EAP-based critical incident stress management: utilization of a practice-based assessment of incident severity level in responding to workplace trauma.

Science.gov (United States)

DeFraia, Gary S

2013-01-01

Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of clinical impact of event scales. Workplace incidents however, affect not only individual employees, but also work organizations, requiring a multi-level response. Critical incident stress management (CISM) is the most prevalent multi-level incident response strategy utilized by organizations, often through specialized CISM units operating within their employee assistance programs (EAPs). While EAP-based CISM units seeks to support both individuals and organizations, studies focused on individual stress dominate the literature, mirroring assessment scales that tend to emphasize clinical as opposed to organizational practice. This research contributes to less-prevalent studies exploring incident characteristics as disruptive to organizations, rather than clinical symptoms as disruptive to individuals. To measure incident disruption, an EAP-based CISM unit developed a critical incident severity scale. By analyzing this unit's extensive practice database, this exploratory study examines how critical incident severity level varies among various types of incidents. Employing the methodology of clinical data mining, this practice-based research generates evidence-informed practice recommendations in the areas of EAP-based CISM intake assessment, organizational consultation and incident response planning.

Nature of Blame in Patient Safety Incident Reports: Mixed Methods Analysis of a National Database.

Science.gov (United States)

Cooper, Jennifer; Edwards, Adrian; Williams, Huw; Sheikh, Aziz; Parry, Gareth; Hibbert, Peter; Butlin, Amy; Donaldson, Liam; Carson-Stevens, Andrew

2017-09-01

A culture of blame and fear of retribution are recognized barriers to reporting patient safety incidents. The extent of blame attribution in safety incident reports, which may reflect the underlying safety culture of health care systems, is unknown. This study set out to explore the nature of blame in family practice safety incident reports. We characterized a random sample of family practice patient safety incident reports from the England and Wales National Reporting and Learning System. Reports were analyzed according to prespecified classification systems to describe the incident type, contributory factors, outcomes, and severity of harm. We developed a taxonomy of blame attribution, and we then used descriptive statistical analyses to identify the proportions of blame types and to explore associations between incident characteristics and one type of blame. Health care professionals making family practice incident reports attributed blame to a person in 45% of cases (n = 975 of 2,148; 95% CI, 43%-47%). In 36% of cases, those who reported the incidents attributed fault to another person, whereas 2% of those reporting acknowledged personal responsibility. Blame was commonly associated with incidents where a complaint was anticipated. The high frequency of blame in these safety, incident reports may reflect a health care culture that leads to blame and retribution, rather than to identifying areas for learning and improvement, and a failure to appreciate the contribution of system factors in others' behavior. Successful improvement in patient safety through the analysis of incident reports is unlikely without achieving a blame-free culture. © 2017 Annals of Family Medicine, Inc.

An evaluation of the effect of natural background radiation on cancer incidence

International Nuclear Information System (INIS)

Cohen, Jerry J.

1978-01-01

Previous studies on the relationship between levels of natural background radiation and cancer incidence indicate no significant correlation. This observation is shown to be consistent with certain predicted effect levels of ionizing radiation on malignancy production (BEIR, ICRP). Other theoretical predictions on the effects of ionizing radiation indicate induction rates to be as high as 8 x 10 -3 cancers/person-rem. Assuming this factor were correct, then roughly one-half of the cancer incidence in the USA could be attributed to exposure to natural background radiation. By statistically testing various hypothetically assigned cancer induction rates against observed data, it is possible to develop a probabilistic perspective on the cause-effect relationship. Tests have been performed using normalized (by age, death rate, etc.) cancer incidence by state against levels of background radiation. This evaluation allows for the determination of the probability of observing the actual data given that the hypotheses were correct. Graphic relationships between hypothetically assigned radiation induced cancer rates vs. the probability of observing the actual incidence are developed and presented. It is shown that if the cancer induction rate were in excess of ∼10 -3 cancers/person-rem, it would be highly improbable that there would, in fact, be a lack of correlation between the rates of natural background radiation and cancer incidence. (author)

The Equivalent Uniform Dose as a severity metric for radiation treatment incidents

International Nuclear Information System (INIS)

Dunscombe, Peter B.; Iftody, Sandra; Ploquin, Nicolas; Ekaette, Edidiong U.; Lee, Robert C.

2007-01-01

In allocating resources within a risk management program, ideally we would like to know both the probabilities and consequences of potential incidents. We simulate, on a treatment planning computer, several commonly reported incidents in radiation treatment and explore their consequences for the EUDs of targets and organs at risk

Incidence and nature of epidemiological injuries to elite South ...

African Journals Online (AJOL)

Objectives. The study investigated the incidence and nature of injuries sustained by elite cricketers during a season and the possible risk factors associated with these injuries. Methods. Fourteen physiotherapists and three doctors recorded 163 injuries sustained by 88 cricketers. Results. Bowling accounted for 40.5% of the ...

Flare-ups incidence and severity after using calcium hydroxide as intracanal dressing.

Science.gov (United States)

Ghoddusi, Jamileh; Javidi, Maryam; Zarrabi, Mohammad Hasan; Bagheri, Hossein

2006-01-01

Acute pain and swelling following endodontic treatment are a challenge for both the patient and the dentist. According to previous studies, the incidence of flare-ups increases after endodontic treatment of teeth with necrotic pulps. Calcium hydroxide is currently used as a multi-purpose drug in root canal therapy. The aim of this study was to evaluate the incidence and severity of flare-ups after treatment of pulpless teeth using calcium hydroxide as an intracanal dressing. Sixty patients with single-root necrotic teeth participated in this study. These patients were randomly divided into three groups of 20. The patients were treated in Group A in a single-visit approach, in group B with a two-visit approach without any intracanal dressing and group C with a two-visit approach using calcium hydroxide as an intracanal dressing for one week. All of the patients were followed for 72 hours after each treatment session. The information about the incidence and severity of pain and swelling was recorded in tables, using a modified Visual Analogue Scale for pain severity measurement and a scale with four degrees for measuring the severity of swelling. The data were analyzed by chi-square test and GENMODE procedure.

The causes and circumstances of drinking water incidents impact consumer behaviour: Comparison of a routine versus a natural disaster incident.

