WorldWideScience

Sample records for high consequence risks

  1. 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.

  2. 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.``

  3. 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 (phypertension. 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

  4. 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

    of extreme events and damage costs is developed and applied to a case study of urban flooding for the medium sized Danish city of Odense. Moving from our current climate to higher atmospheric greenhouse gas (GHG) concentrations including a 2°, 4°, and a high-end 6°C scenario implies that the frequency...... 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...... in determining the risks of extreme climate events and, thereby, of the level of cost-effective adaptation seen from the society’s point of view....

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

    Science.gov (United States)

    2015-09-30

    attributes of each species that are associated with susceptibility to acoustically mediated disturbance and tissue damage. Furthermore, by identifying high... mediated trauma, 1) tissue/whole animal/physiological exercise assessments to determine the impact of behavioral and environmental challenges to the...susceptibility to acoustically mediated disturbance and tissue damage. This will subsequently allow us to achieve our overall goal of enabling Navy personnel

  6. 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

  7. Implications of Public Reporting of Risk-Adjusted Mortality Following Percutaneous Coronary Intervention: Misperceptions and Potential Consequences for High-Risk Patients Including Nonsurgical Patients.

    Science.gov (United States)

    Gupta, Anuj; Yeh, Robert W; Tamis-Holland, Jacqueline E; Patel, Shalin H; Guyton, Robert A; Klein, Lloyd W; Rab, Tanveer; Kirtane, Ajay J

    2016-10-24

    Assessment of clinical outcomes such as 30-day mortality following coronary revascularization procedures has historically been used to spur quality improvement programs. Public reporting of risk-adjusted outcomes is already mandated in several states, and proposals to further expand public reporting have been put forward as a means of increasing transparency and potentially incentivizing high quality care. However, for public reporting of outcomes to be considered a useful surrogate of procedural quality of care, several prerequisites must be met. First, the reporting measure must be truly representative of the quality of the procedure itself, rather than be dominated by other underlying factors, such as the overall level of illness of a patient. Second, to foster comparisons among physicians and institutions, the metric requires accurate ascertainment of and adjustment for differences in patient risk profiles. This is particularly relevant for high-risk clinical patient scenarios. Finally, the potential deleterious consequences of public reporting of a quality metric should be considered prior to expanding the use of public reporting more broadly. In this viewpoint, the authors review in particular the characterization of high-risk patients currently treated by percutaneous coronary interventional procedures, assessing the adequacy of clinical risk models used in this population. They then expand upon the limitations of 30-day mortality as a quality metric for percutaneous coronary intervention, addressing the strengths and limitations of this metric, as well as offering suggestions to enhance its future use in public reporting. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  8. 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

  9. 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.

  10. Software development methodology for high consequence systems

    Energy Technology Data Exchange (ETDEWEB)

    Baca, L.S.; Bouchard, J.F.; Collins, E.W.; Eisenhour, M.; Neidigk, D.D.; Shortencarier, M.J.; Trellue, P.A.

    1997-10-01

    This document describes a Software Development Methodology for High Consequence Systems. A High Consequence System is a system whose failure could lead to serious injury, loss of life, destruction of valuable resources, unauthorized use, damaged reputation or loss of credibility or compromise of protected information. This methodology can be scaled for use in projects of any size and complexity and does not prescribe any specific software engineering technology. Tasks are described that ensure software is developed in a controlled environment. The effort needed to complete the tasks will vary according to the size, complexity, and risks of the project. The emphasis of this methodology is on obtaining the desired attributes for each individual High Consequence System.

  11. 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

    2017-08-10

    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.

  12. Explosion risks and consequences for tunnels

    NARCIS (Netherlands)

    Weerheijm, J.; Berg, A.C. van den

    2014-01-01

    Tunnel accidents with transports of dangerous goods may lead to explosions. Risk assessment for these accidents is complicated because of the low probability and the unknown, but disastrous effects expected. Especially the lack of knowledge on the strength of the explosion and the consequences for t

  13. Preventing the Consequences of Alcohol Abuse: Identification of Soldiers at High Risk for Fatal and Serious Injuries

    Science.gov (United States)

    2007-01-01

    249-254, 1993. 92. Ottman R, Annegers JF, Hauser WA, and Kurland LT. Higher risk of seizures in offspring of mothers than of fathers with epilepsy . Am...OIF Operation Iraqi Freedom PASBA Patient Administration Systems and Biostatistics Activity PEB Physical Evaluation Board PTSD Post-traumatic Stress...a devastating outcome and thus important to consider. In addition, the more recent Operation Iraqi Freedom (OIF), the largest military action

  14. 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.

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

    African Journals Online (AJOL)

    African Journal of Drug and Alcohol Studies ... Further, cannabis was used in selected high schools, and its abuse prevalence was greater in urban private schools, ... enhanced sexual activity, with increased risks for negative consequences.

  16. Avoid the Consequences of High Blood Pressure

    Science.gov (United States)

    ... Thromboembolism Aortic Aneurysm More Avoid the Consequences of High Blood Pressure Infographic Updated:Oct 31,2016 View a downloadable version of this infographic High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  17. Risks and consequences of childhood and adolescent obesity.

    Science.gov (United States)

    Must, A; Strauss, R S

    1999-03-01

    This report reviews the risks and consequences associated with childhood and adolescent obesity. Although no consensus definition of childhood obesity exists, the various measures encountered in the literature are moderately well correlated. The paper is organized in three parts. The first section reviews childhood obesity sequelae that occur during childhood. These short-term risks, for orthopedic, neurological, pulmonary, gasteroenterological, and endocrine conditions, although largely limited to severely overweight children, are becoming more common as the prevalence of severe overweight rises. The social burden of pediatric obesity, especially during middle childhood and adolescence, may have lasting effects on self-esteem, body image and economic mobility. The second section examines the intermediate consequences, such as the development of cardiovascular risk factors and persistence of obesity into adulthood. These mid-range effects of early obesity presage later adult disease and premature mortality. In the final section, the small body of research on the long-term morbidity and mortality associated with childhood obesity is reviewed. These studies suggest that risk of cardiovascular disease and all-cause mortality is elevated among those who were overweight during childhood. The high prevalence and dramatic secular trend toward increasing childhood obesity suggest that without aggressive approaches to prevention and treatment, the attendant health and social consequences will be both substantial and long-lasting.

  18. Risk management of domino effects considering dynamic consequence analysis.

    Science.gov (United States)

    Khakzad, Nima; Khan, Faisal; Amyotte, Paul; Cozzani, Valerio

    2014-06-01

    Domino effects are low-probability high-consequence accidents causing severe damage to humans, process plants, and the environment. Because domino effects affect large areas and are difficult to control, preventive safety measures have been given priority over mitigative measures. As a result, safety distances and safety inventories have been used as preventive safety measures to reduce the escalation probability of domino effects. However, these safety measures are usually designed considering static accident scenarios. In this study, we show that compared to a static worst-case accident analysis, a dynamic consequence analysis provides a more rational approach for risk assessment and management of domino effects. This study also presents the application of Bayesian networks and conflict analysis to risk-based allocation of chemical inventories to minimize the consequences and thus to reduce the escalation probability. It emphasizes the risk management of chemical inventories as an inherent safety measure, particularly in existing process plants where the applicability of other safety measures such as safety distances is limited. © 2013 Society for Risk Analysis.

  19. 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.

  20. 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

  1. 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.

  2. Drink driving - Why risk the consequences?

    CERN Document Server

    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...

  3. Development of economic consequence methodology for process risk analysis.

    Science.gov (United States)

    Zadakbar, Omid; Khan, Faisal; Imtiaz, Syed

    2015-04-01

    A comprehensive methodology for economic consequence analysis with appropriate models for risk analysis of process systems is proposed. This methodology uses loss functions to relate process deviations in a given scenario to economic losses. It consists of four steps: definition of a scenario, identification of losses, quantification of losses, and integration of losses. In this methodology, the process deviations that contribute to a given accident scenario are identified and mapped to assess potential consequences. Losses are assessed with an appropriate loss function (revised Taguchi, modified inverted normal) for each type of loss. The total loss is quantified by integrating different loss functions. The proposed methodology has been examined on two industrial case studies. Implementation of this new economic consequence methodology in quantitative risk assessment will provide better understanding and quantification of risk. This will improve design, decision making, and risk management strategies.

  4. Crises communication practices and their consequences for risk communication

    DEFF Research Database (Denmark)

    Andersen, Nina Blom

    2009-01-01

    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...

  5. Crises communication practices and their consequences for risk communication

    DEFF Research Database (Denmark)

    Andersen, Nina Blom

    2009-01-01

    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...

  6. Breast cancer in women at high risk: the role of rapid genetic testing for BRCA1 and -2 mutations and the consequences for treatment strategies.

    Science.gov (United States)

    Francken, Anne Brecht; Schouten, Philip C; Bleiker, Eveline M A; Linn, Sabine C; Rutgers, Emiel J Th

    2013-10-01

    Specific clinical questions rise when patients, who are diagnosed with breast cancer, are at risk of carrying a mutation in BRCA1 and -2 gene due to a strong family history or young age at diagnosis. These questions concern topics such as 1. Timing of genetic counseling and testing, 2. Choices to be made for BRCA1 or -2 mutation carriers in local treatment, contralateral treatment, (neo)adjuvant systemic therapy, and 3. The psychological effects of rapid testing. The knowledge of the genetic status might have several advantages for the patient in treatment planning, such as the choice whether or not to undergo mastectomy and/or prophylactic contralateral mastectomy. The increased risk of developing a second breast cancer in the ipsilateral breast in mutation carriers, is only slightly higher after primary cancer treatment, than in the general population. Prophylactic contralateral mastectomy provides a substantial reduction of contralateral breast cancer, although only a small breast cancer specific survival benefit. Patients should be enrolled in clinical trials to investigate (neo)-adjuvant drug regimens, that based on preclinical and early clinical evidence might be targeting the homologous recombination defect, such as platinum compounds and PARP inhibitors. If rapid testing is performed, the patient can make a well-balanced decision. Although rapid genetic counseling and testing might cause some distress, most women reported this approach to be worthwhile. In this review the literature regarding these topics is evaluated. Answers and suggestions, useful in clinical practice are discussed.

  7. High-Risk Pregnancy

    Science.gov (United States)

    ... NICHD Research Information Clinical Trials Resources and Publications High-Risk Pregnancy: Condition Information Skip sharing on social media links Share this: Page Content A high-risk pregnancy refers to anything that puts the ...

  8. Risking Your Health : Causes, Consequences, and Interventions to Prevent Risky Behaviors

    OpenAIRE

    de Walque, Damien

    2013-01-01

    Behaviors that pose risks for an individual’s health and that also represent important threats for public health, such as drug use, smoking, alcohol, unhealthy eating causing obesity, and unsafe sex, are highly prevalent in low income countries, even though they are traditionally associated with richer countries. Individual choices are an important part of the risky behaviors. Risking Your Health: Causes, Consequences, and Interventions to Prevent Risky Behaviors explore how those choices...

  9. 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.

  10. 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; Grant, Evan H Campbell

    2016-02-01

    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 Bsalecology, 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.

  11. 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

  12. Integration of human reliability analysis into the high consequence process

    Energy Technology Data Exchange (ETDEWEB)

    Houghton, F.K.; Morzinski, J.

    1998-12-01

    When performing a hazards analysis (HA) for a high consequence process, human error often plays a significant role in the hazards analysis. In order to integrate human error into the hazards analysis, a human reliability analysis (HRA) is performed. Human reliability is the probability that a person will correctly perform a system-required activity in a required time period and will perform no extraneous activity that will affect the correct performance. Even though human error is a very complex subject that can only approximately be addressed in risk assessment, an attempt must be made to estimate the effect of human errors. The HRA provides data that can be incorporated in the hazard analysis event. This paper will discuss the integration of HRA into a HA for the disassembly of a high explosive component. The process was designed to use a retaining fixture to hold the high explosive in place during a rotation of the component. This tool was designed as a redundant safety feature to help prevent a drop of the explosive. This paper will use the retaining fixture to demonstrate the following HRA methodology`s phases. The first phase is to perform a task analysis. The second phase is the identification of the potential human, both cognitive and psychomotor, functions performed by the worker. During the last phase the human errors are quantified. In reality, the HRA process is an iterative process in which the stages overlap and information gathered in one stage may be used to refine a previous stage. The rationale for the decision to use or not use the retaining fixture and the role the HRA played in the decision will be discussed.

  13. 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.

  14. Contact allergy to epoxy resin: risk occupations and consequences.

    Science.gov (United States)

    Bangsgaard, Nannie; Thyssen, Jacob Pontoppidan; Menné, Torkil; Andersen, Klaus Ejner; Mortz, Charlotte G; Paulsen, Evy; Sommerlund, Mette; Veien, Niels Kren; Laurberg, Grete; Kaaber, Knud; Thormann, Jens; Andersen, Bo Lasthein; Danielsen, Anne; Avnstorp, Christian; Kristensen, Berit; Kristensen, Ove; Vissing, Susanne; Nielsen, Niels Henrik; Johansen, Jeanne Duus

    2012-08-01

    Epoxy resin monomers are strong skin sensitizers that are widely used in industrial sectors. In Denmark, the law stipulates that workers must undergo a course on safe handling of epoxy resins prior to occupational exposure, but the effectiveness of this initiative is largely unknown. To evaluate the prevalence of contact allergy to epoxy resin monomer (diglycidyl ether of bisphenol A; MW 340) among patients with suspected contact dermatitis and relate this to occupation and work-related consequences. The dataset comprised 20 808 consecutive dermatitis patients patch tested during 2005-2009. All patients with an epoxy resin-positive patch test were sent a questionnaire. A positive patch test reaction to epoxy resin was found in 275 patients (1.3%), with a higher proportion in men (1.9%) than in women (1.0%). The prevalence of sensitization to epoxy resin remained stable over the study period. Of the patients with an epoxy resin-positive patch test, 71% returned a questionnaire; 95 patients had worked with epoxy resin in the occupational setting, and, of these, one-third did not use protective gloves and only 50.5% (48) had participated in an educational programme. The 1% prevalence of epoxy resin contact allergy is equivalent to reports from other countries. The high occurrence of epoxy resin exposure at work, and the limited use of protective measures, indicate that reinforcement of the law is required. © 2012 John Wiley & Sons A/S.

  15. High risk pregnancy

    Directory of Open Access Journals (Sweden)

    Bernardita Donoso Bernales

    2012-06-01

    Full Text Available It is estimated that roughly 20% of pregnancies fall into the high risk category, which in turn are responsible for over 80% of perinatal adverse outcome. Modern obstetrics has been very successful in reducing maternal morbidity and mortality. It has focused mainly on fetal and neonatal aspects, and on identifying the subgroup of pregnant women that need greater surveillance and care because of clearly identifiable risk factors. The article describes the preconceptional advice, its components and recommendations for its implementation, as well as its role in maternal and perinatal risk assessment. These interventions attempt to reduce the rates of maternal and perinatal mortality.

  16. [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.

  17. Consideration of Collision "Consequence" in Satellite Conjunction Assessment and Risk Analysis

    Science.gov (United States)

    Hejduk, M.; Laporte, F.; Moury, M.; Newman, L.; Shepperd, R.

    2017-01-01

    Classic risk management theory requires the assessment of both likelihood and consequence of deleterious events. Satellite conjunction risk assessment has produced a highly-developed theory for assessing collision likelihood but holds a completely static solution for collision consequence, treating all potential collisions as essentially equally worrisome. This may be true for the survival of the protected asset, but the amount of debris produced by the potential collision, and therefore the degree to which the orbital corridor may be compromised, can vary greatly among satellite conjunctions. This study leverages present work on satellite collision modeling to develop a method by which it can be estimated, to a particular confidence level, whether a particular collision is likely to produce a relatively large or relatively small amount of resultant debris and how this datum might alter conjunction remediation decisions. The more general question of orbital corridor protection is also addressed, and a preliminary framework presented by which both collision likelihood and consequence can be jointly considered in the risk assessment process.

  18. Falls in Korean Polio Survivors: Incidence, Consequences, and Risk Factors

    OpenAIRE

    Nam, Kiyeun; Lee, Seungyeol; Yang, Eun Joo; Kim, Keewon; Jung, Se Hee; Jang, Soong-Nang; Han, Soo Jeong; Kim, Wan-Ho; Lim, Jae-Young

    2016-01-01

    Falls and fall-related injuries are important issue among polio survivors. The purpose of this study was to determine the incidence of, and consequences and factors associated with falls among Korean polio survivors. A total of 317 polio survivors participated in this study. All participants completed a questionnaire including fall history, symptoms related to post-polio syndrome and other information through a telephone interview. Among them, 80 participants visited our clinic for additional...

  19. 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.

  20. Potential Population Consequences of Active Sonar Disturbance in Atlantic Herring: Estimating the Maximum Risk.

    Science.gov (United States)

    Sivle, Lise Doksæter; Kvadsheim, Petter Helgevold; Ainslie, Michael

    2016-01-01

    Effects of noise on fish populations may be predicted by the population consequence of acoustic disturbance (PCAD) model. We have predicted the potential risk of population disturbance when the highest sound exposure level (SEL) at which adult herring do not respond to naval sonar (SEL(0)) is exceeded. When the population density is low (feeding), the risk is low even at high sonar source levels and long-duration exercises (>24 h). With densely packed populations (overwintering), a sonar exercise might expose the entire population to levels >SEL(0) within a 24-h exercise period. However, the disturbance will be short and the response threshold used here is highly conservative. It is therefore unlikely that naval sonar will significantly impact the herring population.

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

    Science.gov (United States)

    Richgels, Katherine; 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.

  2. [Epidemiological research on environmental health risks and their economic consequences].

    Science.gov (United States)

    Haucke, F; Holle, R; Wichmann, H E

    2009-12-01

    In environmental health research, methods for quantitative analysis of human population studies data are gaining importance. In recent years, it has been realized that they can also provide an important link to the economic view on environmental health effects. In this review, fundamental concepts and methods from environmental epidemiology and health economics are presented and it is shown how they can be linked in order to support environmental policy decisions. In addition, the characteristics of environmental epidemiology and the role of epidemiologic studies in risk assessment are discussed. From the economic point of view, cost-of-illness studies and cost effectiveness studies are the main approaches, and we have placed special focus on methods of monetary valuation of health effects that are generally proposed in the environmental context. Two conceptually differing strategies to combine epidemiologic and economic evidence are presented: the environmental attributable fraction model as a top-down approach and the impact pathway approach which follows a bottom-up analysis strategy. Finally, two examples are used to illustrate the application of these concepts and methods: health risks caused by fine particle air pollution and their costs, and the cost-effectiveness of radon exposure reduction policies.

  3. 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

  4. 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.

  5. 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.

  6. The Consequences of State-Level Intrusions: A Risk Worth Taking?

    Directory of Open Access Journals (Sweden)

    Murdoch Watney

    2015-05-01

    Full Text Available Over the years states have intruded the cyberspace of other states. Does the offending state consider the consequences it may face for the intrusion under international law and/or at international level? Is the position at present so uncertain that a state may decide that the risk is worth taking in view of the problems experienced with establishing attribution or is the injured state being second guessed on its reaction? This discussion explores, with reference to examples of state-level intrusions, whether the intrusion is prohibited under the international law or not and the possible consequences the offending state may face. The danger exists that as countries develop and/or improve their cyber capabilities, they may follow the example of countries who had intruded the cyberspace of other countries. It will be difficult for the latter to preach restraint from the moral high ground. Past state behaviour illustrates that states will put national interests and aspirations above trust, openness and transparency in cyberspace. Cyberspace is becoming a crowded place where state behaviour necessitates governance otherwise cyberspace will become lawless to the detriment of all states including those states who in the past may have decided state-intrusion is a risk worth taking.

  7. Jet fire consequence modeling for high-pressure gas pipelines

    Science.gov (United States)

    Coccorullo, Ivano; Russo, Paola

    2016-12-01

    A simple and reliable approach for sizing the hazard area potentially affected by a jet fire as consequence of the failure of high-pressure pipeline is proposed. A release rate model, taking pipeline operation properties and source release properties into account, is coupled with SLAB dispersion model and point source radiation model to calculate the hazard distance. The hazard distance is set beyond the distance at which a low chance of fatality can occur to people exposed and a wooden structure is not expected to burn due to radiation heat of jet fire. The comparison between three gases with different physico-chemical properties (i.e. natural gas, hydrogen, ethylene) is shown. The influence of pipeline operating parameters, such as: pressure, pipeline diameter and length, hole size, on the hazard area for the three gases is evaluated. Finally, a simple correlation is proposed for calculating the hazard distance as function of these parameters.

  8. Assessment of risk, damage and severity of consequences of accident into storage for LPG

    Science.gov (United States)

    Tzenova, Zlatina

    2016-12-01

    In this work an accident scenario in store for LPG is considered and consequences - forming a toxic cloud of vapor, fire and blast are modeled through models built into the software product ALOHA. The risk assessment of contamination with certain concentration is done, provided that it is an accident. Definitions for model mixture and risk assessment using geometric probability are introduced.

  9. 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.

  10. The prevalence and consequences of malnutrition risk in elderly Albanian intensive care unit patients

    Directory of Open Access Journals (Sweden)

    Shpata V

    2015-02-01

    Full Text Available Vjollca Shpata,1 Ilir Ohri,2 Tatjana Nurka,1 Xhensila Prendushi1 1Faculty of Medical Technical Sciences, 2University Hospital Center of Tirana “Mother Theresa”, Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania Purpose: Many investigators have reported rising numbers of elderly patients admitted to the intensive care units (ICUs. The aim of the study was to estimate the prevalence of malnutrition risk in the ICU by comparing the prevalence of malnutrition between older adults (aged 65 years and above and adults (aged 18–64 years, and to examine the negative consequences associated with risk of malnutrition in older adults. Materials and methods: A prospective cohort study in the ICU of the University Hospital Center of Tirana, Albania, was conducted. Logistic regression analysis was used to analyze the effect of malnutrition risk on the length of ICU stay, the duration of being on the ventilator, the total complications, the infectious complications, and the mortality. Results: In this study, 963 patients participated, of whom 459 patients (47.7% were aged ≥65 years. The prevalence of malnutrition risk at the time of ICU admission of the patients aged ≥65 years old was 71.24%. Logistic regression adjusted for confounders showed that malnutrition risk was an independent risk factor of poor clinical outcome for elderly ICU patients, for 1 infections (odds ratio [OR] =4.37; 95% confidence interval [CI]: 2.61–7.31; 2 complications (OR =6.73; 95% CI: 4.26–10.62; 3 mortality (OR =2.68; 95% CI: 1.72–4.18; and 4 ICU length of stay >14 days (OR =5.18, 95% CI: 2.43–11.06. Conclusion: Malnutrition risk is highly prevalent among elderly ICU patients, especially among severely ill patients with malignancy admitted to the emergency ward. ICU elderly patients at malnutrition risk will have higher complication and infection rates, longer duration of ICU stay, and increased mortality. Efforts should be made to implement a

  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. The prevalence and consequences of malnutrition risk in elderly Albanian intensive care unit patients

    Science.gov (United States)

    Shpata, Vjollca; Ohri, Ilir; Nurka, Tatjana; Prendushi, Xhensila

    2015-01-01

    Purpose Many investigators have reported rising numbers of elderly patients admitted to the intensive care units (ICUs). The aim of the study was to estimate the prevalence of malnutrition risk in the ICU by comparing the prevalence of malnutrition between older adults (aged 65 years and above) and adults (aged 18–64 years), and to examine the negative consequences associated with risk of malnutrition in older adults. Materials and methods A prospective cohort study in the ICU of the University Hospital Center of Tirana, Albania, was conducted. Logistic regression analysis was used to analyze the effect of malnutrition risk on the length of ICU stay, the duration of being on the ventilator, the total complications, the infectious complications, and the mortality. Results In this study, 963 patients participated, of whom 459 patients (47.7%) were aged ≥65 years. The prevalence of malnutrition risk at the time of ICU admission of the patients aged ≥65 years old was 71.24%. Logistic regression adjusted for confounders showed that malnutrition risk was an independent risk factor of poor clinical outcome for elderly ICU patients, for 1) infections (odds ratio [OR] =4.37; 95% confidence interval [CI]: 2.61–7.31); 2) complications (OR =6.73; 95% CI: 4.26–10.62); 3) mortality (OR =2.68; 95% CI: 1.72–4.18); and 4) ICU length of stay >14 days (OR =5.18, 95% CI: 2.43–11.06). Conclusion Malnutrition risk is highly prevalent among elderly ICU patients, especially among severely ill patients with malignancy admitted to the emergency ward. ICU elderly patients at malnutrition risk will have higher complication and infection rates, longer duration of ICU stay, and increased mortality. Efforts should be made to implement a variety of nutritional care strategies, to change the nutritional practices not only at ward level, but nationally, according to the best clinical practice and recent guidelines. PMID:25733824

  13. The prevalence and consequences of malnutrition risk in elderly Albanian intensive care unit patients

    OpenAIRE

    2015-01-01

    Purpose Many investigators have reported rising numbers of elderly patients admitted to the intensive care units (ICUs). The aim of the study was to estimate the prevalence of malnutrition risk in the ICU by comparing the prevalence of malnutrition between older adults (aged 65 years and above) and adults (aged 18–64 years), and to examine the negative consequences associated with risk of malnutrition in older adults. Materials and methods A prospective cohort study in the ICU of the Universi...

  14. Epidemiology, risk factors, and consequences of obstructive sleep apnea and short sleep duration.

    Science.gov (United States)

    Al Lawati, Nabil M; Patel, Sanjay R; Ayas, Najib T

    2009-01-01

    We will review the epidemiology, risk factors, and consequences of obstructive sleep apnea (OSA) and short/long sleep duration. Obstructive sleep apnea is a disease characterized by recurrent upper airway obstruction during sleep. Obstructive sleep apnea is common, with moderate to severe disease present in approximately 9% of middle aged men and 4% of women. The prevalence of OSA in certain patient populations (such as elderly patients, hypertensive patients, patients with coronary disease, and prebariatric surgery patients) is even greater. There are a number or risk factors for disease including obesity, male sex, and family history. Obstructive sleep apnea negatively impacts quality of life and is also associated with a number of adverse safety and health consequences including cardiovascular disease and motor vehicle crashes. Short habitual sleep duration can result in excessive daytime sleepiness and reduced neurocognitive function. Sleep loss may have long-term health consequences and may lead to premature death, cardiovascular disease, and the development of diabetes.

  15. Retained placenta in Friesian mares : incidence, risk factors, therapy, and consequences

    NARCIS (Netherlands)

    Sevinga, M; Hesselink, JW; Barkema, H.W.

    2001-01-01

    This study concerns incidence, risk factors, therapy and consequences of retained placenta after normal foalings in Friesian mares. Retained placenta was defined as failure to expel all fetal membranes within 3 hours after the delivery of the foal. Incidence of retained placenta was studied in 495 p

  16. Infectious diseases and immune system in infants Risk factors and consequences: The Generation R Study

    NARCIS (Netherlands)

    L. Duijts (Liesbeth)

    2008-01-01

    textabstractPreterm birth and low birth weight are considered as important public health concerns since both are important causes of perinatal morbidity and mortality (1-3). Furthermore, these adverse birth outcomes seem to have long term consequences. Preterm birth infants are at risk for

  17. 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.

  18. Proactive Disciplinary Consequences in Three Illinois High Schools

    Science.gov (United States)

    Golomb, Sara R.

    2010-01-01

    Disciplinary codes of conduct guide administrators when determining the consequences for student misconduct. The codes of conduct commonly found in schools rely on exclusionary measures that have been associated with negative student outcomes and controversy but little is being done to provide positive model for these written policies. Schools…

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    OpenAIRE

    2016-01-01

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

  1. 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

  2. Associated Factors and Consequences of Risk of Bias in Randomized Controlled Trials of Yoga: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Holger Cramer

    Full Text Available Bias in randomized controlled trials (RCTs of complementary therapy interventions seems to be associated with specific factors and to potentially distort the studies' conclusions. This systematic review assessed associated factors of risk of bias and consequences for the studies' conclusions in RCTs of yoga as one of the most commonly used complementary therapies.Medline/PubMed, Scopus, IndMED and the Cochrane Library were searched through February 2014 for yoga RCTs. Risk of selection bias was assessed using the Cochrane tool and regressed to a publication year; b country of origin; c journal type; and d impact factor using multiple logistic regression analysis. Likewise, the authors' conclusions were regressed to risk of bias.A total of 312 RCTs were included. Impact factor ranged from 0.0 to 39.2 (median = 1.3; 60 RCT (19.2% had a low risk of selection bias, and 252 (80.8% had a high or unclear risk of selection bias. Only publication year and impact factor significantly predicted low risk of bias; RCTs published after 2001 (adjusted odds ratio (OR = 12.6; 95% confidence interval (CI = 1.7, 94.0; p<0.001 and those published in journals with impact factor (adjusted OR = 2.6; 95%CI = 1.4, 4.9; p = 0.004 were more likely to have low risk of bias. The authors' conclusions were not associated with risk of bias.Risk of selection bias was generally high in RCTs of yoga; although the situation has improved since the publication of the revised CONSORT statement 2001. Pre-CONSORT RCTs and those published in journals without impact factor should be handled with increased care; although risk of bias is unlikely to distort the RCTs' conclusions.

  3. GRiP - A flexible approach for calculating risk as a function of consequence, vulnerability, and threat.

    Energy Technology Data Exchange (ETDEWEB)

    Whitfield, R. G.; Buehring, W. A.; Bassett, G. W. (Decision and Information Sciences)

    2011-04-08

    Get a GRiP (Gravitational Risk Procedure) on risk by using an approach inspired by the physics of gravitational forces between body masses! In April 2010, U.S. Department of Homeland Security Special Events staff (Protective Security Advisors [PSAs]) expressed concern about how to calculate risk given measures of consequence, vulnerability, and threat. The PSAs believed that it is not 'right' to assign zero risk, as a multiplicative formula would imply, to cases in which the threat is reported to be extremely small, and perhaps could even be assigned a value of zero, but for which consequences and vulnerability are potentially high. They needed a different way to aggregate the components into an overall measure of risk. To address these concerns, GRiP was proposed and developed. The inspiration for GRiP is Sir Isaac Newton's Universal Law of Gravitation: the attractive force between two bodies is directly proportional to the product of their masses and inversely proportional to the squares of the distance between them. The total force on one body is the sum of the forces from 'other bodies' that influence that body. In the case of risk, the 'other bodies' are the components of risk (R): consequence, vulnerability, and threat (which we denote as C, V, and T, respectively). GRiP treats risk as if it were a body within a cube. Each vertex (corner) of the cube represents one of the eight combinations of minimum and maximum 'values' for consequence, vulnerability, and threat. The risk at each of the vertices is a variable that can be set. Naturally, maximum risk occurs when consequence, vulnerability, and threat are at their maximum values; minimum risk occurs when they are at their minimum values. Analogous to gravitational forces among body masses, the GRiP formula for risk states that the risk at any interior point of the box depends on the squares of the distances from that point to each of the eight vertices. The risk

  4. GRiP - A flexible approach for calculating risk as a function of consequence, vulnerability, and threat.

    Energy Technology Data Exchange (ETDEWEB)

    Whitfield, R. G.; Buehring, W. A.; Bassett, G. W. (Decision and Information Sciences)

    2011-04-08

    Get a GRiP (Gravitational Risk Procedure) on risk by using an approach inspired by the physics of gravitational forces between body masses! In April 2010, U.S. Department of Homeland Security Special Events staff (Protective Security Advisors [PSAs]) expressed concern about how to calculate risk given measures of consequence, vulnerability, and threat. The PSAs believed that it is not 'right' to assign zero risk, as a multiplicative formula would imply, to cases in which the threat is reported to be extremely small, and perhaps could even be assigned a value of zero, but for which consequences and vulnerability are potentially high. They needed a different way to aggregate the components into an overall measure of risk. To address these concerns, GRiP was proposed and developed. The inspiration for GRiP is Sir Isaac Newton's Universal Law of Gravitation: the attractive force between two bodies is directly proportional to the product of their masses and inversely proportional to the squares of the distance between them. The total force on one body is the sum of the forces from 'other bodies' that influence that body. In the case of risk, the 'other bodies' are the components of risk (R): consequence, vulnerability, and threat (which we denote as C, V, and T, respectively). GRiP treats risk as if it were a body within a cube. Each vertex (corner) of the cube represents one of the eight combinations of minimum and maximum 'values' for consequence, vulnerability, and threat. The risk at each of the vertices is a variable that can be set. Naturally, maximum risk occurs when consequence, vulnerability, and threat are at their maximum values; minimum risk occurs when they are at their minimum values. Analogous to gravitational forces among body masses, the GRiP formula for risk states that the risk at any interior point of the box depends on the squares of the distances from that point to each of the eight vertices. The risk

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

    Energy Technology Data Exchange (ETDEWEB)

    Gorham, E.D.; Breeding, R.J.; Brown, T.D.; Harper, F.T. [Sandia National Labs., Albuquerque, NM (United States); Helton, J.C. [Arizona State Univ., Tempe, AZ (United States); Murfin, W.B. [Technadyne Engineering Consultants, Inc., Albuquerque, NM (United States); Hora, S.C. [Hawaii Univ., Hilo, HI (United States)

    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.

  6. 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.

  7. 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

  8. Burden and consequences of child maltreatment in high-income countries.

    Science.gov (United States)

    Gilbert, Ruth; Widom, Cathy Spatz; Browne, Kevin; Fergusson, David; Webb, Elspeth; Janson, Staffan

    2009-01-03

    Child maltreatment remains a major public-health and social-welfare problem in high-income countries. Every year, about 4-16% of children are physically abused and one in ten is neglected or psychologically abused. During childhood, between 5% and 10% of girls and up to 5% of boys are exposed to penetrative sexual abuse, and up to three times this number are exposed to any type of sexual abuse. However, official rates for substantiated child maltreatment indicate less than a tenth of this burden. Exposure to multiple types and repeated episodes of maltreatment is associated with increased risks of severe maltreatment and psychological consequences. Child maltreatment substantially contributes to child mortality and morbidity and has longlasting effects on mental health, drug and alcohol misuse (especially in girls), risky sexual behaviour, obesity, and criminal behaviour, which persist into adulthood. Neglect is at least as damaging as physical or sexual abuse in the long term but has received the least scientific and public attention. The high burden and serious and long-term consequences of child maltreatment warrant increased investment in preventive and therapeutic strategies from early childhood.

  9. 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…

  10. 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 sensitiza...

  11. 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

  12. Consequences of high-frequency operation on EUV source efficiency

    Science.gov (United States)

    Sizyuk, Tatyana

    2017-08-01

    A potential problem of future extreme ultraviolet (EUV) sources, required for high volume manufacture regimes, can be related to the contamination of the chamber environment by products of preceding laser pulse/droplet interactions. Implementation of high, 100 kHz and higher, repetition rate of EUV sources using Sn droplets ignited with laser pulses can cause high accumulation of tin in the chamber in the form of vapor, fine mist, or fragmented clusters. In this work, the effects of the residual tin accumulation in the EUV chamber in dependence on laser parameters and mitigation system efficiency were studied. The effect of various pressures of tin vapor on the CO2 and Nd:YAG laser beam propagation and on the size, the intensity, and the resulting efficiency of the EUV sources was analyzed. The HEIGHTS 3D package was used for this analysis to study the effect of residual background pressure and spatial distribution on EUV photon emission and collection. It was found that background pressure in the range of 1-5 Pa does not significantly influence the EUV source produced by CO2 lasers. A larger volume with this pressure condition, however, can reduce the efficiency of the source. However, an optimized volume of mix with proper density could increase the efficiency of the sources produced by CO2 lasers.

  13. High Tc as a consequence of structure deformation

    Energy Technology Data Exchange (ETDEWEB)

    Djajic, R.P. (Faculty of Technical Sciences, Univ. of Novi Sad (Yugoslavia)); Tosic, B.S.; Setrajcic, J.P. (Inst. of Physics, Univ. of Novi Sad (Yugoslavia)); Mirjanic, D.L. (Faculty of Tech., Univ. of Banja Luka (Yugoslavia))

    1991-12-01

    Based on the experimental fact that doped perovskite structures behave as a system of energetically independent thin layers we developed a theoretical model for a single layer behaviour. It was shown that electron and phonon spectra are functions of azimuthal angle which in turn gives the specific relations for Tc which on the other hand differs significantly from the corresponding value in the BCS theory. The crucial fact, which allows the solution of this equation with high Tc, is the electron-electron interaction constant which in a thin doped layer is for an order or two orders of magnitude greater than the same interaction constant in the ideal infinite structure. (orig.).

  14. 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.

  15. Experimental consequences of quantum critical points at high temperatures

    Science.gov (United States)

    Freitas, D. C.; Rodière, P.; Núñez, M.; Garbarino, G.; Sulpice, A.; Marcus, J.; Gay, F.; Continentino, M. A.; Núñez-Regueiro, M.

    2015-11-01

    We study the C r1 -xR ex phase diagram finding that its phase transition temperature towards an antiferromagnetic order TN follows a quantum [(xc-x ) /xc ] ψ law, with ψ =1 /2 , from the quantum critical point (QCP) at xc=0.25 up to TN≈600 K . We compare this system to others in order to understand why this elemental material is affected by the QCP up to such unusually high temperatures. We determine a general criterion for the crossover, as a function of an external parameter such as concentration, from the region controlled solely by thermal fluctuations to that where quantum effects become observable. The properties of materials with low coherence lengths will thus be altered far away from the QCP.

  16. Ecological Recovery Potential of Freshwater Organisms: Consequences for Environmental Risk Assessment of Chemicals.

    Science.gov (United States)

    Gergs, Andre; Classen, Silke; Strauss, Tido; Ottermanns, Richard; Brock, Theo C M; Ratte, Hans Toni; Hommen, Udo; Preuss, Thomas G

    2016-01-01

    Chemical contaminants released into the in the environment may have adverse effects on (non-target) species, populations and communities. The return of a stressed system to its pre-disturbance or other reference state, i.e. the ecological recovery, may depend on various factors related to the affected taxon, the ecosystem of concern and the type of stressor with consequences for the assessment and management of risks associated with chemical contaminants. Whereas the effects caused by short-term exposure might be acceptable to some extent, the conditions under which ecological recovery can serve as a decision criterion in the environmental risk assessment of chemical stressors remains to be evaluated. For a generic consideration of recovery in the risk assessment of chemicals, we reviewed case studies of natural and artificial aquatic systems and evaluate five aspects that might cause variability in population recovery time: (1) taxonomic differences and life-history variability, (2) factors related to ecosystem type and community processes, (3) type of disturbance, (4) comparison of field and semi-field studies, and (5) effect magnitude, i.e., the decline in population size following disturbance. We discuss our findings with regard to both retrospective assessments and prospective risk assessment.

  17. 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.

  18. Statistical Surrogate Models for Estimating Probability of High-Consequence Climate Change

    Science.gov (United States)

    Field, R.; Constantine, P.; Boslough, M.

    2011-12-01

    We have posed the climate change problem in a framework similar to that used in safety engineering, by acknowledging that probabilistic risk assessments focused on low-probability, high-consequence climate events are perhaps more appropriate than studies focused simply on best estimates. 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 have developed specialized statistical surrogate models (SSMs) that can be used to make predictions about the tails of the associated probability distributions. A SSM is different than a deterministic surrogate model in that it represents each climate variable of interest as a space/time random field, that is, a random variable for every fixed location in the atmosphere at all times. The SSM can be calibrated to available spatial and temporal data from existing climate databases, or to a collection of outputs from general circulation models. 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 was also developed to provide quantitative measures of confidence, via Bayesian credible intervals, to assess these risks. To illustrate the use of the SSM, we considered two collections of NCAR CCSM 3.0 output data. The first collection corresponds to average December surface temperature for years 1990-1999 based on a collection of 8 different model runs obtained from the Program for Climate Model Diagnosis and Intercomparison (PCMDI). We calibrated the surrogate model to the available model data and make various point predictions. We also analyzed average precipitation rate in June, July, and August over a 54-year period assuming a cyclic Y2K ocean model. We

  19. [Falls in the Spanish elderly population: Incidence, consequences and risk factors].

    Science.gov (United States)

    Rodríguez-Molinero, Alejandro; Narvaiza, Leire; Gálvez-Barrón, César; de la Cruz, Juan José; Ruíz, Jorge; Gonzalo, Natalia; Valldosera, Esther; Yuste, Antonio

    2015-01-01

    Falls in the elderly constitute a public health concern. The objective of the present study was to collect updated data on the frequency of falls in the Spanish elderly population, as well as to analyse their consequences and associated risk factors. This prospective study was conducted on a probabilistic sample of 772 Spanish, community dwelling, older adults. During the baseline visit, data were collected on functional capacity, history of falls, disease background, number of medications used, balance impairment, use of walking aids, cognitive capacity and depression symptoms. Participants were followed up for one year by means of quarterly phone calls, where they were asked about the number of falls occurred in that period, as well as their consequences and associated use of healthcare resources. During the one-year follow up period, 28.4% (95%CI 24.9-32.1) of participants suffered one or more falls, while 9.9% (95%CI 7.4-11.4) suffered multiple falls. One-third of the falls were due to accidental extrinsic causes. Among participants who had suffered falls, 9.3% suffered a fracture (3.1% hip fracture), and 55.4% required healthcare services (29% were managed in the hospital emergency room, and 7.3% were admitted to hospital). Risk factors identified through multivariate analysis were: advanced age (>79 years), not having a companion, using more than 2 drugs, dependency in BADLs, impaired strength or balance, and use of walking aids. Falls continue to be a major public health concern in Spain. Given that some of the associated risk factors may be modified, introducing programs aimed at tackling this problem should be regarded as a priority. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

  20. Questioning Psychosocial Resilience After Flooding and the Consequences for Disaster Risk Reduction

    DEFF Research Database (Denmark)

    Crabtree, Andrew

    2013-01-01

    may suffer from mental disorders following a PTE, but disagrees that the majority of people are resilient. Furthermore it argues that we should not see PTEs as one event, but as involving a number of stressors and having a variety of consequences. Drawing on fieldwork carried out in Rajni village......, Bihar following the 2008 Kosi River flooding, it documents, 18 months post flood, that flood onset gave rise to symptoms related to Post Traumatic Stress Disorder (primarily re-experiencing). The villagers’ primary concern was livelihood loss which, together with their lack of hope for the future, led...... to symptoms of depression. It argues that mental health issues should be fully integrated into Disaster Risk Reduction plans and policies, which are likely to be included in the Post-2015 Millennium Development Goals. In addition to supporting mental health interventions, the paper suggests that deep socio...

  1. 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.

