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Sample records for high risk communities

  1. Research on the nutrition and cognition of high-risk stroke groups in community and the relevant factors.

    Science.gov (United States)

    Zhao, N-N; Zeng, K-X; Wang, Y-L; Sheng, P-J; Tang, C-Z; Xiao, P; Liu, X-W

    2017-12-01

    To investigate the prevalence rate of nutritional risk in high-risk stroke groups in community, analyze its influencing factors, and analyze and compare the relationship between nutritional risk or malnutrition assessed by different nutritional evaluation methods and cognitive function, so as to provide the basis and guidance for clinical nutritional assessment and support. A cross-sectional survey was performed for 1196 cases in high-risk stroke groups in community from December 2015 to January 2017. At the same time, the nutritional status of patients was evaluated using the mini nutritional assessment (MNA) and MNA-short form (MNA-SF), and the cognitive status of patients was evaluated using the mini-mental state examination (MMSE). Moreover, the relevant influencing factors of nutritional risk and MMSE score were analyzed and compared. High-risk stroke groups in community suffered from a high risk of malnutrition. MNA-SF had a higher specificity and lower false positive rate than MNA. Nutritional risk occurred more easily in high-risk stroke groups in community with a history of diabetes mellitus, less physical exercise or light manual labor, daily use of multiple drugs, and higher age. Those with a higher nutritional risk were more prone to cognitive impairment. High-risk stroke groups in community, complicated with hyperhomocysteinemia, daily use of three or more kinds of prescription drugs, and a previous history of stroke, were accompanied by cognitive impairment easily. MNA-SF can be used for the nutritional screening of high-risk stroke groups in community. For the high-risk stroke groups in community, the rational nutritional diet should be publicized, blood sugar should be controlled in a scientific manner and physical exercise should be moderately increased.

  2. Perceptions of Community HIV/STI Risk Among U.S Women Living in Areas with High Poverty and HIV Prevalence Rates.

    Science.gov (United States)

    Blackstock, Oni J; Frew, Paula; Bota, Dorothy; Vo-Green, Linda; Parker, Kim; Franks, Julie; Hodder, Sally L; Justman, Jessica; Golin, Carol E; Haley, Danielle F; Kuo, Irene; Adimora, Adaora A; Rompalo, Anne; Soto-Torres, Lydia; Wang, Jing; Mannheimer, Sharon B

    2015-08-01

    Although studies have consistently demonstrated that women at high risk for HIV and non-HIV sexually transmitted infections (STIs) tend to underestimate their individual risk, little is known about how women at risk perceive their community's HIV/STI risk. We explored perceptions of community HIV/STI risk among U.S. women living in areas with high poverty and HIV prevalence rates as part of a qualitative substudy of the Women's HIV SeroIncidence Study. Semi-structured focus groups were conducted. Data were coded and analyzed using the constant comparative method. Participants expressed the perception that their communities were at elevated HIV/STI risk, mostly due to contextual and structural factors such as lack of access to health care and education. Findings suggest that HIV prevention messages that target U.S. women at high risk for HIV may be strengthened by addressing the high perceived community HIV/STI risk driven by structural factors.

  3. A Community-Based Randomized Trial of Hepatitis B Screening Among High-Risk Vietnamese Americans.

    Science.gov (United States)

    Ma, Grace X; Fang, Carolyn Y; Seals, Brenda; Feng, Ziding; Tan, Yin; Siu, Philip; Yeh, Ming Chin; Golub, Sarit A; Nguyen, Minhhuyen T; Tran, Tam; Wang, Minqi

    2017-03-01

    To evaluate the effectiveness of a community-based liver cancer prevention program on hepatitis B virus (HBV) screening among low-income, underserved Vietnamese Americans at high risk. We conducted a cluster randomized trial involving 36 Vietnamese community-based organizations and 2337 participants in Pennsylvania, New Jersey, and New York City between 2009 and 2014. We randomly assigned 18 community-based organizations to a community-based multilevel HBV screening intervention (n = 1131). We randomly assigned the remaining 18 community-based organizations to a general cancer education program (n = 1206), which included information about HBV-related liver cancer prevention. We assessed HBV screening rates at 6-month follow-up. Intervention participants were significantly more likely to have undergone HBV screening (88.1%) than were control group participants (4.6%). In a Cochran-Mantel-Haenszel analysis, the intervention effect on screening outcomes remained statistically significant after adjustment for demographic and health care access variables, including income, having health insurance, having a regular health provider, and English proficiency. A community-based, culturally appropriate, multilevel HBV screening intervention effectively increases screening rates in a high-risk, hard-to-reach Vietnamese American population.

  4. Coupling mode-destination accessibility with seismic risk assessment to identify at-risk communities

    International Nuclear Information System (INIS)

    Miller, Mahalia; Baker, Jack W.

    2016-01-01

    In this paper, we develop a framework for coupling mode-destination accessibility with quantitative seismic risk assessment to identify communities at high risk for travel disruptions after an earthquake. Mode-destination accessibility measures the ability of people to reach destinations they desire. We use a probabilistic seismic risk assessment procedure, including a stochastic set of earthquake events, ground-motion intensity maps, damage maps, and realizations of traffic and accessibility impacts. For a case study of the San Francisco Bay Area, we couple our seismic risk framework with a practical activity-based traffic model. As a result, we quantify accessibility risk probabilistically by community and household type. We find that accessibility varies more strongly as a function of travelers' geographic location than as a function of their income class, and we identify particularly at-risk communities. We also observe that communities more conducive to local trips by foot or bike are predicted to be less impacted by losses in accessibility. This work shows the potential to link quantitative risk assessment methodologies with high-resolution travel models used by transportation planners. Quantitative risk metrics of this type should have great utility for planners working to reduce risk to a region's infrastructure systems. - Highlights: • We couple mode-destination accessibility with probabilistic seismic risk assessment. • Results identify communities at high risk for post-earthquake travel disruptions. • Accessibility varies more as a function of home location than by income. • Our model predicts reduced accessibility risk for more walking-friendly communities.

  5. COPD case finding by spirometry in high-risk customers of urban community pharmacies: a pilot study.

    Science.gov (United States)

    Castillo, D; Guayta, R; Giner, J; Burgos, F; Capdevila, C; Soriano, J B; Barau, M; Casan, P

    2009-06-01

    COPD case finding is currently recommended at primary and tertiary care levels only. To evaluate the feasibility of a community pharmacy program for COPD case finding in high-risk customers by means of spirometry. Pilot cross-sectional descriptive study in 13 urban community pharmacies in Barcelona, Spain, from April to May 2007. Customers >40 years old with respiratory symptoms and/or a history of smoking were invited to participate in the study during pharmacists' routine work shifts. High-risk customers were identified by means of a 5-item COPD screening questionnaire based on criteria of the Global Initiative for Chronic Obstructive Lung Disease, and were invited to perform spirometry accordingly. Those with an FEV(1)/FVC ratio less than 0.70 were referred to the hospital for a repeat spirometry. Of the 161 pharmacy customers studied, 100 (62%) scored 3 or more items in the COPD screening questionnaire, and after spirometry, 21 (24%) had an FEV(1)/FVC ratiocustomers of urban community pharmacies is feasible. Similarly to primary care practitioners, pharmacists have access to high-risk, middle-aged subjects who have never been tested for COPD. Pharmacists can help with early detection of COPD if they are correctly trained.

  6. Reducing cancer risk in rural communities through supermarket interventions.

    Science.gov (United States)

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

    2013-09-01

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

  7. Effects of Community Based Educational Prevention Program of Drug Abuse in Reduction of High Risk Behavior

    Directory of Open Access Journals (Sweden)

    H Aranpour

    2010-08-01

    Full Text Available Introduction: Overcoming social problems requires a participatory approach. This study was performed in order to determine the effect of community based educational prevention program of drug abuse in reduction of high risk behavior. Methods: This study was a community based participatory research. According to planned approach to community health model, "the health companion group" was established with participation of public representatives of villages, researchers, and managers of health sectors. Need assessment and priority setting of health problems was done. Drug abuse was selected as the topmost priority of health problems. By interviewing 10 year olds and older members of households, the questionnaires were completed. By conducting workshops, distributing educational pamphlets and face to face training for six months, the educational program was carried out. After this period, the study population was interviewed again. Data was analyzed by SPSS software, X2, and T tests. Results: The mean score of drug abuse related high risk behavior was 26.8 +/- 2.05 before educational program and 25.2 ±2.3 after the program. The mean score of psychological health was 26.2±5.8 before educational program and 26.4±5.7 after the program. The rate of negative drug abusing related behavior decreased and positive behavior increased after the educational program. Conclusion: The community based participatory research with participation of the public can be a proper pattern to prevent drug abuse and related high risk behaviors and as a result reduce costs and complications of this problem.

  8. Analysis of dysphagia risk using the modified dysphagia risk assessment for the community-dwelling elderly.

    Science.gov (United States)

    Byeon, Haewon

    2016-09-01

    [Purpose] The elderly are susceptible to dysphagia, and complications can be minimized if high-risk groups are screened in early stages and properly rehabilitated. This study provides basic material for the early detection and prevention of dysphagia by investigating the risks of dysphagia and related factors in community-dwelling elders. [Subjects and Methods] Participants included 325 community-dwelling elderly people aged 65 or older. The modified dysphagia risk assessment for the community-dwelling elderly was used to assess dysphagia risk. [Results] Approximately 52.6% (n=171) of participants belonged to the high-risk group for dysphagia. After adjusting for confounding variables, people aged 75+, who used dentures, and who needed partial help in daily living had a significantly higher risk of dysphagia. [Conclusion] It is necessary to develop guidelines for dysphagia for early detection and rehabilitation.

  9. Diabetes Screening and Prevention in a High-Risk, Medically Isolated Border Community

    Directory of Open Access Journals (Sweden)

    Ann V. Millard

    2017-06-01

    Full Text Available IntroductionA project in a Texas border community setting, Prevention Organized against Diabetes and Dialysis with Education and Resources (POD2ER, offered diabetes prevention information, screening, and medical referrals. The setting was a large, longstanding flea market that functions as a shopping mall for low-income people. The priority population included medically underserved urban and rural Mexican Americans. Components of the program addressed those with diabetes, prediabetes, and accompanying relatives and friends.BackgroundPeople living in the Lower Rio Grande Valley (LRGV face challenges of high rates of type 2 diabetes, lack of knowledge about prevention, and inadequate access to medical care. Recent statistics from actual community-wide screenings indicate a high diabetes prevalence, 30.7% among adults in the LRGV compared with 12.3% nationwide.MethodsA diverse team composed of public health faculty, students, a physician, a community health worker, and community volunteers conceived and developed the project with a focus on cultural and economic congruence and a user-friendly atmosphere. The program provided screening for prediabetes and diabetes with a hemoglobin A1c test. Screening was offered to those who were at least 25 years of age and not pregnant. When results indicated diabetes, a test for kidney damage was offered (urinary albumin-to-creatinine ratio. A medical appointment at a community clinic within a week was provided to those who tested positive for diabetes and lacked a medical home. Health education modules addressed all family members.DiscussionThe project was successful in recruiting 2,332 high-risk people in 26 months in a community setting, providing clinic referrals to those without a doctor, introducing them to treatment, and providing diabetes prevention information to all project participants. Implications for research and practice are highlighted.ConclusionThis study shows that a regular access point in

  10. A Real-World Community Health Worker Care Coordination Model for High-Risk Children.

    Science.gov (United States)

    Martin, Molly A; Perry-Bell, Kenita; Minier, Mark; Glassgow, Anne Elizabeth; Van Voorhees, Benjamin W

    2018-04-01

    Health care systems across the United States are considering community health worker (CHW) services for high-risk patients, despite limited data on how to build and sustain effective CHW programs. We describe the process of providing CHW services to 5,289 at-risk patients within a state-run health system. The program includes 30 CHWs, six care coordinators, the Director of Care Coordination, the Medical Director, a registered nurse, mental health specialists, and legal specialists. CHWs are organized into geographic and specialized teams. All CHWs receive basic training that includes oral and mental health; some receive additional disease-specific training. CHWs develop individualized care coordination plans with patients. The implementation of these plans involves delivery of a wide range of social service and coordination support. The number of CHW contacts is determined by patient risk. CHWs spend about 60% of their time in an office setting. To deliver the program optimally, we had to develop multiple CHW job categories that allow for CHW specialization. We created new technology systems to manage operations. Field issues resulted in program changes to improve service delivery and ensure safety. Our experience serves as a model for how to integrate CHWs into clinical and community systems.

  11. An Agent-Based Model of Evolving Community Flood Risk.

    Science.gov (United States)

    Tonn, Gina L; Guikema, Seth D

    2017-11-17

    Although individual behavior plays a major role in community flood risk, traditional flood risk models generally do not capture information on how community policies and individual decisions impact the evolution of flood risk over time. The purpose of this study is to improve the understanding of the temporal aspects of flood risk through a combined analysis of the behavioral, engineering, and physical hazard aspects of flood risk. Additionally, the study aims to develop a new modeling approach for integrating behavior, policy, flood hazards, and engineering interventions. An agent-based model (ABM) is used to analyze the influence of flood protection measures, individual behavior, and the occurrence of floods and near-miss flood events on community flood risk. The ABM focuses on the following decisions and behaviors: dissemination of flood management information, installation of community flood protection, elevation of household mechanical equipment, and elevation of homes. The approach is place based, with a case study area in Fargo, North Dakota, but is focused on generalizable insights. Generally, community mitigation results in reduced future damage, and individual action, including mitigation and movement into and out of high-risk areas, can have a significant influence on community flood risk. The results of this study provide useful insights into the interplay between individual and community actions and how it affects the evolution of flood risk. This study lends insight into priorities for future work, including the development of more in-depth behavioral and decision rules at the individual and community level. © 2017 Society for Risk Analysis.

  12. Risk Denial and Socio-Economic Factors Related to High HIV Transmission in a Fishing Community in Rakai, Uganda: A Qualitative Study.

    Directory of Open Access Journals (Sweden)

    Muhamadi Lubega

    Full Text Available In Kasensero fishing community, home of the first recorded case of HIV in Uganda, HIV transmission is still very high with an incidence of 4.3 and 3.1 per 100 person-years in women and men, respectively, and an HIV prevalence of 44%, reaching up to 74% among female sex workers. We explored drivers for the high HIV transmission at Kasensero from the perspective of fishermen and other community members to inform future policy and preventive interventions.20 in-depth interviews including both HIV positive and HIV negative respondents, and 12 focus-group discussions involving a total of 92 respondents from the Kasensero fishing community were conducted during April-September 2014. Content analysis was performed to identify recurrent themes.The socio-economic risk factors for high HIV transmission in Kasensero fishing community cited were multiple and cross-cutting and categorized into the following themes: power of money, risk denial, environmental triggers and a predisposing lifestyle and alcoholism and drug abuse. Others were: peer pressure, poor housing and the search for financial support for both the men and women which made them vulnerable to HIV exposure and or risk behavior.There is a need for context specific combination prevention interventions in Kasensero that includes the fisher folk and other influential community leaders. Such groups could be empowered with the knowledge and social mobilization skills to fight the negative and risky behaviors, perceptions, beliefs, misconceptions and submission attitudes to fate that exposes the community to high HIV transmission. There is also need for government/partners to ensure effective policy implementation, life jackets for all fishermen, improve the poor housing at the community so as to reduce overcrowding and other housing related predispositions to high HIV rates at the community. Work place AIDS-competence teams have been successfully used to address high HIV transmission in similar

  13. Community narratives about women and HIV risk in 21 high-burden communities in Zambia and South Africa

    Directory of Open Access Journals (Sweden)

    Viljoen L

    2017-11-01

    Full Text Available Lario Viljoen,1 Rhoda Ndubani,2 Virginia Bond,2,3 Janet Seeley,3 Lindsey Reynolds,4,5 Graeme Hoddinott1 On behalf of the HPTN 071 (PopART Study Team 1Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; 2Zambia AIDS-related Tuberculosis Project (Zambart, School of Medicine, Lusaka, Zambia; 3Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK; 4Population Studies and Training Center, Brown University, Providence, RI, USA; 5Department of Sociology and Social Anthropology, Stellenbosch University, Stellenbosch, South Africa Abstract: Public health researchers repeatedly represent women as a group vulnerable to ill health. This has been particularly true in the field of HIV research, where women are disproportionately affected by HIV in terms of disease burden and the social effects of the epidemic. Although women have been the focus of many prevention and treatment programs, structural barriers to implementation of these targeted programs persist. In this article we explore how high HIV-burden communities in South Africa and Zambia engage with the concepts of “woman” and “HIV risk”. The data are drawn from participatory storytelling activities completed with 604 participants across 78 group discussions between December 2012 and May 2013. During discussions we found that participants made use of the core archetypal caricatures of “goodness,” “badness,” and “vulnerability” when describing women’s HIV risk. Community members shifted between these categories in their characterizations of women, as they acknowledged the multiple roles women play, internalized different stories about women, and sometimes shifted register in the same stories. Findings suggest that health implementers, in consultation with community members, should consider

  14. Comparison of the Mini Mental State Examination and depressive symptoms between high cardiovascular risk and healthy community elderly groups

    Science.gov (United States)

    da Costa, Amanda Lucas; Varela, Juliana Santos; Mazetti, Osmar; Restelatto, Luciane; Costa, Andry Fitterman; Godinho, Claudia; Camozzato, Ana Luiza; Picon, Paulo D.; Chaves, Márcia L.

    2008-01-01

    The aging of the population is a universal phenomenon with direct consequences upon the public health system. One of the main repercussions of the growth in this sector of the population is the increased prevalence of disorders such as dementia and depression which are very frequent among the elderly. The relationship between cardiovascular risk factors, dementia and depression have been addressed in many recent investigations. Objectives To evaluate the relationship of cognitive performance and depressive symptoms with cardiovascular risk in the elderly. Methods 94 high cardiovascular risk elderly patients and 160 healthy community elderly were evaluated cross-sectionally. The Mini Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS-15) were used as the main measures. The cutoff for presence of depression was 6 on the GDS. Results The high cardiovascular risk elderly group showed significantly lower scores on the MMSE (p<0.001) and was significantly associated to depression (p<0.001), independently of education. The logistic regression analysis for depression as the dependent variable, age and group (healthy community or high cardiovascular risk elderly) were kept in the final equation. Higher age (Odds Ratio=0.92; 95% CI 0.86–0.98) and high cardiovascular risk elderly (OR=2.99; 95% CI 1.36–6.59) were associated to depression. Conclusions The present findings corroborate the different cognitive performance of elderly with high cardiovascular risk factors and the association of depressive symptoms with this group. PMID:29213588

  15. Perceptions of Community HIV/ STI Risk Among U.S Women Living in Areas with High Poverty and HIV Prevalence Rates

    OpenAIRE

    Blackstock, Oni J.; Frew, Paula; Bota, Dorothy; Vo-Green, Linda; Parker, Kim; Franks, Julie; Hodder, Sally L.; Justman, Jessica; Golin, Carol E.; Haley, Danielle F.; Kuo, Irene; Adimora, Adaora A.; Rompalo, Anne; Soto-Torres, Lydia; Wang, Jing

    2015-01-01

    Although studies have consistently demonstrated that women at high risk for HIV and non-HIV sexually transmitted infections (STIs) tend to underestimate their individual risk, little is known about how women at risk perceive their community’s HIV/STI risk. We explored perceptions of community HIV/ STI risk among U.S. women living in areas with high poverty and HIV prevalence rates as part of a qualitative substudy of the Women’s HIV SeroIncidence Study. Semi-structured focus groups were condu...

  16. Analysis of dysphagia risk using the modified dysphagia risk assessment for the community-dwelling elderly

    OpenAIRE

    Byeon, Haewon

    2016-01-01

    [Purpose] The elderly are susceptible to dysphagia, and complications can be minimized if high-risk groups are screened in early stages and properly rehabilitated. This study provides basic material for the early detection and prevention of dysphagia by investigating the risks of dysphagia and related factors in community-dwelling elders. [Subjects and Methods] Participants included 325 community-dwelling elderly people aged 65 or older. The modified dysphagia risk assessment for the communit...

  17. Prevalence and Correlates of Leprosy in a High-Risk Community Setting in Sri Lanka.

    Science.gov (United States)

    Dabrera, Thushani Marie Elizabeth; Tillekeratne, L Gayani; Fernando, M S Nilanthi; Kasturiaratchi, S T Kaushlya; Østbye, Truls

    2016-10-01

    Leprosy is caused by the Mycobacterium leprae bacillus. Pockets of high endemicity remain in a number of countries including Sri Lanka, in spite of the fact that elimination has been achieved at the national level. In 2012, in a village in the Puttlam district, dermatologists reported an increase in individuals with leprosy. This village had been established in the 1990s for people displaced from Northern Sri Lanka during a civil war. A comprehensive household survey was conducted by district health officials from June to July 2012, and all household members present during the survey period were examined for leprosy lesions. Patients with suspected leprosy were referred to a dermatology clinic for clinical or pathological confirmation. The prevalence of leprosy was high (511 per 10 000 population). Household contact with another patient with leprosy increased the risk of leprosy (odds ratio = 6.69; P leprosy at bay in high-risk communities.

  18. Risk perception of tsunami in the community of Arauco, Chile - a contribution of risk perception to disaster risk management at local level

    Science.gov (United States)

    Kubisch, M. Sc. Susanne; Edilia Jaque Castillo, Dra.; Braun, JProf. Andreas Ch., ,, Dr.

    2017-04-01

    The research was carried out in the city center of the coastal community of Arauco, Central Chile. The community of Arauco was one of the most affected communities of the tsunami in Chile, the 27th of February 2010. For the data evaluation, the affected inhabitants of the community have been surveyed via standardized questionnaires. Furthermore experts of different fields, amongst others, Disaster Risk Management (DRM), risk education, urban and regional planning, as well as geology have been consulted in form of expert interviews. The results revealed a high risk perception part of the affected community and a weakness of DRM especially at local level, which opens a gap between the evaluation and treatment of risk by experts and risk perception of the affected community. The risk perception of the affected community, here, is predominantly determined by ecological vulnerability, expressed in direct and indirect experience of a tsunami and by institutional vulnerability, expressed among others by a weakness of DRM at local level and a mistrust in responsible institutions for DRM. Due to the institutional vulnerability and the mistrust in responsible institutions we recommend a Community Based Approach (CBA) to strengthen DRM at local level and to take advantage of the high risk perception and knowledge of the affected community. Involving the community in DRM, we assume to close the gap between risk evaluation of experts and risk perception of the inhabitants and to come up with the unique necessities and conditions at local level. Especially in centralized countries, DRM is less effective, because at the one hand, decisions are made distant from the affected communities, so that measures often do not come up with the unique conditions and necessities at local level, and on the other hand measures often do not find acceptance by the affected community. Furthermore centralized DRM is often not effective and quick in response in case of emergency. Another obstacle

  19. Managing Communities – Mining MNEs’ Community Risk Management Practices

    DEFF Research Database (Denmark)

    Taarup Esbensen, Jacob

    This PhD reflects the effort to close a gap in the multinational enterprise (MNE) risk management literature on the identification and mitigation of risk arising from local communities. Small villages and towns that are situated geographically close to the MNEs’ place of operation have increasingly......-to-date information about mining MNE operations. This improved outreach has meant that mines have been closed due to conflicts with local communities and therefor a need had arisen for MNEs to implement management practices that can effectively mitigate these types of risks....... been identified as a source of risk (BSR, 2003; ICMM, 2015). The mining industry is one of the most exposed to risks from local communities, where there historically have been many conflicts between mine owners on one side and the people living close to the mine on the other (Godoy, 1985; Hoskin, 1912...

  20. 'Hip-hop' stroke: a stroke educational program for elementary school children living in a high-risk community.

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    Williams, Olajide; Noble, James M

    2008-10-01

    Public stroke recognition is poor and poses a barrier to acute stroke treatment. We describe a stroke literacy program that teaches elementary school children in high-risk communities to recognize stroke and form an urgent action plan; we then present results of an intervention study using the program. "Hip-Hop" Stroke uses culturally and age-appropriate music and dance to enhance an interactive didactic curriculum including the FAST mnemonic (Facial droop, Arm weakness, Speech disturbance, Time to call 911). The program occurred in central Harlem, New York City, a community with high stroke risk. During the 2006 to 2007 school year, 582 fourth, fifth, and sixth graders (9 to 11 years of age) participated in 1-hour sessions over 3 consecutive days. Stroke knowledge was tested before and after the program with a 94% group participant retention. Students learned and retained knowledge well for stroke localization (20% correct before intervention, 93% correct immediately afterward, and 86% correct after 3-month delay; Phip-hop music may improve retention of stroke knowledge among the youth.

  1. Examining cumulative victimization, community violence exposure, and stigma as contributors to PTSD symptoms among high-risk young women.

    Science.gov (United States)

    Kennedy, Angie C; Bybee, Deborah; Greeson, Megan R

    2014-05-01

    This study examines patterns of lifetime victimization within the family, community violence exposure, and stigma as contributors to posttraumatic stress disorder (PTSD) symptoms within a sample of 198 high-risk young women who are pregnant or parenting. We used cluster analysis to identify 5 profiles of cumulative victimization, based on participants' levels of witnessing intimate partner violence (IPV), physical abuse by an adult caregiver, and sexual victimization, all beginning by age 12. Hierarchical regression was used to examine these 5 clusters (ranging from a High All Victimization cluster characterized by high levels of all 3 forms of violence, to a Low All Victimization cluster characterized by low levels of all 3 forms), along with community violence exposure and stigma, as predictors of PTSD symptoms. We found that 3 of the cumulative victimization clusters, in comparison with Low All Victimization, were significant predictors of PTSD symptoms, as was stigma, while community violence exposure was not a significant predictor. PsycINFO Database Record (c) 2014 APA, all rights reserved

  2. Perceptions of environmental health risks among residents in the "Toxic Doughnut": opportunities for risk screening and community mobilization.

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    White, Brandi M; Hall, Eric S

    2015-12-10

    Surrounded by landfills, and toxic and hazardous facilities, Altgeld Gardens is located in a "toxic doughnut". With high rates of environmentally-related conditions, residents have called for a community-based environmental health assessment to improve overall health in their community. The purpose of this study was to investigate the attitudes and beliefs of environmental health risks of Altgeld's residents which would assist community organizing efforts and provide the groundwork for a community-based environmental health assessment. A questionnaire was designed and administered to 42 Altgeld residents who also participated in focus groups to assess their perceptions of environmental health risks. All participants were Altgeld residents for at least two years and were fairly representative of the broader community. Physical and social hazards were primarily identified as posing risks to participants' family and the broader community. Physical hazards included the dumping of hazardous waste and landfills; social hazards were crime and drugs. These findings have been useful in community organizing efforts and in program planning for local community-based organizations and public health agencies. The results have also been used to prioritize health and environmental risk issues impacting the community.

  3. Prevalence of Teen Dating Violence and Co-occurring Risk Factors Among Middle School Youth in High-Risk Urban Communities

    Science.gov (United States)

    Niolon, Phyllis Holditch; Vivolo-Kantor, Alana M.; Latzman, Natasha E.; Valle, Linda Anne; Kuoh, Henrietta; Burton, Tessa; Taylor, Bruce G.; Tharp, Andra T.

    2018-01-01

    Purpose This study describes the lifetime prevalence of teen dating violence (TDV) perpetration in a sample of middle school students from high-risk urban communities and examines the relation between TDV and related cognitive and behavioral risk factors. Methods Surveys were administered to 2,895 middle school students in four U.S. cities; 1,673 students (58%) reported having dated and were included in analyses. The sample was 52.3% female, 48.2% non-Hispanic black/African-American, 38.2% Hispanic, 4.8% non-Hispanic white, and 7.6% other race. Six types of TDV perpetration were assessed: threatening behaviors, verbal/emotional abuse, relational abuse, physical abuse, sexual abuse, and stalking. Results Of the students who had dated, 77% reported perpetrating verbal/emotional abuse, 32% reported perpetrating physical abuse, 20% reported threatening a partner, 15% reported perpetrating sexual abuse, 13% reported perpetrating relational abuse, and 6% reported stalking. Girls were more likely than boys to report perpetrating threatening behaviors, verbal/emotional abuse, and physical abuse, and boys were more likely to report perpetrating sexual abuse. Involvement in bullying positively predicted perpetration of TDV, albeit, in different ways for boys and girls. Other risk factors differed by sex. For instance, alcohol use and sex initiation predicted multiple forms of TDV perpetration for boys, whereas weapon carrying and emotional symptoms predicted several forms of TDV perpetration for girls. Conclusions The prevalence of TDV was high in our sample. Important sex differences in rates of perpetration and risk factors emerged. Comprehensive prevention programs that target TDV and related risk factors, such as bullying and other risk factors, seem warranted. PMID:25620454

  4. Rural Community Disaster Preparedness and Risk Perception in Trujillo, Peru.

    Science.gov (United States)

    Stewart, Matthew; Grahmann, Bridget; Fillmore, Ariel; Benson, L Scott

    2017-08-01

    , vulnerability, and preparedness in LMIC communities. The current study established that selected communities near Trujillo, Peru recognize a high disaster impact from earthquakes and infection, but are not adequately prepared for potential future disasters. By identifying high-risk demographics, targeted public health interventions are needed to prepare vulnerable communities in the following areas: emergency food supplies, emergency water plan, medical supplies at home, and establishing evacuation plans. Stewart M , Grahmann B , Fillmore A , Benson LS . Rural community disaster preparedness and risk perception in Trujillo, Peru. Prehosp Disaster Med. 2017;32(4):387-392.

  5. Community Gardens as Environmental Health Interventions: Benefits Versus Potential Risks.

    Science.gov (United States)

    Al-Delaimy, W K; Webb, M

    2017-06-01

    The purpose of this paper was to summarize current findings on community gardens relevant to three specific areas of interest as follows: (1) health benefits, (2) garden interventions in developing versus developed countries, and (3) the concerns and risks of community gardening. Community gardens are a reemerging phenomenon in many low- and high-income urban neighborhoods to address the common risk factors of modern lifestyle. Community gardens are not limited to developed countries. They also exist in developing low-income countries but usually serve a different purpose of food security. Despite their benefits, community gardens can become a source of environmental toxicants from the soil of mostly empty lands that might have been contaminated by toxicants in the past. Therefore, caution should be taken about gardening practices and the types of foods to be grown on such soil if there was evidence of contamination. We present community gardens as additional solutions to the epidemic of chronic diseases in low-income urban communities and how it can have a positive physical, mental and social impact among participants. On balance, the benefits of engaging in community gardens are likely to outweigh the potential risk that can be remedied. Quantitative population studies are needed to provide evidence of the benefits and health impacts versus potential harms from community gardens.

  6. Provider perceptions of barriers and facilitators of HPV vaccination in a high-risk community.

    Science.gov (United States)

    Javanbakht, Marjan; Stahlman, Shauna; Walker, Susan; Gottlieb, Sami; Markowitz, Lauri; Liddon, Nicole; Plant, Aaron; Guerry, Sarah

    2012-06-22

    Maximizing HPV vaccine uptake among those at highest risk for cervical cancer is critical. We explored healthcare provider perspectives on factors influencing HPV vaccination among adolescent girls in a community with high cervical cancer rates. From March to May 2009, we conducted in-depth interviews with 21 medical staff providing care to adolescent girls at two clinics in Los Angeles, CA, serving a predominantly Hispanic population with high cervical cancer rates. Interviews were recorded and transcribed data were reviewed for coding and thematic content related to potential barriers and facilitators of HPV vaccination. Providers and medical staff overwhelmingly focused on parental beliefs as barriers to HPV vaccination. Perceived parental misconceptions acting as barriers included the belief that adolescents do not need vaccinations and that no-cost vaccine programs like Vaccines for Children are only available for younger children. Perceived parental concerns that the vaccine will promote sexual activity were prevalent, which prompted providers to frame HPV vaccine as a "routine" vaccine. However, the medical staff felt mothers with a friend or relative supportive of HPV vaccination were more likely to request the vaccine. The staff also noted that for Hispanic parents the "preferred" source of information is peers; if the "right people" in the community were supportive of HPV vaccine, parents were more willing to vaccinate. Other barriers included lack of immunization records among immigrant parents and a difficult-to-reach, mobile clientele. Providers noted a number of barriers to HPV vaccination, including some perceived parental misconceptions that could be addressed with education about the need for adolescent vaccines and available free vaccine programs. Because community support appears particularly important to Hispanic parents, the use of promotoras - peer liaisons between health organizations and the community - may increase HPV vaccine uptake in

  7. Effectiveness of a Lifestyle Intervention Program among Persons at High Risk for Cardiovascular Disease and Diabetes in a Rural Community

    Science.gov (United States)

    Vadheim, Liane M.; Brewer, Kari A.; Kassner, Darcy R.; Vanderwood, Karl K.; Hall, Taryn O.; Butcher, Marcene K.; Helgerson, Steven D.; Harwell, Todd S.

    2010-01-01

    Purpose: To evaluate the feasibility of translating the Diabetes Prevention Program (DPP) lifestyle intervention into practice in a rural community. Methods: In 2008, the Montana Diabetes Control Program worked collaboratively with Holy Rosary Healthcare to implement an adapted group-based DPP lifestyle intervention. Adults at high risk for…

  8. Creating a Flood Risk Index to Improve Community Resilience

    Science.gov (United States)

    Klima, K.; El Gammal, L.

    2017-12-01

    While flood risk reduction is an existent discourse and agenda in policy and insurance, vulnerabilities vary between communities; some communities may have aging infrastructure, or an older/poorer population less able to absorb a flood, putting them at increased risk from the hazards. As a result, some are considering environmental justice aspects of flood risk reduction. To date, catastrophe models have focused on creating floodmaps (e.g., NOAA's Sea Level Rise Viewer, Climate Central's Surging Seas), or on linking hydrological models to economic loss models (e.g., HEC-RAS + HAZUS). However, this approach may be highly inequitable between areas of different income (as well as other demographics). Some have begun work on combining hydrology with vulnerability information (e.g., USACE's North Atlantic Comprehensive Coastal Study). To our knowledge, no one has tried to adapt the more advanced known heat risk theory to water risk by combining hydrology information (e.g., HEC-RAS, floodplain maps) with the social vulnerability (e.g., Cutter et al.) of the residents. This project will create a method to combine water hazard data with a derived water vulnerability index to help a community understand their current and future water risk. We will use the case study area of Pittsburgh, PA, which faces severe precipitation and riverine flooding hazards. Building on present literature of factors influencing water vulnerability contextualized to the Pittsburgh region, we will identify, quantify, and map the top factors impacting water vulnerability. We will combine these with flood maps to identify the geospatial distribution of water risk. This work will allow policy makers to identify location-specific aspects of water vulnerability and risk in any community, thus promoting environmental justice. It is possible that this type of original research would create maps of relative water risk that may prove as understandable to the general public as other flood maps, and may also

  9. A Collaborative Study of Disproportionate Chemical Risks in Seven Delaware Communities

    Science.gov (United States)

    Dryden, O.; Goldman, G. T.; White, R.; Moore, D.; Roberts, M.; Thomas, J.; Johnson, C.

    2017-12-01

    Studies have found that, compared to national averages, a significantly greater percentage of Blacks (African-Americans), Latinos (Hispanics), and people at or near poverty levels tend to live near industrial facilities that use large quantities of toxic chemicals and present a risk of major chemical disasters with potentially severe consequences for nearby communities. The Union of Concerned Scientists, the Environmental Justice Health Alliance for Chemical Policy Reform, and Delaware Concerned Residents for Environmental Justice collaborated on a study to examine the potential for cumulative impacts from health and safety risks for seven Delaware communities with a percentage of people of color and/or poverty levels greater than the Delaware average located along an industrial corridor in the northern portion of Delaware's New Castle County. These risks include close proximity to major industrial sources, as well as facilities that use large quantities of toxic, flammable or explosive chemicals and pose a high risk of a major chemical release or catastrophic incident. Additionally, proximity to contaminated waste sites was assessed, as well as the risk of cancer and potential for respiratory disease impacts from exposure to toxic air pollution. We found that people in these seven communities face a substantial cumulative health risk from exposure to toxic air pollution, proximity to polluting industrial facilities and hazardous chemical facilities, as well as contaminated waste sites. These health risks are substantially greater when compared to a wealthier and predominantly White Delaware community and for Delaware as a whole. Significant and expedited improvements in regulatory and public policy are needed at the national, state, and municipal levels to address the health and well-being of at-risk communities in Delaware and elsewhere.

  10. Understanding social capital and HIV risk in rural African American communities.

    Science.gov (United States)

    Cené, Crystal W; Akers, Aletha Y; Lloyd, Stacey W; Albritton, Tashuna; Powell Hammond, Wizdom; Corbie-Smith, Giselle

    2011-07-01

    African Americans (AA) and rural communities often suffer disproportionately from poorer health. Theory-guided research examining how individual- and community-level factors influence health behaviors and contribute to disparities is needed. To understand how a social network model that captures the interplay between individual and community factors might inform community-based interventions to reduce HIV risk in rural AA communities. Qualitative study. Eleven focus groups with 38 AA 16-24 year olds, 42 adults over age 25, and 13 formerly incarcerated individuals held in community settings in two rural, predominantly AA counties in North Carolina. Thirty-seven semi-structured interviews with multiethnic key informants. Semi-structured interviews and focus groups with open-ended questions assessed a) perceptions of multi-level HIV risk determinants from a social network model (individual, interpersonal, social, economic, political and structural) identified through literature review and b) community needs and assets affecting local HIV rates. Qualitative data was analyzed using directive content analysis guided by a social network model. We identified four themes regarding the interaction between individuals and their communities that mediate HIV risk: interpersonal processes, community structural environment, social disorder, and civic engagement. Communities were characterized as having a high degree of cohesiveness, tension, and HIV-related stigma. The community structural environment-characterized by neighborhood poverty, lack of skilled jobs, segregation, political disenfranchisement and institutional racism-was felt to reduce the availability and accessibility of resources to combat HIV. Adults noted an inability to combat social problems due to social disorder, which fuels HIV risk behaviors. Civic engagement as a means of identifying community concerns and developing solutions is limited by churches' reluctance to address HIV-related issues. To combat HIV

  11. Lifestyle risk factors in an urban South African community

    Directory of Open Access Journals (Sweden)

    SCD Wright

    2008-09-01

    Full Text Available The research question addressed in the study was to determine the prevalence of the following lifestyle risk factors: obesity, waist-hip ratio, physical inactivity, high blood glucose, and hypertension in an urban community. The research objective for the study was to determine the prevalence of specific risk factors in an urban community. Based on the results, a health intervention could be planned and implemented to reduce the prevalence of the risk factors and the possibility of chronic noncommunicable diseases in later life. The design was a quantitative survey using physical measurement and a structured questionnaire. The target population of the study was black urban adults (n=218. The sampling method was convenient and purposive. The results of the study indicated that the prevalence of hypertension and obesity were higher than the national prevalence for South Africa. The waist-hip ratio revealed that 20% of the men and 49.7% of the women were at risk for cardiovascular disease. High blood glucose levels were demonstrated for 21.6% of the group. Physical activity was also shown to be inadequate. In conclusion, the potential for cardiovascular and metabolic health problems in future is high. It is recommended that an intervention, based on the results of the study, should and must be developed and implemented. The more challenging question is to know what to do and how to do it. A framework is suggested to guide the development of an intervention.

  12. Referral outcomes of individuals identified at high risk of cardiovascular disease by community health workers in Bangladesh, Guatemala, Mexico, and South Africa.

    Science.gov (United States)

    Levitt, Naomi S; Puoane, Thandi; Denman, Catalina A; Abrahams-Gessel, Shafika; Surka, Sam; Mendoza, Carlos; Khanam, Masuma; Alam, Sartaj; Gaziano, Thomas A

    2015-01-01

    We have found that community health workers (CHWs) with appropriate training are able to accurately identify people at high cardiovascular disease (CVD) risk in the community who would benefit from the introduction of preventative management, in Bangladesh, Guatemala, Mexico, and South Africa. This paper examines the attendance pattern for those individuals who were so identified and referred to a health care facility for further assessment and management. Patient records from the health centres in each site were reviewed for data on diagnoses made and treatment commenced. Reasons for non-attendance were sought from participants who had not attended after being referred. Qualitative data were collected from study coordinators regarding their experiences in obtaining the records and conducting the record reviews. The perspectives of CHWs and community members, who were screened, were also obtained. Thirty-seven percent (96/263) of those referred attended follow-up: 36 of 52 (69%) were urgent and 60 of 211 (28.4%) were non-urgent referrals. A diagnosis of hypertension (HTN) was made in 69% of urgent referrals and 37% of non-urgent referrals with treatment instituted in all cases. Reasons for non-attendance included limited self-perception of risk, associated costs, health system obstacles, and lack of trust in CHWs to conduct CVD risk assessments and to refer community members into the health system. The existing barriers to referral in the health care systems negatively impact the gains to be had through screening by training CHWs in the use of a simple risk assessment tool. The new diagnoses of HTN and commencement on treatment in those that attended referrals underscores the value of having persons at the highest risk identified in the community setting and referred to a clinic for further evaluation and treatment.

  13. Referral outcomes of individuals identified at high risk of cardiovascular disease by community health workers in Bangladesh, Guatemala, Mexico, and South Africa

    Science.gov (United States)

    Levitt, Naomi S.; Puoane, Thandi; Denman, Catalina A.; Abrahams-Gessel, Shafika; Surka, Sam; Mendoza, Carlos; Khanam, Masuma; Alam, Sartaj; Gaziano, Thomas A.

    2015-01-01

    Background We have found that community health workers (CHWs) with appropriate training are able to accurately identify people at high cardiovascular disease (CVD) risk in the community who would benefit from the introduction of preventative management, in Bangladesh, Guatemala, Mexico, and South Africa. This paper examines the attendance pattern for those individuals who were so identified and referred to a health care facility for further assessment and management. Design Patient records from the health centres in each site were reviewed for data on diagnoses made and treatment commenced. Reasons for non-attendance were sought from participants who had not attended after being referred. Qualitative data were collected from study coordinators regarding their experiences in obtaining the records and conducting the record reviews. The perspectives of CHWs and community members, who were screened, were also obtained. Results Thirty-seven percent (96/263) of those referred attended follow-up: 36 of 52 (69%) were urgent and 60 of 211 (28.4%) were non-urgent referrals. A diagnosis of hypertension (HTN) was made in 69% of urgent referrals and 37% of non-urgent referrals with treatment instituted in all cases. Reasons for non-attendance included limited self-perception of risk, associated costs, health system obstacles, and lack of trust in CHWs to conduct CVD risk assessments and to refer community members into the health system. Conclusions The existing barriers to referral in the health care systems negatively impact the gains to be had through screening by training CHWs in the use of a simple risk assessment tool. The new diagnoses of HTN and commencement on treatment in those that attended referrals underscores the value of having persons at the highest risk identified in the community setting and referred to a clinic for further evaluation and treatment. PMID:25854780

  14. Evaluating the use of cell phone messaging for community Ebola syndromic surveillance in high risked settings in Southern Sierra Leone.

    Science.gov (United States)

    Jia, Kangbai; Mohamed, Koroma

    2015-09-01

    Most underdeveloped countries do not meet core disease outbreak surveillance because of the lack of human resources, laboratory and infrastructural facilities. The use of cell phone technology for disease outbreak syndromic surveillance is a new phenomenon in Sierra Leone despite its successes in other developing countries like Sri Lanka. In this study we set to evaluate the effectiveness of using cell phone technology for Ebola hemorrhagic fever syndromic surveillance in a high risked community in Sierra Leone. This study evaluated the effectiveness of using cell phone messaging (text and calls) for community Ebola hemorrhagic fever syndromic surveillance in high risked community in southern Sierra Leone. All cell phone syndromic surveillance data used for this study was reported as cell phone alert messages-texts and voice calls; by the Moyamba District Health Management Team for both Ebola hemorrhagic fever suspect and mortalities. We conducted a longitudinal data analysis of the monthly cumulative confirmed Ebola hemorrhagic fever cases and mortalities collected by both the traditional sentinel and community cell phone syndromic surveillance from August 2014 to October 2014. A total of 129 and 49 Ebola hemorrhagic fever suspect and confirmed cases respectively were recorded using the community Ebola syndromic surveillance cell phone alert system by the Moyamba District Health Management Team in October 2014. The average number of Ebola hemorrhagic fever suspects and confirmed cases for October 2014 were 4.16 (Std.dev 3.76) and 1.58 (Std.dev 1.43) respectively. Thirty-four percent (n=76) of the community Ebola syndromic surveillance cell phone alerts that were followed-up within 24 hours reported Ebola hemorrhagic fever suspect cases while 65.92% (n=147) reported mortality. Our study suggests some form of underreporting by the traditional sentinel Ebola hemorrhagic fever disease surveillance system in Moyamba District southern Sierra Leone for August

  15. Naloxone Distribution and Training for Patients with High-Risk Opioid Use in a Veterans Affairs Community-Based Primary Care Clinic.

    Science.gov (United States)

    Raffel, Katie E; Beach, Leila Y; Lin, John; Berchuck, Jacob E; Abram, Shelly; Markle, Elizabeth; Patel, Shalini

    2018-03-30

    Naloxone distribution has historically been implemented in a community-based, expanded public health model; however, there is now a need to further explore primary care clinic-based naloxone delivery to effectively address the nationwide opioid epidemic. To create a general medicine infrastructure to identify patients with high-risk opioid use and provide 25% of this population with naloxone autoinjector prescription and training within a 6-month period. The quality improvement study was conducted at an outpatient clinic serving 1238 marginally housed veterans with high rates of comorbid substance use and mental health disorders. Patients at high risk of opioid-related adverse events were identified using the Stratification Tool for Opioid Risk Management and were contacted to participate in a one-on-one, 15-minute, hands-on naloxone training led by nursing staff. The number of patients identified at high risk and rates of naloxone training/distribution. There were 67 patients identified as having high-risk opioid use. None of these patients had been prescribed naloxone at baseline. At the end of the intervention, 61 patients (91%) had been trained in the use of naloxone. Naloxone was primarily distributed by licensed vocational nurses (42/61, 69%). This study demonstrates the feasibility of high-risk patient identification and of a primary care-based and nursing-championed naloxone distribution model. This delivery model has the potential to provide access to naloxone to a population of patients with opioid use who may not be engaged in mental health or specialty care.

  16. Medication Exposure and Risk of Recurrent Clostridium difficile Infection in Community-Dwelling Older People and Nursing Home Residents.

    Science.gov (United States)

    Haran, John P; Bradley, Evan; Howe, Emily; Wu, Xun; Tjia, Jennifer

    2018-02-01

    It is unclear how medication exposures differ in their association with recurrent Clostridium difficile infection (rCDI) in elderly nursing home (NH) residents and community-dwelling individuals. This study examined these exposures to determine whether the risk of rCDI differs according to living environment. Retrospective. Academic and community healthcare settings. Individuals aged 65 and older with CDI (N = 616). Information on participant characteristics and medications was extracted from the electronic medical record (EMR). We used separate extended Cox models according to living environment to identify the association between medication use and risk of rCDI. Of the 616 elderly adults treated for CDI, 24.1% of those living in the community and 28.1% of NH residents experienced recurrence within 1 year. For community-dwelling participants, the risk of rCDI was 1.6 times as high with antibiotic exposure and 2.5 times as high with acid-reducing medication exposure, but corticosteroid exposure was associated with a 39% lower risk of recurrence. For NH residents, the risk of rCDI was 2.9 times as high with acid-reducing medication exposure and 5.9 times as high with corticosteroid medication exposure. Antibiotic exposure was associated with an increased risk of recurrence only in community-dwelling participants (adjusted hazard ratio = 1.63, 95% confidence interval = 1.00-2.67). Risk of rCDI is greater with acid-reducing medication use than antibiotic use after initial CDI treatment, although the risk varied depending on living environment. Corticosteroid use is associated with greater risk of recurrence in NH residents but lower risk in community-dwelling elderly adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  17. Community-Based Diabetes Screening and Risk Assessment in Rural West Virginia

    Directory of Open Access Journals (Sweden)

    Ranjita Misra

    2016-01-01

    Full Text Available This project utilized a cross-sectional study design to assess diabetes risk among 540 individuals from 12 counties using trained extension agents and community organizations in West Virginia. Individuals were screened for diabetes using (1 the validated 7-item diabetes risk assessment survey and (2 hemoglobin A1c tests. Demographic and lifestyle behaviors were also collected. The average age, body mass index, and A1c were 51.2±16.4, 31.1±7.5, and 5.8±0.74, respectively. The majority were females, Non-Hispanic Whites with no prior diagnosis of diabetes. Screenings showed that 61.8% of participants were at high risk for diabetes. Family history of diabetes (siblings or parents, overweight or obese status, sedentary lifestyle, and older age were commonly prevalent risk factors. Higher risk scores computed from the 7-item questions correlated positively with higher A1c (r=0.221, P<0.001. In multivariate logistic regression analyses, higher diabetes risk was predicted by obesity, older age, family history of hypertension, and gestational diabetes. Females were 4 times at higher risk than males. The findings indicated that community-based screenings were an effective way to assess diabetes risk in rural West Virginia. Linking diabetes screenings with referrals to lifestyle programs for high risk individuals can help reduce the burden of diabetes in the state.

  18. Rat infestation associated with environmental deficiencies in an urban slum community with high risk of leptospirosis transmission.

    Science.gov (United States)

    Santos, Norlan de Jesus; Sousa, Erica; Reis, Mitermayer G; Ko, Albert I; Costa, Federico

    2017-03-09

    We analyzed environmental factors that provide food, water and harborage to rodents and the risk of household rodent infestation in a slum community with a high risk of leptospirosis transmission. Detailed environmental surveys were performed in 221 households. Multivariate regression models evaluated the association between rodent infestation and socioeconomic status and environmental attributes obtained from Geographical Information System surveys. The general household infestation rate was 45.9%. Rattus norvegicus signs were the most prevalent, present in 74% of the infested households. The risk for rodent infestation was associated with environmental factors supporting harborage for rats, such as dilapidated fences/walls (OR: 8.95; 95%CI: 2.42-33.12) and households built on an earthen slope (OR: 4.68; 95%CI: 2.23-9.81). An increase of 1 meter from the nearest sewer was associated with a 3% (95%CI: 1%-5%) decrease in the risk of rodent infestation. A lack of sanitation where poor people live provides factors for rat infestation and could the target of educational interventions.

  19. Examination of validity of fall risk assessment items for screening high fall risk elderly among the healthy community-dwelling Japanese population

    OpenAIRE

    DEMURA, Shinichi; SATO, Susumu; YAMAJI, Shunsuke; KASUGA, Kosho; NAGASAWA, Yoshinori

    2010-01-01

    We aimed to examine the validity of fall risk assessment items for the healthy community-dwelling elderly Japanese population. Participants were 1122 healthy elderly individuals aged 60 years and over (380 males and 742 females). The percentage who had experienced a fall was 15.8%. This study used fall experience and 50 fall risk assessment items representing the five risk factors (symptoms of falling, physical function, disease and physical symptom, environment, and behavior and character), ...

  20. Concussions in Community-Level Rugby: Risk, Knowledge, and Attitudes.

    Science.gov (United States)

    Martin, R Kyle; Hrubeniuk, Travis J; Witiw, Christopher D; MacDonald, Peter; Leiter, Jeff

    Rugby is a popular collision sport where participants are at risk of sustaining concussions. Most research focuses on elite-level or youth divisions. Comparatively, little is known about adult community rugby. The aim of this research was to estimate the risk of sustaining a concussion during participation in community-level rugby and summarize the collective knowledge and attitudes toward concussions. Concussion symptoms will be reported frequently among community-level rugby players and a substantial proportion will report a willingness to continue participation despite the risk. Cross-sectional analysis. Level 3. An anonymous, voluntary survey was administered to all 464 senior rugby players registered in the province of Manitoba in 2015. Two primary domains were assessed: (1) concussion history from the preceding season including occurrence, symptomatology, and impact on daily activities and (2) knowledge and attitudes toward concussion risks and management. In total, 284 (61.2%) rugby players responded. Concussive symptoms were reported by 106 (37.3%). Of those, 87% were formally diagnosed with a concussion and 27% missed school and/or work as a result. The danger of playing while symptomatic was recognized by 93.7% of participants, yet 29% indicated they would continue while symptomatic. Furthermore, 39% felt they were letting others down if they stopped playing due to a concussion. Concussive symptoms were common among the study cohort and had a notable impact on daily activities. A high proportion of players were willing to continue while experiencing symptoms despite recognizing the danger. The observed discord between knowledge and attitudes implicates a culture of "playing injured." Understanding the risk of injury may affect an individual's decision to participate in community-level rugby. Moreover, evidence of discord between the knowledge and attitudes of players may direct future research initiatives and league governance.

  1. Replication of High Fetal Alcohol Spectrum Disorders Prevalence Rates, Child Characteristics, and Maternal Risk Factors in a Second Sample of Rural Communities in South Africa.

    Science.gov (United States)

    May, Philip A; De Vries, Marlene M; Marais, Anna-Susan; Kalberg, Wendy O; Buckley, David; Adnams, Colleen M; Hasken, Julie M; Tabachnick, Barbara; Robinson, Luther K; Manning, Melanie A; Bezuidenhout, Heidre; Adam, Margaret P; Jones, Kenneth L; Seedat, Soraya; Parry, Charles D H; Hoyme, H Eugene

    2017-05-12

    Background : Prevalence and characteristics of fetal alcohol syndrome (FAS) and total fetal alcohol spectrum disorders (FASD) were studied in a second sample of three South African rural communities to assess change. Methods : Active case ascertainment focused on children with height, weight and/or head circumference ≤25th centile and randomly-selected children. Final diagnoses were based on dysmorphology, neurobehavioral scores, and maternal risk interviews. Results : Cardinal facial features, head circumference, and total dysmorphology scores differentiated specific FASD diagnostic categories in a somewhat linear fashion but all FASD traits were significantly worse than those of randomly-selected controls. Neurodevelopmental delays were significantly worse for children with FASD than controls. Binge alcohol use was clearly documented as the proximal maternal risk factor for FASD, and significant distal risk factors were: low body mass, education, and income; high gravidity, parity, and age at birth of the index child. FAS rates continue to extremely high in these communities at 9-129 per 1000 children. Total FASD affect 196-276 per 1000 or 20-28% of the children in these communities. Conclusions : Very high rates of FASD persist in these general populations where regular, heavy drinking, often in a binge fashion, co-occurs with low socioeconomic conditions.

  2. Spatiotemporal Modeling of Community Risk

    Science.gov (United States)

    2016-03-01

    Ertugay, and Sebnem Duzgun, “Exploratory and Inferential Methods for Spatio-Temporal Analysis of Residential Fire Clustering in Urban Areas,” Fire ...response in communities.”26 In “Exploratory and Inferential Methods for Spatio-temporal Analysis of Residential Fire Clustering in Urban Areas,” Ceyhan...of fire resources spread across the community. Spatiotemporal modeling shows that actualized risk is dynamic and relatively patterned. Though

  3. Assessing Wildland Fire Risk Transmission to Communities in Northern Spain

    Directory of Open Access Journals (Sweden)

    Fermín J. Alcasena

    2017-01-01

    Full Text Available We assessed potential economic losses and transmission to residential houses from wildland fires in a rural area of central Navarra (Spain. Expected losses were quantified at the individual structure level (n = 306 in 14 rural communities by combining fire model predictions of burn probability and fire intensity with susceptibility functions derived from expert judgement. Fire exposure was estimated by simulating 50,000 fire events that replicated extreme (97th percentile historical fire weather conditions. Spatial ignition probabilities were used in the simulations to account for non-random ignitions, and were estimated from a fire occurrence model generated with an artificial neural network. The results showed that ignition probability explained most of spatial variation in risk, with economic value of structures having only a minor effect. Average expected loss to residential houses from a single wildfire event in the study area was 7955€, and ranged from a low of 740 to the high of 28,725€. Major fire flow-paths were analyzed to understand fire transmission from surrounding municipalities and showed that incoming fires from the north exhibited strong pathways into the core of the study area, and fires spreading from the south had the highest likelihood of reaching target residential structures from the longest distances (>5 km. Community firesheds revealed the scale of risk to communities and extended well beyond administrative boundaries. The results provided a quantitative risk assessment that can be used by insurance companies and local landscape managers to prioritize and allocate investments to treat wildland fuels and identify clusters of high expected loss within communities. The methodological framework can be extended to other fire-prone southern European Union countries where communities are threatened by large wildland fires.

  4. Receipt of Caregiving and Fall Risk in US Community-dwelling Older Adults.

    Science.gov (United States)

    Hoffman, Geoffrey J; Hays, Ron D; Wallace, Steven P; Shapiro, Martin F; Yakusheva, Olga; Ettner, Susan L

    2017-04-01

    Falls and fall-related injuries (FRI) are common and costly occurrences among older adults living in the community, with increased risk for those with physical and cognitive limitations. Caregivers provide support for older adults with physical functioning limitations, which are associated with fall risk. Using the 2004-2012 waves of the Health and Retirement Study, we examined whether receipt of low (0-13 weekly hours) and high levels (≥14 weekly hours) of informal care or any formal care is associated with lower risk of falls and FRIs among community-dwelling older adults. We additionally tested whether serious physical functioning (≥3 activities of daily living) or cognitive limitations moderated this relationship. Caregiving receipt categories were jointly significant in predicting noninjurious falls (P=0.03) but not FRIs (P=0.30). High levels of informal care category (P=0.001) and formal care (Pfall risk relative to low levels of informal care. Among individuals with ≥3 activities of daily living, fall risks were reduced by 21% for those receiving high levels of informal care; additionally, FRIs were reduced by 42% and 58% for those receiving high levels of informal care and any formal care. High levels of informal care receipt were also associated with a 54% FRI risk reduction among the cognitively impaired. Fall risk reductions among older adults occurred predominantly among those with significant physical and cognitive limitations. Accordingly, policy efforts involving fall prevention should target populations with increased physical functioning and cognitive limitations. They should also reduce financial barriers to informal and formal caregiving.

  5. Risk factors for coronary heart disease in the white comm.unity ...

    African Journals Online (AJOL)

    major risk factors showed that 35,1% (age and sex adjusted) had at least one major risk factor at the higher level (level A) and 33,8% (age and sex adjusted) ... in a number of other countries with a high CHD mor- ... Afrikaans-speaking community in the south-western ... in an average week; (viI) physical activity both at work.

  6. Community rating in the absence of risk equalisation: lessons from the Irish private health insurance market.

    Science.gov (United States)

    Turner, Brian; Shinnick, Edward

    2013-04-01

    Ireland's private health insurance market operates on the basis of community rating, alongside open enrolment and lifetime cover. A risk equalisation scheme was introduced in 2003 to bolster community rating. However, in July 2008 the Irish Supreme Court set aside this scheme, on the basis of the interpretation of community rating in Irish legislation. This decision has significant implications for the Irish private health insurance market. This paper reviews the development of the market, focusing in particular on community rating. The breakdown of community rating in a market with multiple insurers with differing risk profiles is discussed. Applying this to the Irish market, it can be seen that the Irish Supreme Court judgment has significant implications for the application of community rating. Specifically, while community rating operates within plans, it no longer operates across the market, leading to high-risk lives paying more, on average, than low-risk lives. It has also led to greater opportunities for insurers to engage in market segmentation. This may have relevance for the design and operation of other community rated markets.

  7. Introduction of high risk pregnancy care in rural Cameroon: health service research approach.

    Science.gov (United States)

    Leke, R J; Nasah, B T; Mtango, F D

    1988-05-01

    A 3-year study (1982-1985) in Cameroon showed that high-risk pregnancy identification and care could successfully be introduced in rural communities through inexpensive training and supervision of local nurses, particularly when motivation for use of antenatal clinics (ANCs) was provided by the local Community Women's Organization (CWO). 11 communities, all rural except Tsinga, were randomly allocated to Groups I (control) or II. A retrospective baseline survey of ANCs showed that high-risk pregnancy detection had been nonexistent. For both groups, nurses were given 2-week training courses on high-risk identification and family planning. The registers for recording prenatal consultations and deliveries were modified to include recording of risk factors. Special forms were created for reporting on each high-risk case thus identified. These forms proved more difficult for the nurses to complete than the registers. For Group II communities, CWO leaders were recruited to urge women to attend ANCs. 2548 cases of high-risk pregnancy (21.9% of pregnancies) were identified on the special forms, although the number of cases identified in clinic registers was consistently higher. Posttest attendance at ANCs was higher than pretest and significantly higher in areas where CWO motivation had been used. Major risk factors in the identified cases were grand multiparity, teenage pregnancy and previous complicated obstetrics history, although semiurban Tsinga had less grand multiparity and teenage pregnancy and more obesity, diabetes, hypertension and preclampsia. Only 23.4% of the identified cases delivered in the clinics, showing the need for more comprehensive maternal service programs. Since only 5% of the high-risk pregnancy population accepted modern contraceptives after delivery, research is needed on the determinants.

  8. Opportunities for Skin Cancer Prevention Education among Individuals Attending a Community Skin Cancer Screening in a High-Risk Catchment Area.

    Science.gov (United States)

    Parsons, Bridget Grahmann; Gren, Lisa H; Simonsen, Sara E; Harding, Garrett; Grossman, Douglas; Wu, Yelena P

    2018-04-01

    Despite the highly preventable nature of skin cancer, it remains the most commonly diagnosed form of cancer in the United States. Recommendations for a complete skin cancer prevention regimen include engaging in photoprotection (e.g., sunscreen use), avoiding skin cancer risk behaviors (e.g., tanning), and receiving total body skin exams from a health care provider. The current study examined reported engagement in these behaviors among participants attending a community skin cancer screening (N = 319) in a high-risk catchment area to assess the need for increased health education on skin cancer prevention. Participants' responses indicate a history of suboptimal avoidance of skin cancer risk behaviors. Over half of participants (52%) reported four or more blistering sunburns before age 20, and 46% reported indoor tanning at least one during their lifetime. There is a need among this population for education regarding a complete skin cancer prevention regimen, which could improve adherence to photoprotection and avoidance of skin cancer risk behaviors, thereby reducing morbidity and mortality due to skin cancer.

  9. Risk profiles of personality traits for suicidality among mood disorder patients and community controls.

    Science.gov (United States)

    Su, M-H; Chen, H-C; Lu, M-L; Feng, J; Chen, I-M; Wu, C-S; Chang, S-W; Kuo, P-H

    2018-01-01

    To examine the associations between personality traits and suicidal ideation (SI) and attempt (SA) in mood disorder patients and community controls. We recruited 365 bipolar, 296 major depressive disorder patients, and 315 community controls to assess their lifetime suicidality. Participants filled out self-reported personality questionnaires to collect data of personality traits, including novelty seeking (NS), harm avoidance (HA), extraversion (E), and neuroticism (N). We used logistic regression models adjusted for diagnoses to analyze combinational effects of personality traits on the risk of suicide. Additionally, radar charts display personality profiles for suicidal behaviours by groups. All personality traits were associated with the risk of suicidality with various effect size, except for E that showed protective effect. High N or HA had prominent and independent risk effects on SI and SA. Combinations of high N and low E, or high HA and NS were the risk personality profiles for suicidality. Higher N scores further distinguished SA from SI in mood disorder patients. Introvert personality traits showed independent risk effects on suicidality regardless of diagnosis status. Among high-risk individuals with suicidal thoughts, higher neuroticism tendency is further associated with increased risk of suicide attempt. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. High-Risk Series: An Update

    Science.gov (United States)

    2015-02-01

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

  11. Community perceptions and response to flood risks in Nyando District, Western Kenya

    Directory of Open Access Journals (Sweden)

    Hellen Nyakundi

    2010-04-01

    Full Text Available In Kenya, the ability of local people to resist the impact of disasters has not been given adequate attention. A descriptive cross sectional study sought to investigate community perceptions and responses to flood risks in low and high risk areas of the Nyando District, Western Kenya. A total of 528 households, six government officials and have project managers of Community Based Organizations (CBOs and Non Governmental Organizations (NGOs were interviewed. Additionally, seven Focus Group Discussions(FGDs involving three women, two male and two teacher groups were conducted. Data were analysed using the Statistical Package for the Social Sciences (SPSS Program. The Chi-square test was used to determine associations and di'erences between variables. In the study, 83% of the respondents were aware of Traditional Flood Knowledge (TFK and 80% acknowledged its use. Perception of the risk is influenced by several variables, most notably past experience of major floods and having survived them. Residents in the high risk areas had signfficantly higher levels of awareness and use of traditional flood knowledge. they were more aware of the nature of the flood related health risks they were exposed to and appeared better prepared for future flood risk. They were, however, more dependent on external aid. On the other hand, residents living in the low risk area reported better success with their response mechanisms.

  12. 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.

  13. The EPA's human exposure research program for assessing cumulative risk in communities.

    Science.gov (United States)

    Zartarian, Valerie G; Schultz, Bradley D

    2010-06-01

    Communities are faced with challenges in identifying and prioritizing environmental issues, taking actions to reduce their exposures, and determining their effectiveness for reducing human health risks. Additional challenges include determining what scientific tools are available and most relevant, and understanding how to use those tools; given these barriers, community groups tend to rely more on risk perception than science. The U.S. Environmental Protection Agency's Office of Research and Development, National Exposure Research Laboratory (NERL) and collaborators are developing and applying tools (models, data, methods) for enhancing cumulative risk assessments. The NERL's "Cumulative Communities Research Program" focuses on key science questions: (1) How to systematically identify and prioritize key chemical stressors within a given community?; (2) How to develop estimates of exposure to multiple stressors for individuals in epidemiologic studies?; and (3) What tools can be used to assess community-level distributions of exposures for the development and evaluation of the effectiveness of risk reduction strategies? This paper provides community partners and scientific researchers with an understanding of the NERL research program and other efforts to address cumulative community risks; and key research needs and opportunities. Some initial findings include the following: (1) Many useful tools exist for components of risk assessment, but need to be developed collaboratively with end users and made more comprehensive and user-friendly for practical application; (2) Tools for quantifying cumulative risks and impact of community risk reduction activities are also needed; (3) More data are needed to assess community- and individual-level exposures, and to link exposure-related information with health effects; and (4) Additional research is needed to incorporate risk-modifying factors ("non-chemical stressors") into cumulative risk assessments. The products of this

  14. Community-Led Assessment of Risk from Exposure to Mercury by Native Amerindian Wayana in Southeast Suriname

    International Nuclear Information System (INIS)

    Peplow, D.; Augustine, S.; Peplow, D.

    2012-01-01

    This study was a collaboration between Western public health researchers and Suriname indigenous communities. The question asked was how can Western researchers effectively engage traditional indigenous communities in Suriname, South America, in public health research. The approach used a combination of Participatory Action Research methods in which Western researchers became participating observers in an indigenous-led research initiative. The Wayana communities of Puleowime (Apetina) and Kawemhakan (Anapayke) defined a single objective: determine for themselves whether they are at risk from exposure to mercury (Hg) contamination. Community members collected hair samples for analysis. Hair samples were analyzed using a portable Hg analyzer. Individual, community and hazard quotient indices were used to quantify risk. Results showed the Wayana were at a high lifetime risk of adverse effects from exposure to Hg. This study showed that the community-led approach is an effective way Westerners can engage indigenous communities and address serious public health threats. While factors that appealed to indigenous communities were identified, obstacles inherent to Western research methodology were also encountered

  15. Alerting the apathetic and reassuring the alarmed: communicating about radon risk in three communities. Final report

    International Nuclear Information System (INIS)

    Chess, C.; Hance, B.J.

    1988-01-01

    Public reaction to the risk from radon varied widely in three communities chosen for qualitative analysis. In Boyertown, PA, some residents were very alarmed, but most were apathetic toward this newly identified environmental risk. In Clinton, NJ, residents were concerned and worked with the mayor and the state to determine whether they were at risk and to disseminate information about mitigation of high indoor radon levels. Residents in Vernon, New Jersey were very alarmed and actively opposed the state's decision to site low-level radium wastes there. The qualitative study examines why reactions differed among the three communities, and extracts lessons for communicating about the risk from radon. These lessons should apply to communicating about other environmental hazards to individuals and communities

  16. Fall risk factors in community-dwelling elderly who receive Medicaid-supported home- and community-based care services.

    Science.gov (United States)

    Yamashita, Takashi; Jeon, Haesang; Bailer, A John; Nelson, Ian M; Mehdizadeh, Shahla

    2011-06-01

    This study identifies fall risk factors in an understudied population of older people who receive community-based care services. Data were collected from enrollees of Ohio's Medicaid home- and community-based waiver program (preadmission screening system providing options and resources today [PASSPORT]). A total of 23,182 participants receiving PASSPORT services in 2005/2006 was classified as fallers and nonfallers, and a variety of risk factors for falling was analyzed using logistic regressions. The following factors were identified as risk factors for falling: previous fall history, older age, White race, incontinence, higher number of medications, fewer numbers of activity of daily living limitations, unsteady gait, tremor, grasping strength, and absence of supervision. Identifying risk factors for the participants of a Medicaid home- and community-based waiver program are useful for a fall risk assessment, but it would be most helpful if the community-based care service programs incorporate measurements of known fall risk factors into their regular data collection, if not already included.

  17. Are HPV vaccination services accessible to high-risk communities? A spatial analysis of HPV-associated cancer and Chlamydia rates and safety-net clinics.

    Science.gov (United States)

    Tsui, Jennifer; Rodriguez, Hector P; Gee, Gilbert C; Escobedo, Loraine A; Kominski, Gerald F; Bastani, Roshan

    2013-12-01

    While HPV vaccines can greatly benefit adolescents and young women from high-risk areas, little is known about whether safety-net immunization services are geographically accessible to communities at greatest risk for HPV-associated diseases. We explore the spatial relationship between areas with high HPV risk and proximity to safety-net clinics from an ecologic perspective. We used cancer registry data and Chlamydia surveillance data to identify neighborhoods within Los Angeles County with high risk for HPV-associated cancers. We examined proximity to safety-net clinics among neighborhoods with the highest risk. Proximity was measured as the shortest distance between each neighborhood center and the nearest clinic and having a clinic within 3 miles of each neighborhood center. The average 5-year non-age-adjusted rates were 1,940 cases per 100,000 for Chlamydia and 60 per 100,000 for HPV-associated cancers. A large majority, 349 of 386 neighborhoods with high HPV-associated cancer rates and 532 of 537 neighborhoods with high Chlamydia rates, had a clinic within 3 miles of the neighborhood center. Clinics were more likely to be located within close proximity to high-risk neighborhoods in the inner city. High-risk neighborhoods outside of this urban core area were less likely to be near accessible clinics. The majority of high-risk neighborhoods were geographically near safety-net clinics with HPV vaccination services. Due to low rates of vaccination, these findings suggest that while services are geographically accessible, additional efforts are needed to improve uptake. Programs aimed to increase awareness about the vaccine and to link underserved groups to vaccination services are warranted.

  18. Linking High Risk Postpartum Women with a Technology Enabled Health Coaching Program to Reduce Diabetes Risk and Improve Wellbeing: Program Description, Case Studies, and Recommendations for Community Health Coaching Programs.

    Science.gov (United States)

    Athavale, Priyanka; Thomas, Melanie; Delgadillo-Duenas, Adriana T; Leong, Karen; Najmabadi, Adriana; Harleman, Elizabeth; Rios, Christina; Quan, Judy; Soria, Catalina; Handley, Margaret A

    2016-01-01

    Background . Low-income minority women with prior gestational diabetes mellitus (pGDM) or high BMIs have increased risk for chronic illnesses postpartum. Although the Diabetes Prevention Program (DPP) provides an evidence-based model for reducing diabetes risk, few community-based interventions have adapted this program for pGDM women. Methods . STAR MAMA is an ongoing randomized control trial (RCT) evaluating a hybrid HIT/Health Coaching DPP-based 20-week postpartum program for diabetes prevention compared with education from written materials at baseline. Eligibility includes women 18-39 years old, ≥32 weeks pregnant, and GDM or BMI > 25. Clinic- and community-based recruitment in San Francisco and Sonoma Counties targets 180 women. Sociodemographic and health coaching data from a preliminary sample are presented. Results . Most of the 86 women included to date (88%) have GDM, 80% were identified as Hispanic/Latina, 78% have migrant status, and most are Spanish-speaking. Women receiving the intervention indicate high engagement, with 86% answering 1+ calls. Health coaching callbacks last an average of 9 minutes with range of topics discussed. Case studies presented convey a range of emotional, instrumental, and health literacy-related supports offered by health coaches. Discussion . The DPP-adapted HIT/health coaching model highlights the possibility and challenge of delivering DPP content to postpartum women in community settings. This trial is registered with ClinicalTrials.gov NCT02240420.

  19. 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…

  20. Physical activity level and fall risk among community-dwelling older adults.

    Science.gov (United States)

    Low, Sok Teng; Balaraman, Thirumalaya

    2017-07-01

    [Purpose] To find the physical activity level and fall risk among the community-dwelling Malaysian older adults and determine the correlation between them. [Subjects and Methods] A cross-sectional study was conducted in which, the physical activity level was evaluated using the Rapid Assessment of Physical Activity questionnaire and fall risk with Fall Risk Assessment Tool. Subjects recruited were 132 community-dwelling Malaysian older adults using the convenience sampling method. [Results] The majority of the participants were under the category of under-active regular light-activities and most of them reported low fall risk. The statistical analysis using Fisher's exact test did not show a significant correlation between physical activity level and fall risk. [Conclusion] The majority of community-dwelling Malaysian older adults are performing some form of physical activity and in low fall risk category. But this study did not find any significant correlation between physical activity level and fall risk among community-dwelling older adults in Malaysia.

  1. Growing up as a part of teenage communities: Current trends and risks

    Directory of Open Access Journals (Sweden)

    G H Azashikov

    2015-12-01

    Full Text Available The article describes teenage communities as a special space of growing up. The authors examine some major transformations of the contemporary society and socialization risks generated by them in teenage communities for today’s high parental employment outside the home makes peer groups the most important agent of socialization and a key space for teenagers’ growing up. The article identifies the main socio-psychological conceptions of group dynamics, types of relationships among teenagers and functions of peer communities that provide teens a chance to grow up in a system of intergroup communications. The authors emphasize the fact that traditionally peer relationships serve as a “school” of social experience necessary for the normal format of growing up, but today communicational and recreational practices of teens and youth are increasingly “constructed” by the consumption industry. The article considers tendencies of consumerism and virtualization in teenage communities that are changing not only the shape but also the very essence of interactions and relationships among teens and youngsters; discusses the criminalization risks in these groups due to today’s mass media impact, and the risks associated with the Internet activity, such as intellectual primitivization and infantilization due to the overreliance on the Internet.

