultivation in microplates, which allows employing diverse cell- or phenotype-based chemical screens. In such screens, a chemical’s bioactivity is typically assessed either through scoring its impact on morphological traits or quantifying molecular attributes such as enzyme or reporter activities. Here, we describe a facile forward chemical screening methodology for intact Arabidopsis seedlings harboring the β-glucuronidase (GUS reporter by directly quantifying GUS activity in situ with 4-methylumbelliferyl-β-D-glucuronide (4-MUG as substrate. The quantitative nature of this screening assay has an obvious advantage over the also convenient histochemical GUS staining method, as it allows application of statistical procedures and unbiased hit selection based on threshold values as well as distinction between compounds with strong or weak bioactivity. At the same time, the in situ bioassay is very convenient requiring less effort and time for sample handling in comparison to the conventional quantitative in vitro GUS assay using 4-MUG, as validated with several Arabidopsis lines harboring different GUS reporter constructs. To demonstrate that the developed assays is particularly suitable for large-scale screening projects, we performed a pilot screen for chemical activators or inhibitors of salicylic acid-mediated defense signaling using the Arabidopsis PR1p::GUS line. Importantly, the screening methodology provided here can be adopted for any inducible GUS reporter line.

  19. Lung cancer risk prediction to select smokers for screening CT--a model based on the Italian COSMOS trial.

    Science.gov (United States)

    Maisonneuve, Patrick; Bagnardi, Vincenzo; Bellomi, Massimo; Spaggiari, Lorenzo; Pelosi, Giuseppe; Rampinelli, Cristiano; Bertolotti, Raffaella; Rotmensz, Nicole; Field, John K; Decensi, Andrea; Veronesi, Giulia

    2011-11-01

    Screening with low-dose helical computed tomography (CT) has been shown to significantly reduce lung cancer mortality but the optimal target population and time interval to subsequent screening are yet to be defined. We developed two models to stratify individual smokers according to risk of developing lung cancer. We first used the number of lung cancers detected at baseline screening CT in the 5,203 asymptomatic participants of the COSMOS trial to recalibrate the Bach model, which we propose using to select smokers for screening. Next, we incorporated lung nodule characteristics and presence of emphysema identified at baseline CT into the Bach model and proposed the resulting multivariable model to predict lung cancer risk in screened smokers after baseline CT. Age and smoking exposure were the main determinants of lung cancer risk. The recalibrated Bach model accurately predicted lung cancers detected during the first year of screening. Presence of nonsolid nodules (RR = 10.1, 95% CI = 5.57-18.5), nodule size more than 8 mm (RR = 9.89, 95% CI = 5.84-16.8), and emphysema (RR = 2.36, 95% CI = 1.59-3.49) at baseline CT were all significant predictors of subsequent lung cancers. Incorporation of these variables into the Bach model increased the predictive value of the multivariable model (c-index = 0.759, internal validation). The recalibrated Bach model seems suitable for selecting the higher risk population for recruitment for large-scale CT screening. The Bach model incorporating CT findings at baseline screening could help defining the time interval to subsequent screening in individual participants. Further studies are necessary to validate these models.

  20. Applicability of the ankle-brachial-index measurement as screening device for high cardiovascular risk: an observational study

    Directory of Open Access Journals (Sweden)

    Bendermacher Bianca LW

    2012-07-01

    Full Text Available Abstract Background Screening with ankle-brachial index (ABI measurement could be clinically relevant to avoid cardiovascular events in subjects with asymptomatic atherosclerosis. To assess the practical impact of guidelines regarding the use of ABI as a screening tool in general practice, the corresponding number needed to screen, including the required time investment, and the feasibility of ABI performance, was assessed. Methods An observational study was performed in the setting of 955 general practices in the Netherlands. Overall, 13,038 subjects of ≥55 years presenting with symptoms of intermittent claudication and/or presenting with ≥ one vascular risk factor were included. Several guidelines recommend the ABI as an additional measurement in selected populations for risk assessment for cardiovascular morbidity. Results Screening of the overall population of ≥50 years results in ≈862 subjects per general practice who should be screened, resulting in a time-requirement of approximately 6 weeks of full time work. Using an existing clinical prediction model, 247 patients per general practice should be screened for PAD by ABI measurement. Conclusion Screening the entire population of ≥50 years will in our opinion not be feasible in general practice. A more rationale and efficient approach might be screening of subsets of the population of ≥55 years based on a clinical prediction model.

  1. Simple and practical screening approach to identify HIV-infected individuals with depression or at risk of developing depression

    DEFF Research Database (Denmark)

    Rodkjaer, L; Gabel, C; Laursen, T

    2016-01-01

    OBJECTIVES: Studies have shown that depression and other mental illnesses are under-diagnosed among HIV-infected individuals. The aim of this study was to evaluate the use of mental health history and questionnaire-based screening instruments to identify HIV-infected individuals at risk...... of depression. CONCLUSIONS: We suggest that the mental health of HIV-infected individuals should be reviewed and a "risk-flag" three-step approach should be used (1) to screen routinely with the two verbal questions suggested by the EACS, (2) to identify whether there is a risk of depression and then screen...... with the BDI-II, and (3) to identify whether there is still a risk and then perform a full evaluation and obtain an accurate psychiatric diagnosis by a psychiatrist....

  2. Accelerometry-based gait analysis, an additional objective approach to screen subjects at risk for falling.

    Science.gov (United States)

    Senden, R; Savelberg, H H C M; Grimm, B; Heyligers, I C; Meijer, K

    2012-06-01

    This study investigated whether the Tinetti scale, as a subjective measure for fall risk, is associated with objectively measured gait characteristics. It is studied whether gait parameters are different for groups that are stratified for fall risk using the Tinetti scale. Moreover, the discriminative power of gait parameters to classify elderly according to the Tinetti scale is investigated. Gait of 50 elderly with a Tinneti>24 and 50 elderly with a Tinetti≤24 was analyzed using acceleration-based gait analysis. Validated algorithms were used to derive spatio-temporal gait parameters, harmonic ratio, inter-stride amplitude variability and root mean square (RMS) from the accelerometer data. Clear differences in gait were found between the groups. All gait parameters correlated with the Tinetti scale (r-range: 0.20-0.73). Only walking speed, step length and RMS showed moderate to strong correlations and high discriminative power to classify elderly according to the Tinetti scale. It is concluded that subtle gait changes that have previously been related to fall risk are not captured by the subjective assessment. It is therefore worthwhile to include objective gait assessment in fall risk screening.

  3. Caregiving associated with selected cancer risk behaviors and screening utilization among women: cross-sectional results of the 2009 BRFSS

    Directory of Open Access Journals (Sweden)

    Reeves Katherine W

    2012-08-01

    Full Text Available Abstract Background Informal caregiving is increasingly common as the U.S. population ages, and there is concern that caregivers are less likely than non-caregivers to practice health-promoting behaviors, including cancer screening. We examined caregiving effects on cancer risk behaviors and breast and cervical cancer screening in the 2009 Behavioral Risk Factor Surveillance System. Methods Women age ≥41 with data on breast and cervical cancer screening were included (weighted frequency 3,478,000 women. Cancer screening was classified according to American Cancer Society guidelines. We evaluated the association of caregiving with cancer risk behaviors (obesity, physical activity, alcohol intake, smoking status, and fruit/vegetable consumption and cancer screening (mammography, clinical breast exam [CBE], and Pap test using logistic regression overall and with stratification on age ( Results Caregivers had greater odds of being obese, physically active, and current smokers. Subgroup analyses revealed that caregiving was associated with obesity in younger women and whites, and with less obesity in older women. Also, caregiving was associated with smoking only among younger women and non-whites. Caregivers had greater odds of ever having had a mammogram or CBE, yet there was no association with mammogram, CBE, or Pap test within guidelines. Conclusions Caregiving was associated with some health behaviors that increase cancer risk, yet not with cancer screening within guidelines. Effects of caregiving by age and race require confirmation by additional studies.

  4. Evaluation of a Community Pharmacy-Based Screening Questionnaire to Identify Patients at Risk for Drug Therapy Problems.

    Science.gov (United States)

    Pammett, Robert T; Blackburn, David; Taylor, Jeff; Mansell, Kerry; Kwan, Debbie; Papoushek, Christine; Jorgenson, Derek

    2015-09-01

    To determine if a short screening questionnaire can identify patients at risk for drug therapy problems (DTPs) in a community pharmacy setting. Self-administered questionnaire. Three community pharmacies in Saskatoon, Canada. Forty-nine adults who were picking up a refill prescription for a medication that had remained stable over the past 6 months (i.e., no changes to drug, dose, or regimen) during 4 consecutive weeks at each of the three pharmacies between November 2013 and February 2014. All patients completed a self-administered screening questionnaire and underwent a blinded comprehensive medication assessment with a clinical pharmacist. Agreement between the screening questionnaire responses and responses based on information from the medication assessment were assessed with Cohen's κ coefficient. The DTPs identified during the medication assessments were categorized in one of the eight standard DTP categories: unnecessary drug therapy, inappropriate drug, subtherapeutic dose, supratherapeutic dose, drug therapy required, adverse drug reaction, noncompliance, and other or unsure. The DTPs were also assigned a severity-mild, moderate, or severe-using adapted Schneider criteria. The number and severity of DTPs identified were compared among patients categorized as high versus low risk for DTPs as determined by the questionnaire responses. Of the 49 patients who completed the study, 18 (37%) were high risk and 31 (63%) low risk. The agreement between risk categorization based on the screening questionnaire and medication assessment was very good (κ = 0.91, pidentified as high risk on the screening questionnaire had a mean of 3.7 (prisk patients. Seventeen (94%) of the 18 high-risk patients had at least one moderate or severe DTP compared with 15 (48%) of the 31 low-risk patients. The screening questionnaire was a reliable method for identifying patients in community pharmacies who have a large number of DTPs. © 2015 Pharmacotherapy Publications, Inc.

  5. [Development of a screening scale for children at risk of baby bottle tooth decay].

    Science.gov (United States)

    Khadra-Eid, J; Baudet, D; Fourny, M; Sellier, E; Brun, C; François, P

    2012-03-01

    Baby bottle tooth decay is a severe form of early childhood caries. This study aims to elaborate a screening tool for at risk children in order to facilitate primary prevention. A case-control study was conducted among children suffering from baby bottle tooth decay and children with no dental caries. Cases were children aged 5 years or less at diagnosis who experienced at least four caries with one or more affecting maxillary incisors. Controls were children matched for age and sex. Parents were interviewed by phone about their child's exposure to potential risk factors. We included 88 children suffering from baby bottle tooth decay and 88 children with no dental caries. In multivariate analysis, low social class (OR 6.39 [95% CI, 1.45-28.11]), prolonged bottle feeding or bedtime feeding (OR 153.2 [95% CI, 11.77-1994.96]), and snacking (OR 5.94 [95% CI, 1.35-26.2]) were significantly associated with baby bottle tooth decay. Regular dental visits were a significant protecting factor (OR 0.13 [95% CI, 0.02-0.77]). A score was developed using these significant risk factors and tested on the survey population. The mean score was 13/20 for cases and 4/20 for controls. These results are in accordance with the literature, except for brushing teeth, which was not significantly associated with baby bottle tooth decay in our study. A screening scale with a score of 20 points was proposed. Future validation is required. Pediatricians and general practitioners should encourage parents to change their habits. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  6. Age and other risk factors of pneumonia among residents of Polish long-term care facilities.