  2. Neurobiological consequences of juvenile stress: A GABAergic perspective on risk and resilience.

    Science.gov (United States)

    Albrecht, Anne; Müller, Iris; Ardi, Ziv; Çalışkan, Gürsel; Gruber, David; Ivens, Sebastian; Segal, Menahem; Behr, Joachim; Heinemann, Uwe; Stork, Oliver; Richter-Levin, Gal

    2017-03-01

    ALBRECHT, A., MÜLLER, I., ARDI, Z., ÇALIŞKAN, G., GRUBER, D., IVENS, S., SEGAL, M., BEHR, J., HEINEMANN, U., STORK, O., and RICHTER-LEVIN, G. Neurobiological consequences of juvenile stress: A GABAergic perspective on risk and resilience. NEUROSCI BIOBEHAV REV XXX-XXX, 2016.- Childhood adversity is among the most potent risk factors for developing mood and anxiety disorders later in life. Therefore, understanding how stress during childhood shapes and rewires the brain may optimize preventive and therapeutic strategies for these disorders. To this end, animal models of stress exposure in rodents during their post-weaning and pre-pubertal life phase have been developed. Such 'juvenile stress' has a long-lasting impact on mood and anxiety-like behavior and on stress coping in adulthood, accompanied by alterations of the GABAergic system within core regions for the stress processing such as the amygdala, prefrontal cortex and hippocampus. While many regionally diverse molecular and electrophysiological changes are observed, not all of them correlate with juvenile stress-induced behavioral disturbances. It rather seems that certain juvenile stress-induced alterations reflect the system's attempts to maintain homeostasis and thus promote stress resilience. Analysis tools such as individual behavioral profiling may allow the association of behavioral and neurobiological alterations more clearly and the dissection of alterations related to the pathology from those related to resilience.

  3. 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

  4. 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

  5. Surety of human elements of high consequence systems: An organic model

    Energy Technology Data Exchange (ETDEWEB)

    FORSYTHE,JAMES C.; WENNER,CAREN A.

    2000-04-25

    Despite extensive safety analysis and application of safety measures, there is a frequent lament, ``Why do we continue to have accidents?'' Two breakdowns are prevalent in risk management and prevention. First, accidents result from human actions that engineers, analysts and management never envisioned and second, controls, intended to preclude/mitigate accident sequences, prove inadequate. This paper addresses the first breakdown, the inability to anticipate scenarios involving human action/inaction. The failure of controls has been addressed in a previous publication (Forsythe and Grose, 1998). Specifically, this paper presents an approach referred to as surety. The objective of this approach is to provide high levels of assurance in situations where potential system failure paths cannot be fully characterized. With regard to human elements of complex systems, traditional approaches to human reliability are not sufficient to attain surety. Consequently, an Organic Model has been developed to account for the organic properties exhibited by engineered systems that result from human involvement in those systems.

  6. 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.

  7. The consequences of human actions on risks for infectious diseases: a review

    Science.gov (United States)

    Lindahl, Johanna F.; Grace, Delia

    2015-01-01

    The human population is growing, requiring more space for food production, and needing more animals to feed it. Emerging infectious diseases are increasing, causing losses in both human and animal lives, as well as large costs to society. Many factors are contributing to disease emergence, including climate change, globalization and urbanization, and most of these factors are to some extent caused by humans. Pathogens may be more or less prone to emergence in themselves, and rapidly mutating viruses are more common among the emerging pathogens. The climate-sensitive vector-borne diseases are likely to be emerging due to climate changes and environmental changes, such as increased irrigation. This review lists the factors within pathogens that make them prone to emergence, and the modes of transmission that are affected. The anthropogenic changes contributing to disease emergence are described, as well as how they directly and indirectly cause either increased numbers of susceptible or exposed individuals, or cause increased infectivity. Many actions may have multiple direct or indirect effects, and it may be difficult to assess what the consequences may be. In addition, most anthropogenic drivers are related to desired activities, such as logging, irrigation, trade, and travelling, which the society is requiring. It is important to research more about the indirect and direct effects of the different actions to understand both the benefits and the risks. PMID:26615822

  8. The consequences of human actions on risks for infectious diseases: a review.

    Science.gov (United States)

    Lindahl, Johanna F; Grace, Delia

    2015-01-01

    The human population is growing, requiring more space for food production, and needing more animals to feed it. Emerging infectious diseases are increasing, causing losses in both human and animal lives, as well as large costs to society. Many factors are contributing to disease emergence, including climate change, globalization and urbanization, and most of these factors are to some extent caused by humans. Pathogens may be more or less prone to emergence in themselves, and rapidly mutating viruses are more common among the emerging pathogens. The climate-sensitive vector-borne diseases are likely to be emerging due to climate changes and environmental changes, such as increased irrigation. This review lists the factors within pathogens that make them prone to emergence, and the modes of transmission that are affected. The anthropogenic changes contributing to disease emergence are described, as well as how they directly and indirectly cause either increased numbers of susceptible or exposed individuals, or cause increased infectivity. Many actions may have multiple direct or indirect effects, and it may be difficult to assess what the consequences may be. In addition, most anthropogenic drivers are related to desired activities, such as logging, irrigation, trade, and travelling, which the society is requiring. It is important to research more about the indirect and direct effects of the different actions to understand both the benefits and the risks.

  9. 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…

  10. 49 CFR 195.452 - Pipeline integrity management in high consequence areas.

    Science.gov (United States)

    2010-10-01

    ... as to fall within the definition in § 195.450 of a high population area or other populated area, the... protection history; (iv) Product transported; (v) Operating stress level; (vi) Existing or projected... failure would affect the high consequence area, such as location of the water intake. (h) What...

  11. Pharmacokinetic drug interaction profile of omeprazole with adverse consequences and clinical risk management

    Directory of Open Access Journals (Sweden)

    Li W

    2013-05-01

    Full Text Available Wei Li,1 Su Zeng,2 Lu-Shan Yu,2 Quan Zhou31Division of Medical Affairs, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China; 2Department of Pharmaceutical Analysis and Drug Metabolism, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, People’s Republic of China; 3Department of Pharmacy, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of ChinaBackground: Omeprazole, a proton pump inhibitor (PPI, is widely used for the treatment of dyspepsia, peptic ulcer, gastroesophageal reflux disease, and functional dyspepsia. Polypharmacy is common in patients receiving omeprazole. Drug toxicity and treatment failure resulting from inappropriate combination therapy with omeprazole have been reported sporadically. Systematic review has not been available to address the pharmacokinetic drug-drug interaction (DDI profile of omeprazole with adverse consequences, the factors determining the degree of DDI between omeprazole and comedication, and the corresponding clinical risk management.Methods: Literature was identified by performing a PubMed search covering the period from January 1988 to March 2013. The full text of each article was critically reviewed, and data interpretation was performed.Results: Omeprazole has actual adverse influences on the pharmacokinetics of medications such as diazepam, carbamazepine, clozapine, indinavir, nelfinavir, atazanavir, rilpivirine, methotrexate, tacrolimus, mycophenolate mofetil, clopidogrel, digoxin, itraconazole, posaconazole, and oral iron supplementation. Meanwhile, low efficacy of omeprazole treatment would be anticipated, as omeprazole elimination could be significantly induced by comedicated efavirenz and herb medicines such as St John's wort, Ginkgo biloba, and yin zhi huang. The mechanism for DDI involves induction or inhibition of cytochrome P450, inhibition of P-glycoprotein or breast

  12. A review of research and methods for producing high-consequence software

    Energy Technology Data Exchange (ETDEWEB)

    Collins, E.; Dalton, L.; Peercy, D.; Pollock, G.; Sicking, C.

    1994-12-31

    The development of software for use in high-consequence systems mandates rigorous (formal) processes, methods, and techniques to improve the safety characteristics of those systems. This paper provides a brief overview of current research and practices in high-consequence software, including applied design methods. Some of the practices that are discussed include: fault tree analysis, failure mode effects analysis, petri nets, both hardware and software interlocks, n-version programming, Independent Vulnerability Analyses, and watchdogs. Techniques that offer improvement in the dependability of software in high-consequence systems applications are identified and discussed. Limitations of these techniques are also explored. Research in formal methods, the cleanroom process, and reliability models are reviewed. In addition, current work by several leading researchers as well as approaches being used by leading practitioners are examined.

  13. Plastic Instabilities and Their Consequences in Steels and Other High Strength Alloys

    Science.gov (United States)

    1991-09-01

    rate yes Superalloys * Alloy 600 quasi-static no Rend 41 quasi-static no Steels * HY80 quasi-static no ultra-soft5 no low temperatures no AISI 4340...AD-A240 976 ([f) A Final Technical Report Contract No. N00014-88-K-0111 S PLASTIC INSTABILITIES AND THEIR CONSEQUENCES IN STEELS AND OTHER HIGH...PLASTIC INSTABILITIES AND THEIR CONSEQUENCES IN STEELS AND OTHER HIGH STRENGTH ALLOYS Submitted to: Office of Naval Research 800 North Quincy Street

  14. 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

  15. Evaluation of severe accident risks: Quantification of major input parameters: MAACS (MELCOR Accident Consequence Code System) input

    Energy Technology Data Exchange (ETDEWEB)

    Sprung, J.L.; Jow, H-N (Sandia National Labs., Albuquerque, NM (USA)); Rollstin, J.A. (GRAM, Inc., Albuquerque, NM (USA)); Helton, J.C. (Arizona State Univ., Tempe, AZ (USA))

    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.

  16. Household Consequences of High Fertility in Pakistan. World Bank Discussion Paper Series No. 111.

    Science.gov (United States)

    Cochrane, Susan Hill; And Others

    The theory and evidence of the consequences of high fertility in Pakistan are reviewed in this paper. Several data sets are analyzed to examine the effects of the number of children on school participation and labor participation in urban Pakistan. Other data are utilized to examine the effects of children on savings in urban and rural areas.…

  17. 49 CFR 192.905 - How does an operator identify a high consequence area?

    Science.gov (United States)

    2010-10-01

    ... SAFETY TRANSPORTATION OF NATURAL AND OTHER GAS BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Gas... 49 Transportation 3 2010-10-01 2010-10-01 false How does an operator identify a high consequence area? 192.905 Section 192.905 Transportation Other Regulations Relating to Transportation (Continued...

  18. Effects of breach formation parameter uncertainty on inundation risk area and consequence analysis

    Energy Technology Data Exchange (ETDEWEB)

    Skousen, Benjamin Don [Los Alamos National Laboratory; David, Judi [Los Alamos National Laboratory; Mc Pherson, Timothy [Los Alamos National Laboratory; Burian, Steve [UNIV OF UTAH

    2010-01-01

    According to the national inventory of dams (NID), there are approximately 79,500 dams in the United States, with 11,800 of these dams being classified as high-hazard. It has been recommended that each high-hazard dam in the United States have an emergency action plan (EAP), but it has been found that only about 60% of the high-hazard dams have a complete EAP. A major aspect of these plans is inundation risk area identification and associated impacts in the event of dam failure. In order to determine the inundation risk area an estimation of breach discharge must be completed. Most methods used to determine breach discharge, including the NWS-DAMBRK model, require modelers to select size, shape, and time of breach formation. Federal agencies (e.g. Bureau of Reclamation, Federal Energy Regulatory Commission) with oversight of U.S. dams have recommended ranges of values for each of these parameters based on dam type. However, variations in these parameters even within the recommended range have the potential to impose significant transformation on the discharge hydrograph relative to both timing and magnitude of the peak discharge. Therefore, it has also been recommended that sensitivity of these parameters be investigated when performing breach inundation analyses. This paper presents a sensitivity analysis of three breach parameters (average breach width, side slope, and time to failure) on a case study dam located in the United States. The sensitivity analysis employed was based on the 3{sup 3} factorial design, in which three levels (e.g. low, medium, and high) were selected for each of the three parameters, resulting in twenty-seven combinations. The three levels remained within the recommended range of values for each parameter type. With each combination of input parameters, a discharge hydrograph was generated and used as a source condition for inundation analysis using a two-dimensional shallow water equation model. The resulting simulations were compared to

  19. Effects of breach formation parameter uncertainty on inundation risk area and consequence analysis

    Energy Technology Data Exchange (ETDEWEB)

    Skousen, Benjamin Don [Los Alamos National Laboratory; David, Judi [Los Alamos National Laboratory; Mc Pherson, Timothy [Los Alamos National Laboratory; Burian, Steve [UNIV OF UTAH

    2010-01-01

    According to the national inventory of dams (NID), there are approximately 79,500 dams in the United States, with 11,800 of these dams being classified as high-hazard. It has been recommended that each high-hazard dam in the United States have an emergency action plan (EAP), but it has been found that only about 60% of the high-hazard dams have a complete EAP. A major aspect of these plans is inundation risk area identification and associated impacts in the event of dam failure. In order to determine the inundation risk area an estimation of breach discharge must be completed. Most methods used to determine breach discharge, including the NWS-DAMBRK model, require modelers to select size, shape, and time of breach formation. Federal agencies (e.g. Bureau of Reclamation, Federal Energy Regulatory Commission) with oversight of U.S. dams have recommended ranges of values for each of these parameters based on dam type. However, variations in these parameters even within the recommended range have the potential to impose significant transformation on the discharge hydrograph relative to both timing and magnitude of the peak discharge. Therefore, it has also been recommended that sensitivity of these parameters be investigated when performing breach inundation analyses. This paper presents a sensitivity analysis of three breach parameters (average breach width, side slope, and time to failure) on a case study dam located in the United States. The sensitivity analysis employed was based on the 3{sup 3} factorial design, in which three levels (e.g. low, medium, and high) were selected for each of the three parameters, resulting in twenty-seven combinations. The three levels remained within the recommended range of values for each parameter type. With each combination of input parameters, a discharge hydrograph was generated and used as a source condition for inundation analysis using a two-dimensional shallow water equation model. The resulting simulations were compared to

  20. 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.

  1. Risk Factors for High Blood Pressure

    Science.gov (United States)

    ... Share this page from the NHLBI on Twitter. Risk Factors for High Blood Pressure Anyone can develop high blood pressure; however, age, ... Lifestyle Habits Unhealthy lifestyle habits can raise your risk for high blood pressure, and they include: Eating too much sodium or ...

  2. Depression during pregnancy: rates, risks and consequences--Motherisk Update 2008.

    Science.gov (United States)

    Marcus, Sheila M

    2009-01-01

    particularly high risk.

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

    Science.gov (United States)

    2006-05-31

    commanders the opportunity to experiment with the application and misapplication of C3 in a relatively low-risk environment. Failure to maximize the...39 Yaacov Y. Vertzberger, Risk Taking and Decisionmaking; Foreign Miliary Intervention Decisions (Stanford: Standford University

  4. Risk preferences: consequences for test and treatment thresholds and optimal cutoffs.

    Science.gov (United States)

    Felder, Stefan; Mayrhofer, Thomas

    2014-01-01

    Risk attitudes include risk aversion as well as higher-order risk preferences such as prudence and temperance. This article analyzes the effects of such preferences on medical test and treatment decisions, represented either by test and treatment thresholds or-when the test result is not given-by optimal cutoff values for diagnostic tests. For a risk-averse decision maker, effective treatment is a risk-reducing strategy since it prevents the low health outcome of forgoing treatment in the sick state. Compared with risk neutrality, risk aversion thus lowers both the test and the treatment threshold and decreases the optimal test cutoff value. Risk vulnerability, which combines risk aversion, prudence, and temperance, is relevant if there is a comorbidity risk: thresholds and optimal cutoff values decrease even more. Since common utility functions imply risk vulnerability, our findings suggest that diagnostics in low prevalence settings (e.g., screening) may be considered more beneficial when risk preferences are taken into account.

  5. Parity and longevity of Aedes aegypti according to temperatures in controlled conditions and consequences on dengue transmission risks.

    Directory of Open Access Journals (Sweden)

    Daniella Goindin

    Full Text Available In Guadeloupe, Aedes aegypti mosquitoes are the only vectors of dengue and chikungunya viruses. For both diseases, vector control is the only tool for preventing epidemics since no vaccine or specific treatment is available. However, to efficiently implement control of mosquitoes vectors, a reliable estimation of the transmission risks is necessary. To become infective an Ae. aegypti female must ingest the virus during a blood meal and will not be able to transmit the virus during another blood-meal until the extrinsic incubation period is completed. Consequently the aged females will carry more infectious risks. The objectives of the present study were to estimate under controlled conditions the expectation of infective life for females and thus the transmission risks in relation with their reproductive cycle and parity status.Larvae of Ae. aegypti were collected in central Guadeloupe and breed under laboratory conditions until adult emergence. The experiments were performed at constant temperatures (± 1.5°C of 24°C, 27°C and 30°C on adults females from first generation (F1. Females were kept and fed individually and records of blood-feeding, egg-laying and survival were done daily. Some females were dissected at different physiological stages to observe the ovaries development. The data were analyzed to follow the evolution of parity rates, the number of gonotrophic cycles, the fecundity and to study the mean expectation of life and the mean expectation of infective life for Ae. aegypti females according to temperatures. The expectation of life varies with the parity rates and according to the temperatures, with durations from about 10 days at low parity rates at the higher temperature to an optimal duration of about 35 days when 70% of females are parous at 27°C. Infective life expectancy was found highly variable in the lower parous rates and again the optimal durations were found when more than 50% of females are parous for the mean

  6. Prevalence, risk factors and consequences of overweight and obesity among schoolchildren: a cross-sectional study in Kashmir, India.

    Science.gov (United States)

    Ganie, Mohd Ashraf; Bhat, Gulzar Ahmad; Wani, Ishfaq Ahmad; Rashid, Aafia; Zargar, Showkat Ali; Charoo, Bashir Ahmad; Shah, Zaffar Amin; Mudassar, Syed

    2017-02-01

    Obesity among children and adolescents is a growing public health problem. The objective of this study was to evaluate the prevalence, risk factors and metabolic consequences of obesity among schoolchildren from Kashmir, India. The study subjects (n=2024) included 870 boys and 1154 girls, aged between 6 and 18 years. Data were collected by interviewer-administered questionnaires. Information was obtained about different lifestyles, anthropometric parameters and dietary habits. Obesity was defined as body mass index (BMI) percentile as per the guidelines of Centers for Disease Control, 2000. For the evaluation of different clinical parameters, blood samples were collected from the subjects in the fasting state at 8 to 9 am after an overnight (10-12 h) fast. The highest representation of subjects was from fee-paying private schools. Out of the total subjects, 6.69% were overweight and 4.64% were obese. The hip circumference, abdominal circumference, BMI, blood pressure (BP), use of ready-made foods as well as the clinical parameters like glucose, phosphorous, cholesterol and triglycerides were found significantly higher among girls than boys (pobese (5.63%). Rural dwelling subjects (4.22%) exhibited a lower percentage of obesity than urban population (5.00%). The difference in obesity among the different age groups was found statistically significant (pobesity among children was high in our population.

  7. 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

  8. 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…

  9. 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.

  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. 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...

  12. 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.

  13. 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.

  14. 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.

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

    Science.gov (United States)

    Saleh Gargari, Soraya; Seify, Zahra; Haghighi, Ladan; Khoshnood Shariati, Maryam; Mirzamoradi, Masoumeh

    2016-11-01

     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 (Pplacenta 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.

  16. 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

  17. 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...

  18. Understand Your Risk for High Cholesterol

    Science.gov (United States)

    ... Aortic Aneurysm More Understand Your Risk for High Cholesterol Updated:Apr 1,2016 LDL (bad) cholesterol is ... content was last reviewed on 04/21/2014. Cholesterol Guidelines: Putting the pieces together Myth vs. Truth – ...

  19. High Blood Pressure May Hike Dementia Risk

    Science.gov (United States)

    ... fullstory_161398.html High Blood Pressure May Hike Dementia Risk New statement from American Heart Association warns ... in middle age, might open the door to dementia, the American Heart Association warns in a new ...

  20. Breast cancer risk among Swedish hemangioma patients and possible consequences of radiation-induced genomic instability

    Energy Technology Data Exchange (ETDEWEB)

    Eidemueller, Markus, E-mail: markus.eidemueller@helmholtz-muenchen.de [Helmholtz Zentrum Muenchen, Institute of Radiation Protection, 85764 Neuherberg (Germany); Holmberg, Erik [Department of Oncology, Sahlgrenska University Hospital, SE-413 45 Goeteborg (Sweden); Jacob, Peter [Helmholtz Zentrum Muenchen, Institute of Radiation Protection, 85764 Neuherberg (Germany); Lundell, Marie [Department of Medical Physics, Radiumhemmet, Karolinska University Hospital, SE-171 76 Stockholm (Sweden); Karlsson, Per [Department of Oncology, Sahlgrenska University Hospital, SE-413 45 Goeteborg (Sweden)

    2009-10-02

    Breast cancer incidence among 17,158 female Swedish hemangioma patients was analyzed with empirical excess relative risk models and with a biologically-based model of carcinogenesis. The patients were treated in infancy mainly by external application of radium-226. The mean and median absorbed doses to the breast were 0.29 and 0.04 Gy, and a total of 678 breast cancer cases have been observed. Both models agree very well in the risk estimates with an excess relative risk and excess absolute risk at the age of 50 years, about the mean age of breast cancer incidence, of 0.25 Gy{sup -1}(95% CI 0.14; 0.37) and 30.7 (10{sup 5}BYRGy){sup -1} (95% CI 16.9; 42.8), respectively. Models incorporating effects of radiation-induced genomic instability were developed and applied to the hemangioma cohort. The biologically-based description of the radiation risk was significantly improved with a model of genomic instability at an early stage of carcinogenesis.

  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. 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.

  3. 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.

  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. The consequences of polyandry for population viability, extinction risk and conservation.

    Science.gov (United States)

    Holman, Luke; Kokko, Hanna

    2013-03-05

    Polyandry, by elevating sexual conflict and selecting for reduced male care relative to monandry, may exacerbate the cost of sex and thereby seriously impact population fitness. On the other hand, polyandry has a number of possible population-level benefits over monandry, such as increased sexual selection leading to faster adaptation and a reduced mutation load. Here, we review existing information on how female fitness evolves under polyandry and how this influences population dynamics. In balance, it is far from clear whether polyandry has a net positive or negative effect on female fitness, but we also stress that its effects on individuals may not have visible demographic consequences. In populations that produce many more offspring than can possibly survive and breed, offspring gained or lost as a result of polyandry may not affect population size. Such ecological 'masking' of changes in population fitness could hide a response that only manifests under adverse environmental conditions (e.g. anthropogenic change). Surprisingly few studies have attempted to link mating system variation to population dynamics, and in general we urge researchers to consider the ecological consequences of evolutionary processes.

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

    OpenAIRE

    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 formula used to calculate the price in a farmer-processor transaction, may reduce incentives for farmers to produce high quality products. This can increase the risks that low quality products are excha...

  7. Nonequilibrium of Organic Compounds in Sediment - Water systems. Consequences for Risk Assessment and Remediation Measures

    NARCIS (Netherlands)

    Noort, van P.C.M.; Koelmans, A.A.

    2012-01-01

    In many cases, sediment risk assessment, and remediation rely on the assumption of equilibrium between chemical concentrations in sediment pore water and overlying surface water and thus rely on pore water concentrations only and do not additionally include assessment of the overlying water concentr

  8. Structural and Dynamic Process Family Risk Factors: Consequences for Holistic Adolescent Functioning

    Science.gov (United States)

    Matjasko, Jennifer L.; Grunden, Leslie N.; Ernst, Jody L.

    2007-01-01

    This study utilized a dynamic cumulative family risk model to explain changes in adolescent functioning. We used a person-centered approach to detect patterns of academic, emotional, and behavioral functioning and the stability of these patterns using two waves of the National Longitudinal Study of Adolescent Health (N = 10,173). Four adjustment…

  9. Nonequilibrium of Organic Compounds in Sediment - Water systems. Consequences for Risk Assessment and Remediation Measures

    NARCIS (Netherlands)

    Noort, van P.C.M.; Koelmans, A.A.

    2012-01-01

    In many cases, sediment risk assessment, and remediation rely on the assumption of equilibrium between chemical concentrations in sediment pore water and overlying surface water and thus rely on pore water concentrations only and do not additionally include assessment of the overlying water

  10. 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...

  11. 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

  12. Risk Factors and Consequences of Cortical Thickness in an Asian Population

    NARCIS (Netherlands)

    Hilal, S.; Xin, X.; Ang, S.L.; Tan, C.S.; Venketasubramanian, N.; Niessen, W.J.; Vrooman, H.; Wong, T.Y.; Chen, C.; Ikram, M.K.

    2015-01-01

    Cortical thickness has been suggested to be one of the most important markers of cortical atrophy. In this study, we examined potential risk factors of cortical thickness and its association with cognition in an elderly Asian population from Singapore. This is a cross-sectional study among 572 Chi

  13. 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 one-dimens

  14. 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 ne

  15. 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

  16. Late Talkers: A Population-Based Study of Risk Factors and School Readiness Consequences

    Science.gov (United States)

    Hammer, Carol Scheffner; Morgan, Paul; Farkas, George; Hillemeier, Marianne; Bitetti, Dana; Maczuga, Steve

    2017-01-01

    Purpose: This study was designed to (a) identify sociodemographic, pregnancy and birth, family health, and parenting and child care risk factors for being a late talker at 24 months of age; (b) determine whether late talkers continue to have low vocabulary at 48 months; and (c) investigate whether being a late talker plays a unique role in…

  17. 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.

  18. [Exposure to the risk of loss of life or detriment to health as a consequence of an organizational error--a case report].

    Science.gov (United States)

    Chowaniec, Czesław; Jabłoński, Christian; Kobek, Mariusz; Chowaniec, Małgorzata

    2007-01-01

    Frequent changes in organization of the Polish health care sector observed over the past few years may lead to disruption of work in health care institutions, particularly in tertiary, highly specialist centers. Such a situation may result in decreasing the quality of services, what may potentially cause exposing the patient to the risk of death or severe detriment to health. To illustrate the problem, the authors present a case of a 45-year old man, where some organizational errors led to a delay in rendering medical care and in consequence to a poorer therapeutic outcome and poorer prognosis.

  19. Risk factors and long-term health consequences of macrosomia: a prospective study in Jiangsu Province, China.

    Science.gov (United States)

    Gu, Shouyong; An, Xiaofei; Fang, Liang; Zhang, Xiaomin; Zhang, Chunyan; Wang, Jingling; Liu, Qilan; Zhang, Yanfang; Wei, Yongyue; Hu, Zhibin; Chen, Feng; Shen, Hongbing

    2012-07-01

    We sought to determine risk factors associated with fetal macrosomia and to explore the long-term consequence of infant macrosomia at the age of 7 years. A prospective population based cohort study was designed to examine the associations between maternal and perinatal characteristics and the risk of macrosomia. A nested case-control study was conducted to explore the long-term health consequence of infant macrosomia. The mean maternal age of the macrosomia group was 24.74±3.32 years, which is slightly older than that in the control group (24.35±3.14 years, P = 0.000). The mean maternal body mass index (BMI) at early pregnancy was 22.75±2.81 kg/m(2), which was also higher than that in the control group (21.76±2.59 kg/m(2), P = 0.000). About 64.6% of macrosomic neonates were males, compared with 51.0% in the control group (P = 0.000). Compared with women with normal weight (BMI: 18.5-23.9 kg/m(2)), women who were overweight (BMI: 24-27.9 kg/m(2)) or obese (BMI≥28 kg/m(2)), respectively, had a 1.69-fold (P = 0.000) and a 1.49-fold (P = 0.000) increased risks of having a neonate with macrosomia, while light weight (BMImacrosomia infant had a 1.52-fold and 1.50-fold risk, respectively, of developing overweight or obesity at the age of 7 years (P = 0.001 and P = 0.000). Older maternal age, higher maternal BMI at early pregnancy and male gender were independent risk factors of macrosomia. Macrosomic infant was associated with an increased predisposition to develop overweight or obesity at the beginning of their childhood.

  20. The prevalence and consequences of malnutrition risk in elderly Albanian intensive care unit patients

    OpenAIRE

    2015-01-01

    Vjollca Shpata,1 Ilir Ohri,2 Tatjana Nurka,1 Xhensila Prendushi1 1Faculty of Medical Technical Sciences, 2University Hospital Center of Tirana “Mother Theresa”, Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania Purpose: Many investigators have reported rising numbers of elderly patients admitted to the intensive care units (ICUs). The aim of the study was to estimate the prevalence of malnutrition risk in the ICU by comparing the prevalence of malnutritio...

  1. The prevalence and consequences of malnutrition risk in elderly Albanian intensive care unit patients

    OpenAIRE

    2015-01-01

    Vjollca Shpata,1 Ilir Ohri,2 Tatjana Nurka,1 Xhensila Prendushi1 1Faculty of Medical Technical Sciences, 2University Hospital Center of Tirana “Mother Theresa”, Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania Purpose: Many investigators have reported rising numbers of elderly patients admitted to the intensive care units (ICUs). The aim of the study was to estimate the prevalence of malnutrition risk in the ICU by comparing the prevalence of mal...

  2. 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…

  3. 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…

  4. 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…

  5. 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.

  6. The emergence of cardiometabolic disease risk in Chinese children and adults: consequences of changes in diet, physical activity and obesity.

    Science.gov (United States)

    Adair, L S; Gordon-Larsen, P; Du, S F; Zhang, B; Popkin, B M

    2014-01-01

    Strong secular declines in physical activity, increased fat and salt intake, and increased obesity, especially abdominal obesity, mark China's recent nutrition transition. The China Health and Nutrition 2009 Survey collected anthropometry, blood pressure and fasting blood samples from more than 9,000 individuals ≥ 7 years of age. We focus on elevated blood pressure and plasma markers of diabetes, inflammation and dyslipidemia. We used international definitions of cardiometabolic risk and estimated age- and sex-specific prevalence ratios for each outcome for high waist circumference or overweight. We used logistic regression to assess each risk factor's association with diet, physical activity, overweight and abdominal obesity. Cardiometabolic risk prevalence was high in all age groups Prevalence ratios for most risk factors were nearly doubled for overweight or high waist circumference groups. Prevalence ratios were higher in younger than older adults. Low physical activity consistently predicted higher cardiometabolic risk across most outcomes and age-sex groups. The co-occurrence of overweight and high waist circumference was highly predictive of dyslipidemia, elevated glycated haemoglobin and diabetes. High prevalence of cardiometabolic risk factors and their strong association with weight status and abdominal obesity in young adults portend increases in cardiometabolic morbidity and mortality. Early interventions will be required to reverse trends. © 2014 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.

  7. Risk factors and consequences of unexpected trapping for ruptured anterior communicating artery aneurysms

    Directory of Open Access Journals (Sweden)

    Hitoshi Fukuda

    2014-01-01

    Full Text Available Background: While clipping cerebral aneurysms at the neck is optimal, in some cases this is not possible and other strategies are necessary. The purpose of this study was to describe the incidence, risk factors, and outcomes for inability to clip reconstruct ruptured anterior communicating artery (ACoA aneurysms. Methods: Of the 70 cases of ruptured ACoA aneurysms between January 2006 and December 2013, our institutional experience revealed four cases of small ACoA aneurysms that had been considered clippable prior to operation but required trapping. When a unilateral A2 segment of anterior cerebral artery (ACA was compromised by trapping, revascularization was performed by bypass surgery. Clinical presentation, angiographic characteristics, operative approach, intraoperative findings, and treatment outcomes were assessed. Results: Very small aneurysm under 3 mm was a risk factor for unexpected trapping. The reason for unexpected trapping was laceration of the aneurysmal neck in two cases, and lack of clippaple component due to disintegration of entire aneurysmal wall at the time of rupture in the others. Aneurysms with bilateral A1 were treated with sole trapping through pterional approach in two cases. The other two cases had hypoplastic unilateral A1 segment of ACA and were treated with combination of aneurysm trapping and revascularization of A2 segment of ACA through interhemispheric approach. No patients had new cerebral infarctions of cortical ACA territory from surgery. Cognitive dysfunction was observed in three cases, but all patients became independent at 12-month follow up. Conclusions: Unexpected trapping was performed when ruptured ACoA aneurysms were unclippable. Trapping with or without bypass can result in reasonable outcomes, with acceptable risk of cognitive dysfunction.

  8. KEY RISKS OF LABOR VALUES TRANSFORMATION OF RUSSIAN YOUTH AND ITS SOCIAL CONSEQUENCES

    Directory of Open Access Journals (Sweden)

    Maksim A. GNATYUK

    2015-01-01

    Full Text Available The key trend in labor values transformation of youth is gradual devaluation of the spiritual and moral values of the labor component while fixing pragmatic and primarily financially oriented component that contributes to the formation of risks of Russian youth deprofessionalization. For the modern Russia, this problem is also becoming increasingly relevant, since the informal sector is a significant portion of the labor market, and the part of the young people who in search of higher pay does not want to tie themselves a permanent place of work, they are quite mobile and ready to move to another city and even in other countries with the prospects of favorable earnings. Based on the analysis of labor values of youth, the conditions of their formation and changes in the current state of the labor market in Russia, we can say that the key trends in labor values transformation of Russian youth are such as pragmatism, instrumentalization, dehumanization. Russian youth like a mirror, which reflects the extremely unattractive image of the whole of Russian society at the present stage. Becoming of the work values occurs in risk-filled social environment that causes risk-taking transformation vector of labor values of youth. The declarative principles of equal opportunities and chances for the realization of subjectivity of youth in unregulated vocational and labor market in the existing system of social inequality and a freedom have determined labor values transformation of the Russian youth. This article analyzes this problem.

  9. Jurisdictional Consequences Associated with the Multiplication of International Tribunals: What Are the Potential Risks?

    Directory of Open Access Journals (Sweden)

    Carlos Bellei Tagle

    2016-01-01

    Full Text Available The dispute resolution system is an essential aspect in order to grant efficacy to international law. In recent years various transformations have been tried, the most significant of which are the multiplication of international courts and tribunals. This work explores the different effects this result has generated, concentrating on some considered negative. Likewise, it reviews different alternatives that have arisen to mitigate the jurisdictional risks occasioned by the explosive increase in organs of adjudication.

  10. Risk and Consequences of Child Abuse in Attention Deficit Hyperactivity Disorder

    Directory of Open Access Journals (Sweden)

    s. Gulin Evinc

    2015-06-01

    Full Text Available Awareness about child physical and emotional abuse and ndash;as well as sexual abuse- is increasing day by day. It is stated that the physical or emotional harm given to a child can result in serious psychological problems both in short and long terms. In addition to this, it is known that, the traditional discipline styles, especially applied in developing countries, can be physically and emotionally harmful and sometimes abusive. The stress level of the parent determines the parent's choice of discipline style and psychopathologies such as attention deficit hyperactivity disorder seem to be riskfull for physical and emotional abuse because they increase the stress level of parents. This paper will review the literature related to the probability of exposure to physically or emotionally abusive discipline styles for children with attention deficit hyperactivity disorder and also the literarture related to the consequences of these abusive discipline styles on these children. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(2: 166-177

  11. Planning High-Risk High-Reward Activities.

    NARCIS (Netherlands)

    Casault, Sébastien

    2014-01-01

    This body of work addresses a gap in financial and economic theories related to assets that are typically associated with high uncertainty. Specifically, this thesis provides some foundational work towards a new way to quantify and explain how high-risk high-reward activities, such as exploration,

  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. 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.

  14. Positive and negative perceived consequences of first intercourse among middle and high school students in Puebla, Mexico.

    Science.gov (United States)

    Vasilenko, Sara A; Espinosa-Hernández, Graciela; Halgunseth, Linda C

    2016-01-01

    Relatively little is known about young people's interpretations of sexual behaviour in Latin America. In this study, we examine the most commonly perceived consequences of first sexual intercourse among Mexican middle and high school students, how perceived consequences differ by gender, and factors that may predict experiencing more positive or negative consequences. Sexually active Mexican students aged 12-19 years (n = 268) reported whether they had experienced each of 19 consequences following first intercourse. Both positive consequences, such as physical satisfaction and closeness to partner, and negative consequences, such as worry about STDs and pregnancy, were common. Sex with a non-relationship partner was associated with fewer positive and more negative consequences, with the effect for positive consequences being stronger for young women. Pressure to have sex was associated with fewer positive consequences of first intercourse, and pressure to remain a virgin was associated with more positive and negative consequences. These findings suggest that young people often report mixed feelings about their first sexual intercourse and that relationship context and sexual socialisation influence their perceptions of the event.

  15. Psychological implications of high-risk pregnancy.

    Science.gov (United States)

    Cumberbatch, Carla-Joy; Birndorf, Catherine; Dresner, Nehama

    2005-01-01

    The psychological adjustments of "normal" pregnancy are complex, and those of high-risk pregnancy are even more pronounced and severe. A pregnancy may be determined to be at high risk because of obstetric factors in previous pregnancies or the present one; more general medical factors, such as preexisting or emergent disease (often, diabetes); and conditions that are, themselves, psychosocial: anxiety disorders (GAD, OCD, panic disorder, PTSD), mood disorders, and schizophrenia, all of which are a background for a disturbed pregnancy and might complicate a pregnancy denominated high risk for some other reason. This paper discusses these concepts and, in addition, includes sections on pregnancy in adolescence, in the developmentally disabled, and in the situation of chemical dependence (substance abuse).

  16. 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)

  17. Climatic consequences of very high carbon dioxide levels in the earth's early atmosphere

    Science.gov (United States)

    Kasting, James F.; Ackerman, Thomas P.

    1986-01-01

    The possible consequences of very high carbon dioxide concentrations in the earth's early atmosphere have been investigated with a radiative-convective climate model. The early atmosphere would apparently have been stable against the onset of a runaway greenhouse (that is, the complete evaporation of the oceans) for carbon dioxide pressures up to at least 100 bars. A 10- to 20-bar carbon dioxide atmosphere, such as may have existed during the first several hundred million years of the earth's history, would have had a surface temperature of approximately 85 to 110 C. The early stratosphere should have been dry, thereby precluding the possibility of an oxygenic prebiotic atmosphere caused by photodissociation of water vapor followed by escape of hydrogen to space. Earth's present atmosphere also appears to be stable against a carbon dioxide-induced runaway greenhouse.

  18. International biosecurity symposium : securing high consequence pathogens and toxins : symposium summary.

    Energy Technology Data Exchange (ETDEWEB)

    2004-06-01

    The National Nuclear Security Administration (NNSA) Office of Nonproliferation Policy sponsored an international biosecurity symposium at Sandia National Laboratories (SNL). The event, entitled 'Securing High Consequence Pathogens and Toxins', took place from February 1 to February 6, 2004 and was hosted by Dr. Reynolds M. Salerno, Principal Member of the Technical Staff and Program Manager of the Biosecurity program at Sandia. Over 60 bioscience and policy experts from 14 countries gathered to discuss biosecurity, a strategy aimed at preventing the theft and sabotage of dangerous pathogens and toxins from bioscience facilities. Presentations delivered during the symposium were interspersed with targeted discussions that elucidated, among other things, the need for subsequent regional workshops on biosecurity, and a desire for additional work toward developing international biosecurity guidelines.

  19. Climatic consequences of very high carbon dioxide levels in the earth's early atmosphere

    Science.gov (United States)

    Kasting, James F.; Ackerman, Thomas P.

    1986-01-01

    The possible consequences of very high carbon dioxide concentrations in the earth's early atmosphere have been investigated with a radiative-convective climate model. The early atmosphere would apparently have been stable against the onset of a runaway greenhouse (that is, the complete evaporation of the oceans) for carbon dioxide pressures up to at least 100 bars. A 10- to 20-bar carbon dioxide atmosphere, such as may have existed during the first several hundred million years of the earth's history, would have had a surface temperature of approximately 85 to 110 C. The early stratosphere should have been dry, thereby precluding the possibility of an oxygenic prebiotic atmosphere caused by photodissociation of water vapor followed by escape of hydrogen to space. Earth's present atmosphere also appears to be stable against a carbon dioxide-induced runaway greenhouse.

  20. Psychological profile of high risk sports athlets

    Directory of Open Access Journals (Sweden)

    Tanja Kajtna

    2004-05-01

    Full Text Available The research attempted to compose a psycjhological profile of high risk sports athletes, based on personality, values and sensation seeking. 38 high risk sports athletes participated in the research (alpinists, sky divers, parachute gliders, white water kayakers, downhill mountain bikers, motocross riders, downhill skiers and Nordic jumpers, the non risk sports athletes consisted of 38 swimmers, track athletes, sailers, still water kayakers, rowers, Nordic skiers, sports climbers and karate players, whereas non athletes were equalled with both groups in age and education and included 76 non athletes. We used the self descriptive scale Big five observer, Musek's Value scale and Zuckerman' Sensation seeking scale IV. The dimensions, obtained from the discrimination analysis, were named personality maturity and sensation seeking in a social environment. Our results show that high risk sports athletes are more mature personalities than non risk sports athletes and non athletes and that they do not attempt to find stimulation in social environments. We also suggest some possibilities for further research.

  1. Identification of Patients at High Cardiovascular Risk

    Directory of Open Access Journals (Sweden)

    Igor V. Sergienko, PhD, ScD

    2012-06-01

    Full Text Available Objective: To identify individuals at high cardiovascular risk (CVR to check for an additional estimate of CVR with the use of the ESH/ESC Guidelines (2003, 2007 in patients earlier classified as being at low and moderate risk on «SCORE». Material and methods: The study included 600 people (155 men and 445 women with low and moderate cardiovascular risk on the SCORE scale. All patients were examined with duplex scanning of the carotid arteries (DSCA to the determined of the thickness of the intima – media (IMT, the presence of atherosclerotic plaques (ASP; it has also been performed sphygmographic computer (SC with automatic estimation of brachial-ankle pulse wave velocity (baPWV, biochemical analysis of blood lipid spectrum. Results: The frequency of ASP was 59.5% (357 out of 600, and a thickening of thecomplex "intima-media" (IMT> 0.9 mm was detected in only 5% of the cases (28 persons out of 600, that indicated a slight contribution to the magnitude of the risk of such parameters as the IMT. The total number of patients with signs of preclinicallesions of the arterial wall (the presence of ASP and/or increased baPWV was 337 (56% of 600. Our results showed that the presence of subclinical atherosclerosis is in itself a risk factor. Conclusion: The usage of instrumental methods of research (DSCA, SC allowed to detect 32% of individuals with high CVR from 600 previously classified as low and moderate risk on SCORE scale. In our opinion, the proposed algorithm is convenient and easy to use for transfer of the patients into high-risk group.

  2. Early Identification of Educationally High Potential and High Risk Children.

    Science.gov (United States)

    Keogh, Barbara K.; Smith, Carol E.

    Early identification of educationally high potential and high risk children was investigated by following the same 49 children from kindergarten entrance through grade five of a regular school program. Kindergarten predictive measures were the Bender Gestalt Test and teachers' evaluations; follow-up measures were yearly standard achievement test…

  3. 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.

  4. Breast MRI in high risk patients

    NARCIS (Netherlands)

    A.I.M. Obdeijn (Inge-Marie)

    2015-01-01

    markdownabstractAbstract In this thesis we address various indications of breast MRI, with the emphasis on the value of MRI in screening of women with high genetic risk for breast cancer, and especially in BRCA1 mutation carriers. We showed that in the era of up-to-date MRI expertise and digital

  5. Suicide in the global chinese aging population: a review of risk and protective factors, consequences, and interventions.

