WorldWideScience

Sample records for high consequence risks

  1. The risk ogf high-risk jobs : psychological health consequences in forensic physicians and ambulance workers

    NARCIS (Netherlands)

    Ploeg, E. van der

    2003-01-01

    The risk of high-risk jobs: Psychological health consequences in forensic doctors and ambulance workers This thesis has shown that forensic physicians and ambulance personnel frequently suffer from psychological complaints as a result of dramatic events and sources of chronic work stress. A

  2. Women's Ways of Drinking: College Women, High-Risk Alcohol Use, and Negative Consequences

    Science.gov (United States)

    Smith, Margaret A.; Berger, Joseph B.

    2010-01-01

    The purpose of this study was to explore college women's high-risk alcohol use and related consequences. This study employed a qualitative approach to understand and provide visibility for a gender-related perspective on college women's alcohol experiences and related outcomes. Data were collected from interviews with 10 undergraduate females at a…

  3. Key drivers and economic consequences of high-end climate scenarios: uncertainties and risks

    DEFF Research Database (Denmark)

    Halsnæs, Kirsten; Kaspersen, Per Skougaard; Drews, Martin

    2015-01-01

    The consequences of high-end climate scenarios and the risks of extreme events involve a number of critical assumptions and methodological challenges related to key uncertainties in climate scenarios and modelling, impact analysis, and economics. A methodological framework for integrated analysis...... of extreme events increase beyond scaling, and in combination with economic assumptions we find a very wide range of risk estimates for urban precipitation events. A sensitivity analysis addresses 32 combinations of climate scenarios, damage cost curve approaches, and economic assumptions, including risk...... aversion and equity represented by discount rates. Major impacts of alternative assumptions are investigated. As a result, this study demonstrates that in terms of decision making the actual expectations concerning future climate scenarios and the economic assumptions applied are very important...

  4. Risk management & organizational uncertainty implications for the assessment of high consequence organizations

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, C.T.

    1995-02-23

    Post hoc analyses have demonstrated clearly that macro-system, organizational processes have played important roles in such major catastrophes as Three Mile Island, Bhopal, Exxon Valdez, Chernobyl, and Piper Alpha. How can managers of such high-consequence organizations as nuclear power plants and nuclear explosives handling facilities be sure that similar macro-system processes are not operating in their plants? To date, macro-system effects have not been integrated into risk assessments. Part of the reason for not using macro-system analyses to assess risk may be the impression that standard organizational measurement tools do not provide hard data that can be managed effectively. In this paper, I argue that organizational dimensions, like those in ISO 9000, can be quantified and integrated into standard risk assessments.

  5. Development of risk assessment simulation tool for optimal control of a low probability-high consequence disaster

    International Nuclear Information System (INIS)

    Yotsumoto, Hiroki; Yoshida, Kikuo; Genchi, Hiroshi

    2011-01-01

    In order to control low probability-high consequence disaster which causes huge social and economic damage, it is necessary to develop simultaneous risk assessment simulation tool based on the scheme of disaster risk including diverse effects of primary disaster and secondary damages. We propose the scheme of this risk simulation tool. (author)

  6. The external costs of low probability-high consequence events: Ex ante damages and lay risks

    International Nuclear Information System (INIS)

    Krupnick, A.J.; Markandya, A.; Nickell, E.

    1994-01-01

    This paper provides an analytical basis for characterizing key differences between two perspectives on how to estimate the expected damages of low probability - high consequence events. One perspective is the conventional method used in the U.S.-EC fuel cycle reports [e.g., ORNL/RFF (1994a,b]. This paper articulates another perspective, using economic theory. The paper makes a strong case for considering this, approach as an alternative, or at least as a complement, to the conventional approach. This alternative approach is an important area for future research. I Interest has been growing worldwide in embedding the external costs of productive activities, particularly the fuel cycles resulting in electricity generation, into prices. In any attempt to internalize these costs, one must take into account explicitly the remote but real possibilities of accidents and the wide gap between lay perceptions and expert assessments of such risks. In our fuel cycle analyses, we estimate damages and benefits' by simply monetizing expected consequences, based on pollution dispersion models, exposure-response functions, and valuation functions. For accidents, such as mining and transportation accidents, natural gas pipeline accidents, and oil barge accidents, we use historical data to estimate the rates of these accidents. For extremely severe accidents--such as severe nuclear reactor accidents and catastrophic oil tanker spills--events are extremely rare and they do not offer a sufficient sample size to estimate their probabilities based on past occurrences. In those cases the conventional approach is to rely on expert judgments about both the probability of the consequences and their magnitude. As an example of standard practice, which we term here an expert expected damage (EED) approach to estimating damages, consider how evacuation costs are estimated in the nuclear fuel cycle report

  7. The external costs of low probability-high consequence events: Ex ante damages and lay risks

    Energy Technology Data Exchange (ETDEWEB)

    Krupnick, A J; Markandya, A; Nickell, E

    1994-07-01

    This paper provides an analytical basis for characterizing key differences between two perspectives on how to estimate the expected damages of low probability - high consequence events. One perspective is the conventional method used in the U.S.-EC fuel cycle reports [e.g., ORNL/RFF (1994a,b]. This paper articulates another perspective, using economic theory. The paper makes a strong case for considering this, approach as an alternative, or at least as a complement, to the conventional approach. This alternative approach is an important area for future research. I Interest has been growing worldwide in embedding the external costs of productive activities, particularly the fuel cycles resulting in electricity generation, into prices. In any attempt to internalize these costs, one must take into account explicitly the remote but real possibilities of accidents and the wide gap between lay perceptions and expert assessments of such risks. In our fuel cycle analyses, we estimate damages and benefits' by simply monetizing expected consequences, based on pollution dispersion models, exposure-response functions, and valuation functions. For accidents, such as mining and transportation accidents, natural gas pipeline accidents, and oil barge accidents, we use historical data to estimate the rates of these accidents. For extremely severe accidents--such as severe nuclear reactor accidents and catastrophic oil tanker spills--events are extremely rare and they do not offer a sufficient sample size to estimate their probabilities based on past occurrences. In those cases the conventional approach is to rely on expert judgments about both the probability of the consequences and their magnitude. As an example of standard practice, which we term here an expert expected damage (EED) approach to estimating damages, consider how evacuation costs are estimated in the nuclear fuel cycle report.

  8. Risk-averse decision-making for civil infrastructure exposed to low-probability, high-consequence events

    International Nuclear Information System (INIS)

    Cha, Eun Jeong; Ellingwood, Bruce R.

    2012-01-01

    Quantitative analysis and assessment of risk to civil infrastructure has two components: probability of a potentially damaging event and consequence of damage, measured in terms of financial or human losses. Decision models that have been utilized during the past three decades take into account the probabilistic component rationally, but address decision-maker attitudes toward consequences and risk only to a limited degree. The application of models reflecting these attitudes to decisions involving low-probability, high-consequence events that may impact civil infrastructure requires a fundamental understanding of risk acceptance attitudes and how they affect individual and group choices. In particular, the phenomenon of risk aversion may be a significant factor in decisions for civil infrastructure exposed to low-probability events with severe consequences, such as earthquakes, hurricanes or floods. This paper utilizes cumulative prospect theory to investigate the role and characteristics of risk-aversion in assurance of structural safety.

  9. An examination of the consequences in high consequence operations

    Energy Technology Data Exchange (ETDEWEB)

    Spray, S.D.; Cooper, J.A.

    1996-06-01

    Traditional definitions of risk partition concern into the probability of occurrence and the consequence of the event. Most safety analyses focus on probabilistic assessment of an occurrence and the amount of some measurable result of the event, but the real meaning of the ``consequence`` partition is usually afforded less attention. In particular, acceptable social consequence (consequence accepted by the public) frequently differs significantly from the metrics commonly proposed by risk analysts. This paper addresses some of the important system development issues associated with consequences, focusing on ``high consequence operations safety.``

  10. Portal hypertension in children: High-risk varices, primary prophylaxis and consequences of bleeding.

    Science.gov (United States)

    Duché, Mathieu; Ducot, Béatrice; Ackermann, Oanez; Guérin, Florent; Jacquemin, Emmanuel; Bernard, Olivier

    2017-02-01

    Primary prophylaxis of bleeding is debated for children with portal hypertension because of the limited number of studies on its safety and efficacy, the lack of a known endoscopic pattern carrying a high-risk of bleeding for all causes, and the assumption that the mortality of a first bleed is low. We report our experience with these issues. From 1989 to 2014, we managed 1300 children with portal hypertension. Endoscopic features were recorded; high-risk varices were defined as: grade 3 esophageal varices, grade 2 varices with red wale markings, or gastric varices. Two hundred forty-six children bled spontaneously and 182 underwent primary prophylaxis. The results of primary prophylaxis were reviewed as well as bleed-free survival, overall survival and life-threatening complications of bleeding. High-risk varices were found in 96% of children who bled spontaneously and in 11% of children who did not bleed without primary prophylaxis (pportal hypertension. Life-threatening complications of bleeding were recorded in 19% of children with cirrhosis and high-risk varices who bled spontaneously. Ten-year probabilities of bleed-free survival after primary prophylaxis in children with high-risk varices were 96% and 72% for non-cirrhotic causes and cirrhosis respectively. Ten-year probabilities of overall survival after primary prophylaxis were 100% and 93% in children with non-cirrhotic causes and cirrhosis respectively. In children with portal hypertension, bleeding is linked to the high-risk endoscopic pattern reported here. Primary prophylaxis of bleeding based on this pattern is fairly effective and safe. In children with liver disease, the risk of bleeding from varices in the esophagus is linked to their large size, the presence of congestion on their surface and their expansion into the stomach but not to the child's age nor to the cause of portal hypertension. Prevention of the first bleed in children with high-risk varices can be achieved by surgery or endoscopic

  11. High Risk Behaviors in Marine Mammals: Linking Behavioral Responses to Anthropogenic Disturbance to Biological Consequences

    Science.gov (United States)

    2015-09-30

    1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. High Risk Behaviors in Marine Mammals : Linking...comprehensive evaluation of biological safety zones for diving marine mammals . In this way we intend to identify those marine mammal species or specific...improving the protection of marine mammals during naval operations. OBJECTIVES We are testing the hypothesis that extreme behaviors requiring

  12. High-risk versus low-risk football game weekends: differences in problem drinking and alcohol-related consequences on college campuses in the United States.

    Science.gov (United States)

    Champion, Heather; Blocker, Jill N; Buettner, Cynthia K; Martin, Barbara A; Parries, Maria; Mccoy, Thomas P; Mitra, Ananda; Andrews, David W; Rhodes, Scott D

    2009-01-01

    Collegiate football games provide multiple social opportunities for alcohol use by students over the course of the weekend. The goal of this study was to examine alcohol use and alcohol-related consequences on football game weekends to determine differences based on characteristics of the game. A random sample of students from two large, public universities in the United States completed a survey on the Sunday-Friday following a high-risk weekend (HRW, important, home game) and low-risk weekend (LRW, no home game or game of importance) (N = 3,238 total). The survey measured the number of days students drank (0-3) and got drunk (0-3) over the weekend and whether 1+ consequences were experienced due to one's own drinking (yes/no) and due to others' drinking (yes/no). Ordinal logistic regression analyses revealed greater odds of drinking alcohol (OR = 1.70, CI = 1.46-1.97) and getting drunk (OR = 1.49, CI = 1.27-1.76) on HRW versus LRW. Logistic regression analyses revealed greater odds of experiencing 1+ consequences as a result of one's own drinking (OR = 1.38, CI = 1.16-1.63) and experiencing 1+ consequences as a result of others' drinking (OR = 1.52, CI = 1.30-1.78) on HRW versus LRW. These findings suggest that additional prevention efforts aimed at reducing risky drinking are needed over HRW and have implications for campus administrators, law enforcement, and substance abuse program coordinators.

  13. Low-Probability High-Consequence (LPHC) Failure Events in Geologic Carbon Sequestration Pipelines and Wells: Framework for LPHC Risk Assessment Incorporating Spatial Variability of Risk

    Energy Technology Data Exchange (ETDEWEB)

    Oldenburg, Curtis M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Budnitz, Robert J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2016-08-31

    If Carbon dioxide Capture and Storage (CCS) is to be effective in mitigating climate change, it will need to be carried out on a very large scale. This will involve many thousands of miles of dedicated high-pressure pipelines in order to transport many millions of tonnes of CO2 annually, with the CO2 delivered to many thousands of wells that will inject the CO2 underground. The new CCS infrastructure could rival in size the current U.S. upstream natural gas pipeline and well infrastructure. This new infrastructure entails hazards for life, health, animals, the environment, and natural resources. Pipelines are known to rupture due to corrosion, from external forces such as impacts by vehicles or digging equipment, by defects in construction, or from the failure of valves and seals. Similarly, wells are vulnerable to catastrophic failure due to corrosion, cement degradation, or operational mistakes. While most accidents involving pipelines and wells will be minor, there is the inevitable possibility of accidents with very high consequences, especially to public health. The most important consequence of concern is CO2 release to the environment in concentrations sufficient to cause death by asphyxiation to nearby populations. Such accidents are thought to be very unlikely, but of course they cannot be excluded, even if major engineering effort is devoted (as it will be) to keeping their probability low and their consequences minimized. This project has developed a methodology for analyzing the risks of these rare but high-consequence accidents, using a step-by-step probabilistic methodology. A key difference between risks for pipelines and wells is that the former are spatially distributed along the pipe whereas the latter are confined to the vicinity of the well. Otherwise, the methodology we develop for risk assessment of pipeline and well failures is similar and provides an analysis both of the annual probabilities of

  14. Evaluation of consequences and risks in Slovenia

    International Nuclear Information System (INIS)

    Susnik, J.

    1996-01-01

    The paper describes the evaluation of nuclear power plant accident consequences and risks using probabilistic safety codes during the last 12 years at the J. Stefan Institute. They cover classic individual and population risk studies due to assumed potential severe accident scenarios, prediction and estimation of Chernobyl accident consequences, the optimization of emergency countermeasures at the Krsko site, where the 632 MWe Westinghouse PWR NPP went into commercial operation on January 1983, and the ranking of population risk within the public debate in connection with the civil initiative to close the NPP Krsko. We report on the initial use of the CRAC2 code in 1984 and later, when it was first applied for the study of population risk in the area of the second planned Slovenian-Croatian NPP for the Prevlaka site. The study was completed a few weeks before the Chernobyl accident in April 1986. Risk evaluation was also included in the analysis of nuclear safety at the NPP Krsko during the war for Slovenia's independence in 1991. We report on the (CRAC2) analyses of the Chernobyl accident: on initial estimation of the maximal potentially expected consequences in Slovenia, on the effect of the radioactive cloud rise on the consequences relatively close to the NPP; on the further research after the detailed information on the radioactivity release and on the air masses movement were published; then the cloud activity which moved towards Slovenia was assessed and the expected consequences along its path were calculated. As the calculated integral individual exposure to the I 131 inhalation and the ground Cs 137 contamination matched with the measurements in Ljubljana and with the UNSCEAR 1988 data, our reliance on the CRAC2 code and on its ancestors is high. We report on the analyses, performed by the CRAC2 code and since 1993 also by the PC COSYMA code, related to the countermeasure effects. The consequences studied were extended to late health effects. We analyzed

  15. Managing and understanding risk perception of surface leaks from CCS sites: risk assessment for emerging technologies and low-probability, high-consequence events

    Science.gov (United States)

    Augustin, C. M.

    2015-12-01

    Carbon capture and storage (CCS) has been suggested by the Intergovernmental Panel on Climate Change as a partial solution to the greenhouse gas emissions problem. As CCS has become mainstream, researchers have raised multiple risk assessment issues typical of emerging technologies. In our research, we examine issues occuring when stored carbon dioxide (CO2) migrates to the near-surface or surface. We believe that both the public misperception and the physical reality of potential environmental, health, and commercial impacts of leak events from such subsurface sites have prevented widespread adoption of CCS. This paper is presented in three parts; the first is an evaluation of the systemic risk of a CCS site CO2 leak and models indicating potential likelihood of a leakage event. As the likelihood of a CCS site leak is stochastic and nonlinear, we present several Bayesian simulations for leak events based on research done with other low-probability, high-consequence gaseous pollutant releases. Though we found a large, acute leak to be exceptionally rare, we demonstrate potential for a localized, chronic leak at a CCS site. To that end, we present the second piece of this paper. Using a combination of spatio-temporal models and reaction-path models, we demonstrate the interplay between leak migrations, material interactions, and atmospheric dispersion for leaks of various duration and volume. These leak-event scenarios have implications for human, environmental, and economic health; they also have a significant impact on implementation support. Public acceptance of CCS is essential for a national low-carbon future, and this is what we address in the final part of this paper. We demonstrate that CCS remains unknown to the general public in the United States. Despite its unknown state, we provide survey findings -analyzed in Slovic and Weber's 2002 framework - that show a high unknown, high dread risk perception of leaks from a CCS site. Secondary findings are a

  16. Perceived vulnerability moderates the relations between the use of protective behavioral strategies and alcohol use and consequences among high-risk young adults.

    Science.gov (United States)

    Garcia, Tracey A; Fairlie, Anne M; Litt, Dana M; Waldron, Katja A; Lewis, Melissa A

    2018-06-01

    Drinking protective behavioral strategies (PBS) have been associated with reductions in alcohol use and alcohol-related consequences in young adults. PBS subscales, Limiting/Stopping (LS), Manner of Drinking (MOD), and Serious Harm Reduction (SHR), have been examined in the literature; LS, MOD, and SHR have mixed support as protective factors. Understanding moderators between PBS and alcohol use and related consequences is an important development in PBS research in order to delineate when and for whom PBS use is effective in reducing harm from alcohol use. Perceptions of vulnerability to negative consequences, included in health-risk models, may be one such moderator. The current study examined whether two types of perceived vulnerability (perceived vulnerability when drinking; perceived vulnerability in uncomfortable/unfamiliar situations) moderated the relations between LS, MOD, SHR strategies and alcohol use and related negative consequences. High-risk young adults (N = 400; 53.75% female) recruited nationally completed measures of PBS, alcohol use and related consequences, and measures of perceived vulnerability. Findings demonstrated that perceived vulnerability when drinking moderated the relations between MOD strategies and alcohol use. The interactions between perceived vulnerability when drinking and PBS did not predict alcohol-related consequences. Perceived vulnerability in unfamiliar/uncomfortable social situations moderated relations between MOD strategies and both alcohol use and related negative consequences; no other significant interactions emerged. Across both perceived vulnerability types and MOD strategies, those with the highest levels of perceived vulnerability and who used MOD strategies the most had the greatest decrements in alcohol use and related negative consequences. Prevention and intervention implications are discussed. Copyright © 2018. Published by Elsevier Ltd.

  17. Assuring quality in high-consequence engineering

    Energy Technology Data Exchange (ETDEWEB)

    Hoover, Marcey L.; Kolb, Rachel R.

    2014-03-01

    In high-consequence engineering organizations, such as Sandia, quality assurance may be heavily dependent on staff competency. Competency-dependent quality assurance models are at risk when the environment changes, as it has with increasing attrition rates, budget and schedule cuts, and competing program priorities. Risks in Sandia's competency-dependent culture can be mitigated through changes to hiring, training, and customer engagement approaches to manage people, partners, and products. Sandia's technical quality engineering organization has been able to mitigate corporate-level risks by driving changes that benefit all departments, and in doing so has assured Sandia's commitment to excellence in high-consequence engineering and national service.

  18. Communicating Low-Probability High-Consequence Risk, Uncertainty and Expert Confidence: Induced Seismicity of Deep Geothermal Energy and Shale Gas.

    Science.gov (United States)

    Knoblauch, Theresa A K; Stauffacher, Michael; Trutnevyte, Evelina

    2018-04-01

    Subsurface energy activities entail the risk of induced seismicity including low-probability high-consequence (LPHC) events. For designing respective risk communication, the scientific literature lacks empirical evidence of how the public reacts to different written risk communication formats about such LPHC events and to related uncertainty or expert confidence. This study presents findings from an online experiment (N = 590) that empirically tested the public's responses to risk communication about induced seismicity and to different technology frames, namely deep geothermal energy (DGE) and shale gas (between-subject design). Three incrementally different formats of written risk communication were tested: (i) qualitative, (ii) qualitative and quantitative, and (iii) qualitative and quantitative with risk comparison. Respondents found the latter two the easiest to understand, the most exact, and liked them the most. Adding uncertainty and expert confidence statements made the risk communication less clear, less easy to understand and increased concern. Above all, the technology for which risks are communicated and its acceptance mattered strongly: respondents in the shale gas condition found the identical risk communication less trustworthy and more concerning than in the DGE conditions. They also liked the risk communication overall less. For practitioners in DGE or shale gas projects, the study shows that the public would appreciate efforts in describing LPHC risks with numbers and optionally risk comparisons. However, there seems to be a trade-off between aiming for transparency by disclosing uncertainty and limited expert confidence, and thereby decreasing clarity and increasing concern in the view of the public. © 2017 Society for Risk Analysis.

  19. Consequence Prioritization Process for Potential High Consequence Events (HCE)

    Energy Technology Data Exchange (ETDEWEB)

    Freeman, Sarah G. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-10-31

    This document describes the process for Consequence Prioritization, the first phase of the Consequence-Driven Cyber-Informed Engineering (CCE) framework. The primary goal of Consequence Prioritization is to identify potential disruptive events that would significantly inhibit an organization’s ability to provide the critical services and functions deemed fundamental to their business mission. These disruptive events, defined as High Consequence Events (HCE), include both events that have occurred or could be realized through an attack of critical infrastructure owner assets. While other efforts have been initiated to identify and mitigate disruptive events at the national security level, such as Presidential Policy Directive 41 (PPD-41), this process is intended to be used by individual organizations to evaluate events that fall below the threshold for a national security. Described another way, Consequence Prioritization considers threats greater than those addressable by standard cyber-hygiene and includes the consideration of events that go beyond a traditional continuity of operations (COOP) perspective. Finally, Consequence Prioritization is most successful when organizations adopt a multi-disciplinary approach, engaging both cyber security and engineering expertise, as in-depth engineering perspectives are required to recognize and characterize and mitigate HCEs. Figure 1 provides a high-level overview of the prioritization process.

  20. VOLCANIC RISK ASSESSMENT - PROBABILITY AND CONSEQUENCES

    International Nuclear Information System (INIS)

    G.A. Valentine; F.V. Perry; S. Dartevelle

    2005-01-01

    Risk is the product of the probability and consequences of an event. Both of these must be based upon sound science that integrates field data, experiments, and modeling, but must also be useful to decision makers who likely do not understand all aspects of the underlying science. We review a decision framework used in many fields such as performance assessment for hazardous and/or radioactive waste disposal sites that can serve to guide the volcanological community towards integrated risk assessment. In this framework the underlying scientific understanding of processes that affect probability and consequences drive the decision-level results, but in turn these results can drive focused research in areas that cause the greatest level of uncertainty at the decision level. We review two examples of the determination of volcanic event probability: (1) probability of a new volcano forming at the proposed Yucca Mountain radioactive waste repository, and (2) probability that a subsurface repository in Japan would be affected by the nearby formation of a new stratovolcano. We also provide examples of work on consequences of explosive eruptions, within the framework mentioned above. These include field-based studies aimed at providing data for ''closure'' of wall rock erosion terms in a conduit flow model, predictions of dynamic pressure and other variables related to damage by pyroclastic flow into underground structures, and vulnerability criteria for structures subjected to conditions of explosive eruption. Process models (e.g., multiphase flow) are important for testing the validity or relative importance of possible scenarios in a volcanic risk assessment. We show how time-dependent multiphase modeling of explosive ''eruption'' of basaltic magma into an open tunnel (drift) at the Yucca Mountain repository provides insight into proposed scenarios that include the development of secondary pathways to the Earth's surface. Addressing volcanic risk within a decision

  1. Magnitude and consequences of undertreatment of high-risk patients with non-ST segment elevation acute coronary syndromes: insights from the DESCARTES Registry.

    Science.gov (United States)

    Heras, M; Bueno, H; Bardají, A; Fernández-Ortiz, A; Martí, H; Marrugat, J

    2006-11-01

    To analyse intensity of treatment of high-risk patients with non-ST elevation acute coronary syndromes (NSTEACS) included in the DESCARTES (Descripción del Estado de los Sindromes Coronarios Agudos en un Registro Temporal Español) registry. Patients with NSTEACS (n = 1877) admitted to 45 randomly selected Spanish hospitals in April and May 2002 were studied. Patients with ST segment depression and troponin rise were considered high risk (n = 478) and were compared with non-high risk patients (n = 1399). 46.9% of high-risk patients versus 39.5% of non-high-risk patients underwent angiography (p = 0.005), 23.2% versus 18.8% (p = 0.038) underwent percutaneous revascularisation, and 24.9% versus 7.4% (p or = 4, 2-3 and or = 4 (OR 2.87, 95% CI 1.27 to 6.52, p = 0.012). Class I recommended treatments were underused in high-risk patients in the DESCARTES registry. This undertreatment was an independent predictor of death of patients with an acute coronary syndrome.

  2. Low-Incidence, High-Consequence Pathogens

    Centers for Disease Control (CDC) Podcasts

    2014-02-21

    Dr. Stephan Monroe, a deputy director at CDC, discusses the impact of low-incidence, high-consequence pathogens globally.  Created: 2/21/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 2/26/2014.

  3. Risks of accidents and their consequences

    International Nuclear Information System (INIS)

    Gauvenet, A.

    1977-01-01

    The idea of risk calls out both the probability of occurrence of a damageable event and the damage intensity. Probability calculus was originated in the 17th century; PASCAL, its initiator, immediately considered its application to everyday life. Presently two trends are to be observed: the former will apply probability calculus, and the game theory that follows, to decision-making in the technical, economical or management fields; the latter remains subjective, close to ancestral fears, hardly pervaded with the principles of risk rationalization. A number of original probabilitic studies have been devoted to the nuclear field showing that nuclear risks just as the collective risks experienced by man are lower than individual risks yet little considered by up-to-date mass media. It is desirable that society should be clearly aware of these problems. Such a long-term problem goes through youth education and public information [fr

  4. Sexting: definition, risk factors and consequences

    OpenAIRE

    Mercado Contreras, Cinthia Tomasa; Pedraza Cabrera, Francisco Javier; Martínez Martínez, Kalina Isela

    2016-01-01

    [EN] The advance of the technology in communications has led to social networking sites fulfill an important role in society. Among the most used and known is Facebook, that social network allows to make public certain information and provides the opportunity to hold private conversations. This new trend of talks, and the natural desire to explore sexuality has led young people interested at phenomenon known as sexting. This phenomenon, from some of the negative consequences be...

  5. Iatrogenic disease in the elderly: risk factors, consequences, and prevention

    Directory of Open Access Journals (Sweden)

    Sompol Permpongkosol

    2011-03-01

    Full Text Available Sompol PermpongkosolDivision of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandAbstract: The epidemiology of iatrogenic disease in the elderly has not been extensively reported. Risk factors of iatrogenic disease in the elderly are drug-induced iatrogenic disease, multiple chronic diseases, multiple physicians, hospitalization, and medical or surgical procedures. Iatrogenic disease can have a great psychomotor impact and important social consequences. To identify patients at high risk is the first step in prevention as most of the iatrogenic diseases are preventable. Interventions that can prevent iatrogenic complications include specific interventions, the use of a geriatric interdisciplinary team, pharmacist consultation and acute care for the elderly units.Keywords: iatrogenic disease, elderly, risk factors, prevention

  6. Achieving strategic surety for high consequence software

    Energy Technology Data Exchange (ETDEWEB)

    Pollock, G.M.

    1996-09-01

    A strategic surety roadmap for high consequence software systems under the High Integrity Software (HIS) Program at Sandia National Laboratories guides research in identifying methodologies to improve software surety. Selected research tracks within this roadmap are identified and described detailing current technology and outlining advancements to be pursued over the coming decade to reach HIS goals. The tracks discussed herein focus on Correctness by Design, and System Immunology{trademark}. Specific projects are discussed with greater detail given on projects involving Correct Specification via Visualization, Synthesis, & Analysis; Visualization of Abstract Objects; and Correct Implementation of Components.

  7. A risk standard based on societal cost with bounded consequences

    International Nuclear Information System (INIS)

    Worledge, D.H.

    1982-01-01

    A risk standard is proposed that relates the frequency of occurrence of single events to the consequences of the events. Maximum consequences and risk aversion are used to give the cumulative risk curve a shape similar to the results of a risk assessment and to bound the expectation of deaths. Societal costs in terms of deaths are used to fix the parameters of the model together with an approximate comparison with individual risks. The proposed standard is compared with some practical applications of risk assessment to nuclear reactor systems

  8. Simulation of high consequence areas for gas pipelines

    OpenAIRE

    Orlando Díaz-Parra; Enrique Vera-López

    2018-01-01

    The gas pipeline is used for the transport of natural gas at a great distance. Risks derived from the handling of a combustible material transported under high pressure, by pipelines that pass close to where people live, makes it necessary to adopt prevention, mitigation and control measures to reduce the effect in case of ignition of a gas leak. This work shows the development of a new mathematical model to determine areas of high consequence and their application, using widely available and...

  9. Drink driving - Why risk the consequences?

    CERN Multimedia

    2004-01-01

    In the second of the series of articles about alcohol, CERN is highlighting the dangers of drinking and driving. Have you ever driven after drinking alcohol? If you did, then you were more likely to be involved in an accident that could kill or injure yourself or other people. Why risk it? Any alcohol can impair driving ability. The risk of being in an accident rises significantly after alcohol is consumed: at the French legal limit of 0.5 grams of alcohol per litre of blood, a driver is twice as likely to have an accident as someone who has had no alcohol. At the Swiss legal limit of 0.8 g/l, a driver is five times more likely to be involved in an accident. Many EU countries share the French limit. Penalties for breaking the law vary depending on the severity of the offence, but they include disqualification, fines and imprisonment. Drink Drive Limits and Penalties in the European Union Country Limit g/l Prison Sentence (maximum) Austria 0,5 up to 3 months / 3 years (if fatal) Belgiu...

  10. Biological consequences of radiation: risk factors

    International Nuclear Information System (INIS)

    1985-01-01

    This publication is a syllabus of a course on Radiation Protection. The publication offers an overview of the biological radiation effects at cellular level. For that purpose, different forms of cancers and their incidence are first discussed; structure and functioning of normal cells are considered and an introduction in genetics is given. Finally, an overview is presented of the character of tissue damage after high-dose irradiation. (G.J.P.)

  11. Dynamical tendencies of health consequences caused by competitive risk factors

    International Nuclear Information System (INIS)

    Bykov, A.A.; Pronina, I.A.; Kudriavtsev, G.I.

    2000-01-01

    The paper deals with the generalized probabilistic approach for analyzing health consequences caused by various exposure factors. Formally basing on the competitive risk theory, it is introduced a general risk model for analysis the influence of environmental risk factors to human health. The usefulness of the model approach is in the opportunity of taking into account: time delay of impact and consequence manifestation; easy comparisons of exposure factors with different nature and various consequences (morbidity and mortality, carcinogenic and genetic); social and environmental components in overall mortality. Preliminary examples of comparative risk analysis are demonstrated on the Russian demography and environmental data with the attempt of characterizing the dynamical tendencies and evolution of introduced risk index. The prospects of the probabilistic approach and the results obtaining on this basis are discussed. (author)

  12. Falls in institutionalized older adults: risks, consequences and antecedents

    OpenAIRE

    Araújo Neto, Antonio Herculano de; Patrício, Anna Cláudia Freire de Araújo; Ferreira, Milenna Azevedo Minhaqui; Rodrigues, Brenda Feitosa Lopes; Santos, Thayná Dias dos; Rodrigues, Thays Domingos de Brito; Silva, Richardson Augusto Rosendo da

    2017-01-01

    ABSTRACT Objective: To analyze the occurrence of falls in institutionalized elderly addressing the risks, consequences and antecedents. Method: Cross-sectional study carried out with 45 older adults in Long-Term Care Facilities for the Older adult in João Pessoa, Brazil, in June and July 2016. A socio-demographic questionnaire and the Berg Balance Scale were applied, classifying as risk of fall scores lower than 45. Descriptive statistics and tests were conducted: independent t-test, Anova ...

  13. Crises communication practices and their consequences for risk communication

    DEFF Research Database (Denmark)

    Andersen, Nina Blom

    Title of paper: Crisis communication practices and their consequences for risk communication   There is a close coverage of disasters in modern western societies in the media. And there is a growing expectation that authorities handle the tasks of crisis communication in certain ways.   The first...... aim of this paper is to show, that the communication practices about the consequences of a disaster tend to focus on the individual citizen’s situation, and include the psychological consequences and suffering to a large degree. At least for a while. Then the debates and discussions about the event...... change from concern and care about the people affected towards discussions about e.g. cause, responsibility or even guilt.   The second aim of the paper is to discuss other ways for a society to come to terms with risks that leads to disastrous situations than through the topics mentioned above...

  14. Crises communication practices and their consequences for risk communication

    DEFF Research Database (Denmark)

    Andersen, Nina Blom

    2016-01-01

    Title of paper: Crisis communication practices and their consequences for risk communication There is a close coverage of disasters in modern western societies in the media. And there is a growing expectation that authorities handle the tasks of crisis communication in certain ways. The first aim...... of this paper is to show, that the communication practices about the consequences of a disaster tend to focus on the individual citizen?s situation, and include the psychological consequences and suffering to a large degree. At least for a while. Then the debates and discussions about the event change from...... concern and care about the people affected towards discussions about e.g. cause, responsibility or even guilt. The second aim of the paper is to discuss other ways for a society to come to terms with risks that leads to disastrous situations than through the topics mentioned above, and as well how...

  15. Simulation of high consequence areas for gas pipelines

    Directory of Open Access Journals (Sweden)

    Orlando Díaz-Parra

    2018-01-01

    Full Text Available The gas pipeline is used for the transport of natural gas at a great distance. Risks derived from the handling of a combustible material transported under high pressure, by pipelines that pass close to where people live, makes it necessary to adopt prevention, mitigation and control measures to reduce the effect in case of ignition of a gas leak. This work shows the development of a new mathematical model to determine areas of high consequence and their application, using widely available and easy to use software, such as Google Earth and Excel, to determine and visualize the area up to which the level of radiation can affect the integrity of people and buildings. The model takes into account the pressure drop into the gas pipeline from the compression station, the gas leakage rate and possible forms of gas ignition. This development is an alternative to the use of specialized software and highly trained personnel. The simulation is applied to a traced of the Miraflores-Tunja gas pipeline, using a macro developed in Excel to determine the impact area and compare it with the coordinates of the vulnerable areas. The zones where these areas intersect are constituted in high consequence areas and are identified along with the sections of the pipeline that affect them, to provide the operator with a risk analysis tool for the determination and visualization of the gas pipeline and its environment.

  16. Climatic change in Germany. Development, consequences, risks and perspectives

    International Nuclear Information System (INIS)

    Brasseur, Guy; Jacob, Daniela; Schuck-Zoeller, Susanne

    2017-01-01

    The book on the climatic change in Germany includes contributions to the following issues: global climate projections and regional projections in Germany and Europe: observation of the climatic change in Central Europe, regional climate modeling, limits and challenges of the regional climate modeling; climatic change in Germany - regional features and extremes: temperature and heat waves, precipitation, wind and cyclones, sea-level increase, tides, storm floods and sea state, floods, definition uncertainties, draughts, forest fires, natural risks; consequences of the climatic change in Germany: air quality, health, biodiversity, water resources, biochemical cycles, agriculture, forestry, soils, personal and commercial transport, cities and urban regions, tourism, infrastructure, energy and water supplies, cost of the climatic change and economic consequences; overall risks and uncertainties: assessment of vulnerabilities, literature review, climatic change as risk enhancement in complex systems, overall risks and uncertainties, decision making under uncertainties in complex systems; integrated strategies for the adaptation to the climatic change: the climate resilient society - transformations and system changes, adaptation to the climatic change as new political field, options for adaptation strategies.

  17. Aspects of risk analysis application to estimation of nuclear accidents and tests consequences and intervention management

    International Nuclear Information System (INIS)

    Demin, V.F.; Hedemann-Jensen, P.; Rolevich, I.V.; Schneider, T.S.; Sobolev, B.G.

    1996-01-01

    For assessment of accident consequences and a post-accident management a risk analysis methodology and data bank (BARD) with allowance for radiation and non-radiation risk causes should be developed and used. Aspects of these needs and developments are considered. Some illustrative results of health risk estimation made with BARD for the Bryansk region territory with relatively high radioactive contamination from the Chernobyl accident are presented

  18. Falls in institutionalized older adults: risks, consequences and antecedents

    Directory of Open Access Journals (Sweden)

    Antonio Herculano de Araújo Neto

    Full Text Available ABSTRACT Objective: To analyze the occurrence of falls in institutionalized elderly addressing the risks, consequences and antecedents. Method: Cross-sectional study carried out with 45 older adults in Long-Term Care Facilities for the Older adult in João Pessoa, Brazil, in June and July 2016. A socio-demographic questionnaire and the Berg Balance Scale were applied, classifying as risk of fall scores lower than 45. Descriptive statistics and tests were conducted: independent t-test, Anova (Tukey, Chi-square, Mann Whitney. Statistically significance was p <0.05. Data were processed in SPSS version 19.0. Results: A total of 66.7% (30 falls occurred, 20% (9 of them in the external area, with 66.7% (30 of the participants having hypertension as a previous disease and, as consequence, the fracture was highlighted with 11.2% (5. The Berg Scale had different scores when compared to the falls suffered by the elderly and previous diseases influenced the occurrence of falls (p <0.05. Conclusion: It is necessary to implement public financing policies or partnerships that allow environments adaptations aiming at reducing the risks of falls.

  19. Assessing Vulnerabilities, Risks, and Consequences of Damage to Critical Infrastructure

    International Nuclear Information System (INIS)

    Suski, N.; Wuest, C.

    2011-01-01

    Since the publication of 'Critical Foundations: Protecting America's Infrastructure,' there has been a keen understanding of the complexity, interdependencies, and shared responsibility required to protect the nation's most critical assets that are essential to our way of life. The original 5 sectors defined in 1997 have grown to 18 Critical Infrastructures and Key Resources (CIKR), which are discussed in the 2009 National Infrastructure Protection Plan (NIPP) and its supporting sector-specific plans. The NIPP provides the structure for a national program dedicated to enhanced protection and resiliency of the nation's infrastructure. Lawrence Livermore National Laboratory (LLNL) provides in-depth, multi-disciplinary assessments of threat, vulnerability, and consequence across all 18 sectors at scales ranging from specific facilities to infrastructures spanning multi-state regions, such as the Oil and Natural Gas (ONG) sector. Like many of the CIKR sectors, the ONG sector is comprised of production, processing, distribution, and storage of highly valuable and potentially dangerous commodities. Furthermore, there are significant interdependencies with other sectors, including transportation, communication, finance, and government. Understanding the potentially devastating consequences and collateral damage resulting from a terrorist attack or natural event is an important element of LLNL's infrastructure security programs. Our work began in the energy sector in the late 1990s and quickly expanded other critical infrastructure sectors. We have performed over 600 physical assessments with a particular emphasis on those sectors that utilize, store, or ship potentially hazardous materials and for whom cyber security is important. The success of our approach is based on building awareness of vulnerabilities and risks and working directly with industry partners to collectively advance infrastructure protection. This approach consists of three phases: The Pre

  20. High-consequence analysis, evaluation, and application of select criteria

    International Nuclear Information System (INIS)

    Gutmanis, I.; Jaksch, J.A.

    1984-01-01

    A number of characteristics distinguish environmental risk from pollution problems. The characteristics make environmental risk problems harder to manage through existing regulatory, legal, and economic institutions. Hence, technologies involving environmental risk impose on society extremely difficult collective decisions. This paper is concerned with the process of reaching social decisions that involve low-probability, high-consequence outcomes. It is divided into five major parts. Part I contains the introduction. Part II reviews the two main classes of criteria that have been proposed for social decisions: approaches based on market mechanisms and their extension, and approaches associated with Rawls and Buchanan, which not only focus on outcomes, but also impose a set of minimal constraints on the process for reaching decisions and social consensus. Part III proposes a set of eight criteria for evaluating social decision processes. In Parts IV and V we investigate applying the criteria to two case studies -- one on nuclear waste disposal and the other on transportation of liquefied natural gas

  1. Falls in institutionalized older adults: risks, consequences and antecedents.

    Science.gov (United States)

    Araújo, Antonio Herculano de; Patrício, Anna Cláudia Freire de Araújo; Ferreira, Milenna Azevedo Minhaqui; Rodrigues, Brenda Feitosa Lopes; Santos, Thayná Dias Dos; Rodrigues, Thays Domingos de Brito; Silva, Richardson Augusto Rosendo da

    2017-01-01

    To analyze the occurrence of falls in institutionalized elderly addressing the risks, consequences and antecedents. Cross-sectional study carried out with 45 older adults in Long-Term Care Facilities for the Older adult in João Pessoa, Brazil, in June and July 2016. A socio-demographic questionnaire and the Berg Balance Scale were applied, classifying as risk of fall scores lower than 45. Descriptive statistics and tests were conducted: independent t-test, Anova (Tukey), Chi-square, Mann Whitney. Statistically significance was p falls occurred, 20% (9) of them in the external area, with 66.7% (30) of the participants having hypertension as a previous disease and, as consequence, the fracture was highlighted with 11.2% (5). The Berg Scale had different scores when compared to the falls suffered by the elderly and previous diseases influenced the occurrence of falls (p risks of falls. Analisar a ocorrência de quedas em idosos institucionalizados quanto aos riscos, consequências e antecedentes. Estudo transversal, realizado com 45 idosos em Instituições de Longa Permanência para Idosos em João Pessoa/PB, Brasil, em junho e julho de 2016. Aplicou-se questionário sociodemográfico e Escala de Equilíbrio de Berg classificando risco de quedas quando escore inferior a 45. Realizou-se estatística descritiva e testes: t independente, Anova (Tukey), Qui-quadrado, Mann Whitney. Considerado significativamente estatístico p < 0,05 e processados no SPSS versão 19.0. As quedas ocorreram em 66,7% (30), sendo 20% (9) na área externa, 66,7% (30) com doença prévia hipertensão e como consequência destacou-se fratura com 11,2% (5). A Escala de Berg avaliou pontuações diferentes (p < 0,05) quando comparadas às quedas sofridas pelos idosos, e as doenças prévias influenciaram ocorrência de quedas (p < 0,05). Necessita-se implementar políticas públicas de financiamento ou parcerias que possibilitem adaptação dos ambientes visando a redução dos riscos de quedas.

  2. High-Risk List

    Science.gov (United States)

    2017-01-01

    economy. The World Bank has said that “corruption creates an unfavorable business environment by undermining the operation efficiency of firms and... Bank Began as ‘Ponzi Scheme,’” 11/27/2012. 64 Independent Joint Anti-Corruption Monitoring and Evaluation Committee, Unfinished Business : The Follow...HIGH RISK AREA 7: Oversight 51 HIGH-RISK AREA 8: Strategy and Planning 55 CONCLUSION HIGH RISK LIST I JANUARY 11, 2017 2 EXECUTIVE SUMMARY

  3. Consequences of Erika's wreckage. Risks, environment, society, rehabilitation

    International Nuclear Information System (INIS)

    Beurier, J.; Pouchus, Y.

    2005-01-01

    On December 12, 1999, the wreckage of the Erika tanker ship led to a huge oil spill along the western coast of France. Important means were implemented to fight against the oil pollution and important research means were mobilized by the university of Nantes to establish a medium and long-term diagnosis and status of the consequences of the wreckage on the coastal environments, on the fauna and flora, on men and on the society. A colloquium was organized on January 23-25, 2002, at the university of medicine and pharmacy of Nantes, to present the results of these studies. This book summarizes the content of the presentations given at this colloquium: past experiences, risks and environment (basic data, impacts of petroleum and of hydrocarbons treatment on the coastal environment), problem of the reference state of environments: what should be protected and according to what scientific argument?, risks and society (economic aspects, risks and warranties, experience feedback, rehabilitation approach at the Guerande peninsula). (J.S.)

  4. Nuclear installations abroad the accident risks and their potential consequences

    International Nuclear Information System (INIS)

    Turvey, F.J.

    1996-01-01

    This paper endeavors to assess the threat to Ireland from severe accidents at civil nuclear installations. Among the various types of nuclear installations worldwide, reactors and reprocessing plants are considered to be the most threatening and so the paper focuses on these. The threat is assumed to be a function of the risk of severe accidents at the above types of installations and the probability of unfavourable weather conditions carrying the radioactive releases to Ireland. Although nuclear installations designed in eastern Europe and Asia are less safe than others, the greatest threat to Ireland arises from nearby installations in the UK. The difficulty of measuring the probabilities and consequences of severe nuclear accidents at nuclear installations in general is explained. In the case of the UK installations, this difficulty is overcome to some degree by using values of 'tolerable' risk adopted by the national nuclear regulator to define the radiotoxic releases from nuclear accidents. These are used as input to atmospheric dispersion models in which unfavourable weather conditions for Ireland are assumed and radiation doses are calculated to members of the Irish public. No countermeasures, such as sheltering, are assumed. In the worst cast scenario no deaths would be expected in Ireland in the immediate aftermath of the accident however, an increase in cancers over a period of 25 years or so would be expected assuming present-day models for the effect of low level radiation are valid

  5. Nuclear installations abroad the accident risks and their potential consequences

    Energy Technology Data Exchange (ETDEWEB)

    Turvey, F J [Radiological Protection Inst. of Ireland (Ireland)

    1996-10-01

    This paper endeavors to assess the threat to Ireland from severe accidents at civil nuclear installations. Among the various types of nuclear installations worldwide, reactors and reprocessing plants are considered to be the most threatening and so the paper focuses on these. The threat is assumed to be a function of the risk of severe accidents at the above types of installations and the probability of unfavourable weather conditions carrying the radioactive releases to Ireland. Although nuclear installations designed in eastern Europe and Asia are less safe than others, the greatest threat to Ireland arises from nearby installations in the UK. The difficulty of measuring the probabilities and consequences of severe nuclear accidents at nuclear installations in general is explained. In the case of the UK installations, this difficulty is overcome to some degree by using values of `tolerable` risk adopted by the national nuclear regulator to define the radiotoxic releases from nuclear accidents. These are used as input to atmospheric dispersion models in which unfavourable weather conditions for Ireland are assumed and radiation doses are calculated to members of the Irish public. No countermeasures, such as sheltering, are assumed. In the worst cast scenario no deaths would be expected in Ireland in the immediate aftermath of the accident however, an increase in cancers over a period of 25 years or so would be expected assuming present-day models for the effect of low level radiation are valid.

  6. Incidental Parathyroidectomy during Total Thyroidectomy: Risk Factors and Consequences

    Directory of Open Access Journals (Sweden)

    Dimitrios K. Manatakis

    2016-01-01

    Full Text Available Objective. To evaluate the incidence of accidental parathyroidectomy in our series of total thyroidectomies, to investigate its clinical and biochemical consequences, and to identify potential risk factors. Methods. Patients who underwent total thyroidectomy between January 2006 and December 2015 were retrospectively analyzed. Pathology reports were reviewed to identify those cases who had an incidental parathyroidectomy and these were compared to patients with no parathyroidectomy, in terms of clinical (age, sex, and symptoms of hypocalcemia, pathological (thyroid specimen weight, Hashimoto thyroiditis, and malignancy, and biochemical (serum calcium and phosphate levels factors. Results. 281 patients underwent total thyroidectomy during the study period. Incidental parathyroidectomy was noticed in 24.9% of cases, with 44.3% of parathyroid glands found in an intrathyroidal location. Evidence of postoperative biochemical hypocalcemia was noticed in 28.6% of patients with parathyroidectomy, compared with 13.3% in the no-parathyroidectomy group (p=0.003. Symptomatic hypocalcemia was observed in 5.7% and 3.8%, respectively (p=0.49. Age, sex, thyroid specimen weight, Hashimoto thyroiditis, and malignancy did not differ significantly between the two groups. Conclusions. Our study found an association of incidental parathyroidectomy with transient postoperative biochemical hypocalcemia, but not with clinically symptomatic disease. Age, sex, thyroid gland weight, Hashimoto thyroiditis, and malignancy were not identified as risk factors.

  7. A strategic surety roadmap for high consequence software

    Energy Technology Data Exchange (ETDEWEB)

    Pollock, G.M.; Dalton, L.J.

    1995-12-31

    A strategic surety roadmap for high consequence software systems developed under the High Integrity Software (HIS) Program at Sandia National Laboratories is presented. Selected research tracks are identified and described detailing current technology and outlining advancements to be pursued over the coming decade to reach HIS goals.

  8. Being an 'adolescent': The consequences of gendered risks for young people in rural Uganda.

    Science.gov (United States)

    Bernays, Sarah; Bukenya, Dominic; Thompson, Claire; Ssembajja, Fatuma; Seeley, Janet

    2018-02-01

    The behaviour of adolescents is recognised increasingly as having substantial and long-term consequences for their health. We examined the meaning of 'adolescence' in southern Uganda with HIV-positive young people aged 11-24 years. Adolescent girls and boys are described differently in the local language (Luganda). Adolescence is described as a behavioural rather than a life course category and an inherently dangerous one. The practices, risks and consequences of 'adolescent' behaviour are highly gendered. Local understandings of adolescence are likely to have a significant impact on the efficacy of interventions designed to minimise their 'risky behaviour'.

  9. Being an ‘adolescent’: The consequences of gendered risks for young people in rural Uganda

    Science.gov (United States)

    Bernays, Sarah; Bukenya, Dominic; Thompson, Claire; Ssembajja, Fatuma; Seeley, Janet

    2017-01-01

    The behaviour of adolescents is recognised increasingly as having substantial and long-term consequences for their health. We examined the meaning of ‘adolescence’ in southern Uganda with HIV-positive young people aged 11–24 years. Adolescent girls and boys are described differently in the local language (Luganda). Adolescence is described as a behavioural rather than a life course category and an inherently dangerous one. The practices, risks and consequences of ‘adolescent’ behaviour are highly gendered. Local understandings of adolescence are likely to have a significant impact on the efficacy of interventions designed to minimise their ‘risky behaviour’. PMID:29472746

  10. Neonatal Nurses Experience Unintended Consequences and Risks to Patient Safety With Electronic Health Records.

    Science.gov (United States)

    Dudding, Katherine M; Gephart, Sheila M; Carrington, Jane M

    2018-04-01

    In this article, we examine the unintended consequences of nurses' use of electronic health records. We define these as unforeseen events, change in workflow, or an unanticipated result of implementation and use of electronic health records. Unintended consequences experienced by nurses while using electronic health records have been well researched. However, few studies have focused on neonatal nurses, and it is unclear to what extent unintended consequences threaten patient safety. A new instrument called the Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire has been validated, and secondary analysis using the tool explored the phenomena among neonatal nurses (N = 40). The purposes of this study were to describe unintended consequences of use of electronic health records for neonatal nurses and to explore relationships between the phenomena and characteristics of the nurse and the electronic health record. The most frequent unintended consequences of electronic health record use were due to interruptions, followed by a heavier workload due to the electronic health record, changes to the workflow, and altered communication patterns. Neonatal nurses used workarounds most often with motivation to better assist patients. Teamwork was moderately related to higher unintended consequences including patient safety risks (r = 0.427, P = .007), system design (r = 0.419, P = .009), and technology barriers (r = 0.431, P = .007). Communication about patients was reduced when patient safety risks were high (r = -0.437, P = .003). By determining the frequency with which neonatal nurses experience unintended consequences of electronic health record use, future research can be targeted to improve electronic health record design through customization, integration, and refinement to support patient safety and better outcomes.

  11. Anorexia of Aging: Risk Factors, Consequences, and Potential Treatments

    Science.gov (United States)

    Landi, Francesco; Calvani, Riccardo; Tosato, Matteo; Martone, Anna Maria; Ortolani, Elena; Savera, Giulia; Sisto, Alex; Marzetti, Emanuele

    2016-01-01

    Older people frequently fail to ingest adequate amount of food to meet their essential energy and nutrient requirements. Anorexia of aging, defined by decrease in appetite and/or food intake in old age, is a major contributing factor to under-nutrition and adverse health outcomes in the geriatric population. This disorder is indeed highly prevalent and is recognized as an independent predictor of morbidity and mortality in different clinical settings. Even though anorexia is not an unavoidable consequence of aging, advancing age often promotes its development through various mechanisms. Age-related changes in life-style, disease conditions, as well as social and environmental factors have the potential to directly affect dietary behaviors and nutritional status. In spite of their importance, problems related to food intake and, more generally, nutritional status are seldom attended to in clinical practice. While this may be the result of an “ageist” approach, it should be acknowledged that simple interventions, such as oral nutritional supplementation or modified diets, could meaningfully improve the health status and quality of life of older persons. PMID:26828516

  12. Anorexia of Aging: Risk Factors, Consequences, and Potential Treatments.

    Science.gov (United States)

    Landi, Francesco; Calvani, Riccardo; Tosato, Matteo; Martone, Anna Maria; Ortolani, Elena; Savera, Giulia; Sisto, Alex; Marzetti, Emanuele

    2016-01-27

    Older people frequently fail to ingest adequate amount of food to meet their essential energy and nutrient requirements. Anorexia of aging, defined by decrease in appetite and/or food intake in old age, is a major contributing factor to under-nutrition and adverse health outcomes in the geriatric population. This disorder is indeed highly prevalent and is recognized as an independent predictor of morbidity and mortality in different clinical settings. Even though anorexia is not an unavoidable consequence of aging, advancing age often promotes its development through various mechanisms. Age-related changes in life-style, disease conditions, as well as social and environmental factors have the potential to directly affect dietary behaviors and nutritional status. In spite of their importance, problems related to food intake and, more generally, nutritional status are seldom attended to in clinical practice. While this may be the result of an "ageist" approach, it should be acknowledged that simple interventions, such as oral nutritional supplementation or modified diets, could meaningfully improve the health status and quality of life of older persons.

  13. Anorexia of Aging: Risk Factors, Consequences, and Potential Treatments

    Directory of Open Access Journals (Sweden)

    Francesco Landi

    2016-01-01

    Full Text Available Older people frequently fail to ingest adequate amount of food to meet their essential energy and nutrient requirements. Anorexia of aging, defined by decrease in appetite and/or food intake in old age, is a major contributing factor to under-nutrition and adverse health outcomes in the geriatric population. This disorder is indeed highly prevalent and is recognized as an independent predictor of morbidity and mortality in different clinical settings. Even though anorexia is not an unavoidable consequence of aging, advancing age often promotes its development through various mechanisms. Age-related changes in life-style, disease conditions, as well as social and environmental factors have the potential to directly affect dietary behaviors and nutritional status. In spite of their importance, problems related to food intake and, more generally, nutritional status are seldom attended to in clinical practice. While this may be the result of an “ageist” approach, it should be acknowledged that simple interventions, such as oral nutritional supplementation or modified diets, could meaningfully improve the health status and quality of life of older persons.

  14. Cancer Risk in Astronauts: A Constellation of Uncommon Consequences

    Science.gov (United States)

    Milder, Caitlin M.; Elgart, S. Robin; Chappell, Lori; Charvat, Jaqueline M.; Van Baalen, Mary; Huff, Janice L.; Semones, Edward J.

    2017-01-01

    Excess cancers resulting from external radiation exposures have been noted since the early 1950s, when a rise in leukemia rates was first reported in young atomic bomb survivors [1]. Further studies in atomic bomb survivors, cancer patients treated with radiotherapy, and nuclear power plant workers have confirmed that radiation exposure increases the risk of not only leukemia, but also a wide array of solid cancers [2,3]. NASA has long been aware of this risk and limits astronauts' risk of exposure-induced death (REID) from cancer by specifying permissible mission durations (PMD) for astronauts on an individual basis. While cancer is present among astronauts, current data does not suggest any excess of known radiation-induced cancers relative to a comparable population of U.S. adults; however, very uncommon cancers have been diagnosed in astronauts including nasopharyngeal cancer, lymphoma of the brain, and acral myxoinflammatory fibroblastic sarcoma. In order to study cancer risk in astronauts, a number of obstacles must be overcome. Firstly, several factors make the astronaut cohort considerably different from the cohorts that have previously been studied for effects resulting from radiation exposure. The high rate of accidents and the much healthier lifestyle of astronauts compared to the U.S. population make finding a suitable comparison population a problematic task. Space radiation differs substantially from terrestrial radiation exposures studied in the past; therefore, analyses of galactic cosmic radiation (GCR) in animal models must be conducted and correctly applied to the human experience. Secondly, a large enough population of exposed astronauts must exist in order to obtain the data necessary to see any potential statistically significant differences between the astronauts and the control population. Thirdly, confounders and effect modifiers, such as smoking, diet, and other space stressors, must be correctly identified and controlled for in those

  15. [Detecting high risk pregnancy].

    Science.gov (United States)

    Doret, Muriel; Gaucherand, Pascal

    2009-12-20

    Antenatal care is aiming to reduce maternal land foetal mortality and morbidity. Maternal and foetal mortality can be due to different causes. Their knowledge allows identifying pregnancy (high risk pregnancy) with factors associated with an increased risk for maternal and/or foetal mortality and serious morbidity. Identification of high risk pregnancies and initiation of appropriate treatment and/or surveillance should improve maternal and/or foetal outcome. New risk factors are continuously described thanks to improvement in antenatal care and development in biology and cytopathology, increasing complexity in identifying high risk pregnancies. Level of risk can change all over the pregnancy. Ideally, it should be evaluated prior to the pregnancy and at each antenatal visit. Clinical examination is able to screen for intra-uterin growth restriction, pre-eclampsia, threatened for preterm labour; ultrasounds help in the diagnosis of foetal morphological anomalies, foetal chromosomal anomalies, placenta praevia and abnormal foetal growth; biological exams are used to screen for pre-eclampsia, gestational diabetes, trisomy 21 (for which screening method just changed), rhesus immunisation, seroconversion for toxoplasmosis or rubeola, unknown infectious disease (syphilis, hepatitis B, VIH). During pregnancy, most of the preventive strategies have to be initiated during the first trimester or even before conception. Prevention for neural-tube defects, neonatal hypocalcemia and listeriosis should be performed for all women. On the opposite, some measures are concerning only women with risk factors such as prevention for toxoplasmosis, rhesus immunization (which recently changed), tobacco complications and pre-eclampsia and intra-uterine growth factor restriction.

  16. Leukemia risk as a consequence of Mayak PA operation

    International Nuclear Information System (INIS)

    Kuznetsova, I.S.; Koshurnikova, N. A.

    2004-01-01

    The purpose of this study is the epidemiological risk assessment of leukemia incidence and mortality in population of Ozyorsk, the closest town to Mayak Production Association as well as in Mayak workers during 1948-2000. Standardized rates of leukemia incidence and mortality in the whole population of Ozyorsk were proved to be significantly higher in comparison with national rates. Relative risk values decrease 10-30% in occupationally non-exposed population ( the rest of the population) compared with estimations on the whole population, however, remaining to be more than one. Standardized incidence rate (SIR) in males was: 1, 33 (95% CI: 1,00-1,75), in females: 1,17 (95% CI: 0,90-1,49), Standardized mortality rate (SMR) in males was 1,34 (95%CI:1,01-1,74), in females 1,24 (95% CI:0,97-1,56). Given more accurate diagnostics in the city compared with national one, there are no grounds to connect the increase in leukemia incidence and mortality in the rest of the population with radiation factor also because now there is no information on dose effect due to living in the vicinity of Mayak Production Association. Standardized leukemia mortality ratio in Mayak workers was 1,91 (95% CI: 1,48-2,43) in males and 2,07 (95% CI:1,31-3,10) in females. Regardless of the better quality of fit in linear-quadratic model, the preference in the analysis is given to linear dependence which allows to avoid underestimation of risk at doses of most interest for radiation protection. The doses were lagged for 2 years. Thus, using linear model with 2-year lag excess relative risk per 1 Gy of external g-exposure was 1.8 (95% CI:0.8-3,6). The study of risk dependence to time since exposure demonstrated that the highest risk of leukemia mortality falls on the period of 2-5 years after exposure (excess relative risk of leukemia mortality in this, period was 11,1 compared to the period of 0-2 years). Excess relative risk for the period of 5-10 years is 7,6, i. e. 1,5 times lower than in the

  17. Radiation Risk and Possible Consequences for Ukrainian Population

    Energy Technology Data Exchange (ETDEWEB)

    Pivovarov, Alexander [Ukrainian State Chemical-Technology Univ., Dnepropetrovsk (Ukraine)

    2006-09-15

    The paper deals with the values of risk related to environmental pollution with radionuclides from the main sources located both on the territory of Ukraine and outside, which affect the Ukrainian population, in the context of long-range outlook. Ratios of risk for stochastic effects occurrence are given per unit of individual or collective dose, as well as for occurrence of fatal cancer, non-fatal cancer or serious hereditary effects. Besides, the paper mentions not only the impact of ionizing radiation, but severe population stress as well, which in certain regions turns into radiophobia. It is shown that for essential decrease of radiation risk in Ukraine, global problems should be solved, first of all, at the governmental level. Whereas a number of issues connected with the Chernobyl catastrophe are at least partially solved, the problems concerning the effects of radon and other radiation-dangerous factors are still to be tackled.

  18. Radiation Risk and Possible Consequences for Ukrainian Population

    International Nuclear Information System (INIS)

    Pivovarov, Alexander

    2006-01-01

    The paper deals with the values of risk related to environmental pollution with radionuclides from the main sources located both on the territory of Ukraine and outside, which affect the Ukrainian population, in the context of long-range outlook. Ratios of risk for stochastic effects occurrence are given per unit of individual or collective dose, as well as for occurrence of fatal cancer, non-fatal cancer or serious hereditary effects. Besides, the paper mentions not only the impact of ionizing radiation, but severe population stress as well, which in certain regions turns into radiophobia. It is shown that for essential decrease of radiation risk in Ukraine, global problems should be solved, first of all, at the governmental level. Whereas a number of issues connected with the Chernobyl catastrophe are at least partially solved, the problems concerning the effects of radon and other radiation-dangerous factors are still to be tackled

  19. Proceedings of the High Consequence Operations Safety Symposium

    Energy Technology Data Exchange (ETDEWEB)

    1994-12-01

    Many organizations face high consequence safety situations where unwanted stimuli due to accidents, catastrophes, or inadvertent human actions can cause disasters. In order to improve interaction among such organizations and to build on each others` experience, preventive approaches, and assessment techniques, the High Consequence Operations Safety Symposium was held July 12--14, 1994 at Sandia National Laboratories, Albuquerque, New Mexico. The symposium was conceived by Dick Schwoebel, Director of the SNL Surety Assessment Center. Stan Spray, Manager of the SNL System Studies Department, planned strategy and made many of the decisions necessary to bring the concept to fruition on a short time scale. Angela Campos and about 60 people worked on the nearly limitless implementation and administrative details. The initial symposium (future symposia are planned) was structured around 21 plenary presentations in five methodology-oriented sessions, along with a welcome address, a keynote address, and a banquet address. Poster papers addressing the individual session themes were available before and after the plenary sessions and during breaks.

  20. High plasma uric acid concentration: causes and consequences

    Directory of Open Access Journals (Sweden)

    de Oliveira Erick

    2012-04-01

    Full Text Available Abstract High plasma uric acid (UA is a precipitating factor for gout and renal calculi as well as a strong risk factor for Metabolic Syndrome and cardiovascular disease. The main causes for higher plasma UA are either lower excretion, higher synthesis or both. Higher waist circumference and the BMI are associated with higher insulin resistance and leptin production, and both reduce uric acid excretion. The synthesis of fatty acids (tryglicerides in the liver is associated with the de novo synthesis of purine, accelerating UA production. The role played by diet on hyperuricemia has not yet been fully clarified, but high intake of fructose-rich industrialized food and high alcohol intake (particularly beer seem to influence uricemia. It is not known whether UA would be a causal factor or an antioxidant protective response. Most authors do not consider the UA as a risk factor, but presenting antioxidant function. UA contributes to > 50% of the antioxidant capacity of the blood. There is still no consensus if UA is a protective or a risk factor, however, it seems that acute elevation is a protective factor, whereas chronic elevation a risk for disease.

  1. Practical consequences of the assessment of different energy health risks

    International Nuclear Information System (INIS)

    Hamilton, L.D.

    1984-01-01

    Public authorities must make decisions about energy, and the risks of alternative strategies need to be calculated including health and environmental costs. Information from various sources must be organized into a logical framework for comparing impacts. This must include the widest practicable range of health and environmental damage - public health impact of pollution, role of accidents, disease and hazardous materials in the workplace, and odds for catastrophes. It must put each part of the energy cycle into perspective - giving particular attention to uncertainties in knowledge - to convey what is known, what is uncertain, and the importance of each factor in the overall picture. This paper gives examples of the use of health-impact assessment by decision-makers: (1) comparative risk assessment of the health effects of coal and nuclear fuel cycles used in nuclear power plant siting and licensing hearings, and (2) health risks of acid deposition and other air-transported pollutants, carried out as part of an assessment for the U.S. Congress Office of Technology Assessment. (author)

  2. Consequence of climate mitigation on the risk of hunger.

    Science.gov (United States)

    Hasegawa, Tomoko; Fujimori, Shinichiro; Shin, Yonghee; Tanaka, Akemi; Takahashi, Kiyoshi; Masui, Toshihiko

    2015-06-16

    Climate change and mitigation measures have three major impacts on food consumption and the risk of hunger: (1) changes in crop yields caused by climate change; (2) competition for land between food crops and energy crops driven by the use of bioenergy; and (3) costs associated with mitigation measures taken to meet an emissions reduction target that keeps the global average temperature increase to 2 °C. In this study, we combined a global computable general equilibrium model and a crop model (M-GAEZ), and we quantified the three impacts on risk of hunger through 2050 based on the uncertainty range associated with 12 climate models and one economic and demographic scenario. The strong mitigation measures aimed at attaining the 2 °C target reduce the negative effects of climate change on yields but have large negative impacts on the risk of hunger due to mitigation costs in the low-income countries. We also found that in a strongly carbon-constrained world, the change in food consumption resulting from mitigation measures depends more strongly on the change in incomes than the change in food prices.

  3. 49 CFR 195.452 - Pipeline integrity management in high consequence areas.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Pipeline integrity management in high consequence... Management § 195.452 Pipeline integrity management in high consequence areas. (a) Which pipelines are covered... that could affect a high consequence area, including any pipeline located in a high consequence area...

  4. Spatial variation in risk and consequence of Batrachochytrium salamandrivorans introduction in the USA

    Science.gov (United States)

    Richgels, Katherine L. D.; Russell, Robin E.; Adams, Michael J.; White, C. LeAnn; Campbell Grant, Evan H.

    2016-01-01

    A newly identified fungal pathogen, Batrachochytrium salamandrivorans (Bsal), is responsible for mass mortality events and severe population declines in European salamanders. The eastern USA has the highest diversity of salamanders in the world and the introduction of this pathogen is likely to be devastating. Although data are inevitably limited for new pathogens, disease-risk assessments use best available data to inform management decisions. Using characteristics of Bsal ecology, spatial data on imports and pet trade establishments, and salamander species diversity, we identify high-risk areas with both a high likelihood of introduction and severe consequences for local salamanders. We predict that the Pacific coast, southern Appalachian Mountains and mid-Atlantic regions will have the highest relative risk from Bsal. Management of invasive pathogens becomes difficult once they are established in wildlife populations; therefore, import restrictions to limit pathogen introduction and early detection through surveillance of high-risk areas are priorities for preventing the next crisis for North American salamanders.

  5. Project risk as identity threat: explaining the development and consequences of risk discourse in an infrastructure project

    NARCIS (Netherlands)

    van Os, A.; van Berkel, F.J.F.W.; de Gilder, T.C.; van Dyck, C.; Groenewegen, P.

    2015-01-01

    This paper explores the role of social identity threat in risk discourse in an infrastructure project, and the consequences risk discourse has for cooperation between stakeholders. We show that risks posed a threat to the identity of the project team, resulting in a discourse focused on attributing

  6. Assessments of high-consequence platforms: Issues and applications

    International Nuclear Information System (INIS)

    Digre, K.A.; Craig, M.J.K.