    Science.gov (United States)

    Wójkowska-Mach, Jadwiga; Gryglewska, Barbara; Romaniszyn, Dorota; Natkaniec, Joanna; Pobiega, Monika; Adamski, Paweł; Grodzicki, Tomasz; Kubicz, Dariusz; Heczko, Piotr B

    2013-01-01

    Pneumonia is one of the leading causes of morbidity and mortality in the elderly population. Nursing home-acquired pneumonia (NHAP) is probably the largest health problem in long-term care facilities (LTCFs). It is the second most common infection in LTCFs and frequently requires hospitalization. The aim of this study was to investigate the incidence rate of NHAP among LTCF residents, its microbial etiology, and the frequency of multidrug-resistant microorganisms. Risk factors for NHAP were analyzed. This was a prospective study conducted on a group of 217 elderly subjects aged ≥65 years, recruited from the inhabitants of LTCFs, with disabled elderly individuals living in the community serving as controls. Continuous surveillance was carried out from December 1, 2009 to November 30, 2010. The incidence rate of NHAP in the observed population of Polish residents was 0.6/1000 resident-days. Vulnerability to NHAP was due to the poor general condition of residents, expressed by low Barthel index values (relative risk (RR) 1.6), the activities of daily living (ADL) score (RR 1.7), the Katz scale (RR 1.2), and limited physical activity (RR 1.6). Also significant were malnutrition (RR 2.3), the use of a bladder catheter (RR 1.3), dysphagia (RR 1.7), tracheotomy tube (RR 3.1), and gastric feeding tube (RR 3.5). Enterobacteriaceae were the predominant etiological agents of NHAP (56.3%). The significance of risk factors for NHAP among residents in LTCFs was confirmed. Unfortunately, we also found that a lack of proper supervision with regard to the microbiology of infections is characteristic of Polish health care and LTCFs. There is an opportunity to improve the medical care of patients with severe disabilities, limit the rise in antimicrobial resistance and the need for hospitalization, and improve the prognosis. Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  7. Incorporating uncertainties into risk assessment with an application to the exploratory studies facilities at Yucca Mountain

    Energy Technology Data Exchange (ETDEWEB)

    Fathauer, Paul M. [Clemson Univ., SC (United States)

    1995-08-01

    A methodology that incorporates variability and reducible sources of uncertainty into the probabilistic and consequence components of risk was developed. The method was applied to the north tunnel of the Exploratory Studies Facility at Yucca Mountain in Nevada. In this assessment, variability and reducible sources of uncertainty were characterized and propagated through the risk assessment models using a Monte Carlo based software package. The results were then manipulated into risk curves at the 5% and 95% confidence levels for both the variability and overall uncertainty analyses, thus distinguishing between variability and reducible sources of uncertainty. In the Yucca Mountain application, the designation of the north tunnel as an item important to public safety, as defined by 10 CFR 60, was determined. Specifically, the annual frequency of a rock fall breaching a waste package causing an off-site dose of 500 mrem (5x10-3 Sv) was calculated. The annual frequency, taking variability into account, ranged from 1.9x10-9 per year at the 5% confidence level to 2.5x10-9 per year at the 95% confidence level. The frequency range after including all uncertainty was 9.5x10-10 to 1.8x10-8 per year. The maximum observable frequency, at the 100% confidence level, was 4.9x10-8 per year. This is below the 10-6 per year frequency criteria of 10 CFR 60. Therefore, based on this work, the north tunnel does not fall under the items important to public safety designation for the event studied.

  8. Impact of risk factors on different interval cancer subtypes in a population-based breast cancer screening programme.

    Directory of Open Access Journals (Sweden)

    Jordi Blanch

    Full Text Available BACKGROUND: Interval cancers are primary breast cancers diagnosed in women after a negative screening test and before the next screening invitation. Our aim was to evaluate risk factors for interval cancer and their subtypes and to compare the risk factors identified with those associated with incident screen-detected cancers. METHODS: We analyzed data from 645,764 women participating in the Spanish breast cancer screening program from 2000-2006 and followed-up until 2009. A total of 5,309 screen-detected and 1,653 interval cancers were diagnosed. Among the latter, 1,012 could be classified on the basis of findings in screening and diagnostic mammograms, consisting of 489 true interval cancers (48.2%, 235 false-negatives (23.2%, 172 minimal-signs (17.2% and 114 occult tumors (11.3%. Information on the screening protocol and women's characteristics were obtained from the screening program registry. Cause-specific Cox regression models were used to estimate the hazard ratios (HR of risks factors for interval cancer and incident screen-detected cancer. A multinomial regression model, using screen-detected tumors as a reference group, was used to assess the effect of breast density and other factors on the occurrence of interval cancer subtypes. RESULTS: A previous false-positive was the main risk factor for interval cancer (HR = 2.71, 95%CI: 2.28-3.23; this risk was higher for false-negatives (HR = 8.79, 95%CI: 6.24-12.40 than for true interval cancer (HR = 2.26, 95%CI: 1.59-3.21. A family history of breast cancer was associated with true intervals (HR = 2.11, 95%CI: 1.60-2.78, previous benign biopsy with a false-negatives (HR = 1.83, 95%CI: 1.23-2.71. High breast density was mainly associated with occult tumors (RRR = 4.92, 95%CI: 2.58-9.38, followed by true intervals (RRR = 1.67, 95%CI: 1.18-2.36 and false-negatives (RRR = 1.58, 95%CI: 1.00-2.49. CONCLUSION: The role of women's characteristics differs among

  9. Impact of Risk Factors on Different Interval Cancer Subtypes in a Population-Based Breast Cancer Screening Programme

    Science.gov (United States)

    Blanch, Jordi; Sala, Maria; Ibáñez, Josefa; Domingo, Laia; Fernandez, Belén; Otegi, Arantza; Barata, Teresa; Zubizarreta, Raquel; Ferrer, Joana; Castells, Xavier; Rué, Montserrat; Salas, Dolores

    2014-01-01

    Background Interval cancers are primary breast cancers diagnosed in women after a negative screening test and before the next screening invitation. Our aim was to evaluate risk factors for interval cancer and their subtypes and to compare the risk factors identified with those associated with incident screen-detected cancers. Methods We analyzed data from 645,764 women participating in the Spanish breast cancer screening program from 2000–2006 and followed-up until 2009. A total of 5,309 screen-detected and 1,653 interval cancers were diagnosed. Among the latter, 1,012 could be classified on the basis of findings in screening and diagnostic mammograms, consisting of 489 true interval cancers (48.2%), 235 false-negatives (23.2%), 172 minimal-signs (17.2%) and 114 occult tumors (11.3%). Information on the screening protocol and women's characteristics were obtained from the screening program registry. Cause-specific Cox regression models were used to estimate the hazard ratios (HR) of risks factors for interval cancer and incident screen-detected cancer. A multinomial regression model, using screen-detected tumors as a reference group, was used to assess the effect of breast density and other factors on the occurrence of interval cancer subtypes. Results A previous false-positive was the main risk factor for interval cancer (HR = 2.71, 95%CI: 2.28–3.23); this risk was higher for false-negatives (HR = 8.79, 95%CI: 6.24–12.40) than for true interval cancer (HR = 2.26, 95%CI: 1.59–3.21). A family history of breast cancer was associated with true intervals (HR = 2.11, 95%CI: 1.60–2.78), previous benign biopsy with a false-negatives (HR = 1.83, 95%CI: 1.23–2.71). High breast density was mainly associated with occult tumors (RRR = 4.92, 95%CI: 2.58–9.38), followed by true intervals (RRR = 1.67, 95%CI: 1.18–2.36) and false-negatives (RRR = 1.58, 95%CI: 1.00–2.49). Conclusion The role of women's characteristics differs among

  10. Screening for Cardiovascular Risk in Asymptomatic Users of the Primary Health Care Network in Lebanon, 2012–2013

    Science.gov (United States)

    Adib, Salim M.; Hamadeh, Randa; Freidi, Alia; Ammar, Walid

    2014-01-01

    Introduction In 2012, the Ministry of Public Health in Lebanon piloted a service of multifactorial cardiovascular screening in the publicly subsidized Primary Health Care (PHC) Network. We present an epidemiological analysis of data produced during this pilot to justify the inclusion of this service in the package of essential services offered through PHC and to present a preliminary cardiovascular risk profile in an asymptomatic population. Methods A total of 4,205 participants (two-thirds of which were women) aged at least 40 years and reportedly free from diabetes, hypertension, dyslipidemia, and cardiovascular disease (CVD) were screened. The screening protocol used a questionnaire and direct measurements to assess 5 modifiable cardiovascular risk factors; total cardiovascular risk score was calculated according to a paper-based algorithm developed by the World Health Organization and the International Society of Hypertension. Results Approximately 25% of the sample displayed metabolic impairments (11% for impaired blood glucose metabolism and 17% for impaired systolic blood pressure), and 6.6% were classified at total cardiovascular risk of 10% or more. Just over one-quarter of the sample was obese, almost half had a substantially elevated waist circumference, and 41% were smokers. Men were significantly more likely to screen positive for metabolic impairment than women, and women were more likely to be obese. Conclusion The implementation of a multifactorial screening for CVD among asymptomatic subjects detected a substantial proportion of previously undiagnosed cases of high metabolic risk, people who could now be referred to optimal medical follow-up. PMID:25032835

  11. Offering Lung Cancer Screening to High-Risk Medicare Beneficiaries Saves Lives and Is Cost-Effective: An Actuarial Analysis

    Science.gov (United States)

    Pyenson, Bruce S.; Henschke, Claudia I.; Yankelevitz, David F.; Yip, Rowena; Dec, Ellynne

    2014-01-01

    Background By a wide margin, lung cancer is the most significant cause of cancer death in the United States and worldwide. The incidence of lung cancer increases with age, and Medicare beneficiaries are often at increased risk. Because of its demonstrated effectiveness in reducing mortality, lung cancer screening with low-dose computed tomography (LDCT) imaging will be covered without cost-sharing starting January 1, 2015, by nongrandfathered commercial plans. Medicare is considering coverage for lung cancer screening. Objective To estimate the cost and cost-effectiveness (ie, cost per life-year saved) of LDCT lung cancer screening of the Medicare population at high risk for lung cancer. Methods Medicare costs, enrollment, and demographics were used for this study; they were derived from the 2012 Centers for Medicare & Medicaid Services (CMS) beneficiary files and were forecast to 2014 based on CMS and US Census Bureau projections. Standard life and health actuarial techniques were used to calculate the cost and cost-effectiveness of lung cancer screening. The cost, incidence rates, mortality rates, and other parameters chosen by the authors were taken from actual Medicare data, and the modeled screenings are consistent with Medicare processes and procedures. Results Approximately 4.9 million high-risk Medicare beneficiaries would meet criteria for lung cancer screening in 2014. Without screening, Medicare patients newly diagnosed with lung cancer have an average life expectancy of approximately 3 years. Based on our analysis, the average annual cost of LDCT lung cancer screening in Medicare is estimated to be $241 per person screened. LDCT screening for lung cancer in Medicare beneficiaries aged 55 to 80 years with a history of ≥30 pack-years of smoking and who had smoked within 15 years is low cost, at approximately $1 per member per month. This assumes that 50% of these patients were screened. Such screening is also highly cost-effective, at <$19,000 per life

  12. Use of risk projection models to estimate mortality and incidence from radiation-induced breast cancer in screening programs

    Energy Technology Data Exchange (ETDEWEB)

    Ramos, M [Chemical and Nuclear Engineering Department, Polytechnic University of Valencia, Camino de Vera s/n 46022 Valencia (Spain); Ferrer, S [Chemical and Nuclear Engineering Department, Polytechnic University of Valencia, Camino de Vera s/n 46022 Valencia (Spain); Villaescusa, J I [Radiation Protection Service, Hospital Universitario La Fe, Avda Campanar, 21 46009 Valencia (Spain); Verdu, G [Chemical and Nuclear Engineering Department, Polytechnic University of Valencia, Camino de Vera s/n 46022 Valencia (Spain); Salas, M D [Public Health General Direction, Conselleria de Sanitat de Valencia, C/Micer Masco, 31 46021 Valencia (Spain); Cuevas, M D [Assistential Service General Direction, Conselleria de Sanitat de Valencia, C/Micer Masco, 31 46021 Valencia (Spain)

    2005-02-07

    The authors report on a method to calculate radiological risks, applicable to breast screening programs and other controlled medical exposures to ionizing radiation. In particular, it has been applied to make a risk assessment in the Valencian Breast Cancer Early Detection Program (VBCEDP) in Spain. This method is based on a parametric approach, through Markov processes, of hazard functions for radio-induced breast cancer incidence and mortality, with mean glandular breast dose, attained age and age-at-exposure as covariates. Excess relative risk functions of breast cancer mortality have been obtained from two different case-control studies exposed to ionizing radiation, with different follow-up time: the Canadian Fluoroscopy Cohort Study (1950-1987) and the Life Span Study (1950-1985 and 1950-1990), whereas relative risk functions for incidence have been obtained from the Life Span Study (1958-1993), the Massachusetts tuberculosis cohorts (1926-1985 and 1970-1985), the New York post-partum mastitis patients (1930-1981) and the Swedish benign breast disease cohort (1958-1987). Relative risks from these cohorts have been transported to the target population undergoing screening in the Valencian Community, a region in Spain with about four and a half million inhabitants. The SCREENRISK software has been developed to estimate radiological detriments in breast screening. Some hypotheses corresponding to different screening conditions have been considered in order to estimate the total risk associated with a woman who takes part in all screening rounds. In the case of the VBCEDP, the total radio-induced risk probability for fatal breast cancer is in a range between [5 x 10{sup -6}, 6 x 10{sup -4}] versus the natural rate of dying from breast cancer in the Valencian Community which is 9.2 x 10{sup -3}. The results show that these indicators could be included in quality control tests and could be adequate for making comparisons between several screening programs.