    Science.gov (United States)

    Dong, XinQi; Chang, E-Shien; Zeng, Ping; Simon, Melissa A

    2015-03-01

    As one of the leading causes of death around the world, suicide is a global public health threat. In the Chinese population, suicides constitute one-fifth of all recorded suicides in the world. Despite the factual data on suicide rates, the understanding of various causal factors behind suicide, including risk and protective factors and adverse health care, remained incomplete among the global Chinese aging population. To fill in the knowledge void, this paper reviews the epidemiology of suicide among Chinese older adults globally as well as explores the existing intervention strategies. Using the PRISMA statement, we performed a systematic review of exiting research on the topic, including studies describing suicide among Chinese older adults in communities outside of Asia. A literature search was conducted online by using both medical and social science data-bases. Our findings highlighted that elderly suicide in Chinese populations is significantly affected by the social, cultural, and familial contexts within which the individual lived prior to committing suicide. Reviewing such research indicated that while reducing risk factors may contribute to lowering suicides amongst Chinese older adults, measures to improve protective factors are also critical. Support through ongoing family and community care relationships is necessary to improve resilience in older adults and positive aging. Future longitudinal studies on the risk factors and protective factors, and adverse health consequences are called for to devise culturally and linguistically appropriate prevention and intervention programs in global Chinese aging populations.

  6. 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 musculoskeletal pain among blue-collar workers....

  7. Breast MRI in high risk patients

    OpenAIRE

    Obdeijn, Inge-Marie

    2015-01-01

    markdownabstractAbstract In this thesis we address various indications of breast MRI, with the emphasis on the value of MRI in screening of women with high genetic risk for breast cancer, and especially in BRCA1 mutation carriers. We showed that in the era of up-to-date MRI expertise and digital mammography the screening efficacy is improved. However, the additional value of mammography over MRI is little while at the same time BRCA carriers are more sensitive the risks of low dose radiation ...

  8. Consequences of high-$x$ proton size fluctuations in small collision systems at RHIC

    CERN Document Server

    McGlinchey, D; Perepelitsa, D V

    2016-01-01

    Recent measurements of jet production rates at large transverse momentum ($p_T$) in the collisions of small projectiles with large nuclei at RHIC and the LHC indicate that they have an unexpected relationship with estimates of the collision centrality. One compelling interpretation of the data is that it captures an $x_p$-dependent decrease in the average interaction strength of the nucleon in the projectile undergoing a hard scattering. A weakly interacting or "shrinking" nucleon in the projectile strikes fewer nucleons in the nucleus, resulting in a particular pattern of centrality-dependent modifications to high-$p_T$ processes. We describe a simple one-parameter geometric implementation of this picture within a modified Monte Carlo Glauber model tuned to $d$$+$Au jet data, and explore two of its major consequences. First, the model predicts a particular projectile-species dependence to the centrality dependence at high-$x_p$, opposite to that expected from an energy loss effect. Second, we find that some ...

  9. Short-term herbivory has long-term consequences in warmed and ambient high Arctic tundra

    Science.gov (United States)

    Little, Chelsea J.; Cutting, Helen; Alatalo, Juha; Cooper, Elisabeth

    2017-02-01

    Climate change is occurring across the world, with effects varying by ecosystem and region but already occurring quickly in high-latitude and high-altitude regions. Biotic interactions are important in determining ecosystem response to such changes, but few studies have been long-term in nature, especially in the High Arctic. Mesic tundra plots on Svalbard, Norway, were subjected to grazing at two different intensities by captive Barnacle geese from 2003–2005, in a factorial design with warming by Open Top Chambers. Warming manipulations were continued through 2014, when we measured vegetation structure and composition as well as growth and reproduction of three dominant species in the mesic meadow. Significantly more dead vascular plant material was found in warmed compared to ambient plots, regardless of grazing history, but in contrast to many short-term experiments no difference in the amount of living material was found. This has strong implications for nutrient and carbon cycling and could feed back into community productivity. Dominant species showed increased flowering in warmed plots, especially in those plots where grazing had been applied. However, this added sexual reproduction did not translate to substantial shifts in vegetative cover. Forbs and rushes increased slightly in warmed plots regardless of grazing, while the dominant shrub, Salix polaris, generally declined with effects dependent on grazing, and the evergreen shrub Dryas octopetala declined with previous intensive grazing. There were no treatment effects on community diversity or evenness. Thus despite no changes in total live abundance, a typical short-term response to environmental conditions, we found pronounced changes in dead biomass indicating that tundra ecosystem processes respond to medium- to long-term changes in conditions caused by 12 seasons of summer warming. We suggest that while high arctic tundra plant communities are fairly resistant to current levels of climate warming

  10. 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.

  11. 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

  12. 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.

  13. Cry me a river: identifying the behavioral consequences of extremely high-stakes interpersonal deception.

    Science.gov (United States)

    Ten Brinke, Leanne; Porter, Stephen

    2012-12-01

    Deception evolved as a fundamental aspect of human social interaction. Numerous studies have examined behavioral cues to deception, but most have involved inconsequential lies and unmotivated liars in a laboratory context. We conducted the most comprehensive study to date of the behavioral consequences of extremely high-stakes, real-life deception--relative to comparable real-life sincere displays--via 3 communication channels: speech, body language, and emotional facial expressions. Televised footage of a large international sample of individuals (N = 78) emotionally pleading to the public for the return of a missing relative was meticulously coded frame-by-frame (30 frames/s for a total of 74,731 frames). About half of the pleaders eventually were convicted of killing the missing person on the basis of overwhelming evidence. Failed attempts to simulate sadness and leakage of happiness revealed deceptive pleaders' covert emotions. Liars used fewer words but more tentative words than truth-tellers, likely relating to increased cognitive load and psychological distancing. Further, each of these cues explained unique variance in predicting pleader sincerity.

  14. MYBPC3's alternate ending: consequences and therapeutic implications of a highly prevalent 25 bp deletion mutation

    Science.gov (United States)

    Kuster, Diederik W. D.

    2014-01-01

    Hypertrophic cardiomyopathy (HCM) is the most common form of inherited cardiac disease and the leading cause of sudden cardiac death in young people. HCM is caused by mutations in genes encoding contractile proteins. Cardiac myosin binding protein-C (cMyBP-C) is a thick filament contractile protein that regulates sarcomere organization and cardiac contractility. About 200 different mutations in the cMyBP-C gene (MYBPC3) have thus far been reported as causing HCM. Among them, a 25 base pair deletion in the branch point of intron 32 of MYBPC3 is widespread, particularly in South Asia, where it affects ≈4% of South Asian descendants worldwide. This polymorphic mutation results in skipping of exon 33 and a reading frame shift, which, in turn, replaces the last 65 amino acids of the C-terminal C10 domain of cMyBP-C (cMyBP-CC10mut) with a novel sequence of 58 residues. Carriers of the 25 base pair deletion mutation are at increased risk of developing cardiomyopathy and heart failure. Because of the high prevalence of this mutation in certain populations, genetic screening of at-risk groups might be beneficial. Scientifically, the functional consequences of C-terminal mutations and the precise mechanisms leading to HCM should be defined using induced pluripotent stem cells and engineered heart tissue in vitro, or mouse models in vivo. Most importantly, therapeutic strategies that include pharmacology, gene repair and gene therapy should be developed to prevent the adverse clinical effects of cMyBP-CC10mut. This review article aims to examine the effects of cMyBP-CC10mut on cardiac function, emphasizing the need for the development of genetic testing and expanded therapeutic strategies. PMID:24327208

  15. Having knowledge of metabolic syndrome: does the meaning and consequences of the risk factors influence the life situation of Swedish adults?

    Science.gov (United States)

    Frisman, Gunilla Hollman; Berterö, Carina

    2008-12-01

    The underlying causes of metabolic syndrome (MS) are uncertain. Knowledge from those who have experience of this syndrome should provide new insight. The aim was to explore the meaning and consequences of MS. Thirteen Swedish adults with MS, aged between 33 and 82 years, were interviewed. The interviews were analyzed using constant comparative analysis, which is the basis of grounded theory. The core category for the meaning and consequences of having the risk factors of MS consisted of the recurrence of behavior. The participants attempted to balance their insight into the causes and consequences by referring to their normal life, lifestyle, and fatalistic approach to life. Attention needs to be paid to the attitudes of the individuals with MS, as well as the known risk factors and their consequences, in order to facilitate a long-term lifestyle change in these individuals.

  16. 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…

  17. 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…

  18. Increasing risk of glacial lake outburst floods as a consequence of climate change in the Himalayan region

    Directory of Open Access Journals (Sweden)

    Somana Riaz

    2014-03-01

    Full Text Available The greater Himalayan Mountains host the largest snow covered area outside the polar regions and serves as the source for some of the major fluvial systems of the world. The region acts as the lifeline for approximately 10% of the world’s population. The terrain is geologically active, highly susceptible to climate change processes and plays a significant role in global hydro-meteorological cycles and biodiversity. With the increasing impacts of climate change to the glaciers and ice caps during the past few decades, people living in the Himalayas have become vulnerable to a higher risk of floods, avalanches and glacial lake outburst floods(GLOFs. This study reviewed the work carried out by earlier researchers to understand the history and science of GLOFs and their potential risk to the communities in the Himalayanbelt, particularly in Pakistan.

  19. Influencing factors on high-risk sexual behaviors in young people: an ecological perspective.

    Science.gov (United States)

    Arabi-Mianrood, Hoda; Hamzehgardeshi, Zeinab; Khoori, Elham; Moosazadeh, Mahmood; Shahhosseini, Zohreh

    2017-04-19

    Background In recent years, high-risk sexual behaviors due to their negative consequences both for the individual and society have received more attention than other high-risk behaviors. Objective The aim of this study was to review the influencing factors of high-risk sexual behaviors among young people from an ecological point of view. Methods This review was conducted through searching databases including PubMed, Web of Science, Scopus, Google Scholar and the Cochrane Library with keywords such as sexual risk-taking behavior, high-risk sex, unprotected sex and unsafe sex. The relevant papers published between 1995 and 2016 were extracted. After reviewing the abstract and full text of the articles, 45 papers were used to write this article. Results From an ecological theory approach, factors which influence high-risk sexual behaviors are divided into three categories - the microsystem, the mesosystem and the macrosystem. The microsystem includes factors such as age, gender, race, marital status, place of residence, religion, level of education, personality traits, psychological problems, childhood experiences, body image and coincidence of high-risk behaviors; the mesosystem includes factors such as family structure, peers and sex education; in the macrosystem, the impact of culture and traditions of the society, economic status and the media are presented. Conclusion Given that high-risk sexual behaviors often have multiple causes, it seems that health policymakers must consider multi-dimensional interventions to influence high-risk sexual behaviors based on the ecological approach.

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

    Science.gov (United States)

    ... atrial fibrillation has more than five times the risk of stroke.” “Because high blood pressure is so frequent, affecting tens of millions of ... is a more potent risk factor.” The two risk factors are also related to each other: High blood pressure is a risk factor for atrial fibrillation. Middle- ...

  1. High-Risk Childhood Acute Lymphoblastic Leukemia

    Science.gov (United States)

    Bhojwani, Deepa; Howard, Scott C.; Pui, Ching-Hon

    2009-01-01

    Although most children with acute lymphoblastic leukemia (ALL) are cured, certain subsets have a high risk of relapse. Relapse risk can be predicted by early response to therapy, clinical and pharmacogenetic features of the host, and genetic characteristics of leukemic cells. Though early treatment response can be assessed by the peripheral blast cell count after 1 week of single-agent glucocorticoid treatment or percent of bone marrow blasts by morphology after 1 or 2 weeks of multiagent induction treatment, determination of minimal residual disease by polymerase chain reaction (PCR) or flow cytometry after 2 to 6 weeks of induction is the most precise and useful measure. Augmented therapy has improved outcome for the poor responders to initial treatment. Infants with mixed-lineage leukemia (MLL)–rearranged ALL comprise a very poor-risk group wherein further intensification of chemotherapy causes significant toxicity. Hybrid protocols incorporating drugs effective for acute myeloid leukemia could improve survival, a strategy being tested in international trials. Studies on the biology of MLL-induced leukemogenesis have prompted the development of novel targeted agents, currently under evaluation in clinical trials. Short-term outcomes of patients with Philadelphia chromosome (Ph)–positive ALL have improved significantly by adding tyrosine kinase inhibitors to standard chemotherapy regimens. New agents and methods to overcome resistance are under investigation, and allogeneic stem cell transplantation is recommended for certain subsets of patients, for example those with Ph+ and T-cell ALL with poor early response. Genome-wide interrogation of leukemic cell genetic abnormalities and germline genetic variations promise to identify new molecular targets for therapy. PMID:19778845

  2. 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

  3. 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)

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

    OpenAIRE

    Rosalva Ruiz-Ramírez; José Luis García-Cué; María Antonia Pérez-Olvera

    2014-01-01

    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...

  5. Cardiac Atrophy and Diastolic Dysfunction During and After Long Duration Spaceflight: Functional Consequences for Orthostatic Intolerance, Exercise Capability and Risk for Cardiac Arrhythmias

    Science.gov (United States)

    Levine, Benjamin D.; Bungo, Michael W.; Platts, Steven H.; Hamilton, Douglas R.; Johnston, Smith L.

    2009-01-01

    Cardiac Atrophy and Diastolic Dysfunction During and After Long Duration Spaceflight: Functional Consequences for Orthostatic Intolerance, Exercise Capability and Risk for Cardiac Arrhythmias (Integrated Cardiovascular) will quantify the extent of long-duration space flightassociated cardiac atrophy (deterioration) on the International Space Station crewmembers.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-01

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

  7. Challenging Propofol Sedation in Gastrointestinal Endoscopy: High Risk Patients and High Risk Procedures

    Directory of Open Access Journals (Sweden)

    Eduardo Redondo-Cerezo

    2012-12-01

    Full Text Available Sedation is increasingly becoming a must for most endoscopic procedures. Non-anesthesiologist administration of propofol is the standard of practice in many European countries. Nevertheless, despite anesthesiology societies concerns about sedation guided by endoscopist, practitioners find some limits to propofol administration, related to high risk patients or high risk and complex procedures, which can be long lasting and technically challenging. The main patient related risk factors for sedation are elderly patients, obesity, ASA≥3 patients, individuals with craniofacial abnormalities or with pharyngolaringeal tumors, patients with an acute gastrointestinal bleeding, under pain medications, sedatives, antidepressants, or who consume significant amounts of alcohol or drugs. Procedure related risk factors have more to do with the duration and complexity of the procedure than with other factors, in which considering a general anesthesia allows the endoscopist to concentrate on a difficult task. Published papers addressing the most challenging sedation groups in endoscopy are exploring and even trespassing previously assumed frontiers, and new scenarios are opening to the endoscopist, increasing his/her autonomy, reducing costs and giving patients levels of comfort previously unknown. In this review we analyse each risk group determining the ones in which a sedation protocol could be widely applied, and other in which the published evidence does not guarantee a safe endoscopist guided propofol sedation.

  8. 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

  9. Personal, Social and Environmental Risk Factors of Problematic Gambling Among High School Adolescents in Addis Ababa, Ethiopia

    NARCIS (Netherlands)

    Abdi, T.A.; Ruiter, R.A.C.; Adal, T.A.

    2014-01-01

    Understanding risk factors of problematic gambling is prerequisite to effective intervention design to alleviate the negative consequences of gambling. This study explored the personal, social and environmental risk factors of problematic gambling in four high schools in Addis Ababa, Ethiopia, among

  10. 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

  11. 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

    2013-01-01

    College students continue to report being disrupted by other students’ alcohol use. Objective: 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. Study group: A stratified random sample of undergraduate students (N = 3,908) from ten universities in North Carolina, USA, completed a web-based assessment. Methods: 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. Results: 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 < .001). Minority students, students who lived on campus and students who reported getting drunk experienced significantly more community consequences from others’ drinking (p < .01). Conclusions: These findings demonstrate that 4 out of 5 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. PMID:20306764

  12. 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.

  13. Evolution of social learning when high expected payoffs are associated with high risk of failure

    Science.gov (United States)

    Arbilly, Michal; Motro, Uzi; Feldman, Marcus W.; Lotem, Arnon

    2011-01-01

    In an environment where the availability of resources sought by a forager varies greatly, individual foraging is likely to be associated with a high risk of failure. Foragers that learn where the best sources of food are located are likely to develop risk aversion, causing them to avoid the patches that are in fact the best; the result is sub-optimal behaviour. Yet, foragers living in a group may not only learn by themselves, but also by observing others. Using evolutionary agent-based computer simulations of a social foraging game, we show that in an environment where the most productive resources occur with the lowest probability, socially acquired information is strongly favoured over individual experience. While social learning is usually regarded as beneficial because it filters out maladaptive behaviours, the advantage of social learning in a risky environment stems from the fact that it allows risk aversion to be circumvented and the best food source to be revisited despite repeated failures. Our results demonstrate that the consequences of individual risk aversion may be better understood within a social context and suggest one possible explanation for the strong preference for social information over individual experience often observed in both humans and animals. PMID:21508013

  14. Probability, consequences, and mitigation for lightning strikes of Hanford high level waste tanks

    Energy Technology Data Exchange (ETDEWEB)

    Zach, J.J.

    1996-06-05

    The purpose of this report is to summarize selected lightning issues concerning the Hanford Waste Tanks. These issues include the probability of a lightning discharge striking the area immediately adjacent to a tank including a riser, the consequences of significant energy deposition from a lightning strike in a tank, and mitigating actions that have been or are being taken. The major conclusion of this report is that the probability of a lightning strike deposition sufficient energy in a tank to cause an effect on employees or the public is unlikely;but there are insufficient, quantitative data on the tanks and waste to prove that. Protection, such as grounding of risers and air terminals on existing light poles, is recommended.

  15. Probability, consequences, and mitigation for lightning strikes to Hanford site high-level waste tanks

    Energy Technology Data Exchange (ETDEWEB)

    Zach, J.J.

    1996-08-01

    The purpose of this report is to summarize selected lightning issues concerning the Hanford Waste Tanks. These issues include the probability of lightning discharge striking the area immediately adjacent to a tank including a riser, the consequences of significant energy deposition from a lightning strike in a tank, and mitigating actions that have been or are being taken. The major conclusion of this report is that the probability of a lightning strike depositing sufficient energy in a tank to cause an effect on employees or the public is unlikely;but there are insufficient, quantitative data on the tanks and waste to prove that. Protection, such as grounding of risers and air terminals on existing light poles, is recommended.

  16. 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.

  17. Lung cancer screening: identifying the high risk cohort

    OpenAIRE

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

    2015-01-01

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

  18. The consequences of "Culture's consequences"

    DEFF Research Database (Denmark)

    Knudsen, Fabienne; Loloma Froholdt, Lisa

    2009-01-01

    , but it may also have unintentional outcomes. It may lead to a deterministic view of other cultures, thereby reinforcing prejudices and underestimating other forms of differences; it risks blinding the participants of the specific context of a given communicative situation. The article opens with a critical...... 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...

  19. 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.

  20. A New Method to Generate the Complete Set of Unique Signals for Application in High Consequence System

    Institute of Scientific and Technical Information of China (English)

    TAN Shun-yi; CHEN Wen-yuan; ZHANG Wei-ping; FENG Min-hua; LI Sheng-yong

    2007-01-01

    This paper proposed a new method to generate the complete sets of unique signals. It contains sequences comparing, improved exhaustive searches and ranking method. Characters of this new method are complete set;higher effective ;independent of certain mathematical constraints. And also some 24 bi-valued events sets generated by this method were discussed and these set are now used in our high consequence system.

  1. Trainees operating on high-risk patients without cardiopulmonary bypass: a high-risk strategy?

    Science.gov (United States)

    Ascione, Raimondo; Reeves, Barnaby C; Pano, Marco; Angelini, Gianni D

    2004-07-01

    The safety of teaching off-pump coronary artery bypass grafting to trainees is best tested in high-risk patients, who are more likely to experience significant morbidity after surgery. This study compared outcomes of off-pump coronary artery bypass grafting operations performed by consultants and trainees in high-risk patients. Data for consecutive patients undergoing off-pump coronary artery bypass grafting were collected prospectively. Patients satisfying at least one of the following criteria were classified as high-risk: age older than 75 years, ejection fraction less than 0.30, myocardial infarction in the previous month, current congestive heart failure, previous cerebrovascular accident, creatinine greater than 150 micromol/L, respiratory impairment, peripheral vascular disease, previous cardiac surgery, and left main stem stenosis greater than 50%. Early morbidity, 30-day mortality, and late survival were compared. From April 1996 to December 2002, 686 high-risk patients underwent off-pump coronary artery bypass grafting revascularization. Operations by five consultants (416; 61%) and four trainees (239; 35%) were the focus of subsequent analyses. Nine visiting or research fellows performed the other 31 operations. Prognostic factors were more favorable in trainee-led operations. On average, consultants and trainees grafted the same number of vessels. There were 18 (4.3%) and 5 (1.9%) deaths within 30 days, and 14 (3.4%) and 5 (1.9%) myocardial infarctions in consultant and trainee groups, respectively. After adjusting for imbalances in prognostic factors, odd ratios for almost all adverse outcomes implied no increased risk with trainee operators, although patients operated on by trainees had longer postoperative stays and were more likely to have a red blood cell transfusion. Kaplan-Meier cumulative mortality estimates at 24-month follow-up were 10.5% (95% confidence interval, 7.7% to 14.2%) and 6.4% (95% confidence interval, 3.8% to 10.9%) in consultant

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

    Science.gov (United States)

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

    2016-12-15

    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. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. [Anesthesiological management of the high-risk surgical patient].

    Science.gov (United States)

    Bertoldi, G; Avalle, M

    1980-03-01

    Evaluation of the anaesthesiological risk in surgical patients is described and an account is given of results obtained with an association of ketamin and NLA II in 57 high-risk patients subjected to general surgical management.

  4. 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.

  5. Loss of genetic diversity as a consequence of selection in response to high pCO 2

    OpenAIRE

    Lloyd, Melanie M.; Makukhov, April D.; Pespeni, Melissa H.

    2016-01-01

    Abstract Standing genetic variation may allow for rapid evolutionary response to the geologically unprecedented changes in global conditions. However, there is little known about the consequences of such rapid evolutionary change. Here, we measure genetic responses to experimental low and high pCO 2 levels in purple sea urchin larvae, Strongylocentrotus purpuratus. We found greater loss of nucleotide diversity in high pCO 2 levels (18.61%; 900 μatm) compared to low pCO 2 levels (10.12%; 400 μ...

  6. Statistical Analysis of High Impact Climate Projections and their Economic Consequences

    DEFF Research Database (Denmark)

    von Bülow, Catharina Wolff

    of the relevant behavioral anomalies may include loss aversion, ambiguity aversion, pre-commitment preference, under- over- updating, coordination failure and inequality aversion. Objectives and Deliverables How people make decisions involving risk and uncertainty and how economists and researchers think people......Background and Motivation There are two main factors that motivate this project. One, climate change is intrinsically uncertain. Two, people are not perfectly rational. This combination sets the stage for a framework in which bounded rational individuals must make decisions in a hazardous world...... economic models will be examined through the lens of behavioral economics. The motivation is to identify decision-making frameworks that can be applied in the absence of quantifiable probabilistic information, while taking people's cognitive biases, and other-regarding preferences into account. Some...

  7. 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 <5 years had a height-for-age z score and weight-for-age z score, respectively, of <-2 ) and an under-5 child mortality rate of 5.8%. Human immunodeficiency virus prevalence among 18-month-old children is <0.5%. TZH represents a remote rural African population with profound poverty and malnutrition, but a strong community-based research infrastructure.

  8. Incidence, Risk Factors and Consequences of Emergence Agitation in Adult Patients after Elective Craniotomy for Brain Tumor: A Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Lu Chen

    Full Text Available Emergence agitation is a frequent complication that can have serious consequences during recovery from general anesthesia. However, agitation has been poorly investigated in patients after craniotomy. In this prospective cohort study, adult patients were enrolled after elective craniotomy for brain tumor. The sedation-agitation scale was evaluated during the first 12 hours after surgery. Agitation developed in 35 of 123 patients (29%. Of the agitated patients, 28 (80% were graded as very and dangerously agitated. By multivariate stepwise logistic regression analysis, independent predictors for agitation included male sex, history of long-term use of anti-depressant drugs or benzodiazepines, frontal approach of the operation, method and duration of anesthesia and presence of endotracheal intubation. Total intravenous anesthesia and balanced anesthesia with short duration were protective factors. Emergence agitation was associated with self-extubation (8.6% vs 0%, P = 0.005. Sedatives were administered more in agitated patients than non-agitated patients (85.7% vs 6.8%, P<0.001. In conclusion, emergence agitation was a frequent complication in patients after elective craniotomy for brain tumors. The clarification of risk factors could help to identify the high-risk patients, and then to facilitate the prevention and treatment of agitation. For patients undergoing craniotomy, greater attention should be paid to those receiving a frontal approach for craniotomy and those anesthetized under balanced anesthesia with long duration. More researches are warranted to elucidate whether total intravenous anesthesia could reduce the incidence of agitation after craniotomy.ClinicalTrials.gov NCT00590499.

  9. Systemic Immunomodulatory Strategies in High-risk Corneal Transplantation

    Science.gov (United States)

    Abud, Tulio B.; Di Zazzo, Antonio; Kheirkhah, Ahmad; Dana, Reza

    2017-01-01

    The cornea is the most commonly transplanted tissue in the body. Although corneal grafts generally have high success rates, transplantation onto inflamed and vascularized host beds, or so-called high-risk corneal transplantation, has a high rate of graft rejection. The management of this high-risk corneal transplantation is challenging and involves numerous measures. One of the key measures to prevent graft rejection in these cases is the use of systemic immunosuppressive agents. In this article, we will review the systemic immunosuppressive agents most commonly used for high-risk corneal transplantation, which include corticosteroids, cysclosporine A, tacrolimus, mycophenolate mofetil, and rapamycin. Benefits, risks, and published data on the use of these medications for high-risk corneal transplantation will be detailed. We will also summarize novel immunoregulatory approaches that may be used to prevent graft rejection in high-risk corneal transplantation.

  10. 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...

  11. 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

  12. Truth or Consequences: The Intertemporal Consistency of Adolescent Self-report on the Youth Risk Behavior Survey

    OpenAIRE

    Rosenbaum, Janet E.

    2009-01-01

    Surveys are the primary information source about adolescents’ health risk behaviors, but adolescents may not report their behaviors accurately. Survey data are used for formulating adolescent health policy, and inaccurate data can cause mistakes in policy creation and evaluation. The author used test-retest data from the Youth Risk Behavior Survey (United States, 2000) to compare adolescents’ responses to 72 questions about their risk behaviors at a 2-week interval. Each question was evaluate...

  13. Permissive and Non-permissive Hypercapnia: Mechanisms of Action and Consequences of High Carbon Dioxide Levels

    Science.gov (United States)

    Briva, Arturo; Lecuona, Emilia; Sznajder, Jacob I.

    2013-01-01

    Acute lung injury is a disease with high mortality, which affects a large numbers of patients whose treatment continues to be debated. It has recently been postulated that hypercapnia can attenuate the inflammatory response during lung injury, which would assign it a specific role within lung protection strategies during mechanical ventilation. In this paper, we review current evidence on the role that high levels of CO2 in the blood play in lung injury. We conclude that, although there are reports that show benefits, the most recent evidence suggests that hypercapnia can be harmful and can contribute to worsening lung damage. PMID:20303638

  14. Managing Errors to Reduce Accidents in High Consequence Networked Information Systems

    Energy Technology Data Exchange (ETDEWEB)

    Ganter, J.H.

    1999-02-01

    Computers have always helped to amplify and propagate errors made by people. The emergence of Networked Information Systems (NISs), which allow people and systems to quickly interact worldwide, has made understanding and minimizing human error more critical. This paper applies concepts from system safety to analyze how hazards (from hackers to power disruptions) penetrate NIS defenses (e.g., firewalls and operating systems) to cause accidents. Such events usually result from both active, easily identified failures and more subtle latent conditions that have resided in the system for long periods. Both active failures and latent conditions result from human errors. We classify these into several types (slips, lapses, mistakes, etc.) and provide NIS examples of how they occur. Next we examine error minimization throughout the NIS lifecycle, from design through operation to reengineering. At each stage, steps can be taken to minimize the occurrence and effects of human errors. These include defensive design philosophies, architectural patterns to guide developers, and collaborative design that incorporates operational experiences and surprises into design efforts. We conclude by looking at three aspects of NISs that will cause continuing challenges in error and accident management: immaturity of the industry, limited risk perception, and resource tradeoffs.

  15. Exemestane Reduces Breast Cancer Risk in High-Risk Postmenopausal Women

    Science.gov (United States)

    Clinical trial results presented at the 2011 ASCO annual meeting showed that the aromatase inhibitor exemestane—used to treat early and advanced breast cancer—substantially reduced the risk of invasive breast cancer in high-risk postmenopausal women.

  16. 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…

  17. Risk of cardiovascular disease? A qualitative study of risk interpretation among patients with high cholesterol

    OpenAIRE

    Kirkegaard, Pia; Edwards, Adrian; Risør, Mette Bech; Thomsen, Janus Laust

    2013-01-01

    Background Previous studies have shown the importance of paying attention to lay peoples’ interpretations of risk of disease, in order to explain health-related behavior. However, risk interpretations interplay with social context in complex ways. The objective was to explore how asymptomatic patients with high cholesterol interpret risk of cardiovascular disease. Methods Fourteen patients with high cholesterol and risk of cardiovascular disease were interviewed, and patterns across patient a...

  18. 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 formu

  19. 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 cont

  20. Chemical interferences when using high gradient magnetic separation for phosphate removal: consequences for lake restoration.

    Science.gov (United States)

    de Vicente, I; Merino-Martos, A; Guerrero, F; Amores, V; de Vicente, J

    2011-09-15

    A promising method for lake restoration is the treatment of lake inlets through the specific adsorption of phosphate (P) on strongly magnetizable particles (Fe) and their subsequent removal using in-flow high gradient magnetic separation (HGMS) techniques. In this work, we report an extensive investigation on the chemical interferences affecting P removal efficiencies in natural waters from 20 Mediterranean ponds and reservoirs. A set of three treatments were considered based on different Fe particles/P concentration ratios. High P removal efficiencies (>80%) were found in freshwater lakes (conductivities<600 μ S cm(-1)). However, a significant reduction in P removal was observed for extremely high mineralized waters. Correlation analysis showed that major cations (Mg(2+), Na(+) and K(+)) and anions (SO(4)(2-) and Cl(-)) played an essential role in P removal efficiency. Comparison between different treatments have shown that when increasing P and Fe concentrations at the same rate or when increasing Fe concentrations for a fixed P concentration, there exist systematic reductions in the slope of the regression lines relating P removal efficiency and the concentration of different chemical variables. These results evidence a general reduction in the chemical competition between P and other ions for adsorption sites on Fe particles. Additional analyses also revealed a reduction in water color, dissolved organic carbon (DOC) and reactive silicate (Si) concentrations with the addition of Fe microparticles.

  1. The high-risk plaque initiative

    DEFF Research Database (Denmark)

    Falk, Erling; Sillesen, Henrik; Muntendam, Pieter;

    2011-01-01

    were assessed for both risk factors and subclinical atherosclerosis (n = 6104). The latter two groups underwent baseline examination in a dedicated mobile facility equipped with advanced imaging tools suitable for noninvasive screening for subclinical atherosclerosis (coronary artery calcium...... 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...... by computed tomography [CT], carotid and aortic disease by ultrasound, and ankle-brachial index). Selected participants were offered advanced imaging (contrast-enhanced CT, magnetic resonance imaging, and positron emission tomography/CT). Plasma, PAXgene RNA, and DNA samples were obtained for biomarker...

  2. 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.

  3. 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

    of the muscle and finally how will this affect the performance of the athlete. In addition, the review will deal with muscle hypertrophy and how it develops with strength training. Overall, it is not the purpose of this review to give a comprehensive up-date of the area, but to pin-point a few issues from which...... 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...

  4. Consequences of bursty star formation on galaxy observables at high redshifts

    CERN Document Server

    Domínguez, Alberto; Brooks, Alyson M; Christensen, Charlotte R; Bruzual, Gustavo; Stark, Daniel P; Alavi, Anahita

    2014-01-01

    The star formation histories (SFHs) of dwarf galaxies are thought to be bursty, with large -- order of magnitude -- changes in the star formation rate on timescales similar to O-star lifetimes. As a result, the standard interpretations of many galaxy observables (which assume a slowly varying SFH) are often incorrect. Here we use the SFHs from hydro-dynamical simulations to investigate the effects of bursty SFHs on sample selection and interpretation of observables and make predictions to confirm such SFHs in future surveys. First, because dwarf galaxies' star formation rates change rapidly, the mass-to-light ratio is also changing rapidly in both the ionizing continuum and, to a lesser extent, the non-ionizing UV continuum. Therefore, flux limited surveys are highly biased toward selecting galaxies in the burst phase and very deep observations are required to detect all dwarf galaxies at a given stellar mass. Second, we show that a $\\log_{10}[\

  5. High CO₂ and marine animal behaviour: potential mechanisms and ecological consequences.

    Science.gov (United States)

    Briffa, Mark; de la Haye, Kate; Munday, Philip L

    2012-08-01

    Exposure to pollution and environmental change can alter the behaviour of aquatic animals and here we review recent evidence that exposure to elevated CO₂ and reduced sea water pH alters the behaviour of tropical reef fish and hermit crabs. Three main routes through which behaviour might be altered are discussed; elevated metabolic load, 'info-disruption' and avoidance behaviour away from polluted locations. There is clear experimental evidence that exposure to high CO₂ disrupts the ability to find settlement sites and shelters, the ability to detect predators and the ability to detect prey and food. In marine vertebrates and marine crustaceans behavioural change appears to occur via info-disruption. In hermit crabs and other crustaceans impairment of performance capacities might also play a role. We discuss the implications for such behavioural changes in terms of potential impacts at the levels of population health and ecosystem services, and consider future directions for research.

  6. 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.

  7. 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.

  8. Manual rotation in occiput posterior or transverse positions: risk factors and consequences on the cesarean delivery rate

    National Research Council Canada - National Science Library

    Le Ray, Camille; Serres, Pauline; Schmitz, Thomas; Cabrol, Dominique; Goffinet, François

    2007-01-01

    To identify the risk factors for failure of manual rotation in patients with occiput posterior or transverse positions during labor and to study the cesarean rate according to the success of the rotation...

  9. On the value of aiming high: the causes and consequences of ambition.

    Science.gov (United States)

    Judge, Timothy A; Kammeyer-Mueller, John D

    2012-07-01

    Ambition is a commonly mentioned but poorly understood concept in social science research. We sought to contribute to understanding of the concept by developing and testing a model in which ambition is a middle-level trait (Cantor, 1990)-predicted by more distal characteristics but, due to its teleological nature, more proximally situated to predict career success. A 7-decade longitudinal sample of 717 high-ability individuals from the Terman life-cycle study (Terman, Sears, Cronbach, & Sears, 1989) was used in the current study. Results indicated that ambition was predicted by individual differences-conscientiousness, extraversion, neuroticism, and general mental ability-and a socioeconomic background variable: parents' occupational prestige. Ambition, in turn, was positively related to educational attainment, occupation prestige, and income. Ambition had significant total effects with all of the endogenous variables except mortality. Overall, the results support the thesis that ambition is a middle-level trait-related to but distinct from more distal individual difference variables-that has meaningful effects on career success.

  10. SIM and PALM: high-resolution microscopy methods and their consequences for cell biology

    Science.gov (United States)

    Krampert, Gerhard; Kleppe, Ingo; Kalkbrenner, Thomas; Weisshart, Klaus; Wolleschensky, Ralf; Kempe, Michael

    2010-04-01

    The diffraction limit in traditional fluorescence microscopy (approximately 200 and 600 nanometers in lateral and axial directions, respectively) has restricted the applications in bio-medical research. However, over the last 10 years various techniques have emerged to overcome this limit. Each of these techniques has its own characteristics that influence its application in biology. This paper will show how two of the techniques, Structured Illumination Microscopy (SIM) and PhotoActivated Localization Microscopy (PALM), complement each other in imaging of biological samples beyond the resolution of classical widefield fluorescence microscopy. As a reference the properties of two well known standard imaging techniques in this field, confocal Laser Scanning Microscopy (LSM) and Total Internal Reflection (TIRF) microscopy, are compared to the properties of the two high resolution techniques. Combined SIM/PALM imaging allows the extremely accurate localization of individual molecules within the context of various fluorescent structures already resolved in 3D with a resolution of up to 100nm using SIM. Such a combined system provides the biologist with an unprecedented view of the sub-cellular organization of life.

  11. Consequences of brief exposure to high concentrations of carbon monoxide in conscious rats.

    Science.gov (United States)

    Gu, Zengfa; Januszkiewicz, Adolph J; Mayorga, Maria A; Coleman, Gary D; Morrissette, Craig R

    2005-12-01

    Exposure to high-concentration carbon monoxide (CO) is of concern in military operations. Experimentally, the physiologic manifestations of a brief exposure to elevated levels of CO have not been fully described. This study investigated the development of acute CO poisoning in conscious male Sprague-Dawley rats (220-380 g). Animals were randomly grouped (n = 6) and exposed to either air or 1 of 6 CO concentrations (1000, 3000, 6000, 10,000, 12,000, or 24,000 ppm) in a continuous air/CO dynamic exposure chamber for 5 min. Respiration was recorded prior to and during exposures. Mixed blood carboxyhemoglobin (COHb) and pH were measured before and immediately after exposure. Before exposure the mean baselines of respiratory minute volumes (RMVs) were 312.6 +/- 43.9, 275.2 +/- 40.8, and 302.3 +/- 39.1 ml/min for the 10,000, 12,000 and 24,000 ppm groups, respectively. In the last minute of exposure RMVs were 118.9 +/- 23.7, 62.1 +/- 10.4, and 22.0 +/- 15.1% (p 82%. Blood pH was unaltered and no death occurred in rats exposed to CO at concentrations 10,000 ppm for brief periods as short as 5 min may change RMV, resulting in acute respiratory failure, acidemia, and even death.

  12. 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

  13. High risk pesticides in sugar beet protection

    Directory of Open Access Journals (Sweden)

    Šovljanski Radmila A.

    2006-01-01

    Full Text Available According to traits of pesticides permitted to use in sugar beet (oral percutaneus and inhalation toxicity, toxicity to wildlife, bees and aquatic organisms, re-entry interval, maximum number of treatments, effects on reproduction do not present health risk in sugar production/technology. However, the danger exists for workers by chronic exposure during the application, especially from pesticide being potential endocrine disruptors (EDS (fentin acetate, benomyl, endosulfan, methomyl, methidathion. EDS can cause sterility or decreased fertility, impaired development, birth defects of the reproductive tract and metabolic disorders. Authors recommend limited application of EDS pesticides (to limit the number of treatments to only one during the vegetation, replacement with pesticides with low risk to humans game and fishes, as well as mandatory submission of re-entry data for registration.

  14. High-risk pregnancy and the rheumatologist.

    Science.gov (United States)

    Soh, May Ching; Nelson-Piercy, Catherine

    2015-04-01

    Rheumatologists are increasingly involved in the care of young women who, in the age of biologic therapy, are now gaining control of their rheumatic diseases and attempting pregnancy. With careful planning, most women with rheumatic diseases have successful pregnancies. This article focuses specifically on the highest-risk pregnancies and controversial areas. We discuss the women at risk of complications, the types of maternal and fetal complications, the treatments that can be used in pregnancy (and breastfeeding) and longer-term outcomes that could affect the mother. SLE, RA, ANCA-associated vasculitides, large vessel vasculitis (e.g. Takayasu's) and other CTDs (e.g. scleroderma) are among the conditions covered. The evidence and controversies regarding the recommendations for the use of biologics in pregnancy are discussed. The role of the rheumatologist in pregnancy planning and caring for the pregnant and post-partum woman as part of the multidisciplinary team is discussed.

  15. (Brown) adipose tissue associated metabolic dysfunction and risk of cardiovascular disease in high risk patients

    NARCIS (Netherlands)

    Franssens, BT

    2016-01-01

    In this thesis it was shown that (brown) adipose tissue associated metabolic dysfunction increases the risk on development of cardiovascular disease in high risk patients. Quantity of adipose tissue is an important risk factor for adipose tissue dysfunction but functionality of adipose tissue not so

  16. How can we identify the high-risk patient?

    Science.gov (United States)

    Sankar, Ashwin; Beattie, W Scott; Wijeysundera, Duminda N

    2015-08-01

    Accurate and early identification of high-risk surgical patients allows for targeted use of perioperative monitoring and interventions that may improve their outcomes. This review summarizes current evidence on how information from the preoperative, operative, and immediate postoperative periods can help identify such individuals. Simple risk indices, such as the Revised Cardiac Risk Index or American Society of Anesthesiologists Physical Status scale, and online calculators allow risk to be estimated with moderate accuracy using readily available preoperative clinical information. Both specific specialized tests (i.e., cardiopulmonary exercise testing and cardiac stress testing) and promising novel biomarkers (i.e., troponins and natriuretic peptides) can help refine these risk estimates before surgery. Estimates of perioperative risk can be further informed by information acquired during the operative and immediate postoperative periods, such as risk indices (i.e., surgical Apgar score), individual risk factors (i.e., intraoperative hypotension), or postoperative biomarkers (i.e., troponins and natriuretic peptides). Preoperative clinical risk indices and risk calculators estimate surgical risk with moderate accuracy. Although novel biomarkers, specialized preoperative testing, and immediate postoperative risk indices show promise as methods to refine these risk estimates, more research is needed on how best to integrate risk information from these different sources.

  17. Elite High Schools Breed Higher Risk of Addiction

    Science.gov (United States)

    ... html Elite High Schools Breed Higher Risk of Addiction: Study Rates are two to three times higher ... Privilege doesn't necessarily offer protection from drug addiction, new research suggests. Teens at elite U.S. high ...

  18. Toddlers at High Risk of Chemical Eye Burns

    Science.gov (United States)

    ... fullstory_160258.html Toddlers at High Risk of Chemical Eye Burns: Study Access to household cleaning products to blame, ... and 2 years have relatively high rates of chemical eye burns, with everyday cleaners a common cause, researchers say. ...

  19. 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:Sep ... have a stroke for the first time have high blood pressure . And an irregular atrial heart rhythm — a condition ...

  20. 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.