  2. Increasing Risk Awareness: The Coastal Community Resilience Index

    Science.gov (United States)

    Thompson, Jody A.; Sempier, Tracie; Swann, LaDon

    2012-01-01

    As the number of people moving to the Gulf Coast increases, so does the risk of exposure to floods, hurricanes, and other storm-related events. In an effort to assist communities in preparing for future storm events, the Coastal Community Resilience Index was created. The end result is for communities to take actions to address the weaknesses they…

  3. Enterprise Resource Planning Systems: Assessment of Risk Factors by California Community College Leaders

    Science.gov (United States)

    Valente, Mario Manuel

    2011-01-01

    Most California Community Colleges have chosen to purchase and implement a Management Information Systems software solution also known as an Enterprise Resource Planning (ERP) system in order to monitor, control, and automate their administrative tasks. ERP implementations are complex, expensive, high profile, and therefore high risk. To reduce…

  4. Using community archetypes to better understand differential community adaptation to wildfire risk.

    Science.gov (United States)

    Carroll, Matthew; Paveglio, Travis

    2016-06-05

    One of the immediate challenges of wildfire management concerns threats to human safety and property in residential areas adjacent to non-cultivated vegetation. One approach for relieving this problem is to increase human community 'adaptiveness' to deal with the risk and reality of fire in a variety of landscapes. The challenge in creating 'fire-adapted communities' (FACs) is the great diversity in character and make-up of populations at risk from wildfire. This paper outlines a recently developed categorization scheme for Wildland-Urban Interface (WUI) communities based on a larger conceptual approach for understanding how social diversity is likely to influence the creation of FACs. The WUI categorization scheme situates four community archetypes on a continuum that recognizes dynamic change in human community functioning. We use results from the WUI classification scheme to outline key characteristics associated with each archetype and results from recent case studies to demonstrate the diversity across WUI communities. Differences among key characteristics of local social context will likely result in the need for different adaptation strategies to wildfire. While the WUI archetypes described here may not be broadly applicable to other parts of the world, we argue that the conceptual approach and strategies for systematically documenting local influences on wildfire adaptation have potential for broad application.This article is part of the themed issue 'The interaction of fire and mankind'. © 2016 The Author(s).

  5. Analysis of the population at high risk of stroke detected with carotid artery ultrasonography in Tianjin urban communities

    Directory of Open Access Journals (Sweden)

    Wei YUE

    2015-04-01

    Full Text Available Objective To investigate the features of carotid atherosclerosis in a population at high risk of stroke in urban communities of Tianjin, so as to provide inspiration for carotid ultrasonography to play a greater role in the prevention and control of stroke.  Methods A total of 956 residents at high risk of stroke were selected from 4 urban communities in Tianjin using cluster random sampling method. Doppler ultrasound screening was performed in bilateral common carotid artery (CCA, internal carotid artery (ICA, external carotid artery (ECA, vertebral artery (VA, subclavian artery (SCA and innominate artery of the population. The intima-media thickness (IMT, atherosclerotic plaque formation and its location and size, vascular stenosis or occlusion, and flow spectrum were detected. The results and features of carotid ultrasound screening were analyzed and compared among different gender and age groups.  Results 1 The detection rate of carotid atherosclerosis was 71.55% (684/956, and the detection rate in males was significantly higher than that in females (79.08% vs 65.87%; χ2 = 20.067, P = 0.000. 2 Among the population with carotid atherosclerosis, the most common manifestation was the formation of atherosclerotic plaques (81.58%, 558/684, secondly intima-media thickening (13.01%, 89/684, followed by moderate to severe stenosis or occlusion (5.41%, 37/684. The proportion of intima-media thickening in males was lower than that in females (7.08% vs 18.38%; χ2 = 19.269, P = 0.000. The proportion of carotid atherosclerotic plaque formation in males was higher than that in females (86.46% vs 77.16%; χ2 = 9.824, P = 0.002. The median rating of carotid atherosclerosis was 1.79, with males higher than females [1.98 (0.70, 3.26 vs 1.52 (0.20, 2.84; Z = 2.304, P = 0.042]. The site of plaque formation was most commonly located in carotid bulb (36.61%, secondly SCA (22.18%. Of the type of carotid stenosis, ICA stenosis was detected in 30 cases, VA

  6. Risk assessment and model for community-based construction ...

    African Journals Online (AJOL)

    It, therefore, becomes necessary to systematically manage uncertainty in community-based construction in order to increase the likelihood of meeting project objectives using necessary risk management strategies. Risk management, which is an iterative process due to the dynamic nature of many risks, follows three main ...

  7. Mitigating fall risk: A community fall reduction program.

    Science.gov (United States)

    Reinoso, Humberto; McCaffrey, Ruth G; Taylor, David W M

    One fourth of all American's over 65 years of age fall each year. Falls are a common and often devastating event that can pose a serious health risk for older adults. Healthcare providers are often unable to spend the time required to assist older adults with fall risk issues. Without a team approach to fall prevention the system remains focused on fragmented levels of health promotion and risk prevention. The specific aim of this project was to engage older adults from the community in a fall risk assessment program, using the Stopping Elderly Accidents, Deaths & Injuries (STEADI) program, and provide feedback on individual participants' risks that participants could share with their primary care physician. Older adults who attended the risk screening were taking medications that are known to increase falls. They mentioned that their health care providers do not screen for falls and appreciated a community based screening. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Patient satisfaction with a chronic kidney disease risk assessment service in community pharmacies.

    Science.gov (United States)

    Gheewala, Pankti A; Peterson, Gregory M; Zaidi, Syed Tabish R; Jose, Matthew D; Castelino, Ronald L

    2018-04-01

    Patient satisfaction is an important determinant of the feasibility and sustainability of community pharmacy screening services. However, few studies have evaluated this, with no such study performed for a chronic kidney disease risk assessment service. The aim was to determine patient satisfaction with a chronic kidney disease risk assessment service performed in community pharmacies. Community pharmacies in the state of Tasmania, Australia. An anonymous nine-item satisfaction survey, with Likert-type scales, was developed following a literature review of existing surveys. Reliability of the nine-item scale was determined using Cronbach's alpha. Patients were asked an additional question on willingness to pay, with choices of amount from $5 to $25. The satisfaction survey was mailed to 389 patients who participated in the chronic kidney disease risk assessment study. Patient level of satisfaction with and willingness to pay for the chronic kidney disease service. Responses from 143 participants were included in the final analysis. Cronbach's alpha for the nine-item satisfaction scale was 0.87. The majority of participants agreed that the time required to undergo the risk assessment process was justified (90.2%); overall, they were satisfied with the chronic kidney disease risk assessment service (90.0%) and they felt comfortable with the pharmacist referring their results to their doctor (88.9%). Of 136 participants who answered the question on willingness to pay, 62.9% indicated that they would pay for the chronic kidney disease service. Of these, 29.2, 25.8 and 19.1% were willing to pay $20, $10 and $5, respectively. Patient satisfaction with the community pharmacy-based chronic kidney disease risk assessment was high. These findings provide support for the implementation of the service within community pharmacy practice.

  9. Risk-communication capability for public health emergencies varies by community diversity

    Directory of Open Access Journals (Sweden)

    Viswanath Kasisomayajula

    2008-03-01

    Full Text Available Abstract Background Public health emergencies heighten several challenges in risk-communication: providing trustworthy sources of information, reaching marginalized populations, and minimizing fear and public confusion. In emergencies, however, information may not diffuse equally among all social groups, and gaps in knowledge may increase. Such knowledge gaps vary by social structure and the size, socioeconomic status, and diversity of the population. This study explores the relationship between risk-communication capabilities, as perceived by public officials participating in emergency tabletop exercises, and community size and diversity. Findings For each of the three communication functions tested, risk-communication capabilities are perceived to be greater in communities with fewer then 10% of the population speaking a language other than English at home, decreasing as the percentage grows to 20% (ANOVA P ≤ 0.02. With respect to community size, however, we found an N-shaped relationship between perceived risk communication capabilities and population size. Capabilities are perceived highest in the largest communities and lowest in the smallest, but lower in communities with 20,000–49,999 inhabitants compared to those with 2,500–19,999. Conclusion The results of this study suggest the need to factor population diversity into risk communication plans and the need for improved state or regional risk-communication capabilities, especially for communities with limited local capacity.

  10. Social and psychological risks expertise in crisis communities

    International Nuclear Information System (INIS)

    Shvalb, Y.

    1998-01-01

    Emerging and development of crises in the communities leads to considerable increase of individual's risks' quality and quantity. Irrespectively of risk scale - partial or total influence on a community - a number of tendencies of risks increase could be identified. On social level risks result from the tendency of social protection decrease and restriction in free choice of activities' forms and kinds. On group level confrontation and clashes emerge, increase intolerance and decrease tolerance are identified. On interpersonal (micro group) level aggression and abuse intensify. On individual level a complex of negative psychological statuses develops, which is diverse both as for its content and forms. Reasons of crisis development and its dynamics determine the content and concrete forms of risks on all levels. Systematic description of risks and development of psychological support programmes for population in risk presupposes organization and delivering of comprehensive social and psychological expertise of situation. Such an expertise makes it possible to unite in a comprehensive model of the multi-professional descriptions of crisis situations on the above mentioned levels, the subjective concepts of the population (or its separate groups) together with evaluation of various projects and programmes on crisis coping and risks decrease options. (author)

  11. Risk factors associated with sexually transmitted infections among women under community supervision in New York City.

    Science.gov (United States)

    Davis, Alissa; Goddard-Eckrich, Dawn; Dasgupta, Anindita; El-Bassel, Nabila

    2018-01-01

    The number of women under community supervision in the United States has increased, and this population has a high risk for sexually transmitted infections (STIs). We examined STI prevalence and multiple risk factors among drug-involved women under community supervision in New York City. Data were from a randomized controlled trial testing the efficacy of a behavioral HIV/STI intervention (Women on the Road to Health [WORTH]) among drug-involved women in the community corrections system in New York City from 2009 to 2012. To be eligible for inclusion, women had to be under community supervision within the past 90 days, have used illicit drugs at least once in the past six months, and have unprotected sex at least once in the past 90 days. Participants completed a survey containing items on STI risk factors and were tested for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Multivariable regression was used to examine associations between risk factors and STI diagnosis. Of 333 women tested, 89 (26.7%) tested positive for an STI. Ten (3.0%) were positive for C. trachomatis, 4 (1.2%) for N. gonorrhoeae, and 77 (23.1%) for T. vaginalis. Women with any STI were more likely to be black (AOR: 2.02; 95% CI: 1.08-3.77), homeless in the past 90 days (AOR: 2.07; 95% CI: 1.01-4.26), arrested in the past 90 days (AOR: 1.97; 95% CI: 1.14-3.39), and have a greater number of sexual partners in the past 90 days (AOR: 1.24; 95% CI: 1.08-1.42). Drug-using women under community supervision have a high burden of STIs driven by multiple risk factors. Implementing STI screening, prevention, and treatment programs in community supervision settings could facilitate a reduction in STIs among this population.

  12. Cardiometabolic risk factors in the Agarwal business community in India: Jaipur Heart Watch-6.

    Science.gov (United States)

    Dhabriya, Ritu; Agrawal, Mukta; Gupta, Rajeev; Mohan, Indu; Sharma, Krishna Kumar

    2015-01-01

    Agarwal is one of the largest business communities in India. To determine prevalence of cardiovascular risk factors and their distribution according to educational status (ES) in this community we performed a study. 1781 (men 1039, women 742) of 2500 selected subjects (71.2%) were evaluated and fasting blood sample obtained in 1130. Age-adjusted prevalence of risk factors was tobacco use 12.2%, sedentary habits 54.2%, overweight/obesity 54.4%, obesity 19.5%, abdominal obesity 61.2%, hypertension 36.0%, diabetes 19.2%, hypercholesterolemia ≥200 mg/dl 25.8%, low HDL cholesterol 29.2%, hypertriglyceridemia 32.8% and metabolic syndrome 22.3%. Low ES subjects had significantly greater prevalence of sedentary habits, low fruit/vegetable intake, hypertension, low HDL cholesterol and diabetes. Cardiometabolic risk factors are highly prevalent in the Agarwal business community. Prevalence is greater in subjects with low educational status. Copyright © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  13. Ferritin levels and risk of heart failure-the Atherosclerosis Risk in Communities Study.

    Science.gov (United States)

    Silvestre, Odilson M; Gonçalves, Alexandra; Nadruz, Wilson; Claggett, Brian; Couper, David; Eckfeldt, John H; Pankow, James S; Anker, Stefan D; Solomon, Scott D

    2017-03-01

    Severe iron overload is associated with cardiac damage, while iron deficiency has been related to worse outcomes in subjects with heart failure (HF). This study investigated the relationship between ferritin, a marker of iron status, and the incidence of HF in a community-based cohort. We examined 1063 participants who were free of heart failure from the Atherosclerosis Risk in Communities (ARIC) Study in whom ferritin serum levels were measured at baseline (1987-1989). The participants (mean age 52.7 ± 5.5 years, 62% women), were categorized in low (200 ng/mL in women and >300 ng/mL in men; n = 247) ferritin levels. Multivariable Cox proportional hazards models were used to evaluate the relationship between ferritin and incident HF. After 21 ± 4.6 years of follow-up, HF occurred in 144 (13.5%) participants. When compared with participants with normal ferritin levels, participants with low ferritin levels had a higher risk of HF [hazard ratio (HR) = 2.24, 95% confidence interval (CI) 1.15-4.35; P = 0.02] as did those with high ferritin levels (HR = 1.81, 95% CI 1.01-3.25; P = 0.04), after adjusting for potential confounders. Notably, low ferritin levels remained associated with incident HF even after excluding subjects with anaemia (HR = 2.28, 95% CI 1.11-4.68; P = 0.03). Derangements in iron metabolism, either low or high ferritin serum levels, were associated with higher risk of incident HF in a general population, even without concurrent anaemia. These findings suggest that iron imbalance might play a role in the development of HF. © 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology.

  14. Quantifying links between stroke and risk factors: a study on individual health risk appraisal of stroke in a community of Chongqing.

    Science.gov (United States)

    Wu, Yazhou; Zhang, Ling; Yuan, Xiaoyan; Wu, Yamin; Yi, Dong

    2011-04-01

    The objective of this study is to investigate the risk factors of stroke in a community in Chongqing by setting quantitative criteria for determining the risk factors of stroke. Thus, high-risk individuals can be identified and laid a foundation for predicting individual risk of stroke. 1,034 cases with 1:2 matched controls (2,068) were chosen from five communities in Chongqing including Shapingba, Xiaolongkan, Tianxingqiao, Yubei Road and Ciqikou. Participants were interviewed with a uniform questionnaire. The risk factors of stroke and the odds ratios of risk factors were analyzed with a logistic regression model, and risk exposure factors of different levels were converted into risk scores using statistical models. For men, ten risk factors including hypertension (5.728), family history of stroke (4.599), and coronary heart disease (5.404), among others, were entered into the main effect model. For women, 11 risk factors included hypertension (5.270), family history of stroke (4.866), hyperlipidemia (4.346), among others. The related risk scores were added to obtain a combined risk score to predict the individual's risk of stoke in the future. An individual health risk appraisal model of stroke, which was applicable to individuals of different gender, age, health behavior, disease and family history, was established. In conclusion, personal diseases including hypertension, diabetes mellitus, etc., were very important to the prevalence of stoke. The prevalence of stroke can be effectively reduced by changing unhealthy lifestyles and curing the positive individual disease. The study lays a foundation for health education to persuade people to change their unhealthy lifestyles or behaviors, and could be used in community health services.

  15. A case-control study of support/opposition to wind turbines: Perceptions of health risk, economic benefits, and community conflict

    International Nuclear Information System (INIS)

    Baxter, Jamie; Morzaria, Rakhee; Hirsch, Rachel

    2013-01-01

    Despite considerable quantitative case study research on communities living with turbines, few have studied the roles played by the perceptions of: health risk, economic benefits/fairness, and intra-community conflict. We report the findings from a case-control survey which compares residents living with/without turbines in their community to understand the relative importance of these variables as predictors of turbine support. Ontario is the context for this study as it is a place where the pace of turbine installations is both very high and extremely politicized. As expected 69% of residents in the case community would vote in favour of local turbines yet surprisingly, only 25% would do so in the control community. Though the literature suggests that aesthetic preferences best predict turbine support the key predictors in this study are: health risk perception, community benefits, general community enhancement, and a preference for turbine-generated electricity. Concern about intra-community conflict is high in both the case (83%) and control (85%) communities as is concern about the fairness of local economic benefits (56% and 62%, respectively); yet neither is significant in the models. We discuss the implications of these findings particularly in terms of the consequences of a technocratic decide-announce-defend model of renewable facility siting. - Highlights: • We compare turbine support in a community living with turbines against a matched control. • We include health risk perception, economic benefits, and community conflict as predictors. • Turbine support is highest in the turbine community and surprisingly low in the control. • Health risk perception and economic benefits consistently predict turbine support. • Economic benefits distribution and conflict are important, but not consistent predictors

  16. A multicentre randomised controlled trial of day hospital-based falls prevention programme for a screened population of community-dwelling older people at high risk of falls

    OpenAIRE

    Conroy, Simon; Kendrick, Denise; Harwood, Rowan; Gladman, John; Coupland, Carol; Sach, Tracey; Drummond, Avril; Youde, Jane; Edmans, Judi; Masud, Tahir

    2010-01-01

    Objective: to determine the clinical effectiveness of a day hospital-delivered multifactorial falls prevention programme, for community-dwelling older people at high risk of future falls identified through a screening process. Design: multicentre randomised controlled trial. Setting: eight general practices and three day hospitals based in the East Midlands, UK. Participants: three hundred and sixty-four participants, mean age 79 years, with a median of three falls risk factors per person at ...

  17. Worker, workplace, and community/environmental risk factors for workplace violence in emergency departments.

    Science.gov (United States)

    Gillespie, Gordon Lee; Pekar, Bunnany; Byczkowski, Terri L; Fisher, Bonnie S

    2017-03-04

    Workplace violence committed by patients and visitors has high propensity to occur against emergency department employees. This article reports the association of worker, workplace, and community/environmental factors with violence risks. A cross-sectional research design was used with 280 employees from six emergency departments in the Midwest United States. Respondents completed the Survey of Violence Experienced by Staff and a 10-item demographic questionnaire. Data were analyzed using frequencies, percentages, Chi-square tests, and adjusted relative risks with 95% confidence intervals. Over 80% of respondents experienced at least one type of workplace violence with their current employer and approximately 40% experienced all three types. Risks for workplace violence were significantly higher for registered nurses and hospital-based emergency departments. Workplace violence can impact all employees in the emergency department regardless of worker, workplace, and community/environmental factors.

  18. Urban Climate Risk Communities

    DEFF Research Database (Denmark)

    Blok, Anders

    2016-01-01

    of Beck’s forward-looking agenda for a post-Euro-centric social science, outlines the contours of such an urban-cosmopolitan ‘realpolitik’ of climate risks, as this is presently unfolding across East Asian world cities. Much more than a theory-building endeavour, the essay suggests, Beck’s sociology......Ulrich Beck’s cosmopolitan sociology affords a much-needed rethinking of the transnational politics of climate change, not least in pointing to an emerging inter-urban geography of world cities as a potential new source of community, change and solidarity. This short essay, written in honour...... provides a standing invitation for further transnational dialogue and collaborative empirical work, in East Asia and beyond, on what are, arguably, the defining challenges for the 21st century world of global risks....

  19. Risk assessment: A European Community perspective

    International Nuclear Information System (INIS)

    Haigh, R.

    1992-01-01

    The world is a risky place in which to live! The world tolerates that 750,000 deaths occur on the roads each year. Society has not yet come to terms with the added burden that urbanisation brings to developing countries. Pollution from the use of fossil fuels creates incalculable loss to the world's environment and to the health of its inhabitants. The misuse of chemicals provokes suffering and deformity. In the European Community alone, over 21 million tonnes of toxic waste have to be treated each year. Of course, there are different types of risk: individual and societal. Individuals continue to travel by air in defiance of terrorists or faulty machinery. Whilst society urges caution in diet and nutrition, the individual is probably more worried about food additives that he is about eating too much or making a rigorous appraisal of the value of his die!. As the conference progresses many people will die from the causes of malnutrition, from war or societal neglect while we, individually, will be more at risk from overeating. In other words, we perceive risks is in a multitude of ways. We tolerate these risks according to our perception of what we feel is acceptable without carrying out scientific assessment of the relative severity of those risks. If applied at a governmental level, this subjective tolerance can lead to unnecessary burdens or constraints that are disproportionate to the risk. Clearly, this is not acceptable for policy makers. We have just seen the closure of the UNCED World Conference on the Environment in Rio de Janeiro, where the absolute need for more effective cooperation in the protection of the environment and the world inhabitants was convincingly demonstrated. The European Communities already coordinate risk assessment with its twelve Member States in a large number of areas and is increasing its international cooperation. We have recognized that it is no longer possible to carry out effective risk assessment in one country alone or to

  20. Risk assessment: A European Community perspective

    Energy Technology Data Exchange (ETDEWEB)

    Haigh, R [Industrial Medicine and Hygiene Unit Health and Safety Directorate, Directorate-General Employment, Industrial Relations and Social Affairs Commission of the European Communities, Luxembourg (Luxembourg)

    1992-07-01

    The world is a risky place in which to live{exclamation_point} The world tolerates that 750,000 deaths occur on the roads each year. Society has not yet come to terms with the added burden that urbanisation brings to developing countries. Pollution from the use of fossil fuels creates incalculable loss to the world's environment and to the health of its inhabitants. The misuse of chemicals provokes suffering and deformity. In the European Community alone, over 21 million tonnes of toxic waste have to be treated each year. Of course, there are different types of risk: individual and societal. Individuals continue to travel by air in defiance of terrorists or faulty machinery. Whilst society urges caution in diet and nutrition, the individual is probably more worried about food additives that he is about eating too much or making a rigorous appraisal of the value of his die{exclamation_point}. As the conference progresses many people will die from the causes of malnutrition, from war or societal neglect while we, individually, will be more at risk from overeating. In other words, we perceive risks is in a multitude of ways. We tolerate these risks according to our perception of what we feel is acceptable without carrying out scientific assessment of the relative severity of those risks. If applied at a governmental level, this subjective tolerance can lead to unnecessary burdens or constraints that are disproportionate to the risk. Clearly, this is not acceptable for policy makers. We have just seen the closure of the UNCED World Conference on the Environment in Rio de Janeiro, where the absolute need for more effective cooperation in the protection of the environment and the world inhabitants was convincingly demonstrated. The European Communities already coordinate risk assessment with its twelve Member States in a large number of areas and is increasing its international cooperation. We have recognized that it is no longer possible to carry out effective risk

  1. High School Football and Risk of Neurodegeneration: A Community-Based Study

    Science.gov (United States)

    Savica, Rodolfo; Parisi, Joseph E.; Wold, Lester E.; Josephs, Keith A.; Ahlskog, J. Eric

    2012-01-01

    Objective To assess whether high school football played between 1946 and 1956, when headgear was less protective than today, was associated with development of neurodegenerative diseases later in life. Methods All male students who played football from 1946 to 1956 in the high schools of Rochester, Minnesota, plus a non–football-playing referent group of male students in the band, glee club, or choir were identified. Using the records-linkage system of the Rochester Epidemiology Project, we reviewed (from October 31, 2010, to March 30, 2011) all available medical records to assess later development of dementia, Parkinson disease (PD), or amyotrophic lateral sclerosis (ALS). We also compared the frequency of dementia, PD, or ALS with incidence data from the general population of Olmsted County, Minnesota. Results We found no increased risk of dementia, PD, or ALS among the 438 football players compared with the 140 non–football-playing male classmates. Parkinson disease and ALS were slightly less frequent in the football group, whereas dementia was slightly more frequent, but not significantly so. When we compared these results with the expected incidence rates in the general population, only PD was significantly increased; however, this was true for both groups, with a larger risk ratio in the non–football group. Conclusion Our findings suggest that high school students who played American football from 1946 to 1956 did not have an increased risk of later developing dementia, PD, or ALS compared with non–football-playing high school males, despite poorer equipment and less regard for concussions compared with today and no rules prohibiting head-first tackling (spearing). PMID:22469346

  2. Urban community gardeners' knowledge and perceptions of soil contaminant risks.

    Science.gov (United States)

    Kim, Brent F; Poulsen, Melissa N; Margulies, Jared D; Dix, Katie L; Palmer, Anne M; Nachman, Keeve E

    2014-01-01

    Although urban community gardening can offer health, social, environmental, and economic benefits, these benefits must be weighed against the potential health risks stemming from exposure to contaminants such as heavy metals and organic chemicals that may be present in urban soils. Individuals who garden at or eat food grown in contaminated urban garden sites may be at risk of exposure to such contaminants. Gardeners may be unaware of these risks and how to manage them. We used a mixed quantitative/qualitative research approach to characterize urban community gardeners' knowledge and perceptions of risks related to soil contaminant exposure. We conducted surveys with 70 gardeners from 15 community gardens in Baltimore, Maryland, and semi-structured interviews with 18 key informants knowledgeable about community gardening and soil contamination in Baltimore. We identified a range of factors, challenges, and needs related to Baltimore community gardeners' perceptions of risk related to soil contamination, including low levels of concern and inconsistent levels of knowledge about heavy metal and organic chemical contaminants, barriers to investigating a garden site's history and conducting soil tests, limited knowledge of best practices for reducing exposure, and a need for clear and concise information on how best to prevent and manage soil contamination. Key informants discussed various strategies for developing and disseminating educational materials to gardeners. For some challenges, such as barriers to conducting site history and soil tests, some informants recommended city-wide interventions that bypass the need for gardener knowledge altogether.

  3. Urban community gardeners' knowledge and perceptions of soil contaminant risks.

    Directory of Open Access Journals (Sweden)

    Brent F Kim

    Full Text Available Although urban community gardening can offer health, social, environmental, and economic benefits, these benefits must be weighed against the potential health risks stemming from exposure to contaminants such as heavy metals and organic chemicals that may be present in urban soils. Individuals who garden at or eat food grown in contaminated urban garden sites may be at risk of exposure to such contaminants. Gardeners may be unaware of these risks and how to manage them. We used a mixed quantitative/qualitative research approach to characterize urban community gardeners' knowledge and perceptions of risks related to soil contaminant exposure. We conducted surveys with 70 gardeners from 15 community gardens in Baltimore, Maryland, and semi-structured interviews with 18 key informants knowledgeable about community gardening and soil contamination in Baltimore. We identified a range of factors, challenges, and needs related to Baltimore community gardeners' perceptions of risk related to soil contamination, including low levels of concern and inconsistent levels of knowledge about heavy metal and organic chemical contaminants, barriers to investigating a garden site's history and conducting soil tests, limited knowledge of best practices for reducing exposure, and a need for clear and concise information on how best to prevent and manage soil contamination. Key informants discussed various strategies for developing and disseminating educational materials to gardeners. For some challenges, such as barriers to conducting site history and soil tests, some informants recommended city-wide interventions that bypass the need for gardener knowledge altogether.

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

    LENUS (Irish Health Repository)

    O Caoimh, Rónán

    2014-09-19

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

  5. Supporting families in a high-risk setting: proximal effects of the SAFEChildren preventive intervention.

    Science.gov (United States)

    Tolan, Patrick; Gorman-Smith, Deborah; Henry, David

    2004-10-01

    Four hundred twenty-four families who resided in inner-city neighborhoods and had a child entering 1st grade were randomly assigned to a control condition or to a family-focused preventive intervention combined with academic tutoring. SAFEChildren, which was developed from a developmental-ecological perspective, emphasizes developmental tasks and community factors in understanding risk and prevention. Tracking of linear-growth trends through 6 months after intervention indicated an overall effect of increased academic performance and better parental involvement in school. High-risk families had additional benefits for parental monitoring, child-problem behaviors, and children's social competence. High-risk youth showed improvement in problem behaviors and social competence. Results support a family-focused intervention that addresses risk in low-income communities as managing abnormal challenges.

  6. High rates of bacterial vaginosis and Chlamydia in a low-income, high-population-density community in Cape Town

    Directory of Open Access Journals (Sweden)

    Katie S. Lennard

    2017-12-01

    Full Text Available Young South African women, from resource-poor communities, face several sexual and reproductive health challenges. Here we describe the vaginal microbiota and sexually transmitted infection (STI prevalence of 102; 16–22-year-old, HIV-negative South African women from a low-income, high-population-density community in Cape Town (CPT. Vaginal microbiota were profiled using 16S rRNA amplicon sequencing; bacterial vaginosis (BV status was established using Nugent scoring and STIs were determined by multiplex polymerase chain reaction. STIs were common, with 55% of women having at least one STI; 41% were infected with high-risk human papilloma virus (HPV and a further 28% with low-risk HPV; 44% were infected with Chlamydia, 16% of whom had at least one additional STI. Similarly, BV rates were very high, with 55% of women classified as BV-positive (Nugent score ≥7, 7% as BV-intermediate (Nugent score 3–6 and 38% as BV-negative (Nugent 0–2. Group B Streptococcus (Streptococcus agalactiae, the leading cause of neonatal sepsis, was present in 25% of BV-positive women and 28% of BV-negative women, and was significantly more abundant among BV-negative women. Both Chlamydia infection and BV may adversely affect reproductive health and place these women at additional risk for HIV acquisition. The high abundance of Prevotella amnii, in particular, may increase HIV risk, given its inflammatory capacity. Laboratory-based testing for STIs (Chlamydia and Gonorrhoeae in particular appear to be warranted in this community, together with further monitoring or treatment of BV. Research correlation: This article is the original version, of which an Afrikaans translation was made available to provide access to a larger readership, available here: https://doi.org/10.4102/satnt.v36i1.1495

  7. A text message intervention for alcohol risk reduction among community college students: TMAP.

    Science.gov (United States)

    Bock, Beth C; Barnett, Nancy P; Thind, Herpreet; Rosen, Rochelle; Walaska, Kristen; Traficante, Regina; Foster, Robert; Deutsch, Chris; Fava, Joseph L; Scott-Sheldon, Lori A J

    2016-12-01

    Students at community colleges comprise nearly half of all U.S. college students and show higher risk of heavy drinking and related consequences compared to students at 4-year colleges, but no alcohol safety programs currently target this population. To examine the feasibility, acceptability, and preliminary efficacy of an alcohol risk-reduction program delivered through text messaging designed for community college (CC) students. Heavy drinking adult CC students (N=60) were enrolled and randomly assigned to the six-week active intervention (Text Message Alcohol Program: TMAP) or a control condition of general motivational (not alcohol related) text messages. TMAP text messages consisted of alcohol facts, strategies to limit alcohol use and related risks, and motivational messages. Assessments were conducted at baseline, week 6 (end of treatment) and week 12 (follow up). Most participants (87%) completed all follow up assessments. Intervention messages received an average rating of 6.8 (SD=1.5) on a 10-point scale. At week six, TMAP participants were less likely than controls to report heavy drinking and negative alcohol consequences. The TMAP group also showed significant increases in self-efficacy to resist drinking in high risk situations between baseline and week six, with no such increase among controls. Results were maintained through the week 12 follow up. The TMAP alcohol risk reduction program was feasible and highly acceptable indicated by high retention rates through the final follow up assessment and good ratings for the text message content. Reductions in multiple outcomes provide positive indications of intervention efficacy. Copyright © 2016. Published by Elsevier Ltd.

  8. Community perceptions of risk factors for interpersonal violence in townships in Cape Town, South Africa: A focus group study.

    Science.gov (United States)

    Makanga, Prestige Tatenda; Schuurman, Nadine; Randall, Ellen

    2017-10-01

    Interpersonal violence is a major contributor to the burden of disease globally, and in South Africa, it is the leading cause of injury. There is an emerging consensus that the development of actionable policy and effective prevention strategies for interpersonal violence requires an understanding of the contextual matters that elevate risk for interpersonal violence. The objective of this study was to explore community perceptions of risks for interpersonal violence in five townships in Cape Town, South Africa, with high rates of violence. Focus group discussions were conducted with community members to identify key factors in that contributed to being either a perpetrator or victim of interpersonal violence. The ecological framework was used to classify the risk factors as occurring at individual, relationship, community or society levels. Some of the risk factors identified included alcohol abuse, poverty, informality of settlements and cultural norms. Differences in how each of these risk factors are expressed and experienced in the five communities are also elucidated. This approach enabled the collection of contextual community-based data that can complement conventional surveillance data in the development of relevant community-level strategies for interpersonal violence prevention.

  9. Health risk assessment of heavy metals and metalloid in drinking water from communities near gold mines in Tarkwa, Ghana.

    Science.gov (United States)

    Bortey-Sam, Nesta; Nakayama, Shouta M M; Ikenaka, Yoshinori; Akoto, Osei; Baidoo, Elvis; Mizukawa, Hazuki; Ishizuka, Mayumi

    2015-07-01

    Concentrations of heavy metals and metalloid in borehole drinking water from 18 communities in Tarkwa, Ghana, were measured to assess the health risk associated with its consumption. Mean concentrations of heavy metals (μg/L) exceeded recommended values in some communities. If we take into consideration the additive effect of heavy metals and metalloid, then oral hazard index (HI) results raise concerns about the noncarcinogenic adverse health effects of drinking groundwater in Huniso. According to the US Environmental Protection Agency's (USEPA) guidelines, HI values indicating noncarcinogenic health risk for adults and children in Huniso were 0.781 (low risk) and 1.08 (medium risk), respectively. The cancer risk due to cadmium (Cd) exposure in adults and children in the sampled communities was very low. However, the average risk values of arsenic (As) for adults and children through drinking borehole water in the communities indicated medium cancer risk, but high cancer risk in some communities such as Samahu and Mile 7. Based on the USEPA assessment, the average cancer risk values of As for adults (3.65E-05) and children (5.08E-05) indicated three (adults) and five (children) cases of neoplasm in a hundred thousand inhabitants. The results of this study showed that residents in Tarkwa who use and drink water from boreholes could be at serious risk from exposure to these heavy metals and metalloid.

  10. Risk factors for cardiovascular disease in the Ga-Rankuwa community

    Directory of Open Access Journals (Sweden)

    Y.Q. Li

    2007-09-01

    Full Text Available Cardiovascular disease is the most common and yet one of the most preventable causes of death in the world. Rapid urbanization in South Africa is accompanied by rapid changes in lifestyle and environmental exposure that increase the burden of chronic cardiovascular diseases. Risk factors, modifiable or nonmodifiable, exist that increases a person’s chances of developing cardiovascular disease. Though some knowledge is available about the prevalence of the risk factors in South Africa, no information is available regarding the community of Ga-Rankuwa. The purpose of the study was therefore to investigate the prevalence of risk factors for cardiovascular disease amongst the working-age people (18-40 years in Ga-Rankuwa community. A quantitative survey was done and the sample was selected from zone 1,2,4, and 16 of Ga-Rankuwa from July 2005 to October 2005. The sampling method was census sampling (n=604. The data-gathering was self-report using a structured questionnaire as well as physical measurement. Data were analysed using descriptive statistics. The results indicated that risk factors, specifically obesity, physical inactivity and hypertension, were very prevalent in Ga-Rankuwa community. Different distributions of risk factors exist in the various sex and age groups. This finding again emphasises the importance of not developing health interventions with a single focus, for example hypertension or obesity. The risk factors are interwoven and affect each other. It is important to initiate a comprehensive health project to lower the risk factors of cardiovascular disease in the Ga-Rankuwa community.

  11. Prevalence of risk factors for noncommunicable diseases in an indigenous community in Santiago Atitlán, Guatemala

    Directory of Open Access Journals (Sweden)

    David Chen

    2017-04-01

    Full Text Available ABSTRACT Objective To describe the prevalence of noncommunicable disease (NCD risk factors and assess knowledge of those risk factors in the indigenous community of Santiago Atitlán in Guatemala, a lower-middle income country. Methods A population-based, cross-sectional study was conducted using a modified version of the World Health Organization’s STEPS protocol. Adults aged 20–65 years were surveyed regarding demographics and NCD risk factors, and the survey was followed by anthropometric and biochemical measurements. Results Out of 501 screened individuals, 350 respondents were enrolled. The mean age was 36.7 years, and 72.3% were women. Over 90% reported earning less than US$ 65 per month. Almost 80% were stunted. Among women, 37.3% were obese and over three-quarters had central obesity. Over three-quarters of the entire group had dyslipidemia and 18.3% had hypertension, but only 3.0% had diabetes. Overall, 36.0% of participants met criteria for metabolic syndrome. There was no significant association between participants’ education and NCD risk factors except for an inverse association with obesity by percent body fat. Conclusions Santiago Atitlán is a rural, indigenous Guatemalan community with high rates of poverty and stunting coexisting alongside high rates of obesity, particularly among women. Additionally, high rates of hypertension and dyslipidemia were found, but a low rate of diabetes mellitus. Knowledge of NCDs and their risk factors was low, suggesting that educational interventions may be a high-yield, low-cost approach to combating NCDs in this community.

  12. A community based study of NCD risk factors among adult population in Dehradun, India

    Directory of Open Access Journals (Sweden)

    Himanshu Agarwal

    2016-06-01

    Full Text Available Background: A Non-Communicable disease (NCD is one which is non-infectious and non-transmissible among people. NCDs account for leading causes of death and disease burden worldwide. To decrease the burden of NCDs experts stress on the importance of prevention and control with respect to modifiable risk factors. The World Health Organization's World Health Report 2002 identified tobacco use, alcohol consumption, overweight, physical inactivity, high blood pressure and high cholesterol as the most important risk factors for NCDs.(1  Aims & Objectives: 1. To know the prevalence of risk factors leading to NCDs in the study population. 2. To know the socio-demographic correlates associated with risk factors of NCDs. 3. To suggest appropriate recommendations regarding modifiable risk factors of NCDs in study population. Material & Methods: A Cross-sectional study, Community-based study among 18+ population in field practice areas of Community Medicine Department, SGRRIM&HS, Dehradun. Sample Size: 300 each in urban and rural, total 60. Results: The prevalence of Smoking was 11.3%, Smokeless tobacco use 10.5%, Alcohol use 13.2%, Unhealthy diet 99.5%, Low physical activity 0.8%, High BMI (≥ 25 kg/m2 51.2%, above normal waist-hip ratio 57.0%, Raised blood pressure 58.5% and raised blood sugar 25.2%. Conclusion: Smoking is significantly associated with age, sex and occupation. Raised blood pressure is significantly associated with age, sex and social class.

  13. Development of a capacity building program for village health volunteers to support self-management in a high risk population for diabetes in a rural community in northeast Thailand

    Directory of Open Access Journals (Sweden)

    Pakinee Srisarakham

    2016-07-01

    Full Text Available Similar to other parts of the world, the prevalence of type 2 diabetes mellitus (T2DM in the Asia-Pacific Region has rapidly increased during the last few decades. The purposes of this pilot study were to determine the feasibility and the effects of a capacity building program for Village Health Volunteers (VHVs to support self-management in a T2DM high risk population from a rural subdistrict in Northeast Thailand. Both quantitative and qualitative data were collected using surveys, focus group discussions, and in-depth interviews. Data were analyzed and used to develop a 12-week capacity building program for VHVs. This program was then implemented on 60 subjects at high risk of T2DM in the selected community. According to the paired t-test and Wilcoxon-signed rank test, VHVs had higher scores on knowledge and self-efficacy of T2DM prevention after a 12 week intervention (p = .03 and p = .02, respectively. Study participants at risk for T2DM also had a significant increase in T2DM knowledge and self-management (p < .001. Implementation of the capacity building program for VHVs in Northeast Thailand was feasible. The key successes were strong community bonding, community empowerment, and support from family and public health nurses. Effects of the program should be examined with those in other Asia-Pacific countries.

  14. A Descriptive Study of Health, Lifestyle and Sociodemographic Characteristics and their Relationship to Known Dementia Risk Factors in Rural Victorian Communities

    Directory of Open Access Journals (Sweden)

    Kaye Ervin

    2015-08-01

    Full Text Available It is essential to determine the key health risk factors among populations to specifically plan future services and explore interventions that modify risk factors for communities. This aims to reduce risks and delay the onset of chronic conditions, which frequently results in dementia, particularly for small rural communities which experience health workforce shortages, a higher proportion of those in the chronic conditions age group, and reduced access to care. The aim of the study was to determine existing rates of chronic disease, and current lifestyle and sociodemographic factors which may predispose the population to higher risk of dementia. Residents from three shires in rural Victoria, Australia were recruited by random and non-random sampling techniques to complete a survey regarding health perceptions, pre-existing illnesses, health behaviors and social activity in their community. A total of 1474 people completed the survey. Positive factors reported were social participation and low rates of smoking. Negative factors included low rates of physical activity, high rates of obesity and high rates of chronic conditions that indicate significant risk factors for dementia in these communities. Although some factors are modifiable, these communities also have a large population of older residents. This study suggests that community interventions could modify lifestyle risk factors in these rural communities. These lifestyle factors, age of residents and the current chronic conditions are also important for rural service planning to increase preventive actions, and warn of the likely increase in the number of people developing chronic conditions with predispositon to dementia.

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

    LENUS (Irish Health Repository)

    O’Caoimh, Rónán

    2015-01-01

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

  16. An assessment of community health workers' ability to screen for cardiovascular disease risk with a simple, non-invasive risk assessment instrument in Bangladesh, Guatemala, Mexico, and South Africa: an observational study.

    Science.gov (United States)

    Gaziano, Thomas A; Abrahams-Gessel, Shafika; Denman, Catalina A; Montano, Carlos Mendoza; Khanam, Masuma; Puoane, Thandi; Levitt, Naomi S

    2015-09-01

    that 263 (6%) of 4049 people had a 5-year cardiovascular disease risk of greater than 20%. Health workers without formal professional training can be adequately trained to effectively screen for, and identify, people at high risk of cardiovascular disease. Using community health workers for this screening would free up trained health professionals in low-resource settings to do tasks that need high levels of formal, professional training. Copyright © 2015 Gaziano et al. Open Access article published under the terms of CC BY-NC-ND 4.0. Published by Elsevier Ltd.. All rights reserved.

  17. Framing risks and benefits of medical tourism: a content analysis of medical tourism coverage in Korean American community newspapers.

    Science.gov (United States)

    Jun, Jungmi; Oh, Kyeung Mi

    2015-01-01

    This study examines Korean American community newspapers' representation of risks and benefits involved with medical tourism offered in Korea. Using framing theory, this research attempts to explain Korean Americans' highly positive perceptions and high willingness to use health and medical services in Korea through medical tourism rather than using such services in the United States. The result of content analyses indicated that Korean American community newspapers are rarely engaged in risk communication and lack sufficient information about potential risks of medical tourism while emphasizing diverse benefits. Korean ethnic media, as the primary source of health communication for Korean Americans, should provide more reliable health and medical information for the population's appropriate health management.

  18. Individualizing Risk of Multidrug-Resistant Pathogens in Community-Onset Pneumonia

    OpenAIRE

    Falcone, Marco; Russo, Alessandro; Giannella, Maddalena; Cangemi, Roberto; Scarpellini, Maria Gabriella; Bertazzoni, Giuliano; Alarc?n, Jos? Mart?nez; Taliani, Gloria; Palange, Paolo; Farcomeni, Alessio; Vestri, Annarita; Bouza, Emilio; Violi, Francesco; Venditti, Mario

    2015-01-01

    Introduction The diffusion of multidrug-resistant (MDR) bacteria has created the need to identify risk factors for acquiring resistant pathogens in patients living in the community. Objective To analyze clinical features of patients with community-onset pneumonia due to MDR pathogens, to evaluate performance of existing scoring tools and to develop a bedside risk score for an early identification of these patients in the Emergency Department. Patients and Methods This was an open, observation...

  19. Prevalence and risk factors for human toxoplasmosis in a rural community

    Directory of Open Access Journals (Sweden)

    JM Marques

    2008-01-01

    Full Text Available Toxoplasma gondii infection may lead to important pathological questions, especially in rural areas, where several sources of infection exist. Therefore, it is important to determine risk factors in order to establish adequate prophylactic measures. The present study aimed to assess the prevalence and risk factors involved in human toxoplasmosis infection in a rural community, in Eldorado, Mato Grosso do Sul State, Brazil. This community was composed of 185 farms - with 671 inhabitants - from which 20 were randomly chosen. In these farms, blood samples were collected from rural workers, who also answered a risk factor questionnaire. Serum samples were analyzed by means of direct agglutination test for the detection of anti-Toxoplasma gondii antibodies. From 73 samples collected, 79.45% were positive. None of the studied variables was significantly associated with the prevalence of the infection. However, among the individuals who reported eyesight impairments, 94.4% had anti-T. gondii antibodies, compared with 74.0% who did not report eyesight changes (p = 0.0594. Moreover, most individuals in the study (68.20% were older than 18 years and presented 84.44% positivity, compared with 66.67% of positive individuals younger than 18 years old. We were able to conclude that a high prevalence of antibodies did not imply significant associations with the risk factors studied.

  20. Socio-hydrological modelling of floods: investigating community resilience, adaptation capacity and risk

    Science.gov (United States)

    Ciullo, Alessio; Viglione, Alberto; Castellarin, Attilio

    2016-04-01

    Changes in flood risk occur because of changes in climate and hydrology, and in societal exposure and vulnerability. Research on change in flood risk has demonstrated that the mutual interactions and continuous feedbacks between floods and societies has to be taken into account in flood risk management. The present work builds on an existing conceptual model of an hypothetical city located in the proximity of a river, along whose floodplains the community evolves over time. The model reproduces the dynamic co-evolution of four variables: flooding, population density of the flooplain, amount of structural protection measures and memory of floods. These variables are then combined in a way to mimic the temporal change of community resilience, defined as the (inverse of the) amount of time for the community to recover from a shock, and adaptation capacity, defined as ratio between damages due to subsequent events. Also, temporal changing exposure, vulnerability and probability of flooding are also modelled, which results in a dynamically varying flood-risk. Examples are provided that show how factors such as collective memory and risk taking attitude influence the dynamics of community resilience, adaptation capacity and risk.

  1. Dengue risk factors and community participation in Binh Thuan Province, Vietnam, a household survey

    NARCIS (Netherlands)

    Phuong, Hoang Lan; de Vries, Peter J.; Boonshuyar, Chaweewon; Binh, Tran Q.; Nam, Nguyen V.; Kager, Piet A.

    2008-01-01

    To look for risk factors for dengue and community participation in dengue control in Binh Thuan Province, Vietnam, three communes with a low incidence of dengue and three with a high incidence, in Binh Thuan Province, were compared. Knowledge, perception and preventive practice of dengue were

  2. Low acceptance of HSV-2 testing among high-risk women.

    Science.gov (United States)

    Roth, A M; Dodge, B M; Van Der Pol, B; Reece, M; Zimet, G D

    2011-06-01

    We evaluated the acceptability of a community-based herpes simplex virus type 2 (HSV-2) screening programme for at-risk women and assessed factors related to uptake of point of care HSV-2 testing. One hundred recently arrested women (median age 34 years) were recruited from a community court handling lower-level misdemeanour cases in Indianapolis, Indiana. Individuals completed a survey assessing factors related to HSV-2 screening intentions and were offered point of care HSV-2 testing. Rates of HSV-2 infection in this population are high; 61.1% of women tested were positive. The majority (81%) accepted a prescription for suppressive therapy. Women in this sample indicated that HSV-2 screening is an important component of health care but were unwilling to pay the US$10 it cost to be tested. To encourage this and other high-risk populations to be screened for HSV-2, public health resources will be needed to help individuals overcome cost-related barriers to care.

  3. HIV-1 transmission networks in high risk fishing communities on the shores of Lake Victoria in Uganda: A phylogenetic and epidemiological approach.

    Directory of Open Access Journals (Sweden)

    Sylvia Kiwuwa-Muyingo

    Full Text Available Fishing communities around Lake Victoria in sub-Saharan Africa have been characterised as a population at high risk of HIV-infection.Using data from a cohort of HIV-positive individuals aged 13-49 years, enrolled from 5 fishing communities on Lake Victoria between 2009-2011, we sought to identify factors contributing to the epidemic and to understand the underlying structure of HIV transmission networks. Clinical and socio-demographic data were combined with HIV-1 phylogenetic analyses. HIV-1 gag-p24 and env-gp-41 sub-genomic fragments were amplified and sequenced from 283 HIV-1-infected participants. Phylogenetic clusters with ≥2 highly related sequences were defined as transmission clusters. Logistic regression models were used to determine factors associated with clustering.Altogether, 24% (n = 67/283 of HIV positive individuals with sequences fell within 34 phylogenetically distinct clusters in at least one gene region (either gag or env. Of these, 83% occurred either within households or within community; 8/34 (24% occurred within household partnerships, and 20/34 (59% within community. 7/12 couples (58% within households clustered together. Individuals in clusters with potential recent transmission (11/34 were more likely to be younger 71% (15/21 versus 46% (21/46 in un-clustered individuals and had recently become resident in the community 67% (14/21 vs 48% (22/46. Four of 11 (36% potential transmission clusters included incident-incident transmissions. Independently, clustering was less likely in HIV subtype D (adjusted Odds Ratio, aOR = 0.51 [95% CI 0.26-1.00] than A and more likely in those living with an HIV-infected individual in the household (aOR = 6.30 [95% CI 3.40-11.68].A large proportion of HIV sexual transmissions occur within house-holds and within communities even in this key mobile population. The findings suggest localized HIV transmissions and hence a potential benefit for the test and treat approach even at a community

  4. Routine Violence Risk Assessment in Community Forensic Mental Healthcare

    NARCIS (Netherlands)

    van den Brink, Rob H. S.; Hooijschuur, Alex; van Os, Titus W. D. P.; Savenije, Wim; Wiersma, Durk

    2010-01-01

    We developed a method for periodic monitoring of violence risk, as part of routine community forensic mental healthcare. The feasibility of the method was tested, as well as its predictive validity for violent and risk enhancing behavior in the subsequent months. Participants were 83 clients who

  5. Community risk assessment of rainfall variability under rain-fed ...

    African Journals Online (AJOL)

    However, a nuanced understanding of the perspectives of climate related risks among local populations affected is often lacking and or seldom explored in vulnerability assessments due to the dominance of top-down approaches. This paper explores the potential of Community Risk Assessment (CRA) and local knowledge ...

  6. Step UP: Retaining High-Risk Students and Transforming the College Culture

    Science.gov (United States)

    Frankel, Susan; Gale, Melodie; Walton, Peggy

    2009-01-01

    Step UP addresses retention of high-risk students through tapping into Howard Community College's finest qualities. The program encourages employees from all constituencies to engage and connect with students in a unique and personal way by implementing life coaching skills.

  7. The reliability and preliminary validity of game-based fall risk assessment in community-dwelling older adults.

    Science.gov (United States)

    Yamada, Minoru; Aoyama, Tomoki; Nakamura, Masatoshi; Tanaka, Buichi; Nagai, Koutatsu; Tatematsu, Noriatsu; Uemura, Kazuki; Nakamura, Takashi; Tsuboyama, Tadao; Ichihashi, Noriaki

    2011-01-01

    The purpose of this study was to examine whether the Nintendo Wii Fit program could be used for fall risk assessment in healthy, community-dwelling older adults. Forty-five community-dwelling older women participated in this study. The "Basic Step" and "Ski Slalom" modules were selected from the Wii Fit game program. The following 5 physical performance tests were performed: the 10-m walk test under single- and dual-task conditions, the Timed Up and Go test under single- and dual-task conditions, and the Functional Reach test. Compared with the faller group, the nonfaller group showed a significant difference in the Basic Step (P game-based fall risk assessment using the Basic Step has a high generality and is useful in community-dwelling older adults. Copyright © 2011 Mosby, Inc. All rights reserved.

  8. Local knowledge: Empirical Fact to Develop Community Based Disaster Risk Management Concept for Community Resilience at Mangkang Kulon Village, Semarang City

    Science.gov (United States)

    Kapiarsa, A. B.; Sariffuddin, S.

    2018-02-01

    Local knowledge in disaster management should not be neglected in developing community resilience. The circular relation between humans and their living habitat and community social relation have developed the local knowledge namely specialized knowledge, shared knowledge, and common knowledge. Its correlation with community-based disaster management has become an important discussion specially to answer can local knowledge underlie community-based disaster risk reduction concept development? To answer this question, this research used mix-method. Interview and crosstab method for 73 respondents with 90% trust rate were used to determine the correlation between local knowledge and community characteristics. This research found out that shared knowledge dominated community local knowledge (77%). While common knowledge and specialized knowledge were sequentially 8% and 15%. The high score of shared value (77%) indicated that local knowledge was occurred in household level and not yet indicated in community level. Shared knowledge was found in 3 phases of the resilient community in dealing with disaster, namely mitigation, emergency response, and recovery phase. This research, therefore, has opened a new scientific discussion on the self-help concept in community-help concept in CBDRM concept development in Indonesia.

  9. COREDAR: COmmunicating Risk of sea level rise and Engaging stakeholDers in framing community based Adaptation stRategies

    Science.gov (United States)

    Amsad Ibrahim Khan, S. K.; Chen, R. S.; de Sherbinin, A. M.; Andimuthu, R.; Kandasamy, P.

    2015-12-01

    Accelerated sea-level rise (SLR) is a major long term outcome of climate change leading to increased inundation of low-lying areas. Particularly, global cities that are located on or near the coasts are often situated in low lying areas and these locations put global cities at greater risk to SLR. Localized flooding will profoundly impact vulnerable communities located in high-risk urban areas. Building community resilience and adapting to SLR is increasingly a high priority for cities. On the other hand, Article 6 of the United Nations Framework Convention on Climate Change addresses the importance of climate change communication and engaging stakeholders in decision making process. Importantly, Community Based Adaptation (CBA) experiences emphasize that it is important to understand a community's unique perceptions of their adaptive capacities to identify useful solutions and that scientific and technical information on anticipated coastal climate impacts needs to be translated into a suitable language and format that allows people to be able to participate in adaptation planning. To address this challenge, this study has put forth three research questions from the lens of urban community engagement in SLR adaptation, (1) What, if any, community engagement in addressing SLR occurring in urban areas; (2) What information do communities need and how does it need to be communicated, in order to be better prepared and have a greater sense of agency? and (3) How can government agencies from city to federal levels facilitate community engagement and action?. To answer these questions this study has evolved a framework "COREDAR" (COmmunicating Risk of sea level rise and Engaging stakeholDers in framing community based Adaptation StRategies) to communicate and transfer complex climate data and information such as projected SLR under different scenarios of IPCC AR5, predicted impact of SLR, prioritizing vulnerability, etc. to concerned stakeholders and local communities

  10. Mediators of the Relation Between Community Violence and Sexual Risk Behavior Among Adults Attending a Public Sexually Transmitted Infection Clinic.

    Science.gov (United States)

    Senn, Theresa E; Walsh, Jennifer L; Carey, Michael P

    2016-07-01

    Prior research shows that violence is associated with sexual risk behavior, but little is known about the relation between community violence (i.e., violence that is witnessed or experienced in one's neighborhood) and sexual risk behavior. To better understand contextual influences on HIV risk behavior, we asked 508 adult patients attending a publicly funded STI clinic in the U.S. (54 % male, M age = 27.93, 68 % African American) who were participating in a larger trial to complete a survey assessing exposure to community violence, sexual risk behavior, and potential mediators of the community violence-sexual risk behavior relation (i.e., mental health, substance use, and experiencing intimate partner violence). A separate sample of participants from the same trial completed measures of sexual behavior norms, which were aggregated to create measures of census tract sexual behavior norms. Data analyses controlling for socioeconomic status revealed that higher levels of community violence were associated with more sexual partners for men and with more episodes of unprotected sex with non-steady partners for women. For both men and women, substance use and mental health mediated the community violence-sexual risk behavior relation; in addition, for men only, experiencing intimate partner violence also mediated this relation. These results confirm that, for individuals living in communities with high levels of violence, sexual risk reduction interventions need to address intimate partner violence, substance use, and mental health to be optimally effective.

  11. Perceived Risk of Developing Cancer in a Suburban Community

    Science.gov (United States)

    Pasi, Hafizah; Md Isa, Zaleha; Azhar Shah, Shamsul

    2018-02-26

    Objective: To determine the perceived risk of developing cancer in a suburban community in Malaysia. Methods: A cross sectional study using a simple random sampling was conducted among residents aged 18 years old and above (n=520) who had never been diagnosed with cancer, in selected households in a suburban area of Pahang state in Malaysia. The study instruments were a validated questionnaire on risk perception, an automatic blood pressure monitor, a weighing scale and a measuring tape. Data were analyzed using IBM SPSS Statistics for Windows, Version 20.0 and the p value was taken at p history of cancer (adjusted OR of 4.80; 95% CI = 1.45-15.82) (p=0.010) among this population. Conclusion: The perceived risk of developing cancer in the selected suburban community of Pahang state in Malaysia is low as compared to that for other non-communicable diseases in this country, whilst the perceived severity was higher than for other diseases. Thus, considering the importance of correct perceptions for behavioral changes, more health education and promotion is needed to make the community better aware of the actual threat of cancer. Creative Commons Attribution License

  12. Pharmacotherapy and the risk for community-acquired pneumonia

    Directory of Open Access Journals (Sweden)

    Mody Lona

    2010-07-01

    Full Text Available Abstract Background Some forms of pharmacotherapy are shown to increase the risk of community-acquired pneumonia (CAP. The purpose of this study is to investigate whether pharmacotherapy with proton pump inhibitors (PPI, inhaled corticosteroids, and atypical antipsychotics was associated with the increased risk for CAP in hospitalized older adults with the adjustment of known risk factors (such as smoking status and serum albumin levels. Methods A retrospective case-control study of adults aged 65 years or older at a rural community hospital during 2004 and 2006 was conducted. Cases (N = 194 were those with radiographic evidence of pneumonia on admission. The controls were patients without the discharge diagnosis of pneumonia or acute exacerbation of chronic obstructive pulmonary disease (COPD (N = 952. Patients with gastric tube feeding, ventilator support, requiring hemodialysis, metastatic diseases or active lung cancers were excluded. Results Multiple logistic regression analysis revealed that the current use of inhaled corticosteroids (adjusted odds ratio [AOR] = 2.89, 95% confidence interval [CI] = 1.56-5.35 and atypical antipsychotics (AOR = 2.26, 95% CI = 1.23-4.15 was an independent risk factor for CAP after adjusting for confounders, including age, serum albumin levels, sex, smoking status, a history of congestive heart failure, coronary artery disease, and COPD, the current use of PPI, β2 agonist and anticholinergic bronchodilators, antibiotic(s, iron supplement, narcotics, and non-steroidal anti-inflammatory drugs. The crude OR and the AOR of PPI use for CAP was 1.41 [95% CI = 1.03 - 1.93] and 1.18 [95% CI = 0.80 - 1.74] after adjusting for the above confounders, respectively. Lower serum albumin levels independently increased the risk of CAP 1.89- fold by decreasing a gram per deciliter (AOR = 2.89, 95% CI = 2.01 - 4.16. Conclusion Our study reaffirmed that the use of inhaled corticosteroids and atypical antipsychotics was both

  13. A framework for widespread replication of a highly spatially resolved childhood lead exposure risk model.

    Science.gov (United States)

    Kim, Dohyeong; Galeano, M Alicia Overstreet; Hull, Andrew; Miranda, Marie Lynn

    2008-12-01

    Preventive approaches to childhood lead poisoning are critical for addressing this longstanding environmental health concern. Moreover, increasing evidence of cognitive effects of blood lead levels system-based childhood lead exposure risk models, especially if executed at highly resolved spatial scales, can help identify children most at risk of lead exposure, as well as prioritize and direct housing and health-protective intervention programs. However, developing highly resolved spatial data requires labor-and time-intensive geocoding and analytical processes. In this study we evaluated the benefit of increased effort spent geocoding in terms of improved performance of lead exposure risk models. We constructed three childhood lead exposure risk models based on established methods but using different levels of geocoded data from blood lead surveillance, county tax assessors, and the 2000 U.S. Census for 18 counties in North Carolina. We used the results to predict lead exposure risk levels mapped at the individual tax parcel unit. The models performed well enough to identify high-risk areas for targeted intervention, even with a relatively low level of effort on geocoding. This study demonstrates the feasibility of widespread replication of highly spatially resolved childhood lead exposure risk models. The models guide resource-constrained local health and housing departments and community-based organizations on how best to expend their efforts in preventing and mitigating lead exposure risk in their communities.

  14. One size does not fit all: HIV testing preferences differ among high-risk groups in Northern Tanzania.

    Science.gov (United States)

    Ostermann, Jan; Njau, Bernard; Mtuy, Tara; Brown, Derek S; Mühlbacher, Axel; Thielman, Nathan

    2015-01-01

    In order to maximize the effectiveness of "Seek, Test, and Treat" strategies for curbing the HIV epidemic, new approaches are needed to increase the uptake of HIV testing services, particularly among high-risk groups. Low HIV testing rates among such groups suggest that current testing services may not align well with the testing preferences of these populations. Female bar workers and male mountain porters have been identified as two important high-risk groups in the Kilimanjaro Region of Tanzania. We used conventional survey methods and a discrete choice experiment (DCE), a preference elicitation method increasingly applied by economists and policy-makers to inform health policy and services, to analyze trade-offs made by individuals and quantify preferences for HIV testing services. Bivariate descriptive statistics were used to analyze differences in survey responses across groups. Compared to 486 randomly selected community members, 162 female bar workers and 194 male Kilimanjaro porters reported 2-3 times as many lifetime sexual partners (p porters preferred testing in venues where antiretroviral therapy was readily available. Both high-risk groups were less averse to traveling longer distances to test compared to their community counterparts. These results expose systematic differences in HIV testing preferences across high-risk populations compared to their community peers. Tailoring testing options to the preferences of high-risk populations should be evaluated as a means of improving uptake of testing in these populations.

  15. A Clinical Risk Score for Atrial Fibrillation in a Biracial Prospective Cohort (From the Atherosclerosis Risk in Communities (ARIC) Study)

    OpenAIRE

    Chamberlain, Alanna M.; Agarwal, Sunil K.; Folsom, Aaron R.; Soliman, Elsayed Z.; Chambless, Lloyd E.; Crow, Richard; Ambrose, Marietta; Alonso, Alvaro

    2011-01-01

    A risk score for AF has been developed by the Framingham Heart Study; however the applicability of this risk score, derived from whites, to predict new-onset AF in non-whites is uncertain. Therefore, we developed a 10-year risk score for new-onset AF using risk factors commonly measured in clinical practice using 14,546 individuals from the Atherosclerosis Risk in Communities study, a prospective community-based cohort of blacks and whites in the United States. During 10 years of follow-up, 5...

  16. Cardiovascular Risk and Events in 17 Low-, Middle-, and High-Income Countries.

    OpenAIRE

    Yusuf, S; Rangarajan, S; Teo, K; Islam, S; Li, W; Liu, L; Bo, J; Lou, Q; Lu, F; Liu, T; Yu, L; Zhang, S; Mony, P; Swaminathan, S; Mohan, V

    2014-01-01

    : More than 80% of deaths from cardiovascular disease are estimated to occur in low-income and middle-income countries, but the reasons are unknown. : We enrolled 156,424 persons from 628 urban and rural communities in 17 countries (3 high-income, 10 middle-income, and 4 low-income countries) and assessed their cardiovascular risk using the INTERHEART Risk Score, a validated score for quantifying risk-factor burden without the use of laboratory testing (with higher scores indicating greater r...

  17. Evaluation of a Successful High Risk Nursing Student Assistance Program: One ADN Program's Journey

    Science.gov (United States)

    O'Sullivan, Ciaran Anthony Mary

    2013-01-01

    A college education is, for many in America, part and parcel of the American Dream, and is certainly achievable. For countless reasons, students may enroll at community colleges underprepared, unprepared, anxious, and destined for a high risk of failure. Although community colleges are higher education institutions open and accessible to all who…

  18. Developing an objective evaluation method to estimate diabetes risk in community-based settings.

    Science.gov (United States)

    Kenya, Sonjia; He, Qing; Fullilove, Robert; Kotler, Donald P

    2011-05-01

    Exercise interventions often aim to affect abdominal obesity and glucose tolerance, two significant risk factors for type 2 diabetes. Because of limited financial and clinical resources in community and university-based environments, intervention effects are often measured with interviews or questionnaires and correlated with weight loss or body fat indicated by body bioimpedence analysis (BIA). However, self-reported assessments are subject to high levels of bias and low levels of reliability. Because obesity and body fat are correlated with diabetes at different levels in various ethnic groups, data reflecting changes in weight or fat do not necessarily indicate changes in diabetes risk. To determine how exercise interventions affect diabetes risk in community and university-based settings, improved evaluation methods are warranted. We compared a noninvasive, objective measurement technique--regional BIA--with whole-body BIA for its ability to assess abdominal obesity and predict glucose tolerance in 39 women. To determine regional BIA's utility in predicting glucose, we tested the association between the regional BIA method and blood glucose levels. Regional BIA estimates of abdominal fat area were significantly correlated (r = 0.554, P < 0.003) with fasting glucose. When waist circumference and family history of diabetes were added to abdominal fat in multiple regression models, the association with glucose increased further (r = 0.701, P < 0.001). Regional BIA estimates of abdominal fat may predict fasting glucose better than whole-body BIA as well as provide an objective assessment of changes in diabetes risk achieved through physical activity interventions in community settings.

  19. Diabetes and Risk of Community-Acquired Respiratory Tract Infections, Urinary Tract Infections, and Bacteremia

    DEFF Research Database (Denmark)

    Thomsen, Reimar W.; Mor, Anil

    2013-01-01

    This review provides an update on the risk of several important community-acquired infections seen in patients with diabetes: respiratory tract infections, urinary tract infections, and bacteremia. Respiratory tract infections: Recent epidemiological evidence shows a modest (1.25 to 1.75-fold) risk...... increase for hospitalization with pneumonia associated with diabetes. The increase of risk for tuberculosis is of similar magnitude in highly developed countries, and possibly higher in low-income countries. Poor glycemic control and long diabetes duration predict higher risk for both pneumonia...... and tuberculosis. Limited data is available for diabetes and influenza, yet both influenza and pneumococcal vaccination is recommended in patients with diabetes. Urinary tract infections: The risk of asymptomatic bacteriuria and cystitis is 1.5 to 2 times increased in diabetes patients, while their risk...

  20. Financial services and disaster risk finance; Examples from the community level

    NARCIS (Netherlands)

    Warner, K.; Bouwer, L.M.; Ammann, W.

    2007-01-01

    Increased attention has recently been given to the possible role of financial services in the management of natural disaster risk. Local communities have been at the forefront of developing innovative disaster risk finance strategies and implementing risk-oriented incentive programs. In view of

  1. Community-based randomized controlled trial of diabetes prevention study for high-risk individuals of type 2 diabetes: lifestyle intervention using web-based system.

    Science.gov (United States)

    Cha, Seon-Ah; Lim, Sun-Young; Kim, Kook-Rye; Lee, Eun-Young; Kang, Borami; Choi, Yoon-Hee; Yoon, Kun-Ho; Ahn, Yu-Bae; Lee, Jin-Hee; Ko, Seung-Hyun

    2017-05-05

    The trend of increasing numbers of patients with type 2 diabetes emphasizes the need for active screening of high-risk individuals and intensive lifestyle modification (LSM). The community-based Korean Diabetes Prevention Study (C-KDPS) is a randomized controlled clinical trial to prevent type 2 diabetes by intensive LSM using a web-based program. The two public healthcare centers in Korea are involved, and 420 subjects are being recruited for 6 months and will be followed up for 22 months. The participants are allocated randomly to intensive LSM (18 individual sessions for 24 weeks) and usual care (control group). The major goals of the C-KDPS lifestyle intervention program are: 1) a minimum of 5-7% loss of initial body weight in 6 months and maintenance of this weight loss, 2) increased physical activity (≥ 150 min/week of moderate intensity activity), 3) balanced healthy eating, and 4) quitting smoking and alcohol with stress management. The web-based program includes education contents, video files, visit schedules, and inter-communicable keeping track sites. Primary outcomes are the diagnoses of newly developed diabetes. A 75-g oral glucose tolerance test with hemoglobin A1c level determination and cardiovascular risk factor assessment is scheduled at 6, 12, 18, and 22 months. Active screening of high-risk individuals and an effective LSM program are an essential prerequisite for successful diabetes prevention. We hope that our C-KDPS program can reduce the incidence of newly developed type 2 diabetes and be implemented throughout the country, merging community-based public healthcare resources and a web-based system. Clinical Research Information Service (CRIS), Republic of Korea (No. KCT0001981 ). Date of registration; July 28, 2016.

  2. Community-based randomized controlled trial of diabetes prevention study for high-risk individuals of type 2 diabetes: lifestyle intervention using web-based system

    Directory of Open Access Journals (Sweden)

    Seon-Ah Cha

    2017-05-01

    Full Text Available Abstract Background The trend of increasing numbers of patients with type 2 diabetes emphasizes the need for active screening of high-risk individuals and intensive lifestyle modification (LSM. Methods/design The community-based Korean Diabetes Prevention Study (C-KDPS is a randomized controlled clinical trial to prevent type 2 diabetes by intensive LSM using a web-based program. The two public healthcare centers in Korea are involved, and 420 subjects are being recruited for 6 months and will be followed up for 22 months. The participants are allocated randomly to intensive LSM (18 individual sessions for 24 weeks and usual care (control group. The major goals of the C-KDPS lifestyle intervention program are: 1 a minimum of 5–7% loss of initial body weight in 6 months and maintenance of this weight loss, 2 increased physical activity (≥ 150 min/week of moderate intensity activity, 3 balanced healthy eating, and 4 quitting smoking and alcohol with stress management. The web-based program includes education contents, video files, visit schedules, and inter-communicable keeping track sites. Primary outcomes are the diagnoses of newly developed diabetes. A 75-g oral glucose tolerance test with hemoglobin A1c level determination and cardiovascular risk factor assessment is scheduled at 6, 12, 18, and 22 months. Discussion Active screening of high-risk individuals and an effective LSM program are an essential prerequisite for successful diabetes prevention. We hope that our C-KDPS program can reduce the incidence of newly developed type 2 diabetes and be implemented throughout the country, merging community-based public healthcare resources and a web-based system. Trial registration Clinical Research Information Service (CRIS, Republic of Korea (No. KCT0001981 . Date of registration; July 28, 2016.

  3. High risk pregnancy in the workplace. Influencing positive outcomes.

    Science.gov (United States)

    Cannon, R B; Schmidt, J V; Cambardella, B; Browne, S E

    2000-09-01

    Childbearing employees are well served by the occupational health nurse who promotes optimal preconceptual and pregnancy health practices, uses community resources, and maintains current knowledge about high risk pregnancy prevention and care. These broad goals of care can lead to decreased absenteeism, healthier and happier employees, and more positive outcomes of pregnancy. For employees with high risk pregnancies, the role of the occupational health nurse includes, but is not limited to, facilitating awareness with the employer, making suggestions for adjusting working conditions, making frequent assessments of the employee's needs, and communicating with prenatal health care providers. Occupational health nurses should never underestimate their role and potential influence on the mother, and on her significant other, for a positive outcome of her pregnancy.

  4. Developing rural community health risk assessments for climate change: a Tasmanian pilot study.

    Science.gov (United States)

    Bell, Erica J; Turner, Paul; Meinke, Holger; Holbrook, Neil J

    2015-01-01

    This article examines the development and pilot implementation of an approach to support local community decision-makers to plan health adaptation responses to climate change. The approach involves health and wellbeing risk assessment supported through the use of an electronic tool. While climate change is a major foreseeable public health threat, the extent to which health services are prepared for, or able to adequately respond to, climate change impact-related risks remains unclear. Building health decision-support mechanisms in order to involve and empower local stakeholders to help create the basis for agreement on these adaptive actions is an important first step. The primary research question was 'What can be learned from pilot implementation of a community health and well-being risk assessment (CHWRA) information technology-based tool designed to support understanding of, and decision-making on, local community challenges and opportunities associated with health risks posed by climate change? The article examines the complexity of climate change science to adaptation translational processes, with reference to existing research literature on community development. This is done in the context of addressing human health risks for rural and remote communities in Tasmania, Australia. This process is further examined through the pilot implementation of an electronic tool designed to support the translation of physically based climate change impact information into community-level assessments of health risks and adaptation priorities. The procedural and technical nature of the CHWRA tool is described, and the implications of the data gathered from stakeholder workshops held at three rural Tasmanian local government sites are considered and discussed. Bushfire, depression and waterborne diseases were identified by community stakeholders as being potentially 'catastrophic' health effects 'likely' to 'almost certain' to occur at one or more Tasmanian rural sites

  5. An Effective Community?Academic Partnership to Extend the Reach of Screenings for Fall Risk

    OpenAIRE

    Schrodt, Lori A.; Garbe, Kathie C.; Chaplin, Rebecca; Busby-Whitehead, Jan; Shubert, Tiffany E.

    2013-01-01

    Older adults should be screened for fall risk annually. Community providers (people without formal medical training who work with older adults in senior centers or aging services) may be a viable group to expand the reach of screenings. Our community–academic partnership developed a program to increase and assess fall risk screenings by community providers. Community sites hosted training workshops and screening events. Community screenings were well attended and received by providers and old...

  6. A Risk Radar driven by Internet of intelligences serving for emergency management in community.

    Science.gov (United States)

    Huang, Chongfu; Wu, Tong; Renn, Ortwin

    2016-07-01

    Today, most of the commercial risk radars only have the function to show risks, as same as a set of risk matrixes. In this paper, we develop the Internet of intelligences (IOI) to drive a risk radar monitoring dynamic risks for emergency management in community. An IOI scans risks in a community by 4 stages: collecting information and experience about risks; evaluating risk incidents; verifying; and showing risks. Employing the information diffusion method, we optimized to deal with the effective information for calculating risk value. Also, a specific case demonstrates the reliability and practicability of risk radar. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. High risk behaviour near OPG dams and power stations : results from two surveys

    Energy Technology Data Exchange (ETDEWEB)

    Giesbrecht, N.; Schmidt, R.; Ialomiteanu, A. [Centre for Addiction and Mental Health, Toronto, ON (Canada)

    2009-07-01

    High risk behaviour near dams is not uncommon. This presentation discussed the results from 2 surveys on high risk behaviour near dams and power stations operated by Ontario Power Generation (OPG). The main components of the project were presented, with particular reference to analyses of recent literature on high-risk behaviour; interviews with OPG managers and staff in 4 regions; main survey of respondents from 4 regions; follow-up interviews with high-risk respondents; interviews with community members and contacts from recreational associations; and recommendations. Specific questions and results were provided from each survey. From the first survey, the characteristics of respondents that used OPG sites for recreation were identified. One hundred high risk respondents completed a follow-up interview. The survey showed that although high-risk behaviour is not uncommon, the main reason people use the facilities are for recreation and relaxation, and not for thrill seeking purposes. Recommendations stemming from the surveys included the need for definition of boundaries and delivery of messages via children, recreational associations, and law enforcement personnel. tabs., figs.

  8. Values for gender roles and relations among high school and non-high school adolescents in a Maya community in Chiapas, Mexico.

    Science.gov (United States)

    Manago, Adriana M

    2015-02-01

    In the current study, I describe values for gender roles and cross-sex relations among adolescents growing up in a southern Mexican Maya community in which high school was introduced in 1999. A total of 80 adolescent girls and boys, half of whom were attending the new high school, provided their opinions on two ethnographically derived vignettes that depicted changes in gender roles and relations occurring in their community. Systematic coding revealed that adolescents not enrolled in high school tended to prioritise ascribed and complementary gender roles and emphasise the importance of family mediation in cross-sex relations. Adolescents who were enrolled in high school tended to prioritise equivalent and chosen gender roles, and emphasised personal responsibility and personal fulfillment in cross-sex relations. Perceptions of risks and opportunities differed by gender: girls favourably evaluated the expansion of adult female role options, but saw risks in personal negotiations of cross-sex relations; boys emphasised the loss of the female homemaker role, but favourably evaluated new opportunities for intimacy in cross-sex relations. © 2014 International Union of Psychological Science.