Science.gov (United States)

Rundblad, Gabriella; Knapton, Olivia; Hunter, Paul R

2014-11-18

When public health is endangered, the general public can only protect themselves if timely messages are received and understood. Previous research has shown that the cause of threats to public health can affect risk perception and behaviours. This study compares compliance to public health advice and consumer behaviour during two "Boil Water" notices issued in the UK due to a routine incident versus a natural disaster incident. A postal questionnaire was sent to 1000 randomly selected households issued a routine "Boil Water" notice. Findings were then compared to a previous study that explored drinking water behaviour during a "Boil Water" notice issued after serious floods. Consumers affected by the routine incident showed a significant preference for official water company information, whereas consumers affected by the natural disaster preferred local information sources. Confusion over which notice was in place was found for both incidents. Non-compliance was significantly higher for the natural disaster (48.3%) than the routine incident (35.4%). For the routine incident, compliance with advice on drinking as well as preparing/cooking food and brushing teeth was positively associated with receiving advice from the local radio, while the opposite was true for those receiving advice from the water company/leaflet through the post; we suggest this may largely be due to confusion over needing boiled tap water for brushing teeth. No associations were found for demographic factors. We conclude that information dissemination plans should be tailored to the circumstances under which the advice is issued. Water companies should seek to educate the general public about water notices and which actions are safe and unsafe during which notice, as well as construct and disseminate clearer advice on brushing teeth and preparing/cooking food.

The Causes and Circumstances of Drinking Water Incidents Impact Consumer Behaviour: Comparison of a Routine versus a Natural Disaster Incident

Directory of Open Access Journals (Sweden)

Gabriella Rundblad

2014-11-01

Full Text Available When public health is endangered, the general public can only protect themselves if timely messages are received and understood. Previous research has shown that the cause of threats to public health can affect risk perception and behaviours. This study compares compliance to public health advice and consumer behaviour during two “Boil Water” notices issued in the UK due to a routine incident versus a natural disaster incident. A postal questionnaire was sent to 1000 randomly selected households issued a routine “Boil Water” notice. Findings were then compared to a previous study that explored drinking water behaviour during a “Boil Water” notice issued after serious floods. Consumers affected by the routine incident showed a significant preference for official water company information, whereas consumers affected by the natural disaster preferred local information sources. Confusion over which notice was in place was found for both incidents. Non-compliance was significantly higher for the natural disaster (48.3% than the routine incident (35.4%. For the routine incident, compliance with advice on drinking as well as preparing/cooking food and brushing teeth was positively associated with receiving advice from the local radio, while the opposite was true for those receiving advice from the water company/leaflet through the post; we suggest this may largely be due to confusion over needing boiled tap water for brushing teeth. No associations were found for demographic factors. We conclude that information dissemination plans should be tailored to the circumstances under which the advice is issued. Water companies should seek to educate the general public about water notices and which actions are safe and unsafe during which notice, as well as construct and disseminate clearer advice on brushing teeth and preparing/cooking food.

The Causes and Circumstances of Drinking Water Incidents Impact Consumer Behaviour: Comparison of a Routine versus a Natural Disaster Incident

Science.gov (United States)

Rundblad, Gabriella; Knapton, Olivia; Hunter, Paul R.

2014-01-01

When public health is endangered, the general public can only protect themselves if timely messages are received and understood. Previous research has shown that the cause of threats to public health can affect risk perception and behaviours. This study compares compliance to public health advice and consumer behaviour during two “Boil Water” notices issued in the UK due to a routine incident versus a natural disaster incident. A postal questionnaire was sent to 1000 randomly selected households issued a routine “Boil Water” notice. Findings were then compared to a previous study that explored drinking water behaviour during a “Boil Water” notice issued after serious floods. Consumers affected by the routine incident showed a significant preference for official water company information, whereas consumers affected by the natural disaster preferred local information sources. Confusion over which notice was in place was found for both incidents. Non-compliance was significantly higher for the natural disaster (48.3%) than the routine incident (35.4%). For the routine incident, compliance with advice on drinking as well as preparing/cooking food and brushing teeth was positively associated with receiving advice from the local radio, while the opposite was true for those receiving advice from the water company/leaflet through the post; we suggest this may largely be due to confusion over needing boiled tap water for brushing teeth. No associations were found for demographic factors. We conclude that information dissemination plans should be tailored to the circumstances under which the advice is issued. Water companies should seek to educate the general public about water notices and which actions are safe and unsafe during which notice, as well as construct and disseminate clearer advice on brushing teeth and preparing/cooking food. PMID:25411725

Self-Reported Minimalist Running Injury Incidence and Severity: A Pilot Study.

Science.gov (United States)

Ostermann, Katrina; Ridpath, Lance; Hanna, Jandy B

2016-08-01

Minimalist running entails using shoes with a flexible thin sole and is popular in the United States. Existing literature disagrees over whether minimalist running shoes (MRS) improve perceived severity of injuries associated with running in traditional running shoes (TRS). Additionally, the perceived injury patterns associated with MRS are relatively unknown. To examine whether injury incidence and severity (ie, degree of pain) by body region change after switching to MRS, and to determine if transition times affect injury incidences or severity with MRS. Runners who were either current or previous users of MRS were recruited to complete an Internet-based survey regarding self-reported injury before switching to MRS and whether self-reported pain from that injury decreased after switching. Questions regarding whether new injuries developed in respondents after switching to MRS were also included. Analyses were calculated using t tests, Wilcoxon signed rank tests, and Fischer exact tests. Forty-seven runners completed the survey, and 16 respondents reported injuries before switching to MRS. Among these respondents, pain resulting from injuries of the feet (P=.03) and knees (P=.01) decreased. Eighteen respondents (38.3%) indicated they sustained new injuries after switching to MRS, but the severity of these did not differ significantly from no injury. Neither time allowed for transition to MRS nor use or disuse of a stretching routine during this period was correlated with an increase in the incidence or severity of injuries. After switching to MRS, respondents perceived an improvement in foot and knee injuries. Additionally, respondents using MRS reported an injury rate of 38.3%, compared with the approximately 64% that the literature reports among TRS users. Future studies should be expanded to determine the full extent of the differences in injury patterns between MRS and TRS.