  1. Clinical options for women at high risk for breast cancer.

    Science.gov (United States)

    Hartmann, L C; Sellers, T A; Schaid, D J; Nayfield, S; Grant, C S; Bjoraker, J A; Woods, J; Couch, F

    1999-10-01

    Women at hereditary risk of breast cancer face a difficult clinical decision. Each of the options available to them has unique advantages and disadvantages that are summarized in Table 9. Many components enter a high-risk woman's decision: her objective risk of breast cancer; clinical features, such as the consistency of breast tissue and resultant ease of examination; breast density on mammography; personal characteristics, including her experience with cancer within her family; her role and [table: see text] responsibilities within her own nuclear family; her values and goals; her experiences with the medical system; and her subjective assessment of risk. It is generally believed that women significantly overestimate their risk of breast cancer. Thus, it is vital that a woman at risk have access to a genetic counselor who can provide accurate assessment of her risk. Women should be encouraged to take time to understand their risk level and the advantages and disadvantages of the options before them.

  2. 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...... of the muscle and finally how will this affect the performance of the athlete. In addition, the review will deal with muscle hypertrophy and how it develops with strength training. Overall, it is not the purpose of this review to give a comprehensive up-date of the area, but to pin-point a few issues from which...

  3. High risk populations and HIV-1 infection in China

    Institute of Scientific and Technical Information of China (English)

    Tuo Fu ZHU; Chun Hui WANG; Peng LIN; Na HE

    2005-01-01

    China is currently experiencing one of the most rapidly expanding HIV epidemics in the world. Although the overall prevalence rate is still low, with a population of 1.3 billion, high-risk factors which have contributed to the HIV/AIDS epidemics worldwide continue to prevail in China, including a high rate of injecting drug use and needle sharing,commercial sex with low rates of condom use, and concurrent sex with both commercial sex workers and noncommercial casual or steady sex partners. In addition, there are increasing "double risk" populations overlapping drug users and sex workers, as well as increasing rates of STDs and HIV among high-risk populations. Sexual transmission,therefore, may serve as a bridge connecting high-risk populations with general populations. There is an urgent need to prevent the spread of HIV from these high-risk populations into the general population of China.

  4. 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.

  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. 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 characterist

  7. Precursors and Consequences of Phonemic Length Discrimination Ability Problems in Children with Reading Disabilities and Familial Risk for Dyslexia

    Science.gov (United States)

    Pennala, Riitta; Eklund, Kenneth; Hamalainen, Jarmo; Martin, Maisa; Richardson, Ulla; Leppanen, Paavo H. T.; Lyytinen, Heikki

    2013-01-01

    Purpose: The authors investigated the importance of phonemic length discrimination ability on reading and spelling skills among children with reading disabilities and familial risk for dyslexia and among children with typical reading skills, as well as the role of prereading skills in reading and spelling development in children with reading…

  8. Collision Risk for Fixed Offshore Structures Close to High-density Shipping Lanes

    DEFF Research Database (Denmark)

    Pedersen, Preben Terndrup

    2002-01-01

    Fixed offshore structures in the vicinity of intense ship traffic pose a potential collision hazard such as risk of loss of life, economic loss, environmental damage and other possible unwanted events. Therefore, one of the many performance goals in the design phase of such structures is to ensure...... risk analysis procedure for fixed offshore structures in shipping lanes with high traffic densities. It deals with the following items: the basic information and the navigational studies needed for a rational collision risk assessment, exemplification of target risk acceptance criteria for the bridge...... structure, an analysis procedure for ship collision frequencies as a function of the structural layout, elements in a calculation of the probabilistic distribution of collision forces on the fixed structure given a collision has taken place, and finally it is shown how the consequences due to accidental...

  9. Consequences of a Maternal High-Fat Diet and Late Gestation Diabetes on the Developing Rat Lung

    OpenAIRE

    Michelle L Baack; Forred, Benjamin J.; Larsen, Tricia D.; Jensen, Danielle N.; Wachal, Angela L.; Khan, Muhammad Ali; Vitiello, Peter F.

    2016-01-01

    Rationale Infants born to diabetic or obese mothers are at risk of respiratory distress and persistent pulmonary hypertension of the newborn (PPHN), conceivably through fuel-mediated pathogenic mechanisms. Prior research and preventative measures focus on controlling maternal hyperglycemia, but growing evidence suggests a role for additional circulating fuels including lipids. Little is known about the individual or additive effects of a maternal high-fat diet on fetal lung development. Objec...

  10. 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....

  11. 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...

  12. 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.

  13. Identifying and Mitigating the Impact of the Budget Control Act on High Risk Sectors and Tiers of the Defense Industrial Base: Assessment Approach to Industrial Base Risks

    Science.gov (United States)

    2016-04-30

    measured by the likelihood of losing critical capabilities and the consequences of that loss High Risk Industrial Base Sectors & Tiers Likelihood...Risk Sectors and Tiers of the Defense Industrial Base : Assessment Approach to Industrial Base Risks Lirio Avilés, Engineer, MIBP, OUSD(AT&L) Sally...Ñçê=fåÑçêãÉÇ=`Ü~åÖÉ= - 326 - Panel 10. Assessing Industrial Base Implications of a Constrained Fiscal Climate Wednesday, May 4, 2016 3:30 p.m. – 5

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. Cost tradeoffs in consequence management at nuclear power plants: A risk based approach to setting optimal long-term interdiction limits for regulatory analyses

    Energy Technology Data Exchange (ETDEWEB)

    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.

  19. POPULATION CHARACTERS IN HIGH RISK PEDIGREES OF NASOPHARYNGEAL CARCINOMA (NPC)

    Institute of Scientific and Technical Information of China (English)

    HUANG Teng-bo; ZHANG Jin-ming; HUANG Hui-ming; LI Jing-lian; HUANG Guo-dong

    1999-01-01

    Objective: To investigate population characters in high risk pedigrees of NPC in Guangdong area and to explore the effect each other between tumor genetic susceptibility and infection of EB virus on pathogenic mechanism. Methods: Pedigree investigation, examination of DNA fingerprint, multi-antibodies of EB virus and nasopharyngeal cavity were done for all of the members in each high risk pedigree. Results: High positive rate of EBV VCA/IgA (23.22%), high percentage of high risk population of NPC (6.53-10.40%),high detected rate of malignant tumor (9552.59/105), and high detected rate of NPC (8464.32/105) were discovered and NPC was most common in first degree relative of a pedigree. Conclusion: Tumor genetic susceptibility,infection of EB virus might play a role in coordination of reinforced effect on occurrence of NPC.

  20. 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.

  1. Treating Patients with High-Risk Smoldering Myeloma

    Science.gov (United States)

    In this phase III clinical trial, patients with smoldering myeloma classified as high risk for progression will be randomly assigned to undergo standard observation or six 4-week courses of treatment with the drug lenalidomide.

  2. 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...

  3. Risk-taking behaviour of Cape Peninsula high school students ...

    African Journals Online (AJOL)

    Risk-taking behaviour of Cape Peninsula high school students. ... PROMOTING ACCESS TO AFRICAN RESEARCH. AFRICAN ... South African Medical Journal ... 7 340 students from 16 schools in the three major ed ucation departments.

  4. High Pain Tolerance Tied to 'Silent' Heart Attack Risk

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_162666.html High Pain Tolerance Tied to 'Silent' Heart Attack Risk Unusual symptoms ... is. But the new findings suggest that pain tolerance might be a factor. Using a standard test ...

  5. Suicide Risk Especially High for U.S. Farmers

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_166800.html Suicide Risk Especially High for U.S. Farmers Other occupations ... Two decades after the U.S. farm crisis, the suicide rate among American farmers remains much higher than ...

  6. review article risk factors, threats and prevention of highly ...

    African Journals Online (AJOL)

    Dr Oboro VO

    2006-02-09

    Feb 9, 2006 ... mixing vehicle for re-assortment of the virus. The domestic ducks get ... importation of poultry and poultry products from high risk countries, effective disease surveillance ..... therefore an extremely important safety measure to ...

  7. 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 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.

  8. Beijing Encourages High-Risk Groups to Undertake AIDS Test

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    High-risk groups in Beijing, China's capital city, such as sex workers, drug-takers who share needles and gay communities are being encouraged to take voluntary counseling and tests (VCT) as part of an effort to stem the spread of AIDS. Tens of thousands of flyers have been distributed to disease control centers at district levels, and they will be handed to high-risk individuals by AIDS workers and volunteers over the next few weeks.

  9. Individuals at high risk for suicide are categorically distinct from those at low risk.

    Science.gov (United States)

    Witte, Tracy K; Holm-Denoma, Jill M; Zuromski, Kelly L; Gauthier, Jami M; Ruscio, John

    2017-04-01

    Although suicide risk is often thought of as existing on a graded continuum, its latent structure (i.e., whether it is categorical or dimensional) has not been empirically determined. Knowledge about the latent structure of suicide risk holds implications for suicide risk assessments, targeted suicide interventions, and suicide research. Our objectives were to determine whether suicide risk can best be understood as a categorical (i.e., taxonic) or dimensional entity, and to validate the nature of any obtained taxon. We conducted taxometric analyses of cross-sectional, baseline data from 16 independent studies funded by the Military Suicide Research Consortium. Participants (N = 1,773) primarily consisted of military personnel, and most had a history of suicidal behavior. The Comparison Curve Fit Index values for MAMBAC (.85), MAXEIG (.77), and L-Mode (.62) all strongly supported categorical (i.e., taxonic) structure for suicide risk. Follow-up analyses comparing the taxon and complement groups revealed substantially larger effect sizes for the variables most conceptually similar to suicide risk compared with variables indicating general distress. Pending replication and establishment of the predictive validity of the taxon, our results suggest the need for a fundamental shift in suicide risk assessment, treatment, and research. Specifically, suicide risk assessments could be shortened without sacrificing validity, the most potent suicide interventions could be allocated to individuals in the high-risk group, and research should generally be conducted on individuals in the high-risk group. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  10. 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.

  11. Gender Role Discrepancy Stress, High-Risk Sexual Behavior, and Sexually Transmitted Disease.

    Science.gov (United States)

    Reidy, Dennis E; Brookmeyer, Kathryn A; Gentile, Brittany; Berke, Danielle S; Zeichner, Amos

    2016-02-01

    Nearly 20 million new sexually transmitted infections occur every year in the United States. Traditionally, men have demonstrated much greater risk for contraction of and mortality from STDs perhaps because they tend to engage in a number of risky sexual activities. Research on masculinity suggests that gender roles influence males' sexual health by encouraging risk-taking behavior, discouraging access to health services, and narrowly defining their roles as partners. However, despite the propensity of highly masculine men to engage in high-risk sexual behavior, there is reason to suspect that men at the other end of the continuum may still be driven to engage in similar high-risk behaviors as a consequence of gender socialization. Discrepancy stress is a form of gender role stress that occurs when men fail to live up to the ideal manhood derived from societal prescriptions (i.e., Gender Role Discrepancy). In the present study, we surveyed a national sample of 600 men via Amazon Mechanical Turk to assess perceived gender role discrepancy, experience of discrepancy stress, and the associations with risky sexual behavior and potential contraction of STDs. Results indicated that men who believe they are less masculine than the typical man (i.e., gender role discrepancy) and experience distress stemming from this discrepancy (i.e., discrepancy stress) engage in high-risk sexual behavior and are subsequently diagnosed with more STDs. Findings are discussed in relation to implications for primary prevention strategies.

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

    Institute of Scientific and Technical Information of China (English)

    Alina Stoita; Ian D Penman; David B Williams

    2011-01-01

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

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

    Science.gov (United States)

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

    2011-05-21

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

  14. High Risk for Thoracotomy but not Thoracoscopic Lobectomy.

    Science.gov (United States)

    Donahoe, Laura L; de Valence, Moira; Atenafu, Eshetu G; Hanna, Waël C; Waddell, Thomas K; Pierre, Andrew F; Yasufuku, Kazuhiro; de Perrot, Marc; Cypel, Marcelo; Keshavjee, Shaf; Darling, Gail E

    2017-06-01

    Pulmonary lobectomy is the standard of care for resection of non-small cell lung cancer (NSCLC). Patients with compromised lung function who are considered high risk may be denied surgical treatment; thus, proper identification of those truly at high risk is critical. Video-assisted thoracic surgery (VATS) may reduce the operative risk. This study reviews our institutional experience of pulmonary lobectomy by open thoracotomy or VATS techniques in patients deemed to be high risk. A retrospective review of an institutional database was performed for all patients undergoing lobectomy from 2002 to 2010. Patients were grouped into high-risk (HR) and standard-risk (SR) cohorts according to the American College of Surgeons Oncology Group Z4099/Radiation Therapy Oncology Group 1021 criteria. From 2002 to 2010, 72 HR and 536 SR patients underwent lobectomy. Mean age was 73 years for HR and 66 years for SR (p risk for open lobectomy a feasible procedure, with no difference in overall survival compared with SR patients, and decreased morbidity compared with open lobectomy. VATS lobectomy should be considered for patients who historically may not have been considered for surgical resection. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  15. 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

  16. Clinical risk factors for gestational hypertensive disorders in pregnant women at high risk for developing preeclampsia

    NARCIS (Netherlands)

    Wong, Tsz Y.; Groen, Henk; Faas, Marijke M.; van Pampus, Maria G.

    2013-01-01

    Objectives: To evaluate clinical risk factors for the development of gestational hypertensive disorders in a group of pregnant women at high risk for developing preeclampsia. Secondly we evaluated the incidence and recurrence rate of preeclampsia and pregnancy-induced hypertension. Study design: A

  17. Clinical risk factors for gestational hypertensive disorders in pregnant women at high risk for developing preeclampsia

    NARCIS (Netherlands)

    Wong, Tsz Y.; Groen, Henk; Faas, Marijke M.; van Pampus, Maria G.

    2013-01-01

    Objectives: To evaluate clinical risk factors for the development of gestational hypertensive disorders in a group of pregnant women at high risk for developing preeclampsia. Secondly we evaluated the incidence and recurrence rate of preeclampsia and pregnancy-induced hypertension. Study design: A p

  18. 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…

  19. 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 negati

  20. 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.

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

    Science.gov (United States)

    Nielsen, C; Ostergaard, S; Emanuelson, U; Andersson, H; Berglund, B; Strandberg, E

    2010-10-01

    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, SimHerd, 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 no clinical mastitis (CM) while keeping the incidence of subclinical mastitis (SCM) constant and vice versa. Six different strategies to withdraw milk with high SCC were compared. The decision to withdraw milk was based on herd-level information in three scenarios: withdrawal was initiated when the predicted bulk tank SCC exceeded 220 000, 200 000 or 180 000 cells/ml, and on cow-level information in three scenarios: withdrawal was initiated when the predicted SCC in an individual cow's milk exceeded 1 000 000, 750 000 or 500 000 cells/ml. The accuracy with which SCC was measured and predicted was assumed to affect the profitability of withdrawing milk with high SCC and this was investigated by applying high, low or no uncertainty to true SCC. The yearly avoidable cost of mastitis was estimated at €8235, assuming that the initial incidence of mastitis could be reduced by 50%. This cost corresponded to 5% 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 withdrawal that was not offset by a sufficient increase in the average price per delivered kg milk. It had the most negative impact on net return when

  2. 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; prelative to sleeping 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.

  3. 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

  4. [Lipid control in high-risk patients: focus on PCSK9 inhibitors].

    Science.gov (United States)

    Filardi, Pasquale Perrone; Paolillo, Stefania; Trimarco, Bruno

    2015-01-01

    Low-density lipoprotein (LDL)-cholesterol levels are strictly related to the risk of major cardiovascular events. Statins have been demonstrated to significantly reduce LDL-cholesterol levels, contributing to cardiovascular risk reduction especially in high-risk patients. However, low adherence to statins, due to adverse effects, is often observed and many patients in secondary prevention exhibit LDL-cholesterol levels >70 mg/dl. As a consequence, there is the need for new therapeutic approaches with different mechanisms of action to reach recommended lipid targets in high-risk patients. One potential approach is to inhibit PCSK9, a serum protein with an active role in controlling the expression of LDL receptors, by reducing their recycling and targeting it for lysosomal destruction. Monoclonal antibodies against PCSK9, in particular alirocumab and evolocumab, have been shown to reduce LDL substantially, either with or without concomitant statin therapy with good tolerability. Ongoing trials will further define the efficacy of these drugs as an emerging approach to the treatment of hypercholesterolemia in primary and secondary prevention of high-risk patients.

  5. Landslide risk assessment in the Göta Älv river valley to limit consequences of climate change on society

    Science.gov (United States)

    Hedlund, Jonas; Lind, Bo; Tremblay, Marius; Zackrisson, Peter; Cederbom, Charlotte

    2010-05-01

    Higher temperatures, higher average precipitation and increased occurrence of extreme rainfall events are some expected climate changes in Sweden during the coming 70-100 years. Due to the changing climate the risk for floods, erosion and landslides are expected to increase. in large parts of the country. To prevent extensive floodings and damages of cities and infrastructure around Lake Vänern, it is necessary to allow controlled overflow from Lake Vänern through the river Göta Älv. An overflow in the river, in turn, leads to increased risk for erosion and landslides along the Göta Älv valley. In order to meet the upcoming climate changes and to handle the increasing flows through the river, we need to improve the knowledge of the stability of the entire river bank. The Swedish Government has commissioned the Swedish Geotechnical Institute (SGI) to investigate the landslide potential of the Göta Älv valley, taking the predicted climate changes into consideration. The investigated area includes the parts of Göta Älv that could be affected by the increased flows from Lake Vänern; areas where the increased flow will affect stability and where landslides could cause serious damages or damming of the river. The investigation area includes c. 90 km of the Göta Älv river plus tributaries in connection to Göta Älv. In the landslide risk analyses developed for Göta Älv, the likelihood of landslides and estimation of the subsequent consequences are included. The methodology involves mapping of landslide hazards and a judgement of the risk area on the basis of a risk matrix. The landslide risk analysis allows for an assessment of where geotechnical reinforcements would be necessary. A cost estimation for the required reinforcement measures is also provided. In areas where the estimated risk for a landslide is low (e.g. limited consequences), stability mapping in accordance with the model used by the Swedish Civil Contingencies Agency (MSB) is developed

  6. 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; Gloeckner, 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

    2015-10-29

    Neuroblastoma is a malignant paediatric tumour of the sympathetic nervous system. 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 elusive. 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 type. 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.

  7. 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.

  8. Mitigating the consequences of extreme events on strategic facilities: evaluation of volcanic and seismic risk affecting the Caspian oil and gas pipelines in the Republic of Georgia.

    Science.gov (United States)

    Pasquarè, F A; Tormey, D; Vezzoli, L; Okrostsvaridze, A; Tutberidze, B

    2011-07-01

    In this work we identify and quantify new seismic and volcanic risks threatening the strategic Caspian oil and gas pipelines through the Republic of Georgia, in the vicinity of the recent Abuli Samsari Volcanic Ridge, and evaluate risk reduction measures, mitigation measures, and monitoring. As regards seismic risk, we identified a major, NW-SE trending strike-slip fault; based on the analysis of fault planes along this major transcurrent structure, an about N-S trend of the maximum, horizontal compressive stress (σ1) was determined, which is in good agreement with data instrumentally derived after the 1986, M 5.6 Paravani earthquake and its aftershock. Particularly notable is the strong alignment of volcanic vents along an about N-S trend that suggests a magma rising controlled by the about N-S-directed σ1. The original pipeline design included mitigation measures for seismic risk and other geohazards, including burial of the pipeline for its entire length, increased wall thickness, block valve spacing near recognized hazards, and monitoring of known landslide hazards. However, the design did not consider volcanic risk or the specific seismic hazards revealed by this study. The result of our analysis is that the Baku-Tbilisi-Ceyhan (BTC) oil pipeline, as well as the Baku-Tbilisi-Erzerum South Caucasian natural gas pipeline (SCP) were designed in such a way that they significantly reduce the risk posed by the newly-identified geohazards in the vicinity of the Abuli-Samsari Ridge. No new measures are recommended for the pipeline itself as a result of this study. However, since the consequences of long-term shut-down would be very damaging to the economies of Western Europe, we conclude that the regionally significant BTC and SCP warrant greater protections, described in the final section of or work. The overall objective of our effort is to present the results in a matrix framework that allows the technical information to be used further in the decision

  9. Detection of high risk campylobacteriosis clusters at three geographic levels

    Directory of Open Access Journals (Sweden)

    Jennifer Weisent

    2011-11-01

    Full Text Available Campylobacteriosis is a leading cause of bacterial gastroenteritis in the United States and many other developed countries. Understanding the spatial distribution of this disease and identifying high-risk areas is vital to focus resources for prevention and control measures. In addition, determining the appropriate scale for geographical analysis of surveillance data is an area of concern to epidemiologists and public health officials. The purpose of this study was to (i compare standardized risk estimates for campylobacteriosis in Tennessee over three distinct geographical scales (census tract, zip code and county subdivision, and (ii identify and investigate high-risk spatial clustering of campylobacteriosis at the three geographical scales to determine if clustering is scale dependent. Significant high risk clusters (P <0.05 were detected at all three spatial scales. There were overlaps in regions of high-risk and clusters at all three geographic levels. At the census tract level, spatial analysis identified smaller clusters of finer resolution and detected more clusters than the other two levels. However, data aggregation at zip code or county subdivision yielded similar findings. The importance of this line of research is to create a framework whereby economically efficient disease control strategies become more attainable through improved geographical precision and risk detection. Accurate identification of disease clusters for campylobacteriosis can enable public health personnel to focus scarce resources towards prevention and control programmes on the most at-risk populations. Consistent results at multiple spatial levels highlight the robustness of the geospatial techniques utilized in this study. Furthermore, analyses at the zip code and county subdivision levels can be useful when address level information (finer resolution data are not available. These procedures may also be used to help identify regionally specific risk factors for

  10. Reducing mortality for high risk surgical patients in the UK.

    Science.gov (United States)

    Rogers, B A; Carrothers, A D; Jones, Chris

    2012-06-01

    Over 40 million surgical procedures are performed per annum in the USA and Europe, including several million patients who are considered to be high risk (Bennett-Guerrero et al 2003). Overall, the risk of death or major complications after surgery in the general surgical patient population is low, with a post-operative mortality rate of less than1% during the same hospital admission (Niskanen et al 2001).

  11. High Risk Infants Follow-Up: A Case Study in Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Heidarzadeh

    2015-01-01

    Full Text Available Background. A follow-up program for high risk infants was initiated in Alzahra Maternity Hospital in Tabriz city, Iran, in 2013. The aim of this paper is to give a brief report of the program. Material and Methods. Two groups of high risk neonates were studied. The first group comprising 509 infants received services in Alzahra Maternity Hospital implemented by the follow-up program. This included a full package for family to look after high risk infant and periodic clinical evaluation at two and four weeks after birth and then two, three, four, five, and six months later again. The second group including 131 infants in Taleqani Maternity Hospital received routine services after birth with no specific follow-up care. Results. Some anthropometric indices showed a significant improvement in the intervention hospital compared to control group. These included the following: head circumference at first and second months; weight in the first, fourth, fifth, and sixth months; and height in sixth month only. Clinical evaluation of infants showed an improvement for some of the medical conditions. Conclusion. Follow-up care program for a minimum of six months after discharge from maternity hospitals may help to avoid adverse and life threatening consequences in high risk infants.

  12. The MSSA consequence tables

    Energy Technology Data Exchange (ETDEWEB)

    Sacks, I.J.

    1988-01-01

    The Master Safeguards and Security Agreement (MSSA) is the mechanism through which the U.S. Department of Energy is implementing a policy of graded safeguards. Under this concept, the level of protection provided to a target is proportional to the ''cost'' of the loss of the target. Cost is measured by use of the conditional risk equation in which the protection system ineffectiveness is multiplied by the consequence to society of a successful adversary attempt. The consequences which are used in the MSSA process were developed in the summer of the 1986 by a consensus of DOE personnel and contractors. There are separate consequence tables for theft of SNM, radiological sabotage. The consequence values in the tables were deliberately not cross-normalized. The consequence values in each table correspond to a societal or DOE cost, for example, the consequence values for SNM theft compared to a normalized estimate of the expected number of fatalities from a successful use of the stolen material times an estimate of the likelihood of successfully using the material. Consequence values for radiological sabotage correspond very roughly to a similar expected fatality level. Values for industrial sabotage are an estimate of the impact on DOE weapons production or impact on the nuclear weapons stockpile. Problems have arisen in the use of these tables and are discussed in the paper.

  13. Caffeine and cognitive decline in elderly women at high vascular risk. : Caffeine and cognition in high-risk women

    OpenAIRE

    Vercambre, Marie-Noël; Berr, Claudine; Ritchie, Karen,; Kang, Jae,

    2013-01-01

    International audience; BACKGROUND: Persons with vascular disorders are at higher risk of cognitive decline. OBJECTIVE: To determine whether caffeine may be associated with cognitive decline reduction in elderly at high vascular risk. METHODS: We included 2,475 women aged 65+ years in the Women's Antioxidant Cardiovascular Study, a randomized trial of antioxidants and B vitamins for cardiovascular disease secondary prevention. We ascertained regular caffeine intake at baseline (1995-1996) usi...

  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.

  15. Hypertension Management in the High Cardiovascular Risk Population

    Directory of Open Access Journals (Sweden)

    Ilir Maraj

    2013-01-01

    Full Text Available The incidence of hypertension is increasing every year. Blood pressure (BP control is an important therapeutic goal for the slowing of progression as well as for the prevention of Cardiovascular disease. The management of hypertension in the high cardiovascular risk population remains a real challenge as the population continues to age, the incidence of diabetes increases, and more and more people survive acute myocardial infarction. We will review hypertension management in the high cardiovascular risk population: patients with coronary heart disease (CHD and heart failure (HF as well as in diabetic patients.

  16. Choice & Consequence

    DEFF Research Database (Denmark)

    Khan, Azam

    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....

  17. Choice & Consequence

    DEFF Research Database (Denmark)

    Khan, Azam

    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....

  18. Risk factors for acute chemical releases with public health consequences: Hazardous Substances Emergency Events Surveillance in the U.S., 1996–2001

    Directory of Open Access Journals (Sweden)

    Kaye Wendy E

    2004-10-01

    Full Text Available Abstract Background Releases of hazardous materials can cause substantial morbidity and mortality. To reduce and prevent the public health consequences (victims or evacuations from uncontrolled or illegally released hazardous substances, a more comprehensive analysis is needed to determine risk factors for hazardous materials incidents. Methods Hazardous Substances Emergency Events Surveillance (HSEES data from 1996 through 2001 were analyzed using bivariate and multiple logistic regression. Fixed-facility and transportation-related events were analyzed separately. Results For fixed-facility events, 2,327 (8% resulted in at least one victim and 2,844 (10% involved ordered evacuations. For transportation-related events, 759 (8% resulted in at least one victim, and 405 (4% caused evacuation orders. Fire and/or explosion were the strongest risk factors for events involving either victims or evacuations. Stratified analysis of fixed-facility events involving victims showed a strong association for acid releases in the agriculture, forestry, and fisheries industry. Chlorine releases in fixed-facility events resulted in victims and evacuations in more industry categories than any other substance. Conclusions Outreach efforts should focus on preventing and preparing for fires and explosions, acid releases in the agricultural industry, and chlorine releases in fixed facilities.

  19. Personality and sensation seeking in high-risk sports

    Directory of Open Access Journals (Sweden)

    Polona Klinar

    2017-03-01

    Full Text Available Background: Personality represents a relatively consistent and unique sum of psychological, cognitive and physical characteristics of an individual. Sensation seeking is defined as an action, characterized by the search for different, new, complex and intensive emotions and experiences and preparedness to take physical, social, legal and financial risks in order to achieve these experiences.Objective: We were looking for differences in personality and sensation seeking between high-risk sports athletes and recreational athletes and the correlation between one's purpose to participate in high-risk sports and actual participation.Method: The data was acquired using three different questionnaires: Sensation Seeking Scale (forms SSS - V and SSS - VI and the Big Five Questionnaire. The sample consisted of 76 high-risk sports athletes and 51 recreational athletes. Data was analyzed using the SPSS statistical program.Results: The results were unexpected because we noticed differences between the two groups in which recreational athletes received higher results, especially in openness. Mostly results from such research show the converse - athletes of high-risk sports are more open. We did not find any difference between the two groups in sensation seeking. We found some correlations between personality traits and factors of Sensation Seeking Scale (SSS - V and SSS - VI. Openness and the Thrill and adventure seeking factor correlated in both versions of SSS.Conclusions: We conclude that high-risk sports athletes differ from recreational athletes, especially in openness. Also, we can confirm that both used versions of SSS are equally effective for analyzing sensation seeking.

  20. HIV Sentinel Surveillance Among High Risk Groups: Scenario In Gujarat

    Directory of Open Access Journals (Sweden)

    L B Chavan, Prakash Patel, Vaibhav Gharat

    2011-01-01

    Full Text Available Background: Surveillance is the ongoing systematic collection, collation, analysis and interpretation of data so that appropriate action can be taken within time. Aims and Objective: The present annual HIV sentinel surveillance (HSS was carried out for monitoring trends of HIV epidemic in high risk group populations in selected sites of Gujarat state.. Methodology: The HSS was carried out in representative populations from High Risk Group (HRG like Female Sex Workers (FSW, Man having Sex with Man (MSM and Single Male Migrant. Target sample size was 250 at each HRG site (Female Sex Worker, Male Sex Male & SMM. Consecutive sampling was done at designated sentinel site for selecting the survey participants. Results: Overall 3726 samples (1494 FSWs, 1732 MSMs & 500 SMM were tested in the High risk group of HSS 2008. The overall sero-positivity in samples from FSWs, MSMs sites was 4.5%. Sero-positivity was more or less high (? 5% among FSWs as well as MSMs irrespective of age, place of residence, literacy level, occupation; and migration status. Conclusion: The overall trend of sero-positivity in High risk groups shows decreasing trend of HIV in the state from 2004 to 2008.

  1. Circulating tumor cells in high-risk nonmetastatic colorectal cancer.

    Science.gov (United States)

    Gazzaniga, Paola; Gianni, Walter; Raimondi, Cristina; Gradilone, Angela; Lo Russo, Giuseppe; Longo, Flavia; Gandini, Orietta; Tomao, Silverio; Frati, Luigi

    2013-10-01

    The identification of patients at higher risk of recurrence after primary colorectal cancer resection is currently one of the challenges facing medical oncologists. Circulating tumor cell (CTC) may represent a surrogate marker of an early spread of disease in patients without overt metastases. Thirty-seven high-risk stages II-III colorectal cancer patients were evaluated for the presence of CTC. Enumeration of CTCs in 7.5 ml of blood was carried out with the FDA-cleared CellSearch system. CTC count was performed after primary tumor resection and before the start of adjuvant therapy. CTC was detected in 22 % of patients with a significant correlation with regional lymph nodes involvement and stage of disease. No significant correlation was found among the presence of CTC and other clinicopathological parameters. These data suggest that CTCs detection might help in the selection of high-risk stage II colorectal cancer patient candidates for adjuvant chemotherapy.

  2. Dysphagia in the high-risk infant: potential factors and mechanisms.

    Science.gov (United States)

    Jadcherla, Sudarshan

    2016-02-01

    Neonatal dysphagia, or abnormalities of swallowing, represent a major global problem, and consequences of dysfunctional feeding patterns carry over into infancy and toddler age groups. Growth, development, and independent feeding skills are all delayed among high-risk infants. Such a group comprises premature birth, low-birth-weight, congenital anomalies, perinatal asphyxia, postsurgical, and sepsis categories. The conflict between pathophysiologic and pragmatic feeding strategies remains a major conundrum and is largely due to a lack of validated diagnostic approaches amid heterogeneity of the patient phenotype. Thus, well-tested feeding management strategies that can be generalizable are lacking. Furthermore, the aerodigestive symptoms and signs, potential risk factors, and contributory etiologies remain nonspecific. This article presents mechanistic evidence related to the pathophysiologic basis of neonatal dysphagia as well as potential opportunities to improve feeding abilities and long-term development.

  3. Complement C3 and High Risk of Venous Thromboembolism

    DEFF Research Database (Denmark)

    Nørgaard, Ina; Nielsen, Sune Fallgaard; Nordestgaard, Børge Grønne

    2016-01-01

    BACKGROUND: Complement activation may contribute to venous thromboembolism, including deep venous thrombosis and pulmonary embolism. We tested the hypothesis that high complement C3 concentrations are associated with high risk of venous thromboembolism in the general population. METHODS: We...... similar for deep venous thrombosis and pulmonary embolism separately. The multivariable-adjusted hazard ratio for venous thromboembolism for a 1-g/L increase in complement C3 was 2.43 (1.74-3.40). CONCLUSIONS: High concentrations of complement C3 were associated with high risk of venous thromboembolism...... included 80 517 individuals without venous thromboembolism from the Copenhagen General Population Study recruited in 2003-2012. Plasma complement C3 concentrations were measured at baseline, and venous thromboembolism (n = 1176) was ascertained through April 2013 in nationwide registries. No individuals...

  4. Hypertensive patients and diabetes : A high-risk population

    NARCIS (Netherlands)

    Bilo, HJG; Gans, ROB

    1998-01-01

    Rising worldwide rates of diabetes mellitus heighten the need to maintain adequate metabolic control in diabetic patients and to control for other cardiovascular risk factors, such as lipid profile disturbances, high blood pressure, and smoking habits. This is especially the case in diabetic patient

  5. 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....

  6. Distribution of influenza vaccine to high-risk groups.

    Science.gov (United States)

    Ompad, Danielle C; Galea, Sandro; Vlahov, David

    2006-01-01

    Vaccine distribution programs have historically targeted individuals at high risk of complications due to influenza. Despite recommendations from the Advisory Committee on Immunization Practices, vaccination coverage among high-risk populations has been generally low. This review systematically summarizes the recent literature evaluating programs in different settings, from within medical settings to venue-based and community-based approaches, in an effort to identify successful program components. The published literature was identified by using the MEDLINE database from 1990 to 2006 covering studies that reported on interventions or programs aimed at vaccinating high-risk populations. The authors reviewed 56 studies. In the United States, the Healthy People 2010 goals included 90% vaccination coverage for adults aged > or = 65 years and 60% for high-risk adults aged 18-64 years. Only a handful of the studies reviewed managed to meet those goals. Interventions that increased vaccination coverage to Healthy People 2010 goals included advertising, provider and patient mailings, registry-based telephone calls, patient and staff education, standing orders coupled with standardized forms, targeting of syringe exchange customers, and visiting nurses. Few studies evaluated the impact of vaccination programs by race/ethnicity and socioeconomic status. Few studies targeted individuals outside of the health-care and social services sectors. Given the growing disparities in health and health-care access, understanding the way in which interventions can remedy disparities is crucial.

  7. 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

    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) is regar......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......) 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 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...

  8. Differentiated Instruction to Support High-Risk Preschool Learners

    Science.gov (United States)

    DeBaryshe, Barbara D.; Gorecki, Dana M.; Mishima-Young, Lori N.

    2009-01-01

    Differentiated instruction is a strategy for meeting the needs of diverse learners. In this article, we describe a differentiated instruction model and examine the effects on high-risk children. One hundred twenty-eight children and their teachers from 8 Head Start classrooms participated in the project. Teachers provided developmentally…

  9. Economic evaluation studies of obstetric interventions in high risk pregnancies

    NARCIS (Netherlands)

    Vijgen, S.M.C.

    2013-01-01

    In this thesis we performed comparative costs and cost-effectiveness analyses for several clinical dilemmas in high risk pregnancies or deliveries, and explored practical and methodological issues in such research and to discuss the context of evidence-based policy making in relation to complex dile

  10. 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.…

  11. 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...

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

    Science.gov (United States)

    Barnes, R W

    1977-08-01

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

  13. ORIGINAL ARTICLES Factors associated with female high-risk ...

    African Journals Online (AJOL)

    Africa in 2002,1 7% of disability-adjusted life-years (DALYS) and 7.1% of deaths ... high-risk drinking in women of reproductive age in a rural and an urban South .... hungry; employment status; highest level of education; and the presence of 8 ...

  14. 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.…

  15. 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.

  16. Big Books from Little Voices: Reaching High Risk Beginning Readers.

    Science.gov (United States)

    Trachtenburg, Phyllis; Ferruggia, Ann

    1989-01-01

    Discusses how interactive, whole class techniques (using a student-generated Big Book adaptation of "Corduroy") improved the reading skills of high risk first grade readers. Describes several activities, including sight word strategies, decoding techniques, and word processing, and suggests 27 Big Books for use with these activities. (MM)

  17. Health risk behaviours of high school learners and their perceptions ...

    African Journals Online (AJOL)

    Health risk behaviours of high school learners and their perceptions of preventive services offered by general ... Journal Home > Vol 51, No 3 (2009) > ... and the use of alcohol, tobacco and other drugs (ATOD use). ... Furthermore, the NAFCI initiative does not involve the general practitioner (GP) in the private sector.

  18. Risk factors for high-risk human papillomavirus infection and cofactors for high-grade cervical disease in Peru.

    Science.gov (United States)

    Almonte, Maribel; Ferreccio, Catterina; Gonzales, Miguel; Delgado, Jose Manuel; Buckley, C Hilary; Luciani, Silvana; Robles, Sylvia C; Winkler, Jennifer L; Tsu, Vivien D; Jeronimo, Jose; Cuzick, Jack; Sasieni, Peter

    2011-12-01

    To evaluate the association between potential risk factors for high-risk human papillomavirus (HR-HPV) infection and cofactors for cervical intraepithelial lesions grade 2 or worse (CIN2+) in women attending cervical screening in Amazonian Peru. Participants completed a risk factor questionnaire before screening. High-risk human papillomavirus infection was determined by Hybrid Capture II. Logistic regression was used to evaluate associations between potential risk factors for HR-HPV infection and between cofactors and risk of CIN2+ among women with HR-HPV infection. Screening and questionnaires were completed by 5435 women aged 25 to 49 years. The prevalence of HR-HPV was 12.6% (95% confidence interval [CI], 11.8%-13.6%) and decreased by age. Early age at first sexual intercourse and several lifetime sexual partners increased the risk of having HR-HPV (age-adjusted odds ratio [AOR] of age at first sexual intercourse <18 vs ≥20, 1.5; 95% CI, 1.2-2.0; AOR of ≥5 lifetime sexual partners vs 1, 2.1; 95% CI, 1.4-3.2). Among women with HR-HPV infection, those with no schooling (AOR relative to 1-5 years of schooling, 3.2; 95% CI, 1.3-8.3) and those with parity ≥3 (AOR relative to parity <3, 2.6; 95% CI, 1.4-4.9) were at increased risk of CIN2+. The effect of parity was stronger for cancer (AOR of parity ≥3 vs <3, 8.3; 95% CI, 1.0-65.6). Further analysis showed that the association between parity and CIN2+ was restricted to women younger than 40. Most women (83%) had previously been screened. Sixty-four percent of CIN2+ cases detected in this study occurred in women who reported having had a Papanicolaou test in the previous 3 years. Only 4 of 20 cancers were detected in women never screened before. Having had a previous abnormal Papanicolaou test increased the risk of CIN2+ (OR, 16.1; 95% CI, 6.2-41.9). Among women with HR-HPV, high parity (in young women), no schooling, lack of good-quality screening and of adequate follow-up care are the main risk factors for

  19. 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.

  20. Risk factors for FEV1 decline in mild COPD and high-risk populations

    Science.gov (United States)

    Chen, Shujing; Wang, Changhui; Li, Bing; Shi, Guochao; Li, Huiping; Zhang, Jing; Gu, Yutong; Zhou, Jian; Song, Yuanlin; Bai, Chunxue

    2017-01-01

    Background Early diagnosis of COPD is often not achieved due to limited recognition and limited access to the pulmonary function test. Our hypothesis was that lung function decline may be different between populations with mild COPD and those who are at high risk and do not receive treatment. Patients and methods Subjects with mild COPD and those from a high-risk COPD population were recruited from a community-based COPD epidemiological study after obtaining consent. Baseline clinical characteristics, symptom questionnaire, spirometry, low-dose computed tomography (LDCT) chest scan, and blood plasma biomarker data were collected initially and then 1 year later. Results A total of 617 participants were recruited, and 438 eventually completed the first-year follow-up visit; 72 participants (46 males) were in the mild COPD group, and 225 participants (165 males) were in the high-risk group. The mean forced expiratory volume in the first second of expiration (FEV1) decline in the mild COPD group was 129 mL, which was significantly higher than the 30 mL decline in the high-risk population group (P=0.005). Group category (odds ratio [OR] =0.230) and COPD Assessment Test (CAT) score (OR =9.912) were independent risk factors for an FEV1% predicted decline of >15% for all participants. In the mild COPD group, patients with a higher CAT (OR =5.310) and Emphysema Index (OR =5.681) were associated with a FEV1% predicted decline of >15% at the first-year follow-up. No factor showed a significantly predictive effect on FEV1 decline in the high-risk COPD group. Conclusion Group category was an independent influential factor associated with FEV1 decline. PMID:28184155

  1. Who takes risks in high-risk sport?: the role of alexithymia.

    Science.gov (United States)

    Barlow, Matthew; Woodman, Tim; Chapman, Caradog; Milton, Matthew; Stone, Daniel; Dodds, Tom; Allen, Ben

    2015-02-01

    People who have difficulty identifying and describing their emotions are more likely to seek out the experience of emotions in the high-risk domain. This is because the high-risk domain provides the experience of more easily identifiable emotions (e.g., fear). However, the continued search for intense emotion may lead such individuals to take further risks within this domain, which, in turn, would lead to a greater likelihood of experiencing accidents. Across three studies, we provide the first evidence in support of this view. In Study 1 (n = 762), alexithymia was associated with greater risk taking and a greater propensity to experience accidents and close calls. In Study 2 (n = 332) and Study 3 (n = 356), additional bootstrapped mediation models confirmed these relationships. The predictive role of alexithymia remained significant when controlling for sensation seeking (Study 1) and anhedonia (Study 2 and Study 3). We discuss the practical implications of the present model as they pertain to minimizing accidents and close calls in the high-risk domain.

  2. High wall shear stress and high-risk plaque: an emerging concept.

    Science.gov (United States)

    Eshtehardi, Parham; Brown, Adam J; Bhargava, Ankit; Costopoulos, Charis; Hung, Olivia Y; Corban, Michel T; Hosseini, Hossein; Gogas, Bill D; Giddens, Don P; Samady, Habib

    2017-01-10

    In recent years, there has been a significant effort to identify high-risk plaques in vivo prior to acute events. While number of imaging modalities have been developed to identify morphologic characteristics of high-risk plaques, prospective natural-history observational studies suggest that vulnerability is not solely dependent on plaque morphology and likely involves additional contributing mechanisms. High wall shear stress (WSS) has recently been proposed as one possible causative factor, promoting the development of high-risk plaques. High WSS has been shown to induce specific changes in endothelial cell behavior, exacerbating inflammation and stimulating progression of the atherosclerotic lipid core. In line with experimental and autopsy studies, several human studies have shown associations between high WSS and known morphological features of high-risk plaques. However, despite increasing evidence, there is still no longitudinal data linking high WSS to clinical events. As the interplay between atherosclerotic plaque, artery, and WSS is highly dynamic, large natural history studies of atherosclerosis that include WSS measurements are now warranted. This review will summarize the available clinical evidence on high WSS as a possible etiological mechanism underlying high-risk plaque development.