  9. A metric-based assessment of flood risk and vulnerability of rural communities in the Lower Shire Valley, Malawi

    Science.gov (United States)

    Adeloye, A. J.; Mwale, F. D.; Dulanya, Z.

    2015-06-01

    In response to the increasing frequency and economic damages of natural disasters globally, disaster risk management has evolved to incorporate risk assessments that are multi-dimensional, integrated and metric-based. This is to support knowledge-based decision making and hence sustainable risk reduction. In Malawi and most of Sub-Saharan Africa (SSA), however, flood risk studies remain focussed on understanding causation, impacts, perceptions and coping and adaptation measures. Using the IPCC Framework, this study has quantified and profiled risk to flooding of rural, subsistent communities in the Lower Shire Valley, Malawi. Flood risk was obtained by integrating hazard and vulnerability. Flood hazard was characterised in terms of flood depth and inundation area obtained through hydraulic modelling in the valley with Lisflood-FP, while the vulnerability was indexed through analysis of exposure, susceptibility and capacity that were linked to social, economic, environmental and physical perspectives. Data on these were collected through structured interviews of the communities. The implementation of the entire analysis within GIS enabled the visualisation of spatial variability in flood risk in the valley. The results show predominantly medium levels in hazardousness, vulnerability and risk. The vulnerability is dominated by a high to very high susceptibility. Economic and physical capacities tend to be predominantly low but social capacity is significantly high, resulting in overall medium levels of capacity-induced vulnerability. Exposure manifests as medium. The vulnerability and risk showed marginal spatial variability. The paper concludes with recommendations on how these outcomes could inform policy interventions in the Valley.

  10. High-Risk List

    Science.gov (United States)

    2017-01-01

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

  11. The high burden of infant deaths in rural Burkina Faso: a prospective community-based cohort study

    Directory of Open Access Journals (Sweden)

    Diallo Abdoulaye

    2012-09-01

    Full Text Available Abstract Background Infant mortality rates (IMR remain high in many sub-Saharan African countries, especially in rural settings where access to health services may be limited. Studies in such communities can provide relevant data on the burden of and risk factors for infant death. We measured IMR and explored risk factors for infant death in a cohort of children born in Banfora Health District, a rural area in South-West Burkina Faso. Methods A prospective community-based cohort study was nested within the PROMISE-EBF trial (NCT00397150 in 24 villages of the study area. Maternal and infant baseline characteristics were collected at recruitment and after birth, respectively. Home visits were conducted at weeks 3, 6, 12, 24 and 52 after birth. Descriptive statistics were calculated using robust standard errors to account for cluster sampling. Cox multivariable regression was used to investigate potential risk factors for infant death. Results Among the 866 live born children included in the study there were 98 infant deaths, yielding an IMR of 113 per 1000 live births (95% CI: 89–143. Over 75% of infant deaths had occurred by 6 months of age and the post neonatal infant mortality rate was 67 per 1000 live births (95% CI: 51–88. Infections (35% and preterm births complications (23% were the most common probable causes of death by 6 months. Multivariable analyses identified maternal history of child death, polygyny, twin births and poor anthropometric z-scores at week-3 as factors associated with increased risk of infant death. Conclusions We observed a very high IMR in a rural area of Burkina Faso, a country where 75% of the population lives in rural settings. Community-based health interventions targeting mothers and children at high risk are urgently needed to reduce the high burden of infant deaths in these areas.

  12. The high burden of infant deaths in rural Burkina Faso: a prospective community-based cohort study.

    Science.gov (United States)

    Hama Diallo, Abdoulaye; Meda, Nicolas; Sommerfelt, Halvor; Traore, Germain S; Cousens, Simon; Tylleskar, Thorkild

    2012-09-05

    Infant mortality rates (IMR) remain high in many sub-Saharan African countries, especially in rural settings where access to health services may be limited. Studies in such communities can provide relevant data on the burden of and risk factors for infant death. We measured IMR and explored risk factors for infant death in a cohort of children born in Banfora Health District, a rural area in South-West Burkina Faso. A prospective community-based cohort study was nested within the PROMISE-EBF trial (NCT00397150) in 24 villages of the study area. Maternal and infant baseline characteristics were collected at recruitment and after birth, respectively. Home visits were conducted at weeks 3, 6, 12, 24 and 52 after birth. Descriptive statistics were calculated using robust standard errors to account for cluster sampling. Cox multivariable regression was used to investigate potential risk factors for infant death. Among the 866 live born children included in the study there were 98 infant deaths, yielding an IMR of 113 per 1000 live births (95% CI: 89-143). Over 75% of infant deaths had occurred by 6 months of age and the post neonatal infant mortality rate was 67 per 1000 live births (95% CI: 51-88). Infections (35%) and preterm births complications (23%) were the most common probable causes of death by 6 months. Multivariable analyses identified maternal history of child death, polygyny, twin births and poor anthropometric z-scores at week-3 as factors associated with increased risk of infant death. We observed a very high IMR in a rural area of Burkina Faso, a country where 75% of the population lives in rural settings. Community-based health interventions targeting mothers and children at high risk are urgently needed to reduce the high burden of infant deaths in these areas.

  13. Community vulnerability and stratified risk: Hegemonic masculinity, socioeconomic status, and HIV/AIDS in a sex work community in Kampala, Uganda.

    Science.gov (United States)

    Schmidt-Sane, Megan M

    2018-01-29

    This article examines the social patterning of health, economic uncertainty, hegemonic masculinity, and vulnerability among men who live and work in a low-income sex work community in Kampala, Uganda. This problematises the notion that vulnerable communities are homogenous, in demographics, economic status, and risk. This article draws on ethnographic data collected in 2016, including semi-structured interviews and participant observation. This article uses a stratified risk framework to describe the central finding of this study, which is that men's experience in Kataba is characterised by a struggle to fulfil the provider role that constitutes a core aspect of their socially ascribed gender role. In a context of economic scarcity, men's lives are fraught with strain and this intersects with other forms of risk. Finally, by focusing on community vulnerability rather than individual risk, this work contributes to theories of gender and sex work, and informs HIV/AIDS praxis.

  14. Reducing disaster risk in rural Arctic communities through effective communication strategies

    Science.gov (United States)

    Kontar, Y. Y.

    2015-12-01

    Communication is the process of exchanging and relaying vital information that has bearing on the effectiveness of all phases of emergency management: mitigation, preparedness, response, and recovery, making it one of the most important activities in disasters. Lack of communication between emergency managers, policy makers, and communities at risk may result in an inability to accurately identify disaster risk, and failure to determine priorities during a hazard event. Specific goals of communication change during the four phases of emergency management. Consequently, the communication strategy changes as well. Communication strategy also depends on a variety of attitudinal and motivational characteristics of the population at risk, as well as socioeconomic, cultural, and geographical features of the disaster-prone region. In May 2013, insufficient communication patterns between federal, state, tribal agencies, and affected communities significantly contributed to delays in the flood response and recovery in several rural villages along the Yukon River in central Alaska. This case study finds that long term dialogue is critical for managing disaster risk and increasing disaster resilience in rural Northern communities. It introduces new ideas and highlights best practices in disaster communication.

  15. Community Care and the Location and Governance of Risk in Mental Health

    Directory of Open Access Journals (Sweden)

    Joanne Warner

    2006-01-01

    Full Text Available The concept of risk is now central to all areas of health and social welfare in the UK, although its exact character in relation to different groups varies. It has been argued that risk in mental health has been characterised by a preoccupation with the perceived risk of violence to others posed by those experiencing mental distress, particularly since the implementation of community care policies in the 1990s. The present paper draws on qualitative materials from semi-structured interviews with thirty-nine mental health social workers to demonstrate the significance for policy and practice of identifying where professionals see risk as being located. In the present study, three key sites were identified: firstly, risk was located in dangerous individuals, where the concept "high-risk" was particularly closely identified with young Black men with a diagnosis of schizophrenia. Secondly, social workers located risk in within-subject entities such as active psychotic illness, when it was the symptom rather than the whole individual that was subject to surveillance and control. Thirdly, social workers located risk in social context and regarded risk in multidimensional ways compared to their psychiatric colleagues. The paper highlights how a theory of risk location can be a useful conceptual tool. URN: urn:nbn:de:0114-fqs0601310

  16. Social network, social support, and risk of incident stroke: Atherosclerosis Risk in Communities study.

    Science.gov (United States)

    Nagayoshi, Mako; Everson-Rose, Susan A; Iso, Hiroyasu; Mosley, Thomas H; Rose, Kathryn M; Lutsey, Pamela L

    2014-10-01

    Having a small social network and lack of social support have been associated with incident coronary heart disease; however, epidemiological evidence for incident stroke is limited. We assessed the longitudinal association of a small social network and lack of social support with risk of incident stroke and evaluated whether the association was partly mediated by vital exhaustion and inflammation. The Atherosclerosis Risk in Communities study measured social network and social support in 13 686 men and women (mean, 57 years; 56% women; 24% black; 76% white) without a history of stroke. Social network was assessed by the 10-item Lubben Social Network Scale and social support by a 16-item Interpersonal Support Evaluation List-Short Form. During a median follow-up of 18.6 years, 905 incident strokes occurred. Relative to participants with a large social network, those with a small social network had a higher risk of stroke (hazard ratio [95% confidence interval], 1.44 [1.02-2.04]) after adjustment for demographics, socioeconomic variables, marital status, behavioral risk factors, and major stroke risk factors. Vital exhaustion, but not inflammation, partly mediated the association between a small social network and incident stroke. Social support was unrelated to incident stroke. In this sample of US community-dwelling men and women, having a small social network was associated with excess risk of incident stroke. As with other cardiovascular conditions, having a small social network may be associated with a modestly increased risk of incident stroke. © 2014 American Heart Association, Inc.

  17. Environmental policies, politics, and community risk perception: case study of community contamination in Casper, Wyoming.

    Science.gov (United States)

    Tajik, Mansoureh; Gottlieb, Karen; Lowndes, Nita; Stewart, Gloria

    2007-01-01

    We identify and explain factors that affected a community's perception of risk due to extensive industrial contamination and people's distrust of government agencies regarding the environmental investigations. Intrinsic bounded case study methodology was used to conduct research about extensive environmental contaminations due to activities of an oil refinery in North Casper, Wyoming, and the citizens' response. Data were collected from multiple sources that included public testimonies, observations, public hearings and meetings minutes, newspaper articles, archived records obtained from federal and state environmental and health agencies, as well as industry records obtained through Freedom of Information Act (FOIA) requests. The overarching theme that emerged was lack of trust due to several critical events and factors such as no response or delay in response time to community concerns, lack of transparency, perceived cover up, vague and fragmented communication by government and state officials, perception of pro-industry stance, and perceived unfair treatment. People's perception of environmental risks and their willingness to accept official explanations and outcomes of environmental investigations are strongly affected by their direct experiences with government agencies and the evidence of influence the powerful industries exert over relevant investigations. The government cannot successfully address public and community concerns about environmental health impacts of contaminations and in turn the public perception of risk unless it adopts and implements policies, procedures, and protocols that are clear, timely, transparent, and free from industry influence.

  18. Environmental risk factors and health outcomes in selected communities of the Niger delta area, Nigeria.

    Science.gov (United States)

    Ana, Godson; Sridhar, Mynepalli K C; Bamgboye, Elijah A

    2009-07-01

    The main aim of this study was to assess the prevalence of various health outcomes associated with exposure to environmental risk factors including industrial pollution in selected communities of Nigeria's oil-rich Niger delta area (NDA). The study involved both laboratory experiments and community health surveys using questionnaires and hospital records. A total of 14 air samples, 16 grab soil samples and 18 surface water samples were collected and analyzed for physicochemical parameters including heavy metals and polycyclic aromatic hydrocarbons (PAHs) using standard methods. A 77-item questionnaire was administered on randomly selected 349 subjects. A five-year record was collected from health facilities located in the two communities. The laboratory results indicated that the median PAH level at Eleme as compared to Ahoada East was higher than the guideline limit 50 ng/l for surface waters. The mean TSP level at Eleme was higher than the level at Ahoada East and the guideline limit 100 microg/m3. The median PAH level at Eleme was higher than the level at Ahoada East and the guideline limit problem (p = 0.044). At Ahoada East commonly consumed aquatic food was highly significantly associated with painful body outgrowth (p fuel types was also highly significantly associated with child deformities (p < 0.0001). Hospital records showed high proportions of respiratory disorder among males (3.85%) and females (4.39%) at Eleme as compared to the proportion of respiratory disorder among males (3.68%) and females (4.18%) at Ahoada East. The study shows that industrial communities such as Eleme, which are exposed to higher levels of air pollution, are more predisposed to respiratory morbidities, skin disorders and other related health risks.

  19. The Family Check-Up and Service Use in High-Risk Families of Young Children: A Prevention Strategy with a Bridge to Community-Based Treatment

    NARCIS (Netherlands)

    Leijten, Patty; Shaw, Daniel S.; Gardner, Frances; Wilson, Melvin N.; Matthys, Walter; Dishion, Thomas J.

    2015-01-01

    Integration of empirically supported prevention programs into existing community services is a critical step toward effecting sustainable change for the highest-risk members in a community. We examined if the Family Check-Up—known to reduce disruptive behavior problems in young children—can provide

  20. The family check-up and service use in high-risk families of young children: a prevention strategy with a bridge to community-based treatment

    NARCIS (Netherlands)

    Leijten, P.; Shaw, D.S.; Gardner, F.; Wilson, M.N.; Matthys, W.; Dishion, T.J.

    2015-01-01

    Integration of empirically supported prevention programs into existing community services is a critical step toward effecting sustainable change for the highest-risk members in a community. We examined if the Family Check-Up—known to reduce disruptive behavior problems in young children—can provide

  1. Finding the High-Risk Patient in Primary Prevention Is Not as Easy as a Conventional Risk Score!

    Science.gov (United States)

    Ambrose, John A; Acharya, Tushar; Roberts, Micah J

    2016-12-01

    Patients with coronary artery disease or its equivalent are an appropriate target for guideline-directed therapy. However, finding and treating the individuals at risk for myocardial infarction or sudden death in primary prevention has been problematic. Most initial cardiovascular events are acute syndromes, and only a minority of these occurs in those deemed high risk by contemporary algorithms. Even newer noninvasive modalities cannot detect a majority of those at risk. Furthermore, accurate and early detection of high risk/vulnerability does not guarantee event prevention. Until new tools can be identified, one should consider a few simplistic solutions. In addition to a greater emphasis on lifestyle, earlier use of statins than currently recommended and a direct assault on tobacco could go a long way in reducing acute syndromes and cardiovascular mortality. To achieve the tobacco goal, the medical community would have to be directly and communally engaged. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Community Risk Assessment of Rainfall Variability under Rain-fed ...

    African Journals Online (AJOL)

    2016-10-02

    Oct 2, 2016 ... Department of Planning and Management ... Risk Assessment (CRA) and local knowledge as a bottom-up approach to community-based .... (Care International, 2010; Ghana, 2011; World Bank Group [WBG], 2010). Forecast ...

  3. Vulnerability Risk Index Profile for Elder Abuse in Community-Dwelling Population

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa A.

    2013-01-01

    Objectives Elder abuse is associated with increased morbidity and mortality. This study aims to develop a vulnerability index for elder abuse in a community-dwelling population. Design Population-based study Setting Geographically defined community in Chicago. Participants A population-based study was conducted in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project (CHAP). Of the 8,157 participants in the CHAP study, 213 participants were reported to social services agency for suspected elder abuse. Measurements A vulnerability index for elder abuse was constructed from sociodemographic, health-related, and psychosocial factors. The outcomes of interest were reported and confirmed elder abuse. Logistic regression models were used to determine the accuracy of the index with respect to elder abuse outcomes. Results Out of the selected risk index for elder abuse, every one point increase in the 9 item vulnerability index items, there was a two fold increase in the risk for reported elder abuse (OR, 2.19 (2.00–2.40) and confirmed elder abuse (OR, 2.19 (1.94–2.47). Compared to the reference group, older adults with 3–4 vulnerability index items had increased risk for reported elder abuse (OR, 2.98 (1.98–4.49) and confirmed elder abuse (OR, 3.90, (2.07–7.36); and older adults with 5 or more risk index items, there was an 18 fold increase in risk for reported elder abuse (OR, 18.46 (12.15–28.04) and confirmed elder abuse (OR, 26.79 (14.18–50.61). Receiver Operating Characteristic (ROC) statistically derived curves for identifying reported elder abuse ranged between 0.77–0.84 and for predicting confirmed elder abuse ranged between 0.79–0.86. Conclusion The vulnerability risk index demonstrates value for identifying individuals at risk for elder abuse. Additional studies are needed to validate this index in other community dwelling populations. PMID:25180376

  4. Surveillane of Middle and High School Mental Health Risk by Student Self-Report Screener

    Directory of Open Access Journals (Sweden)

    Bridget V Dever

    2013-08-01

    Full Text Available Introduction: A 2009 National Academies of Sciences report on child mental health prevention and treatment concluded that screening for mental health risk is an essential component of service delivery. To date, however, there are few practical assessments available or practices in place that measure individual child risk, or risk aggregated at the school or community level. This study examined the utility of a 30-item paper and pencil student self-report screener of behavioral and emotional risk (BER for surveying community risk among 7 schools. Methods: In 2010, 2,222 students in 3 middle and 4 high schools in a medium-sized school district in Georgia were administered the Behavioral and Emotional Screening System Self-Report Child/Adolescent form (BESS Student. The BESS is designed to measure 4 sub-syndromal BER factors for developing mental health disorders: inattention/hyperactivity, internalizing, school problems, and personal adjustment. Analysis of Variance and Chi Square analyses were used to assess the association between adolescent self-reported BER as an indicator of school BER, grade level, child ethnic identification and gender, socioeconomic status, and special education placement status.Results: BESS scores differentiated well between schools for overall BER and special education status, as well as between grade levels, ethnicity, and gender groups. One high school, known by the school administration to have numerous incidents of student behavior problems, had the most deviant 4 BER domain scores of all 7 schools. Girls rated themselves as having a higher prevalence of BER (14% than boys (12%; middle school students reported fewer difficulties than high school students.Conclusion: Middle and high school students were capable of identifying significant differences in their own BER across schools, suggesting that universal mental health risk screening viastudent self-report is potentially useful for identifying aggregated community

  5. Self-Esteem and Feelings of Community Connectedness of At-Risk Adolescents Attending Community-Based Afterschool Programs

    Directory of Open Access Journals (Sweden)

    Tina Loughlin

    2013-03-01

    Full Text Available This research investigated the relationship between adolescent afterschool program attendance, self-esteem and feelings of community connectedness. Thirty-nine of the 61 at-risk adolescents enrolled in two federally funded, community based afterschool programs participated in the study. Participants completed a 10-item self-esteem questionnaire and a 5-item section of the Youth Involved in Community Issues Survey (YICI to measure perceptions of community connectedness. Attendance records were also collected from the sites. Data were analyzed using Pearson Correlations. Results indicated that there was not a significant relationship between the total variables. The individual item analysis, however, did find a significant relationship between adolescent community connectedness and self esteem items. Findings suggest that there is a relationship to be explored and strengthened through means of community outreach for adolescents. Conclusions from this study have important implications for youth practice. Specifically, program leaders need to help adolescents get involved in the community as contributing members.

  6. Perceptions of Obvious and Disruptive Climate Change: Community-Based Risk Assessment for Two Native Villages in Alaska

    Directory of Open Access Journals (Sweden)

    Jon Rosales

    2015-10-01

    Full Text Available This work operationalizes the determinants of climate change risk, exposure and vulnerability, through the perceptions held by Native hunters, fishers, and gatherers in Savoonga and Shaktoolik, Alaska. Informed by their skill, experience, and the traditional knowledge of their elders, hunters, fishers, and gatherers in these communities are astute observers of their environment and environmental change. A questionnaire is used to sort and rank their perceptions of the most obvious and disruptive elements of climate change as representations of exposure and vulnerability, respectively. Results represent the relative strength and significance of those perceptions of environmental change. In addition to other changes, storms are among the most obvious and disruptive impacts of climate change to respondents in both communities, while changes to sea ice tend to be more disruptive in Savoonga, a more ice-obligate culture, than Shaktoolik. Changes on the tundra are more obvious in Shaktoolik, but is the least disruptive category of change in both villages. Changes along the coast were both obvious and disruptive, albeit more so in Shaktoolik than Savoonga. The findings suggest that traditional ecological knowledge is a valuable source of information to access perceptions of risk, and develop climate risk management and adaptation plans. The questionnaire design and statistical methodology may be of interest to those working on community-based adaptation and risk assessment projects in high-risk, poor, and marginalized Native communities with small populations.

  7. Associations between injection risk and community disadvantage among suburban injection drug users in southwestern Connecticut, USA.

    Science.gov (United States)

    Heimer, Robert; Barbour, Russell; Palacios, Wilson R; Nichols, Lisa G; Grau, Lauretta E

    2014-03-01

    Increases in drug abuse, injection, and opioid overdoses in suburban communities led us to study injectors residing in suburban communities in southwestern Connecticut, US. We sought to understand the influence of residence on risk and injection-associated diseases. Injectors were recruited by respondent-driven sampling and interviewed about sociodemographics, somatic and mental health, injection risk, and interactions with healthcare, harm reduction, substance abuse treatment, and criminal justice systems. HIV, hepatitis B and C (HBV and HCV) serological testing was also conducted. Our sample was consistent in geographic distribution and age to the general population and to the patterns of heroin-associated overdose deaths in the suburban towns. High rates of interaction with drug abuse treatment and criminal justice systems contrasted with scant use of harm reduction services. The only factors associated with both dependent variables-residence in less disadvantaged census tracts and more injection risk-were younger age and injecting in one's own residence. This contrasts with the common association among urban injectors of injection-associated risk behaviors and residence in disadvantaged communities. Poor social support and moderate/severe depression were associated with risky injection practices (but not residence in specific classes of census tracts), suggesting that a region-wide dual diagnosis approach to the expansion of harm reduction services could be effective at reducing the negative consequences of injection drug use.

  8. Early detection of psychosis: finding those at clinical high risk.

    Science.gov (United States)

    Addington, Jean; Epstein, Irvin; Reynolds, Andrea; Furimsky, Ivana; Rudy, Laura; Mancini, Barbara; McMillan, Simone; Kirsopp, Diane; Zipursky, Robert B

    2008-08-01

    In early detection work, recruiting individuals who meet the prodromal criteria is difficult. The aim of this paper was to describe the development of a research clinic for individuals who appear to be at risk of developing a psychosis and the process for educating the community and obtaining referrals. The outcome of all referrals to the clinic over a 4-year period was examined. Following an ongoing education campaign that was over inclusive in order to aid recruitment, approximately 27% of all referrals met the criteria for being at clinical high risk of psychosis. We are seeing only a small proportion of those in the community who eventually go on to develop a psychotic illness. This raises two important issues, namely how to remedy the situation, and second, the impact of this on current research in terms of sampling bias and generalizability of research findings. © 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Asia Pty Ltd.

  9. Sandy Lake Health and Diabetes Project: A Community-Based Intervention Targeting Type 2 Diabetes and Its Risk Factors in a First Nations Community

    Science.gov (United States)

    Kakekagumick, Kara E.; Naqshbandi Hayward, Mariam; Harris, Stewart B.; Saksvig, Brit; Gittelsohn, Joel; Manokeesic, Gary; Goodman, Starsky; Hanley, Anthony J.

    2013-01-01

    The Sandy Lake Health and Diabetes Project (SLHDP) was initiated in 1991 as a partnership between Sandy Lake First Nation and researchers interested in addressing the high rates of type 2 diabetes mellitus (T2DM) in the community. Following the expressed wishes of the community, the SLHDP has encompassed a variety of community-wide interventions and activities including: community surveys to document T2DM prevalence and risk factors, the Northern Store program aimed at increasing the availability and knowledge of healthy food options, a home visit program for the prevention and management of T2DM, a local diabetes radio show, a school diabetes curriculum for grades 3 and 4, a community-wide walking trail to encourage increased physical activity, youth diabetes summer camps, and a variety of community events focusing on nutrition and physical activity. Over the 22 year existence of the SLHDP, the community has taken ownership of the program and activities have evolved in alignment with community needs and priorities. This paper discusses the history, implementation, evaluation, and outcomes of the SLHDP and describes its sustainability. The SLHDP is a model of culturally appropriate participatory research that is iterative, with reciprocal capacity building for both key community stakeholders and academic partners. PMID:24302919

  10. Sandy Lake Health and Diabetes Project: A community-based intervention targeting type 2 diabetes and its risk factors in a First Nations community

    Directory of Open Access Journals (Sweden)

    Kara Elizabeth Kakekagumick

    2013-11-01

    Full Text Available The Sandy Lake Health and Diabetes Project (SLHDP was initiated in 1991 as a partnership between Sandy Lake First Nation and researchers interested in addressing the high rates of type 2 diabetes mellitus (T2DM in the community. Following the expressed wishes of the community, the SLHDP has encompassed a variety of community-wide interventions and activities including: community surveys to document T2DM prevalence and risk factors, the Northern Store program aimed at increasing the availability and knowledge of healthy food options, a home visit program for the prevention and management of T2DM, a local diabetes radio show, a school diabetes curriculum for grades 3 and 4, a community-wide walking trail to encourage increased physical activity, youth diabetes summer camps, and a variety of community events focusing on nutrition and physical activity. Over the twenty-two year existence of the SLHDP, the community has taken ownership of the program and activities have evolved in alignment with community needs and priorities. This paper discusses the history, implementation, evaluation and outcomes of the SLHDP and describes its sustainability. The SLHDP is a model of culturally appropriate participatory research that is iterative, with reciprocal capacity building for both key community stakeholders and academic partners.

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

    International Nuclear Information System (INIS)

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

    1993-01-01

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

  12. Risk prediction of major complications in individuals with diabetes: the Atherosclerosis Risk in Communities Study.

    Science.gov (United States)

    Parrinello, C M; Matsushita, K; Woodward, M; Wagenknecht, L E; Coresh, J; Selvin, E

    2016-09-01

    To develop a prediction equation for 10-year risk of a combined endpoint (incident coronary heart disease, stroke, heart failure, chronic kidney disease, lower extremity hospitalizations) in people with diabetes, using demographic and clinical information, and a panel of traditional and non-traditional biomarkers. We included in the study 654 participants in the Atherosclerosis Risk in Communities (ARIC) study, a prospective cohort study, with diagnosed diabetes (visit 2; 1990-1992). Models included self-reported variables (Model 1), clinical measurements (Model 2), and glycated haemoglobin (Model 3). Model 4 tested the addition of 12 blood-based biomarkers. We compared models using prediction and discrimination statistics. Successive stages of model development improved risk prediction. The C-statistics (95% confidence intervals) of models 1, 2, and 3 were 0.667 (0.64, 0.70), 0.683 (0.65, 0.71), and 0.694 (0.66, 0.72), respectively (p < 0.05 for differences). The addition of three traditional and non-traditional biomarkers [β-2 microglobulin, creatinine-based estimated glomerular filtration rate (eGFR), and cystatin C-based eGFR] to Model 3 significantly improved discrimination (C-statistic = 0.716; p = 0.003) and accuracy of 10-year risk prediction for major complications in people with diabetes (midpoint percentiles of lowest and highest deciles of predicted risk changed from 18-68% to 12-87%). These biomarkers, particularly those of kidney filtration, may help distinguish between people at low versus high risk of long-term major complications. © 2016 John Wiley & Sons Ltd.

  13. Availability of high school extracurricular sports programs and high-risk behaviors.

    Science.gov (United States)

    Cohen, Deborah A; Taylor, Stephanie L; Zonta, Michela; Vestal, Katherine D; Schuster, Mark A

    2007-02-01

    The Surgeon General has called for an expansion of school-based extracurricular sports programs to address the obesity epidemic. However, little is known about the availability of and participation in high school extracurricular sports and how participation in these sports is related to high-risk behaviors. We surveyed Los Angeles County public high schools in 2002 to determine the number of extracurricular sports programs offered and the percentage of students participating in those programs. We used community data on rates of arrests, births, and sexually transmitted diseases (STDs) among youth to examine associations between risk behaviors and participation in sports programs. The average school offered 14 sports programs, and the average participation rate was 39% for boys and 30% for girls. Smaller schools and schools with higher percentages of disadvantaged students offered fewer programs. The average school offering 13 or fewer programs had 14% of its students participating, while the average school offering 16 or more programs had 31% of its students participating in sports. Controlling for area-level demographics, juvenile arrest rates and teen birth rates, but not STD rates, were lower in areas where schools offered more extracurricular sports. Opportunities for participation in high school extracurricular sports are limited. Future studies should test whether increased opportunities will increase physical activity and impact the increasing overweight problem in youths.

  14. High Risk Human Papilloma Virus Genotypes in Kurdistan Region in Patients with Vaginal Discharge.

    Science.gov (United States)

    Hussein, Nawfal R; Balatay, Amer A; Assafi, Mahde S; AlMufty, Tamara Abdulezel

    2016-01-01

    The human papilloma virus (HPV) is considered as the major risk factor for the development of cervical cancer. This virus is of different genotypes and generally can be classified into high and low risk types. To determine the rate of high risk HPV genotypes in women with vaginal discharge and lower abdominal pain in Kurdistan region, Iraq. Cervical swabs were taken from 104 women. DNA was extracted and the polymerase chain reaction (PCR) technique was used to determine the presence of high risk genotypes. It was found that 13/104 (12.5%) of the samples were positive for high risk HPV genotypes. Amongst those who were positive, 4/13 (30.7%) were typed as genotype 16 and 7/13 (53.8%) showed mixed genotyping. On the other hand, genotypes 53 and 56 were found in only one sample each. High risk HPV genotypes are not uncommon and further community based study is needed to determine the prevalence of HPV and its genotypes and plan for prevention of infection.

  15. Making sense of climate change risks and responses at the community level: A cultural-political lens

    Directory of Open Access Journals (Sweden)

    Ainka A. Granderson

    2014-01-01

    Full Text Available How to better assess, communicate and respond to risks from climate change at the community level have emerged as key questions within climate risk management. Recent research to address these questions centres largely on psychological factors, exploring how cognition and emotion lead to biases in risk assessment. Yet, making sense of climate change and its responses at the community level demands attention to the cultural and political processes that shape how risk is conceived, prioritized and managed. I review the emergent literature on risk perceptions and responses to climate change using a cultural-political lens. This lens highlights how knowledge, meaning and power are produced and negotiated across multiple stakeholders at the community level. It draws attention to the different ways of constructing climate change risks and suggests an array of responses at the community level. It further illustrates how different constructions of risk intersect with agency and power to shape the capacity for response and collective action. What matters are whose constructions of risk, and whose responses, count in decision-making. I argue for greater engagement with the interpretive social sciences in research, practice and policy. The interpretive social sciences offer theories and tools for capturing and problematising the ways of knowing, sense-making and mobilising around risks from climate change. I also highlight the importance of participatory approaches in incorporating the multiplicity of interests at the community level into climate risk management in fair, transparent and culturally appropriate ways.

  16. Modern Risk Assessment for Nuclear Power Plants High-Voltage Substations

    International Nuclear Information System (INIS)

    Ioan, S.; Hurdubetiu, S.; Marza, F.; Mocanu, M.; Stefan, M.

    2002-01-01

    The paper describes a first Romanian attempt to set up the methodology for risk assessment and control within high-voltage substations, developed for the Nuclear power plant in Cernavoda (Romania). Considering the present risk assessment methods the MENER Project will develop a new methodology, in line with the European Community legislation and with the specific regional needs. In order to correctly shape the necessary resources required by a risk analysis a large size enterprise (a nuclear power plant) is selected and the following five indicators will be estimated: the economic profit, environmental risk, indirect (future) risk, technology improvement and physic and psychological risk. The results are expected to considerably facilitate risk assessment, by: evaluating project acceptability; evaluating equipment compliance to regulatory criteria; estimating excluding clearances; easing the design of emergency programmes; identifying the equipment use restrictions; identifying the risk sources; selecting the maintenance and risk reduction methods; testing the procedures leading to future regulatory norms; suitability of the risk management system modification. The immediate result of employing modern risk assessment methods could be the decrease by one third of the expenses required by environment protection, staff health and labor safety and quality management. (author)

  17. Community-based stillbirth rates and risk factors in rural Sarlahi, Nepal.

    Science.gov (United States)

    Lee, Anne C; Mullany, Luke C; Tielsch, James M; Katz, Joanne; Khatry, Subarna K; Leclerq, Steven C; Adhikari, Ramesh K; Darmstadt, Gary L

    2011-06-01

    To assess stillbirth rates and antepartum risk factors in rural Nepal. Data were collected prospectively during a cluster-randomized, community-based trial in Sarlahi, Nepal, from 2002 to 2006. Multivariate regression modeling was performed to calculate adjusted relative risk estimates. Among 24531 births, the stillbirth rate was 35.4 per 1000 births (term stillbirth rate 21.2 per 1000 births). Most births occurred at home without a skilled birth attendant. The majority (69%) of intrapartum maternal deaths resulted in stillbirth. The adjusted RR (aRR) of stillbirth was 2.74 among nulliparas and 1.47 among mothers with history of a child death. Mothers above the age of 30 years carried a 1.59-fold higher risk for stillbirth than mothers who were 20-24 years old. The stillbirth risk was lower among households where the father had any formal education (aRR 0.70). Land ownership (aRR 0.85) and Pahadi ethnicity (aRR 0.67; reference: Madhesi ethnicity) were associated with significantly lower risks of stillbirth. Stillbirth rates were high in rural Nepal, with the majority of stillbirths occurring at full-term gestation. Nulliparity, history of prior child loss, maternal age above 30 years, Madhesi ethnicity, and socioeconomic disadvantage were significant risk factors for stillbirth. Clinicaltrials.govNCT00 109616. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  18. A risk profile for identifying community-dwelling elderly with a highrisk of recurrent falling: results of a 3-year prospective study

    NARCIS (Netherlands)

    Pluym, S.M.F.; Smit, J.H.; Tromp, A.M.; Stel, V.S.; Deeg, D.J.H.; Bouter, L.M.; Lips, P.T.A.M.

    2007-01-01

    Introduction: The aim of the prospective study reported here was to develop a risk profile that can be used to identify community-dwelling elderly at a high risk of recurrent falling. Materials and methods: The study was designed as a 3-year prospective cohort study. A total of 1365

  19. Individualizing risk of multidrug-resistant pathogens in community-onset pneumonia.

    Directory of Open Access Journals (Sweden)

    Marco Falcone

    Full Text Available The diffusion of multidrug-resistant (MDR bacteria has created the need to identify risk factors for acquiring resistant pathogens in patients living in the community.To analyze clinical features of patients with community-onset pneumonia due to MDR pathogens, to evaluate performance of existing scoring tools and to develop a bedside risk score for an early identification of these patients in the Emergency Department.This was an open, observational, prospective study of consecutive patients with pneumonia, coming from the community, from January 2011 to January 2013. The new score was validated on an external cohort of 929 patients with pneumonia admitted in internal medicine departments participating at a multicenter prospective study in Spain.A total of 900 patients were included in the study. The final logistic regression model consisted of four variables: 1 one risk factor for HCAP, 2 bilateral pulmonary infiltration, 3 the presence of pleural effusion, and 4 the severity of respiratory impairment calculated by use of PaO2/FiO2 ratio. A new risk score, the ARUC score, was developed; compared to Aliberti, Shorr, and Shindo scores, this point score system has a good discrimination performance (AUC 0.76, 95% CI 0.71-0.82 and calibration (Hosmer-Lemeshow, χ2 = 7.64; p = 0.469. The new score outperformed HCAP definition in predicting etiology due to MDR organism. The performance of this bedside score was confirmed in the validation cohort (AUC 0.68, 95% CI 0.60-0.77.Physicians working in ED should adopt simple risk scores, like ARUC score, to select the most appropriate antibiotic regimens. This individualized approach may help clinicians to identify those patients who need an empirical broad-spectrum antibiotic therapy.

  20. A coupled human and landscape conceptual model of risk and resilience in mountain communities

    Science.gov (United States)

    Ramirez, Jorge; Haisch, Tina; Martius, Olivia; Mayer, Heike; Ifejika Speranza, Chinwe; Keiler, Margreth

    2017-04-01

    Recent extreme natural disasters have focused the attention of the global community to society's vulnerability to these events. Simultaneously these natural disasters occur within a broader social and physical context that is interconnected and may include social upheavals, economic crises, and climate change. While progress has been made to mitigate and adapt to natural hazards, much of the existing research lacks interdisciplinary approaches that equally consider both natural and social processes. More importantly, this lack of integration between approaches remains a major challenge in developing disaster risk management plans for communities. In this study we focus on European Alpine communities that face numerous human and environmental risks and differ regarding their ability to cope with these risks and develop resilience. Herein we present a conceptual model of mountain communities exposed to socio-economic (e.g. economic downturn) and biophysical (e.g. floods) "shocks". We identify system boundaries, structure, components, and processes required to describe both human and landscape systems for mountain communities. More importantly we determine feedbacks within and between both systems. The purpose of the model is to investigate which shocks overcome the buffering capacity of mountain communities, and determine which shocks have a greater effect on mountain communities. Socioeconomic, climate, and hazard 'shock' scenarios have been developed for communities with different geographic sizes. Examples of inputs for the model and methods required to test the model are provided. Guided by the model and scenarios we discuss potential outcomes regarding community resilience.

  1. A measure of fall risk behaviors and perceptions among community-dwelling older adults.

    Science.gov (United States)

    Yuen, Hon Keung; Carter, Rickey E

    2006-01-01

    Relatively little is known about the interaction between behavioral and environmental circumstances associated with falls among community-dwelling older adults. This study is designed to develop an instrument that measures community-dwelling older adults' participation in and perceptions of fall risk behaviors. Eighty-seven community-dwelling older adults aged 60 or above (mean +/- SD = 76 +/- 7.9), who had experienced at least one fall in the past 12 months, completed a questionnaire dealing with frequency of their participation in fall risk behaviors, their perceptions of these behaviors, and their fall history. Data were subjected to exploratory factor analysis. A 20-item instrument consisting of three constructs was presented as the Fall Risk Behaviors and Perceptions Scale (FRB&PS). Two of the three constructs of the instrument were de-stabilizers and non-supports, both of which measure participation in fall risk behaviors; the third was perceptions of fall risk behaviors. Internal consistency coefficient of the FRB&PS is 0.733 with a root mean square error of approximation (RMSEA) score of 0.075, which indicates an adequate model fit. Results from the stepwise regression analyses indicated that adults aged 75 and above (the old-old) participated less frequently in fall risk activities (p = 0.025), and had more knowledge about fall risks as measured by a higher perception score (p = 0.025) than those aged 60 to 75 (the young-old). Older men tended to participate more frequently in fall risk activities (p = 0.020) than older women; in addition, those older adults who are more mobile (p = 0.002) also participated more frequently in fall risk behaviors than those who are less mobile. Preliminary findings indicate that the pilot FRB&PS is a reliable and valid instrument to measure community-dwelling older adults' participation in and perceptions of fall risk behaviors. Additional psychometric validation of the FRB&PS on predicting the likelihood of falls is

  2. [Fall risk factors and sex differences among community-dwelling elderly individuals in Japan. A Kameoka study].

    Science.gov (United States)

    Masumoto, Taeko; Yamada, Yosuke; Yamada, Minoru; Nakaya, Tomoki; Miyake, Motoko; Watanabe, Yuya; Yoshida, Tsukasa; Yokoyama, Keiichi; Yamagata, Emi; Date, Heiwa; Nanri, Hinako; Komatsu, Mitsuyo; Yoshinaka, Yasuko; Fujiwara, Yoshinori; Okayama, Yasuko; Kimura, Misaka

    2015-01-01

    Although factors associated with falls might differ between men and women, no large-scale studies were conducted to examine the sex difference of risk factors for falls in Japanese elderly. The purpose of this study was to examine fall risk factors and sex differences among community-dwelling elderly individuals using a complete survey of the geriatric population in Kameoka city. A self-administered questionnaire survey was conducted with 18,231 community-dwelling elderly individuals aged 65 years or over in Kameoka city, Kyoto Prefecture, between July and August 2011, excluding people who were publicly certified with a long-term care need of grade 3 or higher. The questionnaire was individually distributed and collected via mail. Out of 12,159 responders (recovery rate of 72.2%), we analyzed the data of 12,054 elderly individuals who were not certified as having long-term care needs. The questionnaire was composed of basic attributes, a simple screening test for fall risk, the Kihon Check List with 25 items, and the Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence with 13 items. These items were grouped into nine factors: motor function, malnutrition, oral function, houseboundness, forgetfulness, depression, Instrumental Activity of Daily Living (IADL), intellectual activities, and social role. Of all the respondents, 20.8% experienced falls within the last year, and 26.6% were classified as having high fall risk. Fall risk increased with age in both sexes, and risk in all age groups was higher for women than for men. All factors were significantly associated with fall risk in both sexes. After controlling for these factors, a significant relationship was found between fall risk and motor function, malnutrition, oral function, forgetfulness, depression, and IADL in men and motor function, oral function, forgetfulness, depression, and IADL in women. The deterioration of motor function was associated with three-times-higher risk than non

  3. Knowledge and Risk Factors for Glaucoma among Adults in a Rural Community of Kwara State, North-Central Nigeria

    Directory of Open Access Journals (Sweden)

    Kabir Adekunle Durowade

    2014-10-01

    Full Text Available AIM: Glaucoma is becoming an increasingly important public health problem and presents a greater public health challenge because the blindness it causes is irreversible. This study is aimed at assessing the knowledge and risk factors for glaucoma among adults in Oke-ose community, Kwara State in North-Cental Nigeria. METHODS: This is a cross-sectional study which assessed the knowledge and risk factors for glaucoma among adults in a rural community of Kwara State. The respondents were selected using cluster sampling technique. Interviewer- administered semi-structured questionnaire was used to collect data. Data was analyzed using SPSS version 15. RESULTS: Less than half 94(47.0% respondents were aware of glaucoma. Only 11(5.5% respondents had some knowledge of symptoms and 18(9.0% had knowledge of the risk factors. Socio-economic status, age of respondents and educational status and family history of glaucoma among the respondents significantly influenced the awareness and knowledge of the disease (p<0.05. Among the respondents, a total of 22(11.0% and 37(18.5% were diabetic and hypertensive respectively. Only five (2.5% of respondents had high risk perception of glaucoma. CONCLUSION: The presence of risk factors for glaucoma coupled with the poor risk perception and poor knowledge of the disease require urgent community directed eye care interventions to reduce the devastating effects of glaucoma. [TAF Prev Med Bull 2014; 13(5.000: 375-380

  4. Strategy for distribution of influenza vaccine to high-risk groups and children.

    Science.gov (United States)

    Longini, Ira M; Halloran, M Elizabeth

    2005-02-15

    Despite evidence that vaccinating schoolchildren against influenza is effective in limiting community-level transmission, the United States has had a long-standing government strategy of recommending that vaccine be concentrated primarily in high-risk groups and distributed to those people who keep the health system and social infrastructure operating. Because of this year's influenza vaccine shortage, a plan was enacted to distribute the limited vaccine stock to these groups first. This vaccination strategy, based on direct protection of those most at risk, has not been very effective in reducing influenza morbidity and mortality. Although it is too late to make changes this year, the current influenza vaccine crisis affords the opportunity to examine an alternative for future years. The alternative plan, supported by mathematical models and influenza field studies, would be to concentrate vaccine in schoolchildren, the population group most responsible for transmission, while also covering the reachable high-risk groups, who would also receive considerable indirect protection. In conjunction with a plan to ensure an adequate vaccine supply, this alternative influenza vaccination strategy would help control interpandemic influenza and be instrumental in preparing for pandemic influenza. The effectiveness of the alternative plan could be assessed through nationwide community studies.

  5. Understanding Falls Risk and Impacts in Chinese American Older Patients at a Community Health Center.

    Science.gov (United States)

    Huang, Susan; Duong, Thomas; Ieong, Liss; Quach, Thu

    2017-08-01

    While falls are highly prevalent and costly for older adults, little is known about falls for Asian Americans. Using a custom, evidence-based, bilingual fall risk assessment and management tool, our study examined the prevalence of falls among older Chinese-speaking patients at a community health center. We identified the risks for falls and explored an association of fall risk with emergency room (ER) and hospital use in this population. The setting was at a community health center in Oakland, CA. Participants included 839 older Asian American adults (ages 65-80 years) who spoke Cantonese/Mandarin. Primary care clinic staff administered a fall risk assessment and management tool at the time of clinic visits to assess patients' risk factors for falls. Of the total, 173 (20.6%) reported having fallen in the past year, with women comprising a majority (71.7%). 362 patients in the cohort (43.1%) reported fear of falling. For the subset of Medicaid managed care patients (n = 455, 54.3% of total) for whom we were able to obtain ER and hospital utilization data, 31 patients (14.5%) who reported a fall risk had an ER/hospital episode compared to 15 (6.2%) of those who did not self-report fall risks (statistically significant, p cultural competence to focus on Asian American older adults, can help establish the prevalence of falls in this understudied population and effectively identify those at higher risk for falls and subsequent ER/hospital utilization. More research is needed to understand the risk and impacts of falls in understudied populations and identify ways to prevent these costly falls.

  6. Association of Educational Attainment With Lifetime Risk of Cardiovascular Disease: The Atherosclerosis Risk in Communities Study.

    Science.gov (United States)

    Kubota, Yasuhiko; Heiss, Gerardo; MacLehose, Richard F; Roetker, Nicholas S; Folsom, Aaron R

    2017-08-01

    Estimates of lifetime risk may help raise awareness of the extent to which educational inequalities are associated with risk of cardiovascular disease (CVD). To estimate lifetime risks of CVD according to categories of educational attainment. Participants were followed from 1987 through December 31, 2013. All CVD events (coronary heart disease, heart failure, and stroke) were confirmed by physician review and International Classification of Diseases codes. A total of 13 948 whites and African Americans who were 45 to 64 years old and free of CVD at baseline were included from 4 US communities (Washington County, Maryland; Forsyth County, North Carolina; Jackson, Mississippi; and suburbs of Minneapolis, Minnesota). The data analysis was performed from June 7 to August 31, 2016. Educational attainment. We used a life table approach to estimate lifetime risks of CVD from age 45 through 85 years according to educational attainment. We adjusted for competing risks of death from underlying causes other than CVD. The sample of 13 948 participants was 56% female and 27% African American. During 269 210 person-years of follow-up, we documented 4512 CVD events and 2401 non-CVD deaths. Educational attainment displayed an inverse dose-response relation with cumulative risk of CVD, which became evident in middle age, with the most striking gap between those not completing vs completing high school. In men, lifetime risks of CVD were 59.0% (95% CI, 54.0%-64.1%) for grade school, 52.5% (95% CI, 47.7%-56.8%) for high school education without graduation, 50.9% (95% CI, 47.3%-53.9%) for high school graduation, 47.2% (95% CI, 41.5%-52.5%) for vocational school, 46.4% (95% CI, 42.8%-49.6%) for college with or without graduation, and 42.2% (95% CI, 36.6%-47.0%) for graduate/professional school; in women, 50.8% (95% CI, 45.7%-55.8%), 49.3% (95% CI, 45.1%-53.1%), 36.3% (95% CI, 33.4%-39.1%), 32.2% (95% CI, 26.0%-37.3%), 32.8% (95% CI, 29.1%-35.9%), and 28.0% (95% CI, 21

  7. The hookworm Ancylostoma ceylanicum: An emerging public health risk in Australian tropical rainforests and Indigenous communities.

    Science.gov (United States)

    Smout, Felicity A; Skerratt, Lee F; Butler, James R A; Johnson, Christopher N; Congdon, Bradley C; Thompson, R C Andrew

    2017-06-01

    Ancylostoma ceylanicum is the common hookworm of domestic dogs and cats throughout Asia, and is an emerging but little understood public health risk in tropical northern Australia. We investigated the prevalence of A. ceylanicum in soil and free-ranging domestic dogs at six rainforest locations in Far North Queensland that are Indigenous Australian communities and popular tourist attractions within the Wet Tropics World Heritage Area. By combining PCR-based techniques with traditional methods of hookworm species identification, we found the prevalence of hookworm in Indigenous community dogs was high (96.3% and 91.9% from necropsy and faecal samples, respectively). The majority of these infections were A. caninum. We also observed, for the first time, the presence of A. ceylanicum infection in domestic dogs (21.7%) and soil (55.6%) in an Indigenous community. A. ceylanicum was present in soil samples from two out of the three popular tourist locations sampled. Our results contribute to the understanding of dogs as a public health risk to Indigenous communities and tourists in the Wet Tropics. Dog health needs to be more fully addressed as part of the Australian Government's commitments to "closing the gap" in chronic disease between Indigenous and other Australians, and encouraging tourism in similar locations.

  8. The hookworm Ancylostoma ceylanicum: An emerging public health risk in Australian tropical rainforests and Indigenous communities

    Directory of Open Access Journals (Sweden)

    Felicity A. Smout

    2017-06-01

    Full Text Available Ancylostoma ceylanicum is the common hookworm of domestic dogs and cats throughout Asia, and is an emerging but little understood public health risk in tropical northern Australia. We investigated the prevalence of A. ceylanicum in soil and free-ranging domestic dogs at six rainforest locations in Far North Queensland that are Indigenous Australian communities and popular tourist attractions within the Wet Tropics World Heritage Area. By combining PCR-based techniques with traditional methods of hookworm species identification, we found the prevalence of hookworm in Indigenous community dogs was high (96.3% and 91.9% from necropsy and faecal samples, respectively. The majority of these infections were A. caninum. We also observed, for the first time, the presence of A. ceylanicum infection in domestic dogs (21.7% and soil (55.6% in an Indigenous community. A. ceylanicum was present in soil samples from two out of the three popular tourist locations sampled. Our results contribute to the understanding of dogs as a public health risk to Indigenous communities and tourists in the Wet Tropics. Dog health needs to be more fully addressed as part of the Australian Government's commitments to “closing the gap” in chronic disease between Indigenous and other Australians, and encouraging tourism in similar locations.

  9. High-resolution phylogenetic microbial community profiling

    Energy Technology Data Exchange (ETDEWEB)

    Singer, Esther; Coleman-Derr, Devin; Bowman, Brett; Schwientek, Patrick; Clum, Alicia; Copeland, Alex; Ciobanu, Doina; Cheng, Jan-Fang; Gies, Esther; Hallam, Steve; Tringe, Susannah; Woyke, Tanja

    2014-03-17

    The representation of bacterial and archaeal genome sequences is strongly biased towards cultivated organisms, which belong to merely four phylogenetic groups. Functional information and inter-phylum level relationships are still largely underexplored for candidate phyla, which are often referred to as microbial dark matter. Furthermore, a large portion of the 16S rRNA gene records in the GenBank database are labeled as environmental samples and unclassified, which is in part due to low read accuracy, potential chimeric sequences produced during PCR amplifications and the low resolution of short amplicons. In order to improve the phylogenetic classification of novel species and advance our knowledge of the ecosystem function of uncultivated microorganisms, high-throughput full length 16S rRNA gene sequencing methodologies with reduced biases are needed. We evaluated the performance of PacBio single-molecule real-time (SMRT) sequencing in high-resolution phylogenetic microbial community profiling. For this purpose, we compared PacBio and Illumina metagenomic shotgun and 16S rRNA gene sequencing of a mock community as well as of an environmental sample from Sakinaw Lake, British Columbia. Sakinaw Lake is known to contain a large age of microbial species from candidate phyla. Sequencing results show that community structure based on PacBio shotgun and 16S rRNA gene sequences is highly similar in both the mock and the environmental communities. Resolution power and community representation accuracy from SMRT sequencing data appeared to be independent of GC content of microbial genomes and was higher when compared to Illumina-based metagenome shotgun and 16S rRNA gene (iTag) sequences, e.g. full-length sequencing resolved all 23 OTUs in the mock community, while iTags did not resolve closely related species. SMRT sequencing hence offers various potential benefits when characterizing uncharted microbial communities.

  10. Insights from socio-hydrology modelling on dealing with flood risk - Roles of collective memory, risk-taking attitude and trust

    Science.gov (United States)

    Viglione, Alberto; Di Baldassarre, Giuliano; Brandimarte, Luigia; Kuil, Linda; Carr, Gemma; Salinas, José Luis; Scolobig, Anna; Blöschl, Günter

    2014-10-01

    The risk coping culture of a community plays a major role in the development of urban floodplains. In this paper we analyse, in a conceptual way, the interplay of community risk coping culture, flooding damage and economic growth. We particularly focus on three aspects: (i) collective memory, i.e., the capacity of the community to keep risk awareness high; (ii) risk-taking attitude, i.e., the amount of risk the community is collectively willing to be exposed to; and (iii) trust of the community in risk reduction measures. To this end, we use a dynamic model that represents the feedback between the hydrological and social system components. Model results indicate that, on the one hand, by under perceiving the risk of flooding (because of short collective memory and too much trust in flood protection structures) in combination with a high risk-taking attitude, community development is severely limited because of high damages caused by flooding. On the other hand, overestimation of risk (long memory and lack of trust in flood protection structures) leads to lost economic opportunities and recession. There are many scenarios of favourable development resulting from a trade-off between collective memory and trust in risk reduction measures combined with a low to moderate risk-taking attitude. Interestingly, the model gives rise to situations in which the development of the community in the floodplain is path dependent, i.e., the history of flooding may lead to community growth or recession.

  11. Arm crank ergometry improves cardiovascular disease risk factors and community mobility independent of body composition in high motor complete spinal cord injury.

    Science.gov (United States)

    Bresnahan, James J; Farkas, Gary J; Clasey, Jody L; Yates, James W; Gater, David R

    2018-01-15

    Evaluate the effect of aerobic exercise using arm crank ergometry (ACE) in high motor complete (ISNCSCI A/B) spinal cord injury (SCI) as primarily related to cardiovascular disease (CVD) risk factors and functional mobility and secondarily to body composition and metabolic profiles. Longitudinal interventional study at an academic medical center. Ten previously untrained participants (M8/F2, Age 36.7 y ± 10.1, BMI 24.5 ± 6.0) with high motor complete SCI (C7-T5) underwent ACE exercise training 30 minutes/day × 3 days/week for 10 weeks at 70% VO 2Peak . Primary outcome measures were pre- and post-intervention changes in markers of cardiovascular fitness (graded exercise testing (GXT): VO 2 , VO 2Peak , respiratory quotient [RQ], GXT time, peak power, and energy expenditure [EE]) and community mobility (time to traverse a 100ft-5° ramp, and 12-minute WC propulsion test). Secondary outcome measures were changes in body composition and metabolic profiles (fasting and area under the curve for glucose and insulin, homeostasis model assessment [HOMA] for %β-cell activity [%β], %insulin sensitivity [%S], and insulin resistance [IR], and Matsuda Index [ISI Matsuda ]). Resting VO 2 , relative VO 2Peak , absolute VO 2Peak , peak power, RQ, 12-minute WC propulsion, fasting insulin, fasting G:I ratio, HOMA-%S, and HOMA-IR all significantly improved following intervention (P 0.05). Ten weeks of ACE at 70% VO 2Peak in high motor complete SCI improves aerobic capacity, community mobility, and metabolic profiles independent of changes in body composition.

  12. Multifactorial screening for fall risk in community-dwelling older adults in the primary care office: development of the fall risk assessment & screening tool.

    Science.gov (United States)

    Renfro, Mindy Oxman; Fehrer, Steven

    2011-01-01

    Unintentional falls is an increasing public health problem as incidence of falls rises and the population ages. The Centers for Disease Control and Prevention reports that 1 in 3 adults aged 65 years and older will experience a fall this year; 20% to 30% of those who fall will sustain a moderate to severe injury. Physical therapists caring for older adults are usually engaged with these patients after the first injury fall and may have little opportunity to abate fall risk before the injuries occur. This article describes the content selection and development of a simple-to-administer, multifactorial, Fall Risk Assessment & Screening Tool (FRAST), designed specifically for use in primary care settings to identify those older adults with high fall risk. Fall Risk Assessment & Screening Tool incorporates previously validated measures within a new multifactorial tool and includes targeted recommendations for intervention. Development of the multifactorial FRAST used a 5-part process: identification of significant fall risk factors, review of best evidence, selection of items, creation of the scoring grid, and development of a recommended action plan. Fall Risk Assessment & Screening Tool has been developed to assess fall risk in the target population of older adults (older than 65 years) living and ambulating independently in the community. Many fall risk factors have been considered and 15 items selected for inclusion. Fall Risk Assessment & Screening Tool includes 4 previously validated measures to assess balance, depression, falls efficacy, and home safety. Reliability and validity studies of FRAST are under way. Fall risk for community-dwelling older adults is an urgent, multifactorial, public health problem. Providing primary care practitioners (PCPs) with a very simple screening tool is imperative. Fall Risk Assessment & Screening Tool was created to allow for safe, quick, and low-cost administration by minimally trained office staff with interpretation and

  13. Feasibility of interdisciplinary community-based fall risk screening.

    Science.gov (United States)

    Elliott, Sharon J; Ivanescu, Andrada; Leland, Natalie E; Fogo, Jennifer; Painter, Jane A; Trujillo, Leonard G

    2012-01-01

    This pilot study examined the feasibility of (1) conducting interdisciplinary fall risk screens at a communitywide adult fall prevention event and (2) collecting preliminary follow-up data from people screened at the event about balance confidence and home and activity modifications made after receiving educational information at the event. We conducted a pilot study with pre- and posttesting (4-mo follow-up) with 35 community-dwelling adults ≥55 yr old. Approximately half the participants were at risk for falls. Most participants who anticipated making environmental or activity changes to reduce fall risk initiated changes (n = 8/11; 72.7%) during the 4-mo follow-up period. We found no significant difference in participants' balance confidence between baseline (median = 62.81) and follow-up (median = 64.06) as measured by the Activities-specific Balance Confidence scale. Conducting interdisciplinary fall risk screens at an adult fall prevention event is feasible and can facilitate environmental and behavior changes to reduce fall risk. Copyright © 2012 by the American Occupational Therapy Association, Inc.

  14. Psychosis risk screening: Validation of the youth psychosis at-risk questionnaire - brief in a community-derived sample of adolescents.

    Science.gov (United States)

    Fonseca-Pedrero, Eduardo; Ortuño-Sierra, Javier; Chocarro, Edurne; Inchausti, Felix; Debbané, Martin; Bobes, Julio

    2017-12-01

    There have been several attempts to identify individuals potentially at high risk for psychotic-spectrum disorders using brief screening measures. However, relatively few studies have tested the psychometric properties of the psychosis screening measures in representative samples of adolescents. The main purpose of the present study was to analyse the prevalence, factorial structure, measurement invariance across gender, and reliability of the Youth Psychosis At-Risk Questionnaire - Brief (YPARQ-B) in a community-derived sample of adolescents. Additionally, the relationship between YPARQ-B, depressive symptoms, psychopathology, stress manifestations, and prosocial skills was analysed. One thousand and twenty students from high schools participated in a cross-sectional survey. The YPARQ-B, the Reynolds Adolescent Depression Scale, the Strengths and Difficulties Questionnaire, and the Student Stress Inventory - Stress Manifestations were used. A total of 85.1% of the total sample self-reported at least one subclinical psychotic experience. We observed a total of 10.9% of adolescents with a cutoff score of ≥11 or 6.8% with a cutoff score of ≥13. The analysis of internal structure of the YPARQ-B yielded an essentially unidimensional structure. The YPARQ-B scores showed measurement invariance across gender. The internal consistency of the YPARQ-B total score was 0.94. Furthermore, self-reported subclinical psychotic experiences were associated with depressive symptoms, emotional and behavioural problems, poor prosocial skills, and stress manifestations. These results would appear to indicate that YPARQ-B is a brief and easy tool to assess self-reported subclinical psychotic experiences in adolescents from the general population. The assessment of these experiences in community settings, and its associations with psychopathology, may help us to enhance the possibility of an early identification of adolescents potentially at risk for psychosis and mental health

  15. The role of risk perceptions in the risk mitigation process: The case of wildfire in high risk communities

    Science.gov (United States)

    Wade E. Martin; Ingrid M. Martin; Brian Kent

    2009-01-01

    An important policy question receiving considerable attention concerns the risk perception-risk mitigation process that guides how individuals choose to address natural hazard risks. This question is considered in the context of wildfire. We analyze the factors that influence risk reduction behaviors by homeowners living in the wildland-urban interface. The factors...

  16. High Risk Parolees in Transition from Institution to Community Life.

    Science.gov (United States)

    McMurray, Harvey L.

    1993-01-01

    Examined parolees released in three central North Carolina counties between July 1 and December 31, 1988. Findings indicated that many parolees wanted change of lifestyle and reported being motivated when released. Community factors (discrimination) and individual factors (finances, low self-esteem, drug use) appeared to hamper successful…

  17. Programs to increase high school completion: a community guide systematic health equity review.

    Science.gov (United States)

    Hahn, Robert A; Knopf, John A; Wilson, Sandra Jo; Truman, Benedict I; Milstein, Bobby; Johnson, Robert L; Fielding, Jonathan E; Muntaner, Carles J M; Jones, Camara Phyllis; Fullilove, Mindy T; Moss, Regina Davis; Ueffing, Erin; Hunt, Pete C

    2015-05-01

    High school completion (HSC) is an established predictor of long-term morbidity and mortality. U.S. rates of HSC are substantially lower among students from low-income families and most racial/ethnic minority populations than students from high-income families and the non-Hispanic white population. This systematic review assesses the effectiveness of programs to increase HSC and the potential of these programs to improve lifelong health among at-risk students. A search located a meta-analysis (search period 1985-2010/2011) on the effects of programs to increase HSC or General Educational Development (GED) diploma receipt; the meta-analysis was concordant with Community Guide definitions and methodologic standards. Programs were assessed separately for the general student population (152 studies) and students who were parents or pregnant (15 studies). A search for studies published between 2010 and August 2012 located ten more recent studies, which were assessed for consistency with the meta-analysis. Analyses were conducted in 2013. The review focused on the meta-analysis. Program effectiveness was measured as the increased rate of HSC (or GED receipt) by the intervention group compared with controls. All assessed program types were effective in increasing HSC in the general student population: vocational training, alternative schooling, social-emotional skills training, college-oriented programming, mentoring and counseling, supplemental academic services, school and class restructuring, multiservice packages, attendance monitoring and contingencies, community service, and case management. For students who had children or were pregnant, attendance monitoring and multiservice packages were effective. Ten studies published after the search period for the meta-analysis were consistent with its findings. There is strong evidence that a variety of HSC programs can improve high school or GED completion rates. Because many programs are targeted to high-risk students and

  18. Community Level Risk Factors for Maternal Mortality in Madagascar

    African Journals Online (AJOL)

    AJRH Managing Editor

    This paper explores the effect of risk and socioeconomic factors on maternal mortality at the ... to study maternal mortality, however, studying maternal mortality at the community ... causes of maternal mortality at the country level in ... Antananarivo, the capital city of Madagascar, .... cyclones, and crime can be associated with.

  19. Disaster Preparedness activities in Havana: the study of the Community leaders´ Perception of risks

    Directory of Open Access Journals (Sweden)

    Nuria Gaeta Carrillo

    2017-06-01

    Full Text Available Risk reduction and build resilience in order to prevent some disasters require not just well coordinated authorities, a sound legislation and strong institutions. It is also vital to involve the local communities in preventive measures. The design of community training and community based preparedness activities is not ofen planned properly and is done without enough information, leading to a breakdown in the intervention. Based on personal and group interviews and a survey, this study performs an exploration of community leaders´ perceptions about risks in Havana that strengthens or constrains preventive measures and enhance or not response capacities. information that helps to design capacity building activities at studied community.

  20. Identifying Aboriginal-specific AUDIT-C and AUDIT-3 cutoff scores for at-risk, high-risk, and likely dependent drinkers using measures of agreement with the 10-item Alcohol Use Disorders Identification Test.

    Science.gov (United States)

    Calabria, Bianca; Clifford, Anton; Shakeshaft, Anthony P; Conigrave, Katherine M; Simpson, Lynette; Bliss, Donna; Allan, Julaine

    2014-09-01

    The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item alcohol screener that has been recommended for use in Aboriginal primary health care settings. The time it takes respondents to complete AUDIT, however, has proven to be a barrier to its routine delivery. Two shorter versions, AUDIT-C and AUDIT-3, have been used as screening instruments in primary health care. This paper aims to identify the AUDIT-C and AUDIT-3 cutoff scores that most closely identify individuals classified as being at-risk drinkers, high-risk drinkers, or likely alcohol dependent by the 10-item AUDIT. Two cross-sectional surveys were conducted from June 2009 to May 2010 and from July 2010 to June 2011. Aboriginal Australian participants (N = 156) were recruited through an Aboriginal Community Controlled Health Service, and a community-based drug and alcohol treatment agency in rural New South Wales (NSW), and through community-based Aboriginal groups in Sydney NSW. Sensitivity, specificity, and positive and negative predictive values of each score on the AUDIT-C and AUDIT-3 were calculated, relative to cutoff scores on the 10-item AUDIT for at-risk, high-risk, and likely dependent drinkers. Receiver operating characteristic (ROC) curve analyses were conducted to measure the detection characteristics of AUDIT-C and AUDIT-3 for the three categories of risk. The areas under the receiver operating characteristic (AUROC) curves were high for drinkers classified as being at-risk, high-risk, and likely dependent. Recommended cutoff scores for Aboriginal Australians are as follows: at-risk drinkers AUDIT-C ≥ 5, AUDIT-3 ≥ 1; high-risk drinkers AUDIT-C ≥ 6, AUDIT-3 ≥ 2; and likely dependent drinkers AUDIT-C ≥ 9, AUDIT-3 ≥ 3. Adequate sensitivity and specificity were achieved for recommended cutoff scores. AUROC curves were above 0.90.

  1. Geographic variance of cardiovascular risk factors among community women: the national Sister to Sister campaign.

    Science.gov (United States)

    Jarvie, Jennifer L; Johnson, Caitlin E; Wang, Yun; Wan, Yun; Aslam, Farhan; Athanasopoulos, Leonidas V; Pollin, Irene; Foody, JoAnne M

    2011-01-01

    There are substantial variations in cardiovascular disease (CVD) risk and outcomes among women. We sought to determine geographic variation in risk factor prevalence in a contemporary sample of U.S. women. Using 2008-2009 Sister to Sister (STS) free heart screening data from 17 U.S. cities, we compared rates of obesity (body mass index [BMI] ≥30 kg/m(2)), hypertension (HTN ≥140/90 mm Hg), low high-density lipoprotein cholesterol (HDL-C cities had higher rates of hyperglycemia and low HDL-C. In a large, community-based sample of women nationwide, this comprehensive analysis shows remarkable geographic variation in risk factors, which provides opportunities to improve and reduce a woman's CVD risk. Further investigation is required to understand the reasons behind such variation, which will provide insight toward tailoring preventive interventions to narrow gaps in CVD risk reduction in women.

  2. Reaching and Supporting At-Risk Community Based Seniors: Results of a Multi-church Partnership.

    Science.gov (United States)

    Ellis, Julie L; Morzinski, Jeffrey A

    2018-04-26

    The purpose of this study was to determine the impact of a nurse-led, church-based educational support group for "at-risk," older African Americans on hospitalization and emergency department use. Study nurses enrolled 81 "at-risk" older adult members of ten churches. Participants completed a trifold pamphlet identifying personal health information and support, and they attended eight monthly educational/support group sessions in their church during the 10-month intervention. Study nurses completed a risk assessment interview with each senior both pre- and post-participation. The study nurse completed post-program assessments with 64 seniors, a 79% retention rate. At the program's conclusion researchers conducted a focus group with the study RNs and used an anonymous written survey to gather participant appraisals of program elements. Neither hospitalization nor emergency department/urgent care usage was significantly different from pre- to post-program. Session attendance was moderate to high and over half of the seniors brought a family member or friend to one or more sessions. The majority of seniors initiated positive health changes (e.g., smoking cessation, weight loss, or diet changes). Participants expressed high satisfaction and expressed satisfaction to perceive that they were supporting other seniors in their community. We conclude that this intervention was successful in engaging and motivating seniors to initiate health behavior change and contributed to a health-supportive church-based community. To demonstrate a statistically significant difference in hospital and ED usage, however, a stronger intervention or a larger sample size is needed.

  3. Prevención de la violencia familiar, escolar y urbana en una comunidad de alto riesgo psicosocial Prevention of family, school and urban violence in a high psychosocial risk community

    Directory of Open Access Journals (Sweden)

    Susana Quiroga

    2006-12-01

    Full Text Available En el Programa de Psicología Clínica para Adolescentes se han implementado dispositivos de prevención de patologías específicas que se presentan en adolescentes con alto riesgo psicosocial. El objetivo de estos dispositivos es optimizar la posibilidad de creación y mantenimiento de redes comunitarias que asistan a la población adolescente de riesgo y su familia y prevengan conductas de desajuste familiar, social y educacional (conductas transgresoras violentas, suicidas y autodestructivas. En este trabajo se presenta la experiencia de prevención realizada por la Unidad de Prevención y Asistencia en Violencia Familiar, Escolar y Urbana en escuelas públicas del Distrito de Avellaneda. Los datos obtenidos a través del Cuestionario Exposición a la Violencia Comunitaria demuestran el alto riesgo de muerte y/o autodestrucción al que se encuentran expuestos estos adolescentes y corroboran la alta vulnerabilidad psicosocial y comunitaria que predomina en esta población y su contexto.In the Clinical Psychology Program for Adolescents, prevention devices of specific pathologies that are present in adolescents with high psychosocial risk have been implemented. The aim of these devices is to optimise the possibility of creating and maintaining community groups that can assist the teenage population at risk and their family and that can prevent behaviours of family, social and educational disruption (violent, suicidal and self-destructive transgressive behaviours. In this study, the prevention experience in Family, School and Urban Violence in state schools in the district of Avellaneda, which was carried out by the Prevention and Assistance Unit, is presented. The data obtained by means of the Exposure to Community Violence Questionnaire show the high risk of death and/or self-destruction these adolescents are exposed to and corroborate the high psychosocial and community vulnerability that prevails in this population and its environment.

  4. Reducing 30-Day Readmission Rates in a High-Risk Population Using a Lay-Health Worker Model in Appalachia Kentucky

    Science.gov (United States)

    Cardarelli, Roberto; Horsley, Mary; Ray, Lisa; Maggard, Nancy; Schilling, Jennifer; Weatherford, Sarah; Feltner, Fran; Gilliam, Kayla

    2018-01-01

    This exploratory study aimed to address the effectiveness of a lay-health worker (LHW) model in addressing social needs and readmissions of high-risk patients admitted in a rural community hospital. A quasi-experimental study design assessed implementation of a LHW model for assisting high-risk patients with their post-discharge social needs.…

  5. Noctural Enuresis as a Risk Factor for Falls in Older Community Dwelling Women with Urinary Incontinence.

    Science.gov (United States)

    Pahwa, Avita K; Andy, Uduak U; Newman, Diane K; Stambakio, Hanna; Schmitz, Kathryn H; Arya, Lily A

    2016-05-01

    We determined the association of urinary symptoms with fall risk and physical limitations in older community dwelling women with urinary incontinence. We performed an in-depth assessment of daytime and nighttime urinary symptoms, fall risk, physical function, physical performance tests and mental function in older community dwelling women with urinary incontinence who had not sought care for urinary symptoms. All assessments were performed in participant homes. We used univariable and multivariable linear regression to examine the relationship of urinary symptoms to fall risk, physical function and physical performance. Of 37 women with a mean ± SD age of 74 ± 8.4 years who had urinary incontinence 48% were at high risk for falls. Nocturnal enuresis was reported by 50% of the women. Increased fall risk was associated with increasing frequency of nocturnal enuresis (p = 0.04), worse lower limb function (p Women with nocturnal enuresis had significantly lower physical performance test scores than women without nocturnal enuresis (median 7, range 0 to 11 vs 9, range 1 to 12, p = 0.04). In a multivariable regression model including age, nocturnal enuresis episodes and physical function only physical function was associated with an increased fall risk (p women with urinary incontinence. It may serve as a marker of fall risk even in women who do not seek care for urinary symptoms. Interventions targeting upper and lower body physical function could potentially decrease the risk of falls in older women with urinary incontinence. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  6. A Practical Risk Stratification Approach for Implementing a Primary Care Chronic Disease Management Program in an Underserved Community.

    Science.gov (United States)

    Xu, Junjun; Williams-Livingston, Arletha; Gaglioti, Anne; McAllister, Calvin; Rust, George

    2018-01-01

    The use of value metrics is often dependent on payer-initiated health care management incentives. There is a need for practices to define and manage their own patient panels regardless of payer to participate effectively in population health management. A key step is to define a panel of primary care patients with high comorbidity profiles. Our sample included all patients seen in an urban academic family medicine clinic over a two-year period. The simplified risk stratification was built using internal electronic health record and billing system data based on ICD-9 codes. There were 347 patients classified as high-risk out of the 5,364 patient panel. Average age was 59 years (SD 15). Hypertension (90%), hyperlipidemia (62%), and depression (55%) were the most common conditions among high-risk patients. Simplified risk stratification provides a feasible option for our team to understand and respond to the nuances of population health in our underserved community.

  7. Safe sleep practices in a New Zealand community and development of a Sudden Unexpected Death in Infancy (SUDI) risk assessment instrument.

    Science.gov (United States)

    Galland, Barbara C; Gray, Andrew; Sayers, Rachel M; Heath, Anne-Louise M; Lawrence, Julie; Taylor, Rachael; Taylor, Barry J

    2014-10-13

    Interventions to prevent sudden unexpected death in infancy (SUDI) have generally been population wide interventions instituted after case-control studies identified specific childcare practices associated with sudden death. While successful overall, in New Zealand (NZ), the rates are still relatively high by international comparison. This study aims to describe childcare practices related to SUDI prevention messages in a New Zealand community, and to develop and explore the utility of a risk assessment instrument based on international guidelines and evidence. Prospective longitudinal study of 209 infants recruited antenatally. Participant characteristics and infant care data were collected by questionnaire at: baseline (third trimester), and monthly from infant age 3 weeks through 23 weeks. Published meta-analyses data were used to estimate individual risk ratios for 6 important SUDI risk factors which, when combined, yielded a "SUDI risk score". Most infants were at low risk for SUDI with 72% at the lowest or slightly elevated risk (combined risk ratio ≤1.5). There was a high prevalence of the safe practices: supine sleeping (86-89% over 3-19 weeks), mother not smoking (90-92% over 3-19 weeks), and not bed sharing at a young age (87% at 3 weeks). Five independent predictors of a high SUDI risk score were: higher parity (P =0.028), younger age (P =0.030), not working or caring for other children antenatally (P =0.031), higher depression scores antenatally (P =0.036), and lower education (P =0.042). Groups within the community identified as priorities for education about safe sleep practices beyond standard care are mothers who are young, have high parity, low educational levels, and have symptoms of depression antenatally. These findings emphasize the importance of addressing maternal depression as a modifiable risk factor in pregnancy.

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

    Directory of Open Access Journals (Sweden)

    Vinayak Muralidhar

    2016-02-01

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

  9. High-Risk Sexual Behavior at Social Venues in Madagascar

    Science.gov (United States)

    KHAN, MARIA R.; RASOLOFOMANANA, JUSTIN R.; McCLAMROCH, KRISTI J.; RALISIMALALA, ANDRIAMAMPIANINA; ZAFIMANJAKA, MAURICE G.; BEHETS, FRIEDA; WEIR, SHARON S.