  13. Nuclear-fuel-cycle risk assessment: descriptions of representative non-reactor facilities. Sections 1-14

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, K.J.

    1982-09-01

    The Fuel Cycle Risk Assessment Program was initiated to provide risk assessment methods for assistance in the regulatory process for nuclear fuel cycle facilities other than reactors. This report, the first from the program, defines and describes fuel cycle elements that are being considered in the program. One type of facility (and in some cases two) is described that is representative of each element of the fuel cycle. The descriptions are based on real industrial-scale facilities that are current state-of-the-art, or on conceptual facilities where none now exist. Each representative fuel cycle facility is assumed to be located on the appropriate one of four hypothetical but representative sites described. The fuel cycles considered are for Light Water Reactors with once-through flow of spent fuel, and with plutonium and uranium recycle. Representative facilities for the following fuel cycle elements are described for uranium (or uranium plus plutonium where appropriate): mining, milling, conversion, enrichment, fuel fabrication, mixed-oxide fuel refabrication, fuel reprocessing, spent fuel storage, high-level waste storage, transuranic waste storage, spent fuel and high-level and transuranic waste disposal, low-level and intermediate-level waste disposal, and transportation. For each representative facility the description includes: mainline process, effluent processing and waste management, facility and hardware description, safety-related information and potential alternative concepts for that fuel cycle element. The emphasis of the descriptive material is on safety-related information. This includes: operating and maintenance requirements, input/output of major materials, identification and inventories of hazardous materials (particularly radioactive materials), unit operations involved, potential accident driving forces, containment and shielding, and degree of hands-on operation.

  14. Physical Activity, Screen-Based Sedentary Behavior, and Sleep Duration in Adolescents: Youth Risk Behavior Survey, 2011?2013

    OpenAIRE

    Kim, Youngdeok; Umeda, Masataka; Lochbaum, Marc; Stegemeier, Steven

    2016-01-01

    This study examined the concurrent associations of physical activity and screen-based sedentary behavior with sleep duration among adolescents by using data from the national Youth Risk Behavior Survey 2011?2013. Using latent class analysis, we identified 4 latent subgroups of adolescents with various levels of physical activity and screen-based sedentary behavior. The subgroup with high levels of physical activity and low levels of sedentary behavior generally showed greater odds of having s...

  15. Risk factors for fecal colonization with multiple distinct strains of Escherichia coli among long-term care facility residents.

    Science.gov (United States)

    Lautenbach, Ebbing; Tolomeo, Pam; Black, Nicole; Maslow, Joel N

    2009-05-01

    Of 49 long-term care facility residents, 21 (43%) were colonized with 2 or more distinct strains of Escherichia coli. There were no significant risk factors for colonization with multiple strains of E. coli. These results suggest that future efforts to efficiently identify the diversity of colonizing strains will be challenging.

  16. Residential proximity to industrial combustion facilities and risk of non-Hodgkin lymphoma: A case-control study

    NARCIS (Netherlands)

    Pronk, A.; Nuckols, J.R.; Roos, A.J. de; Airola, M.; Colt, J.S.; Cerhan, J.R.; Morton, L.; Cozen, W.; Severson, R.; Blair, A.; Cleverly, D.; Ward, M.H.

    2013-01-01

    Background: Residence near municipal solid waste incinerators, a major historical source of dioxin emissions, has been associated with increased risk of non-Hodgkin lymphoma (NHL) in European studies. The aim of our study was to evaluate residence near industrial combustion facilities and estimates

  17. Residential proximity to industrial combustion facilities and risk of non-Hodgkin lymphoma: A case-control study

    NARCIS (Netherlands)

    Pronk, A.; Nuckols, J.R.; Roos, A.J. de; Airola, M.; Colt, J.S.; Cerhan, J.R.; Morton, L.; Cozen, W.; Severson, R.; Blair, A.; Cleverly, D.; Ward, M.H.

    2013-01-01

    Background: Residence near municipal solid waste incinerators, a major historical source of dioxin emissions, has been associated with increased risk of non-Hodgkin lymphoma (NHL) in European studies. The aim of our study was to evaluate residence near industrial combustion facilities and estimates

  18. Evaluating Potential Human Health Risks Associated with the Development of Utility-Scale Solar Energy Facilities on Contaminated Sites

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, J. -J. [Argonne National Lab. (ANL), Argonne, IL (United States); Chang, Y. -S. [Argonne National Lab. (ANL), Argonne, IL (United States); Hartmann, H. [Argonne National Lab. (ANL), Argonne, IL (United States); Wescott, K. [Argonne National Lab. (ANL), Argonne, IL (United States); Kygeris, C. [Indiana Univ. of Pennsylvania, PA (United States)

    2013-09-01

    This report presents a general methodology for obtaining preliminary estimates of the potential human health risks associated with developing a utility-scale solar energy facility on a contaminated site, based on potential exposures to contaminants in soils (including transport of those contaminants into the air).

  19. Predictors of suboptimal bowel preparation in asymptomatic patients undergoing average-risk screening colonoscopy.

    Science.gov (United States)

    Govani, Shail M; Elliott, Eric E; Menees, Stacy B; Judd, Stephanie L; Saini, Sameer D; Anastassiades, Constantinos P; Urganus, Annette L; Boyce, Suzanna J; Schoenfeld, Philip S

    2016-09-16

    To identify risk factors for a suboptimal preparation among a population undergoing screening or surveillance colonoscopy. Retrospective review of the University of Michigan and Veteran's Administration (VA) Hospital records from 2009 to identify patients age 50 and older who underwent screening or surveillance procedure and had resection of polyps less than 1 cm in size and no more than 2 polyps. Patients with inflammatory bowel disease or a family history of colorectal cancer were excluded. Suboptimal procedures were defined as procedure preparations categorized as fair, poor or inadequate by the endoscopist. Multivariable logistic regression was used to identify predictors of suboptimal preparation. Of 4427 colonoscopies reviewed, 2401 met our inclusion criteria and were analyzed. Of our population, 16% had a suboptimal preparation. African Americans were 70% more likely to have a suboptimal preparation (95%CI: 1.2-2.4). Univariable analysis revealed that narcotic and tricyclic antidepressants (TCA) use, diabetes, prep type, site (VA vs non-VA), and presence of a gastroenterology (GI) fellow were associated with suboptimal prep quality. In a multivariable model controlling for gender, age, ethnicity, procedure site and presence of a GI fellow, diabetes [odds ratio (OR) = 2.3; 95%CI: 1.6-3.2], TCA use (OR = 2.5; 95%CI: 1.3-4.9), narcotic use (OR = 1.7; 95%CI: 1.2-2.5) and Miralax-Gatorade prep vs 4L polyethylene glycol 3350 (OR = 0.6; 95%CI: 0.4-0.9) were associated with a suboptimal prep quality. Diabetes, narcotics use and TCA use were identified as predictors of poor preparation in screening colonoscopies while Miralax-Gatorade preps were associated with better bowel preparation.

  20. Tattoos and transfusion-transmitted disease risk: implications for the screening of blood donors in Brazil

    Directory of Open Access Journals (Sweden)

    Sérgio de A. Nishioka

    2002-08-01

    Full Text Available Having a tattoo has been associated with serological evidence of hepatitis B and C viruses, as well as human immunodeficiency virus infections and syphilis; all of these are known to be transmissible by blood transfusion. These associations are of higher magnitude for individuals with nonprofessionally-applied tattoos and with two or more tattoos. Tattoos are common among drug addicts and prisoners, conditions that are also associated with transfusion-transmitted diseases. We examined the implications of these associations for the screening of blood donors in Brazil. Numbers of individuals who would be correctly or unnecessarily deferred from blood donation on the basis of the presence of tattoos, and on their number and type, were calculated for different prevalence situations based on published odds ratios. If having a tattoo was made a deferral criterion, cost savings (due to a reduced need for laboratory testing and subsequent follow-up would accrue at the expense of the deferral of appropriate donors. Restricting deferral to more `at-risk' sub-groups of tattooed individuals would correctly defer less individuals and would also reduce the numbers of potential donors unnecessarily deferred. Key factors in balancing cost savings and unnecessary deferrals include the magnitude of the pool of blood donors in the population, the prevalence of individuals with tattoos and the `culture' of tattoos in the population. Tattoos can therefore be an efficient criterion for the screening of blood donors in certain settings, a finding that requires corroboration from larger population-based studies.

  1. Risk and Interaction Aversion: Screening Mechanisms in the Prisoner's Dilemma Game

    Science.gov (United States)

    Canova, Gabriel A.; Arenzon, Jeferson J.

    2017-09-01

    When the interactions between cooperators (C) and defectors (D) can be partially avoided within a population, there may be an overall enhancement of cooperation. One example of such screening mechanism occurs in the presence of risk-averse agents (loners, L) that are neutral towards others, i.e., both L and its opponent, whatever its strategy, receive the same payoff. Their presence in the Prisoner's Dilemma (PD) game sustains the coexistence of cooperators and defectors far beyond the level attained in their absence. Another screening mechanism is a heterogeneous landscape obtained, for example, by site diluting the lattice. In this case, cooperation is enhanced with some fraction of such inactive, interaction-averse sites. By considering the interplay of both mechanisms, we show that there is an explosive increase in the range of densities, just above the percolation threshold, where neutrality is prevented and loners become extinct, the behavior reverting to the pure PD game. Interestingly, this occurs despite defectors being usually abundant in that region. This has to be compared with the corresponding loner-free region in the undiluted case that, besides being very small, is dominated by cooperators.

  2. Neonatal hearing screening in a low-risk maternity hospital in São Paulo state

    Directory of Open Access Journals (Sweden)

    Adriana Aparecida Tahara Kemp

    2015-10-01

    Full Text Available ABSTRACT INTRODUCTION: The literature indicates that neonatal hearing screening should be universal, so a description of programs that adopt this recommendation is relevant. OBJECTIVE: To describe the results of newborn hearing screening and the profile of mothers and newborns attended to in a low-risk maternity setting, and to correlate the characteristics of this population with the results of transient evoked otoacoustic emissions. METHODS: A contemporary cross-sectional cohort study. The sample consisted of 670 infants and the procedures performed were audiological history, transient-evoked otoacoustic emissions (TEOAE, distortion product-evoked otoacoustic emissions (DPEOAE, and automated-brainstem auditory evoked potential (ABSAEP. RESULTS: The rate of success in this program was 98.5%, the failure rate was 0.62%, and that of non-attendance to finalize the diagnostic process, 0.93%. When correlating the variables studied with the results of transient evoked otoacoustic emissions, there was a significant negative correlation only for age of infant. CONCLUSION: The program of this maternity hospital was effective and complies with national and international recommendations. The population consisted of young mothers with few pregnancy complications and healthy infants. The only variable that influenced transient evoked otoacoustic emission results, after hospital discharge, was the age at which infants were evaluated.