    1994-01-01

    An API task group has developed a process for the assessment of existing platforms to determine their fitness for purpose. This has been released as a draft supplement to API RP 2A-WSD, 20th edition. Details and the background of this work are described in a companion paper. The assessment of a platform's fitness for purpose involves firstly a definition of the platform's exposure; and secondly, an evaluation of the platform's predicted performance relative to the assessment criteria associated with that exposure. This paper deals with platforms in the high exposure category. That is, platforms whose potential failure consequences, in terms of potential life loss and environmental damage, are significant. The criteria for placement of a platform in a high exposure category are explained, as are the performance criteria demanded of these high exposure platforms. In the companion paper, the metocean assessment process and associated API-developed acceptance criteria are highlighted. This paper addresses primarily ice and seismic loading assessments and associated API-developed criteria, which are based on over thirty years of successful offshore operation and field experience, as well as extrapolation of land-based performance criteria. Three West Coast, USA production platforms are used for illustration

  7. Probabilistic risk assessment course documentation. Volume 7. Environmental transport and consequence analysis

    International Nuclear Information System (INIS)

    Ritchie, L.T.; Alpert, D.J.; Burke, R.P.; Ostmeyer, R.M.; Kaiser, G.D.; Runkle, G.E.; Woodard, K.

    1985-08-01

    Consequence models have been designed to assess health and economic risks from potential accidents at nuclear power plants. These models have been applied to an ever increasing variety of problems with ever increasing demands to improve modeling capabilities and provide greater realism. This course discusses the environmental transport of postulated radiological releases and the elements and purpose of accident consequence evaluation

  8. The Unspoken Consequence of Command, Control Communications Technology: Enhanced Micromanagement by Risk-Averse Commanders

    National Research Council Canada - National Science Library

    Carozza, John

    2004-01-01

    .... However, along with its benefits, this command, control and communications (C3) network includes the dangerous consequence of eroding the autonomy of tactical command through enhanced micromanagement by risk-averse operational commanders...

  9. Delirium in cardiac surgery : A study on risk-assessment and long-term consequences

    NARCIS (Netherlands)

    Hogen-Koster, S.

    2011-01-01

    BACKGROUND: Delirium or acute confusion is a temporary mental disorder, which occurs frequently among hospitalized elderly patients. Patients who undergo cardiac surgery have an increased risk of developing delirium. Delirium is associated with many negative consequences. Therefore, prevention or

  10. The Impact of Marijuana Legalization on Adolescent Use, Consequences, and Perceived Risk.

    Science.gov (United States)

    Estoup, Ashley C; Moise-Campbell, Claudine; Varma, Malini; Stewart, David G

    2016-12-05

    Currently, only four states have legalized recreational marijuana use for adults over 21 years of age. Therefore, little is known about the influence that legalization will have on adolescent marijuana use. This study examines how marijuana legalization has impacted the frequency and consequences of adolescent use in a sample of participants in a school-based, substance use intervention. We hypothesized that adolescents enrolled in the intervention in years after marijuana legalization would present with more problematic use compared to those enrolled prior, and that changes in the perceived risk of marijuana would be a mechanism of problematic use. Participants were 262 students enrolled in a school-based substance use intervention in 2010 to 2015. The Customary Drinking and Drug Use Record, Alcohol and Drug Use Consequences Questionnaire, and a decisional balance matrix were used to assess marijuana frequency, negative consequences, and perceived risk of use. A mediation model was used to test the degree to which marijuana legalization may lead to increased frequency and consequences of use through perceived risk. Findings indicated a significantly positive correlation between marijuana-related consequences and perceived risk post legalization. Despite relatively equal use between both groups, adolescents in the legalization group experienced higher levels of perceived risk and increased negative consequences. Due to the rising legalization status of marijuana in the United States, it is imperative that psychoeducation is provided to adults and adolescents about the consequences of underage marijuana use.

  11. A probabilistic consequence assessment for a very high temperature reactor

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joeun; Kim, Jintae; Jae, Moosung [Hanyang Univ., Seoul (Korea, Republic of). Dept. of Nuclear Engineering

    2017-02-15

    Currently, fossil fuel is globally running out. If current trends continue, crude oil will be depleted in 20 years and natural gas in 40 years. In addition, the use of fossil resource has increased emissions of green gas such as carbon dioxide. Therefore, there has been a strong demand in recent years for producing large amounts of hydrogen as an alternative energy [1]. To generate hydrogen energy, very high temperature more than 900 C is required but this level is not easy to reach. Because a Very High Temperature Reactor (VHTR), one of next generation reactor, is able to make the temperature, it is regarded as a solution of the problem. Also, VHTR has an excellent safety in comparison with existing and other next generation reactors. Especially, a passive system, Reactor Cavity Cooling System (RCCS), is adopted to get rid of radiant heat in case of accidents. To achieve variety requirements of new designed-reactors, however, it needs to develop new methodologies and definitions different with existing method. At the same time, an application of probability safety assessment (PSA) has been proposed to ensure the safety of next generation NPPs. For this, risk-informed designs of structures have to be developed and verified. Particularly, the passive system requires to be evaluated for its reliability. The objective of this study is to improve safety of VIITR by conducting risk profile.

  12. Statistical surrogate models for prediction of high-consequence climate change.

    Energy Technology Data Exchange (ETDEWEB)

    Constantine, Paul; Field, Richard V., Jr.; Boslough, Mark Bruce Elrick

    2011-09-01

    In safety engineering, performance metrics are defined using probabilistic risk assessments focused on the low-probability, high-consequence tail of the distribution of possible events, as opposed to best estimates based on central tendencies. We frame the climate change problem and its associated risks in a similar manner. To properly explore the tails of the distribution requires extensive sampling, which is not possible with existing coupled atmospheric models due to the high computational cost of each simulation. We therefore propose the use of specialized statistical surrogate models (SSMs) for the purpose of exploring the probability law of various climate variables of interest. A SSM is different than a deterministic surrogate model in that it represents each climate variable of interest as a space/time random field. The SSM can be calibrated to available spatial and temporal data from existing climate databases, e.g., the Program for Climate Model Diagnosis and Intercomparison (PCMDI), or to a collection of outputs from a General Circulation Model (GCM), e.g., the Community Earth System Model (CESM) and its predecessors. Because of its reduced size and complexity, the realization of a large number of independent model outputs from a SSM becomes computationally straightforward, so that quantifying the risk associated with low-probability, high-consequence climate events becomes feasible. A Bayesian framework is developed to provide quantitative measures of confidence, via Bayesian credible intervals, in the use of the proposed approach to assess these risks.

  13. Dutch monitor on stress and physical load : risk factors, consequences, and preventive action

    NARCIS (Netherlands)

    Houtman, I.L.D.; Goudswaard, A.; Dhondt, S.; Grinten, M.P. van der; Hildebrandt, V.H.; Poel, E.G.T. van der

    1998-01-01

    Objectives - Due to recent changes in legislation on occupational health and safety, a national monitor on stress and physical load was developed in The Netherlands to monitor (a) risks and consequences of stress and physical load at work, (b) preventive actions in companies to reduce these risks,

  14. The Prevalence, Risk Factors and Consequences of Neck Pain in Office Employees

    Directory of Open Access Journals (Sweden)

    Fatemeh Ehsani

    2017-01-01

    Full Text Available Background Office workers, especially computer users are at risk of developing neck pain (NP, while limited studies have been conducted on this issue. Objectives The purpose of this study was to identify the prevalence, risk factors, and consequences of NP in office employees, and its effect on their quality of life and work. Methods This research was a cross sectional study conducted during years 2014 and 2015. Among all employees, 220 people were randomly selected from 10 welfare organization offices of Semnan city of Iran. Data regarding the individual characteristics, occurrence of NP and its intensity, health status, risk factors and consequences of NP including functional disability and quality of life and work, as well as work-related factors were collected. Results Immediate, last month, last six months, last year, and lifetime prevalence of NP were 38.1%, 39.7%, 41.1%, 45.8% and, 62.1%, respectively. The point prevalence of NP was significantly related to age, gender, health status, job satisfaction, and length of employment (P < 0.05. Elongated working hours on the computer, taking a prolonged sitting position, and static postures were the most irritating factors, respectively (P < 0.001. Taking medications and physiotherapy were the most effective intervention strategies that participants chose for the treatment of NP (60.2%. Conclusions The findings provide evidence that the prevalence of NP in office employees was high. The modifiable individual and work-related factors were as follows, improving health status, job satisfaction, reduction of working hours on the computer, avoiding prolonged sitting and static postures, having a rest time during working hours, and performing regular daily exercises.

  15. Mechanisms of Evolution in High-Consequence Drug Resistance Plasmids.

    Science.gov (United States)

    He, Susu; Chandler, Michael; Varani, Alessandro M; Hickman, Alison B; Dekker, John P; Dyda, Fred

    2016-12-06

    The dissemination of resistance among bacteria has been facilitated by the fact that resistance genes are usually located on a diverse and evolving set of transmissible plasmids. However, the mechanisms generating diversity and enabling adaptation within highly successful resistance plasmids have remained obscure, despite their profound clinical significance. To understand these mechanisms, we have performed a detailed analysis of the mobilome (the entire mobile genetic element content) of a set of previously sequenced carbapenemase-producing Enterobacteriaceae (CPE) from the National Institutes of Health Clinical Center. This analysis revealed that plasmid reorganizations occurring in the natural context of colonization of human hosts were overwhelmingly driven by genetic rearrangements carried out by replicative transposons working in concert with the process of homologous recombination. A more complete understanding of the molecular mechanisms and evolutionary forces driving rearrangements in resistance plasmids may lead to fundamentally new strategies to address the problem of antibiotic resistance. The spread of antibiotic resistance among Gram-negative bacteria is a serious public health threat, as it can critically limit the types of drugs that can be used to treat infected patients. In particular, carbapenem-resistant members of the Enterobacteriaceae family are responsible for a significant and growing burden of morbidity and mortality. Here, we report on the mechanisms underlying the evolution of several plasmids carried by previously sequenced clinical Enterobacteriaceae isolates from the National Institutes of Health Clinical Center (NIH CC). Our ability to track genetic rearrangements that occurred within resistance plasmids was dependent on accurate annotation of the mobile genetic elements within the plasmids, which was greatly aided by access to long-read DNA sequencing data and knowledge of their mechanisms. Mobile genetic elements such as

  16. Spent fuel transport in Romania by road: An approach considering safety, risk and radiological consequences

    International Nuclear Information System (INIS)

    Vieru, G.

    2001-01-01

    The transport of high-level radioactive wastes, involving Type B packages, is a part of the safety of the Romanian waste management programme and the overall aim of this activity is to promote the safe transport of radioactive materials in Romania. The paper presents a safety case analysis of the transport of a single spent fuel CANDU bundle, using a Romanian built Type B package, from the CANDU type nuclear power plant Cernavoda to the INR Pitesti, in order to be examined within INR's hot-cells facilities. The safety assessment includes the following main aspects: (1) evaluation and analysis of available data on road traffic accidents; (2) estimation of the expected frequency for severe road accident scenarios resulting in potential radionuclide release; and (3) evaluation of the expected radiological consequences and accident risks of transport operations. (author)

  17. Application of the accident consequences model of the German risk study to assessments of accident risks in different types of nuclear power plants

    International Nuclear Information System (INIS)

    Ehrhardt, J.; Bayer, A.

    1982-01-01

    Within the scope of the 'German Risk Study for Nuclear Power Plants' (Phase A) the accident consequence model UFOMOD was developed in the Karlsruhe Nuclear Research Center. This model originally developed for pressurized water reactors has now been extended in order to obtain results about accidental releases of activity from fast breeder and high-temperature reactors, too. (RW) [de

  18. Comprehensive transportation risk assessment system based on unit-consequence factors

    International Nuclear Information System (INIS)

    Biwer, B.M.; Monette, F.A.; LePoire, D.J.; Chen, S.Y.

    1994-01-01

    The U.S. Department of Energy (DOE) Environmental Restoration and Waste Management Programmatic Environmental Impact Statement requires a comprehensive transportation risk analysis of radioactive waste shipments for large shipping campaigns. Thousands of unique shipments involving truck and rail transport must be analyzed; a comprehensive risk analysis is impossible with currently available methods. Argonne National Laboratory developed a modular transportation model that can handle the demands imposed by such an analysis. The modular design of the model facilitates the simple addition/updating of transportation routes and waste inventories, as required, and reduces the overhead associated with file maintenance and quality assurance. The model incorporates unit-consequences factors generated with the RADTRAN 4 transportation risk analysis code that are combined with an easy-to-use, menu-driven interface on IBM-compatible computers running under DOS. User selection of multiple origin/destination site pairs for the shipment of multiple radioactive waste inventories is permitted from pop-up lists. Over 800 predefined routes are available among more than 30 DOE sites and waste inventories that include high-level waste, spent nuclear fuel, transuranic waste, low-level waste, low-level mixed waste, and greater-than-Class C waste

  19. Risk factors for fatigue in shipping, the consequences for seafarers’ health and options for preventive intervention

    DEFF Research Database (Denmark)

    Jepsen, Jørgen Riis; Zhao, Zhiwei; Pekcan, Claire

    2017-01-01

    fatigue. A literature study was conducted aimed at collecting publications that address risk factors for fatigue, short-term and long-term consequences for health and safety, and options for fatigue mitigation at sea. Due to the limited number of publications that deal with seafarers, experiences from...

  20. Risk and Protective Factors Associated with Gambling Consequences for Indigenous Australians in North Queensland

    Science.gov (United States)

    Breen, Helen M.

    2012-01-01

    The purpose of this paper was to examine risk and protective factors associated with the consequences of card gambling and commercial gambling for Indigenous Australians in north Queensland. With Indigenous Elders' approval and using qualitative methodology, semi-structured interviews were conducted with 60 Indigenous and 48 non-Indigenous…

  1. Prevalence, risk factors and consequences of cerebral small vessel diseases: data from three Asian countries.

    Science.gov (United States)

    Hilal, Saima; Mok, Vincent; Youn, Young Chul; Wong, Adrian; Ikram, Mohammad Kamran; Chen, Christopher Li-Hsian

    2017-08-01

    Cerebral small vessel disease (SVD) has been suggested to be more common in Asians compared with Caucasians. However, data from population-based studies in Asia are lacking. We report on the prevalence, risk factors and consequences of SVD from contemporary studies in three Asian countries using 3-Tesla MRI for the evaluation of SVD. Clinical, cognitive and 3-Tesla brain MRI assessments were performed among participants of three studies from Singapore, Hong Kong and Korea. SVD markers include white matter hyperintensities (WMHs) using the modified Fazekas scale, lacunes and microbleeds. Cognition was assessed using the Mini Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Adjustments were made for age, sex and cardiovascular risk factors. A total of 1797 subjects were available for analysis (mean age: 70.1±6.3 years and 57% women). The prevalence of confluent WMH was 36.6%, lacunes, 24.6% and microbleeds, 26.9%. Presence of all three SVD markers showed a steeper increase with increasing age rising from 1.9% in the lowest to 46.2% in the highest 5-year age strata. The major risk factors for the increased severity of SVD markers were advancing age and hypertension. Moreover, increasing severity of SVD markers was independently associated with worse performance on MMSE and MoCA. Elderly Asians have a high burden of SVD which was associated with cognitive dysfunction. This suggests that SVD markers should be a potential target for treatment in clinical trials so as to delay progression of cerebrovascular disease and potentially cognitive decline. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Consequences of corrosion of the high flux reactor channels

    International Nuclear Information System (INIS)

    1987-01-01

    The effects of corrosion can increase the probability of the channel losing its seal. In case of a slow leak, the phenomena happening can be considered as quasi-static. The closing of the safety valve takes place even before the leak water reaches the level of the exit window. In case of a fast leak in the case of helium filled channels, the dynamic effects are limited to the front part of the plug. As for the back part of the plug and the housing/safety valve unit, the consequences of a fast leak can be assimilated to those of a slow leak. This paper evaluates the results of an incident such as this for the reactor and the surrounding experimental zones

  3. Evaluation of sanitary consequences of Chernobylsk accident in France. Epidemiological surveillance plan, state of knowledge, risks evaluation and perspectives

    International Nuclear Information System (INIS)

    Verger, P.; Cherie-Challine, L.

    2000-12-01

    This report jointly written by IPSN and InVS, reviews the sanitary consequences in France of the Chernobyl accident, which occurred in 1986. The first point is dedicated to a short presentation of the knowledge relative to the sanitary consequences of the Chernobyl accident in the high contaminated countries and to the risk factors of the thyroid cancer. Secondly, this report describes the main systems of epidemiological surveillance of health implemented in France in 1986 and in 1999, as well as the data of the incidence and mortality of thyroid cancer observed in France since 1975. In addition, this report presents an analysis of the risk of thyroid cancer related to radioactive contamination in France, for young people of less than 15 years of age who where living in 1986 in the highest contaminated areas of France (Eastern territories). For this purpose, the theoretical number of thyroid cancers in excess is evaluated for this population, on the basis of different available risk model. Finally starting from the results of risk assessment, there is a discussion about the relevance and the feasibility of different epidemiological methods in view of answering the questions related to the sanitary consequences of the Chernobyl accident. In conclusion, this report recommends to reinforce the surveillance of thyroid cancer in France. (author)

  4. Systematic literature review of the risk factors, comorbidities, and consequences of hypogonadism in men.

    Science.gov (United States)

    Zarotsky, V; Huang, M-Y; Carman, W; Morgentaler, A; Singhal, P K; Coffin, D; Jones, T H

    2014-11-01

    The objective of this review was to summarize the literature on the risk factors, comorbidities, and consequences of male hypogonadism, which is defined as a syndrome complex that includes biochemical confirmation of low testosterone (T) and the consistent symptoms and signs associated with low T. A systematic literature search was performed in PubMed/MEDLINE, EMBASE, Cochrane Library for articles published in the last 10 years on risk factors, comorbidities, and consequences of male hypogonadism. Of the 53 relevant studies identified, nine examined potential risk factors, 14 examined potential comorbidities, and 30 examined potential consequences of male hypogonadism. Based on studies conducted in Asia, Australia, Europe, and North & South America, the important factors that predicted and correlated with hypogonadism were advanced age, obesity, a diagnosis of metabolic syndrome (MetS), and a poor general health status. Diabetes mellitus was correlated with hypogonadism in most studies, but was not established as a risk factor. Although diseases, such as coronary heart disease, hypertension, stroke, and peripheral arterial disease did not predict hypogonadism, they did correlate with incident low T. The data reviewed on potential consequences suggest that low T levels may be linked to earlier all-cause and cardiovascular related mortality among men. This literature review suggests that men with certain factors, such as advanced age, obesity, MetS, and poor general health, are more likely to have and develop hypogonadism. Low levels of T may have important long-term negative health consequences. © 2014 American Society of Andrology and European Academy of Andrology.

  5. Changes in Classes of Injury-Related Risks and Consequences of Risk-Level Drinking: a Latent Transition Analysis.

    Science.gov (United States)

    Cochran, Gerald; Field, Craig; Caetano, Raul

    2015-07-01

    Risk-level drinking, drinking and driving, and alcohol-related violence are risk factors that result in injuries. The current study sought to identify which subgroups of patients experience the most behavioral change following a brief intervention. A secondary analysis of data from a brief alcohol intervention study was conducted. The sample (N = 664) includes at-risk drinkers who experienced an injury and were admitted for care to a Level 1 trauma center. Injury-related items from the Short Inventory of Problems+6 were used to perform a latent transition analysis to describe class transitions participants experienced following discharge. Four classes emerged for the year before and after the current injury. Most individuals transitioned from higher-risk classes into those with lower risk. Some participants maintained risky profiles, and others increased risks and consequences. Drinking and driving remained a persistent problem among the study participants. Although a large portion of intervention recipients improved risks and consequences of alcohol use following discharge, more intensive intervention services may be needed for a subset of patients who showed little or no improvement.

  6. Understanding and acknowledging the ice throw hazard - consequences for regulatory frameworks, risk perception and risk communication

    Science.gov (United States)

    Bredesen, R. E.; Drapalik, M.; Butt, B.

    2017-11-01

    This study attempts to provide the necessary framework required to make sufficiently informed decisions regarding the safety implications of ice throw. The framework elaborates on how to cope with uncertainties, and how to describe results in a meaningful and useful manner to decision makers. Moreover, it points out the moral, judicial and economical obligations of wind turbine owners such that they are able to minimize risk of ice throws as much as possible. Building on the strength of knowledge as well as accounting for uncertainty are also essential in enabling clear communication with stakeholders on the most important/critical/vital issues. With increasing empirical evidence, one can assign a higher confidence level on the expert opinions on safety. Findings regarding key uncertainties of ice risk assessments are presented here to support the ongoing IEA Wind Task 19's work on creating the international guidelines on ice risk assessment due in 2018 (Krenn et al. 2017)[1-6]. In addition the study also incorporates the findings of a Norwegian information project, which focuses on the ice throw hazard for the public (Bredesen, Flage, Butt, Winterwind 2018)[7-9]. This includes measures to reduce damage and hazard from wind turbines for the general public. Recent theory of risk assessment questions the use of risk criteria for achieving optimum risk reduction and favours the use of the ALARA (as low as reasonably achievable) principle. Given the several practical problems associated with the ALARA approach (e.g. judicial realization), a joint approach, which uses a minimum set of criteria as well as the obligation to meet ALARA is suggested (associated with acceptable cost). The actual decision about acceptance criteria or obligations is a societal one, thus suggestions can be made at best. Risk acceptance, risk perception and risk communication are inextricably linked and should thus never be considered separately. Risk communication can shape risk perception

  7. Original Research Identifying patients at high risk for obstructive ...

    African Journals Online (AJOL)

    determine the factors associated with high risk for obstructive sleep apnoea and use it to identify patients at risk for the condition in ... mainstay of management is CPAP in addition to behavioral ..... the present study has some potential limitations which ... consequences of obstructive sleep apnea and short sleep duration.

  8. Prevalence and consequences of substance use among high school ...

    African Journals Online (AJOL)

    Alcohol, khat and cigarettes were commonly used by both high school and college students in urban as well as rural areas. While the use patterns of the substances were related to the gender, education/age and religion of the users, no clear-cut patterns were observed in relation to several other factors including ...

  9. Withdrawal rates as a consequence of disclosure of risk associated with manipulation of the cervical spine

    Directory of Open Access Journals (Sweden)

    Forrest Lianne

    2010-10-01

    Full Text Available Abstract Background The risk associated with cervical manipulation is controversial. Research in this area is widely variable but as yet the risk is not easily quantifiable. This presents a problem when informing the patient of risks when seeking consent and information may be withheld due to the fear of patient withdrawal from care. As yet, there is a lack of research into the frequency of risk disclosure and consequent withdrawal from manipulative treatment as a result. This study seeks to investigate the reality of this and to obtain insight into the attitudes of chiropractors towards informed consent and disclosure. Methods Questionnaires were posted to 200 UK chiropractors randomly selected from the register of the General Chiropractic Council. Results A response rate of 46% (n = 92 was achieved. Thirty-three per cent (n = 30 respondents were female and the mean number of years in practice was 10. Eighty-eight per cent considered explanation of the risks associated with any recommended treatment important when obtaining informed consent. However, only 45% indicated they always discuss this with patients in need of cervical manipulation. When asked whether they believed discussing the possibility of a serious adverse reaction to cervical manipulation could increase patient anxiety to the extent there was a strong possibility the patient would refuse treatment, 46% said they believed this could happen. Nonetheless, 80% said they believed they had a moral/ethical obligation to disclose risk associated with cervical manipulation despite these concerns. The estimated number of withdrawals throughout respondents' time in practice was estimated at 1 patient withdrawal for every 2 years in practice. Conclusion The withdrawal rate from cervical manipulation as a direct consequence of the disclosure of associated serious risks appears unfounded. However, notwithstanding legal obligations, reluctance to disclose risk due to fear of increasing patient

  10. Medical radiological consequences of the Chernobyl catastrophe in Russia. Estimation of radiation risks

    International Nuclear Information System (INIS)

    Ivanov, V.; Tsyb, A.; Ivanov, S.; Pokrovsky, V.

    2004-01-01

    The Chernobyl accident, one of the worst radiation-related disasters ever, occurred about 18 year ago. A lot has been done over the past years to mitigate the consequences of this accident, especially in the worst affected territories of Belarus, Russia and Ukraine. The efforts to study health effects of the accident, however, need to be continued for many years to come, being an integral part of developing a general strategy for dealing with long-term effects. The question now arises: To what extent health consequences could be evaluated in 1986, given the existing scientific base of radiation epidemiology? The latest 20-30 years have seen a rapid development of radiation epidemiology, which was brought about, first of all, by the need to analyze long-term radiation effects of the 1945 atomic bombing in Hiroshima and Nagasaki. It may now be considered as proved that high and medium radiation doses (above 0.3 Sv) lead to an increase in cancer incidence rates. Based on the Japanese data, the ICRP proposed mathematical models to be used for predicting long-term effects of radiation exposure. This brings up a question: Are radiation risks derived for Hiroshima and Nagasaki applicable to low doses (0.2 Sv)? An answer is critically important, as the overwhelming majority of emergency workers and the population exposed as a result of the Chernobyl accident received doses within this range. Actually, understanding of these issues is crucial for dealing with long-term radiation effects of the Chernobyl accident. Deriving radiation risk factors for the Japanese cohort with medium and high doses was based on large-scale epidemiological studies of 86.5 thousand people during a prolonged period. As of now, no other approaches exist to estimating long-term radiation effects. Following the Chernobyl accident the All-Union Distributed Registry of persons exposed to radiation was established as soon as in the summer 1986. The Research Institute of Medical Radiology (Medical

  11. Mechanisms of Evolution in High-Consequence Drug Resistance Plasmids

    Directory of Open Access Journals (Sweden)

    Susu He

    2016-12-01

    Full Text Available The dissemination of resistance among bacteria has been facilitated by the fact that resistance genes are usually located on a diverse and evolving set of transmissible plasmids. However, the mechanisms generating diversity and enabling adaptation within highly successful resistance plasmids have remained obscure, despite their profound clinical significance. To understand these mechanisms, we have performed a detailed analysis of the mobilome (the entire mobile genetic element content of a set of previously sequenced carbapenemase-producing Enterobacteriaceae (CPE from the National Institutes of Health Clinical Center. This analysis revealed that plasmid reorganizations occurring in the natural context of colonization of human hosts were overwhelmingly driven by genetic rearrangements carried out by replicative transposons working in concert with the process of homologous recombination. A more complete understanding of the molecular mechanisms and evolutionary forces driving rearrangements in resistance plasmids may lead to fundamentally new strategies to address the problem of antibiotic resistance.

  12. An Overview. High Risk Series.

    Science.gov (United States)

    General Accounting Office, Washington, DC.

    This report provides an overview of efforts undertaken by the U.S. General Accounting Office (GAO) in 1990 to review and report on federal program areas its work identified as high risk because of vulnerabilities to waste, fraud, abuse, and mismanagement. It reviews the current status of efforts to address these concerns. The six categories of…

  13. Financial system loss as an example of high consequence, high frequency events

    Energy Technology Data Exchange (ETDEWEB)

    McGovern, D.E.

    1996-07-01

    Much work has been devoted to high consequence events with low frequency of occurrence. Characteristic of these events are bridge failure (such as that of the Tacoma Narrows), building failure (such as the collapse of a walkway at a Kansas City hotel), or compromise of a major chemical containment system (such as at Bhopal, India). Such events, although rare, have an extreme personal, societal, and financial impact. An interesting variation is demonstrated by financial losses due to fraud and abuse in the money management system. The impact can be huge, entailing very high aggregate costs, but these are a result of the contribution of many small attacks and not the result of a single (or few) massive events. Public awareness is raised through publicized events such as the junk bond fraud perpetrated by Milikin or gross mismanagement in the failure of the Barings Bank through unsupervised trading activities by Leeson in Singapore. These event,s although seemingly large (financial losses may be on the order of several billion dollars), are but small contributors to the estimated $114 billion loss to all types of financial fraud in 1993. This paper explores the magnitude of financial system losses and identifies new areas for analysis of high consequence events including the potential effect of malevolent intent.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...... 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......-screening of psychological status did not influence the psychological impact of screening. Conclusions: This large, randomised intervention study supports that screening for risk factors to IHD does not increase mental distress, not even in the mentally or socioeconomically most vulnerable persons.This study included...

  15. Evaluation of severe accident risks: Methodology for the containment, source term, consequence, and risk integration analyses. Volume 1, Revision 1

    International Nuclear Information System (INIS)

    Gorham, E.D.; Breeding, R.J.; Brown, T.D.; Harper, F.T.; Helton, J.C.; Murfin, W.B.; Hora, S.C.

    1993-12-01

    NUREG-1150 examines the risk to the public from five nuclear power plants. The NUREG-1150 plant studies are Level III probabilistic risk assessments (PRAs) and, as such, they consist of four analysis components: accident frequency analysis, accident progression analysis, source term analysis, and consequence analysis. This volume summarizes the methods utilized in performing the last three components and the assembly of these analyses into an overall risk assessment. The NUREG-1150 analysis approach is based on the following ideas: (1) general and relatively fast-running models for the individual analysis components, (2) well-defined interfaces between the individual analysis components, (3) use of Monte Carlo techniques together with an efficient sampling procedure to propagate uncertainties, (4) use of expert panels to develop distributions for important phenomenological issues, and (5) automation of the overall analysis. Many features of the new analysis procedures were adopted to facilitate a comprehensive treatment of uncertainty in the complete risk analysis. Uncertainties in the accident frequency, accident progression and source term analyses were included in the overall uncertainty assessment. The uncertainties in the consequence analysis were not included in this assessment. A large effort was devoted to the development of procedures for obtaining expert opinion and the execution of these procedures to quantify parameters and phenomena for which there is large uncertainty and divergent opinions in the reactor safety community

  16. The meaning and consequences of tuberculosis for an at-risk urban group in Ecuador.

    Science.gov (United States)

    Armijos, Rodrigo X; Weigel, M Margaret; Qincha, Matilde; Ulloa, Bernarda

    2008-03-01

    To explore knowledge, beliefs, perceptions, and attitudes about tuberculosis (TB) in a high-risk group in Ecuador. This included signs and symptoms, causation, transmission, treatment, treatment adherence, impact on lifestyle and role functioning, and stigma. A convenience sample of 212 adults undergoing diagnostic TB testing at a public health facility in Quito, Ecuador, was recruited for the study. Data were collected from subjects during face-to-face interviews using a structured instrument containing closed and openended questions. Descriptive and bivariate statistics were used for quantitative analyses; content analysis was used to analyze qualitative data. Most subjects were familiar with TB and some of its characteristics and treatment aspects. However, many also held misconceptions or lacked key knowledge which could adversely affect early diagnosis and treatment and adherence to treatment, and thereby allow the disease to spread. Subject education was the single most important predictor of knowledge, beliefs, perceptions, and attitudes followed by gender, age, and prior disease experience. The subjects linked TB to multiple adverse health, economic, psychological, and social consequences, including stigma. Although none knew if they had TB when interviewed, many reported feeling stigmatized just by being tested. The subjects identified a strong need for formal educational opportunities to learn about TB prevention and control but had little access to these. The study findings highlight a need for enhanced population access to TB education. Health education and social marketing directed toward increasing TB knowledge and changing perceptions and attitudes could ultimately contribute to improved early diagnosis, treatment adherence, prevention, and decreased stigma. This could be accomplished providing that the public health infrastructure is adequate to meet demands.

  17. The several faces of fear: ecological consequences of predation risk in a lagoon model system

    Directory of Open Access Journals (Sweden)

    Rafael Dettogni Guariento

    Full Text Available AIM: The aim of this study was to evaluate the role of predation risk on the occurrence of trophic cascades in a benthic food chain, and detect if the ecological consequences of predation risk can reverberate in patterns observed across different hierarchical scales, such as prey size, prey growth efficiency and nutrient recycling patterns. METHODS: The model system used in the present experiment consisted of a simple linear food chain comprising a predator, a consumer and periphyton as basal resources. For 2 weeks, we manipulated predation risk using caged predators, incapable of killing their prey, across twelve outdoor mesocosms, simulating natural lagoon conditions. RESULTS: Our results showed that predation risk can be responsible for the occurrence of a trophic cascade and the strength of the cascade is proportional to the intensity of risk. Predation risk can also negatively influence prey biomass and growth efficiency as well as affect nutrient recycling patterns by altering prey nutrient excretion rates. Through a simple mathematical formulation, we attempted to show that individual-level experimental results can be generalized to natural populations if evolutionary constraints to prey fitness can be reproduced in experimental conditions. CONCLUSIONS: Our results corroborate to integrate ecosystem dynamics with animal behavior, highlighting that not only bottom-up but also top-down mechanisms are responsible for determining ecosystem properties. We ultimately claim that prey adaptive foraging may serve to integrate ecosystem and evolutionary ecology, resulting in the development of a more robust and predictive theory of the functioning of aquatic ecosystems.

  18. Radiation accidents with global consequences for the population. Problems of risk evaluation

    International Nuclear Information System (INIS)

    Vasilev, G.; Doncheva, B.; Stoilova, S.; Miloslavov, V.; Tsenova, T.; Novkirishki, V.

    1987-01-01

    The theoretical problems concerning the delayed impacts as a result of considerable radiation accidents are discussed. The attention is paid to the maximum individual doses which are relatively low but many people are affected. In these cases, the risk evaluation is based on the cancerogenesis, genetic and teratogenetic consequences among the concerned population. The main equation of the linear threshold-free model 'dose effect' is subjected to analysis. Considering the real prognostic importance of this equation the following recommendations are made: further observation on epidemic diseases; investigation of teratogenetic consequences in connection with the radiation doses obtained during the antenatal development; radiation-hygienic standardization of the oral absorbtion of radionuclides for short and long periods of time; effective equivalent dose determination according to the irradiated organ or tissue (mammary glands, lungs, red marrow, gonads, skin); necessity of national system for in time announcement of radiation accidents, as well as suitable control of the internal and the external irradiation

  19. Temporal framing and consideration of future consequences: effects on smokers' and at-risk nonsmokers' responses to cigarette health warnings.

    Science.gov (United States)

    Zhao, Xiaoquan; Nan, Xiaoli; Iles, Irina Alexandra; Yang, Bo

    2015-01-01

    This research examines the influence of temporal framing (long-term vs. short-term) and individual difference in consideration of future consequences (CFC) on the effectiveness of cigarette health warnings among smokers and at-risk nonsmokers in a college population. An online experiment (N = 395) revealed a three-way interaction among temporal framing, CFC, and smoking status. The results among at-risk nonsmokers supported the temporal fit hypothesis--those high in CFC responded more favorably to long-term framing, whereas those low in CFC responded more positively to short-term framing. The findings among smokers revealed a different pattern in which short-term framing was more effective among high-CFC smokers, whereas among low-CFC smokers the framing effect was not distinct. Theoretical and practical implications of the findings are discussed.

  20. Clinical high risk for psychosis

    DEFF Research Database (Denmark)

    van der Steen, Y; Gimpel-Drees, J; Lataster, T

    2017-01-01

    OBJECTIVE: The aim of this study was to assess associations between momentary stress and both affective and psychotic symptoms in everyday life of individuals at clinical high risk (CHR), compared to chronic psychotic patients and healthy controls, in search for evidence of early stress...... and 26 healthy controls. RESULTS: Multilevel models showed significantly larger associations between negative affect (NA) and activity-related stress for CHR patients than for psychotic patients (P = 0.008) and for CHR compared to controls (P

  1. Risks, consequences, and prevention of falls of older people in oral healthcare centers.

    Science.gov (United States)

    de Baat, Cees; de Baat, Paul; Gerritsen, Anneloes E; Flohil, Karien A; van der Putten, Gert-Jan; van der Maarel-Wierink, Claar D

    2017-03-01

    One-third of community-dwelling people older than 65 years of age fall each year, and half of them fall at least twice a year. Older care home residents are approximately three times more likely to fall when compared to community-dwelling older people. Risk indicators for falls are related to the older people's body, environment, behavior, and activities. An important health risk indicator is (orthostatic or postprandial) hypotension, which may induce cerebral hypoperfusion. Although the majority of falls remain without major consequences, 10% to 25% of falls in care homes result in bodily trauma. Prevalent fall-related injuries are brain injury, lower extremity fracture including hip fracture and forearm/wrist fracture, facial fracture, humeral fracture, and rib/scapular fracture. As fall accidents by older people can have severe consequences, prevention of falls is of paramount importance. Healthcare providers, including oral healthcare providers, should inform older people on risks of falling and draw attention to potentially hazardous arrangements. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

  2. Injuries, negative consequences, and risk behaviors among both injured and uninjured emergency department patients who report using alcohol and marijuana

    Directory of Open Access Journals (Sweden)

    Woolard Robert

    2009-01-01

    Full Text Available Background: Brief intervention (BI to reduce hazardous drinking and negative consequences such as injury has been effective when given in the emergency department (ED. The effectiveness and effect of BI has varied between injured and uninjured ED patients. This study compares injured and uninjured ED patients who admit to alcohol and marijuana use to determine their need and their readiness for BI. Patients and Methods: Participants volunteered to enter a randomized controlled trial of BI to reduce hazardous alcohol and marijuana use. Adult ED patients who had had alcohol in the last month and smoked marijuana in the last year were recruited. Those patients who were admitted to hospital, were under police custody, or were seeking treatment for substance use or psychiatric disorder were excluded. Research assistants interviewed participants using a validated questionnaire. Data were analyzed using SAS (version 9.1. Binominal tests of proportions, t-test analyses, and transformations were conducted as appropriate. Results: Injured (n = 249 and uninjured (n = 266 study participants reported very high, statistically equivalent (P > 0.05, rates of binge drinking (4-5 days/month, marijuana use (13 days/month, driving under the influence of marijuana or alcohol (>49% in the last 3 months, injury (>83% in the last year, and other negative consequences (>64% in the last 3 months prior to their ED visit. These behaviors and the consequences demonstrate a need for change. Both injured and uninjured subjects were ready to change (>56% and confident they could change (>91% alcohol and marijuana use. Discussion: ED patients who admit to alcohol and marijuana use also use other hazardous substances and participate in high-risk behaviors. In both injured and uninjured patients who admit using alcohol and marijuana, the ED visit is an opportunity to deliver BI to reduce alcohol and marijuana use and associated risk behaviors and the subsequent injury and

  3. Risk-based consequences of extreme natural hazard processes in mountain regions - Multi-hazard analysis in Tyrol (Austria)

    Science.gov (United States)

    Huttenlau, Matthias; Stötter, Johann

    2010-05-01

    Reinsurance companies are stating a high increase in natural hazard related losses, both insured and economic losses, within the last decades on a global scale. This ongoing trend can be described as a product of the dynamic in the natural and in the anthroposphere. To analyze the potential impact of natural hazard process to a certain insurance portfolio or to the society in general, reinsurance companies or risk management consultants have developed loss models. However, those models are generally not fitting the scale dependent demand on regional scales like it is appropriate (i) for analyses on the scale of a specific province or (ii) for portfolio analyses of regional insurance companies. Moreover, the scientific basis of most of the models is not transparent documented and therefore scientific evaluations concerning the methodology concepts are not possible (black box). This is contrary to the scientific principles of transparency and traceability. Especially in mountain regions like the European Alps with their inherent (i) specific characteristic on small scales, (ii) the relative high process dynamics in general, (iii) the occurrence of gravitative mass movements which are related to high relief energy and thus only exists in mountain regions, (iv) the small proportion of the area of permanent settlement on the overall area, (v) the high value concentration in the valley floors, (vi) the exposition of important infrastructures and lifelines, and others, analyses must consider these circumstances adequately. Therefore, risk-based analyses are methodically estimating the potential consequences of hazard process on the built environment standardized with the risk components (i) hazard, (ii) elements at risk, and (iii) vulnerability. However, most research and progress have been made in the field of hazard analyses, whereas the other both components are not developed accordingly. Since these three general components are influencing factors without any

  4. Prescription of the High Risk Narcotics and Trading or Illicit Purchasing of High Risk Narcotics

    Directory of Open Access Journals (Sweden)

    Nicoleta-Elena Buzatu

    2012-05-01

    Full Text Available The present essay will analyze the offence of prescribing high risk narcotics and trading or illicit purchasing of high risk narcotics, as it was regulated - together with other offences - by Law no 143 of July 26, 2000 on preventing and fighting against the traffic and illicit consumption of narcotics. The same law defines the meaning of such a phrase “substances which are under national control” by mentioning the fact that they are the narcotics and their precursors listed in Annexes I-IV of the law. The analysis of the offence of prescribing the high risk narcotics and trading or illicit purchasing of high risk narcotics is following the already known structure mentioned in the doctrine and which consists of: object and subjects of the offence, its constituent content: the objective side with its material element, the immediate consequence and causality connections; the subjective side of the offence, as well as forms and modalities of these offences, and the applicable sanctions, of course.

  5. Risks and Transaction Costs of Distributed-Ledger Fintech: Boundary Effects and Consequences

    OpenAIRE

    Kaivanto, Kim; Prince, Daniel

    2017-01-01

    Fintech business models based on distributed ledgers -- and their smart-contract variants in particular -- offer the prospect of democratizing access to faster, anywhere-accessible, lower cost, reliable-and-secure high-quality financial services. In addition to holding great, economically transformative promise, these business models pose new, little-studied risks and transaction costs. However, these risks and transaction costs are not evident during the demonstration and testing phases of d...

  6. Identifying patients at high risk for obstructive sleep apnoea ...

    African Journals Online (AJOL)

    Background: Obstructive sleep apnoea is associated with significant health consequences. A significant proportion of hospitalized patients at risk for obstructive sleep apnoea were never identified and referred for polysomnography for diagnosis. The objective of this study was to determine the factors associated with high ...

  7. Back pain and its consequences among Polish Air Force pilots flying high performance aircraft

    Directory of Open Access Journals (Sweden)

    Aleksandra Truszczyńska

    2014-04-01

    Full Text Available Objectives: Back pain in Air Force fast jet pilots has been studied by several air forces and found to be relatively common. The objective of the study was to determine the prevalence and degree of the pain intensity in the cervical, thoracic and lumbar spine, subjective risk factors and their effect on the pilots' performance while flying high maneuver aircrafts and the consequences for cognitive deficiencies. Material and Methods: The study was designed as a retrospective, anonymous questionnaire survey, collecting data on the age, aircraft type, flying hours, pain characteristics, physical activity, etc. The study was participated by 94 pilots aged 28-45 years (mean age: 35.9±3.3 years, actively flying fast jet aircrafts Su-22, Mig-29 and F-16. The estimates regarding the level of the subjective back pain were established using visual analogue scales (VAS. Results: The values of the Cochran and Cox T-test for heterogeneous variances are as follows: for the total number of flying hours: F = 2.53, p = 0.0145, for the pilot's age: F = 3.15, p = 0.003, and for the BMI factor F = 2.73, p = 0.008. Conclusions: Our questionnaire survey showed a significant problem regarding spinal conditions in high performance aircraft pilots. The determination of the risk factors may lead to solving this problem and help eliminate the effect of the unfavorable environment on piloting jet aircrafts. Experiencing back pain during the flight might influence the mission performance and flight safety. The costs of pilots education are enormous and inability to fly, or even disability, leads to considerable economic loss. More research on specific prevention strategies is warranted in order to improve the in-flight working environment of fighter pilots.

  8. Dutch monitor on stress and physical load: risk factors, consequences, and preventive action.

    Science.gov (United States)

    Houtman, I L; Goudswaard, A; Dhondt, S; van der Grinten, M P; Hildebrandt, V H; van der Poel, E G

    1998-02-01

    Due to recent changes in legislation on occupational health and safety, a national monitor on stress and physical load was developed in The Netherlands to monitor (a) risks and consequences of stress and physical load at work, (b) preventive actions in companies to reduce these risks, and (c) organisational and environmental variables that facilitate preventive actions. Information was gathered from employers, employees, and employees' representatives. The monitor was used with a nationally representative sample of companies in industry, wholesale trade, and banking and finance, 782 companies in total. The information from the employees, aggregated at the company level, was not found to be correlated with that from the employer from the same companies. Although many employers do recognise risk factors for both physical load and stress as a problem they often seem to underestimate the problem when compared with employees or their representatives. This is particularly the case for psychosocial risk factors. Also, the perception of outcome measures, especially employers who consider emotional exhaustion to be work related, were fewer than the employees' representatives of the same organisation. Preventive measures on physical load are much more popular than measures against stress. It is the responsibility of the employer to take more preventive action of all kinds. They need to recognise risk factors as problems and health outcomes to be related to work. Employees of larger companies should participate with employers to consider effective measures, and more use should be made of support at branch level. For specific preventive measures, specific predictors emerged. Except for measures to prevent work stress, information from employees did not sufficiently contribute to the initiation of preventive measures in the workplace.

  9. Race, gender, and risk perceptions of the legal consequences of drinking and driving.

    Science.gov (United States)

    Sloan, Frank A; Chepke, Lindsey M; Davis, Dontrell V

    2013-06-01

    This study investigated whether subjective beliefs about the consequences of driving while intoxicated (DWI) differ by race/gender. Beliefs affect driving behaviors and views of police/judicial fairness. The researchers compared risk perceptions of DWI using a survey of drinkers in eight cities in four states with actual arrest and conviction rates and fines from court data in the same cities. With state arrest data as a benchmark, Black males were overly pessimistic about being stopped, whether or not actual drinking occurred, and attributed higher jail penalties to DWI conviction. That Black males overestimated jail sentences incurred by the general population suggests that they did not attribute higher jail penalties to racial bias. Arrest data did not reveal disparities in judicial outcomes following DWI arrest. Blacks' subjective beliefs about DWI consequences may reflect social experiences, which are not jurisdiction- or crime-specific; this is a challenge to policymakers aiming to deter DWI by changing statutes and enforcement. If perception of bias exists despite no actual bias, a change in enforcement policy would not be effective, but a public relations campaign would be helpful in realigning beliefs. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

  10. Prevalence, Risk Factors and Consequent Effect of Dystocia in Holstein Dairy Cows in Iran

    Science.gov (United States)

    Atashi, Hadi; Abdolmohammadi, Alireza; Dadpasand, Mohammad; Asaadi, Anise

    2012-01-01

    The objective of this research was to determine the prevalence, risk factors and consequent effect of dystocia on lactation performance in Holstein dairy cows in Iran. The data set consisted of 55,577 calving records on 30,879 Holstein cows in 30 dairy herds for the period March 2000 to April 2009. Factors affecting dystocia were analyzed using multivariable logistic regression models through the maximum likelihood method in the GENMOD procedure. The effect of dystocia on lactation performance and factors affecting calf birth weight were analyzed using mixed linear model in the MIXED procedure. The average incidence of dystocia was 10.8% and the mean (SD) calf birth weight was 42.13 (5.42) kg. Primiparous cows had calves with lower body weight and were more likely to require assistance at parturition (pdystocia than male calves (pdystocia than singletons (pdystocia at calving compared with those that did not (p<0.05). PMID:25049584

  11. Romanian experience in a assessment of the risk and environmental consequences due to radioactive materials transportation

    International Nuclear Information System (INIS)

    Vieru, Gheorghe

    2006-01-01

    Full text: The transport of radioactive materials (RAM) is a very important problem taking into consideration its potential risks over the environment and the radiological consequences of this activity. Romania as a Member State of the International Atomic Energy Agency has implemented national regulations for a safe transport of RAM in complying with the Agency's recommendations as well as other international specialized organizations. The paper will present the main sources of radioactive materials in Romania, and their transportation routes with a particular focus on the radioactive wastes (very low level and mixed low-level radioactive materials), radioactive isotopes and sources, and natural uranium ore. Starting from the fact that the safety in the transport of radioactive materials is dependent on packaging appropriate for the contents being shipped, rather than operational and/or administrative actions required for the package, the paper presents, very briefly, the qualification tests for the main packages used for transport and storage of RAM in Romania. There are presented also specific problems related to the identification and evaluation of the environmental risks and impacts as well as the potential radiological consequences associated with the transport of radioactive materials, for all those three possible situations: routine transport (without incidents), normal transport (with minor incidents) and during potential accidents. As a conclusion, it is stated that the evaluated annual collective dose for the population due to RAM transport is less than those received by natural radiation sources. At the same time it is concluded that Romanian made packages are safe and prevent loss of its radioactive contents into environment. (author)

  12. Risk-based input-output analysis of influenza epidemic consequences on interdependent workforce sectors.

    Science.gov (United States)

    Santos, Joost R; May, Larissa; Haimar, Amine El

    2013-09-01

    Outbreaks of contagious diseases underscore the ever-looming threat of new epidemics. Compared to other disasters that inflict physical damage to infrastructure systems, epidemics can have more devastating and prolonged impacts on the population. This article investigates the interdependent economic and productivity risks resulting from epidemic-induced workforce absenteeism. In particular, we develop a dynamic input-output model capable of generating sector-disaggregated economic losses based on different magnitudes of workforce disruptions. An ex post analysis of the 2009 H1N1 pandemic in the national capital region (NCR) reveals the distribution of consequences across different economic sectors. Consequences are categorized into two metrics: (i) economic loss, which measures the magnitude of monetary losses incurred in each sector, and (ii) inoperability, which measures the normalized monetary losses incurred in each sector relative to the total economic output of that sector. For a simulated mild pandemic scenario in NCR, two distinct rankings are generated using the economic loss and inoperability metrics. Results indicate that the majority of the critical sectors ranked according to the economic loss metric comprise of sectors that contribute the most to the NCR's gross domestic product (e.g., federal government enterprises). In contrast, the majority of the critical sectors generated by the inoperability metric include sectors that are involved with epidemic management (e.g., hospitals). Hence, prioritizing sectors for recovery necessitates consideration of the balance between economic loss, inoperability, and other objectives. Although applied specifically to the NCR, the proposed methodology can be customized for other regions. © 2012 Society for Risk Analysis.

  13. THE IMPORTANCE OF AFFECT TO BUILD CONSUMER TRUST IN HIGH-CONSEQUENCES EXCHANGES

    Directory of Open Access Journals (Sweden)

    Mellina da Silva Terres

    2012-12-01

    Full Text Available The present article investigates the importance of affect displayed by service provider to build consumer trust in high consequence exchanges. High-consequence exchanges are difficult situations in which the choices present a dilemma that can cause stress and severe emotional reactions (KAHN; LUCE, 2003. In this specific case, trust based on affect seems to become important; mainly because consumers may not have ability to evaluate the cognitive aspects of the situation, and moreover, a medical services failure can be highly problematic or even fatal (LEISEN; HYMAN, 2004. On the other hand, in low-consequence choices, we are predicting that cognition will be more important than affect in building trust. In this kind of situation, patients are more self-confident, less sensitive, and don’t perceive a high probability of loss (KUNREUTHER et al., 2002, and therefore focuses more on the rational outcomes.

  14. The renal consequences of maternal obesity in offspring are overwhelmed by postnatal high fat diet

    Science.gov (United States)

    Glastras, Sarah J.; Chen, Hui; Tsang, Michael; Teh, Rachel; McGrath, Rachel T.; Zaky, Amgad; Chen, Jason; Wong, Muh Geot; Pollock, Carol A.; Saad, Sonia

    2017-01-01

    Aims/Hypothesis Developmental programming induced by maternal obesity influences the development of chronic disease in offspring. In the present study, we aimed to determine whether maternal obesity exaggerates obesity-related kidney disease. Methods Female C57BL/6 mice were fed high-fat diet (HFD) for six weeks prior to mating, during gestation and lactation. Male offspring were weaned to normal chow or HFD. At postnatal Week 8, HFD-fed offspring were administered one dose streptozotocin (STZ, 100 mg/kg i.p.) or vehicle control. Metabolic parameters and renal functional and structural changes were observed at postnatal Week 32. Results HFD-fed offspring had increased adiposity, glucose intolerance and hyperlipidaemia, associated with increased albuminuria and serum creatinine levels. Their kidneys displayed structural changes with increased levels of fibrotic, inflammatory and oxidative stress markers. STZ administration did not potentiate the renal effects of HFD. Though maternal obesity had a sustained effect on serum creatinine and oxidative stress markers in lean offspring, the renal consequences of maternal obesity were overwhelmed by the powerful effect of diet-induced obesity. Conclusion Maternal obesity portends significant risks for metabolic and renal health in adult offspring. However, diet-induced obesity is an overwhelming and potent stimulus for the development of CKD that is not potentiated by maternal obesity. PMID:28225809

  15. The renal consequences of maternal obesity in offspring are overwhelmed by postnatal high fat diet.

    Directory of Open Access Journals (Sweden)

    Sarah J Glastras

    Full Text Available Developmental programming induced by maternal obesity influences the development of chronic disease in offspring. In the present study, we aimed to determine whether maternal obesity exaggerates obesity-related kidney disease.Female C57BL/6 mice were fed high-fat diet (HFD for six weeks prior to mating, during gestation and lactation. Male offspring were weaned to normal chow or HFD. At postnatal Week 8, HFD-fed offspring were administered one dose streptozotocin (STZ, 100 mg/kg i.p. or vehicle control. Metabolic parameters and renal functional and structural changes were observed at postnatal Week 32.HFD-fed offspring had increased adiposity, glucose intolerance and hyperlipidaemia, associated with increased albuminuria and serum creatinine levels. Their kidneys displayed structural changes with increased levels of fibrotic, inflammatory and oxidative stress markers. STZ administration did not potentiate the renal effects of HFD. Though maternal obesity had a sustained effect on serum creatinine and oxidative stress markers in lean offspring, the renal consequences of maternal obesity were overwhelmed by the powerful effect of diet-induced obesity.Maternal obesity portends significant risks for metabolic and renal health in adult offspring. However, diet-induced obesity is an overwhelming and potent stimulus for the development of CKD that is not potentiated by maternal obesity.

  16. Occupational diseases in the Netherlands: incidence, type, consequences and risk factors: abstract and presentation

    NARCIS (Netherlands)

    Venema, A.; Steenbeek, R.; Dam, L. van; Vroome, E. de

    2017-01-01

    Objectives: Occupational diseases are common and result in a substantial disease burden and high sickness absence. Reliable data on the incidence and a better understanding of the risk factors will help to develop preventive measures. Methods: Several sources of measuring occupational diseases were

  17. Awareness of Consequence of High School Students on Loss of Bio-Diversity

    Science.gov (United States)

    Kasot, Nazim; Özbas, Serap

    2015-01-01

    The aim of this study is to assess the egoistic, altruistic and biospheric awareness of the consequence of high school students regarding the loss of bio-diversity, then comparing the results on the basis of some independent variables (gender, class and family income). The research data were collected from 884 ninth and tenth grade high school…

  18. Petroleum business of high risk

    International Nuclear Information System (INIS)

    Carta Petrolera

    2001-01-01

    The paper is about the economic risk and of the geologic risk that assist the industry of the petroleum; an analysis of these types of risk, possibilities of success and investments to carry out in the search of hydrocarbons are made

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Julie A Beston

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

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

    Science.gov (United States)

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

    2016-01-01

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

  2. Evaluation of nuclear accidents consequences. Risk assessment methodologies, current status and applications

    International Nuclear Information System (INIS)

    Rodriguez, J.M.

    1996-01-01

    General description of the structure and process of the probabilistic methods of assessment the external consequences in the event of nuclear accidents is presented. attention is paid in the interface with Probabilistic Safety Analysis level 3 results (source term evaluation) Also are described key issues in accident consequence evaluation as: effects evaluated (early and late health effects and economic effects due to countermeasures), presentation of accident consequences results, computer codes. Briefly are presented some relevant areas for the applications of Accident Consequence Evaluation

  3. Risk perception in women with high-risk pregnancies

    OpenAIRE

    Lee, S.

    2014-01-01

    Risk perception in women with high risk pregnancies affects the decisions they make about antenatal care and so may therefore influence the wellbeing of mother and baby. This article addresses the factors which influence women when making risk assessments and how these assessments may differ from those of healthcare professionals.\\ud \\ud Women use multiple sources of information to determine their risk status including advice from professionals, from other trusted sources, and their own intui...

  4. 49 CFR 192.905 - How does an operator identify a high consequence area?

    Science.gov (United States)

    2010-10-01

    ...) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY TRANSPORTATION OF NATURAL AND OTHER GAS BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Gas Transmission Pipeline Integrity Management § 192.905 How does an operator identify a high consequence area? (a...

  5. [Stigma - risk factor and consequence of suicidal behavior : Implications for suicide prevention].

    Science.gov (United States)

    Oexle, N; Rüsch, N

    2017-11-16

    Mental illness, previous suicidal behavior and loss of a relative by suicide are strong risk factors for suicidality. Both mental illness and suicide are stigmatized, which is a burden for those affected and potentially contributes to suicidality among stigmatized individuals. Many consequences of stigma, e. g. social isolation, low self-esteem and hopelessness, are well-known predictors of suicidality. Interventions to reduce stigmatization might therefore be an important component of successful suicide prevention. This paper discusses the currently available knowledge regarding this hypothesis. Many studies confirmed the association between the stigmatization of mental illness and suicidality and there is initial evidence for the influence of suicide stigma and suicidality. Nevertheless, the effectiveness of anti-stigma interventions to reduce suicidality and prevent suicide has not yet been tested. Reducing stigma among members of the general population and mental health care professionals as well as programs to support individuals in coping with stigmatization could be important components of successful suicide prevention.

  6. Prevalence, Risk Factors and Consequent Effect of Dystocia in Holstein Dairy Cows in Iran

    Directory of Open Access Journals (Sweden)

    Hadi Atashi

    2012-04-01

    Full Text Available The objective of this research was to determine the prevalence, risk factors and consequent effect of dystocia on lactation performance in Holstein dairy cows in Iran. The data set consisted of 55,577 calving records on 30,879 Holstein cows in 30 dairy herds for the period March 2000 to April 2009. Factors affecting dystocia were analyzed using multivariable logistic regression models through the maximum likelihood method in the GENMOD procedure. The effect of dystocia on lactation performance and factors affecting calf birth weight were analyzed using mixed linear model in the MIXED procedure. The average incidence of dystocia was 10.8% and the mean (SD calf birth weight was 42.13 (5.42 kg. Primiparous cows had calves with lower body weight and were more likely to require assistance at parturition (p<0.05. Female calves had lower body weight, and had a lower odds ratio for dystocia than male calves (p<0.05. Twins had lower birth weight, and had a higher odds ratio for dystocia than singletons (p<0.05. Cows which gave birth to a calf with higher weight at birth experienced more calving difficulty (OR (95% CI = 1.1(1.08–1.11. Total 305-d milk, fat and protein yield was 135 (23, 3.16 (0.80 and 6.52 (1.01 kg less, in cows that experienced dystocia at calving compared with those that did not (p<0.05.

  7. Urinary tract infection (UTI) in newborns: risk factors, identification and prevention of consequences.

    Science.gov (United States)

    Milas, Vesna; Puseljić, Silvija; Stimac, Maja; Dobrić, Hana; Lukić, Gordana

    2013-09-01

    The aim of the study is identification of urinary tract infections (UTI) and urinary tract anomalies (UTA) already in the perinatal period. The authors attempted to prevent serious consequences of the above conditions in the examined children. Family history data, certain conditions in pregnancy and appertaining symptoms in children were elaborated to specify selective distinctive criteria for children at risk. Newborns (1200) were selected for potential existence of a UTI. All the examined newborns underwent a urinalysis. Those with significant bacteriuria were taken urine specimens, C-reactive protein (RVP), Complete Blood Count (CBC) and bilirubin. The newborns with a UTI and a suspected UTA were sent to ultrasound examination, direct radio nuclide cystography and Tc99m MAG3 dynamic scanning. The frequency of a UTI in the perinatal period amounted to 4.5%. A UTA was found in 29.6% of the examinees. The infection was more likely to appear among newborns with a UTA in their families, a UTI, pre-eclampsia and a febrile infection in mother, intrauterine growth retardation, premature rupture of membranes (RVP), umbilical cord strangulation, jaundice, cyanosis, breathing difficulties, seizures and asphyxia.

  8. [Neonatal arterial ischemic stroke: Which thrombotic biological risk factors to investigate and which practical consequences?

    Science.gov (United States)

    Perez, T; Valentin, J B; Saliba, E; Gruel, Y

    2017-09-01

    All biological risk factors that have been previously identified to increase the risk of thrombosis in adults, have also been studied in neonates with arterial Ischemic Stroke (NAIS), but most studies were retrospective and included relatively low numbers of affected children. We therefore could not suggest recommendations with a strong level of evidence and only expert proposals potentially useful for clinical practice will be presented in this text. Despite these limitations, the extensive analysis of published data supported that factor V Leiden (FVL) and increased levels of Lp(a) could be significant risk factors for NAIS. Importantly, these 2 risk factors cannot be considered as having provoked NAIS, and moreover, they do not influence the prognosis and the immediate treatment. However, since the FVL may have an impact for the prescription of a thromboprophylaxis when the neonate will become adult, to look for its presence in affected patients may be justified. For clinical practice, the following propositions can be applied: 1. Routine testing for thrombophilia (AT, PC PS deficiency, FV Leiden or FII20210A) or for detecting other biological risk factors such as antiphospholipid antibodies, high FVIII, homocystein or Lp(a) levels, MTHFR thermolabile variant, should not be considered in neonates with NAIS. 2. Testing for FV Leiden can be performed in case of documented family history of venous thromboembolic disease. 3. Testing neonates for the presence of antiphospholipid antibodies (APA) is mandatory in case of clinical events suggesting antiphospholipid syndrome in the mother (vascular thrombosis, and/or pregnancy morbidity). 4. Routine testing for thrombophilia is not proposed in both parents in case of early death of the neonate, apart from APA in the mother. © 2017 Elsevier Masson SAS. Tous droits réservés.

  9. List of High risk countries

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

    Francine Sinzinkayo

    2013-07-26

    Higher Risk Countries and Territories. Reviewed regularly. Last update: July 26, 2013. Country/Territory. Note (1). Sources of Concern. Canadian. Law or. Policy. Knowledge of research setting. Ability to monitor research activities. (Note 2). Operational. Issues. (Note 3). Banking. Restrictions. (Note 4). Afghanistan. X. X.

  10. Intimate partner violence as seen in post-conflict eastern Uganda: prevalence, risk factors and mental health consequences.

    Science.gov (United States)

    Kinyanda, Eugene; Weiss, Helen A; Mungherera, Margaret; Onyango-Mangen, Patrick; Ngabirano, Emmanuel; Kajungu, Rehema; Kagugube, Johnson; Muhwezi, Wilson; Muron, Julius; Patel, Vikram

    2016-01-29

    Conflict and post-conflict communities in sub-Saharan Africa have a high under recognised problem of intimate partner violence (IPV). Part of the reason for this has been the limited data on IPV from conflict affected sub-Saharan Africa. This paper reports on the prevalence, risk factors and mental health consequences of IPV victimisation in both gender as seen in post-conflict eastern Uganda. A cross-sectional survey was carried out in two districts of eastern Uganda. The primary outcome of IPV victimisation was assessed using a modified Intimate Partner Violence assessment questionnaire of the American Congress of Obstetricians and Gynaecologists. The prevalence of any form of IPV victimisation (physical and/or sexual and/or psychological IPV) in this study was 43.7 % [95 % CI, 40.1-47.4 %], with no statistically significant difference between the two gender. The factors significantly associated with IPV victimisation were: sub-county (representing ecological factors), poverty, use of alcohol, and physical and sexual war torture experiences. The mental health problems associated with IPV victimisation were probable problem alcohol drinking, attempted suicide and probable major depressive disorder. In post-conflict eastern Uganda, in both gender, war torture was a risk factor for IPV victimisation and IPV victimisation was associated with mental health problems.

  11. PERSPECTIVE: Technical fixes and climate change: optimizing for risks and consequences

    Science.gov (United States)

    Rasch, Philip J.

    2010-09-01

    Scientists and society in general are becoming increasingly concerned about the risks of climate change from the emission of greenhouse gases (IPCC 2007). Yet emissions continue to increase (Raupach et al 2007), and achieving reductions soon enough to avoid large and undesirable impacts requires a near-revolutionary global transformation of energy and transportation systems (Hoffert et al 1998). The size of the transformation and lack of an effective societal response have motivated some to explore other quite controversial strategies to mitigate some of the planetary consequences of these emissions. These strategies have come to be known as geoengineering: 'the deliberate manipulation of the planetary environment to counteract anthropogenic climate change' (Keith 2000). Concern about society's inability to reduce emissions has driven a resurgence in interest in geoengineering, particularly following the call for more research in Crutzen (2006). Two classes of geoengineering solutions have developed: (1) methods to draw CO2 out of the atmosphere and sequester it in a relatively benign form; and (2) methods that change the energy flux entering or leaving the planet without modifying CO2 concentrations by, for example, changing the planetary albedo. Only the latter methods are considered here. Summaries of many of the methods, scientific questions, and issues of testing and implementation are discussed in Launder and Thompson (2009) and Royal Society (2009). The increased attention indicates that geoengineering is not a panacea and all strategies considered will have risks and consequences (e.g. Robock 2008, Trenberth and Dai 2007). Recent studies involving comprehensive Earth system models can provide insight into subtle interactions between components of the climate system. For example Rasch et al (2009) found that geoengineering by changing boundary clouds will not simultaneously 'correct' global averaged surface temperature, precipitation, and sea ice to present

  12. Adolescents who perceive fewer consequences of risk-taking choose to switch off games later at night.

    Science.gov (United States)

    Reynolds, Chelsea M; Gradisar, Michael; Kar, Kellyann; Perry, Ashleigh; Wolfe, Jasper; Short, Michelle A

    2015-05-01

    Technology use by adolescents close to bedtime commonly leads to sleep problems, and individual factors predicting those at heightened risk are under studied. We investigated whether risk-taking perceptions influenced length of adolescent technology use at bedtime and whether being aware of time moderated this association. We recruited 16 males and five females, with a mean age of 17.6 years, from school and university populations to assess adolescent technology use and bedtimes. They were assessed for trait risk-taking using the Cognitive Appraisal of Risky Events questionnaire and had unrestrained access to a video game on two separate nights, counterbalanced for clock present or clock absent conditions. The adolescents' self-selected bedtime provided a measure of the level of technology use and was the dependent variable. Adolescents who perceived fewer negative consequences of risky activities on the Cognitive Appraisal of Risky Events played the video game longer and went to bed later than those who perceived more negative consequences (p = 0.03). There was no influence on bedtimes from perceived benefits of risk-taking or clock presence. Adolescents who perceived fewer negative consequences of risk-taking were more likely to stay up later using technology, facing a heightened risk of displaced sleep. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  13. Evaluation of severe accident risks: Quantification of major input parameters: MAACS [MELCOR Accident Consequence Code System] input

    International Nuclear Information System (INIS)

    Sprung, J.L.; Jow, H-N; Rollstin, J.A.; Helton, J.C.

    1990-12-01

    Estimation of offsite accident consequences is the customary final step in a probabilistic assessment of the risks of severe nuclear reactor accidents. Recently, the Nuclear Regulatory Commission reassessed the risks of severe accidents at five US power reactors (NUREG-1150). Offsite accident consequences for NUREG-1150 source terms were estimated using the MELCOR Accident Consequence Code System (MACCS). Before these calculations were performed, most MACCS input parameters were reviewed, and for each parameter reviewed, a best-estimate value was recommended. This report presents the results of these reviews. Specifically, recommended values and the basis for their selection are presented for MACCS atmospheric and biospheric transport, emergency response, food pathway, and economic input parameters. Dose conversion factors and health effect parameters are not reviewed in this report. 134 refs., 15 figs., 110 tabs

  14. [A model list of high risk drugs].

    Science.gov (United States)

    Cotrina Luque, J; Guerrero Aznar, M D; Alvarez del Vayo Benito, C; Jimenez Mesa, E; Guzman Laura, K P; Fernández Fernández, L

    2013-12-01

    «High-risk drugs» are those that have a very high «risk» of causing death or serious injury if an error occurs during its use. The Institute for Safe Medication Practices (ISMP) has prepared a high-risk drugs list applicable to the general population (with no differences between the pediatric and adult population). Thus, there is a lack of information for the pediatric population. The main objective of this work is to develop a high-risk drug list adapted to the neonatal or pediatric population as a reference model for the pediatric hospital health workforce. We made a literature search in May 2012 to identify any published lists or references in relation to pediatric and/or neonatal high-risk drugs. A total of 15 studies were found, from which 9 were selected. A model list was developed mainly based on the ISMP one, adding strongly perceived pediatric risk drugs and removing those where the pediatric use was anecdotal. There is no published list that suits pediatric risk management. The list of pediatric and neonatal high-risk drugs presented here could be a «reference list of high-risk drugs » for pediatric hospitals. Using this list and training will help to prevent medication errors in each drug supply chain (prescribing, transcribing, dispensing and administration). Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  15. Does Alcohol Use Mediate the Association between Consequences Experienced in High School and Consequences Experienced during the First Semester of College?

    Science.gov (United States)

    Romosz, Ann Marie; Quigley, Brian M.