Cumulative incidence of postoperative severe pain at Hospital Universitario San Jose, Popayan. Preliminar report

Directory of Open Access Journals (Sweden)

Ingrid Muñoz

2013-12-01

Full Text Available Introduction: Postoperative pain remains as a problem. National studies report incidences of 31% for moderate and 22% for severe pain. Inadequate analgesia is related to dissatisfaction and adverse outcomes. The aim of this study was to describe the incidence and characteristics of the postoperative pain in the post-anesthesia care unit (PACU at Hospital Universitario San José of Popayán (HUSJ in patients undergoing general anesthesia during the first postoperative hour. Methods: Cohort study. We recruited patients attending PACU and undergoing procedures using general anesthesia, between 18 and 70 years. Using a standardized collection form medical history, demographic data, medical history, anesthetic management, intraoperative analgesia and postoperative pain assessment by verbal and numerical pain scale (1-10 were recorded. Postoperative outcome data were also collected in the PACU. Results: The incidence of severe postoperative pain at 10 minutes was 12.3% 95%CI [7.1-18.2] (19 patients. Within 30 minutes of assessment 4.5% 95%CI [1.3-8.4] (7 patients and 1.9% 60 minutes 95%CI [0-4.5] (3 patients. 48.7% required rescue analgesic at PACU. Incidence of postoperative nausea and vomiting (PONV was significantly different in patients requiring rescue analgesic. Conclusion: The incidence of severe postoperative pain in the first postoperative hour at HUSJ is close to 12% and it decreases as time goes by. Patients requiring rescue analgesic have a higher incidence of postoperative complications such as PONV.

Using multiclass classification to automate the identification of patient safety incident reports by type and severity.

Science.gov (United States)

Wang, Ying; Coiera, Enrico; Runciman, William; Magrabi, Farah

2017-06-12

Approximately 10% of admissions to acute-care hospitals are associated with an adverse event. Analysis of incident reports helps to understand how and why incidents occur and can inform policy and practice for safer care. Unfortunately our capacity to monitor and respond to incident reports in a timely manner is limited by the sheer volumes of data collected. In this study, we aim to evaluate the feasibility of using multiclass classification to automate the identification of patient safety incidents in hospitals. Text based classifiers were applied to identify 10 incident types and 4 severity levels. Using the one-versus-one (OvsO) and one-versus-all (OvsA) ensemble strategies, we evaluated regularized logistic regression, linear support vector machine (SVM) and SVM with a radial-basis function (RBF) kernel. Classifiers were trained and tested with "balanced" datasets (n_ Type  = 2860, n_ SeverityLevel  = 1160) from a state-wide incident reporting system. Testing was also undertaken with imbalanced "stratified" datasets (n_ Type  = 6000, n_ SeverityLevel =5950) from the state-wide system and an independent hospital reporting system. Classifier performance was evaluated using a confusion matrix, as well as F-score, precision and recall. The most effective combination was a OvsO ensemble of binary SVM RBF classifiers with binary count feature extraction. For incident type, classifiers performed well on balanced and stratified datasets (F-score: 78.3, 73.9%), but were worse on independent datasets (68.5%). Reports about falls, medications, pressure injury, aggression and blood products were identified with high recall and precision. "Documentation" was the hardest type to identify. For severity level, F-score for severity assessment code (SAC) 1 (extreme risk) was 87.3 and 64% for SAC4 (low risk) on balanced data. With stratified data, high recall was achieved for SAC1 (82.8-84%) but precision was poor (6.8-11.2%). High risk incidents (SAC2) were confused

The incidence of ARDS and associated mortality in severe TBI using the Berlin definition.

Science.gov (United States)

Aisiku, Imoigele P; Yamal, Jose-Miguel; Doshi, Pratik; Rubin, Maria Laura; Benoit, Julia S; Hannay, Julia; Tilley, Barbara C; Gopinath, Shankar; Robertson, Claudia S

2016-02-01

The incidence of adult respiratory distress syndrome (ARDS) in severe traumatic brain injury (TBI) is poorly reported. Recently, a new definition for ARDS was proposed, the Berlin definition. The percentage of patients represented by TBI in the Berlin criteria study is limited. This study describes the incidence and associated mortality of ARDS in TBI patients. The study was an analysis of the safety of erythropoietin administration and transfusion threshold on the incidence of ARDS in severe TBI patients. Three reviewers independently assessed all patients enrolled in the study for acute lung injury/ARDS using the Berlin and the American-European Consensus Conference (AECC) definitions. A Cox proportional hazards model was used to assess the relationship between ARDS and mortality and 6-month Glasgow Outcome Scale (GOS) score. Two hundred patients were enrolled in the study. Of the patients, 21% (41 of 200) and 26% (52 of 200) developed ARDS using the AECC and Berlin definitions, respectively, with a median time of 3 days (interquartile range, 3) after injury. ARDS by either definition was associated with increased mortality (p = 0.04) but not with differences in functional outcome as measured by the GOS score at 6 months. Adjusted analysis using the Berlin criteria showed an increased mortality associated with ADS (p = 0.01). Severe TBI is associated with an incidence of ARDS ranging from 20% to 25%. The incidence is comparable between the Berlin and AECC definitions. ARDS is associated with increased mortality in severe TBI patients, but further studies are needed to validate these findings. Epidemiologic study, level II.

Development of several data bases related to reactor safety research including probabilistic safety assessment and incident analysis at JAERI

International Nuclear Information System (INIS)

Kobayashi, Kensuke; Oikawa, Tetsukuni; Watanabe, Norio; Izumi, Fumio; Higuchi, Suminori

1986-01-01

Presented are several databases developed at JAERI for reactor safety research including probabilistic safety assessment and incident analysis. First described are the recent developments of the databases such as 1) the component failure rate database, 2) the OECD/NEA/IRS information retrieval system, 3) the nuclear power plant database and so on. Then several issues are discussed referring mostly to the operation of the database (data input and transcoding) and to the retrieval and utilization of the information. Finally, emphasis is given to the increasing role which artifitial intelligence techniques such as natural language treatment and expert systems may play in improving the future capabilities of the databases. (author)

Insomnia and incident depression: role of objective sleep duration and natural history.