  3. Risk factors for neurocognitive impairment in HIV-infected patients and comparison of different screening tools

    Directory of Open Access Journals (Sweden)

    Elisa Moreira de Souza

    Full Text Available HIV-associated neurocognitive disorder (HAND is relatively frequent among HIV-infected patients and is often underdiagnosed. Assessment of HAND in daily clinical practice is challenging and different tools have been proposed. Objective : To evaluate risk factors and compare different screening tools for neurocognitive impairment in HIV-infected patients. Methods : HIV-infected patients were evaluated using the International HIV-Dementia Scale (IHDS, Mini-Mental State Examination (MMSE and a neurocognitive self-perception questionnaire recommended by the European AIDS Clinical Society. Sociodemographic, clinical and laboratory data were obtained through chart review and patient interview. Results : Among the 63 patients included, low performance on the IHDS was observed in 54.0% and IHDS score was inversely associated with age (OR 0.13; 95%CI [0.02-0.67]. Regarding cognitive self-perception, 63.5% of patients reported no impairment on the three domains covered by the questionnaire. Among those patients self-reporting no problems, 42.1% had low performance on the IHDS. None of the patients scored below the education-adjusted cut-off on the MMSE. Conclusion : IHDS scores suggestive of HAND were observed in more than half of the patients and lower scores were found among older patients. There was low agreement between the different tools, suggesting that the MMSE may be inadequate for assessing HAND. The self-assessment questionnaire had low sensitivity and might not be useful as a screening tool.

  4. Screening study for waste biomass to ethanol production facility using the Amoco process in New York State. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    This report evaluates the economic feasibility of locating biomass-to-ethanol waste conversion facilities in New York State. Part 1 of the study evaluates 74 potential sites in New York City and identifies two preferred sites on Staten, the Proctor Gamble and the Arthur Kill sites, for further consideration. Part 2 evaluates upstate New York and determines that four regions surrounding the urban centers of Albany, Buffalo, Rochester, and Syracuse provide suitable areas from which to select specific sites for further consideration. A separate Appendix provides supplemental material supporting the evaluations. A conceptual design and economic viability evaluation were developed for a minimum-size facility capable of processing 500 tons per day (tpd) of biomass consisting of wood or paper, or a combination of the two for upstate regions. The facility would use Amoco`s biomass conversion technology and produce 49,000 gallons per day of ethanol and approximately 300 tpd of lignin solid by-product. For New York City, a 1,000-tpd processing facility was also evaluated to examine effects of economies of scale. The reports evaluate the feasibility of building a biomass conversion facility in terms of city and state economic, environmental, and community factors. Given the data obtained to date, including changing costs for feedstock and ethanol, the project is marginally attractive. A facility should be as large as possible and located in a New York State Economic Development Zone to take advantage of economic incentives. The facility should have on-site oxidation capabilities, which will make it more financially viable given the high cost of energy. 26 figs., 121 tabs.

  5. [Risk-taking in adolescence. Screening and counseling strategies for primary care professionals].

    Science.gov (United States)

    Meynard, Anne; Haller, Dagmar M; Navarro, Carol; Narring, Françoise

    2008-06-11

    Meeting adolescents' health needs in primary care implies knowledge of developmental, psycho-social and physical specificities of this age group. Primary care physicians need appropriate communication skills and knowledge of specific adolescent health issues such as the role of families, the need for confidential services and networking with schools, social services and other key individuals in young people's lives. Primary care physicians rarely receive training in adolescent health and are usually interested in practical screening or counselling strategies. HEADSSS is a useful mnemonic to guide the psychosocial interview of an adolescent. It can be used in daily practice to help the physician to focus not only on "risk taking", but also on the personal strengths and protective factors that allow young people to develop harmoniously.

  6. Risk factors for false positive and for false negative test results in screening with fecal occult blood testing.

    Science.gov (United States)

    Stegeman, Inge; de Wijkerslooth, Thomas R; Stoop, Esther M; van Leerdam, Monique; van Ballegooijen, M; Kraaijenhagen, Roderik A; Fockens, Paul; Kuipers, Ernst J; Dekker, Evelien; Bossuyt, Patrick M

    2013-11-15

    Differences in the risk of a false negative or a false positive fecal immunochemical test (FIT) across subgroups may affect optimal screening strategies. We evaluate whether subgroups are at increased risk of a false positive or a false negative FIT result, whether such variability in risk is related to differences in FIT sensitivity and specificity or to differences in prior CRC risk. Randomly selected, asymptomatic individuals were invited to undergo colonoscopy. Participants were asked to undergo one sample FIT and to complete a risk questionnaire. We identified patient characteristics associated with a false negative and false positive FIT results using logistic regression. We focused on statistically significant differences as well as on variables influencing the false positive or negative risk for which the odds ratio exceeded 1.25. Of the 1,426 screening participants, 1,112 (78%) completed FIT and the questionnaire; 101 (9.1%) had advanced neoplasia. 102 Individuals were FIT positive, 65 (64%) had a false negative FIT result and 66 (65%) a false positive FIT result. Participants at higher age and smokers had a significantly higher risk of a false negative FIT result. Males were at increased risk of a false positive result, so were smokers and regular NSAID users. FIT sensitivity was lower in females. Specificity was lower for males, smokers and regular NSAID users. FIT sensitivity was lower in women. FIT specificity was lower in males, smokers and regular NSAID users. Our results can be used for further evidence based individualization of screening strategies.

  7. Probabilistic Risk Based Decision Support for Oil and Gas Exploration and Production Facilities in Sensitive Ecosystems

    Energy Technology Data Exchange (ETDEWEB)

    Greg Thoma; John Veil; Fred Limp; Jackson Cothren; Bruce Gorham; Malcolm Williamson; Peter Smith; Bob Sullivan

    2009-05-31

    This report describes work performed during the initial period of the project 'Probabilistic Risk Based Decision Support for Oil and Gas Exploration and Production Facilities in Sensitive Ecosystems.' The specific region that is within the scope of this study is the Fayetteville Shale Play. This is an unconventional, tight formation, natural gas play that currently has approximately 1.5 million acres under lease, primarily to Southwestern Energy Incorporated and Chesapeake Energy Incorporated. The currently active play encompasses a region from approximately Fort Smith, AR east to Little Rock, AR approximately 50 miles wide (from North to South). The initial estimates for this field put it almost on par with the Barnett Shale play in Texas. It is anticipated that thousands of wells will be drilled during the next several years; this will entail installation of massive support infrastructure of roads and pipelines, as well as drilling fluid disposal pits and infrastructure to handle millions of gallons of fracturing fluids. This project focuses on gas production in Arkansas as the test bed for application of proactive risk management decision support system for natural gas exploration and production. The activities covered in this report include meetings with representative stakeholders, development of initial content and design for an educational web site, and development and preliminary testing of an interactive mapping utility designed to provide users with information that will allow avoidance of sensitive areas during the development of the Fayetteville Shale Play. These tools have been presented to both regulatory and industrial stakeholder groups, and their feedback has been incorporated into the project.

  8. Comparison of cumulative false-positive risk of screening mammography in the United States and Denmark

    DEFF Research Database (Denmark)

    Jacobsen, Katja Kemp

    2015-01-01

    INTRODUCTION: In the United States (US), about one-half of women screened with annual mammography have at least one false-positive test after ten screens. The estimate for European women screened ten times biennially is much lower. We evaluate to what extent screening interval, mammogram type......, and statistical methods, can explain the reported differences. METHODS: We included all screens from women first screened at age 50-69 years in the US Breast Cancer Surveillance Consortium (BCSC) (n=99,455) between 1996-2010, and from two population-based mammography screening programs in Denmark (n=230,452 and n...

  9. Toxic chemical hazard classification and risk acceptance guidelines for use in DOE facilities. Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Craig, D.K. [Westinghouse Savannah River Co., Aiken, SC (United States); Davis, J.S. [Westinghouse Hanford Co., Richland, WA (United States); Prowse, J. [Westinghouse Idaho Nuclear Co., Inc., Idaho Falls, ID (United States); Hoffman, P.W. [Westinghouse Electric Corp., Carlsbad, NM (United States). Waste Isolation Div.

    1995-03-24

    The concentration-limit guidelines presented in this document apply to airborne releases of chemicals evaluated with respect to human health effects for the purposes of hazard classification and categorization, risk assessment and safety analysis. They apply to all DOE facilities and operations involving the use of potentially hazardous chemicals. The guidelines do not address other nonradiological hazards such as fire, pressure releases (including explosions), and chemical reactivity, but the guidelines are applicable to hazardous chemical releases resulting from these events. This report presents the subcommittee`s evaluation and recommendations regarding analyses of accidentally released toxic chemicals. The premise upon which these recommendations are based is that the mechanism of action of toxic chemicals is fundamentally different from that associated with radionuclides, with the exception of carcinogens. The recommendations reported herein are restricted to the airborne pathway because in an accident scenario this typically represents the most immediately significant route of public exposure. However, the subcommittee recognizes that exposure to chemicals through other pathways, in particular waterborne, can have significant impacts on human health and the environment. Although there are a number of chemicals for which absorption through the skin can contribute measurably to the total dose in chronic (e.g., occupational) exposure situations, this pathway has not been considered for the acute exposure scenarios considered in this report. Later studies. will address these issues if it appears desirable.

  10. Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania.

    Science.gov (United States)

    Kuchibanda, Kizito; Mayo, Aloyce W

    2015-01-01

    The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interview, and observation checklist. The results revealed that healthcare wastes are not quantified or segregated in all the three hospitals. Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed of by on-site incineration and burning and some wastes are disposed off-site. At Kolandoto DDH only on-site burning and land disposal are practiced, while at Kambarage UHC healthcare solid wastes are incinerated, disposed of on land disposal, and burned. Waste management workers do not have formal training in waste management techniques and the hospital administrations pay very little attention to appropriate management of healthcare wastes. In light of this, it is evident that management of healthcare solid wastes is not practiced in accordance with the national and WHO's recommended standards.

  11. Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania

    Directory of Open Access Journals (Sweden)

    Kizito Kuchibanda

    2015-01-01

    Full Text Available The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interview, and observation checklist. The results revealed that healthcare wastes are not quantified or segregated in all the three hospitals. Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed of by on-site incineration and burning and some wastes are disposed off-site. At Kolandoto DDH only on-site burning and land disposal are practiced, while at Kambarage UHC healthcare solid wastes are incinerated, disposed of on land disposal, and burned. Waste management workers do not have formal training in waste management techniques and the hospital administrations pay very little attention to appropriate management of healthcare wastes. In light of this, it is evident that management of healthcare solid wastes is not practiced in accordance with the national and WHO’s recommended standards.

  12. [Performance of different methods of estimating risk screening for chromosomal anomalies].