    2013-01-01

    Approximately 80% of college students drink alcohol; almost half of these students reporting that they drink to get drunk and over 22% engage in heavy episodic drinking. Heavy alcohol consumption during the transition from high school to college is associated with negative personal and academic consequences. Sixty-seven freshmen volunteered to…

  16. Resuscitation of newborn in high risk deliveries

    International Nuclear Information System (INIS)

    Yousaf, U.F.; Hayat, S.

    2015-01-01

    High risk deliveries are usually associated with increased neonatal mortality and morbidity. Neonatal resuscitation can appreciably affect the outcome in these types of deliveries. Presence of personnel trained in basic neonatal resuscitation at the time of delivery can play an important role in reducing perinatal complications in neonates at risk. The study was carried out to evaluate the effects of newborn resuscitation on neonatal outcome in high risk deliveries. Methods: This descriptive case series was carried out at the Department of Obstetrics and Gynecology, Jinnah Hospital, Lahore. Ninety consecutive high risk deliveries were included and attended by paediatricians trained in newborn resuscitation. Babies delivered by elective Caesarean section, normal spontaneous vaginal deliveries and still births were excluded. Neonatal resuscitation was performed in babies who failed to initiate breathing in the first minute after birth. Data was analyzed using SPSS-16.0. Results: A total of 90 high risk deliveries were included in the study. Emergency caesarean section was the mode of delivery in 94.4% (n=85) cases and spontaneous vaginal delivery in 5.6% (n=5). Preterm pregnancy was the major high risk factor. Newborn resuscitation was required in 37.8% (n=34) of all high risk deliveries (p=0.013). All the new-borns who required resuscitation survived. Conclusion: New-born resuscitation is required in high risk pregnancies and personnel trained in newborn resuscitation should be available at the time of delivery. (author)

  17. A risk measurement tool for an underground electricity distribution system considering the consequences and uncertainties of manhole events

    International Nuclear Information System (INIS)

    Garcez, Thalles Vitelli; Teixeira de Almeida, Adiel

    2014-01-01

    This paper explores a risk measure of underground vaults that considers the consequences of arc faults. The increasing use of underground systems, together with the aging of networks, the lack of maintenance and interference from other (third party) underground systems nearby have caused many accidents in urban areas, thus endangering human life. The involvement of a large number (hundreds or thousands) of underground vaults with different characteristics, the lack of historical data on modes of failure, the rarity of the occurrence of some faults, the magnitude of their consequences and the involvement of a complex environment surrounding the hazard zone make risk management even more complex and uncertain. Furthermore, given that the (monetary, time, staff, etc.) resources of an electrical power company are limited and scarce, it is necessary to use decision-making tools that aggregate the consequences and the uncertainties to assess the risks jointly with the preference structure of the company, thus solving the problem more realistically. Therefore, this paper puts forward the use of an additional risk analysis for manhole events in underground electrical distribution networks with a view to its being used as a decision aid tool in risk management. As an illustration of the use of the risk measurement tool proposed, a numerical application is presented. The result rather than showing a ranking of underground vaults, gives a measure of the risk used that can show the decision-maker (DM) how much better one group of alternatives (formed by alternatives with quite similar risk values) is than other groups, based on the DM’s attitude to risk and grounded on the axiomatic structure of utility theory. - Highlights: • The paper proposes a risk measure of underground vaults for manhole events. • It makes risk analysis in underground electrical distribution networks. • It makes more than show a risk ranking of underground vaults. • It can show to the DM how

  18. Re-assessment of road accident data-analysis policy : applying theory from involuntary, high-consequence, low-probability events like nuclear power plant meltdowns to voluntary, low-consequence, high-probability events like traffic accidents

    Science.gov (United States)

    2002-02-01

    This report examines the literature on involuntary, high-consequence, low-probability (IHL) events like nuclear power plant meltdowns to determine what can be applied to the problem of voluntary, low-consequence high-probability (VLH) events like tra...

  19. Victimization of patients with severe psychiatric disorders: prevalence, risk factors, protective factors and consequences for mental health. A longitudinal study

    Directory of Open Access Journals (Sweden)

    Van Rien

    2010-11-01

    Full Text Available Abstract Background Victimization among people with a Severe Mental Illness is a common phenomenon. The objectives of this study proposal are: to delineate the extent and kind of victimization in a representative sample of chronic psychiatric patients; to contribute to the development and validation of a set of instruments registering victimization of psychiatric patients; to determine risk factors and protective factors; and to gain insight into the possible consequences of victimization. Methods/Design An extensive data set of 323 patients with Sever Mental Illness (assessed 4 years ago is used. In 2010 a second measurement will be performed, enabling longitudinal research on the predictors and consequences of victimization. Discussion The consequences of (revictimization have barely been subjected to analysis, partially due to the lack of a comprehensive, conceptual model for victimization. This research project will contribute significantly to the scientific development of the conceptual model of victimization in chronic psychiatric patients.

  20. Improving antenatal risk assessment in women exposed to high risks.

    Science.gov (United States)

    Perry, Natasha; Newman, Louise K; Hunter, Mick; Dunlop, Adrian

    2015-01-01

    Antenatal substance use and related psychosocial risk factors are known to increase the likelihood of child protection involvement; less is known about the predictive nature of maternal reflective functioning (RF) in this population. This preliminary study assessed psychosocial and psychological risk factors for a group of substance dependent women exposed to high risks in pregnancy, and their impact on child protection involvement. Pregnant women on opiate substitution treatment (n = 11) and a comparison group (n = 15) were recruited during their third trimester to complete measures of RF (Pregnancy Interview), childhood trauma, mental health and psychosocial assessments. At postnatal follow-up, RF was reassessed (Parent Development Interview - Revised Short Version) and mother-infant dyads were videotaped to assess emotional availability (EA). Child protection services were contacted to determine if any concerns had been raised for infant safety. Significant between-group differences were observed for demographics, psychosocial factors, trauma and mental health symptoms. Unexpectedly, no significant differences were found for RF or EA between groups. Eight women in the 'exposed to high risks' group became involved with child protection services. Reflective functioning was not significantly associated with psychosocial risk factors, and therefore did not mediate the outcome of child protection involvement. Women 'exposed to high risks' were equally able to generate a model of their own and their infants' mental states and should not be seen within a deficit perspective. Further research is required to better understand the range of risk factors that predict child protection involvement in high risk groups. © The Author(s) 2013.

  1. Twinning in Iranian Holstein Dairy Cattle: A Study of Risk Factors and Production and Reproduction Consequences

    Directory of Open Access Journals (Sweden)

    abolfazl mahnani

    2016-08-01

    Full Text Available Introduction Cattle are a monotocous species meaning that, under most circumstances, a successful pregnancy results in the birth of one calf. Twinning rate has been reported in dairy cows from 3 to 5 percent, which can be influenced by maternal age.The birth of twins is detrimental to the majority of beef and dairy cattle producer. Financial loss arising from any of twinning has been reported in Europe between 109 to 201 dollars in recent years. Because it is associated with undesirable consequences such as reduced survival, calf, cow increased removal rate and poor performance. This also reduces pregnancy rates and profitability herds. One of the effects of twinning severe is reduction of the number of calves for replacement fertility in dairy cows. This is a loss arising from an increase in infant mortality and a gender bias in bull calves homo zygote.Twinning rate increases significantly the incidence of reproductive abnormalities, including the retained placenta, dystocia, stillbirth and abortion. Many studies have been done on the effect of multiple pregnancies in cattle production and reproduction. Higher milk production for cows twin issue is controversial as some studies have shown that there is a positive correlation between the rate of twinning in dairy cattle and milk production. But in the next lactation, production for cows that have been the twin of the infected cow metabolic disease in the previous period was lower. In a study reported that cows spend fewer days in the twin peak production. The results of the study on the effect of twinning on reproductive traits of Holstein cows-Farzin showed that only half of the twin cows are prone to reproduce in the next period. It is also reported a greater number of insemination per conception in twin compared to single cows. In addition, it has been reported that the twin was more than 15 days from calving to first services. Average twin cows experiencing 1.7 times more death and removal

  2. Systems engineering applied to integrated safety management for high consequence facilities

    International Nuclear Information System (INIS)

    Barter, R; Morais, B.

    1998-01-01

    Integrated Safety Management is a concept that is being actively promoted by the U.S. Department of Energy as a means of assuring safe operation of its facilities. The concept involves the integration of safety precepts into work planning rather than adjusting for safe operations after defining the work activity. The system engineering techniques used to design an integrated safety management system for a high consequence research facility are described. An example is given to show how the concepts evolved with the system design

  3. Evaluation of sanitary consequences of Chernobyl accident in France: epidemiological monitoring device, state of knowledge, evaluation of risks and perspectives

    International Nuclear Information System (INIS)

    Verger, P.; Champion, D.; Gourmelon, P.; Hubert, Ph.; Joly, J.; Renaud, Ph.; Tirmarche, M.; Vidal, M.; Cherie-Challine, L.; Boutou, O.; Isnard, H.; Jouan, M.; Pirard, Ph.

    2000-12-01

    The objectives of this document are firstly, to present the situation of knowledge both on the sanitary consequences of the Chernobyl accident and on the risk factors of thyroid cancers, these ones constituting one of the most principal consequences observed in Belarus, in Ukraine and Russia; secondly, the give the principal system contributing to the epidemiological surveillance of effects coming from a exposure to ionizing radiations, in France and to give the knowledge on incidence and mortality of thyroid cancer in France; thirdly, to discuss the pertinence and the feasibility of epidemiological approaches that could be considered to answer questions that the public and authorities ask relatively to the sanitary consequences of Chernobyl accident in France; fourthly to male a calculation of thyroid cancer risk in relation with Chernobyl fallout in France from works and studies made from 1986 on the consequences of this disaster in terms of radioecology and dosimetry at the national level. Besides, the improvement of thyroid cancer surveillance is also tackled. (N.C.)

  4. Global situational awareness and early warning of high-consequence climate change.

    Energy Technology Data Exchange (ETDEWEB)

    Backus, George A.; Carr, Martin J.; Boslough, Mark Bruce Elrick

    2009-08-01

    Global monitoring systems that have high spatial and temporal resolution, with long observational baselines, are needed to provide situational awareness of the Earth's climate system. Continuous monitoring is required for early warning of high-consequence climate change and to help anticipate and minimize the threat. Global climate has changed abruptly in the past and will almost certainly do so again, even in the absence of anthropogenic interference. It is possible that the Earth's climate could change dramatically and suddenly within a few years. An unexpected loss of climate stability would be equivalent to the failure of an engineered system on a grand scale, and would affect billions of people by causing agricultural, economic, and environmental collapses that would cascade throughout the world. The probability of such an abrupt change happening in the near future may be small, but it is nonzero. Because the consequences would be catastrophic, we argue that the problem should be treated with science-informed engineering conservatism, which focuses on various ways a system can fail and emphasizes inspection and early detection. Such an approach will require high-fidelity continuous global monitoring, informed by scientific modeling.

  5. Risk factors for and consequences of inadequate surgical margins in oral squamous cell carcinoma

    DEFF Research Database (Denmark)

    Lawaetz, Mads; Homøe, Preben

    2014-01-01

    OBJECTIVE: The purpose of this study was to examine which factors are associated with inadequate surgical margins and to assess the postoperative consequences. STUDY DESIGN: A retrospective cohort of 110 patients with oral squamous cell carcinoma treated with surgery during a 2-year period...

  6. Interaction between physical and psychosocial work risk factors for low back symptoms and its consequences amongst Indonesian coal mining workers.

    Science.gov (United States)

    Widanarko, Baiduri; Legg, Stephen; Devereux, Jason; Stevenson, Mark

    2015-01-01

    This study assessed the interaction between physical and psychosocial factors for low back symptoms (LBS) and its consequences (reduced activities and absenteeism) in a developing country. A sample of 1294 Indonesian coal mining workers reported occupational exposures, LBS and its consequences using a self-administered questionnaire. Respondents were placed into one of four combination exposure groups: high physical and high psychosocial (HPhyHPsy); high physical and low psychosocial (HPhyLPsy); low physical and high psychosocial (LPhyHPsy), and; low physical and low psychosocial (LPhyLPsy). The attributable proportion due to interaction between physical and psychosocial factors was examined. Individuals in the HPhyHPsy group were most likely to report LBS (OR 5.42, 95% CI 3.30-8.89), reduced activities (OR 4.89, 95% CI 3.09-7.74), and absenteeism (OR 4.96, 95% CI 3.05-8.06). Interactions between physical and psychosocial factors were present for LBS, reduced activities, and absenteeism; although for LBS and absenteeism the interactions were not significant. Current smokers were more likely to report LBS consequences. Permanent employment and night shift work increased the odds of LBS and its consequences. We conclude that interventions aimed at reducing LBS and its consequences should address both physical and psychosocial factors, with a focus on smokers, permanent employment and night shift work. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  7. Consequences of the new atomic bomb survivor dosimetry on radiation risk estimates

    International Nuclear Information System (INIS)

    Doerschel, B.

    1990-01-01

    The assessment of radiation risk includes the following steps: a) selection of biological data from epidemiological studies, b) adjustment of biological data to radiation doses, c) time projection of risk beyond the observation period. The life-time risk used by the ICRP since 1977 is mainly based on the epidemiological data for the survivors of Hiroshima and Nagasaki as well as on the linear dose-response and the absolute risk model. A re-evaluation of the life-time risk seems to be useful because since that time the observation period was further growing and better arguments for choosing a time projection model are available. On the other hand the revised dose can cause changes in the shape of the dose-response curves and of the RBE of neutrons. In the present paper the influence of these factors on the life-time risk will be investigated. (author)

  8. RISKIND: A computer program for calculating radiological consequences and health risks from transportation of spent nuclear fuel

    Energy Technology Data Exchange (ETDEWEB)

    Yuan, Y.C. [Square Y Consultants, Orchard Park, NY (US); Chen, S.Y.; Biwer, B.M.; LePoire, D.J. [Argonne National Lab., IL (US)

    1995-11-01

    This report presents the technical details of RISKIND, a computer code designed to estimate potential radiological consequences and health risks to individuals and the collective population from exposures associated with the transportation of spent nuclear fuel. RISKIND is a user-friendly, interactive program that can be run on an IBM or equivalent personal computer under the Windows{trademark} environment. Several models are included in RISKIND that have been tailored to calculate the exposure to individuals under various incident-free and accident conditions. The incident-free models assess exposures from both gamma and neutron radiation and can account for different cask designs. The accident models include accidental release, atmospheric transport, and the environmental pathways of radionuclides from spent fuels; these models also assess health risks to individuals and the collective population. The models are supported by databases that are specific to spent nuclear fuels and include a radionuclide inventory and dose conversion factors. In addition, the flexibility of the models allows them to be used for assessing any accidental release involving radioactive materials. The RISKIND code allows for user-specified accident scenarios as well as receptor locations under various exposure conditions, thereby facilitating the estimation of radiological consequences and health risks for individuals. Median (50% probability) and typical worst-case (less than 5% probability of being exceeded) doses and health consequences from potential accidental releases can be calculated by constructing a cumulative dose/probability distribution curve for a complete matrix of site joint-wind-frequency data. These consequence results, together with the estimated probability of the entire spectrum of potential accidents, form a comprehensive, probabilistic risk assessment of a spent nuclear fuel transportation accident.

  9. RISKIND: A computer program for calculating radiological consequences and health risks from transportation of spent nuclear fuel

    International Nuclear Information System (INIS)

    Yuan, Y.C.; Chen, S.Y.; Biwer, B.M.; LePoire, D.J.

    1995-11-01

    This report presents the technical details of RISKIND, a computer code designed to estimate potential radiological consequences and health risks to individuals and the collective population from exposures associated with the transportation of spent nuclear fuel. RISKIND is a user-friendly, interactive program that can be run on an IBM or equivalent personal computer under the Windows trademark environment. Several models are included in RISKIND that have been tailored to calculate the exposure to individuals under various incident-free and accident conditions. The incident-free models assess exposures from both gamma and neutron radiation and can account for different cask designs. The accident models include accidental release, atmospheric transport, and the environmental pathways of radionuclides from spent fuels; these models also assess health risks to individuals and the collective population. The models are supported by databases that are specific to spent nuclear fuels and include a radionuclide inventory and dose conversion factors. In addition, the flexibility of the models allows them to be used for assessing any accidental release involving radioactive materials. The RISKIND code allows for user-specified accident scenarios as well as receptor locations under various exposure conditions, thereby facilitating the estimation of radiological consequences and health risks for individuals. Median (50% probability) and typical worst-case (less than 5% probability of being exceeded) doses and health consequences from potential accidental releases can be calculated by constructing a cumulative dose/probability distribution curve for a complete matrix of site joint-wind-frequency data. These consequence results, together with the estimated probability of the entire spectrum of potential accidents, form a comprehensive, probabilistic risk assessment of a spent nuclear fuel transportation accident

  10. The effects of mental health symptoms and marijuana expectancies on marijuana use and consequences among at-risk adolescents

    OpenAIRE

    Pedersen, Eric R.; Miles, Jeremy N. V.; Osilla, Karen Chan; Ewing, Brett A.; Hunter, Sarah B.; D’Amico, Elizabeth J.

    2014-01-01

    Based on expectancy theory, adolescents at risk for mental health symptoms, such as those involved in the juvenile court system, may use marijuana due to the belief that use will attenuate anxiety and depressive symptoms. In a diverse sample of youth involved in the Santa Barbara Teen Court system (N = 193), we examined the association between mental health symptoms and marijuana expectancies on marijuana use and consequences. In general, stronger positive expectancies and weaker negative exp...

  11. Highly Enhanced Risk Management Emergency Satellite

    DEFF Research Database (Denmark)

    Dalmeir, Michael; Gataullin, Yunir; Indrajit, Agung

    HERMES (Highly Enhanced Risk Management Emergency Satellite) is potential European satellite mission for global flood management, being implemented by Technical University Munich and European Space Agency. With its main instrument - a reliable and precise Synthetic Aperture Radar (SAR) antenna...

  12. The high-risk plaque initiative

    DEFF Research Database (Denmark)

    Falk, Erling; Sillesen, Henrik; Muntendam, Pieter

    2011-01-01

    The High-Risk Plaque (HRP) Initiative is a research and development effort to advance the understanding, recognition, and management of asymptomatic individuals at risk for a near-term atherothrombotic event such as myocardial infarction or stroke. Clinical studies using the newest technologies...... have been initiated, including the BioImage Study in which novel approaches are tested in a typical health plan population. Asymptomatic at-risk individuals were enrolled, including a survey-only group (n = 865), a group undergoing traditional risk factor scoring (n = 718), and a group in which all...

  13. An Embedded System for Safe, Secure and Reliable Execution of High Consequence Software

    Energy Technology Data Exchange (ETDEWEB)

    MCCOY,JAMES A.

    2000-08-29

    As more complex and functionally diverse requirements are placed on high consequence embedded applications, ensuring safe and secure operation requires an execution environment that is ultra reliable from a system viewpoint. In many cases the safety and security of the system depends upon the reliable cooperation between the hardware and the software to meet real-time system throughput requirements. The selection of a microprocessor and its associated development environment for an embedded application has the most far-reaching effects on the development and production of the system than any other element in the design. The effects of this choice ripple through the remainder of the hardware design and profoundly affect the entire software development process. While state-of-the-art software engineering principles indicate that an object oriented (OO) methodology provides a superior development environment, traditional programming languages available for microprocessors targeted for deeply embedded applications do not directly support OO techniques. Furthermore, the microprocessors themselves do not typically support nor do they enforce an OO environment. This paper describes a system level approach for the design of a microprocessor intended for use in deeply embedded high consequence applications that both supports and enforces an OO execution environment.

  14. Risk assessment and consequence modeling of BLEVE explosion wave phenomenon of LPG spherical tank in a refinery

    Directory of Open Access Journals (Sweden)

    Mohammad Kamaei

    2016-06-01

    Full Text Available Introduction: Although human industrial activities are as a part of efforts to achieve greater prosperity, the risks related to these activities are also expanding. Hazard identification and risk assessment in the oil and gas industries are essential to reduce the frequency and severity of accidents and minimize damage to people and property before their occurrence. The aim of this study was to evaluate the liquefied and pressurized petroleum gas spherical tanks in a refinery and assessing the risks of Boiling Liquid Expanding Vapor Explosion (BLEVE phenomenon. Material and Method: In this study, the risks of BLEVE phenomenon were assessed, using the Bowtie method. The consequences of explosion wave phenomenon and the resulting wave quantity and its impacts on the neighboring machineries and equipment were analyzed. PHAST software version 6.54 has been used for modeling the BLEVE phenomenon. Result: In this evaluation, generally five causes and two consequences were identified for BLEVE phenomenon. In order to reduce its consequences, forty-three controlling measures were introduced to prevent the BLEVE phenomenon and the impacts of 31 control measures were identified. According to the conducted analysis, it was found that the spherical tank blast wave caused by LPG can lead to explosion of close located tanks which can create a chain of explosions. Conclusion: The results of modeling and risk assessment can be used to identify the BLEVE phenomenon causes and its effects on nearby people and equipment. Based on these results, preventive controlling measures can be implemented and also be determined by adopting proper design and layout, margin of safety for personnel, equipment and accessories.

  15. Risk assessments for the disposal of high level radioactive wastes

    International Nuclear Information System (INIS)

    Smith, C.F.

    1975-01-01

    The risks associated with the disposal of high level wastes derive from the potential for release of radioactive materials into the environment. The assessment of these risks requires a methodology for risk analysis, an identification of the radioactive sources, and a method by which to express the relative hazard of the various radionuclides that comprise the high level waste. The development of a methodology for risk analysis is carried out after a review of previous work in the area of probabilistic risk assessment. The methodology suggested involves the probabilistic analysis of a general accident consequence distribution. In this analysis, the frequency aspect of the distribution is treated separately from the normalized probability function. At the final stage of the analysis, the frequency and probability characteristics of the distribution are recombined to provide an estimate of the risk. The characterization of the radioactive source term is accomplished using the ORIGEN computer code. Calculations are carried out for various reactor types and fuel cycles, and the overall waste hazard for a projected thirty-five year nuclear power program is determined

  16. THE RISK OF FAILURE - CAUSES AND CONSEQUENCES OF THE IT INDUSTRY

    OpenAIRE

    Moscviciov Andrei

    2011-01-01

    In this paper the author shows the ways to asses the bankruptcy risk using a related system of methods: economic, managerial, banking and statistics. At the end of this paper is addressed this issue with the help of Robertson Model.

  17. Climatic change in Germany. Development, consequences, risks and perspectives; Klimawandel in Deutschland. Entwicklung, Folgen, Risiken und Perspektiven

    Energy Technology Data Exchange (ETDEWEB)

    Brasseur, Guy [Max-Planck-Institut fuer Meteorologie, Hamburg (Germany); Jacob, Daniela; Schuck-Zoeller, Susanne (eds.) [Helmholtz-Zentrum Geesthacht, Hamburg (Germany). Climate Service Center Germany

    2017-06-01

    The book on the climatic change in Germany includes contributions to the following issues: global climate projections and regional projections in Germany and Europe: observation of the climatic change in Central Europe, regional climate modeling, limits and challenges of the regional climate modeling; climatic change in Germany - regional features and extremes: temperature and heat waves, precipitation, wind and cyclones, sea-level increase, tides, storm floods and sea state, floods, definition uncertainties, draughts, forest fires, natural risks; consequences of the climatic change in Germany: air quality, health, biodiversity, water resources, biochemical cycles, agriculture, forestry, soils, personal and commercial transport, cities and urban regions, tourism, infrastructure, energy and water supplies, cost of the climatic change and economic consequences; overall risks and uncertainties: assessment of vulnerabilities, literature review, climatic change as risk enhancement in complex systems, overall risks and uncertainties, decision making under uncertainties in complex systems; integrated strategies for the adaptation to the climatic change: the climate resilient society - transformations and system changes, adaptation to the climatic change as new political field, options for adaptation strategies.

  18. Assessing the environmental justice consequences of flood risk: a case study in Miami, Florida

    Science.gov (United States)

    Montgomery, Marilyn C.; Chakraborty, Jayajit

    2015-09-01

    Recent environmental justice (EJ) research has emphasized the need to analyze social inequities in the distribution of natural hazards such as hurricanes and floods, and examine intra-ethnic diversity in patterns of EJ. This study contributes to the emerging EJ scholarship on exposure to flooding and ethnic heterogeneity by analyzing the racial/ethnic and socioeconomic characteristics of the population residing within coastal and inland flood risk zones in the Miami Metropolitan Statistical Area (MSA), Florida—one of the most ethnically diverse MSAs in the U.S. and one of the most hurricane-prone areas in the world. We examine coastal and inland flood zones separately because of differences in amenities such as water views and beach access. Instead of treating the Hispanic population as a homogenous group, we disaggregate the Hispanic category into relevant country-of-origin subgroups. Inequities in flood risk exposure are statistically analyzed using socio-demographic variables derived from the 2010 U.S. Census and 2007-2011 American Community Survey estimates, and 100-year flood risk zones from the Federal Emergency Management Agency (FEMA). Social vulnerability is represented with two neighborhood deprivation indices called economic insecurity and instability. We also analyze the presence of seasonal/vacation homes and proximity to public beach access sites as water-related amenity variables. Logistic regression modeling is utilized to estimate the odds of neighborhood-level exposure to coastal and inland 100-year flood risks. Results indicate that neighborhoods with greater percentages of non-Hispanic Blacks, Hispanics, and Hispanic subgroups of Colombians and Puerto Ricans are exposed to inland flood risks in areas without water-related amenities, while Mexicans are inequitably exposed to coastal flood risks. Our findings demonstrate the importance of treating coastal and inland flood risks separately while controlling for water-related amenities, and

  19. Temporal patterns of lung cancer risk from radon and smoking - consequences to remediation measures

    International Nuclear Information System (INIS)

    Tomasek, L.

    2004-01-01

    Studies of uranium miners conducted since the late 1960s demonstrated that the risk depends on cumulated exposure in terms of working level months (WLM) integrating both duration of exposure and concentration of radon. It has been also demonstrated that the risk from radon decreases with time since exposure. The present analysis of temporal changes of relative risk is based on a model where the total individual exposure is partitioned into components in dependence on time. Exposure to radon is studied in a cohort of 9411 Czech uranium miners with 766 cases of lung cancer and in a residential study of 11 803 inhabitants exposed to radon in houses with 218 cases. In addition, temporal patterns of the risk from smoking are analyzed in a case-control study of patients from a major Prague hospital including 566 cases. For both carcinogens, the relative risk decreases with time since exposure. The risk from exposures before 20-34 years is 36% and 34% in comparison to period 5-19 for smoking and radon, respectively. The effect of exposures from more distant periods 35-49 is only 5% for smoking and 14% for radon in comparison to 5-19 years. This substantial decrease of relative risk with time may contribute to a better evaluation of remediation measures taken in houses and in the cost effectiveness of remediation. Combined effect of smoking and radon is studied by a nested case-control approach including 434 cases and 962 controls. Analyses of the joint effects of smoking and radon, conducted in the occupational and the residential studies, suggest a sub-multiplicative interaction. The relative risk from radon among non-smokers is higher by a factor of 2-3 in comparison to smokers, suggesting different patterns of lung deposition and clearance among smokers and non-smokers. (author)

  20. Consequences of long-term power outages and high electricity prices lasting for months

    International Nuclear Information System (INIS)

    2005-01-01

    Several areas in the world have experienced electricity outages for longer periods of time, but the consequences of these are sparsely documented. There is a need for further analysis of the socioeconomic consequences of the outages. In addition to KILE (Quality adjusted revenue framework for un supplied energy) costs one has to take into account that the costs often increase proportionally with the durance of the outage, and that KILE tariffs do not reflect lost consumer's surplus for products that are not produced during an outage. A good example is the public underground transport, where the company's economical loss can be significantly smaller than the loss of utility value for the travellers. If the authorities act with reasonability it is difficult to see that periods with very high prices represent a big problem. The most important problems are related to diffused effects, especially for households with a weak economy. These problems can be solved with improved contractual forms (price guarantees) or by transfers to the households, without weakening the incentives for electricity economising (ml)

  1. Risk of long-lasting negative cognitive consequences after electroconvulsive therapy

    DEFF Research Database (Denmark)

    Svendsen, Anne Marie; Miskowiak, Kamilla; Vinberg, Maj

    2013-01-01

    This case study describes a patient who had a unipolar depression and experienced long-lasting cognitive problems after electroconvulsive therapy (ECT). Neuropsychological testing revealed lower scores on measures of learning, memory and sustained attention. These results stress the importance...... of informing patients who have ECT of the potential cognitive consequences of this treatment as it may influence the patients' functional capabilities. Prospective studies are needed since we do not have sufficient knowledge regarding the 3-5% of these patients who experience sustained cognitive problems....

  2. [Health-related consequences of obstructive sleep apnea: daytime sleepiness, accident risk and legal aspects].

    Science.gov (United States)

    Orth, M; Kotterba, S

    2012-04-01

    Daytime sleepiness for any reason leads to impairment of daytime performance and an increased accident rate. The consequences are an increase of illness- and accident-related costs for the health system. Obstructive sleep apnea (OSA) is one of the major reasons for increased daytime sleepiness, especially in professional drivers. The accident frequency in OSA can be significantly reduced by adequate continuous positive airway pressure (CPAP) therapy. Up till now there are no uniform legal regulations about the handling of OSAS patients or patients with daytime sleepiness due to other diseases as far as driving ability is concerned.

  3. Consequence analysis

    International Nuclear Information System (INIS)

    Woodard, K.

    1985-01-01

    The objectives of this paper are to: Provide a realistic assessment of consequences; Account for plant and site-specific characteristics; Adjust accident release characteristics to account for results of plant-containment analysis; Produce conditional risk curves for each of five health effects; and Estimate uncertainties

  4. The positive bystander effect: passive bystanders increase helping in situations with high expected negative consequences for the helper.

    Science.gov (United States)

    Fischer, Peter; Greitemeyer, Tobias

    2013-01-01

    The present field study investigated the interplay between the presence of a passive bystander (not present versus present) in a simulated bike theft and expected negative consequences (low versus high) in predicting intervention behavior when no physical victim is present. It was found that an additional bystander increases individual intervention in situations where the expected negative consequences for the helper in case of intervention were high (i.e., when the bike thief looks fierce) compared to situations where the expected negative consequences for the helper were low (i.e., when the bike thief does not look fierce). In contrast, no such effect for high vs. low expected negative consequences was observed when no additional bystander observed the critical situation. The results are discussed in light of previous laboratory findings on expected negative consequences and bystander intervention.

  5. Exploring the context of trafficking and adolescent sex industry involvement in Tijuana, Mexico: consequences for HIV risk and prevention.

    Science.gov (United States)

    Goldenberg, Shira M; Silverman, Jay G; Engstrom, David; Bojorquez-Chapela, Ietza; Usita, Paula; Rolón, María Luisa; Strathdee, Steffanie A

    2015-04-01

    Coerced and adolescent sex industry involvement are linked to serious health and social consequences, including enhanced risk of HIV infection. Using ethnographic fieldwork, including interviews with 30 female sex workers with a history of coerced or adolescent sex industry involvement, we describe contextual factors influencing vulnerability to coerced and adolescent sex industry entry and their impacts on HIV risk and prevention. Early gender-based violence and economic vulnerability perpetuated vulnerability to coercion and adolescent sex exchange, while HIV risk mitigation capacities improved with increased age, control over working conditions, and experience. Structural interventions addressing gender-based violence, economic factors, and HIV prevention among all females who exchange sex are needed. © The Author(s) 2015.

  6. Dosimetric Consequences of Interobserver Variability in Delineating the Organs at Risk in Gynecologic Interstitial Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Damato, Antonio L., E-mail: adamato@lroc.harvard.edu [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, Massachusetts (United States); Townamchai, Kanopkis [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, Massachusetts (United States); Albert, Michele [Department of Radiation Oncology, Saint Anne' s Hospital Regional Cancer Center, Fall River, Massachusetts (United States); Bair, Ryan J. [Department of Radiology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Cormack, Robert A. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, Massachusetts (United States); Jang, Joanne [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (United States); Kovacs, Arpad [Department of Radiology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Lee, Larissa J. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, Massachusetts (United States); Mak, Kimberley S.; Mirabeau-Beale, Kristina L.; Mouw, Kent W.; Phillips, John G.; Pretz, Jennifer L.; Russo, Andrea L. [Harvard Radiation Oncology Program, Harvard Medical School, Boston, Massachusetts (United States); Lewis, John H.; Viswanathan, Akila N. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, Massachusetts (United States)

    2014-07-01

    Purpose: To investigate the dosimetric variability associated with interobserver organ-at-risk delineation differences on computed tomography in patients undergoing gynecologic interstitial brachytherapy. Methods and Materials: The rectum, bladder, and sigmoid of 14 patients treated with gynecologic interstitial brachytherapy were retrospectively contoured by 13 physicians. Geometric variability was calculated using κ statistics, conformity index (CI{sub gen}), and coefficient of variation (CV) of volumes contoured across physicians. Dosimetric variability of the single-fraction D{sub 0.1cc} and D{sub 2cc} was assessed through CV across physicians, and the standard deviation of the total EQD2 (equivalent dose in 2 Gy per fraction) brachytherapy dose (SD{sup TOT}) was calculated. Results: The population mean ± 1 standard deviation of κ, CI{sub gen}, and volume CV were, respectively: 0.77 ± 0.06, 0.70 ± 0.08, and 20% ± 6% for bladder; 0.74 ± 06, 0.67 ± 0.08, and 20% ± 5% for rectum; and 0.33 ± 0.20, 0.26 ± 0.17, and 82% ± 42% for sigmoid. Dosimetric variability was as follows: for bladder, CV = 31% ± 19% (SD{sup TOT} = 72 ± 64 Gy) for D{sub 0.1cc} and CV = 16% ± 10% (SD{sup TOT} = 9 ± 6 Gy) for D{sub 2cc}; for rectum, CV = 11% ± 5% (SD{sup TOT} = 16 ± 17 Gy) for D{sub 0.1cc} and CV = 7% ± 2% (SD{sup TOT} = 4 ± 3 Gy) for D{sub 2cc}; for sigmoid, CV = 39% ± 28% (SD{sup TOT} = 12 ± 18 Gy) for D{sub 0.1cc} and CV = 34% ± 19% (SD{sup TOT} = 4 ± 4 Gy) for D{sub 2cc.} Conclusions: Delineation of bladder and rectum by 13 physicians demonstrated substantial geometric agreement and resulted in good dosimetric agreement for all dose-volume histogram parameters except bladder D{sub 0.1cc.} Small delineation differences in high-dose regions by the posterior bladder wall may explain these results. The delineation of sigmoid showed fair geometric agreement. The higher dosimetric variability for sigmoid compared with rectum and bladder did not correlate with

  7. Dosimetric Consequences of Interobserver Variability in Delineating the Organs at Risk in Gynecologic Interstitial Brachytherapy

    International Nuclear Information System (INIS)

    Damato, Antonio L.; Townamchai, Kanopkis; Albert, Michele; Bair, Ryan J.; Cormack, Robert A.; Jang, Joanne; Kovacs, Arpad; Lee, Larissa J.; Mak, Kimberley S.; Mirabeau-Beale, Kristina L.; Mouw, Kent W.; Phillips, John G.; Pretz, Jennifer L.; Russo, Andrea L.; Lewis, John H.; Viswanathan, Akila N.

    2014-01-01

    Purpose: To investigate the dosimetric variability associated with interobserver organ-at-risk delineation differences on computed tomography in patients undergoing gynecologic interstitial brachytherapy. Methods and Materials: The rectum, bladder, and sigmoid of 14 patients treated with gynecologic interstitial brachytherapy were retrospectively contoured by 13 physicians. Geometric variability was calculated using κ statistics, conformity index (CI gen ), and coefficient of variation (CV) of volumes contoured across physicians. Dosimetric variability of the single-fraction D 0.1cc and D 2cc was assessed through CV across physicians, and the standard deviation of the total EQD2 (equivalent dose in 2 Gy per fraction) brachytherapy dose (SD TOT ) was calculated. Results: The population mean ± 1 standard deviation of κ, CI gen , and volume CV were, respectively: 0.77 ± 0.06, 0.70 ± 0.08, and 20% ± 6% for bladder; 0.74 ± 06, 0.67 ± 0.08, and 20% ± 5% for rectum; and 0.33 ± 0.20, 0.26 ± 0.17, and 82% ± 42% for sigmoid. Dosimetric variability was as follows: for bladder, CV = 31% ± 19% (SD TOT = 72 ± 64 Gy) for D 0.1cc and CV = 16% ± 10% (SD TOT = 9 ± 6 Gy) for D 2cc ; for rectum, CV = 11% ± 5% (SD TOT = 16 ± 17 Gy) for D 0.1cc and CV = 7% ± 2% (SD TOT = 4 ± 3 Gy) for D 2cc ; for sigmoid, CV = 39% ± 28% (SD TOT = 12 ± 18 Gy) for D 0.1cc and CV = 34% ± 19% (SD TOT = 4 ± 4 Gy) for D 2cc. Conclusions: Delineation of bladder and rectum by 13 physicians demonstrated substantial geometric agreement and resulted in good dosimetric agreement for all dose-volume histogram parameters except bladder D 0.1cc. Small delineation differences in high-dose regions by the posterior bladder wall may explain these results. The delineation of sigmoid showed fair geometric agreement. The higher dosimetric variability for sigmoid compared with rectum and bladder did not correlate with higher variability in the total brachytherapy dose but rather may be due to the

  8. Risk from a pressurized toxic gas system: Part 2, Dispersal consequences

    International Nuclear Information System (INIS)

    Brereton, S.J.; Martin, D.; Lane, S.G.; Altenbach, T.J.

    1995-04-01

    During the preparation of a Safety Analysis Report at the Lawrence Livermore National Laboratory, we studied the release of chlorine from a compressed gas experimental apparatus. This paper presents the second part in a series of two papers on this topic. The first paper focuses on the frequency of an unmitigated release from the system; this paper discusses the consequences of the release. The release of chlorine from the experimental apparatus was modeled as an unmitigated blowdown through a 0.25 inch (0.0064 m) outside diameter tube. The physical properties of chlorine were considered as were the dynamics of the fluid flow problem. The calculated release rate was used as input for the consequence assessment. Downwind concentrations as a function of time were evaluated and then compared to suggested guidelines. For comparison purposes, a typical water treatment plant was briefly studied. The lower hazard presented by the LLNL operation becomes evident when its release is compared to the release of material from a water treatment plant, a hazard which is generally accepted by the public

  9. Risk from a pressurized toxic gas system: Part 2, Dispersal consequences

    International Nuclear Information System (INIS)

    Brereton, S.J.; Altenbach, T.J.; Lane, S.G.; Martin, D.W.

    1995-02-01

    During the preparation of a Safety Analysis Report at the Lawrence Livermore National Laboratory. we studied the release of chlorine from a compressed gas experimental apparatus. This paper presents the second pan in a series of two papers on this topic. The first paper focuses on the frequency of an unmitigated release from the system; paper focuses the consequences of the release. The release of chlorine from the experimental apparatus was modeled as an unmitigated blowdown through a 0.25 inch (0.006.4 m) outside diameter tube. The physical properties of chlorine were considered as were the dynamics of the fluid flow problem. The calculated release rate was used as input for the consequence assessment. Downwind concentrations as a function of time were evaluated and then compared to suggested guidelines. For comparison purposes, a typical water treatment plant was briefly studied. The lower hazard presented by the LLNL operation becomes evident when its release is compared to the release of material from a water treatment plant, a hazard which is generally accepted by the public

  10. Measurement of natural radionuclides in Malaysian bottled mineral water and consequent health risk estimation

    Energy Technology Data Exchange (ETDEWEB)

    Priharti, W.; Samat, S. B.; Yasir, M. S. [School of Applied Physics, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor (Malaysia)

    2015-09-25

    The radionuclides of {sup 226}Ra, {sup 232}Th and {sup 40}K were measured in ten mineral water samples, of which from the radioactivity obtained, the ingestion doses for infants, children and adults were calculated and the cancer risk for the adult was estimated. Results showed that the calculated ingestion doses for the three age categories are much lower than the average worldwide ingestion exposure of 0.29 mSv/y and the estimated cancer risk is much lower than the cancer risk of 8.40 × 10{sup −3} (estimated from the total natural radiation dose of 2.40 mSv/y). The present study concludes that the bottled mineral water produced in Malaysia is safe for daily human consumption.

  11. Measurement of natural radionuclides in Malaysian bottled mineral water and consequent health risk estimation

    Science.gov (United States)

    Priharti, W.; Samat, S. B.; Yasir, M. S.

    2015-09-01

    The radionuclides of 226Ra, 232Th and 40K were measured in ten mineral water samples, of which from the radioactivity obtained, the ingestion doses for infants, children and adults were calculated and the cancer risk for the adult was estimated. Results showed that the calculated ingestion doses for the three age categories are much lower than the average worldwide ingestion exposure of 0.29 mSv/y and the estimated cancer risk is much lower than the cancer risk of 8.40 × 10-3 (estimated from the total natural radiation dose of 2.40 mSv/y). The present study concludes that the bottled mineral water produced in Malaysia is safe for daily human consumption.

  12. High-risk facilities. Emergency management in nuclear, chemical and hazardous waste facilities

    International Nuclear Information System (INIS)

    Kloepfer, Michael

    2012-01-01

    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.

  13. Core Competencies and the Prevention of High-Risk Sexual Behavior

    Science.gov (United States)

    Charles, Vignetta Eugenia; Blum, Robert Wm.

    2008-01-01

    Adolescent sexual risk-taking behavior has numerous individual, family, community, and societal consequences. In an effort to contribute to the research and propose new directions, this chapter applies the core competencies framework to the prevention of high-risk sexual behavior. It describes the magnitude of the problem, summarizes explanatory…

  14. Student-Generated Protective Behaviors to Avert Severe Harm Due to High-Risk Alcohol Consumption

    Science.gov (United States)

    Smith, Sandi W.; LaPlante, Carolyn; Wibert, Wilma Novales; Mayer, Alex; Atkin, Charles K.; Klein, Katherine; Glazer, Edward; Martell, Dennis

    2011-01-01

    High-risk alcohol consumption is a significant problem on college campuses that many students see as a rite of passage in their development into adulthood. Developing effective prevention campaigns designed to lessen or avert the risks associated with alcohol consumption entails understanding how students perceive harmful consequences as well as…

  15. PARTITION: A program for defining the source term/consequence analysis interface in the NUREG--1150 probabilistic risk assessments

    International Nuclear Information System (INIS)

    Iman, R.L.; Helton, J.C.; Johnson, J.D.

    1990-05-01

    The individual plant analyses in the US Nuclear Regulatory Commission's reassessment of the risk from commercial nuclear power plants (NUREG-1150) consist of four parts: systems analysis, accident progression analysis, source term analysis, and consequence analysis. Careful definition of the interfaces between these parts is necessary for both information flow and computational efficiency. This document has been designed for users of the PARTITION computer program developed by the authors at Sandia National Laboratories for defining the interface between the source term analysis (performed with the XXSOR programs) and the consequence analysis (performed with the MACCS program). This report provides a tutorial that details how the interactive partitioning is performed, along with detailed information on the partitioning process. The PARTITION program was written in ANSI standard FORTRAN 77 to make the code as machine-independent (i.e., portable) as possible. 9 refs., 4 figs

  16. Postmastectomy irradiation in high-risk breast cancer patients

    International Nuclear Information System (INIS)

    Overgaard, M.; Juul Christensen, J.; Johansen, H.; Nybo-Rasmussen, A.; Brincker, H.; Kooy, P. van der; Frederiksen, P.L.; Laursen, F.; Panduro, J.; Soerensen, N.E.; Gadeberg, C.C.; Hjelm-Hansen, M.; Overgaard, J.; West Andersen, K.; Zedeler, K.

    1988-01-01

    All pre- and postmenopausal high-risk breast cancer patients in the protocols DBCG 77 of the Danish Breast Cancer Cooperative Group received postmastectomy irradiation before randomization to either adjuvant systemic therapy or no such treatment. The actuarial loco-regional recurrence rate at 9 years was 6-17%, with the lowest rate in patients who also received additional adjuvant chemotherapy or tamoxifen. In a subsequent study (DBCG 82) the role of postmastectomy irradiation together with systemic treatment was evaluated in high-risk patients. Pre- and menopausal patients were randomized to postmastectomy irradiation+CMF (cyclophosphamide, methotrexate, 5-fluorouracil), CMF alone or CMF+TAM (tamoxifen). Postmenopausal patients were randomized to postmastectomy irradiation+TAM, TAM or CMF+TAM. At 4 years the loco-regional recurrence rate was significantly lower in the irradiated patients (5-7% vs. 23-33%). Further, disease-free survival was significantly improved in both pre- and postmenopausal irradiated patients compared with those who had only systemic treatment. At present, there are no significant differences between survival in the treatment groups. Thus, adjuvant systemic treatment alone (chemotherapy and/or tamoxifen) did not prevent loco-regional recurrences in high-risk patients after mastectomy and axillary lymph node sampling. However, a longer observation time is necessary to evaluate the consequence of primary optimal loco-regional tumour control in high-risk breast cancer patients with respect to survival. (orig.)

  17. Consequences of preferential flow in cracking clay soils for contamination-risk of shallow aquifers

    NARCIS (Netherlands)

    Oostindie, K.; Bronswijk, J.J.B.

    1995-01-01

    A method is presented to asses the contamination risk of aquifers covered with cracking clay soils, with special emphasis on preferential flow through shrinkage cracks. A water extraction area was divided into units with homogeneous soil types and hydrological conditions. For each unit, a

  18. Risks, consequences, and prevention of falls of older people in oral healthcare centers.

    NARCIS (Netherlands)

    Baat, C. de; Baat, P. de; Gerritsen, A.E.; Flohil, K.A.; Putten, G.J. van der; Maarel-Wierink, C.D. van der

    2017-01-01

    One-third of community-dwelling people older than 65 years of age fall each year, and half of them fall at least twice a year. Older care home residents are approximately three times more likely to fall when compared to community-dwelling older people. Risk indicators for falls are related to the

  19. Risk Factors and Consequent Outcomes of Placenta Previa: Report From a Referral Center

    Directory of Open Access Journals (Sweden)

    Soraya Saleh Gargari

    2016-12-01

    Full Text Available  Because of an unknown factor, the frequency of complicated pregnancy with placenta previa has been raised during past decade. This study was designed to deepen our understanding of risk factors and outcomes of placenta previa in our country. This study investigated 694 cases of placenta previa comparing with 600 healthy pregnant women with not overlie placenta in two referral and tertiary Obstetrics and Gynecological Hospital in Iran on the basis of the clinical and para-clinical analysis, in order to find the probable risk factors for occurrence of placenta previa and its effect on maternal and neonatal complications. The most important risk factor for the occurrence of placenta previa was advanced maternal age (P<0.001 and history of stillbirth (OR=117.2, CI=58.3-236.0. In the other hand, the most substantial outcome of this disorder was a reduction of gestational age (P<0.001 and low birth weight neonatally (P<0.001. The conservative follow-up should be programmed for women with placenta previa based on the type of risk factors which can provide the best possible management to decrease the morbidity and mortality of their related complications.

  20. Relative absorption and dermal loading of chemical substances: Consequences for risk assessment

    NARCIS (Netherlands)

    Buist, H.E.; Schaafsma, G.; Sandt, J.J.M. van de

    2009-01-01

    Quantification of skin absorption is an essential step in reducing the uncertainty of dermal risk assessment. Data from literature indicate that the relative dermal absorption of substances is dependent on dermal loading. Therefore, an internal exposure calculated with absorption data determined at

  1. THE RISK OF FAILURE - CAUSES AND CONSEQUENCES OF THE IT INDUSTRY

    Directory of Open Access Journals (Sweden)

    Moscviciov Andrei

    2011-12-01

    Full Text Available In this paper the author shows the ways to asses the bankruptcy risk using a related system of methods: economic, managerial, banking and statistics. At the end of this paper is addressed this issue with the help of Robertson Model.

  2. Quantitative risk analysis of gas explosions in tunnels; probability, effects, and consequences

    NARCIS (Netherlands)

    Weerheijm, J.; Voort, M.M. van der; Verreault, J.; Berg, A.C. van den

    2015-01-01

    Tunnel accidents with transports of combustible liquefied gases may lead to explosions. Depending on the substance involved this can be a Boiling Liquid Expanding Vapour Explosion (BLEVE), a Gas Expansion Explosion (GEE) or a gas explosion. Quantification of the risk of these scenarios is important

  3. Practical examples of modeling choices and their consequences for risk assessment

    Science.gov (United States)

    Although benchmark dose (BMD) modeling has become the preferred approach to identifying a point of departure (POD) over the No Observed Adverse Effect Level, there remain challenges to its application in human health risk assessment. BMD modeling, as currently implemented by the...

  4. Adaptive aspirations : Performance consequences of risk preferences at extremes and alternative reference groups

    NARCIS (Netherlands)

    Hu, S.; Blettner, D.P.; Bettis, R.

    2011-01-01

    Goals or aspirations and their relationships to risk taking and performance are important issues in both psychology and strategic management. The concept of adaptive aspirations, as discussed in Cyert and March's Behavioral Theory of the Firm, has long been a topic of interest in both fields.

  5. Individual Tariffs for Mobile Services: Analysis of Operator Business and Risk Consequences

    NARCIS (Netherlands)

    H. Chen (Hong); L-F. Pau (Louis-François)

    2007-01-01

    textabstractA design approach is offered for individual tariffs for mass customized mobile service products, whereby operators can determine their contract acceptance rules to guarantee with a set probability their minimum profit and risk levels. It uses realistic improvements to earlier reported

  6. Renal transplantation in high cardiovascular risk patients.

    Science.gov (United States)

    Bittar, Julio; Arenas, Paula; Chiurchiu, Carlos; de la Fuente, Jorge; de Arteaga, Javier; Douthat, Walter; Massari, Pablo U

    2009-10-01

    Current transplant success allows recipients with previous contraindications to transplant to have access to this procedure with more frequency and safety. The concept of high-risk patient has changed since the first stages of transplantation. In the first studies, the high-risk concept was based on probability of early graft failure or on a patient's clinical condition to cope with high perioperatory morbimortality. Later on, this concept implied immunological factors that were crucial to ensure transplant success because hypersensitized or polytransfused patients experienced a higher risk of acute rejection and subsequent graft loss. Afterward, the presence of various comorbidities would redefine the high-risk concept for renal transplant mainly considering recipient's clinical aspects. Currently, the change in epidemiological characteristics of patients starting dialysis causes that we now deal with a greater increase of elderly patients, diabetic patients, and patients with history of cardiovascular disease. Today, high-risk patients are those with clinical features that predict an increase in the risk of perioperative morbimortality or death with functioning graft. In this review, we will attempted to analyze currents results of renal transplant outcomes in terms of patients and graft survival in elderly patients, diabetic patients, and patients with previous cardiovascular disease from the most recent experiences in the literature and from experiences in our center. In any of the groups previously analyzed, survival offered by renal transplant is significantly higher compared to dialysis. Besides, these patients are the recipient group that benefit the most with the transplant because their mortality while remaining on dialysis is extremely high. Hence, renal transplantation should be offered more frequently to older patients, diabetic patients, and patients with pretransplant cardiac and peripheral vascular disease. A positive attitude toward renal

  7. Indirect assessment of economic damages from the Prestige oil spill: consequences for liability and risk prevention.

    Science.gov (United States)

    Garza, María Dolores; Prada, Albino; Varela, Manuel; Rodríguez, María Xosé Vázquez

    2009-03-01

    The social losses arising from the Prestige oil spill exceed the compensation granted under the IOPC (International Oil Pollution Compensation) system, with losses estimated at 15 times more than the applicable limit of compensations. This is far above the level of costs for which those responsible for hydrocarbons spills are liable. The highest market losses correspond to sectors of extraction, elaboration and commercialisation of seafood. However, damages to non-commercial natural resources could constitute an outstanding group of losses for which further primary data are needed: these losses would only be compensable under the current system by means of a refund for cleaning and restoration costs. Results show that, in Europe, the responsibility for oil spills in maritime transport is limited and unclear. The consequence of this is net social losses from recurrent oil spills and internationally accepted incentives for risky strategies in the marine transport of hydrocarbons.

  8. On risk assessment of high level radioactive waste disposal

    International Nuclear Information System (INIS)

    Smith, C.F.; Kastenberg, W.E.

    1976-01-01

    One of the major concerns with the continued growth of the nuclear power industry is the production of the high level radioactive wastes. The risks associated with the disposal of these wastes derives from the potential for release of radioactive materials into the environment. The development of a methodology for risk analysis is carried out. The methodology suggested involves the probabilistic analysis of a general accident consequence distribution. In this analysis, the frequency aspect of the distribution is treated separately from the normalized probability function. In the final stage of the analysis, the frequency and probability characteristics of the distribution are recombined to provide an estimate of the risk. The characterization of the radioactive source term is accomplished using the ORIGEN computer code. Calculations are carried out for various reactor types and fuel cycles, and the overall waste hazard for a projected 35 year nuclear power program is determined. An index of relative nuclide hazard appropriate to problems involving the management of high level radioactive wastes is developed. As an illustration of the methodology, risk analyses are made for two proposed methods for waste management: extraterrestrial disposal and interim surface storage. The results of these analyses indicate that, within the assumptions used, the risks of these management schemes are small compared with natural background radiation doses. (Auth.)

  9. High risk process control system assessment methodology

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Venetia [Pontificia Universidade Catolica do Rio de Janeiro (PUC-Rio), RJ (Brazil); Zamberlan, Maria Cristina [National Institute of Tehnology (INT), Rio de Janeiro, RJ (Brazil). Human Reliability and Ergonomics Research Group for the Oil, Gas and Energy Sector

    2009-07-01

    The evolution of ergonomics methodology has become necessary due to the dynamics imposed by the work environment, by the increase of the need of human cooperation and by the high interaction between various sections within a company. In the last 25 years, as of studies made in the high risk process control, we have developed a methodology to evaluate these situations that focus on the assessment of activities and human cooperation, the assessment of context, the assessment of the impact of work of other sectors in the final activity of the operator, as well as the modeling of existing risks. (author)

  10. Sexual dysfunction among reproductive-aged Chinese married women in Hong Kong: prevalence, risk factors, and associated consequences.

    Science.gov (United States)

    Zhang, Huiping; Fan, Susan; Yip, Paul S F

    2015-03-01

    Although female sexual dysfunction (FSD) is a serious public health issue endangering women's well-being, systematic research on FSD among reproductive-aged Chinese women in Hong Kong is quite scarce. This study aims to estimate the prevalence, risk factors, and associated consequences of FSD among reproductive-aged Chinese married women in Hong Kong. This study was based on a community-based survey across Hong Kong conducted by the Family Planning Association of Hong Kong in 2012 with 1,518 married women aged 21-49 years. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition classification was adopted to assess FSD. It was found that 25.6% of the married women surveyed reported at least one form of sexual dysfunction and that the prevalence of six domains of sexual dysfunction was as follows: 10.6% for lack of interest in sex, 10.5% for not finding sex pleasurable, 9.3% for lubrication difficulties, 8.8% for inability to achieve orgasm, 8.8% for orgasm delay, and 8.4% for physical pain during sex. Multivariate analyses showed that low education and income, average or poor health, lower frequency of sex, abortion history, traditional attitudes toward sex, and marital dissatisfaction are all significant risk factors for different components of FSD. It was also been found that four domains of FSD (the exceptions being orgasm delay and physical pain during sex) have severe consequences for married women's life satisfaction and sexual satisfaction. The prevalence of FSD is lower among reproductive-aged Chinese married women in Hong Kong than among women in the United States and some Asian countries. The risk factors associated with FSD include sociodemographic factors, physical health, sexual experience and attitudes, and relationship factors. FSD has significant consequences for married women's life quality. These findings have great implications for FSD prevention and relevant service delivery. © 2014 International Society for Sexual

  11. New information on high risk breast screening

    International Nuclear Information System (INIS)

    Riedl, C.C.; Ponhold, L.; Gruber, R.; Pinker, K.; Helbich, T.H.

    2010-01-01

    Women with an elevated risk for breast cancer require intensified screening beginning at an early age. Such high risk screening differs considerably from screening in the general population. After an expert has evaluated the exact risk a breast MRI examination should be offered at least once a year and beginning latest at the age of 30 depending on the patients risk category. Complementary mammograms should not be performed before the age of 35. An additional ultrasound examination is no longer recommended. To ensure a high sensitivity and specificity high risk screening should be performed only at a nationally or regionally approved and audited service. Adequate knowledge about the phenotypical characteristics of familial breast cancer is essential. Besides the common malignant phenotypes, benign morphologies (round or oval shape and smooth margins) as well as a low prevalence of calcifications have been described. Using MRI benign contrast media kinetics as well as non-solid lesions with focal, regional and segmental enhancement can often be visualized. (orig.) [de

  12. Not all risks are equal: the risk taking inventory for high-risk sports.

    Science.gov (United States)

    Woodman, Tim; Barlow, Matt; Bandura, Comille; Hill, Miles; Kupciw, Dominika; Macgregor, Alexandra

    2013-10-01

    Although high-risk sport participants are typically considered a homogenous risk-taking population, attitudes to risk within the high-risk domain can vary considerably. As no validated measure allows researchers to assess risk taking within this domain, we validated the Risk Taking Inventory (RTI) for high-risk sport across four studies. The RTI comprises seven items across two factors: deliberate risk taking and precautionary behaviors. In Study 1 (n = 341), the inventory was refined and tested via a confirmatory factor analysis used in an exploratory fashion. The subsequent three studies confirmed the RTI's good model-data fit via three further separate confirmatory factor analyses. In Study 2 (n = 518) and in Study 3 (n = 290), concurrent validity was also confirmed via associations with other related traits (sensation seeking, behavioral activation, behavioral inhibition, impulsivity, self-esteem, extraversion, and conscientiousness). In Study 4 (n = 365), predictive validity was confirmed via associations with mean accidents and mean close calls in the high-risk domain. Finally, in Study 4, the self-report version of the inventory was significantly associated with an informant version of the inventory. The measure will allow researchers and practitioners to investigate risk taking as a variable that is conceptually distinct from participation in a high-risk sport.

  13. Genetic consequences of forest fragmentation for a highly specialized arboreal mammal--the edible dormouse.

    Directory of Open Access Journals (Sweden)

    Joanna Fietz

    Full Text Available Habitat loss and fragmentation represent the most serious extinction threats for many species and have been demonstrated to be especially detrimental for mammals. Particularly, highly specialized species with low dispersal abilities will encounter a high risk of extinction in fragmented landscapes. Here we studied the edible dormouse (Glis glis, a small arboreal mammal that is distributed throughout Central Europe, where forests are mostly fragmented at different spatial scales. The aim of this study was to investigate the effect of habitat fragmentation on genetic population structures using the example of edible dormouse populations inhabiting forest fragments in south western Germany. We genotyped 380 adult individuals captured between 2001 and 2009 in four different forest fragments and one large continuous forest using 14 species-specific microsatellites. We hypothesised, that populations in small forest patches have a lower genetic diversity and are more isolated compared to populations living in continuous forests. In accordance with our expectations we found that dormice inhabiting forest fragments were isolated from each other. Furthermore, their genetic population structure was more unstable over the study period than in the large continuous forest. Even though we could not detect lower genetic variability within individuals inhabiting forest fragments, strong genetic isolation and an overall high risk to mate with close relatives might be precursors to a reduced genetic variability and the onset of inbreeding depression. Results of this study highlight that connectivity among habitat fragments can already be strongly hampered before genetic erosion within small and isolated populations becomes evident.

  14. Risk of suicide in high risk pregnancy: an exploratory study.

    Science.gov (United States)

    Benute, Gláucia Rosana Guerra; Nomura, Roseli Mieko Yamamoto; Jorge, Vanessa Marques Ferreira; Nonnenmacher, Daniele; Fráguas Junior, Renério; Lucia, Mara Cristina Souza de; Zugaib, Marcelo

    2011-01-01

    To identify the risk of suicidal behavior in high-risk pregnant women at a public hospital in São Paulo. We conducted a semi-structured interview with each of the participants (n = 268) through a previously prepared questionnaire. Risk of suicidal behavior was assessed by the Portuguese version of PRIME-MD. The mean age of patients was 29 years (SD = 0.507) and gestation period was 30 weeks (SD = 0.556). Of the total sample, specific risk of suicide was found in 5% (n = 14). Of these, 85% have a stable relationship (married or cohabitating), the pregnancy was planned in 50% of cases, and 71% have no religion or professional activities. The correlation of risk of suicide with data from marital status, planned birth, age, education, professional practice, risk of prematurity, and religion showed that having a religion is statistically significant (p = 0.012). There were no positive associations for any of the other selected variables when compared with the risk of suicide. By correlating the risk of suicide with other characteristic symptoms of major depression, there was statistical significance in the sample with regard to insomnia or hypersomnia (p = 0.003), fatigue or loss of energy (p = 0.001), decreased or increased appetite (p = 0.005), less interest in daily activities (p = 0.000), depressed mood (p = 0.000), feelings of worthlessness or guilt (p = 0.000), decreased concentration (p = 0.002), and agitation or psychomotor retardation (p = 0.002). We found that religion can be a protective factor against suicidal behavior. Besides providing a social support network needed by women during pregnancy, religion supports belief in life after death and in a loving God, giving purpose to life and self esteem and providing models for coping with crises. The results show the importance of prevention and early diagnosis of suicidal behavior, since suicide is an attempt to move from one sphere to another by force, seeking to solve what seems impossible.

  15. RISKIND: A computer program for calculating radiological consequences and health risks from transportation of spent nuclear fuel

    International Nuclear Information System (INIS)

    Yuan, Y.C.; Chen, S.Y.; LePoire, D.J.

    1993-02-01

    This report presents the technical details of RISIUND, a computer code designed to estimate potential radiological consequences and health risks to individuals and the collective population from exposures associated with the transportation of spent nuclear fuel. RISKIND is a user-friendly, semiinteractive program that can be run on an IBM or equivalent personal computer. The program language is FORTRAN-77. Several models are included in RISKIND that have been tailored to calculate the exposure to individuals under various incident-free and accident conditions. The incidentfree models assess exposures from both gamma and neutron radiation and can account for different cask designs. The accident models include accidental release, atmospheric transport, and the environmental pathways of radionuclides from spent fuels; these models also assess health risks to individuals and the collective population. The models are supported by databases that are specific to spent nuclear fuels and include a radionudide inventory and dose conversion factors

  16. RISKIND: A computer program for calculating radiological consequences and health risks from transportation of spent nuclear fuel

    Energy Technology Data Exchange (ETDEWEB)

    Yuan, Y.C. [Square Y, Orchard Park, NY (United States); Chen, S.Y.; LePoire, D.J. [Argonne National Lab., IL (United States). Environmental Assessment and Information Sciences Div.; Rothman, R. [USDOE Idaho Field Office, Idaho Falls, ID (United States)

    1993-02-01

    This report presents the technical details of RISIUND, a computer code designed to estimate potential radiological consequences and health risks to individuals and the collective population from exposures associated with the transportation of spent nuclear fuel. RISKIND is a user-friendly, semiinteractive program that can be run on an IBM or equivalent personal computer. The program language is FORTRAN-77. Several models are included in RISKIND that have been tailored to calculate the exposure to individuals under various incident-free and accident conditions. The incidentfree models assess exposures from both gamma and neutron radiation and can account for different cask designs. The accident models include accidental release, atmospheric transport, and the environmental pathways of radionuclides from spent fuels; these models also assess health risks to individuals and the collective population. The models are supported by databases that are specific to spent nuclear fuels and include a radionudide inventory and dose conversion factors.

  17. Quinolone resistant campylobacter infections in Denmark: risk factors and clinical consequences

    DEFF Research Database (Denmark)

    Engberg, J.; Neimann, J.; Nielsen, E. M.

    2004-01-01

    origin) was associated with a decreased risk. Typing data showed an association between strains from retail food products and broiler chickens and quinolone-sensitive domestically acquired C. jejuni infections. An association between treatment with a fluoroquinolone before stool-specimen collection......We integrated data on quinolone and macrolide susceptibility patterns with epidemiologic and typing data from Campylobacter jejuni and C. coli infections in two Danish counties. The mean duration of illness was longer for 86 patients with quinolone-resistant C. jejuni infections (median 13.2 days...

  18. Laser prostatectomy in high-risk patients

    International Nuclear Information System (INIS)

    Tayib, Abdulmalik M.

    2008-01-01

    Objective was to evaluate the short-term tolerability and outcome of high power green light potassium titanyl phosphate laser prostatectomy in high-risk patients with symptomatic benign prostatic hyperplasia. Eleven high risk operative patients were included in this study at the International Medical Center, Jeddah, Kingdom of Saudi Arabia, between January and September 2007. Patients enrolled in this study underwent preoperative and postoperative, cardiac and anesthesia evaluation. Clinical presentations, ultrasound of urinary tract and preoperative laboratory investigation were recorded. All patients underwent high power green light laser prostatectomy using the green light photo vaporization system with setting of 120 watts. The intraoperative and postoperative complications and follow-up were recorded. The patient's age varied between 65-82 years with a mean age of 75.3+-8.6 years old. Seven patients presented with refractory acute urinary retention and 4 patients presented with severe lower urinary tract symptoms. The average prostate volume was 61.22 cc. All patients had uneventful intra- and postoperative course, without the intensive care. The average blood loss was insignificant and only one of the patients required blood transfusion. Foley catheters were removed one day after the procedure. All patients voided satisfactorily after removal of catheter and 8 patients complained of urgency. High power green light laser prostatectomy is a safe and effective method of treating symptomatic benign prostatic hyperplasia in patients with high operative risk. (author)

  19. Uncertainties in geologic disposal of high-level wastes - groundwater transport of radionuclides and radiological consequences

    International Nuclear Information System (INIS)

    Kocher, D.C.; Sjoreen, A.L.; Bard, C.S.

    1983-01-01

    The analysis for radionuclide transport in groundwater considers models and methods for characterizing (1) the present geologic environment and its future evolution due to natural geologic processes and to repository development and waste emplacement, (2) groundwater hydrology, (3) radionuclide geochemistry, and (4) the interactions among these phenomena. The discussion of groundwater transport focuses on the nature of the sources of uncertainty rather than on quantitative estimates of their magnitude, because of the lack of evidence that current models can provide realistic quantitative predictions of radionuclide transport in groundwater for expected repository environments. The analysis for the long-term health risk to man following releases of long-lived radionuclides to the biosphere is more quantitative and involves estimates of uncertainties in (1) radionuclide concentrations in man's exposure environment, (2) radionuclide intake by exposed individuals per unit concentration in the environment, (3) the dose per unit intake, (4) the number of exposed individuals, and (5) the health risk per unit dose. For the important long-lived radionuclides in high-level waste, uncertainties in most of the different components of a calculation of individual and collective dose per unit release appear to be no more than two or three orders of magnitude; these uncertainties are certainly much less than uncertainties in predicting groundwater transport of radionuclides between a repository and the biosphere. Several limitations in current models for predicting the health risk to man per unit release to the biosphere are discussed

  20. Arsenic accumulation in rice: Consequences of rice genotypes and management practices to reduce human health risk.

    Science.gov (United States)

    Islam, Shofiqul; Rahman, Mohammad Mahmudur; Islam, M R; Naidu, Ravi

    2016-11-01

    Rice is an essential staple food and feeds over half of the world's population. Consumption of rice has increased from limited intake in Western countries some 50years ago to major dietary intake now. Rice consumption represents a major route for inorganic arsenic (As) exposure in many countries, especially for people with a large proportion of rice in their daily diet as much as 60%. Rice plants are more efficient in assimilating As into its grains than other cereal crops and the accumulation may also adversely affect the quality of rice and their nutrition. Rice is generally grown as a lowland crop in flooded soils under reducing conditions. Under these conditions the bioavailability of As is greatly enhanced leading to excessive As bioaccumulation compared to that under oxidizing upland conditions. Inorganic As species are carcinogenic to humans and even at low levels in the diet pose a considerable risk to humans. There is a substantial genetic variation among the rice genotypes in grain-As accumulation as well as speciation. Identifying the extent of genetic variation in grain-As concentration and speciation of As compounds are crucial to determining the rice varieties which accumulate low inorganic As. Varietal selection, irrigation water management, use of fertilizer and soil amendments, cooking practices etc. play a vital role in reducing As exposure from rice grains. In the meantime assessing the bioavailability of As from rice is crucial to understanding human health exposure and reducing the risk. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Radiotherapy for stomach cancer: the dosimetric consequences of physiological movement of organs at risk

    International Nuclear Information System (INIS)

    Kai, C.; Joon, D.L.; Joon, M.L.; Quong, G.; Feigen, M.; Wada, M.; Choy, T.; Chui, T.; Mantle, C.; Viotto, A.; Rolfo, A.; Rykers, K.; Grace, M.; Fernando, W.; Liu, G.; Khoo, V.; Chao, M.W.