    2018-01-01

    Background Persistent high levels of sexually transmitted infection (STI) in Madagascar indicate current prevention strategies are inadequate. STI/HIV prevention based in social venues may play an important role in reaching individuals at risk of infection. We identified venues where people meet sexual partners and measured the need and potential for venue-based prevention. Methods Interviews were conducted in 7 Madagascar towns with 1) community informants to identify social venues, 2) individuals socializing at a sample of venues to assess sexual behavior among venue patrons, and 3) venue representatives to assess the potential for venue-based intervention. Results Community informants identified numerous venues (range: 67–211 venues, depending on the town); streets, bars, and hotels were most commonly reported. Among 2982 individuals socializing at venues, 78% of men and 74% of women reported new sexual partnership or sex trade for money, goods, or services in the past 4 weeks and 19% of men and 18% of women reported symptoms suggestive of STI in the past 4 weeks. STI symptom levels were disproportionately high among respondents reporting either sex trade or new sexual partnership in the past 4 weeks. Twenty-eight percent of men and 41% of women reported condom use during the last sex act with a new partner. Although 24% to 45% of venues had hosted STI/HIV interventions, interventions were deemed possible at 73% to 90% venues according to 644 interviews with venue representatives. Conclusions Venue-based intervention is possible and would reach a spectrum of populations vulnerable to STI/HIV including sex workers, their clients, and other high-risk populations. PMID:18496471

  10. Risk factors for mobility limitation in community-dwelling older adults: a social ecological perspective.

    Science.gov (United States)

    Yeom, Hye A; Fleury, Julie; Keller, Colleen

    2008-01-01

    Although a variety of risk factors for mobility limitation in older adults have been examined, a collective review of relevant literature has not been reported. The purposes of this review are to report the intrapersonal, interpersonal, environmental, and organizational risk factors related to mobility limitation using a social ecological perspective and to discuss the direction of future clinical practice consistent with current literature on mobility limitation of community-dwelling older adults. Intrapersonal risk factors related to mobility limitation include advanced age, female gender, low socioeconomic status, comorbidity, lack of motivation (i.e., dependent personality, decreased self-efficacy), lifestyle factors (i.e., sedentary lifestyle, smoking, obesity), and physiological factors (i.e., vitamin D deficiency, inflammation, poor nutritional status). Interpersonal risk factors related to mobility limitation include weak social networks and limited social activities. Geriatric clients may also experience a decline in mobility when they encounter environmental challenges such as an inconvenient home environment and lack of availability of services in their community, as well as lack of organizational resources stemming from social policy. Potential intervention strategies focused on modifiable risk factors may include lifestyle modifications, social networking programs, and enhancing awareness of environmental and organizational resources in the community for older adults at risk for mobility limitation.

  11. Too risky to settle: avian community structure changes in response to perceived predation risk on adults and offspring

    Science.gov (United States)

    Hua, Fangyuan; Fletcher, Robert J.; Sieving, Kathryn E.; Dorazio, Robert M.

    2013-01-01

    Predation risk is widely hypothesized as an important force structuring communities, but this potential force is rarely tested experimentally, particularly in terrestrial vertebrate communities. How animals respond to predation risk is generally considered predictable from species life-history and natural-history traits, but rigorous tests of these predictions remain scarce. We report on a large-scale playback experiment with a forest bird community that addresses two questions: (i) does perceived predation risk shape the richness and composition of a breeding bird community? And (ii) can species life-history and natural-history traits predict prey community responses to different types of predation risk? On 9 ha plots, we manipulated cues of three avian predators that preferentially prey on either adult birds or offspring, or both, throughout the breeding season. We found that increased perception of predation risk led to generally negative responses in the abundance, occurrence and/or detection probability of most prey species, which in turn reduced the species richness and shifted the composition of the breeding bird community. Species-level responses were largely predicted from the key natural-history trait of body size, but we did not find support for the life-history theory prediction of the relationship between species' slow/fast life-history strategy and their response to predation risk.

  12. Utility of repeated praziquantel dosing in the treatment of schistosomiasis in high-risk communities in Africa: a systematic review.

    Directory of Open Access Journals (Sweden)

    Charles H King

    2011-09-01

    Full Text Available Controversy persists about the optimal approach to drug-based control of schistosomiasis in high-risk communities. In a systematic review of published studies, we examined evidence for incremental benefits from repeated praziquantel dosing, given 2 to 8 weeks after an initial dose, in Schistosoma-endemic areas of Africa.We performed systematic searches of electronic databases PubMed and EMBASE for relevant data using search terms 'schistosomiasis', 'dosing' and 'praziquantel' and hand searches of personal collections and bibliographies of recovered articles. In 10 reports meeting study criteria, improvements in parasitological treatment outcomes after two doses of praziquantel were greater for S. mansoni infection than for S. haematobium infection. Observed cure rates (positive to negative conversion in egg detection assays were, for S. mansoni, 69-91% cure after two doses vs. 42-79% after one dose and, for S. haematobium, 46-99% cure after two doses vs. 37-93% after a single dose. Treatment benefits in terms of reduction in intensity (mean egg count were also different for the two species-for S. mansoni, the 2-dose regimen yielded an weighted average 89% reduction in standardized egg counts compared to a 83% reduction after one dose; for S. haematobium, two doses gave a 93% reduction compared to a 94% reduction with a single dose. Cost-effectiveness analysis was performed based on Markov life path modeling.Although schedules for repeated treatment with praziquantel require greater inputs in terms of direct costs and community participation, there are incremental benefits to this approach at an estimated cost of $153 (S. mansoni-$211 (S. haematobium per additional lifetime QALY gained by double treatment in school-based programs. More rapid reduction of infection-related disease may improve program adherence, and if, as an externality of the program, transmission can be reduced through more effective coverage, significant additional benefits are

  13. Feasibility of community-based screening for cardiovascular disease risk in an ethnic community: the South Asian Cardiovascular Health Assessment and Management Program (SA-CHAMP).

    Science.gov (United States)

    Jones, Charlotte A; Nanji, Alykhan; Mawani, Shefina; Davachi, Shahnaz; Ross, Leanne; Vollman, Ardene; Aggarwal, Sandeep; King-Shier, Kathryn; Campbell, Norman

    2013-02-21

    South Asian Canadians experience disproportionately high rates of cardiovascular disease (CVD). The goal of this qualitative study was to determine the feasibility of implementing a sustainable, culturally adapted, community-based CVD risk factor screening program for this population. South Asians (≥ 45 years) in Calgary, Alberta underwent opportunistic cardiovascular risk factor screening by lay trained volunteers at local religious facilities. Those with elevated blood pressure (BP) or ≥ 1 risk factor underwent point of care cholesterol testing, 10-year CVD risk calculation, counseling, and referral to family physicians and local culturally tailored chronic disease management (CDM) programs. Participants were invited for re-screening and were surveyed about health system follow-up, satisfaction with the program and suggestions for improvement. Changes in risk factors from baseline were estimated using McNemar's test (proportions) and paired t-tests (continuous measures). Baseline assessment was completed for 238 participants (median age 64 years, 51% female). Mean TC, HDL and TC/HDL were 5.41 mmol/L, 1.12 mmol/L and 4.7, respectively. Mean systolic and diastolic blood pressures (mmHg) were 129 and 75 respectively. Blood pressure and TC/HDL ratios exceeded recommended targets in 36% and 58%, respectively, and 76% were at high risk for CVD. Ninety-nine participants (47% female) attended re-screening. 82% had accessed health care providers, 22% reported medication changes and 3.5% had attended the CDM programs. While BP remained unchanged, TC and TC/HDL decreased and HDL increased significantly (mean differences: -0.52 mmol/L, -1.04 and +0.07 mmol/L, respectively). Participants were very satisfied (80%) or satisfied (20%) with the project. Participants suggested screening sessions and CDM programs be more accessible by: delivering evening or weekends programs at more sites, providing transportation, offering multilingual programs/translation assistance, reducing

  14. Differentiating Community Dwellers at Risk for Pathological Narcissism From Community Dwellers at Risk for Psychopathy Using Measures of Emotion Recognition and Subjective Emotional Activation.

    Science.gov (United States)

    Fossati, Andrea; Somma, Antonella; Pincus, Aaron; Borroni, Serena; Dowgwillo, Emily A

    2017-06-01

    The Italian translations of the Pathological Narcissism Inventory (PNI) and Triarchic Psychopathy Measure (TriPM) were administered to 609 community dwelling adults. Participants who scored in the upper 10% of the distribution of the PNI total score were assigned to the group of participants at risk for pathological narcissism, whereas participants who scored in the upper 10% of the distribution of the TriPM total score were assigned to the group of participants at risk for psychopathy. The final sample included 126 participants who were administered the Reading the Mind in the Eyes Test (RMET) and emotion-eliciting movie clips. Participants at risk for pathological narcissism scored significantly lower on the RMET total score than participants who were not at risk for pathological narcissism. Participants at risk for psychopathy showed a significant reduction in the subjective experience of disgust, fear, sadness, and tenderness compared to participants who were not at risk for psychopathy.

  15. Predation risk determines breeding territory choice in a Mediterranean cavity-nesting bird community.

    Science.gov (United States)

    Parejo, Deseada; Avilés, Jesús M

    2011-01-01

    Non-direct effects of predation can be an important component of the total effect of predation, modulating animal population and community dynamics. The isolated effects of predation risk on the spatial organisation of the breeding bird community, however, remains poorly studied. We investigated whether an experimentally increased predation risk prior to reproduction affected breeding territory selection and subsequent reproductive strategies in three Mediterranean cavity-nesting birds, i.e., the little owl Athene noctua, European roller Coracias garrulus and scops owl Otus scops. We found that territories used the previous year were more likely to be re-occupied when they belonged to the safe treatment rather than to the risky treatment. The first choice of breeders of all three species was for safe territories over risky ones. When all breeding attempts in the season (i.e., final occupation) were considered, breeders also preferred safe to risky sites. In addition, little owls laid larger eggs in risky territories than in safe territories. Our study provides experimental evidence of a rapid preventive response of the three most abundant species in a cavity-nesting bird community to a short-term manipulation of predation risk. This response highlights the key role of the non-direct effects of predation in modulating avian community organisation.

  16. Sex Differences and Similarities in Atrial Fibrillation Epidemiology, Risk Factors, and Mortality in Community Cohorts

    DEFF Research Database (Denmark)

    Magnussen, Christina; Niiranen, Teemu J; Ojeda, Francisco M

    2017-01-01

    BACKGROUND: Atrial fibrillation (AF) is a common cardiac disease in aging populations with high comorbidity and mortality. Sex differences in AF epidemiology are insufficiently understood. METHODS: In N=79 793 individuals without AF diagnosis at baseline (median age, 49.6 years; age range, 24.......1-97.6 years; 51.7% women) from 4 community-based European studies (FINRISK, DanMONICA, Moli-sani Northern Sweden) of the BiomarCaRE consortium (Biomarker for Cardiovascular Risk Assessment in Europe), we examined AF incidence, its association with mortality, common risk factors, biomarkers, and prevalent...... cardiovascular disease, and their attributable risk by sex. Median follow-up time was 12.6 (to a maximum of 28.2) years. RESULTS: Fewer AF cases were observed in women (N=1796; 4.4%), than in men (N=2465; 6.4%). Cardiovascular risk factor distribution and lipid profile at baseline were less beneficial in men...

  17. Blending science and community voices for multi-scale disaster risk ...

    African Journals Online (AJOL)

    This paper documents the experience of CARE International in Ethiopia in facilitating bottom-up approaches to promote community-led disaster risk management and climate change adaptation planning through a participator scenario planning (PSP) methodology. PSP is a coordinated approach which leverages a variety ...

  18. Relationships Between Simple Toe Elevation Angle in the Standing Position and Dynamic Balance and Fall Risk Among Community-Dwelling Older Adults.

    Science.gov (United States)

    Takatori, Katsuhiko; Matsumoto, Daisuke

    2015-10-01

    To investigate the relationships between toe elevation ability in the standing position and dynamic balance and fall risk among community-dwelling older adults. Cross-sectional survey. General community. Community-dwelling older adults (N = 287). Toe elevation angles in the standing position. Intra-rater and inter-rater reliability of measurements of the toe elevation angle was high (internal coefficient of correlation [ICC] (1,2) = 0.94 for the former and ICC (2,1) = 0.90 for the latter). Significant correlations were found between the toe elevation angle and age (r = -0.20, P fall in the previous 6 months had a significantly lower toe elevation angle compared with subjects who did not experience a fall (t = 2.19, P balance ability and appears to be a simple screening test for fall risk in community-dwelling older adults. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  19. Part-Time Community College Instructors Teaching in Learning Communities: An Exploratory Multiple Case Study

    Science.gov (United States)

    Paterson, John W.

    2017-01-01

    Community colleges have a greater portion of students at-risk for college completion than four-year schools and faculty at these institutions are overwhelmingly and increasingly part-time. Learning communities have been identified as a high-impact practice with numerous benefits documented for community college instructors and students: a primary…

  20. Parenting and youth sexual risk in context: The role of community factors.

    Science.gov (United States)

    Goodrum, Nada M; Armistead, Lisa P; Tully, Erin C; Cook, Sarah L; Skinner, Donald

    2017-06-01

    Black South African youth are disproportionately affected by HIV, and risky sexual behaviors increase youths' vulnerability to infection. U.S.-based research has highlighted several contextual influences on sexual risk, but these processes have not been examined in a South African context. In a convenience sample of Black South African caregivers and their 10-14-year-old youth (M age  = 11.7, SD = 1.4; 52.5% female), we examined the relation between parenting and youth sexual risk within the context of community-level processes, including neighborhood quality and maternal social support. Hypotheses were evaluated using structural equation modeling. Results revealed that better neighborhood quality and more social support predicted positive parenting, which in turn predicted less youth sexual risk. There was a significant indirect effect from neighborhood quality to youth sexual risk via parenting. Results highlight the importance of the community context in parenting and youth sexual risk in this understudied sample. HIV prevention-interventions should be informed by these contextual factors. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  1. Community Perceptions of Air Pollution and Related Health Risks in Nairobi Slums

    Science.gov (United States)

    Egondi, Thaddaeus; Kyobutungi, Catherine; Ng, Nawi; Muindi, Kanyiva; Oti, Samuel; van de Vijver, Steven; Ettarh, Remare; Rocklöv, Joacim

    2013-01-01

    Air pollution is among the leading global risks for mortality and responsible for increasing risk for chronic diseases. Community perceptions on exposure are critical in determining people’s response and acceptance of related policies. Therefore, understanding people’ perception is critical in informing the design of appropriate intervention measures. The aim of this paper was to establish levels and associations between perceived pollution and health risk perception among slum residents. A cross-sectional study of 5,317 individuals aged 35+ years was conducted in two slums of Nairobi. Association of perceived score and individual characteristics was assessed using linear regression. Spatial variation in the perceived levels was determined through hot spot analysis using ArcGIS. The average perceived air pollution level was higher among residents in Viwandani compared to those in Korogocho. Perceived air pollution level was positively associated with perceived health risks. The majority of respondents were exposed to air pollution in their place of work with 66% exposed to at least two sources of air pollution. Less than 20% of the respondents in both areas mentioned sources related to indoor pollution. The perceived air pollution level and related health risks in the study community were lowamong the residents indicating the need for promoting awareness on air pollution sources and related health risks. PMID:24157509

  2. Changes in gait performance over several years are associated with recurrent falls status in community-dwelling older women at high risk of fracture.

    Science.gov (United States)

    Scott, David; McLaughlin, Patrick; Nicholson, Geoff C; Ebeling, Peter R; Stuart, Amanda L; Kay, Deborah; Sanders, Kerrie M

    2015-03-01

    Gait analysis is a recommended geriatric assessment for falls risk and sarcopenia; however, previous research utilises measurements at a single time point only. It is presently unclear how changes in gait over several years influence risk of recurrent falls in older adults. We investigated 135 female volunteers (mean age±SD: 76.7±5.0 years; range: 70-92 years) at high risk of fracture. Gait parameters (speed, cadence, step length, step width, swing time and double support phase) were assessed using the GAITRite Electronic Walkway System at four annual clinics over ∼3.7±0.5 years. Participants reported incident falls monthly for 3.7±1.2 years. Increasing gait speed (odds ratio: 0.96; 95% confidence interval 0.93, 0.99) and step length (0.87; 0.77, 0.98) from baseline to final follow-up was associated with reduced likelihood of being a recurrent faller over the study period. No significant associations were observed for baseline gait parameters (all P≥0.05). At the second follow-up (2.8±0.6 years), an increase in swing time (0.65; 0.43, 0.98) was associated with reduced likelihood, while an increase in double support phase (1.31; 1.04, 1.66) was associated with increased likelihood, for being a recurrent faller in the subsequent 1.3 years following this time point. Changes in gait parameters over several years are significantly associated with the likelihood of being a recurrent faller among community-dwelling older women at high risk of fracture. Further research is required to develop gait monitoring guidelines and gait parameter decline cut points that may be utilised by clinicians to identify older adults at risk of incident falls and sarcopenia. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. 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.

  4. Risk prediction model for knee pain in the Nottingham community: a Bayesian modelling approach.

    Science.gov (United States)

    Fernandes, G S; Bhattacharya, A; McWilliams, D F; Ingham, S L; Doherty, M; Zhang, W

    2017-03-20

    Twenty-five percent of the British population over the age of 50 years experiences knee pain. Knee pain can limit physical ability and cause distress and bears significant socioeconomic costs. The objectives of this study were to develop and validate the first risk prediction model for incident knee pain in the Nottingham community and validate this internally within the Nottingham cohort and externally within the Osteoarthritis Initiative (OAI) cohort. A total of 1822 participants from the Nottingham community who were at risk for knee pain were followed for 12 years. Of this cohort, two-thirds (n = 1203) were used to develop the risk prediction model, and one-third (n = 619) were used to validate the model. Incident knee pain was defined as pain on most days for at least 1 month in the past 12 months. Predictors were age, sex, body mass index, pain elsewhere, prior knee injury and knee alignment. A Bayesian logistic regression model was used to determine the probability of an OR >1. The Hosmer-Lemeshow χ 2 statistic (HLS) was used for calibration, and ROC curve analysis was used for discrimination. The OAI cohort from the United States was also used to examine the performance of the model. A risk prediction model for knee pain incidence was developed using a Bayesian approach. The model had good calibration, with an HLS of 7.17 (p = 0.52) and moderate discriminative ability (ROC 0.70) in the community. Individual scenarios are given using the model. However, the model had poor calibration (HLS 5866.28, p prediction model for knee pain, regardless of underlying structural changes of knee osteoarthritis, in the community using a Bayesian modelling approach. The model appears to work well in a community-based population but not in individuals with a higher risk for knee osteoarthritis, and it may provide a convenient tool for use in primary care to predict the risk of knee pain in the general population.

  5. Comparison of seven fall risk assessment tools in community-dwelling Korean older women.

    Science.gov (United States)

    Kim, Taekyoung; Xiong, Shuping

    2017-03-01

    This study aimed to compare seven widely used fall risk assessment tools in terms of validity and practicality, and to provide a guideline for choosing appropriate fall risk assessment tools for elderly Koreans. Sixty community-dwelling Korean older women (30 fallers and 30 matched non-fallers) were evaluated. Performance measures of all tools were compared between the faller and non-faller groups through two sample t-tests. Receiver Operating Characteristic curves were generated with odds ratios for discriminant analysis. Results showed that four tools had significant discriminative power, and the shortened version of Falls Efficacy Scale (SFES) showed excellent discriminant validity, followed by Berg Balance Scale (BBS) with acceptable discriminant validity. The Mini Balance Evaluation System Test and Timed Up and Go, however, had limited discriminant validities. In terms of practicality, SFES was also excellent. These findings suggest that SFES is the most suitable tool for assessing the fall risks of community-dwelling Korean older women, followed by BBS. Practitioner Summary: There is no general guideline on which fall risk assessment tools are suitable for community-dwelling Korean older women. This study compared seven widely used assessment tools in terms of validity and practicality. Results suggested that the short Falls Efficacy Scale is the most suitable tool, followed by Berg Balance Scale.

  6. Cognitive function is associated with risk aversion in community-based older persons.

    Science.gov (United States)

    Boyle, Patricia A; Yu, Lei; Buchman, Aron S; Laibson, David I; Bennett, David A

    2011-09-11

    Emerging data from younger and middle-aged persons suggest that cognitive ability is negatively associated with risk aversion, but this association has not been studied among older persons who are at high risk of experiencing loss of cognitive function. Using data from 369 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal epidemiologic study of aging, we examined the correlates of risk aversion and tested the hypothesis that cognition is negatively associated with risk aversion. Global cognition and five specific cognitive abilities were measured via detailed cognitive testing, and risk aversion was measured using standard behavioral economics questions in which participants were asked to choose between a certain monetary payment ($15) versus a gamble in which they could gain more than $15 or gain nothing; potential gamble gains ranged from $21.79 to $151.19 with the gain amounts varied randomly over questions. We first examined the bivariate associations of age, education, sex, income and cognition with risk aversion. Next, we examined the associations between cognition and risk aversion via mixed models adjusted for age, sex, education, and income. Finally, we conducted sensitivity analyses to ensure that our results were not driven by persons with preclinical cognitive impairment. In bivariate analyses, sex, education, income and global cognition were associated with risk aversion. However, in a mixed effect model, only sex (estimate = -1.49, standard error (SE) = 0.39, p risk aversion. Thus, a lower level of global cognitive function and female sex were associated with greater risk aversion. Moreover, performance on four out of the five cognitive domains was negatively related to risk aversion (i.e., semantic memory, episodic memory, working memory, and perceptual speed); performance on visuospatial abilities was not. A lower level of cognitive ability and female sex are associated with greater

  7. Identifying Aboriginal-specific AUDIT-C and AUDIT-3 cutoff scores for at-risk, high-risk, and likely dependent drinkers using measures of agreement with the 10-item Alcohol Use Disorders Identification Test

    Science.gov (United States)

    2014-01-01

    Background The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item alcohol screener that has been recommended for use in Aboriginal primary health care settings. The time it takes respondents to complete AUDIT, however, has proven to be a barrier to its routine delivery. Two shorter versions, AUDIT-C and AUDIT-3, have been used as screening instruments in primary health care. This paper aims to identify the AUDIT-C and AUDIT-3 cutoff scores that most closely identify individuals classified as being at-risk drinkers, high-risk drinkers, or likely alcohol dependent by the 10-item AUDIT. Methods Two cross-sectional surveys were conducted from June 2009 to May 2010 and from July 2010 to June 2011. Aboriginal Australian participants (N = 156) were recruited through an Aboriginal Community Controlled Health Service, and a community-based drug and alcohol treatment agency in rural New South Wales (NSW), and through community-based Aboriginal groups in Sydney NSW. Sensitivity, specificity, and positive and negative predictive values of each score on the AUDIT-C and AUDIT-3 were calculated, relative to cutoff scores on the 10-item AUDIT for at-risk, high-risk, and likely dependent drinkers. Receiver operating characteristic (ROC) curve analyses were conducted to measure the detection characteristics of AUDIT-C and AUDIT-3 for the three categories of risk. Results The areas under the receiver operating characteristic (AUROC) curves were high for drinkers classified as being at-risk, high-risk, and likely dependent. Conclusions Recommended cutoff scores for Aboriginal Australians are as follows: at-risk drinkers AUDIT-C ≥ 5, AUDIT-3 ≥ 1; high-risk drinkers AUDIT-C ≥ 6, AUDIT-3 ≥ 2; and likely dependent drinkers AUDIT-C ≥ 9, AUDIT-3 ≥ 3. Adequate sensitivity and specificity were achieved for recommended cutoff scores. AUROC curves were above 0.90. PMID:25179547

  8. Assessing public flood risk perception for understanding the level of risk preparedness - Evidence from a community-based survey (the Bend Subcarpathians, Romania)

    Science.gov (United States)

    Balteanu, Dan; Micu, Dana; Dumitrascu, Monica; Chendes, Viorel; Dragota, Carmen; Kucsicsa, Gheorghita; Grigorescu, Ines; Persu, Mihaela; Costache, Andra

    2016-04-01

    Floods (slow-onset and rapid) are among the costliest hydro-meteorological hazards in Romania, with strong societal and economic impacts, especially in small rural settlements, with a limited adaptive capacity to their adverse effects induced by the regional socio-economic context (e.g. aging population, low economic power). The study-area is located in the Bend Subcarpathians (Romania), a region with high tectonic mobility (the Seismic Vrancea Region), active slope processes (e.g. shallow and deep-seated landslides, mud flow, gully erosion) and increasing frequency of flash floods associated to heavy rainfalls. The study was conducted in the framework of the project "Vulnerability of the environment and human settlements to floods in the context of Global Environmental Change - VULMIN" (PN-II-PT-PCCA-2011-3.1-1587), funded by the Ministry of National Education over the 2012-2016 period (http://www.igar-vulmin.ro). Prior research derived valuable insights into the local population vulnerability to extreme hydro-meteorological events, revealing an increased individual experience to past hydrological events, a high level of worry associated to flood recurrence, a low rate of the perceived trustworthiness in national institutions and authorities, as well as evident differences between the perception of community members and local authorities in terms of risk preparedness. In the present study, an attempt has been made for developing an advanced understanding of the current level of flood risk preparedness within some communities strongly affected by the floods of 1970-1975, 2005 and 2010. The recent events had a significant impact on local communities and infrastructure in terms of the financial losses, causing a visible stress and even psychological trauma on some residents of the most affected households. The selected communities are located in areas affected by recurrent hydro-meteorological hazards (floods and flash floods), with return periods below 10 years. A

  9. Dark Side of Development: Modernity, Disaster Risk and Sustainable Livelihoods in Two Coastal Communities in Fiji

    Directory of Open Access Journals (Sweden)

    Per Becker

    2017-12-01

    Full Text Available The world is changing rapidly, as are the remotest rural communities. Modernity is spreading across the world under the guise of development and it is transforming disaster risk. This raises issues concerning how disaster risk is changing in such milieus. Using a sustainable livelihood approach, this article investigates access to different types of capital that central to the vulnerability of two coastal communities in Fiji that are affected by modernity to different extents. This comparative case study is based on semi-structured interviews, focus groups and observation. The results indicate that modernity transforms access to and use of key capitals (natural, physical, financial, human, and social capital on both community and household levels, increasing dependence on external resources that are unequally distributed, while undermining social cohesion and support. Although disaster risk might be of a similar magnitude across the board at the community level, modernity transforms vulnerability significantly and skews the distribution of disaster risk, to the detriment of the households left behind by development.

  10. Ecological risk assessment in a large river-reservoir. 2: Fish community

    International Nuclear Information System (INIS)

    Suter, G.W. II; Barnthouse, L.W.; Efroymson, R.A.; Jager, H.

    1999-01-01

    This paper summarizes the assessment of risks to fishes in the Clinch River Operable Unit due to contaminants released by the US Department of Energy's activities on its Oak Ridge Reservation in Tennessee. This paper focuses on the most contaminated area, the Poplar Creek (PC) embayment. The assessment is of interest because of its use of five distinct lines of evidence: fish community surveys, fish body burdens, toxicity tests of ambient waters, suborganismal bioindicators, and single chemical toxicity tests. None of these lines of evidence provided unambiguous evidence of a significant risk, but the surveys indicated that the fish community in PC was depauperate, polychlorinated biphenyl body burdens may have been at toxic levels in catfish, one of the three tests of ambient water showed clear toxicity, some of the indicators were indicative of toxic effects, and concentrations that have been toxic in the laboratory were detected periodically. Interpretation was further complicated by upstream contamination of both the Clinch River and PC. The risk characterization was performed by evaluating each line of evidence separately and then weighing the evidence using an ecoepidemiological approach

  11. Chylomicronemia risk factors ranked by importance for the individual and community in 108 711 women and men

    DEFF Research Database (Denmark)

    Pedersen, S. B.; Varbo, A.; Langsted, A.

    2018-01-01

    and community. Methods: A total of 108 711 individuals from the Copenhagen General Population Study were grouped as unlikely chylomicronemia (nonfasting triglycerides ....4%) and sedentary lifestyle (PAF: 6.0%). Conclusions: Obesity and type 2 diabetes were the most important modifiable chylomicronemia risk factors in women and men, both for the individual and community. This could influence chylomicronemia prevention and help design randomized trials aimed at reducing triglycerides......Background: Hypertriglyceridemia prevalence is increasing as more individuals become obese, and chylomicronemia risk factors for the individual and community have not been described previously. Objective: To describe chylomicronemia risk factors in the general population for individuals...

  12. Prevalence and determinants of cardiovascular disease risk factors among the residents of urban community housing projects in Malaysia.

    Science.gov (United States)

    Amiri, Mohammadreza; Majid, Hazreen Abdul; Hairi, FarizahMohd; Thangiah, Nithiah; Bulgiba, Awang; Su, Tin Tin

    2014-01-01

    The objectives are to assess the prevalence and determinants of cardiovascular disease (CVD) risk factors among the residents of Community Housing Projects in metropolitan Kuala Lumpur, Malaysia. By using simple random sampling, we selected and surveyed 833 households which comprised of 3,722 individuals. Out of the 2,360 adults, 50.5% participated in blood sampling and anthropometric measurement sessions. Uni and bivariate data analysis and multivariate binary logistic regression were applied to identify demographic and socioeconomic determinants of the existence of having at least one CVD risk factor. As a Result, while obesity (54.8%), hypercholesterolemia (51.5%), and hypertension (39.3%) were the most common CVD risk factors among the low-income respondents, smoking (16.3%), diabetes mellitus (7.8%) and alcohol consumption (1.4%) were the least prevalent. Finally, the results from the multivariate binary logistic model illustrated that compared to the Malays, the Indians were 41% less likely to have at least one of the CVD risk factors (OR = 0.59; 95% CI: 0.37 - 0.93). In Conclusion, the low-income individuals were at higher risk of developing CVDs. Prospective policies addressing preventive actions and increased awareness focusing on low-income communities are highly recommended and to consider age, gender, ethnic backgrounds, and occupation classes.

  13. Cognitive function is associated with risk aversion in community-based older persons

    Directory of Open Access Journals (Sweden)

    Buchman Aron S

    2011-09-01

    Full Text Available Abstract Background Emerging data from younger and middle-aged persons suggest that cognitive ability is negatively associated with risk aversion, but this association has not been studied among older persons who are at high risk of experiencing loss of cognitive function. Methods Using data from 369 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal epidemiologic study of aging, we examined the correlates of risk aversion and tested the hypothesis that cognition is negatively associated with risk aversion. Global cognition and five specific cognitive abilities were measured via detailed cognitive testing, and risk aversion was measured using standard behavioral economics questions in which participants were asked to choose between a certain monetary payment ($15 versus a gamble in which they could gain more than $15 or gain nothing; potential gamble gains ranged from $21.79 to $151.19 with the gain amounts varied randomly over questions. We first examined the bivariate associations of age, education, sex, income and cognition with risk aversion. Next, we examined the associations between cognition and risk aversion via mixed models adjusted for age, sex, education, and income. Finally, we conducted sensitivity analyses to ensure that our results were not driven by persons with preclinical cognitive impairment. Results In bivariate analyses, sex, education, income and global cognition were associated with risk aversion. However, in a mixed effect model, only sex (estimate = -1.49, standard error (SE = 0.39, p i.e., semantic memory, episodic memory, working memory, and perceptual speed; performance on visuospatial abilities was not. Conclusion A lower level of cognitive ability and female sex are associated with greater risk aversion in advanced age.

  14. Natural hazards knowledge and risk perception of Wujie indigenous community in Taiwan

    Science.gov (United States)

    Roder, Giulia; Ruljigaljig, Tjuku; Lin, Ching-Weei; Tarolli, Paolo

    2015-04-01

    The purpose of this work is to investigate the natural hazard knowledge and risk perception of Wujie indigenous community, located in Fazhi Village in the Central Mountain Range of Taiwan. Taiwan has encountered many different types of natural hazards (e.g. landslides and debris flows) that have increased sharply in the last century. Because of that, they are one of the most critical issues for the government and for the people living in mountainous areas. These areas are mainly populated by indigenous people that have experienced economic competition and military conflict with a series of colonizing periods causing a progressive loss of their original cultural identity. The motivation of selecting the case study of Wujie community is because (i) it has suffered, more than others, generations of devastating colonial oppression by foreign governments; (ii) the consequences of hydroelectric projects that moved a lot of water and sediment to the valley and modified the path of the river through the years; (iii) the documented landslides and debris flows occurred in the region during the last decades. Two questions appear spontaneously: How indigenous people are nowadays living with natural hazards? Have land use change or any other human footprint affected their knowledge and perception on natural hazards? This research, the first carried out in Taiwan involving an indigenous community, can offer a unique opportunity to answer these questions. The investigation utilized a variety of participatory methods conducted at the household and community level by the use of 65 face-to-face interviews. Results revealed that residents felt a higher worry about landslide and flood risks, and a slight preparedness to face them. This discrepancy may derive from an unsatisfactory level of communication and information, and the most considerable differences were found between the evaluations of individual subjects as opposed to overall communities. Results revealed also the complexity

  15. Exploring the Life Course Perspective in Maternal and Child Health through Community-Based Participatory Focus Groups: Social Risks Assessment.

    Science.gov (United States)

    Salinas-Miranda, Abraham A; King, Lindsey M; Salihu, Hamisu M; Berry, Estrellita; Austin, Deborah; Nash, Susan; Scarborough, Kenneth; Best, Evangeline; Cox, Lillian; King, Georgette; Hepburn, Carrie; Burpee, Conchita; Richardson, Eugene; Ducket, Marlo; Briscoe, Richard; Baldwin, Julie

    2017-01-01

    Little is known about the patterns of risk factors experienced by communities of color and how diverse community contexts shape the health trajectory of women from the early childhood period to the time of their pregnancies. Thus, we conducted a focus group study to identify social risks over the life course that contribute to maternal and child health from the perspective of community members residing in low income urban areas. Ten community-based participatory focus groups were conducted with residents from selected communities in Tampa, Florida, from September to November 2013. We used the life course perspective to illuminate and explain the experiences reported by the interviewees. A total of 78 residents participated in the focus groups. Children and adolescents' health risks were childhood obesity, lack of physical activity, and low self-esteem. Women's health risks were low self-esteem, low educational level, low health literacy, inadequate parenting skills, and financial problems. Risks during pregnancy included stress, low self-esteem, inadequate eating patterns, lack of physical activity, healthcare issues, lack of social support, and lack of father involvement during pregnancy. Multiple risk factors contribute to maternal and child health in low income communities in Tampa Bay. The intersection of risk factors in different life periods suggest possible pathways, cumulative, and latent effects, which must be considered in future longitudinal studies and when developing effective maternal and child health programs and policies.

  16. Late life socioeconomic status and hypertension in an aging cohort: the Atherosclerosis Risk in Communities Study.

    Science.gov (United States)

    McDoom, M Maya; Palta, Priya; Vart, Priya; Juraschek, Stephen P; Kucharska-Newton, Anna; Diez Roux, Ana V; Coresh, Josef

    2018-06-01

    To investigate the association between individual and area-level socioeconomic status and hypertension risk among individuals later in life. We used Cox proportional hazards models to examine the association of socioeconomic status with incident hypertension using race-specific neighborhood socioeconomic status, median household income, and education among 3372 participants (mean age, 61 years) from the Atherosclerosis Risk in Communities Study at Visit 4 (1996-1998). Incident hypertension was defined as self-reported diagnosis or reported use of antihypertensive medications. Over a median follow-up time of 9.4 years, there were 1874 new cases of hypertension (62.1 per 1000 person-years). Overall, being in high as compared with low socioeconomic status categories was associated with a lower risk of developing hypertension in late life, with hazard ratios (95% confidence intervals) of 0.87 (0.77-0.98) for high neighborhood socioeconomic status tertile, 0.79 (0.69-0.90) for high individual income, and 0.75 (0.63-0.89) for college education after adjustment for traditional risk factors. These findings were consistent and robust whenever accounting for competing risks of all-cause mortality. No significant interactions by race and age (dichotomized at age 65) were observed. Among participants free of hypertension in midlife, high neighborhood and individual socioeconomic status are associated with a decreased risk of incident hypertension. Our findings support population-level interventions, such as blood pressure screening at senior centers and faith-based organizations, that are tailored to shift the distribution of blood pressure and reduce hypertension health inequalities among older adults.

  17. Assessing awareness and knowledge of hypertension in an at-risk population in the Karen ethnic rural community, Thasongyang, Thailand.

    Science.gov (United States)

    Aung, Myo Nyein; Lorga, Thaworn; Srikrajang, Janthila; Promtingkran, Nongluk; Kreuangchai, Suchart; Tonpanya, Wilawan; Vivarakanon, Phatchanan; Jaiin, Puangpet; Praipaksin, Nara; Payaprom, Apiradee

    2012-01-01

    Hypertension is currently a global health concern. Rural and minority populations are increasingly exposed to risk factors as a result of urbanization, leading to hypertension and cardiovascular disease. We conducted a survey in the rural Karen community in Thasongyang District, Tak Province, Thailand, with the aims of determining: the distribution of blood pressure across different age groups; the prevalence of hypertension and other risk factors for cardiovascular diseases (CVDs), including diabetes, smoking, sedentary lifestyle, and excess alcohol use; knowledge and awareness of hypertension as a disease; and knowledge and awareness of risk factors for hypertension among the population at risk. This was a community-based, cross-sectional survey of 298 rural Karen residents. A set of questionnaires assessing lifestyle-related health risk behaviors and awareness and knowledge of hypertension were used. Blood pressure, fasting plasma glucose, weight, height, and waist circumference were measured. Median systolic and diastolic blood pressures were 110 (range 100-120) mmHg and 70 (range 60-80) mmHg, respectively. High blood pressure was observed in more than 27% of the population, with 15% being hypertensive and 12% being prehypertensive. Multinomial logistic regression analysis showed that people in the Karen community who were aware of hypertension were less likely to be current smokers (odds ratio [OR] 0.53, confidence interval [CI] 0.29-0.97) and those with primary school education were more likely to be aware of hypertension than those who did not have a primary school education (OR 6.5, CI 1.9-22.24). Overall, our survey showed that less than half of the Karen community had such knowledge and awareness. It is urgently necessary to promote knowledge, awareness, and health literacy among the ethnic Karen tribes to prevent hypertension and associated CVDs.

  18. Scores for post-myocardial infarction risk stratification in the community.

    Science.gov (United States)

    Singh, Mandeep; Reeder, Guy S; Jacobsen, Steven J; Weston, Susan; Killian, Jill; Roger, Véronique L

    2002-10-29

    Several scores, most of which were derived from clinical trials, have been proposed for stratifying risk after myocardial infarctions (MIs). Little is known about their generalizability to the community, their respective advantages, and whether the ejection fraction (EF) adds prognostic information to the scores. The purpose of this study is to evaluate the Thrombolysis in Myocardial Infarction (TIMI) and Predicting Risk of Death in Cardiac Disease Tool (PREDICT) scores in a geographically defined MI cohort and determine the incremental value of EF for risk stratification. MIs occurring in Olmsted County were validated with the use of standardized criteria and stratified with the ECG into ST-segment elevation (STEMI) and non-ST-segment elevation (NSTEMI) MI. Logistic regression examined the discriminant accuracy of the TIMI and PREDICT scores to predict death and recurrent MI and assessed the incremental value of the EF. After 6.3+/-4.7 years, survival was similar for the 562 STEMIs and 717 NSTEMIs. The discriminant accuracy of the TIMI score was good in STEMI but only fair in NSTEMI. Across time and end points, irrespective of reperfusion therapy, the discriminant accuracy of the PREDICT score was consistently superior to that of the TIMI scores, largely because PREDICT includes comorbidity; EF provided incremental information over that provided by the scores and comorbidity. In the community, comorbidity and EF convey important prognostic information and should be included in approaches for stratifying risk after MI.

  19. The prevalence and risk factors of metabolic syndrome a suburban community in Pathum Thani province, Thailand

    Directory of Open Access Journals (Sweden)

    Kornanong Yuenyongchaiwat

    2017-12-01

    Full Text Available This study investigated prevalence and risk factors of metabolic syndrome (MetS in a suburban community in Pathum Thani province, Thailand. Anthropometric data, blood pressure, blood glucose and lipid levels were recorded from 222 participants, 35-65 years old. Identification of MetS was based on guidelines of the National Cholesterol Education Program III. The study found the prevalence of MetS was 36.49% with no significant differences between male and female participants. An advancing body mass index (BMI emerged as one of the most significant risk factors. Participants with BMI > 23 kg*m -2 had an increased risk of MetS (OR 3.17. Furthermore, participants in the age group 55-65 years had an increased risk of MetS (OR 2.28. Lack of exercise and high waist to height ratio were also important risk factors (OR 2.38 and 3.37, respectively. Therefore, increased physical activity or exercise and weight control are advised to reduce the prevalence of MetS.

  20. Runaway chemical reaction exposes community to highly toxic chemicals

    International Nuclear Information System (INIS)

    Kaszniak, Mark; Vorderbrueggen, John

    2008-01-01

    The U.S. Chemical Safety and Hazard Investigation Board (CSB) conducted a comprehensive investigation of a runaway chemical reaction at MFG Chemical (MFG) in Dalton, Georgia on April 12, 2004 that resulted in the uncontrolled release of a large quantity of highly toxic and flammable allyl alcohol and allyl chloride into the community. Five people were hospitalized and 154 people required decontamination and treatment for exposure to the chemicals. This included police officers attempting to evacuate the community and ambulance personnel who responded to 911 calls from residents exposed to the chemicals. This paper presents the findings of the CSB report (U.S. Chemical Safety and Hazard Investigation Board (CSB), Investigation Report: Toxic Chemical Vapor Cloud Release, Report No. 2004-09-I-GA, Washington DC, April 2006) including a discussion on tolling practices; scale-up of batch reaction processes; Process Safety Management (PSM) and Risk Management Plan (RMP) implementation; emergency planning by the company, county and the city; and emergency response and mitigation actions taken during the incident. The reactive chemical testing and atmospheric dispersion modeling conducted by CSB after the incident and recommendations adopted by the Board are also discussed

  1. Risk factors for arbovirus infections in a low-income community of Rio de Janeiro, Brazil, 2015-2016.

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    Nádia Cristina Pinheiro Rodrigues

    Full Text Available Dengue epidemics have occurred in the city of Rio de Janeiro (Brazil since 1986. In the year 2015, Zika and chikungunya viruses were introduced in the city, causing sequential and simultaneous epidemics. Poor socioeconomic conditions have been suggested as contributing factors of arboviral infection.To describe the spatial distribution of human cases of symptomatic arboviral infections and to identify risk factors for infection in a poor community of Rio de Janeiro in the years 2015 and 2016.We built thematic maps of incidence rates for 78 micro-areas in the Manguinhos neighborhood. The micro-areas congregate about 600 inhabitants. Simple and multiple multilevel logistic regression models were used to evaluate the association between the incidence of arboviral diseases and socio-demographic factors at both the individual and micro-area levels.From 2015 to 2016, 370 human cases of arbovirus infection were reported in the Manguinhos community: 123 in 2015 and 247 in 2016. There was a significant difference in the risk of arbovirus diseases among different micro-areas, but this was not explained by water and sanitation indicators. The cumulative incidence rate was 849/100,000 in two years. The incidence was greater in those individuals with familiar vulnerability (1,156/100,000 vs. 794/100,000. The multilevel adjusted model showed that the odds of acquiring an arbovirus infection was 55% greater in those with familiar vulnerability.Arbovirus infections cause a high burden of disease in Brazilian urban centers. Our results suggest that even in poor neighborhoods, there is a high spatial variability in the risk of acquiring an arbovirus infection. The conditions that favor vector proliferation and infection by arboviruses are complex and involve both individual and environmental characteristics that vary from place to place. To reduce the burden of arboviral diseases, continued public health policies and basic services should be provided to the

  2. Annual risk of tuberculous infection using different methods in communities with a high prevalence of TB and HIV in Zambia and South Africa.

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    Kwame Shanaube

    Full Text Available BACKGROUND: The annual risk of tuberculous infection (ARTI is a key epidemiological indicator of the extent of transmission in a community. Several methods have been suggested to estimate the prevalence of tuberculous infection using tuberculin skin test data. This paper explores the implications of using different methods to estimate prevalence of infection and ARTI. The effect of BCG vaccination on these estimates is also investigated. METHODOLOGY/PRINCIPAL FINDINGS: Tuberculin surveys among school children in 16 communities in Zambia and 8 in South Africa (SA were performed in 2005, as part of baseline data collection and for randomisation purposes of the ZAMSTAR study. Infection prevalence and ARTI estimates were calculated using five methods: different cut-offs with or without adjustments for sensitivity, the mirror method, and mixture analysis. A total of 49,835 children were registered for the surveys, of which 25,048 (50% had skin tests done and 22,563 (90% of those tested were read. Infection prevalence was higher in the combined SA than Zambian communities. The mirror method resulted in the least difference of 7.8%, whereas that estimated by the cut-off methods varied from 12.2% to 17.3%. The ARTI in the Zambian and SA communities was between 0.8% and 2.8% and 2.5% and 4.2% respectively, depending on the method used. In the SA communities, the ARTI was higher among the younger children. BCG vaccination had little effect on these estimates. CONCLUSIONS/SIGNIFICANCE: ARTI estimates are dependent on the calculation method used. All methods agreed that there were substantial differences in infection prevalence across the communities, with higher rates in SA. Although TB notification rates have increased over the past decades, the difference in cumulative exposure between younger and older children is less dramatic and a rise in risk of infection in parallel with the estimated incidence of active tuberculosis cannot be excluded.

  3. Beyond Quarterly Earnings: Preparing the Business Community for Long-term Climate Risks

    Science.gov (United States)

    Carlson, C.; Goldman, G. T.

    2014-12-01

    The business community stands to be highly impacted by climate change. In both short and long-term timescales, climate change presents material and financial risks to companies in diverse economic sectors. How the private sector accounts for long-term risks while making short-term decisions about operations is a complex challenge. Companies are accountable to shareholders and must report performance to them on a quarterly basis. At the same time, company investors are exposed to long-term climate-related risks and face losses if companies fail to prepare for climate impacts. The US Securities and Exchange Commission (SEC) obligates publicly traded companies to discuss risks that might materially affect their business and since 2010, the agency recommends that companies consider and discuss any significant risks to their business from climate change. Some companies have complied with this guidance and comprehensively analyze potential climate change impacts, yet others fail to consider climate change at all. Such omissions leave companies without plans for addressing future risks and expose investors and the public to potential catastrophic events from climate change impacts. Climate risk projections can inform companies about the vulnerability of their facilities, supply chains, transportation pathways, and other assets. Such projections can help put climate-related risks in terms of material costs for companies and their investors. Focusing on the vulnerability of coastal facilities, we will use climate change impact projections to demonstrate the economic impacts of climate change faced by the private sector. These risks are then compared to company disclosures to the SEC to assess the degree to which companies have considered their vulnerability to climate change. Finally, we will discuss ways that companies can better assess and manage long-term climate risks.

  4. Self-Harm and Suicide Attempts among High-Risk, Urban Youth in the U.S.: Shared and Unique Risk and Protective Factors

    Directory of Open Access Journals (Sweden)

    Angela C. Jones

    2012-01-01

    Full Text Available The extent to which self-harm and suicidal behavior overlap in community samples of vulnerable youth is not well known. Secondary analyses were conducted of the “linkages study” (N = 4,131, a cross-sectional survey of students enrolled in grades 7, 9, 11/12 in a high-risk community in the U.S. in 2004. Analyses were conducted to determine the risk and protective factors (i.e., academic grades, binge drinking, illicit drug use, weapon carrying, child maltreatment, social support, depression, impulsivity, self-efficacy, parental support, and parental monitoring associated with both self-harm and suicide attempt. Findings show that 7.5% of participants reported both self-harm and suicide attempt, 2.2% of participants reported suicide attempt only, and 12.4% of participants reported self-harm only. Shared risk factors for co-occurring self-harm and suicide attempt include depression, binge drinking, weapon carrying, child maltreatment, and impulsivity. There were also important differences by sex, grade level, and race/ethnicity that should be considered for future research. The findings show that there is significant overlap in the modifiable risk factors associated with self-harm and suicide attempt that can be targeted for future research and prevention strategies.

  5. Longitudinal Youth-At-Risk Study (LYRIKS): outreach strategies based on a community-engaged framework.

    Science.gov (United States)

    Mitter, Natasha; Nah, Guo Quan Ryan; Bong, Yioe Ling; Lee, Jimmy; Chong, Siow-Ann

    2014-08-01

    Schizophrenia and psychoses are debilitating disorders often leading to serious functional impairments. Early detection efforts have shifted focus to the prodromal phase and the emphasis is now on individuals at risk of developing psychosis. The Longitudinal Youth-At-Risk Study (LYRIKS) seeks to elucidate the biological markers of psychosis. This paper describes the application of a community-engaged framework to the outreach strategies of LYRIKS. It describes the outreach goals, strategies used and their impact, as well as the various challenges faced by the research team and community partners. The target population was defined. Community organizations having close ties with the target population were identified and approached for collaboration. These included educational and healthcare institutions, and government and welfare organizations. Strategies were categorized as active or passive. Active strategies included clinical screening and recruitment, workshops, roadshows and student internships. Passive strategies included utilizing print and social media. Three thousand three hundred twenty-one youth were approached and 401 called the hotline to find out more about the study. Three thousand five hundred one were pre-screened; 864 were further screened using the Comprehensive Assessment of At Risk Mental State. One hundred seventy-eight and 346 were eventually recruited as subjects and controls, respectively. Challenges encountered included differing priorities, maintaining collaborative relationships, stigmatization and inadequate understanding of the profile of at risk youth. Future community-engaged research should be conducted more comprehensively to generate maximum benefits. © 2013 Wiley Publishing Asia Pty Ltd.

  6. Detecting highly overlapping community structure by greedy clique expansion

    OpenAIRE

    Lee, Conrad; Reid, Fergal; McDaid, Aaron; Hurley, Neil

    2010-01-01

    In complex networks it is common for each node to belong to several communities, implying a highly overlapping community structure. Recent advances in benchmarking indicate that existing community assignment algorithms that are capable of detecting overlapping communities perform well only when the extent of community overlap is kept to modest levels. To overcome this limitation, we introduce a new community assignment algorithm called Greedy Clique Expansion (GCE). The algorithm identifies d...

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

    Science.gov (United States)

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

    2017-09-01

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

  8. Imaging Frontostriatal Function in Ultra-High-Risk, Early, and Chronic Schizophrenia During Executive Processing

    Science.gov (United States)

    Morey, Rajendra A.; Inan, Seniha; Mitchell, Teresa V.; Perkins, Diana O.; Lieberman, Jeffrey A.; Belger, Aysenil

    2009-01-01

    Context Individuals experiencing prodromal symptoms of schizophrenia (ultra-high-risk group) demonstrate impaired performance on tasks of executive function, attention, and working memory. The neurobiological underpinnings of such executive deficits in ultra-high-risk individuals remains unclear. Objective We assessed frontal and striatal functions during a visual oddball continuous performance task, in ultra-high-risk, early, and chronic schizophrenic patients with the use of functional magnetic resonance imaging. Design Cross-sectional case-control design. Setting Community; outpatient clinic. Patients Fifty-two individuals (control, n = 16; ultra-high risk, n = 10; early, n = 15; chronic, n = 11) from a referred clinical sample and age- and sex-matched control volunteers underwent scanning. Main Outcome Measures Percentage of active voxels and percentage signal change calculated for the anterior cingulate gyrus (ACG), middle frontal gyrus (MFG), inferior frontal gyrus (IFG), basal ganglia, and thalamus. Performance on the visual oddball task was measured with percentage of hits and d′ (a measure based on the hit rate and the false-alarm rate). Results The ultra-high-risk group showed significantly smaller differential activation between task-relevant and task-irrelevant stimuli in the frontal regions (ACG, IFG, MFG) than the control group. Frontostriatal activation associated with target stimuli in the early and chronic groups was significantly lower than the control group, while the ultra-high-risk group showed a trend toward the early group. Conclusions Our findings suggest that prefrontal function begins to decline before the onset of syndromally defined illness and hence may represent a vulnerability marker in assessing the risk of developing psychotic disorders among ultra-high-risk individuals. PMID:15753238

  9. High-risk medical devices, children and the FDA: regulatory challenges facing pediatric mechanical circulatory support devices.

    Science.gov (United States)

    Almond, Christopher S D; Chen, Eric A; Berman, Michael R; Less, Joanne R; Baldwin, J Timothy; Linde-Feucht, Sarah R; Hoke, Tracey R; Pearson, Gail D; Jenkins, Kathy; Duncan, Brian W; Zuckerman, Bram D

    2007-01-01

    Pediatric mechanical circulatory support is a critical unmet need in the United States. Infant- and child-sized ventricular assist devices are currently being developed largely through federal contracts and grants through the National Heart, Lung, and Blood Institute (NHLBI). Human testing and marketing of high-risk devices for children raises epidemiologic and regulatory issues that will need to be addressed. Leaders from the US Food and Drug Administration (FDA), NHLBI, academic pediatric community, and industry convened in January 2006 for the first FDA Workshop on the Regulatory Process for Pediatric Mechanical Circulatory Support Devices. The purpose was to provide the pediatric community with an overview of the federal regulatory process for high-risk medical devices and to review the challenges specific to the development and regulation of pediatric mechanical circulatory support devices. Pediatric mechanical circulatory support present significant epidemiologic, logistic, and financial challenges to industry, federal regulators, and the pediatric community. Early interactions with the FDA, shared appreciation of challenges, and careful planning will be critical to avoid unnecessary delays in making potentially life-saving devices available for children. Collaborative efforts to address these challenges are warranted.

  10. Social risk factors for falls among rural Nigerian community-dwelling older adults.

    Science.gov (United States)

    Maruf, Fatai Adesina; Muonwe, Chidile; Odetunde, Marufat

    2016-06-01

    Reports on social risk factors for falls are scarce. This study explored the associations of selected sociodemographic and health variables with falls among rural Nigerian community-dwelling older adults. The present cross-sectional study involved 131 community-dwelling older adults (84 women and 47 men) recruited at an outreach center. Demographic (age, sex and marital status), social (frequency of visiting relations and friends, and number of consistent informal carers) and health (number of comorbid conditions) variables were recorded. Having fewer than two informal carers (0.26, 95% CI 0.10-0.68) was independently associated with reduced risk for falls. Visiting relations and friends less than twice per week was independently associated with greater risks for falls (3.85, 95% CI 1.42-10.46) and recurrent falls (4.86, 95% CI 1.25-18.85). The number of informal carers and frequency of social visits are risk factors for falls in older adults, and need to be taken into consideration in any strategy for fall prevention in older adults. Geriatr Gerontol Int 2015; ●●: ●●-●●. © 2015 Japan Geriatrics Society.

  11. Perspectives on enhancing physical activity and diet for health promotion among at-risk urban UK South Asian communities: a qualitative study

    OpenAIRE

    Cross-Bardell, Laura; George, Tracey; Bhoday, Mandeep; Tuomainen, Helena; Qureshi, Nadeem; Kai, Joe

    2015-01-01

    Objectives \\ud \\ud To explore perspectives on enhancing physical activity and diet among South Asians in urban deprived communities at high risk of chronic disease and to inform development of culturally appropriate health promotion intervention. \\ud \\ud Design\\ud \\ud Qualitative study using semistructured one-to-one and family group interviews with thematic analysis of data. \\ud \\ud \\ud Setting \\ud \\ud Urban disadvantaged communities in the East Midlands of the UK. \\ud \\ud \\ud Participants \\...

  12. Association between metabolic syndrome and bone fracture risk: A community-based study using a fracture risk assessment tool.

    Science.gov (United States)

    Yu, Chia-Ying; Chen, Fang-Ping; Chen, Li-Wei; Kuo, Sheng-Fong; Chien, Rong-Nan

    2017-12-01

    Osteoporosis and metabolic syndrome (MS) share similar risk factors. Previous studies of association between bone marrow density (BMD) and MS are controversial. Moreover, some studies revealed that MS is associated with BMD but not with bone fracture. In clinical practice, patients pay more attention to bone fracture risk than BMD values. Hence, this study aimed to evaluate the association between MS and the 10-year bone fracture risk probability using a fracture risk assessment tool (FRAX) from community-based data. From March 2014 to August 2015, 2689 participants (897 men and 1792 women) were enrolled in this study. Inflammatory cytokines, such as tumor necrosis factor alpha and C-reactive protein, and adipokines were included for analysis.The mean age was 60.2 ± 10.7 years in men and 58.9 ± 9.6 years in women. The percentage of MS was 27.6% in men and 27.9% in women. Participants were divided into 2 groups, those with or without MS. Compared with women without MS, women with MS had a higher rate of fracture risk (22.8% vs 16.3%, P = .001). In contrast, men with MS had a lower rate of fracture risk then men without MS (5.6% vs 12.3%, P = .004). However, MS loss the association with a high bone fracture risk in men based on multivariate logistical regression analysis, after adjusting for confounding factor of body mass index (BMI). Conclusively, the result of regression analysis between MS and the bone fracture risk may be different in men and women, and BMI was an important confounding factor to interfere with the regression analysis. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  13. Low physical activity as a key differentiating factor in the potential high-risk profile for depressive symptoms in older adults.

    Science.gov (United States)

    Holmquist, Sofie; Mattsson, Sabina; Schele, Ingrid; Nordström, Peter; Nordström, Anna

    2017-09-01

    The identification of potential high-risk groups for depression is of importance. The purpose of the present study was to identify high-risk profiles for depressive symptoms in older individuals, with a focus on functional performance. The population-based Healthy Ageing Initiative included 2,084 community-dwelling individuals (49% women) aged 70. Explorative cluster analysis was used to group participants according to functional performance level, using measures of basic mobility skills, gait variability, and grip strength. Intercluster differences in depressive symptoms (measured by the Geriatric Depression Scale [GDS]-15), physical activity (PA; measured objectively with the ActiGraph GT3X+), and a rich set of covariates were examined. The cluster analysis yielded a seven-cluster solution. One potential high-risk cluster was identified, with overrepresentation of individuals with GDS scores >5 (15.1 vs. 2.7% expected; relative risk = 6.99, P risk cluster had significant overrepresentations of obese individuals (39.7 vs. 17.4% expected) and those with type 2 diabetes (24.7 vs. 8.5% expected), and underrepresentation of individuals who fulfilled the World Health Organization's PA recommendations (15.6 vs. 59.1% expected; all P risk profile for depressive symptoms among elderly community-dwelling individuals, which included low levels functional performance combined with low levels of PA. Including PA in medical screening of the elderly may aid in identification of potential high-risk individuals for depressive symptoms. © 2017 Wiley Periodicals, Inc.

  14. Gender roles and perceptions of malaria risk in agricultural communities of Mwea Division in Central Kenya.

    Science.gov (United States)

    Woldu, Dawit Okubatsion; Haile, Zelalem Teka

    2015-01-01

    We examined gender differences in the perception of high malaria risk in women and factors associated with a high number of malaria episodes in the Mwea Division of Central Kenya. Ethnographic and successive free listing interviews (an open-ended data collection technique used to show the relation of items in a given domain) with 53 key informants and structured interviews conducted from June to October 2010 with 250 respondents who represented the socioeconomic and geographical diversity of the area were analyzed. Qualitative text analysis and inferential statistics were employed. While a greater proportion of men (51.6%) attributed women's high malaria risk to their "biological weakness," most women believed that their high malaria risk was related to their role in the agricultural fields (43.6%) and to their household responsibilities (23.1%). Compared to men, women were more likely to work in wet aspects of agricultural activities (χ(2) (2, N = 153) = 13.47, p gender roles in agricultural communities in Mwea may play an important role in explaining disparity in reported malaria incidence. While identification of ecological and economic determinants of malaria is important, gender-based research can make a significant contribution to the development of effective and sustainable malaria reduction strategies.

  15. Gender-specific hip fracture risk in community-dwelling and institutionalized seniors age 65 years and older.

    Science.gov (United States)

    Finsterwald, M; Sidelnikov, E; Orav, E J; Dawson-Hughes, B; Theiler, R; Egli, A; Platz, A; Simmen, H P; Meier, C; Grob, D; Beck, S; Stähelin, H B; Bischoff-Ferrari, H A

    2014-01-01

    In this study of acute hip fracture patients, we show that hip fracture rates differ by gender between community-dwelling seniors and seniors residing in nursing homes. While women have a significantly higher rate of hip fracture among the community-dwelling seniors, men have a significantly higher rate among nursing home residents. Differences in gender-specific hip fracture risk between community-dwelling and institutionalized seniors have not been well established, and seasonality of hip fracture risk has been controversial. We analyzed detailed data from 1,084 hip fracture patients age 65 years and older admitted to one large hospital center in Zurich, Switzerland. In a sensitivity analysis, we extend to de-personalized data from 1,265 hip fracture patients from the other two large hospital centers in Zurich within the same time frame (total n = 2,349). The denominators were person-times accumulated by the Zurich population in the corresponding age/gender/type of dwelling stratum in each calendar season for the period of the study. In the primary analysis of 1,084 hip fracture patients (mean age 85.1 years; 78% women): Among community-dwelling seniors, the risk of hip fracture was twofold higher among women compared with men (RR = 2.16; 95% CI, 1.74-2.69) independent of age, season, number of comorbidities, and cognitive function; among institutionalized seniors, the risk of hip fracture was 26% lower among women compared with men (RR = 0.77; 95% CI: 0.63-0.95) adjusting for the same confounders. In the sensitivity analysis of 2,349 hip fracture patients (mean age 85.0 years, 76% women), this pattern remained largely unchanged. There is no seasonal swing in hip fracture incidence. We confirm for seniors living in the community that women have a higher risk of hip fracture than men. However, among institutionalized seniors, men are at higher risk for hip fracture.

  16. Dietary protein intake and coronary heart disease in a large community based cohort: results from the Atherosclerosis Risk in Communities (ARIC study [corrected].

    Directory of Open Access Journals (Sweden)

    Bernhard Haring

    Full Text Available Prospective data examining the relationship between dietary protein intake and incident coronary heart disease (CHD are inconclusive. Most evidence is derived from homogenous populations such as health professionals. Large community-based analyses in more diverse samples are lacking.We studied the association of protein type and major dietary protein sources and risk for incident CHD in 12,066 middle-aged adults (aged 45-64 at baseline, 1987-1989 from four U.S. communities enrolled in the Atherosclerosis Risk in Communities (ARIC Study who were free of diabetes mellitus and cardiovascular disease at baseline. Dietary protein intake was assessed at baseline and after 6 years of follow-up by food frequency questionnaire. Our primary outcome was adjudicated coronary heart disease events or deaths with following up through December 31, 2010. Cox proportional hazard models with multivariable adjustment were used for statistical analyses.During a median follow-up of 22 years, there were 1,147 CHD events. In multivariable analyses total, animal and vegetable protein were not associated with an increased risk for CHD before or after adjustment. In food group analyses of major dietary protein sources, protein intake from red and processed meat, dairy products, fish, nuts, eggs, and legumes were not significantly associated with CHD risk. The hazard ratios [with 95% confidence intervals] for risk of CHD across quintiles of protein from poultry were 1.00 [ref], 0.83 [0.70-0.99], 0.93 [0.75-1.15], 0.88 [0.73-1.06], 0.79 [0.64-0.98], P for trend  = 0.16. Replacement analyses evaluating the association of substituting one source of dietary protein for another or of decreasing protein intake at the expense of carbohydrates or total fats did not show any statistically significant association with CHD risk.Based on a large community cohort we found no overall relationship between protein type and major dietary protein sources and risk for CHD.

  17. Evaluating Determinants of Environmental Risk Perception for Risk Management in Contaminated Sites

    Science.gov (United States)

    Janmaimool, Piyapong; Watanabe, Tsunemi

    2014-01-01

    Understanding the differences in the risk judgments of residents of industrial communities potentially provides insights into how to develop appropriate risk communication strategies. This study aimed to explore citizens’ fundamental understanding of risk-related judgments and to identify the factors contributing to perceived risks. An exploratory model was created to investigate the public’s risk judgments. In this model, the relationship between laypeople’s perceived risks and the factors related to the physical nature of risks (such as perceived probability of environmental contamination, probability of receiving impacts, and severity of catastrophic consequences) were examined by means of multiple regression analysis. Psychological factors, such as the ability to control the risks, concerns, experiences, and perceived benefits of industrial development were also included in the analysis. The Maptaphut industrial area in Rayong Province, Thailand was selected as a case study. A survey of 181 residents of communities experiencing different levels of hazardous gas contamination revealed rational risk judgments by inhabitants of high-risk and moderate-risk communities, based on their perceived probability of contamination, probability of receiving impacts, and perceived catastrophic consequences. However, risks assessed by people in low-risk communities could not be rationally explained and were influenced by their collective experiences. PMID:24937530

  18. Integrating community based disaster risk reduction and climate change adaptation: examples from the Pacific

    Directory of Open Access Journals (Sweden)

    A. Gero

    2011-01-01

    Full Text Available It is acknowledged by academics and development practitioners alike that many common strategies addressing community based disaster risk reduction and climate change adaptation duplicate each other. Thus, there is a strong push to integrate the two fields to enhance aid effectiveness and reduce confusion for communities. Examples of community based disaster risk reduction (DRR and climate change adaptation (CCA projects are presented to highlight some of the ways these issues are tackled in the Pacific. Various approaches are employed but all aim to reduce the vulnerability and enhance the resilience of local communities to the impacts of climate change and disasters. By focusing on three case studies, elements of best practice are drawn out to illustrate how DRR and CCA can be integrated for enhanced aid effectiveness, and also look at ways in which these two often overlapping fields can be better coordinated in ongoing and future projects. Projects that address vulnerability holistically, and target the overall needs and capacity of the community are found to be effective in enhancing the resilience of communities. By strategically developing a multi-stakeholder and multi-sector approach, community projects are likely to encapsulate a range of experience and skills that will benefit the community. Furthermore, by incorporating local knowledge, communities are far more likely to be engaged and actively participate in the project. From selected case studies, commonly occurring best practice methods to integrate DRR and CCA are identified and discussed and recommendations on how to overcome the common challenges also presented.

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

    Science.gov (United States)

    Lee, Suzanne; Ayers, Susan; Holden, Des

    2014-04-01

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

  20. [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.

  1. Survey on serum acetylecholinesterase (SAChE activity in selected farming communities at risk of organophosphate exposure, Southern Ghana

    Directory of Open Access Journals (Sweden)

    Ato Kwamena Tetteh

    2017-12-01

    Material and Methods ― The study was cross-sectional, involving 963 participants who consented to being screened for serum acetylcholinesterase (SAChE activity, using the dry chemistry test strips. The SAChE activity was then categorized into normal, low or high risk of developing symptoms associated with OP poisoning. Results ― The total group included 54.5% females and 45.5% males. Majority were crop farmers (46.3% and students/pupils (30.8%. The remaining 22.9% consisted mainly of traders, teachers, fishermen/fish processors, drivers and dressmakers. Very low SAChE activity unit of 30 U/ml. By this, a significant majority had either low or high risk of developing OP poisoning (χ2=4.43, 95%CI: 4.12–4.65, p=0.014 compared with those with normal activity. Most of the participants were in the 10–19 years age group of which 15.6% were in the high risk category, while 13.6% had low risk of OP poisoning. Reduced SAChE activity was predominant among all age groups compared with those with normal activity of the enzyme. As well, 27.3% who were females had reduced SAChE activity rate <30 U/ml (high risk of OP poisoning. Similarly, 23.4% of males were also at high risk of OP poisoning. There was however no statistical significance between the sex with regards to the numbers at risk of OP poisoning (χ2=4.80, 95% CI: 4.25–4.75, p=0.160. Conclusion ― This study provides some evidence of exposure, deduced from reduced SAChE activity, which potentially puts participants at a high risk of developing symptoms associated with OP poisoning. A follow-up study might be able to suggest to physicians in Ghana considering diagnostics of OP poisoning, especially for clients from farming communities where pesticides are used extensively.

  2. Testing the efficacy of a brief sexual risk reduction intervention among high-risk American Indian adults: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Rachel Chambers

    2016-04-01

    Full Text Available Abstract Background American Indian adults are more likely to experience co-occurring mental health and substance use disorders than adults of other racial/ethnic groups and are disproportionately burdened by the most common sexually transmitted infections, namely chlamydia and gonorrhea. Several behavioral interventions are proven efficacious in lowering risk for sexually transmitted infection in various populations and, if adapted to address barriers experienced by American Indian adults who suffer from mental health and substance use problems, may be useful for dissemination in American Indian communities. The proposed study aims to examine the efficacy of an adapted evidence-based intervention to increase condom use and decrease sexual risk-taking and substance use among American Indian adults living in a reservation-based community in the Southwestern United States. Methods/Design The proposed study is a randomized controlled trial to test the efficacy of an adapted evidence-based intervention compared to a control condition. Participants will be American Indian adults ages 18–49 years old who had a recent episode of binge substance use and/or suicide ideation. Participants will be randomized to the intervention, a two-session risk-reduction counseling intervention or the control condition, optimized standard care. All participants will be offered a self-administered sexually transmitted infection test. Participants will complete assessments at baseline, 3 and 6 months follow-up. The primary outcome measure is condom use at last sex. Discussion This is one of the first randomized controlled trials to assess the efficacy of an adapted evidence-based intervention for reducing sexual risk behaviors among AI adults with substance use and mental health problems. If proven successful, there will be an efficacious program for reducing risk behaviors among high-risk adults that can be disseminated in American Indian communities as well as other

  3. Community Level Risk Factors for Maternal Mortality in Madagascar ...

    African Journals Online (AJOL)

    Previous work in this area uses individual or cross-country data to study maternal mortality, however, studying maternal mortality at the community level is imperative because this is the level at which most policy is implemented. The results show that longer travel time from the community to the hospital leads to a high level ...

  4. Adjustment of High School Dropouts in Closed Religious Communities

    Science.gov (United States)

    Itzhaki, Yael; Itzhaky, Haya; Yablon, Yaacov B.

    2018-01-01

    Background: While extensive research has been done on high-school dropouts' adjustment, there is little data on dropouts from closed religious communities. Objective: This study examines the contribution of personal and social resources to the adjustment of high school dropouts in Ultraorthodox Jewish communities in Israel. Method: Using a…

  5. Community-Based Disaster Risk Management in the Philippines: Achievements and Challenges of the Purok System

    Directory of Open Access Journals (Sweden)

    Angelina Matthies

    2017-06-01

    Full Text Available The purok system in the Philippines is promoted as a voluntary self-organization at the sub-village level which strengthens community resilience to natural hazards. In 2011, the system received the UN Sasakawa Award and gained prominence among the practitioner community. Based on a qualitative study in the municipality of San Francisco (Cebu province from December 2014 to March 2015, the article elaborates on the achievements and challenges of the purok system. Striking merits encompass efficient and effective information dissemination and evacuation measurements between all levels of political administration that stem from the system’s remarkable enforcement of human and social capital. This is underpinned by a clear determination of roles and responsibility that is subsumed under the concept of accountability. However, the purok system faces internal challenges of maintenance and implies profound conceptual ambiguities regarding the notion of voluntarism and capabilities that favor clientelism. Nevertheless, the purok system clearly distinguishes itself from conventional community-based disaster risk management practices and implies potentials that are highly beneficial for strengthening resilience in disaster prone areas.

  6. Risk perception in women with high-risk pregnancies

    OpenAIRE

    Lee, S.

    2014-01-01

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

  7. Identifying community risk factors for HIV among South African ...

    African Journals Online (AJOL)

    High risk sexual behaviour, alcohol and drug use, and mental health problems combine to yield high levels of HIV-risk behaviour among adolescents with mental health problems. In South Africa, little research has been conducted on parental perspectives of HIV-risk among this population. We conducted a series of focus ...

  8. An Innovative Multiphased Strategy to Recruit Underserved Adults into a Randomized Trial of a Community-Based Diabetes Risk Reduction Program

    Science.gov (United States)

    Santoyo-Olsson, Jasmine; Cabrera, Julissa; Freyre, Rachel; Grossman, Melanie; Alvarez, Natalie; Mathur, Deepika; Guerrero, Maria; Delgadillo, Adriana T.; Kanaya, Alka M.; Stewart, Anita L.

    2011-01-01

    Purpose: To conduct and evaluate a two-phased community-based approach to recruit lower socioeconomic status, minority, or Spanish-speaking adults at risk of developing diabetes to a randomized trial of a lifestyle intervention program delivered by a public health department. Design: Within geographic areas comprising our target population, 4 community organizations provided local space for conducting the study and program. Phase I—outreach in venues surrounding these organizations—included diabetes education, a short diabetes risk appraisal (DRA), and diabetes risk screening based on a fasting fingerstick glucose test. Phase II—trial recruitment—began concurrently for those found to be at risk of developing diabetes in Phase I by explaining the study, lifestyle program, and research process. Those interested and eligible enrolled in the 1-year study. Results: Over 2 years, approximately 5,110 individuals received diabetes education, 1,917 completed a DRA, and 1,164 were screened of which 641 (55%) had an elevated fingerstick result of ≥106 mg/dl. Of the study sampling frame—persons over age 25 at risk of developing diabetes (N = 544)—238 (43%) enrolled in the trial; of those who were study eligible (n = 427), 56% enrolled. In the final sample, mean age was 56 years (SD = 17), 78% were ethnic minorities, 32% were Spanish-speaking, and 15% had a high school education or less. Implications: Providing diabetes health education and screening prior to study recruitment may help overcome barriers to research participation in underserved communities, thus helping address difficulties recruiting minority and older populations into research, particularly research pertaining to chronic disease risk factors. PMID:21565823

  9. Community Disaster and Sustainability Teams for Civil Protection

    Science.gov (United States)

    Kelman, I.; Cordonnier, B.

    2009-04-01

    Many examples of community-based teams for civil protection and disaster risk reduction exist. Turkey has a Community Disaster Volunteer Training Program while the USA has Community Emergency Response Teams which have been extended into secondary schools as Teen School Emergency Response Training. The principles and practices of these teams further apply directly to other development and sustainability endeavours, all of which are intricately linked to disaster risk reduction and civil protection. An example is keeping local water courses and storm drains clear from rubbish. That improves community health and cleanliness while assisting rainfall drainage to reduce flood risk. The "community teams" concept, as implemented for civil protection and disaster risk reduction, therefore connects with day-to-day living, such as ensuring that all community members have adequate access to water, food, waste management, shelter, health care, education, and energy. Community teams should be based on the best science and pedagogy available to ensure that concepts, training, skills, and implementation are effective and are maintained over the long-term. That entails going beyond the interest that is commonly generated by highlighting high-profile events, such as hurricanes and earthquakes, or high-profile concerns, such as climate change or terrorism. When community teams are focused on high-profile challenges, maintaining interest can be difficult without specific manifestations of the perceived "number one threat". Incorporating day-to-day concerns into civil protection can overcome that. For example, the community teams' talents and energy could be used for picking up rubbish, for educating about health and waste disposal, and for conducting vulnerability assessments in order to inspire action for continual vulnerability reduction. In addition to the examples given above, Japan's Jishu-bosai-soshiki community activities and Asia's "Townwatch" initiative adopt wider and deeper

  10. Dark Side of Development: Modernity, Disaster Risk and Sustainable Livelihoods in Two Coastal Communities in Fiji

    OpenAIRE

    Per Becker

    2017-01-01

    The world is changing rapidly, as are the remotest rural communities. Modernity is spreading across the world under the guise of development and it is transforming disaster risk. This raises issues concerning how disaster risk is changing in such milieus. Using a sustainable livelihood approach, this article investigates access to different types of capital that central to the vulnerability of two coastal communities in Fiji that are affected by modernity to different extents. This comparativ...