    Science.gov (United States)

    Avătăjitei, Maria-Cristina; Moscalu, Mihaela; Martiniuc, Violeta; Onofriescu, M

    2012-01-01

    In the last 10 years, several studies have been carried out on additional ultrasound markers in the first trimester of pregnancy in order to improve detection rate of fetal numerical chromosome abnormalities (aneuploidy) and to reduce the rate of false-positive diagnosis. The purpose of this study was to evaluate the performance of various recommendations for which amniocentesis was performed followed by FISH testing in the diagnosis of aneuploidy. These evaluations were conducted in order to determine whether ultrasound aspects are associated with fetal aneuploidy and to estimate the risk level of individual markers using probability estimation analysis. The study has been carried out at the Clinical Hospital of Obstetrics and Gynecology "CuzaVodă" Iaşi, at the Laboratory of cytogenetic--prenatal diagnosis, during January 2004-December 2011, on a target group of 1406 pregnant women. As part of this study, 1411 amniocentesis were performed. increased efficiency of screening for fetal aneuploidy in the first trimester of pregnancy is obtained through combined method (maternal age over 35 years, increased nuchal translucency and the presence of double test risk) which has 100% detection rate and a rate false-positive result of 0%. The efficiency of this method is provided also by the relatively high risk (RR = 17.2) and its specificity (Sp = 100%). Making the assessment following the study false positive rate, it appears that a good method of risk assessment for aneuploidy is the combined evaluation of increased nuchal translucency (NT) with maternal age over 35 years (specificity 99.5%, a detection rate of 40% false positive rate of 0.45% and a relative risk of 7.09 for the presence of aneuploidy). The achievement of a correct prenatal diagnosis and the increase of the method efficiency, requires a correct selection of cases with aneuploidy risk assessment, based on the results of ultrasound and biochemical (double test risk) investigations correlated with

  13. Diabetes Screening and Prevention in a High-Risk, Medically Isolated Border Community

    Directory of Open Access Journals (Sweden)

    Ann V. Millard

    2017-06-01

    Full Text Available IntroductionA project in a Texas border community setting, Prevention Organized against Diabetes and Dialysis with Education and Resources (POD2ER, offered diabetes prevention information, screening, and medical referrals. The setting was a large, longstanding flea market that functions as a shopping mall for low-income people. The priority population included medically underserved urban and rural Mexican Americans. Components of the program addressed those with diabetes, prediabetes, and accompanying relatives and friends.BackgroundPeople living in the Lower Rio Grande Valley (LRGV face challenges of high rates of type 2 diabetes, lack of knowledge about prevention, and inadequate access to medical care. Recent statistics from actual community-wide screenings indicate a high diabetes prevalence, 30.7% among adults in the LRGV compared with 12.3% nationwide.MethodsA diverse team composed of public health faculty, students, a physician, a community health worker, and community volunteers conceived and developed the project with a focus on cultural and economic congruence and a user-friendly atmosphere. The program provided screening for prediabetes and diabetes with a hemoglobin A1c test. Screening was offered to those who were at least 25 years of age and not pregnant. When results indicated diabetes, a test for kidney damage was offered (urinary albumin-to-creatinine ratio. A medical appointment at a community clinic within a week was provided to those who tested positive for diabetes and lacked a medical home. Health education modules addressed all family members.DiscussionThe project was successful in recruiting 2,332 high-risk people in 26 months in a community setting, providing clinic referrals to those without a doctor, introducing them to treatment, and providing diabetes prevention information to all project participants. Implications for research and practice are highlighted.ConclusionThis study shows that a regular access point in

  14. Donor blood procurement and the risk of transfusion transmissible viral infections in a tertiary health facility in South-South Nigeria

    Directory of Open Access Journals (Sweden)

    Benedict Nwogoh

    2011-01-01

    Full Text Available Background: Blood and blood products are scarce commodities. The demand often outweighs the supply. This study is directed at investigating the blood procurement sources and the risk of viral transfusion transmissible infection. Materials and Methods: The records of the blood transfusion unit of a tertiary health facility in south-south Nigeria were studied. The procurement and screening records from 1 January to 31 December 2009 were analyzed. Results: 7,552 donor records were analyzed, 6,931 were commercial donor and 621 replacement donors. 891 commercial donors were infected, 500 (7.2% were HIV positive, 323 (4.7% HBV positive, 42 (0.6% had HIV and HBV co-infection, while 28 (0.4% were HCV positive. Twenty-three replacement donors were infected, 16 (2.6% were HIV positive, 6 (1% were HBV positive, while 1 (0.2% were HCV positive. None of the replacement donors had co-infection. The risk of infection was significantly higher with commercial donor procurement (X2=45.07, P<0.001, OD=3.845. Conclusion: Commercial blood donors are still the major source of blood to the hospital and they also have the highest prevalence of transfusion transmissible viral infections in this region thus constitute a major risk transmitting infections to potential recipients.

  15. Radiation risks in lung cancer screening programs: a comparison with nuclear industry workers and atomic bomb survivors.

    Science.gov (United States)

    McCunney, Robert J; Li, Jessica

    2014-03-01

    The National Lung Cancer Screening Trial (NLST) demonstrated that screening with low-dose CT (LDCT) scan reduced lung cancer and overall mortality by 20% and 7%, respectively. The LDCT scanning involves an approximate 2-mSv dose, whereas full-chest CT scanning, the major diagnostic study used to follow up nodules, may involve a dose of 8 mSv. Radiation associated with CT scanning and other diagnostic studies to follow up nodules may present an independent risk of lung cancer. On the basis of the NLST, we estimated the incidence and prevalence of nodules detected in screening programs. We followed the Fleischner guidelines for follow-up of nodules to assess cumulative radiation exposure over 20- and 30-year periods. We then evaluated nuclear worker cohort studies and atomic bomb survivor studies to assess the risk of lung cancer from radiation associated with long-term lung cancer screening programs. The findings indicate that a 55-year-old lung screening participant may experience a cumulative radiation exposure of up to 280 mSv over a 20-year period and 420 mSv over 30 years. These exposures exceed those of nuclear workers and atomic bomb survivors. This assessment suggests that long-term (20-30 years) LDCT screening programs are associated with nontrivial cumulative radiation doses. Current lung cancer screening protocols, if conducted over 20- to 30-year periods, can independently increase the risk of lung cancer beyond cigarette smoking as a result of cumulative radiation exposure. Radiation exposures from LDCT screening and follow-up diagnostic procedures exceed lifetime radiation exposures among nuclear power workers and atomic bomb survivors.

  16. A Prospective Study of Pravastatin in the Elderly at Risk (PROSPER): Screening Experience and Baseline Characteristics.

    LENUS (Irish Health Repository)

    Ford, Ian

    2002-05-20

    BACKGROUND: PROSPER was designed to investigate the benefits of treatment with pravastatin in elderly patients for whom a typical doctor might consider the prescription of statin therapy to be a realistic option. METHODS: The PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) is a randomised, double blind, placebo-controlled trial to test the hypothesis that treatment with pravastatin (40 mg\\/day) will reduce the risk of coronary heart disease death, non-fatal myocardial infarction, and fatal or non-fatal stroke in elderly men and women with pre-existing vascular disease or with significant risk of developing this condition. RESULTS: In Scotland, Ireland, and the Netherlands, 23,770 individuals were screened, and 5,804 subjects (2,804 men and 3,000 women), aged 70 to 82 years (average 75 years) and with baseline cholesterol 4.0-9.0 mmol\\/l, were randomised. Randomised subjects had similar distributions with respect to age, blood pressure, and body mass index when compared to the entire group of screenees, but had a higher prevalence of smoking, diabetes, hypertension, and a history of vascular disease. The average total cholesterol level at baseline was 5.4 mmol\\/l (men) and 6.0 mmol\\/l (women). CONCLUSIONS: Compared with previous prevention trials of cholesterol-lowering drugs, the PROSPER cohort is significantly older and for the first time includes a majority of women. The study, having achieved its initial goal of recruiting more than 5,500 elderly high-risk men and women, aims to complete all final subject follow-up visits in the first half of 2002 with the main results being available in the fourth quarter of 2002.

  17. A Prospective Study of Pravastatin in the Elderly at Risk (PROSPER: Screening Experience and Baseline Characteristics

    Directory of Open Access Journals (Sweden)

    Lagaay A Margot

    2002-05-01

    Full Text Available Abstract Background PROSPER was designed to investigate the benefits of treatment with pravastatin in elderly patients for whom a typical doctor might consider the prescription of statin therapy to be a realistic option. Methods The PROspective Study of Pravastatin in the Elderly at Risk (PROSPER is a randomised, double blind, placebo-controlled trial to test the hypothesis that treatment with pravastatin (40 mg/day will reduce the risk of coronary heart disease death, non-fatal myocardial infarction, and fatal or non-fatal stroke in elderly men and women with pre-existing vascular disease or with significant risk of developing this condition. Results In Scotland, Ireland, and the Netherlands, 23,770 individuals were screened, and 5,804 subjects (2,804 men and 3,000 women, aged 70 to 82 years (average 75 years and with baseline cholesterol 4.0–9.0 mmol/l, were randomised. Randomised subjects had similar distributions with respect to age, blood pressure, and body mass index when compared to the entire group of screenees, but had a higher prevalence of smoking, diabetes, hypertension, and a history of vascular disease. The average total cholesterol level at baseline was 5.4 mmol/l (men and 6.0 mmol/l (women. Conclusions Compared with previous prevention trials of cholesterol-lowering drugs, the PROSPER cohort is significantly older and for the first time includes a majority of women. The study, having achieved its initial goal of recruiting more than 5,500 elderly high-risk men and women, aims to complete all final subject follow-up visits in the first half of 2002 with the main results being available in the fourth quarter of 2002.

  18. Diabetes Status and Being Up-to-Date on Colorectal Cancer Screening, 2012 Behavioral Risk Factor Surveillance System.

    Science.gov (United States)

    Porter, Nancy R; Eberth, Jan M; Samson, Marsha E; Garcia-Dominic, Oralia; Lengerich, Eugene J; Schootman, Mario

    2016-02-04

    Although screening rates for colorectal cancer are increasing, 22 million Americans are not up-to-date with recommendations. People with diabetes are an important and rapidly growing group at increased risk for colorectal cancer. Screening status and predictors of being up-to-date on screening are largely unknown in this population. This study used logistic regression modeling and data from the 2012 Behavioral Risk Factor Surveillance System to examine the association between diabetes and colorectal cancer screening predictors with being up-to-date on colorectal cancer screening according to criteria of the US Preventive Services Task Force for adults aged 50 or older. State prevalence rates of up-to-date colorectal cancer screening were also calculated and mapped. The prevalence of being up-to-date with colorectal cancer screening for all respondents aged 50 or older was 65.6%; for respondents with diabetes, the rate was 69.2%. Respondents with diabetes were 22% more likely to be up-to-date on colorectal cancer screening than those without diabetes. Among those with diabetes, having a routine checkup within the previous year significantly increased the odds of being up-to-date on colorectal cancer screening (odds ratio, 1.90). Other factors such as age, income, education, race/ethnicity, insurance status, and history of cancer were also associated with up-to-date status. Regardless of diabetes status, people who had a routine checkup within the past year were more likely to be up-to-date than people who had not. Among people with diabetes, the duration between routine checkups may be of greater importance than the frequency of diabetes-related doctor visits. Continued efforts should be made to ensure that routine care visits occur regularly to address the preventive health needs of patients with and patients without diabetes.

  19. Prevalence, risk factors of human papillomavirus infection and papanicolaou smear pattern among women attending a tertiary health facility in south-west Nigeria

    Directory of Open Access Journals (Sweden)

    Olatunji Mathew Kolawole

    2015-12-01

    Full Text Available Aim: Cervical cancer amongst Nigerian women has been on the increase in the past decade, and is regarded as the second highest cause of cancer deaths among Nigerian women. This study was aimed at determining the prevalence, risk factors of HPV infection, and Papanicolaou smear pattern amongst a cohort of women attending the Gynaecology clinic of a tertiary health facility in Ido-Ekiti, South west Nigeria. Method: This was a cross-sectional study involving the screening of women between the ages of 15-64 years for cervical intraepithelial neoplasia using Papanicolaou smear staining technique and serological diagnosis using IgG enzyme linked immunosorbent assay kits. Respondents were selected through convenience sampling of subjects, while interviewer- administered questionnaire and clinical report form were also used to collect data, and data was analyzed using SPSS version 17. Results: Of the 200 blood samples examined for Human papillomavirus infection, 135 (67.5% were sero-positive while 65 (32.5% were sero-negative. For cervical cytology using Papanicolaou smear, 14 (7% were positive (had presence of cervical abnormality while 186 (93% were negative (had no cervical abnormality. Result showed a direct relationship between seropositivity, development of cervical intraepithelial neoplasia and Human papillomavirus infection. The risk factors for the development of HPV infection included age, type of marriage, parity, history of genital infection and tobacco usage. Non circumcision of male partner was also found to be a risk factor. Conclusion: The presence of abnormal cervical cytology and high level of serological positivity clearly showed why there is need for a holistic approach to the screening, vaccination methodologies and early detection of HPV infection in the country. [TAF Prev Med Bull 2015; 14(6.000: 453-459

  20. Novel screening metric for the identification of at-risk peripheral artery disease patients using administrative claims data.