    2003-01-01

    To assess the impact of movement of the liver and kidneys (organs at risk) on the dose volume histogram (DVH) when treating stomach cancer with radiation therapy. Immediate serial CT non-contrast and contrast scans are obtained as part of the planning process for treating stomach cancer with radiation in the neo-adjuvant and adjuvant setting at our institution. In a series of five patients the liver and right and left kidneys were contoured on both sets of scans. The maximal translational movement in three planes and volume changes of each structure was measured. The maximum, minimum and mean dose was calculated and compared for each organ at risk in both scans. To assess the change in the DVH, the following dose volume parameters were analysed: V50Gy, V35Gy, V30Gy, and V10GY for liver; V50Gy, V30Gy, V23Gy and V15Gy for both kidneys. A complete analysis of results will be presented

  2. Bomb survivor selection and consequences for estimates of population cancer risks

    International Nuclear Information System (INIS)

    Little, M.P.; Charles, M.W.

    1990-01-01

    Health records of the Japanese bomb survivor population [with the 1965 (T65D) and 1986 (DS86) dosimetry systems] have been analyzed and some evidence found for the selection effect hypothesized by Stewart and Kneale. This is found to be significant in only the first of the periods examined (1950-1958), and the effect diminishes in magnitude thereafter. There are indications that the effect might be an artifact of the T65D dosimetry, in which it is observed more strongly than in the DS86 data. There is no evidence to suggest that selection on this basis might confer correspondingly reduced susceptibility to radiation-induced cancer. If, however, one makes this assumption, as suggested by Stewart and Kneale, then current estimates of population cancer risks might need to be inflated by between 5% and 35% (for excess cancer deaths, Gy-1) or between 8% and 40% (for years of life lost, Gy-1) to account for this. It is likely that these figures, even assuming them not to be simply an artifact of the T65D dosimetry, overestimate the degree of adjustment required to the risk estimates

  3. Risk assessment methodology for Hanford high-level waste tanks

    International Nuclear Information System (INIS)

    Bott, T.F.; Mac Farlane, D.R.; Stack, D.W.; Kindinger, J.

    1992-01-01

    A methodology is presented for applying Probabilistic Safety Assessment techniques to quantification of the health risks posed by the high-level waste (HLW) underground tanks at the Department of Energy's Hanford reservation. This methodology includes hazard screening development of a list of potential accident initiators, systems fault trees development and quantification, definition of source terms for various release categories, and estimation of health consequences from the releases. Both airborne and liquid pathway releases to the environment, arising from aerosol and spill/leak releases from the tanks, are included in the release categories. The proposed methodology is intended to be applied to a representative subset of the total of 177 tanks, thereby providing a baseline risk profile for the HLW tank farm that can be used for setting clean-up/remediation priorities. Some preliminary results are presented for Tank 101-SY

  4. Functional consequences of the macrophage stimulating protein 689C inflammatory bowel disease risk allele.

    Directory of Open Access Journals (Sweden)

    Steven E Kauder

    Full Text Available Macrophage stimulating protein (MSP is a serum growth factor that binds to and activates the receptor tyrosine kinase, Recepteur d'Origine Nantais (RON. A non-synonymous coding variant in MSP (689C has been associated with genetic susceptibility to both Crohn's disease and ulcerative colitis, two major types of inflammatory bowel disease (IBD characterized by chronic inflammation of the digestive tract. We investigated the consequences of this polymorphism for MSP-RON pathway activity and IBD pathogenesis.RON expression patterns were examined on mouse and human cells and tissues under normal and disease conditions to identify cell types regulated by MSP-RON. Recombinant MSP variants were tested for their ability to bind and stimulate RON and undergo proteolytic activation. MSP concentrations were quantified in the serum of individuals carrying the MSP 689R and 689C alleles.In intestinal tissue, RON was primarily expressed by epithelial cells under normal and disease conditions. The 689C polymorphism had no impact on the ability of MSP to bind to or signal through RON. In a cohort of normal individuals and IBD patients, carriers of the 689C polymorphism had lower concentrations of MSP in their serum.By reducing the quantities of circulating MSP, the 689C polymorphism, or a variant in linkage disequilibrium with this polymorphism, may impact RON ligand availability and thus receptor activity. Given the known functions of RON in regulating wound healing and our analysis of RON expression patterns in human intestinal tissue, these data suggest that decreased RON activity may impact the efficiency of epithelial repair and thus underlie the increased IBD susceptibility associated with the MSP 689C allele.

  5. In the Casino of Life: Betting on Risks and Ignoring the Consequences of Climate Change and Hazards

    Science.gov (United States)

    Brosnan, D. M.

    2016-12-01

    two related but frequently decoupled factors 1. How does the audience identify and rank risks? 2.What are the consequences of ignoring risks and facing the outcomes? Presentation explores scientists' and decision makers' betting on risks and ignoring the consequences on climate change and hazards.

  6. Risk factors, incidence, consequences and prevention strategies for falls and fall-injury within older indigenous populations: a systematic review.

    Science.gov (United States)

    Lukaszyk, Caroline; Harvey, Lara; Sherrington, Cathie; Keay, Lisa; Tiedemann, Anne; Coombes, Julieann; Clemson, Lindy; Ivers, Rebecca

    2016-12-01

    To examine the risk factors, incidence, consequences and existing prevention strategies for falls and fall-related injury in older indigenous people. Relevant literature was identified through searching 14 electronic databases, a range of institutional websites, online search engines and government databases, using search terms pertaining to indigenous status, injury and ageing. Thirteen studies from Australia, the United States, Central America and Canada were identified. Few studies reported on fall rates but two reported that around 30% of indigenous people aged 45 years and above experienced at least one fall during the past year. The most common hospitalised fall injuries among older indigenous people were hip fracture and head injury. Risk factors significantly associated with falls within indigenous populations included poor mobility, a history of stroke, epilepsy, head injury, poor hearing and urinary incontinence. No formally evaluated, indigenous-specific fall prevention interventions were identified. Falls are a significant and growing health issue for older indigenous people worldwide that can lead to severe health consequences and even death. No fully-evaluated, indigenous-specific fall prevention programs were identified. Implications for Public Health: Research into fall patterns and fall-related injury among indigenous people is necessary for the development of appropriate fall prevention interventions. © 2016 Public Health Association of Australia.

  7. Radiation risk of tissue late effects, a net consequence of probabilities of various cellular responses

    International Nuclear Information System (INIS)

    Feinendegen, L.E.

    1991-01-01

    Late effects from the exposure to low doses of ionizing radiation are hardly or not at all observed in man mainly due to the low values of risk coefficients that preclude statistical analyses of data from populations that are exposed to doses less than 0.2 Gy. In order to arrive at an assessment of potential risk from radiation exposure in the low dose range, the microdosimetry approach is essential. In the low dose range, ionizing radiation generates particle tracks, mainly electrons, which are distributed rather heterogeneously within the exposed tissue. Taking the individual cell as the elemental unit of life, observations and calculations of cellular responses to being hit by energy depositions events from low LET type are analysed. It emerges that besides the probability of a hit cell to sustain a detrimental effect with the consequense of malignant transformation there are probabilities of various adaptive responses that equipp the hit cell with a benefit. On the one hand, an improvement of cellular radical detoxification was observed in mouse bone marrow cells; another adaptive response pertaining to improved DNA repair, was reported for human lymphocytes. The improved radical detoxification in mouse bone marrow cells lasts for a period of 5-10 hours and improved DNA repair in human lymphocytes was seen for some 60 hours following acute irradiation. It is speculated that improved radical detoxification and improved DNA repair may reduce the probability of spontaneous carcinogenesis. Thus it is proposed to weigh the probability of detriment for a hit cell within a multicellular system against the probability of benefit through adaptive responses in other hit cells in the same system per radiation exposure. In doing this, the net effect of low doses of low LET radiation in tissue with individual cells being hit by energy deposition events could be zero or even beneficial. (orig./MG)

  8. HIGH RISK ZONES ON FLOODS AND LANDSLIDES DISASTERS IN RWANDA

    Directory of Open Access Journals (Sweden)

    Nsengiyumva J.ean Baptiste

    2014-01-01

    Full Text Available Disaster risk management as an issue at stake worldwide shifts its emphases from post disaster to pre-disaster phases. Management activities required in pre-disaster phases, such as risk assessment, hazard identification, preparedness or preventive and mitigation measures needs detailed information about hazard characteristics, social, economic, structural vulnerability and capacity. That information is not usually available in many different countries, as it is the case in Rwanda. Based on the international experiences and practices, knowledge of disaster prone areas can be assumed as an alternative for detailed information acquisition, thus contributing to effective disaster risk management. Identification of disaster higher risk zones on floods and landslides, can lead to better understanding of disaster risk and putting in place measures for risk reduction. Consequently, as Rwanda is prone to natural hazards with lack of adequate information that is essential for effective disaster risk management, due to limited scientific researches; this study aims to address that gap. The results revealed that some areas of the North-Western parts of Rwanda are highly prone to floods and landslides, namely Burera, Musanze, Rulindo, Nyabihu, Ngororero and Rubavu Districts. This is aggravated by some triggering factors such as steep slopes, soil types, heavy rains, landuse Practices and others. Intensity and frequency of disaster events vary from district to district and this geographical dispersal confirms the non-spatial clustering (as confirmed by Moran’s I analysis of risks due to uneven level of Disaster vulnerabilities, coping capacities and available hazards whereby lack of normal distribution of hazards all over all Districts.

  9. High body mass index and cancer risk

    DEFF Research Database (Denmark)

    Benn, Marianne; Tybjærg-Hansen, Anne; Smith, George Davey

    2016-01-01

    of follow-up (range 0-37), 8002 developed non-skin cancer, 3347 non-melanoma skin cancer, 1396 lung cancer, 637 other smoking related cancers, 1203 colon cancer, 159 kidney cancer, 1402 breast cancer, 1062 prostate cancer, and 2804 other cancers. Participants were genotyped for five genetic variants...... with a BMI ≥ 30 versus 18.5-24.9 kg/m(2). Corresponding risk of breast cancer was 20 % (0-44 %) higher in postmenopausal women. BMI was not associated with risk of colon, kidney, other smoking related cancers, prostate cancer, or other cancers. In genetic analyses, carrying 7-10 versus 0-4 BMI increasing......High body mass index (BMI) has been associated with increased risk of some cancer. Whether these reflect causal associations is unknown. We examined this issue. Using a Mendelian randomisation approach, we studied 108,812 individuals from the general population. During a median of 4.7 years...

  10. Lessons from the domestic Ebola response: Improving health care system resilience to high consequence infectious diseases.

    Science.gov (United States)

    Meyer, Diane; Kirk Sell, Tara; Schoch-Spana, Monica; Shearer, Matthew P; Chandler, Hannah; Thomas, Erin; Rose, Dale A; Carbone, Eric G; Toner, Eric

    2018-05-01

    The domestic response to the West Africa Ebola virus disease (EVD) epidemic from 2014-2016 provides a unique opportunity to distill lessons learned about health sector planning and operations from those individuals directly involved. This research project aimed to identify and integrate these lessons into an actionable checklist that can improve health sector resilience to future high-consequence infectious disease (HCID) events. Interviews (N = 73) were completed with individuals involved in the domestic EVD response in 4 cities (Atlanta, Dallas, New York, and Omaha), and included individuals who worked in academia, emergency management, government, health care, law, media, and public health during the response. Interviews were transcribed and analyzed qualitatively. Two focus groups were then conducted to expand on themes identified in the interviews. Using these themes, an evidence-informed checklist was developed and vetted for completeness and feasibility by an expert advisory group. Salient themes identified included health care facility issues-specifically identifying assessment and treatment hospitals, isolation and treatment unit layout, waste management, community relations, patient identification, patient isolation, limitations on treatment, laboratories, and research considerations-and health care workforce issues-specifically psychosocial impact, unit staffing, staff training, and proper personal protective equipment. The experiences of those involved in the domestic Ebola response provide critical lessons that can help strengthen resilience of health care systems and improve future responses to HCID events. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  11. High-intensity interval exercise and cerebrovascular health: curiosity, cause, and consequence.

    Science.gov (United States)

    Lucas, Samuel J E; Cotter, James D; Brassard, Patrice; Bailey, Damian M

    2015-06-01

    Exercise is a uniquely effective and pluripotent medicine against several noncommunicable diseases of westernised lifestyles, including protection against neurodegenerative disorders. High-intensity interval exercise training (HIT) is emerging as an effective alternative to current health-related exercise guidelines. Compared with traditional moderate-intensity continuous exercise training, HIT confers equivalent if not indeed superior metabolic, cardiac, and systemic vascular adaptation. Consequently, HIT is being promoted as a more time-efficient and practical approach to optimize health thereby reducing the burden of disease associated with physical inactivity. However, no studies to date have examined the impact of HIT on the cerebrovasculature and corresponding implications for cognitive function. This review critiques the implications of HIT for cerebrovascular function, with a focus on the mechanisms and translational impact for patient health and well-being. It also introduces similarly novel interventions currently under investigation as alternative means of accelerating exercise-induced cerebrovascular adaptation. We highlight a need for studies of the mechanisms and thereby also the optimal dose-response strategies to guide exercise prescription, and for studies to explore alternative approaches to optimize exercise outcomes in brain-related health and disease prevention. From a clinical perspective, interventions that selectively target the aging brain have the potential to prevent stroke and associated neurovascular diseases.

  12. Prevalence, risk factors, clinical consequences, and treatment of enteral feed intolerance during critical illness.

    Science.gov (United States)

    Gungabissoon, Usha; Hacquoil, Kimberley; Bains, Chanchal; Irizarry, Michael; Dukes, George; Williamson, Russell; Deane, Adam M; Heyland, Daren K

    2015-05-01

    We aimed to determine the incidence of enteral feed intolerance and factors associated with intolerance and to assess the influence of intolerance on nutrition and clinical outcomes. We conducted a retrospective analysis of data from an international observational cohort study of nutrition practices among 167 intensive care units (ICUs). Data were collected on nutrition adequacy, ventilator-free days (VFDs), ICU stay, and 60-day mortality. Intolerance was defined as interruption of enteral nutrition (EN) due to gastrointestinal (GI) reasons (large gastric residuals, abdominal distension, emesis, diarrhea, or subjective discomfort). Logistic regression was used to determine risk factors for intolerance and their clinical significance. A sensitivity analysis restricted to sites specifying a gastric residual volume ≥200 mL to identify intolerance was also conducted. Data from 1,888 ICU patients were included. The incidence of intolerance was 30.5% and occurred after a median 3 days from EN initiation. Patients remained intolerant for a mean (±SD) duration of 1.9 ± 1.3 days . Intolerance was associated with worse nutrition adequacy vs the tolerant (56% vs 64%, P intolerance remained associated with negative outcomes. Although mortality was greater among the intolerant patients, this was not statistically significant. Intolerance occurs frequently during EN in critically ill patients and is associated with poorer nutrition and clinical outcomes. © 2014 American Society for Parenteral and Enteral Nutrition.

  13. [Eating disorders in sports: risk factors, health consequences, treatment and prevention].

    Science.gov (United States)

    Márquez, S

    2008-01-01

    Eating disorders appear with relative frequency in sports, such as gymnastics, figure skating or resistance sports, in which weight control is important. Their incidence is greater in women, frequently appearing a low self-esteem, a distorted body image in which the body is perceived with an excess of weight, inefficiency, perfectionism and a sense of control loss, with compensatory attempts exerted through food manipulation and the use of inadequate methods of control weight. Frequently, they are associated in female athletes to irregularities of the menstrual cycle, reduction of the bone mineral density and osteoporosis, giving rise to so-called female athlete triad. Cardiovascular problems, a greater incidence of fractures, and muscular power and resistance losses which impair performance, can also develop. Between the risk for their appearance are attempts to lose weight, often by recommendation of the coach, increases of training loads associated to weight losses, characteristics of the personality that take to excessive preoccupation by body image, or injuries and traumatisms. Treatment requires a multidisciplinary approach, with participation of physicians, psychologists/psychiatrists, nutricionists, coaches and family, being specially important the emphasis on preventive measures.

  14. Sarcopenia in hiding: The risk and consequence of underestimating muscle dysfunction in nonalcoholic steatohepatitis.

    Science.gov (United States)

    Bhanji, Rahima A; Narayanan, Praveena; Allen, Alina M; Malhi, Harmeet; Watt, Kymberly D

    2017-12-01

    Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. Up to one third of individuals with NAFLD will develop nonalcoholic steatohepatitis (NASH), which is associated with progression to cirrhosis and is rapidly becoming the leading indication for liver transplantation. Sarcopenia is defined as a progressive and generalized loss of skeletal muscle mass, strength, and function. It is observed in up to 60% of patients with end-stage liver disease and portends a poor prognosis. Recent studies have shown that sarcopenia is a novel risk factor for developing NAFLD. Pathophysiological mechanisms relating sarcopenia and NASH may include insulin resistance (IR) and increased inflammation. IR leads to accumulation of triglycerides in both muscle tissue and the liver. It also exacerbates proteolysis and leads to muscle depletion. Chronic inflammation leads to liver injury and progression of fibrosis. The inflammatory milieu also stimulates protein catabolism. Viewing skeletal muscle as an endocrine organ that secretes various salutary myokines may help us understand its role in the development of steatosis. A better understanding of the pathophysiology will aid in developing physical and pharmacological therapeutic interventions. In this review, we will explore the complex inter-relationships between sarcopenia and NASH. We will discuss the impact of sarcopenia in patients with NASH and therapeutic options for the management of sarcopenia. (Hepatology 2017;66:2055-2065). © 2017 by the American Association for the Study of Liver Diseases.

  15. Predation Risk versus Pesticide Exposure: Consequences of Fear and Loathing in the Life of Stream Shredders

    Science.gov (United States)

    Pestana, J. T.; Baird, D. J.; Soares, A. M.

    2005-05-01

    Stream invertebrates are exposed to complex stressor regimes including both biotic and abiotic factors. Species living in streams in agricultural landscapes are often subjected to episodic or continuous exposures to low levels of agrochemicals, which may approach or exceed specific substance guidelines. Sublethal effects of pesticides may result in direct effects on organisms (e.g. reduced physiological performance), which may in turn contribute to indirect effects relating to survival (e.g. increased predation risk). Here, we investigate the possibility that predator-release kairomones can act additively with low-level pesticide exposure to reduce physiological performance and survival of stream invertebrates in previously unforeseen ways. Feeding, metabolic and behavioural responses of two shredder insects, the North American stonefly Pteronarcys comstockii and the European caddisfly Sericostoma vittatum were measured under exposure to the insecticide imidacloprid at different levels of indirect predation stress using predator-release kairomones from Brown Trout (Salmo trutta). Pteronarcys feeding was measured in terms of mass of naturally conditioned alder leaf discs consumed over a 6-day and 10 -day period in animals held in cages in stream mesocosms. Pteronarcys feeding was impaired at 1 ppb in the 6-day trial and at 0,5 ppb in the 10-day trial relatively to unexposed controls. Metabolic rate was measured in the lab in terms of oxygen consumption of Pteronarcys. Animals exposed to 0.5 and 1 ppb imidacloprid showed elevated respiratory rates compared to controls. Laboratory experiments with Sericostoma, currently in progress, are examining the separate and combined effects of imidacloprid and predator kairomone on similar endpoints. These preliminary results are discussed in relation to the development of the Mechanistic Unifying Stressor Effects (MUSE) model which can be used to predict combined ecological effects of multiple stressors at the population level.

  16. Future consequences of decreasing marginal production efficiency in the high-yielding dairy cow.

    Science.gov (United States)

    Moallem, U

    2016-04-01

    The objectives were to examine the gross and marginal production efficiencies in high-yielding dairy cows and the future consequences on dairy industry profitability. Data from 2 experiments were used in across-treatments analysis (n=82 mid-lactation multiparous Israeli-Holstein dairy cows). Milk yields, body weights (BW), and dry matter intakes (DMI) were recorded daily. In both experiments, cows were fed a diet containing 16.5 to 16.6% crude protein and net energy for lactation (NEL) at 1.61 Mcal/kg of dry matter (DM). The means of milk yield, BW, DMI, NEL intake, and energy required for maintenance were calculated individually over the whole study, and used to calculate gross and marginal efficiencies. Data were analyzed in 2 ways: (1) simple correlation between variables; and (2) cows were divided into 3 subgroups, designated low, moderate, and high DMI (LDMI, MDMI, and HDMI), according to actual DMI per day: ≤ 26 kg (n=27); >26 through 28.2 kg (n=28); and >28.2 kg (n=27). The phenotypic Pearson correlations among variables were analyzed, and the GLM procedure was used to test differences between subgroups. The relationships between milk and fat-corrected milk yields and the corresponding gross efficiencies were positive, whereas BW and gross production efficiency were negatively correlated. The marginal production efficiency from DM and energy consumed decreased with increasing DMI. The difference between BW gain as predicted by the National Research Council model (2001) and the present measurements increased with increasing DMI (r=0.68). The average calculated energy balances were 1.38, 2.28, and 4.20 Mcal/d (standard error of the mean=0.64) in the LDMI, MDMI, and HDMI groups, respectively. The marginal efficiency for milk yields from DMI or energy consumed was highest in LDMI, intermediate in MDMI, and lowest in HDMI. The predicted BW gains for the whole study period were 22.9, 37.9, and 75.8 kg for the LDMI, MDMI, and HDMI groups, respectively. The

  17. High-Risk Series: An Update

    Science.gov (United States)

    2015-02-01

    the Medicare Trustees, the Office of the Actuary , and the Congressional Budget Office have raised concerns about whether some of the Medicare... actuarially sound. For more information, see the National Flood Insurance Program section of this High-Risk report. Among other things, the report...and mathematics (STEM) functional community. In addition to the efforts of the Working Group, the President’s Fiscal Year 2013 budget—released in

  18. Evidence and Consequence of a Highly Adapted Clonal Haplotype within the Australian Ascochyta rabiei Population

    Directory of Open Access Journals (Sweden)

    Yasir Mehmood

    2017-06-01

    Full Text Available The Australian Ascochyta rabiei (Pass. Labr. (syn. Phoma rabiei population has low genotypic diversity with only one mating type detected to date, potentially precluding substantial evolution through recombination. However, a large diversity in aggressiveness exists. In an effort to better understand the risk from selective adaptation to currently used resistance sources and chemical control strategies, the population was examined in detail. For this, a total of 598 isolates were quasi-hierarchically sampled between 2013 and 2015 across all major Australian chickpea growing regions and commonly grown host genotypes. Although a large number of haplotypes were identified (66 through short sequence repeat (SSR genotyping, overall low gene diversity (Hexp = 0.066 and genotypic diversity (D = 0.57 was detected. Almost 70% of the isolates assessed were of a single dominant haplotype (ARH01. Disease screening on a differential host set, including three commonly deployed resistance sources, revealed distinct aggressiveness among the isolates, with 17% of all isolates identified as highly aggressive. Almost 75% of these were of the ARH01 haplotype. A similar pattern was observed at the host level, with 46% of all isolates collected from the commonly grown host genotype Genesis090 (classified as “resistant” during the term of collection identified as highly aggressive. Of these, 63% belonged to the ARH01 haplotype. In conclusion, the ARH01 haplotype represents a significant risk to the Australian chickpea industry, being not only widely adapted to the diverse agro-geographical environments of the Australian chickpea growing regions, but also containing a disproportionately large number of aggressive isolates, indicating fitness to survive and replicate on the best resistance sources in the Australian germplasm.

  19. Risk factors and consequences of maternal anaemia and elevated haemoglobin levels during pregnancy: a population-based prospective cohort study.

    Science.gov (United States)

    Gaillard, Romy; Eilers, Paul H C; Yassine, Siham; Hofman, Albert; Steegers, Eric A P; Jaddoe, Vincent W V

    2014-05-01

    To determine sociodemographic and life style-related risk factors and trimester specific maternal, placental, and fetal consequences of maternal anaemia and elevated haemoglobin levels in pregnancy. In a population-based prospective cohort study of 7317 mothers, we measured haemoglobin levels in early pregnancy [gestational age median 14.4 weeks (inter-quartile-range 12.5-17.5)]. Anaemia (haemoglobin ≤11 g/dl) and elevated haemoglobin levels (haemoglobin ≥13.2 g/dl) were defined according to the WHO criteria. Maternal blood pressure, placental function and fetal growth were measured in each trimester. Data on gestational hypertensive disorders and birth outcomes was collected from hospitals. Older maternal age, higher body mass index, primiparity and European descent were associated with higher haemoglobin levels (P pregnancy (mean differences 5.1 mmHg, 95% confidence interval [CI] 3.8, 6.5 and 4.1 mmHg, 95% CI 3.0, 5.2, respectively) and with a higher risk of third trimester uterine artery notching (RR 1.3, 95% CI 1.0, 1.7). As compared with maternal normal haemoglobin levels, not anaemia, but elevated haemoglobin levels were associated with fetal head circumference, length, and weight growth restriction from third trimester onwards (P pregnancy. Elevated haemoglobin levels are associated with increased risks of maternal, placental, and fetal complications. © 2014 John Wiley & Sons Ltd.

  20. Abnormal pelvic morphology and high cervical length are responsible for high-risk pregnancies in women displaying achondroplasia.

    Science.gov (United States)

    Vivanti, Alexandre J; Cordier, Anne-Gael; Baujat, Geneviève; Benachi, Alexandra

    2016-12-05

    Pregnancies of women displaying achondroplasia are at high risk of adverse events. Early sonographic assessment of affected women can indicate an unusually long cervical length. It is the consequence of pathological anatomy of the pelvis. Thus, there is a foreseeable dystocia owing to cephalopelvic disproportion. Furthermore, this situation could also complicate cervical ripening prior to fetal extraction.

  1. Evidence of underdiagnosis and markers of high blood pressure risk in children aged 6 to 13 years

    Directory of Open Access Journals (Sweden)

    Jeanne Teixeira Bessa Fuly

    2014-01-01

    Conclusions: Overweight and family history constitute the main risk markers of high BP in children. The low frequency of BP measurement in children observed in this municipality contributes to the underdiagnosis of the disease, with irreversible consequences for these individuals.

  2. Physical activities at work and risk of musculoskeletal pain and its consequences

    DEFF Research Database (Denmark)

    Jørgensen, Marie Birk; Korshøj, Mette; Lagersted-Olsen, Julie

    2013-01-01

    Among blue-collar workers, high physical work demands are generally considered to be the main cause of musculoskeletal pain and work disability. However, current available research on this topic has been criticised for using self-reported data, cross-sectional design, insufficient adjustment...... for potential confounders, and inadequate follow-up on the recurrent and fluctuating pattern of musculoskeletal pain. Recent technological advances have provided possibilities for objective diurnal field measurements of physical activities and frequent follow-up on musculoskeletal pain.The main aim...... of this paper is to describe the background, design, methods, limitations and perspectives of the Danish Physical Activity cohort with Objective measurements (DPhacto) investigating the association between objectively measured physical activities capturing work and leisure time and frequent measurements...

  3. From Exploitation to Industry: Definitions, Risks, and Consequences of Domestic Sexual Exploitation and Sex Work Among Women and Girls.

    Science.gov (United States)

    Gerassi, Lara

    In the last 15 years, terms such as prostitution, sex trafficking, sexual exploitation, modern-day slavery, and sex work have elicited much confusion and debate as to their definitions. Consequently several challenges have emerged for both law enforcement in the prosecution of criminals and practitioners in service provision. This article reviews the state of the literature with regard to domestic, sexual exploitation among women and girls in the United States and seeks to (1) provide definitions and describe the complexity of all terms relating to domestic sexual exploitation of women and girls in the United States, (2) explore available national prevalence data according to the definitions provided, and (3) review the evidence of mental health, social, and structural risk factors at the micro-, mezzo-, and macrolevels.

  4. From Exploitation to Industry: Definitions, Risks, and Consequences of Domestic Sexual Exploitation and Sex Work Among Women and Girls

    Science.gov (United States)

    Gerassi, Lara

    2015-01-01

    In the last 15 years, terms such as prostitution, sex trafficking, sexual exploitation, modern-day slavery, and sex work have elicited much confusion and debate as to their definitions. Consequently several challenges have emerged for both law enforcement in the prosecution of criminals and practitioners in service provision. This article reviews the state of the literature with regard to domestic, sexual exploitation among women and girls in the United States and seeks to (1) provide definitions and describe the complexity of all terms relating to domestic sexual exploitation of women and girls in the United States, (2) explore available national prevalence data according to the definitions provided, and (3) review the evidence of mental health, social, and structural risk factors at the micro-, mezzo-, and macrolevels. PMID:26726289

  5. Effect of dissolved humic acid on the Pb bioavailability in soil solution and its consequence on ecological risk.

    Science.gov (United States)

    An, Jinsung; Jho, Eun Hea; Nam, Kyoungphile

    2015-04-09

    Current risk characterization in ecological risk assessment does not consider bioavailability of heavy metals, which highly depends on physicochemical properties of environmental media. This study was set to investigate the effect of humic acid (HA), used as a surrogate of organic matter, on Pb toxicity and the subsequent effect on risk characterization in ecological risk assessment. Pb toxicity was assessed using Microtox(®) in the presence and absence of two different forms of HA, particulate HA (pHA) and dissolved HA (dHA). With increasing contact time, the EC10 values increased (i.e., the toxic effects decreased) and the dissolved Pb concentrations of the filtrates decreased. The high correlation (R = 0.88, p < 0.001) between toxic effects determined using both the mixture and its filtrate as exposure media leads us to conclude that the Pb toxicity highly depends on the soluble fraction. Also, reduced Pb toxicity with increasing dHA concentrations, probably due to formation of Pb-dHA complexes, indicated that Pb toxicity largely comes from free Pb ions. Overall, this study shows the effect of HA on metal toxicity alleviation, and emphasizes the need for incorporating the bioavailable heavy metal concentrations in environmental media as a point of exposure in ecological risk assessment. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Childhood Obesity Causes & Consequences

    Science.gov (United States)

    ... and Local Programs Related Topics Diabetes Nutrition Childhood Obesity Causes & Consequences Recommend on Facebook Tweet Share Compartir ... determine how a community is designed. Consequences of Obesity More Immediate Health Risks Obesity during childhood can ...

  7. High-Performing Families: Causes, Consequences, and Clinical Solutions. The Family Psychology and Counseling Series.

    Science.gov (United States)

    Robinson, Bryan E., Ed.; Chase, Nancy D., Ed.

    This book explores the dilemma of the increasing obsession with work and the resulting imbalances between career and family life. Through theoretical frameworks and case examples it discusses the negative consequences of the societal phenomena of over-work and over-dedication to careers, which have been misdiagnosed or ignored by mental health…

  8. Metal stress consequences on frost hardiness of plants at northern high latitudes: a review and hypothesis

    International Nuclear Information System (INIS)

    Taulavuori, Kari; Prasad, M.N.V.; Taulavuori, Erja; Laine, Kari

    2005-01-01

    This paper reviews the potential of trace/heavy metal-induced stress to reduce plant frost hardiness at northern high latitudes. The scientific questions are first outlined prior to a brief summary of heavy metal tolerance. The concepts of plant capacity and survival adaptation were used to formulate a hypothesis, according to which heavy metal stress may reduce plant frost hardiness for the following reasons: (1) Heavy metals change membrane properties through impaired resource acquisition and subsequent diminution of the cryoprotectant pool. (2) Heavy metals change membrane properties directly through oxidative stress, i.e. an increase of active oxygen species. (3) The involved co-stress may further increase oxidative stress. (4) The risk of frost injury increases due to membrane alterations. An opposite perspective was also discussed: could metal stress result in enhanced plant frost hardiness? This phenomenon could be based on the metabolism (i.e. glutathione, polyamines, proline, heat shock proteins) underlying a possible general adaptation syndrome of stress (GAS). As a result of the review it was suggested that metal-induced stress seems to reduce rather than increase plant frost hardiness. - Metal stress may reduce plant frost hardiness

  9. Metal stress consequences on frost hardiness of plants at northern high latitudes: a review and hypothesis.

    Science.gov (United States)

    Taulavuori, Kari; Prasad, M N V; Taulavuori, Erja; Laine, Kari

    2005-05-01

    This paper reviews the potential of trace/heavy metal-induced stress to reduce plant frost hardiness at northern high latitudes. The scientific questions are first outlined prior to a brief summary of heavy metal tolerance. The concepts of plant capacity and survival adaptation were used to formulate a hypothesis, according to which heavy metal stress may reduce plant frost hardiness for the following reasons: (1) Heavy metals change membrane properties through impaired resource acquisition and subsequent diminution of the cryoprotectant pool. (2) Heavy metals change membrane properties directly through oxidative stress, i.e. an increase of active oxygen species. (3) The involved co-stress may further increase oxidative stress. (4) The risk of frost injury increases due to membrane alterations. An opposite perspective was also discussed: could metal stress result in enhanced plant frost hardiness? This phenomenon could be based on the metabolism (i.e. glutathione, polyamines, proline, heat shock proteins) underlying a possible general adaptation syndrome of stress (GAS). As a result of the review it was suggested that metal-induced stress seems to reduce rather than increase plant frost hardiness.

  10. Metal stress consequences on frost hardiness of plants at northern high latitudes: a review and hypothesis

    Energy Technology Data Exchange (ETDEWEB)

    Taulavuori, Kari [Department of Biology, University of Oulu, PO Box 3000, FIN-90014, Oulu (Finland)]. E-mail: kari.taulavuori@oulu.fi; Prasad, M.N.V. [Department of Plant Sciences, University of Hyderabad, Hyderabad 500 046, Andhra Pradesh (India); Taulavuori, Erja [Department of Biology, University of Oulu, PO Box 3000, FIN-90014, Oulu (Finland); Laine, Kari [Department of Biology, University of Oulu, PO Box 3000, FIN-90014, Oulu (Finland)

    2005-05-01

    This paper reviews the potential of trace/heavy metal-induced stress to reduce plant frost hardiness at northern high latitudes. The scientific questions are first outlined prior to a brief summary of heavy metal tolerance. The concepts of plant capacity and survival adaptation were used to formulate a hypothesis, according to which heavy metal stress may reduce plant frost hardiness for the following reasons: (1) Heavy metals change membrane properties through impaired resource acquisition and subsequent diminution of the cryoprotectant pool. (2) Heavy metals change membrane properties directly through oxidative stress, i.e. an increase of active oxygen species. (3) The involved co-stress may further increase oxidative stress. (4) The risk of frost injury increases due to membrane alterations. An opposite perspective was also discussed: could metal stress result in enhanced plant frost hardiness? This phenomenon could be based on the metabolism (i.e. glutathione, polyamines, proline, heat shock proteins) underlying a possible general adaptation syndrome of stress (GAS). As a result of the review it was suggested that metal-induced stress seems to reduce rather than increase plant frost hardiness. - Metal stress may reduce plant frost hardiness.

  11. Perceived Sexual Benefits of Alcohol Use among Recent High School Graduates: Longitudinal Associations with Drinking Behavior and Consequences

    Science.gov (United States)

    Brady, Sonya S.; Wilkerson, J. Michael; Jones-Webb, Rhonda

    2012-01-01

    In this research study of 153 college-bound students, perceived sexual benefits of alcohol use were associated with greater drinking and related consequences during the senior year of high school and freshman year of college. Perceived benefits predicted drinking outcomes during fall after adjustment for gender, sensation seeking, parental…

  12. Transformations, transport, and potential unintended consequences of high sulfur inputs to Napa Valley vineyards

    OpenAIRE

    Hinckley, Eve-Lyn S.; Matson, Pamela A.

    2011-01-01

    Unintended anthropogenic deposition of sulfur (S) to forest ecosystems has a range of negative consequences, identified through decades of research. There has been far less study of purposeful S use in agricultural systems around the world, including the application of elemental sulfur (S0) as a quick-reacting fungicide to prevent damage to crops. Here we report results from a three-year study of the transformations and flows of applied S0 in soils, vegetation, and hydrologic export pathways ...

  13. Integrating mHealth Mobile Applications to Reduce High Risk Drinking among Underage Students

    Science.gov (United States)

    Kazemi, Donna M.; Cochran, Allyson R.; Kelly, John F.; Cornelius, Judith B.; Belk, Catherine

    2014-01-01

    Objective: College students embrace mobile cell phones (MCPs) as a primary communication and entertainment device. The aim of this study was to investigate college students' perceptions toward using mHealth technology to deliver interventions to prevent high-risk drinking and associated consequences. Design/setting: Four focus group interviews…

  14. Ecological risk assessment of deep geological disposal of high-level nuclear waste

    International Nuclear Information System (INIS)

    Hart, D.R.; Lush, D.L.; Acton, D.W.

    1993-01-01

    Contaminant fate and transport models, radiological dosimetry models, chemical dose-response models and population dynamic models were used to estimate ecological risks to moose and brook trout populations arising from a proposed high-level nuclear waste repository. Risks from potential contaminant releases were compared with risks from physical habitat alteration in constructing a repository and service community, and with risks from increased hunting and fish pressure in the area. For a reference environment typical of a proposed location somewhere in the Canadian Shield, preliminary results suggest that the population consequences of contaminant release will be minor relative to those of habitat alteration and natural resource use

  15. Mining geriatric assessment data for in-patient fall prediction models and high-risk subgroups

    OpenAIRE

    Marschollek, Michael; Gövercin, Mehmet; Rust, Stefan; Gietzelt, Matthias; Schulze, Mareike; Wolf, Klaus-Hendrik; Steinhagen-Thiessen, Elisabeth

    2012-01-01

    Abstract Background Hospital in-patient falls constitute a prominent problem in terms of costs and consequences. Geriatric institutions are most often affected, and common screening tools cannot predict in-patient falls consistently. Our objectives are to derive comprehensible fall risk classification models from a large data set of geriatric in-patients' assessment data and to evaluate their predictive performance (aim#1), and to identify high-risk subgroups from the data (aim#2). Methods A ...

  16. Cardiovascular and metabolic consequences of the association between chronic stress and high-fat diet in rats.

    Science.gov (United States)

    Simas, Bruna B; Nunes, Everson A; Crestani, Carlos C; Speretta, Guilherme F

    2018-05-01

    Obesity and chronic stress are considered independent risk factors for the development of cardiovascular diseases and changes in autonomic system activity. However, the cardiovascular consequences induced by the association between high-fat diet (HFD) and chronic stress are not fully understood. We hypothesized that the association between HFD and exposure to a chronic variable stress (CVS) protocol for four weeks might exacerbate the cardiovascular and metabolic disturbances in rats when compared to these factors singly. To test this hypothesis, male Wistar rats were divided into four groups: control-standard chow diet (SD; n = 8); control-HFD (n = 8); CVS-SD (n = 8); and CVS-HFD (n = 8). The CVS consisted of repeated exposure of the rats to different inescapable and unpredictable stressors (restraint tress; damp sawdust, cold, swim stress and light cycle inversion). We evaluated cardiovascular function, autonomic activity, dietary intake, adiposity and metabolism. The HFD increased body weight, adiposity and blood glucose concentration (∼15%) in both control and CVS rats. The CVS-HFD rats showed decreased insulin sensitivity (25%) compared to CVS-SD rats. The control-HFD and CVS-HFD rats presented increased intrinsic heart rate (HR) values (∼8%). CVS increased cardiac sympathetic activity (∼65%) in both SD- and HFD-fed rats. The HFD increased basal HR (∼10%). Blood pressure and baroreflex analyzes showed no differences among the experimental groups. In conclusion, the present data indicate absence of interaction on autonomic imbalance evoked by either CVS or HFD. Additionally, HFD increased HR and evoked metabolic disruptions which are independent of stress exposure.

  17. High resolution fire risk mapping in Italy

    Science.gov (United States)

    Fiorucci, Paolo; Biondi, Guido; Campo, Lorenzo; D'Andrea, Mirko

    2014-05-01

    The high topographic and vegetation heterogeneity makes Italy vulnerable to forest fires both in the summer and in winter. In particular, northern regions are predominantly characterized by a winter fire regime, mainly due to frequent extremely dry winds from the north, while southern and central regions and the large islands are characterized by a severe summer fire regime, because of the higher temperatures and prolonged lack of precipitation. The threat of wildfires in Italy is not confined to wooded areas as they extend to agricultural areas and urban-forest interface areas. The agricultural and rural areas, in the last century, have been gradually abandoned, especially in areas with complex topography. Many of these areas were subject to reforestation, leading to the spread of pioneer species mainly represented by Mediterranean conifer, which are highly vulnerable to fire. Because of the frequent spread of fire, these areas are limited to the early successional stages, consisting mainly of shrub vegetation; its survival in the competition with the climax species being ensured by the spread of fire itself. Due to the frequency of fire ignition — almost entirely man caused — the time between fires on the same area is at least an order of magnitude less than the time that would allow the establishment of forest climax species far less vulnerable to fire. In view of the limited availability of fire risk management resources, most of which are used in the management of national and regional air services, it is necessary to precisely identify the areas most vulnerable to fire risk. The few resources available can thus be used on a yearly basis to mitigate problems in the areas at highest risk by defining a program of forest management interventions, which is expected to make a significant contribution to the problem in a few years' time. The goal of such detailed planning is to dramatically reduce the costs associated with water bombers fleet management and fire

  18. The blues broaden, but the nasty narrows: attentional consequences of negative affects low and high in motivational intensity.

    Science.gov (United States)

    Gable, Philip; Harmon-Jones, Eddie

    2010-02-01

    Positive and negative affects high in motivational intensity cause a narrowing of attentional focus. In contrast, positive affects low in motivational intensity cause a broadening of attentional focus. The attentional consequences of negative affects low in motivational intensity have not been experimentally investigated. Experiment 1 compared the attentional consequences of negative affect low in motivational intensity (sadness) relative to a neutral affective state. Results indicated that low-motivation negative affect caused attentional broadening. Experiment 2 found that disgust, a high-motivation negative affect not previously investigated in attentional studies, narrowed attentional focus. These experiments support the conceptual model linking high-motivation affective states to narrowed attention and low-motivation affective states to broadened attention.

  19. A Risk Management Framework to Characterize Black Swan Risks: A Case Study of Lightning Effects on Insensitive High Explosives

    Science.gov (United States)

    Sanders, Gary A.

    Effective and efficient risk management processes include the use of high fidelity modeling and simulation during the concept exploration phase as part of the technology and risk assessment activities, with testing and evaluation tasks occurring in later design development phases. However, some safety requirements and design architectures may be dominated by the low probability/high consequence "Black Swan" vulnerabilities that require very early testing to characterize and efficiently mitigate. Failure to address these unique risks has led to catastrophic systems failures including the space shuttle Challenger, Deepwater Horizon, Fukushima nuclear reactor, and Katrina dike failures. Discovering and addressing these risks later in the design and development process can be very costly or even lead to project cancellation. This paper examines the need for risk management process adoption of early hazard phenomenology testing to inform the technical risk assessment, requirements definition and conceptual design. A case study of the lightning design vulnerability of the insensitive high explosives being used in construction, mining, demolition, and defense industries will be presented to examine the impact of this vulnerability testing during the concept exploration phase of the design effort. While these insensitive high explosives are far less sensitive to accidental initiation by fire, impact, friction or even electrical stimuli, their full range of sensitivities have not been characterized and ensuring safe engineering design and operations during events such as lightning storms requires vulnerability testing during the risk assessment phase.

  20. People at High Risk of Developing Flu-Related Complications

    Science.gov (United States)

    ... Influenza Types Seasonal Avian Swine Variant Pandemic Other People at High Risk of Developing Flu–Related Complications ... related complications if they get sick with influenza. People at High Risk for Developing Flu-Related Complications ...

  1. Risk-oriented analysis of the German prototype fast breeder reactor SNR-300: off-site accident consequence model and results of the study

    International Nuclear Information System (INIS)

    Bayer, A.; Ehrhardt, J.

    1984-01-01

    Accident off-site consequence calculations and risk assessments performed for the ''risk oriented analysis'' of the German prototype fast breeder reactor SNR-300 were performed with a modified version of the off-site accident consequence model UFOMOD. The modifications mainly relate to the deposition and resuspension processes, the ingestion model, and the dose factors. Consequence calculations at the site of Kalkar on the Rhine River were performed for 115 weather sequences in 36 wind directions. They were based on seven release categories evaluated for the SNR-300 with two different fueling strategies: plutonium from Magnox reactors only and plutonium from light water reactors and Magnox reactors. In parallel, the corresponding frequencies of occurrence are determined. The following results are generated: 1. complementary cumulative frequency distribution functions for collective fatalities and collective doses 2. expected values of the collective fatalities and collective doses as well as distance-dependent expected values of individual fatality 3. contributions of the different exposure pathways to fatalities with respect to the various organs. For comparison with the risk of a PWR-1300, calculations for the PWR-1300 of the ''German Risk Study'' were repeated with the same modified consequence model. Comparison shows that smaller risks result for the SNR-300. However, the confidence interval bandwidths obtained for the frequencies of the release categories for the SNR-300 are larger than those of the PWR-1300

  2. Transformations, transport, and potential unintended consequences of high sulfur inputs to Napa Valley vineyards.

    Science.gov (United States)

    Hinckley, Eve-Lyn S; Matson, Pamela A

    2011-08-23

    Unintended anthropogenic deposition of sulfur (S) to forest ecosystems has a range of negative consequences, identified through decades of research. There has been far less study of purposeful S use in agricultural systems around the world, including the application of elemental sulfur (S(0)) as a quick-reacting fungicide to prevent damage to crops. Here we report results from a three-year study of the transformations and flows of applied S(0) in soils, vegetation, and hydrologic export pathways of Napa Valley, CA vineyards, documenting that all applied S is lost from the vineyard ecosystem on an annual basis. We found that S(0) oxidizes rapidly to sulfate ( ) on the soil surface where it then accumulates over the course of the growing season. Leaf and grape tissues accounted for only 7-13% of applied S whereas dormant season cover crops accounted for 4-10% of applications. Soil S inventories were largely and ester-bonded sulfates; they decreased from 1,623 ± 354 kg ha(-1) during the dry growing season to 981 ± 526 kg ha(-1) (0-0.5 m) during the dormant wet season. Nearly all S applied to the vineyard soils is transported offsite in dissolved oxidized forms during dormant season rainstorms. Thus, the residence time of reactive S is brief in these systems, and largely driven by hydrology. Our results provide new insight into how S use in vineyards constitutes a substantial perturbation of the S cycle in Northern California winegrowing regions and points to the unintended consequences that agricultural S use may have at larger scales.

  3. Risk Associated With The Decompression Of High Pressure High Temperature Fluids - Study On Black Oil

    DEFF Research Database (Denmark)

    Figueroa, D. C.; Fosbøl, P. L.; Thomsen, K.

    2015-01-01

    Fluids produced from deep underground reservoirs may result in exponential increase in temperature. It is a consequence of adiabatic fluid decompression from the inverse Joule Thomson Effect (JTE). The phenomenon requires analysis in order to avoid any operational risks. This study evaluates...... the JTE upon decompression of black oil in high pressure-high temperature reservoirs. Also the effect caused by the presence of water and brine on the black oil is studied. The final temperature is calculated from the corresponding energy balance at isenthalpic and non-isenthalpic conditions. It is found...... that the final temperature of black oil increases upon adiabatic decompression. In the case of the isenthalpic process at initial conditions of the reservoir, e.g. 150°C and 1000 bars, it is found that the final temperature can increase to 173.7°C. At non-isenthalpic conditions the final temperature increases...

  4. The negative consequences of other students' drinking: inventory development and assessment of differences by student characteristics and risk behaviors.

    Science.gov (United States)

    Rhodes, Scott D; McCoy, Thomas P; Omli, Morrow R; Cohen, Gail M; Wagoner, Kimberly G; Durant, Robert H; Vissman, Aaron T; Wolfson, Mark

    2009-01-01

    College students continue to report being disrupted by other students' alcohol use. This study was designed to develop measures to document the consequences resulting from other students' drinking and identify differences in experiencing these consequences by student characteristics and drinking behaviors. A stratified random sample of undergraduate students (N = 3,908) from ten universities in North Carolina, USA, completed a web-based assessment. Exploratory factor analysis (EFA) was performed on the random first split-half sample (n = 1,954) to identify factor structure. Confirmatory factor analysis (CFA) was performed on the remaining half sample (n = 1,954) using structural equation modeling. EFA revealed two inventories: interpersonal and community consequences of others' drinking inventories. CFA on the second split-half sample identified model fits for the two factor structure suggested by EFA. Of 3,908 participants, 78% reported experiencing one or more consequences due to others' drinking during the past 30 days. Multivariable generalized linear mixed modeling further validated the inventories and resulted in several associations. Male students who reported getting drunk experienced significantly more interpersonal consequences from others' drinking (p students, students who lived on campus and students who reported getting drunk experienced significantly more community consequences from others' drinking (p college students experience consequences from others' drinking, and consequences vary for different subgroups of students. Although these inventories should be tested further, these findings propose standardized measures that may be useful to assess the consequences of others' drinking among college students.

  5. CAUSES AND CONSEQUENCES OF THE SCHOOL IN HIGH SCHOOL DROPOUT: CASE UNIVERSIDAD AUTÓNOMA DE SINALOA

    Directory of Open Access Journals (Sweden)

    Rosalva Ruiz-Ramírez

    2014-07-01

    Full Text Available The present investigation has the objective to establish the personal, economic and social causes and consequences that create school desertion of high school in Universidad Autónoma de Sinaloa (UAS. The investigation took place in the high school located in the municipality of El Fuerte, Sinaloa, in the academic unit (UA of San Blas and its extensions The Constancia and The Higueras of the Natoches in 2013. A mixed approach was used to analyze qualitative and quantitative information; the studied population was 18 women and 17 men deserters of the school cycle 2011-2012, ten teachers, four directors and twenty non-deserting students. In the results one can see that the principal factor for school desertion was the personnel to be married and not approving classes. The main consequence was economic, highlighting that the poverty cycle is hard to break.

  6. Client experiences with perinatal healthcare for high-risk and low-risk women

    NARCIS (Netherlands)

    van Stenus, Cherelle M.V.; Boere-Boonekamp, Magda M.; Kerkhof, Erna F.G.M.; Need, Ariana

    2018-01-01

    Problem: It is unknown if client experiences with perinatal healthcare differ between low-risk and high-risk women. Background: In the Netherlands, risk selection divides pregnant women into low- and high-risk groups. Receiving news that a pregnancy or childbirth has an increased likelihood of

  7. The Consequences of Commercialization Choices for New Entrants in High-Tech Industries: A Venture Emergence Perspective

    DEFF Research Database (Denmark)

    Giones, Ferran; Gurses, Kerem

    for these different markets. We test our hypotheses on longitudinal dataset of 453 new firms started in 2004 in different high-tech industries in the US. We find that that technology and human capital resources favor the adoption of alternative commercialization strategies; nevertheless, we do not observe significant...... differences in the venture emergence or survival likelihood. Our findings offer a closer view of the venture emergence process of new firms, clarifying the causes and consequences of the technology commercialization choices....

  8. Incidence, Risk Factors and Consequences of Epilepsy-Related Injuries and Accidents: A Retrospective, Single Center Study

    Directory of Open Access Journals (Sweden)

    Laurent M. Willems

    2018-06-01

    Full Text Available Introduction: This study was designed to evaluate risk factors and incidence of epilepsy-related injuries and accidents (ERIA at an outpatient clinic of a German epilepsy center providing healthcare to a mixed urban and rural population of over one million inhabitants.Methods: Data acquisition was performed between 10/2013 and 09/2014 using a validated patient questionnaire on socioeconomic status, course of epilepsy, quality of life (QoL, depression, injuries and accidents associated with seizures or inadequate periictal patterns of behavior concerning a period of 3 months. Univariate analysis, multiple testing and regression analysis were performed to identify possible variables associated with ERIA.Results: A total of 292 patients (mean age 40.8 years, range 18–86; 55% female were enrolled and analyzed. Focal epilepsy was diagnosed in 75% of the patients. The majority was on an antiepileptic drug (AEDs polytherapy (mean number of AEDs: 1.65. Overall, 41 patients (14.0% suffered from epilepsy-related injuries and accidents in a 3-month period. Besides lacerations (n = 18, 6.2%, abrasions and bruises (n = 9, 3.1%, fractures (n = 6, 2.2% and burns (n = 3, 1.0%, 17 mild injuries (5.8% were reported. In 20 (6.8% of the total cohort cases, urgent medical treatment with hospitalization was necessary. Epilepsy-related injuries and accidents were related to active epilepsy, occurrence of generalized tonic-clonic seizures (GTCS and drug-refractory course as well as reported ictal falls, ictal loss of consciousness and abnormal peri-ictal behavior in the medical history. In addition, patients with ERIA had significantly higher depression rates and lower QoL.Conclusion: ERIA and their consequences should be given more attention and standardized assessment for ERIA should be performed in every outpatient visit.

  9. Study of risk of developing a delayed ettringite formation and its consequences in concrete of nuclear structures

    International Nuclear Information System (INIS)

    Al Shamaa, M.

    2012-01-01

    Delayed ettringite formation (DEF) in concrete structures is a pathology that can develop when special conditions on the concrete composition, the thermal conditions at the young age and the environment are met. This phenomenon provokes swelling of the material and cracking in the structure. It affects two types of concrete: the concrete heat-treated and the concrete cast in place in massive parts. Although many studies were done before in order to better understand this pathology, the DEF is still not well known. This is due to its complex mechanism, the influential parameters and its consequences on microscopic and structural scales. For that purpose, the thesis work was designed in order to better understand this pathology. Experimental studies were done to evaluate the impact of certain factors during the reaction, by focusing on nuclear application. An important part of this study was dedicated to assess the risk of DEF development in a nuclear power plant, and to understand how this pathology affects the mechanical characteristics and transfer properties of the concrete. Then, we have studied the impact of the hygrometry on the development of DEF. This has lead to identify a relation between environmental humidity and swelling. We have also examined the role of alkali leaching. A follow up study of the transfer properties was also done and was confronted to the observed swelling. Finally, we were interested in the characterization of the aggregates effect on the kinetics and the amplitude of DEF swelling. So, we have examined the parameters related to the size and the volume fraction of granular inclusions. Furthermore, an application of a mesoscopic numerical modeling of swelling is proposed. (author)

  10. Peritonitis before Peritoneal Dialysis Training: Analysis of Causative Organisms, Clinical Outcomes, Risk Factors, and Long-Term Consequences

    Science.gov (United States)

    Ma, Terry King-Wing; Chow, Kai Ming; Kwan, Bonnie Ching-Ha; Pang, Wing Fai; Leung, Chi Bon; Li, Philip Kam-Tao

    2016-01-01

    Background and objectives Peritonitis before peritoneal dialysis (PD) training (pretraining peritonitis [PTP]) is an uncommon event. The study aim was to examine the causative organisms, clinical outcomes, risk factors, and long-term consequences of PTP. Design, setting, participants, & measurements In this single–center, retrospective, observational study involving all incident patients on PD who developed PTP between 1998 and 2012, we examined the causative organisms, primary response rate, complete cure rate, risk factors, and associations of PTP with peritoneal equilibration test (PET) and patient survival. For each patient in the PTP group, the patients who underwent catheter insertion immediately before and after the index case were identified as controls. Results Among 1252 incident patients on PD, 52 (4.2%) patients developed PTP, and 104 patients were identified as controls. The two groups were similar in age, sex distribution, comorbidities, and residual renal function, but the PTP group had significantly lower hemoglobin and serum albumin. Patients were followed up for a median of 37.5 months (interquartile range [IQR], 16.3–62.2 months). The most common causative organisms of PTP were Staphylococcus aureus (30.8%) and polymicrobial (21.2%); 25% had negative growth. The primary response and complete cure rates were 82.7% and 78.8%, respectively. In the PTP group, 7.7% of patients died, 9.6% of patients required catheter removal, and PD training was significantly delayed (median =42.0; IQR, 26.0–65.8 days versus 27.5; IQR, 23.0–35.0 days; P=0.01). Multivariate logistic regression analysis showed that serum albumin was the only predictor of PTP (adjusted odds ratio, 0.89 per 1-g/dl increase; 95% confidence interval, 0.82 to 0.97). There were no differences in PET results and dialysis adequacy (measured around 1 month after PD training). The PTP group had significantly worse patient survival (median =41.2; IQR, 21.8–60.5 months versus 55.8; IQR

  11. Prevalence and Risk Factors of High Risk Human Papillomavirus ...

    African Journals Online (AJOL)

    Cervical cancer is the most common female cancer in northern Nigeria, yet the pattern of infection with human papillomavirus, the principal aetiologic agent is unknown. This was a preliminary study conducted in two referral hospitals in order to establish base-line data on the prevalence and risk factors for the infection in ...

  12. Evaluation of sanitary consequences of Chernobylsk accident in France. Epidemiological surveillance plan, state of knowledge, risks evaluation and perspectives; Evaluation des consequences sanitaires de l'accident de Tchernobyl en France. Dispositif de surveillance epidemiologique, etat des connaissances, evaluation des risques et perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Verger, P.; Cherie-Challine, L

    2000-12-15

    This report jointly written by IPSN and InVS, reviews the sanitary consequences in France of the Chernobyl accident, which occurred in 1986. The first point is dedicated to a short presentation of the knowledge relative to the sanitary consequences of the Chernobyl accident in the high contaminated countries and to the risk factors of the thyroid cancer. Secondly, this report describes the main systems of epidemiological surveillance of health implemented in France in 1986 and in 1999, as well as the data of the incidence and mortality of thyroid cancer observed in France since 1975. In addition, this report presents an analysis of the risk of thyroid cancer related to radioactive contamination in France, for young people of less than 15 years of age who where living in 1986 in the highest contaminated areas of France (Eastern territories). For this purpose, the theoretical number of thyroid cancers in excess is evaluated for this population, on the basis of different available risk model. Finally starting from the results of risk assessment, there is a discussion about the relevance and the feasibility of different epidemiological methods in view of answering the questions related to the sanitary consequences of the Chernobyl accident. In conclusion, this report recommends to reinforce the surveillance of thyroid cancer in France. (author)

  13. The subthalamic nucleus keeps you high on emotion: behavioral consequences of its inactivation

    Directory of Open Access Journals (Sweden)

    Yann ePelloux

    2014-12-01

    Full Text Available The subthalamic nucleus (STN belongs to the basal ganglia and is the current target for the surgical treatment of neurological and psychiatric disorders such as Parkinson’s Disease (PD and obsessive compulsive disorders, but also a proposed site for the treatment of addiction. It is therefore very important to understand its functions in order to anticipate and prevent possible side-effects in the patients. Although the involvement of the STN is well documented in motor, cognitive and motivational processes, less is known regarding emotional processes. Here we have investigated the direct consequences of STN inactivation by excitotoxic lesions on emotional processing and reinforcement in the rat. We have used various behavioral procedures to assess affect for neutral, positive and negative reinforcers in STN lesioned rats. STN lesions reduced affective responses for positive (sweet solutions and negative (electric foot shock, Lithium Chloride-induced sickness reinforcers while they had no effect on responses for a more neutral reinforcer (novelty induced place preference. Furthermore, when given the choice between saccharine, a sweet but non caloric solution, and glucose, a more bland but caloric solution, in contrast to sham animals that preferred saccharine, STN lesioned animals preferred glucose over saccharine. Taken altogether these results reveal that STN plays a critical role in emotional processing. These results, in line with some clinical observations in PD patients subjected to STN surgery, suggest possible emotional side-effects of treatments targeting the STN. They also suggest that the increased motivation for sucrose previously reported cannot be due to increased pleasure, but could be responsible for the decreased motivation for cocaine reported after STN inactivation.

  14. High capacity hydrogen absorption in transition-metal ethylene complexes: consequences of nanoclustering

    International Nuclear Information System (INIS)

    Phillips, A B; Shivaram, B S

    2009-01-01

    We have recently shown that organo-metallic complexes formed by laser ablating transition metals in ethylene are high hydrogen absorbers at room temperature (Phillips and Shivaram 2008 Phys. Rev. Lett. 100 105505). Here we show that the absorption percentage depends strongly on the ethylene pressure. High ethylene pressures (>100 mTorr) result in a lowered hydrogen uptake. Transmission electron microscopy measurements reveal that while low pressure ablations result in metal atoms dispersed uniformly on a near atomic scale, high pressure ones yield distinct nanoparticles with electron energy-loss spectroscopy demonstrating that the metal atoms are confined solely to the nanoparticles.

  15. The burden of hypertension, diabetes mellitus, and cardiovascular risk factors among adult Malawians in HIV care: consequences for integrated services.

    Science.gov (United States)

    Divala, Oscar H; Amberbir, Alemayehu; Ismail, Zahra; Beyene, Teferi; Garone, Daniela; Pfaff, Colin; Singano, Victor; Akello, Harriet; Joshua, Martias; Nyirenda, Moffat J; Matengeni, Alfred; Berman, Josh; Mallewa, Jane; Chinomba, Gift S; Kayange, Noel; Allain, Theresa J; Chan, Adrienne K; Sodhi, Sumeet K; van Oosterhout, Joep J

    2016-12-12

    Hypertension and diabetes prevalence is high in Africans. Data from HIV infected populations are limited, especially from Malawi. Integrating care for chronic non-communicable co-morbidities in well-established HIV services may provide benefit for patients by preventing multiple hospital visits but will increase the burden of care for busy HIV clinics. Cross-sectional study of adults (≥18 years) at an urban and a rural HIV clinic in Zomba district, Malawi, during 2014. Hypertension and diabetes were diagnosed according to stringent criteria. Proteinuria, non-fasting lipids and cardio/cerebro-vascular disease (CVD) risk scores (Framingham and World Health Organization/International Society for Hypertension) were determined. The association of patient characteristics with diagnoses of hypertension and diabetes was studied using multivariable analyses. We explored the additional burden of care for integrated drug treatment of hypertension and diabetes in HIV clinics. We defined that burden as patients with diabetes and/or stage II and III hypertension, but not with stage I hypertension unless they had proteinuria, previous stroke or high Framingham CVD risk. Nine hundred fifty-two patients were enrolled, 71.7% female, median age 43.0 years, 95.9% on antiretroviral therapy (ART), median duration 47.7 months. Rural and urban patients' characteristics differed substantially. Hypertension prevalence was 23.7% (95%-confidence interval 21.1-26.6; rural 21.0% vs. urban 26.5%; p = 0.047), of whom 59.9% had stage I (mild) hypertension. Diabetes prevalence was 4.1% (95%-confidence interval 3.0-5.6) without significant difference between rural and urban settings. Prevalence of proteinuria, elevated total/high-density lipoprotein-cholesterol ratio and high CVD risk score was low. Hypertension diagnosis was associated with increasing age, higher body mass index, presence of proteinuria, being on regimen zidovudine/lamivudine/nevirapine and inversely with World Health

  16. EMBRYONIC VASCULAR DISRUPTION ADVERSE OUTCOMES: LINKING HIGH THROUGHPUT SIGNALING SIGNATURES WITH FUNCTIONAL CONSEQUENCES

    Science.gov (United States)

    Embryonic vascular disruption is an important adverse outcome pathway (AOP) given the knowledge that chemical disruption of early cardiovascular system development leads to broad prenatal defects. High throughput screening (HTS) assays provide potential building blocks for AOP d...

  17. Navigation safety and risk assessment challenges in the High North

    DEFF Research Database (Denmark)

    Marchenko, N.A.; Borch, O.J.; Andreassen, N.

    2017-01-01

    marine accidents. Therefore, in this study a mostly qualitative analysis and expert judgement is the basis for the risk assessments. Implications for the emergency preparedness system of the region are discussed. The consequences of incidents depend on the incident type, scale and location,....... In this paper we look into the risks of accidents in the Atlantic Arctic based on previous ship accidents and the changes in maritime activity. The risk has to be assessed to ensure a proper level of response in emergency situations. As accidents are rare, there are limited statistics available for Arctic...

  18. Understanding the Risk Factors and Long-Term Consequences of Cisplatin-Associated Acute Kidney Injury: An Observational Cohort Study.

    Directory of Open Access Journals (Sweden)

    Zeenat Yousuf Bhat

    Full Text Available Acute kidney injury (AKI is a well-known complication of cisplatin-based chemotherapy; however, its impact on long-term patient survival is unclear. We sought to determine the incidence and risk factors for development of cisplatin-associated AKI and its impact on long-term renal function and patient survival. We identified 233 patients who received 629 cycles of high-dose cisplatin (99±9mg/m2 for treatment of head and neck cancer between 2005 and 2011. These subjects were reviewed for development of AKI. Cisplatin nephrotoxicity (CN was defined as persistent rise in serum creatinine, with a concomitant decline in serum magnesium and potassium, in absence of use of nephrotoxic agents and not reversed with hydration. All patients were hydrated per protocol and none had baseline glomerular filtration rate (GFR via CKD-EPI<60mL/min/1.73m2. The patients were grouped based on development of AKI and were staged for levels of injury, per KDIGO-AKI definition. Renal function was assessed via serum creatinine and estimated glomerular filtration rate (eGFR via CKD-EPI at baseline, 6- and 12-months. Patients with AKI were screened for the absence of nephrotoxic medication use and a temporal decline in serum potassium and magnesium levels. Logistic regression models were constructed to determine risk factors for cisplatin-associated AKI. Twelve-month renal function was compared among groups using ANOVA. Kaplan-Maier curves and Cox proportional hazard models were constructed to study its impact on patient survival. Of 233 patients, 158(68% developed AKI; 77 (49% developed stage I, 55 (35% developed stage II, and 26 (16% developed stage III AKI. Their serum potassium and magnesium levels correlated negatively with level of injury (p<0.05. African American race was a significant risk factor for cisplatin-associated AKI, OR 2.8 (95% CI 1.3 to 6.3 and 2.8 (95% CI 1.2 to 6.7 patients with stage III AKI had the lowest eGFR value at 12 months (p = 0.05 and long

  19. The Psychosis High-Risk State

    Science.gov (United States)

    Fusar-Poli, Paolo; Borgwardt, Stefan; Bechdolf, Andreas; Addington, Jean; Riecher-Rössler, Anita; Schultze-Lutter, Frauke; Keshavan, Matcheri; Wood, Stephen; Ruhrmann, Stephan; Seidman, Larry J.; Valmaggia, Lucia; Cannon, Tyrone; Velthorst, Eva; De Haan, Lieuwe; Cornblatt, Barbara; Bonoldi, Ilaria; Birchwood, Max; McGlashan, Thomas; Carpenter, William; McGorry, Patrick; Klosterkötter, Joachim; McGuire, Philip; Yung, Alison

    2014-01-01

    Context During the past 2 decades, a major transition in the clinical characterization of psychotic disorders has occurred. The construct of a clinical high-risk (HR) state for psychosis has evolved to capture the prepsychotic phase, describing people presenting with potentially prodromal symptoms. The importance of this HR state has been increasingly recognized to such an extent that a new syndrome is being considered as a diagnostic category in the DSM-5. Objective To reframe the HR state in a comprehensive state-of-the-art review on the progress that has been made while also recognizing the challenges that remain. Data Sources Available HR research of the past 20 years from PubMed, books, meetings, abstracts, and international conferences. Study Selection and Data Extraction Critical review of HR studies addressing historical development, inclusion criteria, epidemiologic research, transition criteria, outcomes, clinical and functional characteristics, neurocognition, neuroimaging, predictors of psychosis development, treatment trials, socioeconomic aspects, nosography, and future challenges in the field. Data Synthesis Relevant articles retrieved in the literature search were discussed by a large group of leading worldwide experts in the field. The core results are presented after consensus and are summarized in illustrative tables and figures. Conclusions The relatively new field of HR research in psychosis is exciting. It has the potential to shed light on the development of major psychotic disorders and to alter their course. It also provides a rationale for service provision to those in need of help who could not previously access it and the possibility of changing trajectories for those with vulnerability to psychotic illnesses. PMID:23165428

  20. [Targeting high-risk drugs to optimize clinical pharmacists' intervention].