Science.gov (United States)

Fernandez-Mendoza, Julio; Shea, Sarah; Vgontzas, Alexandros N; Calhoun, Susan L; Liao, Duanping; Bixler, Edward O

2015-08-01

Longitudinal studies that have examined the association of insomnia with incident depression using objective sleep measures are very limited. The aim of this study was to examine the predictive role of the severity of insomnia for incident depression in a general population sample using psychometric and polysomnographic data. From a random, general population sample of 1741 individuals of the Penn State Adult Cohort, 1137 adults without depression were followed up with a structured telephone interview after 7.5 years. All subjects completed a full medical evaluation, 1-night polysomnogram and Multiphasic Minnesota Personality Inventory at baseline. The incidence of depression was 15%. Poor sleep (odds ratio = 1.5, P = 0.001) and insomnia (odds ratio = 1.9, P = 0.031) were significantly associated with incident depression. The odds of incident depression were highest (odds ratio = 2.2, P = 0.019) in insomnia with objective short sleep duration and independent of Multiphasic Minnesota Personality Inventory Ego Strength scores, an index of poor coping resources. The persistence of insomnia and worsening of poor sleep into insomnia significantly increased the odds of incident depression (odds ratios ranged from 1.8 to 6.3), whereas their full remission did not (odds ratio ranged from 1.2 to 1.8). Insomnia with short sleep duration is associated with incident depression independent of poor coping resources, whereas the association of insomnia with normal sleep duration with incident depression was mediated by poor coping resources. Persistence and worsening of poor sleep or insomnia, but not their full remission, are significant predictors of incident depression. These data suggest that there is a significant relationship between the severity of insomnia and incident depression. © 2015 European Sleep Research Society.

Comparison of the incidence, nature and cause of injuries sustained on dirt field and artificial turf field by amateur football players

Directory of Open Access Journals (Sweden)

Kordi Ramin

2011-02-01

Full Text Available Abstract Background Data on the incidence, nature, severity and cause of match football injuries sustained on dirt field are scarce. The objectives of this study was to compare the incidence, nature, severity and cause of match injuries sustained on dirt field and artificial turf field by amateur male football players. Methods A prospective two-cohort design was employed. Participants were 252 male football players (mean age 27 years, range 18-43 in 14 teams who participated in a local championship carried on a dirt field and 216 male football players (mean age 28 years, range 17-40 in 12 teams who participated in a local championship carried on a artificial turf field in the same zone of the city. Injury definitions and recording procedures were compliant with the international consensus statement for epidemiological studies of injuries in football. Results The overall incidence of match injuries for men was 36.9 injuries/1000 player hours on dirt field and 19.5 on artificial turf (incidence rate ratio 1.88; 95% CI 1.19-3.05. Most common injured part on dirt field was ankle (26.7% and on artificial turf was knee (24.3%. The most common injury type in the dirt field was skin injuries (abrasion and laceration and in the artificial turf was sprain and ligament injury followed by haematoma/contusion/bruise. Most injuries were acute (artificial turf 89%, dirt field 91% and resulted from player-to-player contact (artificial turf 59.2%, dirt field 51.4%. Most injuries were slight and minimal in dirt field cohort but in artificial turf cohort the most injuries were mild. Conclusions There were differences in the incidence and type of football match injuries sustained on dirt field and artificial turf.

Comparison of the incidence, nature and cause of injuries sustained on dirt field and artificial turf field by amateur football players.

Science.gov (United States)

Kordi, Ramin; Hemmati, Farajollah; Heidarian, Hamid; Ziaee, Vahid

2011-02-09

Data on the incidence, nature, severity and cause of match football injuries sustained on dirt field are scarce. The objectives of this study was to compare the incidence, nature, severity and cause of match injuries sustained on dirt field and artificial turf field by amateur male football players. A prospective two-cohort design was employed. Participants were 252 male football players (mean age 27 years, range 18-43) in 14 teams who participated in a local championship carried on a dirt field and 216 male football players (mean age 28 years, range 17-40) in 12 teams who participated in a local championship carried on a artificial turf field in the same zone of the city. Injury definitions and recording procedures were compliant with the international consensus statement for epidemiological studies of injuries in football. The overall incidence of match injuries for men was 36.9 injuries/1000 player hours on dirt field and 19.5 on artificial turf (incidence rate ratio 1.88; 95% CI 1.19-3.05).Most common injured part on dirt field was ankle (26.7%) and on artificial turf was knee (24.3%). The most common injury type in the dirt field was skin injuries (abrasion and laceration) and in the artificial turf was sprain and ligament injury followed by haematoma/contusion/bruise.Most injuries were acute (artificial turf 89%, dirt field 91%) and resulted from player-to-player contact (artificial turf 59.2%, dirt field 51.4%).Most injuries were slight and minimal in dirt field cohort but in artificial turf cohort the most injuries were mild. There were differences in the incidence and type of football match injuries sustained on dirt field and artificial turf.

Incidence and severity of stage IV bronchopulmonary dysplasia in infants of very low birth weight

International Nuclear Information System (INIS)

Parker, B.R.; Stevens, S.K.; Northway, W.H.

1989-01-01

To evaluate the incidence and severity of stage IV bronchopulmonary dysplasia (BPD) in infants of very low birth weight, the authors reviewed the clinical course and chest radiographs of 138 such infants. In the lowest weight group ( 1500 g, 10%). However, the severity of BPD (graded by the Toce-Edwards Scale) was highest (6.3) in the < 1500-g group (< 900 g, 5.4; 1200-1500 g, 5.9). These data showed that, although the incidence of stage IV BVD significantly decreased as birth weight increased, the severity of chronic changes was independent of birth weight

Airborne incidents : an econometric analysis of severity, December 19, 2014 : Final report

Science.gov (United States)

2014-12-19

Airborne loss of separation incidents occur when an aircraft breaches the defined separation limit (vertical and/or horizontal) with another aircraft or terrain imposed by Air Traffic Control. Identifying conditions that lead to more severe loss of s...

cricket: nature and incidence of fast-bowling injuries at an elite ...