  11. Insights from socio-hydrology modelling on dealing with flood risk: roles of collective memory, risk-taking attitude and trust (Invited)

    Science.gov (United States)

    Viglione, A.; Di Baldassarre, G.; Brandimarte, L.; Kuil, L.; Carr, G.; Salinas, J.; Scolobig, A.

    2013-12-01

    The risk coping culture of a community plays a major role in decision making in urban flood plains. While flood awareness is not necessarily linked to being prepared to face flooding at an individual level, the connection at the community level seems to be stronger through creating policy and initiating protection works. In this work we analyse, in a conceptual way, the interplay of community risk coping culture, flooding damage and economic growth. We particularly focus on three aspects: (i) collective memory, i.e., the capacity of the community to keep the awareness of flooding high; (ii) risk-taking attitude, i.e., the amount of risk a community is collectively willing to expose themselves to; and (iii) trust of people in risk protection measures. We use a dynamic model that represents the feedbacks between the hydrological and social system components. The model results indicate that, on one hand, by under perceiving the risk of flooding (because of short collective memory and too much trust in flood protection structures) in combination with a high risk-attitude, community survival is severely limited because of destruction caused by flooding. On the other hand, high perceived risk (long memory and lack of trust in flood protection structures) relative to the actual risk leads to lost economic opportunities and recession. There are many optimal scenarios for survival and economic growth, but greater certainty of survival plus economic growth can be achieved by ensuring community has accurate risk perception (memory neither too long nor too short and trust in flood protection neither too great nor too low) combined with a low to moderate risk-taking attitude. Interestingly, the model gives rise to situations in which the development of the community in the floodplain is path dependent, i.e., the history of flooding may lead to its growth or recession. Schematic of human adjustments to flooding: (a) settling away from the river; (b) raising levees/dikes.

  12. Community-Based Risk Communication Survey: Risk Prevention Behaviors in Communities during the H1N1 crisis, 2010.

    Science.gov (United States)

    Kim, Soo Jeong; Han, Jin A; Lee, Tae-Yong; Hwang, Tae-Yoon; Kwon, Keun-Sang; Park, Ki Soo; Lee, Kyung Jong; Kim, Moon Shik; Lee, Soon Young

    2014-02-01

    The present study aimed to investigate the prevalence of and factors associated with H1N1 preventive behaviors in a community-based population. A cross-sectional study was conducted in three urban and two rural communities in Korea. Interviews were conducted with 3462 individuals (1608 men and 1854 women) aged ≥ 19 years during February-March 2010. Influenza-related information including anxiety, preventive behaviors and their perceived effectiveness, vaccination status, past influenza-like illness symptoms, and sources of and trust in information was obtained. Among 3462 participants, 173 reported experiencing influenza-like illness symptoms within the past 12 months. The mean H1N1 preventive behavior score was 25.5 ± 5.5 (out of a possible 40). The percent of participants reporting high perceived effectiveness and high anxiety was 46.2% and 21.4%, respectively. After controlling for potential confounders, H1N1 preventive behavior scores were predicted by a high (β = 3.577, p < 0.001) or moderate (β = 2.529, p < 0.001) perception of their effectiveness. Similarly, moderate (β = 1.516, p < 0.001) and high (β = 4.103, p < 0.001) anxiety scores predicted high preventive behavior scores. Effective methods of promoting population behavior change may be nationwide campaigns through mass media, as well as education and promotion by health care providers and broadcasters.

  13. Urogenital Schistosomiasis among Schoolchildren and the Associated Risk Factors in Selected Rural Communities of Kwara State, Nigeria

    Directory of Open Access Journals (Sweden)

    Babamale Olarewaju Abdulkareem

    2018-01-01

    Full Text Available Urogenital schistosomiasis is a chronic parasitic disease that causes severe morbidity among schoolchildren in many poor-resource communities in Nigeria. We investigated the prevalence, intensity, and risk factors of the infection in three communities of Kwara State to ascertain the current status of the disease. Of the 724 urine samples screened, using filtration method, 332 (45.6% school-aged children were infected with average intensity and mean population eggs load of 127.9 eggs/10 ml of urine and 0.794, respectively. Prevalence and intensity of infection varied with communities: high in Ajase-Ipo (57.1%; X = 100.7 ± 23.01 eggs/10 ml and low in Shonga (37.5%; X = 91.4 ± 78.0. Infection was significantly (P<0.05 higher in males (50.8% than the females (42.4%. Similarly, infection significantly (P<0.05 increased with increasing age. Multivariate logistic analysis of risk factors revealed that lack of portable drinking water (adjusted odd ratio (aOR = 4.76; 95% CI = 2.64–5.98, unemployment (aOR = 2.23; 1.87–2.294, lack of knowledge of infection (aOR = 2.16; 0.59–3.83, and frequent contact with contaminated water bodies (aOR = 2.01; 1.45–2.70 were important predictors of urinary schistosomiasis. Therefore, continuous evaluation of the intervention strategies that address risk factors must compliment Mass Drug Administration to curtail the transmission and debilitating health consequences of infection in endemic settings.

  14. Community-Engaged Research to Identify House Parent Perspectives on Support and Risk within the House and Ball Scene

    Science.gov (United States)

    Kubicek, Katrina; Beyer, William H.; McNeeley, Miles; Weiss, George; Omni, Legendary Father Taz Ultra; Kipke, Michele D.

    2012-01-01

    This paper describes a community-engaged study with the Los Angeles House and Ball scene, in which the perspectives of the leaders of these communities are captured to better understand how the House and Ball communities may protect and/or increase its members’ risks for HIV infection. Data were collected through in-depth interviews with House parents (N=26). This study identified key features of both support (e.g., family and support; acceptance; validation and recognition) and risk (e.g., members’ struggle to maintain status in the Ballroom scene; sex work; substance use; danger of becoming too involved in the Ball community; perception and stigma of Ballroom scene within the larger gay community) within these communities. Findings are discussed in relation to framing how to leverage the supportive aspects of the House and Ball communities to design relevant HIV prevention interventions. PMID:22206442

  15. Novel strategies lead to pre-elimination of malaria in previously high-risk areas in Suriname, South America

    NARCIS (Netherlands)

    Hiwat, H.; Hardjopawiro, L.S.; Takken, W.; Villegas, L.

    2012-01-01

    Background Suriname was a high malaria risk country before the introduction of a new five-year malaria control program in 2005, the Medical Mission Malaria Programme (MM-MP). Malaria was endemic in the forested interior, where especially the stabile village communities were affected. Case

  16. Identifying community risk factors for HIV among South African adolescents with mental health problems: a qualitative study of parental perceptions.

    Science.gov (United States)

    Kagee, Ashraf; Donenberg, Geri; Davids, Alicia; Vermaak, Redwaan; Simbayi, Leickness; Ward, Catherine; Naidoo, Pamela; Mthembu, Jacky

    2014-01-01

    High risk sexual behaviour, alcohol and drug use, and mental health problems combine to yield high levels of HIV-risk behaviour among adolescents with mental health problems. In South Africa, little research has been conducted on parental perspectives of HIV-risk among this population. We conducted a series of focus group discussions with 28 mothers of adolescents receiving services at two mental health clinics in South Africa to identify, from their perspectives, the key community problems facing their children. Participants indicated that HIV remained a serious threat to their adolescent children's well-being, in addition to substance abuse, early sexual debut, and teenage pregnancy. These social problems were mentioned as external to their household dynamics, and thus seemingly beyond the purview of the parent-adolescent relationship. These data have implications for the design of family-based interventions to ameliorate the factors associated with HIV-risk among youth receiving mental health services.

  17. High-school football and late-life risk of neurodegenerative syndromes, 1956–1970

    Science.gov (United States)

    Janssen, Pieter HH; Mandrekar, Jay; Mielke, Michelle M; Ahlskog, J. Eric; Boeve, Bradley F; Josephs, Keith; Savica, Rodolfo

    2017-01-01

    BACKGROUND Repeated head trauma has been associated with risk of neurodegenerative diseases. Few studies have evaluated the long-term risk of neurodegenerative diseases in collision sports like football. OBJECTIVE To assess whether athletes who played American varsity high-school football between 1956 and 1970 have an increased risk of neurodegenerative diseases later in life. PATIENTS AND METHODS We identified all male varsity football players between 1956 and 1970 in the public high schools of Rochester, Minnesota, compared to non-football-playing male varsity swimmers, wrestlers or basketball players. Using the records-linkage system of the Rochester Epidemiology Project, we ascertained the incidence of late-life neurodegenerative diseases: dementia, parkinsonism, or amyotrophic lateral sclerosis. We also recorded medical record-documented head trauma during high school years. RESULTS We identified 296 varsity football players and 190 athletes engaging in other sports. Football players had an increased risk of medically documented head trauma, especially if they played football for more than one year. Compared to non-football athletes, football players did not have an increased risk of neurodegenerative disease overall, nor the individual conditions of dementia, parkinsonism, or amyotrophic lateral sclerosis. CONCLUSION In this community based study, varsity high school football players from 1956 to 1970 did not have an increased risk of developing neurodegenerative diseases compared with athletes engaged in other varsity sports. This was from an era where there was a generally nihilistic view of concussion dangers, less protective equipment and without prohibition of spearing (head-first tackling). However, size and strength of players from prior eras may not be comparable to current high-school athletes. PMID:27979411

  18. Preventing Australian bat lyssavirus: community knowledge and risk perception of bats in South East Queensland.

    Science.gov (United States)

    Young, Megan K; El Saadi, Debra; McCall, Bradley J

    2014-04-01

    Ongoing potential exposure of members of the public to Australian bat lyssavirus (ABLV) in South East Queensland, Australia, prompted investigation of community knowledge, risk perception, and intention to handle bats to inform future prevention efforts. After pilot testing, a computer-assisted telephone survey of a representative sample of 700 adults without previous potential exposure to ABLV was undertaken in the defined geographic region. Twenty-four percent of eligible contacted individuals participated. Basic knowledge of bats and ABLV was generally high, with 65% of participants answering nine or more of 12 knowledge questions correctly. The perceived risk that bats pose to human health was also high, with 93% indicating some degree of risk. Although 88% of participants indicated they would handle bats in one or more of the scripted situations, overall intention to handle bats was low, with 59% indicating they would handle a bat in four or less of the 12 scenarios. Younger males with lower risk perception of bats most frequently indicated intention to handle bats in varying situations. Knowledge score was not associated with intention to handle bats on multivariate modeling. Future public health prevention efforts, both in Australia and overseas, should focus further on conveying the risk to humans and to bats when nontrained, nonvaccinated people attempt to handle bats rather than attempting to purely convey knowledge about bats and ABLV or rabies. Suitable alternative measures to handling should be included. Younger adult males are a particular target group for prevention efforts.

  19. Community nephrology: audit of screening for renal insufficiency in a high risk population.

    Science.gov (United States)

    Kissmeyer, L; Kong, C; Cohen, J; Unwin, R J; Woolfson, R G; Neild, G H

    1999-09-01

    The rate of acceptance onto dialysis programmes has doubled in the past 10 years and is steadily increasing. Early detection and treatment of renal failure slows the rate of progression. Is it feasible to screen for patients who are at increased risk of developing renal failure? We have audited primary care records of patients aged 50-75 years who have either hypertension or diabetes, and are therefore considered to be at high risk of developing renal insufficiency. Our aim was to see whether patients had had their blood pressure measured and urine tested for protein within 12 months, and plasma creatinine measured within 24 months. This was a retrospective study of case notes and computer records in 12 general practices from inner and greater London. A total of 16,855 patients were aged 50-75 years. From this age group, 2693 (15.5%) patients were identified as being either hypertensive or diabetic, or both. Of the 2561 records audited, 1359 (53.1%) contained a plasma creatinine measured within 24 months, and 11% of these (150) had a value > 125 micromol/l. This equates to a prevalence of renal insufficiency of > 110,000 patients per million in this group. Forty two patients (28%) had been referred to a nephrologist. Of records audited, 73% contained a blood pressure measurement and 29% contained a test for proteinuria within 12 months. There is a high prevalence of chronic renal insufficiency in hypertensive and diabetic patients. It is feasible to detect renal insufficiency at a primary care level, but an effective system will require computerized databases that code for age, ethnicity, measurement of blood pressure and renal function, as well as diagnoses.

  20. An overdue alignment of risk and resilience? A conceptual contribution to community resilience.

    Science.gov (United States)

    Mochizuki, Junko; Keating, Adriana; Liu, Wei; Hochrainer-Stigler, Stefan; Mechler, Reinhard

    2018-04-01

    A systematic review of literature on community resilience measurement published between 2005 and 2014 revealed that the profound lack of clarity on risk and resilience is one of the main reasons why confusion about terms such as adaptive capacity, resilience, and vulnerability persists, despite the effort spared to operationalise these concepts. Resilience is measured in isolation in some cases, where a shock is perceived to arise external to the system of interest. Problematically, this contradicts the way in which the climate change and disaster communities perceive risk as manifesting itself endogenously as a function of exposure, hazard, and vulnerability. The common conceptualisation of resilience as predominantly positive is problematic as well when, in reality, many undesirable properties of a system are resilient. Consequently, this paper presents an integrative framework that highlights the interactions between risk drivers and coping, adaptive, and transformative capacities, providing an improved conceptual basis for resilience measurement. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

  1. Gender-specific differences in high-risk sexual behaviors among methamphetamine users in Myanmar-China border city, Muse, Myanmar: who is at risk?

    Science.gov (United States)

    Saw, Yu Mon; Saw, Thu Nandar; Chan, Nyein; Cho, Su Myat; Jimba, Masamine

    2018-02-01

    Methamphetamine (MA) use is a significant public health concern due to its negative effects on health. However, to date, no epidemiological research has examined high-risk sexual behaviors (inconsistent condom use, having multiple sexual partners and having a history of sexually transmitted infections) among MA users. This topic is particularly important in Myanmar, which is recognized as one of the key MA production countries in the Southeast Asia region. Therefore, this study examined factors associated with high-risk sexual behaviors among MA users in Muse city, Myanmar. A community-based cross-sectional study was conducted from January to March 2013 in Muse city, Northern Shan State, Myanmar. In total, 1183 MA users (772 male; 411 female) were recruited using respondent-driven sampling and a computer assisted self-interviewing method. Generalized estimating equation models were used to examine factors associated with high-risk sexual behaviors. A large proportion of MA users engaged in high-risk sexual behaviors (inconsistent condom use: males, 90.7%, females, 85.2%; multiple sexual partners: males, 94.2%, females, 47.2%; and history of STIs: males, 55.7%, females, 56.0%). Among males, being a multiple stimulants drug user (adjusted odds ratio [AOR] =1.77; 95% confidence interval [CI] =1.30-2.41) and being a client of sex workers (AOR = 1.41; 95% CI = 1.08-1.83) were risk factors for engaging in high-risk sexual behaviors. Among females, being a migrant worker (AOR = 2.70; 95% CI = 1.86-3.93) and being employed (AOR = 1.57; 95% CI = 1.13-2.18) were risk factors for engaging in high-risk sexual behaviors as well. High-risk sexual behaviors were particularly pronounced among both male and female MA users. MA prevention programs that reflect gender considerations should be developed to pay more attention to vulnerable populations such as migrants, clients of sex workers, and less educated female MA users.

  2. Modelling condom use: Does the theory of planned behaviour explain condom use in a low risk, community sample?

    Science.gov (United States)

    Thomas, Joanna; Shiels, Chris; Gabbay, Mark B

    2014-01-01

    To date, most condom research has focused on young or high-risk groups, with little evidence about influences on condom use amongst lower-risk community samples. These groups are not risk free and may still wish to negotiate safer sex; yet the considerations involved could be different from those in higher-risk groups. Our research addresses this gap: We report a cross-sectional questionnaire study enquiring about recent condom use and future use intentions in community settings. Our sample (n = 311) purposively included couples in established relationships, known to be condom users. Items included demographics, sexual history and social-cognitive variables taken from the theory of planned behaviour. The strongest association with condom use/use intentions amongst our respondents was sexual partner's perceived willingness to use them. This applied across both univariate and multivariate analyses. Whilst most social-cognitive variables (attitudes; self-efficacy and peer social norms) were significant in univariate analyses, this was not supported in multivariate regression. Of the social-cognitive variables, only "condom-related attitudes" were retained in the model explaining recent condom use, whilst none of them entered the model explaining future use intentions. Further analysis showed that attitudes concerning pleasure, identity stigma and condom effectiveness were most salient for this cohort. Our results suggest that, in community samples, the decision to use a condom involves different considerations from those highlighted in previous research. Explanatory models for established couples should embrace interpersonal perspectives, emphasising couple-factors rather than individual beliefs. Messages to this cohort could usefully focus on negotiation skills, condom advantages (other than disease prevention) and reducing the stigma associated with use.

  3. High School Football and Late-Life Risk of Neurodegenerative Syndromes, 1956-1970.

    Science.gov (United States)

    Janssen, Pieter H H; Mandrekar, Jay; Mielke, Michelle M; Ahlskog, J Eric; Boeve, Bradley F; Josephs, Keith; Savica, Rodolfo

    2017-01-01

    To assess whether athletes who played American varsity high school football between 1956 and 1970 have an increased risk of neurodegenerative diseases later in life. We identified all male varsity football players between 1956 and 1970 in the public high schools of Rochester, Minnesota, and non-football-playing male varsity swimmers, wrestlers, and basketball players. Using the medical records linkage system of the Rochester Epidemiology Project, we ascertained the incidence of late-life neurodegenerative diseases: dementia, parkinsonism, and amyotrophic lateral sclerosis. We also recorded medical record-documented head trauma during high school years. We identified 296 varsity football players and 190 athletes engaging in other sports. Football players had an increased risk of medically documented head trauma, especially if they played football for more than 1 year. Compared with nonfootball athletes, football players did not have an increased risk of neurodegenerative disease overall or of the individual conditions of dementia, parkinsonism, and amyotrophic lateral sclerosis. In this community-based study, varsity high school football players from 1956 to 1970 did not have an increased risk of neurodegenerative diseases compared with athletes engaged in other varsity sports. This was from an era when there was a generally nihilistic view of concussion dangers, less protective equipment, and no prohibition of spearing (head-first tackling). However, the size and strength of players from previous eras may not be comparable with that of current high school athletes. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  4. Quantitative microbial risk assessment of Cryptosporidium and Giardia in well water from a native community of Mexico.

    Science.gov (United States)

    Balderrama-Carmona, Ana Paola; Gortáres-Moroyoqui, Pablo; Álvarez-Valencia, Luis Humberto; Castro-Espinoza, Luciano; Balderas-Cortés, José de Jesús; Mondaca-Fernández, Iram; Chaidez-Quiroz, Cristóbal; Meza-Montenegro, María Mercedes

    2015-01-01

    Cryptosporidium and Giardia are gastrointestinal disease-causing organisms transmitted by the fecal-oral route, zoonotic and prevalent in all socioeconomic segments with greater emphasis in rural communities. The goal of this study was to assess the risk of cryptosporidiosis and giardiasis of Potam dwellers consuming drinking water from communal well water. To achieve the goal, quantitative microbial risk assessment (QMRA) was carried out as follows: (a) identification of Cryptosporidium oocysts and Giardia cysts in well water samples by information collection rule method, (b) assessment of exposure to healthy Potam residents, (c) dose-response modelling, and (d) risk characterization using an exponential model. All well water samples tested were positive for Cryptosporidium and Giardia. The QMRA results indicate a mean of annual risks of 99:100 (0.99) for cryptosporidiosis and 1:1 (1.0) for giardiasis. The outcome of the present study may drive decision-makers to establish an educational and treatment program to reduce the incidence of parasite-borne intestinal infection in the Potam community, and to conduct risk analysis programs in other similar rural communities in Mexico.

  5. Kidney Measures with Diabetes and Hypertension on Cardiovascular Disease : The Atherosclerosis Risk in Communities Study

    NARCIS (Netherlands)

    Alexander, Nadine; Matsushita, Kunihiro; Sang, Yingying; Ballew, Shoshana; Mahmoodi, Bakhtawar K.; Astor, Brad C.; Coresh, Josef

    2015-01-01

    Background: Whether the association of chronic kidney disease (CKD) with cardiovascular risk differs based on diabetes mellitus (DM) and hypertension (HTN) status remains unanswered. Methods: We investigated 11,050 participants from the Atherosclerosis Risk in Communities Study (fourth examination

  6. Stress, Health Risk Behaviors, and Weight Status among Community College Students

    Science.gov (United States)

    Pelletier, Jennifer E.; Lytle, Leslie A.; Laska, Melissa N.

    2016-01-01

    The objective of this study was to describe the relationship between stress, weight-related health risk behaviors (e.g., eating behaviors, physical activity, sedentary behavior, sleep, cigarette smoking, and binge drinking), and weight status using cross-sectional data on 2-year community college students enrolled in a randomized controlled weight…

  7. The Community – Based Flood Disaster Risk Reduction (CBDRR in Beringin Watershed in Semarang City

    Directory of Open Access Journals (Sweden)

    Tiara Sartika Worowirasmi

    2015-08-01

    Full Text Available Population growth in Semarang city is certainly increasing land demand for settlement. Limited land and weak regulation enforcement of land control trigger the land use change including the watershed area. Semarang City Spatial Plan 2011-2031 has determined Beringin as a buffer area with limited physical development allocation but the citizens utilized the watershed area for settlement. Settlement developments in the area reduce the watershed ability to catch water and river capacity due to increased sedimentation. These two reasons are the main cause of the flash flood disaster (regularly in rainy season in seven villages of Beringin watershed. The condition is exacerbated by the tidal flood occurred in two village lies in coastal. In 2012, Semarang City government developed Flood Forecasting and Warning System as one of Climate Change Adaptation Measures known as Flood Early Warning System (FEWS. One of important output of FEWS is community-based disaster risk reduction. Community participation process in the FEWS has made it possible for the community to identify disaster risk characteristics, to propose solution for reducing flood risk which is suitable to the local wisdom, to increase the community capacity and to organize one of themselves in a disaster preparedness group which run quite independently.

  8. Social Determinants of Health in Environmental Justice Communities: Examining Cumulative Risk in Terms of Environmental Exposures and Social Determinants of Health.

    Science.gov (United States)

    Prochaska, John D; Nolen, Alexandra B; Kelley, Hilton; Sexton, Ken; Linder, Stephen H; Sullivan, John

    2014-01-01

    Residents of environmental justice (EJ) communities may bear a disproportionate burden of environmental health risk, and often face additional burdens from social determinants of health. Accounting for cumulative risk should include measures of risk from both environmental sources and social determinants. This study sought to better understand cumulative health risk from both social and environmental sources in a disadvantaged community in Texas. Key outcomes were determining what data are currently available for this assessment, clarifying data needs, identifying data gaps, and considering how those gaps could be filled. Analyses suggested that the traditionally defined EJ community in Port Arthur may have a lower environmental risk from air toxics than the rest of the City of Port Arthur (although the entire city has a higher risk than the average for the state), but may have a larger burden from social determinants of health. However, the results should be interpreted in light of the availability of data, the definitions of community boundaries, and the areal unit utilized. Continued focus on environmental justice communities and the cumulative risks faced by their residents is critical to protecting these residents and, ultimately, moving towards a more equitable distribution and acceptable level of risk throughout society.

  9. Androgen deprivation therapy for prostate cancer and the risk of hospitalisation for community-acquired pneumonia.

    Science.gov (United States)

    Hicks, Blánaid M; Yin, Hui; Bladou, Franck; Ernst, Pierre; Azoulay, Laurent

    2017-07-01

    Androgens have been shown to influence both the immune system and lung tissue, raising the hypothesis that androgen deprivation therapy (ADT) for prostate cancer may increase the risk of pneumonia. Thus, the aim of this study was to determine whether ADT is associated with an increased risk of hospitalisation for community-acquired pneumonia in patients with prostate cancer. This was a population-based cohort study using the United Kingdom Clinical Practice Research Datalink linked to the Hospital Episode Statistics repository. The cohort consisted of 20 310 men newly diagnosed with non-metastatic prostate cancer between 1 April 1998 and 31 March 2015. Time-dependent Cox proportional hazards models were used to estimate adjusted HRs and 95% CIs for hospitalisation for community-acquired pneumonia associated with current and past use of ADT compared with non-use. During a mean follow-up of 4.3 years, there were 621 incident hospitalisations for community-acquired pneumonia (incidence rate: 7.2/1000 person-years). Current ADT use was associated with an 81% increased risk of hospitalisation for community-acquired pneumonia (12.1 vs 3.8 per 1000 person-years, respectively; HR 1.81, 95% CI 1.47 to 2.23). The association was observed within the first six months of use (HR 1.73, 95% CI 1.23 to 2.42) and remained elevated with increasing durations of use (≥25 months; HR 1.79, 95% CI 1.39 to 2.30). In contrast, past ADT use was not associated with an increased risk (HR 1.23, 95% CI 0.95 to 1.60). The use of ADT is associated with an increased risk of hospitalisation for community-acquired pneumonia in men with prostate cancer. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Community care of individuals at risk of suicide: the Life Promotion Clinic model

    Directory of Open Access Journals (Sweden)

    Kairi Kolves

    2013-09-01

    Full Text Available Assistance to suicidal patients is problematic both at the hospital and community care level. Inadequacy of facilities, pressured personnel, long waiting time, and professional and social stigmatization are just some of the many issues that interfere with successful treatment. The goal of this paper is to present the functioning of the Life Promotion Clinic (LPC, Australia, and describe its users. The LPC is the first specialized outpatient service in Australia dedicated to the treatment of individuals with suicidal thoughts and behaviors. A description of the service and characteristics of its clients (demographic, psychopathology, risk of suicide are herein presented. Data were collected for 63 male and 175 female patients who attended the LPC over a three-year period. Patients were mostly single females, aged up to 44 years, poorly educated, unemployed or on a pension/benefit. The majority of patients reported at least one suicide attempt, severe depression and anxiety scores, moderate-severe feelings of hopelessness, and high impulsiveness scores. Compared to females, male patients presented with more active desire to kill themselves and higher level of suicidal ideation. We can conclude that establishing a specialist service for treatment of individuals at increased risk for suicide requires consideration of both patient and clinicians needs. The LPC presents an innovative model of community service, capable of engaging patients with serious mental health issues, while making the service accessible to people from various social categories.

  11. Risk assessment and HbA1c measurement in Norwegian community pharmacies to identify people with undiagnosed type 2 diabetes – A feasibility study

    Science.gov (United States)

    Kjome, Reidun Lisbet Skeide; Sandberg, Sverre; Sølvik, Una Ørvim

    2018-01-01

    Objectives Determine the feasibility of using a diabetes risk assessment tool followed by HbA1c-measurement in a community-pharmacy setting in Norway. Methods In this longitudinal study two pharmacists in each of three community pharmacies were trained to perform risk assessments, HbA1c-measurements and counselling. Pharmacy customers who were > 18 years old and could understand and speak Norwegian or English were recruited in the pharmacies during a two-months-period. Information about the service was presented in local newspapers, social media, leaflets and posters at the pharmacy. Customers wishing to participate contacted the pharmacy staff. Participants completed a validated diabetes risk test and a background questionnaire including a validated instrument for self-rated health. A HbA1c measurement was performed for individuals with a moderate to high risk of developing diabetes. If HbA1c ≥ 6.5% they were recommended to visit their general practitioner for follow-up. The pharmacies performed internal and external quality control of the HbA1c instrument. Results Of the 211 included participants 97 (46%) were > 50 years old. HbA1c was measured for the 47 participants (22%) with high risk. Thirty-two (15%) had HbA1c values internal and external quality control for HbA1c were within set limits. Conclusion The pharmacists were able to perform the risk assessment and measurement of HbA1c, and pharmacy customers were willing to participate. The HbA1c measurements fulfilled the requirements for analytical quality. Thus, it is feasible to implement this service in community pharmacies in Norway. In a large-scale study the inclusion criteria should be increased to 45 years in accordance with the population the risk test has been validated for. PMID:29474501

  12. The Environmental Protection Agency's Community-Focused Exposure and Risk Screening Tool (C-FERST) and its potential use for environmental justice efforts.

    Science.gov (United States)

    Zartarian, Valerie G; Schultz, Bradley D; Barzyk, Timothy M; Smuts, Marybeth; Hammond, Davyda M; Medina-Vera, Myriam; Geller, Andrew M

    2011-12-01

    Our primary objective was to provide higher quality, more accessible science to address challenges of characterizing local-scale exposures and risks for enhanced community-based assessments and environmental decision-making. After identifying community needs, priority environmental issues, and current tools, we designed and populated the Community-Focused Exposure and Risk Screening Tool (C-FERST) in collaboration with stakeholders, following a set of defined principles, and considered it in the context of environmental justice. C-FERST is a geographic information system and resource access Web tool under development for supporting multimedia community assessments. Community-level exposure and risk research is being conducted to address specific local issues through case studies. C-FERST can be applied to support environmental justice efforts. It incorporates research to develop community-level data and modeled estimates for priority environmental issues, and other relevant information identified by communities. Initial case studies are under way to refine and test the tool to expand its applicability and transferability. Opportunities exist for scientists to address the many research needs in characterizing local cumulative exposures and risks and for community partners to apply and refine C-FERST.

  13. Blind Spots: Small Rural Communities and High Turnover in the Superintendency

    Science.gov (United States)

    Kamrath, Barry; Brunner, C. Cryss

    2014-01-01

    This article examines high superintendency turnover through rural community members' perceptions of such attrition in their districts. Findings indicate that community members perceived high turnover as negative and believed that turnover was created by financial pressures, rural community resistance to educational trends, and bias against…

  14. 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.

  15. Integrated Risk Research. Case of Study: Motozintla, Chiapas, Mexico

    Science.gov (United States)

    Novelo-Casanova, D. A.; Jaimes, M.

    2015-12-01

    This integrated risk research include the analysis of all components of individual constituents of risk such hazard identification, hazard exposure, and vulnerability. We determined risk to natural hazards in the community of Motozintla located in southern Mexico in the state of Chiapas (15.37ºN, 92.25ºW. Due to its geographical and geological location, this community is continuously exposed mainly to earthquakes, landslides and floods. We developed integrated studies and analysis of seismic zonation, landslides and flood susceptibility using standard methodologies. Vulnerability was quantified from data collected from local families interviews considering five social variables: characteristics of housing construction, availability of basic public services, family economic conditions, existing community plans for disaster preparedness, and risk perception. Local families surveyed were randomly selected considering a sample statistically significant. Our results were spatially represented using a Geographical Information System (GIS). Structural vulnerability curves were generated for typical housing constructions. Our integrated risk analysis demonstrates that the community of Motozintla has a high level of structural and socio-economical risk to floods and earthquakes. More than half of the population does not know any existing Civil Protection Plan and perceive that they are in high risk to landslides and floods. Although the community is located in a high seismic risk zone, most of the local people believe that cannot be impacted by a large earthquake. These natural and social conditions indicate that the community of Motozintla has a very high level of risk to natural hazards. This research will support local decision makers in developing an integrated comprehensive natural hazards mitigation and prevention program.

  16. Caries Epidemiology and Community Dentistry: Chances for Future Improvements in Caries Risk Groups. Outcomes of the ORCA Saturday Afternoon Symposium, Greifswald, 2014. Part 1.

    Science.gov (United States)

    Splieth, Christian H; Christiansen, Jette; Foster Page, Lyndie A

    2016-01-01

    This paper reviews the first part of the outcomes of the ORCA Saturday Afternoon Symposium 2014 dealing with 'caries epidemiology and community dentistry: chances for future improvements in caries risk groups'. After the caries decline in many countries, there are remaining pockets of higher caries levels, mostly in the primary dentition and/or linked to a low socio-economic status (SES). The review into the evidence of caries-preventive measures clearly points to the use of fluorides, especially toothbrushing with fluoridated toothpaste and collective measures such as water fluoridation. In contrast to several unsuccessful high-risk approaches, community and public health programmes seem to be able to ensure a population-wide access and compliance in risk groups. Their simple and evidence-based measures mostly combine regular plaque removal and fluoride applications via toothbrushing, at least for children and adolescents. For the future, the common risk factor approach which addresses associations between oral health, social deprivation, diet, hygiene, smoking, alcohol use and stress should lead to combined efforts with other community health and education specialists. Further engagement with public policy, community leaders and administration is needed in order to strengthen healthy choices and behaviour, e.g. in 'healthy' schools and kindergartens. It seems advisable that these population programmes also aim at improving upstream factors. © 2016 S. Karger AG, Basel.

  17. Perceived Benefits of Participation and Risks of Soil Contamination in St. Louis Urban Community Gardens.

    Science.gov (United States)

    Wong, Roger; Gable, Leah; Rivera-Núñez, Zorimar

    2018-06-01

    Community gardens are credited for promoting health within neighborhoods, by increasing healthy food intake and exercise frequency. These benefits, however, are potentially undermined as urban soils are often contaminated from industrial legacies. The purpose of this study was to examine the perceived benefits of participation and risks of soil contamination within urban community gardens, and factors associated with soil contamination concerns. Ninety-three gardeners were interviewed across 20 community gardens in St. Louis, Missouri between June and August 2015. Surveys included questions on demographics, gardening practices, and perceptions of community gardening. Multilevel logistic models assessed how gardener demographics, gardening practices, and garden characteristics were associated with soil contamination concerns. Common perceived benefits of community gardening were community building (68.8%), healthy and fresh food (35.5%), and gardening education (18.3%). Most gardeners (62.4%) were not concerned about soil contamination, but nearly half (48.4%) stated concerns about heavy metals. Black race was significantly associated with soil contamination concerns (OR 5.47, 95% CI 1.00-30.15, p = .04). Community gardens offer numerous social and health benefits. Although most gardeners were not concerned about soil contamination, black gardeners were more likely to have concerns. Garden leaders should provide resources to gardeners to learn about soil contamination and methods to manage their risk, particularly in minority neighborhoods.

  18. Community Resilience: Increasing Public Understanding of Risk and Vulnerability to Natural Hazards through Informal Education

    Science.gov (United States)

    Salna, E.

    2017-12-01

    The Extreme Events Institute's (EEI) International Hurricane Research Center (IHRC) at Florida International University (FIU) in Miami, Florida, as a NOAA Weather-Ready Nation Ambassador, is dedicated to make South Florida, Ready, Responsive and Resilient. IHRC with funding from the Florida Division of Emergency Management (FDEM) has developed several museum exhibits and events. This includes the hands-on FIU Wall of Wind exhibit for the National Building Museum in Washington, DC, the Frost Science Museum in Miami, Florida, and the Museum of Discovery and Science (MODS) in Fort Lauderdale, Florida. The exhibit teaches the public about hurricane wind engineering research, enhanced building codes, and the importance of protecting your home's windows and doors with code-approved shutters. In addition, IHRC and MODS facilitate Eye of the Storm, a free-of-charge, community event with interactive hurricane science, and preparedness activities, including the entertaining Owlie Skywarn live theater show and live air cannon missile impact demonstrations. This annual event includes many local, state and federal partners, including NOAA and NWS. The IHRC also developed the FIU Wall of Wind Mitigation Challenge. As the next generation of engineers to address natural hazards and extreme weather, this STEM education event features a competition between high school teams to develop innovative wind mitigation concepts and real-life human safety and property protection solutions. IHRC and MODS are also developing a new exhibit of a Hazard/Risk Equation that will "come to life," through virtual reality (VR) technology in a state-of-the art 7D theater. The exhibit will provide a better public understanding of how changes in exposures and vulnerabilities will determine whether a community experiences an emergency, disaster or catastrophe. It will raise public consciousness and drive home the point that communities need not passively accept natural hazard risks. Ultimately, if we raise

  19. Radical prostatectomy for high-risk prostate cancer.

    Science.gov (United States)

    Yossepowitch, Ofer; Eastham, James A

    2008-06-01

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

  20. A Screening Tool Using Five Risk Factors Was Developed for Fall-Risk Prediction in Chinese Community-Dwelling Elderly Individuals.

    Science.gov (United States)

    Kang, Li; Chen, Xiaoyu; Han, Peipei; Ma, Yixuan; Jia, Liye; Fu, Liyuan; Yu, Hairui; Wang, Lu; Hou, Lin; Yu, Xing; An, Zongyang; Wang, Xuetong; Li, Lu; Zhang, Yuanyuan; Zhao, Peng; Guo, Qi

    2018-01-22

    The objective of this study was to determine falls risk profiles to derive a falls risk prediction score and establish a simple and practical clinical screening tool for Chinese community-dwelling elderly individuals. This was a prospective cohort study (n = 619) among adults aged 60 years and older. Falls were ascertained at a 1-year follow-up appointment. Sociodemographic information, medical history, and physical performance data were collected. The mean age was 67.4 years; 57.7% were women. Female sex (odds ratios [ORs] 1.82; 95% confidence interval [95% CI] 1.17-2.82), diabetes (OR 2.13; 95% CI 1.13-3.98), a Timed Up and Go Test (TUGT) ≥10.49 seconds (OR 1.51; 95% CI 1.23-1.94), a history of falls (OR 3.15; 95% CI 1.72-5.79), and depression (Geriatric Depression Scale [GDS] ≥11, OR 2.51; 95% CI 1.36-4.63) were the strongest predictors. These predictors were used to establish a risk score. The area under the curve of the score was 0.748. From a clinical point of view, the most appropriate cutoff value was 7 (97.5% specificity, 70.7% positive predictive value, and 83.6% negative predictive value). For this cutoff, the fraction correctly classified was 82.5%. A cutoff score of 7 derived from a risk assessment tool using four risk factors (gender, falls history, diabetes, and depression) and the TUGT may be used in Chinese community-dwelling elderly individuals as an initial step to screen those at low risk for falls.

  1. Experiences on the development of a Community Based Early Warning System for mountain risks in northern Italy

    Science.gov (United States)

    Garcia, Carolina; Sterlacchini, Simone; de Amicis, Mattia; Fontana, Michele; Trozzi, Arianna; Frigerio, Ivan

    2010-05-01

    In the framework of the European project Mountain Risks (http://mountain-risks.eu/), one of the projects currently developed is a methodology to integrate risk management and evacuation emergency plans, focused on prevention as a key element for disaster risk reduction, applied in the Mountain Community Valtellina of Tirano, an area recurrently affected by several mountain hazards. Taking into account the actual state of disaster risk reduction initiatives in the study area, including the existence of a real time emergency plan based on GIS (Geographical Information Systems), DSS (Decision Support Systems), and ICT (Information & Communication Technology), but knowing the lack involvement of the general community in any of the preparation activities developed until the present and the lack of divulgation of the current emergency plan, it was decided that the methodology that could better adapt to the actual conditions of the study area would be a non structural Community Based Early Warning System (CBEWS). A CBEWS has been recognized by institutions as the UN and the INSDR, as an effective and important strategy for disaster risk reduction. This strategy is broadly used especially in developing countries and has proved its effectiveness in many disasters crisis all over the world. In spite of that, possibly for political and social reasons, there are really few applications of CBEWS in developed countries which has made the elaboration of this research project a particularly difficult process due to the lack of previous references with similar conditions to the one in the study area. Difficulties related to any multidisciplinary work which also involves the general community have been faced during the development of the project such as the differences in language (both the technical jargon of the different disciplines and the native language), time restrictions, the process of learning and adapting to different social structures, the process of contacting several

  2. Association of cardiovascular risk factors between Hispanic/Latino parents and youth: the Hispanic Community Health Study/Study of Latino Youth.

    Science.gov (United States)

    Carnethon, Mercedes R; Ayala, Guadalupe X; Bangdiwala, Shrikant I; Bishop, Virginia; Daviglus, Martha L; Delamater, Alan M; Gallo, Linda C; Perreira, Krista; Pulgaron, Elizabeth; Reina, Samantha; Talavera, Gregory A; Van Horn, Linda H; Isasi, Carmen R

    2017-04-01

    Hispanic/Latinos have a high burden of cardiovascular disease (CVD) risk factors which may begin at young ages. We tested the association of CVD risk factors between Hispanic/Latino parents and their children. We conducted a cross-sectional study in the Hispanic Community Health Study/Study of Latinos Youth study. Girls (n = 674) and boys (n = 667) aged 8 to 16 years (mean age 12.1 years) and their parents (n = 942) had their CVD risk factors measured. CVD risk factors in parents were significantly positively associated with those same risk factors among youth. After adjustment for demographic characteristics, diet and physical activity, obese parents were significantly more likely to have youth who were overweight (odds ratios [ORs], 2.39; 95% confidence interval [CI], 1.20-4.76) or obese (OR, 6.16; 95% CI, 3.23-11.77) versus normal weight. Dyslipidemia among parents was associated with 1.98 higher odds of dyslipidemia among youth (95% CI, 1.37-2.87). Neither hypertension nor diabetes was associated with higher odds of high blood pressure or hyperglycemia (prediabetes or diabetes) in youth. Findings were consistent by sex and in younger (age parents, which portends high risk for adult CVD. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Evaluation of the benefits and risks of introducing Ebola community care centers, Sierra Leone.

    Science.gov (United States)

    Kucharski, Adam J; Camacho, Anton; Checchi, Francesco; Waldman, Ron; Grais, Rebecca F; Cabrol, Jean-Clement; Briand, Sylvie; Baguelin, Marc; Flasche, Stefan; Funk, Sebastian; Edmunds, W John

    2015-03-01

    In some parts of western Africa, Ebola treatment centers (ETCs) have reached capacity. Unless capacity is rapidly scaled up, the chance to avoid a generalized Ebola epidemic will soon diminish. The World Health Organization and partners are considering additional Ebola patient care options, including community care centers (CCCs), small, lightly staffed units that could be used to isolate patients outside the home and get them into care sooner than otherwise possible. Using a transmission model, we evaluated the benefits and risks of introducing CCCs into Sierra Leone's Western Area, where most ETCs are at capacity. We found that use of CCCs could lead to a decline in cases, even if virus transmission occurs between CCC patients and the community. However, to prevent CCC amplification of the epidemic, the risk of Ebola virus-negative persons being exposed to virus within CCCs would have to be offset by a reduction in community transmission resulting from CCC use.

  4. Vulnerability to high risk sexual behaviour (HRSB following exposure to war trauma as seen in post-conflict communities in eastern uganda: a qualitative study

    Directory of Open Access Journals (Sweden)

    Muron Julius

    2011-10-01

    Full Text Available Abstract Background Much of the literature on the relationship between conflict-related trauma and high risk sexual behaviour (HRSB often focuses on refugees and not mass in-country displaced people due to armed conflicts. There is paucity of research about contexts underlying HRSB and HIV/AIDS in conflict and post-conflict communities in Uganda. Understanding factors that underpin vulnerability to HRSB in post-conflict communities is vital in designing HIV/AIDS prevention interventions. We explored the socio-cultural factors, social interactions, socio-cultural practices, social norms and social network structures that underlie war trauma and vulnerability to HRSB in a post-conflict population. Methods We did a cross-sectional qualitative study of 3 sub-counties in Katakwi district and 1 in Amuria in Uganda between March and May 2009. We collected data using 8 FGDs, 32 key informant interviews and 16 in-depth interviews. We tape-recorded and transcribed the data. We followed thematic analysis principles to manage, analyse and interpret the data. We constantly identified and compared themes and sub-themes in the dataset as we read the transcripts. We used illuminating verbatim quotations to illustrate major findings. Results The commonly identified HRSB behaviours include; transactional sex, sexual predation, multiple partners, early marriages and forced marriages. Breakdown of the social structure due to conflict had resulted in economic destruction and a perceived soaring of vulnerable people whose propensity to HRSB is high. Dishonour of sexual sanctity through transactional sex and practices like incest mirrored the consequence of exposure to conflict. HRSB was associated with concentration of people in camps where idleness and unemployment were the norm. Reports of girls and women who had been victims of rape and defilement by men with guns were common. Many people were known to have started to display persistent worries, hopelessness, and

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

    NARCIS (Netherlands)

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

    2018-01-01

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

  6. Gout in Older Adults: The Atherosclerosis Risk in Communities Study

    Science.gov (United States)

    Burke, Bridget Teevan; Köttgen, Anna; Law, Andrew; Grams, Morgan; Baer, Alan N.; Coresh, Josef

    2016-01-01

    Background: It is unclear whether traditional and genetic risk factors in middle age predict the onset of gout in older age. Methods: We studied the incidence of gout in older adults using the Atherosclerosis Risk in Communities study, a prospective U.S. population–based cohort of middle-aged adults enrolled between 1987 and 1989 with ongoing follow-up. A genetic urate score was formed from common urate-associated single nucleotide polymorphisms for eight genes. The adjusted hazard ratio and 95% confidence interval of incident gout by traditional and genetic risk factors in middle age were estimated using a Cox proportional hazards model. Results: The cumulative incidence from middle age to age 65 was 8.6% in men and 2.5% in women; by age 75 the cumulative incidence was 11.8% and 5.0%. In middle age, increased adiposity, beer intake, protein intake, smoking status, hypertension, diuretic use, and kidney function (but not sex) were associated with an increased gout risk in older age. In addition, a 100 µmol/L increase in genetic urate score was associated with a 3.29-fold (95% confidence interval: 1.63–6.63) increased gout risk in older age. Conclusions: These findings suggest that traditional and genetic risk factors in middle age may be useful for identifying those at risk of gout in older age. PMID:26714568

  7. Risk assessment and HbA1c measurement in Norwegian community pharmacies to identify people with undiagnosed type 2 diabetes - A feasibility study.

    Science.gov (United States)

    Risøy, Aslaug Johanne; Kjome, Reidun Lisbet Skeide; Sandberg, Sverre; Sølvik, Una Ørvim

    2018-01-01

    Determine the feasibility of using a diabetes risk assessment tool followed by HbA1c-measurement in a community-pharmacy setting in Norway. In this longitudinal study two pharmacists in each of three community pharmacies were trained to perform risk assessments, HbA1c-measurements and counselling. Pharmacy customers who were > 18 years old and could understand and speak Norwegian or English were recruited in the pharmacies during a two-months-period. Information about the service was presented in local newspapers, social media, leaflets and posters at the pharmacy. Customers wishing to participate contacted the pharmacy staff. Participants completed a validated diabetes risk test and a background questionnaire including a validated instrument for self-rated health. A HbA1c measurement was performed for individuals with a moderate to high risk of developing diabetes. If HbA1c ≥ 6.5% they were recommended to visit their general practitioner for follow-up. The pharmacies performed internal and external quality control of the HbA1c instrument. Of the 211 included participants 97 (46%) were > 50 years old. HbA1c was measured for the 47 participants (22%) with high risk. Thirty-two (15%) had HbA1c values HbA1c ≥ 6.5%. Two participants with HbA1 ≥ 6.5% were diagnosed with diabetes by their general practitioner. The third was lost to follow-up. Results from internal and external quality control for HbA1c were within set limits. The pharmacists were able to perform the risk assessment and measurement of HbA1c, and pharmacy customers were willing to participate. The HbA1c measurements fulfilled the requirements for analytical quality. Thus, it is feasible to implement this service in community pharmacies in Norway. In a large-scale study the inclusion criteria should be increased to 45 years in accordance with the population the risk test has been validated for.

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

    Science.gov (United States)

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

    2015-01-01

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

  9. Cultural practices and sexual risk behaviour among adolescent orphans and non-orphans: a qualitative study on perceptions from a community in western Kenya

    OpenAIRE

    Juma, Milka; Askew, Ian; Alaii, Jane; Bartholomew, L Kay; van den Borne, Bart

    2014-01-01

    Background This study explored community perceptions of cultural beliefs and practices that may increase sexual risk behaviour of adolescents, to understand more about meaning they hold within the culture and how they expose adolescent orphans and non-orphans to higher risks in a high HIV and teenage pregnancy prevalence context. Methods Using a qualitative descriptive cross-sectional design 14 focus group discussions were conducted with 78 adolescents and 68 parents/guardians purposively sel...

  10. Learning Communities for University Students At-Risk of School Failure: Can They Make a Difference?

    Science.gov (United States)

    Tharp, Terri J.

    2009-01-01

    This study investigated the impact of learning communities on the academic success of university students at-risk of academic failure. The effects of learning communities (LC) at Middle Tennessee State University (MTSU) on cumulative GPAs, retention rates, and earned cumulative hours of students with ACT sub-scores of 17 or 18 in math who were…

  11. Cultural practices and sexual risk behaviour among adolescent orphans and non-orphans: a qualitative study on perceptions from a community in Western Kenya.

    Science.gov (United States)

    Juma, Milka; Askew, Ian; Alaii, Jane; Bartholomew, L Kay; van den Borne, Bart

    2014-01-27

    This study explored community perceptions of cultural beliefs and practices that may increase sexual risk behaviour of adolescents, to understand more about meaning they hold within the culture and how they expose adolescent orphans and non-orphans to higher risks in a high HIV and teenage pregnancy prevalence context. Using a qualitative descriptive cross-sectional design 14 focus group discussions were conducted with 78 adolescents and 68 parents/guardians purposively selected to represent their communities. Thirteen key informant interviews were also conducted with community leaders, health care and child welfare workers, and adolescents who were also selected purposively. The two methods were used to explore how cultural beliefs and practices predispose adolescent orphans and non- orphans to risky sexual behaviours. Data were analysed through line-by-line coding, grouped into families and retrieved as themes and sub-themes. Identified cultural practices that predisposed adolescents orphans and non-orphans to risky sexual behaviours included: adolescent sleeping arrangements, funeral ceremonies, replacing a deceased married daughter with her younger sister in marriage, widow inheritance among boys, early marriage among girls, and preference for boys/sons. Cultural risks perceived to equally affect both orphans and non-orphans were sleeping arrangements, funeral ceremonies, and sister replacement. Factors associated more with orphans than non-orphans were widow inheritance among boys and a preference for boy over girl children. Adolescent sexual risk reduction programs should be developed considering the specific cultural context, using strategies that empower communities to challenge the widely accepted cultural norms that may predispose young people in general to sexual risks while targeting those that unequally influence orphans.

  12. Chronic Disease Risk Typologies among Young Adults in Community College.

    Science.gov (United States)

    Jeffries, Jayne K; Lytle, Leslie; Sotres-Alvarez, Daniela; Golden, Shelley; Aiello, Allison E; Linnan, Laura

    2018-03-01

    To address chronic disease risk holistically from a behavioral perspective, insights are needed to refine understanding of the covariance of key health behaviors. This study aims to identify distinct typologies of young adults based on 4 modifiable risk factors of chronic disease using a latent class analysis approach, and to describe patterns of class membership based on demographic characteristics, living arrangements, and weight. Overall, 441 young adults aged 18-35 attending community colleges in the Minnesota Twin Cities area completed a baseline questionnaire for the Choosing Healthy Options in College Environments and Settings study, a RCT. Behavioral items were used to create indicators for latent classes, and individuals were classified using maximum-probability assignment. Three latent classes were identified: 'active, binge-drinkers with a healthy dietary intake' (13.1%); 'non-active, moderate-smokers and non-drinkers with poor dietary intake' (38.2%); 'moderately active, non-smokers and non-drinkers with moderately healthy dietary intake' (48.7%). Classes exhibited unique demographic and weight-related profiles. This study may contribute to the literature on health behaviors among young adults and provides evidence that there are weight and age differences among subgroups. Understanding how behaviors cluster is important for identifying groups for targeted interventions in community colleges.

  13. Assessing hazard risk, cost of adaptation and traditional land use activities in the context of permafrost thaw in communities in Yukon and the Northwest Territories, Canada

    Science.gov (United States)

    Benkert, B.; Perrin, A.; Calmels, F.

    2015-12-01

    Together with its partners, the Northern Climate ExChange (NCE, part of the Yukon Research Centre at Yukon College) has been mapping permafrost-related hazard risk in northern communities since 2010. By integrating geoscience and climate project data, we have developed a series of community-scale hazard risk maps. The maps depict hazard risk in stoplight colours for easy interpretation, and support community-based, future-focused adaptation planning. Communities, First Nations, consultants and local regulatory agencies have used the hazard risk maps to site small-scale infrastructure projects, guide land planning processes, and assess suitability of land development applications. However, we know that assessing risk is only one step in integrating the implications of permafrost degradation in societal responses to environmental change. To build on our permafrost hazard risk maps, we are integrating economic principles and traditional land use elements. To assess economic implications of adaptation to permafrost change, we are working with geotechnical engineers to identify adaptation options (e.g., modified building techniques, permafrost thaw mitigation approaches) that suit the risks captured by our existing hazard risk maps. We layer this with an economic analysis of the costs associated with identified adaptation options, providing end-users with a more comprehensive basis upon which to make decisions related to infrastructure. NCE researchers have also integrated traditional land use activities in assessments of permafrost thaw risk, in a project led by Jean Marie River First Nation in the Northwest Territories. Here, the implications of permafrost degradation on food security and land use priorities were assessed by layering key game and gathering areas on permafrost thaw vulnerability maps. Results indicated that close to one quarter of big and small game habitats, and close to twenty percent of key furbearer and gathering areas within the First Nation

  14. The Components of Community Awareness and Preparedness; its Effects on the Reduction of Tsunami Vulnerability and Risk

    Science.gov (United States)

    Tufekci, Duygu; Lutfi Suzen, Mehmet; Cevdet Yalciner, Ahmet

    2017-04-01

    The resilience of coastal communities against tsunamis are dependent on preparedness of the communities. Preparedness covers social and structural components which increases with the awareness in the community against tsunamis. Therefore, proper evaluation of all components of preparedness will help communities to reduce the adverse effects of tsunamis and increase the overall resilience of communities. On the other hand, the complexity of the metropolitan life with its social and structural components necessitates explicit vulnerability assessments for proper determination of tsunami risk, and development of proper mitigation strategies and recovery plans. Assessing the vulnerability and resilience level of a region against tsunamis and efforts for reducing the tsunami risk are the key components of disaster management. Since increasing the awareness of coastal communities against tsunamis is one of the main objectives of disaster management, then it should be considered as one of the parameter in tsunami risk analysis. In the method named MetHuVA (METU - Metropolitan Human Tsunami Vulnerability Assessment) proposed by Cankaya et al., (2016) and Tufekci et al., (2016), the awareness and preparedness level of the community is revealed to be an indispensable parameter with a great effect on tsunami risk. According to the results obtained from those studies, it becomes important that the awareness and preparedness parameter (n) must be analyzed by considering their interaction and all related components. While increasing awareness can be achieved, vulnerability and risk will be reduced. In this study the components of awareness and preparedness parameter (n) is analyzed in different categories by considering administrative, social, educational, economic and structural preparedness of the coastal communities. Hence the proposed awareness and preparedness parameter can properly be analyzed and further improvements can be achieved in vulnerability and risk analysis

  15. Interactive effect between depression and chronic medical conditions on fall risk in community-dwelling elders.

    Science.gov (United States)

    Kao, Senyeong; Wang, Yun-Chang; Tzeng, Ya-Mei; Liang, Chang-Kuo; Lin, Fu-Gong

    2012-09-01

    It is well documented that fall risk among elderly people is associated with poor health and depression. In this study, we set out to examine the combined effects of medical condition and depression status on fall incidents among community-dwelling elderly people. A cross-sectional study was carried out to investigate the fall history of community-dwelling elders involving 360 participants. Those who had experienced at least two falls over the previous year, or one injurious fall, were defined as "fallers." The Geriatric Depression Scale-15 was used as a screening instrument for depression status. Based on a multivariate logistic regression and stratification analysis, depression was found to interact with various medical conditions on fall risk. In comparison with the non-depressive reference group, a six-fold fall risk was discernible among depressed elders with polypharmacy, while a five-fold risk was found among depressive elders using ancillary devices, along with a four-fold risk among depressive elders with diabetes or cardiovascular disease. Finally, arthritis was found to produce a nine-fold risk of falls among such populations. These findings suggest that greater emphasis should be placed on the integration of depression screening as an element of fall risk assessment in elderly people.

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

    Science.gov (United States)

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

    2013-12-01

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

  17. Structural Impediments to Condom Access in a High HIV/STI-Risk Area

    Directory of Open Access Journals (Sweden)

    Christine Rizkalla

    2010-01-01

    Full Text Available As embarrassment is a known obstacle to condom acquisition, selling condoms from physically inaccessible places that require personnel assistance constitutes a barrier to access. This study investigates the extent of this barrier in the Bronx, a high HIV/STI prevalence county of New York. 75 of 320 listed Bronx pharmacies were sampled via computer randomization. Investigators coded condom placement and physical accessibility within these pharmacies and 140 surrounding stores. 91% of sites sold condoms. In 82%, condoms could not be accessed without assistance. Condoms were physically inaccessible in venues most encountered in the community: grocery stores versus pharmacies (OR=15; 95% CI, 5–48, independent versus chain pharmacies (OR=32; 95% CI, 6–235. They were physically inaccessible more in the lowest SES/highest HIV prevalence areas versus the highest SES/lowest HIV prevalence areas (OR = 4.3, 95% CI, 1.1–17. Findings can inform efforts to increase accessibility of condoms, distribute condoms in alternative settings, and prompt similar investigations in other high-risk communities.

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

    OpenAIRE

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

    2014-01-01

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

  19. High rates of child hypertension associated with obesity: a community survey in China, India and Mexico.

    Science.gov (United States)

    Dyson, Pamela A; Anthony, Denis; Fenton, Brenda; Matthews, David R; Stevens, Denise E

    2014-02-01

    Hypertension is a significant risk factor for cardiovascular disease, and epidemiological evidence suggests that it is increasing in parallel with obesity in children and adolescents in low- and middle-income countries. To identify and determine the relationship between overweight, obesity and hypertension in a community sample of school children. Anthropometric data were collected from 12,730 school children aged 12-18 years in China, India and Mexico as part of the Community Interventions for Health programme, an international study evaluating community interventions to reduce non-communicable disease by addressing the three main risk factors of tobacco use, unhealthy diets and physical inactivity. Logistic regression was used to examine the association of body mass index and gender and hypertension. Prevalence rates of hypertension were 5.2% in China, 10.1% in India and 14.1% in Mexico, and pre-hypertension rates in China, India and Mexico were 13.4%, 9.4% and 11.2%, respectively. Overweight and obesity prevalence rates varied by country and were 16.6% in China, 4.1% in India and 37.1% in Mexico. In all countries there was a significant association between overweight and obesity and rates of hypertension. Overweight children were 1.7-2.3 times more likely to be hypertensive and obese children 3.5-5.5 more likely to show hypertension than those of normal weight. Rates of hypertension and overweight and obesity are high in school children in China, India and Mexico, and increased bodyweight is a significant risk factor for hypertension.

  20. Pilot research project of risk communication on nuclear technology and its utilization. Toward communication and collaboration with community

    International Nuclear Information System (INIS)

    Tsuchiya, Tomoko

    2003-01-01

    Although the importance of risk communication has been pointed out over the last decade in nuclear community, both public authorities and nuclear industry have not conducted the definite actions yet. It will be reflected in the public eye that nuclear community's attitude toward communication and consultation with the public about risk issues is half-hearted, comparing with chemical and food safety fields which recently launched their risk communication activities. In this study, we conduct risk communication experiments on some risk issues associated with nuclear technology and its utilization in Tokai village, for the purpose of establishment of risk communication in our society that might be one of the new relationships between science and technology and society. The outcomes of FY2002 study are the following threefold; 1) preparation of risk communication experiments on nuclear technology and its utilization, 2) assessment of social effects of risk communication activities, 3) preparation of practical guidebook for risk communication experiments. (J.P.N.)

  1. Avoiding "culture rejection" in healthcare mergers and acquisitions: how New Heights Community Health Centres and York Community Services minimized the culture risk when forming Unison Health and Community Services.

    Science.gov (United States)

    Chan, Jeff

    2013-01-01

    Among the requirements for a successful merger or acquisition are strategic rationale, rigorous due diligence, the right price and revenue and cost synergies. However, bridging the culture gap between organizations is frequently overlooked. The leaders of New Heights Community Health Centres and York Community Services explicitly considered culture in their merger to form Unison Health and Community Services, and they used employee engagement surveys to assess culture in their merger planning and post-merger integration. How Unison Health leaders avoided the risk of culture rejection to achieve a successful merger, and the lessons learned from their experience, is the focus of this article.

  2. Social Determinants of Health in Environmental Justice Communities: Examining Cumulative Risk in Terms of Environmental Exposures and Social Determinants of Health

    OpenAIRE

    Prochaska, John D.; Nolen, Alexandra B.; Kelley, Hilton; Sexton, Ken; Linder, Stephen H.; Sullivan, John

    2014-01-01

    Residents of environmental justice (EJ) communities may bear a disproportionate burden of environmental health risk, and often face additional burdens from social determinants of health. Accounting for cumulative risk should include measures of risk from both environmental sources and social determinants. This study sought to better understand cumulative health risk from both social and environmental sources in a disadvantaged community in Texas. Key outcomes were determining what data are cu...

  3. Physical activity, obesity, weight change, and risk of atrial fibrillation: the Atherosclerosis Risk in Communities study.

    Science.gov (United States)

    Huxley, Rachel R; Misialek, Jeffrey R; Agarwal, Sunil K; Loehr, Laura R; Soliman, Elsayed Z; Chen, Lin Y; Alonso, Alvaro

    2014-08-01

    Physical activity (PA) has previously been suggested to attenuate the risk of atrial fibrillation (AF) conferred by excess body weight and weight gain. We prospectively examined the relationship between body size, weight change, and level of PA in a biracial cohort of middle-aged men and women. Baseline characteristics on risk factor levels were obtained on 14 219 participants from the Atherosclerosis Risk in Communities Study. AF incidence was ascertained from 1987 to 2009. Adjusted Cox proportional hazards models were used to estimate the associations between body mass index, waist circumference, relative weight change, and PA level with incident AF. During follow-up, there were 1775 cases of incident AF. Body mass index and waist circumference were positively associated with AF as was weight loss/gain of >5% initial body weight. An ideal level of PA had a small protective effect on AF risk and partially attenuated the risk of AF associated with excess weight in men but not women: compared with men with a normal body mass index, the risk of AF in obese men with an ideal, intermediate, and poor level of PA at baseline was increased by 37%, 129%, and 156% (Pinteraction=0.04). During follow-up, PA did not modify the association between weight gain and risk of AF. Obesity and extreme weight change are risk factors for incident AF, whereas being physically active is associated with a small reduction in risk. In men only, being physically active offset some, but not all, of the risk incurred with excess body weight. © 2014 American Heart Association, Inc.

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

    Science.gov (United States)

    Davis, J Allen; Burgoon, Lyle D

    2015-01-01

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

  5. Assessing awareness and knowledge of hypertension in an at-risk population in the Karen ethnic rural community, Thasongyang, Thailand

    Directory of Open Access Journals (Sweden)

    Aung MN

    2012-06-01

    Full Text Available Myo Nyein Aung,1,2 Thaworn Lorga,2 Janthila Srikrajang,2 Nongluk Promtingkran,2 Suchart Kreuangchai,2 Wilawan Tonpanya,2 Phatchanan Vivarakanon,2 Puangpet Jaiin,2 Nara Praipaksin,3 Apiradee Payaprom41Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan; 2Boromarajonani College of Nursing Nakhon Lampang (BCNLP, Lampang, Thailand; 3Baan Rekati Health Station, Thasongyang, Thailand; 4Thasongyang Hospital, ThailandBackground: Hypertension is currently a global health concern. Rural and minority populations are increasingly exposed to risk factors as a result of urbanization, leading to hypertension and cardiovascular disease. We conducted a survey in the rural Karen community in Thasongyang District, Tak Province, Thailand, with the aims of determining: the distribution of blood pressure across different age groups; the prevalence of hypertension and other risk factors for cardiovascular diseases (CVDs, including diabetes, smoking, sedentary lifestyle, and excess alcohol use; knowledge and awareness of hypertension as a disease; and knowledge and awareness of risk factors for hypertension among the population at risk.Methods: This was a community-based, cross-sectional survey of 298 rural Karen residents. A set of questionnaires assessing lifestyle-related health risk behaviors and awareness and knowledge of hypertension were used. Blood pressure, fasting plasma glucose, weight, height, and waist circumference were measured.Results: Median systolic and diastolic blood pressures were 110 (range 100–120 mmHg and 70 (range 60–80 mmHg, respectively. High blood pressure was observed in more than 27% of the population, with 15% being hypertensive and 12% being prehypertensive. Multinomial logistic regression analysis showed that people in the Karen community who were aware of hypertension were less likely to be current smokers (odds ratio [OR] 0.53, confidence interval [CI] 0.29–0.97 and those with primary

  6. Novel strategies lead to pre-elimination of malaria in previously high-risk areas in Suriname, South America

    Directory of Open Access Journals (Sweden)

    Hiwat Hélène

    2012-01-01

    Full Text Available Abstract Background Suriname was a high malaria risk country before the introduction of a new five-year malaria control program in 2005, the Medical Mission Malaria Programme (MM-MP. Malaria was endemic in the forested interior, where especially the stabile village communities were affected. Case description The interventions of the MM-MP included new strategies for prevention, vector control, case management, behavioral change communication (BCC/information, education and communication (IEC, and strengthening of the health system (surveillance, monitoring and evaluation and epidemic detection system. After a slow first year with non-satisfying scores for the performance indicators, the MM-MP truly engaged in its intervention activities in 2006 and kept its performance up until the end of 2009. A total of 69,994 long-lasting insecticide-treated nets were distributed and more than 15,000 nets re-impregnated. In high-risk areas, this was complemented with residual spraying of insecticides. Over 10,000 people were screened with active case detection in outbreak and high-risk areas. Additional notification points were established and the national health system was strengthened. Discussion and evaluation In the current paper, the MM-MP is evaluated both on account of the targets established within the programme and on account of its impact on the malaria situation in Suriname. Malaria vector populations, monitored in sentinel sites, collapsed after 2006 and concurrently the number of national malaria cases decreased from 8,618 in 2005 to 1,509 in 2009. Malaria transmission risk shifted from the stabile village communities to the mobile gold mining communities, especially those along the French Guiana border. Conclusions The novel strategies for malaria control introduced in Suriname within the MM-MP have led to a significant decrease in the national malaria burden. The challenge is to further reduce malaria using the available strategies as

  7. Novel strategies lead to pre-elimination of malaria in previously high-risk areas in Suriname, South America.

    Science.gov (United States)

    Hiwat, Hélène; Hardjopawiro, Loretta S; Takken, Willem; Villegas, Leopoldo

    2012-01-09

    Suriname was a high malaria risk country before the introduction of a new five-year malaria control program in 2005, the Medical Mission Malaria Programme (MM-MP). Malaria was endemic in the forested interior, where especially the stabile village communities were affected. The interventions of the MM-MP included new strategies for prevention, vector control, case management, behavioral change communication (BCC)/information, education and communication (IEC), and strengthening of the health system (surveillance, monitoring and evaluation and epidemic detection system). After a slow first year with non-satisfying scores for the performance indicators, the MM-MP truly engaged in its intervention activities in 2006 and kept its performance up until the end of 2009. A total of 69,994 long-lasting insecticide-treated nets were distributed and more than 15,000 nets re-impregnated. In high-risk areas, this was complemented with residual spraying of insecticides. Over 10,000 people were screened with active case detection in outbreak and high-risk areas. Additional notification points were established and the national health system was strengthened. In the current paper, the MM-MP is evaluated both on account of the targets established within the programme and on account of its impact on the malaria situation in Suriname. Malaria vector populations, monitored in sentinel sites, collapsed after 2006 and concurrently the number of national malaria cases decreased from 8,618 in 2005 to 1,509 in 2009. Malaria transmission risk shifted from the stabile village communities to the mobile gold mining communities, especially those along the French Guiana border. The novel strategies for malaria control introduced in Suriname within the MM-MP have led to a significant decrease in the national malaria burden. The challenge is to further reduce malaria using the available strategies as appropriate in the affected areas and populations. Elimination of malaria in the country will

  8. Managing forest disturbances and community responses: lessons from the Kenai Peninsula, Alaska.

    Science.gov (United States)

    Courtney G. Flint; Richard. Haynes

    2006-01-01

    Managing forest disturbances can be complicated by diverse human community responses. Interview and quantitative analysis of mail surveys were used to assess risk perceptions and community actions in response to forest disturbance by spruce bark beetles. Despite high risk perception of immediate threats to personal safety and property, risk perceptions of broader...

  9. Resuscitation of newborn in high risk deliveries

    International Nuclear Information System (INIS)

    Yousaf, U.F.; Hayat, S.

    2015-01-01

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

  10. High HIV prevalence and associated factors in a remote community in the Rwenzori region of Western Uganda

    Directory of Open Access Journals (Sweden)

    John Rubaihayo

    2010-10-01

    Full Text Available In Uganda, previous studies have shown a tremendous decline in HIV prevalence over the past two decades due to changes in sexual behavior with a greater awareness of the risks involved. However, studies in Fort-Portal municipality, a rural town in Western Uganda, continued to show a persistent high HIV prevalence despite the various interventions in place. We conducted a study to establish the current magnitude of HIV prevalence and the factors associated with HIV prevalence in this community. This cross-sectional study was conducted between July and November 2008. Participants were residents of Fort-Portal municipality aged 15-49 years. A population-based HIV sero-survey and a clinical review of prevention of mother to child HIV transmission (PMTCT and voluntary counseling and HIV Testing (VCT records were used to collect quantitative data. An inteviewer administered structured questionnaire was used to collect qualitative data on social deographics, risk behaviour and community perceptions. Focus group discussions (FGDs and in-depth interviews provided supplementary data on community perceptions. Logistic regression was used in the analysis. The overall HIV prevalence in the general population was 16.1% [95% CI; 12.5-20.6]. Prevalence was lower among women (14.5%; 95% CI; 10.0-19.7 but not significantly different from that among men (18.7%; 95% CI; 12.5-26.3 (c2=0.76, P=0.38. Having more than 2 sexual partners increased the odds of HIV by almost 2.5 times. None or low education and age over 35 years were independently associated with HIV prevalence (P<0.05. Most participants attributed the high HIV prevalence to promiscuity/multiple sexual partners (32.5%, followed by prostitution (13.6%, alcoholism (10.1%, carelessness (10.1%, poverty (9.7%, ignorance (9.5%, rape (4.7%, drug abuse (3.6% and others (malice/malevolence, laziness, etc. (6.2%. Although there was a slight decline compared to previous reports, the results from this study confirm

  11. Flood Risk, Flood Mitigation, and Location Choice: Evaluating the National Flood Insurance Program's Community Rating System.

    Science.gov (United States)

    Fan, Qin; Davlasheridze, Meri

    2016-06-01

    Climate change is expected to worsen the negative effects of natural disasters like floods. The negative impacts, however, can be mitigated by individuals' adjustments through migration and relocation behaviors. Previous literature has identified flood risk as one significant driver in relocation decisions, but no prior study examines the effect of the National Flood Insurance Program's voluntary program-the Community Rating System (CRS)-on residential location choice. This article fills this gap and tests the hypothesis that flood risk and the CRS-creditable flood control activities affect residential location choices. We employ a two-stage sorting model to empirically estimate the effects. In the first stage, individuals' risk perception and preference heterogeneity for the CRS activities are considered, while mean effects of flood risk and the CRS activities are estimated in the second stage. We then estimate heterogeneous marginal willingness to pay (WTP) for the CRS activities by category. Results show that age, ethnicity and race, educational attainment, and prior exposure to risk explain risk perception. We find significant values for the CRS-creditable mitigation activities, which provides empirical evidence for the benefits associated with the program. The marginal WTP for an additional credit point earned for public information activities, including hazard disclosure, is found to be the highest. Results also suggest that water amenities dominate flood risk. Thus, high amenity values may increase exposure to flood risk, and flood mitigation projects should be strategized in coastal regions accordingly. © 2015 Society for Risk Analysis.

  12. Risk perception in planning

    Energy Technology Data Exchange (ETDEWEB)

    Roh, S K

    1987-01-01

    The general public's perception of the risks involved with hazardous industries is increasing, especially in countries that high environmental amenity characteristics. This increased public awareness of risk may be an important factor in the future of countries who produce a large quantity of petroleum and chemical products. However, existing decision-making processes for determining safety controls do not take sufficient account of the community perception of risk. Identification of perceived risk levels could contribute to the determination of safe land-use planning policies and practices. The objective of land-use planning for hazardous industries is to reduce the gap between the calculated or technical assessment of risk and the risk as perceived by the community. This also facilitates a balanced approach in the decision making process between meeting industry requirements and community concerns. The comprehensive analysis presented in this study, based on a questionnaire given to residents in each of the three study areas (Australia, Japan and Korea), focused on identifying and measuring the respondent's understanding of the risk posed by nearby hazardous industrial developments.

  13. Gout in Older Adults: The Atherosclerosis Risk in Communities Study.

    Science.gov (United States)

    Burke, Bridget Teevan; Köttgen, Anna; Law, Andrew; Grams, Morgan; Baer, Alan N; Coresh, Josef; McAdams-DeMarco, Mara A

    2016-04-01

    It is unclear whether traditional and genetic risk factors in middle age predict the onset of gout in older age. We studied the incidence of gout in older adults using the Atherosclerosis Risk in Communities study, a prospective U.S. population-based cohort of middle-aged adults enrolled between 1987 and 1989 with ongoing follow-up. A genetic urate score was formed from common urate-associated single nucleotide polymorphisms for eight genes. The adjusted hazard ratio and 95% confidence interval of incident gout by traditional and genetic risk factors in middle age were estimated using a Cox proportional hazards model. The cumulative incidence from middle age to age 65 was 8.6% in men and 2.5% in women; by age 75 the cumulative incidence was 11.8% and 5.0%. In middle age, increased adiposity, beer intake, protein intake, smoking status, hypertension, diuretic use, and kidney function (but not sex) were associated with an increased gout risk in older age. In addition, a 100 µmol/L increase in genetic urate score was associated with a 3.29-fold (95% confidence interval: 1.63-6.63) increased gout risk in older age. These findings suggest that traditional and genetic risk factors in middle age may be useful for identifying those at risk of gout in older age. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Implementing Domestic Violence Gun Confiscation Policy in Rural and Urban Communities: Assessing the Perceived Risk, Benefits, and Barriers.

    Science.gov (United States)

    Lynch, Kellie R; Logan, T K

    2017-07-01

    The purpose of this study was to gain a deeper understanding of why communities differing in culture and resources are willing and able to implement gun confiscation as part of a protective order in the absence of a uniform statewide gun law. Specifically, the perceived risk of intimate partner homicide and gun violence, effectiveness of implementing gun confiscation, and the barriers to implementing gun confiscation were assessed. Interviews were conducted with key community professionals ( N = 133) who worked in victim services and the justice system in one urban community and four rural, under-resourced communities. Analyses revealed that professionals in the rural communities viewed the risk of intimate partner homicide and gun violence as lower, and the process of implementing gun confiscation as less effective than professionals in the urban community. In addition, urban justice system professionals, in comparison with all other professionals, reported fewer barriers to enforcing the gun confiscation police and were more likely to downplay law enforcement limitations in the community. The results have implications for developing more effective regional strategies in states that lack domestic violence gun laws as a means to increase a community's ability to enforce gun policies and initiatives.