    Science.gov (United States)

    Mouterde, Anne-Laure; Bourdelin, Magali; Maison, Ophélie; Coursier, Sandra; Bontemps, Hervé

    2016-12-01

    By the Order of 6 April 2011, the pharmacist must validate all the prescriptions containing "high-risk drugs" or those of "patients at risk". To optimize this clinical pharmacy activity, we identified high-risk drugs. A list of high-risk drugs has been established using literature, pharmacists' interventions (PI) performed in our hospital and a survey sent to hospital pharmacists. In a prospective study (analysis of 100 prescriptions for each high-risk drug selected), we have identified the most relevant to target. We obtained a statistically significant PI rate (P<0.05) for digoxin, oral anticoagulants direct, oral methotrexate and colchicine. This method of targeted pharmaceutical validation based on high-risk drugs is relevant to detect patients with high risk of medicine-related illness. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  1. Experimental Consequences of Mottness in High-Temperature Copper-Oxide Superconductors

    Science.gov (United States)

    Chakraborty, Shiladitya

    2009-01-01

    It has been more than two decades since the copper-oxide high temperature superconductors were discovered. However, building a satisfactory theoretical framework to study these compounds still remains one of the major challenges in condensed matter physics. In addition to the mechanism of superconductivity, understanding the properties of the…

  2. High-intensity interval exercise and cerebrovascular health: curiosity, cause, and consequence

    OpenAIRE

    Lucas, Samuel J E; Cotter, James D; Brassard, Patrice; Bailey, Damian M

    2015-01-01

    Exercise is a uniquely effective and pluripotent medicine against several noncommunicable diseases of westernised lifestyles, including protection against neurodegenerative disorders. High-intensity interval exercise training (HIT) is emerging as an effective alternative to current health-related exercise guidelines. Compared with traditional moderate-intensity continuous exercise training, HIT confers equivalent if not indeed superior metabolic, cardiac, and systemic vascular adaptation. Con...

  3. From a supply gap to a demand gap? The risk and consequences of over-indebting the underbanked

    OpenAIRE

    Jessica Schicks

    2011-01-01

    In the past, the microfinance industry focused mainly on growth and outreach. Addressing financial exclusion implied a huge supply gap. Recent over-indebtedness crises in several countries have shown that this gap can turn into over-supply. The industry urgently requires research to understand the magnitude and consequences of this shift. This chapter reveals the broad spectrum of consequences over-indebtedness can have on borrowers and other stakeholders, mainly MFIs. It emphasizes that over...

  4. An audit to assess the consequences of the use of a pluripotential risk syndrome: the case to move on from "psychosis risk syndrome (PRS) ".

    Science.gov (United States)

    Agius, Mark; Zaman, Rashid; Hanafy, Dean

    2013-09-01

    An audit has been carried out of the patients who have been assessed using the CAARMS tool in order to assess patients who have been judged to have a prodromal psychotic syndrome. Instead of advocating PRS, Johannessen & McGorry (Johannessen 2010), have offered an alternative: a 'Pluripotent risk syndrome'. This less specific prodrome reflects the unpredictable nature of "Ultra-High Risk" states which have been shown to be more likely to develop into a non-psychotic mood disorder than schizophrenia (Hoon 2012). The corollary this is thus; could patients who exhibit significant depressive features (regardless of diagnosis) be initially identified as having a 'Pluripotent risk syndrome'? Ten adult patients (6 males & 4 females, aged 19-26 years old) with four broad psychiatric diagnoses (Depression, Schizoaffective disorder, Borderline personality disorder and psychotic illness) were chosen from an anonimised database of the patients and their symptomatology as assessed by CAARMS was retrospectively assessed to see if the presence of depressive symptoms supported the case for a "Pluripotent risk syndrome". Though patients diagnosed with depression frequently exhibited depressive symptoms, psychotic symptoms were also apparent, albeit in comparatively decreased severity. Patients diagnosed with schizoaffective disorder had depressive symptoms more frequently than psychotic symptoms, but these were comparatively less severe. Borderline personality disorder patients exhibited depressive symptoms more frequently than psychotic symptoms. Psychotic illnesses frequently had depressive symptoms, but more typically (and unsurprisingly) had comparatively more severe psychotic than depressive symptoms. Hence we propose that the concept of a "Pluripotent risk syndrome" is in our view born out.

  5. The consequences of high cigarette excise taxes for low-income smokers.

    Directory of Open Access Journals (Sweden)

    Matthew C Farrelly

    Full Text Available BACKGROUND: To illustrate the burden of high cigarette excise taxes on low-income smokers. METHODOLOGY/PRINCIPAL FINDINGS: Using data from the New York and national Adult Tobacco Surveys from 2010-2011, we estimated how smoking prevalence, daily cigarette consumption, and share of annual income spent on cigarettes vary by annual income (less than $30,000; $30,000-$59,999; and more than $60,000. The 2010-2011 sample includes 7,536 adults and 1,294 smokers from New York and 3,777 adults and 748 smokers nationally. Overall, smoking prevalence is lower in New York (16.1% than nationally (22.2% and is strongly associated with income in New York and nationally (P<.001. Smoking prevalence ranges from 12.2% to 33.7% nationally and from 10.1% to 24.3% from the highest to lowest income group. In 2010-2011, the lowest income group spent 23.6% of annual household income on cigarettes in New York (up from 11.6% in 2003-2004 and 14.2% nationally. Daily cigarette consumption is not related to income. CONCLUSIONS/SIGNIFICANCE: Although high cigarette taxes are an effective method for reducing cigarette smoking, they can impose a significant financial burden on low-income smokers.

  6. Isotope and fast ions turbulence suppression effects: Consequences for high-β ITER plasmas

    Science.gov (United States)

    Garcia, J.; Görler, T.; Jenko, F.

    2018-05-01

    The impact of isotope effects and fast ions on microturbulence is analyzed by means of non-linear gyrokinetic simulations for an ITER hybrid scenario at high beta obtained from previous integrated modelling simulations with simplified assumptions. Simulations show that ITER might work very close to threshold, and in these conditions, significant turbulence suppression is found from DD to DT plasmas. Electromagnetic effects are shown to play an important role in the onset of this isotope effect. Additionally, even external ExB flow shear, which is expected to be low in ITER, has a stronger impact on DT than on DD. The fast ions generated by fusion reactions can additionally reduce turbulence even more although the impact in ITER seems weaker than in present-day tokamaks.

  7. Molecular origins and consequences of High-800 LH2 in Roseobacter denitrificans.

    Science.gov (United States)

    Duquesne, Katia; Blanchard, Cecile; Sturgis, James N

    2011-08-09

    Roseobacter denitrificans is a marine bacterium capable of using a wide variety of different metabolic schemes and in particular is an anoxygenic aerobic photosynthetic bacterium. In the work reported here we use a deletion mutant that we have constructed to investigate the structural origin of the unusual High-800 light-harvesting complex absorption in this bacterium. We suggest that the structure is essentially unaltered when compared to the usual nonameric complexes but that a change in the environment of the C(13:1) carbonyl group is responsible for the change in spectrum. We tentatively relate this change to the presence of a serine residue in the α-polypeptide. Surprisingly, the low spectral overlap between the peripheral and core light-harvesting systems appears not to compromise energy collection efficiency too severely. We suggest that this may be at the expense of maintaining a low antenna size. © 2011 American Chemical Society

  8. Challenges of characterization of radioactive waste with High composition variability and their consequences measurement methodology

    International Nuclear Information System (INIS)

    Lexa, D.

    2014-01-01

    Radioactive waste characterization is a key step in every nuclear decommissioning project. It normally relies on a combination of facility operational history with results of destructive and non-destructive analysis. A particularly challenging situation arises when historical waste from a nuclear research facility is to be characterized, meaning little or no radiological information is available and the composition of the waste is highly variable. The nuclide vector concept is of limited utility, resulting in increased requirements placed on both the extent and performance of destructive and non-destructive analysis. Specific challenges are illustrated on an example of the decommissioning project underway at the Joint Research Center of the European Commission in Ispra. (author)

  9. Uremic anorexia: a consequence of persistently high brain serotonin levels? The tryptophan/serotonin disorder hypothesis.

    Science.gov (United States)

    Aguilera, A; Selgas, R; Codoceo, R; Bajo, A

    2000-01-01

    Anorexia is a frequent part of uremic syndrome, contributing to malnutrition in dialysis patients. Many factors have been suggested as responsible for uremic anorexia. In this paper we formulate a new hypothesis to explain the appetite disorders in dialysis patients: "the tryptophan/serotonin disorder hypothesis." We review current knowledge of normal hunger-satiety cycle control and the disorders described in uremic patients. There are four phases in food intake regulation: (1) the gastric phase, during which food induces satiety through gastric distention and satiety peptide release; (2) the post absorptive phase, during which circulating compounds, including glucose and amino acids, cause satiety by hepatic receptors via the vagus nerve; (3) the hepatic phase, during which adenosine triphosphate (ATP) concentration is the main stimulus inducing hunger or satiety, with cytokines inhibiting ATP production; and (4) the central phase, during which appetite is regulated through peripheral (circulating plasma substances and neurotransmitters) and brain stimuli. Brain serotonin is the final target for peripheral mechanisms controlling appetite. High brain serotonin levels and a lower serotonin/dopamine ratio cause anorexia. Plasma and brain amino acid concentrations are recognized factors involved in neurotransmitter synthesis and appetite control. Tryptophan is the substrate of serotonin synthesis. High plasma levels of anorectics such as tryptophan (plasma and brain), cholecystokinin, tumor necrosis factor alpha, interleukin-1, and leptin, and deficiencies of nitric oxide and neuropeptide Y have been described in uremia; all increase intracerebral serotonin. We suggest that brain serotonin hyperproduction due to a uremic-dependent excess of tryptophan may be the final common pathway involved in the genesis of uremic anorexia. Various methods of ameliorating anorexia by decreasing the central effects of serotonin are proposed.

  10. An assessment of high risk sexual behaviour and HIV transmission ...

    African Journals Online (AJOL)

    An assessment of high risk sexual behaviour and HIV transmission among migrant oil workers in the Niger Delta area of Nigeria. ... questionnaires to evaluate key highrisk sexual behavioral parameters such as multiplicity of sexual partners, bisexuality (closet homosexuality), high grade sexual behaviour and lesbianism.

  11. Review of the partitioning of chemicals into different plastics: Consequences for the risk assessment of marine plastic debris

    International Nuclear Information System (INIS)

    O'Connor, Isabel A.; Golsteijn, Laura; Hendriks, A. Jan

    2016-01-01

    Marine plastic debris are found worldwide in oceans and coastal areas. They degrade only slowly and contain chemicals added during manufacture or absorbed from the seawater. Therefore, they can pose a long-lasting contaminant source and potentially transfer chemicals to marine organisms when ingested. In order to assess their risk, the contaminant concentration in the plastics needs to be estimated and differences understood. We collected from literature plastic water partition coefficients of various organic chemicals for seven plastic types: polydimethylsiloxane (PDMS), high-density, low-density and ultra-high molecular weight polyethylene (LDPE, HDPE, UHMWPE), polystyrene (PS), polypropylene (PP), and polyvinyl chloride (PVC). Most data was available for PDMS (1060) and LDPE (220), but much less for the remaining plastics (73). Where possible, regression models were developed and the partitioning was compared between the different plastic types. The partitioning of chemicals follows the order of LDPE ≈ HDPE ≥ PP > PVC ≈ PS. Data describing the impact of weathering are urgently needed. - Highlights: • Comparison of organic chemicals partitioning into seven plastic types • Linear correlation between plastic-water partition coefficient K pw and K ow • More data is needed for polypropylene, polystyrene and polyvinyl chloride. • In all plastic types, most K pw were similar to/smaller than the corresponding K ow .

  12. Global risk of pharmaceutical contamination from highly populated developing countries.

    Science.gov (United States)

    Rehman, Muhammad Saif Ur; Rashid, Naim; Ashfaq, Muhammad; Saif, Ameena; Ahmad, Nasir; Han, Jong-In

    2015-11-01

    Global pharmaceutical industry has relocated from the west to Asian countries to ensure competitive advantage. This industrial relocation has posed serious threats to the environment. The present study was carried out to assess the possible pharmaceutical contamination in the environment of emerging pharmaceutical manufacturing countries (Bangladesh, China, India and Pakistan). Although these countries have made tremendous progress in the pharmaceutical sector but most of their industrial units discharge wastewater into domestic sewage network without any treatment. The application of untreated wastewater (industrial and domestic) and biosolids (sewage sludge and manure) in agriculture causes the contamination of surface water, soil, groundwater, and the entire food web with pharmaceutical compounds (PCs), their metabolites and transformed products (TPs), and multidrug resistant microbes. This pharmaceutical contamination in Asian countries poses global risks via product export and international traveling. Several prospective research hypotheses including the development of new analytical methods to monitor these PCs/TPs and their metabolites, highly resistant microbial strains, and mixture toxicity as a consequence of pharmaceutical contamination in these emerging pharmaceutical exporters have also been proposed based on the available literature. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Fall prevention in high-risk patients.

    Science.gov (United States)

    Shuey, Kathleen M; Balch, Christine

    2014-12-01

    In the oncology population, disease process and treatment factors place patients at risk for falls. Fall bundles provide a framework for developing comprehensive fall programs in oncology. Small sample size of interventional studies and focus on ambulatory and geriatric populations limit the applicability of results. Additional research is needed. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Systems reliability in high risk situations

    International Nuclear Information System (INIS)

    Hunns, D.M.

    1974-12-01

    A summary is given of five papers and the discussion of a seminar promoted by the newly-formed National Centre of Systems Reliability. The topics covered include hazard analysis, reliability assessment, and risk assessment in both nuclear and non-nuclear industries. (U.K.)

  15. Unification of favourable intermediate-, unfavourable intermediate-, and very high-risk stratification criteria for prostate cancer.

    Science.gov (United States)

    Zumsteg, Zachary S; Zelefsky, Michael J; Woo, Kaitlin M; Spratt, Daniel E; Kollmeier, Marisa A; McBride, Sean; Pei, Xin; Sandler, Howard M; Zhang, Zhigang

    2017-11-01

    To improve on the existing risk-stratification systems for prostate cancer. This was a retrospective investigation including 2 248 patients undergoing dose-escalated external beam radiotherapy (EBRT) at a single institution. We separated National Comprehensive Cancer Network (NCCN) intermediate-risk prostate cancer into 'favourable' and 'unfavourable' groups based on primary Gleason pattern, percentage of positive biopsy cores (PPBC), and number of NCCN intermediate-risk factors. Similarly, NCCN high-risk prostate cancer was stratified into 'standard' and 'very high-risk' groups based on primary Gleason pattern, PPBC, number of NCCN high-risk factors, and stage T3b-T4 disease. Patients with unfavourable-intermediate-risk (UIR) prostate cancer had significantly inferior prostate-specific antigen relapse-free survival (PSA-RFS, P prostate cancer-specific mortality (PCSM, P prostate cancer. Similarly, patients with very high-risk (VHR) prostate cancer had significantly worse PSA-RFS (P prostate cancer. Moreover, patients with FIR and low-risk prostate cancer had similar outcomes, as did patients with UIR and SHR prostate cancer. Consequently, we propose the following risk-stratification system: Group 1, low risk and FIR; Group 2, UIR and SHR; and Group 3, VHR. These groups have markedly different outcomes, with 8-year distant metastasis rates of 3%, 9%, and 29% (P < 0.001) for Groups 1, 2, and 3, respectively, and 8-year PCSM of 1%, 4%, and 13% (P < 0.001) after EBRT. This modified stratification system was significantly more accurate than the three-tiered NCCN system currently in clinical use for all outcomes. Modifying the NCCN risk-stratification system to group FIR with low-risk patients and UIR with SHR patients, results in modestly improved prediction of outcomes, potentially allowing better personalisation of therapeutic recommendations. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  16. Characterization and consequences of intermittent sediment oxygenation by macrofauna: interpretation of high-resolution data sets

    Science.gov (United States)

    Meile, C. D.; Dwyer, I.; Zhu, Q.; Polerecky, L.; Volkenborn, N.

    2017-12-01

    Mineralization of organic matter in marine sediments leads to the depletion of oxygen, while activities of infauna introduce oxygenated seawater to the subsurface. In permeable sediments solutes can be transported from animals and their burrows into the surrounding sediment through advection over several centimeters. The intermittency of pumping leads to a spatially heterogeneous distribution of oxidants, with the temporal dynamics depending on sediment reactivity and activity patterns of the macrofauna. Here, we present results from a series of experiments in which these dynamics are studied at high spatial and temporal resolution using planar optodes. From O2, pH and pCO2 optode data, we quantify rates of O2 consumption and dissolved inorganic carbon production, as well alkalinity dynamics, with millimeter-scale resolution. Simulating intermittent irrigation by imposed pumping patterns in thin aquaria, we derive porewater flow patterns, which together with the production and consumption rates cause the chemical distributions and the establishment of reaction fronts. Our analysis thus establishes a quantitative connection between the locally dynamic redox conditions relevant for biogeochemical transformations and macroscopic observations commonly made with sediment cores.

  17. The impact of high-risk drivers and benefits of limiting their driving degree of freedom.

    Science.gov (United States)

    Habtemichael, Filmon G; de Picado-Santos, Luis

    2013-11-01

    The perception of drivers regarding risk-taking behaviour is widely varied. High-risk drivers are the segment of drivers who are disproportionately represented in the majority of crashes. This study examines the typologies of drivers in risk-taking behaviour, the common high-risk driving errors (speeding, close following, abrupt lane-changing and impaired driving), their safety consequences and the technological (ITS) devices for their detection and correction. Limiting the driving degree of freedom of high-risk drivers is proposed and its benefits on safety as well as traffic operations are quantified using VISSIM microscopic traffic simulation at various proportions of high-risk drivers; namely, 4%, 8% and 12%. Assessment of the safety benefits was carried out by using the technique of simulated vehicle conflicts which was validated against historic crashes, and reduction in travel time was used to quantify the operational benefits. The findings imply that limiting the freedom of high-risk drivers resulted in a reduction of crashes by 12%, 21% and 27% in congested traffic conditions; 9%, 13% and 18% in lightly congested traffic conditions as well as 9%, 10% and 17% in non-congested traffic conditions for high-risk drivers in proportions of 4%, 8% and 12% respectively. Moreover, the surrogate safety measures indicated that there was a reduction in crash severity levels. The operational benefits amounted to savings of nearly 1% in travel time for all the proportions of high-risk drivers considered. The study concluded that limiting the freedom of high-risk drivers has safety and operational benefits; though there could be social, legal and institutional concerns for its practical implementation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Behavioral and cellular consequences of high-electrode count Utah Arrays chronically implanted in rat sciatic nerve

    Science.gov (United States)

    Wark, H. A. C.; Mathews, K. S.; Normann, R. A.; Fernandez, E.

    2014-08-01

    Objective. Before peripheral nerve electrodes can be used for the restoration of sensory and motor functions in patients with neurological disorders, the behavioral and histological consequences of these devices must be investigated. These indices of biocompatibility can be defined in terms of desired functional outcomes; for example, a device may be considered for use as a therapeutic intervention if the implanted subject retains functional neurons post-implantation even in the presence of a foreign body response. The consequences of an indwelling device may remain localized to cellular responses at the device-tissue interface, such as fibrotic encapsulation of the device, or they may affect the animal more globally, such as impacting behavioral or sensorimotor functions. The objective of this study was to investigate the overall consequences of implantation of high-electrode count intrafascicular peripheral nerve arrays, High Density Utah Slanted Electrode Arrays (HD-USEAs; 25 electrodes mm-2). Approach. HD-USEAs were implanted in rat sciatic nerves for one and two month periods. We monitored wheel running, noxious sensory paw withdrawal reflexes, footprints, nerve morphology and macrophage presence at the tissue-device interface. In addition, we used a novel approach to contain the arrays in actively behaving animals that consisted of an organic nerve wrap. A total of 500 electrodes were implanted across all ten animals. Main results. The results demonstrated that chronic implantation (⩽8 weeks) of HD-USEAs into peripheral nerves can evoke behavioral deficits that recover over time. Morphology of the nerve distal to the implantation site showed variable signs of nerve fiber degeneration and regeneration. Cytology adjacent to the device-tissue interface also showed a variable response, with some electrodes having many macrophages surrounding the electrodes, while other electrodes had few or no macrophages present. This variability was also seen along the length

  19. High temperature oxidation of metals: vacancy injection and consequences on the mechanical properties

    International Nuclear Information System (INIS)

    Perusin, S.

    2004-11-01

    The aim of this work is to account for the effects of the high temperature oxidation of metals on their microstructure and their mechanical properties. 'Model' materials like pure nickel, pure iron and the Ni-20Cr alloy are studied. Nickel foils have been oxidised at 1000 C on one side only in laboratory air, the other side being protected from oxidation by a reducing atmosphere. After the oxidation treatment, the unoxidized face was carefully examined by using an Atomic Force Microscope (AFM). Grain boundaries grooves were characterised and their depth were compared to the ones obtained on the same sample heat treated in the reducing atmosphere during the same time. They are found to be much deeper in the case of the single side oxidised samples. It is shown that this additional grooving is directly linked to the growth of the oxide scale on the opposite side and that it can be explained by the diffusion of the vacancies produced at the oxide scale - metal interface, across the entire sample through grain boundaries. Moreover, the comparison between single side oxidised samples and samples oxidised on both sides points out that voids in grain boundaries are only observed in this latter case proving the vacancies condensation in the metal when the two faces are oxidised. The role of the carbon content and the sample's geometry on this phenomenon is examined in detail. The diffusion of vacancies is coupled with the transport of oxygen so that a mechanism of oxygen transport by vacancies is suggested. The tensile tests realised at room temperature on nickel foils (bamboo microstructure) show that the oxide scale can constitute a barrier to the emergence of dislocations at the metal surface. Finally, the Ni-20Cr alloy is tested in tensile and creep tests between 25 and 825 C in oxidising or reducing atmospheres. (author)

  20. Consequences of high effective Prandtl number on solar differential rotation and convective velocity

    Science.gov (United States)

    Karak, Bidya Binay; Miesch, Mark; Bekki, Yuto

    2018-04-01

    Observations suggest that the large-scale convective velocities obtained by solar convection simulations might be over-estimated (convective conundrum). One plausible solution to this could be the small-scale dynamo which cannot be fully resolved by global simulations. The small-scale Lorentz force suppresses the convective motions and also the turbulent mixing of entropy between upflows and downflows, leading to a large effective Prandtl number (Pr). We explore this idea in three-dimensional global rotating convection simulations at different thermal conductivity (κ), i.e., at different Pr. In agreement with previous non-rotating simulations, the convective velocity is reduced with the increase of Pr as long as the thermal conductive flux is negligible. A subadiabatic layer is formed near the base of the convection zone due to continuous deposition of low entropy plumes in low-κ simulations. The most interesting result of our low-κ simulations is that the convective motions are accompanied by a change in the convection structure that is increasingly influenced by small-scale plumes. These plumes tend to transport angular momentum radially inward and thus establish an anti-solar differential rotation, in striking contrast to the solar rotation profile. If such low diffusive plumes, driven by the radiative-surface cooling, are present in the Sun, then our results cast doubt on the idea that a high effective Pr may be a viable solution to the solar convective conundrum. Our study also emphasizes that any resolution of the conundrum that relies on the downward plumes must take into account the angular momentum transport and heat transport.

  1. Evaluation of Risk Management Strategies for a Low-Cost, High-Risk Project

    Science.gov (United States)

    Shishko, Robert; Jorgensen, Edward J.

    1996-01-01

    This paper summarizes work in progress to define and implement a risk management process tailored to a low-cost, high-risk, NASA mission -the Microrover Flight Experiment (MFEX, commonly called the Mars microrover).

  2. The etiology, risk factors, and interactions of enteric infections and malnutrition and the consequences for child health and development study (MAL-ED): description of the Tanzanian site.

    Science.gov (United States)

    Mduma, Estomih R; Gratz, Jean; Patil, Crystal; Matson, Kristine; Dakay, Mary; Liu, Sarah; Pascal, John; McQuillin, Lauren; Mighay, Emmanuel; Hinken, Elizabeth; Ernst, Alexandra; Amour, Caroline; Mvungi, Regisiana; Bayyo, Eliwaza; Zakaria, Yeconia; Kivuyo, Sokoine; Houpt, Eric R; Svensen, Erling

    2014-11-01

    The Haydom, Tanzania, site (TZH) of The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) Study is in north-central Tanzania, 300 km from the nearest urban center. TZH is in a remote rural district where most of the population are agropastoralists and grow maize as the staple food. The average household size is 7. The average woman achieves a parity of 6 and has 1 child death. Socioeconomic indicators are poor, with essentially no household having access to electricity, piped water, or improved sanitary facilities (compared with 14%, 7%, and 12%, respectively, reported nationally). The Demographic Health Survey Tanzania 2004 indicated that the region had high rates of stunting and underweight (40% and 31% of children aged child mortality rate of 5.8%. Human immunodeficiency virus prevalence among 18-month-old children is rural African population with profound poverty and malnutrition, but a strong community-based research infrastructure. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  3. Updating of adventitious fuel pin failure frequency in sodium-cooled fast reactors and probabilistic risk assessment on consequent severe accident in Monju

    International Nuclear Information System (INIS)

    Fukano, Yoshitaka; Kurisaka, Kenichi; Nishimura, Masahiro; Naruto, Kenichi

    2015-01-01

    Experimental studies, deterministic approaches and probabilistic risk assessments (PRAs) on local fault (LF) propagation in sodium-cooled fast reactors (SFRs) have been performed in many countries because LFs have been historically considered as one of the possible causes of severe accidents. Adventitious-fuel-pin-failures (AFPFs) have been considered to be the most dominant initiators of LFs in these PRAs because of their high frequency of occurrence during reactor operation and possibility of fuel-element-failure-propagation (FEFP). A PRA on FEFP from AFPF (FEFPA) in the Japanese prototype SFR (Monju) was performed in this study based on the state-of-the-art knowledge, reflecting the most recent operation procedures under off-normal conditions. Frequency of occurrence of AFPF in SFRs which was the initiating event of the event tree in this PRA was updated using a variety of methods based on the above-mentioned latest review on experiences of this phenomenon. As a result, the frequency of occurrence of, and the core damage frequency (CDF) from, AFPF in Monju was significantly reduced to a negligible magnitude compared with those in the existing PRAs. It was, therefore concluded that the CDF of FEFPA in Monju could be comprised in that of anticipated transient without scram or protected loss of heat sink events from both the viewpoint of occurrence probability and consequences. (author)

  4. Household exposure to violence and human rights violations in western Bangladesh (I: prevalence, risk factors and consequences

    Directory of Open Access Journals (Sweden)

    Montgomery Edith

    2009-11-01

    Full Text Available Abstract Background The ruling parties in Bangladesh have systematically used violence against political opponents and criminals. It is essential to 1 determine the magnitude and burden of organised crime and political violence (OPV and human rights violations in the affected community, and to 2 identify the risk factors and key indicators for developing effective health intervention and prevention measures. Methods The population-based study consisted of two parts: a household survey and OPV screening at mobile clinics (presented in Part II. A cross-sectional, multistage cluster household survey was conducted in the Meherpur district in February-March 2008; 22 clusters with a sample size of 1,101 households (population of 4,870 were selected. Results Around 83% of households reported being exposed to at least two categories of OPV or human rights violations: 29% reported that the family members had been arrested or detained; 31% reported torture or other cruel, inhuman or degrading treatment or punishment. Crude mortality rate was 17.9/1,000 and under 5 mortality rate was 75/1,000. The annual injury rate was 36%, lifetime experience of violence-related injury was 50%, and pain experience within 2 weeks was reported by 57%. Over 80% of the population over 35 years old complained of pain. High prevalence of injury, lifetime experience of OPV-related injury and pain complaints are related to the level of exposure to OPV and human rights violations. A financial burden was imposed on families with an injured person. A geographical variation was revealed regarding reports of torture and lifetime experience of violence-related injury. A combination of individual, relational, community and societal factors, including variables such as political party affiliation, conflict with other families, household income and residential area, affected the risk of victimisation in the household. The odds ratio for reporting extrajudicial execution of a family

  5. Household exposure to violence and human rights violations in western Bangladesh (I): prevalence, risk factors and consequences.

    Science.gov (United States)

    Wang, Shr-Jie; Modvig, Jens; Montgomery, Edith

    2009-11-21

    The ruling parties in Bangladesh have systematically used violence against political opponents and criminals. It is essential to 1) determine the magnitude and burden of organised crime and political violence (OPV) and human rights violations in the affected community, and to 2) identify the risk factors and key indicators for developing effective health intervention and prevention measures. The population-based study consisted of two parts: a household survey and OPV screening at mobile clinics (presented in Part II). A cross-sectional, multistage cluster household survey was conducted in the Meherpur district in February-March 2008; 22 clusters with a sample size of 1,101 households (population of 4,870) were selected. Around 83% of households reported being exposed to at least two categories of OPV or human rights violations: 29% reported that the family members had been arrested or detained; 31% reported torture or other cruel, inhuman or degrading treatment or punishment. Crude mortality rate was 17.9/1,000 and under 5 mortality rate was 75/1,000. The annual injury rate was 36%, lifetime experience of violence-related injury was 50%, and pain experience within 2 weeks was reported by 57%. Over 80% of the population over 35 years old complained of pain. High prevalence of injury, lifetime experience of OPV-related injury and pain complaints are related to the level of exposure to OPV and human rights violations. A financial burden was imposed on families with an injured person. A geographical variation was revealed regarding reports of torture and lifetime experience of violence-related injury. A combination of individual, relational, community and societal factors, including variables such as political party affiliation, conflict with other families, household income and residential area, affected the risk of victimisation in the household. The odds ratio for reporting extrajudicial execution of a family member was 9.22 for Awami League supporters, 9.15 for

  6. A metasynthesis of risk perception in women with high risk pregnancies

    OpenAIRE

    Lee, S.; Ayers, S.; Holden, D.

    2014-01-01

    Introduction: Risk perception in women with high risk pregnancies affects their decisions about perinatal care and is of interest to anyone involved in the care of pregnant women. This paper provides a metasynthesis of qualitative studies of risk perception in women with high risk pregnancies.\\ud \\ud Methods: A systematic search of eight electronic databases was conducted. Additional papers were obtained through searching references of identified articles. Six studies were identified that rep...

  7. The Convergence of High-Consequence Livestock and Human Pathogen Research and Development: A Paradox of Zoonotic Disease

    Directory of Open Access Journals (Sweden)

    Julia M. Michelotti

    2018-05-01

    Full Text Available The World Health Organization (WHO estimates that zoonotic diseases transmitted from animals to humans account for 75 percent of new and emerging infectious diseases. Globally, high-consequence pathogens that impact livestock and have the potential for human transmission create research paradoxes and operational challenges for the high-containment laboratories that conduct work with them. These specialized facilities are required for conducting all phases of research on high-consequence pathogens (basic, applied, and translational with an emphasis on both the generation of fundamental knowledge and product development. To achieve this research mission, a highly-trained workforce is required and flexible operational methods are needed. In addition, working with certain pathogens requires compliance with regulations such as the Centers for Disease Control (CDC and the U.S. Department of Agriculture (USDA Select Agent regulations, which adds to the operational burden. The vast experience from the existing studies at Plum Island Animal Disease Center, other U.S. laboratories, and those in Europe and Australia with biosafety level 4 (BSL-4 facilities designed for large animals, clearly demonstrates the valuable contribution this capability brings to the efforts to detect, prepare, prevent and respond to livestock and potential zoonotic threats. To raise awareness of these challenges, which include biosafety and biosecurity issues, we held a workshop at the 2018 American Society for Microbiology (ASM Biothreats conference to further discuss the topic with invited experts and audience participants. The workshop covered the subjects of research funding and metrics, economic sustainment of drug and vaccine development pipelines, workforce turnover, and the challenges of maintaining operational readiness of high containment laboratories.

  8. Health and environmental risk-related impacts of actinide burning on high-level waste disposal

    International Nuclear Information System (INIS)

    Forsberg, C.W.

    1992-05-01

    The potential health and environmental risk-related impacts of actinide burning for high-level waste disposal were evaluated. Actinide burning, also called waste partitioning-transmutation, is an advanced method for radioactive waste management based on the idea of destroying the most toxic components in the waste. It consists of two steps: (1) selective removal of the most toxic radionuclides from high-level/spent fuel waste and (2) conversion of those radionuclides into less toxic radioactive materials and/or stable elements. Risk, as used in this report, is defined as the probability of a failure times its consequence. Actinide burning has two potential health and environmental impacts on waste management. Risks and the magnitude of high-consequence repository failure scenarios are decreased by inventory reduction of the long-term radioactivity in the repository. (What does not exist cannot create risk or uncertainty.) Risk may also be reduced by the changes in the waste characteristics, resulting from selection of waste forms after processing, that are superior to spent fuel and which lower the potential of transport of radionuclides from waste form to accessible environment. There are no negative health or environmental impacts to the repository from actinide burning; however, there may be such impacts elsewhere in the fuel cycle

  9. Effects of strength training on muscle fiber types and size; consequences for athletes training for high-intensity sport

    DEFF Research Database (Denmark)

    Andersen, J L; Aagaard, P

    2010-01-01

    Training toward improving performance in sports involving high intense exercise can and is done in many different ways based on a mixture of tradition in the specific sport, coaches' experience and scientific recommendations. Strength training is a form of training that now-a-days have found its...... way into almost all sports in which high intense work is conducted. In this review we will focus on a few selected aspects and consequences of strength training; namely what effects do strength training have of muscle fiber type composition, and how may these effects change the contractile properties...... functional training advises can be made. Thus, more than a review in the traditional context this review should be viewed upon as an attempt to bring sports-physiologists and coaches or others working directly with the athletes together for a mutual discussion on how recently acquired physiological knowledge...

  10. Economic consequences of mastitis and withdrawal of milk with high somatic cell count in Swedish dairy herds

    DEFF Research Database (Denmark)

    Nielsen, C; Østergaard, Søren; Emanuelson, U

    2010-01-01

    Herd, was used to study the effects of mastitis in a herd with 150 cows. Results given the initial incidence of mastitis (32 and 33 clinical and subclinical cases per 100 cow-years, respectively) were studied, together with the consequences of reducing or increasing the incidence of mastitis by 50%, modelling......% of the herd net return given the initial incidence of mastitis. Expressed per cow-year, the avoidable cost of mastitis was €55. The costs per case of CM and SCM were estimated at €278 and €60, respectively. Withdrawing milk with high SCC was never profitable because this generated a substantial amount of milk......The main aim was to assess the impact of mastitis on technical and economic results of a dairy herd under current Swedish farming conditions. The second aim was to investigate the effects obtained by withdrawing milk with high somatic cell count (SCC). A dynamic and stochastic simulation model, Sim...

  11. Effects of strength training on muscle fiber types and size; consequences for athletes training for high-intensity sport

    DEFF Research Database (Denmark)

    Andersen, J L; Aagaard, P

    2010-01-01

    way into almost all sports in which high intense work is conducted. In this review we will focus on a few selected aspects and consequences of strength training; namely what effects do strength training have of muscle fiber type composition, and how may these effects change the contractile properties......Training toward improving performance in sports involving high intense exercise can and is done in many different ways based on a mixture of tradition in the specific sport, coaches' experience and scientific recommendations. Strength training is a form of training that now-a-days have found its...... functional training advises can be made. Thus, more than a review in the traditional context this review should be viewed upon as an attempt to bring sports-physiologists and coaches or others working directly with the athletes together for a mutual discussion on how recently acquired physiological knowledge...

  12. Radical prostatectomy for high-risk prostate cancer.

    Science.gov (United States)

    Yossepowitch, Ofer; Eastham, James A

    2008-06-01

    Consensus recommendations for the identification and treatment of men whose apparent organ confined prostate cancer has high risk features are lacking. Despite ongoing refinements in surgical technique and improvements in morbidity and functional outcomes, the tradition of steering high-risk patients away from radical prostatectomy (RP) remains steadfast. We performed a medical literature search in English using MEDLINE/PubMed that addressed high risk prostate cancer. We analyzed the literature with respect to the historical evolution of this concept, current risk stratification schemes and treatment guidelines and related short and long term outcomes following RP. Contemporary evidence suggest that patients classified with high-risk prostate cancer by commonly used definitions do not have a uniformly poor prognosis after RP. Many cancers categorized clinically as high risk are actually pathologically confined to the prostate, and most men with such cancers who undergo RP are alive and free of additional therapy long after surgery. RP in the high-risk setting appears to be associated with a similar morbidity as in lower-risk patients. Men with clinically localized high-risk prostate cancer should not be categorically disqualified from local definitive therapy with RP. With careful attention to surgical technique, cancer control rates should improve further, and adverse effects on quality of life after RP should continue to decrease.

  13. A metasynthesis of risk perception in women with high risk pregnancies.

    Science.gov (United States)

    Lee, Suzanne; Ayers, Susan; Holden, Des

    2014-04-01

    risk perception in women with high risk pregnancies affects their decisions about perinatal care and is of interest to anyone involved in the care of pregnant women. This paper provides a metasynthesis of qualitative studies of risk perception in women with high risk pregnancies. a systematic search of eight electronic databases was conducted. Additional papers were obtained through searching references of identified articles. Six studies were identified that reported qualitative research into risk perception in relation to high risk pregnancy. A metasynthesis was developed to describe and interpret the studies. the synthesis resulted in the identification of five themes: determinants of risk perception; not seeing it the way others do; normality versus risk; if the infant is ok, I׳m ok; managing risk. this metasynthesis suggests women at high risk during pregnancy use multiple sources of information to determine their risk status. It shows women are aware of the risks posed by their pregnancies but do not perceive risk in the same way as healthcare professionals. They will take steps to ensure the health of themselves and their infants but these may not include following all medical recommendations. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. High Blood Pressure, Afib and Your Risk of Stroke

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More High Blood Pressure, AFib and Your Risk of Stroke Updated:Aug ... have a stroke for the first time have high blood pressure . And an irregular atrial heart rhythm — a condition ...

  15. Supply Chain-Wide Consequences of Transaction Risks and Their Contractual Solutions: Towards an Extended Transaction Cost Economics Framework

    NARCIS (Netherlands)

    Wever, M.; Wognum, P.M.; Trienekens, J.H.; Omta, S.W.F.

    2012-01-01

    How supply chain actors manage their exposure to both supply- and demand-side risks is a topic that has been insufficiently examined within the transaction cost economics (TCE) literature. TCE studies often only examine transaction risks in the context of bilateral exchanges. This study aims to

  16. Chain-wide consequences of transaction risks and their contractual solutions : managing interdependencies in differentiated agri-food supply chains

    NARCIS (Netherlands)

    Wever, M.

    2012-01-01

    Agri-food supply chains are characterized by strong interdependencies between the different stages. These interdependencies may lead to risk-spillovers, as when a downstream company is exposed to risks resulting from activities further upstream in the supply chain. For example, a change in the

  17. Alcohol consumption and high risk sexual behaviour among female ...

    African Journals Online (AJOL)

    Alcohol consumption has been associated with high risk sexual behaviour among key populations such as female sex workers. We explored the drivers of alcohol consumption and its relationship to high risk sexual behaviour. Participants were drawn from a cohort of 1 027 women selected from 'hot spots' in the suburbs of ...

  18. Correlation between high-risk pregnancy and developmental delay ...

    African Journals Online (AJOL)

    Background: The future development of children is considered more than ever now due to the advances in medical knowledge and thus the increase in survival rates of high-risk infants. This study investigated the correlation between high-risk pregnancy and developmental delay in children aged 4- 60 months. Methods: ...

  19. Drug response prediction in high-risk multiple myeloma

    DEFF Research Database (Denmark)

    Vangsted, A J; Helm-Petersen, S; Cowland, J B

    2018-01-01

    from high-risk patients by GEP70 at diagnosis from Total Therapy 2 and 3A to predict the response by the DRP score of drugs used in the treatment of myeloma patients. The DRP score stratified patients further. High-risk myeloma with a predicted sensitivity to melphalan by the DRP score had a prolonged...

  20. Elevated level of serum triglyceride among high risk stress bank ...

    African Journals Online (AJOL)

    The objective of this study was to estimate lipid profile among high risk stress bank employees' correlated with heart disorders in Riyadh, Saudi Arabia. A total of 129 patients with high risk stress employees were involved in this study, which were divided into 69 males and 60 females between the age of 25 to 55 years.

  1. Marijuana usage in relation to harmfulness ratings, perceived likelihood of negative consequences, and defense mechanisms in high school students.

    Science.gov (United States)

    Como-Lesko, N; Primavera, L H; Szeszko, P R

    1994-08-01

    This study investigated high school students' marijuana usage patterns in relation to their harmfulness ratings of 15 licit and illicit drugs, perceived negative consequences from using marijuana, and types of defense mechanisms employed. Subjects were classified into one of five pattern-of-use groups based on marijuana usage: principled nonusers, nonusers, light users, moderate users, and heavy users. Principled nonusers (individuals who have never used marijuana and would not do so if it was legalized) rated marijuana, hashish, cocaine, and alcohol as significantly more harmful than heavy users. A cluster analysis of the drugs' harmfulness ratings best fit a three cluster solution and were named medicinal drugs, recreational drugs, and hard drugs. In general, principled nonusers rated negative consequences from using marijuana as significantly more likely to occur than other groups. Principled nonusers and heavy users utilized reversal from the Defense Mechanism Inventory, which includes repression and denial, significantly more than nonusers, indicating some trait common to the two extreme pattern-of-use groups.

  2. From Exploitation to Industry: Definitions, Risks, and Consequences of Domestic Sexual Exploitation and Sex Work Among Women and Girls

    OpenAIRE

    Gerassi, Lara

    2015-01-01

    In the last 15 years, terms such as prostitution, sex trafficking, sexual exploitation, modern-day slavery, and sex work have elicited much confusion and debate as to their definitions. Consequently several challenges have emerged for both law enforcement in the prosecution of criminals and practitioners in service provision. This article reviews the state of the literature with regard to domestic, sexual exploitation among women and girls in the United States and seeks to (1) provide definit...

  3. Patients at High-Risk for Surgical Site Infection.

    Science.gov (United States)

    Mueck, Krislynn M; Kao, Lillian S

    Surgical site infections (SSIs) are a significant healthcare quality issue, resulting in increased morbidity, disability, length of stay, resource utilization, and costs. Identification of high-risk patients may improve pre-operative counseling, inform resource utilization, and allow modifications in peri-operative management to optimize outcomes. Review of the pertinent English-language literature. High-risk surgical patients may be identified on the basis of individual risk factors or combinations of factors. In particular, statistical models and risk calculators may be useful in predicting infectious risks, both in general and for SSIs. These models differ in the number of variables; inclusion of pre-operative, intra-operative, or post-operative variables; ease of calculation; and specificity for particular procedures. Furthermore, the models differ in their accuracy in stratifying risk. Biomarkers may be a promising way to identify patients at high risk of infectious complications. Although multiple strategies exist for identifying surgical patients at high risk for SSIs, no one strategy is superior for all patients. Further efforts are necessary to determine if risk stratification in combination with risk modification can reduce SSIs in these patient populations.

  4. High Center Volume Does Not Mitigate Risk Associated with Using High Donor Risk Organs in Liver Transplantation.

    Science.gov (United States)

    Beal, Eliza W; Black, Sylvester M; Mumtaz, Khalid; Hayes, Don; El-Hinnawi, Ashraf; Washburn, Kenneth; Tumin, Dmitry

    2017-09-01

    High-risk donor allografts increase access to liver transplant, but potentially reduce patient and graft survival. It is unclear whether the risk associated with using marginal donor livers is mitigated by increasing center experience. The United Network for Organ Sharing registry was queried for adult first-time liver transplant recipients between 2/2002 and 12/2015. High donor risk was defined as donor risk index >1.9, and 1-year patient and graft survival were compared according to donor risk index in small and large centers. Multivariable Cox regression estimated the hazard ratio (HR) associated with using high-risk donor organs, according to a continuous measure of annual center volume. The analysis included 51,770 patients. In 67 small and 67 large centers, high donor risk index predicted increased mortality (p = 0.001). In multivariable analysis, high-donor risk index allografts predicted greater mortality hazard at centers performing 20 liver transplants per year (HR 1.35; 95% CI 1.22, 1.49; p donor risk index and center volume was not statistically significant (p = 0.747), confirming that the risk associated with using marginal donor livers was comparable between smaller and larger centers. Results were consistent when examining graft loss. At both small and large centers, high-risk donor allografts were associated with reduced patient and graft survival after liver transplant. Specific strategies to mitigate the risk of liver transplant involving high-risk donors are needed, in addition to accumulation of center expertise.

  5. Current drinking and health-risk behaviors among male high school students in central Thailand

    Directory of Open Access Journals (Sweden)

    Pichainarong Natchaporn

    2011-04-01

    Full Text Available Abstract Background Alcohol drinking is frequently related to behavioral problems, which lead to a number of negative consequences. This study was to evaluate the characteristics of male high school students who drink, the drinking patterns among them, and the associations between current drinking and other health risk behaviors which focused on personal safety, violence-related behaviors, suicide and sexual behaviors. Method A cross-sectional study was conducted to explore current alcohol drinking and health-risk behaviors among male high school students in central Thailand. Five thousand one hundred and eighty four male students were classified into 2 groups according to drinking in the previous 30 days (yes = 631, no = 4,553. Data were collected by self-administered, anonymous questionnaire which consisted of 3 parts: socio-demographic factors, health-risk behaviors and alcohol drinking behavior during the past year from December 2007 to February 2008. Results The results showed that the percent of current drinking was 12.17. Most of them were 15-17 years (50.21%. Socio-demographic factors such as age, educational level, residence, cohabitants, grade point average (GPA, having a part time job and having family members with alcohol/drug problems were significantly associated with alcohol drinking (p Conclusions An increased risk of health-risk behaviors, including driving vehicles after drinking, violence-related behaviors, sad feelings and attempted suicide, and sexual behaviors was higher among drinking students that led to significant health problems. Effective intervention strategies (such as a campaign mentioning the adverse health effects and social consequences to the risk groups, and encouraging parental and community efforts to prevent drinking among adolescents should be implemented to prevent underage drinking and adverse consequences.

  6. Costs of fear: Behavioral and life-history responses to risk and their demographic consequences vary across species

    Science.gov (United States)

    LaManna, Joseph A.; Martin, Thomas E.

    2016-01-01

    Behavioural responses to reduce predation risk might cause demographic ‘costs of fear’. Costs differ among species, but a conceptual framework to understand this variation is lacking. We use a life-history framework to tie together diverse traits and life stages to better understand interspecific variation in responses and costs. We used natural and experimental variation in predation risk to test phenotypic responses and associated demographic costs for 10 songbird species. Responses such as increased parental attentiveness yielded reduced development time and created benefits such as reduced predation probability. Yet, responses to increased risk also created demographic costs by reducing offspring production in the absence of direct predation. This cost of fear varied widely across species, but predictably with the probability of repeat breeding. Use of a life-history framework can aid our understanding of potential demographic costs from predation, both from responses to perceived risk and from direct predation mortality.

  7. Determinants of participation in a web-based health risk assessment and consequences for health promotion programs

    NARCIS (Netherlands)

    M.A.J. Niessen (Maurice); E.L. Laan (Eva); S.J.W. Robroek (Suzan); M.L.E. Essink-Bot (Marie-Louise); N. Peek (Niels); R.A. Kraaijenhagen (Roderik); C.K. van Kalken (Coen); A. Burdorf (Alex)

    2013-01-01

    textabstractBackground: The health risk assessment (HRA) is a type of health promotion program frequently offered at the workplace. Insight into the underlying determinants of participation is needed to evaluate and implement these interventions. Objective: To analyze whether individual

  8. Determinants of participation in a web-based health risk assessment and consequences for health promotion programs

    NARCIS (Netherlands)

    Niessen, Maurice A. J.; Laan, Eva L.; Robroek, Suzan J. W.; Essink-Bot, Marie-Louise; Peek, Niels; Kraaijenhagen, Roderik A.; van Kalken, Coen K.; Burdorf, Alex

    2013-01-01

    The health risk assessment (HRA) is a type of health promotion program frequently offered at the workplace. Insight into the underlying determinants of participation is needed to evaluate and implement these interventions. To analyze whether individual characteristics including demographics, health

  9. Actual directions in study of ecological consequences of a highly toxic 1,1-dimethylhydrazine-based rocket fuel spills

    Directory of Open Access Journals (Sweden)

    Bulat Kenessov

    2012-05-01

    Full Text Available The paper represents a review of the actual directions in study of ecological consequences of highly toxic 1,1-dimethylhydrazine-based rocket fuel spills. Recent results on study of processes of transformation of 1,1-dimethylhydrazine, identification of its main metabolites and development of analytical methods for their determination are generalized. Modern analytical methods of determination of 1,1-dimethylhydrazine and its transformation products in environmental samples are characterized. It is shown that in recent years, through the use of most modern methods of physical chemical analysis and sample preparation, works in this direction made significant progress and contributed to the development of studies in adjacent areas. A character of distribution of transformation products in soils of fall places of first stages of rocket-carriers is described and the available methods for their remediation are characterized.

  10. Magnitude and reactivity consequences of accidental moisture ingress into the Modular High-Temperature Gas-Cooled Reactor core

    International Nuclear Information System (INIS)

    Smith, O.L.

    1992-01-01

    Accidental admission of moisture into the primary system of a Modular High-Temperature Gas-Cooled Reactor (MHTGR) has been identified in US Department of Energy-sponsored studies as an important safety concern. The work described here develops an analytical methodology to quantify the pressure and reactivity consequences of steam-generator tube rupture and other moistureingress-related incidents. Important neutronic and thermohydraulic processes are coupled with reactivity feedback and safety and control system responses. Rate and magnitude of steam buildup are found to be dominated by major system features such as break size in comparison with safety valve capacity and reliability, while being less sensitive to factors such as heat transfer coefficients. The results indicate that ingress transients progress at a slower pace than previously predicted by bounding analyses, with milder power overshoots and more time for operator or automatic corrective actions

  11. Magnitude and reactivity consequences of moisture ingress into the modular High-Temperature Gas-Cooled Reactor core

    International Nuclear Information System (INIS)

    Smith, O.L.

    1992-12-01

    Inadvertent admission of moisture into the primary system of a modular high-temperature gas-cooled reactor has been identified in US Department of Energy-sponsored studies as an important safety concern. The work described here develops an analytical methodology to quantify the pressure and reactivity consequences of steam-generator tube rupture and other moisture-ingress-related incidents. Important neutronic and thermohydraulic processes are coupled with reactivity feedback and safety and control system responses. The rate and magnitude of steam buildup are found to be dominated by major system features such as break size compared with safety valve capacity and reliability and less sensitive to factors such as heat transfer coefficients. The results indicate that ingress transients progress at a slower pace than previously predicted by bounding analyses, with milder power overshoots and more time for operator or automatic corrective actions

  12. Risk-taking and risky decision-making in Internet gaming disorder: Implications regarding online gaming in the setting of negative consequences.

    Science.gov (United States)

    Dong, Guangheng; Potenza, Marc N

    2016-02-01

    Individuals with Internet gaming disorder (IGD) continue gaming despite adverse consequences. However, the precise mechanism underlying this behavior remains unknown. In this study, data from 20 IGD subjects and 16 otherwise comparable healthy control subjects (HCs) were recorded and compared when they were undergoing risk-taking and risky decision-making during functional magnetic resonance imaging (fMRI). During risk-taking and as compared to HCs, IGD subjects selected more risk-disadvantageous trials and demonstrated less activation of the anterior cingulate, posterior cingulate and middle temporal gyrus. During risky decision-making and as compared to HCs, IGD subjects showed shorter response times and less activations of the inferior frontal and superior temporal gyri. Taken together, data suggest that IGD subjects show impaired executive control in selecting risk-disadvantageous choices, and they make risky decisions more hastily and with less recruitment of regions implicated in impulse control. These results suggest a possible neurobiological underpinning for why IGD subjects may exhibit poor control over their game-seeking behaviors even when encountering negative consequences and provide possible therapeutic targets for interventions in this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. High Framingham risk score decreases quality of life in adults

    Directory of Open Access Journals (Sweden)

    Christian Yosaputra

    2010-04-01

    Full Text Available Cardiovascular disease (CVD risk factors, such as diabetes, hypertension, hypercholesterolemia, smoking, and obesity tend to occur together in the general population. Increasing prevalence of multiple CVD risk factors has been related to increased risk of death from coronary heart disease and stroke. Studies have suggested that people with several risk factors of CVD may have impaired health-related quality of life. The objective of this study was to assess the association of CVD risk factors with quality of life (QOL among adults aged 40 to 65 years. A cross-sectional study was conducted involving 220 subjects 40 - 65 years of age at a health center. The CVD risk factors were assessed using the Framingham risk score that is the standard instrument for assessment of the risk of a first cardiac event. The risk factors assessed were age, smoking, blood pressure, total cholesterol and high density lipoprotein cholesterol concentrations. QOL was assessed by means of the WHOQOL-BREF instrument that had been prevalidated. The results of the study showed that 28.2% of subjects were smokers, 56.4% had stage 1 hypertension, 42.8% high total cholesterol and 13.6% low HDL cholesterol. The high risk group amounted to 45.5% and 42.3% constitued an intermediate risk group. High CVD risk scores were significantly associated with a low QOL for all domains (physical, psychological, social and environment (p=0.000. Preventing or reducing the multiple CVD risk factors to improve QOL is necessary among adults.

  14. The Very High Risk Prostate Cancer – a Contemporary Update

    Science.gov (United States)

    Mano, Roy; Eastham, James; Yossepowitch, Ofer

    2017-01-01

    Background Treatment of high-risk prostate cancer has evolved considerably over the past two decades, yet patients with very high-risk features may still experience poor outcome despite aggressive therapy. We review the contemporary literature focusing on current definitions, role of modern imaging and treatment alternatives in very high-risk prostate cancer. Methods We searched the MEDLINE database for all clinical trials or practice guidelines published in English between 2000 – 2016 with the following search terms: ‘prostatic neoplasms’ (MeSH Terms) AND (‘high risk’ (keyword) OR ‘locally advanced’ (keyword) OR ‘node positive’ (keyword)). Abstracts pertaining to very high-risk prostate cancer were evaluated and 40 pertinent studies served as the basis for this review. Results The term ‘very’ high-risk prostate cancer remains ill defined. The EAU and NCCN guidelines provide the only available definitions, categorizing those with clinical stage T3-4 or minimal nodal involvement as very-high risk irrespective of PSA level or biopsy Gleason score. Modern imaging with mpMRI and PET-PSMA scans plays a role in pretreatment assessment. Local definitive therapy by external beam radiation combined with androgen deprivation is supported by several randomized clinical trials whereas the role of surgery in the very high-risk setting combined with adjuvant radiation/ androgen deprivation therapy is emerging. Growing evidence suggest neoadjuvant taxane based chemotherapy in the context of a multimodal approach may be beneficial. Conclusions Men with very high-risk tumors may benefit from local definitive treatment in the setting of a multimodal regimen, offering local control and possibly cure in well selected patients. Further studies are necessary to better characterize the ‘very’ high-risk category and determine the optimal therapy for the individual patient. PMID:27618950

  15. Communicating and Sharing in the Semantic Web: An Examination of Social Media Risks, Consequences, and Attitudinal Awareness

    Directory of Open Access Journals (Sweden)

    Nicole A. Buzzetto-More

    2015-05-01

    Full Text Available Empowered by and tethered to ubiquitous technologies, the current generation of youth yearns for opportunities to engage in self-expression and information sharing online with personal disclosure no longer governed by concepts of propriety and privacy. This raises issues about the unsafe online activities of teens and young adults. The following paper presents the findings of a study examining the social networking activities of undergraduate students and also highlights a program to increase awareness of the dangers and safe practices when using and communicating, via social media. According to the survey results, young adults practice risky social networking site (SNS behaviors with most having experienced at least one negative consequence. Further, females were more likely than males to engage in oversharing as well as to have experienced negative consequences. Finally, results of a post-treatment survey found that a targeted program that includes flyers, posters, YouTube videos, handouts, and in-class information sessions conducted at a Mid-Atlantic Historically Black College or University (HBCU increased student awareness of the dangers of social media as well as positively influenced students to practice more prudent online behaviors.

  16. A review of multi-risk methodologies for natural hazards: Consequences and challenges for a climate change impact assessment.

    Science.gov (United States)

    Gallina, Valentina; Torresan, Silvia; Critto, Andrea; Sperotto, Anna; Glade, Thomas; Marcomini, Antonio

    2016-03-01

    This paper presents a review of existing multi-risk assessment concepts and tools applied by organisations and projects providing the basis for the development of a multi-risk methodology in a climate change perspective. Relevant initiatives were developed for the assessment of multiple natural hazards (e.g. floods, storm surges, droughts) affecting the same area in a defined timeframe (e.g. year, season, decade). Major research efforts were focused on the identification and aggregation of multiple hazard types (e.g. independent, correlated, cascading hazards) by means of quantitative and semi-quantitative approaches. Moreover, several methodologies aim to assess the vulnerability of multiple targets to specific natural hazards by means of vulnerability functions and indicators at the regional and local scale. The overall results of the review show that multi-risk approaches do not consider the effects of climate change and mostly rely on the analysis of static vulnerability (i.e. no time-dependent vulnerabilities, no changes among exposed elements). A relevant challenge is therefore to develop comprehensive formal approaches for the assessment of different climate-induced hazards and risks, including dynamic exposure and vulnerability. This requires the selection and aggregation of suitable hazard and vulnerability metrics to make a synthesis of information about multiple climate impacts, the spatial analysis and ranking of risks, including their visualization and communication to end-users. To face these issues, climate impact assessors should develop cross-sectorial collaborations among different expertise (e.g. modellers, natural scientists, economists) integrating information on climate change scenarios with sectorial climate impact assessment, towards the development of a comprehensive multi-risk assessment process. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Patients at high risk of tuberculosis recurrence

    Directory of Open Access Journals (Sweden)

    Mehdi Mirsaeidi

    2018-01-01

    Full Text Available Recurrent tuberculosis (TB continues to be a significant problem and is an important indicator of the effectiveness of TB control. Recurrence can occur by relapse or exogenous reinfection. Recurrence of TB is still a major problem in high-burden countries, where there is lack of resources and no special attention is being given to this issue. The rate of recurrence is highly variable and has been estimated to range from 4.9% to 47%. This variability is related to differences in regional epidemiology of recurrence and differences in the definitions used by the TB control programs. In addition to treatment failure from noncompliance, there are several key host factors that are associated with high rates of recurrence. The widely recognized host factors independent of treatment program that predispose to TB recurrence include gender differences, malnutrition; comorbidities such as diabetes, renal failure, and systemic diseases, especially immunosuppressive states such as human immunodeficiency virus; substance abuse; and environmental exposures such as silicosis. With improved understanding of the human genome, proteome, and metabolome, additional host-specific factors that predispose to recurrence are being identified. Information on temporal and geographical trends of TB cases as well as studies with whole-genome sequencing might provide further information to enable us to fully understand TB recurrence and discriminate between reactivation and new infection. The recently launched World Health Organization End TB Strategy emphasizes the importance of integrated, patient-centered TB care. Continued improvement in diagnosis, treatment approaches, and an understanding of host-specific factors are needed to fully understand the clinical epidemiological and social determinants of TB recurrence.

  18. Patients at high risk of tuberculosis recurrence.

    Science.gov (United States)

    Mirsaeidi, Mehdi; Sadikot, Ruxana T

    2018-01-01

    Recurrent tuberculosis (TB) continues to be a significant problem and is an important indicator of the effectiveness of TB control. Recurrence can occur by relapse or exogenous reinfection. Recurrence of TB is still a major problem in high-burden countries, where there is lack of resources and no special attention is being given to this issue. The rate of recurrence is highly variable and has been estimated to range from 4.9% to 47%. This variability is related to differences in regional epidemiology of recurrence and differences in the definitions used by the TB control programs. In addition to treatment failure from noncompliance, there are several key host factors that are associated with high rates of recurrence. The widely recognized host factors independent of treatment program that predispose to TB recurrence include gender differences, malnutrition; comorbidities such as diabetes, renal failure, and systemic diseases, especially immunosuppressive states such as human immunodeficiency virus; substance abuse; and environmental exposures such as silicosis. With improved understanding of the human genome, proteome, and metabolome, additional host-specific factors that predispose to recurrence are being identified. Information on temporal and geographical trends of TB cases as well as studies with whole-genome sequencing might provide further information to enable us to fully understand TB recurrence and discriminate between reactivation and new infection. The recently launched World Health Organization End TB Strategy emphasizes the importance of integrated, patient-centered TB care. Continued improvement in diagnosis, treatment approaches, and an understanding of host-specific factors are needed to fully understand the clinical epidemiological and social determinants of TB recurrence.

  19. High-Risk and Low-Risk Human Papillomavirus and the Absolute Risk of Cervical Intraepithelial Neoplasia or Cancer

    DEFF Research Database (Denmark)

    Thomsen, Louise T; Frederiksen, Kirsten; Munk, Christian

    2014-01-01

    OBJECTIVE: To determine the absolute risk of cervical intraepithelial neoplasia (CIN) grade 3 or cervical cancer (CIN 3 or worse) after detection of low-risk human papillomavirus (HPV) and after a negative high-risk HPV test. METHODS: In this prospective cohort study, consecutive liquid......-based cervical cytology samples were collected from women screened for cervical cancer in Copenhagen, Denmark, during 2002-2005. Samples were tested with a clinical test for 13 high-risk and five low-risk HPV types. The cohort (N=35,539; aged 14-90 years) was monitored in a nationwide pathology register for up...... cytology. Detection of low-risk HPV does not predict CIN 3 or worse. Cervical cancer screening should not include testing for low-risk HPV types. LEVEL OF EVIDENCE: II....

  20. An assessment of the radiological consequences of disposal of high-level waste in coastal geologic formations

    International Nuclear Information System (INIS)

    Hill, M.D.; Lawson, G.

    1980-11-01

    This study was carried out with the objectives of assessing the potential radiological consequences of entry of circulating ground-water into a high-level waste repository sited on the coast; and comparing the results with those of previous assessments for a repository sited inland. Mathematical models are used to calculate the rate of release of radioactivity into ground-water by leaching, the rates of migration of radionuclides with ground-water from the repository to the sea and the concentrations of radionuclides in sea-water and sea-food as a function of time. Estimates are made of the peak annual collective doses and collective dose commitments which could be received as a result of sea-food consumption. Since there are considerable uncertainties associated with the values of many of the parameters used in the calculations the broad features of the results are more significant than the numerical values of predicted annual doses and collective dose commitments. The results of the assessment show that the rates of migration of radionuclides with ground-water are of primary importance in determining the radiological impact of ground-water ingress. The implications of this result for selection of coastal sites and allocation of research effort are discussed. The comparison of coastal and inland sites suggest that coastal siting may have substantial advantages in terms of the radiological consequences to the public after disposal and that a significant fraction of available research effort should therefore be directed towards investigation of coastal sites. This study has been carried out under contract to the United Kingdom Atomic Energy Authority, Harwell, on behalf of the Commission of the European Communities. (author)

  1. A social work study high-risk behavior among teenagers

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Iravani

    2012-01-01

    Full Text Available Teenagers are believed the people who are supposed to build the world's future. High-risk behaviors such as addiction to drugs, smoking cigarettes, sex, etc. could significantly hurts teenagers and there must be some supporting programs to reduce these issues as much as possible. This paper performs an empirical investigation to study the different factors influencing high- risk behavior among teenagers who live in a city of Esfahan, Iran. The proposed study designs a questionnaire and distribute between two groups of female and male teenagers. The results indicate that while there is a meaningful relationship between high-risk behaviors and average high school marks among male students there is no meaningful relationship between high-risk behaviors and high school grades among female students. The results also indicate that there is a meaningful difference between gender and high-risk behavior. The season of birth for female and male students is another important factor for having high-risk behaviors. While the order of birth plays an important role among male students, the order of birth is not an important factor among female teenagers. Finally, the results indicate that teenagers' parental financial affordability plays a vital role on both female and male teenagers.

  2. Risk and consequences of osteoarthritis after a professional football career: a systematic review of the recent literature

    NARCIS (Netherlands)

    Gouttebarge, V.; Inklaar, H.; Frings-Dresen, M. H.

    2014-01-01

    The aim of the present study was to assess whether previous injury is a risk determinant for knee and ankle osteoarthritis (OA) in former professional football players and to explore OA-related activity and work limitations. To retrieve the relevant recent literature, the Medline, Embase and

  3. Risk-adaptive optimization: Selective boosting of high-risk tumor subvolumes

    International Nuclear Information System (INIS)

    Kim, Yusung; Tome, Wolfgang A.

    2006-01-01

    Background and Purpose: A tumor subvolume-based, risk-adaptive optimization strategy is presented. Methods and Materials: Risk-adaptive optimization employs a biologic objective function instead of an objective function based on physical dose constraints. Using this biologic objective function, tumor control probability (TCP) is maximized for different tumor risk regions while at the same time minimizing normal tissue complication probability (NTCP) for organs at risk. The feasibility of risk-adaptive optimization was investigated for a variety of tumor subvolume geometries, risk-levels, and slopes of the TCP curve. Furthermore, the impact of a correlation parameter, δ, between TCP and NTCP on risk-adaptive optimization was investigated. Results: Employing risk-adaptive optimization, it is possible in a prostate cancer model to increase the equivalent uniform dose (EUD) by up to 35.4 Gy in tumor subvolumes having the highest risk classification without increasing predicted normal tissue complications in organs at risk. For all tumor subvolume geometries investigated, we found that the EUD to high-risk tumor subvolumes could be increased significantly without increasing normal tissue complications above those expected from a treatment plan aiming for uniform dose coverage of the planning target volume. We furthermore found that the tumor subvolume with the highest risk classification had the largest influence on the design of the risk-adaptive dose distribution. The parameter δ had little effect on risk-adaptive optimization. However, the clinical parameters D 5 and γ 5 that represent the risk classification of tumor subvolumes had the largest impact on risk-adaptive optimization. Conclusions: On the whole, risk-adaptive optimization yields heterogeneous dose distributions that match the risk level distribution of different subvolumes within the tumor volume

  4. Vibratory perception threshold in young and middle-aged patients at high risk of knee osteoarthritis compared to controls

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Shakoor, Najia; Ageberg, Eva

    2012-01-01

    Vibratory perception threshold (VPT) is impaired in patients with knee osteoarthritis (OA). It is, however, not known if sensory deficits precede or follow as a consequence of OA. The aim of this study was to investigate VPT in 2 independent groups of patients with high risk of future OA (young a...

  5. Awareness and prevalence of metabolic syndrome among high-risk ...

    African Journals Online (AJOL)

    MetS) in high-risk individuals attending 30 internal medicine clinics in Amman, Jordan, and also to evaluate the various factors associated with increased risk of MetS among them. Methods: This retrospective cross-sectional study was carried out ...

  6. Incidence of infective endocarditis among patients considered at high risk

    DEFF Research Database (Denmark)

    Østergaard, Lauge; Valeur, Nana; Ihlemann, Nikolaj

    2018-01-01

    Aims: Patients with prior infective endocarditis (IE), a prosthetic heart valve, or a cyanotic congenital heart disease (CHD) are considered to be at high risk of IE by guidelines. However, knowledge is sparse on the relative risk of IE between these three groups and compared controls. Methods...

  7. Incorporating risk communication into highly pathogenic avian influenza preparedness and response efforts.

    Science.gov (United States)

    Voss, Shauna J; Malladi, Sasidhar; Sampedro, Fernando; Snider, Tim; Goldsmith, Timothy; Hueston, William D; Lauer, Dale C; Halvorson, David A

    2012-12-01

    A highly pathogenic avian influenza (HPAI) outbreak in the United States will initiate a federal emergency response effort that will consist of disease control and eradication efforts, including quarantine and movement control measures. These movement control measures will not only apply to live animals but also to animal products. However, with current egg industry "just-in-time" production practices, limited storage is available to hold eggs. As a result, stop movement orders can have significant unintended negative consequences, including severe disruptions to the food supply chain. Because stakeholders' perceptions of risk vary, waiting to initiate communication efforts until an HPAI event occurs can hinder disease control efforts, including the willingness of producers to comply with the response, and also can affect consumers' demand for the product. A public-private-academic partnership was formed to assess actual risks involved in the movement of egg industry products during an HPAI event through product specific, proactive risk assessments. The risk analysis process engaged a broad representation of stakeholders and promoted effective risk management and communication strategies before an HPAI outbreak event. This multidisciplinary team used the risk assessments in the development of the United States Department of Agriculture, Highly Pathogenic Avian Influenza Secure Egg Supply Plan, a comprehensive response plan that strives to maintain continuity of business. The collaborative approach that was used demonstrates how a proactive risk communication strategy that involves many different stakeholders can be valuable in the development of a foreign animal disease response plan and build working relationships, trust, and understanding.