African Journals Online (AJOL)

. T3. TT. Fig. 1. Seasonal injury incidence per anatomical area. 0. 5. 10. 15. 20. 25. 30. 35. 40. 45. 50 strain other sprain tear fracture bruise break dislocation. T1. T2. T3. TT. Fig. 2. The nature of injuries to fast bowlers. saJsM Vol 20 no. 2 2008.

Trends in the incidence of cervical cancer and severe precancerous lesions in Denmark, 1997-2012

DEFF Research Database (Denmark)

Baldur-Felskov, Birgitte; Munk, Christian; Nielsen, Thor Schütt Svane

2015-01-01

the Danish incidence trends during 1997-2011 when cervical screening coverage was high. Incidences of cervical intraepithelial neoplasia grade 3 (CIN3) and adenocarcinoma in situ (AIS) were also assessed, with the latest part of the study period coinciding with introduction of free-of-charge human......PURPOSE: The incidence of cervical cancer, including squamous cell carcinoma (SCC), has been decreasing in several developed countries since the onset of organized screening programs; in some countries, however, the incidence of adenocarcinoma has increased among young women. We investigated......, importantly, they decreased significantly during 2009-2012 in women aged ≤20 years. CONCLUSIONS: The Danish screening program has successfully reduced the incidence of cervical cancer, especially of SCC in older women; however, the program has not significantly reduced the incidence in young women...

Do Cancer-Related Beliefs Influence the Severity, Incidence, and Persistence of Psychological Symptoms?

Science.gov (United States)

Desautels, Caroline; Trudel-Fitzgerald, Claudia; Ruel, Sophie; Ivers, Hans; Savard, Josée

Previous studies have suggested that negative beliefs about cancer may impair patients' psychological well-being, but only a few of these studies focused on specific psychological symptoms, and many were cross-sectional. The aim of this study was to investigate longitudinally the relationship of cancer-related cognitions with the severity, incidence, and persistence of anxiety, fear of cancer recurrence, depression, and insomnia symptoms during an 18-month period. Patients scheduled to undergo surgery for cancer (N = 962) completed a questionnaire assessing cancer-related cognitions at baseline (T1), the Hospital Anxiety and Depression Scale, the severity subscale of the Fear of Cancer Recurrence Inventory, and the Insomnia Severity Index at baseline (T1) and 2 (T2), 6 (T3), 10 (T4), 14 (T5), and 18 (T6) months later. Group × time factorial analyses using mixed models revealed that participants endorsing more negative cancer-related cognitions consistently reported more severe symptoms throughout the 18-month period. Logistic regression analyses suggested that endorsing more negative cancer-related cognitions at T1 significantly increased incidence and persistence rates of clinical levels of psychological symptoms. These findings suggest that the endorsement of negative cancer-related beliefs at the perioperative period influences the longitudinal evolution of anxiety, fear of cancer recurrence, depression, and insomnia symptoms in the following months. These results highlight the relevance of using cognitive restructuring early during the cancer care trajectory to potentially revise erroneous beliefs about cancer and prevent the incidence and persistence of psychological disturbances over time.

The incidence and nature of injuries sustained on grass and 3rd generation artificial turf: a pilot study in elite Saudi National Team footballers.

Science.gov (United States)

Almutawa, M; Scott, M; George, K P; Drust, B

2014-02-01

To compare the incidence, severity and nature of injuries sustained by Saudi National Team footballers during match-play and training on natural grass and 3rd generation (3G) artificial turf. Injury data was collected on all Saudi National Team players competing at the Gulf Cup (Yemen December 2010: 3G) and the Asian Cup (Qatar January 2011; grass). A total of 49 players were studied (mean ± SD; Age 27 ± 4 yr; body mass 71.4 ± 6.7 kg; height 176.8 ± 6.3 cm; professional playing experience 9 ± 3 yr) of which 31 competed at the Gulf Cup, 32 at the Asian Cup (14 at both). A prospective cohort design was used to investigate the incidence, nature and severity of injuries sustained with data collected using a standardised injury questionnaire. All data were collected by the team physiotherapist with the definition of injury set at any injury that required player and clinician contact. Injury and exposure data were collected and reported for games, training and all football activity. A total of 82 injuries [incidence - 56.1 per 1000 h total game and training exposure] were recorded at the Asian Cup (grass) and 72 injuries [incidence - 37.9 per 1000 h total game and training exposure] were recorded at the Gulf Cup (3G). Incidence data for training, game and all football exposure injury rates were higher when playing on grass. The vast majority of injuries on both surfaces were very minor that, whilst requiring medical attention, did not result in loss of match/training exposure. Injuries that resulted in 1-3 days absence from training or game play had similar incidence rates (Grass: 7.4 vs. 3G: 7.4 injuries per 1000 h exposure). More severe injuries were less frequent but with a higher incidence when playing on grass. Lower limb injuries were the most common in both tournaments with a higher incidence on grass (Grass: 14.2 vs. 3G: 7.9 injuries per 1000 h exposure). Muscle injuries were the most frequent of all injuries with similar incidence rates on

Severity scale for incidents and accidents in French nuclear power plant

International Nuclear Information System (INIS)

Dupuis, M.C.; Guimbail, H.; Debes, M.; Roels, C.

1988-10-01

All countries operating nuclear power stations have developed systems for declaring and analyzing incidents occurring when the stations are in service. These systems, are inevitably extensive and complex, as the search for perfection in terms of operating safety leads not only to identification and analysis of incidents which are evidenced by their consequences, but also to identification of all those other incidents which have not had repercussions, but which nevertheless constitute precursor events for more serious situations. For example in France, a system based on safety significance criteria has been in service since the early 1980s, and is applied and operated by EDF and the safety authorities. While experts obtain maximum benefit from this system, public opinion and the relay points constituted by the media are somewhat at a loss, being unable to discriminate in the mass of non-hierarchized information which may come their way, between what is genuinely important and what is less important or even totally unimportant. For this reason, the CSSIN recommended examination of a severity scale, simple to understand and easy to use, which could be employed to classify all incidents and which could become, in due course, as familiar to all of us as the Richter seismic scale is today. We will now examine the composition of this scale, applied on an experimental basis by the Minister for Industry for a period of about one and a half years, as from 20th April 1988

The incidence and nature of injuries in South African rugby players in the rugby Super 12 competition.