  15. The Metabolic Syndrome and Risk of Sudden Cardiac Death: The Atherosclerosis Risk in Communities Study.

    Science.gov (United States)

    Hess, Paul L; Al-Khalidi, Hussein R; Friedman, Daniel J; Mulder, Hillary; Kucharska-Newton, Anna; Rosamond, Wayne R; Lopes, Renato D; Gersh, Bernard J; Mark, Daniel B; Curtis, Lesley H; Post, Wendy S; Prineas, Ronald J; Sotoodehnia, Nona; Al-Khatib, Sana M

    2017-08-23

    Prior studies have demonstrated a link between the metabolic syndrome and increased risk of cardiovascular mortality. Whether the metabolic syndrome is associated with sudden cardiac death is uncertain. We characterized the relationship between sudden cardiac death and metabolic syndrome status among participants of the ARIC (Atherosclerosis Risk in Communities) Study (1987-2012) free of prevalent coronary heart disease or heart failure. Among 13 168 participants, 357 (2.7%) sudden cardiac deaths occurred during a median follow-up of 23.6 years. Participants with the metabolic syndrome (n=4444) had a higher cumulative incidence of sudden cardiac death than those without it (n=8724) (4.1% versus 2.3%, P metabolic syndrome, the metabolic syndrome was independently associated with sudden cardiac death (hazard ratio, 1.70, 95% confidence interval, 1.37-2.12, P metabolic syndrome criteria components. The risk of sudden cardiac death varied according to the number of metabolic syndrome components (hazard ratio 1.31 per additional component of the metabolic syndrome, 95% confidence interval, 1.19-1.44, P metabolic syndrome was associated with a significantly increased risk of sudden cardiac death irrespective of sex or race. The risk of sudden cardiac death was proportional to the number of metabolic syndrome components. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  16. Identification and Characterization of Prodromal Risk Syndromes in Young Adolescents in the Community: A Population-Based Clinical Interview Study.

    LENUS (Irish Health Repository)

    2012-02-01

    While a great deal of research has been conducted on prodromal risk syndromes in relation to help-seeking individuals who present to the clinic, there is a lack of research on prodromal risk syndromes in the general population. The current study aimed first to establish whether prodromal risk syndromes could be detected in non-help-seeking community-based adolescents and secondly to characterize this group in terms of Axis-1 psychopathology and general functioning. We conducted in-depth clinical interviews with a population sample of 212 school-going adolescents in order to assess for prodromal risk syndromes, Axis-1 psychopathology, and global (social\\/occupational) functioning. Between 0.9% and 8% of the community sample met criteria for a risk syndrome, depending on varying disability criteria. The risk syndrome group had a higher prevalence of co-occurring nonpsychotic Axis-1 psychiatric disorders (OR = 4.77, 95% CI = 1.81-12.52; P < .01) and poorer global functioning (F = 24.5, df = 1, P < .0001) compared with controls. Individuals in the community who fulfill criteria for prodromal risk syndromes demonstrate strong similarities with clinically presenting risk syndrome patients not just in terms of psychotic symptom criteria but also in terms of co-occurring psychopathology and global functioning.

  17. Focus-on-Teens, sexual risk-reduction intervention for high-school adolescents: impact on knowledge, change of risk-behaviours, and prevalence of sexually transmitted diseases.

    Science.gov (United States)

    Gaydos, C A; Hsieh, Y-H; Galbraith, J S; Barnes, M; Waterfield, G; Stanton, B

    2008-10-01

    A community-based intervention, Focus-on-Kids (FOK) has demonstrated risk-behaviour reduction of urban youth. We modified FOK to Focus-on-Teens (FOT) for high schools. High school adolescents (n=1190) were enrolled over successive school semesters. The small-group sessions were presented during the school-lunch hours. Confidential surveys were conducted at baseline, immediate, six-, and 12-month postintervention for demographics, parental communication/monitoring, sexual risk behaviours and sexually transmitted diseases (STDs)/HIV/condom-usage knowledge. Sexually active participants were encouraged to volunteer for urine-based STDs testing at the School-Based Health Centres. Many (47.4%) students reported having had sexual intercourse at baseline. Overall behaviours changed towards 'safer' sex behaviours (intent-to-use and using condoms, communicating with partner/parents about sex/condoms/STDs) with time (Pcorrect knowledge of STDs/HIV increased to 88% at time 4 from 80% at baseline after adjusting for age, gender and sexual activity (Pcondom usage, decreases in sexual risk behaviours supported the effectiveness of this intervention.

  18. [Development of a portable fall risk index for elderly people living in the community].

    Science.gov (United States)

    Toba, Kenji; Okochi, Jiro; Takahashi, Tai; Matsubayashi, Kozo; Nishinaga, Masanori; Yamada, Shizuru; Takahashi, Ryutaro; Nishijima, Reiko; Kobayashi, Yoshio; Machida, Ayako; Akishita, Masahiro; Sasaki, Hidetada

    2005-05-01

    To develop a portable risk index for falls. Risk factors were chosen from previously established factors then we added several environmental factors to the risk index; previous falls in the last 12 month, trippig or stumbling, inability to ascend or descend stairs without help, decreased walking speed, inability to cross a road within the green signal interval, inability to walk 1km without a break, inability to stand on one leg for 5 seconds (eyes open), using a cane, inability to wring out a towel, dizziness or faintness, stooped or rounded back, knee joint pain, visual disturbance, hearing disturbance, cognitive decline, fear of falling, receiving 5 or more prescribed drugs, sensation of darkness at home, obstacles inside, barrier on the carpet or floor, using steps daily at home, steep slopes around home. The questionnaire sheet was completed by 2,439 community-dwelling elderly subjects (76.3 +/- 7.4 years old). The frequency of each items of fall risk index was compared between fallers (history of fall within one year) and non-fallers. Multiple regression analysis was performed to identify independent risk factors for previous falls. Except barrier, step use and steep slope around home, all items in the fall risk index were more frequent in fallers. Multivariate analysis revealed that tripping or stumbling, inability to cross a road within the green signal interval, dizziness or faintness, obstacles inside, inability to wring out a towel, cane use and knee joint pain were independent risk factors for previous falls. These 7 selected items were further analyzed as predictors. The maximum sum of sensitivity and specificity was reached at the cut-off point of 2/3 (sensitivity 0.65, specificity 0.72) by receiver operating curve. Portable fall risk index is useful for clinical settings to identify high-risk subjects.

  19. Clinical risk stratification optimizes value of biomarkers to predict new-onset heart failure in a community-based cohort.

    Science.gov (United States)

    Brouwers, Frank P; van Gilst, Wiek H; Damman, Kevin; van den Berg, Maarten P; Gansevoort, Ron T; Bakker, Stephan J L; Hillege, Hans L; van Veldhuisen, Dirk J; van der Harst, Pim; de Boer, Rudolf A

    2014-09-01

    We aim to identify and quantify the value of biomarkers for incident new-onset heart failure (HF) in a community-based cohort and subgroups based on cardiovascular risk and evaluate the prognostic value of 13 biomarkers for HF with reduced and preserved ejection fraction. Thirteen biomarkers reflecting diverse pathophysiologic domains were examined in 8569 HF-free participants in Prevention of Vascular and Renal Endstage Disease (mean age, 49 years; 50% men). Subjects were categorized in 2 risk groups based on cardiovascular history. Incremental value per biomarker was assessed using Harrell C-indices. One hundred sixty-eight subjects (2.4%) were diagnosed with new-onset HF in the low-risk group (n=6915; Framingham Risk Score, 5.9%) and 206 (12.2%) subjects in the high-risk group (n=1654; Framingham Risk Score, 18.6%). The association of natriuretic peptides, adrenomedullin, endothelin, and galectin-3 with new-onset HF was stronger in the high-risk group (all Prisk for new-onset HF between both risk groups. The best model for new-onset HF included the combination of N-terminal pro-B-type natriuretic peptide, troponin-T, and urinary albumin excretion, increasing model accuracy to 0.81 (9.5%, Prisk group. Except for a modest effect of cystatin-C, no biomarker was associated with increased risk for HF with preserved ejection fraction. Risk stratification increases the incremental value per biomarker to predict new-onset HF, especially HF with reduced ejection fraction. We suggest that routine biomarker testing should be limited to the use of natriuretic peptides and troponin-T in patients with increased cardiovascular risk. © 2014 American Heart Association, Inc.

  20. Walking the Leadership Tightrope: Building Community Cohesiveness and Social Capital in Schools in Highly Disadvantaged Urban Communities

    Science.gov (United States)

    Riley, Kathryn A.

    2013-01-01

    School leaders in highly disadvantaged urban communities across the globe walk a tightrope, caught between the needs of communities and the requirements of national policies. This article aims to enrich our understanding of the potential of school-community relationships. It examines the policy discourse on urban schools and the practice of…

  1. Brain function and structure and risk for incident diabetes: The Atherosclerosis Risk in Communities Study.

    Science.gov (United States)

    Bancks, Michael P; Alonso, Alvaro; Gottesman, Rebecca F; Mosley, Thomas H; Selvin, Elizabeth; Pankow, James S

    2017-12-01

    Diabetes is prospectively associated with cognitive decline. Whether lower cognitive function and worse brain structure are prospectively associated with incident diabetes is unclear. We analyzed data for 10,133 individuals with cognitive function testing (1990-1992) and 1212 individuals with brain magnetic resonance imaging (1993-1994) from the Atherosclerosis Risk in Communities cohort. We estimated hazard ratios for incident diabetes through 2014 after adjustment for traditional diabetes risk factors and cohort attrition. Higher level of baseline cognitive function was associated with lower risk for diabetes (per 1 standard deviation, hazard ratio = 0.94; 95% confidence interval = 0.90, 0.98). This association did not persist after accounting for baseline glucose level, case ascertainment methods, and cohort attrition. No association was observed between any brain magnetic resonance imaging measure and incident diabetes. This is one of the first studies to prospectively evaluate the association between both cognitive function and brain structure and the incidence of diabetes. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  2. Sampling from complex networks with high community structures.

    Science.gov (United States)

    Salehi, Mostafa; Rabiee, Hamid R; Rajabi, Arezo

    2012-06-01

    In this paper, we propose a novel link-tracing sampling algorithm, based on the concepts from PageRank vectors, to sample from networks with high community structures. Our method has two phases; (1) Sampling the closest nodes to the initial nodes by approximating personalized PageRank vectors and (2) Jumping to a new community by using PageRank vectors and unknown neighbors. Empirical studies on several synthetic and real-world networks show that the proposed method improves the performance of network sampling compared to the popular link-based sampling methods in terms of accuracy and visited communities.

  3. HIV Risk Perception, Sexual Behavior, and HIV Prevalence among Men-Who-Have-Sex-with-Men at a Community-Based Voluntary Counseling and Testing Center in Kuala Lumpur, Malaysia.

    Science.gov (United States)

    Koh, Kwee Choy; Yong, Lit Sin

    2014-01-01

    We describe the HIV risk perception, sexual behavior, and HIV prevalence among 423 men-who-have-sex-with-men (MSM) clients who received voluntary counseling and testing (VCT) services at a community-based center in Kuala Lumpur, Malaysia. The mean age was 29 years old. One hundred one (23.9%) clients rated themselves as low risk, 118 (27.9%) as medium risk, 36 (8.5%) as high risk, and 168 (39.7%) were unsure of their risk. Twenty-four (9.4%) clients tested HIV positive (4 (4%) low risk, 9 (7.6%) medium risk, 11 (30.6%) high risk, and 13 (7.7%) unsure risk). We found a positive correlation between risk perception and HIV infection in this study. Clients with high HIV risk perception have 17x the odds of testing HIV positive compared to low risk clients. High HIV risk perception was significantly associated with multiple sex partners, multiple types of sex partners, alcohol use before intercourse, unprotected sex beyond 6 months, and inconsistent condom use during anal sex compared to low risk clients. There were no statistically significant differences between medium risk and unsure risk clients compared to low risk clients. Strategies should be targeted towards change in sexual practices among those who are perceived to be at high risk.

  4. Dietary Protein Sources and Risk for Incident Chronic Kidney Disease: Results From the Atherosclerosis Risk in Communities (ARIC) Study.

    Science.gov (United States)

    Haring, Bernhard; Selvin, Elizabeth; Liang, Menglu; Coresh, Josef; Grams, Morgan E; Petruski-Ivleva, Natalia; Steffen, Lyn M; Rebholz, Casey M

    2017-07-01

    Dietary protein restriction is recommended for patients with moderate to severe renal insufficiency. Long-term data on the relationship between dietary protein sources and risk for incident kidney disease in individuals with normal kidney function are largely missing. This study aimed to assess the association between dietary protein sources and incident chronic kidney disease (CKD). Prospective cohort. Atherosclerosis Risk in Communities study participants from 4 US communities. A total of 11,952 adults aged 44-66 years in 1987-1989 who were free of diabetes mellitus, cardiovascular disease, and had an estimated glomerular filtration rate (eGFR) ≥ 60 mL/minute/1.73 m 2 . A 66-item food frequency questionnaire was used to assess food intake. CKD stage 3 was defined as a decrease in eGFR of ≥25% from baseline resulting in an eGFR of less than 60 mL/minute/1.73 m 2 ; CKD-related hospitalization; CKD-related death; or end-stage renal disease. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression. During a median follow-up of 23 years, there were 2,632 incident CKD cases. Red and processed meat consumption was associated with increased CKD risk (HR Q5 vs. Q1 : 1.23, 95% CI: 1.06-1.42, p trend  = 0.01). In contrast, higher dietary intake of nuts, legumes, and low-fat dairy products was associated with lower CKD risk (nuts: HR Q5 vs. Q1 : 0.81, 95% CI: 0.72-0.92, p trend protein sources with risk of incident CKD; with red and processed meat being adversely associated with CKD risk; and nuts, low-fat dairy products, and legumes being protective against the development of CKD. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  5. Fall risks assessment among community dwelling elderly using wearable wireless sensors

    Science.gov (United States)

    Lockhart, Thurmon E.; Soangra, Rahul; Frames, Chris

    2014-06-01

    Postural stability characteristics are considered to be important in maintaining functional independence free of falls and healthy life style especially for the growing elderly population. This study focuses on developing tools of clinical value in fall prevention: 1) Implementation of sensors that are minimally obtrusive and reliably record movement data. 2) Unobtrusively gather data from wearable sensors from four community centers 3) developed and implemented linear and non-linear signal analysis algorithms to extract clinically relevant information using wearable technology. In all a total of 100 community dwelling elderly individuals (66 non-fallers and 34 fallers) participated in the experiment. All participants were asked to stand-still in eyes open (EO) and eyes closed (EC) condition on forceplate with one wireless inertial sensor affixed at sternum level. Participants' history of falls had been recorded for last 2 years, with emphasis on frequency and characteristics of falls. Any participant with at least one fall in the prior year were classified as faller and the others as non-faller. The results indicated several key factors/features of postural characteristics relevant to balance control and stability during quite stance and, showed good predictive capability of fall risks among older adults. Wearable technology allowed us to gather data where it matters the most to answer fall related questions, i.e. the community setting environments. This study opens new prospects of clinical testing using postural variables with a wearable sensor that may be relevant for assessing fall risks at home and patient environment in near future.

  6. The Perception of Volcanic Risk in Kona Communities from Mauna Loa and Hualalai Volcanoes, Hawai`i

    Science.gov (United States)

    Gregg, C. E.; Houghton, B. F.; Johnston, D. M.; Paton, D.; Swanson, D. A.

    2002-12-01

    Hawai`i's coastal communities are becoming increasingly vulnerable to natural hazards as a consequence of increasing population and infrastructure. Volcanic hazards in Kona (i.e., western side of the island) stem primarily from Mauna Loa and Hualalai volcanoes. The former has erupted thirty-nine times since 1832. Lava flows were emplaced in Kona during six of these, but last impacted Kona in 1950. Hualalai last erupted in c. 1800. The most recent eruptions at each volcano were damaging to society, but future eruptions would exact much greater impacts. The second largest city on the island, several resort complexes, and an international airport are located within 15 km of vents. Society's proximity to potential eruptive sources, a potential for relatively fast moving lavas, and the relatively long time intervals since the last eruptions in Kona, are the stimuli for this study of risk perception. Target populations were high school students and their parents, and the greater adult public (n=462). Using this data, we discuss threat knowledge as an influence on risk perception and perceptions as a driving mechanism for preparedness. Threat knowledge and perception of risk were found to be low to moderate. On average less than two-thirds of residents were aware of the most recent eruptions that impacted Kona and a minority felt that Mauna Loa and Hualalai could erupt again. Furthermore, only about one-third were aware that lava flows could reach the coast in Kona in under three hours. Lava flows and ash fall were perceived to be among the least likely hazards to affect the respondent's community. Not unexpectedly, individual preparedness measures were found to be limited to simple tasks, while measures specific to infrequent hazard events such as volcanic eruptions and earthquakes were seldom adopted. Respondents exhibit an "unrealistic optimism bias" and infer that responsibility for community preparedness for future eruptions rests primarily with officials. Hazard

  7. HIV Risk Perception, Sexual Behavior, and HIV Prevalence among Men-Who-Have-Sex-with-Men at a Community-Based Voluntary Counseling and Testing Center in Kuala Lumpur, Malaysia

    OpenAIRE

    Koh, Kwee Choy; Yong, Lit Sin

    2014-01-01

    We describe the HIV risk perception, sexual behavior, and HIV prevalence among 423 men-who-have-sex-with-men (MSM) clients who received voluntary counseling and testing (VCT) services at a community-based center in Kuala Lumpur, Malaysia. The mean age was 29 years old. One hundred one (23.9%) clients rated themselves as low risk, 118 (27.9%) as medium risk, 36 (8.5%) as high risk, and 168 (39.7%) were unsure of their risk. Twenty-four (9.4%) clients tested HIV positive (4 (4%) low risk, 9 (7....

  8. Coral community response to bleaching on a highly disturbed reef.

    Science.gov (United States)

    Guest, J R; Low, J; Tun, K; Wilson, B; Ng, C; Raingeard, D; Ulstrup, K E; Tanzil, J T I; Todd, P A; Toh, T C; McDougald, D; Chou, L M; Steinberg, P D

    2016-02-15

    While many studies of coral bleaching report on broad, regional scale responses, fewer examine variation in susceptibility among coral taxa and changes in community structure, before, during and after bleaching on individual reefs. Here we report in detail on the response to bleaching by a coral community on a highly disturbed reef site south of mainland Singapore before, during and after a major thermal anomaly in 2010. To estimate the capacity for resistance to thermal stress, we report on: a) overall bleaching severity during and after the event, b) differences in bleaching susceptibility among taxa during the event, and c) changes in coral community structure one year before and after bleaching. Approximately two thirds of colonies bleached, however, post-bleaching recovery was quite rapid and, importantly, coral taxa that are usually highly susceptible were relatively unaffected. Although total coral cover declined, there was no significant change in coral taxonomic community structure before and after bleaching. Several factors may have contributed to the overall high resistance of corals at this site including Symbiodinium affiliation, turbidity and heterotrophy. Our results suggest that, despite experiencing chronic anthropogenic disturbances, turbid shallow reef communities may be remarkably resilient to acute thermal stress.

  9. Preliminary Efficacy of Adapted Responsive Teaching for Infants at Risk of Autism Spectrum Disorder in a Community Sample

    Directory of Open Access Journals (Sweden)

    Grace T. Baranek

    2015-01-01

    Full Text Available This study examined the (a feasibility of enrolling 12-month-olds at risk of ASD from a community sample into a randomized controlled trial, (b subsequent utilization of community services, and (c potential of a novel parent-mediated intervention to improve outcomes. The First Year Inventory was used to screen and recruit 12-month-old infants at risk of ASD to compare the effects of 6–9 months of Adapted Responsive Teaching (ART versus referral to early intervention and monitoring (REIM. Eighteen families were followed for ~20 months. Assessments were conducted before randomization, after treatment, and at 6-month follow-up. Utilization of community services was highest for the REIM group. ART significantly outperformed REIM on parent-reported and observed measures of child receptive language with good linear model fit. Multiphase growth models had better fit for more variables, showing the greatest effects in the active treatment phase, where ART outperformed REIM on parental interactive style (less directive, child sensory responsiveness (less hyporesponsive, and adaptive behavior (increased communication and socialization. This study demonstrates the promise of a parent-mediated intervention for improving developmental outcomes for infants at risk of ASD in a community sample and highlights the utility of earlier identification for access to community services earlier than standard practice.

  10. Determinants of Mental Health Care Utilization in a Suicide High-risk Group With Suicidal Ideation

    Directory of Open Access Journals (Sweden)

    Hyun-Soo Kim

    2016-01-01

    Full Text Available Objectives: The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide. Methods: Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization. Results: The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size. Conclusions: It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.

  11. Determinants of Mental Health Care Utilization in a Suicide High-risk Group With Suicidal Ideation.

    Science.gov (United States)

    Kim, Hyun-Soo; Lee, Moo-Sik; Hong, Jee-Young

    2016-01-01

    The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide. Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization. The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size. It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.

  12. Decision Tree Identified Risk Groups with High Suicidal Ideation in South Korea: A Population-Based Study.

    Science.gov (United States)

    Kim, Hyun Kyung; Kim, Ji Young; Kim, Jong Hyen; Hyoung, Hee Kyoung

    2016-01-01

    The aim of this study was to identify risk groups with high suicidal ideation among South Korean adults. A descriptive cross-sectional design was adopted using secondary data from the 2011 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 5,963 adults aged 19 years and older who participated in the 2011 KNHANES served as participants. The prevalence of suicidal ideation and its related factors, including physical, psychological, health behavioral, and sociodemographic characteristics, were examined. Descriptive statistics and a decision tree were used for data analysis. Nine groups with high suicidal ideation were identified. The coexistence of depression and high levels of stress increased the prevalence of suicidal ideation. The highest risk group was widowed or divorced adults with depression and high levels of stress, and 82.5% of these participants had suicidal ideation (the prevalence rate of this group was 5.7 times higher than the mean suicidal ideation prevalence rate in this study). Public health nurses and community mental health professionals should recognize risk groups with high suicidal ideation, and target these groups when implementing preventive interventions. © 2015 Wiley Periodicals, Inc.

  13. Depression and blood pressure in high-risk children and adolescents: an investigation using two longitudinal cohorts

    Science.gov (United States)

    Hammerton, Gemma; Harold, Gordon; Thapar, Anita; Thapar, Ajay

    2013-01-01

    Objective To examine the relationship between blood pressure and depressive disorder in children and adolescents at high risk for depression. Design Multisample longitudinal design including a prospective longitudinal three-wave high-risk study of offspring of parents with recurrent depression and an on-going birth cohort for replication. Setting Community-based studies. Participants High-risk sample includes 281 families where children were aged 9–17 years at baseline and 10–19 years at the final data point. Replication cohort includes 4830 families where children were aged 11–14 years at baseline and 14–17 years at follow-up and a high-risk subsample of 612 offspring with mothers that had reported recurrent depression. Main outcome measures The new-onset of Diagnostic and Statistical Manual of Mental Disorder, fourth edition defined depressive disorder in the offspring using established research diagnostic assessments—the Child and Adolescent Psychiatric Assessment in the high-risk sample and the Development and Wellbeing Assessment in the replication sample. Results Blood pressure was standardised for age and gender to create SD scores and child's weight was statistically controlled in all analyses. In the high-risk sample, lower systolic blood pressure at wave 1 significantly predicted new-onset depressive disorder in children (OR=0.65, 95% CI 0.44 to 0.96; p=0.029) but diastolic blood pressure did not. Depressive disorder at wave 1 did not predict systolic blood pressure at wave 3. A significant association between lower systolic blood pressure and future depression was also found in the replication cohort in the second subset of high-risk children whose mothers had experienced recurrent depression in the past. Conclusions Lower systolic blood pressure predicts new-onset depressive disorder in the offspring of parents with depression. Further studies are needed to investigate how this association arises. PMID:24071459

  14. Using public relations strategies to prompt populations at risk to seek health information: the Hanford Community Health Project.

    Science.gov (United States)

    Thomas, Gregory D; Smith, Stephen M; Turcotte, Joseph A

    2009-01-01

    The Hanford Community Health Project (HCHP) addressed health concerns among "downwinders" exposed to releases of radioactive iodine (I-131) from the Hanford Nuclear Reservation in the 1940s and 1950s. After developing educational materials and conducting initial outreach, HCHP had to decide whether to apply its limited resources to an advertising or public relations approach. The decision to apply public relations strategies was effective in driving awareness of the risk communication message at the community level, reinvigorating the affected community, and ultimately increasing the number of people who sought information about their risk of exposure and related health issues. HCHP used a series of communication tools to reach out to local and regional media, medical and health professionals, and community organizations. The campaign was successful in increasing the number of unique visitors to HCHP Web site and educating and activating the medical community around the releases of I-131 and patient care choices.

  15. An intervention to improve care and reduce costs for high-risk patients with frequent hospital admissions: a pilot study

    Directory of Open Access Journals (Sweden)

    Kostrowski Shannon

    2011-10-01

    Full Text Available Abstract Background A small percentage of high-risk patients accounts for a large proportion of Medicaid spending in the United States, which has become an urgent policy issue. Our objective was to pilot a novel patient-centered intervention for high-risk patients with frequent hospital admissions to determine its potential to improve care and reduce costs. Methods Community and hospital-based care management and coordination intervention with pre-post analysis of health care utilization. We enrolled Medicaid fee-for-service patients aged 18-64 who were admitted to an urban public hospital and identified as being at high risk for hospital readmission by a validated predictive algorithm. Enrolled patients were evaluated using qualitative and quantitative interview techniques to identify needs such as transportation to/advocacy during medical appointments, mental health/substance use treatment, and home visits. A community housing partner initiated housing applications in-hospital for homeless patients. Care managers facilitated appropriate discharge plans then worked closely with patients in the community using a harm reduction approach. Results Nineteen patients were enrolled; all were male, 18/19 were substance users, and 17/19 were homeless. Patients had a total of 64 inpatient admissions in the 12 months before the intervention, versus 40 in the following 12 months, a 37.5% reduction. Most patients (73.3% had fewer inpatient admissions in the year after the intervention compared to the prior year. Overall ED visits also decreased after study enrollment, while outpatient clinic visits increased. Yearly study hospital Medicaid reimbursements fell an average of $16,383 per patient. Conclusions A pilot intervention for high-cost patients shows promising results for health services usage. We are currently expanding our model to serve more patients at additional hospitals to see if the pilot's success can be replicated. Trial registration

  16. Functional Traits, Flocking Propensity, and Perceived Predation Risk in an Amazonian Understory Bird Community.

    Science.gov (United States)

    Martínez, Ari E; Gomez, Juan P; Ponciano, José Miguel; Robinson, Scott K

    2016-05-01

    Within a community, different species might share similar predation risks, and, thus, the ability of species to signal and interpret heterospecific threat information may determine species' associations. We combined observational, experimental, and phylogenetic approaches to determine the extent to which evolutionary history and functional traits determined flocking propensity and perceived predation risk (response to heterospecific alarm calls) in a lowland Amazonian bird community. We predicted that small birds that feed myopically and out in the open would have higher flocking propensities and account for a higher proportion of positive responses to alarms. Using generalized linear models and the incorporation of phylogeny on data from 56 species, our results suggest that phylogenetic relationships alongside body size, foraging height, vegetation density, and response to alarm calls influence flocking propensity. Conversely, phylogenetic relationships did not influence response to heterospecific alarm calls. Among functional traits, however, foraging strategy, foraging density, and flocking propensity partially explained responses to alarm calls. Our results suggest that flocking propensity and perceived predation risk are positively related and that functional ecological traits and evolutionary history may explain certain species' associations.

  17. The high-risk plaque initiative

    DEFF Research Database (Denmark)

    Falk, Erling; Sillesen, Henrik; Muntendam, Pieter

    2011-01-01

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

  18. Risk factors for community-acquired bacterial meningitis

    DEFF Research Database (Denmark)

    Lundbo, Lene Fogt; Benfield, Thomas

    2017-01-01

    of these are pathogen-specific, while some are shared between different bacteria. METHODS: We searched the database PubMed to identify host risk factors for bacterial meningitis caused by the pathogens Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b, because they are three most common...... causative bacteria beyond the neonatal period. RESULTS: We describe a number of risk factors; including socioeconomic factors, age, genetic variation of the host and underlying medical conditions associated with increased susceptibility to invasive bacterial infections in both children and adults....... CONCLUSIONS: As conjugated vaccines are available for these infections, it is of utmost importance to identify high risk patients to be able to prevent invasive disease....

  19. Outcome evaluation of a community center-based program for mothers at high psychosocial risk.

    Science.gov (United States)

    Rodrigo, María José; Máiquez, María Luisa; Correa, Ana Delia; Martín, Juan Carlos; Rodríguez, Guacimara

    2006-09-01

    This study reported the outcome evaluation of the "Apoyo Personal y Familiar" (APF) program for poorly-educated mothers from multi-problem families, showing inadequate behavior with their children. APF is a community-based multi-site program delivered through weekly group meetings in municipal resource centers. A total of 340 mothers referred by the municipal social services of Tenerife, Spain were assessed; 185 mothers participated in the APF program that lasted 8 months, and 155 mothers were in the control group. Pre-post test comparisons for the intervention group and post-test comparisons with the control group on self-rating measures of maternal beliefs, personal agency and child-rearing practices were performed. Multivariate tests, t tests and effect sizes (ES) were calculated to determine the program effectiveness on the outcome measures. Mothers' support of nurturist and nativist beliefs and the reported use of Neglect-permissive and Coercive practices significantly decreased after program completion whereas the reported use of Inductive practices significantly increased. Increases in self-efficacy, internal control and role difficulty were also significant in relation to those of the control group. The program was especially effective for older mothers, with fewer children, living in a two-parent family, in urban areas and with either low or medium educational levels. The program was very effective in changing the mothers' perceived competences and modestly effective in changing their beliefs about child development and education and reported child-rearing practices. Changes in personal agency are very important for at-risk parents who feel helpless and with no control over their lives.

  20. Testing the Cuckoldry Risk Hypothesis of Partner Sexual Coercion in Community and Forensic Samples

    Directory of Open Access Journals (Sweden)

    Joseph A. Camilleri

    2009-04-01

    Full Text Available Evolutionary theory has informed the investigation of male sexual coercion but has seldom been applied to the analysis of sexual coercion within established couples. The cuckoldry risk hypothesis, that sexual coercion is a male tactic used to reduce the risk of extrapair paternity, was tested in two studies. In a community sample, indirect cues of infidelity predicted male propensity for sexual coaxing in the relationship, and direct cues predicted propensity for sexual coercion. In the forensic sample, we found that most partner rapists experienced cuckoldry risk prior to committing their offence and experienced more types of cuckoldry risk events than non-sexual partner assaulters. These findings suggest that cuckoldry risk influences male sexual coercion in established sexual relationships.

  1. Strength and balance training for adults with peripheral neuropathy and high risk of fall: current evidence and implications for future research.

    Science.gov (United States)

    Tofthagen, Cindy; Visovsky, Constance; Berry, Donna L

    2012-09-01

    To evaluate the evidence for strength- and balance-training programs in patients at high risk for falls, discuss how results of existing studies might guide clinical practice, and discuss directions for additional research. A search of PubMed and CINAHL® databases was conducted in June 2011 using the terms strength, balance training, falls, elderly, and neuropathy. Only clinical trials conducted using specific strength- or balance-training exercises that included community-dwelling adults and examined falls, fall risk, balance, and/or strength as outcome measures were included in this review. One matched case-control study and two randomized, controlled studies evaluating strength and balance training in patients with diabetes-related peripheral neuropathy were identified. Eleven studies evaluating strength and balance programs in community-dwelling adults at high risk for falls were identified. The findings from the reviewed studies provide substantial evidence to support the use of strength and balance training for older adults at risk for falls, and detail early evidence to support strength and balance training for individuals with peripheral neuropathy. The evidence demonstrates that strength and balance training is safe and effective at reducing falls and improving lower extremity strength and balance in adults aged 50 years and older at high risk for falls, including patients with diabetic peripheral neuropathy. Future studies should evaluate the effects of strength and balance training in patients with cancer, particularly individuals with chemotherapy-induced peripheral neuropathy.

  2. Salud Para Su Corazon (health for your heart) community health worker model: community and clinical approaches for addressing cardiovascular disease risk reduction in Hispanics/Latinos.

    Science.gov (United States)

    Balcazar, H; Alvarado, M; Ortiz, G

    2011-01-01

    This article describes 6 Salud Para Su Corazon (SPSC) family of programs that have addressed cardiovascular disease risk reduction in Hispanic communities facilitated by community health workers (CHWs) or Promotores de Salud (PS). A synopsis of the programs illustrates the designs and methodological approaches that combine community-based participatory research for 2 types of settings: community and clinical. Examples are provided as to how CHWs can serve as agents of change in these settings. A description is presented of a sustainability framework for the SPSC family of programs. Finally, implications are summarized for utilizing the SPSC CHW/PS model to inform ambulatory care management and policy.

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

    Science.gov (United States)

    Mueck, Krislynn M; Kao, Lillian S

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

  4. HIV Risk Perception, Sexual Behavior, and HIV Prevalence among Men-Who-Have-Sex-with-Men at a Community-Based Voluntary Counseling and Testing Center in Kuala Lumpur, Malaysia

    Directory of Open Access Journals (Sweden)

    Kwee Choy Koh

    2014-01-01

    Full Text Available We describe the HIV risk perception, sexual behavior, and HIV prevalence among 423 men-who-have-sex-with-men (MSM clients who received voluntary counseling and testing (VCT services at a community-based center in Kuala Lumpur, Malaysia. The mean age was 29 years old. One hundred one (23.9% clients rated themselves as low risk, 118 (27.9% as medium risk, 36 (8.5% as high risk, and 168 (39.7% were unsure of their risk. Twenty-four (9.4% clients tested HIV positive (4 (4% low risk, 9 (7.6% medium risk, 11 (30.6% high risk, and 13 (7.7% unsure risk. We found a positive correlation between risk perception and HIV infection in this study. Clients with high HIV risk perception have 17x the odds of testing HIV positive compared to low risk clients. High HIV risk perception was significantly associated with multiple sex partners, multiple types of sex partners, alcohol use before intercourse, unprotected sex beyond 6 months, and inconsistent condom use during anal sex compared to low risk clients. There were no statistically significant differences between medium risk and unsure risk clients compared to low risk clients. Strategies should be targeted towards change in sexual practices among those who are perceived to be at high risk.

  5. The association between neighborhood socioeconomic disadvantage and high-risk injection behavior among people who inject drugs.

    Science.gov (United States)

    DeCuir, Jennifer; Lovasi, Gina S; El-Sayed, Abdulrahman; Lewis, Crystal Fuller

    2018-02-01

    Although much research has been conducted on the determinants of HIV risk behavior among people who inject drugs (PWID), the influence of the neighborhood context on high-risk injection behavior remains understudied. To address this gap in the literature, we measured associations between neighborhood socioeconomic disadvantage and high-risk injection behavior, and determined whether these associations were modified by drug-related police activity and syringe exchange program (SEP) accessibility. Our sample was comprised of 484 pharmacy-recruited PWID in New York City. Measures of neighborhood socioeconomic disadvantage were created using data from the 2006-2010 American Community Survey. Associations with high-risk injection behavior were estimated using multivariable Poisson regression. Effect modification by drug-related police activity and SEP accessibility was assessed by entering cross-product terms into adjusted models of high-risk injection behavior. Neighborhood socioeconomic disadvantage was associated with decreased receptive syringe sharing and unsterile syringe use. In neighborhoods with high drug-related police activity, associations between neighborhood disadvantage and unsterile syringe use were attenuated to the null. In neighborhoods with high SEP accessibility, neighborhood disadvantage was associated with decreased acquisition of syringes from an unsafe source. PWID in disadvantaged neighborhoods reported safer injection behaviors than their counterparts in neighborhoods that were relatively better off. The contrasting patterns of effect modification by SEP accessibility and drug-related police activity support the use of harm reduction approaches over law enforcement-based strategies for the control of blood borne virus transmission among PWID in disadvantaged urban areas. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. High School Journalism Research: Community College Program Implications.

    Science.gov (United States)

    Dvorak, Jack

    1987-01-01

    Reviews findings from a Journalism Education Association study comparing the American College Testing (ACT) Program standardized scores, writing samples, and Language Arts Survey responses of students who were involved in high school journalism programs with students who were not. Urges community college journalism educators to support high school…

  7. Risk prediction in the community: A systematic review of case-finding instruments that predict adverse healthcare outcomes in community-dwelling older adults.

    LENUS (Irish Health Repository)

    O'Caoimh, Rónán

    2015-09-01

    Few case-finding instruments are available to community healthcare professionals. This review aims to identify short, valid instruments that detect older community-dwellers risk of four adverse outcomes: hospitalisation, functional-decline, institutionalisation and death. Data sources included PubMed and the Cochrane library. Data on outcome measures, patient and instrument characteristics, and trial quality (using the Quality In Prognosis Studies [QUIPS] tool), were double-extracted for derivation-validation studies in community-dwelling older adults (>50 years). Forty-six publications, representing 23 unique instruments, were included. Only five were externally validated. Mean patient age range was 64.2-84.6 years. Most instruments n=18, (78%) were derived in North America from secondary analysis of survey data. The majority n=12, (52%), measured more than one outcome with hospitalisation and the Probability of Repeated Admission score the most studied outcome and instrument respectively. All instruments incorporated multiple predictors. Activities of daily living n=16, (70%), was included most often. Accuracy varied according to instruments and outcomes; area under the curve of 0.60-0.73 for hospitalisation, 0.63-0.78 for functional decline, 0.70-0.74 for institutionalisation and 0.56-0.82 for death. The QUIPS tool showed that 5\\/23 instruments had low potential for bias across all domains. This review highlights the present need to develop short, reliable, valid instruments to case-find older adults at risk in the community.

  8. Are Outness and Community Involvement Risk or Protective Factors for Alcohol and Drug Abuse Among Sexual Minority Women?

    Science.gov (United States)

    Feinstein, Brian A; Dyar, Christina; London, Bonita

    2017-07-01

    Sexual minority women (SMW) are at increased risk for substance abuse compared to heterosexual women. Two psychosocial factors that have been implicated in SMW's substance abuse are outness and LGBT community involvement, but findings have been mixed as to whether these are risk or protective factors. One possible explanation is that they may have different consequences for subgroups of SMW (lesbians, bisexual women, and queer women). While being open about one's sexual orientation and involved in the community may be protective for lesbians, discrimination against bisexual women may lead these same factors to contribute to substance abuse for bisexual women. It is unclear how these associations will operate for queer women, given limited research on this subpopulation. The current study examined whether sexual identity moderated the associations between outness and community involvement with alcohol and drug abuse. We also examined whether perceived discrimination would help explain why these associations may be different for subgroups of SMW. A sample of 288 self-identified SMW (113 lesbians, 106 bisexual women, and 69 queer women) completed an online survey. Higher outness was associated with higher alcohol and drug abuse for bisexual women, but not for lesbians or queer women. Similarly, higher community involvement was associated with higher drug abuse for bisexual women, but not for lesbians or queer women. Among bisexual women, the association between community involvement and drug abuse was mediated by perceived discrimination. Further, the association between outness and drug abuse was mediated by both community involvement and perceived discrimination. Findings demonstrate that outness and community involvement function as risk factors for substance abuse for bisexual women, in part due to their associations with discrimination.

  9. Differences in gay men's AIDS risk knowledge and behavior patterns in high and low AIDS prevalence cities.

    Science.gov (United States)

    St Lawrence, J S; Hood, H V; Brasfield, T; Kelly, J A

    1989-01-01

    Several studies have found reductions in acquired immunodeficiency syndrome (AIDS) risk practices among gay men in high AIDS-prevalence cities since the start of the AIDS crisis. Much less is known about risk behavior patterns among gay men in smaller cities, where AIDS cases are less common and the prevalence of human immunodeficiency virus infection is relatively lower. In the study, men entering gay bars in three cities, one large and two small, completed anonymous surveys of sexual practices and AIDS risk knowledge. Men in high AIDS-prevalence areas were found to have had a greater number of sexual partners, were more knowledgeable about AIDS, were much more likely to engage in low-risk practices (such as mutual masturbation or body rubbing), and had unprotected anal intercourse less frequently than gay men in smaller cities. The most common sexual activity among gay men in the larger city was mutual masturbation, a low-risk practice. The most common sexual activity among gay men in the smaller cities was unprotected anal intercourse. Increased efforts are needed to educate gay men and to promote risk behavior changes among those living in smaller cities and in communities outside the prominent AIDS epicenters.

  10. Best practices for community gardening in a US-Mexico border community.

    Science.gov (United States)

    Mangadu, Thenral; Kelly, Michael; Orezzoli, Max C E; Gallegos, Rebecca; Matharasi, Pracheta

    2017-12-01

    Minority communities such as those on the US-Mexico border are placed at disproportionate high risk for child and adult obesity, diabetes and cardiovascular diseases. A built environment characterized by an arid desert climate, lack of access to healthy foods, barriers to increasing physical activity, cultural and community norms which deter healthy eating and sustainable food production, shape obesity-related health disparities in these communities. Three pilot community gardens (implemented by two local governmental organizations and one community-based organization) were funded through the local Healthy Eating Active Living (HEAL) initiative in El Paso, Texas, and Las Cruces and Anthony, New Mexico (US-MX border communities with high obesity rates) in order to encourage healthy lifestyles among families in the region. A mixed-methods evaluation (n = 223) examined the implementation process, immediate outcomes and best practices of implementing and sustaining community gardens in these minority binational communities. In addition to nutrition-related outcomes, the potential for psychosocial outcomes from participating in community and school garden projects were observed. The best practices in relation to (i) assessing community norms related to growing food, (ii) increasing access to land and water for community/school gardening and (iii) enhancing social support for gardening are discussed. The implications of these best practices for obesity prevention and implementing community gardens in a minority US-MX border community characterized by cultural, geographical and socioeconomic barriers are examined. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Predictive Accuracy of a Cardiovascular Disease Risk Prediction Model in Rural South India – A Community Based Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Farah N Fathima

    2015-03-01

    Full Text Available Background: Identification of individuals at risk of developing cardiovascular diseases by risk stratification is the first step in primary prevention. Aims & Objectives: To assess the five year risk of developing a cardiovascular event from retrospective data and to assess the predictive accuracy of the non laboratory based National Health and Nutrition Examination Survey (NHANES risk prediction model among individuals in a rural South Indian population. Materials & Methods: A community based retrospective cohort study was conducted in three villages where risk stratification was done for all eligible adults aged between 35-74 years at the time of initial assessment using the NHANES risk prediction charts. Household visits were made after a period of five years by trained doctors to determine cardiovascular outcomes. Results: 521 people fulfilled the eligibility criteria of whom 486 (93.3% could be traced after five years. 56.8% were in low risk, 36.6% were in moderate risk and 6.6% were in high risk categories. 29 persons (5.97% had had cardiovascular events over the last five years of which 24 events (82.7% were nonfatal and five (17.25% were fatal. The mean age of the people who developed cardiovascular events was 57.24 ± 9.09 years. The odds ratios for the three levels of risk showed a linear trend with the odds ratios for the moderate risk and high risk category being 1.35 and 1.94 respectively with the low risk category as baseline. Conclusion: The non laboratory based NHANES charts did not accurately predict the occurrence of cardiovascular events in any of the risk categories.

  12. Determinants for hospitalization in " low-risk" community acquired pneumonia

    Directory of Open Access Journals (Sweden)

    Aliyu Muktar H

    2003-06-01

    Full Text Available Abstract Background A variable decision in managing community acquired pneumonia (CAP is the initial site of care; in-patient versus outpatient. These variations persist despite comprehensive practice guidelines. Patients with a Pneumonia Severity Index (PSI score lower than seventy have low risk for complications and outpatient antibiotic management is recommended in this group. These patients are generally below the age of fifty years, non-nursing home residents, HIV negative and have no major cardiac, hepatic, renal or malignant diseases. Methods A retrospective analysis of 296 low-risk CAP patients evaluated within a year one period at St. Agnes Hospital, Baltimore, Maryland was undertaken. All patients were assigned a PSI score. 208 (70% were evaluated and discharged from the emergency department (E.D. to complete outpatient antibiotic therapy, while 88 (30% were hospitalized. Patients were sub-stratified into classes I-V according to PSI. A comparison of demographic, clinical, social and financial parameters was made between the E.D. discharged and hospitalized groups. Results Statistically significant differences in favor of the hospitalized group were noted for female gender (CI: 1.46-5.89, p= 0.0018, African Americans (CI: 0.31-0.73, p= 0.004, insurance coverage (CI: 0.19-0.63, p= 0.0034, temperature (CI: 0.04-0.09, p= 0.0001 and pulse rate (CI: 0.03-0.14, p= 0.0001. No statistically significant differences were observed between the two groups for altered mental status, hypotension, tachypnea, laboratory/radiological parameters and social indicators (p>0.05. The average length of stay for in-patients was 3.5 days at about eight time's higher cost than outpatient management. There was no difference in mortality or treatment failures between the two groups. The documentation rate and justifications for hospitalizing low risk CAP patients by admitting physicians was less than optimal. Conclusions High fever, tachycardia, female gender

  13. Ultra high risk of psychosis on committal to a young offender prison: an unrecognised opportunity for early intervention

    Directory of Open Access Journals (Sweden)

    Flynn Darran

    2012-08-01

    Full Text Available Abstract Background The ultra high risk state for psychosis has not been studied in young offender populations. Prison populations have higher rates of psychiatric morbidity and substance use disorders. Due to the age profile of young offenders one would expect to find a high prevalence of individuals with pre-psychotic or ultra-high risk mental states for psychosis (UHR. Accordingly young offender institutions offer an opportunity for early interventions which could result in improved long term mental health, social and legal outcomes. In the course of establishing a mental health in-reach service into Ireland’s only young offender prison, we sought to estimate unmet mental health needs. Methods Every third new committal to a young offenders prison was interviewed using the Comprehensive Assessment of At-Risk Mental States (CAARMS to identify the Ultra High Risk (UHR state and a structured interview for assessing drug and alcohol misuse according to DSM-IV-TR criteria, the Developmental Understanding of Drug Misuse and Dependence - Short Form (DUNDRUM-S. Results Over a twelve month period 171 young male offenders aged 16 to 20 were assessed. Of these 39 (23%, 95% confidence interval 18% to 30% met UHR criteria. UHR states peaked at 18 years, were associated with lower SOFAS scores for social and occupational function and were also associated with multiple substance misuse. The relationship with lower SOFAS scores persisted even when co-varying for multiple substance misuse. Conclusions Although psychotic symptoms are common in community samples of children and adolescents, the prevalence of the UHR state in young offenders was higher than reported for community samples. The association with impaired function also suggests that this may be part of a developing disorder. Much more attention should be paid to the relationship of UHR states to substance misuse and to the health needs of young offenders.

  14. Sociospatial Knowledge Networks: Appraising Community as Place.

    Science.gov (United States)

    Skelly, Anne H.; Arcury, Thomas A.; Gesler, Wilbert M.; Cravey, Altha J.; Dougherty, Molly C.; Washburn, Sarah A.; Nash, Sally

    2002-01-01

    A new theory of geographical analysis--sociospatial knowledge networks--provides a framework for understanding the social and spatial locations of a community's health knowledge and beliefs. This theory is guiding an ethnographic study of health beliefs, knowledge, and knowledge networks in a diverse rural community at high risk for type-2…

  15. Preservation of microbial communities enriched on lignocellulose under thermophilic and high-solid conditions.

    Science.gov (United States)

    Yu, Chaowei; Reddy, Amitha P; Simmons, Christopher W; Simmons, Blake A; Singer, Steven W; VanderGheynst, Jean S

    2015-01-01

    Microbial communities enriched from diverse environments have shown considerable promise for the targeted discovery of microorganisms and enzymes for bioconversion of lignocellulose to liquid fuels. While preservation of microbial communities is important for commercialization and research, few studies have examined storage conditions ideal for preservation. The goal of this study was to evaluate the impact of preservation method on composition of microbial communities enriched on switchgrass before and after storage. The enrichments were completed in a high-solid and aerobic environment at 55 °C. Community composition was examined for each enrichment to determine when a stable community was achieved. Preservation methods included cryopreservation with the cryoprotective agents DMSO and glycerol, and cryopreservation without cryoprotective agents. Revived communities were examined for their ability to decompose switchgrass under high-solid and thermophilic conditions. High-throughput 16S rRNA gene sequencing of DNA extracted from enrichment samples showed that the majority of the shift in composition of the switchgrass-degrading community occurred during the initial three 2-week enrichments. Shifts in community structure upon storage occurred in all cryopreserved samples. Storage in liquid nitrogen in the absence of cryoprotectant resulted in variable preservation of dominant microorganisms in enriched samples. Cryopreservation with either DMSO or glycerol provided consistent and equivalent preservation of dominant organisms. A stable switchgrass-degrading microbial community was achieved after three 2-week enrichments. Dominant microorganisms were preserved equally well with DMSO and glycerol. DMSO-preserved communities required more incubation time upon revival to achieve pre-storage activity levels during high-solid thermophilic cultivation on switchgrass. Despite shifts in the community with storage, the samples were active upon revival under thermophilic and

  16. The correlates of urinary albumin to creatinine ratio (ACR) in a high risk Australian aboriginal community.

    Science.gov (United States)

    Wang, Zaimin; Hoy, Wendy E; Wang, Zhiqiang

    2013-08-16

    Albuminuria marks renal disease and cardiovascular risk. It was estimated to contribute 75% of the risk of all-cause natural death in one Aboriginal group. The urine albumin/creatinine ratio (ACR) is commonly used as an index of albuminuria. This study aims to examine the associations between demographic factors, anthropometric index, blood pressure, lipid-protein measurements and other biomarkers and albuminuria in a cross-sectional study in a high-risk Australian Aboriginal population. The models will be evaluated for albuminuria at or above the microalbuminuria threshold, and at or above the "overt albuminuria" threshold with the potential to distinguish associations they have in common and those that differ. This was a cross-sectional study of 598 adults aged 18-76 years. All participants were grouped into quartiles by age. Logistic regression models were used to explore the correlates of ACR categories. The significant correlates were systolic blood pressure (SBP), C-reactive protein (CRP), uric acid, diabetes, gamma-glutamyl transferase (GGT) (marginally significant, p=0.054) and serum albumin (negative association) for ACR 17+ (mg/g) for men and 25+ for women. Independent correlates were SBP, uric acid, diabetes, total cholesterol, alanine amino transferase (ALT), Cystatin C and serum albumin (negative association) for overt albuminuria; and SBP, CRP and serum albumin only for microalbuminuria. This is the most detailed modelling of pathologic albuminuria in this setting to date. The somewhat variable association with risk factors suggests that microalbuminuria and overt albuminuria might reflect different as well as shared phenomena.

  17. 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.

  18. A Descriptive Study of Health, Lifestyle and Sociodemographic Characteristics and their Relationship to Known Dementia Risk Factors in Rural Victorian Communities

    OpenAIRE

    Kaye Ervin; Julie Pallant; Daniel R. Terry; Lisa Bourke; David Pierce; Kristen Glenister

    2015-01-01

    It is essential to determine the key health risk factors among populations to specifically plan future services and explore interventions that modify risk factors for communities. This aims to reduce risks and delay the onset of chronic conditions, which frequently results in dementia, particularly for small rural communities which experience health workforce shortages, a higher proportion of those in the chronic conditions age group, and reduced access to care. The aim of the study was to de...

  19. Diabetes and Prediabetes and Risk of Hospitalization: The Atherosclerosis Risk in Communities (ARIC) Study.

    Science.gov (United States)

    Schneider, Andrea L C; Kalyani, Rita R; Golden, Sherita; Stearns, Sally C; Wruck, Lisa; Yeh, Hsin Chieh; Coresh, Josef; Selvin, Elizabeth

    2016-05-01

    To examine the magnitude and types of hospitalizations among persons with prediabetes, undiagnosed diabetes, and diagnosed diabetes. This study included 13,522 participants in the Atherosclerosis Risk in Communities (ARIC) study (mean age 57 years, 56% female, 24% black, 18% with prediabetes, 4% with undiagnosed diabetes, 9% with diagnosed diabetes) with follow-up in 1990-2011 for hospitalizations. Participants were categorized by diabetes/HbA1c status: without diagnosed diabetes, HbA1c prediabetes, 5.7 to prediabetes had 1.3 times higher rates of hospitalization than those without diabetes and HbA1c prediabetes are at a significantly elevated risk of hospitalization compared with those without diabetes. Substantial excess rates of hospitalizations in persons with diagnosed diabetes were for endocrine, infection, and iatrogenic/injury causes, which may be preventable with improved diabetes care. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  20. Indigenous knowledge management to enhance community resilience to tsunami risk: lessons learned from Smong traditions in Simeulue island, Indonesia

    Science.gov (United States)

    Rahman, A.; Sakurai, A.; Munadi, K.

    2017-02-01

    Knowledge accumulation and production embedded in communities through social interactions meant that the Smong tradition of indigenous knowledge of tsunami risk successfully alerted people to the 2004 tsunami, on the island of Simeulue, in Aceh, Indonesia. Based on this practical example, an indigenous management model was developed for Smong information. This knowledge management method involves the transformation of indigenous knowledge into applicable ways to increase community resilience, including making appropriate decisions and taking action in three disaster phases. First, in the pre-disaster stage, the community needs to be willing to mainstream and integrate indigenous knowledge of disaster risk reduction issues into related activities. Second, during disasters, the Smong tradition should make the community able to think clearly, act based on informed decisions, and protect themselves and others by using their indigenous knowledge. Last, in the post-disaster phase, the community needs to be strong enough to face challenges and support each other and “building back better” efforts, using local resources. The findings for the Smong tradition provide valuable knowledge about community resilience. Primary community resilience to disasters is strongly related to existing knowledge that triggers appropriate decisions and actions during pre-disaster, disaster, and post-disaster phases.

  1. Monitoring community mobilisation and organisational capacity among high-risk groups in a large-scale HIV prevention programme in India: selected findings using a Community Ownership and Preparedness Index.

    Science.gov (United States)

    Narayanan, Pradeep; Moulasha, K; Wheeler, Tisha; Baer, James; Bharadwaj, Sowmyaa; Ramanathan, T V; Thomas, Tom

    2012-10-01

    In a participatory approach to health and development interventions, defining and measuring community mobilisation is important, but it is challenging to do this effectively, especially at scale. A cross-sectional, participatory monitoring tool was administered in 2008-2009 and 2009-2010 across a representative sample of 25 community-based groups (CBGs) formed under the Avahan India AIDS Initiative, to assess their progress in mobilisation, and to inform efforts to strengthen the groups and make them sustainable. The survey used a weighted index to capture both qualitative and quantitative data in numeric form. The index permitted broad, as well as highly detailed, analysis of community mobilisation, relevant at the level of individual groups, as well as state-wide and across the whole programme. The survey demonstrated that leadership and programme management were the strongest areas among the CBGs, confirming the programme's investment in these areas. Discussion of the Round 1 results led to efforts to strengthen governance and democratic decision making in the groups, and progress was reflected in the Round 2 survey results. CBG engagement with state authorities to gain rights and entitlements and securing the long-term financial stability of groups remain a challenge. The survey has proven useful for informing the managers of programmes about what is happening on the ground, and it has opened spaces for discussion within community groups about the nature of leadership, decision making and their goals, which is leading to accelerated progress. The tool provided useful data to manage community mobilisation in Avahan.

  2. [Community Nutrition].

    Science.gov (United States)

    Aranceta, Javier

    2004-06-01

    In the last 20 years, Public Health Nutrition focused mainly on the qualitative aspects which may influence the onset of chronic diseases, quality of life, physical and mental performance and life expectancy. This applied knowledge organised as part of preventive and health promotion programs led to the development of Community Nutrition. The aim of Community Nutrition actions is to adequate lifestyles related to food consumption patterns in order to improve the quality of life and contribute to health promotion of the population in the community where programs and services are delivered. Key functions to develop in a Community Nutrition Unit consist in the identification and assessment of nutrition problems in the community as well as the design, implementation and evaluation of intervention programs by means of appropriate strategies. These should aim at different populations groups and settings, such as work places, schools, high risk groups or the general public. Nowadays, Community Nutrition work efforts should focus on three main aspects: nutrition education in schools and in the community; food safety and food security and the development and reinforcement of food preparation skills across all age groups. Social catering services, either in schools, the work place or at the community level, need to ensure adequate nutritional supply, provide foods contributing to healthy eating practices as well as to enhance culinary traditions and social learning. Food safety and food security have become a top priority in Public Health. The concepts referes to the availability of food safe and adequate as well as in sufficient amount in order to satisfy nutrition requirements of all individuals in the community. Social changes along new scientific developments will introduce new demands in Community Nutrition work and individual dietary counselling will become a key strategy. In order to face new challenges, community nutrition pactitioners require a high quality

  3. Hyperuricemia Is a Risk Factor for the Onset of Impaired Fasting Glucose in Men with a High Plasma Glucose Level: A Community-Based Study

    Science.gov (United States)

    Miyake, Teruki; Kumagi, Teru; Furukawa, Shinya; Hirooka, Masashi; Kawasaki, Keitarou; Koizumi, Mitsuhito; Todo, Yasuhiko; Yamamoto, Shin; Abe, Masanori; Kitai, Kohichiro; Matsuura, Bunzo; Hiasa, Yoichi

    2014-01-01

    Background It is not clear whether elevated uric acid is a risk factor for the onset of impaired fasting glucose after stratifying by baseline fasting plasma glucose levels. We conducted a community-based retrospective longitudinal cohort study to clarify the relationship between uric acid levels and the onset of impaired fasting glucose, according to baseline fasting plasma glucose levels. Methods We enrolled 6,403 persons (3,194 men and 3,209 women), each of whom was 18–80 years old and had >2 annual check-ups during 2003–2010. After excluding persons who had fasting plasma glucose levels ≥6.11 mM and/or were currently taking anti-diabetic agents, the remaining 5,924 subjects were classified into quartiles according to baseline fasting plasma glucose levels. The onset of impaired fasting glucose was defined as fasting plasma glucose ≥6.11 mM during the observation period. Results In the quartile groups, 0.9%, 2.1%, 3.4%, and 20.2% of the men developed impaired fasting glucose, respectively, and 0.1%, 0.3%, 0.5%, and 5.6% of the women developed impaired fasting glucose, respectively (P trend fasting glucose in men with highest-quartile fasting plasma glucose levels (adjusted hazard ratio, 1.003; 95% confidence interval, 1.0001–1.005, P = 0.041). Conclusions Among men with high fasting plasma glucose, hyperuricemia may be independently associated with an elevated risk of developing impaired fasting glucose. PMID:25237894

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

    Science.gov (United States)

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

    2011-10-19

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

  5. [Risk scores for community acquired pneumonia in elderly and geriatric patients].

    Science.gov (United States)

    Pflug, M A; Wesemann, T; Heppner, H J; Thiem, U

    2015-10-01

    Community-acquired pneumonia (CAP) is still an important and serious disease for elderly and geriatric patients. For epidemiological and clinical reasons it is important to collate the frequencies of the various degrees of severity of CAP and to obtain information on the spread and degree of the threat to the various risk groups by CAP. In outpatient treatment a simple to execute prognosis score can be used to objectify the assessment of the clinical status of a patient and to support therapeutic decision-making. For this purpose knowledge of the appropriate instruments should be available to potential users. Since the 1990s a variety of risk scores for stratification of CAP have been developed and evaluated. This article presents the content and value of the available risk scores whereby the advantages and disadvantages of the individual scores are critically compared. Special emphasis is placed on the importance of the risk scores for geriatric patients. At present the decision about outpatient or inpatient treatment is primarily based on the risk score CRB-65. Criteria for intensive care unit admissions are provided by the modified American Thoracic Society (ATS) set of criteria. Overall, risk scores are less reliable for elderly patients than for younger adults. For treatment decisions for the elderly, functional aspects should also be considered in addition to the aspects of risk scores discussed here. In particular, the decision about inpatient admission for elderly, geriatric CAP patients should be made on an individual basis taking the benefit-risk relationship into consideration.

  6. Drinking water management: health risk perceptions and choices in First Nations and non-First Nations communities in Canada.

    Science.gov (United States)

    Dupont, Diane; Waldner, Cheryl; Bharadwaj, Lalita; Plummer, Ryan; Carter, Blair; Cave, Kate; Zagozewski, Rebecca

    2014-05-30

    The relationship between tap water and health has been a topic of public concern and calls for better management in Canada since well-publicized contamination events in two provinces (Ontario and Saskatchewan) in 2000-2001. This study reports the perspectives on health risks from tap water and corresponding use of, and spending on, bottled water in a number of different communities in Canada. In 2009-2010, four First Nations communities (three from Ontario and one from Saskatchewan) and a geographically diverse sample of non-First Nations Canadians were surveyed about their beliefs concerning health risks from tap water and their spending practices for bottled water as a substitute. Responses to five identical questions were examined, revealing that survey respondents from Ontario First Nations communities were more likely than non-First Nations Canadians to believe bottled water is safer than tap water (OR 1.6); more likely to report someone became ill from tap water (OR 3.6); more likely to express water and health concerns related to tap water consumption (OR 2.4); and more likely to spend more on bottled water (OR 4.9). On the other hand, participants from one Saskatchewan First Nations community were less likely than non-First Nations Canadians to believe that someone had become ill from drinking tap water (OR 3.8), less likely to believe bottled water is safer than tap (OR 2.0), and less likely to have health concerns with tap water (OR 1.5). These differences, however, did not translate into differences in the likelihood of high bottled water expenditures or being a 100% bottled water consumer. The paper discusses how the differences observed may be related to water supply and regulation, trust, perceived control, cultural background, location, and past experience.

  7. Drinking Water Management: Health Risk Perceptions and Choices in First Nations and Non-First Nations Communities in Canada

    Science.gov (United States)

    Dupont, Diane; Waldner, Cheryl; Bharadwaj, Lalita; Plummer, Ryan; Carter, Blair; Cave, Kate; Zagozewski, Rebecca

    2014-01-01

    The relationship between tap water and health has been a topic of public concern and calls for better management in Canada since well-publicized contamination events in two provinces (Ontario and Saskatchewan) in 2000–2001. This study reports the perspectives on health risks from tap water and corresponding use of, and spending on, bottled water in a number of different communities in Canada. In 2009–2010, four First Nations communities (three from Ontario and one from Saskatchewan) and a geographically diverse sample of non-First Nations Canadians were surveyed about their beliefs concerning health risks from tap water and their spending practices for bottled water as a substitute. Responses to five identical questions were examined, revealing that survey respondents from Ontario First Nations communities were more likely than non-First Nations Canadians to believe bottled water is safer than tap water (OR 1.6); more likely to report someone became ill from tap water (OR 3.6); more likely to express water and health concerns related to tap water consumption (OR 2.4); and more likely to spend more on bottled water (OR 4.9). On the other hand, participants from one Saskatchewan First Nations community were less likely than non-First Nations Canadians to believe that someone had become ill from drinking tap water (OR 3.8), less likely to believe bottled water is safer than tap (OR 2.0), and less likely to have health concerns with tap water (OR 1.5). These differences, however, did not translate into differences in the likelihood of high bottled water expenditures or being a 100% bottled water consumer. The paper discusses how the differences observed may be related to water supply and regulation, trust, perceived control, cultural background, location, and past experience. PMID:24886757

  8. Prevalence of gastro-esophageal reflux disease and its risk factors in a community-based population in southern India.

    Science.gov (United States)

    Wang, Hai-Yun; Leena, Kondarapassery Balakumaran; Plymoth, Amelie; Hergens, Maria-Pia; Yin, Li; Shenoy, Kotacherry Trivikrama; Ye, Weimin

    2016-03-15

    The prevalence of gastro-esophageal reflux disease (GERD) varies widely around the world. This study aimed to investigate the prevalence and risk factors of GERD in a general population of southern India. An interview-based observational study was carried out in southern India during 2010 and early 2011 using a GERD questionnaire (GerdQ). In total 1072 participants were enrolled using a multi-stage cluster sampling method. Presence of GERD was defined as a score of ≥ 8. Logistic regression models were used to derive odds ratios (ORs) with 95 % confidence intervals (CIs). The prevalence of GERD was 22.2 % (238/1072) in southern India, and was more common among older subjects and men. Overweight and obese subjects had a dose-dependent increased risk of GERD, compared to those with body mass index less than 25 (multivariate-adjusted OR = 1.4, 95 % CI 1.0-2.0; OR = 2.3, 95 % CI 1.3-4.1, respectively). People residing in urban community were more vulnerable to GERD than those in rural community (multivariate-adjusted OR = 1.8, 95 % CI 1.3-2.5). Similarly, those with a lower educational level appeared to have an increased risk of GERD. Further, those with a habit of pan masala chewing were more likely to develop GERD compared with those abstained from the habit (multivariate-adjusted OR = 2.0, 95 % CI 1.2-3.2). GERD is highly prevalent in southern India. Increasing age and BMI, an urban environment, lower educational level, and pan masala chewing appear to be risk factors of GERD symptoms for the studied population.

  9. Perspectives on enhancing physical activity and diet for health promotion among at-risk urban UK South Asian communities: a qualitative study.

    Science.gov (United States)

    Cross-Bardell, Laura; George, Tracey; Bhoday, Mandeep; Tuomainen, Helena; Qureshi, Nadeem; Kai, Joe

    2015-02-27

    To explore perspectives on enhancing physical activity and diet among South Asians in urban deprived communities at high risk of chronic disease and to inform development of culturally appropriate health promotion intervention. Qualitative study using semistructured one-to-one and family group interviews with thematic analysis of data. Urban disadvantaged communities in the East Midlands of the UK. 45 respondents, including 34 people of South Asian origin (16 at-risk individuals, six family groups involving 18 relatives), of mainly Pakistani and Indian origin, including 16 non-English speakers; and 11 health professionals working locally with communities of concern. South Asian participants underlined the challenges of requiring family members across generations to engage in modifying dietary behaviours, and the central role of communal eating of traditional 'Asian' food in their cultural lives. Barriers to increasing physical activity included cost, personal safety and lack of time outside of long working hours and carer commitments. However, increasing walking activity was regarded as feasible by both community and health professional participants. Respondents emphasised using a social approach for potential interventions, undertaking activity with family or friends and with bilingual community peers to facilitate engagement, motivation and support. Spoken content and delivery of interventions was favoured, including personal stories and multilingual audio-visual information; within local informal rather than provider settings, including the home; and aided by pedometers for self-monitoring. Focusing on physical activity by increasing walking may hold promise as health promotion in this deprived South Asian community context. Further intervention development, with exploration of feasibility and acceptability of the social approach and elements suggested, is merited. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

  10. Exploring the co-production of digital storytelling for lay knowledge exchange within and between flood risk communities: the case of the River Severn, UK

    Directory of Open Access Journals (Sweden)

    Holmes Andrew

    2016-01-01

    Full Text Available This paper evaluates the potential role of co-produced digital storytelling as a medium of linking flood memories and lay knowledge exchange around flood preparedness for resilience within flood risk communities. The objectives of the described action focus on both process andd output - to capture memory of flood events, and to share critical reflection on, and adaptive learning from, flood experiences within and between communities. Very specific pieces of resilience stories on preparedness were co-produced into digital stories (audio and images working with individuals and small clusters of people. In the development process, stories were shared within the communities who created them, and within new communities. At all community events, the experience of sharing the stories was observed and evaluated using participant and facilitator questionnaires and independent observation. When shared in community events, the value of the digital media, nature of the story construction, the local or transferable nature of messages, and emotional weight given to the story were all appraised. The stories stimulated new discussions within different community groups and in multi-stakeholder meetings; conversations generated by the same digital story were found to differ depending on the setting. Listeners had high degrees of empathy with the stories gaining insights around “mobilising community#x201D; and “developing emotional resilience”. The paper explores issues of engagement in order to produce a participatory media -demonstrating the process and tensions of exchanging knowledge, and how the cultural practice of digital storytelling can jump the divide to policymaking and function as a successful way of engaging a wider public at flood risk.

  11. The baseline characteristics and interim analyses of the high-risk sentinel cohort of the Vietnam Initiative on Zoonotic InfectiONS (VIZIONS)

    OpenAIRE

    Carrique-Mas, Juan J.; Tue, Ngo T.; Bryant, Juliet E.; Saylors, Karen; Cuong, Nguyen V.; Hoa, Ngo T.; An, Nguyen N.; Hien, Vo B.; Lao, Pham V.; Tu, Nguyen C.; Chuyen, Nguyen K.; Chuc, Nguyen T.K.; Tan, Dinh V.; Duong, Hoang Van V.; Toan, Tran K.

    2015-01-01

    The Vietnam Initiative for Zoonotic Infections (VIZIONS) includes community-based 'high-risk sentinel cohort' (HRSC) studies investigating individuals at risk of zoonotic infection due to occupational or residential exposure to animals. A total of 852 HRSC members were recruited between March 2013 and August 2014 from three provinces (Ha Noi, Dak Lak, and Dong Thap). The most numerous group (72.8%) corresponded to individuals living on farms, followed by slaughterers (16.3%) and animal health...

  12. Assessing residential buildings value in Spain for risk analyses. Application to the landslide hazard in the Autonomous Community of Valencia

    Science.gov (United States)

    Cantarino, I.; Torrijo, F. J.; Palencia, S.; Gielen, E.

    2014-05-01

    This paper proposes a method of valuing the stock of residential buildings in Spain as the first step in assessing possible damage caused to them by natural hazards. For the purposes of the study we had access to the SIOSE (the Spanish Land Use and Cover Information System), a high-resolution land-use model, as well as to a report on the financial valuations of this type of buildings throughout Spain. Using dasymetric disaggregation processes and GIS techniques we developed a geolocalized method of obtaining this information, which was the exposure variable in the general risk assessment formula. If hazard maps and risk assessment methods - the other variables - are available, the risk value can easily be obtained. An example of its application is given in a case study that assesses the risk of a landslide in the entire 23 200 km2 of the Valencia Autonomous Community (NUT2), the results of which are analyzed by municipal areas (LAU2) for the years 2005 and 2009.

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

    Science.gov (United States)

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

    2016-12-01

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

  14. Risk Jyouhou Navi (risk information navigator). Web tool for fostering of risk literacy. Set of data

    International Nuclear Information System (INIS)

    Mitsui, Seiichiro

    2003-06-01

    In addition to the conventional public understanding activities, Risk communication study team of Japan Nuclear Cycle Development Institutes (JNC) Tokai Works has started practical studies to promote risk communication with its local communities. Since its establishment in 2001, Risk communication study team has conducted analyses of already available results of public attitude surveys, case studies of domestic and overseas risk communication activities, and development of risk communication tools. A web tool for fostering of risk literacy 'Risk Jyouhou Navi (risk information navigator in English)', was developed as a web content for the official home page of Techno Kouryuu Kan Ricotti (Techno Community Square Ricotti in English)'. The objectives of this content are to provide risk information for public and to provide an electronic platform for promoting risk communication with the local community. To develop 'Risk Jyouhou Navi', the following concepts were considered. 1) To create public interest in risks in daily lives and in global risks. 2) To provide risk knowledge and information. 3) To support risk communication activities in Techno community square ricotti. (author)

  15. Remote Sensing of Wildland Fire-Induced Risk Assessment at the Community Level.

    Science.gov (United States)

    Ahmed, M Razu; Rahaman, Khan Rubayet; Hassan, Quazi K

    2018-05-15

    Wildland fires are some of the critical natural hazards that pose a significant threat to the communities located in the vicinity of forested/vegetated areas. In this paper, our overall objective was to study the structural damages due to the 2016 Horse River Fire (HRF) that happened in Fort McMurray (Alberta, Canada) by employing primarily very high spatial resolution optical satellite data, i.e., WorldView-2. Thus, our activities included the: (i) estimation of the structural damages; and (ii) delineation of the wildland-urban interface (WUI) and its associated buffers at certain intervals, and their utilization in assessing potential risks. Our proposed method of remote sensing-based estimates of the number of structural damages was compared with the ground-based information available from the Planning and Development Recovery Committee Task Force of Regional Municipality of Wood Buffalo (RMWB); and found a strong linear relationship (i.e., r² value of 0.97 with a slope of 0.97). Upon delineating the WUI and its associated buffer zones at 10 m, 30 m, 50 m, 70 m and 100 m distances; we found existence of vegetation within the 30 m buffers from the WUI for all of the damaged structures. In addition, we noticed that the relevant authorities had removed vegetation in some areas between 30 m and 70 m buffers from the WUI, which was proven to be effective in order to protect the structures in the adjacent communities. Furthermore, we mapped the wildland fire-induced vulnerable areas upon considering the WUI and its associated buffers. Our analysis revealed that approximately 30% of the areas within the buffer zones of 10 m and 30 m were vulnerable due to the presence of vegetation; in which, approximately 7% were burned during the 2016 HRF event that led the structural damages. Consequently, we suggest to remove the existing vegetation within these critical zones and also monitor the region at a regular interval in order to reduce the wildland fire-induced risk.

  16. Engaging with Underserved Urban Communities on Climate Resilience

    Science.gov (United States)

    Akerlof, K.; Moser, F. C.; Baja, K.; Dindinger, J. M.; Chanse, V.; Rowan, K. E.; Rohring, B.

    2016-12-01

    Meeting the needs of urban high-risk/low-resource communities is one of the most critical challenges in improving climate resilience nationally, but little tailored information exists to guide community engagement efforts specifically for these contexts. This case study describes a collaboration between universities, local governments, and community members working in underserved neighborhoods of the City of Baltimore and Prince George's County, Maryland. In service of current and developing community programs, the team surveyed residents door-to-door about their perceptions of the socio-environmental risks they face, their priorities for change, and the ways in which communication may build protective social capital. We highlight theoretical, applied, and pedagogical aspects of the study that inform both the promise and limitations of these collaborations. These include: 1) the role of citizen participation in climate adaptation decision-making; 2) the meaning, use, and potential impact of community data; 3) balancing differing organizational priorities, timelines, and cultures within community-based projects; and 4) research participation of undergraduate students. The results of the survey illuminate climate risk perceptions in neighborhoods facing complex stressors with lessons for communication and engagement in other urban areas facing similar adaptation challenges.

  17. Resilience of an Earthquake-Stricken Rural Community in Southwest China: Correlation with Disaster Risk Reduction Efforts.

    Science.gov (United States)

    Cui, Ke; Han, Ziqiang; Wang, Dongming

    2018-02-27

    Disaster risk reduction (DRR) activities have given growing attention to building community resilience, but the effects of such efforts on community resilience are still under-investigated, especially in China where the concept of community resilience has only just emerged. Using the Communities Advancing Resilience Toolkit Assessment Survey, data on self-perceived community resilience were collected in 2017 from a post-disaster Chinese rural community in Yingxiu Town, which was the epicenter of the Wenchuan earthquake (Magnitude = 8.0) in the year 2008. Linear regression analyses were conducted to explore the correlations between residents' DRR behaviors and perceived community resilience with the control of their socio-demographic characteristics including age, ethnicity, gender, education, income level, employment status and marital status. Results indicate that residents who volunteered for DRR activities received geological disaster education, participated in evacuation drills, and reported higher income levels had a perception of higher community resilience. Practice research is suggested to help clarify the cause and effect of DRR work on the enhancement of community resilience to disasters in China and abroad. Attention is also called to the development of a Chinese indigenous community resilience concept and assessment instrument.