  8. The effects of actinide separation on the radiological consequences of geologic disposal of high-level waste

    International Nuclear Information System (INIS)

    Hill, M.D.; White, I.F.; Fleishman, A.B.

    1980-01-01

    It has often been suggested that the potential hazard to man from the disposal of high-level radioactive waste could be reduced by removing a substantial fraction of the actinide elements. In this report the effects of actinide separation on the radiological consequences of one of the disposal options currently under consideration, that of burial in deep geologic formations, are examined. The results show that the potential radiological impact of geologic disposal of high-level waste arises from both long-lived fission products and actinides (and their daughter radionuclides). Neither class of radionuclides is of overriding importance and actinide separation would therefore reduce the radiological impact to only a limited extent and over limited periods. There might be a case for attempting to reduce doses from 237 Np. To achieve this it appears to be necessary to separate both neptunium and its precursor element americium. However, there are major uncertainties in the data needed to predict doses from 237 Np; further research is required to resolve these uncertainties. In addition, consideration should be given to alternative methods of reducing the radiological impact of geologic disposal. The conclusions of this assessment differ considerably from those of similar studies based on the concept of toxicity indices. Use of these indices can lead to incorrect allocation of research and development effort. (author)

  9. Brachytherapy boost and cancer-specific mortality in favorable high-risk versus other high-risk prostate cancer

    Directory of Open Access Journals (Sweden)

    Vinayak Muralidhar

    2016-02-01

    Full Text Available Purpose : Recent retrospective data suggest that brachytherapy (BT boost may confer a cancer-specific survival benefit in radiation-managed high-risk prostate cancer. We sought to determine whether this survival benefit would extend to the recently defined favorable high-risk subgroup of prostate cancer patients (T1c, Gleason 4 + 4 = 8, PSA 20 ng/ml. Material and methods: We identified 45,078 patients in the Surveillance, Epidemiology, and End Results database with cT1c-T3aN0M0 intermediate- to high-risk prostate cancer diagnosed 2004-2011 treated with external beam radiation therapy (EBRT only or EBRT plus BT. We used multivariable competing risks regression to determine differences in the rate of prostate cancer-specific mortality (PCSM after EBRT + BT or EBRT alone in patients with intermediate-risk, favorable high-risk, or other high-risk disease after adjusting for demographic and clinical factors. Results : EBRT + BT was not associated with an improvement in 5-year PCSM compared to EBRT alone among patients with favorable high-risk disease (1.6% vs. 1.8%; adjusted hazard ratio [AHR]: 0.56; 95% confidence interval [CI]: 0.21-1.52, p = 0.258, and intermediate-risk disease (0.8% vs. 1.0%, AHR: 0.83, 95% CI: 0.59-1.16, p = 0.270. Others with high-risk disease had significantly lower 5-year PCSM when treated with EBRT + BT compared with EBRT alone (3.9% vs. 5.3%; AHR: 0.73; 95% CI: 0.55-0.95; p = 0.022. Conclusions : Brachytherapy boost is associated with a decreased rate of PCSM in some men with high-risk prostate cancer but not among patients with favorable high-risk disease. Our results suggest that the recently-defined “favorable high-risk” category may be used to personalize therapy for men with high-risk disease.

  10. Physical activity barriers and motivators among high-risk employees.

    Science.gov (United States)

    Paguntalan, John C; Gregoski, Mathew

    2016-11-22

    Worksite wellness programs offer an ideal setting to target high-risk sedentary workers to improve health status. Lack of physical activity is associated with increased risk for coronary heart disease and mortality. Despite the risks, the number of sedentary workers is increasing. This study examined the perceived barriers and motivators for physical activity among employees at high-risk for coronary heart disease. A purposive sample of 24 high-risk workers participating in a wellness program in rural South Carolina were enrolled in the study. Qualitative data was obtained through semi-structured face-to-face interviews. Grounded theory was used to analyze qualitative data, and identify overarching themes. Physical limitations due to pain and weakness, lack of motivation, and lack of time emerged as the main barriers to physical activity. Family relationships were reported as the strongest motivator along with social support and potential health benefits. Findings highlight the unique experience of high-risk workers with physical activity. The findingsunderscore the need to design and implement effective interventions specifically designed to meet the needs of high-risk employees.

  11. DASH - Youth Risk Behavior Surveillance System (YRBSS): High School

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1991-2015. High School Dataset. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health behaviors among youth and young...

  12. Chemicals in Meat Cooked at High Temperatures and Cancer Risk

    Science.gov (United States)

    ... Services Directory Cancer Prevention Overview Research Chemicals in Meat Cooked at High Temperatures and Cancer Risk On ... hydrocarbons, and how are they formed in cooked meats? What factors influence the formation of HCA and ...

  13. Pesticide mixtures in the Swedish streams: Environmental risks, contributions of individual compounds and consequences of single-substance oriented risk mitigation.

    Science.gov (United States)

    Gustavsson, Mikael; Kreuger, Jenny; Bundschuh, Mirco; Backhaus, Thomas

    2017-11-15

    This paper presents the ecotoxicological assessment and environmental risk evaluation of complex pesticide mixtures occurring in freshwater ecosystems in southern Sweden. The evaluation is based on exposure data collected between 2002 and 2013 by the Swedish pesticide monitoring program and includes 1308 individual samples, detecting mixtures of up to 53 pesticides (modal=8). Pesticide mixture risks were evaluated using three different scenarios for non-detects (best-case, worst-case and using the Kaplan-Meier method). The risk of each scenario was analyzed using Swedish Water Quality Objectives (WQO) and trophic-level specific environmental thresholds. Using the Kaplan-Meier method the environmental risk of 73% of the samples exceeded acceptable levels, based on an assessment using Concentration-Addition and WQOs for the individual pesticides. Algae were the most sensitive organism group. However, analytical detection limits, especially for insecticides, were insufficient to analyze concentrations at or near their WQO's. Thus, the risk of the analyzed pesticide mixtures to crustaceans and fish is systematically underestimated. Treating non-detects as being present at their individual limit of detection increased the estimated risk by a factor 100 or more, compared to the best-case or the Kaplan-Meier scenario. Pesticide mixture risks are often driven by only 1-3 compounds. However, the risk-drivers (i.e., individual pesticides explaining the largest share of potential effects) differ substantially between sites and samples, and 83 of the 141 monitored pesticides need to be included in the assessment to account for 95% of the risk at all sites and years. Single-substance oriented risk mitigation measures that would ensure that each individual pesticide is present at a maximum of 95% of its individual WQO, would also reduce the mixture risk, but only from a median risk quotient of 2.1 to a median risk quotient of 1.8. Also, acceptable total risk levels would still

  14. Sensation seeking in males involved in recreational high risk sports

    OpenAIRE

    M Guszkowska; A Bołdak

    2010-01-01

    The study examined sensation seeking intensity level in males involved in recreational high risk sports and investigated whether its level depends on type of sport practised. Additionally, in case of parachutists, sport experience of study participants were scrutinised with regard to its possible impact on the level of sensation seeking.The research involved 217 males aged 17 to 45, practising recreational high risk sports, namely: parachuting (n=98); wakeboarding (n=30); snowboarding (n=30);...

  15. Increased Cardiometabolic Risk and Worsening Hypoxemia at High Altitude

    OpenAIRE

    Miele, Catherine H.; Schwartz, Alan R.; Gilman, Robert H.; Pham, Luu; Wise, Robert A.; Davila-Roman, Victor G.; Jun, Jonathan C.; Polotsky, Vsevolod Y.; Miranda, J. Jaime; Leon-Velarde, Fabiola; Checkley, William

    2016-01-01

    Miele, Catherine H., Alan R. Schwartz, Robert H. Gilman, Luu Pham, Robert A. Wise, Victor G. Davila-Roman, Jonathan C. Jun, Vsevolod Y. Polotsky, J. Jaime Miranda, Fabiola Leon-Velarde, and William Checkley. Increased cardiometabolic risk and worsening hypoxemia at high altitude. High Alt Med Biol. 17:93���100, 2016.���Metabolic syndrome, insulin resistance, diabetes, and dyslipidemia are associated with an increased risk of cardiovascular disease. While excessive erythrocytosis is associated...

  16. Identification of the high risk emergency surgical patient: Which risk prediction model should be used?

    Science.gov (United States)

    Stonelake, Stephen; Thomson, Peter; Suggett, Nigel

    2015-09-01

    National guidance states that all patients having emergency surgery should have a mortality risk assessment calculated on admission so that the 'high risk' patient can receive the appropriate seniority and level of care. We aimed to assess if peri-operative risk scoring tools could accurately calculate mortality and morbidity risk. Mortality risk scores for 86 consecutive emergency laparotomies, were calculated using pre-operative (ASA, Lee index) and post-operative (POSSUM, P-POSSUM and CR-POSSUM) risk calculation tools. Morbidity risk scores were calculated using the POSSUM predicted morbidity and compared against actual morbidity according to the Clavien-Dindo classification. The actual mortality was 10.5%. The average predicted risk scores for all laparotomies were: ASA 26.5%, Lee Index 2.5%, POSSUM 29.5%, P-POSSUM 18.5%, CR-POSSUM 10.5%. Complications occurred following 67 laparotomies (78%). The majority (51%) of complications were classified as Clavien-Dindo grade 2-3 (non-life-threatening). Patients having a POSSUM morbidity risk of greater than 50% developed significantly more life-threatening complications (CD 4-5) compared with those who predicted less than or equal to 50% morbidity risk (P = 0.01). Pre-operative risk stratification remains a challenge because the Lee Index under-predicts and ASA over-predicts mortality risk. Post-operative risk scoring using the CR-POSSUM is more accurate and we suggest can be used to identify patients who require intensive care post-operatively. In the absence of accurate risk scoring tools that can be used on admission to hospital it is not possible to reliably audit the achievement of national standards of care for the 'high-risk' patient.

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

    Science.gov (United States)

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

    2009-01-01

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

  18. High-risk PCI: how to define it today?

    Science.gov (United States)

    DE Marzo, Vincenzo; D'Amario, Domenico; Galli, Mattia; Vergallo, Rocco; Porto, Italo

    2018-04-11

    Before the percutaneous spread, the mortality rate of patients with coronary heart disease not suitable for cardiac surgery was markedly high. This limit has been progressively exceeded with the advent of minimally invasive approaches, which, although was initially intended exclusively for low risk patients, was then employed in complex patients often too compromised to undergo cardiac surgery. Given to the rising of high-risk population, due to an increase of patients with multiple chronic conditions linked to the best care offered, we are witnessing an expansion of the high-risk percutaneous coronary interventions (PCI) population. Despite defining what high-risk is remains still unclear, all proposed definitions of high-risk PCI combine features related to three clinical areas: 1) patient risk factors and comorbidities (incorporating those which preclude surgical or percutaneous revascularization such as diabetes, COPD, CKD, lung disease, frailty, advanced age); 2) location of the disease and complexity of coronary anatomy (including multi-vessel disease, left main disease, CTO, bifurcations); 3) hemodynamic clinical status (ventricular dysfunction, concomitant valvular disease or unstable characteristics). Since cardiologists have ascertained the encouraging results in terms of efficacy and rewards compared to the low-risks patients, the important role of treating high-risk patients is becoming more and more relevant to the point that current guidelines have now changed the appropriateness of percutaneous interventions indications. Considering the complexity in managing higher-risk patients with coronary artery disease, the next step to ensure the best care for this type of patients is to create a team-based model of cooperation in order to properly establish the right treatment for the right patient.

  19. Screening for breast cancer in a high-risk series

    International Nuclear Information System (INIS)

    Woodard, E.D.; Hempelmann, L.H.; Janus, J.; Logan, W.; Dean, P.

    1982-01-01

    A unique cohort of women at increased risk of breast cancer because of prior X-ray treatment of acute mastitis and their selected high-risk siblings were offered periodic breast cancer screening including physical examination of the breasts, mammography, and thermography. Twelve breast cancers were detected when fewer than four would have been expected based on age-specific breast cancer detection rates from the National Cancer institute/American Cancer Society Breast Cancer Demonstration Detection Projects. Mammograpy was positive in all cases but physical examination was positive in only three cases. Thermography was an unreliable indicator of disease. Given the concern over radiation-induced risk, use of low-dose technique and of criteria for participation that select women at high risk of breast cancer will maximize the benefit/risk ratio for mammography screening

  20. The behavioral and health consequences of sleep deprivation among U.S. high school students: relative deprivation matters.

    Science.gov (United States)

    Meldrum, Ryan Charles; Restivo, Emily

    2014-06-01

    To evaluate whether the strength of the association between sleep deprivation and negative behavioral and health outcomes varies according to the relative amount of sleep deprivation experienced by adolescents. 2011 Youth Risk Behavior Survey data of high school students (N=15,364) were analyzed. Associations were examined on weighted data using logistic regression. Twelve outcomes were examined, ranging from weapon carrying to obesity. The primary independent variable was a self-reported measure of average number of hours slept on school nights. Participants who reported deprivations in sleep were at an increased risk of a number of negative outcomes. However, this varied considerably across different degrees of sleep deprivation. For each of the outcomes considered, those who slept less than 5h were more likely to report negative outcomes (adjusted odds ratios ranging from 1.38 to 2.72; psleeping 8 or more hours. However, less extreme forms of sleep deprivation were, in many instances, unrelated to the outcomes considered. Among U.S. high school students, deficits in sleep are significantly and substantively associated with a variety of negative outcomes, and this association is particularly pronounced for students achieving fewer than 5h of sleep at night. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Pharmacists as providers: targeting pneumococcal vaccinations to high risk populations.

    Science.gov (United States)

    Taitel, Michael; Cohen, Ed; Duncan, Ian; Pegus, Cheryl

    2011-10-19

    Older adults and persons with chronic conditions are at increased risk for pneumococcal disease. Severe pneumococcal disease represents a substantial humanistic and economic burden to society. Although pneumococcal vaccination (PPSV) can decrease risk for serious consequences, vaccination rates are suboptimal. As more people seek annual influenza vaccinations at community pharmacies, pharmacists have the ability to identify at-risk patients and provide PPSV. The objective of this study was to evaluate the impact of pharmacists educating at-risk patients on the importance of receiving a pneumococcal vaccination. Using de-identified claims from a large, national pharmacy chain, all patients who had received an influenza vaccination between August 1, 2010 and November 14, 2010 and who were eligible for PPSV were identified for the analysis. Based on the Advisory Committee on Immunization Practices recommendations, at-risk patients were identified as over 65 years of age or as aged 2-64 with a comorbid conditions. A benchmark medical and pharmacy claims database of commercial and Medicare health plan members was used to derive a PPSV vaccination rate typical of traditional care delivery to compare to pharmacy-based vaccination. Period incidence of PPSV was calculated and compared. Among the 1.3 million at-risk patients who were vaccinated by a pharmacist during the study period, 65,598 (4.88%) also received a pneumococcal vaccine. This vaccination rate was significantly higher than the benchmark rate of 2.90% (34,917/1,204,104; pvaccination rate (6.60%; 26,430/400,454) of any age group. Pharmacists were successful at identifying at-risk patients and providing additional immunization services. Concurrent immunization of PPSV with influenza vaccination by pharmacists has potential to improve PPSV coverage. These results support the expanding role of community pharmacists in the provision of wellness and prevention services. Copyright © 2011 Elsevier Ltd. All rights

  2. High-Risk Cutaneous Squamous Cell Carcinoma of the Head and Neck

    Directory of Open Access Journals (Sweden)

    Michael J. Veness

    2007-01-01

    Full Text Available Nonmelanoma skin cancers (squamous cell and basal cell carcinomas occur at an epidemic rate in many countries with the worldwide incidence increasing. The sun-exposed head and neck are the most frequent sites for these cancers to arise and in most patients diagnosed with a cutaneous squamous cell carcinoma, local treatment is usually curative. However, a subset is diagnosed with a high-risk cutaneous squamous cell carcinoma. High-risk factors include size (> 2 cm, thickness/depth of invasion (> 4 mm, recurrent lesions, the presence of perineural invasion, location near the parotid gland, and immunosuppression. These patients have a higher risk (> 10–20% of developing metastases to regional lymph nodes (often parotid nodes, and in some cases also of experiencing local morbidity (perineural invasion, based on unfavourable primary lesion and patient factors. Despite treatment, many patients developing metastatic cutaneous squamous cell carcinoma experience mortality and morbidity usually as a consequence of uncontrolled metastatic nodal disease. It is therefore important that clinicians treating nonmelanoma skin cancers have an understanding and awareness of these high-risk patients. The aim of this article is to discuss the factors that define a high-risk patient and to present some of the issues pertinent to their management.

  3. High prevalence of suicide risk in people living with HIV: who is at higher risk?

    Science.gov (United States)

    Passos, Susane Müller Klug; Souza, Luciano Dias de Mattos; Spessato, Bárbara Coiro

    2014-01-01

    A cross-sectional study was developed to evaluate suicide risk and associated factors in HIV/AIDS patients at a regional reference center for the treatment of HIV/AIDS in southern Brazil. We assessed 211 patients in regard to suicide risk, clinical and sociodemographic characteristics, drug use, depression, and anxiety. Suicide risk was assessed with Mini International Neuropsychiatric Interview, Module C. Multivariate analysis was performed using Poisson regression. Of the total sample, 34.1% were at risk of suicide. In the multivariate analysis, the following variables were independently associated with suicide risk: female gender; age up to 47 years; unemployment; indicative of anxiety; indicative of depression; and abuse or addiction on psychoactive substances. Suicide risk is high in this population. Psychosocial factors should be included in the physical and clinical evaluation, given their strong association with suicide risk.

  4. Communicating about risk: strategies for situations where public concern is high but the risk is low

    Directory of Open Access Journals (Sweden)

    Claire Hooker

    2017-02-01

    Full Text Available In this article, we summarise research that identifies best practice for communicating about hazards where the risk is low but public concern is high. We apply Peter Sandman’s ‘risk = hazard + outrage’ formulation to these risks, and review factors associated with the amplification of risk signals. We discuss the structures that determine the success of risk communication strategies, such as the capacity for early communication to ‘capture’ the dominant representation of risk issues, the importance of communicating uncertainty, and the usefulness of engaging with communities. We argue that, when facing trade-offs in probable outcomes from communication, it is always best to choose strategies that maintain or build trust, even at the cost of initial overreactions. We discuss these features of successful risk communication in relation to a range of specific examples, particularly opposition to community water fluoridation, Ebola, and routine childhood immunisation.

  5. Cause or consequence? Investigating attention bias and self-regulation skills in children at risk for obesity.

    Science.gov (United States)

    Mehl, Nora; Bergmann, Sarah; Klein, Annette M; Daum, Moritz; von Klitzing, Kai; Horstmann, Annette

    2017-03-01

    Impaired self-regulation, especially in food-specific situations, has been linked to childhood obesity. These deficits may be acquired during the development of obesity rather than being a prerequisite thereof. The current study, hence, focused on an at-risk population versus controls. Normal-weight children of obese and normal-weight parents were tested regarding attentional flexibility, emotion regulation, and inhibitory control. A sample of 50 preschoolers of obese parents (n=25) or normal-weight parents (n=25) participated in this study. Through eye-tracking, attentional bias for food cues was measured during a visual probe task using food and toy images. Emotion regulation was assessed during a distress-evoking task, and inhibitory control was examined through a delay-of-gratification task. Both tasks are standardized and were conducted in non-food contexts. Results showed no significant group differences in overall attentional bias to food images over toy images. However, children of normal-weight parents showed a preference for toy images. Regarding emotion regulation, children in the risk group expressed significantly less overall emotional distress. In addition, less gaze aversion and bodily sadness could be observed in this group. No differences were found for inhibitory control. Findings suggest that general deficits in self-regulation are not yet present in normal-weight children at risk for obesity. Instead, they might develop as a by-product of unhealthy weight gain. Results indicate, however, that children of obese parents are less emotionally expressive compared with children of normal-weight parents. Furthermore, children of normal-weight parents appeared to be more interested in toy images than in food images. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Predicting reattendance at a high-risk breast cancer clinic.

    Science.gov (United States)

    Ormseth, Sarah R; Wellisch, David K; Aréchiga, Adam E; Draper, Taylor L

    2015-10-01

    The research about follow-up patterns of women attending high-risk breast-cancer clinics is sparse. This study sought to profile daughters of breast-cancer patients who are likely to return versus those unlikely to return for follow-up care in a high-risk clinic. Our investigation included 131 patients attending the UCLA Revlon Breast Center High Risk Clinic. Predictor variables included age, computed breast-cancer risk, participants' perceived personal risk, clinically significant depressive symptomatology (CES-D score ≥ 16), current level of anxiety (State-Trait Anxiety Inventory), and survival status of participants' mothers (survived or passed away from breast cancer). A greater likelihood of reattendance was associated with older age (adjusted odds ratio [AOR] = 1.07, p = 0.004), computed breast-cancer risk (AOR = 1.10, p = 0.017), absence of depressive symptomatology (AOR = 0.25, p = 0.009), past psychiatric diagnosis (AOR = 3.14, p = 0.029), and maternal loss to breast cancer (AOR = 2.59, p = 0.034). Also, an interaction was found between mother's survival and perceived risk (p = 0.019), such that reattendance was associated with higher perceived risk among participants whose mothers survived (AOR = 1.04, p = 0.002), but not those whose mothers died (AOR = 0.99, p = 0.685). Furthermore, a nonlinear inverted "U" relationship was observed between state anxiety and reattendance (p = 0.037); participants with moderate anxiety were more likely to reattend than those with low or high anxiety levels. Demographic, medical, and psychosocial factors were found to be independently associated with reattendance to a high-risk breast-cancer clinic. Explication of the profiles of women who may or may not reattend may serve to inform the development and implementation of interventions to increase the likelihood of follow-up care.

  7. Interpersonal Problem-Solving Skills, Executive Function and Learning Potential in Preadolescents with High/Low Family Risk.

    Science.gov (United States)

    Mata, Sara; Gómez-Pérez, M Mar; Molinero, Clara; Calero, M Dolores

    2017-10-30

    Situations generated by high family risk have a negative effect on personal development, especially during preadolescence. Growing up in the presence of risk factors can lead to negative consequences on mental health or on school performance. The objective of this study focuses on individual factors related to this phenomenon during preadolescence. Specifically, we seek to establish whether level of family risk (high vs. low risk) is related to interpersonal problem-solving skills, executive function and learning potential in a sample of preadolescents controlling age, sex, total IQ, verbal comprehension ability and the classroom influences. The participants were 40 children, 23 boys and 17 girls between the ages of 7 and 12, twenty of which had a record on file with the Social and Childhood Protection Services of Information deleted to maintain the integrity of the review process, and therefore, a high family risk situation. The other 20 participants had a low family risk situation. Results show that the preadolescents from high family risk performed worse on interpersonal solving-problem skills and executive function (p family risk. These results highlight the negative effects of high family risk situation in preadolescents and give value of taking into account protective factors such as learning potential when assessing preadolescents from high family risk.

  8. Cost tradeoffs in consequence management at nuclear power plants: A risk based approach to setting optimal long-term interdiction limits for regulatory analyses

    International Nuclear Information System (INIS)

    Mubayi, V.

    1995-05-01

    The consequences of severe accidents at nuclear power plants can be limited by various protective actions, including emergency responses and long-term measures, to reduce exposures of affected populations. Each of these protective actions involve costs to society. The costs of the long-term protective actions depend on the criterion adopted for the allowable level of long-term exposure. This criterion, called the ''long term interdiction limit,'' is expressed in terms of the projected dose to an individual over a certain time period from the long-term exposure pathways. The two measures of offsite consequences, latent cancers and costs, are inversely related and the choice of an interdiction limit is, in effect, a trade-off between these two measures. By monetizing the health effects (through ascribing a monetary value to life lost), the costs of the two consequence measures vary with the interdiction limit, the health effect costs increasing as the limit is relaxed and the protective action costs decreasing. The minimum of the total cost curve can be used to calculate an optimal long term interdiction limit. The calculation of such an optimal limit is presented for each of five US nuclear power plants which were analyzed for severe accident risk in the NUREG-1150 program by the Nuclear Regulatory Commission

  9. The high-risk HPV infection and urinary system tumor

    Directory of Open Access Journals (Sweden)

    Yang Wenyan

    2018-04-01

    Full Text Available HPV is classified into high-risk and low-risk types depending on its probability of leading to tumorigenesis. Many studies have shown that HPV infection, especially the infection caused by the high-risk type, is always related to prostate cancer, bladder cancer, penile cancer, testicular cancer, and other urinary system tumors. However, previous studies differed in sexual openness and racial genetic susceptibility of the study object, sample size, and experimental methods. Hence, the correlation between high-risk HPV infection and urinary system tumors remains controversial. The early open reading frame of the HPV genome is composed of E1–E7, among which E6 and E7 are the key transfer proteins. The combination of these proteins with oncogene and anti-oncogene may be one of the mechanisms leading to tumorigenesis.

  10. High-precision atmospheric parameter and abundance determination of massive stars, and consequences for stellar and Galactic evolution

    International Nuclear Information System (INIS)

    Nieva, Maria-Fernanda; Przybilla, Norbert; Irrgang, Andreas

    2011-01-01

    The derivation of high precision/accuracy parameters and chemical abundances of massive stars is of utmost importance to the fields of stellar evolution and Galactic chemical evolution. We concentrate on the study of OB-type stars near the main sequence and their evolved progeny, the BA-type supergiants, covering masses of ∼6 to 25 solar masses and a range in effective temperature from ∼8000 to 35 000 K. The minimization of the main sources of systematic errors in the atmospheric model computation, the observed spectra and the quantitative spectral analysis play a critical role in the final results. Our self-consistent spectrum analysis technique employing a robust non-LTE line formation allows precise atmospheric parameters of massive stars to be derived, achieving 1σ-uncertainties as low as 1% in effective temperature and ∼0.05–0.10 dex in surface gravity. Consequences on the behaviour of the chemical elements carbon, nitrogen and oxygen are discussed here in the context of massive star evolution and Galactic chemical evolution, showing tight relations covered in previous work by too large statistical and systematic uncertainties. The spectral analysis of larger star samples, like from the upcoming Gaia-ESO survey, may benefit from these findings.

  11. Diagnosis and Management of High Risk Group for Gastric Cancer

    Science.gov (United States)

    Yoon, Hyuk; Kim, Nayoung

    2015-01-01

    Gastric cancer is associated with high morbidity and mortality worldwide. To reduce the socioeconomic burden related to gastric cancer, it is very important to identify and manage high risk group for gastric cancer. In this review, we describe the general risk factors for gastric cancer and define high risk group for gastric cancer. We discuss strategies for the effective management of patients for the prevention and early detection of gastric cancer. Atrophic gastritis (AG) and intestinal metaplasia (IM) are the most significant risk factors for gastric cancer. Therefore, the accurate selection of individuals with AG and IM may be a key strategy for the prevention and/or early detection of gastric cancer. Although endoscopic evaluation using enhanced technologies such as narrow band imaging-magnification, the serum pepsinogen test, Helicobacter pylori serology, and trefoil factor 3 have been evaluated, a gold standard method to accurately select individuals with AG and IM has not emerged. In terms of managing patients at high risk of gastric cancer, it remains uncertain whether H. pylori eradication reverses and/or prevents the progression of AG and IM. Although endoscopic surveillance in high risk patients is expected to be beneficial, further prospective studies in large populations are needed to determine the optimal surveillance interval. PMID:25547086

  12. Management of Skin Cancer in the High-Risk Patient.

    Science.gov (United States)

    Behan, James W; Sutton, Adam; Wysong, Ashley

    2016-12-01

    Skin cancer is the most common of human cancers and outnumbers all other types of cancer combined in the USA by over threefold. The majority of non-melanoma skin cancers are easily treated with surgery or locally destructive techniques performed under local anesthesia in the cost-effective outpatient setting. However, there is a subset of "high-risk" cases that prove challenging in terms of morbidity, mortality, adjuvant treatment required, as well as overall cost to the health care system. In our opinion, the term "high risk" when applied to skin cancer can mean one of three things: a high-risk tumor with aggressive histologic and/or clinical features with an elevated risk for local recurrence or regional/distant metastasis, a high-risk patient with the ongoing development of multiple skin cancers, and a high-risk patient based on immunosuppression. We have recently proposed classifying NMSC as a chronic disease in a certain subset of patients. Although no consensus definition exists for a chronic disease in medicine, there are three components that are present in most definitions: duration of at least 1 year, need for ongoing medical care, and functional impairment and/or alteration of activities of daily living (ADLs) and quality of life (QOL). Immunosuppression can refer to exogenous (organ or stem cell transplant patients,) or endogenous (HIV, leukemia, lymphoma, genodermatoses with DNA mismatch repair problems or other immunosuppression) causes. These patients are at risk for high-risk tumors and/or the development of multiple tumors.

  13. Screening for Behavioral Risk: Identification of High Risk Cut Scores within the Social, Academic, and Emotional Behavior Risk Screener (SAEBRS)

    Science.gov (United States)

    Kilgus, Stephen P.; Taylor, Crystal N.; von der Embse, Nathaniel P.

    2018-01-01

    The purpose of this study was to support the identification of Social, Academic, and Emotional Behavior Risk Screener (SAEBRS) cut scores that could be used to detect high-risk students. Teachers rated students across two time points (Time 1 n = 1,242 students; Time 2 n = 704) using the SAEBRS and the Behavioral and Emotional Screening System…

  14. On risk, leverage and banks: do highly leveraged banks take on excessive risk?

    NARCIS (Netherlands)

    Koudstaal, M.; van Wijnbergen, S.

    2012-01-01

    This paper deals with the relation between excessive risk taking and capital structure in banks. Examining a quarterly dataset of U.S. banks between 1993 and 2010, we find that equity is valued higher when more risky portfolios are chosen when leverage is high, and that more risk taking has a

  15. Who Takes Risks in High-Risk Sports? A Typological Personality Approach

    Science.gov (United States)

    Castanier, Carole; Le Scanff, Christine; Woodman, Tim

    2010-01-01

    We investigated the risk-taking behaviors of 302 men involved in high-risk sports (downhill skiing, mountaineering, rock climbing, paragliding, or skydiving). The sportsmen were classified using a typological approach to personality based on eight personality types, which were constructed from combinations of neuroticism, extraversion, and…

  16. An evaluation of health risk to the public as a consequence of in situ uranium mining in Wyoming, USA.

    Science.gov (United States)

    Ruedig, Elizabeth; Johnson, Thomas E

    2015-12-01

    In the United States there is considerable public concern regarding the health effects of in situ recovery uranium mining. These concerns focus principally on exposure to contaminants mobilized in groundwater by the mining process. However, the risk arising as a result of mining must be viewed in light of the presence of naturally occurring uranium ore and other constituents which comprise a latent hazard. The United States Environmental Protection Agency recently proposed new guidelines for successful restoration of an in situ uranium mine by limiting concentrations of thirteen groundwater constituents: arsenic, barium, cadmium, chromium, lead, mercury, selenium, silver, nitrate (as nitrogen), molybdenum, radium, total uranium, and gross α activity. We investigated the changes occurring to these constituents at an ISR uranium mine in Wyoming, USA by comparing groundwater quality at baseline measurement to that at stability (post-restoration) testing. Of the groundwater constituents considered, only uranium and radium-226 showed significant (p < 0.05) deviation from site-wide baseline conditions in matched-wells. Uranium concentrations increased by a factor of 5.6 (95% CI 3.6-8.9 times greater) while radium-226 decreased by a factor of about one half (95% CI 0.42-0.75 times less). Change in risk was calculated using the RESRAD (onsite) code for an individual exposed as a resident-farmer; total radiation dose to a resident farmer decreased from pre-to post-mining by about 5.2 mSv y(-1). Higher concentrations of uranium correspond to increased biomarkers of nephrotoxicity, however the clinical significance of this increase is unclear. Published by Elsevier Ltd.

  17. Identification of the high risk emergency surgical patient: Which risk prediction model should be used?

    Directory of Open Access Journals (Sweden)

    Stephen Stonelake

    2015-09-01

    Conclusions: In the absence of accurate risk scoring tools that can be used on admission to hospital it is not possible to reliably audit the achievement of national standards of care for the ‘high-risk’ patient.

  18. The clinical profile of high-risk mentally disordered offenders.

    Science.gov (United States)

    Yiend, Jenny; Freestone, Mark; Vazquez-Montes, Maria; Holland, Josephine; Burns, Tom

    2013-07-01

    High-risk mentally disordered offenders present a diverse array of clinical characteristics. To contain and effectively treat this heterogeneous population requires a full understanding of the group's clinical profile. This study aimed to identify and validate clusters of clinically coherent profiles within one high-risk mentally disordered population in the UK. Latent class analysis (a statistical technique to identify clustering of variance from a set of categorical variables) was applied to 174 cases using clinical diagnostic information to identify the most parsimonious model of best fit. Validity analyses were performed. Three identified classes were a 'delinquent' group (n = 119) characterised by poor educational history, strong criminal careers and high recidivism risk; a 'primary psychopathy' group (n = 38) characterised by good educational profiles and homicide offences and an 'expressive psychopathy' group (n = 17) presenting the lowest risk and characterised by more special educational needs and sexual offences. Individuals classed as high-risk mentally disordered offenders can be loosely segregated into three discrete subtypes: 'delinquent', 'psychopathic' or 'expressive psychopathic', respectively. These groups represent different levels of risk to society and reflect differing treatment needs.

  19. The "polyenviromic risk score": Aggregating environmental risk factors predicts conversion to psychosis in familial high-risk subjects.

    Science.gov (United States)

    Padmanabhan, Jaya L; Shah, Jai L; Tandon, Neeraj; Keshavan, Matcheri S

    2017-03-01

    Young relatives of individuals with schizophrenia (i.e. youth at familial high-risk, FHR) are at increased risk of developing psychotic disorders, and show higher rates of psychiatric symptoms, cognitive and neurobiological abnormalities than non-relatives. It is not known whether overall exposure to environmental risk factors increases risk of conversion to psychosis in FHR subjects. Subjects consisted of a pilot longitudinal sample of 83 young FHR subjects. As a proof of principle, we examined whether an aggregate score of exposure to environmental risk factors, which we term a 'polyenviromic risk score' (PERS), could predict conversion to psychosis. The PERS combines known environmental risk factors including cannabis use, urbanicity, season of birth, paternal age, obstetric and perinatal complications, and various types of childhood adversity, each weighted by its odds ratio for association with psychosis in the literature. A higher PERS was significantly associated with conversion to psychosis in young, familial high-risk subjects (OR=1.97, p=0.009). A model combining the PERS and clinical predictors had a sensitivity of 27% and specificity of 96%. An aggregate index of environmental risk may help predict conversion to psychosis in FHR subjects. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Factors Influencing Cancer Risk Perception in High Risk Populations: A Systematic Review

    Science.gov (United States)

    2011-01-01

    Background Patients at higher than average risk of heritable cancer may process risk information differently than the general population. However, little is known about clinical, demographic, or psychosocial predictors that may impact risk perception in these groups. The objective of this study was to characterize factors associated with perceived risk of developing cancer in groups at high risk for cancer based on genetics or family history. Methods We searched Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, and Scopus from inception through April 2009 for English-language, original investigations in humans using core concepts of "risk" and "cancer." We abstracted key information and then further restricted articles dealing with perceived risk of developing cancer due to inherited risk. Results Of 1028 titles identified, 53 articles met our criteria. Most (92%) used an observational design and focused on women (70%) with a family history of or contemplating genetic testing for breast cancer. Of the 53 studies, 36 focused on patients who had not had genetic testing for cancer risk, 17 included studies of patients who had undergone genetic testing for cancer risk. Family history of cancer, previous prophylactic tests and treatments, and younger age were associated with cancer risk perception. In addition, beliefs about the preventability and severity of cancer, personality factors such as "monitoring" personality, the ability to process numerical information, as well as distress/worry also were associated with cancer risk perception. Few studies addressed non-breast cancer or risk perception in specific demographic groups (e.g. elderly or minority groups) and few employed theory-driven analytic strategies to decipher interrelationships of factors. Conclusions Several factors influence cancer risk perception in patients at elevated risk for cancer. The science of characterizing and improving risk perception in cancer for high risk groups, although evolving, is still

  1. Factors Influencing Cancer Risk Perception in High Risk Populations: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Tilburt Jon C

    2011-05-01

    Full Text Available Abstract Background Patients at higher than average risk of heritable cancer may process risk information differently than the general population. However, little is known about clinical, demographic, or psychosocial predictors that may impact risk perception in these groups. The objective of this study was to characterize factors associated with perceived risk of developing cancer in groups at high risk for cancer based on genetics or family history. Methods We searched Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, and Scopus from inception through April 2009 for English-language, original investigations in humans using core concepts of "risk" and "cancer." We abstracted key information and then further restricted articles dealing with perceived risk of developing cancer due to inherited risk. Results Of 1028 titles identified, 53 articles met our criteria. Most (92% used an observational design and focused on women (70% with a family history of or contemplating genetic testing for breast cancer. Of the 53 studies, 36 focused on patients who had not had genetic testing for cancer risk, 17 included studies of patients who had undergone genetic testing for cancer risk. Family history of cancer, previous prophylactic tests and treatments, and younger age were associated with cancer risk perception. In addition, beliefs about the preventability and severity of cancer, personality factors such as "monitoring" personality, the ability to process numerical information, as well as distress/worry also were associated with cancer risk perception. Few studies addressed non-breast cancer or risk perception in specific demographic groups (e.g. elderly or minority groups and few employed theory-driven analytic strategies to decipher interrelationships of factors. Conclusions Several factors influence cancer risk perception in patients at elevated risk for cancer. The science of characterizing and improving risk perception in cancer for high risk groups, although

  2. Psychological characteristics in high-risk MSM in China

    Directory of Open Access Journals (Sweden)

    Chen Guanzhi

    2012-01-01

    Full Text Available Abstract Background Men who have sex with men (MSM have become a high-risk group of HIV infection in China. To date, little is known regarding the behavioral, social and psychological characteristics in Chinese MSM, which makes the implementation of preventive and therapeutic strategies for this high-risk subpopulation of people extremely difficult. Methods A total of 714 questionnaires were retrieved from the database of a Chinese government-sponsored National Key Research Project titled "Risk Analysis and Strategic Prevention of HIV Transmission from MSM to the General Population in China". The respondents were categorized into a high-risk group and a control group. Their behavioral, social and psychological characteristics were comparatively analyzed. Results Of the 714 MSM analyzed, 59 (8.26% had high-risk homosexual behaviors. This sub-group of MSM had a higher in-marriage rate, a higher monthly income, heavier alcohol consumption and more serious problems with sexual abuse in childhood, intentional suicide attempts and mistaken assumption on condom's role in protecting HIV infection, as compared with the control group (P P > 0.05. A vast majority of the individuals in both behavior categories expressed support of legally protected gay clubs as well as gay marriage legislation in China. There was a strong correlation between high-risk behaviors and sexual abuse in childhood, alcohol drinking, income level and a mistaken belief in perfect HIV protection through the use of condoms. Conclusions MSM with and without high-risk homosexual behaviors have different social and psychological characteristics, which should be taken into account when implementing behavioral and therapeutic interventions aimed at preventing HIV/AIDS transmission among MSM as well as from MSM to the general population in China.

  3. Telomerase activation by genomic rearrangements in high-risk neuroblastoma

    Science.gov (United States)

    Peifer, Martin; Hertwig, Falk; Roels, Frederik; Dreidax, Daniel; Gartlgruber, Moritz; Menon, Roopika; Krämer, Andrea; Roncaioli, Justin L.; Sand, Frederik; Heuckmann, Johannes M.; Ikram, Fakhera; Schmidt, Rene; Ackermann, Sandra; Engesser, Anne; Kahlert, Yvonne; Vogel, Wenzel; Altmüller, Janine; Nürnberg, Peter; Thierry-Mieg, Jean; Thierry-Mieg, Danielle; Mariappan, Aruljothi; Heynck, Stefanie; Mariotti, Erika; Henrich, Kai-Oliver; Glöckner, Christian; Bosco, Graziella; Leuschner, Ivo; Schweiger, Michal R.; Savelyeva, Larissa; Watkins, Simon C.; Shao, Chunxuan; Bell, Emma; Höfer, Thomas; Achter, Viktor; Lang, Ulrich; Theissen, Jessica; Volland, Ruth; Saadati, Maral; Eggert, Angelika; de Wilde, Bram; Berthold, Frank; Peng, Zhiyu; Zhao, Chen; Shi, Leming; Ortmann, Monika; Büttner, Reinhard; Perner, Sven; Hero, Barbara; Schramm, Alexander; Schulte, Johannes H.; Herrmann, Carl; O’Sullivan, Roderick J.; Westermann, Frank; Thomas, Roman K.; Fischer, Matthias

    2016-01-01

    Neuroblastoma is a malignant paediatric tumour of the sympathetic nervous system1. Roughly half of these tumours regress spontaneously or are cured by limited therapy. By contrast, high-risk neuroblastomas have an unfavourable clinical course despite intensive multimodal treatment, and their molecular basis has remained largely elusive2–4. Here we have performed whole-genome sequencing of 56 neuroblastomas (high-risk, n = 39; low-risk, n = 17) and discovered recurrent genomic rearrangements affecting a chromosomal region at 5p15.33 proximal of the telomerase reverse transcriptase gene (TERT). These rearrangements occurred only in high-risk neuroblastomas (12/39, 31%) in a mutually exclusive fashion with MYCN amplifications and ATRX mutations, which are known genetic events in this tumour type1,2,5. In an extended case series (n = 217), TERT rearrangements defined a subgroup of high-risk tumours with particularly poor outcome. Despite a large structural diversity of these rearrangements, they all induced massive transcriptional upregulation of TERT. In the remaining high-risk tumours, TERT expression was also elevated in MYCN-amplified tumours, whereas alternative lengthening of telomeres was present in neuroblastomas without TERT or MYCN alterations, suggesting that telomere lengthening represents a central mechanism defining this subtype. The 5p15.33 rearrangements juxtapose the TERT coding sequence to strong enhancer elements, resulting in massive chromatin remodelling and DNA methylation of the affected region. Supporting a functional role of TERT, neuroblastoma cell lines bearing rearrangements or amplified MYCN exhibited both upregulated TERT expression and enzymatic telomerase activity. In summary, our findings show that remodelling of the genomic context abrogates transcriptional silencing of TERT in high-risk neuroblastoma and places telomerase activation in the centre of transformation in a large fraction of these tumours. PMID:26466568

  4. Upstream Structural Management Measures for an Urban Area Flooding in Turkey and their Consequences on Flood Risk Management

    Science.gov (United States)

    Akyurek, Z.; Bozoglu, B.; Girayhan, T.

    2015-12-01

    Flooding has the potential to cause significant impacts to economic activities as well as to disrupt or displace populations. Changing climate regimes such as extreme precipitation events increase flood vulnerability and put additional stresses on infrastructure. In this study the flood modelling in an urbanized area, namely Samsun-Terme in Blacksea region of Turkey is done. MIKE21 with flexible grid is used in 2- dimensional shallow water flow modelling. 1/1000 scaled maps with the buildings for the urbanized area and 1/5000 scaled maps for the rural parts are used to obtain DTM needed in the flood modelling. The bathymetry of the river is obtained from additional surveys. The main river passing through the urbanized area has a capacity of Q5 according to the design discharge obtained by simple ungauged discharge estimation depending on catchment area only. The effects of the available structures like bridges across the river on the flooding are presented. The upstream structural measures are studied on scenario basis. Four sub-catchments of Terme River are considered as contributing the downstream flooding. The existing circumstance of the Terme River states that the meanders of the river have a major effect on the flood situation and lead to approximately 35% reduction in the peak discharge between upstream and downstream of the river. It is observed that if the flow from the upstream catchments can be retarded through a detention pond constructed in at least two of the upstream catchments, estimated Q100 flood can be conveyed by the river without overtopping from the river channel. The operation of the upstream detention ponds and the scenarios to convey Q500 without causing flooding are also presented. Structural management measures to address changes in flood characteristics in water management planning are discussed. Flood risk is obtained by using the flood hazard maps and water depth-damage functions plotted for a variety of building types and occupancies

  5. Toward a risk assessment of the spent fuel and high-level nuclear waste disposal system. Risk assessment requirements, literature review, methods evaluation: an interim report

    International Nuclear Information System (INIS)

    Hamilton, L.D.; Hill, D.; Rowe, M.D.; Stern, E.

    1986-04-01

    This report provides background information for a risk assessment of the disposal system for spent nuclear fuel and high-level radioactive waste (HLW). It contains a literature review, a survey of the statutory requirements for risk assessment, and a preliminary evaluation of methods. The literature review outlines the state of knowledge of risk assessment and accident consequence analysis in the nuclear fuel cycle and its applicability to spent fuel and HLW disposal. The survey of statutory requirements determines the extent to which risk assessment may be needed in development of the waste-disposal system. The evaluation of methods reviews and evaluates merits and applicabilities of alternative methods for assessing risks and relates them to the problems of spent fuel and HLW disposal. 99 refs

  6. Toward a risk assessment of the spent fuel and high-level nuclear waste disposal system. Risk assessment requirements, literature review, methods evaluation: an interim report

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, L.D.; Hill, D.; Rowe, M.D.; Stern, E.

    1986-04-01

    This report provides background information for a risk assessment of the disposal system for spent nuclear fuel and high-level radioactive waste (HLW). It contains a literature review, a survey of the statutory requirements for risk assessment, and a preliminary evaluation of methods. The literature review outlines the state of knowledge of risk assessment and accident consequence analysis in the nuclear fuel cycle and its applicability to spent fuel and HLW disposal. The survey of statutory requirements determines the extent to which risk assessment may be needed in development of the waste-disposal system. The evaluation of methods reviews and evaluates merits and applicabilities of alternative methods for assessing risks and relates them to the problems of spent fuel and HLW disposal. 99 refs.

  7. Dissimilar association of conventional immune-reactive versus specific insulin with cardiovascular risk factors: a consequence of proinsulinaemia?

    NARCIS (Netherlands)

    Grootenhuis, P.A.; Mooy, J.M.; Kostense, P.J.; Popp-Snijders, C.; Bouter, L.M.; Heine, R.J.

    1998-01-01

    In this study involving 365 non-diabetic elderly Caucasians, we examined the relationship of immuno-specific insulin (ISI), total immuno-reactive insulin (IRI), proinsulin (PI) and proinsulin-insulin ratio (PI:ISI) to serum high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), systolic

  8. Dissimilar association of conventional immuno-reactive versus specific insulin with cardiovascular risk factors : a consequence of proinsulinaemia?

    NARCIS (Netherlands)

    Grootenhuis, P A; Mooy, J M; Kostense, P J; Popp-Snijders, C; Bouter, L M; Heine, R J

    In this study involving 365 non-diabetic elderly Caucasians, we examined the relationship of immuno-specific insulin (ISI), total immuno-reactive insulin (IRI), proinsulin (PI) and proinsulin-insulin ratio (PI:ISI) to serum high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), systolic

  9. A multi-region approach to assessing fiscal and farm level consequences of government support for farm risk management

    Directory of Open Access Journals (Sweden)

    Joseph Cooper

    2014-12-01

    Full Text Available The 2014 U.S. Farm Act has new programs for providing producers with commodity support payments covering “shallow losses” in revenue. We develop an approach to examine the sensitivity of the farmer’s downside risk protection to marginal changes in the deductible in shallow loss program scenarios. The copula approach we use simultaneously considers price and yield correlation across all U.S. counties producing several major field crops. We find that average payments under the shallow loss program scenarios are elastic with respect to the program’s payment coverage rate. To empirically assess where shallow loss is likely to most benefit producers, we map at the county level the ratios of expected shallow loss payments to crop insurance premiums for corn, soybeans, cotton, and winter wheat. As tail dependencies among individual crop yield densities may vary spatially, we propose a method for grouping counties in a t-copula that allows for heterogeneity in tail dependencies.

  10. MALDI-TOF mass spectrometry and high-consequence bacteria: safety and stability of biothreat bacterial sample testing in clinical diagnostic laboratories.

    Science.gov (United States)

    Tracz, Dobryan M; Tober, Ashley D; Antonation, Kym S; Corbett, Cindi R

    2018-03-01

    We considered the application of MALDI-TOF mass spectrometry for BSL-3 bacterial diagnostics, with a focus on the biosafety of live-culture direct-colony testing and the stability of stored extracts. Biosafety level 2 (BSL-2) bacterial species were used as surrogates for BSL-3 high-consequence pathogens in all live-culture MALDI-TOF experiments. Viable BSL-2 bacteria were isolated from MALDI-TOF mass spectrometry target plates after 'direct-colony' and 'on-plate' extraction testing, suggesting that the matrix chemicals alone cannot be considered sufficient to inactivate bacterial culture and spores in all samples. Sampling of the instrument interior after direct-colony analysis did not recover viable organisms, suggesting that any potential risks to the laboratory technician are associated with preparation of the MALDI-TOF target plate before or after testing. Secondly, a long-term stability study (3 years) of stored MALDI-TOF extracts showed that match scores can decrease below the threshold for reliable species identification (<1.7), which has implications for proficiency test panel item storage and distribution.

  11. High porosity harzburgite and dunite channels for the transport of compositionally heterogeneous melts in the mantle: II. Geochemical consequences

    Science.gov (United States)

    Liang, Y.; Schiemenz, A.; Xia, Y.; Parmentier, E.

    2009-12-01

    In a companion numerical study [1], we explored the spatial distribution of high porosity harzburgite and dunite channels produced by reactive dissolution of orthopyroxene (opx) in an upwelling mantle column and identified a number of new features. In this study, we examine the geochemical consequences of channelized melt flow under the settings outlined in [1] with special attention to the transport of compositionally heterogeneous melts and their interactions with the surrounding peridotite matrix during melt migration in the mantle. Time-dependent transport equations for a trace element in the interstitial melt and solids that include advection, dispersion, and melt-rock reaction were solved in a 2-D upwelling column using the high-order numerical methods outlined in [1]. The melt and solid velocities were taken from the steady state or quasi-steady state solutions of [1]. In terms of trace element fractionation, the simulation domain can be divided into 4 distinct regions: (a) high porosity harzburgite channel, overlain by; (b) high porosity dunite channel; (c) low porosity compacting boundary layer surrounding the melt channels; and (d) inter-channel regions outside (c). In the limit of local chemical equilibrium, melting in region (d) is equivalent to batch melting, whereas melting and melt extraction in (c) is more close to fractional melting with the melt suction rate first increase from the bottom of the melting column to a maximum near the bottom of the dunite channel and then decrease upward in the compacting boundary layer. The melt composition in the high porosity harzburgite channel is similar to that produced by high-degree batch melting (up to opx exhaustion), whereas the melt composition in the dunite is a weighted average of the ultra-depleted melt from the harzburgite channel below, the expelled melt from the compacting boundary layer, and melt produced by opx dissolution along the sidewalls of the dunite channel. Compaction within the dunite

  12. Screening for Hypoglycemia in Exclusively Breastfed High-risk Neonates.

    Science.gov (United States)

    Singh, Princy; Upadhyay, Amit; Sreenivas, Vishnubhatla; Jaiswal, Vijay; Saxena, Pranjali

    2017-06-15

    To determine incidence of hypoglycemia in exclusively breastfed, high-risk but healthy newborns, and risk factors for its development. This observational study enrolled 407 exclusively breastfed high-risk (low birth weight newborns (1800-2499 g), late preterms, small-for-gestation, large-for-gestation and infant of diabetic mother), who did not require admission to neonatal intensive care unit and were kept in postnatal wards with mother. Hypoglycemia was defined as blood glucose £46 mg/dL (2.6 mmol/L). Blood glucose was monitored till 48 hours of life. 27% of the screened newborns developed hypoglycemia in first 48 hours. 31 (7.6%) developed recurrent (>2) episodes, 28 (6.8%) had moderate (<37mg/dL) while 8 (1.9%) developed symptomatic hypoglycemia. With increase in birthweight, risk of hypoglycemia reduced significantly (P=0.003). Hypoglycemia was observed more frequently in first 2 hours as compared to next 48 hours (P=0.0001). Low birth- weight, preterm gestation and male gender was significantly associated with increased risk of hypoglycemia. Healthy, high-risk exclusively breastfed newborns in postnatal wards need close monitoring for hypoglycemia in first 24 hrs of life.

  13. FDA publishes checklist of Y2K high-risk devices.

    Science.gov (United States)

    1999-09-01

    Key points. The federal Food and Drug Administration (FDA) has developed a list of types of medical devices that have the potential for the most serious consequences for patients should they fail because of Y2K-related problems. This list of computer-controlled potentially high-risk devices can provide a guide to health care facilities regarding the types of devices that should receive priority in their assessment and remediation of medical devices. The list may change as the FDA receives comments on the types of devices included in the list.

  14. Determinants of participation in a web-based health risk assessment and consequences for health promotion programs.

    Science.gov (United States)

    Niessen, Maurice A J; Laan, Eva L; Robroek, Suzan J W; Essink-Bot, Marie-Louise; Peek, Niels; Kraaijenhagen, Roderik A; Van Kalken, Coen K; Burdorf, Alex

    2013-08-09

    The health risk assessment (HRA) is a type of health promotion program frequently offered at the workplace. Insight into the underlying determinants of participation is needed to evaluate and implement these interventions. To analyze whether individual characteristics including demographics, health behavior, self-rated health, and work-related factors are associated with participation and nonparticipation in a Web-based HRA. Determinants of participation and nonparticipation were investigated in a cross-sectional study among individuals employed at five Dutch organizations. Multivariate logistic regression was performed to identify determinants of participation and nonparticipation in the HRA after controlling for organization and all other variables. Of the 8431 employees who were invited, 31.9% (2686/8431) enrolled in the HRA. The online questionnaire was completed by 27.2% (1564/5745) of the nonparticipants. Determinants of participation were some periods of stress at home or work in the preceding year (OR 1.62, 95% CI 1.08-2.42), a decreasing number of weekdays on which at least 30 minutes were spent on moderate to vigorous physical activity (OR(dayPA)0.84, 95% CI 0.79-0.90), and increasing alcohol consumption. Determinants of nonparticipation were less-than-positive self-rated health (poor/very poor vs very good, OR 0.25, 95% CI 0.08-0.81) and tobacco use (at least weekly vs none, OR 0.65, 95% CI 0.46-0.90). This study showed that with regard to isolated health behaviors (insufficient physical activity, excess alcohol consumption, and stress), those who could benefit most from the HRA were more likely to participate. However, tobacco users and those who rated their overall health as less than positive were less likely to participate. A strong communication strategy, with recruitment messages that take reasons for nonparticipation into account, could prove to be an essential tool for organizations trying to reach employees who are less likely to participate.

  15. Applying the lessons of high risk industries to health care.

    Science.gov (United States)

    Hudson, P

    2003-12-01

    High risk industries such as commercial aviation and the oil and gas industry have achieved exemplary safety performance. This paper reviews how they have managed to do that. The primary reasons are the positive attitudes towards safety and the operation of effective formal safety management systems. The safety culture provides an important explanation of why such organisations perform well. An evolutionary model of safety culture is provided in which there is a range of cultures from the pathological through the reactive to the calculative. Later, the proactive culture can evolve towards the generative organisation, an alternative description of the high reliability organisation. The current status of health care is reviewed, arguing that it has a much higher level of accidents and has a reactive culture, lagging behind both high risk industries studied in both attitude and systematic management of patient risks.

  16. Radical prostatectomy in clinically localized high-risk prostate cancer

    DEFF Research Database (Denmark)

    Røder, Martin Andreas; Berg, Kasper Drimer; Christensen, Ib Jarle

    2013-01-01

    ) is regarded as primary therapy by others. This study examined the outcome for high-risk localized PCa patients treated with RP. Material and methods. Of 1300 patients who underwent RP, 231 were identified as high-risk. Patients were followed for biochemical recurrence (BCR) (defined as prostate-specific......Abstract Objective. The optimal therapeutic strategy for high-risk localized prostate cancer (PCa) is controversial. Supported by randomized trials, the combination of external beam radiation therapy (EBRT) and endocrine therapy (ET) is advocated by many, while radical prostatectomy (RP...... antigen ≥ 0.2 ng/ml), metastatic disease and survival. Excluding node-positive patients, none of the patients received adjuvant therapy before BCR was confirmed. Univariate and multivariate analysis was performed with Kaplan-Meier and Cox proportional hazard models. Results. Median follow-up was 4.4 years...

  17. The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations

    Science.gov (United States)

    Fazel, Seena; Geddes, John R; Kushel, Margot

    2015-01-01

    In the European Union, more than 400 000 individuals are homeless on any one night and more than 600 000 are homeless in the USA. The causes of homelessness are an interaction between individual and structural factors. Individual factors include poverty, family problems, and mental health and substance misuse problems. The availability of low-cost housing is thought to be the most important structural determinant for homelessness. Homeless people have higher rates of premature mortality than the rest of the population, especially from suicide and unintentional injuries, and an increased prevalence of a range of infectious diseases, mental disorders, and substance misuse. High rates of non-communicable diseases have also been described with evidence of accelerated ageing. Although engagement with health services and adherence to treatments is often compromised, homeless people typically attend the emergency department more often than non-homeless people. We discuss several recommendations to improve the surveillance of morbidity and mortality in homeless people. Programmes focused on high-risk groups, such as individuals leaving prisons, psychiatric hospitals, and the child welfare system, and the introduction of national and state-wide plans that target homeless people are likely to improve outcomes. PMID:25390578

  18. High-Risk Stress Fractures: Diagnosis and Management.

    Science.gov (United States)

    McInnis, Kelly C; Ramey, Lindsay N

    2016-03-01

    Stress fractures are common overuse injuries in athletes. They occur during periods of increased training without adequate rest, disrupting normal bone reparative mechanisms. There are a host of intrinsic and extrinsic factors, including biochemical and biomechanical, that put athletes at risk. In most stress fractures, the diagnosis is primarily clinical, with imaging indicated at times, and management focused on symptom-free relative rest with advancement of activity as tolerated. Overall, stress fractures in athletes have an excellent prognosis for return to sport, with little risk of complication. There is a subset of injuries that have a greater risk of fracture progression, delayed healing, and nonunion and are generally more challenging to treat with nonoperative care. Specific locations of high-risk stress fracture include the femoral neck (tension side), patella, anterior tibia, medial malleolus, talus, tarsal navicular, proximal fifth metatarsal, and great toe sesamoids. These sites share a characteristic region of high tensile load and low blood flow. High-risk stress fractures require a more aggressive approach to evaluation, with imaging often necessary, to confirm early and accurate diagnosis and initiate immediate treatment. Treatment consists of nonweight-bearing immobilization, often with a prolonged period away from sport, and a more methodic and careful reintroduction to athletic activity. These stress fractures may require surgical intervention. A high index of suspicion is essential to avoid delayed diagnosis and optimize outcomes in this subset of stress fractures. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  19. Risks and injuries in laser and high-frequency applications

    Science.gov (United States)

    Giering, K.; Philipp, Carsten M.; Berlien, Hans-Peter

    1995-01-01

    An analysis of injuries and risks using high frequency (HF) and lasers in medicine based on a literature search with MEDLINE was performed. The cases reported in the literature were classified according to the following criteria: (1) Avoidable in an optimal operational procedure. These kind of injuries are caused by a chain of unfortunate incidents. They are in principle avoidable by the 'right action at the right time' which presupposes an appropriate training of the operating team, selection of the optimal parameters for procedure and consideration of all safety instructions. (2) Avoidable, caused by malfunction of the equipment and/or accessories. The injuries classified into this group are avoidable if all safety regulations were fulfilled. This includes a pre-operational check-up and the use of medical lasers and high frequency devices only which meet the international safety standards. (3) Avoidable, caused by misuse/mistake. Injuries of this group were caused by an inappropriate selection of the procedure, wrong medical indication or mistakes during application. (4) Unavoidable, fateful. These injuries can be caused by risks inherent to the type of energy used, malfunction of the equipment and/or accessories though a pre-operational check-up was done. Some risks and complications are common to high frequency and laser application. But whereas these risks can be excluded easily in laser surgery there is often a great expenditure necessary or they are not avoidable if high frequency if used. No unavoidable risks due to laser energy occur.

  20. AIDS Risk Perception and its related factors in Women with High-Risk Behaviors in Iran

    Directory of Open Access Journals (Sweden)

    Mahin Tafazoli

    2016-02-01

    Full Text Available Background & aim: AIDS is one of the major public health challenges all over the world. Perceived risk is a significant predictor of high-risk behaviors related to AIDS. Women constitute more than half of the HIV patients, and the rate of female sex workers with AIDS is more than the rest of female population. Therefore, the present study aimed to evaluate AIDS risk perception and its related factors in females with high-risk behaviors in Mashhad, Iran. Methods:This descriptive study was performed on 58 women who were arrested on prostitution charges and imprisoned in Mashhad Vakil Abad Prison in 2013. The data were collected using self-designed questionnaires assessing knowledge regarding AIDS as well as sexual activities and also perceived risk of HIV questionnaire. One-way ANOVA, independent samples t-test, linear regression, and Chi-square tests were run, using SPSS version 16. Results: The mean score of HIV risk perception was 18.43±5.92, which was average. There was a significant relationship between the mean score of perceived risk of HIV and knowledge regarding AIDS (P=0.005, alcohol consumption (P=0.04, history of addiction (P=0.008, using contraceptive methods (P=0.01, condom use during intercourse (P=0.02, voluntary HIV testing (P=0.001, and follow-up of HIV test (P=0.009. Conclusion:The findings of the present study revealed that knowledge, alcohol consumption, history of addiction, contraceptive methods, the rate of condom use during intercourse, as well as voluntary HIV testing and follow-up were associated with perceived risk of HIV infection. Therefore, taking the necessary steps towards health promotion through appropriate training and interventional approaches seems to be mandatory for reducing high-risk behaviors in populations with low risk perception.

  1. [What do we know about psychosocial risks at work? Part II.The analysis of employee's knowledge of sources and consequences of stress at work].

    Science.gov (United States)

    Potocka, Adrianna; Merecz-Kot, Dorota

    2010-01-01

    Psychosocial risks at work are the challenge facing the occupational health and safety protection. They are seen as a threat to the employees' health and functioning. They also contribute to negative outcomes in the organizations. The study was focused on the assessment of employees' knowledge of occupational stressors, their consequences and preventive measures. The assessment results will help in the development of an educational program aimed at increasing awareness of occupational stress among employees. 210 employees participated in the study. By the mean of survey "Psychosocial Risks at Work-place" the information on the respondents' knowledge of occupational stress issues was collected. Stressors intrinsic to the job (mostly work overload) were recognized as best known to employees (67.62%). The second place was occupied by stressors originating from interpersonal relationships at work (51.9% of respondents pointed out that problem). Almost no one (0.48%) mentioned home-work interference as a source of occupational stress. According to the respondents' opinion, occupational stress mostly results in health decline. The employees who participated in the study believe that the employer (13.81%) or the superior (19.05%) is responsible for psychosocial risks prevention at the work place. Almost a half of subjects (46.67%) did not know whether there are any law regulations on psychosocial risk at work in Poland. The respondents showed an average level of knowledge of psychosocial risk at the work place and knew almost nothing about occupational stress prevention. The results of the study point to the need for systematic education of employees about stress and stress related issues.

  2. InSAR deformation monitoring of high risk landslides

    Science.gov (United States)

    Singhroy, V.; Li, J.

    2013-05-01

    During the past year there were at least twenty five media reports of landslides and seismic activities some fatal, occurring in various areas in Canada. These high risk geohazards sites requires high resolution monitoring both spatially and temporally for mitigation purposes, since they are near populated areas and energy, transportation and communication corridors. High resolution air photos, lidar and satellite images are quite common in areas where the landslides can be fatal. Radar interferometry (InSAR) techniques using images from several radar satellites are increasingly being used in slope stability assessment. This presentation provides examples of using high-resolution (1-3m) frequent revisits InSAR techniques from RADARSAT 2 and TerraSAR X to monitor several types of high-risk landslides affecting transportation and energy corridors and populated areas. We have analyses over 200 high resolution InSAR images over a three year period on geologically different landslides. The high-resolution InSAR images are effective in characterizing differential motion within these low velocity landslides. The low velocity landslides become high risk during the active wet spring periods. The wet soils are poor coherent targets and corner reflectors provide an effective means of InSAR monitoring the slope activities.

  3. Relationship between Background Parenchymal Enhancement on High-risk Screening MRI and Future Breast Cancer Risk.

    Science.gov (United States)

    Grimm, Lars J; Saha, Ashirbani; Ghate, Sujata V; Kim, Connie; Soo, Mary Scott; Yoon, Sora C; Mazurowski, Maciej A

    2018-03-27

    To determine if background parenchymal enhancement (BPE) on screening breast magnetic resonance imaging (MRI) in high-risk women correlates with future cancer. All screening breast MRIs (n = 1039) in high-risk women at our institution from August 1, 2004, to July 30, 2013, were identified. Sixty-one patients who subsequently developed breast cancer were matched 1:2 by age and high-risk indication with patients who did not develop breast cancer (n = 122). Five fellowship-trained breast radiologists independently recorded the BPE. The median reader BPE for each case was calculated and compared between the cancer and control cohorts. Cancer cohort patients were high-risk because of a history of radiation therapy (10%, 6 of 61), high-risk lesion (18%, 11 of 61), or breast cancer (30%, 18 of 61); BRCA mutation (18%, 11 of 61); or family history (25%, 15 of 61). Subsequent malignancies were invasive ductal carcinoma (64%, 39 of 61), ductal carcinoma in situ (30%, 18 of 61) and invasive lobular carcinoma (7%, 4of 61). BPE was significantly higher in the cancer cohort than in the control cohort (P = 0.01). Women with mild, moderate, or marked BPE were 2.5 times more likely to develop breast cancer than women with minimal BPE (odds ratio = 2.5, 95% confidence interval: 1.3-4.8, P = .005). There was fair interreader agreement (κ = 0.39). High-risk women with greater than minimal BPE at screening MRI have increased risk of future breast cancer. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  4. Endometriosis: a high-risk population for major chronic diseases?

    Science.gov (United States)

    Kvaskoff, Marina; Mu, Fan; Terry, Kathryn L.; Harris, Holly R.; Poole, Elizabeth M.; Farland, Leslie; Missmer, Stacey A.

    2015-01-01

    BACKGROUND Despite an estimated prevalence of 10% in women, the etiology of endometriosis remains poorly understood. Over recent decades, endometriosis has been associated with risk of several chronic diseases, such as cancer, autoimmune diseases, asthma/atopic diseases and cardiovascular diseases. A deeper understanding of these associations is needed as they may provide new leads into the causes or consequences of endometriosis. This review summarizes the available epidemiological findings on the associations between endometriosis and other chronic diseases and discusses hypotheses for underlying mechanisms, potential sources of bias and methodological complexities. METHODS We performed a comprehensive search of the PubMed/Medline and ISI Web of Knowledge databases for all studies reporting on the associations between endometriosis and other diseases published in English through to May 2014, using numerous search terms. We additionally examined the reference lists of all identified papers to capture any additional articles that were not identified through computer searches. RESULTS We identified 21 studies on the associations between endometriosis and ovarian cancer, 14 for breast cancer, 8 for endometrial cancer, 4 for cervical cancer, 12 for cutaneous melanoma and 3 for non-Hodgkin's lymphoma, as well as 9 on the links between endometriosis and autoimmune diseases, 6 on the links with asthma and atopic diseases, and 4 on the links with cardiovascular diseases. Endometriosis patients were reported to be at higher risk of ovarian and breast cancers, cutaneous melanoma, asthma, and some autoimmune, cardiovascular and atopic diseases, and at decreased risk of cervical cancer. CONCLUSIONS Increasing evidence suggests that endometriosis patients are at higher risk of several chronic diseases. Although the underlying mechanisms are not yet understood, the available data to date suggest that endometriosis is not harmless with respects to women's long-term health. If

  5. High-Altitude Illnesses: Physiology, Risk Factors, Prevention, and Treatment

    Directory of Open Access Journals (Sweden)

    Andrew T. Taylor

    2011-01-01

    Full Text Available High-altitude illnesses encompass the pulmonary and cerebral syndromes that occur in non-acclimatized individuals after rapid ascent to high altitude. The most common syndrome is acute mountain sickness (AMS which usually begins within a few hours of ascent and typically consists of headache variably accompanied by loss of appetite, nausea, vomiting, disturbed sleep, fatigue, and dizziness. With millions of travelers journeying to high altitudes every year and sleeping above 2,500 m, acute mountain sickness is a wide-spread clinical condition. Risk factors include home elevation, maximum altitude, sleeping altitude, rate of ascent, latitude, age, gender, physical condition, intensity of exercise, pre-acclimatization, genetic make-up, and pre-existing diseases. At higher altitudes, sleep disturbances may become more profound, mental performance is impaired, and weight loss may occur. If ascent is rapid, acetazolamide can reduce the risk of developing AMS, although a number of high-altitude travelers taking acetazolamide will still develop symptoms. Ibuprofen can be effective for headache. Symptoms can be rapidly relieved by descent, and descent is mandatory, if at all possible, for the management of the potentially fatal syndromes of high-altitude pulmonary and cerebral edema. The purpose of this review is to combine a discussion of specific risk factors, prevention, and treatment options with a summary of the basic physiologic responses to the hypoxia of altitude to provide a context for managing high-altitude illnesses and advising the non-acclimatized high-altitude traveler.