  3. 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

    2006-01-01

    Objective 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 and setting Patients with NSTEACS (n  =  1877) admitted to 45 randomly selected Spanish hospitals in April and May 2002 were studied. Design Patients with ST segment depression and troponin rise were considered high risk (n  =  478) and were compared with non‐high risk patients (n  =  1399). Results 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 < 0.001) were given glycoprotein IIb/IIIa inhibitor. In‐hospital and six‐month mortality were 7.5% versus 1.1% and 17% versus 4.6% (p < 0.001), respectively. A treatment score (⩾ 4, 2–3 and < 2) was defined according to the number of class I interventions recommended in clinical guidelines: aspirin, clopidogrel, β blockers, angiotensin‐converting enzyme inhibitors, statins and revascularisation. Independent predictors of six‐month mortality were age (odds ratio (OR) 1.07, 95% confidence interval (CI) 1.04 to 1.10, p < 0.001), diabetes (OR 1.92, 95% CI 1.14 to 3.22, p  =  0.014), previous cardiovascular disease (OR 4.17, 95% CI 1.63 to 10.68, p  =  0.003), high risk (OR 2.20, 95% CI 1.30 to 3.71, p  =  0.003) and treatment score < 2 versus ⩾ 4 (OR 2.87, 95% CI 1.27 to 6.52, p  =  0.012). Conclusions 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. PMID:16644860

  4. Wandering spleen: 'presentation in adolescent with high thrombotic risk'.

    Science.gov (United States)

    Tchidjou, Hyppolite K; Castelluzzo, Maria A; Messia, Virginia; Luciani, Matteo; Monti, Lidia; Grimaldi, Chiara; Bernardi, Stefania; D'Argenio, Patrizia

    2014-07-01

    The term 'wandering spleen' refers to an abnormal hypermobility of the spleen, which may be congenital or acquired. The absence or abnormal laxity of splenic ligaments combined with an abnormally long and mobile vascular pedicle predispose to complications such as torsion of the splenic pedicle, infarction and splenic vein thrombosis. The clinical presentation of such disease is highly variable. In this case, we describe an asymptomatic case of wandering spleen in high thrombotic risk patients with cavernoma of splenic vein and infarction of the spleen. Physical examination was normal except the enlarged and no tender consistency spleen palpable at left iliac fossa. Ultrasonography revealed enlarged spleniform mass below its normal position suggesting vascular impairment and subsequently has been confirmed by colour Doppler ultrasound and computed tomography. The family history was positive for ischemic thrombotic vascular diseases and the screening for thrombotic risk has revealed hyperhomocysteinemia, thrombophilic homozygous gene mutations for factor V (H1299R) and MTHFR (C677T). For high thrombotic risk, prophylaxis postsplenectomy was suggested according to the international recommendations with subcutaneous low molecular weight heparin, associated with a preventive treatment with acetyl salicylic acid and folic acid along with B-vitamin. This case report may be helpful for clinicians involved in the care of splenectomized patients, because it has shown the importance of an appropriate pre and postoperative antithrombotic management to reduce as soon as possible the risk of thrombotic events in such patients after splenectomy.

  5. ASPHYXIA AND DEVELOPMENTAL OUTCOME IN HIGH RISK INFANTS

    Directory of Open Access Journals (Sweden)

    Valentina DUKOVSKA

    2010-04-01

    Full Text Available Asphyxia is a risk factor that is very often related to neuro-developmental issues in high risk infants and equally affects preterm and term infants, however its outcome on the developed brain differs from the outcome on the preterm brain.In preterm infants, asphyxia usually exerts a hemorrhagic or ischaemic event and periventricular leukomalacia.In term infants, asphyxia leads to cerebral edema and atrophy of the brain, which may later lead to hypoxic ischaemic encephalopathy (HIE.The number of term infants with HIE who have survived is lower than those of preterm infants, while the percentage of term infants with HIE who have neuro-developmental issues is higher. Preemies face more problems in their motor development as a result of the brain damage, while term infants suffer from encephalopathy and their cognitive abilities are more affected.We have conducted a study about the effects that asphyxia has on the developmental outcomes in high risk infants. In our study, we did a longitudinal developmental follow-up of 30 high risk infants and an evaluation of their developmental outcome using the Griffiths Mental Development Scales, from the 4th month of life until the end of the 36th month. First, we found that high risk infants had a much lower developmental outcome than the control group during the trial. Finally, we found that asphyxia makes a difference in the developmental outcome of preterm infants without asphyxia who have a very low birth weight, the preterm infants with asphyxia, and the term infants with HIE-II.

  6. Validation of the High-Risk Pregnancy Stress Scale in a sample of hospitalized Greek high-risk pregnant women.

    Science.gov (United States)

    Gourounti, Kleanthi; Karpathiotaki, Natassa; Karapanou, Vassiliki; Antzaklis, Panos; Daskalakis, Georgios

    2016-01-01

    The aim of the authors in this study was to determine the psychometric properties of the Greek adaptation of the High-Risk Pregnancy Stress Scale (HRPSS) in a sample of high-risk hospitalized pregnant women. The sample consisted of 133 high-risk pregnant women with gestational age from 9 to 37 weeks. Data were collected between February and June of 2014. HRPSS was "forward-backward" translated from English to Greek. Principal axis factoring with promax rotation was used to test the factor structure of the HRPSS. Measures of state anxiety (STAI) and depressive symptoms (EPDS) were used to assess the convergent validity of the HRPSS. Exploratory factor analysis suggested three factors: concerns of pregnancy, movement restriction, and isolation and restriction of external activities. Construct validity was confirmed by computing correlations between the HRPSS and constructions of anxiety and depressive symptoms. Internal consistency reliability was satisfactory (α = 0.813). The original factor structure of the HRPSS was only partly replicated. The results of the exploratory factor analysis suggested that a three-factor solution instead of a two-factor solution would be the most adequate. The HRPSS is an appropriate measure for assessing the levels of concerns regarding pregnancy outcome, movement restriction, isolation, and external activity restrictions in Greek high-risk pregnant women.

  7. 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...... anterior cruciate ligament [ACL]-injured patients and middle-aged meniscectomized patients) and compare them to age-matched controls....

  8. 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.

  9. High-dimensional inference by unbiased risk estimation

    Science.gov (United States)

    Chetelat, Didier

    This thesis derives natural and efficient solutions of three high-dimensional statistical problems by exploiting unbiased risk estimation. They exemplify a general methodology that provides attractive estimators in situations where classical theory is unsuccessful, and that could be exploited in many other problems. First, we extend the classical James-Stein shrinkage estimator to the context where the number of covariates is larger than the sample size and the covariance matrix is unknown. The construction is obtained by manipulating an unbiased risk estimator and shown to dominate in invariant squared loss the maximum likelihood estimator. The estimator is interpreted as performing shrinkage only the random subspace spanned by the sample covariance matrix. Second, we investigate the estimation of a covariance and precision matrix, and discriminant coefficients, of linearly dependent data in a normal framework. By boundingthe difference in risk over classes of interest using unbiased risk estimation, we construct interesting estimators and show domination over naive solutions. Finally, we explore the problem of estimating the noise coefficient in the spiked covariance model. By decomposing an unbiased risk estimator and minimizing its dominant part using calculus of variations, we obtain an estimator in closed form that approximates the optimal solution. Several attractive properties are proven about the proposed construction. We conclude by showing that the associated spiked covariance estimators possess excellent behavior under the Frobenius loss.

  10. 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.

  11. Gang masculinity and high-risk sexual behaviours.

    Science.gov (United States)

    Dickson-Gomez, Julia; Quinn, Katherine; Broaddus, Michelle; Pacella, Maria

    2017-02-01

    High-risk sexual behaviours include practices such as relationship violence and substance use, which often cluster together among young people in high-risk settings. Youth gang members often show high rates of such behaviours, substance use and relationship violence. This paper draws on data from in-depth interviews with male and female gang members from six different gangs to explore the role of powerful socialising peer groups that set gender, sexual and relationship roles and expectations for their male and female members. High-risk sexual behaviours among gang members included sex with multiple partners and group sex. Gang norms included the belief that male members were sexually insatiable with multiple sexual partners and that female gang members should be sexually available to male members. Alcohol and drugs were seen to have a large influence on sexual desire and the inability to use condoms. Much sexual behaviour with gangs, such as group sex, was viewed with ambivalence and seen as somewhat coercive. Finally, gendered sexual expectations (boys as sexually insatiable and girls as sexually available) made forming long-term romantic relationships problematic for gang members. The influence of gang norms such as these must be addressed in future programmes and interventions with gang members.

  12. High risk pregnancies and factors associated with neonatal death

    Directory of Open Access Journals (Sweden)

    Marcela de Oliveira Demitto

    Full Text Available Abstract OBJECTIVE To identify the factors associated with intra-hospital neonatal mortality based on the individual characteristics of at-risk pregnant mothers, delivery and newborns. METHOD 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. RESULTS 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. CONCLUSION 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.

  13. Great expectations: different high-risk activities satisfy different motives.

    Science.gov (United States)

    Barlow, Matthew; Woodman, Tim; Hardy, Lew

    2013-09-01

    Research on people's motives for engaging in high-risk activities has typically been viewed through the single-focused lens of sensation seeking. We provide evidence that comprehensively challenges that view. First, we develop and confirm the structure of a 3-factor measure of motives: the Sensation Seeking, Emotion Regulation, and Agency Scale (SEAS; Study 1). We then use the SEAS to provide evidence of differential motives for 2 high-risk activities: skydiving and mountaineering. The motive for skydiving is strongly associated with sensation seeking; the motive for mountaineering is strongly associated with emotion regulation and agency but not with sensation seeking (Study 2). We also show that these conclusions cannot be drawn from existing measures of personality and sensation seeking (Study 3). Finally, individuals who are motivated by emotion regulation and agency needs also have greater expectations regarding their emotion regulation and agency. It is these greater expectations that most successfully discriminate mountaineers from skydivers and control participants (Study 4). It is concluded that researchers should no longer consider risk takers as a homogenous sensation-seeking group and that they should consider risk taking as a potential model of human endeavor. The SEAS can be used as a measure of motives for behavior whenever sensation seeking, agency, or emotion regulation is thought to be at the core of such motives, and the results are discussed in the context of encouraging personality researchers to consider the specific spontaneous behaviors that motivate different people.

  14. Community organizing goes to college: A practice-based model of community organizing to implement environmental strategies to reduce high-risk drinking on college campuses

    OpenAIRE

    Wagoner, Kimberly G.; Rhodes, Scott D.; Lentz, Ashley W.; Wolfson, Mark

    2010-01-01

    Community organizing is a successful method to leverage resources and build community capacity to identify and intervene upon health issues. However, published accounts documenting the systematic facilitation of the process are limited. This qualitative analysis explored community organizing using data collected as part of the Study to Prevent Alcohol Related Consequences (SPARC), a randomized community trial of 10 North Carolina colleges focused on reducing consequences of high-risk drinking...

  15. Management of High-Risk Localized Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Ariel E. Marciscano

    2012-01-01

    Full Text Available Traditionally, patients with high-risk localized prostate cancer have been an extremely challenging group to manage due to a significant likelihood of treatment failure and prostate cancer-specific mortality (PCSM. The results of multiple large, prospective, randomized trials have demonstrated that men with high-risk features who are treated in a multimodal fashion at the time of initial diagnosis have improved overall survival. Advances in local treatments such as dose-escalated radiotherapy in conjunction with androgen suppression and postprostatectomy adjuvant radiotherapy have also demonstrated benefits to this subset of patients. However, therapeutic enhancement with the addition of chemotherapy to the primary treatment regimen may help achieve optimal disease control.

  16. Dual mobility total hip replacement in a high risk population

    Science.gov (United States)

    Luthra, Jatinder Singh; Al Riyami, Amur; Allami, Mohamad Kasim

    2016-01-01

    Objective: The purpose of the study was to evaluate results of dual mobility total replacement in a high risk population who take hip into hyperflexed position while sitting and praying on the floor. Method: The study included 65 (35 primary total replacement and 30 complex total hip replacement) cases of total hip replacement using avantage privilege dual mobility cup system from biomet. A cemented acetabular component and on femoral side a bimetric stem, either cemented or uncemented used depending on the canal type. Ten cases were examined fluoroscopically in follow up. Result: There was dislocation in one patient undergoing complex hip replacement. Fluoroscopy study showed no impingement between the neck of prosthesis and acetabular shell at extremes of all movements. Conclusion: The prevalence of dislocation is low in our high risk population and we consider it preferred concept for patients undergoing complex total hip replacement. PMID:27924742

  17. Dual mobility total hip replacement in a high risk population

    Directory of Open Access Journals (Sweden)

    Luthra Jatinder Singh

    2016-01-01

    Full Text Available Objective: The purpose of the study was to evaluate results of dual mobility total replacement in a high risk population who take hip into hyperflexed position while sitting and praying on the floor. Method: The study included 65 (35 primary total replacement and 30 complex total hip replacement cases of total hip replacement using avantage privilege dual mobility cup system from biomet. A cemented acetabular component and on femoral side a bimetric stem, either cemented or uncemented used depending on the canal type. Ten cases were examined fluoroscopically in follow up. Result: There was dislocation in one patient undergoing complex hip replacement. Fluoroscopy study showed no impingement between the neck of prosthesis and acetabular shell at extremes of all movements. Conclusion: The prevalence of dislocation is low in our high risk population and we consider it preferred concept for patients undergoing complex total hip replacement.

  18. 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.

  19. 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...

  20. Rosuvastatin: Role in Cardiovascular High-risk Patient

    Directory of Open Access Journals (Sweden)

    John E Feliciano-Alfonso

    2013-01-01

    Full Text Available Statins are the lipid-lowering drug family of first choice in situations of hypercholesterolemia or mixed dyslipidemia with predominant increase in cholesterol. The evidence shows conclusively that each one of the commercially available statins have proven benefits on outcomes of cardiovascular morbidity and mortality. However, rosuvastatin has certain pharmacokinetic efficacy and cost-effectiveness characteristics that make it an attractive molecule to be the statin of choice in patients at high cardiovascular risk.

  1. 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

  2. Practical Techniques to Minimize the Risk of CIN in the High-risk Patient

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    Mark Downes

    2008-01-01

    Full Text Available The use of iodinated contrast media (CM is integral to the practice of interventional radiology, facilitating visualization of anatomic structures during MDCT guided diagnostic and therapeutic procedures and leading to advances in patient care.The benefits of contrast-enhanced MDCT imaging,"nhowever, must be viewed in the context of the potential risks of CM use, of which contrast-induced nephropathy (CIN may be the most serious. CIN is the third commonest cause of hospital-acquired renal insufficiency, with approximately 33% of these cases attributed to CM use in CT procedures in patients who are at risk of CIN due to the presence of established risk factors. Reported patient risk factors for CIN include age, congestive heart failure, and dehydration but pre-existing renal impairment, particularly in association with diabetes, is generally recognized as the most important variable. Based on this, it is recommended that patients who are to undergo intravenous administration of an iodinated contrast agent be questioned about potential renal dysfunction at the time of referral and those who answer positively to at least 1 question should be screened for elevated serum Cr. When a high-risk patient is identified, several strategies can be implemented to minimize the occurrence of CIN. Cessation of all nephrotoxic medications should be implemented if possible ≥24 hours before the contrast-enhanced CT procedure. Adequate pre-and post-procedural hydration is considered one of the most effective CIN prevention measures. Studies of pharmacological prophylaxis are less encouraging and the role of N-acetylcysteine for CIN prevention, for example, remains unclear to date. Finally, volume and type of CM used during the CT procedure may influence the development of CIN. Findings from randomized controlled trials that have considered the role of CM osmolality on nephrotoxicity in at-risk populations suggest that the iso-osmolar CM iodixanol is reno

  3. Failure to acknowledge high suicide risk among veterinarians.

    Science.gov (United States)

    Skipper, Gregory E; Williams, Jerome B

    2012-01-01

    A high suicide risk has been reported among veterinarians in comparison to the general population. Postulated causes have included depression, substance abuse, work-related stress, reluctance to admit psychiatric problems, and access to lethal drugs and/or familiarity with euthanasia. Members of the Student Chapter of the American Veterinary Medical Association (AVMA), all veterinarians licensed in Alabama, and all US veterinary-association executive directors were surveyed regarding their attitudes concerning mental health issues, including veterinarian suicide. Only 10% of veterinary student respondents (N=58) believed that suicide risk is higher among veterinarians than in the general population. Of the 22 state associations' executive directors who participated in the survey, 37% believed that suicide is a significant concern for veterinarians and only 44% indicated that a veterinary wellness program was available in their respective states. Of the 1,455 licensed veterinarians in Alabama, 701 responded to the survey; 11% of respondents believed that suicide among veterinarians was a problem. In addition, 66% of respondents indicated that they had been "clinically depressed," but 32% of those with depression had not sought treatment. More females (27%) than males (20%) admitted that they had "seriously considered suicide" (pveterinarians were more likely than male veterinarians (15% versus 7%) to indicate that they were "not sure they'd made the right career choice" (pveterinarians not only have a higher risk of suicide but that they also have fewer support structures. The wide discrepancies between the published risk of suicide for veterinarians and their own views of their risk suggests an inadequate awareness of their own mental health vulnerability which could put them at higher risk.

  4. TOB-G: Tobacco Cessation Guidelines for High risk Populations

    Directory of Open Access Journals (Sweden)

    Panagiotis Behrakis

    2016-03-01

    Full Text Available The TOB-G project is funded under the EU 3rd Health Programme which is the main instrument that the Commission uses to implement the EU Health Strategy. The project started in June 2014 and will be completed in September 2017. The project consortium consists of 5 partners from 4 European countries (Belgium, Greece, Ireland and Romania. The TOB-G project aims to develop and implement an innovative and cost effective approach to prevent chronic diseases related to tobacco dependence by focusing on creating specialized tobacco cessation guidelines for populations of high risk including adolescents, pregnant women, adults with COPD, Cardiovascular disease and diabetes. The specialized guidelines for high risks groups will be developed according to ENSP’s evidence based and good practices in tobacco cessation. The smoking cessation guidelines contain strategies and recommendations designed to assist clinicians/ doctors in delivering and supporting effective treatments for tobacco use and dependence and will also be available within the context of an e-learning platform for European clinicians. Overall, the TOB-G project will enhance the overall European capacity in the treatment of tobacco dependence, through offering smoking cessation tools, appropriately assessed and fitted to the specific needs of high risk groups.

  5. 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.

  6. [HTLV-I infection in a high-risk group].

    Science.gov (United States)

    Pujol, E; Ollero, M; Gimeno, A; Colchero, J; Alcoucer, R; Márquez, P

    1990-07-01

    The aim of this study is to detect the presence of HTLV-1 in a high-risk population in west Andalusia. We studied 267 samples of serum from 255 patients: 179 of these patients being intravenous drug-users, 14 had ADVP sexual partners, 16 were inhalation drug-users, 4 were hemophiliacs, 9 had other high-risk habits and 25 hematological patients afflicted with leukemia or lymphoma. All of them were tested for antibodies against HTLV-1 by means of an in vitro qualitative ELISA technique (ELISA Du Pont HTLV-1). The positive results were confirmed by the Western blot technique. Additionally, the p24 antigen and the antibodies against VIH-1 and VIH-2 (ENV/CORE) were analysed, except in the 25 hematological patients. We found 20 serum samples positive to HTLV-1 by ELISA (7.4%), but only 1 (0.3%) was confirmed by the Western blot technique. The prevalence of VIH-1 was 46%; 9% had p24 VIH antigen and 26% had false positive ELISA to VIH-2. We found a statistically significant relationship (p = 0.0005) between positive ELISA to HTLV-1 and antibodies against VIH. We conclude that HTLV-1 has penetrated into the high-risk population of west Andalusia , although not yet to a great degree, and point out the need for seric epidemiological surveillance to prevent the spread of the retrovirus in these groups.

  7. Learning rate and temperament in a high predation risk environment

    Science.gov (United States)

    DePasquale, C.; Wagner, Tyler; Archard, G.A.; Ferguson, B.; Braithwaite, V.A.

    2014-01-01

    Living in challenging environments can influence the behavior of animals in a number of ways. For instance, populations of prey fish that experience frequent, nonlethal interactions with predators have a high proportion of individuals that express greater reaction to risk and increased activity and exploration—collectively known as temperament traits. Temperament traits are often correlated, such that individuals that are risk-prone also tend to be active and explore more. Spatial learning, which requires the integration of many sensory cues, has also been shown to vary in fish exposed to different levels of predation threat. Fish from areas of low predation risk learn to solve spatial tasks faster than fish from high predation areas. However, it is not yet known whether simpler forms of learning, such as learning associations between two events, are similarly influenced. Simple forms of associative learning are likely to be affected by temperament because a willingness to approach and explore novel situations could provide animals with a learning advantage. However, it is possible that routine-forming and inflexible traits associated with risk-prone and increased exploratory behavior may act in the opposite way and make risk-prone individuals poorer at learning associations. To investigate this, we measured temperament in Panamanian bishop fish (Brachyrhaphis episcopi) sampled from a site known to contain many predators. The B. episcopi were then tested with an associative learning task. Within this population, fish that explored more were faster at learning a cue that predicted access to food, indicating a link between temperament and basic learning abilities.

  8. Learning rate and temperament in a high predation risk environment.

    Science.gov (United States)

    DePasquale, C; Wagner, T; Archard, G A; Ferguson, B; Braithwaite, V A

    2014-11-01

    Living in challenging environments can influence the behavior of animals in a number of ways. For instance, populations of prey fish that experience frequent, nonlethal interactions with predators have a high proportion of individuals that express greater reaction to risk and increased activity and exploration-collectively known as temperament traits. Temperament traits are often correlated, such that individuals that are risk-prone also tend to be active and explore more. Spatial learning, which requires the integration of many sensory cues, has also been shown to vary in fish exposed to different levels of predation threat. Fish from areas of low predation risk learn to solve spatial tasks faster than fish from high predation areas. However, it is not yet known whether simpler forms of learning, such as learning associations between two events, are similarly influenced. Simple forms of associative learning are likely to be affected by temperament because a willingness to approach and explore novel situations could provide animals with a learning advantage. However, it is possible that routine-forming and inflexible traits associated with risk-prone and increased exploratory behavior may act in the opposite way and make risk-prone individuals poorer at learning associations. To investigate this, we measured temperament in Panamanian bishop fish (Brachyrhaphis episcopi) sampled from a site known to contain many predators. The B. episcopi were then tested with an associative learning task. Within this population, fish that explored more were faster at learning a cue that predicted access to food, indicating a link between temperament and basic learning abilities.

  9. Cardiovascular risk factor treatment targets and renal complications in high risk vascular patients: a cohort study

    Directory of Open Access Journals (Sweden)

    Visseren Frank LJ

    2011-07-01

    Full Text Available Abstract Background To determine if recommended treatment targets, as specified in clinical practice guidelines for the management of cardiovascular disease, reduces the risk of renal complications in high risk patient populations. Methods This was a cohort study. Participants in Utrecht, The Netherlands either at risk of, or had cardiovascular disease were recruited. Cardiovascular treatment targets were achievement of control in systolic and diastolic blood pressure, total and low-density cholesterol, and treatment of albuminuria. Outcome measures were time to development of end stage renal failure or symptomatic renal atherosclerotic disease requiring intervention. Results The cohort consisted of 7,208 participants; 1,759 diabetics and 4,859 with clinically manifest vascular disease. The median age was 57 years and 67% were male. Overall, 29% of the cohort achieved the treatment target for systolic blood pressure, 39% for diastolic blood pressure, 28% for total cholesterol, 31% for LDL cholesterol and 78% for albuminuria. The incidence rate for end stage renal failure and renal atherosclerotic disease reduced linearly with each additional treatment target achieved (p value less than 0.001. Achievement of any two treatment targets reduced the risk of renal complications, hazard ratio 0.46 (95% CI 0.26-0.82. For patients with clinically manifest vascular disease and diabetes, the hazard ratios were 0.56 (95% CI 0.28 - 1.12 and 0.28 (95%CI 0.10 - 0.79 respectively. Conclusion Clinical guidelines for cardiovascular disease management do reduce risk of renal complications in high risk patients. Benefits are seen with attainment of any two treatment targets.

  10. 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.

  11. Risk based culling for highly infectious diseases of livestock

    Directory of Open Access Journals (Sweden)

    te Beest Dennis E

    2011-06-01

    Full Text Available Abstract The control of highly infectious diseases of livestock such as classical swine fever, foot-and-mouth disease, and avian influenza is fraught with ethical, economic, and public health dilemmas. Attempts to control outbreaks of these pathogens rely on massive culling of infected farms, and farms deemed to be at risk of infection. Conventional approaches usually involve the preventive culling of all farms within a certain radius of an infected farm. Here we propose a novel culling strategy that is based on the idea that farms that have the highest expected number of secondary infections should be culled first. We show that, in comparison with conventional approaches (ring culling, our new method of risk based culling can reduce the total number of farms that need to be culled, the number of culled infected farms (and thus the expected number of human infections in case of a zoonosis, and the duration of the epidemic. Our novel risk based culling strategy requires three pieces of information, viz. the location of all farms in the area at risk, the moments when infected farms are detected, and an estimate of the distance-dependent probability of transmission.

  12. INSTRUMENTS OF HIGH RISK SEXUAL BEHAVIOR ASSESSMENT: A SYSTEMATIC REVIEW

    Science.gov (United States)

    Mirzaei, Mojtaba; Ahmadi, Khodabakhsh; Saadat, Seyed-Hassan; Ramezani, Mohammad Arash

    2016-01-01

    Background: 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. Methods: 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. Results: 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. Conclusion: 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. PMID:27047267

  13. 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.

  14. Risk perception and choice of place of birth in women with high risk pregnancies: A qualitative study.

    Science.gov (United States)

    Lee, Suzanne; Ayers, Susan; Holden, Des

    2016-07-01

    Objective To examine the perception of risk among a group of women with high risk pregnancies who were either planning to give birth in hospital, or at home despite medical advice to the contrary. The intention was to consider differences and similarities between the groups to examine how perception of risk relates to choice of place of birth. Design Qualitative study using semi-structured interviews. Setting Maternity department in a hospital in South East England. Participants Twenty-six women with high risk pregnancies, at least 32 weeks pregnant. Half were planning hospital births and half homebirths. Measurements and findings Semi-structured interviews to investigate women's understanding and assessment of risk. Results were analysed using thematic analysis. Five themes emerged: understanding of situation; judgement of risk; reassuring factors; impact of risk; and coping with risk. Women from both groups had some understanding of the implications of their medical/obstetric conditions. They displayed concerns about their babies' wellbeing. Women planning homebirths assessed their risks as lower and expressed less concerns than women planning hospital births. Women planning hospital births more frequently described following professional advice. Key conclusions Risk perception is individual and subjective. Women with high risk pregnancies who plan to give birth at home perceive risk differently to women who plan hospital births. Implications for practice Healthcare professionals working with women with high risk pregnancies should be aware of the potential for differences in definitions and perceptions of risk within this group.

  15. 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 (SO2, HNO3, O3, PM10) 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, PM10 and HNO3 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.

  16. 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 (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.

  17. Quantitative breast MRI radiomics for cancer risk assessment and the monitoring of high-risk populations

    Science.gov (United States)

    Mendel, Kayla R.; Li, Hui; Giger, Maryellen L.

    2016-03-01

    Breast density is routinely assessed qualitatively in screening mammography. However, it is challenging to quantitatively determine a 3D density from a 2D image such as a mammogram. Furthermore, dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) is used more frequently in the screening of high-risk populations. The purpose of our study is to segment parenchyma and to quantitatively determine volumetric breast density on pre-contrast axial DCE-MRI images (i.e., non-contrast) using a semi-automated quantitative approach. In this study, we retroactively examined 3D DCE-MRI images taken for breast cancer screening of a high-risk population. We analyzed 66 cases with ages between 28 and 76 (mean 48.8, standard deviation 10.8). DCE-MRIs were obtained on a Philips 3.0 T scanner. Our semi-automated DCE-MRI algorithm includes: (a) segmentation of breast tissue from non-breast tissue using fuzzy cmeans clustering (b) separation of dense and fatty tissues using Otsu's method, and (c) calculation of volumetric density as the ratio of dense voxels to total breast voxels. We examined the relationship between pre-contrast DCE-MRI density and clinical BI-RADS density obtained from radiology reports, and obtained a statistically significant correlation [Spearman ρ-value of 0.66 (p < 0.0001)]. Our method within precision medicine may be useful for monitoring high-risk populations.

  18. Evaluation of high-risk living kidney donors.

    Science.gov (United States)

    Tangdhanakanond, Kawin; Mandelbrot, Didier

    2015-01-01

    Careful evaluation of potential living kidney donors is crucial to assure the well being of the donors, especially because they do not gain any direct medical benefit from donation. This process also helps assess the quality and safety of the organs donated to the recipients. While all programs share these goals, donor selection criteria vary significantly among U.S. transplant centers. In part, this is due to the limited data that exists as to long-term outcomes among donors who are medically complex, or at higher risk for complications, such as those with hypertension, obesity, or lower kidney function. This article reviews available evidence regarding outcomes after living donation and current trends in U.S. practices, and seeks to provide practical guidance in evaluating high-risk potential living kidney donors.

  19. Influenza vaccination in children at high risk of respiratory disease.

    Science.gov (United States)

    Patria, Maria Francesca; Tagliabue, Claudia; Longhi, Benedetta; Esposito, Susanna

    2013-05-01

    Chronic respiratory diseases (CRDs) are a heterogeneous group of diseases that can affect the pediatric population and health authorities throughout the world recommend influenza vaccination because of the significant risk of influenza-related complications. However, despite this recommendation, vaccine coverage is generally unsatisfactory. The aim of this review is to analyze the impact of influenza on children at high risk of respiratory disease, and the immunogenicity, safety and efficacy of influenza vaccination in such children. The results show that there is a significant risk of influenza-related complications in preterm neonates and infants, in whom influenza vaccines are immunogenic and safe (although their efficacy has not been specifically studied). There are conflicting data concerning the effect of influenza infection on asthma morbidity in children, and whether or not influenza vaccination helps to prevent asthma exacerbations. Recent data provide no evidence that influenza is more frequent in patients with cystic fibrosis than in healthy subjects, or that it is responsible for increased lower respiratory tract morbidity. The lack of any clear correlate of protection suggests that future studies should also consider the efficacy of the different influenza vaccines and not only evaluate them in terms of immunogenicity. Furthermore, there is a need for clinical studies to assess the effectiveness of the available vaccines in patients with other rare CRDs and other chronic underlying diseases with possibly severe respiratory involvement. It is also important to determine whether children with recurrent respiratory tract infections should be included in the list of those for whom influenza vaccination is recommended. In the meantime, given the increasing evidence of the burden of influenza on the population as a whole and the benefits associated with vaccination, annual influenza vaccinations should be recommended for all children at high risk of

  20. 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.)

  1. Risk Estimation with Epidemiologic Data When Response Attenuates at High-Exposure Levels

    National Research Council Canada - National Science Library

    Kyle Steenland; Ryan Seals; Mitch Klein; Jennifer Jinot; Henry D. Kahn

    2011-01-01

    Background: In occupational studies, which are commonly used for risk assessment for environmental settings, estimated exposure-response relationships often attenuate at high exposures. Relative risk (RR...

  2. 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

  3. Using risk to target HPV vaccines in high-risk, low-resource organizations.

    Science.gov (United States)

    Small, Stephanie L; Sampselle, Carolyn M; Martyn, Kristy K; Dempsey, Amanda F

    2013-05-01

    Organizations in developed countries with limited financial resources may find it difficult to determine whether it is preferable to use these resources for HPV vaccination, management of HPV-related diseases, or a "hybrid" strategy, such as vaccinating only the highest risk individuals. We determined the organizational costs and clinical impacts of three different organizational approaches to female HPV vaccination in a low-resource setting, including vaccinating everyone, vaccinating no one, or vaccinating only those considered high-risk. To determine patients at highest risk, HPV risk factors were identified using information routinely gathered at the annual preventive maintenance visit. The three vaccination strategies were then compared using a decision tree analysis. The three strategies demonstrated very little difference in cost. However, the least expensive strategy was to vaccinate no one. In contrast, the strategy with the best clinical outcomes was for the organization to vaccinate everyone. Organizations with limited resources must decide how to best allocate these funds to provide the greatest clinical benefits. This study showed little difference in costs but improved clinical outcomes when using the universal HPV vaccination strategy. Thus, the improvement in clinical outcomes when vaccinating everyone may be worth the relatively small increase in cost of vaccinating everyone.

  4. Non-traditional risk factors for atherosclerosis in high risk children.

    Science.gov (United States)

    Blieden, L C; Kuberger, N; Goez, R; Abramov, N; Laron, Z; Weizman, A; Gil-Ad, I

    1996-12-01

    Non-traditional risk factors for atherosclerosis were examined in children whose fathers suffered from myocardial infarction up to age 48. Factors examined were hyperinsulinemia, insulin resistance, lipoprotein(a) [Lp(a)], fibrinogen, cardiovascular hyperreactivity, and autonomic nervous system dysfunction. Hyperinsulinemia was present in five cases (9%) and hypoinsulinemia in two. Insulin output following glucose load was significantly higher in obese children compared with controls. There was an increase in Lp(a) alone in 14 cases (24%) and with low density lipoprotein in 6 cases. Increased fibrinogen and positive correlation with insulin abnormality was present in 29% (76% females) (P >0.02). Cardiac hyperreactivity (increased systolic blood pressure) was present in 9% and increased blood pressure and pulse rate in 17%. Holter monitoring pattern was sympathetic in 39% and parasympathetic in 47% of cases. Thus a number of non-traditional risk factors were found to be higher than normal in a relatively large number of children at high risk for atherosclerosis, with 25 children having more than three risk factors.

  5. 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.

  6. Parental Support, Mental Health, and Alcohol and Marijuana Use in National and High-Risk African-American Adolescent Samples

    Science.gov (United States)

    Maslowsky, Julie; Schulenberg, John; Chiodo, Lisa M.; Hannigan, John H.; Greenwald, Mark K.; Janisse, James; Sokol, Robert J.; Delaney-Black, Virginia

    2015-01-01

    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. PMID:26843811

  7. [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.

  8. Proteomic profiling of high risk medulloblastoma reveals functional biology.

    Science.gov (United States)

    Staal, Jerome A; Lau, Ling San; Zhang, Huizhen; Ingram, Wendy J; Hallahan, Andrew R; Northcott, Paul A; Pfister, Stefan M; Wechsler-Reya, Robert J; Rusert, Jessica M; Taylor, Michael D; Cho, Yoon-Jae; Packer, Roger J; Brown, Kristy J; Rood, Brian R

    2015-06-10

    Genomic characterization of medulloblastoma has improved molecular risk classification but struggles to define functional biological processes, particularly for the most aggressive subgroups. We present here a novel proteomic approach to this problem using a reference library of stable isotope labeled medulloblastoma-specific proteins as a spike-in standard for accurate quantification of the tumor proteome. Utilizing high-resolution mass spectrometry, we quantified the tumor proteome of group 3 medulloblastoma cells and demonstrate that high-risk MYC amplified tumors can be segregated based on protein expression patterns. We cross-validated the differentially expressed protein candidates using an independent transcriptomic data set and further confirmed them in a separate cohort of medulloblastoma tissue samples to identify the most robust proteogenomic differences. Interestingly, highly expressed proteins associated with MYC-amplified tumors were significantly related to glycolytic metabolic pathways via alternative splicing of pyruvate kinase (PKM) by heterogeneous ribonucleoproteins (HNRNPs). Furthermore, when maintained under hypoxic conditions, these MYC-amplified tumors demonstrated increased viability compared to non-amplified tumors within the same subgroup. Taken together, these findings highlight the power of proteomics as an integrative platform to help prioritize genetic and molecular drivers of cancer biology and behavior.

  9. 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

  10. Lifecycle Problems in Consequence Estimation

    Directory of Open Access Journals (Sweden)

    Lehman William

    2016-01-01

    Full Text Available The United States Army Corps of Engineers (USACE guidance documents require economists and planners to meet a very high standard when evaluating consequences resulting from flood events. The guidance documents require analysts to evaluate how government action changes the consequences over time, in addition to evaluating how government inaction changes consequences over time as well. Corps guidance (Engineering Regulation 1105-2-100, Section 2-3.c.4 and Engineering Regulation 1105-2-100, Section 2-3.b respectively require the evaluation of direct and indirect economic impacts, life risk impacts, and agricultural impacts for both current conditions and future most likely conditions across a range of alternatives. Evaluating the potential for impacts from flooding across time, and how time impacts their existence or vulnerability, is considered a “lifecycle approach”. Little to no guidance is available on the process of calculating this “lifecycle approach” regarding changes in the value and number of assets within the floodplain over time. Performing a lifecycle analysis of a project over durations from 30 to 100 years, depending on the project purpose, requires evaluation of the changes in human behavior caused by changes in the floodplain such as reconstruction of structures, maintenance of structures, construction of new structures, population growth, and what type of structures are being built within the study area. This type of evaluation is not fully supported by most of the software programs utilized for flood risk management in the planning context. This paper is intended to describe pros and cons of economic lifecycle evaluation techniques to address the needs stated by policy, and tools that are being developed to support this analysis.

  11. 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.

  12. 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.

  13. 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.

  14. Extreme risk taker who wants to continue taking part in high risk sports after serious injury.

    Science.gov (United States)

    Pain, M; Kerr, J H

    2004-06-01

    The case is reported of a 40 year old male high risk sport athlete who had seriously injured himself several times and as a result was partially physically disabled and had trouble with mental tasks requiring concentration such as spelling, reading numbers, and writing. The athlete was referred to a sports psychologist. In consultations, it became clear that he was having difficulty reconciling the difference between his life as it used to be and as it would be in the future. Part of his difficulty was dealing with the frustration and anger "outbursts" which resulted from not being able to perform straightforward everyday motor skills. In spite of his injuries and disability, the patient badly wanted to continue participating in extreme sports. Reversal theory is used in the discussion to provide theoretical explanations of the motivation for his extreme risk taking behaviour.

  15. Understanding high magnitude flood risk: evidence from the past

    Science.gov (United States)

    MacDonald, N.

    2009-04-01

    The average length of gauged river flow records in the UK is ~25 years, which presents a problem in determining flood risk for high-magnitude flood events. Severe floods have been recorded in many UK catchments during the past 10 years, increasing the uncertainty in conventional flood risk estimates based on river flow records. Current uncertainty in flood risk has implications for society (insurance costs), individuals (personal vulnerability) and water resource managers (flood/drought risk). An alternative approach is required which can improve current understanding of the flood frequency/magnitude relationship. Historical documentary accounts are now recognised as a valuable resource when considering the flood frequency/magnitude relationship, but little consideration has been given to the temporal and spatial distribution of these records. Building on previous research based on British rivers (urban centre): Ouse (York), Trent (Nottingham), Tay (Perth), Severn (Shrewsbury), Dee (Chester), Great Ouse (Cambridge), Sussex Ouse (Lewes), Thames (Oxford), Tweed (Kelso) and Tyne (Hexham), this work considers the spatial and temporal distribution of historical flooding. The selected sites provide a network covering many of the largest river catchments in Britain, based on urban centres with long detailed documentary flood histories. The chronologies offer an opportunity to assess long-term patterns of flooding, indirectly determining periods of climatic variability and potentially increased geomorphic activity. This research represents the first coherent large scale analysis undertaken of historical multi-catchment flood chronologies, providing an unparalleled network of sites, permitting analysis of the spatial and temporal distribution of historical flood patterns on a national scale.

  16. High-sensitivity C-reactive protein is only weakly related to cardiovascular damage after adjustment for traditional cardiovascular risk factors

    DEFF Research Database (Denmark)

    Olsen, Michael H; Christensen, Marina K; Hansen, Tine W;

    2006-01-01

    The independent prognostic value of high-sensitivity C-reactive protein (hsCRP) has been questioned, and consequently we decided to investigate whether hsCRP was associated with subclinical cardiovascular (CV) damage independently of traditional CV risk factors....

  17. 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

  18. Social Cognition in Children at Familial High Risk of Developing an Eating Disorder

    Directory of Open Access Journals (Sweden)

    Radha eKothari

    2015-08-01

    Full Text Available Diagnosis of an eating disorder (ED has been associated with differences in social cognition. To date research investigating social cognition and ED has mainly employed patient and recovered samples. It is therefore unclear whether differences in social cognition are present prior to onset of ED, potentially contributing to development, or whether differences observed are a consequence of the disorder. We aimed to further explore whether individuals at high-risk for ED present social cognition characteristics previously found in ED groups. MethodsOur sample was drawn from a population-based cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC. Data on maternal ED behaviors over the lifetime were collected through in-depth clinical interviews (n = 1,128 conducted using the Structured Clinical Interview for DSM disorders (SCID, and were used to categorize mothers according to ED behaviors over the lifetime: Restricting & Excessive Exercising (n = 58, Purging (n = 70, Binge-eating (n = 72, Bingeing and Purging (n = 66, no ED (n = 862. High-risk status of children was determined using these maternal lifetime behavioral phenotypes. Children at high-risk (maternal ED exposure were compared to children at low-risk (born to mothers with no ED on three measures of social cognition: the Social Communication Disorders Checklist (n = 922, the faces subtest of the Diagnostic Analysis of Non-Verbal Accuracy (n = 722, and the Emotional Triangles Task (n = 750.ResultsChildren at high-risk for ED showed poorer performance on measures of social cognition compared to children at low-risk. Maternal lifetime binge-eating, and maternal lifetime bingeing and purging were associated with poorer social communication in children (OR: 2.4, 95% CI: 1.0, 5.7, p = 0.05; and OR: 2.7, 95% CI: 1.1, 6.5, p = 0.03 respectively. Maternal bingeing and purging was also found to be associated with differential facial emotion processing and poorer recognition of fear fr

  19. 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

  20. 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

  1. Pharmacological management of dyslipidemia in high and very high cardiovascular risk patients

    Directory of Open Access Journals (Sweden)

    V. Pascual Fuster

    Full Text Available Dyslipaemia is one of the main risk factors in the development of cardiovascular diseases. Currently, there are different alternatives available (amongst which statins occupy a pre-eminent place, to optimise the treatment of patients at high or very high cardiovascular risk. Despite this, the percentage of patients that achieve good lipid control is low. The causes of the mismatch with proposed objectives include lack of patient adherence and therapeutic inertia. This review uses available evidence and the latest clinical guides as a basis to assess the pharmacological treatment of dyslipaemia in patients with a background of arteriosclerotic vascular disease, diabetes, chronic kidney disease, cardiovascular risk at ≥5% calculated by SCORE and familial hypercholesterolaemia. The treatment of hypertriglyceridemia is also reviewed along with the special consideration that poly-pharmacy deserves in patients treated with statins, making mention of the treatment of dyslipaemia with HIV infection. The global assessment of cardiovascular risk is of high priority to adapt treatment to the specific objectives of the c-LDL for each risk category.