    Science.gov (United States)

    Bali, Vishal; Yermilov, Irina; Coutts, Kayla; Legorreta, Antonio P

    2016-02-01

    Despite high morbidity and mortality associated with peripheral artery disease (PAD), it remains under-diagnosed and under-treated. The objective of this study was to develop a screening metric to identify undiagnosed patients at high risk of developing PAD using administrative data. Commercial claims data from 2010 to 2012 were utilized to develop and internally validate a PAD screening metric. Medicare data were used for external validation. The study population included adults, aged 30 years or older, with new cases of PAD identified using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis/procedure codes or the Healthcare Common Procedure Coding System (HCPCS) codes. Multivariate logistic regression was conducted to determine PAD risk factors used in the development of the screening metric for the identification of at-risk PAD patients. The cumulative incidence of PAD was 6.6%. Sex, age, congestive heart failure, hypertension, chronic renal insufficiency, stroke, diabetes, acute myocardial infarction, transient ischemic attack, hyperlipidemia, and angina were significant risk factors for PAD. A cut-off score of ⩾20 yielded sensitivity, specificity, positive predictive value, negative predictive value, and c-statistics of 83.5%, 60.0%, 12.8%, 98.1%, and 0.78, respectively. By identifying patients at high risk for developing PAD using only administrative data, the use of the current pre-screening metric could reduce the number of diagnostic tests, while still capturing those patients with undiagnosed PAD. © The Author(s) 2015.

  1. Risk of invasive cervical cancer after atypical glandular cells in cervical screening: nationwide cohort study

    Science.gov (United States)

    Andrae, Bengt; Sundström, Karin; Ström, Peter; Ploner, Alexander; Elfström, K Miriam; Arnheim-Dahlström, Lisen; Dillner, Joakim; Sparén, Pär

    2016-01-01

    Objectives To investigate the risks of invasive cervical cancer after detection of atypical glandular cells (AGC) during cervical screening. Design Nationwide population based cohort study. Setting Cancer and population registries in Sweden. Participants 3 054 328 women living in Sweden at any time between 1 January 1980 and 1 July 2011 who had any record of cervical cytological testing at ages 23-59. Of these, 2 899 968 women had normal cytology results at the first screening record. The first recorded abnormal result was atypical glandular cells (AGC) in 14 625, high grade squamous intraepithelial lesion (HSIL) in 65 633, and low grade squamous intraepithelial lesions (LSIL) in 244 168. Main outcome measures Cumulative incidence of invasive cervical cancer over 15.5 years; proportion of invasive cervical cancer within six months of abnormality (prevalence); crude incidence rates for invasive cervical cancer over 0.5-15.5 years of follow-up; incidence rate ratios compared with women with normal cytology, estimated with Poisson regression adjusted for age and stratified by histopathology of cancer; distribution of clinical assessment within six months after the abnormality. Results The prevalence of cervical cancer was 1.4% for women with AGC, which was lower than for women with HSIL (2.5%) but higher than for women with LSIL (0.2%); adenocarcinoma accounted for 73.2% of the prevalent cases associated with AGC. The incidence rate of invasive cervical cancer after AGC was significantly higher than for women with normal results on cytology for up to 15.5 years and higher than HSIL and LSIL for up to 6.5 years. The incidence rate of adenocarcinoma was 61 times higher than for women with normal results on cytology in the first screening round after AGC, and remained nine times higher for up to 15.5 years. Incidence and prevalence of invasive cervical cancer was highest when AGC was found at ages 30-39. Only 54% of women with AGC underwent histology assessment

  2. Facile synthesis of Prussian blue nanocubes/silver nanowires network as a water-based ink for the direct screen-printed flexible biosensor chips.

    Science.gov (United States)

    Yang, Pengqi; Peng, Jingmeng; Chu, Zhenyu; Jiang, Danfeng; Jin, Wanqin

    2017-06-15

    The large-scale fabrication of nanocomposite based biosensors is always a challenge in the technology commercialization from laboratory to industry. In order to address this issue, we have designed a facile chemical method of fabricated nanocomposite ink applied to the screen-printed biosensor chip. This ink can be derived in the water through the in-situ growth of Prussian blue nanocubes (PBNCs) on the silver nanowires (AgNWs) to construct a composite nanostructure by a facile chemical method. Then a miniature flexible biosensor chip was screen-printed by using the prepared nanocomposite ink. Due to the synergic effects of the large specific surface area, high conductivity and electrocatalytic activity from AgNWs and PBNCs, the as-prepared biosensor chip exhibited a fast response (biosensor chip exhibited excellent stability, good reproducibility and high anti-interference ability towards physiological substances under a very low working potential of -0.05. Hence, the proposed biosensor chip also showed a promising potential for the application in practical analysis.

  3. Impact of the maternal age-related risk in first-trimester combined screening for trisomy 21.

    Science.gov (United States)

    Abele, H; Lüthgens, K; Hoopmann, M; Kagan, K O

    2011-01-01

    To examine the impact of the maternal age-related risk in first-trimester combined screening for trisomy 21. Prospective assessment of risk for trisomy 21 by a combination of maternal age, fetal NT thickness and maternal serum PAPP-A and free β-hCG at 11+0 to 13+6 weeks of gestation between April 2002 and February 2007. Screening for trisomy 21 by patient-specific risks based on the maternal and gestational age-related risk multiplied by a likelihood ratio for NT and for maternal serum biochemistry were compared with a screening policy that is only based on the combined likelihood ratio for fetal NT and maternal serum biochemistry. The study population consisted of 38,603 euploid pregnancies and 109 fetuses with trisomy 21. In screening for trisomy 21 by fetal NT and maternal serum biochemistry in combination with and without maternal age with a fixed false-positive rate of 3%, the detection rate was 82.6 and 79.8%, respectively. In the group of women with a maternal age of less than 30 years and between 30 and 35 years, there was no difference in the detection rate. For women with a maternal age of 35 years or older, the detection rate increased from 77.1% without maternal age to 94.3% with maternal age, respectively. The overall difference between first-trimester screening based on fetal NT and maternal serum biochemistry with and without maternal age is about 3%. In screening with a fixed cut-off, the maternal age-related risk keeps the false-positive rate low in younger women and increases the detection rate in older women. 2011 S. Karger AG, Basel.

  4. Effect of Community Engagement Interventions on Patient Safety and Risk Reduction Efforts in Primary Health Facilities: Evidence from Ghana.

    Directory of Open Access Journals (Sweden)

    Robert Kaba Alhassan

    Full Text Available Patient safety and quality care remain major challenges to Ghana's healthcare system. Like many health systems in Africa, this is largely because demand for healthcare is outstripping available human and material resource capacity of healthcare facilities and new investment is insufficient. In the light of these demand and supply constraints, systematic community engagement (SCE in healthcare quality assessment can be a feasible and cost effective option to augment existing quality improvement interventions. SCE entails structured use of existing community groups to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements identified and rewards provided if the quality gaps are closed.This paper evaluates whether or not SCE, through the assessment of health service quality, improves patient safety and risk reduction efforts by staff in healthcare facilities.A randomized control trail was conducted in 64 primary healthcare facilities in the Greater Accra and Western regions of Ghana. Patient risk assessments were conducted in 32 randomly assigned intervention and control facilities. Multivariate multiple regression test was used to determine effect of the SCE interventions on staff efforts towards reducing patient risk. Spearman correlation test was used to ascertain associations between types of community groups engaged and risk assessment scores of healthcare facilities.Clinic staff efforts towards increasing patient safety and reducing risk improved significantly in intervention facilities especially in the areas of leadership/accountability (Coef. = 10.4, p<0.05 and staff competencies (Coef. = 7.1, p<0.05. Improvement in service utilization and health resources could not be attributed to the interventions because these were outside the control of the study and might have been influenced by institutional or national level developments between the baseline and follow-up period

  5. A globally applicable location-specific screening model for assessing the relative risk of pesticide leaching

    Energy Technology Data Exchange (ETDEWEB)

    Whelan, M.J. [Unilever Safety and Environmental Assurance Centre, Colworth House, Sharnbrook, Bedfordshire, MK44 1LQ (United Kingdom)]. E-mail: mick.whelan@unilever.com; Davenport, E.J. [Unilever Safety and Environmental Assurance Centre, Colworth House, Sharnbrook, Bedfordshire, MK44 1LQ (United Kingdom); Smith, B.G. [Unilever Sustainable Agriculture Team, Colworth House, Sharnbrook, Bedfordshire, MK44 1LQ (United Kingdom)

    2007-05-15

    A screening model of pesticide leaching loss is described which forms part of a multi-criteria risk-based indicator system called PRoMPT (Pesticide Risk Management and Profiling Tool). The leaching model evaluates pesticide fate in soil for any application rate and time of application (including multiple applications), for any land-based location in the world. It considers a generic evaluative environment with fixed dimensions and soil properties. The soil profile is conceptualised as a number of discrete layers. Equilibrium partitioning between adsorbed and dissolved chemical (based on the organic carbon-water partition coefficient [K {sub OC}]) is assumed in each time step, in each layer. Non-leaching losses are described using first order kinetics. Drainage is assumed to be uniform throughout the soil profile but varies temporally. The drainage rate, which can be augmented by evapotranspiration-adjusted irrigation, is derived from long-term mean monthly water balance model calculations performed for 30 arc-minute grid cells across the entire ice-free land surface of the earth. Although, such predictions are approximate, they do capture the seasonality and relative magnitude of drainage and allow the model to be applied anywhere, without the need for extensive data compilation. PRoMPT predictions are shown to be consistent with those made by more sophisticated models (PRZM, PELMO and PEARL) for the FOCUS groundwater scenarios.

  6. Characteristics of and risk factors for colorectal neoplasms in young adults in a screening population.

    Science.gov (United States)

    Lee, Seung Eun; Jo, Hee Bum; Kwack, Won Gun; Jeong, Yun Jin; Yoon, Yeo-Jin; Kang, Hyoun Woo

    2016-03-14

    To investigate prevalence and risk factors for colorectal neoplasms in adults aged colorectal and advanced adenomas in patients aged colorectal and advanced adenoma in young adults, we used multivariable logistic regression models. Colorectal neoplasm characteristics were evaluated and compared with those in older patients. Among 2819 patients included, prevalences of colorectal adenoma and advanced adenoma were 19.7% and 1.5%, respectively. As patient age increased, so did the prevalence of colorectal neoplasm. However, prevalence of advanced adenoma did not differ between age-groups 45-49 years and ≥ 50 years (OR = 0.43, 95%CI: 0.17-1.07, P = 0.070). In younger age-group (colorectal adenoma was significantly associated with older age, waist circumference (OR = 1.72, 95%CI: 1.15-2.55, P = 0.008), and current smoking (OR = 1.60, 95%CI: 1.07-2.41, P = 0.023). Alcohol consumption was an independent risk factor for colorectal advanced adenoma (OR = 3.69, 95%CI: 1.08-12.54, P = 0.037). Multiple neoplasms and large neoplasms (≥ 1 cm) were more prevalent in subjects ≥ 50 years. Current screening strategies for colorectal cancer may need to be amended to account for patient age, especially in young subjects with abdominal obesity, current smoking and alcohol consumption.

  7. Toxicity assessment through multiple endpoint bioassays in soils posing environmental risk according to regulatory screening values.