  6. Value at Risk and Hedge Fund Return - Does High Risk Bring High Return?

    OpenAIRE

    Jing, Tao; Zhao, Hongxiang

    2010-01-01

    This paper mainly focuses on the correlation between live hedge fund return and their value at risk (VaR), and is based on the historical data from May 2000 to April 2010. The authors adopt portfolio level analyses and fund level cross-sectional regression, and find that there is significant positive correlation, both statistically and economically, between the hedge fund return and VaRs (parametric, non-parametric and GARCH). Further research is conducted by sub-dividing the overall period i...

  7. Mining geriatric assessment data for in-patient fall prediction models and high-risk subgroups.

    Science.gov (United States)

    Marschollek, Michael; Gövercin, Mehmet; Rust, Stefan; Gietzelt, Matthias; Schulze, Mareike; Wolf, Klaus-Hendrik; Steinhagen-Thiessen, Elisabeth

    2012-03-14

    Hospital in-patient falls constitute a prominent problem in terms of costs and consequences. Geriatric institutions are most often affected, and common screening tools cannot predict in-patient falls consistently. Our objectives are to derive comprehensible fall risk classification models from a large data set of geriatric in-patients' assessment data and to evaluate their predictive performance (aim#1), and to identify high-risk subgroups from the data (aim#2). A data set of n = 5,176 single in-patient episodes covering 1.5 years of admissions to a geriatric hospital were extracted from the hospital's data base and matched with fall incident reports (n = 493). A classification tree model was induced using the C4.5 algorithm as well as a logistic regression model, and their predictive performance was evaluated. Furthermore, high-risk subgroups were identified from extracted classification rules with a support of more than 100 instances. The classification tree model showed an overall classification accuracy of 66%, with a sensitivity of 55.4%, a specificity of 67.1%, positive and negative predictive values of 15% resp. 93.5%. Five high-risk groups were identified, defined by high age, low Barthel index, cognitive impairment, multi-medication and co-morbidity. Our results show that a little more than half of the fallers may be identified correctly by our model, but the positive predictive value is too low to be applicable. Non-fallers, on the other hand, may be sorted out with the model quite well. The high-risk subgroups and the risk factors identified (age, low ADL score, cognitive impairment, institutionalization, polypharmacy and co-morbidity) reflect domain knowledge and may be used to screen certain subgroups of patients with a high risk of falling. Classification models derived from a large data set using data mining methods can compete with current dedicated fall risk screening tools, yet lack diagnostic precision. High-risk subgroups may be identified

  8. Mining geriatric assessment data for in-patient fall prediction models and high-risk subgroups

    Directory of Open Access Journals (Sweden)

    Marschollek Michael

    2012-03-01

    Full Text Available Abstract Background Hospital in-patient falls constitute a prominent problem in terms of costs and consequences. Geriatric institutions are most often affected, and common screening tools cannot predict in-patient falls consistently. Our objectives are to derive comprehensible fall risk classification models from a large data set of geriatric in-patients' assessment data and to evaluate their predictive performance (aim#1, and to identify high-risk subgroups from the data (aim#2. Methods A data set of n = 5,176 single in-patient episodes covering 1.5 years of admissions to a geriatric hospital were extracted from the hospital's data base and matched with fall incident reports (n = 493. A classification tree model was induced using the C4.5 algorithm as well as a logistic regression model, and their predictive performance was evaluated. Furthermore, high-risk subgroups were identified from extracted classification rules with a support of more than 100 instances. Results The classification tree model showed an overall classification accuracy of 66%, with a sensitivity of 55.4%, a specificity of 67.1%, positive and negative predictive values of 15% resp. 93.5%. Five high-risk groups were identified, defined by high age, low Barthel index, cognitive impairment, multi-medication and co-morbidity. Conclusions Our results show that a little more than half of the fallers may be identified correctly by our model, but the positive predictive value is too low to be applicable. Non-fallers, on the other hand, may be sorted out with the model quite well. The high-risk subgroups and the risk factors identified (age, low ADL score, cognitive impairment, institutionalization, polypharmacy and co-morbidity reflect domain knowledge and may be used to screen certain subgroups of patients with a high risk of falling. Classification models derived from a large data set using data mining methods can compete with current dedicated fall risk screening tools, yet lack

  9. Period prevalence, risk factors and consequent injuries of falling among the Saudi elderly living in Riyadh, Saudi Arabia: a cross-sectional study.

    Science.gov (United States)

    Almegbel, Faisal Yousef; Alotaibi, Ibrahim Muthyib; Alhusain, Faisal Ahmed; Masuadi, Emad M; Al Sulami, Salma Lafyan; Aloushan, Amairah Fahad; Almuqbil, Bashayer Ibrahim

    2018-01-10

    Approximately 28% to 35% of people aged 65 and over fall each year. The consequent injuries of falls are considered a major public health problem. Falls account for more than half of injury-related hospitalisations among old people. The aim of this study was to measure a 1-year period prevalence of falling among old people in Riyadh, Saudi Arabia. In addition, this study described the most common risk factors and consequent injuries of falls. A cross-sectional survey was carried out in Riyadh, using a convenient sampling. The targeted population were Saudi citizens who were 60 years or above. Over a 6-month period, 1182 individuals were sampled (545 men and 637 women). The 1-year prevalence of falling among old Saudis (>=60 years) was 49.9%. Our results show that 74% of the participants who experienced falls had postfall injuries. Old participants who were uneducated and those with middle school certification were associated with falls (adjusted OR (aOR) 1.72; 95% CI 1.15 to 2.56, aOR 1.81; 95% CI 1.15 to 2.85, respectively). Those who live in rented houses had a higher risk of falls. Interestingly, having a caregiver was significantly associated with more falls (aOR 1.39; 95% CI 1.08 to 1.79). However, not using any medications was significantly related to fewer falls. In addition, old individuals using walking aids were more likely to fall than those who did not. Participants who mentioned 'not having stressors were associated with less frequent falls (aOR 0.62; 95% CI 0.39 to 0.97). Cerebrovascular accidents were strongly associated with falls with an estimated OR of 2.75 (95% CI 1.18 to 6.43). Moreover, osteoporosis, poor vision and back pain were found to be predictors for falls among the elderly. 49.9% of elderly Saudis had experienced one or more falls during a 12-month period. Several preventable risk factors could be addressed by routine geriatric assessment. Research on the impact of these risk factors is needed. © Article author(s) (or their

  10. Physical performance following acute high-risk abdominal surgery

    DEFF Research Database (Denmark)

    Jønsson, Line Rokkedal; Ingelsrud, Lina Holm; Tengberg, Line Toft

    2018-01-01

    BACKGROUND: Acute high-risk abdominal (AHA) surgery is associated with high mortality, multiple postoperative complications and prolonged hospital stay. Further development of strategies for enhanced recovery programs following AHA surgery is needed. The aim of this study was to describe physical...... are primarily fatigue and abdominal pain. Further studies investigating strategies for early mobilization and barriers to mobilization in the immediate postoperative period after AHA surgery are needed.......BACKGROUND: Acute high-risk abdominal (AHA) surgery is associated with high mortality, multiple postoperative complications and prolonged hospital stay. Further development of strategies for enhanced recovery programs following AHA surgery is needed. The aim of this study was to describe physical...... performance and barriers to independent mobilization among patients who received AHA surgery (postoperative days [POD] 1-7). METHODS: Patients undergoing AHA surgery were consecutively enrolled from a university hospital in Denmark. In the first postoperative week, all patients were evaluated daily...

  11. Constrained consequence

    CSIR Research Space (South Africa)

    Britz, K

    2011-09-01

    Full Text Available their basic properties and relationship. In Section 3 we present a modal instance of these constructions which also illustrates with an example how to reason abductively with constrained entailment in a causal or action oriented context. In Section 4 we... of models with the former approach, whereas in Section 3.3 we give an example illustrating ways in which C can be de ned with both. Here we employ the following versions of local consequence: De nition 3.4. Given a model M = hW;R;Vi and formulas...

  12. Dronedarone in high-risk permanent atrial fibrillation

    DEFF Research Database (Denmark)

    Connolly, Stuart J; Camm, A John; Halperin, Jonathan L

    2011-01-01

    Dronedarone restores sinus rhythm and reduces hospitalization or death in intermittent atrial fibrillation. It also lowers heart rate and blood pressure and has antiadrenergic and potential ventricular antiarrhythmic effects. We hypothesized that dronedarone would reduce major vascular events...... in high-risk permanent atrial fibrillation....

  13. Prevalence and risk factors of obesity and high blood pressure ...

    African Journals Online (AJOL)

    Background: The prevalence of diet-related chronic diseases like hypertension and obesity among others has become a public health concern. Risk factors for these diseases have been well studied in high income countries but less studied in developing countries. Objective: The study was to document the prevalence and ...

  14. Sensation seeking in males involved in recreational high risk sports

    Directory of Open Access Journals (Sweden)

    M Guszkowska

    2010-09-01

    Full Text Available The study examined sensation seeking intensity level in males involved in recreational high risk sports and investigated whether its level depends on type of sport practised. Additionally, in case of parachutists, sport experience of study participants were scrutinised with regard to its possible impact on the level of sensation seeking.The research involved 217 males aged 17 to 45, practising recreational high risk sports, namely: parachuting (n=98; wakeboarding (n=30; snowboarding (n=30; scuba diving (n=22; alpinism (n=20; paragliding (n=17. The control group included 54 men not involved in sports. Polish version of Sensation Seeking Scale (SSS-IV of Zuckerman was applied.Results show, that high risk sports males are featured by stronger need of sensations in comparison to control group and this concerned all but one aspect of sensation seeking variable. The only exception was the need of intellectual stimulation. Except from the thrill and adventure seeking dimension, type of sport may also be an important determinant of sensation seeking. Men practising snowboard and wakeboard presented stronger need for sensations, especially in the dimension of experience seeking, disinhibition and boredom susceptibility. Sport experience (number of jumps in parachuting did not differentiate the level of sensation seeking among investigated parachutists. Population of sport high risk male takers was not homogeneous, and therefore in future research one should analyse specific sports (or events in a certain sport separately.

  15. Detection of Patients at High Risk of Medication Errors

    DEFF Research Database (Denmark)

    Sædder, Eva Aggerholm; Lisby, Marianne; Nielsen, Lars Peter

    2016-01-01

    Medication errors (MEs) are preventable and can result in patient harm and increased expenses in the healthcare system in terms of hospitalization, prolonged hospitalizations and even death. We aimed to develop a screening tool to detect acutely admitted patients at low or high risk of MEs...

  16. Alcohol-Related Problems And High Risk Sexual Behaviour In ...

    African Journals Online (AJOL)

    There was a significant association between alcohol-related problems and risky sexual behavior. Alcohol-related problems are fairly common in people already infected with HIV/AIDS and are associated with high-risk sexual behavior. Thus, screening and treatment should be part of an effective HIV intervention program.

  17. Cyberbullying and Its Risk Factors among Chinese High School Students

    Science.gov (United States)

    Zhou, Zongkui; Tang, Hanying; Tian, Yuan; Wei, Hua; Zhang, Fengjuan; Morrison, Chelsey M.

    2013-01-01

    Cyberbullying has become a common occurrence among adolescents worldwide; however, it has yet to receive adequate scholarly attention in China, especially in the mainland. The present study investigated the epidemiological characteristics and risk factors of cyberbullying, utilizing a sample of 1,438 high school students from central China.…

  18. The High-mountain Cryosphere: Environmental Changes and Human Risks

    Directory of Open Access Journals (Sweden)

    Maria Shahgedanova

    2016-08-01

    Full Text Available Reviewed: The High-mountain Cryosphere: Environmental Changes and Human Risks Edited by Christian Huggel, Mark Carey, John J. Clague, and Andreas Kääb. Cambridge, UK: Cambridge University Press, 2015. xii + 363 pp. Hardcover: US$ 140.00, ISBN 978-1-107-06584-0. E-book: US$ 112.00, ISBN 978-1-316-35515-2.

  19. Staying Alive! Training High-Risk Teams for Self Correction

    Science.gov (United States)

    Slack, Kelley; Noe, Raymond; Weaver, Sallie

    2011-01-01

    Research examining teams working in high-risk operations has been lacking. The present symposium showcases research on team training that helps to optimize team performance in environments characterized by life or death situations arising spontaneously after long periods of mundane activity by pulling experts from diverse areas of industry: space flight, health care, and medical simulation.

  20. Update on the Management of High-Risk Penetrating Keratoplasty.

    Science.gov (United States)

    Jabbehdari, Sayena; Rafii, Alireza Baradaran; Yazdanpanah, Ghasem; Hamrah, Pedram; Holland, Edward J; Djalilian, Ali R

    2017-03-01

    In this article, we review the indications and latest management of high-risk penetrating keratoplasty. Despite the immune-privilege status of the cornea, immune-mediated graft rejection still remains the leading cause of corneal graft failure. This is particularly a problem in the high-risk graft recipients, namely patients with previous graft failure due to rejection and those with inflamed and vascularized corneal beds. A number of strategies including both local and systemic immunosuppression are currently used to increase the success rate of high-risk corneal grafts. Moreover, in cases of limbal stem cell deficiency, limbal stem cells transplantation is employed. Corticosteroids are still the top medication for prevention and treatment in cases of corneal graft rejection. Single and combined administration of immunosuppressive agents e.g. tacrolimus, cyclosporine and mycophenolate are promising adjunctive therapies for prolonging graft survival. In the future, cellular and molecular therapies should allow us to achieve immunologic tolerance even in high-risk grafts.

  1. Monitoring paneer for Listeria monocytogenes - A high risk food ...

    African Journals Online (AJOL)

    A multiplex polymerase chain reaction (PCR) assay was developed and applied to spiked and natural paneer samples to detect Listeria monocytogenes, a high risk food pathogen. The sensitivity of the assay on L. monocytogenes spiked paneer samples was 104 cells prior to enrichment, was improved to 103 cells after 4 h ...

  2. Optimizing the Management of High-Risk, Localized Prostate Cancer

    OpenAIRE

    Sundi, Debasish; Jeong, Byong Chang; Lee, Seung Bae; Han, Misop

    2012-01-01

    Prostate cancer has a high prevalence and a rising incidence in many parts of the world. Although many screen-detected prostate cancers may be indolent, prostate cancer remains a major contributor to mortality in men. Therefore, the appropriate diagnosis and treatment of localized prostate cancer with lethal potential are of great importance. High-risk, localized prostate cancer has multiple definitions. Treatment options that should be individualized to each patient include observation, radi...

  3. Increased Cardiometabolic Risk and Worsening Hypoxemia at High Altitude.

    Science.gov (United States)

    Miele, Catherine H; Schwartz, Alan R; Gilman, Robert H; Pham, Luu; Wise, Robert A; Davila-Roman, Victor G; Jun, Jonathan C; Polotsky, Vsevolod Y; Miranda, J Jaime; Leon-Velarde, Fabiola; Checkley, William

    2016-06-01

    Miele, Catherine H., Alan R. Schwartz, Robert H. Gilman, Luu Pham, Robert A. Wise, Victor G. Davila-Roman, Jonathan C. Jun, Vsevolod Y. Polotsky, J. Jaime Miranda, Fabiola Leon-Velarde, and William Checkley. Increased cardiometabolic risk and worsening hypoxemia at high altitude. High Alt Med Biol. 17:93-100, 2016.-Metabolic syndrome, insulin resistance, diabetes, and dyslipidemia are associated with an increased risk of cardiovascular disease. While excessive erythrocytosis is associated with cardiovascular complications, it is unclear how worsening hypoxemia of any degree affects cardiometabolic risk factors in high-altitude populations. We studied the relationship between daytime resting oxyhemoglobin saturation and cardiometabolic risk factors in adult participants living in Puno, Peru (3825 m above sea level). We used multivariable logistic regression models to study the relationship between having a lower oxyhemoglobin saturation and markers of cardiometabolic risk. Nine hundred and fifty-four participants (mean age 55 years, 52% male) had information available on pulse oximetry and markers of cardiometabolic risk. Average oxyhemoglobin saturation was 90% (interquartile range 88%-92%) and 43 (4.5%) had excessive erythrocytosis. Older age, decreased height-adjusted lung function, and higher body mass index (BMI) were associated with having an oxyhemoglobin saturation ≤85%. When adjusting for age, sex, socioeconomic status, having excessive erythrocytosis, and site, we found that each 5% decrease in oxyhemoglobin saturation was associated with a higher adjusted odds of metabolic syndrome (OR = 1.35, 95% CI: 1.07-1.72, p 2 mass units (OR = 1.29, 95% CI: 1.00-1.67, p < 0.05), hemoglobin A1c ≥6.5% (OR = 1.66, 95% CI: 1.09-2.51, p < 0.04), and high sensitivity C-reactive protein (hs-CRP) ≥3 mg/L (OR = 1.46, 95% CI: 1.09-1.96, p < 0.01). In high-altitude populations in Puno, Peru, a higher BMI and lower pulmonary function were

  4. Effectiveness of Methadone in Reduction of High Risk Behaviors in Clients of MMT Center

    Directory of Open Access Journals (Sweden)

    F Ehsani

    2010-09-01

    Full Text Available Introduction: Addiction as a social, health problem with its specific complications threatens societies. High risk behaviors such as violence, self mutilation, tattooing, shared injections and unprotected sex behaviors are some of the problems in addicts that need to be treated. One of these treatments is methadone therapy. The purpose of this study was to evaluate effectiveness of methadone in prevention or reduction of high risk behaviors in clients of a MMT center of Shaheed Sadoughi University of medical sciences of Yazd. Methods: This study was done on 93 clients of a MMT center.Questionnaire for this study included items from MAP and questions about some other risky behaviors. This questionnaire was completed at onset of treatment and 6 months after. Data was analyzed with SPSS software program Results: 89.2% of participants were married and 10.8% were single. 63.5% of them were in the20-40 years age group. Most commonly abused substances were heroin and opium. Before onset of treatment, 37.6% of participants had history of imprisonment, 35.5% had shared injections, 32.3%had had unprotected sex, 22.6%had tattooing and 5.4%had mutilated their own selves. Only 36.6% didn’t have any high risk behavior. These behaviors were more common in heroin users and in the20-40 years age group. After onset of treatment and during 6 month of MMT, 86% of clients didn’t have any risky behavior. Only 14%of them continued to have unsafe sex behaviors Conclusion: Addiction can cause high risk behaviors. Data in this paper suggests that young age, heroin use, low education level and no or inadequate information about addictive substances and their consequences are effective and important factors that cause high risk behaviors. Treatment of addicts with methadone maintenance therapy plays an important role in reduction of risky behaviors. Development of appropriate and more MMT centers are recommended.

  5. Adolescent childbearing: consequences and interventions.

    Science.gov (United States)

    Ruedinger, Emily; Cox, Joanne E

    2012-08-01

    Adolescent childbearing in the United States continues to occur at high rates compared with other industrialized nations, despite a recent decline. Adolescent mothers and their offspring are at risk for negative outcomes. Recent literature exploring the consequences of teenage childbearing and interventions to ameliorate these consequences are presented. Negative consequences of adolescent childbearing can impact mothers and their offspring throughout the lifespan. These consequences are likely attributable to social and environmental factors rather than solely to maternal age. Increasing educational attainment, preventing repeat pregnancy and improving mother-child interactions can improve outcomes for mothers and their children. Home, community, school and clinic-based programs are all viable models of service delivery to this population. Connecting teen mothers with comprehensive services to meet their social, economic, health and educational needs can potentially improve long-term outcomes for both mothers and their offspring. Programs that deliver care to this population in culturally sensitive, developmentally appropriate ways have demonstrated success. Future investigation of parenting interventions with larger sample sizes and that assess multiple outcomes will allow comparison among programs. Explorations of the role of the father and coparenting are also directions for future research.

  6. Can I risk using public services? Perceived consequences of seeking help and health care among households living in poverty: qualitative study.

    Science.gov (United States)

    Canvin, Krysia; Jones, Chris; Marttila, Anneli; Burström, Bo; Whitehead, Margaret

    2007-11-01

    To improve understanding of how families living in adverse conditions perceive their encounters with public services and how past experiences influence current and future attempts to seek help. Qualitative interviews with adult members of households living in poverty in deprived areas, plus observations conducted in the surrounding neighbourhoods and service settings. Purposive sample of 25 adults living in a deprived area, on welfare benefits. Eight sites in disadvantaged areas in Merseyside, North Wales, London and Greater Manchester in 2004/05. Participants generally perceived public services as a source of distrust and a potential risk to well-being. Encounters with a range of services were perceived as risky in terms of losing resources, being misunderstood or harshly judged, and carrying the ultimate threat of losing custody of their children. Participants perceived that they were subjected to increasing levels of surveillance, with fear of "being told on" by neighbours, in addition to service providers, adding to anxiety. Adverse consequences included avoiding child health and social services, anxiety and self-imposed isolation. Approaching services was perceived as akin to taking a gamble that might or might not result in their needs being met. Faced with this "choice", participants employed strategies to minimise the risks that on the surface may appear risky to health. If public services are to succeed in providing support to disadvantaged families, greater efforts are needed to build trust and demonstrate understanding for the strategies these families use to maintain their well-being against formidable odds.

  7. THE BANKING SUPERVISION: CAN IT REDUCE THE RISK-TAKING AND, CONSEQUENTLY, STRENGTHEN THE STABILITY OF THE BANKING SECTOR IN MOLDOVA?

    Directory of Open Access Journals (Sweden)

    Elena MARGARINT

    2015-12-01

    Full Text Available Actuality: The empirical studies on the impact of the supervision on the stability of the banking sector are mitigated, varying depending on the particular characteristics of the bank and, in addition, the country's policy in which banks operate. This is why this study is important for the banking sector in Moldova. Purpose: The objective of this article is to studies the effects of the banking supervision on the risk-taking of banks and, consequently, the stability of the banking sector in Moldova. Methods: To order to achieve its purpose, the author applied the method of static panel data with random effect. Results: This empirical analysis reported the following results: increased restrictions on the activities of banks increases the stability of the banking sector. On the other hand, the power and independence of the supervisory authority have a negative impact on the stability of Moldovan banks. The increase of the capital level strengthens the stability of Moldovan banks and, at the same time, reduces the risk. Thus, capital regulations are an important pillar of the policy of the regulation of the banking sector of Moldova.

  8. Unlicensed driving and other related health risk behaviors: a study of Montana high school students.

    Science.gov (United States)

    Hanna, Christian L; Laflamme, Lucie; Elling, Berty; Möller, Jette

    2013-05-01

    Health risk behaviors tend to cluster in young people, not least among young drivers. Less is known about the health risk profile of young unlicensed drivers. This study investigates health risk behaviors among young unlicensed drivers compared to both their licensed and driving peers, and their non-driving peers. High school students participating in the Youth Risk Behavior Surveillance System in Montana (US) and age-eligible to have a driver's license were studied (n=5985), categorized according to their self-reported car driving and license practice (licensed driving, unlicensed driving, and non-driving). Ten health risk behaviors, of which four were related to car riding/driving, were considered. Multinomial logistic regression was used to compile sex-specific odds ratios (with 95% confidence intervals) of adopting those behaviors using licensed drivers as a reference and adjusting for age and race/ethnicity. Health risk behaviors tended to be more common among unlicensed drivers than other groups, although some behaviors were prevalent in all groups (i.e., alcohol use and lack of seat belt use). As a consequence, for both male and female students, there was a significant association between unlicensed driving and most health risk behaviors, except for being involved in a physical fight and riding with a drinking driver among female students. Young unlicensed drivers are more likely than licensed drivers to adopt several health risk behaviors both in car driving/riding or otherwise, in particular alcohol use and cigarette smoking. This challenges any simplistic approach as unlicensed driving in youth is not an isolated act suggesting public health and traffic safety initiatives. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Choice & Consequence

    DEFF Research Database (Denmark)

    Khan, Azam

    to support hypothesis generation, hypothesis testing, and decision making. In addition to sensors in buildings, infrastructure, or the environment, we also propose the instrumentation of user interfaces to help measure performance in decision making applications. We show the benefits of applying principles...... between cause and effect in complex systems complicates decision making. To address this issue, we examine the central role that data-driven decision making could play in critical domains such as sustainability or medical treatment. We developed systems for exploratory data analysis and data visualization...... of data analysis and instructional interface design, to both simulation systems and decision support interfaces. We hope that projects such as these will help people to understand the link between their choices and the consequences of their decisions....

  10. Population at high-risk of indoor heatstroke: the usage of cooling appliances among urban elderlies in Japan.

    Science.gov (United States)

    Kondo, Masahide; Ono, Masaji; Nakazawa, Kouichi; Kayaba, Momoko; Minakuchi, Emiko; Sugimoto, Kazutoshi; Honda, Yasushi

    2013-05-01

    Heatstroke due to a heat wave during the summer is one of the commonly known health impacts of climate change in Japan. The elderly are particularly at high-risk of developing indoor heatstroke with poor prognosis. This study aims to describe the population among elderlies at high-risk of indoor heatstroke by focusing on the usage of cooling appliances. We conducted a web-based household survey in eight urban areas during the winter season of 2011. Households with a person aged 65 and over were selected as samples from panel members of a research firm, and the oldest member of the household was queried about his/her usage of cooling appliances. The population at high-risk of indoor heatstroke is defined as the elderly staying in a room without cooling appliances, or not using the installed cooling appliances, or turning the cooling appliances on only when the room temperature is above 28 °C. 15.4 and 19.1 % of the elderlies living in urban areas of Japan are identified as at high-risk of indoor heatstroke during activity time and sleeping time, respectively, according to the definition of high-risk of indoor heatstroke in this study. These figures are not negligible since the consequences of heatstroke are grave, but its risk can be eliminated by an appropriate usage of cooling appliances. The preventive interventions are needed to protect the elderlies at high-risk of heatstroke.

  11. Chronic kidney disease and bleeding risk in patients at high cardiovascular risk: a cohort study.

    Science.gov (United States)

    Ocak, G; Rookmaaker, M B; Algra, A; de Borst, G J; Doevendans, P A; Kappelle, L J; Verhaar, M C; Visseren, F L

    2018-01-01

    Essentials The association between chronic kidney disease and bleeding is unknown. We followed 10 347 subjects at high cardiovascular risk for bleeding events. Chronic kidney disease was associated with a 1.5-fold increased bleeding risk. Especially albuminuria rather than decreased kidney function was associated with bleeding events. Background There are indications that patients with chronic kidney disease have an increased bleeding risk. Objectives To investigate the association between chronic kidney disease and bleeding in patients at high cardiovascular risk. Methods We included 10 347 subjects referred to the University Medical Center Utrecht (the Netherlands) from September 1996 to February 2015 for an outpatient visit with classic risk factors for arterial disease or with symptomatic arterial disease (Second Manifestation of Arterial disease [SMART] cohort). Patients were staged according to the KDIGO guidelines, on the basis of estimated glomerular filtration rate (eGFR) and albuminuria, and were followed for the occurrence of major hemorrhagic events until March 2015. Hazard ratios (HRs) with 95% confidence intervals (CIs) for bleeding were calculated with Cox proportional hazards analyses. Results The incidence rate for bleeding in subjects with chronic kidney disease was 8.0 per 1000 person-years and that for subjects without chronic kidney disease was 3.5 per 1000 person-years. Patients with chronic kidney disease (n = 2443) had a 1.5-fold (95% CI 1.2-1.9) increased risk of bleeding as compared with subjects without chronic kidney disease (n = 7904) after adjustment. Subjects with an eGFR of Chronic kidney disease is a risk factor for bleeding in patients with classic risk factors for arterial disease or with symptomatic arterial disease, especially in the presence of albuminuria. © 2017 University Medical Center Utrecht. Journal of Thrombosis and Haemostasis © 2017 International Society on Thrombosis and Haemostasis.

  12. Risk factors and the occurrence of cerebral palsy in high risk infants

    Directory of Open Access Journals (Sweden)

    Setyo Handryastuti

    2018-04-01

    Full Text Available Background The incidence of cerebral palsy (CP has increased due to better survival rates of high-risk babies. Early detection and time to the occurrence of CP in the first year of life is important in order to provide early intervention. Objectives To determine the proportion of CP in high-risk babies, the time to the occurrence of CP in the first year, and assess possible associations between risk factors of CP and time to the occurrence of CP. Methods A prospective cohort study was done on 150 high-risk babies up to the age of 12 months. We obtained history of motor ability and assessed primitive reflexes and postural reactions of subjects at the ages of 4 and 6 months. The diagnosis of CP was established at 6 and 12 months of age. Results The proportion of CP was 26% at 6 months and 24% at 12 months of age. Significant risk factors associated with CP at 6 and 12 months of age were cerebral ultrasound abnormalities, hypoxic-ischemic encephalopathy, and intracranial hemorrhage. In 88.7% of subjects with CP, CP was detected in the first 6 months. Mean age at the occurrence of CP was 9.99 months (95%CI 9.46 to 10.53. Risk factors that significantly affected the time to the occurrence of CP by survival analysis were ultrasound abnormalities and hypoxic-ischemic encephalopathy. Conclusions Cerebral palsy can be detected as early as the first 6 months of life. Cerebral ultrasound abnormalities and hypoxic ischemic encephalopathy are the risk factors associated with CP.

  13. Is High Sexual Desire a Risk for Women's Relationship and Sexual Well-Being?

    Science.gov (United States)

    Štulhofer, Aleksandar; Bergeron, Sophie; Jurin, Tanja

    2016-09-01

    Historically, women's sexual desire has been deemed socially problematic. The growing popularity of the concept of hypersexuality-which lists high sexual desire among its core components-poses a risk of re-pathologizing female sexual desire. Data from a 2014 online survey of 2,599 Croatian women aged 18-60 years was used to examine whether high sexual desire is detrimental to women's relationship and sexual well-being. Based on the highest scores on an indicator of sexual desire, 178 women were classified in the high sexual desire (HSD) group; women who scored higher than one standard deviation above the Hypersexual Disorder Screening Inventory mean were categorized in the hypersexuality (HYP) group (n = 239). Fifty-seven women met the classification criteria for both groups (HYP&HSD). Compared to other groups, the HSD was the most sexually active group. Compared to controls, the HYP and HYP&HSD groups-but not the HSD group-reported significantly more negative consequences associated with their sexuality. Compared to the HYP group, women with HSD reported better sexual function, higher sexual satisfaction, and lower odds of negative behavioral consequences. The findings suggest that, at least among women, hypersexuality should not be conflated with high sexual desire and frequent sexual activity.

  14. Custom database development and biomarker discovery methods for MALDI-TOF mass spectrometry-based identification of high-consequence bacterial pathogens.

    Science.gov (United States)

    Tracz, Dobryan M; Tyler, Andrea D; Cunningham, Ian; Antonation, Kym S; Corbett, Cindi R

    2017-03-01

    A high-quality custom database of MALDI-TOF mass spectral profiles was developed with the goal of improving clinical diagnostic identification of high-consequence bacterial pathogens. A biomarker discovery method is presented for identifying and evaluating MALDI-TOF MS spectra to potentially differentiate biothreat bacteria from less-pathogenic near-neighbour species. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  15. High resolution estimates of the corrosion risk for cultural heritage in Italy

    International Nuclear Information System (INIS)

    De Marco, Alessandra; Screpanti, Augusto; Mircea, Mihaela; Piersanti, Antonio; Proietti, Chiara; Fornasier, M. Francesca

    2017-01-01

    Air pollution plays a pivotal role in the deterioration of many materials used in buildings and cultural monuments causing an inestimable damage. This study aims to estimate the impacts of air pollution (SO 2 , HNO 3 , O 3 , PM 10 ) and meteorological conditions (temperature, precipitation, relative humidity) on limestone, copper and bronze based on high resolution air quality data-base produced with AMS-MINNI modelling system over the Italian territory over the time period 2003–2010. A comparison between high resolution data (AMS-MINNI grid, 4 × 4 km) and low resolution data (EMEP grid, 50 × 50 km) has been performed. Our results pointed out that the corrosion levels for limestone, copper and bronze are decreased in Italy from 2003 to 2010 in relation to decrease of pollutant concentrations. However, some problem related to air pollution persists especially in Northern and Southern Italy. In particular, PM 10 and HNO 3 are considered the main responsible for limestone corrosion. Moreover, the high resolution data (AMS-MINNI) allowed the identification of risk areas that are not visible with the low resolution data (EMEP modelling system) in all considered years and, especially, in the limestone case. Consequently, high resolution air quality simulations are suitable to provide concrete benefits in providing information for national effective policy against corrosion risk for cultural heritage, also in the context of climate changes that are affecting strongly Mediterranean basin. - Highlights: • Air pollution plays a pivotal role in the deterioration of cultural materials. • Limestone, copper and bronze corrosion levels decreased in Italy from 2003 to 2010. • PM 10 is considered the main responsible for limestone corrosion in Northern Italy. • HNO3 is considered the main responsible for limestone corrosion in all analyzed years. • High-resolution data are particularly useful to define area at risk for corrosion. - Importance of the high

  16. Prediabetes: a high-risk state for diabetes development.

    Science.gov (United States)

    Tabák, Adam G; Herder, Christian; Rathmann, Wolfgang; Brunner, Eric J; Kivimäki, Mika

    2012-06-16

    Prediabetes (intermediate hyperglycaemia) is a high-risk state for diabetes that is defined by glycaemic variables that are higher than normal, but lower than diabetes thresholds. 5-10% of people per year with prediabetes will progress to diabetes, with the same proportion converting back to normoglycaemia. Prevalence of prediabetes is increasing worldwide and experts have projected that more than 470 million people will have prediabetes by 2030. Prediabetes is associated with the simultaneous presence of insulin resistance and β-cell dysfunction-abnormalities that start before glucose changes are detectable. Observational evidence shows associations between prediabetes and early forms of nephropathy, chronic kidney disease, small fibre neuropathy, diabetic retinopathy, and increased risk of macrovascular disease. Multifactorial risk scores using non-invasive measures and blood-based metabolic traits, in addition to glycaemic values, could optimise estimation of diabetes risk. For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention, with evidence of a 40-70% relative-risk reduction. Accumulating data also show potential benefits from pharmacotherapy. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Prediabetes: A high-risk state for developing diabetes

    Science.gov (United States)

    Tabák, Adam G.; Herder, Christian; Rathmann, Wolfgang; Brunner, Eric J.; Kivimäki, Mika

    2013-01-01

    Summary Prediabetes (or “intermediate hyperglycaemia”), based on glycaemic parameters above normal but below diabetes thresholds is a high risk state for diabetes with an annualized conversion rate of 5%–10%; with similar proportion converting back to normoglycaemia. The prevalence of prediabetes is increasing worldwide and it is projected that >470 million people will have prediabetes in 2030. Prediabetes is associated with the simultaneous presence of insulin resistance and β-cell dysfunction, abnormalities that start before glucose changes are detectable. Observational evidence shows associations of prediabetes with early forms of nephropathy, chronic kidney disease, small fibre neuropathy, diabetic retinopathy, and increased risk of macrovascular disease. Multifactorial risk scores could optimize the estimation of diabetes risk using non-invasive parameters and blood-based metabolic traits in addition to glycaemic values. For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention with evidence of a 40%–70% relative risk reduction. Accumulating data also suggests potential benefits from pharmacotherapy. PMID:22683128

  18. The relationship between default mode network connectivity and social functioning in individuals at familial high-risk for schizophrenia

    OpenAIRE

    Dodell-Feder, David; DeLisi, Lynn E.; Hooker, Christine I.

    2014-01-01

    Unaffected first-degree relatives of individuals with schizophrenia (i.e., those at familial high-risk [FHR]), demonstrate social dysfunction qualitatively similar though less severe than that of their affected relatives. These social difficulties may be the consequence of genetically conferred disruption to aspects of the default mode network (DMN), such as the dMPFC subsystem, which overlaps with the network of brain regions recruited during social cognitive processes. In the present study,...

  19. Treatment recommendations in patients diagnosed with high-risk cutaneous squamous cell carcinoma

    International Nuclear Information System (INIS)

    Veness, M.J.

    2005-01-01

    Non-melanoma cutaneous cancers occur at an epidemic rate in Australia. With an ageing population, more Australians will develop these cancers and at an increasing rate. In the majority of cases local treatment is highly curative. However, a subset of the population will be diagnosed with a high-risk cutaneous squamous cell carcinoma. These can be defined as patients at risk of having subclinical metastases to regional lymph nodes based on unfavourable primary lesion features (including inadequately excised and recurrent lesions), patients with metastatic squamous cell carcinoma to regional lymph nodes, and squamous cell carcinoma in immunosuppressed patients. The mortality and morbidity associated with high-risk cutaneous squamous cell carcinoma is usually as a consequence of uncontrolled metastatic nodal disease and, to a lesser extent, distant metastases. Radiotherapy has an essential role in treating these patients and in many cases the addition of adjuvant radiotherapy may be life saving. It is therefore important that all clinicians treating skin cancers have an understanding and awareness of the optimal approach to these patients. The aim of this article is to present treatment recommendations based on an overview of the current published literature. Copyright (2005) Blackwell Science Pty Ltd

  20. Comparison of the Mini Mental State Examination and depressive symptoms between high cardiovascular risk and healthy community elderly groups

    Science.gov (United States)

    da Costa, Amanda Lucas; Varela, Juliana Santos; Mazetti, Osmar; Restelatto, Luciane; Costa, Andry Fitterman; Godinho, Claudia; Camozzato, Ana Luiza; Picon, Paulo D.; Chaves, Márcia L.

    2008-01-01

    The aging of the population is a universal phenomenon with direct consequences upon the public health system. One of the main repercussions of the growth in this sector of the population is the increased prevalence of disorders such as dementia and depression which are very frequent among the elderly. The relationship between cardiovascular risk factors, dementia and depression have been addressed in many recent investigations. Objectives To evaluate the relationship of cognitive performance and depressive symptoms with cardiovascular risk in the elderly. Methods 94 high cardiovascular risk elderly patients and 160 healthy community elderly were evaluated cross-sectionally. The Mini Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS-15) were used as the main measures. The cutoff for presence of depression was 6 on the GDS. Results The high cardiovascular risk elderly group showed significantly lower scores on the MMSE (p<0.001) and was significantly associated to depression (p<0.001), independently of education. The logistic regression analysis for depression as the dependent variable, age and group (healthy community or high cardiovascular risk elderly) were kept in the final equation. Higher age (Odds Ratio=0.92; 95% CI 0.86–0.98) and high cardiovascular risk elderly (OR=2.99; 95% CI 1.36–6.59) were associated to depression. Conclusions The present findings corroborate the different cognitive performance of elderly with high cardiovascular risk factors and the association of depressive symptoms with this group. PMID:29213588

  1. High risk pregnancy in the workplace. Influencing positive outcomes.

    Science.gov (United States)

    Cannon, R B; Schmidt, J V; Cambardella, B; Browne, S E

    2000-09-01

    Childbearing employees are well served by the occupational health nurse who promotes optimal preconceptual and pregnancy health practices, uses community resources, and maintains current knowledge about high risk pregnancy prevention and care. These broad goals of care can lead to decreased absenteeism, healthier and happier employees, and more positive outcomes of pregnancy. For employees with high risk pregnancies, the role of the occupational health nurse includes, but is not limited to, facilitating awareness with the employer, making suggestions for adjusting working conditions, making frequent assessments of the employee's needs, and communicating with prenatal health care providers. Occupational health nurses should never underestimate their role and potential influence on the mother, and on her significant other, for a positive outcome of her pregnancy.

  2. High risk factors in patient with carcinoma esophagus

    International Nuclear Information System (INIS)

    Afridi, S.P.; Khan, A.; Waheed, I.

    2000-01-01

    This study was conducted to identify the presence of high risk factors in carcinoma esophagus from February, 1992 to August, 1995 at Surgical unit 1, Jinnah Postgraduate Medical Centre (JPMC), Karachi. In all 37 patients, 22 males and 15 females, were included in the study through outpatient department, surgical emergency and those referred from other cities of the country. All patients were cachectic. Diagnosis was made by detailed history, examination and laboratory investigations. Diagnosis was confirmed on barium swallow and endoscopic biopsy. Highest number of patients were in their 6th decade of life. History of snuff inhalation and opium was present in 2.7% cases each. Lower 3rd of the esophagus was affected in 62.16% middle third in 21.62% and upper third in 16.21% cases. Smoking, pan chewing, naswar eating and snuff inhalation were identified as high risk factors among patients of carcinoma esophagus. (author)

  3. Individual and Parental Risk Factors for Sexual Exploitation Among High-Risk Youth in Uganda.

    Science.gov (United States)

    Self-Brown, Shannon; Culbreth, Rachel; Wilson, Rebecca; Armistead, Lisa; Kasirye, Rogers; Swahn, Monica H

    2018-04-01

    This study examined risk factors to determine associations with commercial sexual exploitation of children and youth (CSEC) in a convenience sample of adolescents living in the slums in Kampala, Uganda. Individual-level factors included demographic, adverse experiences (ever living on the streets; victim of dating violence, parental abuse, or rape), and behavioral risk (social media, alcohol use, age at first intercourse). Parental-risk factors included parent alcohol use and approval attitudes toward youth sex. Analyses included those who self-reported sexually active adolescents ( n = 593) of whom 39% reported CSEC history. CSEC was significantly associated with being female (odds ratio [ OR] = 6.85, 95% confidence interval (CI) = [4.22, 11.12]), living on the streets ( OR = 2.68; 95% CI = [1.65, 4.36]), using social media ( OR = 1.48; 95% CI = [0.94, 2.35]), being a victim of physical dating violence ( OR = 1.74; 95% CI = [1.08, 2.80]), and ever being raped ( OR = 4.03; 95% CI = [2.51, 6.47]). Further analyses suggested differential risk associates among females and males. This study contributes to our knowledge of risk factors for CSEC among adolescents living in high-risk circumstances in low-resource countries and suggests that preventive efforts should prioritize adolescents with a history of living on the streets who engage in social media, use alcohol, and have a history of trauma.

  4. Reproductive health education and sexual risk among high-risk female adolescents and young adults.

    Science.gov (United States)

    Ancheta, Rosedelia; Hynes, Colin; Shrier, Lydia A

    2005-04-01

    The objective of this study was to explore the associations of sources, content, and timing of reproductive health education with cognitive and behavioral sexual risk in a sample of high-risk female adolescents and young adults. Female adolescents and young adults (n=113, median age 17 years) receiving treatment for a sexually transmitted disease (STD) reported sources of reproductive health education, topics covered, and when first formal education occurred. Dependent variables included sexual risk knowledge; condom attitudes, negotiation skills, and use (consistent and at last sex); and number of sexual partners. Most participants reported receiving reproductive health education from both parental (80%) and formal sources (92%). Parents discussed the menstrual cycle (94%) more frequently than other sex education topics, while formal sources focused most on teaching about STDs (91%). Although median age of first formal instruction was 12 years, 26% of girls received their first formal education during or after the year they initiated coitus. Girls with a parental source of education and those receiving formal instruction on pregnancy reported greater ability to negotiate condom use. Girls who received education later in relation to the onset of sexual activity and those with a parental source of education reported more sexual partners. Early reproductive health education and education from both parental and formal sources is associated with reduced sexual risk among high-risk adolescent girls. Interestingly, receiving parental education is also associated with more sexual partners, suggesting that parental educational efforts may be reactive to their daughters' increasing sexual risk behavior. Future research should examine multiple sources of reproductive health education and the timing of education from these sources to enhance understanding the dynamic interactions between reproductive health education and adolescent sexual risk.

  5. The consequences of "Culture's consequences"

    DEFF Research Database (Denmark)

    Knudsen, Fabienne; Froholdt, Lisa Loloma

    2009-01-01

      In this article, it is claimed that research on cross-cultural crews is dominated by one specific understanding of the concept of culture, which is static, evenly distributed and context-independent. Such a conception of culture may bring some basic order while facing an unknown culture...... review of the theory of Geert Hofstede, the most renowned representative of this theoretical approach. The practical consequences of using such a concept of culture is then analysed by means of a critical review of an article applying Hofstede to cross-cultural crews in seafaring. Finally, alternative...... views on culture are presented. The aim of the article is, rather than to promote any specific theory, to reflect about diverse perspectives of cultural sense-making in cross-cultural encounters. Udgivelsesdato: Oktober...

  6. Quality assurance system for sitting high risk facilities

    International Nuclear Information System (INIS)

    Rodriguez, Aymee; Peralta, Jose L.; Fernandez, Manuel

    1999-01-01

    The paper shows how we have conceived and designed the quality assurance system for the site selection process of an area for sitting the facility of high risk in correspondence with the approved methodology. The results obtained in the implementation of the system have permitted the satisfactory performance of each one the expected stage, defining the most favorable sectors in order to continue the studies of the repository site for the disposal of low and intermedium. (author)

  7. Monitoring of newborns at high risk for brain injury

    OpenAIRE

    Pisani, Francesco; Spagnoli, Carlotta

    2016-01-01

    Due to the increasing number of surviving preterm newborns and to the recognition of therapeutic hypothermia as the current gold standard in newborns with hypoxic-ischaemic encephalopathy, there has been a growing interest in the implementation of brain monitoring tools in newborns at high risk for neurological disorders. Among the most frequent neurological conditions and presentations in the neonatal period, neonatal seizures and neonatal status epilepticus, paroxysmal non-epileptic motor p...

  8. Improving Asthma Communication in High-Risk Children

    OpenAIRE

    Butz, Arlene M.; Walker, Jennifer; Land, Cassia Lewis; Vibbert, Carrie; Winkelstein, Marilyn

    2007-01-01

    Few child asthma studies address the specific content and techniques needed to enhance child communication during asthma preventive care visits. This study examined the content of child and parent communications regarding their asthma management during a medical encounter with their primary care provider (PCP). The majority of parents and children required prompting to communicate symptom information to the PCP during the clinic visit. Some high-risk families may require an asthma advocate to...

  9. High risk bladder cancer: current management and survival

    Directory of Open Access Journals (Sweden)

    Anna M. Leliveld

    2011-04-01

    Full Text Available PURPOSE: To evaluate the pattern of care in patients with high risk non muscle invasive bladder cancer (NMIBC in the Comprehensive Cancer Center North-Netherlands (CCCN and to assess factors associated with the choice of treatment, recurrence and progression free survival rates. MATERIALS AND METHODS: Retrospective analysis of 412 patients with newly diagnosed high risk NMIBC. Clinical, demographic and follow-up data were obtained from the CCCN Cancer Registry and a detailed medical record review. Uni and multivariate analysis was performed to identify factors related to choice of treatment and 5 year recurrence and progression free survival. RESULTS: 74/412 (18% patients with high risk NMIBC underwent a transurethral resection (TUR as single treatment. Adjuvant treatment after TUR was performed in 90.7% of the patients treated in teaching hospitals versus 71.8 % in non-teaching hospitals (p 80 years OR 0.1 p = 0.001 and treatment in non-teaching hospitals (OR 0.25; p < 0.001 were associated with less adjuvant treatment after TUR. Tumor recurrence occurred in 191/392 (49% and progression in 84 /392 (21.4% patients. The mean 5-years progression free survival was 71.6% (95% CI 65.5-76.8. CONCLUSION: In this pattern of care study in high risk NMIBC, 18% of the patients were treated with TUR as single treatment. Age and treatment in non-teaching hospitals were associated with less adjuvant treatment after TUR. None of the variables sex, age, comorbidity, hospital type, stage and year of treatment was associated with 5 year recurrence or progression rates.

  10. Tamoxifen for women at high risk of breast cancer

    OpenAIRE

    Nazarali, Safia A; Narod, Steven A

    2014-01-01

    Safia A Nazarali, Steven A Narod Women's College Research Institute, Women's College Hospital, and The University of Toronto, Toronto, Ontario, Canada Abstract: Tamoxifen has been used as a treatment for women who have been diagnosed with breast cancer for roughly four decades and has been approved as chemoprevention for over ten years. Although tamoxifen has been proven to be beneficial in preventing breast cancer in high-risk women, its use has not been widely embraced. To ...

  11. Postoperative chemoradiotherapy in high risk locally advanced gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Song, Sang Hyuk; Chie, Eui Kyu; Kim, Kyu Bo; Lee, Hyuk Joon; Yang, Han Kwang; Han, Sae Won; Oh, Do Youn; Im, Seok Ah; Bang, Yung Jue; Ha, Sung W. [Seoul National University College of Medicine, Seoul(Korea, Republic of)

    2012-12-15

    To evaluate treatment outcome of patients with high risk locally advanced gastric cancer after postoperative chemoradiotherapy. Between May 2003 and May 2012, thirteen patients who underwent postoperative chemoradiotherapy for gastric cancer with resection margin involvement or adjacent structure invasion were retrospectively analyzed. Concurrent chemotherapy was administered in 10 patients. Median dose of radiation was 50.4 Gy (range, 45 to 55.8 Gy). The median follow-up duration for surviving patients was 48 months (range, 5 to 108 months). The 5-year overall survival rate was 42% and the 5-year disease-free survival rate was 28%. Major pattern of failure was peritoneal seeding with 46%. Loco-regional recurrence was reported in only one patient. Grade 2 or higher gastrointestinal toxicity occurred in 54% of the patients. However, there was only one patient with higher than grade 3 toxicity. Despite reported suggested role of adjuvant radiotherapy with combination chemotherapy in gastric cancer, only very small portion of the patients underwent the treatment. Results from this study show that postoperative chemoradiotherapy provided excellent locoregional control with acceptable and manageable treatment related toxicity in patients with high risk locally advanced gastric cancer. Thus, postoperative chemoradiotherapy may improve treatment result in terms of locoregional control in these high risk patients. However, as these findings are based on small series, validation with larger cohort is suggested.

  12. Forecasting Value-at-Risk Using High-Frequency Information

    Directory of Open Access Journals (Sweden)

    Huiyu Huang

    2013-06-01

    Full Text Available in the prediction of quantiles of daily Standard&Poor’s 500 (S&P 500 returns we consider how to use high-frequency 5-minute data. We examine methods that incorporate the high frequency information either indirectly, through combining forecasts (using forecasts generated from returns sampled at different intraday interval, or directly, through combining high frequency information into one model. We consider subsample averaging, bootstrap averaging, forecast averaging methods for the indirect case, and factor models with principal component approach, for both direct and indirect cases. We show that in forecasting the daily S&P 500 index return quantile (Value-at-Risk or VaR is simply the negative of it, using high-frequency information is beneficial, often substantially and particularly so, in forecasting downside risk. Our empirical results show that the averaging methods (subsample averaging, bootstrap averaging, forecast averaging, which serve as different ways of forming the ensemble average from using high-frequency intraday information, provide an excellent forecasting performance compared to using just low-frequency daily information.

  13. Sun-protective behaviors in populations at high risk for skin cancer

    Science.gov (United States)

    Diao, Diana Y; Lee, Tim K

    2014-01-01

    Over 3 million new cases of skin cancer are diagnosed in the US annually. Melanoma, a subtype of skin cancer that can be fatal if the disease is not detected and treated at an early stage, is the most common cancer for those aged 25–29 years and the second most common cancer in adolescents and young adults aged 15–29 years. The primary carcinogen for the genesis of skin cancers is ultraviolet light from solar radiation and tanning beds. In spite of massive health campaigns to raise public awareness on ultraviolet radiation, sun-protective practices still fall behind. A plausible explanation is the lack of behavioral change in the populations at risk; in this review article, we examine sun-protective behavior in the four high-risk skin cancer groups: skin cancer survivors, individuals with a family history of melanoma, individuals with physical characteristics associated with skin cancer risk, and organ transplantation patients. Findings in the literature demonstrate that increased knowledge and awareness does not consequently translate into behavioral changes in practice. Behavior can differ as a result of different attitudes and beliefs, depending on the population at risk. Thus, intervention should be tailored to the population targeted. A multidisciplinary health team providing consultation and education is required to influence these much needed changes. PMID:24379732

  14. Racial and gender discrimination: risk factors for high blood pressure?

    Science.gov (United States)

    Krieger, N

    1990-01-01

    Despite controversy as to the biologic and/or social meaning of 'race' and 'sex', few public health studies have directly examined the impact of racial or gender discrimination on health. One plausible condition they might affect is hypertension, since stress and internalized anger may constitute important risk factors for this disease. The present investigation therefore sought to determine the feasibility of asking questions pertaining to race- and gender-biased treatment plus response to unfair treatment, and to assess their predictive value regarding self-reported high blood pressure. Using random-digit dialing, 51 black and 50 white women, ages 20-80, who resided in Alameda County, CA in 1987, were identified and interviewed by phone. Among black respondents, those who stated they usually accepted and kept quiet about unfair treatment were 4.4 times more likely to report hypertension than women who said they took action and talked to others (P = 0.01 for linear trend); no clear association existed among white respondents. The age-adjusted risk of high blood pressure among black respondents who recounted experiencing zero instances of race- and gender-biased treatment was 2.6 times greater than that of black women who reported one or more such instances (95% CI = 0.7, 10.5). Among white respondents, gender discrimination was not associated with hypertension. These results suggest that an internalized response to unfair treatment, plus non-reporting of race and gender discrimination, may constitute risk factors for high blood pressure among black women. They also bolster the view that subjective appraisal of stressors may be inversely associated with risk of hypertension.

  15. Effects of Comprehensive, Multiple High-Risk Behaviors Prevention Program on High School Students

    Science.gov (United States)

    Collier, Crystal

    2013-01-01

    The purpose of this mixed methods study was to examine the effect of a multiple high-risk behaviors prevention program applied comprehensively throughout an entire school-system involving universal, selective, and indicated levels of students at a local private high school during a 4-year period. The prevention program was created based upon the…

  16. INSTRUMENTS OF HIGH RISK SEXUAL BEHAVIOR ASSESSMENT: A SYSTEMATIC REVIEW.

    Science.gov (United States)

    Mirzaei, Mojtaba; Ahmadi, Khodabakhsh; Saadat, Seyed-Hassan; Ramezani, Mohammad Arash

    2016-02-01

    Sexual behavior is a complex activity affecting all aspects of human's life. Risky sexual behaviors impose negative outcomes on family, relationships and health. Unsafe sex is the second most leading cause of disability adjusted life years worldwide. Valid and reliable tools for assessment of risky sexual behaviors are necessary for implementing preventive measures. we searched Medline and the Cochrane Library of Systematic Reviews, with the keywords of "risky sexual behavior assessment", "sexual risk assessment", "high risk sexual behavior", "sexual risk taking". By reviewing references of the articles, some complementary studies were added. Assessment can be performed by questionnaire or non-questionnaire instruments. Questionnaires vary depending on their target population, evaluation of risky sexual behavior as a whole or focusing on an associated risk factor. In order to avoid usual biases in self reports, objective biomarker assessment of unprotected sex are employed. These markers include prostate specific antigen, chromosome Y DNA and Seminogelin. Risky sexual behavior can be assessed by various subjective and objective methods. While self-reports are more feasible, objective methods offer a higher degree of reliability. Further studies for finding more feasible methods of using biomarkers are recommended.

  17. and consequences

    Directory of Open Access Journals (Sweden)

    P. Athanasopoulou

    2011-01-01

    Full Text Available (a Purpose: The purpose of this research is to identify the types of CSR initiatives employed by sports organisations; their antecedents, and their consequences for the company and society. (b Design/methodology/approach: This study is exploratory in nature. Two detailed case studies were conducted involving the football team and the basketball team of one professional, premier league club in Greece and their CSR initiatives. Both teams have the same name, they belong to one of the most popular teams in Greece with a large fan population; have both competed in International Competitions (UEFA’s Champion League; Final Four of the European Tournament and have realised many CSR initiatives in the past. The case studies involved in depth, personal interviews of managers responsible for CSR in each team. Case study data was triangulated with documentation and search of published material concerning CSR actions. Data was analysed with content analysis. (c Findings: Both teams investigated have undertaken various CSR activities the last 5 years, the football team significantly more than the basketball team. Major factors that affect CSR activity include pressure from leagues; sponsors; local community, and global organisations; orientation towards fulfilling their duty to society, and team CSR strategy. Major benefits from CSR include relief of vulnerable groups and philanthropy as well as a better reputation for the firm; increase in fan base; and finding sponsors more easily due to the social profile of the team. However, those benefits are not measured in any way although both teams observe increase in tickets sold; web site traffic and TV viewing statistics after CSR activities. Finally, promotion of CSR is mainly done through web sites; press releases; newspapers, and word-of-mouth communications. (d Research limitations/implications: This study involves only two case studies and has limited generalisability. Future research can extend the

  18. Specialized surveillance for individuals at high risk for melanoma: a cost analysis of a high-risk clinic.

    Science.gov (United States)

    Watts, Caroline G; Cust, Anne E; Menzies, Scott W; Coates, Elliot; Mann, Graham J; Morton, Rachael L

    2015-02-01

    Regular surveillance of individuals at high risk for cutaneous melanoma improves early detection and reduces unnecessary excisions; however, a cost analysis of this specialized service has not been undertaken. To determine the mean cost per patient of surveillance in a high-risk clinic from the health service and societal perspectives. We used a bottom-up microcosting method to measure resource use in a consecutive sample of 102 patients treated in a high-risk hospital-based clinic in Australia during a 12-month period. Surveillance and treatment of melanoma. All surveillance and treatment procedures were identified through direct observation, review of medical records, and interviews with staff and were valued using scheduled fees from the Australian government. Societal costs included transportation and loss of productivity. The mean number of clinic visits per year was 2.7 (95% CI, 2.5-2.8) for surveillance and 3.8 (95% CI, 3.4-4.1) for patients requiring surgical excisions. The mean annual cost per patient to the health system was A $882 (95% CI, A $783-$982) (US $599 [95% CI, US $532-$665]); the cost discounted across 20 years was A $11,546 (95% CI, A $10,263-$12,829) (US $7839 [95% CI, US $6969-$8710]). The mean annual societal cost per patient (excluding health system costs) was A $972 (95% CI, A $899-$1045) (US $660 [95% CI, US $611-$710]); the cost discounted across 20 years was A $12,721 (95% CI, A $12,554-$14,463) (US $8637 [95% CI, US $8523-$9820]). Diagnosis of melanoma or nonmelanoma skin cancer and frequent excisions for benign lesions in a relatively small number of patients was responsible for positively skewed health system costs. Microcosting techniques provide an accurate cost estimate for the provision of a specialized service. The high societal cost reflects the time that patients are willing to invest to attend the high-risk clinic. This alternative model of care for a high-risk population has relevance for decision making about health policy.

  19. Perceptions of risk from workers in high risk industries with work related musculoskeletal disorders.

    Science.gov (United States)

    Hunter, D; Silverstein, B

    2014-01-01

    Work-related musculoskeletal disorders (WMSDs) remain a major occupational health problem, despite decades of research, outreach, and intervention. The aim of this study is to promote early identification and prevention of WMSDs by developing education and outreach materials grounded in interview data collected from workers that have recently filed for workers compensation (WC) for WMSDs. We conducted semi-structured telephone interviews with WC claimants (n=66) from high risk industries identified through the use of a Prevention Index (PI) in Washington state with WMSDs of the back, shoulder, hand/wrist, or knee. Perceptions regarding the degree of exposure to WMSD risk factors, the social construction of pain, and the potential to implement injury-prevention measures varied widely. Many workers dismissed their injuries as the result of "fluke" or "freak" occurrences and framed their exposure to risk factors for WMSDs as either inevitable or "just part of the job." Workers in high-risk industries for WMSDs described their work conditions in ways that suggested: (1) a lack of awareness of the potential for developing a WMSD, (2) a view of work-related pain as normal, and/or (3) a pattern of self-blame for WMSD onset. A paradigm that either asserts the inevitability of WMSDs or dismisses potential control measures presents both a significant barrier to injury prevention efforts as well as a major opportunity for future occupational health research.

  20. High resolution estimates of the corrosion risk for cultural heritage in Italy.

    Science.gov (United States)

    De Marco, Alessandra; Screpanti, Augusto; Mircea, Mihaela; Piersanti, Antonio; Proietti, Chiara; Fornasier, M Francesca

    2017-07-01

    Air pollution plays a pivotal role in the deterioration of many materials used in buildings and cultural monuments causing an inestimable damage. This study aims to estimate the impacts of air pollution (SO 2 , HNO 3 , O 3 , PM 10 ) and meteorological conditions (temperature, precipitation, relative humidity) on limestone, copper and bronze based on high resolution air quality data-base produced with AMS-MINNI modelling system over the Italian territory over the time period 2003-2010. A comparison between high resolution data (AMS-MINNI grid, 4 × 4 km) and low resolution data (EMEP grid, 50 × 50 km) has been performed. Our results pointed out that the corrosion levels for limestone, copper and bronze are decreased in Italy from 2003 to 2010 in relation to decrease of pollutant concentrations. However, some problem related to air pollution persists especially in Northern and Southern Italy. In particular, PM 10 and HNO 3 are considered the main responsible for limestone corrosion. Moreover, the high resolution data (AMS-MINNI) allowed the identification of risk areas that are not visible with the low resolution data (EMEP modelling system) in all considered years and, especially, in the limestone case. Consequently, high resolution air quality simulations are suitable to provide concrete benefits in providing information for national effective policy against corrosion risk for cultural heritage, also in the context of climate changes that are affecting strongly Mediterranean basin. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Early detection of psychosis: finding those at clinical high risk.

    Science.gov (United States)

    Addington, Jean; Epstein, Irvin; Reynolds, Andrea; Furimsky, Ivana; Rudy, Laura; Mancini, Barbara; McMillan, Simone; Kirsopp, Diane; Zipursky, Robert B

    2008-08-01

    In early detection work, recruiting individuals who meet the prodromal criteria is difficult. The aim of this paper was to describe the development of a research clinic for individuals who appear to be at risk of developing a psychosis and the process for educating the community and obtaining referrals. The outcome of all referrals to the clinic over a 4-year period was examined. Following an ongoing education campaign that was over inclusive in order to aid recruitment, approximately 27% of all referrals met the criteria for being at clinical high risk of psychosis. We are seeing only a small proportion of those in the community who eventually go on to develop a psychotic illness. This raises two important issues, namely how to remedy the situation, and second, the impact of this on current research in terms of sampling bias and generalizability of research findings. © 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Asia Pty Ltd.

  2. Risk Factors Associated with Incident Syphilis in a Cohort of High-Risk Men in Peru

    Science.gov (United States)

    Konda, Kelika A.; Roberts, Chelsea P.; Maguiña, Jorge L.; Leon, Segundo R.; Clark, Jesse L.; Coates, Thomas J.; Caceres, Carlos F.; Klausner, Jeffrey D.

    2016-01-01

    Background Syphilis is concentrated among high-risk groups, but the epidemiology of syphilis reinfection is poorly understood. We characterized factors associated with syphilis incidence, including reinfection, in a high-risk cohort in Peru. Methods Participants in the NIMH CPOL trial were assessed at baseline and 2 annual visits with HIV/STI testing and behavioral surveys. Participants diagnosed with syphilis also attended 4- and 9-month visits. All participants underwent syphilis testing with RPR screening and TPPA confirmation. Antibiotic treatment was provided according to CDC guidelines. Reinfection was defined as a 4-fold titer increase or recurrence of seroreactivity after successful treatment with subsequent negative RPR titers. The longitudinal analysis used a Possion generalized estimating equations model with backward selection of variables in the final model (criteria P <0.02). Results Of 2,709 participants, 191 (7.05%) were RPR-reactive (median 1:8, range 1:1–1:1024) with TPPA confirmation. There were 119 total cases of incident syphilis, which included both reinfection and first-time incident cases. In the bivariate analysis, the oldest 2 quartiles of age (incidence ratio (IR) 3.84; P <0.001 and IR 8.15; P <0.001) and being MSM/TW (IR 6.48; P <0.001) were associated with higher risk of incident syphilis infection. Of the sexual risk behaviors, older age of sexual debut (IR 12.53; P <0.001), not being in a stable partnership (IR 1.56, P = 0.035), higher number of sex partners (IR 3.01; P <0.001), unprotected sex in the past 3 months (IR 0.56; P = 0.003), HIV infection at baseline (IR 3.98; P <0.001) and incident HIV infection during the study period (IR 6.26; P = 0.003) were all associated with incident syphilis. In the multivariable analysis, older age group (adjusted incidence ratio (aIR) 6.18; P <0.001), men reporting having sex with a man (aIR 4.63; P <0.001), and incident HIV infection (aIR 4.48; P = 0.008) were significantly associated

  3. The cardiac safety of aripiprazole treatment in patients at high risk for torsade

    DEFF Research Database (Denmark)

    Polcwiartek, Christoffer; Sneider, Benjamin; Graff, Claus

    2015-01-01

    RATIONALE: Certain antipsychotics increase the risk of heart rate-corrected QT (QTc) prolongation and consequently Torsades de Pointes (TdP) and sudden cardiac death (SCD). Drug-induced Brugada syndrome (BrS) is also associated with SCD. Most SCDs occur in patients with additional cardiac risk fa...

  4. High-school software development project helps increasing students' awareness of geo-hydrological hazards and their risks

    Science.gov (United States)

    Marchesini, Ivan; Rossi, Mauro; Balducci, Vinicio; Salvati, Paola; Guzzetti, Fausto; Bianchini, Andrea; Grzeleswki, Emanuell; Canonico, Andrea; Coccia, Rita; Fiorucci, Gianni Mario; Gobbi, Francesca; Ciuchetti, Monica

    2015-04-01

    In Italy, inundation and landslides are widespread phenomena that impact the population and cause significant economic damage to private and public properties. The perception of the risk posed by these natural geo-hydrological hazards varies geographically and in time. The variation in the perception of the risks has negative consequences on risk management, and limits the adoption of effective risk reduction strategies. We maintain that targeted education can foster the understanding of geo-hydrological hazards, improving their perception and the awareness of the associated risk. Collaboration of a research center experienced in geo-hydrological hazards and risks (CNR IRPI, Perugia) and a high school (ITIS Alessandro Volta, Perugia) has resulted in the design and execution of a project aimed at improving the perception of geo-hydrological risks in high school students and teachers through software development. In the two-year project, students, high school teachers and research scientists have jointly developed software broadly related to landslide and flood hazards. User requirements and system specifications were decided to facilitate the distribution and use of the software among students and their peers. This allowed a wider distribution of the project results. We discuss two prototype software developed by the high school students, including an application of augmented reality for improved dissemination of information of landslides and floods with human consequences in Italy, and a crowd science application to allow students (and others, including their families and friends) to collect information on landslide and flood occurrence exploiting modern mobile devices. This information can prove important e.g., for the validation of landslide forecasting models.

  5. 2017 Taiwan lipid guidelines for high risk patients

    Directory of Open Access Journals (Sweden)

    Yi-Heng Li

    2017-04-01

    Full Text Available In Taiwan, the prevalence of hyperlipidemia increased due to lifestyle and dietary habit changes. Low density lipoprotein cholesterol (LDL-C and non-high density lipoprotein cholesterol (non-HDL-C are all significant predicting factors of coronary artery disease in Taiwan. We recognized that lipid control is especially important in patients with existed atherosclerotic cardiovascular diseases (ASCVD, including coronary artery disease (CAD, ischemic stroke and peripheral arterial disease (PAD. Because the risk of ASCVD is high in patients with diabetes mellitus (DM, chronic kidney disease (CKD and familial hypercholesterolemia (FH, lipid control is also necessary in these patients. Lifestyle modification is the first step to control lipid. Weight reduction, regular physical exercise and limitation of alcohol intake all reduce triglyceride (TG levels. Lipid-lowering drugs include HMG-CoA reductase inhibitors (statins, cholesterol absorption inhibitors (ezetimibe, proprotein convertase subtilisin/kexin type 9 (PCSK9 inhibitors, nicotinic acids (niacin, fibric acids derivatives (fibrates, and long-chain omega-3 fatty acids. Statin is usually the first line therapy. Combination therapy with statin and other lipid-lowering agents may be considered in some clinical settings. For patients with acute coronary syndrome (ACS and stable CAD, LDL-C 40 in men and >50 mg/dL in women in DM. LDL-C increased CV risk in patients with CKD. In adults with glomerular filtration rate (GFR < 60 mL/min/1.73m2 without chronic dialysis (CKD stage 3–5, statin therapy should be initiated if LDL-C ≥ 100 mg/dL. Ezetimibe can be added to statin to consolidate the CV protection in CKD patients. Mutations in LDL receptor, apolipoprotein B and PCSK9 genes are the common causes of FH. Diagnosis of FH usually depends on family history, clinical history of premature CAD, physical findings of xanthoma or corneal arcus and high levels of LDL-C. In addition to conventional lipid

  6. Entropy measure of credit risk in highly correlated markets

    Science.gov (United States)

    Gottschalk, Sylvia

    2017-07-01

    We compare the single and multi-factor structural models of corporate default by calculating the Jeffreys-Kullback-Leibler divergence between their predicted default probabilities when asset correlations are either high or low. Single-factor structural models assume that the stochastic process driving the value of a firm is independent of that of other companies. A multi-factor structural model, on the contrary, is built on the assumption that a single firm's value follows a stochastic process correlated with that of other companies. Our main results show that the divergence between the two models increases in highly correlated, volatile, and large markets, but that it is closer to zero in small markets, when asset correlations are low and firms are highly leveraged. These findings suggest that during periods of financial instability, when asset volatility and correlations increase, one of the models misreports actual default risk.