  2. Minimax risks for sparse regressions: Ultra-high-dimensional phenomenons

    CERN Document Server

    Verzelen, Nicolas

    2010-01-01

    Consider the standard linear regression model $Y=X\\theta+\\epsilon$, where $Y\\in R^n$ is a response vector, $X\\in R^{n\\times p}$ is a design matrix, $\\theta\\in R^p$ is the unknown regression vector, and $\\epsilon\\sim N(0_p,\\sigma^2I_p)$ is a Gaussian noise. Numerous work have been devoted to building efficient estimators of $\\theta$ when $p$ is much larger than $n$. In such a situation, a classical approach amounts to assume that $\\theta$ is approximately sparse. This paper studies the minimax risks of estimation and testing over $k$-sparse vectors $\\theta$. These bounds shed light on the limitations due to high-dimensionality. The results encompass the problem of prediction (estimation of $X\\theta$), the inverse problem (estimation of $\\theta$) and linear testing (test of a linear hypothesis on $\\theta$). Interestingly, an elbow effect occurs when the number of variables $p$ becomes larger than $k\\exp(n/k)$. Indeed, the minimax risks and hypothesis separation distances blow up in this ultra-high dimensional s...

  3. 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.

  4. High-Risk Human Papillomavirus Targets Crossroads in Immune Signaling

    Science.gov (United States)

    Tummers, Bart; Van Der Burg, Sjoerd H.

    2015-01-01

    Persistent infections with a high-risk type human papillomavirus (hrHPV) can progress to cancer. High-risk HPVs infect keratinocytes (KCs) and successfully suppress host immunity for up to two years despite the fact that KCs are well equipped to detect and initiate immune responses to invading pathogens. Viral persistence is achieved by active interference with KCs innate and adaptive immune mechanisms. To this end hrHPV utilizes proteins encoded by its viral genome, as well as exploits cellular proteins to interfere with signaling of innate and adaptive immune pathways. This results in impairment of interferon and pro-inflammatory cytokine production and subsequent immune cell attraction, as well as resistance to incoming signals from the immune system. Furthermore, hrHPV avoids the killing of infected cells by interfering with antigen presentation to antigen-specific cytotoxic T lymphocytes. Thus, hrHPV has evolved multiple mechanisms to avoid detection and clearance by both the innate and adaptive immune system, the molecular mechanisms of which will be dealt with in detail in this review. PMID:26008697

  5. How to evaluate the risks of work equipment and installations for health and safety? Research and activities of the German Committee for Plant Safety and consequences for regulation.

    Science.gov (United States)

    Pieper, R

    2012-01-01

    Work equipment and installations with a high risk for health and safety of employees should be paid a special attention. The German Product Safety Act, which is aimed to manufacturers or distributors in order to protect consumers, maintains a conclusive catalogue of these so-called "installations in need of monitoring" fixing the work equipment and installations for which such special inspections can be demanded. This catalogue has remained unchanged for decades and has been transformed nearly unmodified into the Plant Safety Ordinance. Currently, there is a discussion about this catalogue in Germany. A major point of concern is the definition and the significance of "especially" dangerous work equipment and installations. Two recent research projects are dealing with the problem how to define "especially".

  6. Metabolic consequences of craniopharyingioma and their management.

    Science.gov (United States)

    Lamas Oliveira, Cristina

    2013-11-01

    Most patients diagnosed with craniopharyngioma survive long-term, but suffer many consequences of the disease and its treatment. Among the metabolic consequences, there is a high prevalence of panhypopituitarism and diabetes insipidus, mainly due to the surgical treatment. Obesity is also more prevalent in these patients than in the general population, and gets worse with time. It is a consequence of a diminished basal metabolic rate and a lower physical activity compared to that of matched controls, with a similar or lower caloric intake. Many different hormonal alterations that could be responsible for those changes in the energy balance have been found. Patients whose tumor involved the hypothalamus are more prone to develop obesity and its consequences. Cardiovascular risk factors are also more prevalent in these patients, leading to a high cardiovascular morbidity and mortality. Sleep disturbances, dysfunction in thermoregulation and thirst and a lower bone mineral density can also be found. Although randomized clinical trials comparing different treatments are lacking, it looks like therapeutic strategies have a minor influence on the risk of long-term sequelae. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

  7. Evaluation of sanitary consequences of Chernobyl accident in France: epidemiological monitoring device, state of knowledge, evaluation of risks 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.; Champion, D.; Gourmelon, P.; Hubert, Ph.; Joly, J.; Renaud, Ph.; Tirmarche, M.; Vidal, M. [CEA/Fontenay-aux-Roses, Inst. de Protection et de Surete Nucleaire, IPSN, 92 (France); Cherie-Challine, L.; Boutou, O.; Isnard, H.; Jouan, M.; Pirard, Ph. [Institut National de Veille Sanitaire, 94 - Saint-Maurice (France)

    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.)

  8. Agreement between Framingham Risk Score and United Kingdom Prospective Diabetes Study Risk Engine in Identifying High Coronary Heart Disease Risk in North Indian Population.

    Science.gov (United States)

    Bansal, Dipika; Nayakallu, Ramya S R; Gudala, Kapil; Vyamasuni, Rajavikram; Bhansali, Anil

    2015-08-01

    The aim of the study is to evaluate the concurrence between Framingham Risk score (FRS) and United Kingdom Prospective Diabetes Study (UKPDS) risk engine in identifying coronary heart disease (CHD) risk in newly detected diabetes mellitus patients and to explore the characteristics associated with the discrepancy between them. A cross-sectional study involving 489 subjects newly diagnosed with type 2 diabetes mellitus was conducted. Agreement between FRS and UKPDS in classifying patients as high risk was calculated using kappa statistic. Subjects with discrepant scores between two algorithms were identified and associated variables were determined. The FRS identified 20.9% subjects (range, 17.5 to 24.7) as high-risk while UKPDS identified 21.75% (range, 18.3 to 25.5) as high-risk. Discrepancy was observed in 17.9% (range, 14.7 to 21.7) subjects. About 9.4% had high risk by UKPDS but not FRS, and 8.6% had high risk by FRS but not UKPDS. The best agreement was observed at high-risk threshold of 20% for both (κ=0.463). Analysis showed that subjects having high risk on FRS but not UKPDS were elderly females having raised systolic and diastolic blood pressure. Patients with high risk on UKPDS but not FRS were males and have high glycosylated hemoglobin. The FRS and UKPDS (threshold 20%) identified different populations as being at high risk, though the agreement between them was fairly good. The concurrence of a number of factors (e.g., male sex, low high density lipoprotein cholesterol, and smoking) in both algorithms should be regarded as increasing the CHD risk. However, longitudinal follow-up is required to form firm conclusions.

  9. 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

  10. The Allure of High-Risk Rewards in Huntington’s disease

    Science.gov (United States)

    van Wouwe, Nelleke C.; Kanoff, Kristen E.; Claassen, Daniel O.; Ridderinkhof, K. Richard; Hedera, Peter; Harrison, Madaline B.; Wylie, Scott A.

    2017-01-01

    Objectives Huntington’s disease (HD) is a neurodegenerative disorder that produces a bias toward risky, reward-driven decisions in situations where the outcomes of decisions are uncertain and must be discovered. However, it is unclear whether HD patients show similar biases in decision-making when learning demands are minimized and prospective risks and outcomes are known explicitly. We investigated how risk decision-making strategies and adjustments are altered in HD patients when reward contingencies are explicit. Methods HD (N = 18) and healthy control (HC; N = 17) participants completed a risk-taking task in which they made a series of independent choices between a low-risk/low reward and high-risk/high reward risk options. Results Computational modeling showed that compared to HC, who showed a clear preference for low-risk compared to high-risk decisions, the HD group valued high-risks more than low-risk decisions, especially when high-risks were rewarded. The strategy analysis indicated that when high-risk options were rewarded, HC adopted a conservative risk strategy on the next trial by preferring the low-risk option (i.e., they counted their blessings and then played the surer bet). In contrast, following a rewarded high-risk choice, HD patients showed a clear preference for repeating the high-risk choice. Conclusions These results indicate a pattern of high-risk/high-reward decision bias in HD that persists when outcomes and risks are certain. The allure of high-risk/high-reward decisions in situations of risk certainty and uncertainty expands our insight into the dynamic decision-making deficits that create considerable clinical burden in HD. PMID:26708084

  11. Consequences of exchanging carbohydrates for proteins in the cholesterol metabolism of mice fed a high-fat diet.

    Directory of Open Access Journals (Sweden)

    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.

  12. Seroprevalence and risk factors for brucellosis in a high-risk group of individuals in Bangladesh.

    Science.gov (United States)

    Rahman, A K M Anisur; Dirk, Berkvens; Fretin, David; Saegerman, Claude; Ahmed, Muzahed Uddin; Muhammad, Noor; Hossain, Akram; Abatih, Emmanuel

    2012-03-01

    Brucellosis is an occupational hazard of livestock farmers, dairy workers, veterinarians, slaughterhouse workers, and laboratory personnel, all of whom are considered to belong to the high-risk occupational group (HROG). A study was undertaken to determine the seroprevalence of brucellosis, identify risk factors associated with brucellosis seropositivity, and detect Brucella at genus level using real-time polymerase chain reaction (PCR) among people in the HROG in the Dhaka division of Bangladesh. A sample of 500 individuals from the HROG was collected from three districts of Dhaka division of Bangladesh. A multiple random effects logistic regression model was used to identify potential risk factors. Two types of real-time PCR methods were applied to detect Brucella genus-specific DNA using serum from seropositive patients. The prevalence of brucellosis based on the three tests was observed to be 4.4% based on a parallel interpretation. The results of the multiple random effects logistic regression analysis with random intercept for district revealed that the odds of brucellosis seropositivity among individuals who had been in contact with livestock for more than 26 years was about 14 times higher as compared to those who had less than 5 years of contact with livestock. In addition, when the contact was with goats, the odds of brucellosis seropositivity were about 60 times higher as compared to when contact was with cattle only. Noticeable variation in brucellosis seropositivity among humans within the three districts was noted. All of the 13 individuals who tested positive for the serological tests were also positive in two types of real-time PCR using the same serum samples. Livestock farmers of brucellosis positive herds had a significantly higher probability to be seropositive for brucellosis. The study emphasized that contact with livestock, especially goats, is a significant risk factor for the transmission of brucellosis among individuals in the HROG.

  13. Fragmentation of urban forms and the environmental consequences: results from a high-spatial resolution model system

    Science.gov (United States)

    Tang, U. W.; Wang, Z. S.

    2008-10-01

    Each city has its unique urban form. The importance of urban form on sustainable development has been recognized in recent years. Traditionally, air quality modelling in a city is in a mesoscale with grid resolution of kilometers, regardless of its urban form. This paper introduces a GIS-based air quality and noise model system developed to study the built environment of highly compact urban forms. Compared with traditional mesoscale air quality model system, the present model system has a higher spatial resolution down to individual buildings along both sides of the street. Applying the developed model system in the Macao Peninsula with highly compact urban forms, the average spatial resolution of input and output data is as high as 174 receptor points per km2. Based on this input/output dataset with a high spatial resolution, this study shows that even the highly compact urban forms can be fragmented into a very small geographic scale of less than 3 km2. This is due to the significant temporal variation of urban development. The variation of urban form in each fragment in turn affects air dispersion, traffic condition, and thus air quality and noise in a measurable scale.

  14. 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

    no clinical mastitis (CM) while keeping the incidence of subclinical mastitis (SCM) constant and vice versa. Six different strategies to withdraw milk with high SCC were compared. The decision to withdraw milk was based on herd-level information in three scenarios: withdrawal was initiated when the predicted......% 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...... resulted in less negative effect on net return. It was concluded that the current milk-pricing system makes it more profitable for farmers to sell a larger amount of milk with higher SCC than to withdraw milk with high SCC to obtain payment premiums, at least in herds with mastitis incidences within...

  15. Speech therapy procedures in high-risk newborns

    Directory of Open Access Journals (Sweden)

    Hipólito Virgílio Magalhães Júnior

    2010-06-01

    Full Text Available Objective: To investigate the speech therapy procedures performed in a neonatal ICU. Methods: A documental research based on registration records, comprised by a total of 34 newborns that required early stimulation by the speech therapy service in a neonatal ICU of a hospital with tertiary level of care. The study was held in the period between August, 2005 and January, 2006. From the sample, 14 children were female (41.2% and 20 were male (58.8%. The age of the newborns ranged from 3 to 57 life days. The studied variables included: risk conditions of the newborn, clinical assessment procedures, the intervention performed and the results obtained regarding weight. Results: The risk condition of preterm newborn (PTNB associated with respiratory distress syndrome (RDS was present in 25 (73.5% children. The initial weight of 15 (44.11% children ranged from 1170 to 1742 grams. The most widely discussed speech therapy procedures were the assessment of oral functions with identification of changes in sucking and swallowing in 25 (73.5% newborns and intervention by means of non-nutritive sucking in 18 (53% children. At the end of speech therapy, 19 (55.9% children weighed between 1742 to 2314 grams. Conclusions:The benefits of speech therapy performance were related to the identification of high-risk children who required intervention in oral functions and organization of the baby for feeding. It is assumed that the introduction of oral administration as quickly and safely as possible favored the improvement of the nutritional status of children and their clinical evolution

  16. Tolerance for cougars diminished by high perception of risk

    Directory of Open Access Journals (Sweden)

    Aliah Adams Knopff

    2016-12-01

    Full Text Available In North America, both human and cougar populations are expanding and increasingly sharing the same space, including modified landscapes viewed by people as their "backyard." Low tolerance for cougars in modified landscapes has been identified as a key factor that could restrict continued cougar range expansion in North America, or even reverse some of the gains made by cougar populations in recent decades. To better understand factors influencing tolerance and identify opportunities to improve conservation prospects for cougars, we implemented a questionnaire in west-central Alberta, where both human and cougar populations have increased over the past 20 years and where we had developed a resource selection function for cougars from telemetry data. Respondents overestimated risk from cougars, and more than half believed cougars posed the same or greater risk as driving a car, even though only one Albertan has been killed by a cougar in the last century and hundreds die in car accidents each year. Although respondents valued cougars highly, they indicated that cougars belonged in the wilderness and not near their homes. We predicted that tolerance for cougars would be negatively correlated with increased probability of cougar selection near the respondent's home, but our prediction was not supported. Although such correlations have been reported at broader spatial scales, we suggest they may break down at finer scales. Other factors, such as education, were important drivers of tolerance for cougars in Alberta. Our results suggest that education undertaken to improve large carnivore conservation should focus on accurately defining the risks and ecological benefits resulting from maintaining cougars on the landscape. Education may also need to focus on the importance of nonwilderness habitats (i.e., the rapidly expanding backyard as an important part of long-term conservation and continued range expansion and repatriation of adaptable large

  17. High-Achieving Black Students, Biculturalism, and Out-of-School STEM Learning Experiences: Exploring Some Unintended Consequences

    Science.gov (United States)

    McGee, Ebony O.

    2013-01-01

    In this article, the author discusses the complex challenges of high-achieving Black students who are successful in becoming immersed in predominately White STEM (science, technology, engineering, and mathematics) spaces and how such immersion can exacerbate their experiences of racial stereotyping and other forms of racial bias. The author…

  18. Increased risk of eczema but reduced risk of early wheezy disorder from exclusive breast-feeding in high-risk infants

    DEFF Research Database (Denmark)

    Giwercman, Charlotte; Halkjaer, Liselotte B; Jensen, Signe Marie

    2010-01-01

    Breast-feeding is recommended for the prevention of eczema, asthma, and allergy, particularly in high-risk families, but recent studies have raised concern that this may not protect children and may even increase the risk. However, disease risk, disease manifestation, lifestyle, and the choice...

  19. Renal outcomes in hypertensive Black patients at high cardiovascular risk.

    Science.gov (United States)

    Weir, Matthew R; Bakris, George L; Weber, Michael A; Dahlof, Bjorn; Devereux, Richard B; Kjeldsen, Sverre E; Pitt, Bertram; Wright, Jackson T; Kelly, Roxzana Y; Hua, Tsushung A; Hester, R Allen; Velazquez, Eric; Jamerson, Kenneth A

    2012-03-01

    The ACCOMPLISH trial (Avoiding Cardiovascular events through Combination therapy in Patients Living with Systolic Hypertension) was a 3-year multicenter, event-driven trial involving patients with high cardiovascular risk who were randomized in a double-blinded manner to benazepril plus either hydrochlorothiazide or amlodipine and titrated in parallel to reach recommended blood pressure goals. Of the 8125 participants in the United States, 1414 were of self-described Black ethnicity. The composite kidney disease end point, defined as a doubling in serum creatinine, end-stage renal disease, or death was not different between Black and non-Black patients, although the Blacks were significantly more likely to develop a greater than 50% increase in serum creatinine to a level above 2.6 mg/dl. We found important early differences in the estimated glomerular filtration rate (eGFR) due to acute hemodynamic effects, indicating that benazepril plus amlodipine was more effective in stabilizing eGFR compared to benazepril plus hydrochlorothiazide in non-Blacks. There was no difference in the mean eGFR loss in Blacks between therapies. Thus, benazepril coupled to amlodipine was a more effective antihypertensive treatment than when coupled to hydrochlorothiazide in non-Black patients to reduced kidney disease progression. Blacks have a modestly higher increased risk for more advanced increases in serum creatinine than non-Blacks.

  20. High-risk bladder cancer: improving outcomes with perioperative chemotherapy

    Directory of Open Access Journals (Sweden)

    Daniel Y.C. Heng

    2011-12-01

    Full Text Available Despite treatment with radical cystectomy and pelvic lymph node dissection, muscle invasive bladder cancer has a relapse rate of 50%. Patients can develop regionally advanced or metastatic disease that ultimately leads to death. The addition of neoadjuvant or adjuvant chemotherapy to reduce the risk of relapse and death has been extensively studied over the past two decades. Two contemporary trials coupled with a recent meta-analysis evaluating neoadjuvant chemotherapy demonstrated a modest but real improvement in overall survival. This has made neoadjuvant chemotherapy a standard of care. Clinical trials evaluating adjuvant chemotherapy in patients with high-risk disease have been plagued with statistical flaws and have, therefore, been unable to define the survival impact of this approach. It is hoped that ongoing adjuvant trials that are powered to detect small but meaningful clinical differences will clarify the benefit of chemotherapy after cystectomy. Since there are theoretical advantages and disadvantages to each of these approaches, both are widely used in North America. The evidence behind each approach and potential future developments in this field will be described.

  1. High-risk bladder cancer: improving outcomes with perioperative chemotherapy

    Directory of Open Access Journals (Sweden)

    Daniel Y.C. Heng

    2011-12-01

    Full Text Available Despite treatment with radical cystectomy and pelvic lymph node dissection, muscle invasive bladder cancer has a relapse rate of 50%. Patients can develop regionally advanced or metastatic disease that ultimately leads to death. The addition of neoadjuvant or adjuvant chemotherapy to reduce the risk of relapse and death has been extensively studied over the past two decades. Two contemporary trials coupled with a recent meta-analysis evaluating neoadjuvant chemotherapy demonstrated a modest but real improvement in overall survival. This has made neoadjuvant chemotherapy a standard of care. Clinical trials evaluating adjuvant chemotherapy in patients with high-risk disease have been plagued with statistical flaws and have, therefore, been unable to define the survival impact of this approach. It is hoped that ongoing adjuvant trials that are powered to detect small but meaningful clinical differences will clarify the benefit of chemotherapy after cystectomy. Since there are theoretical advantages and disadvantages to each of these approaches, both are widely used in North America. The evidence behind each approach and potential future developments in this field will be described.

  2. Academic Achievement Trajectories of Homeless and Highly Mobile Students: Resilience in the Context of Chronic and Acute Risk

    Science.gov (United States)

    Cutuli, J. J.; Desjardins, Christopher David; Herbers, Janette E.; Long, Jeffrey D.; Heistad, David; Chan, Chi-Keung; Hinz, Elizabeth; Masten, Ann S.

    2012-01-01

    Analyses examined academic achievement data across 3rd through 8th grades (N = 26,474), comparing students identified as homeless or highly mobile (HHM) to other students in the federal free meal program (FM), reduced-price meals (RM), or neither (General). Achievement was lower as a function of rising risk status (General > RM > FM > HHM). Achievement gaps appeared stable or widened between HHM students and lower-risk groups. Math and reading achievement were lower and growth in math was slower in years of HHM identification, suggesting acute consequences of residential instability. Nonetheless, 45% of HHM students scored within or above the average range, suggesting academic resilience. Results underscore the need for research on risk and resilience processes among HHM students to address achievement disparities. PMID:23110492

  3. Social Capital Role in Managing High Risk Behavior: a Narrative Review

    Science.gov (United States)

    Afzali, Mansoure; Shahhosseini, Zohreh; Hamzeghardeshi, Zeinab

    2015-01-01

    Background: Social capital as a social context based concept is a new component in addition to the previous factors including the biologic–environmental, the genetic and the individual behavior factors that influence health and society. Social capital refers to the information that makes people believe being interesting & being paid attention to, & respected, valued, and belonging to a network of bilateral relations. Health issue is greatly affected by the existence of social capital. High risk behaviors refer to the ones enhancing the probability of negative and devastating physical, psychological and social consequences for an individual. Negative & overwhelming results mean keeping one’s distance from social norms as a result rejection and labeling (social stigma) and finally, to distance oneself from the benefits of social life in the individuals with high risk behaviors. The present study reviews social capital in the groups having high risk behaviors. Methods: The present study is a narrative review in which researchers conducted their computer search in public databases like Google Scholar, and more specifically in Pubmed, Magiran, SID, Springer, Science Direct, and ProQuest using the keywords: social capital, social support, risk behaviors, addicts, HIV, AIDS, and selected the articles related to the study subject from 2004 to 2014. Overall 96 articles have been searched. Researchers reviewed the summary of all articles searched, & ultimately, they applied the data from 20 full articles to compile this review paper. Results: Article review results led to organizing the subjects into 6 general categories: Social capital and its role in health; Social capital in groups with high risk behaviors (Including: substance abusers, AIDS patients, the homeless and multi-partner women); Social capital in different social groups; measurement tools for social capital and risk behaviors; the role of health in helping people with risky behaviors with the focus on

  4. Suicide Risk Is High for Psychiatric Patients Long After Discharge from Care

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_166107.html Suicide Risk Is High for Psychiatric Patients Long After ... that psychiatric patients are at high risk for suicide immediately after being discharged from a mental health ...

  5. Risk-taking behaviour of Cape Peninsula high-school students. Part ...

    African Journals Online (AJOL)

    Risk-taking behaviour of Cape Peninsula high-school students. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... South African Medical Journal ... The prevalence of a wide range of risk-taking behaviour among high-school students in ...

  6. Risk-taking behaviour of Cape Peninsula high-school students. Part ...

    African Journals Online (AJOL)

    Risk-taking behaviour of Cape Peninsula high-school students. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... South African Medical Journal ... The prevalence of a wide range of risk-taking behaviour atnong high-school students in ...

  7. 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.

  8. Maintenance antimicrobials in high risk urologic pediatric patients.

    Science.gov (United States)

    McCann, T M; Churchill, B M; Hardy, B E; Arbus, G S

    1982-03-01

    As an alternative to the practice of obtaining repeated laboratory cultures for patients at high risk of renal impairment from recurrent UTI, a program of bone monitoring using a mail-in culture dipspoon was started. A study involving 454 children with neurogenic bladder or other urologic abnormalities showed (1) that the incidence of UTI infection in patients for whom long term antimicrobial therapy had been prescribed was not significantly lower than that in patients who were not on antimicrobials and (2) that at least 50% of dipspoons inoculated due to presentation of UTI symptoms showed no or insignificant growth. These findings suggest that need for further assessment of the efficacy of long term prophylactic antimicrobials in preventing recurrent UTI and the advisability of obtaining a urine culture result before initiating treatment when symptoms are not severe.

  9. Reentry Programming for High-Risk Offenders: Insights From Participants.

    Science.gov (United States)

    Bender, Kimberly A; Cobbina, Jennifer E; McGarrell, Edmund F

    2016-10-01

    The mass increase in imprisonment of the last two decades has led to an increasing number of adults released from prison. Scholarly accounts of prisoner reentry have demonstrated that incarcerated individuals face barriers on release from prison and that intervention programs are necessary to assist their transition to the community. Here, we build from the insights of previous research by examining how high-risk offenders perceive a reentry program. Using a qualitative approach, our findings suggest that procedural and substantive justice affect their satisfaction and involvement with the program. This study highlights the importance of providing employment opportunities, social support, and fair and respectful delivery of services to assist incarcerated individuals transitioning to the community.

  10. Cyberbullying in those at clinical high risk for psychosis.

    Science.gov (United States)

    Magaud, Emilie; Nyman, Karissa; Addington, Jean

    2013-11-01

    Several studies suggest an association between experiences of childhood trauma including bullying and the development of psychotic symptoms. The use of communications technology has created a new media for bullying called 'cyberbullying'. Research has demonstrated associations between traditional bullying and cyberbullying. Negative effects of cyberbullying appear similar in nature and severity to the reported effects of traditional bullying. Our aim was to examine the prevalence and correlates of cyberbullying in those at clinical high risk (CHR) for psychosis. Fifty young people at CHR for psychosis were administered the Childhood Trauma Questionnaire with added questions about cyberbullying. Cyberbullying was reported in 38% of the sample. Those who experienced cyberbullying also reported experiencing previous trauma. It is possible that cyberbullying may be a problem for those at CHR of psychosis, and due to the vulnerable nature of these young people may have longitudinal implications. © 2013 Wiley Publishing Asia Pty Ltd.

  11. Recommendations of activity restriction in high-risk pregnancy scenarios

    DEFF Research Database (Denmark)

    Bendix, Jane; Hegaard, Hanne Kristine; Bergholt, Thomas;

    2015-01-01

    obstetricians and midwives prescribe activity restriction in most high-risk pregnancies. The degree of activity restriction and the presumed effect vary between clinicians. This may reflect different attitudes and lack of guidelines based on clinical studies of a possible benefit of activity restriction....... to the obstetricians, the midwives also reported that they expected the recommendation to be more effective. Most midwives and obstetricians reported that they thought strict activity restriction was associated with severe or moderate adverse effect, and recommended antithrombotic prophylaxis. Conclusions: Danish......Abstract Aims: To describe specific recommendations of activity restriction, place of care, expected beneficial and adverse effects, and recommended antithrombotic prophylaxis in nine clinical scenarios. Methods: A national survey. All members of the Danish Society of Obstetrics and Gynaecology...

  12. Cyberbullying in those at Clinical High Risk for psychosis

    Science.gov (United States)

    Magaud, Emilie; Nyman, Karissa; Addington, Jean

    2012-01-01

    Aim Several studies suggest an association between experiences of childhood trauma including bullying and the development of psychotic symptoms. The use of communications technology has created a new media for bullying called ‘cyberbullying’. Research has demonstrated associations between traditional bullying and cyberbullying. Negative effects of cyberbullying appear similar in nature and severity to the reported effects of traditional bullying. Our aim was to examine the prevalence and correlates of cyberbullying in those at clinical high risk (CHR) for psychosis. Methods Fifty young people at CHR for psychosis were administered the Childhood Trauma Questionnaire with added questions about cyberbullying. Results Cyberbullying was reported in 38% of the sample. Those who experienced cyberbullying also reported experiencing previous trauma. Conclusion It is possible that cyberbullying may be a problem for those at CHR of psychosis and due to the vulnerable nature of these young people, may have longitudinal implications. PMID:23343259

  13. Water, proton, and oxygen transport in high IEC, short side chain PFSA ionomer membranes: consequences of a frustrated network.

    Science.gov (United States)

    Luo, Xiaoyan; Holdcroft, Steven; Mani, Ana; Zhang, Yongming; Shi, Zhiqing

    2011-10-28

    The effect of ion exchange capacity (IEC) on the water sorption properties of high IEC, short side chain (SSC) PFSA ionomer membranes, and the relationships between water content, proton conductivity, proton mobility, water permeation, oxygen diffusion, and oxygen permeation are investigated. SSC PFSA ionomer membranes possessing 1.3, 1.4, and 1.5 mmol g(-1) IEC are compared to a series of long side chain (LSC) PFSA ionomer membranes ranging in IEC from 0.9 to 1.13 mmol g(-1). At 25 °C, fully-hydrated SSC ionomer membranes are characterized as possessing higher water contents (56-75 vol%), moderate λ values (15-18), high analytical acid concentrations (2-2.8 M), and moderate conductivity (88-115 mS/cm); but lower than anticipated effective proton mobility. Complementary measurements of water permeability, oxygen diffusion, and oxygen permeability also yield lower than expected values given their much higher water contents. Potential benefits afforded by reducing the side chain length of PFSA ionomer membranes, such as increased crystallinity, higher IEC, and high hydrated acid concentration are offset by a less-developed, frustrated hydrophilic percolation network, which provides a motivation for future improvements of transport properties for this class of material. This journal is © the Owner Societies 2011

  14. Causes and consequences of the sinkhole at El Trébol of Quito, Ecuador - implications for economic damage and risk assessment

    Science.gov (United States)

    Toulkeridis, Theofilos; Rodríguez, Fabián; Arias Jiménez, Nelson; Simón Baile, Débora; Salazar Martínez, Rodolfo; Addison, Aaron; Carreón Freyre, Dora; Mato, Fernando; Díaz Perez, Carmen

    2016-09-01

    The so-called El Trébol is a critical road interchange in Quito connecting the north and south regions of the city. In addition, it connects Quito with the highly populated Los Chillos Valley, one of the most traveled zones in the Ecuadorian capital. El Trébol was constructed in the late 1960s in order to resolve the traffic jams of the capital city and for that purpose the Machángara River was rerouted through an underground concrete box tunnel. In March 2008, the tunnel contained a high amount of discarded furniture that had been impacting the top portion of the tunnel, compromising the structural integrity. On 31 March 2008 after a heavy rainfall a sinkhole of great proportions formed in the Trébol traffic hub. In the first few minutes, the sinkhole reached an initial diameter of 30 m. The collapse continued to grow in the following days until the final dimensions of 120 m in diameter and some 40 m of depth, revealing the Machángara River at the base of the sinkhole.A state of emergency was declared. The cause of the sinkhole was a result of the lack of monitoring of the older subterranean infrastructure where trash had accumulated and damaged the concrete tunnel that channelized the Machángara River until it was worn away for a length of some 20 m, leaving behind the sinkhole and the fear of recurrence in populated areas.With the intent to understand the causes and consequences of this sinkhole event, rainfall data are shown together with hydrogeological characteristics and a view back to the recent history of sinkhole lineation or arrangement of the city of Quito. The economic impact is also emphasized, where the direct costs of the damage and the reconstruction are presented and compared to indirect costs associated with this socio-natural disaster. These analyses suggest that the costs of indirect financial damage, like time loss or delay, and subsequent higher expenses for different types of vehicles, are equivalent to many times the costs of the

  15. A new dynamic model for highly efficient mass transfer in aerated bioreactors and consequences for kLa identification.

    Science.gov (United States)

    Müller, Stefan; Murray, Douglas B; Machne, Rainer

    2012-12-01

    Gas-liquid mass transfer is often rate-limiting in laboratory and industrial cultures of aerobic or autotrophic organisms. The volumetric mass transfer coefficient k(L) a is a crucial characteristic for comparing, optimizing, and upscaling mass transfer efficiency of bioreactors. Reliable dynamic models and resulting methods for parameter identification are needed for quantitative modeling of microbial growth dynamics. We describe a laboratory-scale stirred tank reactor (STR) with a highly efficient aeration system (k(L) a ≈ 570 h(-1)). The reactor can sustain yeast culture with high cell density and high oxygen uptake rate, leading to a significant drop in gas concentration from inflow to outflow (by 21%). Standard models fail to predict the observed mass transfer dynamics and to identify k(L) a correctly. In order to capture the concentration gradient in the gas phase, we refine a standard ordinary differential equation (ODE) model and obtain a system of partial integro-differential equations (PIDE), for which we derive an approximate analytical solution. Specific reactor configurations, in particular a relatively short bubble residence time, allow a quasi steady-state approximation of the PIDE system by a simpler ODE model which still accounts for the concentration gradient. Moreover, we perform an appropriate scaling of all variables and parameters. In particular, we introduce the dimensionless overall efficiency κ, which is more informative than k(L) a since it combines the effects of gas inflow, exchange, and solution. Current standard models of mass transfer in laboratory-scale aerated STRs neglect the gradient in the gas concentration, which arises from highly efficient bubbling systems and high cellular exchange rates. The resulting error in the identification of κ (and hence k(L) a) increases dramatically with increasing mass transfer efficiency. Notably, the error differs between cell-free and culture-based methods of parameter identification

  16. Smell identification in individuals at clinical high risk for schizophrenia.

    Science.gov (United States)

    Gill, Kelly Elizabeth; Evans, Elizabeth; Kayser, Jürgen; Ben-David, Shelly; Messinger, Julie; Bruder, Gerard; Malaspina, Dolores; Corcoran, Cheryl Mary

    2014-12-15

    Smell identification deficits exist in schizophrenia, and may be associated with its negative symptoms. Less is known about smell identification and its clinical correlates in individuals at clinical high risk (CHR) for schizophrenia and related psychotic disorders. We examined smell identification, symptoms and IQ in 71 clinical high-risk (CHR) subjects and 36 healthy controls. Smell identification was assessed using both the 40-item University of Pennsylvania Smell Identification Test (UPSIT; Doty, R.L., Shaman, P., Kimmelman, C.P., Dann, M.S., 1984. University of Pennsylvania Smell Identification Test: a rapid quantitative olfactory function test for the clinic. Laryngoscope 94, 176-178) and its extracted 12-item Brief Smell Identification Test (Goudsmit, N., Coleman, E., Seckinger, R.A., Wolitzky, R., Stanford, A.D., Corcoran, C., Goetz, R.R., Malaspina, D., 2003. A brief smell identification test discriminates between deficit and non-deficit schizophrenia. Psychiatry Research 120, 155-164). Smell identification did not significantly differ between CHR subjects and controls. Among CHR subjects, smell identification did not predict schizophrenia (N=19; 27%) within 2 years, nor was it associated with negative or positive symptoms. This is the third prospective cohort study to examine smell identification in CHR subjects, and overall, findings are inconclusive, similar to what is found for other disorders in adolescents, such as autism spectrum, attention deficit and anxiety disorders. Smell identification deficit may not have clear utility as a marker of emergent schizophrenia and related psychotic disorders. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Chagas disease, a risk factor for high blood pressure.

    Science.gov (United States)

    Vicco, Miguel Hernán; Rodeles, Luz; Yódice, Agustina; Marcipar, Iván

    2014-12-01

    Chagas disease is a parasite infection caused by the protozoan Trypanosoma cruzi. Its most common complications is chronic Chagas heart disease but impairments of the systemic vasculature also has been observed. Although the different mechanisms that regulate blood pressure are disrupted, to our knowledge data on the association of hypertension and chronic Chagas disease are scarce. In this regard we evaluate whether Chagas disease constitutes a high blood pressure risk factor. We recruited 200 individuals, half of them with positive serology for T. cruzi. They were subjected to a complete clinical examination. The mean age of sampled individuals was 46.7 ± 12.3, and the mean of systolic and diastolic blood pressure were 124 ± 12 mmHg and 82 ± 10 mmHg, respectively. There were no between-group differences regarding age, sex distribution or body mass index. Chagas disease contributed significantly to high blood pressure (OR = 4, 95% CI 1.8323-7.0864, p = 0.0002). Our results reveal an important association between Chagas disease and high blood pressure, which should be contemplated by physicians in order to promote preventive cardiovascular actions in patients with Chagas disease.

  18. Cardiovascular risk in Gullah African Americans with high familial risk of type 2 diabetes mellitus: project SuGAR.

    Science.gov (United States)

    Hunt, Kelly J; Kistner-Griffin, Emily; Spruill, Ida; Teklehaimanot, Abeba A; Garvey, W Timothy; Sale, Michèle; Fernandes, Jyotika

    2014-10-01

    To determine the prevalence of cardiovascular disease, levels of cardiovascular risk factors, and extent of preventive care in Gullah African Americans with a high familial risk of type 2 diabetes mellitus. Between 1995 and 2003, 1321 Gullah African Americans with a high prevalence of diabetes mellitus from the South Carolina Sea Islands consented to and enrolled in the Sea Islands Genetic African American Registry (Project SuGAR). A cross-sectional analysis of cardiometabolic risk, preventive care, and self-reported cardiovascular disease was conducted. Cardiometabolic risk factor levels were high and vascular disease was prevalent. Among the subjects with diabetes mellitus, the mean disease duration was 10.5 years; approximately one-third reported reduced vision or blindness; and >80% reported numbness, pain, or burning in their feet. Preventive diabetes care was limited, with level of cardiovascular risk in this population but also the pathophysiological mechanisms central to ancestral differences in cardiometabolic risk in the broader African American population.

  19. High-dose chemotherapy and autologous haematopoietic stem cell rescue for children with high-risk neuroblastoma.

    Science.gov (United States)

    Yalçin, Bilgehan; Kremer, Leontien C M; van Dalen, Elvira C

    2015-10-05

    available evidence, myeloablative therapy seems to work in terms of event-free survival. For overall survival there is currently no evidence of effect when additional follow-up data are included. No definitive conclusions can be made regarding adverse effects and quality of life, although possible higher levels of adverse effects should be kept in mind. A definitive conclusion regarding the effect of myeloablative therapy in different subgroups is not possible. This systematic review only allows a conclusion on the concept of myeloablative therapy; no conclusions can be made regarding the best treatment strategy. Future trials on the use of myeloablative therapy for high-risk neuroblastoma should focus on identifying the most optimal induction and/or myeloablative regimen. The best study design to answer these questions is a RCT. These RCTs should be performed in homogeneous study populations (e.g. stage of disease and patient age) and have a long-term follow-up. Different risk groups, using the most recent definitions, should be taken into account.It should be kept in mind that recently the age cut-off for high risk disease was changed from one year to 18 months. As a result it is possible that patients with what is now classified as intermediate-risk disease have been included in the high-risk groups. Consequently the relevance of the results of these studies to the current practice can be questioned. Survival rates may be overestimated due to the inclusion of patients with intermediate-risk disease.

  20. High-quality forage can replace concentrate when cows enter the deposition phase without negative consequences for milk production

    DEFF Research Database (Denmark)

    Hymøller, Lone; Alstrup, Lene; Larsen, Mette Krogh

    2014-01-01

    -RP), and low CFR (30:70) and low CP (14% of DM; LCFR-LP), where RP met the Danish recommendations. Cows were fed concentrate in an automatic milking unit. After calving, cows were fed HCFR-RP until entering deposition, defined as 11 kg (Jersey) or 15 kg (Holstein) of weight gain from the lowest weight after...... cows were assigned to 4 mixed rations in a 2 × 2 factorial design with 2 concentrate to forage ratios (CFR) and 2 CP levels: high CFR (40:60) and recommended CP [16% of dry matter (DM); HCFR-RP], high CFR (40:60) and low CP (14% of DM; HCFR-LP), low CFR (30:70) and recommended CP (16% of DM; LCFR...... calving. Subsequently, cows either remained on HCFR-RP or changed to one of the other mixed rations. Comparing strategies during wk 9 to 30 of lactation showed higher dry matter intake (DMI) of mixed ration on HCFR compared with LCFR and on RP compared with LP. The DMI of the concentrate was higher...

  1. Counseling women at high risk for breast cancer.

    Science.gov (United States)

    Stefanek, M E

    1990-01-01

    Cancer risk analysis is a relatively new clinical service that has developed as more precise information has become available regarding specific risk factors. Both epidemiological and genetic factors contribute substantially to the identification of women at higher risk for developing breast cancer. The definition of what constitutes risk, an understanding of which factors influence risk, and the ability to present risk information clearly are critical features. In addition to providing information about risk and assessing each woman's perception of risk, the emotional issues must be addressed. The focus of intervention should center upon the benefits of early detection, assessment of breast self-examination skills, individualized breast cancer screening recommendations, such as mammography and physical exams, and recommendations for life style changes for possible prevention.

  2. how can i recognise the high-risk cardiovascular patient?

    African Journals Online (AJOL)

    Enrique

    duced into clinical medicine by the Framingham Heart Study.2 The major risk fac- tors are shown ... Age, male gender/post-menopausal state, genetics (family history) ... GLOBAL RISK ASSESSMENT .... In the Physician's Health Study,14 per-.

  3. Health risk behaviours of high school learners and their perceptions ...

    African Journals Online (AJOL)

    Most adolescent mortality and morbidity, attributable to such health risk behaviours, .... relevant information and education, immunising at-risk individuals and providing ..... 14% of females felt that they had already been affected by pregnancy.

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

    Science.gov (United States)

    ... meats? What research is being conducted on the relationship between the consumption of HCAs and PAHs and cancer risk in ... 20 ). What research is being conducted on the relationship between the consumption of HCAs and PAHs and cancer risk in ...

  5. Empowering High-Risk Clients to Attain a Better Quality of Life: A Career Resiliency Framework

    Science.gov (United States)

    Rickwood, Rory R.; Roberts, Jillian; Batten, Suzanne; Marshall, Anne; Massie, Kendra

    2004-01-01

    Career counselors frequently encounter clients who are at high risk for career and life development difficulties. Research suggests there is a connection between resiliency and successful career development in high-risk clients. Many high-risk individuals have poor decision-making skills and lack motivation to succeed in life and career…

  6. On the counterintuitive consequences of high-performance work practices in cross-border post-merger human integration

    DEFF Research Database (Denmark)

    Vasilaki, A.; Smith, Pernille; Giangreco, A.

    2012-01-01

    , such as communication, employee involvement, and team building, may not always produce the expected effects on human integration; rather, it can have the opposite effects if top management does not closely monitor the immediate results of deploying such practices. Implications for managers dealing with post......Human integration in cross-border mergers poses challenges to the successful implementation of post-merger processes. Executives often rely on human resource practices to achieve human integration in newly formed organisations. Using an ethnographic study of a merger of four banks in four countries......, this article investigates the impact of systemic and integrated human resource practices [i.e., high-performance work practices (HPWPs)] on human integration and how their implementation affects employees' behaviours and attitudes towards post-merger human integration. We find that the implementation of HPWPs...