    Science.gov (United States)

    Rodriguez-Ruiz, A; Asensio, V; Zaldibar, B; Soto, M; Marigómez, I

    2014-01-01

    Toxicity profiles of two soils (a brownfield in Legazpi and an abandoned iron mine in Zugaztieta; Basque Country) contaminated with several metals (As, Zn, Pb and Cu in Legazpi; Zn, Pb, Cd and Cu in Zugaztieta) and petroleum hydrocarbons (in Legazpi) were determined using a multi-endpoint bioassay approach. Investigated soils exceeded screening values (SVs) of regulatory policies in force (Basque Country; Europe). Acute and chronic toxicity bioassays were conducted with a selected set of test species (Vibrio fischeri, Dictyostelium discoideum, Lactuca sativa, Raphanus sativus and Eisenia fetida) in combination with chemical analysis of soils and elutriates, as well as with bioaccumulation studies in earthworms. The sensitivity of the test species and the toxicity endpoints varied depending on the soil. It was concluded that whilst Zugaztieta soil showed very little or no toxicity, Legazpi soil was toxic according to almost all the toxicity tests (solid phase Microtox, D. discoideum inhibition of fruiting body formation and developmental cycle solid phase assays, lettuce seed germination and root elongation test, earthworm acute toxicity and reproduction tests, D. discoideum cell viability and replication elutriate assays). Thus, albeit both soils had similar SVs, their ecotoxicological risk, and therefore the need for intervening, was different for each soil as unveiled after toxicity profiling based on multiple endpoint bioassays. Such a toxicity profiling approach is suitable to be applied for scenario-targeted soil risk assessment in those cases where applicable national/regional soil legislation based on SVs demands further toxicity assessment.

  8. Screening-level human health risk assessment of toluene and dibutyl phthalate in nail lacquers.

    Science.gov (United States)

    Kopelovich, Luda; Perez, Angela L; Jacobs, Neva; Mendelsohn, Emma; Keenan, James J

    2015-07-01

    Toluene and dibutyl phthalate (DBP) are found in many consumer products, including cosmetics, synthetic fragrances, and nail polish. In 2012, the California Environmental Protection Agency evaluated 25 nail products and found that 83% of the products that claimed to be toluene-free contained toluene at concentrations ranging up to 190,000 ppm, and 14% of the products that claimed to be DBP-free contained DBP at concentrations ranging up to 88,000 ppm. We conducted a preliminary, screening-level analysis of the potential toluene and DBP-related health risks to consumers and professionals based on the medium and maximum concentrations of toluene and DBP presented in the 2012 report and evaluated dermal and inhalation exposure to a salon patron, nail technician, and home user. We concluded that the maximum toluene concentration for the technician and home user scenarios exceeded the California MADL, but the estimated air concentrations did not exceed the Federal or Cal OSHA PEL. The MADL for DBP was exceeded for all user scenarios at both the median and maximum concentrations. Using these highly conservative assumptions, exposures above regulatory limits could possibly occur during routine use of nail products; further research is needed in order to evaluate potential human health risks. Published by Elsevier Ltd.

  9. 78 FR 16705 - Llano Seco Riparian Sanctuary Unit Restoration and Pumping Plant/Fish Screen Facility Protection...

    Science.gov (United States)

    2013-03-18

    ... Street, Orland, CA 95963. Chico Branch Library, 1108 Sherman Avenue, Chico, CA 95926. CDFW Office, 629 Entler Ave, Suite 12, Chico, CA 95928. PCGID-PID Office, 258 South Butte Street, Willows, CA 95988... PCGID-PID consolidated three pumping plants into one new facility equipped with state-of-the-art fish...

  10. Compensation for risks: host community benefits in siting locally unwanted facilities

    Science.gov (United States)

    Himmelberger, Jeffery J.; Ratick, Samuel J.; White, Allen L.

    1991-09-01

    This article analyzes the recent negotiations connected with siting 24 solid-waste landfills in Wisconsin. We examine the association between the type and amount of compensation paid to host communities by facility developers and the size of facilities, certain facility characteristics, the timing of negotiated agreements, the size of the host community, and the socioeconomic status of the host area. Our findings suggest that the level of compensation after adjusting for landfill capacity is positively associated with the percentage of total facility capacity dedicated to host community use, positively associated with the percentage of people of the host area who are in poverty, and larger for public facilities that accept municipal wastes. Other explanatory variables we examined, whose association with levels of compensation proved statistically insignificant, were facility size, facility status (new vs expansion), facility use (countyonly vs multicounty), timing of negotiation, host community size, and the host area education level, population density, and per capita income. We discuss the policy implications of our principal findings and future research questions in light of the persistent opposition surrounding the siting of solid-waste and other waste-management facilities.

  11. 76 FR 20368 - Llano Seco Riparian Sanctuary Unit Restoration and Pumping Plant/Fish Screen Facility Protection...

    Science.gov (United States)

    2011-04-12

    ... Protection Project. FOR FURTHER INFORMATION CONTACT: Kelly Moroney, Refuge Manager, (530) 934-2801... Plant Protection Feasibility Study in August 2005 to identify alternatives that meet the PCGID-PID's pumping plant and fish screen protection objectives. In 2005, River Partners prepared a...

  12. Screening for adolescents' internalizing symptoms in primary care: item response theory analysis of the behavior health screen depression, anxiety, and suicidal risk scales.

    Science.gov (United States)

    Bevans, Katherine B; Diamond, Guy; Levy, Suzanne

    2012-05-01

    To apply a modern psychometric approach to validate the Behavioral Health Screen (BHS) Depression, Anxiety, and Suicidal Risk Scales among adolescents in primary care. Psychometric analyses were conducted using data collected from 426 adolescents aged 12 to 21 years (mean = 15.8, SD = 2.2). Rasch-Masters partial credit models were fit to the data to determine whether items supported the comprehensive measurement of internalizing symptoms with minimal gaps and redundancies. Scales were reduced to ensure that they measured singular dimensions of generalized anxiety, depressed affect, and suicidal risk both comprehensively and efficiently. Although gender bias was observed for some depression and anxiety items, differential item functioning did not impact overall subscale scores. Future revisions to the BHS should include additional items that assess low-level internalizing symptoms. The BHS is an accurate and efficient tool for identifying adolescents with internalizing symptoms in primary care settings. Access to psychometrically sound and cost-effective behavioral health screening tools is essential for meeting the increasing demands for adolescent behavioral health screening in primary/ambulatory care.

  13. Risk assessment of CST-7 proposed waste treatment and storage facilities Volume I: Limited-scope probabilistic risk assessment (PRA) of proposed CST-7 waste treatment & storage facilities. Volume II: Preliminary hazards analysis of proposed CST-7 waste storage & treatment facilities

    Energy Technology Data Exchange (ETDEWEB)

    Sasser, K.

    1994-06-01

    In FY 1993, the Los Alamos National Laboratory Waste Management Group [CST-7 (formerly EM-7)] requested the Probabilistic Risk and Hazards Analysis Group [TSA-11 (formerly N-6)] to conduct a study of the hazards associated with several CST-7 facilities. Among these facilities are the Hazardous Waste Treatment Facility (HWTF), the HWTF Drum Storage Building (DSB), and the Mixed Waste Receiving and Storage Facility (MWRSF), which are proposed for construction beginning in 1996. These facilities are needed to upgrade the Laboratory`s storage capability for hazardous and mixed wastes and to provide treatment capabilities for wastes in cases where offsite treatment is not available or desirable. These facilities will assist Los Alamos in complying with federal and state requlations.

  14. Screening Assessment of Potential Human-Health Risk from Future Natural-Gas Drilling Near Project Rulison in Western Colorado

    Energy Technology Data Exchange (ETDEWEB)

    Daniels Jeffrey I.,Chapman Jenny B.

    2012-01-01

    The Project Rulison underground nuclear test was conducted in 1969 at a depth of 8,400 ft in the Williams Fork Formation of the Piceance Basin, west-central Colorado (Figure 1). The U.S. Department of Energy Office of Legacy Management (LM) is the steward of the site. Their management is guided by data collected from past site investigations and current monitoring, and by the results of calculations of expected behavior of contaminants remaining in the deep subsurface. The purpose of this screening risk assessment is to evaluate possible health risks from current and future exposure to Rulison contaminants so the information can be factored into LM's stewardship decisions. For example, these risk assessment results can inform decisions regarding institutional controls at the site and appropriate monitoring of nearby natural-gas extraction activities. Specifically, the screening risk analysis can provide guidance for setting appropriate action levels for contaminant monitoring to ensure protection of human health.

  15. Nursing assessment of obstructive sleep apnea in hospitalised adults: a review of risk factors and screening tools.

    Science.gov (United States)

    Sheldon, Alison; Belan, Ingrid; Neill, Jane; Rowland, Sharn

    Obstructive sleep apnea (OSA) affects approximately 2-4% of the general population and may be more prevalent in obese adults. However, sleep apnea remains consistently under-diagnosed in the general population as well as in hospital wards. Nurse awareness of OSA during routine monitoring could allow specific observations of hospitalised adults to identify those at high risk and ensure appropriate referral. This integrative literature review analysed major risk factors for OSA and identified screening tools that nurses could utilise in hospital wards. The most important risk factors relevant to nursing practice in hospital settings were obesity, hypertension and sleep position. The most suitable screening tool was the Berlin Questionnaire, while there was some evidence to support measuring waist circumference. A nursing assessment flow chart was developed based on the literature reviewed. This paper highlights a role for nurses in recognising patients at risk of OSA and minimising complications in hospitalised adults.

  16. Environmental health-risk assessment for tritium releases from the National Tritium Labeling Facility (NTLF) at Lawrence Berkeley Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    McKone, T.E.; Brand, K.P.

    1994-12-01

    This report is a health risk assessment that addresses continuous releases of tritium to the environment from the National Tritium Labeling Facility (NTLF) at the Lawrence Berkeley Laboratory (LBL). The NTLF contributes approximately 95% of all tritium releases from LBL. Transport and transformation models were used to determine the movement of tritium releases from the NRLF to the air, surface water, soils, and plants and to determine the subsequent doses to humans. These models were calibrated against environmental measurements of tritium levels in the vicinity of the NTLF and in the surrounding community. Risk levels were determined for human populations in each of these zones. Risk levels to both individuals and populations were calculated. In this report population risks and individual risks were calculated for three types of diseases--cancer, heritable genetic effects, and developmental and reproductive effects.

  17. Are environmental risk estimations linked to the actual environmental impact? Application to an oil handling facility (NE Spain).

    Science.gov (United States)

    Valdor, Paloma F; Puente, Araceli; Gómez, Aina G; Ondiviela, Bárbara; Juanes, José A

    2017-01-30

    The environmental risk analysis of aquatic systems includes the evaluation of the likelihood that adverse ecological effects may occur as a result of exposure to one or more stressors. In harbor areas, pollution is provided by a complex mixture of substances with different levels of toxicity, persistence and bioaccumulation, which complicates the hazards characterization and their multiple effects. A study of the relationship between the environmental impact and the environmental risk assessment at a specific isolated oil handling facility was undertaken. The environmental risk of the oil handling facility, considering the consequences of specific pollutants, was estimated and the associated environmental impact was quantified based on a 'weights of evidence' approach. The contamination quantified at the potentially affected area around the monobuoy of Tarragona has proved to be related with environmental risk estimations but the lines of evidence obtained do not allow us to assert that the activity developed at this facility has an associated environmental impact. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Population-based screening for breast and ovarian cancer risk due to BRCA1 and BRCA2.