Science.gov (United States)

Holtzhausen, Louis J; Schwellnus, Martin P; Jakoet, Ismail; Pretorius, A L

2006-12-01

There are sparse scientific data concerning the aetiology and incidence of injuries in the Super 12 rugby competition. Aim. The aim of the study was to document the incidence, nature and risk factors associated with injuries during a Super 12 rugby competition. Injuries, defined as injuries preventing playing or training, or requiring medical treatment, were recorded in a cohort of 75 South African Super 12 players over one season. Injury severity was graded according to sessions missed: minor (1 - 3 missed), intermediate (4 - 9) and severe (> 9). During the tournament, a total of 740 player game hours and 4 900 player training hours were recorded. The overall incidence of injuries was 55.4 injuries/1,000 player game hours, and 4.3 injuries/1,000 player training hours. The most common injury types were: ligament sprains (25.8%), musculotendinous strains/tears (24.2%). The most common injured sites were: pelvis, hip (19.3%), head and knee (12.9% each). The tackle caused 40.3%, and rucks and mauls 11.3% of injuries. Injuries sustained during training accounted for 34%, and chronic overuse injuries 9.7% of injuries. There is a high injury rate during a Super 12 rugby competition. However, the majority of injuries were minor injuries. The most dangerous phase of play was the tackle. Training in tackling and rucking techniques, and rule enforcement are therefore recommended to reduce risk of injury. Injuries tended to occur late in games and early in the season, suggesting lack of physical conditioning and fatigue as possible causes of injury.

The MentDis_ICF65+study protocol: prevalence, 1-year incidence and symptom severity of mental disorders in the elderly and their relationship to impairment, functioning (ICF) and service utilisation

OpenAIRE

Andreas, Sylke; Haerter, Martin; Volkert, Jana; Hausberg, Maria; Sehner, Susanne; Wegscheider, Karl; Rabung, Sven; Ausin, Berta; Canuto, Alessandra; Da Ronch, Chiara; Grassi, Luigi; Hershkovitz, Yael; Lelliott, Paul; Munoz, Manuel; Quirk, Alan

2013-01-01

Background The EU currently lacks reliable data on the prevalence and incidence of mental disorders in older people. Despite the availability of several national and international epidemiological studies, the size and burden of mental disorders in the elderly remain unclear due to various reasons. Therefore, the aims of the MentDis_ICF65+ study are (1) to adapt existing assessment instruments, and (2) to collect data on the prevalence, the incidence, and the natural course and prognosis of me...

Incidence, severity and prognosis associated with hypernatremia in dogs and cats.

Science.gov (United States)

Ueda, Y; Hopper, K; Epstein, S E

2015-01-01

Hypernatremia has been associated with substantial morbidity and death in human patients. The incidence and importance of hypernatremia in dogs and cats has not been determined. To describe the incidence of and prognosis associated with hypernatremia in dogs and cats at a university teaching hospital. A total of 16,691 dogs and 4,211 cats with measured blood or serum sodium concentration. Retrospective study. Medical records of animals with a blood or serum sodium concentration measured during a 60-month period were reviewed to determine the severity of hypernatremia and its associated case fatality rate. Cases with moderate (11-15 mmol/L above the reference range) or severe hypernatremia (≥16 mmol/L above the reference range) were further reviewed. A total of 957 dogs (5.7%) and 338 cats (8.0%) were diagnosed with hypernatremia. Case fatality rates of dogs and cats with hypernatremia was 20.6 and 28.1%, respectively compared to 4.4 and 4.5% with a normal blood or serum sodium concentration (P dogs and 38.5% of cats presented with community-acquired hypernatremia, and 50% of dogs and 61.5% of cats developed hospital-acquired hypernatremia. Hypernatremia was found infrequently in this population but was associated with increased case fatality rates in dogs and cats. Presence and severity of hypernatremia might be useful as a prognostic indicator. Copyright © 2014 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Increasing Incidence of Severe Epstein-Barr Virus-Related Infectious Mononucleosis: Surveillance Study

Science.gov (United States)

Tattevin, Pierre; Le Tulzo, Yves; Minjolle, Sophie; Person, Arnaud; Chapplain, Jean Marc; Arvieux, Cedric; Thomas, Remi; Michelet, Christian

2006-01-01

Older patients are more susceptible to severe Epstein-Barr virus (EBV)-related infectious mononucleosis (IM). This condition may increase in industrialized countries where primary EBV infection occurs later in life. Between 1990 and 2004, 38 patients were admitted to our department with EBV-related IM. Two patients died. The annual incidence increased significantly (r = 0.623; P = 0.013). PMID:16672427

A dedicated intravenous cannula for postoperative use effect on incidence and severity of phlebitis.

LENUS (Irish Health Repository)

Panadero, A

2012-02-03

A prospective, randomised, controlled clinical study was performed to compare the incidence and severity of postoperative peripheral venous thrombophlebitis associated with a single intravenous cannula used for both intra-operative and postoperative purposes, and two cannulae, one used intra-operatively and the other postoperatively. Sixty American Society of Anaesthesiologists (ASA) physical status I or II patients aged 18-65 years undergoing elective surgery were studied. The technique of cannula insertion was standardised. After surgery, the cannulation sites were examined daily by a blinded investigator for the presence and severity of thrombophlebitis using the Baxter Scale. The two groups were similar in terms of age, gender, weight, type and duration of surgical procedures, and drugs and fluids administered both intra-operatively and postoperatively. The proportion of patients that developed phlebitis was significantly less in the two cannulae group (26.1%) than in the single cannula group (63.3%) (p < 0.0001). The severity of phlebitis was greater in the single cannula group than in the two cannulae group. These results indicate that the use of a dedicated cannula for postoperative use decreases the incidence and severity of postoperative, peripheral, cannula-related phlebitis.

The effect of seasonality on burn incidence, severity and outcome in Central Malawi.