  7. Phenomenological consequences of supersymmetry

    International Nuclear Information System (INIS)

    Hinchliffe, I.; Littenberg, L.

    1982-01-01

    This paper deals with the phenomenological consequences of supersymmetric theories, and with the implications of such theories for future high energy machines. The paper represents the work of a subgroup at the meeting. The authors are concerned only with high energy predictions of supersymmetry; low energy consequences (for example in the K/sub o/K-bar/sub o/ system) are discussed in the context of future experiments by another group, and will be mentioned briefly only in the context of constraining existing models. However a brief section is included on the implication for proton decay, although detailed experimental questions are not discussed

  8. [Residual risk: The roles of triglycerides and high density lipoproteins].

    Science.gov (United States)

    Grammer, Tanja; Kleber, Marcus; Silbernagel, Günther; Scharnagl, Hubert; März, Winfried

    2016-06-01

    In clinical trials, the reduction of LDL-cholesterol (LDL-C) with statins reduces the incidence rate of cardiovascular events by approximately one third. This means, that a sizeable "residual risk" remains. Besides high lipoprotein (a), disorders in the metabolism of triglyceride-rich lipoproteins and high density liproteins have been implicated as effectors of the residual risk. Both lipoprotein parameters correlate inversely with each other. Therefore, the etiological contributions of triglycerides and / or of HDL for developing cardiovascular disease can hardly be estimated from either observational studies or from intervention studies. The largely disappointing results of intervention studies with inhibitors of the cholesteryl ester transfer protein and in particular the available set of genetically-epidemiological studies suggest that in the last decade, the importance of HDL cholesterol has been overvalued, while the importance of triglycerides has been underestimated. High triglycerides not always atherogenic, but only if they are associated with the accumulation relatively cholesterol-enriched, incompletely catabolized remnants of chylomicrons and very low density lipoproteins (familial type III hyperlipidemia, metabolic syndrome, diabetes mellitus). The normalization of the concentration of triglycerides and remnants by inhibiting the expression of apolipoprotein C3 is hence a new, promising therapeutic target. © Georg Thieme Verlag KG Stuttgart · New York.

  9. High-Risk Driving Behaviors among Adolescent Binge-Drinkers

    Science.gov (United States)

    Marcotte, Thomas D.; Bekman, Nicole M.; Meyer, Rachel A.; Brown, Sandra A.

    2013-01-01

    Background Binge drinking is common among adolescents. Alcohol use, and binge-drinking in particular, has been associated with neurocognitive deficits as well as risk-taking behaviors, which may contribute to negative driving outcomes among adolescents even while sober. Objectives To examine differences in self-reported driving behaviors between adolescent binge-drinkers and a matched sample of controls, including (a) compliance with graduated licensing laws, (b) high risk driving behaviors, and (c) driving outcomes (crashes, traffic tickets). Methods The present study examined driving behaviors and outcomes in adolescent recent binge drinkers (n=21) and demographically and driving history matched controls (n=17), ages 16-18. Results Binge drinkers more frequently violated graduated licensing laws (e.g., driving late at night), and engaged in more “high risk” driving behaviors, such as speeding and using a cell-phone while driving. Binge drinkers had more traffic tickets, crashes and “near crashes” than the control group. In a multivariate analysis, binge drinker status and speeding were the most robust predictors of a crash. Conclusion Binge drinking teens consistently engage in more dangerous driving behaviors and experience more frequent crashes and traffic tickets. They are also less compliant with preventative restrictions placed on youth while they are learning critical safe driving skills. Scientific Significance These findings highlight a need to examine the contribution of underlying traits (such as sensation seeking) and binge-related cognitive changes to these high-risk driving behaviors, which may assist researchers in establishing alternative prevention and policy efforts targeting this population. PMID:22324748

  10. Teamwork in high-risk environments analogous to space

    Science.gov (United States)

    Kanki, Barbara G.

    1990-01-01

    Mountaineering expeditions combine a number of factors which make them potentially good analogs to the planetary exploration facet of long-duration space missions. A study of mountain climbing teams was conducted in order to evaluate the usefulness of the environment as a space analog and to specifically identify the factors and issues surrounding teamwork and 'successful' team performance in two mountaineering environments. This paper focuses on social/organizational factors, including team size and structure, leadership styles and authority structure which were found in the sample of 22 climb teams (122 individuals). The second major issue discussed is the construction of a valid performance measure in this high-risk environment.

  11. Against the tide: climate change and high-risk cities

    Energy Technology Data Exchange (ETDEWEB)

    Dodman, David

    2008-11-15

    In the world's poorest and most vulnerable nations, most cities and towns face a distinct dual pressure: rapidly growing population and high vulnerability to the impacts of climate change. Drought, storms, flooding and sea level rise are likely to hit hardest here. These in turn put water supplies, infrastructure, health and livelihoods at risk in the very cities already struggling to provide or safeguard such key needs. An effective response demands capable local and national government and support from strong international networks in building capacity to cope. Most of the Least Developed Countries lack both.

  12. Can everyone become highly intelligent? Cultural differences in and societal consequences of beliefs about the universal potential for intelligence.

    Science.gov (United States)

    Rattan, Aneeta; Savani, Krishna; Naidu, N V R; Dweck, Carol S

    2012-11-01

    We identify a novel dimension of people's beliefs about intelligence: beliefs about the potential to become highly intelligent. Studies 1-3 found that in U.S. American contexts, people tend to believe that only some people have the potential to become highly intelligent. In contrast, in South Asian Indian contexts, people tend to believe that most people have the potential to become highly intelligent. To examine the implications of these beliefs, Studies 4-6 measured and manipulated Americans' beliefs about the potential for intelligence and found that the belief that everyone can become highly intelligent predicted increased support for policies that distribute resources more equally across advantaged and disadvantaged social groups. These findings suggest that the belief that only some people have the potential to become highly intelligent is a culturally shaped belief, and one that can lead people to oppose policies aimed at redressing social inequality. (c) 2012 APA, all rights reserved.

  13. Predicting disease risks from highly imbalanced data using random forest

    Directory of Open Access Journals (Sweden)

    Chakraborty Sounak

    2011-07-01

    Full Text Available Abstract Background We present a method utilizing Healthcare Cost and Utilization Project (HCUP dataset for predicting disease risk of individuals based on their medical diagnosis history. The presented methodology may be incorporated in a variety of applications such as risk management, tailored health communication and decision support systems in healthcare. Methods We employed the National Inpatient Sample (NIS data, which is publicly available through Healthcare Cost and Utilization Project (HCUP, to train random forest classifiers for disease prediction. Since the HCUP data is highly imbalanced, we employed an ensemble learning approach based on repeated random sub-sampling. This technique divides the training data into multiple sub-samples, while ensuring that each sub-sample is fully balanced. We compared the performance of support vector machine (SVM, bagging, boosting and RF to predict the risk of eight chronic diseases. Results We predicted eight disease categories. Overall, the RF ensemble learning method outperformed SVM, bagging and boosting in terms of the area under the receiver operating characteristic (ROC curve (AUC. In addition, RF has the advantage of computing the importance of each variable in the classification process. Conclusions In combining repeated random sub-sampling with RF, we were able to overcome the class imbalance problem and achieve promising results. Using the national HCUP data set, we predicted eight disease categories with an average AUC of 88.79%.

  14. Protecting military personnel from high risk dietary supplements.

    Science.gov (United States)

    Deuster, Patricia A; Lieberman, Harris R

    2016-01-01

    It is legal tomarketmost naturally occurring substances as dietary supplements in the USA without manufacturers demonstrating they are safe or effective, and an endless variety of ingredients, from esoteric botanicals to unapproved pharmaceuticals, can be found in dietary supplements. Use of certain supplements can pose a risk, but since a robust reporting systemdoes not exist in the USA it is difficult to know which are problematic and the number of adverse events (AE) resulting from their use. Certain populations, includingmilitary personnel, aremore likely to use dietary supplements than the general population. Approximately 70% of military personnel take dietary supplements while about 50% of civilians do. Service members prefer supplements purported to enhance physical performance such as supposedly natural stimulants, protein and amino acids, and combination products. Since some of thesemay be problematic, Servicemembers are probably at higher risk of injury than the general population. Ten percent of military populations appear to be taking potentially risky supplements, and the US Department of Defense (DoD) has taken variousmeasures to protect uniformed personnel including education, policy changes, and restricting sales. Actions taken include launching Operation Supplement Safety (OPSS), introducing a High Risk Supplement list, educating health care professionals on reporting AE thatmight be associated with dietary supplements, recommending policy for reporting AE, and developing an online AE reporting system. OPSS is a DoD-wide effort to educate service members, leaders, health care providers, military families, and retirees on how to safely select supplements

  15. Reducing sexual risk behavior among high-risk couples in Northern India.

    Science.gov (United States)

    Jones, Deborah; Bagga, Rashmi; Nehra, Ritu; Deepika; Sethi, Sunil; Walia, Kamini; Kumar, Mahendra; Villar-Loubet, Olga; Lopez, Maria; Weiss, Stephen M

    2013-09-01

    With a population of 1.1 billion, India is considered to be a country in which effective prevention interventions could contain the development of a human immunodeficiency virus (HIV) epidemic. Heterosexual transmission accounts for 85 % of the extant HIV infections. This study sought to assess the feasibility of conducting a group, culturally tailored behavioral intervention and its impact on sexual barrier use, self-efficacy, knowledge, conflict resolution, and coping among high-risk heterosexual couples in Northern India. This pilot study was conducted at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India from February 2008 to January 2009. Thirty sexually active high-risk couples were drawn from a convenience sample of PGIMER patients attending infectious disease and family planning clinics. Couples participated in 1 month of three weekly gender-concordant behavioral intervention groups and were individually administered assessments preintervention and post-intervention. The intervention was tailored to the Northern Indian context and addressed sexual barrier use, human immunodeficiency virus (HIV)/sexually transmitted infection transmission, and cognitive behavioral skill building focusing on sexual negotiation and communication. The participants had a mean age of 32 years (men) and 29 years (women), and the majority had at least 10 years of education. At baseline, the majority reported inconsistent condom use (knowledge, and women increased their use of positive coping tactics. The results highlight the potential to successfully utilize a group intervention to discuss sensitive issues such as sexual risk behavior among both men and women. Strategies to improve condom use and communication without increasing intimate partner violence in high-risk couples may be an important adjunct to preventing the development of a generalized epidemic in India.

  16. High environmental ammonia exposure has developmental-stage specific and long-term consequences on the cortisol stress response in zebrafish.

    Science.gov (United States)

    Williams, Tegan A; Bonham, Luke A; Bernier, Nicholas J

    2017-12-01

    The capacity for early life environmental stressors to induce programming effects on the endocrine stress response in fish is largely unknown. In this study we determined the effects of high environmental ammonia (HEA) exposure on the stress response in larval zebrafish, assessed the tolerance of embryonic and larval stages to HEA, and evaluated whether early life HEA exposure has long-term consequences on the cortisol response to a novel stressor. Exposure to 500-2000μM NH 4 Cl for 16h did not affect the gene expression of corticotropin-releasing factor (CRF) system components in 1day post-fertilization (dpf) embryos, but differentially increased crfa, crfb and CRF binding protein (crfbp) expression and stimulated both dose- and time-dependent increases in the whole body cortisol of 5dpf larvae. Pre-acclimation to HEA at 1dpf did not affect the cortisol response to a subsequent NH 4 Cl exposure at 5dpf. In contrast, pre-acclimation to HEA at 5dpf caused a small but significant reduction in the cortisol response to a second NH 4 Cl exposure at 10dpf. While continuous exposure to 500-2000μM NH 4 Cl between 0 and 5dpf had a modest effect on mean survival time, exposure to 400-1000μM NH 4 Cl between 10 and 14dpf decreased mean survival time in a dose-dependent manner. Moreover, pre-acclimation to HEA at 5dpf significantly decreased the risk of mortality to continuous NH 4 Cl exposure between 10 and 14dpf. Finally, while HEA at 1dpf did not affect the cortisol stress response to a novel vortex stressor at 5dpf, the same HEA treatment at 5dpf abolished vortex stressor-induced increases in whole body cortisol at 10 and 60dpf. Together these results show that the impact of HEA on the cortisol stress response during development is life-stage specific and closely linked to ammonia tolerance. Further, we demonstrate that HEA exposure at the larval stage can have persistent effects on the capacity to respond to stressors in later life. Copyright © 2017 Elsevier Inc. All

  17. At-risk high school seniors: Science remediation for Georgia's High School Graduation Test

    Science.gov (United States)

    Carroll, Carolyn M.

    State departments of education have created a system of accountability for the academic achievement of students under the mandate of the No Child Left Behind Act of 2001. The Georgia Department of Education established the Georgia High School Graduation Test (GHSGT) as their method of evaluating the academic achievement of high school students. The GHSGT consist of five sections and students must pass all five sections before students they are eligible to receive a diploma. The purpose of the study was to examine the effects of teacher-lead and computer based remediation for a group of high school seniors who have been unsuccessful in passing the science portion of the GHSGT. The objectives of this study include (a) Identify the most effective method of remediation for at-risk students on the science section of the GHSGT, and (b) evaluate the methods of remediation for at-risk students on the science section of GHSGT available to high school students. The participants of this study were at-risk seniors enrolled in one high school during the 2007-2008 school year. The findings of this research study indicated that at-risk students who participated in both types of remediation, teacher-led and computer-based, scored significantly higher than the computer-based remediation group alone. There was no significant relationship between the test scores and the number of times the students were tested.

  18. Climate change consequences for terrestrial ecosystem processes in NW Greeland: Results from the High Arctic Biocomplexity project

    Science.gov (United States)

    Welker, J. M.; Sullivan, P.; Rogers, M.; Sharp, E. D.; Sletten, R.; Burnham, J. L.; Hallet, B.; Hagedorn, B.; Czimiczk, C.

    2009-12-01

    Greenland is experiencing some of the fastest rates of climate warming across the Arctic including warmer summers and increases in snow fall. The effects of these new states of Greenland are however, uncertain especially for carbon, nitrogen and water biogeochemical processes, soil traits, vegetation growth patterns, mineral nutrition and plant ecophysiological processes. Since 2003 we have conducted a suite of observational and experimental measurements that have been designed to understand the fundamental nature of polar desert, polar semi-desert and fen landscapes in NW Greenland. In addition, we have established a suite of experiments to ascertain ecosystem responses to warming at multiple levels (~2030 and 2050), in conjunction with added summer rain; the consequences of added snow fall (ambient, intermediate and deep) and the effects of increases in nutrient additions (added N, P and N+P), which represent extreme warming conditions. We find that: a) the soil C pools are 6-fold larger than previously measured, b) extremely old C (up to ~30k bp) which has been buried by frost cracking and frost heaving is reaching the modern atmosphere, but in only trace amounts as measured by respired 14CO2, c) warming that simulates 2030, has only a small effect on net C sequestration but warming that simulates 2050 when combined with added summer rain, increases C sequestration by 300%, d) increases in N deposition almost immediately and completely changes the vegetation composition of polar semi-deserts shifting the NDVI values from 0.2 to 0.5 within 2 years. Our findings depict a system that is poised to contribute stronger feedbacks than previously expected as climates in NW Greenland change.

  19. Proximity to a high traffic road: glucocorticoid and life history consequences for nestling white-crowned sparrows.

    Science.gov (United States)

    Crino, O L; Van Oorschot, B Klaassen; Johnson, E E; Malisch, J L; Breuner, C W

    2011-09-01

    Roads have been associated with decreased reproductive success and biodiversity in avian communities and increased physiological stress in adult birds. Alternatively, roads may also increase food availability and reduce predator pressure. Previous studies have focused on adult birds, but nestlings may also be susceptible to the detrimental impacts of roads. We examined the effects of proximity to a road on nestling glucocorticoid activity and growth in the mountain white-crowned sparrow (Zonotrichia leucophrys oriantha). Additionally, we examined several possible indirect factors that may influence nestling corticosterone (CORT) activity secretion in relation to roads. These indirect effects include parental CORT activity, nest-site characteristics, and parental provisioning. And finally, we assessed possible fitness consequences of roads through measures of fledging success. Nestlings near roads had increased CORT activity, elevated at both baseline and stress-induced levels. Surprisingly, these nestlings were also bigger. Generally, greater corticosterone activity is associated with reduced growth. However, the hypothalamic-pituitary-adrenal axis matures through the nestling period (as nestlings get larger, HPA-activation is greater). Although much of the variance in CORT responses was explained by body size, nestling CORT responses were higher close to roads after controlling for developmental differences. Indirect effects of roads may be mediated through paternal care. Nestling CORT responses were correlated with paternal CORT responses and paternal provisioning increased near roads. Hence, nestlings near roads may be larger due to increased paternal attentiveness. And finally, nest predation was higher for nests close to the road. Roads have apparent costs for white-crowned sparrow nestlings--increased predation, and apparent benefits--increased size. The elevation in CORT activity seems to reflect both increased size (benefit) and elevation due to road

  20. A New Approach in the Design of High-Risk Infusion Technology

    Directory of Open Access Journals (Sweden)

    Robert Murphy

    2010-01-01

    Full Text Available The syringe infusion pump has been established as the instrument of choice for high-risk infusions, where potent drugs are often delivered at low rates of flow. However, numerous instances of unexpected flow error with consequent patient physiological impact have been reported. These include unwanted bolus delivery on release of line occlusion, dosage fluctuation due to pump height change and fluid reflux within the multiple pump installations now common in the Intensive Care Unit (ICU. This article examines the performance of a typical ICU syringe infusion pump and identifies mechanical compliance, inherent in commercial designs, as a source of flow error that should not be ignored by equipment designers. A prototype low compliance system is described and tested with performance compared to the conventional design, demonstrating advantages in terms of lower flow error.

  1. No survival difference after successful {sup 131}I ablation between patients with initially low-risk and high-risk differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Verburg, Frederik Anton [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Stokkel, Marcel P.M.; Verkooijen, Robbert B.T. [Leiden University Medical Center, Department of Radiology, Division of Nuclear Medicine, Leiden (Netherlands); Dueren, Christian; Reiners, Christoph [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Maeder, Uwe [University of Wuerzburg, Comprehensive Cancer Center, Wuerzburg (Germany); Isselt, Johannes W. van [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Marlowe, Robert J. [Spencer-Fontayne Corporation, Jersey City, NJ (United States); Smit, Johannes W. [Leiden University Medical Center, Department of Endocrinology, Leiden (Netherlands); Luster, Markus [University of Ulm, Department of Nuclear Medicine, Ulm (Germany)

    2010-02-15

    To compare disease-specific survival and recurrence-free survival (RFS) after successful {sup 131}I ablation in patients with differentiated thyroid carcinoma (DTC) between those defined before ablation as low-risk and those defined as high-risk according to the European Thyroid Association 2006 consensus statement. Retrospective data from three university hospitals were pooled. Of 2009 consecutive patients receiving ablation, 509 were identified as successfully ablated based on both undetectable stimulated serum thyroglobulin in the absence of antithyroglobulin antibodies and a negative diagnostic whole-body scan in a follow-up examination conducted 8.1{+-}4.6 months after ablation. Of these 509 patients, 169 were defined as high-risk. After a mean follow-up of 81{+-}64 months (range 4-306 months), only three patients had died of DTC, rendering assessment of disease-specific survival differences impossible. Of the 509 patients, 12 (2.4%) developed a recurrence a mean 35 months (range 12-59 months) after ablation. RFS for the duration of follow-up was 96.6% according to the Kaplan-Meier method. RFS did not differ between high-risk and low-risk patients (p=0.68). RFS differed slightly but significantly between those with papillary and those with follicular thyroid carcinoma (p=0.03) and between those aged {<=}45 years those aged >45 years at diagnosis (p=0.018). After (near) total thyroidectomy and successful {sup 131}I ablation, RFS does not differ between patients classified as high-risk and those classified as low-risk based on TNM stage at diagnosis. Consequently, the follow-up protocol should be determined on the basis of the result of initial treatment rather than on the initial tumour classification. (orig.)

  2. Parental Support, Mental Health, and Alcohol and Marijuana Use in National and High-Risk African-American Adolescent Samples

    Directory of Open Access Journals (Sweden)

    Julie Maslowsky

    2015-01-01

    Full Text Available African-American adolescents experience disproportionate rates of negative consequences of substance use despite using substances at average or below-average rates. Due to underrepresentation of African-American adolescents in etiological literature, risk and protective processes associated with their substance use require further study. This study examines the role of parental support in adolescents’ conduct problems (CPs, depressive symptoms (DSs, and alcohol and marijuana use in a national sample and a high-risk sample of African-American adolescents. In both samples, parental support was inversely related to adolescent CPs, DSs, and alcohol and marijuana use. CPs, but not DSs, partially mediated the relation of parental support to substance use. Results were consistent across the national and high-risk samples, suggesting that the protective effect of parental support applies to African-American adolescents from a range of demographic backgrounds.

  3. Characterizing and Reaching High-Risk Drinkers Using Audience Segmentation

    Science.gov (United States)

    Moss, Howard B.; Kirby, Susan D.; Donodeo, Fred

    2010-01-01

    Background Market or audience segmentation is widely used in social marketing efforts to help planners identify segments of a population to target for tailored program interventions. Market-based segments are typically defined by behaviors, attitudes, knowledge, opinions, or lifestyles. They are more helpful to health communication and marketing planning than epidemiologically-defined groups because market-based segments are similar in respect to how they behave or might react to marketing and communication efforts. However, market segmentation has rarely been used in alcohol research. As an illustration of its utility, we employed commercial data that describes the sociodemographic characteristics of high-risk drinkers as an audience segment; where they tend to live, lifestyles, interests, consumer behaviors, alcohol consumption behaviors, other health-related behaviors, and cultural values. Such information can be extremely valuable in targeting and planning public health campaigns, targeted mailings, prevention interventions and research efforts. Methods We describe the results of a segmentation analysis of those individuals who self-report consuming five or more drinks per drinking episode at least twice in the last 30-days. The study used the proprietary PRIZM™ audience segmentation database merged with Center for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) database. The top ten of the 66 PRIZM™ audience segments for this risky drinking pattern are described. For five of these segments we provide additional in-depth details about consumer behavior and the estimates of the market areas where these risky drinkers reside. Results The top ten audience segments (PRIZM clusters) most likely to engage in high-risk drinking are described. The cluster with the highest concentration of binge drinking behavior is referred to as the “Cyber Millenials.” This cluster is characterized as “the nation's tech-savvy singles

  4. Characterizing and reaching high-risk drinkers using audience segmentation.

    Science.gov (United States)

    Moss, Howard B; Kirby, Susan D; Donodeo, Fred

    2009-08-01

    Market or audience segmentation is widely used in social marketing efforts to help planners identify segments of a population to target for tailored program interventions. Market-based segments are typically defined by behaviors, attitudes, knowledge, opinions, or lifestyles. They are more helpful to health communication and marketing planning than epidemiologically defined groups because market-based segments are similar in respect to how they behave or might react to marketing and communication efforts. However, market segmentation has rarely been used in alcohol research. As an illustration of its utility, we employed commercial data that describes the sociodemographic characteristics of high-risk drinkers as an audience segment, including where they tend to live, lifestyles, interests, consumer behaviors, alcohol consumption behaviors, other health-related behaviors, and cultural values. Such information can be extremely valuable in targeting and planning public health campaigns, targeted mailings, prevention interventions, and research efforts. We described the results of a segmentation analysis of those individuals who self-reported to consume 5 or more drinks per drinking episode at least twice in the last 30 days. The study used the proprietary PRIZM (Claritas, Inc., San Diego, CA) audience segmentation database merged with the Center for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) database. The top 10 of the 66 PRIZM audience segments for this risky drinking pattern are described. For five of these segments we provided additional in-depth details about consumer behavior and the estimates of the market areas where these risky drinkers resided. The top 10 audience segments (PRIZM clusters) most likely to engage in high-risk drinking are described. The cluster with the highest concentration of binge-drinking behavior is referred to as the "Cyber Millenials." This cluster is characterized as "the nation's tech

  5. High-risk sexual behavior among drug-using men.

    Science.gov (United States)

    Seidman, S N; Sterk-Elifson, C; Aral, S O

    1994-01-01

    Drug-using men are at high risk for acquisition and transmission of STD, presumably due to the risky behaviors practiced in environments of drug use. To study behaviors associated with STD transmission among drug-using men. Drug outreach workers distributed vouchers to self-identified drug-using men in urban Atlanta. Vouchers could be redeemed for cash at a storefront clinic where subjects provided urine for a urethritis screening test (leukocyte esterase test) and a drug screen, and were interviewed. Of 382 voucher recipients, 252 (66%) came to the clinic. Subjects were predominantly black (92%), homeless (70%), and aged 20 to 40 (88%). All used illicit drugs; none were currently receiving drug abuse treatment. Urine drug screen confirmed recent cocaine use in 63%, and recent opiate use in 4%. Three-fourths reported a history of STD, mostly gonorrhea. In the preceding 3 months, 14% had not had sex, 80% had sex exclusively with women, 4% had sex with both men and women, and 2% had sex exclusively with men. Of the heterosexually active men, 29% had 5 or more recent partners. Compared to other heterosexually active men, these men were more likely to always use alcohol or crack before having sex (prevalence ratio [PR] = 2.0, 95% CI = 1.3-2.5) and to drink alcohol every day (PR = 2.0, 95% CI = 1.2-3.3). Daily crack use was associated with choosing partners at elevated STD risk; daily alcohol use with having more partners. Positive drug screen for cocaine was associated with self-reported crack use. Urethritis, detected in 16%, was not correlated with behavior. A substantial number of drug-using men practice high-risk sexual behavior and should be targeted for intervention. Monetary and other incentives should be considered for recruitment. Further study is needed to clarify the relationship between sexual behavior, cocaine use, and STD.

  6. Relationship between PLAP and high-risk pregnancy

    International Nuclear Information System (INIS)

    Yu Huixin; Xiao Weihong; Cao Guoxian; Li Weiyi; Shen Bo

    2001-01-01

    PLAP was isolated and purified from human placenta and the antiserum was obtained by immunizing the rabbits. A radioimmunoassay of PLAP (PLAP RIA) was established by labelling the antigen using the chloramine-T method. Its sensitivity was 1.54 μg/L, the recovery rate was between 96.7% and 105.2%, the intra- and inter-assay CV were 8.94% and 9.43%, respectively, the antiserum provided a linear response from 2 to 1000 μg/L. The assay has no cross-reactivity with liver AP. Serum level of PLAP were measured by PLAP RIA in 649 cases of normal pregnancy and 164 cases of high-risk pregnancy. The results indicated that the PLAP level increased proportionally with the advance of gestational age (r = 0.9843). In 33 cases of pregnancy induced hypertension and 21 cases of intrauterine fetal growth retardation, the PLAP were at significantly low level. In 7 cases of neonatal asphyxia and 26 cases of fetal distress, the PLAP level in the mother's serum were also low. In 53 cases of intrahepatic cholestasis of pregnancy, the PLAP level were similar to those of normal pregnancy. This study illustrated that PLAP RIA can play an important role in evaluation of placental function and fetal prognosis for cases of high-risk pregnancy

  7. Oral health status of women with high-risk pregnancies.

    Science.gov (United States)

    Merglova, Vlasta; Hecova, Hana; Stehlikova, Jaroslava; Chaloupka, Pavel

    2012-12-01

    The aim of this study was to investigate the oral health status of women with high-risk pregnancies. A case-control study of 142 pregnant women was conducted. The case group included 81 pregnant women with high-risk pregnancies, while 61 women with normal pregnancies served as controls. The following variables were recorded for each woman: age, general health status, DMF, CPITN, and PBI index, amounts of Streptococcus mutans in the saliva and dental treatment needs. The Mann-Whitney test, Kruskal-Wallis test, t-test and chi-squared test were used for statistical analyses. Statistically significant differences were detected between the PBI indices and dental treatment needs of the two groups. Out of the entire study cohort, 77% of the women in the case group and 52% of the women in the control group required dental treatment. In this study, women with complications during pregnancy had severe gingivitis and needed more frequent dental treatment than those in the control group.

  8. [High oncogenic risk human papillomavirus and urinary bladder cancer].

    Science.gov (United States)

    Loran, O B; Sinyakova, L A; Gundorova, L V; Kosov, V A; Kosova, I V; Pogodina, I E; Kolbasov, D N

    2017-07-01

    To determine the role of human papillomavirus (HPV) of high oncogenic risk in the development of urinary bladder cancer. 100 patients (72 men and 28 women) aged 38 to 90 years (mean age 65+/-10 years) diagnosed with bladder cancer were examined and underwent treatment. Clinical assessment was complemented by enzyme-linked immunosorbent assays for the presence of antiviral antibodies to herpes simplex virus (HSV) type 1 and type 2, cytomegalovirus (CMV), Epstein-Barr virus (EBV), urethra scraping for detecting high oncogenic risk HPV. Tumor tissue was sampled for PCR virus detection. Semi-quantitative analysis was used to evaluate the components of lymphocyte-plasmocyte and leukocyte infiltrates and cytopathic changes in tumor tissue. There were positive correlations between cytopathic cell changes (koylocytosis and intranuclear inclusions, as manifestations of HPV) and the level of antiviral antibodies, the presence of viruses in the tumor, as well as with the components of the lymphoid-plasmocyte infiltrate. Negative correlations were found between the presence of papillomatosis and the above changes. Human papillomavirus is believed to be a trigger for the initiation of a tumor in young patients with a latent infection (CMV and EBV, HSV, HPV). Cytopathic changes (kylocytosis and intranuclear inclusions) were associated with the activity and morphological features of herpes-viral infections. Their degree varied depending on the stage of the process, but not on the anaplasia degree. Papillomatosis is associated with a more favorable course of the tumor process.

  9. Personality differences in high risk sports amateurs and instructors.

    Science.gov (United States)

    Watson, Alison E; Pulford, Briony D

    2004-08-01

    This study investigated the personality differences of 21 amateurs and 20 instructors who participated in the high risk sports of skydiving, hang-gliding, paragliding, scuba diving, microlighting, and rock climbing, versus those who did not. 38 men and 28 women (M age=32.6 yr., SD= 10.0) were assessed using the Eysenck Personality Questionnaire-Revised, the General Health Questionnaire, the Generalised Self-efficacy Scale, and a Type A/B personality measure. Instructors and Amateurs scored significantly higher on Extroversion and lower on Neuroticism than Nonparticipants; however, they differed from each other on the General Health Questionnaire and Type A/B personality scores. Amateurs scored significantly higher on Psychoticism and Self-efficacy than Instructors and Nonparticipants. In conclusion, these test scores suggest that people who are attracted to high risk sports tend to be at the extroverted and emotionally stable end of the scale, with a tendency to exhibit Type A characteristics; however, Instructors' scores on Psychoticism and Self-efficacy are more akin to those of Nonparticipants.

  10. Relationship between PLAP and high-risk pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Huixin, Yu; Weihong, Xiao; Guoxian, Cao; Weiyi, Li; Bo, Shen [Jiangsu Inst. of Nuclear Medicine, Wuxi (China). National Key Laboratory of Nuclear Medicine

    2001-04-01

    PLAP was isolated and purified from human placenta and the antiserum was obtained by immunizing the rabbits. A radioimmunoassay of PLAP (PLAP RIA) was established by labelling the antigen using the chloramine-T method. Its sensitivity was 1.54 {mu}g/L, the recovery rate was between 96.7% and 105.2%, the intra- and inter-assay CV were 8.94% and 9.43%, respectively, the antiserum provided a linear response from 2 to 1000 {mu}g/L. The assay has no cross-reactivity with liver AP. Serum level of PLAP were measured by PLAP RIA in 649 cases of normal pregnancy and 164 cases of high-risk pregnancy. The results indicated that the PLAP level increased proportionally with the advance of gestational age (r = 0.9843). In 33 cases of pregnancy induced hypertension and 21 cases of intrauterine fetal growth retardation, the PLAP were at significantly low level. In 7 cases of neonatal asphyxia and 26 cases of fetal distress, the PLAP level in the mother's serum were also low. In 53 cases of intrahepatic cholestasis of pregnancy, the PLAP level were similar to those of normal pregnancy. This study illustrated that PLAP RIA can play an important role in evaluation of placental function and fetal prognosis for cases of high-risk pregnancy.

  11. Uncertainty Instability Risk Analysis of High Concrete Arch Dam Abutments

    Directory of Open Access Journals (Sweden)

    Xin Cao

    2017-01-01

    Full Text Available The uncertainties associated with concrete arch dams rise with the increased height of dams. Given the uncertainties associated with influencing factors, the stability of high arch dam abutments as a fuzzy random event was studied. In addition, given the randomness and fuzziness of calculation parameters as well as the failure criterion, hazard point and hazard surface uncertainty instability risk ratio models were proposed for high arch dam abutments on the basis of credibility theory. The uncertainty instability failure criterion was derived through the analysis of the progressive instability failure process on the basis of Shannon’s entropy theory. The uncertainties associated with influencing factors were quantized by probability or possibility distribution assignments. Gaussian random theory was used to generate random realizations for influence factors with spatial variability. The uncertainty stability analysis method was proposed by combining the finite element analysis and the limit equilibrium method. The instability risk ratio was calculated using the Monte Carlo simulation method and fuzzy random postprocessing. Results corroborate that the modeling approach is sound and that the calculation method is feasible.

  12. An integrative model of risk for high school disordered eating.

    Science.gov (United States)

    Davis, Heather A; Smith, Gregory T

    2018-06-21

    Binge eating and purging behaviors are associated with significant harm and distress among adolescents. The process by which these behaviors develop (often in the high school years) is not fully understood. We tested the Acquired Preparedness (AP) model of risk involving transactions among biological, personality, and psychosocial factors to predict binge eating and purging behavior in a sample of 1,906 children assessed in the spring of 5th grade (the last year of elementary school), the fall of 6th grade (the first year of middle school), spring of 6th grade, and spring of 10th grade (second year of high school). Pubertal onset in spring of 5th grade predicted increases in negative urgency, but not negative affect, in the fall of 6th grade. Negative urgency in the fall of 6th grade predicted increases in expectancies for reinforcement from eating in the spring of 6th grade, which in turn predicted increases in binge eating behavior in the spring of 10th grade. Negative affect in the fall of 6th grade predicted increases in thinness expectancies in the spring of 6th grade, which in turn predicted increases in purging in the spring of 10th grade. Results demonstrate similarities and differences in the development of these two different bulimic behaviors. Intervention efforts targeting the risk factors evident in this model may prove fruitful in the treatment of eating disorders characterized by binge eating and purging. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  13. Consequences of exchanging carbohydrates for proteins in the cholesterol metabolism of mice fed a high-fat diet.

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    Frédéric Raymond

    Full Text Available Consumption of low-carbohydrate, high-protein, high-fat diets lead to rapid weight loss but the cardioprotective effects of these diets have been questioned. We examined the impact of high-protein and high-fat diets on cholesterol metabolism by comparing the plasma cholesterol and the expression of cholesterol biosynthesis genes in the liver of mice fed a high-fat (HF diet that has a high (H or a low (L protein-to-carbohydrate (P/C ratio. H-P/C-HF feeding, compared with L-P/C-HF feeding, decreased plasma total cholesterol and increased HDL cholesterol concentrations at 4-wk. Interestingly, the expression of genes involved in hepatic steroid biosynthesis responded to an increased dietary P/C ratio by first down-regulation (2-d followed by later up-regulation at 4-wk, and the temporal gene expression patterns were connected to the putative activity of SREBF1 and 2. In contrast, Cyp7a1, the gene responsible for the conversion of cholesterol to bile acids, was consistently up-regulated in the H-P/C-HF liver regardless of feeding duration. Over expression of Cyp7a1 after 2-d and 4-wk H-P/C-HF feeding was connected to two unique sets of transcription regulators. At both time points, up-regulation of the Cyp7a1 gene could be explained by enhanced activations and reduced suppressions of multiple transcription regulators. In conclusion, we demonstrated that the hypocholesterolemic effect of H-P/C-HF feeding coincided with orchestrated changes of gene expressions in lipid metabolic pathways in the liver of mice. Based on these results, we hypothesize that the cholesterol lowering effect of high-protein feeding is associated with enhanced bile acid production but clinical validation is warranted. (246 words.

  14. Consequences of exchanging carbohydrates for proteins in the cholesterol metabolism of mice fed a high-fat diet.

    Science.gov (United States)

    Raymond, Frédéric; Wang, Long; Moser, Mireille; Metairon, Sylviane; Mansourian, Robert; Zwahlen, Marie-Camille; Kussmann, Martin; Fuerholz, Andreas; Macé, Katherine; Chou, Chieh Jason

    2012-01-01

    Consumption of low-carbohydrate, high-protein, high-fat diets lead to rapid weight loss but the cardioprotective effects of these diets have been questioned. We examined the impact of high-protein and high-fat diets on cholesterol metabolism by comparing the plasma cholesterol and the expression of cholesterol biosynthesis genes in the liver of mice fed a high-fat (HF) diet that has a high (H) or a low (L) protein-to-carbohydrate (P/C) ratio. H-P/C-HF feeding, compared with L-P/C-HF feeding, decreased plasma total cholesterol and increased HDL cholesterol concentrations at 4-wk. Interestingly, the expression of genes involved in hepatic steroid biosynthesis responded to an increased dietary P/C ratio by first down-regulation (2-d) followed by later up-regulation at 4-wk, and the temporal gene expression patterns were connected to the putative activity of SREBF1 and 2. In contrast, Cyp7a1, the gene responsible for the conversion of cholesterol to bile acids, was consistently up-regulated in the H-P/C-HF liver regardless of feeding duration. Over expression of Cyp7a1 after 2-d and 4-wk H-P/C-HF feeding was connected to two unique sets of transcription regulators. At both time points, up-regulation of the Cyp7a1 gene could be explained by enhanced activations and reduced suppressions of multiple transcription regulators. In conclusion, we demonstrated that the hypocholesterolemic effect of H-P/C-HF feeding coincided with orchestrated changes of gene expressions in lipid metabolic pathways in the liver of mice. Based on these results, we hypothesize that the cholesterol lowering effect of high-protein feeding is associated with enhanced bile acid production but clinical validation is warranted. (246 words).

  15. Synergistic effect of oral corticosteroids use on risk of hepatocellular carcinoma in high risk populations.

    Science.gov (United States)

    Lai, Shih-Wei; Lin, Cheng-Li; Liao, Kuan-Fu

    2018-06-01

    Little evidence is available on the relationship between oral corticosteroids use and hepatocellular carcinoma. The objective of this study was to investigate whether oral corticosteroids use correlates with the risk of hepatocellular carcinoma in high risk populations in Taiwan. Using representative claims database established from the Taiwan National Health Insurance Program with a population coverage rate of 99.6%, we identified 102,182 subjects aged 20-84 years with newly diagnosed hepatocellular carcinoma in 2000-2011 as the cases and 102,182 randomly selected subjects aged 20-84 years without hepatocellular carcinoma as the matched controls. In subjects with any one of comorbidities including alcohol-related disease, chronic liver disease, and diabetes mellitus, the adjusted OR of hepatocellular carcinoma was 29.9 (95% CI 28.7, 31.1) for subjects with never use of oral corticosteroids, and the adjusted OR would increase to 33.7 (95% CI 32.3, 35.3) for those with ever use of oral corticosteroids. The adjusted OR of hepatocellular carcinoma was 1.03 for subjects with increasing cumulative duration of oral corticosteroids use for every one year (95% CI 1.01, 1.06), with a duration-dependent effect. The largest OR occurred in subjects with ever use of oral corticosteroids and concurrently comorbid with alcohol-related disease, chronic liver disease, and diabetes mellitus (adjusted OR 122.7, 95% CI 108.5, 138.8). There is a synergistic effect between oral corticosteroids use and the traditional risk factors on the risk of hepatocellular carcinoma. People with risk factors for hepatocellular carcinoma should receive regular ultrasound surveillance, particularly when they currently use oral corticosteroids. Copyright © 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  16. Brucellosis in a high risk occupational group: sero prevalence and analysis of risk factors

    International Nuclear Information System (INIS)

    Mukhtar, F.

    2010-01-01

    Objectives: To estimate Brucella sero positivity among slaughterhouse workers of Lahore district and to elucidate risk factors associated with sero positivity to Brucella. Method: During the year 2008, a cross-sectional study was conducted in four slaughterhouses of Lahore district. A sample of 360 workers was selected from these slaughterhouses through stratified random sampling on proportional basis. Workers were interviewed using a structured questionnaire to obtain risk factor information and their blood samples were collected to be screened for the presence of anti-Brucella IgG using Enzyme Linked Immunosorbent Assay (ELISA) technique. Data management and analysis were performed using SPSS (statistical package for social sciences) version 16. Risk factors associated with sero positivity to anti-Brucella IgG were identified by constructing a logistic regression model. Results: Of the 360 serum samples tested, 21.7% (95% CI 17.44% - 25.96%) were positive by ELISA test. The logistic regression model identified age (OR 0.96, 95% CI 0.94-0.99), assistance in parturition of animal (OR 0.47, 95% CI 0.23-0.96), consuming raw milk (OR 2.25, 95% CI 1.04-4.87) and handling sheep (OR 0.30, 95% CI 0.09- 0.92) as risk factors for Brucella sero positivity among slaughterhouse workers of Lahore district. Conclusion: To reduce the burden of brucellosis, a national brucellosis control programme should be initiated with special emphasis on the high risk population of slaughterhouse workers. (author)

  17. The reality of life safety consequence classification

    International Nuclear Information System (INIS)

    Hartford, D.N.D.; Assaf, H.; Kerr, I.R.

    1999-01-01

    Because empirical methods of consequence estimation were not designed for application in risk analysis for dam safety, BC Hydro developed its own method for determining loss of life due to dam failures as part of the development of the risk analysis process. Because loss of life estimation for consequence classification entails the generation of essentially the same information, the method can also be used to determine the consequence category of the dam for life safety considerations, and the model can be extended to third party property damage. The methodology adopted for dealing with life safety differs considerably from the empirical approach by modelling the response of the downstream population to a dam failure flood. The algorithm simulates the response of various groups of populations to the warnings of dam failure and the physical process of fleeing from the areas of potential innundation. Assessing the life safety consequences of dam failure is a first step in estimating dam safety in terms of CDA Guidelines, and empirical methods in use are not suitable for determining loss of life due to dam failures. The process described herein is the only physically based method available for estimating loss of life due to dam failures required by the Dam Safety Guidelines. The model is transparent, logically sound, and has been peer reviewed. The method provides a rational basis for the first step in performing safety assessments of dams in terms of the Guidelines, particularly high consequence dams. 8 refs., 3 figs

  18. Addressing risk factors for child abuse among high risk pregnant women: design of a randomised controlled trial of the nurse family partnership in Dutch preventive health care

    Directory of Open Access Journals (Sweden)

    Mejdoubi Jamila

    2011-10-01

    Full Text Available Abstract Background Low socio-economic status combined with other risk factors affects a person's physical and psychosocial health from childhood to adulthood. The societal impact of these problems is huge, and the consequences carry on into the next generation(s. Although several studies show these consequences, only a few actually intervene on these issues. In the United States, the Nurse Family Partnership focuses on high risk pregnant women and their children. The main goal of this program is primary prevention of child abuse. The Netherlands is the first country outside the United States allowed to translate and culturally adapt the Nurse Family Partnership into VoorZorg. The aim of the present study is to assess whether VoorZorg is as effective in the Netherland as in the United States. Methods The study consists of three partly overlapping phases. Phase 1 was the translation and cultural adaptation of Nurse Family Partnership and the design of a two-stage selection procedure. Phase 2 was a pilot study to examine the conditions for implementation. Phase 3 is the randomized controlled trial of VoorZorg compared to the care as usual. Primary outcome measures were smoking cessation during pregnancy and after birth, birth outcomes, child development, child abuse and domestic violence. The secondary outcome measure was the number of risk factors present. Discussion This study shows that the Nurse Family Partnership was successfully translated and culturally adapted into the Dutch health care system and that this program fulfills the needs of high-risk pregnant women. We hypothesize that this program will be effective in addressing risk factors that operate during pregnancy and childhood and compromise fetal and child development. Trial registration Current Controlled Trials ISRCTN16131117

  19. Diagnostic accuracy of high-definition CT coronary angiography in high-risk patients

    International Nuclear Information System (INIS)

    Iyengar, S.S.; Morgan-Hughes, G.; Ukoumunne, O.; Clayton, B.; Davies, E.J.; Nikolaou, V.; Hyde, C.J.; Shore, A.C.; Roobottom, C.A.

    2016-01-01

    Aim: To assess the diagnostic accuracy of computed tomography coronary angiography (CTCA) using a combination of high-definition CT (HD-CTCA) and high level of reader experience, with invasive coronary angiography (ICA) as the reference standard, in high-risk patients for the investigation of coronary artery disease (CAD). Materials and methods: Three hundred high-risk patients underwent HD-CTCA and ICA. Independent experts evaluated the images for the presence of significant CAD, defined primarily as the presence of moderate (≥50%) stenosis and secondarily as the presence of severe (≥70%) stenosis in at least one coronary segment, in a blinded fashion. HD-CTCA was compared to ICA as the reference standard. Results: No patients were excluded. Two hundred and six patients (69%) had moderate and 178 (59%) had severe stenosis in at least one vessel at ICA. The sensitivity, specificity, positive predictive value, and negative predictive value were 97.1%, 97.9%, 99% and 93.9% for moderate stenosis, and 98.9%, 93.4%, 95.7% and 98.3%, for severe stenosis, on a per-patient basis. Conclusion: The combination of HD-CTCA and experienced readers applied to a high-risk population, results in high diagnostic accuracy comparable to ICA. Modern generation CT systems in experienced hands might be considered for an expanded role. - Highlights: • Diagnostic accuracy of High-Definition CT Angiography (HD-CTCA) has been assessed. • Invasive Coronary angiography (ICA) is the reference standard. • Diagnostic accuracy of HD-CTCA is comparable to ICA. • Diagnostic accuracy is not affected by coronary calcium or stents. • HD-CTCA provides a non-invasive alternative in high-risk patients.

  20. Seismic, high wind, tornado, and probabilistic risk assessment of the high flux isotope reactor

    International Nuclear Information System (INIS)

    Harris, S.P.; Hashimoto, P.S.; Dizon, J.O.; Hashimoto, P.S.

    1989-01-01

    Natural phenomena analyses were performed on the High Flux Isotope Reactor (HFIR). Deterministic and probabilistic evaluations were made to determine the risks resulting from earthquakes, high winds, and tornadoes. Analytic methods in conjunction with field evaluations and an earthquake experience data base evaluation methods were used to provide more realistic results in a shorter amount of time. Plant modifications completed in preparation for HFIR restart and potential future enhancements are discussed

  1. Seismic, high wind, tornado, and probabilistic risk assessments of the High Flux Isotope Reactor

    International Nuclear Information System (INIS)

    Harris, S.P.; Stover, R.L.; Hashimoto, P.S.; Dizon, J.O.

    1989-01-01

    Natural phenomena analyses were performed on the High Flux Isotope Reactor (HFIR) Deterministic and probabilistic evaluations were made to determine the risks resulting from earthquakes, high winds, and tornadoes. Analytic methods in conjunction with field evaluations and an earthquake experience data base evaluation methods were used to provide more realistic results in a shorter amount of time. Plant modifications completed in preparation for HFIR restart and potential future enhancements are discussed. 5 figs

  2. Distinct evolutionary mechanisms for genomic imbalances in high-risk and low-risk neuroblastomas

    Directory of Open Access Journals (Sweden)

    Gisselsson David

    2007-09-01

    Full Text Available Abstract Background Neuroblastoma (NB is the most common extracranial solid tumour of childhood. Several genomic imbalances correlate to prognosis in NB, with structural rearrangements, including gene amplification, in a near-diploid setting typically signifying high-risk tumours and numerical changes in a near-triploid setting signifying low-risk tumours. Little is known about the temporal sequence in which these imbalances occur during the carcinogenic process. Methods We have reconstructed the appearance of cytogenetic imbalances in 270 NBs by first grouping tumours and imbalances through principal component analysis and then using the number of imbalances in each tumour as an indicator of evolutionary progression. Results Tumours clustered in four sub-groups, dominated respectively by (1 gene amplification in double minute chromosomes and few other aberrations, (2 gene amplification and loss of 1p sequences, (3 loss of 1p and other structural aberrations including gain of 17q, and (4 whole-chromosome gains and losses. Temporal analysis showed that the structural changes in groups 1–3 were acquired in a step-wise fashion, with loss of 1p sequences and the emergence of double minute chromosomes as the earliest cytogenetic events. In contrast, the gains and losses of whole chromosomes in group 4 occurred through multiple simultaneous events leading to a near-triploid chromosome number. Conclusion The finding of different temporal patterns for the acquisition of genomic imbalances in high-risk and low-risk NBs lends strong support to the hypothesis that these tumours are biologically diverse entities, evolving through distinct genetic mechanisms.

  3. Predictive risk modelling under different data access scenarios: who is identified as high risk and for how long?

    Science.gov (United States)

    Johnson, Tracy L; Kaldor, Jill; Sutherland, Kim; Humphries, Jacob; Jorm, Louisa R; Levesque, Jean-Frederic

    2018-01-01

    Objective This observational study critically explored the performance of different predictive risk models simulating three data access scenarios, comparing: (1) sociodemographic and clinical profiles; (2) consistency in high-risk designation across models; and (3) persistence of high-risk status over time. Methods Cross-sectional health survey data (2006–2009) for more than 260 000 Australian adults 45+ years were linked to longitudinal individual hospital, primary care, pharmacy and mortality data. Three risk models predicting acute emergency hospitalisations were explored, simulating conditions where data are accessed through primary care practice management systems, or through hospital-based electronic records, or through a hypothetical ‘full’ model using a wider array of linked data. High-risk patients were identified using different risk score thresholds. Models were reapplied monthly for 24 months to assess persistence in high-risk categorisation. Results The three models displayed similar statistical performance. Three-quarters of patients in the high-risk quintile from the ‘full’ model were also identified using the primary care or hospital-based models, with the remaining patients differing according to age, frailty, multimorbidity, self-rated health, polypharmacy, prior hospitalisations and imminent mortality. The use of higher risk prediction thresholds resulted in lower levels of agreement in high-risk designation across models and greater morbidity and mortality in identified patient populations. Persistence of high-risk status varied across approaches according to updated information on utilisation history, with up to 25% of patients reassessed as lower risk within 1 year. Conclusion/implications Small differences in risk predictors or risk thresholds resulted in comparatively large differences in who was classified as high risk and for how long. Pragmatic predictive risk modelling design decisions based on data availability or projected

  4. Sun-protective behaviors in populations at high risk for skin cancer

    Directory of Open Access Journals (Sweden)

    Diao DY

    2013-12-01

    Full Text Available Diana Y Diao,1 Tim K Lee1,21Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada; 2Cancer Control Research Program, BC Cancer Agency, Vancouver, British Columbia, CanadaAbstract: Over 3 million new cases of skin cancer are diagnosed in the US annually. Melanoma, a subtype of skin cancer that can be fatal if the disease is not detected and treated at an early stage, is the most common cancer for those aged 25–29 years and the second most common cancer in adolescents and young adults aged 15–29 years. The primary carcinogen for the genesis of skin cancers is ultraviolet light from solar radiation and tanning beds. In spite of massive health campaigns to raise public awareness on ultraviolet radiation, sun-protective practices still fall behind. A plausible explanation is the lack of behavioral change in the populations at risk; in this review article, we examine sun-protective behavior in the four high-risk skin cancer groups: skin cancer survivors, individuals with a family history of melanoma, individuals with physical characteristics associated with skin cancer risk, and organ transplantation patients. Findings in the literature demonstrate that increased knowledge and awareness does not consequently translate into behavioral changes in practice. Behavior can differ as a result of different attitudes and beliefs, depending on the population at risk. Thus, intervention should be tailored to the population targeted. A multidisciplinary health team providing consultation and education is required to influence these much needed changes.Keywords: skin cancer, melanoma, risk, prevention, behaviour

  5. High risk pregnancies and factors associated with neonatal death.

    Science.gov (United States)

    Demitto, Marcela de Oliveira; Gravena, Angela Andréia França; Dell'Agnolo, Cátia Millene; Antunes, Marcos Benatti; Pelloso, Sandra Marisa

    2017-04-03

    To identify the factors associated with intra-hospital neonatal mortality based on the individual characteristics of at-risk pregnant mothers, delivery and newborns. This was a cross-sectional epidemiological study of live newborns delivered by women attended at the high-risk outpatient unit of a philanthropic hospital in Maringá, Paraná, Brazil between September 2012 and September 2013. Six hundred and eighty-eight women participated in the study. The neonatal mortality coefficient found was 17.7/1,000 live births, most in the early neonatal phase. Premature labor, fetal malformation and multiple gestations were associated with neonatal death. Premature, very low birth weight newborns and those with an Apgar score of less than seven, five minutes after birth were at high risk of death. Identifying risk factors can help plan actions to consolidate the perinatal network. Specific programs should be incentivized in other countries, in the search for significant perinatal results such as reducing neonatal mortality. Identificar os fatores associados à mortalidade neonatal intra-hospitalar com base nas características individuais de gestantes de risco, do parto e do recém-nascido. Estudo epidemiológico do tipo transversal, realizado com crianças nascidas vivas de partos hospitalares de mulheres acompanhadas pelo ambulatório de alto risco de um hospital filantrópico de Maringá, Paraná, Brasil, no período de setembro de 2012 a setembro de 2013.RESULTADOS Fizeram parte da pesquisa 688 mulheres. O coeficiente de mortalidade neonatal foi de 17,7 óbitos/1.000 nascidos vivos, sendo sua maioria no período neonatal precoce. Trabalho de parto prematuro, malformação fetal e gestação múltipla foram as intercorrências associadas ao óbito neonatal. Recém-nascidos prematuros, com muito baixo peso ao nascer e Índice de Apgar menor que sete no quinto minuto de vida apresentaram risco elevado de morte. A identificação de fatores de risco pode auxiliar no

  6. Does Discrimination Explain High Risk of Depression among High-Income African American Men?

    Science.gov (United States)

    Assari, Shervin; Lankarani, Maryam Moghani; Caldwell, Cleopatra Howard

    2018-04-19

    Background: Higher socioeconomic status is known to decrease the risk for poor mental health overall. However, African American males of higher socioeconomic status (SES) are at an increased risk for having a major depressive episode (MDE). It is not known whether perceived discrimination (PD) explains this risk. The current study used nationally representative data to explore the role of PD in explaining the association between high-SES and having MDE among African American men. Methods: The National Survey of American Life (NSAL), 2003, included 4461 American adults including 1271 African American men. SES indicators (i.e., household income, educational attainment, employment status, and marital status) were the independent variables. 12-month MDE measured using the Composite International Diagnostic Interview (CIDI) was the outcome. Age, gender, and region were the covariates. PD was the potential mediator. For data analysis, we used logistic regression. Results: Among African American men, household income was positively associated with odds of 12-month MDE. The positive association between household income and odds of MDE remained unchanged after adding PD to the model, suggesting that PD may not explain why high-income African American men are at a higher risk of MDE. Conclusions: Perceived discrimination does not explain the increased risk for depression among African American males of higher SES. Future research should explore the role of other potential mechanisms such as stress, coping, social isolation, and/or negative social interaction that may increase psychological costs of upward social mobility for African American males.

  7. Does Discrimination Explain High Risk of Depression among High-Income African American Men?

    Directory of Open Access Journals (Sweden)

    Shervin Assari

    2018-04-01

    Full Text Available Background: Higher socioeconomic status is known to decrease the risk for poor mental health overall. However, African American males of higher socioeconomic status (SES are at an increased risk for having a major depressive episode (MDE. It is not known whether perceived discrimination (PD explains this risk. The current study used nationally representative data to explore the role of PD in explaining the association between high-SES and having MDE among African American men. Methods: The National Survey of American Life (NSAL, 2003, included 4461 American adults including 1271 African American men. SES indicators (i.e., household income, educational attainment, employment status, and marital status were the independent variables. 12-month MDE measured using the Composite International Diagnostic Interview (CIDI was the outcome. Age, gender, and region were the covariates. PD was the potential mediator. For data analysis, we used logistic regression. Results: Among African American men, household income was positively associated with odds of 12-month MDE. The positive association between household income and odds of MDE remained unchanged after adding PD to the model, suggesting that PD may not explain why high-income African American men are at a higher risk of MDE. Conclusions: Perceived discrimination does not explain the increased risk for depression among African American males of higher SES. Future research should explore the role of other potential mechanisms such as stress, coping, social isolation, and/or negative social interaction that may increase psychological costs of upward social mobility for African American males.

  8. HPV vaccine acceptability in high-risk Greek men.

    Science.gov (United States)

    Hoefer, Lea; Tsikis, Savas; Bethimoutis, George; Nicolaidou, Electra; Paparizos, Vassilios; Antoniou, Christina; Kanelleas, Antonios; Chardalias, Leonidas; Stavropoulos, Georgios-Emmanouil; Schneider, John; Charnot-Katsikas, Angella

    2018-01-02

    HPV is associated with malignancy in men, yet there is a lack of data on HPV knowledge, vaccine acceptability, and factors affecting vaccine acceptability in Greek men. This study aims to identify determinants of knowledge and willingness to vaccinate against HPV among high-risk Greek men. Men (n = 298) between the ages of 18 and 55 were enrolled from the STI and HIV clinics at "Andreas Syggros" Hospital in Athens, Greece from July-October 2015. Participants completed a survey on demographics, economic factors, sexual history, HPV knowledge, and vaccine acceptability. The majority of participants were younger than 40 (76.6%) and unmarried (84.6%). Our sample was 31.2% MSM (men who have sex with men), and 20.1% were HIV-positive. Most participants (>90%) were aware that HPV is highly prevalent in both men and women; however, fewer identified that HPV causes cancers in both sexes (68%) and that vaccination protects men and women (67%). Amongst participants, 76.7% were willing to vaccinate themselves against HPV, 71.4% an adolescent son, and 69.3% an adolescent daughter. HIV-positive men were more likely to be willing to vaccinate themselves (OR 2.83, p = .015), a son (OR 3.3, p = .015) or a daughter (3.01, p = .020). Higher income levels were associated with increased willingness to vaccinate oneself (OR 1.32, p = .027), a son (1.33, p = .032) or daughter (1.34, p = .027). Although there is a HPV knowledge gap, HPV vaccine acceptability is high despite lack of vaccine promotion to Greek men. Future studies should include lower-risk men to adequately inform public health efforts.

  9. [High risk factors of upper gastrointestinal bleeding after neurosurgical procedures].

    Science.gov (United States)

    Zheng, Kang; Wu, Gang; Cheng, Neng-neng; Yao, Cheng-jun; Zhou, Liang-fu

    2005-12-21

    To analyze high risk factors of postoperative upper gastrointestinal (GI) bleeding after neurosurgery so as to give guidance for prevention of GI bleeding. A questionnaire was developed to investigate the medical records of 1500 patients who were hospitalized and underwent neurosurgical operations in 1997. Logistic regression analysis was made. 1430 valid questionnaires were obtained. Postoperative upper GI bleeding occurred in 75 patients (5.24%). The incidence of upper GI bleeding were 6.64% (54/813) in the male patients and 3.40% (21/617) in the female persons (P = 0.007); 9.88% (41/415) in those aged > 50 and 3.35% in those aged hematoma, intraventricular hemorrhage, subdural hematoma, and extradural hematoma were 15.7%, 10.0%, 6.00%, and 2.94% respectively (P = 0.02). The incidence of upper GI bleeding of the patients with tumors of fourth ventricle of cerebrum, brainstem, cerebral hemisphere, and sellar hypothalamus were 15.79% (3/19), 7.89%, 5.71%, and 3.74% respectively. In the emergent cases, the incidence of upper GI bleeding was higher in those with hypertension. The incidence of upper GI bleeding was 5.46% in the patients undergoing adrenocortical hormone treatment, significantly higher than that in those who did not receive such treatment (2.13%). Patients who are at high risk of developing postoperative upper GI bleeding including that: age greater than 50 years; male; Glasgow Coma Score less than 10 pre and post operation; The lesion was located in brain stem and forth ventricle; Hypertensive cerebral hemorrhage; Intracerebral and intraventricular hemorrhagic brain trauma; Postoperative pneumonia, brain edema, encephalic high pressure, pyogenic infection of the central nervous system and other postoperative complications. The mortality of patients with postoperative upper GI bleeding was evidently higher than that of the patients without postoperative upper GI bleeding.

  10. High-Risk Sexual Behavior at Social Venues in Madagascar

    Science.gov (United States)

    KHAN, MARIA R.; RASOLOFOMANANA, JUSTIN R.; McCLAMROCH, KRISTI J.; RALISIMALALA, ANDRIAMAMPIANINA; ZAFIMANJAKA, MAURICE G.; BEHETS, FRIEDA; WEIR, SHARON S.

    2018-01-01

    Background Persistent high levels of sexually transmitted infection (STI) in Madagascar indicate current prevention strategies are inadequate. STI/HIV prevention based in social venues may play an important role in reaching individuals at risk of infection. We identified venues where people meet sexual partners and measured the need and potential for venue-based prevention. Methods Interviews were conducted in 7 Madagascar towns with 1) community informants to identify social venues, 2) individuals socializing at a sample of venues to assess sexual behavior among venue patrons, and 3) venue representatives to assess the potential for venue-based intervention. Results Community informants identified numerous venues (range: 67–211 venues, depending on the town); streets, bars, and hotels were most commonly reported. Among 2982 individuals socializing at venues, 78% of men and 74% of women reported new sexual partnership or sex trade for money, goods, or services in the past 4 weeks and 19% of men and 18% of women reported symptoms suggestive of STI in the past 4 weeks. STI symptom levels were disproportionately high among respondents reporting either sex trade or new sexual partnership in the past 4 weeks. Twenty-eight percent of men and 41% of women reported condom use during the last sex act with a new partner. Although 24% to 45% of venues had hosted STI/HIV interventions, interventions were deemed possible at 73% to 90% venues according to 644 interviews with venue representatives. Conclusions Venue-based intervention is possible and would reach a spectrum of populations vulnerable to STI/HIV including sex workers, their clients, and other high-risk populations. PMID:18496471

  11. HIV Risk Factors among Pregnant and Non-Pregnant High-Risk Women in New York City.

    Science.gov (United States)

    Deren, Sherry; And Others

    1993-01-01

    Compared high-risk pregnant (n=55) and nonpregnant (n=598) women from Harlem on human immunodeficiency virus-related drug and sexual risk behaviors. Found higher percentage of intravenous drug users (IVDUs) among nonpregnant women and no significant differences between pregnant and nonpregnant IVDUs in terms of needle risk behaviors. Pregnant…

  12. Case studies of the perceptions of women with high risk congenital heart disease successfully completing a pregnancy.

    Science.gov (United States)

    Ngu, Kylie; Hay, Margaret; Menahem, Samuel

    2014-09-01

    Women even with moderate to severe congenital heart disease (CHD) seek motherhood despite posing significant health risks to themselves and their infant. This study explored their motivations and perceptions and compared them to those of women with low risk CHD who conceived. Twenty women over 18 years with CHD who had a successful pregnancy were recruited, half of whom were identified as having a high risk cardiac abnormality. They completed a questionnaire and a semi-structured interview following which a thematic analysis was employed. Their medical records and clinical status were also reviewed and their current cardiac status graded by their attending cardiologist. Women with high risk (moderate to severe) CHD (n=10) appeared to have similar motivations for conceiving as women with low-risk (mild) CHD (n=10). Their decision to conceive seemed based on their own and at times unrealistic perceptions of the consequences of their CHD. Women with mild or more severe CHD had similar motivations to conceive tending to down play the seriousness of their CHD. Their drive for motherhood appeared to be stronger than the drive for self care. It behoves clinicians, both obstetricians and cardiologists caring for women with high risk CHD to be knowledgeable of the effects of the CHD on the pregnancy and the impact of the pregnancy on the cardiac status. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  13. When do ego threats lead to self-regulation failure? Negative consequences of defensive high self-esteem.

    Science.gov (United States)

    Lambird, Kathleen Hoffman; Mann, Traci

    2006-09-01

    High self-esteem (HSE) is increasingly recognized as heterogeneous. By measuring subtypes of HSE, the present research reevaluates the finding that HSE individuals show poor self-regulation following ego threat (Baumeister, Heatherton, & Tice, 1993). In Experiment 1, participants with HSE showed poor self-regulation after ego threat only if they also were defensive (high in self-presentation bias). In Experiment 2, two measures--self-presentation bias and implicit self-esteem--were used to subtype HSE individuals as defensive. Both operationalizations of defensive HSE predicted poor self-regulation after ego threat. The results indicate that (a) only defensive HSE individuals are prone to self-regulation failure following ego threat and (b) measures of self-presentation bias and implicit self-esteem can both be used to detect defensiveness.

  14. Noble gases in basalt glasses from a Mid-Atlantic Ridge topographic high at 14deg N - geodynamic consequences

    International Nuclear Information System (INIS)

    Staudacher, T.; Sarda, P.; Richardson, S.H.; Allegre, C.J.; Sagna, I.; Dmitriev, L.V.

    1989-01-01

    We present a complete noble gas study of mid-oceanic ridge basalt glasses (MORB) from a small ridge segment, centered on an along-strike topographic elevation of the Mid-Atlantic Ridge at about 14deg N. We have found the highest 40 Ar/ 36 Ar ratio ever observed for a MORB glass, i.e. 28,150±330 for sample 2ΠD40, correlated with high 129 Xe/ 130 Xe ratios and the highest noble gas concentrations in a so-called popping-rock, labeled 2ΠD43. The latter sample displays a 4 He/ 40 Ar * ratio of 2.0-2.7, which is close to the production ratio in the mantle due to the radioactive decay of U, Th and K. Hence, this sample probably best represents the elemental noble gas ratios in the mantle, from which we have computed the 4 He concentration in the mantle source of MORB to be 1.5x10 -5 cm 3 STP g -1 . High 4 He/ 3 He ratios in two of the samples from the summit of the topographic high indicate the presence of a U, Th-rich component in the mantle source, possibly old subducted oceanic crust and/or sediments, which could originate in the so-called mesosphere boundary layer. (orig.)

  15. 2017 Taiwan lipid guidelines for high risk patients.

    Science.gov (United States)

    Li, Yi-Heng; Ueng, Kwo-Chang; Jeng, Jiann-Shing; Charng, Min-Ji; Lin, Tsung-Hsien; Chien, Kuo-Liong; Wang, Chih-Yuan; Chao, Ting-Hsing; Liu, Ping-Yen; Su, Cheng-Huang; Chien, Shih-Chieh; Liou, Chia-Wei; Tang, Sung-Chun; Lee, Chun-Chuan; Yu, Tse-Ya; Chen, Jaw-Wen; Wu, Chau-Chung; Yeh, Hung-I

    2017-04-01

    In Taiwan, the prevalence of hyperlipidemia increased due to lifestyle and dietary habit changes. Low density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein cholesterol (non-HDL-C) are all significant predicting factors of coronary artery disease in Taiwan. We recognized that lipid control is especially important in patients with existed atherosclerotic cardiovascular diseases (ASCVD), including coronary artery disease (CAD), ischemic stroke and peripheral arterial disease (PAD). Because the risk of ASCVD is high