    Science.gov (United States)

    Gabai-Kapara, Efrat; Lahad, Amnon; Kaufman, Bella; Friedman, Eitan; Segev, Shlomo; Renbaum, Paul; Beeri, Rachel; Gal, Moran; Grinshpun-Cohen, Julia; Djemal, Karen; Mandell, Jessica B; Lee, Ming K; Beller, Uziel; Catane, Raphael; King, Mary-Claire; Levy-Lahad, Ephrat

    2014-09-30

    In the Ashkenazi Jewish (AJ) population of Israel, 11% of breast cancer and 40% of ovarian cancer are due to three inherited founder mutations in the cancer predisposition genes BRCA1 and BRCA2. For carriers of these mutations, risk-reducing salpingo-oophorectomy significantly reduces morbidity and mortality. Population screening for these mutations among AJ women may be justifiable if accurate estimates of cancer risk for mutation carriers can be obtained. We therefore undertook to determine risks of breast and ovarian cancer for BRCA1 and BRCA2 mutation carriers ascertained irrespective of personal or family history of cancer. Families harboring mutations in BRCA1 or BRCA2 were ascertained by identifying mutation carriers among healthy AJ males recruited from health screening centers and outpatient clinics. Female relatives of the carriers were then enrolled and genotyped. Among the female relatives with BRCA1 or BRCA2 mutations, cumulative risk of developing either breast or ovarian cancer by age 60 and 80, respectively, were 0.60 (± 0.07) and 0.83 (± 0.07) for BRCA1 carriers and 0.33 (± 0.09) and 0.76 (± 0.13) for BRCA2 carriers. Risks were higher in recent vs. earlier birth cohorts (P = 0.006). High cancer risks in BRCA1 or BRCA2 mutation carriers identified through healthy males provide an evidence base for initiating a general screening program in the AJ population. General screening would identify many carriers who are not evaluated by genetic testing based on family history criteria. Such a program could serve as a model to investigate implementation and outcomes of population screening for genetic predisposition to cancer in other populations.

  19. Risk assessment of cattle handling on pasture using work environment screening tool.

    Science.gov (United States)

    Geng, Qiuqing; Field, William E; Salomon, Eva

    2015-01-01

    Working with beef cattle in an open area or while on pasture has been shown to expose workers to a high risk of work-related injury. Prior research on this problem has been conducted using mail surveys, interviews, self-reporting of work practices and injury experiences, and summaries of published injury data, including media reports. Prior research on injury prevention has largely focused on worker education in a specific cultural or geographical setting. A pilot study was conducted to test the cross-cultural usability of the Working Environment Screening Tool in Agriculture (WEST-AG), a modification of the WEST, developed for Swedish industrial applications, to assess risk factors associated with farmers working with cattle being raised largely on pasture as compared with cattle raised in confined feeding operations. Swedish and English language versions of WEST-AG were developed and pilot-tested on a convenient sample of eight Swedish and eight Indiana farms that raise beef cattle primarily on pasture. On-site observations were conducted independently by Swedish and US agricultural safety professionals and documented using photography and a 15-risk-of-injury component on an 11-degree linear scale. Comparisons were made between independent observations documented from the Swedish and Indiana application of the WEST, including collective assessment of photographic record, and the results reported. Key findings included (a) a higher level of observed risks on Indiana farms studied as compared with their Swedish counterparts; (b) high levels of worker exposure to cattle, especially mature breeding bulls, on both sets of farms; (c) a higher frequency of self-reported farm-related injuries than anticipated on both Swedish and Indiana farms; (d) substantially different economic, social, cultural, and regulatory forces that influence small-operation Swedish and Indiana beef producers' decisions regarding adoption of safer work practices, including use of new and safer

  20. 24 CFR 35.1320 - Lead-based paint inspections, paint testing, risk assessments, lead-hazard screens, and...

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Lead-based paint inspections, paint testing, risk assessments, lead-hazard screens, and reevaluations. 35.1320 Section 35.1320 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development LEAD-BASED...

  1. Risk for poor outcomes in older patients discharged from an emergency department: feasibility of four screening instruments.

    NARCIS (Netherlands)

    Buurman, B.M.; Berg, W. van den; Korevaar, J.C.; Milisen, K.; Haan, R.J. de; Rooij, S.E. de

    2011-01-01

    Objectives: To compare the prognostic value of four screening instruments used to detect the risk for poor outcomes [in terms of likelihood of recurrent emergency department (ED) visits, hospitalizations, or mortality] for older patients discharged home from an ED in the Netherlands. Methods: This i

  2. Risk for poor outcomes in older patients discharged from an emergency department: feasibility of four screening instruments

    NARCIS (Netherlands)

    B.M. Buurman; W. van den Berg; J.C. Korevaar; K. Milisen; R.J. de Haan; S.E. de Rooij

    2011-01-01

    To compare the prognostic value of four screening instruments used to detect the risk for poor outcomes [in terms of likelihood of recurrent emergency department (ED) visits, hospitalizations, or mortality] for older patients discharged home from an ED in the Netherlands. This is a prospective cohor

  3. Hypertensive disorders of pregnancy and risk of screening positive for Posttraumatic Stress Disorder : A cross-sectional study

    NARCIS (Netherlands)

    Porcel, Jacqueline; Feigal, Christine; Poye, Laney; Postma, Ineke R.; Zeeman, Gerda G.; Olowoyeye, Abiola; Tsigas, Eleni; Wilson, Melissa

    2013-01-01

    Objectives: Hypertensive Disorders of Pregnancy (HDP) encompass a spectrum of disorders that affect 6-8% of US pregnancies. We aim to determine the impact of self-reported history of HDP as a risk factor for screening positive for Posttraumatic Stress Disorder (PTSD), which results from exposure to

  4. Risk of Fetal Loss Associated With Invasive Testing Following Combined First-Trimester Screening for Down Syndrome

    DEFF Research Database (Denmark)

    Wulff, C. B.; Gerds, T. A.; Rode, L.

    2016-01-01

    from being based on maternal age to combined first-trimester screening (cFTS) for trisomy 21. The aim of the study was to assess prospectively the risk of fetal loss associated with CVS and AC after cFTS for Down syndrome. A nationwide population-based study (Danish Fetal Medicine Database, 2008...

  5. Hypertensive disorders of pregnancy and risk of screening positive for Posttraumatic Stress Disorder : A cross-sectional study

    NARCIS (Netherlands)

    Porcel, Jacqueline; Feigal, Christine; Poye, Laney; Postma, Ineke R.; Zeeman, Gerda G.; Olowoyeye, Abiola; Tsigas, Eleni; Wilson, Melissa

    2013-01-01

    Objectives: Hypertensive Disorders of Pregnancy (HDP) encompass a spectrum of disorders that affect 6-8% of US pregnancies. We aim to determine the impact of self-reported history of HDP as a risk factor for screening positive for Posttraumatic Stress Disorder (PTSD), which results from exposure to

  6. Do the malnutrition universal screening tool (MUST and Birmingham nutrition risk (BNR score predict mortality in older hospitalised patients?

    Directory of Open Access Journals (Sweden)

    Lee Emma

    2008-10-01

    Full Text Available Abstract Background Undernutrition is common in older hospitalised patients, and routine screening is advocated. It is unclear whether screening tools such as the Birmingham Nutrition Risk (BNR score and the Malnutrition Universal Screening Tool (MUST can successfully predict outcome in this patient group. Methods Consecutive admissions to Medicine for the Elderly assessment wards in Dundee were assessed between mid-October 2003 and mid-January 2004. Body Mass Index (BMI, MUST and BNR scores were prospectively collected. Time to death was obtained from the Scottish Death Register and compared across strata of risk. Results 115 patients were analysed, mean age 82.1 years. 39/115 (34% were male. 20 patients were identified as high risk by both methods of screening. A further 10 were categorised high risk only with the Birmingham classification and 12 only with MUST. 80/115 (67% patients had died at the time of accessing death records. MUST category significantly predicted death (log rank test, p = 0.022. Neither BMI (log rank p = 0.37 or Birmingham nutrition score (log rank p = 0.35 predicted death. Conclusion The MUST score, but not the BNR, is able to predict increased mortality in older hospitalised patients.

  7. Reactions to a Targeted Intervention to Increase Fecal Occult Blood Testing among Average-Risk Adults Waiting for Screening Colonoscopy

    Directory of Open Access Journals (Sweden)

    S Elizabeth McGregor

    2011-01-01

    Full Text Available BACKGROUND: Increasing demand combined with limited capacity has resulted in long wait times for average-risk adults referred for screening colonoscopy for colorectal cancer. Management of patients on these growing wait lists is an emerging clinical issue.

  8. Comparison of the Validity of Four Fall-Related Psychological Measures in a Community-Based Falls Risk Screening

    Science.gov (United States)

    Moore, Delilah S.; Ellis, Rebecca; Kosma, Maria; Fabre, Jennifer M.; McCarter, Kevin S.; Wood, Robert H.

    2011-01-01

    We examined the measurement properties of fall-related psychological instruments with a sample of 133 older adults (M age = 74.4 years, SD = 9.4). Measures included the Comprehensive Falls Risk Screening Instrument, Falls-efficacy Scale-International (FES-I), Activities-specific Balance Confidence (ABC), modified Survey of Activities and Fear of…

  9. The risk of fetal loss associated with invasive testing following combined first trimester risk screening for Down syndrome - a national cohort of 147 987 singleton pregnancies

    DEFF Research Database (Denmark)

    Wulff, Camilla Bernt; Gerds, Thomas Alexander; Rode, Line

    2016-01-01

    OBJECTIVE: To assess prospectively the risk of fetal loss associated with chorionic villus sampling (CVS) and amniocentesis (AC) following combined first-trimester screening (cFTS) for Down syndrome. METHODS: This was a nationwide population-based study (Danish Fetal Medicine Database, 2008...

  10. Screening Household Members of Acute Brucellosis Cases in Endemic Areas and Risk Factors for Brucellosis.

    Science.gov (United States)

    Deniz, Secil; Baykam, Nurcan; Celikbas, Aysel; Yilmaz, Sirin Menekse; Guzel, Tugba Cirkin; Dokuzoguz, Basak; Ergonul, Onder

    2015-08-01

    Early diagnosis and treatment of acute brucellosis cases were targeted by screening the household members of the index cases. We also aimed to describe the causal relations of brucellosis in an endemic region. A cross-sectional study was performed among household members (29 index cases, 113 household members). Brucellosis was diagnosed on the basis of clinical findings, serum agglutinin titer of ≥1/160 in standard tube agglutination test (STA), or a positive blood culture. Index cases were defined as patients who had been admitted to the clinic on suspicion of brucellosis and then confirmed as brucellosis cases. The people who lived in the same house as the index cases were defined as household members. The risk factors for seropositivity were studied by multivariate analysis. Independent variables of gender, consuming fresh cheese, blood groups, dealing with husbandry, and contact with the placenta of infected animals were included to the model. Backward and forward selections were performed. Nineteen out of 113 (17%) screened individuals had agglutination titers ≥1/160. The mean ages of index cases and household members were 43 years (standard deviation [SD] 18) and 29 years (SD 19), respectively. In multivariate analysis, consuming fresh cheese (odds ratio [OR]=3.1, confidence interval [CI] 1.07-9.68, p=0.049), blood group A (OR=2.6, CI 1.18-5.96, p=0.018), contact with the placenta of the infected animals (OR=3.7, CI 1.42-9.68, p=0.007), and age >30 years (OR=2.8, CI 1.25-6.51, p=0.13) were found to be associated with brucellosis. In univariate analysis, the individuals with blood group B were protected from brucella infection (p=0.013). In conclusion, screening of the people in brucellosis-endemic areas should be considered for early diagnosis and treatment. To our knowledge, blood groups were studied for the first time by this study. Higher prevalence of brucellosis among the individuals with blood group A and less prevalence among the individuals with

  11. Risk of breast cancer after false-positive test results in screening mammography

    DEFF Research Database (Denmark)

    von Euler-Chelpin, My Catarina; Risør, Louise Madeleine; Thorsted, Brian Larsen

    2012-01-01

    Screening for disease in healthy people inevitably leads to some false-positive tests in disease-free individuals. Normally, women with false-positive screening tests for breast cancer are referred back to routine screening. However, the long-term outcome for women with false-positive tests is un...

  12. Family psychosocial risk screening guided by the Pediatric Psychosocial Preventative Health Model (PPPHM) using the Psychosocial Assessment Tool (PAT).

    Science.gov (United States)

    Kazak, Anne E; Schneider, Stephanie; Didonato, Stephen; Pai, Ahna L H

    2015-05-01

    Although families of children with cancer and other serious medical conditions have documented psychosocial needs, the systematic identification of needs and delivery of evidence-based care remain challenges. Screening for multifaceted family psychosocial risk is a means by which psychosocial treatment needs for pediatric patients and their families can be identified in an effective and inc