  18. Prevalence and risk factors of underweight, overweight and obesity among a geriatric population living in a high-altitude region of rural Uttarakhand, India.

    Science.gov (United States)

    Gupta, Aakriti; Kapil, Umesh; Khandelwal, Ritika; Khenduja, Preetika; Sareen, Neha; Pandey, Ravindra Mohan; Upadhyay, Ashish Datt

    2018-03-15

    To assess the prevalence and risk factors of underweight, overweight and obesity among a geriatric population living in a high-altitude region of India. Community-based cross-sectional study. Data were collected on sociodemographic profile and anthropometric parameters. Weight and height measurements were utilized for calculation of BMI. Nutrient intake data were collected using 24 h dietary recall. High-altitude region of Nainital District, Uttarakhand State, North India. Community-dwelling geriatric subjects (n 981) aged 60 years or above. We found that 26·6 % of the elderly subjects were underweight (BMI<18·5 kg/m2). Overweight (BMI 25·0-29·9 kg/m2) and obesity (BMI≥30·0 kg/m2) was seen among 18·0 % and 4·6 %, respectively. After controlling for potential cofounders, risk factors such as low level of education and income, chewing problems and lower number of daily meals were found to be associated with underweight. On the other hand, risk factors for overweight/obesity were lower age, high income and unskilled work. There is a need to develop and implement intervention strategies to prevent underweight, overweight and obesity among the geriatric population of India.

  19. Collaborating To Enhance Resilience in Rural At-Risk Students.

    Science.gov (United States)

    Finley, Mary K.

    This paper links areas of research with implications for community prevention strategies aimed at high-risk children. Collaborative efforts to reduce the number of at-risk children in rural communities can be advanced by merging knowledge from the following areas: (1) the causal pathways leading to substance abuse and identification of risk…

  20. Community Engaged Cumulative Risk Assessment of Exposure to Inorganic Well Water Contaminants, Crow Reservation, Montana

    Science.gov (United States)

    Doyle, John T.; Lefthand, Myra J.; Young, Sara L.; Kindness, Larry; Other Medicine, Roberta; Ford, Timothy E.; Dietrich, Eric; Parker, Albert E.; Hoover, Joseph H.; Camper, Anne K.

    2018-01-01

    An estimated 11 million people in the US have home wells with unsafe levels of hazardous metals and nitrate. The national scope of the health risk from consuming this water has not been assessed as home wells are largely unregulated and data on well water treatment and consumption are lacking. Here, we assessed health risks from consumption of contaminated well water on the Crow Reservation by conducting a community-engaged, cumulative risk assessment. Well water testing, surveys and interviews were used to collect data on contaminant concentrations, water treatment methods, well water consumption, and well and septic system protection and maintenance practices. Additive Hazard Index calculations show that the water in more than 39% of wells is unsafe due to uranium, manganese, nitrate, zinc and/or arsenic. Most families’ financial resources are limited, and 95% of participants do not employ water treatment technologies. Despite widespread high total dissolved solids, poor taste and odor, 80% of families consume their well water. Lack of environmental health literacy about well water safety, pre-existing health conditions and limited environmental enforcement also contribute to vulnerability. Ensuring access to safe drinking water and providing accompanying education are urgent public health priorities for Crow and other rural US families with low environmental health literacy and limited financial resources. PMID:29304032

  1. Linking rural community livelihoods to resilience building in flood risk reduction in Zimbabwe

    Directory of Open Access Journals (Sweden)

    Patrick Gwimbi

    2009-04-01

    Full Text Available The increasing occurrence of disastrous flooding events and the mounting losses in both life and property values in Zimbabwe have drawn attention to the flooding situation in the country, especially the rural areas. This article explores the resilience of vulnerable rural communities to flood risks associated within increasingly frequent and severe events linked to climate change. Starting by reviewing the current literature on rural livelihoods, resilience and vulnerability research, the paper argues for a coordinated teamwork approach in flood risk mitigation in rural areas. The paper concludes with several recommendations for enhanced resilience to flood hazards.

  2. New information on high risk breast screening

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  3. The Aggregate Risk Index: An intuitive tool providing the health risks of air pollution to health care community and public

    Science.gov (United States)

    Sicard, Pierre; Talbot, Charles; Lesne, Olivia; Mangin, Antoine; Alexandre, Nicolas; Collomp, Rémy

    2012-01-01

    In the framework of the European project PASODOBLE (FP7), we set up downstream information services by combining environmental and health data with a view to support the health care community and to improve vulnerable people welfare. Indeed there is a profound relationship between human health, well-being and air pollution levels. The main objectives are to establish correlations between air quality, exposure of populations and their reactivity, to develop and validate air quality indexes and to construct a prediction model of this sanitary index. This index will be implemented on 3 European sites: Greece (Athens and Thessaloniki), the Netherlands and "Provence Alpes Côte d'Azur" (South East of France). The selected region and cities are among the most affected by the atmospheric pollution in Europe and leads to serious sanitary concerns. The service aims to provide up-to-date, detailed information on air quality discomfort. The Aggregate Risk Index is based on the Cairncross's concept, obtained from the Relative Risk associated with short-term exposure to common air pollutants and takes into account the possible effects of a mixture of pollutants. This communication tool, easy to use and intuitive, about the levels of air pollution and the associated health risks, will be used to communicate information to the general population, authorities and to the health care community and will provide advanced warning of potentially health-damaging air pollution events.

  4. Is it Time for a Sudden Infant Death Syndrome (SIDS) Awareness Campaign? Community Stakeholders' Perceptions of SIDS.

    Science.gov (United States)

    Gollenberg, Audra; Fendley, Kim

    2018-01-01

    Sudden infant death syndrome (SIDS) remains a leading cause of infant death in the United States and in Virginia, the SIDS rate is higher than the national average. We sought to gauge the perceptions among community-identified stakeholders as to community resource needs to reduce SIDS. We used snowball sampling to identify important community stakeholders to be interviewed as key informants. A semi-structured interview lasting 45 min-2 hours was delivered to determine resource needs to reduce SIDS, and whether high-risk community members were aware of SIDS risk factors among stakeholders representing a variety of disciplines. Interviews were conducted in two geographic areas with higher than average rates of infant mortality, an urban district, Winchester City, VA and a rural district, Page County, VA. A total of 74 interviews were completed with stakeholders in healthcare, health departments, social services, law enforcement, education/childcare, faith-based institutions, non-profit agencies and non-affiliated community members. The majority of respondents perceive that high-risk community members are not aware of factors that can lead to SIDS (50%). Participants suggested that more "education" is needed to further reduce the rates of SIDS in their communities (73%). Respondents detailed that more pervasive, strategic, and multi-channeled education is necessary to reduce cases of SIDS. Community leaders perceive that high-risk community members are not fully aware of risk factors that can lead to SIDS. Maternal/child health stakeholders in these Virginia locales suggested more community-based education as a potential solution to SIDS.

  5. Rapid assessment of knowledge, attitudes, practices, and risk perception related to the prevention and control of Ebola virus disease in three communities of Sierra Leone.

    Science.gov (United States)

    Jiang, Hai; Shi, Guo-Qing; Tu, Wen-Xiao; Zheng, Can-Jun; Lai, Xue-Hui; Li, Xin-Xu; Wei, Qiang; Li, Mei; Deng, Li-Quan; Huo, Xiang; Chen, Ming-Quan; Xu, Feng; Ye, Long-Jie; Bai, Xi-Chen; Chen, Tong-Nian; Yin, Shao-Hua; Samba, Thomas T; Liang, Xiao-Feng

    2016-06-06

    The recent outbreak of the Ebola virus disease (EVD) in Sierra Leone has been characterized by the World Health Organization as one of the most challenging EVD outbreaks to date. The first confirmed case in Sierra Leone was a young woman who was admitted to a government hospital in Kenema following a miscarriage on 24 May 2014. On 5 January 2015, intensified training for an EVD response project was initiated at the medical university of Sierra Leone in Jui. To understand the knowledge, attitudes, practices, and perceived risk of EVD among the public, especially after this training, a rapid assessment was conducted from 10 to 16 March 2015. Interviews were conducted with 466 participants based on questionnaires that were distributed from 10 to 16 March 2015 by cluster sampling in three adjacent communities, namely Jui, Grafton, and Kossoh Town, in the Western Area Rural District of Sierra Leone. It was found that knowledge about EVD was comprehensive and high. Positive attitude towards prevention was found to be satisfactory. Nearly all participants knew the reporting phone number 117 and had reported some change in behavior since learning about Ebola. More than half (62 %) of the participants had a history of travelling to urban areas, which increases the risk of infection. The multivariable logistic regression analysis showed that community and occupation were variables associated with perceived risk of EVD. Our study showed that community level social mobilization and community engagement were an effective strategy in the special context.

  6. Considering the risk of infection by cryptosporidium via consumption of municipally treated drinking water from a surface water source in a Southwestern Ontario community.

    Science.gov (United States)

    Pintar, K D M; Fazil, A; Pollari, F; Waltner-Toews, D; Charron, D F; McEwen, S A; Walton, T

    2012-07-01

    Through the use of case-control analyses and quantitative microbial risk assessment (QMRA), relative risks of transmission of cryptosporidiosis have been evaluated (recreational water exposure vs. drinking water consumption) for a Canadian community with higher than national rates of cryptosporidiosis. A QMRA was developed to assess the risk of Cryptosporidium infection through the consumption of municipally treated drinking water. Simulations were based on site-specific surface water contamination levels and drinking water treatment log₁₀ reduction capacity for Cryptosporidium. Results suggested that the risk of Cryptosporidium infection via drinking water in the study community, assuming routine operation of the water treatment plant, was negligible (6 infections per 10¹³ persons per day--5th percentile: 2 infections per 10¹⁵ persons per day; 95th percentile: 3 infections per 10¹² persons per day). The risk is essentially nonexistent during optimized, routine treatment operations. The study community achieves between 7 and 9 log₁₀ Cryptosporidium oocyst reduction through routine water treatment processes. Although these results do not preclude the need for constant vigilance by both water treatment and public health professionals in this community, they suggest that the cause of higher rates of cryptosporidiosis are more likely due to recreational water contact, or perhaps direct animal contact. QMRA can be successfully applied at the community level to identify data gaps, rank relative public health risks, and forecast future risk scenarios. It is most useful when performed in a collaborative way with local stakeholders, from beginning to end of the risk analysis paradigm. © 2011 Society for Risk Analysis.

  7. 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....

  8. Risk factors and effectiveness of preventive measures against influenza in the community

    Science.gov (United States)

    Castilla, Jesús; Godoy, Pere; Domínguez, Ángela; Martín, Vicente; Delgado‐Rodríguez, Miguel; Martínez‐Baz, Iván; Baricot, Maretva; Soldevila, Nuria; Mayoral, José M.; Astray, Jenaro; Quintana, José M.; Cantón, Rafael; Castro, Ady; González‐Candelas, Fernando; Alonso, Jordi; Saez, Marc; Tamames, Sonia; Pumarola, Tomás

    2012-01-01

    Please cite this paper as: Castilla et al. (2013) Risk factors and effectiveness of preventive measures against influenza in the community. Influenza and Other Respiratory Viruses 7(2) 177–183. Background  The role of different risk exposures and preventive measures against influenza has not been well established. Objective  The aim of this study was to evaluate risk factors and measures to prevent influenza infection in the community. Methods  We conducted a multicenter case–control study. Cases were 481 outpatients aged 18 years or older with laboratory‐confirmed influenza A(H1N1)09 in the 2009–2010 season in Spain. A control was selected for each case from outpatients from the same area matched by age and date of consultation. Information on risk situations, preventive measures and other variables was obtained by interview and review of the medical record. Results  In the multivariate conditional logistic regression analysis, the risk of a diagnosis of influenza increased with the number of cohabitants (compared with <3 cohabitants, three cohabitants had an OR = 1·80, 95% CI 1·12–2·89, and ≥5 cohabitants had an OR = 2·66, 95% CI 1·31–5·41) and for health care workers (OR = 2·94, 95% CI 1·53–5·66). The use of metropolitan public transport was associated with a lower frequency of a diagnosis of influenza (OR = 0·45, 95% CI 0·30–0·68) but not the use of taxis or long‐distance transport. The influenza A(H1N1)09 vaccine had a protective effect (OR = 0·13, 95% CI 0·04–0·48), unlike hand washing after touching contaminated surfaces or the use of alcohol‐based hand sanitizers. Conclusion  The home environment appears to play an important role in the spread of influenza in adults, but not the use of public transport. Health care workers have a higher risk of contracting influenza. Vaccination was the most effective preventive measure. PMID:22458533

  9. Zonation of High Disaster Potential Communities for Remote Mountainous Areas in Southern Taiwan

    Science.gov (United States)

    Chen, Yie-Ruey; Tsai, Kuang-Jung; Chang, Chwen-Ming; Chen, Jing-Wen; Chiang, Jie-Lun; Lu, Yi-Ching; Tsai, Hui-Wen

    2017-04-01

    About three-quarters of Taiwan are covered by hillside areas. Most of the hillside regions in Taiwan are sedimentary and metamorphic rocks which are fragile and highly weathered. In recent years, human development coupled with the global impact of extreme weather, typhoons and heavy rains have caused the landslide disasters and leaded to human causalities and properties loss. The landslides also endanger the major public works and almost make the overall industrial economic development and transport path overshadowed by disasters. Therefore, this research assesses the exploration of landslide potential analysis and zonation of high disaster potential communities for remote mountainous areas in southern Taiwan. In this study, the time series of disaster records and land change of remote mountainous areas in southern Taiwan are collected using techniques of interpretation from satellite images corresponding to multi-year and multi-rainfall events. To quantify the slope hazards, we adopt statistical analysis model to analyze massive data of slope disasters and explore the variance, difference and trend of influence factors of hillside disaster; establish the disaster potential analysis model under the climate change and construct the threshold of disaster. Through analysis results of disaster potential assessment, the settlement distribution with high-risk hazard potential of study area is drawn with geographic information system. Results of image classification show that the values of coefficient of agreement for different time periods are at high level. Compared with the historical disaster records of research areas, the accuracy of predicted landslide potential is in reasonable confidence level. The spatial distribution of landslide depends on the interaction of rainfall patterns, slope and elevation of the research area. The results also show that the number and scale of secondary landslide sites are much larger than those of new landslide sites after rainfall

  10. Flood risk assessment. Case of study: Motozintla de Mendoza, Chiapas, Mexico

    Directory of Open Access Journals (Sweden)

    David A. Novelo-Casanova

    2016-09-01

    Full Text Available Due to its geographical location, the community of Motozintla de Mendoza (Motozintla in the State of Chiapas, Mexico, is continuously exposed to the impact of natural hazards. In this work, we assessed the flood risk of Motozintla considering the structural, socioeconomic, organizational, and global (structural, socioeconomic, and organizational vulnerabilities. In addition, we also measured the local risk perception. Spatial maps were generated to determine the most vulnerable and risk areas of this community. Our results indicate that the population has a high level of risk to flooding mainly because (1 the majority of the local houses has high structural vulnerability; (2 a high percentage of the families has a daily income less than the official Mexican minimum wage and lacks of basic public services as well as of proper social security services; (3 most of the community does not know any existing Civil Protection Plan; and (4 the community organization for disaster mitigation and response is practically non-existent. For these reasons, we believe that it is necessary for local authorities to establish in the short-term, preparedness, mitigation and response plans as well as land-use measures to reduce the risk to floods in Motozintla.

  11. High Prevalence of Diabetes and Prediabetes and Their Coexistence with Cardiovascular Risk Factors in a Hispanic Community

    Science.gov (United States)

    Soto-Salgado, Marievelisse; Suárez, Erick; Guzmán, Manuel; Ortiz, Ana Patricia

    2014-01-01

    This study examined the prevalence and association of diabetes mellitus (DM) and prediabetes with cardiovascular risk factors among Puerto Ricans adults. Data from a household survey of 857 adults aged 21–79 years who underwent interviews, physical exams, and blood draws were analyzed. Prevalence of total DM and prediabetes was estimated using American Diabetes Association diagnostic criteria of fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c). Poisson regression models were used to estimate the prevalence ratio for each cardiovascular risk factor under study. Age-standardized prevalence of total DM and prediabetes, detected by FPG and/or HbA1c, was 25.5 and 47.4 %, respectively. Compared with participants with normoglycemia, those with previously diagnosed DM, undiagnosed DM, and prediabetes had more adverse cardiovascular risk factor profiles, characterized by a higher prevalence of general and abdominal obesity, hypertension, low HDL cholesterol, elevated LDL cholesterol, elevated triglycerides, and elevated plasminogen activator inhibitor 1 (p < 0.05). The high prevalence of DM and prediabetes calls for public health actions to plan and implement lifestyle interventions to prevent or delay the onset of DM and cardiovascular disease. PMID:24781780

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

    Science.gov (United States)

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

    2018-04-11

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

  13. HIV risk and sense of community: French gay male discourses on barebacking.

    Science.gov (United States)

    Girard, Gabriel

    2016-01-01

    This paper analyses the use of the concept of 'barebacking' as a risk category in the discourses of French gay men. It discusses how the rise and spread of the term barebacking contributes to reframing gay men's personal experiences of HIV prevention and their sense of belonging (or a lack thereof) to a gay community. The study is based on 30 qualitative interviews with French gay men conducted between 2005 and 2008. An import from the USA, the term barebacking emerged publicly in France in the late-1990s and was first used to describe intentionally unprotected sexual practices. Debates surrounding this risk category were marked by violent controversy over its use and its definition among HIV prevention actors. There remains a general lack of consensus on the definition of the term, despite its use by activists, in porn culture and in the daily discourses of gay men. By focusing on the relational roots of risk perception, I consider how uses of the term barebacking invoke a moral framework around risk taking.

  14. Understanding the risk factors of trauma center closures: do financial pressure and community characteristics matter?

    Science.gov (United States)

    Shen, Yu-Chu; Hsia, Renee Y; Kuzma, Kristen

    2009-09-01

    We analyze whether hazard rates of shutting down trauma centers are higher due to financial pressures or in areas with vulnerable populations (such as minorities or the poor). This is a retrospective study of all hospitals with trauma center services in urban areas in the continental US between 1990 and 2005, identified from the American Hospital Association Annual Surveys. These data were linked with Medicare cost reports, and supplemented with other sources, including the Area Resource File. We analyze the hazard rates of trauma center closures among several dimensions of risk factors using discrete-time proportional hazard models. The number of trauma center closures increased from 1990 to 2005, with a total of 339 during this period. The hazard rate of closing trauma centers in hospitals with a negative profit margin is 1.38 times higher than those hospitals without the negative profit margin (P lower hazard of shutting down trauma centers (ratio: 0.58, P penetration face a higher hazard of trauma center closure (ratio: 2.06, P < 0.01). Finally, hospitals in areas with higher shares of minorities face a higher risk of trauma center closure (ratio: 1.69, P < 0.01). Medicaid load and uninsured populations, however, are not risk factors for higher rates of closure after we control for other financial and community characteristics. Our findings give an indication on how the current proposals to cut public spending could exacerbate the trauma closure particularly among areas with high shares of minorities. In addition, given the negative effect of health maintenance organizations on trauma center survival, the growth of Medicaid managed care population should be monitored. Finally, high shares of Medicaid or uninsurance by themselves are not independent risk factors for higher closure as long as financial pressures are mitigated. Targeted policy interventions and further research on the causes, are needed to address these systems-level disparities.

  15. Understanding high traffic injury risks for children in low socioeconomic areas: a qualitative study of parents' views.

    Science.gov (United States)

    Christie, N; Ward, H; Kimberlee, R; Towner, E; Sleney, J

    2007-12-01

    To gain an in-depth qualitative understanding of parents' views about their children's exposure to road traffic injury risk in low socioeconomic areas. Focus groups facilitated by a moderator with content analysis of data. Focus groups were conducted in 10 low socioeconomic English districts that also have high rates of child pedestrian injury. Research was conducted in community venues within each area. Parents of children aged 9-14 years living in low socioeconomic areas. Parents believe that children play in their local streets for the following reasons: they like playing out with friends near home; there are few safe, secure, and well-maintained public spaces for children; children are excluded from affordable leisure venues because of their costs; insufficient parental responsibility. For children that play in the street, the key sources of risk identified by parents were: illegal riding and driving around estates and on the pavements; the speed and volume of traffic; illegal parking; drivers being poorly informed about where children play; children's risk-taking behavior. Intervention programs need to take into account multiple reasons why children in low socioeconomic areas become exposed to hazardous environments thereby increasing their risk of injury. Multi-agency partnerships involving the community are increasingly needed to implement traditional road safety approaches, such as education, engineering, and enforcement, and provide safe and accessible public space, affordable activities for children, and greater support for parents.

  16. Late-life and life history predictors of older adults' high-risk alcohol consumption and drinking problems.

    Science.gov (United States)

    Moos, Rudolf H; Schutte, Kathleen K; Brennan, Penny L; Moos, Bernice S

    2010-04-01

    This prospective, longitudinal study focused on late-life and life history predictors of high-risk alcohol consumption and drinking problems during a 20-year interval as adults matured from age 55-65 to 75-85. A sample of older community residents (N=719) who had consumed alcohol in the past year or shortly before was surveyed at baseline and 10 and 20 years later. At each contact point, participants completed an inventory that assessed their alcohol consumption, drinking problems, and personal and life context factors. Participants also provided information about their life history of drinking and help-seeking. Older adults who, at baseline, had more friends who approved of drinking, relied on substances for tension reduction, and had more financial resources were more likely to engage in high-risk alcohol consumption and to incur drinking problems at 10- and 20-year follow-ups. With respect to life history factors, drinking problems by age 50 were associated with a higher likelihood of late-life high-risk alcohol consumption and drinking problems; having tried to cut down on drinking and participation in Alcoholics Anonymous were associated with a lower likelihood of high-risk consumption and problems. Specific late-life and life history factors can identify older adults likely to engage in excessive alcohol consumption 10 and 20 years later. Targeted screening that considers current alcohol consumption and life context, and history of drinking problems and help-seeking, could help identify older adults at higher risk for excessive or problematic drinking. Published by Elsevier Ireland Ltd.

  17. Hyperglycemia (High Blood Glucose)

    Medline Plus

    Full Text Available ... You At Risk? Diabetes Basics Living with Diabetes Food & Fitness In My Community Advocacy Research & Practice Ways to Give Close Are You at Risk? Home Prevention Diagnosing Diabetes and Learning About Prediabetes Type 2 Diabetes Risk Test Lower Your Risk Healthy Eating Overweight Smoking High ...

  18. High School Community Service as a Predictor of Adult Voting and Volunteering

    Science.gov (United States)

    Hart, Daniel; Donnelly, Thomas M.; Youniss, James; Atkins, Robert

    2007-01-01

    The influences of high school community service participation, extracurricular involvement, and civic knowledge on voting and volunteering in early adulthood were examined using the National Educational Longitudinal Study. The major finding in this study is that both voluntary and school-required community service in high school were strong…

  19. Stress, Health Risk Behaviors, and Weight Status Among Community College Students.

    Science.gov (United States)

    Pelletier, Jennifer E; Lytle, Leslie A; Laska, Melissa N

    2016-04-01

    The objective of this study was to describe the relationship between stress, weight-related health risk behaviors (e.g., eating behaviors, physical activity, sedentary behavior, sleep, cigarette smoking, and binge drinking), and weight status using cross-sectional data on 2-year community college students enrolled in a randomized controlled weight gain prevention trial. Modified Poisson regression and linear regression were used to examine crude and adjusted cross-sectional associations. Higher stress was associated with higher prevalence of overweight/obesity (crude prevalence ratio [PR] = 1.05; 95% confidence interval [CI: 1.01, 1.09]), though the relationship was no longer statistically significant after controlling for a wide range of weight-related health risk behaviors (adjusted PR = 1.04; 95% CI [1.00, 1.08]). Stress levels were significantly associated with meal skipping and being a current smoker. Future research should investigate the mechanisms through which stress is related to obesity risk and examine the causes of stress among this understudied population to inform the design of appropriate interventions. © 2015 Society for Public Health Education.

  20. Screening for Malnutrition in Community Dwelling Older Japanese: Preliminary Development and Evaluation of the Japanese Nutritional Risk Screening Tool (NRST).

    Science.gov (United States)

    Htun, N C; Ishikawa-Takata, K; Kuroda, A; Tanaka, T; Kikutani, T; Obuchi, S P; Hirano, H; Iijima, K

    2016-02-01

    Early and effective screening for age-related malnutrition is an essential part of providing optimal nutritional care to older populations. This study was performed to evaluate the adaptation of the original SCREEN II questionnaire (Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II) for use in Japan by examining its measurement properties and ability to predict nutritional risk and sarcopenia in community-dwelling older Japanese people. The ultimate objective of this preliminary validation study is to develop a license granted full Japanese version of the SCREEN II. The measurement properties and predictive validity of the NRST were examined in this cross-sectional study of 1921 community-dwelling older Japanese people. Assessments included medical history, and anthropometric and serum albumin measurements. Questions on dietary habits that corresponded to the original SCREEN II were applied to Nutritional Risk Screening Tool (NRST) scoring system. Nutritional risk was assessed by the Geriatric Nutrition Risk Index (GNRI) and the short form of the Mini-Nutritional Assessment (MNA-SF). Sarcopenia was diagnosed according to the criteria of the European Working Group on Sarcopenia in Older People. The nutritional risk prevalences determined by the GNRI and MNA-SF were 5.6% and 34.7%, respectively. The prevalence of sarcopenia was 13.3%. Mean NRST scores were significantly lower in the nutritionally at-risk than in the well-nourished groups. Concurrent validity analysis showed significant correlations between NRST scores and both nutritional risk parameters (GNRI or MNA-SF) and sarcopenia. The areas under the receiver operating characteristic curves (AUC) of NRST for the prediction of nutritional risk were 0.635 and 0.584 as assessed by GNRI and MNA-SF, respectively. AUCs for the prediction of sarcopenia were 0.602 (NRST), 0.655 (age-integrated NRST), and 0.676 (age and BMI-integrated NRST). These results indicate that the NRST is a

  1. Community wide interventions for increasing physical activity.

    Science.gov (United States)

    Baker, Philip R A; Francis, Daniel P; Soares, Jesus; Weightman, Alison L; Foster, Charles

    2015-01-05

    and their intensity. The primary outcome measures were grouped according to whether they were dichotomous (per cent physically active, per cent physically active during leisure time, and per cent physically inactive) or continuous (leisure time physical activity time (time spent)), walking (time spent), energy expenditure (as metabolic equivalents or METS)). For dichotomous measures we calculated the unadjusted and adjusted risk difference, and the unadjusted and adjusted relative risk. For continuous measures we calculated percentage change from baseline, unadjusted and adjusted. After the selection process had been completed, 33 studies were included. A total of 267 communities were included in the review (populations between 500 and 1.9 million). Of the included studies, 25 were set in high income countries and eight were in low income countries. The interventions varied by the number of strategies included and their intensity. Almost all of the interventions included a component of building partnerships with local governments or non-governmental organisations (NGOs) (29 studies). None of the studies provided results by socio-economic disadvantage or other markers of equity. However, of those included studies undertaken in high income countries, 14 studies were described as being provided to deprived, disadvantaged or low socio-economic communities. Nineteen studies were identified as having a high risk of bias, 10 studies were unclear, and four studies had a low risk of bias. Selection bias was a major concern with these studies, with only five studies using randomisation to allocate communities. Four studies were judged as being at low risk of selection bias although 19 studies were considered to have an unclear risk of bias. Twelve studies had a high risk of detection bias, 13 an unclear risk and four a low risk of bias. Generally, the better designed studies showed no improvement in the primary outcome measure of physical activity at a population level.All four

  2. Fall risk in community-dwelling elderly cancer survivors: a predictive model for gerontological nurses.

    Science.gov (United States)

    Spoelstra, Sandra; Given, Barbara; von Eye, Alexander; Given, Charles

    2010-02-01

    The aim of this predictive study was to test a structural model to establish predictors of fall risk in elderly cancer survivors. An aging and nursing model of care was synthesized and used to examine the Minimum Data Set for 6,912 low-income older adult participants in a community setting in the midwestern United States. Data analysis established relationships among fall risk and age, race/ethnicity, history of a previous fall, depression, pain, activities of daily living, instrumental activities of daily living, incontinence, vision, and cognitive status. Factors leading to fall risk can direct nursing activities that have the potential to prevent falls, thus improving older adults' quality of life. Copyright 2010, SLACK Incorporated.

  3. Development and Evaluation of an Online Fall-Risk Questionnaire for Nonfrail Community-Dwelling Elderly Persons: A Pilot Study

    Science.gov (United States)

    Obrist, Seraina; Rogan, Slavko; Hilfiker, Roger

    2016-01-01

    Introduction. Falls are frequent in older adults and may have serious consequences but awareness of fall-risk is often low. A questionnaire might raise awareness of fall-risk; therefore we set out to construct and test such a questionnaire. Methods. Fall-risk factors and their odds ratios were extracted from meta-analyses and a questionnaire was devised to cover these risk factors. A formula to estimate the probability of future falls was set up using the extracted odds ratios. The understandability of the questionnaire and discrimination and calibration of the prediction formula were tested in a cohort study with a six-month follow-up. Community-dwelling persons over 60 years were recruited by an e-mail snowball-sampling method. Results and Discussion. We included 134 persons. Response rates for the monthly fall-related follow-up varied between the months and ranged from low 38% to high 90%. The proportion of present risk factors was low. Twenty-five participants reported falls. Discrimination was moderate (AUC: 0.67, 95% CI 0.54 to 0.81). The understandability, with the exception of five questions, was good. The wording of the questions needs to be improved and measures to increase the monthly response rates are needed before test-retest reliability and final predictive value can be assessed. PMID:27247571

  4. Evaluation of a community-based participatory physical activity promotion project: effect on cardiovascular disease risk profiles of school employees

    Directory of Open Access Journals (Sweden)

    Kobza Cee E

    2010-06-01

    Full Text Available Abstract Background The efficacy of physical activity in improving cardiovascular disease (CVD risk profiles has been well established. However, the effectiveness of health promotion programs implemented at the community level remains controversial. This study evaluated a school-based work-site physical activity program. Methods Using a community-based participatory research model, a work-site wellness intervention was implemented in a rural public school system in Southwestern Oklahoma. During the 2005-2006 school year, 187 participants (mean age 45 years completed a pre intervention screening for CVD risk factors followed by a physical activity promotion program. Post intervention screening was conducted after a 6 month period. During both screening sessions, body composition, blood pressure, lipids, glucose and self-reported physical activity levels were assessed. The focus of the intervention was on promoting physical activity. Opportunities for in school physical activity were created by marking hallways, adding a treadmill in each school, and allowing teachers to use planning periods for physical activity. Results During the post intervention screening, compared to pre intervention levels, participants had lower total, low, and high density lipoprotein-cholesterol (t = 5.9, p Conclusions A successful participatory program was associated with improvements in several CVD risk factors among school employees. Limitations of this study such as seasonal variation in the outcome variables and lack of a control group limit our ability to draw solid conclusions about the effectiveness of the intervention.

  5. "It is not possible for me to have diabetes"-community perceptions on diabetes and its risk factors in Rural Purworejo District, Central Java, Indonesia.

    Science.gov (United States)

    Pujilestari, Cahya Utamie; Ng, Nawi; Hakimi, Mohammad; Eriksson, Malin

    2014-06-12

    Accumulating evidence suggests that negative perceptions towards diabetes can limit the management and prevention of the disease. The negative perceptions towards diabetes are prevalent in many different settings, especially among rural communities. Few qualitative studies have been performed to understand how the community views diabetes and its associated risk factors. This study aimed to explore general community perceptions of diabetes and its risk factors in rural Indonesia. A total of 68 participants were recruited to 12 focus group discussions (FGDs) comprised of different age groups and sexes. The FGDs were conducted in six villages in rural Purworejo District, Central Java, Indonesia, from 2011 to 2012. All FGDs were recorded and transcribed. Qualitative content analysis was performed to describe and analyse how the rural community perceived diabetes and its risk factors. Diabetes was perceived as a visible and scary sugar disease, and the affected individuals themselves were blamed for getting the disease. Recognised as 'sugar' or 'sweet-pee' disease with terrifying effects, diabetes was believed to be a disease with no cure. The participants seemed to have an unrealistic optimism with regards to the diabetes risk factors. They believed that diabetes would not affect them, only others, and that having family members with diabetes was necessary for one to develop diabetes. Our findings demonstrate that rural communities have negative perceptions about diabetes and at the same time individuals have unrealistic optimism about their own risk factors. Understanding how such communities perceive diabetes and its risk factors is important for planning prevention strategies. Health messages need to be tailored to health-related behaviours and the local culture's concepts of diseases and risk factors.

  6. Raptor community composition in the Texas Southern High Plains lesser prairie-chicken range

    Science.gov (United States)

    Behney, A.C.; Boal, Clint W.; Whitlaw, Heather A.; Lucia, D.R.

    2012-01-01

    Predation can be a factor in preventing prey population growth and sustainability when prey populations are small and fragmented, and when predator density is unrelated to the density of the single prey species. We conducted monthly raptor surveys from February 2007 to May 2009 in adjacent areas of the Texas Southern High Plains (USA) that do and do not support lesser prairie-chickens (Tympanuchus pallidicinctus), a candidate for protection under the Endangered Species Act. During the summer period corresponding to prairie-chicken nesting and brood-rearing, Swainson's hawks (Buteo swainsoni) were the most abundant raptor. During the lekking and overwintering period, the raptor community was diverse, with northern harriers (Circus cyaneus) being the most abundant species. Raptor abundance peaked during the early autumn and was lowest during the spring. Utility poles were a significant predictor of raptor density at survey points and Swainson's hawks and all raptors, pooled, were found in greater densities in non-prairie-chicken habitat dominated by mesquite (Prosopis glandulosa). Avian predation risk on prairie-chickens, based on presence and abundance of raptors, appears to be greatest during winter when there is a more abundant and diverse raptor community, and in areas with utility poles.

  7. High-sensitivity C-reactive protein and risk of sepsis.

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    Henry E Wang

    Full Text Available Conventional C-reactive protein assays have been used to detect or guide the treatment of acute sepsis. The objective of this study was to determine the association between elevated baseline high-sensitivity C-reactive protein (hsCRP and the risk of future sepsis events.We studied data from 30,239 community dwelling, black and white individuals, age ≥45 years old enrolled in the REasons for Geographic and Racial Differences in Stroke (REGARDS cohort. Baseline hsCRP and participant characteristics were determined at the start of the study. We identified sepsis events through review of hospital records. Elevated hsCRP was defined as values >3.0 mg/L. Using Cox regression, we determined the association between elevated hsCRP and first sepsis event, adjusting for sociodemographic factors (age, sex, race, region, education, income, health behaviors (tobacco and alcohol use, chronic medical conditions (coronary artery disease, diabetes, dyslipidemia, hypertension, chronic kidney disease, chronic lung disease and statin use.Over the mean observation time of 5.7 years (IQR 4.5-7.1, 974 individuals experienced a sepsis event, and 11,447 (37.9% had elevated baseline hsCRP (>3.0 mg/L. Elevated baseline hsCRP was independently associated with subsequent sepsis (adjusted HR 1.56; 95% CI 1.36-1.79, adjusted for sociodemographics, health behaviors, chronic medical conditions and statin use.Elevated baseline hsCRP was associated with increased risk of future sepsis events. hsCRP may help to identify individuals at increased risk for sepsis.

  8. Prevalence and risk factors for porcine cysticercosis in rural communities of eastern Minas Gerais, Brazil

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    Emilio C. Acevedo-Nieto

    Full Text Available ABSTRACT: Cysticercosis is caused by Taenia solium, a parasitic zoonosis that affects human and pigs raised free-range in developing countries. The epidemiology of the taeniosis cysticercosis complex in Brazil is poorly understood especially when it comes to field research. The aim of this study was to estimate the prevalence and identify the risk factors associated with porcine cysticercosis in rural communities located in the east of Minas Gerais (MG, Brazil. From 371 farms in the county of Tumiritinga/MG, 101 farms from 14 communities were randomly sampled. Blood samples from pigs were collected, and epidemiological questionnaires were carried out. The serum samples obtained were analyzed through immunodiagnosis techniques, including ELISA and Western Blot, both for the detection of antibodies. The data obtained by different surveys were analyzed using EpiInfo 3.5.1 software to determine seroprevalence and risk factors associated with cysticercosis. The prevalence of farms with porcine cysticercosis was 9.9% (10/101 and antibody-based seropositive was 5.3% (13/247. The results indicate that cysticercosis occurs in high level in the rural area never studied before. These results suggest the presence of tapeworm carriers contributing to the occurrence and maintenance of this zoonotic life cycle in the county. Regarding risk factors, the most significant determinants for porcine cysticercosis in the field were free-range pig management (OR: 17.4, p: 0.0001, the method of disposal of human faeces in the environmental (OR: 7.6; p 0.012, and the size of the farm. Porcine cysticercosis was diagnosed only in areas represented by Agrarian Reform Settlements. From the results, it is possible to recommend as a means of control and prevention the destination of human faeces in appropriate sanitary landfills and the production of pigs in an enclosed area. Additionally, improving education in the communities sampled will indirectly affect the spreading of

  9. Fall Risk Index predicts functional decline regardless of fall experiences among community-dwelling elderly.

    Science.gov (United States)

    Ishimoto, Yasuko; Wada, Taizo; Kasahara, Yoriko; Kimura, Yumi; Fukutomi, Eriko; Chen, Wenling; Hirosaki, Mayumi; Nakatsuka, Masahiro; Fujisawa, Michiko; Sakamoto, Ryota; Ishine, Masayuki; Okumiya, Kiyohito; Otsuka, Kuniaki; Matsubayashi, Kozo

    2012-10-01

    The 21-item Fall Risk Index (FRI-21) has been used to detect elderly persons at risk for falls. The aim of this longitudinal study was to evaluate the FRI-21 as a predictor of decline in basic activities of daily living (BADL) among Japanese community-dwelling elderly persons independent of fall risk. The study population consisted of 518 elderly participants aged 65 years and older who were BADL independent at baseline in Tosa, Japan. We examined risk factors for BADL decline from 2008 to 2009 by multiple logistic regression analysis on the FRI-21 and other functional status measures in all participants. We carried out the same analysis in selected participants who had no experience of falls to remove the effect of falls. A total of 45 of 518 participants showed decline in BADL within 1 year. Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.05-1.20), FRI-21 ≥ 10 (OR 3.81, 95% CI 1.49-9.27), intellectual activity dependence (OR 3.25, 95% CI 1.42-7.44) and history of osteoarthropathy (OR 3.17, 95% CI 1.40-7.21) were significant independent risk factors for BADL decline within 1 year. FRI-21 ≥ 10 and intellectual activity dependence (≤ 3) remained significant predictors, even in selected non-fallers. FRI-21 ≥ 10 and intellectual activity dependence were significant predictive factors of BADL decline, regardless of fall experience, after adjustment for confounding variables. The FRI-21 is a brief, useful tool not only for predicting falls, but also future decline in functional ability in community-dwelling elderly persons. © 2012 Japan Geriatrics Society.

  10. Renal transplantation in high cardiovascular risk patients.

    Science.gov (United States)

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

    2009-10-01

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

  11. Pathogen reduction requirements for direct potable reuse in Antarctica: evaluating human health risks in small communities.

    Science.gov (United States)

    Barker, S Fiona; Packer, Michael; Scales, Peter J; Gray, Stephen; Snape, Ian; Hamilton, Andrew J

    2013-09-01

    Small, remote communities often have limited access to energy and water. Direct potable reuse of treated wastewater has recently gained attention as a potential solution for water-stressed regions, but requires further evaluation specific to small communities. The required pathogen reduction needed for safe implementation of direct potable reuse of treated sewage is an important consideration but these are typically quantified for larger communities and cities. A quantitative microbial risk assessment (QMRA) was conducted, using norovirus, giardia and Campylobacter as reference pathogens, to determine the level of treatment required to meet the tolerable annual disease burden of 10(-6) DALYs per person per year, using Davis Station in Antarctica as an example of a small remote community. Two scenarios were compared: published municipal sewage pathogen loads and estimated pathogen loads during a gastroenteritis outbreak. For the municipal sewage scenario, estimated required log10 reductions were 6.9, 8.0 and 7.4 for norovirus, giardia and Campylobacter respectively, while for the outbreak scenario the values were 12.1, 10.4 and 12.3 (95th percentiles). Pathogen concentrations are higher under outbreak conditions as a function of the relatively greater degree of contact between community members in a small population, compared with interactions in a large city, resulting in a higher proportion of the population being at risk of infection and illness. While the estimates of outbreak conditions may overestimate sewage concentration to some degree, the results suggest that additional treatment barriers would be required to achieve regulatory compliance for safe drinking water in small communities. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Characteristics of violence among high-risk adolescent girls.

    Science.gov (United States)

    Secor-Turner, Molly; Garwick, Ann; Sieving, Renee; Seppelt, Ann

    2014-01-01

    Recent evidence demonstrates increasing rates of involvement with violence among adolescent girls. The objective of this study was to describe the types and sources of violence experienced within social contexts of adolescent girls at high risk for pregnancy. Qualitative data for this analysis are drawn from intervention summary reports of 116 girls participating in Prime Time, a youth development intervention for adolescent girls. Descriptive content analysis techniques were used to identify types and sources of violence experienced by girls within their daily contexts. Types of violence included physical fighting, witnessing violence, physical abuse, gang-related violence, verbal fighting, verbal abuse, and sexual abuse. Sources of violence included family, peers and friends, romantic partners, community violence, and self-perpetrated violence. Many girls in this study experienced violence in multiple contexts. It is imperative that efforts to assess and prevent violence among adolescent girls include paying attention to the social contexts in which these adolescents live. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

  13. The social construction of risk in a rural community: Responses of local residents to the 1990 Hagersville (Ontario) tire fire

    International Nuclear Information System (INIS)

    Eyles, J.; Taylor, S.M.; Baxter, J.; Sider, D.; Willms, D.

    1993-01-01

    This paper presents the findings of research relating to the 1990 Hagersville (Ontario) tire fire. After reviewing the literature on risk and risk perception, it begins by describing the event as well as the community in which it occurred. The reasons for adopting a qualitative research design are then established practical, conceptual, and methodological. The residents' accounts of the fire, evacuation, and aftermath in terms of concerns, anxieties, and responses are described. Five themes emerge: economic, community, health, environmental, and governance. The paper concludes by putting forward a case study-derived model of risk appraisal and management, and by relating the findings to policy issues. 48 refs., 1 fig

  14. Awareness of cervical cancer risk factors and symptoms: cross-sectional community survey in post-conflict northern Uganda.

    Science.gov (United States)

    Mwaka, Amos D; Orach, Christopher G; Were, Edward M; Lyratzopoulos, Georgios; Wabinga, Henry; Roland, Martin

    2016-08-01

    Lack of awareness of risk factors and symptoms for cancer may lead to late diagnosis and poor prognosis. We assessed community awareness about cervical cancer risk factors and symptoms and perceptions about prevention and cure of cervical cancer in order to contribute data to inform interventions to improve cervical cancer survival. Cross-sectional population-based survey. We conducted this study in Gulu, a post-conflict district in Uganda in 2012. The sample included 448 persons aged 18 years and above, selected through a multi-stage stratified cluster sampling process. We collected data using a pretested structured questionnaire. Logistic regressions were used to determine magnitudes of associations between socio-demographic and outcome variables. Most participants (444/448) had heard about cervical cancer. Known risk factors including multiple sexual partners, human papillomavirus infection, and early onset of sexual activity, were recognized by 88%, 82%, and 78% of respondents respectively. 63% of participants believed that prolonged use of family planning pills and injections caused cervical cancer. The majority of participants recognized symptoms of cervical cancer including inter-menstrual bleeding (85%), post-menopausal bleeding (84%), and offensive vaginal discharge (83%). 70% of participants believed that cervical cancer is preventable and 92% believed that it could be cured if diagnosed at an early stage. Recognition of cervical cancer risk factors and symptoms was high among study participants. Targeted interventions including increasing availability of HPV vaccination, population-based cervical screening and diagnostic services can translate high awareness into actual benefits. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  15. Timed Up And Go Risk Predictor Of Falls In Elderly People Residing In The Community?

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    Mayara Muniz Peixoto Rodrigues

    2017-04-01

    Full Text Available Objective: evaluate the risk of falls of elderly people residing in a community in northeastern Brazil using the “Timed up and go”. Method: descriptive study, with a quantitative approach, performed with elderly people residing in a community. The collected data related to the sociodemographic and economic characteristics of episodes of falls in the last two years, regular practice of physical exercise and complaint of pain at the time of the interview; and, at last, the application of the “Timed Up and Go” test. Result: Most of the elderly were classified as free and independent and independent. There is a direct relationship between advanced age and increased time to perform the test. Conclusion: the "Timed Up and Go" test was not effective in predicting risk of falls alone and should associate with other indicators. Descriptors: Elderly people; Accidents by fall; Walking; Postural balance.

  16. Cardiovascular Risk Factors in a Suburban Community in Nigeria

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    Titilope Modupe Dokunmu

    2018-01-01

    Full Text Available The burden of hypertension, a silent killer, continues to increase in low- and middle-income countries. This study evaluated blood pressure (BP in healthy adults to determine their risk of developing hypertension and to reduce associated morbidity of the disease. Overall, 182 subjects aged >16 years participated in the study. Systolic (SBP and diastolic blood pressure (DBP was measured after a resting period using mercury sphygmomanometer. Random blood glucose (RBG concentration was also determined. Regression models were used to determine risk of high BP with p values 35 years was an independent risk (likelihood ratio: 22.56, p 100 mg/dl. Undiagnosed hypertension rate is high in the study area, and urgent interventions for large scale screening and management of the disease are required to reduce the burden of hypertension in Nigeria.

  17. Effect of Community Engagement Interventions on Patient Safety and Risk Reduction Efforts in Primary Health Facilities: Evidence from Ghana.

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    Robert Kaba Alhassan

    Full Text Available Patient safety and quality care remain major challenges to Ghana's healthcare system. Like many health systems in Africa, this is largely because demand for healthcare is outstripping available human and material resource capacity of healthcare facilities and new investment is insufficient. In the light of these demand and supply constraints, systematic community engagement (SCE in healthcare quality assessment can be a feasible and cost effective option to augment existing quality improvement interventions. SCE entails structured use of existing community groups to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements identified and rewards provided if the quality gaps are closed.This paper evaluates whether or not SCE, through the assessment of health service quality, improves patient safety and risk reduction efforts by staff in healthcare facilities.A randomized control trail was conducted in 64 primary healthcare facilities in the Greater Accra and Western regions of Ghana. Patient risk assessments were conducted in 32 randomly assigned intervention and control facilities. Multivariate multiple regression test was used to determine effect of the SCE interventions on staff efforts towards reducing patient risk. Spearman correlation test was used to ascertain associations between types of community groups engaged and risk assessment scores of healthcare facilities.Clinic staff efforts towards increasing patient safety and reducing risk improved significantly in intervention facilities especially in the areas of leadership/accountability (Coef. = 10.4, p<0.05 and staff competencies (Coef. = 7.1, p<0.05. Improvement in service utilization and health resources could not be attributed to the interventions because these were outside the control of the study and might have been influenced by institutional or national level developments between the baseline and follow-up period

  18. Perturbation Training Can Reduce Community-Dwelling Older Adults’ Annual Fall Risk: A Randomized Controlled Trial

    Science.gov (United States)

    Bhatt, Tanvi; Yang, Feng; Wang, Edward

    2014-01-01

    Background. Previous studies indicated that a single session of repeated-slip exposure can reduce over 40% of laboratory-induced falls among older adults. The purpose of this study was to determine to what degree such perturbation training translated to the reduction of older adults’ annual falls risk in their everyday living. Methods. Two hundred and twelve community-dwelling older adults (≥65 years old) were randomly assigned to either the training group (N = 109), who then were exposed to 24 unannounced repeated slips, or the control group (N = 103), who merely experienced one slip during the same walking in the same protective laboratory environment. We recorded their falls in the preceding year (through self-reported history) and during the next 12 months (through falls diary and monitored with phone calls). Results. With this single session of repeated-slip exposure, training cut older adults’ annual risk of falls by 50% (from 34% to 15%, p fall during the same 12-month follow-up period (p falls. Conclusion. A single session of repeated-slip exposure could improve community-dwelling older adults’ resilience to postural disturbances and, hence, significantly reduce their annual risk of falls. PMID:24966227

  19. Community preparedness for highly pathogenic Avian influenza on Bali and Lombok, Indonesia.

    Science.gov (United States)

    Hunter, C; Birden, H H; Toribio, J-A; Booy, R; Abdurrahman, M; Ambarawati, A I G A A; Adiputra, N

    2014-01-01

    The Asia-Pacific region is the likeliest location for the next significant outbreak of highly pathogenic avian influenza (HPAI). Indonesia has experienced HPAI H5N1 outbreaks in poultry and humans each year since 2003 and has had the highest case fatality rate for human cases. The purposes of this study were to capture the knowledge of avian influenza and of poultry-raising practices in two regions of Indonesia and to evaluate the impact and extent of activities undertaken to 2010 through the National Strategic Plan for Avian Influenza Control at the village level. A combination of quantitative and qualitative methods was used to investigate the multiple influences on behaviours, decisions and actions taken by poultry-raising households, and by villages and communities, regarding the threat of HPAI. Between June 2010 and May 2011 a structured survey of 400 households was conducted on Lombok and of 402 on Bali, inviting Sector 3 (small-scale independent commercial poultry farms) and Sector 4 (village household) poultry raisers to participate. Focus groups and in-depth interviews were convened with key stakeholders, including livestock and animal health and public health officials, community leaders and villagers. From the focus group and in-depth interviews, it appears that the flow of information through the national HPAI control program has been efficient at the top levels (from national to provincial, then to districts and subdistricts). However, these findings show that effective transmission of information from subdistrict to rural village level and from village leaders to community members has been limited. The degree of community preparedness for HPAI on Bali and Lombok appears minimal. Knowledge of government activities was more extensive at Bali sites, while only limited government programs and activities occurred at the village level on Lombok. Activities conducted by government agencies from provincial to village level were limited in scope and need to be

  20. Community risk factors for ocular Chlamydia infection in Niger: pre-treatment results from a cluster-randomized trachoma trial.

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    Abdou Amza

    Full Text Available Trachoma control programs utilize mass azithromycin distributions to treat ocular Chlamydia trachomatis as part of an effort to eliminate this disease world-wide. But it remains unclear what the community-level risk factors are for infection.This cluster-randomized, controlled trial entered 48 randomly selected communities in a 2×2 factorial design evaluating the effect of different treatment frequencies and treatment coverage levels. A pretreatment census and examination established the prevalence of risk factors for clinical trachoma and ocular chlamydia infection including years of education of household head, distance to primary water source, presence of household latrine, and facial cleanliness (ocular discharge, nasal discharge, and presence of facial flies. Univariate and multivariate associations were tested using linear regression and Bayes model averaging.There were a total of 24,536 participants (4,484 children aged 0-5 years in 6,235 households in the study. Before treatment in May to July 2010, the community-level prevalence of active trachoma (TF or TI utilizing the World Health Organization [WHO] grading system was 26.0% (95% CI: 21.9% to 30.0% and the mean community-level prevalence of chlamydia infection by Amplicor PCR was 20.7% (95% CI: 16.5% to 24.9% in children aged 0-5 years. Univariate analysis showed that nasal discharge (0.29, 95% CI: 0.04 to 0.54; P = 0.03, presence of flies on the face (0.40, 95% CI: 0.17 to 0.64; P = 0.001, and years of formal education completed by the head of household (0.07, 95% CI: 0.07 to 0.13; P = 0.03 were independent risk factors for chlamydia infection. In multivariate analysis, facial flies (0.26, 95% CI: 0.02 to 0.49; P = 0.03 and years of formal education completed by the head of household (0.06, 95% CI: 0.008 to 0.11; P = 0.02 were associated risk factors for ocular chlamydial infection.We have found that the presence of facial flies and years of education of the head

  1. Prevalence of risk factors for noncommunicable diseases in an indigenous community in Santiago Atitlán, Guatemala

    OpenAIRE

    David Chen; Álvaro Rivera-Andrade; Jessica González; David Burt; Carlos Mendoza-Montano; James Patrie; Max Luna

    2017-01-01

    ABSTRACT Objective To describe the prevalence of noncommunicable disease (NCD) risk factors and assess knowledge of those risk factors in the indigenous community of Santiago Atitlán in Guatemala, a lower-middle income country. Methods A population-based, cross-sectional study was conducted using a modified version of the World Health Organization’s STEPS protocol. Adults aged 20–65 years were surveyed regarding demographics and NCD risk factors, and the survey was followed by anthropometri...

  2. Specialized surveillance for individuals at high risk for melanoma: a cost analysis of a high-risk clinic.

    Science.gov (United States)

    Watts, Caroline G; Cust, Anne E; Menzies, Scott W; Coates, Elliot; Mann, Graham J; Morton, Rachael L

    2015-02-01

    Regular surveillance of individuals at high risk for cutaneous melanoma improves early detection and reduces unnecessary excisions; however, a cost analysis of this specialized service has not been undertaken. To determine the mean cost per patient of surveillance in a high-risk clinic from the health service and societal perspectives. We used a bottom-up microcosting method to measure resource use in a consecutive sample of 102 patients treated in a high-risk hospital-based clinic in Australia during a 12-month period. Surveillance and treatment of melanoma. All surveillance and treatment procedures were identified through direct observation, review of medical records, and interviews with staff and were valued using scheduled fees from the Australian government. Societal costs included transportation and loss of productivity. The mean number of clinic visits per year was 2.7 (95% CI, 2.5-2.8) for surveillance and 3.8 (95% CI, 3.4-4.1) for patients requiring surgical excisions. The mean annual cost per patient to the health system was A $882 (95% CI, A $783-$982) (US $599 [95% CI, US $532-$665]); the cost discounted across 20 years was A $11,546 (95% CI, A $10,263-$12,829) (US $7839 [95% CI, US $6969-$8710]). The mean annual societal cost per patient (excluding health system costs) was A $972 (95% CI, A $899-$1045) (US $660 [95% CI, US $611-$710]); the cost discounted across 20 years was A $12,721 (95% CI, A $12,554-$14,463) (US $8637 [95% CI, US $8523-$9820]). Diagnosis of melanoma or nonmelanoma skin cancer and frequent excisions for benign lesions in a relatively small number of patients was responsible for positively skewed health system costs. Microcosting techniques provide an accurate cost estimate for the provision of a specialized service. The high societal cost reflects the time that patients are willing to invest to attend the high-risk clinic. This alternative model of care for a high-risk population has relevance for decision making about health policy.

  3. Risk of pneumonia associated with incident benzodiazepine use among community-dwelling adults with Alzheimer disease.

    Science.gov (United States)

    Taipale, Heidi; Tolppanen, Anna-Maija; Koponen, Marjaana; Tanskanen, Antti; Lavikainen, Piia; Sund, Reijo; Tiihonen, Jari; Hartikainen, Sirpa

    2017-04-10

    Knowledge regarding whether benzodiazepines and similarly acting non-benzodiazepines (Z-drugs) are associated with an increased risk of pneumonia among older adults is lacking. We sought to investigate this association among community-dwelling adults with Alzheimer disease, a condition in which both sedative/hypnotic use and pneumonia are common. We obtained data on all community-dwelling adults with a recent diagnosis of Alzheimer disease in Finland (2005-2011) from the Medication use and Alzheimer disease (MEDALZ) cohort, which incorporates national registry data on prescriptions, reimbursement, hospital discharges and causes of death. Incident users of benzodiazepines and Z-drugs were identified using a 1-year washout period and matched with nonusers using propensity scores. The association with hospital admission or death due to pneumonia was analyzed with the Cox proportional hazards model and adjusted for use of other psychotropic drugs in a time-dependent manner. Among 49 484 eligible participants with Alzheimer disease, 5232 taking benzodiazepines and 3269 taking Z-drugs were matched 1:1 with those not taking these drugs. Collectively, use of benzodiazepines and Z-drugs was associated with an increased risk of pneumonia (adjusted hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.05-1.42). When analyzed separately, benzodiazepine use was significantly associated with an increased risk of pneumonia (adjusted HR 1.28, 95% CI 1.07-1.54), whereas Z-drug use was not (adjusted HR 1.10, 95% CI 0.84-1.44). The risk of pneumonia was greatest within the first 30 days of benzodiazepine use (HR 2.09, 95% CI 1.26-3.48). Benzodiazepine use was associated with an increased risk of pneumonia among patients with Alzheimer disease. Risk of pneumonia should be considered when weighing the benefits and risks of benzodiazepines in this population. © 2017 Canadian Medical Association or its licensors.

  4. Improving nursing students' assessment of fall risk in community-dwelling older adults.

    Science.gov (United States)

    Patton, Susan K

    2016-12-09

    Nationally, approximately one third of older adults fall each year. Falls and resulting injury result in decreased mobility, functional impairment, loss of independence, and increased mortality. Utilization of evidence-based protocols by health care providers to identify older adults at risk of falling is limited, and rates of participation by older adults in prevention activities is low. Because of nursing's increasing role in caring for older adults, development of fall prevention education for nursing students would result in increased awareness of the need for fall prevention in community-dwelling older adults and increased access of older adults to falls risk assessment. There is a need to extend research to inform teaching and learning strategies for fall prevention. After pretesting, a convenience sample of 52 undergraduate nursing students and 22 graduate nursing students completed an online education program and performed a falls risk assessment on an older adult. After completing the clinical assignment, students completed a posttest and self-efficacy survey. Data were analyzed using multivariate statistical tests. Results revealed an increase in knowledge and student self-reporting of efficacy of fall risk assessment skills for the older adult population. This study suggests that nursing students acquired the necessary knowledge and self-efficacy for assessing fall risk of older adults through the combination of an online learning module and participating in actual fall risk assessment of an older adult.

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

    Science.gov (United States)

    Paguntalan, John C; Gregoski, Mathew

    2016-11-22

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

  6. Osteo-cise: Strong Bones for Life: Protocol for a community-based randomised controlled trial of a multi-modal exercise and osteoporosis education program for older adults at risk of falls and fractures

    Directory of Open Access Journals (Sweden)

    Gianoudis Jenny

    2012-05-01

    Full Text Available Abstract Background Osteoporosis affects over 220 million people worldwide, and currently there is no ‘cure’ for the disease. Thus, there is a need to develop evidence-based, safe and acceptable prevention strategies at the population level that target multiple risk factors for fragility fractures to reduce the health and economic burden of the condition. Methods/design The Osteo-cise: Strong Bones for Life study will investigate the effectiveness and feasibility of a multi-component targeted exercise, osteoporosis education/awareness and behavioural change program for improving bone health and muscle function and reducing falls risk in community-dwelling older adults at an increased risk of fracture. Men and women aged ≥60 years will participate in an 18-month randomised controlled trial comprising a 12-month structured and supervised community-based program and a 6-month ‘research to practise’ translational phase. Participants will be randomly assigned to either the Osteo-cise intervention or a self-management control group. The intervention will comprise a multi-modal exercise program incorporating high velocity progressive resistance training, moderate impact weight-bearing exercise and high challenging balance exercises performed three times weekly at local community-based fitness centres. A behavioural change program will be used to enhance exercise adoption and adherence to the program. Community-based osteoporosis education seminars will be conducted to improve participant knowledge and understanding of the risk factors and preventative measures for osteoporosis, falls and fractures. The primary outcomes measures, to be collected at baseline, 6, 12, and 18 months, will include DXA-derived hip and spine bone mineral density measurements and functional muscle power (timed stair-climb test. Secondary outcomes measures include: MRI-assessed distal femur and proximal tibia trabecular bone micro-architecture, lower limb and back

  7. Long-term effect of mass chemotherapy, transmission and risk factors for Schistosoma mansoni infection in very low endemic communities of Venezuela.

    Science.gov (United States)

    Hofstede, Stefanie N; Tami, Adriana; van Liere, Genevieve A F S; Ballén, Diana; Incani, Renzo N

    2014-12-01

    The prevalence of Schistosoma mansoni infection in Venezuela has changed from high to low due mostly to successful control activities, including mass chemotherapy and molluscicide applications. This study examined the impact of mass chemotherapy on S. mansoni transmission and risk factors for infection 12 years after administration of praziquantel in Venezuela. Two relatively isolated rural communities were studied, one with snail control (Manuare) and the second without (Los Naranjos). A cross-sectional survey of randomly selected households included 226 (Manuare) and 192 (Los Naranjos) consenting participants. S. mansoni prevalence was determined using a combination of coprological (Kato-Katz) and serological (circumoval precipitin test, alkaline phosphatase immunoassay and Western blot) tests. Data on epidemiological and socioeconomic risk factors were obtained through individual structured interviews. Univariate analysis and multivariate logistic regression models identified independent risk factors for infection. Water sites were examined for the presence of Biomphalaria glabrata snails. Only one participant was positive by coprology. The overall prevalences according to the combined tests were 32.7% in Manuare and 26.6% in Los Naranjos. Lower prevalences (12.7% in Manuare and 13.2% in Los Naranjos) were found in children 25 years), contact with specific water sites, and being a farmer/non-specialised worker. Mass treatment with praziquantel applied once to endemic communities led to an important and long-lasting sustained reduction of S. mansoni infections independent of the application of snail control. A degree of low active transmission of S. mansoni persisted in the treated areas which was associated with similar factors in both communities. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. High-risk regions and outbreak modelling of tularemia in humans.

    Science.gov (United States)

    Desvars-Larrive, A; Liu, X; Hjertqvist, M; Sjöstedt, A; Johansson, A; Rydén, P

    2017-02-01

    Sweden reports large and variable numbers of human tularemia cases, but the high-risk regions are anecdotally defined and factors explaining annual variations are poorly understood. Here, high-risk regions were identified by spatial cluster analysis on disease surveillance data for 1984-2012. Negative binomial regression with five previously validated predictors (including predicted mosquito abundance and predictors based on local weather data) was used to model the annual number of tularemia cases within the high-risk regions. Seven high-risk regions were identified with annual incidences of 3·8-44 cases/100 000 inhabitants, accounting for 56·4% of the tularemia cases but only 9·3% of Sweden's population. For all high-risk regions, most cases occurred between July and September. The regression models explained the annual variation of tularemia cases within most high-risk regions and discriminated between years with and without outbreaks. In conclusion, tularemia in Sweden is concentrated in a few high-risk regions and shows high annual and seasonal variations. We present reproducible methods for identifying tularemia high-risk regions and modelling tularemia cases within these regions. The results may help health authorities to target populations at risk and lay the foundation for developing an early warning system for outbreaks.

  9. Risk Aversion is Associated with Decision Making among Community-Based Older Persons.

    Science.gov (United States)

    Boyle, Patricia A; Yu, Lei; Buchman, Aron S; Bennett, David A

    2012-01-01

    Risk aversion is associated with many important decisions among younger and middle aged persons, but the association of risk aversion with decision making has not been well studied among older persons who face some of the most significant decisions of their lives. Using data from 606 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal epidemiologic study of aging, we examined the association of risk aversion with decision making. Risk aversion was measured using standard behavioral economics questions in which participants were asked to choose between a certain monetary payment ($15) versus a gamble in which they could gain more than $15 or gain nothing; potential gamble gains ranged from $20 to $300 with the gain amounts varied randomly over questions. Decision making was measured using a 12 item version of the Decision Making Competence Assessment Tool. In a linear regression model adjusted for age, sex, education, and income, greater risk aversion was associated with poorer decision making [estimate = -1.03, standard error (SE) = 0.35, p = 0.003]. Subsequent analyses showed that the association of risk aversion with decision making persisted after adjustment for global cognitive function as well as executive and non-executive cognitive abilities. Similar to findings from studies of younger persons, risk aversion is associated with poorer decision making among older persons who face a myriad of complex and influential decisions.

  10. 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.

  11. Laser prostatectomy in high-risk patients

    International Nuclear Information System (INIS)

    Tayib, Abdulmalik M.

    2008-01-01

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

  12. Thromboprophylaxis for Patients with High-risk Atrial Fibrillation and Flutter Discharged from the Emergency Department

    Directory of Open Access Journals (Sweden)

    E. Margaret Warton

    2018-02-01

    Full Text Available Introduction: Many patients with atrial fibrillation or atrial flutter (AF/FL who are high risk for ischemic stroke are not receiving evidence-based thromboprophylaxis. We examined anticoagulant prescribing within 30 days of receiving dysrhythmia care for non-valvular AF/FL in the emergency department (ED. Methods: This prospective study included non-anticoagulated adults at high risk for ischemic stroke (ATRIA score ≥7 who received emergency AF/FL care and were discharged home from seven community EDs between May 2011 and August 2012. We characterized oral anticoagulant prescribing patterns and identified predictors of receiving anticoagulants within 30 days of the index ED visit. We also describe documented reasons for withholding anticoagulation. Results: Of 312 eligible patients, 128 (41.0% were prescribed anticoagulation at ED discharge or within 30 days. Independent predictors of anticoagulation included age (adjusted odds ratio [aOR] 0.89 per year, 95% confidence interval [CI] 0.82–0.96; ED cardiology consultation (aOR 1.89, 95% CI [1.10–3.23]; and failure of sinus restoration by time of ED discharge (aOR 2.65, 95% CI [1.35–5.21]. Reasons for withholding anticoagulation at ED discharge were documented in 139 of 227 cases (61.2%, the most common of which were deferring the shared decision-making process to the patient’s outpatient provider, perceived bleeding risk, patient refusal, and restoration of sinus rhythm. Conclusion: Approximately 40% of non-anticoagulated AF/FL patients at high risk for stroke who presented for emergency dysrhythmia care were prescribed anticoagulation within 30 days. Physicians were less likely to anticoagulate older patients and those with ED sinus restoration. Opportunities exist to improve rates of thromboprophylaxis in this high-risk population.

  13. Crisis and emergency risk communication in a pandemic: a model for building capacity and resilience of minority communities.

    Science.gov (United States)

    Crouse Quinn, Sandra

    2008-10-01

    As public health agencies prepare for pandemic influenza, it is evident from our experience with Hurricane Katrina that these events will occur in the same social, historical, and cultural milieu in which marked distrust of government and health disparities already exist. This article grapples with the challenges of crisis and emergency risk communication with special populations during a pandemic. Recognizing that targeting messages to specific groups poses significant difficulties at that time, this article proposes a model of community engagement, disaster risk education, and crisis and emergency risk communication to prepare minority communities and government agencies to work effectively in a pandemic, build the capacity of each to respond, and strengthen the trust that is critical at such moments. Examples of such engagement and potential strategies to enhance trust include tools familiar to many health educators.

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

    International Nuclear Information System (INIS)

    Kim, Yusung; Tome, Wolfgang A.

    2006-01-01

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

  15. Limited Knowledge of Chronic Kidney Disease and Its Main Risk Factors among Iranian Community: An Appeal for Promoting National Public Health Education Programs

    Directory of Open Access Journals (Sweden)

    Peyman Roomizadeh

    2014-05-01

    Full Text Available Background The aim of this survey was to explore the baseline knowledge of the Iranian community about Chronic Kidney Disease (CKD definition and its two main risk factors, i.e. diabetes and hypertension. This study also introduced a model of public education program with the purpose of reducing the incidence of CKD in high-risk groups and thereby decreasing the economic burden of CKD in Iran. Methods This cross-sectional study was conducted on world kidney day 2013 in Isfahan, Iran. Self-administered anonymous questionnaires evaluating the knowledge of CKD and its risk factors were distributed among subjects who participated in a kidney disease awareness campaign. Chi-square test and logistic regression analysis were used to examine the differences in the level of knowledge across different socio-demographic groups. Results The questionnaires were completed by 748 respondents. The majority of these respondents believed that “pain in the flanks” and “difficulty in urination” was the early symptoms of CKD. Roughly, 10.4% knew that CKD could be asymptomatic in the initial stages. Only 12.7% knew diabetes and 14.4% knew hypertension was a CKD risk factor. The respondents who had a CKD risk factor (i.e. diabetes and/or hypertension were significantly more likely than respondents without CKD risk factor to select “unmanaged diabetes” [Odds Ratio (OR= 2.2, Confidence Interval (CI (95%: 1.4–3.6] and “unmanaged hypertension” [OR= 1.9, CI(95%: 1.2–3.0] as “very likely to result in CKD”. No more than 34.6% of all respondents with diabetes and/or hypertension reported that their physician has ever spoken with them about their increased risk for developing CKD. Conclusion The knowledge of Iranian population about CKD and its risk factors is low. Future public health education programs should put efforts in educating Iranian community about the asymptomatic nature of CKD in its initial stages and highlighting the importance of regular

  16. Brain network characterization of high-risk preterm-born school-age children

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    Elda Fischi-Gomez

    2016-01-01

    Full Text Available Higher risk for long-term cognitive and behavioral impairments is one of the hallmarks of extreme prematurity (EP and pregnancy-associated fetal adverse conditions such as intrauterine growth restriction (IUGR. While neurodevelopmental delay and abnormal brain function occur in the absence of overt brain lesions, these conditions have been recently associated with changes in microstructural brain development. Recent imaging studies indicate changes in brain connectivity, in particular involving the white matter fibers belonging to the cortico-basal ganglia-thalamic loop. Furthermore, EP and IUGR have been related to altered brain network architecture in childhood, with reduced network global capacity, global efficiency and average nodal strength. In this study, we used a connectome analysis to characterize the structural brain networks of these children, with a special focus on their topological organization. On one hand, we confirm the reduced averaged network node degree and strength due to EP and IUGR. On the other, the decomposition of the brain networks in an optimal set of clusters remained substantially different among groups, talking in favor of a different network community structure. However, and despite the different community structure, the brain networks of these high-risk school-age children maintained the typical small-world, rich-club and modularity characteristics in all cases. Thus, our results suggest that brain reorganizes after EP and IUGR, prioritizing a tight modular structure, to maintain the small-world, rich-club and modularity characteristics. By themselves, both extreme prematurity and IUGR bear a similar risk for neurocognitive and behavioral impairment, and the here defined modular network alterations confirm similar structural changes both by IUGR and EP at school age compared to control. Interestingly, the combination of both conditions (IUGR + EP does not result in a worse outcome. In such cases, the alteration

  17. Hospitality: transformative service to children, families, and communities.

    Science.gov (United States)

    Melton, Gary B

    2014-11-01

    Hospitality is an ancient moral practice that was deeply embedded in early Judaism, Christianity, and Islam. Hospitality requires acceptance of, service to, and respect for people who lack a place in the community. The contemporary importance of this practice reflects the social disconnection and economic disadvantage of many young parents and the high frequency of separation of young people, including many young parents, from their communities. Such social deterioration substantially increases the risk of child maltreatment. Building on the proposals of the U.S. Advisory Board on Child Abuse and Neglect, Strong Communities for Children demonstrated the effectiveness of community building in reducing such risk. It further suggested the importance of both relying on and learning from hospitable people in strengthening support for children and their parents. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  18. Flood Risk Management: Exploring the Impacts of the Community Rating System Program on Poverty and Income Inequality.

    Science.gov (United States)

    Noonan, Douglas S; Sadiq, Abdul-Akeem A

    2018-03-01

    Flooding remains a major problem for the United States, causing numerous deaths and damaging countless properties. To reduce the impact of flooding on communities, the U.S. government established the Community Rating System (CRS) in 1990 to reduce flood damages by incentivizing communities to engage in flood risk management initiatives that surpass those required by the National Flood Insurance Program. In return, communities enjoy discounted flood insurance premiums. Despite the fact that the CRS raises concerns about the potential for unevenly distributed impacts across different income groups, no study has examined the equity implications of the CRS. This study thus investigates the possibility of unintended consequences of the CRS by answering the question: What is the effect of the CRS on poverty and income inequality? Understanding the impacts of the CRS on poverty and income inequality is useful in fully assessing the unintended consequences of the CRS. The study estimates four fixed-effects regression models using a panel data set of neighborhood-level observations from 1970 to 2010. The results indicate that median incomes are lower in CRS communities, but rise in floodplains. Also, the CRS attracts poor residents, but relocates them away from floodplains. Additionally, the CRS attracts top earners, including in floodplains. Finally, the CRS encourages income inequality, but discourages income inequality in floodplains. A better understanding of these unintended consequences of the CRS on poverty and income inequality can help to improve the design and performance of the CRS and, ultimately, increase community resilience to flood disasters. © 2017 Society for Risk Analysis.

  19. High rates of advanced gastric cancer in community of Flushing, New York.

    Science.gov (United States)

    Dinani, Amreen; Desai, Amit; Kohn, Nina; Gutkin, Ellen; Nussbaum, Michel; Somnay, Kaumudi

    2012-03-01

    Gastric cancer remains a major public health issue and is a leading cause of death worldwide, accounting for 600,000 deaths annually. Over the last decades, there has been a steady decline in the incidence rates of gastric cancer. Furthermore, the incidence rates of gastric cancer in different parts of the country vary due to epidemiological and migration trends. Despite these trends, several studies that have continued to observe high rates of gastric cancer in populations that come from high-risk regions. The aim of the study was to describe the gastric cancer patients presenting NYHQ with an emphasis on those presenting at a young age and advanced disease. A subanalysis of the Asian population was also done, which is considered a high-risk group. Consecutive chart review of patients admitted with gastric cancer from January 2000 to August 2008 was extracted from the Oncology registry at NYHQ. Parameters that were evaluated were age, sex, race, type of gastric cancer, and stage of gastric cancer at initial presentation. The SAS/PC software package (SAS Institute Inc., Cary, NC) was employed for statistical analyses. Four hundred fifty-seven patients were diagnosed with gastric cancer. Approximately one third of the total patients were younger than 60 years of age. Of the Asian patients, almost half the patients (48.8%) had advanced disease of which two thirds were under the age of 60 years. The rates of advanced gastric cancer observed at NYHQ are significant and comparable to recent epidemiology literature on rates in Asian populations in Asia. Communities, like Flushing, NY, may benefit from early detection of gastric cancers, similar to those instituted in Japan and Taiwan.