  7. Sensitivity of (d,p) reactions to high n-p momenta and the consequences for nuclear spectroscopy studies

    CERN Document Server

    Bailey, G W; Tostevin, J A

    2016-01-01

    Theoretical models of low-energy (d,p) single-neutron transfer reactions are a crucial link between experimentation, nuclear structure and nuclear astrophysical studies. Whereas reaction models that use local optical potentials are insensitive to short-range physics in the deuteron, we show that including the inherent nonlocality of the nucleon-target interactions and realistic deuteron wave functions generates significant sensitivity to high n-p relative momenta and to the underlying nucleon-nucleon interaction. We quantify this effect upon the deuteron channel distorting potentials within the framework of the adiabatic deuteron breakup model. The implications for calculated (d,p) cross sections and spectroscopic information deduced from experiments are discussed.

  8. Reactor safety study. An assessment of accident risks in U. S. commercial nuclear power plants. Appendix VI. Calculation of reactor accident consequences. [PWR and BWR

    Energy Technology Data Exchange (ETDEWEB)

    1975-10-01

    Information is presented concerning the radioactive releases from the containment following accidents; radioactive inventory of the reactor core; atmospheric dispersion; reactor sites and meteorological data; radioactive decay and deposition from plumes; finite distance of plume travel; dosimetric models; health effects; demographic data; mitigation of radiation exposure; economic model; and calculated results with consequence model.

  9. High-Risk Organizations. Resilience And Safety; Organizaciones de alto riesgo. Resiliencia y Seguridad

    Energy Technology Data Exchange (ETDEWEB)

    Sola, R.; Sora, B.

    2007-07-01

    The growing social demand that took place during the second half of the 20th Century brought fast development of complex technologies. These technologies generated new risks, that together with the lack of prevention methodologies increased the amount of incidents and accidents; for example, Bhopal (1984), Chernobyl (1986), Tokaimura (1999), Columbia (2003), Prestige (2002). In order to prevent these tragic events, several knowledge models were developed. These were oriented to analyze the causes of accidents and to obtain the necessary learning to avoid the production of these types of accidents. Consequently, this reactive approach allowed the implementation of corrective measures but not the anticipation or prevention of these undesirable events. The need to prevent such events has prompted a new approach, which does not only identify causes but also reasons, contexts and organizational behaviours in new situations. This new approach is known as engineering resilience. Its aim is to promote that socio-technical systems use all their capabilities and to be able to deploy new capacities in order to adapt to unexpected situations far from unacceptable limits of risk. Thus, high reliability organizations can continue their production in a safe way. (Author) 44 refs.

  10. Selection of high temperatures for hibernation by the pocket mouse, Perognathus longimembris: ecological advantages and energetic consequences

    Energy Technology Data Exchange (ETDEWEB)

    French, A.R.

    Daily metabolism was calculated from food consumption in pocket mice, Perognathus longimembris, at 8/sup 0/C, 18/sup 0/C, and 31/sup 0/C. At temperatures below thermal neutrality for this species, daily metabolism was related to the amount of time the mice spent in torpor. Ambient temperature has no net effect on the minimum energy expenditure during a typical 5-mo hibernation season. Once an animal has accumulated a food store of approximately 130 g of millet seeds, it has the minimum energy necessary to hibernate at any environmental temperature. Such temperature compensation results from the complex effects of temperature on (1) the ratio of time of euthermy to time of torpor, (2) the energetic cost per hour of torpor, (3) the energetic cost per hour of euthermy, and (4) the energetic cost of arousal from torpor. The amount of time spent in torpor was inversely dependent on the food supply, indicating that euthermia is preferred even during the hibernation season. Mice also maximize the time of euthermia by selecting high environmental temperatures at all times of the year. Torpor probably occurs naturally only during the winter when the highest temperatures available to the mice are below thermal neutrality. The maximization of the time of euthermia reduces the chances of freezing during hibernation and enhances the animal's ability to excape from predators.

  11. Age effect on fatigue-induced limb acceleration as a consequence of high-level sustained submaximal contraction.

    Science.gov (United States)

    Huang, Chien-Ting; Huang, Chien-Chun; Young, Ming-Shing; Hwang, Ing-Shiou

    2007-08-01

    In reference to electromyographic measurement, the study was conducted to reassess differences in the behavior of fatigue-related neuromuscular function between young and elderly humans with limb acceleration (LA). Fourteen young and fourteen elderly subjects performed sustained index abduction at 75% of their maximal voluntary contractions (MVC) until task failure. Measures of neuromuscular function, including temporal/spectral features of muscle activity of the first dorsal interosseous (FDI) and LA of the index and hand, were monitored. The results showed a manifest fatigue-induced increase in LA of the index in the elderly group, but not in the young group. In contrast, only the young group developed a significant increase in amplitude of the electromyography (EMG) until task failure. Spectral analyses of LA in the index reflected marked age-dependent reorganization following muscle fatigue, with a greater reduction of relative spectral amplitude of LA in the range of 20-40 Hz, but a lesser reduction in coherence between EMG and LA in the elderly group. In line with fatigue-associated restructuring of LA, the mechanical coupling of the metacarpophalangeal joint was more severely undermined in the elderly group than in the young group. The present study manifested an age-related difference in the relative contributions of neural versus mechanical factors to muscle fatigue. Subsequent to a high-level sustained submaximal isometric contraction, a predominant mechanical failure of the musculotendon complex in the elderly was featured with LA, whereas EMG measurement characterized prevailing impairment of neuromuscular propagation in the young.

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

    Science.gov (United States)

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

    2015-12-01

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

  13. High multiple paternity and low last-male sperm precedence in a hermaphroditic planarian flatworm: consequences for reciprocity patterns.

    Science.gov (United States)

    Pongratz, N; Michiels, N K

    2003-06-01

    It is difficult to predict a priori how mating success translates into fertilization success in simultaneous hermaphrodites with internal fertilization. Whereas insemination decisions will be determined by male interests, fertilization will depend on female interests, possibly leading to discrepancies between insemination and fertilization patterns. The planarian flatworm Schmidtea polychroa, a simultaneous hermaphrodite in which mating partners trade sperm was studied. Sperm can be stored for months yet individuals mate frequently. Using microsatellites, maternity and paternity data were obtained from 748 offspring produced in six groups of 10 individuals during four weeks. Adults produced young from four mates on average. Reciprocal fertilization between two mates was found in only 41 out of 110 registered mate combinations, which is clearly less than what is predicted from insemination patterns. Multiple paternity was high: > 80% of all cocoons had two to five fathers for only three to five offspring per cocoon. Because animals were collected from a natural population, 28% of all hatchlings were sired by unknown sperm donors in the field, despite a 10-day period of acclimatization and within-group mating. This percentage decreased only moderately throughout the experiment, showing that sperm can be stored and used for at least a month, despite frequent mating and sperm digestion. The immediate paternity a sperm donor could expect to obtain was only about 25%. Male reproductive success increased linearly with the number of female partners, providing support for Bateman's principle in hermaphrodites. Our results suggest that hermaphrodites do not trade fertilizations when trading sperm during insemination, lending support to the view that such conditional sperm exchange is driven by exchange of resources.

  14. High alcohol consumption causes high IgE levels but not high risk of allergic disease

    DEFF Research Database (Denmark)

    Lomholt, Frederikke K; Nielsen, Sune F; Nordestgaard, Børge G

    2016-01-01

    disease. Genetically, we explored potential causal relationships between alcohol consumption and IgE levels and allergic disease. RESULTS: The multivariable adjusted odds ratio for IgE levels greater than versus less than 150 kU/L and compared with subjects without allergic disease was 2.3 (95% CI, 2......BACKGROUND: High alcohol consumption is associated with high IgE levels in observational studies; however, whether high alcohol consumption leads to high IgE levels and allergic disease is unclear. OBJECTIVE: We tested the hypothesis that high alcohol consumption is associated with high IgE levels...... for the alcohol-metabolizing enzymes alcohol dehydrogenase 1B (ADH-1B; rs1229984) and alcohol dehydrogenase 1c (ADH-1C; rs698). Observationally, we investigated associations between IgE levels and allergic disease (allergic asthma, rhinitis, and eczema) and between alcohol consumption and IgE levels and allergic...

  15. Establishment of a Risk Assessment Framework for Analysis of the Spread of Highly Pathogenic Avian Influenza

    Institute of Scientific and Technical Information of China (English)

    LI Jing; WANG Jing-fei; WU Chun-yan; YANG Yan-tao; JI Zeng-tao; WANG Hong-bin

    2007-01-01

    To evaluate the risk of highly pathogenic avian influenza (HPAI) in mainland China, a risk assessment framework was built.Risk factors were determined by analyzing the epidemic data using the brainstorming method; the analytic hierarchy process was designed to weigh risk factors, and the integrated multicriteria analysis was used to evaluate the final result.The completed framework included the risk factor system, data standards for risk factors, weights of risk factors, and integrated assessment methods. This risk assessment framework can be used to quantitatively analyze the outbreak and spread of HPAI in mainland China.

  16. Relationships between Sports Team Participation and Health-Risk Behaviors among Alternative High School Students

    Science.gov (United States)

    Johnson, Karen E.; Eisenberg, Marla E.; Bearinger, Linda H.; Fulkerson, Jayne A.; Sieving, Renee E.

    2014-01-01

    Background: Evidence suggests that sports team participation differentially relates to health-risk behaviors. Few studies have explored relationships among high-risk youth. Purpose: To examine associations between weekly sports team participation and health-risk behaviors (substance use, sexual risk-taking, violence involvement) among alternative…

  17. Relationships between Sports Team Participation and Health-Risk Behaviors among Alternative High School Students

    Science.gov (United States)

    Johnson, Karen E.; Eisenberg, Marla E.; Bearinger, Linda H.; Fulkerson, Jayne A.; Sieving, Renee E.

    2014-01-01

    Background: Evidence suggests that sports team participation differentially relates to health-risk behaviors. Few studies have explored relationships among high-risk youth. Purpose: To examine associations between weekly sports team participation and health-risk behaviors (substance use, sexual risk-taking, violence involvement) among alternative…

  18. Sex Differences in Children with Autism Spectrum Disorder Identified within a High-Risk Infant Cohort

    Science.gov (United States)

    Zwaigenbaum, Lonnie; Bryson, Susan E.; Szatmari, Peter; Brian, Jessica; Smith, Isabel M.; Roberts, Wendy; Vaillancourt, Tracy; Roncadin, Caroline

    2012-01-01

    Sex differences were examined in 3-year-olds with autism spectrum disorders (ASD) ascertained from a high-risk cohort, and high- and low-risk comparison groups. Participants included 319 high-risk siblings and 129 low-risk controls. Eighty-five siblings were diagnosed with ASD, including 57 of 176 boys (32.4%) and 28 of 143 girls (19.6%), implying…

  19. Modifiable risk factors and colorectal adenomas among those at high risk of colorectal cancer

    NARCIS (Netherlands)

    Botma, A.

    2011-01-01

    Epidemiological studies have identified several modifiable risk factors for colorectal neoplasms in the general population. However, associations between modifiable risk factors, including body mass index (BMI), smoking, alcohol consumption and dietary patterns, and colorectal neoplasms in two

  20. Metabolic Acidosis Assessment in High-Risk Surgeries: Prognostic Importance.

    Science.gov (United States)

    Silva, João Manoel; Ribas Rosa de Oliveira, Amanda Maria; Mendes Nogueira, Fernando Augusto; Vianna, Pedro M M; Amendola, Cristina Prata; Carvalho Carmona, Maria José; Sá Malbouisson, Luiz M

    2016-11-01

    Metabolic acidosis frequently is present in surgical patients; however, different types of metabolic acidosis (hyperlactatemia, hyperchloremia, and others) may have different relationships to perioperative outcomes. We hypothesized that in postoperative surgical patients, distinctive types of metabolic acidosis would correlate differently with the outcomes of high-risk surgeries. A prospective, multicenter observational study was performed in 3 different tertiary care hospitals. Patients who required postoperative admission to the intensive care unit (ICU) were included in this study. Patients with a short life expectancy (those with untreated cancer and limited treatment), hepatic failure, renal failure, or a diagnosis of diabetes were excluded. Patients were classified at ICU admission according to the presence and type of metabolic acidosis into 4 groups: those without acidosis, those with a base excess 12 mmol/L, and those with a base excess 2 mmol/L. Furthermore, patients were reclassified 12 hours after admission to the ICU to verify the metabolic acidosis behavior and outcome differences among the groups. The study included 618 patients. The incidence of acidosis at ICU admission was 59.1%; 23.9% presented with hyperchloremia, 21.3% with hyperlactatemia, 13.9% with increased anion gap, and 40.9% of the patients presented without metabolic acidosis. Patients whose metabolic acidosis persisted for 12 hours had an incidence of ICU complications rates in hyperlactatemia group of 68.8%, increased anion gap of 68.6%, hyperchloremic of 65.8%, and those without acidosis over 12 hours of 59.3%. A Cox regression model for postoperative 30-day mortality showed: in hyperlactatemic acidosis, hazard ratio (HR) = 1.74, 95% confidence interval (CI) = 1.02-2.96; increased anion gap acidosis, HR = 1.68, 95% CI = 0.85-3.81; hyperchloremic acidosis, HR = 1.47, 95% CI = 0.75-2.89, and 10.3% of 30-day mortality rate in patients without acidosis. An adjusted survival curve by Cox

  1. Risk factors and characteristics of youth living with, or at high risk for, HIV

    NARCIS (Netherlands)

    Huba, GJ; Melchior, LA; Panter, AT; Trevithick, L; Woods, ER; Wright, E; Feudo, R; Tierney, S; Schneir, A; Tenner, A; Remafedi, G; Greenberg, B; Sturdevant, M; Goodman, E; Hodgins, A; Wallace, M; Brady, RE; Singer, B

    2000-01-01

    Over 8,000 adolescents and young adults (4,111 males; 4,085 females) reported on several HIV-related risk behaviors during enrollment into 10 service demonstration projects targeted to youth living with, or at risk for, HIV. Distinct risk patterns emerged by gender when predicting HIV serostatus (ve

  2. Prostate Cancer in Patients With High Prostate-Specific Antigen Levels but Otherwise Very-Low-Risk Disease Behaves Like Prostate Cancer in High-Risk Patients.

    Science.gov (United States)

    Gestaut, Matthew M; Pruszynski, Jessica E; Swanson, Gregory P

    2017-08-01

    Rarely, patients with prostate cancer present with prostate-specific antigen (PSA) scores > 20 ng/mL but with otherwise very-low-risk disease. Oncologists have debated whether the malignancies in these patients behave more comparably to low-risk or high-risk disease. Our objective was to elucidate the behavior of these malignancies. A retrospective review was conducted of prostate cancer patients treated with radiation from 2000 to 2013. The inclusion criteria for very-low-risk disease included stage T1a-T1c, Gleason score ≤ 6, ≤ 3 positive cores, ≤ 50% involvement of any core, and PSA level high-grade, low-volume group consisted of patients with stage T1c-T2a, PSA level low-risk, and high-grade groups, respectively. Biochemical progression-free survival at 5 years was 71.3% for the divergent group, 68.8% for the high-grade group, and 98.3% for the low-risk group. The biochemical failure rate for the divergent group differed significantly from the low-risk group (P = .021), and that for the low-risk group was significantly different from that of the high-grade group (P = .025). However, the divergent group did not appear different from the high-grade group (P = .53). The results of our study have shown that the disease prognosis for the divergent-risk group is worse than that for the very-low-risk disease group and does not appear to be different from that for the low-volume, high-grade disease group. Oncologists should be aware that the outcomes for divergent patients are similarly poor to their low-volume, classically high-risk counterparts. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Efficacy and safety of once daily low molecular weight heparin (tinzaparin sodium) in high risk pregnancy.

    LENUS (Irish Health Repository)

    Ní Ainle, Fionnuala

    2008-10-01

    Low molecular weight heparin (LMWH) is widely regarded as the anticoagulant treatment of choice for the prevention and treatment of venous thromboembolism during pregnancy. However, previous studies have demonstrated that the pharmacokinetic profiles of LMWH vary significantly with increasing gestation. Consequently, it remains unclear whether LMWH regimens recommended for use in nonpregnant individuals can be safely extrapolated to pregnant women. The aims of this study were to assess the safety and the efficacy of tinzaparin sodium (Innohep) administered only once daily during pregnancy. A systematic retrospective review identified a cohort of 37 high-risk pregnancies which had been managed using tinzaparin 175 IU\\/kg once daily. In 26 cases, the index pregnancy had been complicated by development of an acute venous thromboembolism (17 deep vein thrombosis and nine pulmonary embolism). For each individual, case notes were examined and data extracted using a predetermined questionnaire. No episodes of recurrent venous thromboembolism were identified amongst this cohort of pregnancies managed using once daily LMWH administration. However, two unusual thrombotic complications were observed, including a parietal infarct in one patient, and a postpartum cerebral venous thrombosis in another. Once daily tinzaparin was well tolerated, with no cases of heparin-induced thrombocytopaenia, symptomatic osteoporosis, or foetal malformations. Tinzaparin dose modification based upon peak anti-Xa levels occurred in 45% of the cases examined. The present study is the largest study to have examined the clinical efficacy of once daily LMWH for use in pregnant women at high risk of venous thromboembolism. Our data support the safety and efficacy of antenatal tinzaparin at a dose of 175 IU\\/kg. In order to determine whether this once daily regimen provides equivalent (or indeed greater) thromboprophylaxis to twice daily LMWH regimens during pregnancy will require highly powered

  4. Infection with high-risk HPV types among female sex workers in northern Vietnam.

    Science.gov (United States)

    Hoang, Huyen Thi Thanh; Ishizaki, Azumi; Nguyen, Cuong Hung; Tran, Vuong Thi; Matsushita, Kaori; Saikawa, Kunikazu; Hosaka, Norimitsu; Pham, Hung Viet; Bi, Xiuqiong; Ta, Van Thanh; Van Pham, Thuc; Ichimura, Hiroshi

    2013-02-01

    Vaccines against two high-risk human papillomavirus (HPV) types, HPV-16, and HPV-18, are in use currently, with high efficacy for preventing infections with these HPV types and consequent cervical cancers. However, circulating HPV types can vary with geography and ethnicity. The aim of this study was to investigate the prevalence of HPV types and the association between HPV types and abnormal cervical cytology among female sex workers in Northern Vietnam. Cervical swabs and plasma samples were collected from 281 female sex workers at two health centers in Hanoi and Hai Phong in 2009. The HPV L1 gene was amplified by PCR using original and modified GP5(+)/6(+) primers. Amplified PCR products were genotyped by the microarray system GeneSquare (KURABO) and/or clonal sequencing. Of the 281 women, 139 (49.5%) were positive for HPV DNA. Among the HPV-positive samples, 339 strains and 29 different types were identified. Multiple-type and high risk-type HPV infections were found in 85 (61.2%) and 124 (89.2%) women, respectively. The most common genotype was HPV-52, followed by HPV-16, HPV-18, and HPV-58. Abnormal cervical cytology was detected in 3.2% (9/281) of the women, and all of these samples were positive for HPV-DNA. Age ≤25 years and infection with human immunodeficiency virus were associated positively with HPV infection among the women while ever smoking was associated negatively. These results show that HPV-52 is most prevalent among female sex workers in Northern Vietnam, most of whom had normal cervical cytology. This information may be important for designing vaccination strategies in Vietnam.

  5. A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk.

    Directory of Open Access Journals (Sweden)

    Itandehui Castro-Quezada

    Full Text Available OBJECTIVE: Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI and glycemic load (GL are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. MATERIAL AND METHODS: The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ. We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. RESULTS: We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths. As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15-4.04; P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. CONCLUSIONS: High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk.

  6. Phenomenological consequences of supersymmetry

    Energy Technology Data Exchange (ETDEWEB)

    Hinchliffe, I.; Littenberg, L.

    1982-01-01

    This report deals with the phenomenological consequences of supersymmetric theories, and with the implications of such theories for future high energy machines. It is concerned only with high energy predictions of supersymmetry; low energy consequences (for example in the K/sub o/anti K/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. The report is organized as follows. Section I consists of a brief review of supersymmetry and the salient features of existing supersymmetric models; this section can be ignored by those familiar with such models since it contains nothing new. Section 2 deals with the consequences for nucleon decay of SUSY. The remaining sections then discuss the physics possibilities of various machines; e anti e in Section 3, ep in Section 4, pp (or anti pp) colliders in Section 5 and fixed target hadron machines in Section 6.

  7. GAO’s 2011 High-Risk Series: An Update

    Science.gov (United States)

    2011-02-17

    actions aimed at improving tax compliance , some based on GAO’s work. In 2010, IRS began implementing a new regulatory regime for paid tax return...confusion and provide opportunities to hide willful noncompliance. Consequently, improved tax compliance and a smaller tax gap could be one of the

  8. Influenza and pneumococcal pneumonia immunization. Protecting our high risk population.

    Science.gov (United States)

    Siegel, B R; Mahan, C S; Witte, J J; Janowski, H T

    1990-06-01

    Pneumonia and influenza (P & I) constitute Florida's sixth leading cause of death. The P & I death rate in 1987, 10.5 per 100,000, was the highest since 1978. Major target groups for one or both vaccines used in prevention, as recommended by the Immunization Practices Advisory Committee (ACIP), include persons with chronic diseases of the heart or lungs, residents of nursing homes and other chronic care facilities, and persons aged 65 and older. Despite well-defined recommendations, vaccine coverage rates in Florida are as low as 30% in persons greater than or equal to 65 years of age. Knowledge and attitude surveys demonstrate that low coverage among various population groups may be due largely to insufficient awareness and/or negative attitudes regarding pneumococcal and influenza vaccines. Conversely, recommendations by physicians and other health care providers are strongly associated with receiving either vaccine. If the incidence of P & I is to decrease substantively in Florida, much wider use of the vaccines must occur. Because so many high-risk patients depend on private physicians for health care, their role is critical to the success of Florida public health strategies to reverse P & I trends.

  9. Psychology of high risk driving (review of foreign studies

    Directory of Open Access Journals (Sweden)

    Bulygina V.G.

    2016-06-01

    Full Text Available The article presents a brief review of foreign theoretical concepts, empirical data and methodological approaches to the problem of high risk driving. There were defined and described the factors of dangerous driving: factors of external environment and internal factors, including age, fatigue, use of medications, alcohol and drugs, personal styles, impaired sensory analyzers, neurological and cognitive disorders, emotional states, styles of responding to stress. Emphasizes the role of reduction of cognitive functioning, acquired brain injury, persistent or progressive neurological diseases, and acquired somatic disorders. The outline of its main models of driving: motivational, models of information processing, hierarchical management model. A separate section of the article focuses on cognitive factors, describes a wide spectrum of disorders of cognitive functions that may potentially impair driving safety. The theoretical and methodological grounds and empirical studies of cognitive functioning are described. Discuss prospects and limitations in studies of cognitive functioning, the predictive value of some tests, including neuropsychological. The conclusion made about the need for standardization and validation the Protocol of assessment drivers and candidates for drivers, also the necessity of the introduction of a common approach for all medical workers and specialists of nonmedical profile, in order to overcome the existing differences in estimates in the implementation of medical examination, expert activity and enforcement.

  10. High blood pressure in school children: prevalence and risk factors

    Directory of Open Access Journals (Sweden)

    Rivers Patrick A

    2006-11-01

    Full Text Available Abstract Background The purpose of this study was to determine the prevalence of high blood pressure (HBP and associated risk factors in school children 8 to 13 years of age. Methods Elementary school children (n = 1,066 were examined. Associations between HBP, body mass index (BMI, gender, ethnicity, and acanthosis nigricans (AN were investigated using a school based cross-sectional study. Blood pressure was measured and the 95th percentile was used to determine HBP. Comparisons between children with and without HBP were utilized. The crude and multiple logistic regression adjusted odds ratios were used as measures of association. Results Females, Hispanics, overweight children, and children with AN had an increased likelihood of HBP. Overweight children (BMI ≥ 85th percentile and those with AN were at least twice as likely to present with HBP after controlling for confounding factors. Conclusion Twenty one percent of school children had HBP, especially the prevalence was higher among the overweight and Hispanic group. The association identified here can be used as independent markers for increased likelihood of HBP in children.

  11. Improved results in high risk cadaveric kidney transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Toledo-Pereyra, L.H.; Baskin, S.; McNichol, L.; Edford, G.; Whitten, J.; Allaben, R.

    1980-01-01

    In general, cadaver kidney transplantation survival remains at 40-50% for the first year after transplantation. To compare the beneficial effect of a new immunosuppressive protocol to standard therapy (azathioprine and prednisone), we have studied 30 high risk first cadaveric renal allograft recipients who were randomly selected before (Group A, n.15) and after (Group B, n.15) 10/79. At 12 mos, actuarial graft survival of Group B is 75% compared to 46% in Group A. Actuarial patient survival for Group B is 94% for one year compared to 60% in Group A. We feel that these improved results are related to basic changes in our immunosuppressive protocol. These changes consist of: 1. Low doses of azathioprine and prednisolone (less than 1 mg/kg) with rapid reduction to very low levels (less than 0.3 mg/kg); 2. ALG administration at 30 mg/kg/day for 14 times; 3. Rapid placement (one month) on alternate day steroid therapy; 4. Elimination of steroids for the treatment of rejection; 5. Use of ALG (20 mg/kg/day for 10 days) for the treatment of rejection; 6. Use of ALG combined with modified lymph node irradiation for third rejection episodes; and 7. Long-term intermittent ALG administration provided that kidney function continues to be normal. The best immunosuppressive protocol is clearly the one associated with less morbidity and improved quality of life after transplantation. Our current protocol (Group B) provides the best results.

  12. Child and environmental risk factors predicting readiness for learning in children at high risk of dyslexia.

    Science.gov (United States)

    Dilnot, Julia; Hamilton, Lorna; Maughan, Barbara; Snowling, Margaret J

    2017-02-01

    We investigate the role of distal, proximal, and child risk factors as predictors of reading readiness and attention and behavior in children at risk of dyslexia. The parents of a longitudinal sample of 251 preschool children, including children at family risk of dyslexia and children with preschool language difficulties, provided measures of socioeconomic status, home literacy environment, family stresses, and child health via interviews and questionnaires. Assessments of children's reading-related skills, behavior, and attention were used to define their readiness for learning at school entry. Children at family risk of dyslexia and children with preschool language difficulties experienced more environmental adversities and health risks than controls. The risks associated with family risk of dyslexia and with language status were additive. Both home literacy environment and child health predicted reading readiness while home literacy environment and family stresses predicted attention and behavior. Family risk of dyslexia did not predict readiness to learn once other risks were controlled and so seems likely to be best conceptualized as representing gene-environment correlations. Pooling across risks defined a cumulative risk index, which was a significant predictor of reading readiness and, together with nonverbal ability, accounted for 31% of the variance between children.

  13. Molecular mechanisms linking high dose medroxyprogesterone with HIV-1 risk.

    Directory of Open Access Journals (Sweden)

    Susan C Irvin

    Full Text Available Epidemiological studies suggest that medroxyprogesterone acetate (MPA may increase the risk of HIV-1. The current studies were designed to identify potential underlying biological mechanisms.Human vaginal epithelial (VK2/E6E7, peripheral blood mononuclear (PBMC, and polarized endometrial (HEC-1-A cells were treated with a range of concentrations of MPA (0.015-150 μg/ml and the impact on gene expression, protein secretion, and HIV infection was evaluated.Treatment of VK2/E6E7 cells with high doses (>15 μg/ml] of MPA significantly upregulated proinflammatory cytokines, which resulted in a significant increase in HIV p24 levels secreted by latently infected U1 cells following exposure to culture supernatants harvested from MPA compared to mock-treated cells. MPA also increased syndecan expression by VK2/E6E7 cells and cells treated with 15 μg/ml of MPA bound and transferred more HIV-1 to T cells compared to mock-treated cells. Moreover, MPA treatment of epithelial cells and PBMC significantly decreased cell proliferation resulting in disruption of the epithelial barrier and decreased cytokine responses to phytohaemagglutinin, respectively.We identified several molecular mechanisms that could contribute to an association between DMPA and HIV including proinflammatory cytokine and chemokine responses that could activate the HIV promoter and recruit immune targets, increased expression of syndecans to facilitate the transfer of virus from epithelial to immune cells and decreased cell proliferation. The latter could impede the ability to maintain an effective epithelial barrier and adversely impact immune cell function. However, these responses were observed primarily following exposure to high (15-150 μg/ml MPA concentrations. Clinical correlation is needed to determine whether the prolonged MPA exposure associated with contraception activates these mechanisms in vivo.

  14. Molecular mechanisms linking high dose medroxyprogesterone with HIV-1 risk.

    Science.gov (United States)

    Irvin, Susan C; Herold, Betsy C

    2015-01-01

    Epidemiological studies suggest that medroxyprogesterone acetate (MPA) may increase the risk of HIV-1. The current studies were designed to identify potential underlying biological mechanisms. Human vaginal epithelial (VK2/E6E7), peripheral blood mononuclear (PBMC), and polarized endometrial (HEC-1-A) cells were treated with a range of concentrations of MPA (0.015-150 μg/ml) and the impact on gene expression, protein secretion, and HIV infection was evaluated. Treatment of VK2/E6E7 cells with high doses (>15 μg/ml] of MPA significantly upregulated proinflammatory cytokines, which resulted in a significant increase in HIV p24 levels secreted by latently infected U1 cells following exposure to culture supernatants harvested from MPA compared to mock-treated cells. MPA also increased syndecan expression by VK2/E6E7 cells and cells treated with 15 μg/ml of MPA bound and transferred more HIV-1 to T cells compared to mock-treated cells. Moreover, MPA treatment of epithelial cells and PBMC significantly decreased cell proliferation resulting in disruption of the epithelial barrier and decreased cytokine responses to phytohaemagglutinin, respectively. We identified several molecular mechanisms that could contribute to an association between DMPA and HIV including proinflammatory cytokine and chemokine responses that could activate the HIV promoter and recruit immune targets, increased expression of syndecans to facilitate the transfer of virus from epithelial to immune cells and decreased cell proliferation. The latter could impede the ability to maintain an effective epithelial barrier and adversely impact immune cell function. However, these responses were observed primarily following exposure to high (15-150 μg/ml) MPA concentrations. Clinical correlation is needed to determine whether the prolonged MPA exposure associated with contraception activates these mechanisms in vivo.

  15. Teenage cervical screening in a high risk American population

    Directory of Open Access Journals (Sweden)

    Songlin Zhang

    2011-01-01

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

  16. Gender Differences in Empathy in Parents at High- and Low-Risk of Child Physical Abuse

    Science.gov (United States)

    Perez-Albeniz, A.; de Paul, Joaquin

    2004-01-01

    Objectives: The present research was designed to study empathy in high-risk parents for child physical abuse. The main objective was to study if high-risk mothers and fathers, compared to low-risk mothers and fathers, presented more Personal distress, less Perspective-taking, less Empathic concern and a deficit in dispositional empathy toward…

  17. Case finding for patients at risk of readmission to hospital: development of algorithm to identify high risk patients

    National Research Council Canada - National Science Library

    John Billings; Jennifer Dixon; Tod Mijanovich; David Wennberg

    2006-01-01

    Objective To develop a method of identifying patients at high risk of readmission to hospital in the next 12 months for practical use by primary care trusts and general practices in the NHS in England...

  18. High Risk of Depressive Disorders in Patients With Gout

    Science.gov (United States)

    Changchien, Te-Chang; Yen, Yung-Chieh; Lin, Cheng-Li; Lin, Ming-Chia; Liang, Ji-An; Kao, Chia-Hung

    2015-01-01

    Abstract Metabolic abnormalities are common in patients with depressive disorders. However, the relationship between gout and depression is unclear. We explored the causal relationship among gout, antigout medication, and the associated risk of incidental depressive disorders. In this nationwide cohort study, we sampled data from the National Health Insurance Research Database to recruit 34,050 patients with gout as the gout cohort and 68,100 controls (without gout) as the nongout cohort. Our primary endpoint was the diagnosis of depressive disorders during follow-up. The overall study population was followed up until depression diagnosis, withdrawal from the NHI program, or the end of the study. The differences in demographic and clinical characteristics between both cohorts were determined using the Chi-square test for categorical variables and the t-test for continuous variables. Cox proportional hazard regression models were used to examine the effect of gout on the risk of depression, represented using the hazard ratio with the 95% confidence interval. Patients with gout exhibited a higher risk of depressive disorders than controls did. The risk of depressive disorders increased with age and was higher in female patients and those with hypertension, stroke, and coronary artery disease. Nonsteroidal antiinflammatory drug and prednisolone use was associated with a reduced risk of depression. Patients with gout who had received antigout medication exhibited a reduced risk of depressive disorders compared with nongout patients. Our findings support that gout increases the risk of depressive disorders, and that antigout medication use reduces the risk. PMID:26717394

  19. [Accident risk perception in high-voltage electrical maintenance workers].

    Science.gov (United States)

    Micheli, M; Zanaletti, W; Giorgi, I; Argentero, P; Candura, S M

    2006-01-01

    Promoting safety at work represents a fundamental task for achieving improvement in the quality of working life and preventing accidental injuries at work. Nevertheless, over the last few decades injuries at work have continued to constitute a significant problem. The aim of this study was to examine accident risk perception in a sample of 45 subjects employed in the electricity sector and to relate their risk perception to personality characteristics, cognitive functioning, and personal and professional history. The instruments used were: "Cognitive Behavioral Assessment 2.0", the "Workplace safety questionnaire" (an Italian questionnaire on safety at work), and a battery of neuropsychological tests. Findings show that electricity (current variability) was perceived as the most serious risk factor, while the most frequent perceived risk factors for accidents were accidental falls, cuts and bruises. The subjects of our sample showed a good awareness of risk perception, and good mood response and augmented psychophysiological activation during accidental injuries.

  20. Adipose Tissue-Specific Deletion of 12/15-Lipoxygenase Protects Mice from the Consequences of a High-Fat Diet

    Directory of Open Access Journals (Sweden)

    Banumathi K. Cole

    2012-01-01

    Full Text Available Type 2 diabetes is associated with obesity, insulin resistance, and inflammation in adipose tissue. 12/15-Lipoxygenase (12/15-LO generates proinflammatory lipid mediators, which induce inflammation in adipose tissue. Therefore we investigated the role of 12/15-LO activity in mouse white adipose tissue in promoting obesity-induced local and systemic inflammatory consequences. We generated a mouse model for fat-specific deletion of 12/15-LO, aP2-Cre; 12/15-LOloxP/loxP, which we call ad-12/15-LO mice, and placed wild-type controls and ad-12/15-LO mice on a high-fat diet for 16 weeks and examined obesity-induced inflammation and insulin resistance. High-fat diet-fed ad-12/15-LO exhibited improved fasting glucose levels and glucose metabolism, and epididymal adipose tissue from these mice exhibited reduced inflammation and macrophage infiltration compared to wild-type mice. Furthermore, fat-specific deletion of 12/15-LO led to decreased peripheral pancreatic islet inflammation with enlarged pancreatic islets when mice were fed the high-fat diet compared to wild-type mice. These results suggest an interesting crosstalk between 12/15-LO expression in adipose tissue and inflammation in pancreatic islets. Therefore, deletion of 12/15-LO in adipose tissue can offer local and systemic protection from obesity-induced consequences, and blocking 12/15-LO activity in adipose tissue may be a novel therapeutic target in the treatment of type 2 diabetes.

  1. Risky Business: The Science and Art of Radiation Risk Communication in the High Risk Context of Space Travel

    Science.gov (United States)

    Elgart, Shona Robin; Shavers, Mark; Huff, Janice; Patel, Zarana; Semones, Edward

    2016-01-01

    Successfully communicating the complex risks associated with radiation exposure is a difficult undertaking; communicating those risks within the high-risk context of space travel is uniquely challenging. Since the potential risks of space radiation exposure are not expected to be realized until much later in life, it is hard to draw comparisons between other spaceflight risks such as hypoxia and microgravity-induced bone loss. Additionally, unlike other spaceflight risks, there is currently no established mechanism to mitigate the risks of incurred radiation exposure such as carcinogenesis. Despite these challenges, it is the duty of the Space Radiation Analysis Group (SRAG) at NASA's Johnson Space Center to provide astronauts with the appropriate information to effectively convey the risks associated with exposure to the space radiation environment. To this end, astronauts and their flight surgeons are provided with an annual radiation risk report documenting the astronaut's individual radiation exposures from space travel, medical, and internal radiological procedures throughout the astronaut's career. In an effort to improve this communication and education tool, this paper critically reviews the current report style and explores alternative report styles to define best methods to appropriately communicate risk to astronauts, flight surgeons, and management.

  2. Study Shows Aspirin Reduces Colorectal Cancer in Those at High Risk

    Science.gov (United States)

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

  3. Cardiovascular risk factors in high-need psoriasis patients and its implications for biological therapies.

    NARCIS (Netherlands)

    Driessen, R.J.B.; Boezeman, J.B.M.; Kerkhof, P.C.M. van de; Jong, E.M.G.J. de

    2009-01-01

    BACKGROUND: The associations between psoriasis and cardiovascular risk factors are reported to be stronger as psoriasis severity increases. This makes studying cardiovascular risk factors in high-need psoriasis patients, eligible for biological therapy, interesting. OBJECTIVE: To survey the prevalen

  4. Medical consequences of obesity.

    Science.gov (United States)

    Lawrence, Victor J; Kopelman, Peter G

    2004-01-01

    The obese are subject to health problems directly relating to the carriage of excess adipose tissue. These problems range from arthritis, aches and pains, sleep disturbance, dyspnea on mild exertion, and excessive sweating to social stigmatization and discrimination, all of which may contribute to low quality of life and depression (Table 1). The most serious medical consequences of obesity are a result of endocrine and metabolic changes, most notably type 2 diabetes mellitus, cardiovascular disease, and increased risk of cancer. Not all obesity comorbidities are fully reversed by weight loss. The degree and duration of weight loss required may not be achievable by an individual patient. Furthermore, "weight cycling" may be more detrimental to both physical and mental health than failure to achieve weight loss targets with medical and lifestyle advice.

  5. Renal dysfunction and coronary disease: a high-risk combination.

    Science.gov (United States)

    Schiele, Francois

    2009-01-01

    Chronic kidney dysfunction is recognized as a risk factor for atherosclerosis and complicates strategies and treatment. Therefore, it is important for cardiologists not only to detect and measure potential kidney dysfunction, but also to know the mechanisms by which the heart and kidney interact, and recognize that in cases of acute coronary syndrome, the presence of renal dysfunction increases the risk of death. The detection and classification of kidney dysfunction into 5 stages is based on the estimated glomerular filtration rate (GFR). The presence of hypertension, endothelial dysfunction, dyslipidemia, inflammation, activation of the renin-angiotensin system and specific calcifications are the main mechanisms by which renal dysfunction can induce or compound cardiovascular disease. The magnitude of renal dysfunction is related to the cardiovascular risk; a linear relation links the extent of GFR decrease and the risk of cardiovascular events. Renal dysfunction and acute coronary syndromes are a dangerous combination: more common comorbidities, more frequent contraindications for effective drugs and higher numbers of drug-related adverse events such as bleeding partially explain the higher mortality in patients with renal dysfunction. In addition, despite higher risk, patients with renal dysfunction often receive fewer guideline-recommended treatments even in the absence of contraindications. Renal dysfunction induces and promotes atherosclerosis by various pathophysiologic pathways and is associated with other cardiovascular risk factors and underuse of appropriate therapy. Therefore, the assessment of renal function is an important step in the risk evaluation of patients with coronary artery disease.

  6. Next-generation personalised medicine for high-risk paediatric cancer patients - The INFORM pilot study.

    Science.gov (United States)

    Worst, Barbara C; van Tilburg, Cornelis M; Balasubramanian, Gnana Prakash; Fiesel, Petra; Witt, Ruth; Freitag, Angelika; Boudalil, Miream; Previti, Christopher; Wolf, Stephan; Schmidt, Sabine; Chotewutmontri, Sasithorn; Bewerunge-Hudler, Melanie; Schick, Matthias; Schlesner, Matthias; Hutter, Barbara; Taylor, Lenka; Borst, Tobias; Sutter, Christian; Bartram, Claus R; Milde, Till; Pfaff, Elke; Kulozik, Andreas E; von Stackelberg, Arend; Meisel, Roland; Borkhardt, Arndt; Reinhardt, Dirk; Klusmann, Jan-Henning; Fleischhack, Gudrun; Tippelt, Stephan; Dirksen, Uta; Jürgens, Heribert; Kramm, Christof M; von Bueren, Andre O; Westermann, Frank; Fischer, Matthias; Burkhardt, Birgit; Wößmann, Wilhelm; Nathrath, Michaela; Bielack, Stefan S; Frühwald, Michael C; Fulda, Simone; Klingebiel, Thomas; Koscielniak, Ewa; Schwab, Matthias; Tremmel, Roman; Driever, Pablo Hernáiz; Schulte, Johannes H; Brors, Benedikt; von Deimling, Andreas; Lichter, Peter; Eggert, Angelika; Capper, David; Pfister, Stefan M; Jones, David T W; Witt, Olaf

    2016-09-01

    The 'Individualized Therapy for Relapsed Malignancies in Childhood' (INFORM) precision medicine study is a nationwide German program for children with high-risk relapsed/refractory malignancies, which aims to identify therapeutic targets on an individualised basis. In a pilot phase, reported here, we developed the logistical and analytical pipelines necessary for rapid and comprehensive molecular profiling in a clinical setting. Fifty-seven patients from 20 centers were prospectively recruited. Malignancies investigated included sarcomas (n = 25), brain tumours (n = 23), and others (n = 9). Whole-exome, low-coverage whole-genome, and RNA sequencing were complemented with methylation and expression microarray analyses. Alterations were assessed for potential targetability according to a customised prioritisation algorithm and subsequently discussed in an interdisciplinary molecular tumour board. Next-generation sequencing data were generated for 52 patients, with the full analysis possible in 46 of 52. Turnaround time from sample receipt until first report averaged 28 d. Twenty-six patients (50%) harbored a potentially druggable alteration with a prioritisation score of 'intermediate' or higher (level 4 of 7). Common targets included receptor tyrosine kinases, phosphoinositide 3-kinase-mammalian target of rapamycin pathway, mitogen-activated protein kinase pathway, and cell cycle control. Ten patients received a targeted therapy based on these findings, with responses observed in some previously treatment-refractory tumours. Comparative primary relapse analysis revealed substantial tumour evolution as well as one case of unsuspected secondary malignancy, highlighting the importance of re-biopsy at relapse. This study demonstrates the feasibility of comprehensive, real-time molecular profiling for high-risk paediatric cancer patients. This extended proof-of-concept, with examples of treatment consequences, expands upon previous personalised oncology endeavors

  7. Do couples at high risk of relationship problems attend premarriage education?

    Science.gov (United States)

    Halford, W Kim; O'Donnell, Charlotte; Lizzio, Alf; Wilson, Keithia L

    2006-03-01

    The effectiveness of premarriage education is limited by whether couples at high risk of future marital problems attend such education. In the current study, 374 newly married couples were assessed on a range of risk factors for future marital problems as well as whether they had attended marriage education. Couples with certain indices of relationship risk (nonreligious and premarital cohabitation) were underrepresented in premarriage education. Suggestions are offered to attract more couples, particularly those at high risk for future problems, to relationship education.