Science.gov (United States)

Tyson, Anna F; Gallaher, Jared; Mjuweni, Stephen; Cairns, Bruce A; Charles, Anthony G

2017-08-01

In much of the world, burns are more common in cold months. However, few studies have described the seasonality of burns in sub-Saharan Africa. This study examines the effect of seasonality on the incidence and outcome of burns in central Malawi. A retrospective analysis was performed at Kamuzu Central Hospital and included all patients admitted from May 2011 to August 2014. Demographic data, burn mechanism, total body surface area (%TBSA), and mortality were analyzed. Seasons were categorized as Rainy (December-February), Lush (March-May), Cold (June-August) and Hot (September-November). A negative binomial regression was used to assess the effect of seasonality on burn incidence. This was performed using both the raw and deseasonalized data in order to evaluate for trends not attributable to random fluctuation. A total of 905 patients were included. Flame (38%) and Scald (59%) burns were the most common mechanism. More burns occurred during the cold season (41% vs 19-20% in the other seasons). Overall mortality was 19%. Only the cold season had a statistically significant increase in burn . The incidence rate ratios (IRR) for the hot, lush, and cold seasons were 0.94 (CI 0.6-1.32), 1.02 (CI 0.72-1.45) and 1.6 (CI 1.17-2.19), respectively, when compared to the rainy season. Burn severity and mortality did not differ between seasons. The results of this study demonstrate the year-round phenomenon of burns treated at our institution, and highlights the slight predominance of burns during the cold season. These data can be used to guide prevention strategies, with special attention to the implications of the increased burn incidence during the cold season. Though burn severity and mortality remain relatively unchanged between seasons, recognizing the seasonal variability in incidence of burns is critical for resource allocation in this low-income setting. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Factors Associated with the Incidence and Severity of New-Onset Atrial Fibrillation in Adult Critically Ill Patients

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Péricles A. D. Duarte

2017-01-01

Full Text Available Background. Acute Atrial Fibrillation (AF is common in critically ill patients, with significant morbidity and mortality; however, its incidence and severity in Intensive Care Units (ICUs from low-income countries are poorly studied. Additionally, impact of vasoactive drugs on its incidence and severity is still not understood. This study aimed to assess epidemiology and risk factors for acute new-onset AF in critically ill adult patients and the role of vasoactive drugs. Method. Cohort performed in seven general ICUs (including cardiac surgery in three cities in Paraná State (southern Brazil for 45 days. Patients were followed until hospital discharge. Results. Among 430 patients evaluated, the incidence of acute new-onset AF was 11.2%. Patients with AF had higher ICU and hospital mortality. Vasoactive drugs use (norepinephrine and dobutamine was correlated with higher incidence of AF and higher mortality in patients with AF; vasopressin (though used in few patients had no effect on development of AF. Conclusions. In general ICU patients, incidence of new-onset AF was 11.2% with a high impact on morbidity and mortality, particularly associated with the presence of Acute Renal Failure. The use of vasoactive drugs (norepinephrine and dobutamine could lead to a higher incidence of new-onset AF-associated morbidity and mortality.

Incidence and nature of karate injuries.

Science.gov (United States)

Destombe, Claire; Lejeune, Laurent; Guillodo, Yannick; Roudaut, Anne; Jousse, Sandrine; Devauchelle, Valérie; Saraux, Alain

2006-03-01

To determine the incidence and nature of karate injuries sustained in karate clubs and to identify risk factors for injuries. One hundred eighty-six individuals from three karate clubs in Brest, France, were entered in a retrospective study extending from September 2002 to June 2003. Each athlete was asked to complete a questionnaire on karate injuries sustained during the previous year (type, location, mechanism, exercise during which the injury occurred, number of days off training and work, and medical care). Injury types were described by number of injuries and risk factors per number of injured athletes. Forty-eight (28.8%) of the 186 athletes sustained 83 injuries (63 while training and 20 while competing). The annual injury rate was 44.6 per 100 athletes. Incidence rates were similar in males and females and across the three clubs but increased with age, time spent training (3.6+/-1.7 vs. 2.9+/-1.5 h/week; P=0.001), rank (lower ranks vs. brown and black belts, P=0.015), and years of practice (7.3+/-5.5 years in athletes with injuries vs. 5.1+/-4.8 in those without injuries; P=0.03). Injuries consisted of 43 (53%) hematomas, 16 (19%) sprains, seven (7%) muscle lesions, six (7%) fractures, four (5%) malaise episodes, and seven (7%) miscellaneous lesions. Time off training occurred for 26 (31.3%) injuries and ranged from 8 to >30 days. The body region involved was the head in 22 (26.5%) injuries, the torso in eight injuries (9.6%), the upper limb in 24 (28.9%) injuries, and the lower limb in 29 (35%) injuries. Karate injuries are fairly common but usually minor. They are more likely to occur during competitions than while training. The head and limbs are the main regions involved. Longer training times per week and higher rank are associated with an increased risk of injury. Prevention seems crucial.

Incidence of cervical cancer after several negative smear results by age 50: prospective observational study

DEFF Research Database (Denmark)

Rebolj, Matejka; van Ballegooijen, Marjolein; Lynge, Elsebeth

2009-01-01

/100,000 (95% confidence interval 33 to 51) in the younger group and 36/100,000 (24 to 52) in the older group (P=0.48). The cumulative incidence rate of cervical intraepithelial neoplasia grade I+ was twice as high in the younger than in the older group (Pcervical cancer......OBJECTIVE: To determine the incidence of cervical cancer after several negative cervical smear tests at different ages. DESIGN: Prospective observational study of incidence of cervical cancer after the third consecutive negative result based on individual level data in a national registry...... of histopathology and cytopathology (PALGA). SETTING: Netherlands, national data. Population 218,847 women aged 45-54 and 445,382 aged 30-44 at the time of the third negative smear test. MAIN OUTCOME MEASURES: 10 year cumulative incidence of interval cervical cancer. RESULTS: 105 women developed cervical cancer...

Estimated incidence of influenza-associated severe acute respiratory infections in Indonesia, 2013-2016.