  20. Frailty and cardiovascular risk in community-dwelling elderly: a population-based study

    Directory of Open Access Journals (Sweden)

    Ricci NA

    2014-10-01

    Full Text Available Natalia Aquaroni Ricci,1 Germane Silva Pessoa,1 Eduardo Ferriolli,2 Rosangela Correa Dias,3 Monica Rodrigues Perracini1 1Master’s and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID, São Paulo, 2Faculty of Medicine, Universidade de São Paulo (USP, Ribeirão Preto, 3Department of Physiotherapy, Universidade Federal de Minas Gerais (UFMG, Belo Horizonte, Brazil Background: Evidence suggests a possible bidirectional connection between cardiovascular disease (CVD and the frailty syndrome in older people.Purpose: To verify the relationship between CVD risk factors and the frailty syndrome in community-dwelling elderly.Methods: This population-based study used data from the Fragilidade em Idosos Brasileiros (FIBRA Network Study, a cross-sectional study designed to investigate frailty profiles among Brazilian older adults. Frailty status was defined as the presence of three or more out of five of the following criteria: unintentional weight loss, weakness, self-reported fatigue, slow walking speed, and low physical activity level. The ascertained CVD risk factors were self-reported and/or directly measured hypertension, diabetes mellitus, obesity, waist circumference ­measurement, and smoking.Results: Of the 761 participants, 9.7% were characterized as frail, 48.0% as pre-frail, and 42.3% as non-frail. The most prevalent CVD risk factor was hypertension (84.4% and the lowest one was smoking (10.4%. It was observed that among those participants with four or five risk factors there was a higher proportion of frail and pre-frail compared with non-frail (Fisher’s exact test: P=0.005; P=0.021. Self-reported diabetes mellitus was more prevalent among frail and pre-frail participants when compared with non-frail participants (Fisher’s exact test: P≤0.001; P≤0.001. There was little agreement between self-reported hypertension and hypertension identified by blood pressure measurement.Conclusion: Hypertension was

  1. The Community Environmental Monitoring Program: Reducing Public Perception of Risk through Stakeholder Involvement

    International Nuclear Information System (INIS)

    William T. Hartwell

    2007-01-01

    The Community Environmental Monitoring Program (CEMP) has promoted stakeholder involvement, awareness, and understanding of radiological surveillance in communities surrounding the Nevada Test Site (NTS) since 1981. It involves stakeholders in the operation, data collection, and dissemination of information obtained from a network of 29 stations across a wide area of Nevada, Utah and California. It is sponsored by the U.S. Department of Energy, National Nuclear Security Administration's Nevada Site Office (NNSA/NSO) and administered by the Desert Research Institute (DRI) of the Nevada System of Higher Education. Integration of a near real-time communications system, a public web site, training workshops for involved stakeholders, and educational programs all help to alleviate public perception of risk of health effects from past activities conducted at the NTS

  2. 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…

  3. Longitudinal association between habitual walking and fall occurrences among community-dwelling older adults: analyzing the different risks of falling.

    Science.gov (United States)

    Okubo, Yoshiro; Seino, Satoshi; Yabushita, Noriko; Osuka, Yosuke; Jung, Songee; Nemoto, Miyuki; Figueroa, Rafael; Tanaka, Kiyoji

    2015-01-01

    The purpose of this longitudinal study was to examine the association between habitual walking and multiple or injurious falls (falls) among community-dwelling older adults, by considering the relative risk of falling. A cohort of Japanese community-dwelling older adults (n=535) aged 60-91 years (73.1±6.6 year, 157 men and 378 women) who underwent community-based health check-ups from 2008 to 2012 were followed until 2013. Incidence rate of falls between walkers and non-walkers was compared separately by the number of risk factors (Groups R0, R1, R2, R3 and R4+). The Cox proportional hazard model was used to assess the association between habitual walking and falls separately by lower- (Rrisk groups. In Groups R0 and R1, the incidence of falls was lower in walkers than non-walkers; however, in Groups R2, R3, and R4+, the incidence of falls was higher in walkers. The Cox proportional hazard model showed that habitual walking was not significantly associated with falls (hazard ratio (HR): 0.88, 95% confidence interval (CI): 0.48-1.62) among the lower risk group but that it was significantly associated with increased falls (HR: 1.89, 95% CI: 1.04-3.43) among the higher risk group. The significant interaction between habitual walking and higher risk of falling was found (Prisk factors for falling, caution is needed when recommending walking because walking can actually increase their risk of experiencing multiple or injurious falls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Polyunsaturated fats, carbohydrates and carotid disease: The Atherosclerosis Risk in Communities (ARIC) Carotid MRI study.

    Science.gov (United States)

    Dearborn, Jennifer L; Qiao, Ye; Guallar, Eliseo; Steffen, Lyn M; Gottesman, Rebecca F; Zhang, Yiyi; Wasserman, Bruce A

    2016-08-01

    Carbohydrates and fat intake have both been linked to development of atherosclerosis. We examined associations between glycemic index (GI) and fat intake with carotid atherosclerosis. The Atherosclerosis Risk in Communities (ARIC) cohort enrolled participants during the period 1987-1989 and the Carotid MRI sub-study occurred between 2004 and 2006 (1672 participants attending both visits). Measures of carbohydrate quality (usual GI), fat intake (total, polyunsaturated and saturated) and overall dietary quality index (DASH Diet Score) were derived from a 66-item food frequency questionnaire administered at baseline. Trained readers measured lipid core presence and maximum wall thickness. Using multivariate logistic regression, we determined the odds of lipid core presence by quintile (Q) of energy-adjusted dietary components. Restricted cubic spline models were used to examine non-linear associations between dietary components and maximum wall thickness. Mean daily polyunsaturated fat intake was 5 g (SD 1.4). GI and polyunsaturated fat intake had a nonlinear relationship with maximum wall thickness. Low (1-4 g) and high (6-12 g) polyunsaturated fat intake were associated with a statistically significant decreased odds of lipid core presence compared to intake in a majority of participants (OR Q5 vs. Q2-4: 0.64, 95% CI 0.42 to 0.98; OR Q1 vs. Q2-4: 0.64, 95% CI 0.42, 0.96), however, the association with lipid core was attenuated by adjustment for maximum wall thickness, hypertension, hyperlipidemia, and diabetes. GI and polyunsaturated fat intake were not associated with high-risk plaque features, such as lipid core presence, independent of traditional vascular risk factors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. frequency and risk factors for chronic HCV infection: a community based study

    International Nuclear Information System (INIS)

    Tahir, M.; Mustafa, G.; Khan, M.B.

    2011-01-01

    It was a community based, cross-sectional study undertaken to assess the frequency of HCV infection and to find out the risk factors associated with its spread. Methods: Study was carried out from Oct 2004 to Mar 2005. One hundred and twenty five apparently healthy consecutive subjects not known to be infected with HBV or HCV, between the ages 13 and 60 years with equal sex distribution were selected from the population of the Village Mera Kalan near Rawalpindi. They were screened for Anti HCV antibodies using ELISA and interviewed in detail. Subjects found positive for Anti HCV Ab were tested for ALT (Alanine aminotransferase) levels and HCV RNA by PCR. Results: The frequency of HCV was found to be 53.6%. The most important risk factor associated with the transmission of HCV infection was unsafe injection therapy with contaminated equipment. Other risk factors include ear and nose piercing by unsterilized means in females and sharing of razors in males. Conclusion: The prevalence of HCV infection in our population is significantly higher than in the developed world. Public awareness programs should target the identified risk factors to prevent HCV transmission. (author)

  6. Prevalence and burden of chronic kidney disease among the general population and high-risk groups in Africa: a systematic review

    Science.gov (United States)

    Abd ElHafeez, Samar; Bolignano, Davide; D’Arrigo, Graziella; Dounousi, Evangelia; Tripepi, Giovanni; Zoccali, Carmine

    2018-01-01

    Objectives While increasing attention is paid to the rising prevalence of chronic diseases in Africa, there is little focus on chronic kidney disease (CKD). This systematic review assesses CKD burden among the general population and high-risk groups on the entire African continent. Design, setting and participants We searched Medline and PubMed databases for articles published between 1 January 1995 and 7 April 2017 by sensitive search strategies focusing on CKD surveys at the community level and high-risk groups. In total, 7918 references were evaluated, of which 7766 articles were excluded because they did not meet the inclusion criteria. Thus, 152 studies were included in the final analysis. Outcome measurement The prevalence of CKD in each study group was expressed as a range and pooled prevalence rate of CKD was calculated as a point estimate and 95% CI. No meta-analysis was done. Data were presented for different populations. Results In the community-level studies, based on available medium-quality and high-quality studies, the prevalence of CKD ranged from 2% to 41% (pooled prevalence: 10.1%; 95% CI 9.8% to 10.5%). The prevalence of CKD in the high-risk groups ranged from 1% to 46% (pooled prevalence: 5.6%; 95% CI 5.4% to 5.8%) in patients with HIV (based on available medium-quality and high-quality studies), 11%–90% (pooled prevalence: 24.7%; 95% CI 23.6% to 25.7%) in patients with diabetes (based on all available studies which are of low quality except four of medium quality) and 13%–51% (pooled prevalence: 34.5%; 95 % CI 34.04% to 36%) in patients with hypertension (based on all available studies which are of low quality except two of medium quality). Conclusion In Africa, CKD is a public health problem, mainly attributed to high-risk conditions as hypertension and diabetes. The poor data quality restricts the validity of the findings and draws the attention to the importance of designing future robust studies. PMID:29326180

  7. 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.

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

    Science.gov (United States)

    Shishko, Robert; Jorgensen, Edward J.

    1996-01-01

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

  9. Prevalence and distribution of high-risk human papilloma virus (HPV types in invasive squamous cell carcinoma of the cervix and in normal women in Andhra Pradesh, India

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    Rao BN

    2005-12-01

    Full Text Available Abstract Background Despite the high incidence of cervical cancer reported from India, large scale population based studies on the HPV prevalence and genotype distribution are very few from this region. In view of the clinical trials for HPV vaccine taking place in India, it is of utmost importance to understand the prevalence of HPV genotypes in various geographical regions of India. We investigated the genotype distribution of high-risk HPV types in squamous cell carcinomas and the prevalence of high-risk HPV in cervicovaginal samples in the southern state of Andhra Pradesh (AP, India. Methods HPV genotyping was done in cervical cancer specimens (n = 41 obtained from women attending a regional cancer hospital in Hyderabad. HPV-DNA testing was also done in cervicovaginal samples (n = 185 collected from women enrolled in the cervical cancer screening pilot study conducted in the rural community, of Medchal Mandal, twenty kilometers away from Hyderabad. Results High-risk HPV types were found in 87.8% (n = 36/41 of the squamous cell carcinomas using a PCR-based line blot assay. Among the HPV positive cancers, the overall type distribution of the major high-risk HPV types was as follows: HPV 16 (66.7%, HPV 18 (19.4%, HPV 33 (5.6%, HPV 35 (5.6%, HPV 45 (5.6%, HPV 52 (2.8%, HPV 58(2.8%, HPV 59(2.8% and HPV 73 (2.8%. Women participating in the community screening programme provided both a self-collected vaginal swab and a clinician-collected cervical swab for HPV DNA testing. Primary screening for high risk HPV was performed using the Digene Hybrid Capture 2 (hc2 assay. All hc2 positive samples by any one method of collection were further analyzed using the Roche PCR-based line blot for genotype determination. The prevalence of high risk HPV infection in this community-based screening population was 10.3% (19/185 using the clinician-collected and 7.0% (13/185 using the self-collected samples. The overall agreement between self-collected and clinician

  10. Late-Life and Life History Predictors of Older Adults of High-Risk Alcohol Consumption and Drinking Problems

    Science.gov (United States)

    Moos, Rudolf H.; Schutte, Kathleen K.; Brennan, Penny L.; Moos, Bernice S.

    2009-01-01

    Aims This prospective, longitudinal study focused on late-life and life history predictors of high-risk alcohol consumption and drinking problems during a 20-year interval as adults matured from age 55–65 to age 75–85. Design, Setting, Participants A sample of older community residents (N=719) who had consumed alcohol in the past year or shortly before was surveyed at baseline and 10 years and 20 years later. Measurements At each contact point, participants completed an inventory that assessed their alcohol consumption, drinking problems, and personal and life context factors. Participants also provided information about their life history of drinking and help-seeking. Results Older adults who, at baseline, had more friends who approved of drinking, relied on substances for tension reduction, and had more financial resources were more likely to engage in high-risk alcohol consumption and to incur drinking problems at 10-year and 20-year follow-ups. With respect to life history factors, drinking problems by age 50 were associated with a higher likelihood of late-life high-risk alcohol consumption and drinking problems; having tried to cut down on drinking and participation in Alcoholics Anonymous were associated with a lower likelihood of high-risk consumption and problems. Conclusion Specific late-life and life history factors can identify older adults likely to engage in excessive alcohol consumption 10 and 20 years later. Targeted screening that considers current alcohol consumption and life context, and history of drinking problems and help-seeking, could help identify older adults at higher risk for excessive or problematic drinking. PMID:19969428

  11. Communicating Flood Risk with Street-Level Data

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    Sanders, B. F.; Matthew, R.; Houston, D.; Cheung, W. H.; Karlin, B.; Schubert, J.; Gallien, T.; Luke, A.; Contreras, S.; Goodrich, K.; Feldman, D.; Basolo, V.; Serrano, K.; Reyes, A.

    2015-12-01

    Coastal communities around the world face significant and growing flood risks that require an accelerating adaptation response, and fine-resolution urban flood models could serve a pivotal role in enabling communities to meet this need. Such models depict impacts at the level of individual buildings and land parcels or "street level" - the same spatial scale at which individuals are best able to process flood risk information - constituting a powerful tool to help communities build better understandings of flood vulnerabilities and identify cost-effective interventions. To measure understanding of flood risk within a community and the potential impact of street-level models, we carried out a household survey of flood risk awareness in Newport Beach, California, a highly urbanized coastal lowland that presently experiences nuisance flooding from high tides, waves and rainfall and is expected to experience a significant increase in flood frequency and intensity with climate change. Interviews were completed with the aid of a wireless-enabled tablet device that respondents could use to identify areas they understood to be at risk of flooding and to view either a Federal Emergency Management Agency (FEMA) flood map or a more detailed map prepared with a hydrodynamic urban coastal flood model (UCI map) built with grid cells as fine as 3 m resolution and validated with historical flood data. Results indicate differences in the effectiveness of the UCI and FEMA maps at communicating the spatial distribution of flood risk, gender differences in how the maps affect flood understanding, and spatial biases in the perception of flood vulnerabilities.

  12. Community Savings Groups, Financial Security, and HIV Risk Among Female Sex Workers in Iringa, Tanzania.

    Science.gov (United States)

    Mantsios, Andrea; Galai, Noya; Mbwambo, Jessie; Likindikoki, Samuel; Shembilu, Catherine; Mwampashi, Ard; Beckham, S W; Leddy, Anna; Davis, Wendy; Sherman, Susan; Kennedy, Caitlin; Kerrigan, Deanna

    2018-02-24

    This study assessed the association between community savings group participation and consistent condom use (CCU) among female sex workers (FSW) in Iringa, Tanzania. Using cross-sectional data from a survey of venue-based FSW (n = 496), logistic regression was used to examine the associations between financial indicators including community savings group participation and CCU. Over one-third (35%) of the women participated in a savings group. Multivariable regression results indicated that participating in a savings group was significantly associated with nearly two times greater odds of CCU with new clients in the last 30 days (aOR = 1.77, 95% CI 1.10-2.86). Exploratory mediation analysis indicated that the relationship between savings group participation and CCU was partially mediated by financial security, as measured by monthly income. Findings indicate that community savings groups may play an important role in reducing sexual risk behaviors of FSW and hold promise as part of comprehensive, community-led HIV prevention strategies among FSW.

  13. Early risk factors for alcohol use across high school and its covariation with deviant friends.

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    Armstrong, Jeffrey M; Ruttle, Paula L; Burk, Linnea R; Costanzo, Philip R; Strauman, Timothy J; Essex, Marilyn J

    2013-09-01

    Past research has associated childhood characteristics and experiences with alcohol use at single time points in adolescence. Other work has focused on drinking trajectories across adolescence but with risk factors typically no earlier than middle or high school. Similarly, although the connection between underage drinking and affiliation with deviant friends is well established, early risk factors for their covariation across adolescence are uncertain. The present study examines the influence of early individual and contextual factors on (a) trajectories across high school of per-occasion alcohol use and (b) the covariation of alcohol use and deviant friends over time. In a longitudinal community sample (n = 374; 51% female), temperamental disinhibition, authoritarian and authoritative parenting, and parental alcohol use were assessed during childhood, and adolescents reported on alcohol use and affiliation with deviant friends in the spring of Grades 9, 10, 11, and 12. Early parental alcohol use predicted the intercept of adolescent drinking. Subsequent patterns of adolescent alcohol use were predicted by sex and interactions of sex and childhood disinhibition with early authoritarian parenting. Additionally, childhood disinhibition interacted with parental alcohol use to moderate the covariation of drinking and deviant friends. These findings highlight early individual and contextual risk factors for alcohol use across high school, extending previous work and underscoring the importance of developmental approaches and longitudinal techniques for understanding patterns of growth in underage drinking.

  14. Assessing residential building values in Spain for risk analyses - application to the landslide hazard in the Autonomous Community of Valencia

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    Cantarino, I.; Torrijo, F. J.; Palencia, S.; Gielen, E.

    2014-11-01

    This paper proposes a method of valuing the stock of residential buildings in Spain as the first step in assessing possible damage caused to them by natural hazards. For the purposes of the study we had access to the SIOSE (the Spanish Land Use and Cover Information System), a high-resolution land-use model, as well as to a report on the financial valuations of this type of building throughout Spain. Using dasymetric disaggregation processes and GIS techniques we developed a geolocalized method of obtaining this information, which was the exposure variable in the general risk assessment formula. Then, with the application over a hazard map, the risk value can be easily obtained. An example of its application is given in a case study that assesses the risk of a landslide in the entire 23 200 km2 of the Valencia Autonomous Community (NUT2), the results of which are analysed by municipal areas (LAU2) for the years 2005 and 2009.

  15. Risk factors and the occurrence of cerebral palsy in high risk infants

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    Setyo Handryastuti

    2018-04-01

    Full Text Available Background The incidence of cerebral palsy (CP has increased due to better survival rates of high-risk babies. Early detection and time to the occurrence of CP in the first year of life is important in order to provide early intervention. Objectives To determine the proportion of CP in high-risk babies, the time to the occurrence of CP in the first year, and assess possible associations between risk factors of CP and time to the occurrence of CP. Methods A prospective cohort study was done on 150 high-risk babies up to the age of 12 months. We obtained history of motor ability and assessed primitive reflexes and postural reactions of subjects at the ages of 4 and 6 months. The diagnosis of CP was established at 6 and 12 months of age. Results The proportion of CP was 26% at 6 months and 24% at 12 months of age. Significant risk factors associated with CP at 6 and 12 months of age were cerebral ultrasound abnormalities, hypoxic-ischemic encephalopathy, and intracranial hemorrhage. In 88.7% of subjects with CP, CP was detected in the first 6 months. Mean age at the occurrence of CP was 9.99 months (95%CI 9.46 to 10.53. Risk factors that significantly affected the time to the occurrence of CP by survival analysis were ultrasound abnormalities and hypoxic-ischemic encephalopathy. Conclusions Cerebral palsy can be detected as early as the first 6 months of life. Cerebral ultrasound abnormalities and hypoxic ischemic encephalopathy are the risk factors associated with CP.

  16. Factors Influencing Cancer Risk Perception in High Risk Populations: A Systematic Review

    Science.gov (United States)

    2011-01-01

    Background Patients at higher than average risk of heritable cancer may process risk information differently than the general population. However, little is known about clinical, demographic, or psychosocial predictors that may impact risk perception in these groups. The objective of this study was to characterize factors associated with perceived risk of developing cancer in groups at high risk for cancer based on genetics or family history. Methods We searched Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, and Scopus from inception through April 2009 for English-language, original investigations in humans using core concepts of "risk" and "cancer." We abstracted key information and then further restricted articles dealing with perceived risk of developing cancer due to inherited risk. Results Of 1028 titles identified, 53 articles met our criteria. Most (92%) used an observational design and focused on women (70%) with a family history of or contemplating genetic testing for breast cancer. Of the 53 studies, 36 focused on patients who had not had genetic testing for cancer risk, 17 included studies of patients who had undergone genetic testing for cancer risk. Family history of cancer, previous prophylactic tests and treatments, and younger age were associated with cancer risk perception. In addition, beliefs about the preventability and severity of cancer, personality factors such as "monitoring" personality, the ability to process numerical information, as well as distress/worry also were associated with cancer risk perception. Few studies addressed non-breast cancer or risk perception in specific demographic groups (e.g. elderly or minority groups) and few employed theory-driven analytic strategies to decipher interrelationships of factors. Conclusions Several factors influence cancer risk perception in patients at elevated risk for cancer. The science of characterizing and improving risk perception in cancer for high risk groups, although evolving, is still

  17. Factors Influencing Cancer Risk Perception in High Risk Populations: A Systematic Review

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    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

  18. Volcanic Risk Perception and Preparedness in Communities within the Mount Baker and Glacier Peak Lahar Hazard Zones

    Science.gov (United States)

    Corwin, K.; Brand, B. D.

    2014-12-01

    A community's ability to effectively respond to and recover from natural hazards depends on both the physical characteristics of the hazard and the community's inherent resilience. Resilience is shaped by a number of factors including the residents' perception of and preparedness for a natural hazard as well as the level of institutional preparedness. This study examines perception of and preparedness for lahar hazards from Mount Baker and Glacier Peak in Washington's Skagit Valley. Through an online survey, this study isolates the influence of specific variables (e.g., knowledge, past experience, scientific background, trust in various information sources, occupation, self-efficacy, sense of community) on risk perception and explores reasons behind the frequent disconnect between perception and preparedness. We anticipate that individuals with more extensive education in the sciences, especially geology or earth science, foster greater trust in scientists and a more accurate knowledge, understanding, and perception of the volcanic hazards in their community. Additionally, little research exists examining the extent to which first responders and leaders in response-related institutions prepare on a personal level. Since these individuals work toward community preparedness professionally, we hypothesize that they will be more prepared at home than members of the general public. Finally, the Skagit Valley has a significant history of flooding. We expect that the need to respond to and recover from frequent flooding creates a community with an inherently higher level of preparedness for other hazards such as lahars. The results of this study will contribute to the understanding of what controls risk perception and the interplay between perception and preparedness. At a broader level, this study provides local and state-level emergency managers information to evaluate and improve response capabilities and communication with the public and key institutions in order to

  19. Prevalence and associated risk factors of hypertension amongst adults in a rural community of Limpopo Province, South Africa

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    Samuel T. Ntuli

    2015-10-01

    Full Text Available Background: Hypertension is problem already faced by urban populations of South Africa, but little is known about its prevalence and risk factors in rural areas. Aim: To assess the prevalence of and risk factors associated with hypertension amongst adults in a rural community in South Africa. Setting: Dikgale Health and Demographic Surveillance Site, Limpopo Province, South Africa. Methods: A community-based cross-sectional survey was carried out at this site where individuals aged 15 years and older were screened using a locally adapted version of the World Health Organization STEPwise questionnaire. Demographics, anthropometry and three independent blood pressure (BP readings were taken. The average of the three BP measurements was used in analysis, and hypertension taken as systolic and diastolic BP of ≥ 140 or ≥ 90 mmHg respectively, or at least a two-week history of antihypertensive treatment. Analysis included the Chi-square test and statistical significance was set at p ≤ 0.05. Results: A total of 1407 individuals were interviewed, of whom 1281 had complete BP, weight and height measurements taken. The mean age of participants was 44.2 ± 2 0.9 years (range 15–98 years, 63% were female, 55% were single and 90% were unemployed, whilst 13% were tobacco smokers and 20% reported drinking alcohol. Overall prevalence of hypertension was 41% and this was significantly associated with age and marital status. Conclusion: The prevalence of hypertension was found to be high. Prevention strategies are urgently needed to address this life-threatening and important risk factor for cardiovascular disease in rural Limpopo Province.

  20. Development and Evaluation of an Online Fall-Risk Questionnaire for Nonfrail Community-Dwelling Elderly Persons: A Pilot Study

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    Seraina Obrist

    2016-01-01

    Full Text Available Introduction. Falls are frequent in older adults and may have serious consequences but awareness of fall-risk is often low. A questionnaire might raise awareness of fall-risk; therefore we set out to construct and test such a questionnaire. Methods. Fall-risk factors and their odds ratios were extracted from meta-analyses and a questionnaire was devised to cover these risk factors. A formula to estimate the probability of future falls was set up using the extracted odds ratios. The understandability of the questionnaire and discrimination and calibration of the prediction formula were tested in a cohort study with a six-month follow-up. Community-dwelling persons over 60 years were recruited by an e-mail snowball-sampling method. Results and Discussion. We included 134 persons. Response rates for the monthly fall-related follow-up varied between the months and ranged from low 38% to high 90%. The proportion of present risk factors was low. Twenty-five participants reported falls. Discrimination was moderate (AUC: 0.67, 95% CI 0.54 to 0.81. The understandability, with the exception of five questions, was good. The wording of the questions needs to be improved and measures to increase the monthly response rates are needed before test-retest reliability and final predictive value can be assessed.

  1. Association of Source of Memory Complaints and Increased Risk of Cognitive Impairment and Cognitive Decline: A Community-Based Study.

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    Qi, Xue-Mei; Gu, Lin; Tang, Hui-Dong; Chen, Sheng-Di; Ma, Jian-Fang

    2018-04-20

    Memory complaint is common in the elderly. Recently, it was shown that self-report memory complaint was predictive of cognitive decline. This study aimed to investigate the predictive value of the source of memory complaints on the risk of cognitive impairment and cognitive decline in a community-based cohort. Data on memory complaints and cognitive function were collected among 1840 Chinese participants (aged ≥55 years old) in an urban community at baseline interview and 5-year follow-up. Incident cognitive impairment was identified based on education-adjusted Mini-Mental State Examination score. Logistic regression model was used to estimate the association between the source of memory complaints and risk of cognitive impairment conversion and cognitive decline, after adjusting for covariates. A total of 1840 participants were included into this study including 1713 normal participants and 127 cognitive impairment participants in 2009. Among 1713 normal participants in 2009, 130 participants were converted to cognitive impairment after 5 years of follow-up. In 2014, 606 participants were identified as cognitive decline. Both self- and informant-reported memory complaints were associated with an increased risk of cognitive impairment (odds ratio [OR] = 1.60, 95% confidence interval [CI]: 1.04-2.48) and cognitive decline (OR = 1.30, 95% CI: 1.01-1.68). Furthermore, this association was more significant in males (OR = 2.10, 95% CI: 1.04-4.24 for cognitive impairment and OR = 1.87, 95% CI: 1.20-2.99 for cognitive decline) and in higher education level (OR = 1.79, 95% CI: 1.02-3.15 for cognitive impairment and OR = 1.40, 95% CI: 1.02-1.91 for cognitive decline). Both self- and informant-reported memory complaints were associated with an increased risk of cognitive impairment conversion and cognitive decline, especially in persons with male gender and high educational background.

  2. Psychological characteristics in high-risk MSM in China

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    Chen Guanzhi

    2012-01-01

    Full Text Available Abstract Background Men who have sex with men (MSM have become a high-risk group of HIV infection in China. To date, little is known regarding the behavioral, social and psychological characteristics in Chinese MSM, which makes the implementation of preventive and therapeutic strategies for this high-risk subpopulation of people extremely difficult. Methods A total of 714 questionnaires were retrieved from the database of a Chinese government-sponsored National Key Research Project titled "Risk Analysis and Strategic Prevention of HIV Transmission from MSM to the General Population in China". The respondents were categorized into a high-risk group and a control group. Their behavioral, social and psychological characteristics were comparatively analyzed. Results Of the 714 MSM analyzed, 59 (8.26% had high-risk homosexual behaviors. This sub-group of MSM had a higher in-marriage rate, a higher monthly income, heavier alcohol consumption and more serious problems with sexual abuse in childhood, intentional suicide attempts and mistaken assumption on condom's role in protecting HIV infection, as compared with the control group (P P > 0.05. A vast majority of the individuals in both behavior categories expressed support of legally protected gay clubs as well as gay marriage legislation in China. There was a strong correlation between high-risk behaviors and sexual abuse in childhood, alcohol drinking, income level and a mistaken belief in perfect HIV protection through the use of condoms. Conclusions MSM with and without high-risk homosexual behaviors have different social and psychological characteristics, which should be taken into account when implementing behavioral and therapeutic interventions aimed at preventing HIV/AIDS transmission among MSM as well as from MSM to the general population in China.

  3. Prevalence and Risk Factors of Low Health Literacy: A Community-Based Study in Shanghai, China

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    Ying Wu

    2017-06-01

    Full Text Available Background: Health literacy is an increasingly important public health concern. However, little is known about the health literacy of general public in China. The aim of this study was to evaluate the prevalence of low health literacy and demographic associations in Shanghai, China. Methods: This study was a community-based cross-sectional health survey utilizing a multi-stage random sampling design. The sample consisted of 1360 individuals aged 15–69 years with the total community-dwelling Chinese as the sample frame. Health literacy was measured by a questionnaire developed on the basis of a national health literacy manual released by the Chinese Ministry of Health. Multiple logistic regression models were used to identify whether common socio-demographic features were associated with health literacy level. Results: The prevalence of low health literacy was 84.49% (95% CI, 82.56% to 86.41%. The prevalence of low health literacy was negatively associated with the level of education, occupation, and annual household income, but was not associated with gender, age, or the presence of non-communicable chronic disease. Conclusions: Simplifying health services, enhancing health education, and promoting interventions to improve health literacy in high-risk populations should be considered as part of the strategies in the making of health policy in China.

  4. Predictive risk modelling under different data access scenarios: who is identified as high risk and for how long?

    Science.gov (United States)

    Johnson, Tracy L; Kaldor, Jill; Sutherland, Kim; Humphries, Jacob; Jorm, Louisa R; Levesque, Jean-Frederic

    2018-01-01

    Objective This observational study critically explored the performance of different predictive risk models simulating three data access scenarios, comparing: (1) sociodemographic and clinical profiles; (2) consistency in high-risk designation across models; and (3) persistence of high-risk status over time. Methods Cross-sectional health survey data (2006–2009) for more than 260 000 Australian adults 45+ years were linked to longitudinal individual hospital, primary care, pharmacy and mortality data. Three risk models predicting acute emergency hospitalisations were explored, simulating conditions where data are accessed through primary care practice management systems, or through hospital-based electronic records, or through a hypothetical ‘full’ model using a wider array of linked data. High-risk patients were identified using different risk score thresholds. Models were reapplied monthly for 24 months to assess persistence in high-risk categorisation. Results The three models displayed similar statistical performance. Three-quarters of patients in the high-risk quintile from the ‘full’ model were also identified using the primary care or hospital-based models, with the remaining patients differing according to age, frailty, multimorbidity, self-rated health, polypharmacy, prior hospitalisations and imminent mortality. The use of higher risk prediction thresholds resulted in lower levels of agreement in high-risk designation across models and greater morbidity and mortality in identified patient populations. Persistence of high-risk status varied across approaches according to updated information on utilisation history, with up to 25% of patients reassessed as lower risk within 1 year. Conclusion/implications Small differences in risk predictors or risk thresholds resulted in comparatively large differences in who was classified as high risk and for how long. Pragmatic predictive risk modelling design decisions based on data availability or projected

  5. Prevalence and associated risk factors of Taenia solium taeniasis in a rural pig farming community of north India.

    Science.gov (United States)

    Prasad, Kashi N; Prasad, Amit; Gupta, Rakesh K; Pandey, Chandra M; Singh, Uttam

    2007-12-01

    There is a lack of information on the disease burden due to Taenia solium taeniasis and its associated risk factors in pig farming communities throughout the world. The present study was conducted in a rural pig farming community of north India to estimate the prevalence of T. solium taeniasis and associated factors. Demographic, clinical and epidemiological data were collected from 1181 subjects in 210 households in 30 villages. Stool specimens from 924 subjects were examined for eggs of Taenia and other parasites. Identification of T. solium was confirmed by morphological features of segments and species-specific DNA detection from segments and stool. The prevalence of T. solium taeniasis was 18.6% (172/924); factors associated with taeniasis on multivariate analysis were age above 15 years, history of passage of Taenia segments in stool, undercooked pork consumption and poor hand hygiene (hand-washing with clay/water after defecation). Seventy-eight subjects (6.6%) with epilepsy were identified. The study showed alarmingly high rates of epilepsy and T. solium taeniasis in the study community; it highlights the need for large-scale imaging-based surveys to identify the factors associated with epilepsy including neurocysticercosis. Health education, mass anthelminthic therapy and other preventive measures are required to control the menace of the disease.

  6. Community-based study on CKD subjects and the associated risk factors.

    Science.gov (United States)

    Chen, Nan; Wang, Weiming; Huang, Yanping; Shen, Pingyan; Pei, Daoling; Yu, Haijin; Shi, Hao; Zhang, Qianying; Xu, Jing; Lv, Yilun; Fan, Qishi

    2009-07-01

    The study was performed to investigate the prevalence, awareness and the risk factors of chronic kidney disease (CKD) in the community population in Shanghai, China. A total of 2596 residents were randomly recruited from the community population in Shanghai, China. All were screened for albuminuria, haematuria, morning spot urine albumin-to-creatinine ratio and renal function. Serum creatinine, uric acid, cholesterol, triglyceride and haemoglobin were assessed. A simplified MDRD equation was used to estimate the glomerular filtration rate (eGFR). All studied subjects were screened by kidney ultrasound. Haematuria, if present in the morning spot urine dipstick test, was confirmed by microscopy. The associations among the demographic characteristics, health characteristics and indicators of kidney damage were examined. Two thousand five hundred and fifty-four residents (n = 2554), after giving informed consent and with complete data, were entered into this study. Albuminuria and haematuria were detected in 6.3% and 1.2% of all the studied subjects, respectively, whereas decreased kidney function was found in 5.8% of all studied subjects. Approximately 11.8% of subjects had at least one indicator of kidney damage. The rate of awareness of CKD was 8.2%. The logistic regression model showed that age, central obesity, hypertension, diabetes, anaemia, hyperuricaemia and nephrolithiasis each contributed to the development of CKD. This is the first Shanghai community-based epidemiological study data on Chinese CKD patients. The prevalence of CKD in the community population in Shanghai is 11.8%, and the rate of awareness of CKD is 8.2%. All the factors including age, central obesity, hypertension, diabetes, anaemia, hyperuricaemia and nephrolithiasis are positively correlated with the development of CKD in our studied subjects.

  7. Luck, come here! Automatic approach tendencies toward gambling cues in moderate- to high-risk gamblers.

    Science.gov (United States)

    Boffo, Marilisa; Smits, Ruby; Salmon, Joshua P; Cowie, Megan E; de Jong, David T H A; Salemink, Elske; Collins, Pam; Stewart, Sherry H; Wiers, Reinout W

    2018-02-01

    Similar to substance addictions, reward-related cognitive motivational processes, such as selective attention and positive memory biases, have been found in disordered gambling. Despite findings that individuals with substance use problems are biased to approach substance-related cues automatically, no study has yet focused on automatic approach tendencies for motivationally salient gambling cues in problem gamblers. We tested if moderate- to high-risk gamblers show a gambling approach bias and whether this bias was related prospectively to gambling behaviour and problems. Cross-sectional assessment study evaluating the concurrent and longitudinal correlates of gambling approach bias in moderate- to high-risk gamblers compared with non-problem gamblers. Online study throughout the Netherlands. Twenty-six non-treatment-seeking moderate- to high-risk gamblers and 26 non-problem gamblers community-recruited via the internet. Two online assessment sessions 6 months apart, including self-report measures of gambling problems and behaviour (frequency, duration and expenditure) and the gambling approach avoidance task, with stimuli tailored to individual gambling habits. Relative to non-problem gamblers, moderate- to high-risk gamblers revealed a stronger approach bias towards gambling-related stimuli than neutral stimuli (P = 0.03). Gambling approach bias was correlated positively with past-month gambling expenditure at baseline (P = 0.03) and with monthly frequency of gambling at follow-up (P = 0.02). In multiple hierarchical regressions, baseline gambling approach bias predicted monthly frequency positively (P = 0.03) and total duration of gambling episodes (P = 0.01) 6 months later, but not gambling problems or expenditure. In the Netherlands, relative to non-problem gamblers, moderate- to high-risk gamblers appear to have a stronger tendency to approach rather than to avoid gambling-related pictures compared with neutral ones. This gambling approach bias is

  8. "Nursing Students Assaulted": Considering Student Safety in Community-Focused Experiences.

    Science.gov (United States)

    Maneval, Rhonda E; Kurz, Jane

    2016-01-01

    Community nursing experiences for undergraduate students have progressed beyond community-based home visits to a wide array of community-focused experiences in neighborhood-based centers, clinics, shelters, and schools. Our Bachelor of Science in Nursing program chose to use sites situated within neighborhoods close to campus in order to promote student and faculty engagement in the local community. These neighborhood sites provide opportunities for students to deliver nursing services to underserved and vulnerable populations experiencing poverty and health disparities. Some of these neighborhoods are designated as high crime areas that may potentially increase the risk of harm to students and faculty. There is a need to acknowledge the risk to personal safety and to proactively create policies and guidelines to reduce potential harm to students engaged in community-focused experiences. When a group of baccalaureate nursing students was assaulted while walking to a neighborhood clinic, the faculty was challenged as how to respond given the lack of policies and guidelines. Through our experience, we share strategies to promote personal safety for students and recommend transparency by administrators regarding potential safety risks to students engaged in community-focused fieldwork activities. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. High taxonomic variability despite stable functional structure across microbial communities.

    Science.gov (United States)

    Louca, Stilianos; Jacques, Saulo M S; Pires, Aliny P F; Leal, Juliana S; Srivastava, Diane S; Parfrey, Laura Wegener; Farjalla, Vinicius F; Doebeli, Michael

    2016-12-05

    Understanding the processes that are driving variation of natural microbial communities across space or time is a major challenge for ecologists. Environmental conditions strongly shape the metabolic function of microbial communities; however, other processes such as biotic interactions, random demographic drift or dispersal limitation may also influence community dynamics. The relative importance of these processes and their effects on community function remain largely unknown. To address this uncertainty, here we examined bacterial and archaeal communities in replicate 'miniature' aquatic ecosystems contained within the foliage of wild bromeliads. We used marker gene sequencing to infer the taxonomic composition within nine metabolic functional groups, and shotgun environmental DNA sequencing to estimate the relative abundances of these groups. We found that all of the bromeliads exhibited remarkably similar functional community structures, but that the taxonomic composition within individual functional groups was highly variable. Furthermore, using statistical analyses, we found that non-neutral processes, including environmental filtering and potentially biotic interactions, at least partly shaped the composition within functional groups and were more important than spatial dispersal limitation and demographic drift. Hence both the functional structure and taxonomic composition within functional groups of natural microbial communities may be shaped by non-neutral and roughly separate processes.

  10. High Arctic Coasts At Risk - The Impact of Coastal Hazards on Scientific and Community Infrastructure in Svalbard

    Science.gov (United States)

    Strzelecki, M. C.; Pawlowski, L.; Jaskolski, M.; Lim, M.; Zagorski, P.; Long, A. J.; Jensen, M.

    2015-12-01

    The rapid climate warming being observed in the Svalbard is leading to an increase in human activities in the coastal zone, leading to an increased need for coastal hazard assessment. Present-day Svalbard coastal landscapes are modified by increased degradation of permafrost accelerated sediment supply from deglaciated catchments, and prolonged periods of open-water conditions and wave activity. Since the second half of 20thcentury there is also an observed increase in the number and intensity of storms entering the Arctic particularly in summer months when coastlines are free of protective ice cover. Despite the potential significance of these coastal hazards on the security of scientific (research bases and devices) and community (ports, airports, roads, buildings) infrastructure on Svalbard, relatively little is known on the present-day rate of Svalbard coastal zone changes and how they might impact the nearshore infrastructure in the future. Here we report the results of a project that focused on rates of coastal zone changes in Svalbard and examined the impact of extreme coastal processes on scientific and community infrastructure. The project applied combination of remote sensing and field-based mapping techniques to characterise coastal changes observed in the surroundings of main research stations in Svalbard in Hornsund (PPS), Petuniabukta (AMUPS) and Bellsund (Calypsobyen) as well as a major towns: Longyearbyen, Piramiden, Barentsburg and Svea. Our results document dramatic changes of Svalbard coastal zone under intervals characterised by a warming climate, retreating local ice masses, a shortened winter sea-ice season and melting permafrost. The study confirmed the growing importance of extreme processes in shaping coasts of Svalbard and the impact of these changes on human infrastructure. Our study proposes a risk assessment for a development and protection of infrastructure along the coasts of Svalbard under scenarios of climate change, sea level rise

  11. Gut-sparing treatment of urinary tract infection in patients at high risk of Clostridium difficile infection.

    Science.gov (United States)

    Staley, Christopher; Vaughn, Byron P; Graiziger, Carolyn T; Sadowsky, Michael J; Khoruts, Alexander

    2017-02-01

    Recipients of faecal microbiota transplantation (FMT) in treatment of recurrent Clostridium difficile infection (RCDI) remain at markedly increased risk of re-infection with C. difficile with new antibiotic provocations. Urinary tract infections (UTIs) are common indications for antibiotics in these patients, often resulting in C. difficile re-infection. We present a case series of 19 patients treated with parenteral aminoglycosides for UTI following FMT for RCDI. A 3 day outpatient regimen of once-daily intramuscular administration of gentamicin was used to treat 18 consecutive FMT recipients with uncomplicated UTI. One other patient was treated for a complicated UTI with intravenous amikacin. Profiling of 16S rRNA genes was used to track changes in faecal microbial community structure during this regimen in three patients. The protocol was highly effective in treating UTI symptoms. None of the patients suffered a re-infection with C. difficile The faecal microbial communities remained undisturbed by treatment with intramuscular administration of gentamicin. Despite falling out of favour in recent years, aminoglycoside antibiotics given parenterally have the advantage of minimal penetration into the gut lumen. A brief (3 day) course of parenteral gentamicin was safe and effective in curing UTI in patients at high risk of C. difficile infection without perturbing their gut microbiota. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Management of Skin Cancer in the High-Risk Patient.

    Science.gov (United States)

    Behan, James W; Sutton, Adam; Wysong, Ashley

    2016-12-01

    Skin cancer is the most common of human cancers and outnumbers all other types of cancer combined in the USA by over threefold. The majority of non-melanoma skin cancers are easily treated with surgery or locally destructive techniques performed under local anesthesia in the cost-effective outpatient setting. However, there is a subset of "high-risk" cases that prove challenging in terms of morbidity, mortality, adjuvant treatment required, as well as overall cost to the health care system. In our opinion, the term "high risk" when applied to skin cancer can mean one of three things: a high-risk tumor with aggressive histologic and/or clinical features with an elevated risk for local recurrence or regional/distant metastasis, a high-risk patient with the ongoing development of multiple skin cancers, and a high-risk patient based on immunosuppression. We have recently proposed classifying NMSC as a chronic disease in a certain subset of patients. Although no consensus definition exists for a chronic disease in medicine, there are three components that are present in most definitions: duration of at least 1 year, need for ongoing medical care, and functional impairment and/or alteration of activities of daily living (ADLs) and quality of life (QOL). Immunosuppression can refer to exogenous (organ or stem cell transplant patients,) or endogenous (HIV, leukemia, lymphoma, genodermatoses with DNA mismatch repair problems or other immunosuppression) causes. These patients are at risk for high-risk tumors and/or the development of multiple tumors.

  13. Model of decision for the management of technology and risk in a port community

    Directory of Open Access Journals (Sweden)

    Claudia Durán

    2018-10-01

    Full Text Available Strategic management in a port system is complex since the Port Community has to coordinate actions and generate synergy among all the private actors that integrate the export and import logistics chains, trade associations and trade unions. Based on the opinion of the port experts and the analytical network process (ANP, the research identifies the relevant criteria for strategic, business and operational decision-making in the Port Community, in the technological and risk contexts. With the criteria found and considering the strategic alignment that is required, management indicators are constructed. Based on a generic model, a new strategic conceptual model (PORTGD of ANP for decision management is designed for the Port Community, a cause and effect analysis is carried out and a sensitization study is performed on the nodes. The discussion of the results and conclusions highlights the importance of technological investment, control of port security and good practices for the port system investigated.

  14. Sequence Curriculum: High School to College. Middlesex Community College/Haddam-Killingworth High School. Final Report.

    Science.gov (United States)

    Middlesex Community Coll., Middletown, CT.

    Through a collaborative effort between Middlesex Community College (MxCC) and Haddam-Killingworth High School (HKHS), students taking specific high school courses in television production, broadcast journalism, electronics, and photography are granted college credit by MxCC upon admission to the college's Broadcast Communication Program. The…

  15. The "polyenviromic risk score": Aggregating environmental risk factors predicts conversion to psychosis in familial high-risk subjects.

    Science.gov (United States)

    Padmanabhan, Jaya L; Shah, Jai L; Tandon, Neeraj; Keshavan, Matcheri S

    2017-03-01

    Young relatives of individuals with schizophrenia (i.e. youth at familial high-risk, FHR) are at increased risk of developing psychotic disorders, and show higher rates of psychiatric symptoms, cognitive and neurobiological abnormalities than non-relatives. It is not known whether overall exposure to environmental risk factors increases risk of conversion to psychosis in FHR subjects. Subjects consisted of a pilot longitudinal sample of 83 young FHR subjects. As a proof of principle, we examined whether an aggregate score of exposure to environmental risk factors, which we term a 'polyenviromic risk score' (PERS), could predict conversion to psychosis. The PERS combines known environmental risk factors including cannabis use, urbanicity, season of birth, paternal age, obstetric and perinatal complications, and various types of childhood adversity, each weighted by its odds ratio for association with psychosis in the literature. A higher PERS was significantly associated with conversion to psychosis in young, familial high-risk subjects (OR=1.97, p=0.009). A model combining the PERS and clinical predictors had a sensitivity of 27% and specificity of 96%. An aggregate index of environmental risk may help predict conversion to psychosis in FHR subjects. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Interaction Networks: Generating High Level Hints Based on Network Community Clustering

    Science.gov (United States)

    Eagle, Michael; Johnson, Matthew; Barnes, Tiffany

    2012-01-01

    We introduce a novel data structure, the Interaction Network, for representing interaction-data from open problem solving environment tutors. We show how using network community detecting techniques are used to identify sub-goals in problems in a logic tutor. We then use those community structures to generate high level hints between sub-goals.…

  17. Acceptable Interventions to Reduce Syphilis Transmission Among High-Risk Men Who Have Sex With Men in Los Angeles

    Science.gov (United States)

    Plant, Aaron; Javanbakht, Marjan; Cross, John; Montoya, Jorge A.; Bolan, Robert; Kerndt, Peter R.

    2015-01-01

    Objectives. We examined perceptions of and attitudes toward existing and potential syphilis interventions, including case management and Web-based programs, to increase syphilis testing among high-risk men who have sex with men (MSM). Methods. Between October 2010 and June 2011, we conducted in-depth interviews with 19 MSM in Los Angeles, California, with repeat early syphilis infections (primary, secondary, and early latent syphilis) within the previous 5 years. We analyzed the interviews inductively to determine the most acceptable potential interventions. Results. Experiences with health department and community-based standard of care case management were generally positive. The most popular interventions among respondents included a Web site providing information on syphilis and syphilis testing, automated Web reminders to test, being paid to test, free online home testing kits, and preexposure prophylactic medication. Respondents’ beliefs that they would continue to practice high-risk sexual behaviors reinforced their reasons for wanting increased accessibility and convenient testing strategies. Conclusions. Public health officials should consider participant responses to potential interventions for syphilis, which suggest that high-risk MSM would consider testing more often or using other interventions. PMID:25602881

  18. Predicting Community College Outcomes: Does High School CTE Participation Have a Significant Effect?

    Science.gov (United States)

    Dietrich, Cecile; Lichtenberger, Eric; Kamalludeen, Rosemaliza

    2016-01-01

    This study explored the relative importance of participation in high school career and technical education (CTE) programs in predicting community college outcomes. A hierarchical generalized linear model (HGLM) was used to predict community college outcome attainment among a random sample of direct community college entrants. Results show that…

  19. Testing pathways linking exposure to community violence and sexual behaviors among African American youth.

    Science.gov (United States)

    Voisin, Dexter R; Hotton, Anna L; Neilands, Torsten B

    2014-09-01

    Exposure to community violence and HIV sexual risks are two major public health concerns among youth. This study tests various pathways linking exposure to community violence and sexual behaviors among African American adolescents. Using a sample of 563 (61% females) African American youth attending high school we examined whether problematic psychological symptoms, low school engagement, and/or negative perceptions of peer norms about safer sex functioned as pathways linking exposure to community violence and sexual behaviors. Major findings indicated that, for boys, the relationship between exposure to community violence and sexual début and sexual risk behaviors were linked by aggression. In addition, the relationship between exposure to community violence and sexual risk behaviors were linked by negative perceptions of peer attitudes about safer sex. For girls, the relationship between exposure to community violence and sexual début was linked by aggression and negative perceptions of peer attitudes about safer sex. These findings provide support for pathways linking exposure to community violence to sexual behaviors.

  20. Companies and Climate Risk: Opportunities to Engage the Business Community in Promoting Climate-conscious Policies (Invited)

    Science.gov (United States)

    Goldman, G. T.; Rogerson, P.

    2013-12-01

    Regardless of their policy orientation, the business community has an interest in how climate change impacts will affect their operations and ultimately change their bottom line. The reality that climate change presents material and financial risks to many companies in diverse sectors of the economy presents an opportunity to engage companies on climate-related issues. Company investors are exposed to such financial risks and can pressure public companies to change behavior through shareholder resolutions, voting, and election of new board members. The US Securities and Exchange Commission (SEC) obligates all publicly traded companies to discuss risks that might materially affect their business in their annual Form 10-K filings. In 2010, the guidance for the Form 10-K specifically suggested that companies consider and discuss any significant risks to their business from climate change--both from its physical effects and from impacts of climate regulations. Form 10-Ks for 28 US companies were analyzed for the years 2009 and 2010. Results indicate that some companies comprehensively considered climate-related risks. However, in spite of the SEC guidance, some fail to mention climate change at all. Additionally, many companies discuss only the impacts that regulation would have on their business--not the physical effects of climate change itself. The lack of consideration of climate-related risks in companies' risk assessments demonstrates a need for a more uniform understanding of SEC requirements and additionally, this state of affairs presents an opportunity to push companies to more deeply consider climate change impacts. Several avenues are available for engaging with companies themselves, their shareholders, the SEC, and the public. We will explore what strategies have been effective for engaging such actors and what further opportunities exist for working with the business community to promote more climate-conscious policies and practices.

  1. An Australian Indigenous community-led suicide intervention skills training program: community consultation findings.

    Science.gov (United States)

    Nasir, Bushra; Kisely, Steve; Hides, Leanne; Ranmuthugala, Geetha; Brennan-Olsen, Sharon; Nicholson, Geoffrey C; Gill, Neeraj S; Hayman, Noel; Kondalsamy-Chennakesavan, Srinivas; Toombs, Maree

    2017-06-13

    Little is known of the appropriateness of existing gatekeeper suicide prevention programs for Indigenous communities. Despite the high rates of Indigenous suicide in Australia, especially among Indigenous youth, it is unclear how effective existing suicide prevention programs are in providing appropriate management of Indigenous people at risk of suicide. In-depth, semi-structured interviews and focus groups were conducted with Indigenous communities in rural and regional areas of Southern Queensland. Thematic analysis was performed on the gathered information. Existing programs were time-intensive and included content irrelevant to Indigenous people. There was inconsistency in the content and delivery of gatekeeper training. Programs were also not sustainable for rural and regional Indigenous communities. Appropriate programs should be practical, relevant, and sustainable across all Indigenous communities, with a focus on the social, emotional, cultural and spiritual underpinnings of community wellbeing. Programs need to be developed in thorough consultation with Indigenous communities. Indigenous-led suicide intervention training programs are needed to mitigate the increasing rates of suicide experienced by Indigenous peoples living in rural and remote locations.

  2. “Un-Googling”: Research Technologies, Communities at Risk and the Ethics of User Studies in HCI

    DEFF Research Database (Denmark)

    Shklovski, Irina; Vertesi, Janet

    2012-01-01

    Recent increase in volume of qualitative work on transnational technologies, HCI for development, virtual communities, and collaborative systems across a range of areas has resulted in focus on user communities whose very uniqueness may be of interest to HCI, but whose exposure in a research...... setting presents real threats to those individual’s or community’s livelihoods, work, or civil liberties. As the tools of research dissemination increasingly make scholarly publications more easily accessible to the public and other entities outside the academic community through simple search engines......, scholars must grapple with new challenges to the ethics of exposure. We present a case-study of un-Googling publication of research results and consider potential problems with such an approach to minimizing risk to research participants....

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

    African Journals Online (AJOL)

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

  4. The South Asian Heart Lifestyle Intervention (SAHELI) study to improve cardiovascular risk factors in a community setting: design and methods.

    Science.gov (United States)

    Kandula, Namratha R; Patel, Yasin; Dave, Swapna; Seguil, Paola; Kumar, Santosh; Baker, David W; Spring, Bonnie; Siddique, Juned

    2013-11-01

    Disseminating and implementing evidence-based, cardiovascular disease (CVD) prevention lifestyle interventions in community settings and in ethnic minority populations is a challenge. We describe the design and methods for the South Asian Heart Lifestyle Intervention (SAHELI) study, a pilot study designed to determine the feasibility and initial efficacy of a culturally-targeted, community-based lifestyle intervention to improve physical activity and diet behaviors among medically underserved South Asians (SAs). Participants with at least one CVD risk factor will be randomized to either a lifestyle intervention or a control group. Participants in both groups will be screened in a community setting and receive a primary care referral after randomization. Intervention participants will receive 6weeks of group classes, followed by 12weeks of individual telephone support where they will be encouraged to initiate and maintain a healthy lifestyle goal. Control participants will receive their screening results and monthly mailings on CVD prevention. Primary outcomes will be changes in moderate/vigorous physical activity and saturated fat intake between baseline, 3-, and 6-month follow-up. Secondary outcomes will be changes in weight, clinical risk factors, primary care visits, self-efficacy, and social support. This study will be one of the first to pilot-test a lifestyle intervention for SAs, one of the fastest growing racial/ethnic groups in the U.S. and one with disparate CVD risk. Results of this pilot study will provide preliminary data about the efficacy of a lifestyle intervention on CVD risk in SAs and inform community-engaged CVD prevention efforts in an increasingly diverse U.S. population. © 2013.

  5. Featured Article: Community Crime Exposure and Risk for Obesity in Preschool Children: Moderation by the Hypothalamic-Pituitary-Adrenal-Axis Response.

    Science.gov (United States)

    Gartstein, Maria A; Seamon, Erich; Thompson, Stephanie F; Lengua, Liliana J

    2018-05-01

    Identification of early risk factors related to obesity is critical to preventative public health efforts. In this study, we investigated links between the Hypothalamic-Pituitary-Adrenal (HPA)-axis activity (diurnal cortisol pattern), geospatially operationalized exposure to neighborhood crime, and body mass index (BMI) for a sample of 5-year-old children. Greater community crime exposure and lower HPA-axis activity were hypothesized to contribute to higher BMI, with child HPA-axis moderating the association between crime exposure and BMI. Families residing within the boundaries of the City of Seattle (N = 114) provided information concerning demographic/psychosocial risk factors, used to calculate a Cumulative Risk Index, indicating the number of contextual adversities present. Child BMI and diurnal cortisol pattern (derived from assays of saliva samples) were examined, along with neighborhood crime indices computed with publically available information, based on participants' locations. Hierarchical multiple regression analyses, adjusted for covariates (cumulative risk, age, and sex), indicated that crime proximity made a unique contribution to child BMI, in the direction signaling an increase in the risk for obesity. Consistent with our hypothesis, a significant interaction was observed, indicative of moderation by diurnal cortisol pattern. Follow-up simple slope analyses demonstrated that crime exposure was significantly related to higher BMI for children with low-flat (blunted) diurnal cortisol patterns, where community crime and BMI were not significantly associated at higher levels of cortisol. Community crime exposure contributes to higher BMI as early as the preschool period, and blunted diurnal cortisol patterns may place children experiencing neighborhood adversity at greater risk for obesity.

  6. High-Risk Stress Fractures: Diagnosis and Management.

    Science.gov (United States)

    McInnis, Kelly C; Ramey, Lindsay N

    2016-03-01

    Stress fractures are common overuse injuries in athletes. They occur during periods of increased training without adequate rest, disrupting normal bone reparative mechanisms. There are a host of intrinsic and extrinsic factors, including biochemical and biomechanical, that put athletes at risk. In most stress fractures, the diagnosis is primarily clinical, with imaging indicated at times, and management focused on symptom-free relative rest with advancement of activity as tolerated. Overall, stress fractures in athletes have an excellent prognosis for return to sport, with little risk of complication. There is a subset of injuries that have a greater risk of fracture progression, delayed healing, and nonunion and are generally more challenging to treat with nonoperative care. Specific locations of high-risk stress fracture include the femoral neck (tension side), patella, anterior tibia, medial malleolus, talus, tarsal navicular, proximal fifth metatarsal, and great toe sesamoids. These sites share a characteristic region of high tensile load and low blood flow. High-risk stress fractures require a more aggressive approach to evaluation, with imaging often necessary, to confirm early and accurate diagnosis and initiate immediate treatment. Treatment consists of nonweight-bearing immobilization, often with a prolonged period away from sport, and a more methodic and careful reintroduction to athletic activity. These stress fractures may require surgical intervention. A high index of suspicion is essential to avoid delayed diagnosis and optimize outcomes in this subset of stress fractures. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  7. Evaluating the effects of community-based organization engagement on HIV and AIDS-related risk behavior in Kenya.

    Science.gov (United States)

    Riehman, Kara S; Kakietek, Jakub; Manteuffel, Brigitte A; Rodriguez-García, Rosalía; Bonnel, Rene; N'Jie, N'Della; Godoy-Garraza, Lucas; Orago, Alloys; Murithi, Patrick; Fruh, Joseph

    2013-01-01

    International donors have increasingly shifted AIDS funding directly to community-based organizations (CBOs) with the assumption that responding to the epidemic is best achieved at the community level. The World Bank, ICF Macro, and the National Council for Population and Development in Kenya, conducted a study to evaluate the community response in Kenya. The study used a quasi-experimental design comparing seven study communities and seven comparison communities in Nyanza Province and Western Province. We examined the impact of CBO activity on individual and community-level outcomes, including HIV knowledge, awareness and perceptions, sexual risk behavior, and social transformation (gender ideology and social capital). The study consisted of two components: a household survey conducted in all 14 communities, and qualitative data collected in a subset of communities. Individuals in communities with higher CBO engagement were significantly more likely to have reported consistent condom use. Higher CBO engagement was associated with some measures of social capital, including participation in local and national elections, and participation in electoral campaigns. CBOs provide added value in addressing the HIV and AIDS epidemic in very targeted and specific ways that are closely tied to the services they provide (e.g., prevention education); thus, increasing CBO engagement can be an effective measure in scaling up prevention efforts in those areas.

  8. Effects of a multifactorial fall prevention program on fall incidence and physical function in community-dwelling older adults with risk of falls.

    Science.gov (United States)

    Lee, Hsuei-Chen; Chang, Ku-Chou; Tsauo, Jau-Yih; Hung, Jen-Wen; Huang, Yu-Ching; Lin, Sang-I

    2013-04-01

    To evaluate effects of a multifactorial fall prevention program on fall incidence and physical function in community-dwelling older adults. Multicenter randomized controlled trial. Three medical centers and adjacent community health centers. Community-dwelling older adults (N=616) who have fallen in the previous year or are at risk of falling. After baseline assessment, eligible subjects were randomly allocated into the intervention group (IG) or the control group (CG), stratified by the Physiological Profile Assessment (PPA) fall risk level. The IG received a 3-month multifactorial intervention program including 8 weeks of exercise training, health education, home hazards evaluation/modification, along with medication review and ophthalmology/other specialty consults. The CG received health education brochures, referrals, and recommendations without direct exercise intervention. Primary outcome was fall incidence within 1 year. Secondary outcomes were PPA battery (overall fall risk index, vision, muscular strength, reaction time, balance, and proprioception), Timed Up & Go (TUG) test, Taiwan version of the International Physical Activity Questionnaire, EuroQol-5D, Geriatric Depression Scale (GDS), and the Falls Efficacy Scale-International at 3 months after randomization. Participants were 76±7 years old and included low risk 25.6%, moderate risk 25.6%, and marked risk 48.7%. The cumulative 1-year fall incidence was 25.2% in the IG and 27.6% in the CG (hazard ratio=.90; 95% confidence interval, .66-1.23). The IG improved more favorably than the CG on overall PPA fall risk index, reaction time, postural sway with eyes open, TUG test, and GDS, especially for those with marked fall risk. The multifactorial fall prevention program with exercise intervention improved functional performance at 3 months for community-dwelling older adults with risk of falls, but did not reduce falls at 1-year follow-up. Fall incidence might have been decreased simultaneously in both

  9. Enhancing Economic Stability Utilizing the High Technologies in Community Colleges: A Case Study.

    Science.gov (United States)

    Mehnert, Barbara H.; Kurki, Allan W.

    Strategies to enhance the economic stability of community colleges through high technology approaches are discussed in this paper. First, general economic problems facing higher education are identified, and the ways in which they influence community colleges are described. Next, 10 strategies to aid in the economic recovery of community colleges…

  10. Analysis of risk factors for persistent infection of asymptomatic women with high-risk human papilloma virus.

    Science.gov (United States)

    Shi, Nianmin; Lu, Qiang; Zhang, Jiao; Li, Li; Zhang, Junnan; Zhang, Fanglei; Dong, Yanhong; Zhang, Xinyue; Zhang, Zheng; Gao, Wenhui

    2017-06-03

    This study aims to prevent persistentinfection, reduce the incidence of cervical cancer, and improve women's health by understanding the theoretical basis of the risk factors for continuous infection of asymptomatic women with high-risk human papilloma virus (HPV) strains via information collected, which includes the persistent infection rate and the most prevalent HPV strain types of high risk to asymptomatic women in the high-risk area of cervical cancer in Linfen, Shanxi Province. Based on the method of cluster sampling, locations were chosen from the industrial county and agricultural county of Linfen, Shanxi Province, namely the Xiangfen and Quwo counties. Use of the convenience sampling (CS) method enables the identification of women who have sex but without symptoms of abnormal cervix for analyzing risk factors of HPV-DNA detection and performing a retrospective questionnaire survey in these 2 counties. Firstly, cervical exfoliated cell samples were collected for thin-layer liquid-based cytology test (TCT), and simultaneously testing high-risk type HPV DNA, then samples with positive testing results were retested to identify the infected HPV types. The 6-month period of testing was done to derive the 6-month persistent infection rate. The retrospective survey included concepts addressed in the questionnaire: basic situation of the research objects, menstrual history, marital status, pregnancy history, sexual habits and other aspects. The questionnaire was divided into a case group and a comparison group, which are based on the high-risk HPV-DNA testing result to ascertain whether or not there is persistent infection. Statistical analysis employed Epidate3.1 software for date entry, SPSS17.0 for date statistical analysis. Select statistic charts, Chi-Square Analysis, single-factor analysis and multivariate Logistic regression analysis to analyze the protective factors and risk factors of high-risk HPV infection. Risk factors are predicted by using the

  11. Establishing a community of practice of researchers, practitioners, policy-makers and communities to sustainably manage environmental health risks in Ecuador.

    Science.gov (United States)

    Spiegel, Jerry M; Breilh, Jaime; Beltran, Efrain; Parra, Jorge; Solis, Fernanda; Yassi, Annalee; Rojas, Alejandro; Orrego, Elena; Henry, Bonnie; Bowie, William R; Pearce, Laurie; Gaibor, Juan; Velasquez, Patricio; Concepcion, Miriam; Parkes, Margot

    2011-11-08

    The Sustainably Managing Environmental Health Risk in Ecuador project was launched in 2004 as a partnership linking a large Canadian university with leading Cuban and Mexican institutes to strengthen the capacities of four Ecuadorian universities for leading community-based learning and research in areas as diverse as pesticide poisoning, dengue control, water and sanitation, and disaster preparedness. In implementing curriculum and complementary innovations through application of an ecosystem approach to health, our interdisciplinary international team focused on the question: "Can strengthening of institutional capacities to support a community of practice of researchers, practitioners, policy-makers and communities produce positive health outcomes and improved capacities to sustainably translate knowledge?" To assess progress in achieving desired outcomes, we review results associated with the logic framework analysis used to guide the project, focusing on how a community of practice network has strengthened implementation, including follow-up tracking of program trainees and presentation of two specific case studies. By 2009, train-the-trainer project initiation involved 27 participatory action research Master's theses in 15 communities where 1200 community learners participated in the implementation of associated interventions. This led to establishment of innovative Ecuadorian-led master's and doctoral programs, and a Population Health Observatory on Collective Health, Environment and Society for the Andean region based at the Universidad Andina Simon Bolivar. Building on this network, numerous initiatives were begun, such as an internationally funded research project to strengthen dengue control in the coastal community of Machala, and establishment of a local community eco-health centre focusing on determinants of health near Cuenca. Strengthening capabilities for producing and applying knowledge through direct engagement with affected populations and

  12. Establishing a community of practice of researchers, practitioners, policy-makers and communities to sustainably manage environmental health risks in Ecuador

    Directory of Open Access Journals (Sweden)

    Henry Bonnie

    2011-11-01

    Full Text Available Abstract Background The Sustainably Managing Environmental Health Risk in Ecuador project was launched in 2004 as a partnership linking a large Canadian university with leading Cuban and Mexican institutes to strengthen the capacities of four Ecuadorian universities for leading community-based learning and research in areas as diverse as pesticide poisoning, dengue control, water and sanitation, and disaster preparedness. Methods In implementing curriculum and complementary innovations through application of an ecosystem approach to health, our interdisciplinary international team focused on the question: “Can strengthening of institutional capacities to support a community of practice of researchers, practitioners, policy-makers and communities produce positive health outcomes and improved capacities to sustainably translate knowledge?” To assess progress in achieving desired outcomes, we review results associated with the logic framework analysis used to guide the project, focusing on how a community of practice network has strengthened implementation, including follow-up tracking of program trainees and presentation of two specific case studies. Results By 2009, train-the-trainer project initiation involved 27 participatory action research Master’s theses in 15 communities where 1200 community learners participated in the implementation of associated interventions. This led to establishment of innovative Ecuadorian-led master’s and doctoral programs, and a Population Health Observatory on Collective Health, Environment and Society for the Andean region based at the Universidad Andina Simon Bolivar. Building on this network, numerous initiatives were begun, such as an internationally funded research project to strengthen dengue control in the coastal community of Machala, and establishment of a local community eco-health centre focusing on determinants of health near Cuenca. Discussion Strengthening capabilities for producing and

  13. Prevalence and Risk Factor of Neck Pain in Elderly Korean Community Residents

    Science.gov (United States)

    Son, Kyeong Min; Cho, Nam H.; Lim, Seung Hun

    2013-01-01

    Neck pain is a common musculoskeletal condition, which causes substantial medical cost. In Korea, prevalence of neck pain in community based population, especially in elderly subjects, has scarcely been reported. We evaluated the prevalence, the severity and the risk factors of neck pain in elderly Korean community residents. Data for neck pain were collected for 1,655 subjects from a rural farming community. The point, 6-months and cumulative lifetime prevalence of neck pain was obtained in addition to the measurement of the severity of neck pain. The mean age of the study subjects was 61 yr and 57% were females. The lifetime prevalence of neck pain was 20.8% with women having a higher prevalence. The prevalence did not increase with age, and the majority of individuals had low-intensity/low-disability pain. Subjects with neck pain had a significantly worse SF-12 score in all domains except for mental health. The prevalence of neck pain was significantly associated with female gender, obesity and smoking. This is the first large-scale Korean study estimating the prevalence of neck pain in elderly population. Although the majority of individuals had low-intensity/low-disability pain, subjects with neck pain had a significantly worse SF-12 score indicating that neck pain has significant health impact. PMID:23678258

  14. Intensive case management for high-risk patients with first-episode psychosis: service model and outcomes.

    Science.gov (United States)

    Brewer, Warrick J; Lambert, Timothy J; Witt, Katrina; Dileo, John; Duff, Cameron; Crlenjak, Carol; McGorry, Patrick D; Murphy, Brendan P

    2015-01-01

    service showed significant improvement in key service outcomes. Further analysis is needed to determine cost savings and effects on psychosocial outcomes. Targeting intensive case management services to high-risk patients with unmet needs should reduce the distress associated with pathways to care for patients, their families, and the community. National Health & Medical Research Council and the Colonial Foundation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Diet Pattern and Respiratory Morbidity in the Atherosclerosis Risk in Communities Study.

    Science.gov (United States)

    Brigham, Emily P; Steffen, Lyn M; London, Stephanie J; Boyce, Danielle; Diette, Gregory B; Hansel, Nadia N; Rice, Jessica; McCormack, Meredith C

    2018-02-15

    Dietary intake is a potential risk factor for respiratory morbidity in adult populations. Few studies capture the effect of diet patterns, representative of combination of nutrients consumed, on respiratory morbidity in combination with objective measures of lung function. To evaluate patterns of dietary intake in relation to respiratory morbidity and objective measures of lung function in a U.S. The Atherosclerosis Risk in Communities (ARIC) Study enrolled 15,792 participants from four U.S. communities between 1987-1989 and collected a validated food frequency questionnaire to assess diet. Principal components analysis was applied and patterns representative of "Western" and "Prudent" diet emerged. We investigated associations between dietary pattern and pulmonary assessments including asthma and chronic obstructive pulmonary disease (COPD) diagnosis, respiratory symptoms, and lung function. Multivariable logistic regression models included quintiles of dietary patterns and potential confounders. Interaction of dietary patterns with obesity, gender, and smoking status was assessed in relation to all outcomes. A "Western" diet pattern was associated with higher odds of COPD, wheeze, cough, phlegm, and worse lung function, whereas a "Prudent" diet pattern was associated with lower odds of COPD, cough, and better lung function. The prevalence of asthma was not related to dietary intake. Dietary pattern was significantly associated with respiratory outcomes in ARIC participants. A "Western" diet was adverse, whereas a "Prudent" diet was beneficially related to respiratory morbidity and objective measures of lung function. Additional studies of dietary pattern in U.S. populations are needed to verify this effect.

  16. Integration Of Spa Tio- Temporal Analysis Of Rainfall And Community Information System To Reduce Landslide Risk In Indonesia

    Directory of Open Access Journals (Sweden)

    Sudibyakto .

    2013-07-01

    Full Text Available Indonesia is vulnerable to many type of disasters including natural and anthropogenic disasters. Indonesian seasonal rainfall also shows inter annual variation. Sediment-related disaster such as landslide is the mostji-equent disaster occurred and significantly was impacted to natural, human. and social environment. Although. many disaster mitigation e.Oorts have been conducted to reduce disaster risk there are still urgently need to improve the early 1varning .\\~ystem by communicating the risk into local community. Integration qf spatialtemporal analysis qf rainfall and disaster management information !o~vstem would be required to improve the better disaster management in Indonesia. Application of Disaster A1anagement Information System in the study area will presented including evacuation map that used by the local community.

  17. [Impact of fall risk and fear of falling on mobility of independently living senior citizens transitioning to frailty: screening results concerning fall prevention in the community].

    Science.gov (United States)

    Anders, J; Dapp, U; Laub, S; von Renteln-Kruse, W

    2007-08-01

    There is a strong relation between mobility, walking safety and living independently in old age. People with walking problems suffer from fear of falling and tend to restrict their mobility and performance level in the community environment--even before falls occur. This study was planned to test the validity and prognostic value of a fall risk screening instrument ("Sturz-Risiko-Check") that has already shown its feasibility, acceptance and reliability, targeting independently living senior citizens. The study sample was recruited from a sheltered housing complex in Hamburg (with written consent). Persons with need of professional care ("Pflegestufe" in Germany) were excluded. The residents were asked to fill in the multidimensional questionnaire ("Sturz-Risiko- Check"). In a second step, a trained nurse asked the participants in a phone call about their competence in the instrumental activities of daily living (I-ADL mod. from Lawton, Brody 1969) and about their usual mobility performance level (e.g. frequency and distance of daily walks, use of public transport). According to the number and weight of self-reported risk factors for falling, three groups: "low fall risk", "medium fall risk" and "high fall risk" were classified. Finally, this classification was re-tested after one year, asking for falls and fall related injuries. A total of 112 senior citizens without need of personal care, living in a sheltered housing facility were asked to participate. Acceptance was high (76.1%). Self-reported data from 79 participants concerning falls, fall-risk, mobility and instrumental activities of daily living were included in the statistical analyses. Mean age was 78 (64 to 93) years and associated by a high percentage of women (75.9%) in this sample. The older participants reported 0 to 13 different factors (mean 5) related to a high risk of future falls. Most participants (78.5%) quit cycling because of fear of falling. There was a high incidence in the study sample

  18. Natural ventilation reduces high TB transmission risk in traditional homes in rural KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Lygizos, Melissa; Shenoi, Sheela V; Brooks, Ralph P; Bhushan, Ambika; Brust, James C M; Zelterman, Daniel; Deng, Yanhong; Northrup, Veronika; Moll, Anthony P; Friedland, Gerald H

    2013-07-01

    Transmission of drug susceptible and drug resistant TB occurs in health care facilities, and community and households settings, particularly in highly prevalent TB and HIV areas. There is a paucity of data regarding factors that may affect TB transmission risk in household settings. We evaluated air exchange and the impact of natural ventilation on estimated TB transmission risk in traditional Zulu homes in rural South Africa. We utilized a carbon dioxide decay technique to measure ventilation in air changes per hour (ACH). We evaluated predominant home types to determine factors affecting ACH and used the Wells-Riley equation to estimate TB transmission risk. Two hundred eighteen ventilation measurements were taken in 24 traditional homes. All had low ventilation at baseline when windows were closed (mean ACH = 3, SD = 3.0), with estimated TB transmission risk of 55.4% over a ten hour period of exposure to an infectious TB patient. There was significant improvement with opening windows and door, reaching a mean ACH of 20 (SD = 13.1, p ventilation conditions (windows/doors open) and window to volume ratio. Expanding ventilation increased the odds of achieving ≥12 ACH by 60-fold. There is high estimated risk of TB transmission in traditional homes of infectious TB patients in rural South Africa. Improving natural ventilation may decrease household TB transmission risk and, combined with other strategies, may enhance TB control efforts.

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

    Science.gov (United States)

    Mano, Roy; Eastham, James; Yossepowitch, Ofer

    2017-01-01

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

  20. TV viewing and incident venous thromboembolism: the Atherosclerotic Risk in Communities Study.

    Science.gov (United States)

    Kubota, Yasuhiko; Cushman, Mary; Zakai, Neil; Rosamond, Wayne D; Folsom, Aaron R

    2018-04-01

    TV viewing is associated with risk of arterial vascular diseases, but has not been evaluated in relation to venous thromboembolism (VTE) risk in Western populations. In 1987-1989, the Atherosclerosis Risk in Communities Study obtained information on the frequency of TV viewing in participants aged 45-64 and followed them prospectively. In individuals free of prebaseline VTE (n = 15, 158), we used a Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident VTE according to frequency of TV viewing ("Never or seldom", "Sometimes", "Often" or "Very often"). During the 299,767 person-years of follow-up, we identified 691 VTE events. In a multivariable-adjusted model, the frequency of TV viewing showed a positive dose-response relation with VTE incidence (P for trend = 0.036), in which "very often" viewing TV carried 1.71 (95% CI 1.26-2.32) times the risk of VTE compared with "never or seldom" viewing TV. This association to some degree was mediated by obesity (25% mediation, 95% CI 10.7-27.5). Even among individuals who met a recommended level of physical activity, viewing TV "very often" carried 1.80 (1.04-3.09) times the risk of VTE, compared to viewing TV "never or seldom". Greater frequency of TV viewing was independently associated with increased risk of VTE, partially mediated by obesity. Achieving a recommended physical activity level did not eliminate the increased VTE risk associated with frequent TV viewing. Avoiding frequent TV viewing as well as increasing physical activity and controlling body weight might be beneficial for VTE prevention.