  8. Consequences of severe nuclear accidents in Europe

    Science.gov (United States)

    Seibert, Petra; Arnold, Delia; Mraz, Gabriele; Arnold, Nikolaus; Gufler, Klaus; Kromp-Kolb, Helga; Kromp, Wolfgang; Sutter, Philipp

    2013-04-01

    A first part of the presentation is devoted to the consequences of the severe accident in the 1986 Chernobyl NPP. It lead to a substantial radioactive contaminated of large parts of Europe and thus raised the awareness for off-site nuclear accident consequences. Spatial patterns of the (transient) contamination of the air and (persistent) contamination of the ground were studied by both measurements and model simulations. For a variety of reasons, ground contamination measurements have variability at a range of spatial scales. Results will be reviewed and discussed. Model simulations, including inverse modelling, have shown that the standard source term as defined in the ATMES study (1990) needs to be updated. Sensitive measurements of airborne activities still reveal the presence of low levels of airborne radiocaesium over the northern hemisphere which stems from resuspension. Over time scales of months and years, the distribution of radionuclides in the Earth system is constantly changing, for example relocated within plants, between plants and soil, in the soil, and into water bodies. Motivated by the permanent risk of transboundary impacts from potential major nuclear accidents, the multidisciplinary project flexRISK (see http://flexRISK.boku.ac.at) has been carried out from 2009 to 2012 in Austria to quantify such risks and hazards. An overview of methods and results of flexRISK is given as a second part of the presentation. For each of the 228 NPPs, severe accidents were identified together with relevant inventories, release fractions, and release frequencies. Then, Europe-wide dispersion and dose calculations were performed for 2788 cases, using the Lagrangian particle model FLEXPART. Maps of single-case results as well as various aggregated risk parameters were produced. It was found that substantial consequences (intervention measures) are possible for distances up to 500-1000 km, and occur more frequently for a distance range up to 100-300 km, which is in

  9. What are the consequences of the reactor accident in Fukushima for the evaluation of nuclear risk?; Welche Folgen hat der Kernkraftwerksunfall in Fukushima fuer die Bewertung von Kernenergierisiken?

    Energy Technology Data Exchange (ETDEWEB)

    Renn, Ortwin [Univ. Stuttgart (Germany). Inst. Sozialwissenshaften V; Gallego Carrera, Diana [Univ. Stuttgart (Germany). ZIRIUS Zentrum fuer Interdiszipliaere Risiko- und Innovationsforschung

    2015-06-01

    There are historical breaks in the relation of risk analysis, risk perception and regulation policy. The year 2011 with the reactor accident in the NPP Fukushima was such a break, especially in Germany. The nuclear phase-out was reduced to ten years the energy policy turnaround received a broad societal agreement. Nuclear facilities loose public acceptance, the risk perception has changed. The Japanese evaluation results on faulty and nontransparent behavior and the lack of governance of responsible persons and authorities including a poor accident management have further decreased the public confidence. A new concept of safety culture for all nuclear facilities including the radioactive waste management is required, the communication processes between plant operator, authorities, science and the public have to be intensified.

  10. Iatrogenic high-risk populations and foodborne disease.

    Science.gov (United States)

    Acheson, David

    2013-09-01

    Certain subsets of the population are at a greater risk of acquiring foodborne infections and have a greater propensity to develop serious complications. Susceptibility to foodborne infection is dependent on numerous factors that largely relate to the status of an individual's defense systems in regard to both preventing and mitigating foodborne illness. Key examples include the increased susceptibility of pregnant women to listeriosis and increased severity of enteric bacterial infections in patients with AIDS. Clinicians must communicate with higher-risk patients about the risks of foodborne illness, and provide patients with information regarding safe food-handling practices.

  11. Enduring Consequences From the War on Drugs: How Policing Practices Impact HIV Risk Among People Who Inject Drugs in Baltimore City.

    Science.gov (United States)

    Flath, Natalie; Tobin, Karin; King, Kelly; Lee, Alexandra; Latkin, Carl

    2017-07-03

    Neighborhood-level characteristics, including police activity, are associated with HIV and Hepatitis C injection risk-behaviors among people who inject drugs (PWID). However, the pathways through which these neighborhood perceptions shape individual-level HIV risk behaviors are unclear. This study helps to explain perceived behaviors between perceived neighborhood police activity and HIV injection risk behavior (i.e., injection syringe/tool sharing in the previous 6 months). A sample of (n = 366) PWIDs who self-reported recent use were recruited using community-based outreach methods in Baltimore, Maryland. Neighborhood police perceptions were assessed by asking participants whether they would (1) be more likely to ask others to share injection tools in the context of heightened police activity and (2) be less likely to carry syringes with them due to fear of arrest. Poisson regression with robust variance was used to identify statistical relationships. Recent police encounters, frequency of heroin injection, and sociodemographic characteristics were controlled for in the model. Neighborhood police perceptions shaped injection-risk behavior. Half of the sample (49%) reported an aversion of carrying personal syringes, due to fear of arrest. Those who agreed they would be more likely to ask others to share injection equipment in the context of heightened police activity were more likely to share syringes (21% vs. 3%, p police activity (aPR: 2.22, 95% confidence interval (CI): 1.7, 3.0). This study sheds light on how police perceptions may influence injection risk behavior. While these relationships require further elucidation, this study suggests that public health interventions aiming to reduce HIV risk would benefit from improving community-police relationships.

  12. Comparison of methods trial for high-risk HPV.

    Science.gov (United States)

    Kurtycz, Daniel F I; Smith, Michele; He, Rong; Miyazaki, Kayo; Shalkham, John

    2010-02-01

    In efforts to improve service, we compared the performance of four methods of HPV detection: Invader HPV (Hologic), Hybrid Capture 2 (Qiagen), Inform HPV detection (Ventana), and standard PCR.Using blinded/de-identified cervical samples in Preservcyt (Hologic), we compared Ventana's Inform HPV Test, against Hologic's HPV Invader and PCR. In a separate evaluation, we compared Inform versus Invader versus hc2. Ventana employs in situ hybridization; Hologic's technology uses three specifically designed oligonucleotides and a fluorescent signal for detection. Qiagen's hc2 method incorporates enzyme-linked antibody detection of RNA-DNA hybrids. PCR testing was provided by Access Genetics (Minneapolis, MN). The United States Food and Drug Administration recently approved the Third Wave/Hologic Invader HPV high-risk test (rebranded as Cervista HPV HR Test).In this small study, involving a few hundred tests, Third Wave, Qiagen, and PCR tests were comparable. Kappa statistics comparing Third Wave to PCR and Third Wave to Qiagen were 0.88 and 0.74, respectively. Ventana's method did not correlate well with any of the other methods with Kappa's ranging from a low of 0.25 versus Qiagen to 0.31 versus PCR. Kappa statistics measure correlation and not accuracy of measurement.Although we felt that the specificity of our original HPV method, Ventana Inform was satisfactory and lowered our subsequent colposcopy rate, worries about its lower sensitivity caused us to look at other techniques. Other methods, PCR, hc2, and Invader, appeared comparable with one another in our series. We chose to implement the Third Wave test in our laboratory.

  13. Association Between Birth in a High Stroke Mortality State, Race, and Risk of Dementia.

    Science.gov (United States)

    Gilsanz, Paola; Mayeda, Elizabeth Rose; Glymour, M Maria; Quesenberry, Charles P; Whitmer, Rachel A

    2017-09-01

    Birth in a group of predominantly southern US states is robustly linked to increased stroke risk. Given the role of cerebrovascular disease in dementia risk, geographic patterning may also occur for dementia incidence. To determine whether birth in 9 high stroke mortality states (HSMSs) is associated with dementia in a diverse cohort of individuals living in Northern California. An observational cohort study included 7423 members of Kaiser Permanente Northern California (KPNC), an integrated health care delivery system, with health survey and clinical examination data available. Data were collected between 1964 and 1973 when the individuals were middle-aged and 1996 and 2015 when participants were in later life. Self-reported state of birth in an HSMS (top quintile of states for stroke mortality). Dementia diagnoses obtained from electronic health records from January 1, 1996, to October 15, 2015. Place of birth, race, educational level, and midlife vascular risk factors data were collected between 1964 and 1973. Of the 7423 persons included in the analysis, 4049 (54.5%) were women; 1354 (18.2%) were black. The mean (SD) age of study participants at their first visit between 1963 and 1974 was 42.94 (1.73) years and mean (SD) age at the beginning of follow-up for dementia in 1996 was 71.14 (2.72) years. Dementia was diagnosed in 2254 (30.4%) of the participants and was more common among those born in an HSMS than those born outside of one (455 [39.0%] vs 1799 [28.8%]). Birth in an HSMS was 9.6 times more common for black participants (795 [58.7%]) than nonblack participants (371 [6.1%]). Overall, birth in an HSMS was associated with a 28% higher risk of dementia (adjusted hazard ratio [aHR], 1.28; 95% CI, 1.13-1.46) adjusted for age, sex, and race. Compared with nonblack persons born outside of an HSMS, black individuals born in an HSMS had the highest dementia risk (aHR, 1.67; 95% CI, 1.48-1.88), followed by black individuals not born in an HSMS (aHR, 1.48; 95% CI

  14. An Investigation of the Relationship between Social Skills and High Risk Behaviors among the Youth: the Case of Shiraz City

    Directory of Open Access Journals (Sweden)

    Habib Ahmadi

    2015-09-01

    Full Text Available Introduction   A young population and delayed socialization for a new world order in the transitional society of Iran, has led to the development of adolescent and youth delinquency. In this context, young people who cannot direct their desires in a normal channel may turn into deviant and delinquent behaviors (Mohammadi asl, 2006: 11 . This study considers serious delinquent behaviors which are named as high-risk behaviors, namely, behaviors that increase probability of physical, psychological and social negative consequences (Zadeh Mohammadi & AhmadAbadi, 2008: 88-89 . Major causes of death and disease in industrialized and developing countries refer to relatively limited number of high-risk behaviors which are mostly begin from teen and young ages (Anteghini et al. 2001: 1 . Teens and young adults are one of the important groups exposed to high-risk behaviors such as AIDS (Mozafarzadeh & Vahdaninia, 2008, suicide (Aliverdinia et al. 2011 , sexual activities, violence and drugs (Baskin-Sommers & Sommers, 2006; Flisher & Chalton, 2001 . Since social, family and economic factors play an important role in directing behavioral patterns of individuals, particularly adolescents and youth, if these factors do not play a desirable role, adolescents and youth experience challenge and pressures derived from these challenges and difficulties, may attract them towards high-risk behaviors (Barikani, 2008: 192-193. Occurrence and prevalence of high-risk behaviors among adolescents and youth is a result of disruption of social mechanisms and is due to several factors. One of these factors is social skills, which are essential elements of social life and the enjoyment of it can play an important role in deterring high-risk behaviors, especially among youth, because youth age is a period of transition accompanied by various crises. Social Skills are learned adaptive behaviors that enable individuals to interact with different people, expressing positive

  15. Prevalence of and Associated Risk Factors for High Risk Human Papillomavirus among Sexually Active Women, Swaziland

    Science.gov (United States)

    Dlamini, Xolisile; Almonte, Maribel; Herrero, Rolando; Jolly, Pauline E.; Tsoka-Gwegweni, Joyce M.; Weiderpass, Elisabete; Broutet, Nathalie; Sartorius, Benn

    2017-01-01

    Background High risk human papillomavirus (hr-HPV) infection and the dual burden of HIV remains a huge challenge in some low-income countries (LICs) such as Swaziland with limited or no data. We estimated the prevalence and investigated determinants of hr-HPV, including HIV infection among sexually active women in Swaziland. Methods A total of 655 women aged between 15 and 49 years from five health facilities were randomly enrolled using a cross-sectional study design. Cervical cells were tested for hr-HPV types using GeneXpert HPV Assays. Results The overall weighted hr-HPV prevalence was 46.2% (95%CI: 42.8–49.5). Of hr-HPV infected women, 12.4% (95%CI: 8.6–17.5) were HPV16-positive, 13.8% (95%CI:12.0–15.8) were positive for HPV18/45, 26.7% (95%CI: 24.2–29.3) for HPV31/33/35/52/58, 7.6% (95%CI: 7.6–11.9) for HPV51/59 and 11.0%, (95%CI: 7.9–15.3) for HPV39/56/66/68. Prevalence of hr-HPV decreased with increasing age. Overall HIV prevalence remained high (42.7%; 95%CI: 35.7–46.2). HIV infection was associated with hr-HPV infection (Adjusted OR = 4.9, 95%CI: 3.043–7.8, ppolicy development and planning of prevention strategies incorporating HPV infection prevention especially among youth and HIV infected people. PMID:28114325

  16. Prevalence of and Associated Risk Factors for High Risk Human Papillomavirus among Sexually Active Women, Swaziland.

    Science.gov (United States)

    Ginindza, Themba G; Dlamini, Xolisile; Almonte, Maribel; Herrero, Rolando; Jolly, Pauline E; Tsoka-Gwegweni, Joyce M; Weiderpass, Elisabete; Broutet, Nathalie; Sartorius, Benn

    2017-01-01

    High risk human papillomavirus (hr-HPV) infection and the dual burden of HIV remains a huge challenge in some low-income countries (LICs) such as Swaziland with limited or no data. We estimated the prevalence and investigated determinants of hr-HPV, including HIV infection among sexually active women in Swaziland. A total of 655 women aged between 15 and 49 years from five health facilities were randomly enrolled using a cross-sectional study design. Cervical cells were tested for hr-HPV types using GeneXpert HPV Assays. The overall weighted hr-HPV prevalence was 46.2% (95%CI: 42.8-49.5). Of hr-HPV infected women, 12.4% (95%CI: 8.6-17.5) were HPV16-positive, 13.8% (95%CI:12.0-15.8) were positive for HPV18/45, 26.7% (95%CI: 24.2-29.3) for HPV31/33/35/52/58, 7.6% (95%CI: 7.6-11.9) for HPV51/59 and 11.0%, (95%CI: 7.9-15.3) for HPV39/56/66/68. Prevalence of hr-HPV decreased with increasing age. Overall HIV prevalence remained high (42.7%; 95%CI: 35.7-46.2). HIV infection was associated with hr-HPV infection (Adjusted OR = 4.9, 95%CI: 3.043-7.8, p<0.001). Overall hr-HPV/HIV co-infection was 24.4% (95%CI: 20.3-29.1) which was significantly higher among younger age groups (p<0.001). Prevalence of multiple group hr-HPV infection was significantly higher in HIV-positive versus -negative women (27.7% and 12.7% respectively, p<0.001). The presence, absence or unknown of history of STI with HIV did not appear to modify the relationship with hr-HPV (OR = 4.2, 95%CI: 2.6-7.1, OR = 4.6, 95%CI: 2.8-7.7, p<0.001, p<0.001 and OR = 4.1, 95%CI: 1.3-13.4, p<0.021 respectively). The prevalence of hr-HPV infection was high and significantly associated with HIV among sexually active women. Furthermore, the study has provided essential information about the HIV link with hr-HPV infections which may explain the high prevalence among HIV infected women. This can contribute to policy development and planning of prevention strategies incorporating HPV infection prevention especially among

  17. Failure to Respond to Food Resource Decline Has Catastrophic Consequences for Koalas in a High-Density Population in Southern Australia.

    Directory of Open Access Journals (Sweden)

    Desley A Whisson

    Full Text Available Understanding the ability of koalas to respond to changes in their environment is critical for conservation of the species and their habitat. We monitored the behavioural response of koalas to declining food resources in manna gum (Eucalyptus viminalis woodland at Cape Otway, Victoria, Australia, from September 2011 to November 2013. Over this period, koala population density increased from 10.1 to 18.4 koalas.ha-1. As a result of the high browsing pressure of this population, manna gum canopy condition declined with 71.4% manna gum being completely or highly defoliated in September 2013. Despite declining food resources, radio collared koalas (N = 30 exhibited high fidelity to small ranges (0.4-1.2 ha. When trees became severely defoliated in September 2013, koalas moved relatively short distances from their former ranges (mean predicted change in range centroid = 144 m and remained in areas of 0.9 to 1.0 ha. This was despite the high connectivity of most manna gum woodland, and close proximity of the study site (< 3 km to the contiguous mixed forest of the Great Otway National Park. Limited movement had catastrophic consequences for koalas with 71% (15/21 of radio collared koalas dying from starvation or being euthanased due to their poor condition between September and November 2013.

  18. [Branch retinal vein occlusion: high time for cardiovascular risk management

    NARCIS (Netherlands)

    Bredie, S.J.H.

    2013-01-01

    Cardiovascular risk management is common in patients suffering from manifest cardiovascular disease, hypertension, hyperlipidaemia and diabetes mellitus. It is generally accepted that medication is the most effective treatment for reducing cardiovascular morbidity and mortality in these patients. Re

  19. High prevalence of cardiovascular risk factors in Durban South ...

    African Journals Online (AJOL)

    ... risk factors in Durban South African Indians: The Phoenix Lifestyle Project. ... with the emergence of premature coronary artery disease in young Indian subjects. ... factors associated with DM and, together with fasting glucose, also predicted ...

  20. Teacher Effectiveness in Identifying High-Risk Kindergarten Children.

    Science.gov (United States)

    Colarusso, Ronald P.; And Others

    1979-01-01

    Teacher effectiveness in identifying children "at risk" for learning problems was studied with five Head Start teachers. Results showed that, after training in classroom observation techniques, paraprofessional teachers are capable of identifying developmental delays in children. (PHR)

  1. Adaptive and maladaptive personality traits in high-risk gamblers.

    Science.gov (United States)

    Carlotta, Davide; Krueger, Robert F; Markon, Kristian E; Borroni, Serena; Frera, Fernanda; Somma, Antonella; Maffei, Cesare; Fossati, Andrea

    2015-06-01

    Gambling Disorder (GD) is an addictive disorder resulting in significant impairment in occupational and social functioning. The aim of the present study was to investigate the relationship of GD risk to adaptive and maladaptive personality dimensions in a sample of nonreferred Italian gamblers. The authors found the risk for GD to show significant associations with the Openness and Conscientiousness scales of the Big Five Inventory (BFI); however, these effects were not significant after controlling for alcohol and drug use. GD risk showed significant associations with the Detachment and Antagonism domains of the Personality Inventory for DSM-5 (PID-5), as well as with the PID-5 facet scales of Hostility, Callousness, Deceitfulness, Manipulativeness, Irresponsibility, and (low) Rigid Perfectionism, even when controlling for alcohol and drug use. Maladaptive personality dispositions may serve as risk factors for pathological gambling, even beyond their impact on frequently concomitant problems with alcohol and other drugs.

  2. Framework for modeling high-impact, low-frequency power grid events to support risk-informed decisions

    Energy Technology Data Exchange (ETDEWEB)

    Veeramany, Arun; Unwin, Stephen D.; Coles, Garill A.; Dagle, Jeffery E.; Millard, David W.; Yao, Juan; Glantz, Cliff S.; Gourisetti, Sri N. G.

    2016-06-25

    Natural and man-made hazardous events resulting in loss of grid infrastructure assets challenge the security and resilience of the electric power grid. However, the planning and allocation of appropriate contingency resources for such events requires an understanding of their likelihood and the extent of their potential impact. Where these events are of low likelihood, a risk-informed perspective on planning can be difficult, as the statistical basis needed to directly estimate the probabilities and consequences of their occurrence does not exist. Because risk-informed decisions rely on such knowledge, a basis for modeling the risk associated with high-impact, low-frequency events (HILFs) is essential. Insights from such a model indicate where resources are most rationally and effectively expended. A risk-informed realization of designing and maintaining a grid resilient to HILFs will demand consideration of a spectrum of hazards/threats to infrastructure integrity, an understanding of their likelihoods of occurrence, treatment of the fragilities of critical assets to the stressors induced by such events, and through modeling grid network topology, the extent of damage associated with these scenarios. The model resulting from integration of these elements will allow sensitivity assessments based on optional risk management strategies, such as alternative pooling, staging and logistic strategies, and emergency contingency planning. This study is focused on the development of an end-to-end HILF risk-assessment framework. Such a framework is intended to provide the conceptual and overarching technical basis for the development of HILF risk models that can inform decision-makers across numerous stakeholder groups in directing resources optimally towards the management of risks to operational continuity.

  3. HIV and sexual risk behaviors among recognized high-risk groups in Bangladesh: need for a comprehensive prevention program.

    Science.gov (United States)

    Islam, Md Mofizul; Conigrave, Katherine M

    2008-07-01

    To examine trends in HIV and related risk behaviors among recognized high-risk groups in Bangladesh, the types and extent of prevention initiatives that have been undertaken, and highlight the immediate needs. Journal publications and conference abstracts and proceedings were reviewed. Experts involved in the development and evaluation of current programs or policy were contacted for official reports and policy documents. The trends in sexual risk behaviors over five rounds of national surveillance were tabulated. Gaps in the ongoing prevention interventions have been assessed in the light of the Anderson-May equation. Periodic surveillance on recognized high-risk groups shows that HIV prevalence has been increasing steadily. In the capital city, HIV prevalence in one subset of a high-risk group is close to the level of a concentrated epidemic (4.9%). The high prevalence of sexual risk behaviors among drug users and sex workers and their clients is alarming. Although a small increase in condom use and a reduction of syphilis have been noted among subsets of high-risk groups in recent years, this is clearly not enough to curb the threat of a possible HIV epidemic. There is an urgent need for a comprehensive prevention program that should include more efforts on education and condom promotion, effective management of all sexually transmitted infections, a screening program for migrant workers, the continuation of both behavioral and serological components of HIV surveillance, and the expansion of surveillance to cover the remaining high-risk groups, with due consideration to the consistency of surveillance indicators.

  4. Presentation of a method for consequence modeling and quantitative risk assessment of fire and explosion in process industry (Case study: Hydrogen Production Process

    Directory of Open Access Journals (Sweden)

    M J Jafari

    2013-05-01

     .Conclusion: Since the proposed method is applicable in all phases of process or system design, and estimates the risk of fire and explosion by a quantitative, comprehensive and mathematical-based equations approach. It can be used as an alternative method instead of qualitative and semi quantitative methods.

  5. Relative sea-level rise and the conterminous United States : Consequences of potential land inundation in terms of population at risk and GDP loss

    NARCIS (Netherlands)

    Haer, Toon; Kalnay, Eugenia; Kearney, Michael; Moll, Henk

    2013-01-01

    Global sea-level rise poses a significant threat not only for coastal communities as development continues but also for national economies. This paper presents estimates of how future changes in relative sea-level rise puts coastal populations at risk, as well as affect overall GDP in the contermino

  6. Risk factors for high-risk human papillomavirus detection among HIV-negative and HIV-positive women from Tanzania.

    Science.gov (United States)

    Dartell, Myassa; Rasch, Vibeke; Munk, Christian; Kahesa, Crispin; Mwaiselage, Julius; Iftner, Thomas; Kjaer, Susanne Krüger

    2013-09-01

    Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. The prevalence is dependent on several known factors notably sexual behavior and age, and factors still under scrutiny. This study aimed to examine risk factors for high-risk (HR) HPV infection among HIV-positive and HIV-negative women from the general population of Tanzania and to assess whether specific risk factors could contribute to the high prevalence of HR HPV infection in older age found in some populations including Tanzanian women. A cross-sectional study of 3699 women from Tanzania was conducted. We obtained information on sociodemographic and lifestyle factors through personal interview. Cervical swabs were collected for detection of HR HPV (Hybrid Capture 2; Qiagen, Hildesheim, Germany) and genotyping (LiPaExtra; Innogenetics, Gent, Belgium). Finally, we obtained a blood sample for HIV testing. HIV positivity was the strongest risk factor for HR HPV (odds ratio, 4.1; 95% confidence interval, 3.3-5.3). Young age, shorter duration of present relationship, and increasing number of sex partners were also associated with higher risk for HR HPV. Among women 20 to 29 years old, especially number of partners (P = 0.005) and HIV positivity (P HIV positivity (P = 0.0009) increased the risk, whereas increasing number of partners was not related to the risk of HR HPV (P = 0.46). Human papillomavirus risk factors among HIV-positive and HIV-negative women were similar, but the strength of association was greater among HIV-positive women, notably for lifetime number of sex partners, time in present relationship, genital warts, and body mass index. We were not able to identify a clear explanation for the high HPV prevalence among older women. However, in the age-stratified analysis, potential indicators of decreased immunity increased the risk for HPV infection among older women, whereas in younger women, risk was particularly associated with sexual activity.

  7. High Erk-1 activation and Gadd45a expression as prognostic markers in high risk pediatric haemolymphoproliferative diseases

    Directory of Open Access Journals (Sweden)

    Rondelli Roberto

    2009-03-01

    Full Text Available Abstract Studies on activated cell-signaling pathways responsible for neoplastic transformation are numerous in solid tumors and in adult leukemias. Despite of positive results in the evolution of pediatric hematopoietic neoplasias, there are some high-risk subtypes at worse prognosis. The aim of this study was to asses the expression and activation status of crucial proteins involved in cell-signaling pathways in order to identify molecular alterations responsible for the proliferation and/or escape from apoptosis of leukemic blasts. The quantitative and qualitative expression and activation of Erk-1, c-Jun, Caspase8, and Gadd45a was analyzed, by immunocytochemical (ICC and western blotting methods, in bone marrow blasts of 72 patients affected by acute myeloid leukemia (AML, T-cell acute lymphoblastic leukemia (ALL and stage IV non-Hodgkin Lymphoma (NHL. We found an upregulation of Erk-1, Caspase8, c-Jun, and Gadd45a proteins with a constitutive activation in 95.8%, 91.7%, 86.2%, 83.4% of analyzed specimens, respectively. It is worth noting that all AML patients showed an upregulation of all proteins studied and the high expression of GADD45a was associated to the lowest DFS median (p = 0.04. On univariate analysis, only Erk-1 phosphorylation status was found to be correlated with a significantly shorter 5-years DFS in all disease subgroups (p = 0.033 and the lowest DFS median in ALL/NHL subgroup (p = 0.04. Moreover, the simultaneous activation of multiple kinases, as we found for c-Jun and Erk-1 (r = 0.26; p = 0.025, might synergistically enhance survival and proliferation potential of leukemic cells. These results demonstrate an involvement of these proteins in survival of blast cells and, consequently, on relapse percentages of the different subgroups of patients.

  8. Leisure-Time Exercise Could Lower Your Risk of High Blood Pressure

    Science.gov (United States)

    ... Leisure-time exercise could lower your risk of high blood pressure American Heart Association Rapid Access Journal Report September ... copyright American Heart Association Download (1.4 MB) High Blood Pressure A high blood pressure reading. copyright American Heart ...

  9. A risk score to predict type 2 diabetes mellitus in an elderly Spanish Mediterranean population at high cardiovascular risk.

    Directory of Open Access Journals (Sweden)

    Marta Guasch-Ferré

    Full Text Available INTRODUCTION: To develop and test a diabetes risk score to predict incident diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk. MATERIALS AND METHODS: A diabetes risk score was derived from a subset of 1381 nondiabetic individuals from three centres of the PREDIMED study (derivation sample. Multivariate Cox regression model ß-coefficients were used to weigh each risk factor. PREDIMED-personal Score included body-mass-index, smoking status, family history of type 2 diabetes, alcohol consumption and hypertension as categorical variables; PREDIMED-clinical Score included also high blood glucose. We tested the predictive capability of these scores in the DE-PLAN-CAT cohort (validation sample. The discrimination of Finnish Diabetes Risk Score (FINDRISC, German Diabetes Risk Score (GDRS and our scores was assessed with the area under curve (AUC. RESULTS: The PREDIMED-clinical Score varied from 0 to 14 points. In the subset of the PREDIMED study, 155 individuals developed diabetes during the 4.75-years follow-up. The PREDIMED-clinical score at a cutoff of ≥6 had sensitivity of 72.2%, and specificity of 72.5%, whereas AUC was 0.78. The AUC of the PREDIMED-clinical Score was 0.66 in the validation sample (sensitivity = 85.4%; specificity = 26.6%, and was significantly higher than the FINDRISC and the GDRS in both the derivation and validation samples. DISCUSSION: We identified classical risk factors for diabetes and developed the PREDIMED-clinical Score to determine those individuals at high risk of developing diabetes in elderly individuals at high cardiovascular risk. The predictive capability of the PREDIMED-clinical Score was significantly higher than the FINDRISC and GDRS, and also used fewer items in the questionnaire.

  10. A Risk Score to Predict Type 2 Diabetes Mellitus in an Elderly Spanish Mediterranean Population at High Cardiovascular Risk

    Science.gov (United States)

    Guasch-Ferré, Marta; Bulló, Mònica; Costa, Bernardo; Martínez-Gonzalez, Miguel Ángel; Ibarrola-Jurado, Núria; Estruch, Ramon; Barrio, Francisco; Salas-Salvadó, Jordi

    2012-01-01

    Introduction To develop and test a diabetes risk score to predict incident diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk. Materials and Methods A diabetes risk score was derived from a subset of 1381 nondiabetic individuals from three centres of the PREDIMED study (derivation sample). Multivariate Cox regression model ß-coefficients were used to weigh each risk factor. PREDIMED-personal Score included body-mass-index, smoking status, family history of type 2 diabetes, alcohol consumption and hypertension as categorical variables; PREDIMED-clinical Score included also high blood glucose. We tested the predictive capability of these scores in the DE-PLAN-CAT cohort (validation sample). The discrimination of Finnish Diabetes Risk Score (FINDRISC), German Diabetes Risk Score (GDRS) and our scores was assessed with the area under curve (AUC). Results The PREDIMED-clinical Score varied from 0 to 14 points. In the subset of the PREDIMED study, 155 individuals developed diabetes during the 4.75-years follow-up. The PREDIMED-clinical score at a cutoff of ≥6 had sensitivity of 72.2%, and specificity of 72.5%, whereas AUC was 0.78. The AUC of the PREDIMED-clinical Score was 0.66 in the validation sample (sensitivity = 85.4%; specificity = 26.6%), and was significantly higher than the FINDRISC and the GDRS in both the derivation and validation samples. Discussion We identified classical risk factors for diabetes and developed the PREDIMED-clinical Score to determine those individuals at high risk of developing diabetes in elderly individuals at high cardiovascular risk. The predictive capability of the PREDIMED-clinical Score was significantly higher than the FINDRISC and GDRS, and also used fewer items in the questionnaire. PMID:22442692

  11. C-reactive protein and the MASCC risk index identify high-risk patients with febrile neutropenia and hematologic neoplasms.

    Science.gov (United States)

    Combariza, Juan F; Lombana, Milton; Pino, Luis E; Arango, Marcos

    2015-04-01

    The objective of this study is to assess the prognostic usefulness of the Multinational Association of Supportive Care in Cancer (MASCC) risk score in association with the value of C-reactive protein (CRP) to identify high-risk patients with febrile neutropenia and hematologic neoplasms. A retrospective cohort study in which the MASCC score and the CRP values were used to assess the mortality risk at 30 days among patients with febrile neutropenia and hematologic malignancies was performed. Two hundred thiry-seven patients with febrile neutropenia were analyzed; the mortality rate within 30 days was 9 %. High-risk patients according to the MASCC score were significantly more likely to experience adverse outcomes, such as being transferred to the intensive care unit (RR 3.55; CI 95 % 2.73-6.62, p risk group identified by the MASCC score (HR 3.0; CI 95 % 1.12-13.54, p = 0.032) and the mean levels of CRP (HR 17; CI 95 % 2.21-136.48, p = 0.007) and survival. The survival rate within 30 days was 100 % for the patients with a low-risk MASCC score and a mean CRP less than 15 mg/dL. This rate was only 64 % for high-risk patients with a mean CRP greater than 15 mg/dL. The MASCC risk score combined with the mean CRP value successfully identifies patients with febrile neutropenia and hematological malignancies and a high risk of death.

  12. [Climate changes, floods, and health consequences].

    Science.gov (United States)

    Michelozzi, Paola; de' Donato, Francesca

    2014-02-01

    In the European Region, floods are the most common natural disaster, causing extensive damage and disruption. In Italy, it has been estimated that over 68% of municipalities are at high hydrogeological risk and with the recent intense rainfall events local populations have been facing severe disruptions. The health consequences of floods are wide ranging and are dependent upon the vulnerability of the environment and the local population. Health effects can be a direct or indirect consequence of flooding. The immediate health impacts of floods include drowning, heart attacks, injuries and hypothermia. The indirect effects include, injuries and infections, water-borne infectious disease, mental health problems, respiratory disease and allergies in both the medium and long term after a flood. Future efforts should be addressed to integrate health preparedness and prevention measures into emergency flood plans and hydrological warning systems.

  13. Clinical Consequences of Polypharmacy in Elderly

    Science.gov (United States)

    Maher, Robert L.; Hanlon, Joseph T.; Hajjar, Emily R.

    2013-01-01

    Introduction Polypharmacy, defined as the use of multiple drugs or more than are medically necessary, is a growing concern for older adults. Areas Covered We present information about; 1.) Prevalence of polypharmacy and unnecessary medication use. ; 2.) Negative Consequences of Polypharmacy; 3.) Interventions to improve polypharmacy. Expert Opinion International research shows that polypharmacy is common in older adults with the highest number of drugs taken by those residing in nursing homes. Nearly 50% of older adults take one or more medications that are not medically necessary. Research has clearly established a strong relationship between polypharmacy and negative clinical consequences. Moreover, well designed inter-professional (often incuding clinical pharmacist) intervention studies that focus on enrolling high risk older patients with polypharmacy have shown that they can be effective in improving the overall quality of prescribing with mixed results on distal health outcomes. PMID:24073682

  14. Facial emotion perception differs in young persons at genetic and clinical high-risk for psychosis.

    Science.gov (United States)

    Kohler, Christian G; Richard, Jan A; Brensinger, Colleen M; Borgmann-Winter, Karin E; Conroy, Catherine G; Moberg, Paul J; Gur, Ruben C; Gur, Raquel E; Calkins, Monica E

    2014-05-15

    A large body of literature has documented facial emotion perception impairments in schizophrenia. More recently, emotion perception has been investigated in persons at genetic and clinical high-risk for psychosis. This study compared emotion perception abilities in groups of young persons with schizophrenia, clinical high-risk, genetic risk and healthy controls. Groups, ages 13-25, included 24 persons at clinical high-risk, 52 first-degree relatives at genetic risk, 91 persons with schizophrenia and 90 low risk persons who completed computerized testing of emotion recognition and differentiation. Groups differed by overall emotion recognition abilities and recognition of happy, sad, anger and fear expressions. Pairwise comparisons revealed comparable impairments in recognition of happy, angry, and fearful expressions for persons at clinical high-risk and schizophrenia, while genetic risk participants were less impaired, showing reduced recognition of fearful expressions. Groups also differed for differentiation of happy and sad expressions, but differences were mainly between schizophrenia and control groups. Emotion perception impairments are observable in young persons at-risk for psychosis. Preliminary results with clinical high-risk participants, when considered along findings in genetic risk relatives, suggest social cognition abilities to reflect pathophysiological processes involved in risk of schizophrenia. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Erratic pollination, high selfing levels and their correlates and consequences in an altitudinally widespread above-tree-line species in the high Andes of Chile

    Science.gov (United States)

    Arroyo, Mary T. K.; Muñoz, María S.; Henríquez, Carolina; Till-Bottraud, Irène; Pérez, Fernánda

    2006-09-01

    Unfavorable temperatures and weather conditions for biotic pollination in above-tree-line alpine habitats predict self-compatibility, high levels of autogamy and small flower size ("autogamy reproductive assurance hypothesis"), or alternatively, compensatory measures such as greater flower longevity and larger display size so as to capture scarce visits and maintain outcrossing ("increased pollination probability hypothesis"). We assess these possibilities in a fine-tuned study of Chaetanthera euphrasioides (Asteraceae) populations located above-tree-line in the Andes of central Chile, where prior, independently obtained information on community flower visitation rates is available. Visitation by flies and Andrenid bees was highly erratic in all populations and among years, and the rates well below the community averages. We found evidence for high levels of self-compatibility, equally high autogamous potential, low genetic diversity and high and similar F IS in all populations studied, associated with no clear trends in floral morphology. Strong decoupling of C. euphrasioides reproductive biology with community-level pollinator availability in the alpine fails to support either of the above-mentioned hypotheses and suggests early acquisition of autogamy with present-day pollinator conditions being adequate to maintain low visitation rates at all elevations. Our study provides the only instance where alternative hypotheses on alpine breeding systems have been tested with prior access to independently quantified community-level flower visitation rates.

  16. Review of the chronic exposure pathways models in MACCS (MELCOR Accident Consequence Code System) and several other well-known probabilistic risk assessment models

    Energy Technology Data Exchange (ETDEWEB)

    Tveten, U. (Institutt for Energiteknikk, Kjeller (Norway))

    1990-06-01

    The purpose of this report is to document the results of the work performed by the author in connection with the following task, performed for US Nuclear Regulatory Commission, (USNRC) Office of Nuclear Regulatory Research, Division of Systems Research: MACCS Chronic Exposure Pathway Models: Review the chronic exposure pathway models implemented in the MELCOR Accident Consequence Code System (MACCS) and compare those models to the chronic exposure pathway models implemented in similar codes developed in countries that are members of the OECD. The chronic exposures concerned are via: the terrestrial food pathways, the water pathways, the long-term groundshine pathway, and the inhalation of resuspended radionuclides pathway. The USNRC has indicated during discussions of the task that the major effort should be spent on the terrestrial food pathways. There is one chapter for each of the categories of chronic exposure pathways listed above.

  17. The Role of Robot-Assisted Radical Prostatectomy in High-Risk Prostate Cancer.

    Science.gov (United States)

    Srougi, Victor; Tourinho-Barbosa, Rafael R; Nunes-Silva, Igor; Baghdadi, Mohammed; Garcia-Barreras, Silvia; Rembeyo, Gregory; Eiffel, Sophie S; Barret, Eric; Rozet, Francois; Galiano, Marc; Sanchez-Salas, Rafael; Cathelineau, Xavier

    2017-03-01

    Prostate cancer (PCa) is stratified into different risk categories based on the patient's prognosis. High-risk disease was formerly characterized by an increased risk of metastasis and lethality, requiring complex treatments. Surgery was recently highlighted to have a pivotal role for the treatment of such cases, even as monotherapy. In the past, open radical prostatectomy was performed for most patients with high-risk PCa; however, robot-assisted radical prostatectomy (RARP) emerged as a reasonable option because it provided optimal outcomes for low- and intermediate-risk PCa. Robust studies are lacking to properly assess the role of RARP for high-risk PCa. We summarize this knowledge and present a literature review on the perioperative recovery and functional and oncologic outcomes of RARP for the treatment of patients with high-risk PCa.

  18. Seroprevalence of Brucellosis and Risk Factors Related to High Risk Occupational Groups in Kazeroon, South of Iran

    Directory of Open Access Journals (Sweden)

    F Taheri

    2010-03-01

    Full Text Available Background: Brucellosis is a major zoonosis worldwide. Many people for their professions are at higher risk of contracting the disease.Objective: To determine the seroprevalence of brucellosis and its risk factors in a group of high risk professions.Methods: In a cross-sectional study, all personnel or students of veterinary schools, slaughters and butchers working in the city were invited to participate (n=141. A comparison group (n=44 randomly selected from patients who were selected at random from people attended our healthcare center for reasons other than the infectious diseases.Results: 4 veterinarians, 15 veterinary assistants, 42 veterinarian students, 52 butchers, 17 slaughters, 8 slaughterhouse workers and 3 chefs made the first group and 14 storekeepers, 5 students of engineering, 11 clerks, 13 freelance workers, and 1 high school student made the comparison group. While the rate of consumption of most of the studied dairy products was almost similar in both groups, comparison group patients consumed more often milk (p<0.001 and cream (p<0.001 than the high risk group. 11 (7.8%; 95% CI: 3.4%–12.2% cases from high risk group and none of the comparison group were found seropositive for Brucella.Conclusion: Profession is the main factor in seropositivity. Consumption of dairy products and raw milk is not associated with a higher risk of seropositivity.

  19. Veterans’ Health Care: Limited Progress Made to Address Concerns That Led to High Risk Designation

    Science.gov (United States)

    2017-03-15

    VETERANS’ HEALTH CARE Limited Progress Made to Address Concerns That Led to High-Risk Designation Statement of Debra A...Progress Made to Address Concerns That Led to High-Risk Designation What GAO Found The Department of Veterans Affairs (VA) has taken action to...establishing a task force, working groups, and a governance structure for addressing the issues that led to the high-risk designation. VA provided

  20. High Risk Alpha Papillomavirus Oncogenes Impair the Homologous Recombination Pathway.

    Science.gov (United States)

    Wallace, Nicholas A; Khanal, Sujita; Robinson, Kristin L; Wendel, Sebastian O; Messer, Joshua J; Galloway, Denise A

    2017-08-02

    Persistent high risk genus α human papillomavirus (HPV) infections cause nearly every cervical carcinoma and a subset of tumors in the oropharyngeal tract. During the decades required for HPV-associated tumorigenesis, the cellular genome becomes significantly destabilized. Our analysis of cervical tumors from 4 separate data sets found a significant upregulation of the homologous recombination (HR) pathway genes. The increased abundance of HR proteins can be replicated in primary cells by expression of the two HPV oncogenes (E6 and E7) required for HPV-associated transformation. HPV E6 and E7 also enhanced the ability of HR proteins to form repair foci, yet both E6 and E7 reduce the ability of the HR pathway to complete double strand break (DSB) repair by about 50%. The HPV oncogenes hinder HR by allowing the process to begin at points in the cell cycle when the lack of a sister chromatid to serve as a homologous template prevents completion of the repair. Further, HPV E6 attenuates repair by causing RAD51 to be mislocalized away from both transient and persistent DSBs, while HPV E7 is only capable of impairing RAD51 localization to transient lesions. Finally, we show that the inability to robustly repair DSBs causes some of these lesions to be more persistent, a phenotype that correlates with increased integration of episomal DNA. Together these data support our hypothesis that HPV oncogenes contribute to the genomic instability observed in HPV-associated malignancies by attenuating the repair of damaged DNA.IMPORTANCE: This work expands the understanding of HPV biology, establishing a direct role for both HPV E6 and E7 in the destabilization of the host genome by blocking the homologous repair of DSBs. To our knowledge, this is the first time that both viral oncogenes were shown to disrupt this DSB repair pathway. We show that HPV E6 and E7 allow HR to initiate at an inappropriate part of the cell cycle. The mislocalization of RAD51 away from DSBs in cells