Science.gov (United States)

Susilarini, Ni K; Haryanto, Edy; Praptiningsih, Catharina Y; Mangiri, Amalya; Kipuw, Natalie; Tarya, Irmawati; Rusli, Roselinda; Sumardi, Gestafiana; Widuri, Endang; Sembiring, Masri M; Noviyanti, Widya; Widaningrum, Christina; Lafond, Kathryn E; Samaan, Gina; Setiawaty, Vivi

2018-01-01

Indonesia's hospital-based Severe Acute Respiratory Infection (SARI) surveillance system, Surveilans Infeksi Saluran Pernafasan Akut Berat Indonesia (SIBI), was established in 2013. While respiratory illnesses such as SARI pose a significant problem, there are limited incidence-based data on influenza disease burden in Indonesia. This study aimed to estimate the incidence of influenza-associated SARI in Indonesia during 2013-2016 at three existing SIBI surveillance sites. From May 2013 to April 2016, inpatients from sentinel hospitals in three districts of Indonesia (Gunung Kidul, Balikpapan, Deli Serdang) were screened for SARI. Respiratory specimens were collected from eligible inpatients and screened for influenza viruses. Annual incidence rates were calculated using these SIBI-enrolled influenza-positive SARI cases as a numerator, with a denominator catchment population defined through hospital admission survey (HAS) to identify respiratory-coded admissions by age to hospitals in the sentinel site districts. From May 2013 to April 2016, there were 1527 SARI cases enrolled, of whom 1392 (91%) had specimens tested and 199 (14%) were influenza-positive. The overall estimated annual incidence of influenza-associated SARI ranged from 13 to 19 per 100 000 population. Incidence was highest in children aged 0-4 years (82-114 per 100 000 population), followed by children 5-14 years (22-36 per 100 000 population). Incidence rates of influenza-associated SARI in these districts indicate a substantial burden of influenza hospitalizations in young children in Indonesia. Further studies are needed to examine the influenza burden in other potential risk groups such as pregnant women and the elderly. © 2017 The Authors. Influenza and Other Respiratory Viruses. Published by John Wiley & Sons Ltd.

Evolution of the ischio-iliac lordosis during natural growth and its relation with the pelvic incidence.

Science.gov (United States)

Schlösser, Tom P C; Janssen, Michiel M A; Vrtovec, Tomaž; Pernuš, Franjo; Oner, F Cumhur; Viergever, Max A; Vincken, Koen L; Castelein, René M

2014-07-01

Human fully upright ambulation, with fully extended hips and knees, and the body's center of gravity directly above the hips, is unique in nature, and distinguishes humans from all other mammalians. This bipedalism is made possible by the development of a lordosis between the ischium and ilium; it allows to ambulate in this unique bipedal manner, without sacrificing forceful extension of the legs. This configuration in space introduces unique biomechanical forces with relevance for a number of spinal conditions. The aim of this study was to quantify the development of this lordosis between ischium and ilium in the normal growing and adult spine and to evaluate its correlation with the well-known clinical parameter, pelvic incidence. Consecutive series of three-dimensional computed tomography scans of the abdomen of 189 children and 310 adults without spino-pelvic pathologies were used. Scan indications were trauma screening or acute abdominal pathology. Using previously validated image processing techniques, femoral heads, center of the sacral endplate and the axes of the ischial bones were semi-automatically identified. A true sagittal view of the pelvis was automatically reconstructed, on which ischio-iliac angulation and pelvic incidence were calculated. The ischio-iliac angle was defined as the angle between the axes of the ischial bones and the line from the midpoint of the sacral endplate to the center of the femoral heads. A wide natural variation of the ischio-iliac angle (3°-46°) and pelvic incidence (14°-77°) was observed. Pearson's analysis demonstrated a significant correlation between the ischio-iliac angle and pelvic incidence (r = 0.558, P lordosis is unique in nature, is in harmonious continuity with the highly individual lumbar lordosis and defines the way the human spine is biomechanically loaded. The practical parameter that reflects this is the pelvic incidence; both values increase during growth and remain stable in adulthood.

High C-Reactive Protein Predicts Delirium Incidence, Duration, and Feature Severity After Major Noncardiac Surgery.

Science.gov (United States)

Vasunilashorn, Sarinnapha M; Dillon, Simon T; Inouye, Sharon K; Ngo, Long H; Fong, Tamara G; Jones, Richard N; Travison, Thomas G; Schmitt, Eva M; Alsop, David C; Freedman, Steven D; Arnold, Steven E; Metzger, Eran D; Libermann, Towia A; Marcantonio, Edward R

2017-08-01

To examine associations between the inflammatory marker C-reactive protein (CRP) measured preoperatively and on postoperative day 2 (POD2) and delirium incidence, duration, and feature severity. Prospective cohort study. Two academic medical centers. Adults aged 70 and older undergoing major noncardiac surgery (N = 560). Plasma CRP was measured using enzyme-linked immunosorbent assay. Delirium was assessed from Confusion Assessment Method (CAM) interviews and chart review. Delirium duration was measured according to number of hospital days with delirium. Delirium feature severity was defined as the sum of CAM-Severity (CAM-S) scores on all postoperative hospital days. Generalized linear models were used to examine independent associations between CRP (preoperatively and POD2 separately) and delirium incidence, duration, and feature severity; prolonged hospital length of stay (LOS, >5 days); and discharge disposition. Postoperative delirium occurred in 24% of participants, 12% had 2 or more delirium days, and the mean ± standard deviation sum CAM-S was 9.3 ± 11.4. After adjusting for age, sex, surgery type, anesthesia route, medical comorbidities, and postoperative infectious complications, participants with preoperative CRP of 3 mg/L or greater had a risk of delirium that was 1.5 times as great (95% confidence interval (CI) = 1.1-2.1) as that of those with CRP less than 3 mg/L, 0.4 more delirium days (P delirium (3.6 CAM-S points higher, P delirium (95% CI = 1.0-2.4) as those in the lowest quartile (≤127.53 mg/L), had 0.2 more delirium days (P delirium (4.5 CAM-S points higher, P delirium incidence, duration, and feature severity. CRP may be useful to identify individuals who are at risk of developing delirium. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

High incidence of rickets in extremely low birth weight infants with severe parenteral nutrition-associated cholestasis and bronchopulmonary dysplasia.

Science.gov (United States)

Lee, Soon Min; Namgung, Ran; Park, Min Soo; Eun, Ho Sun; Park, Kook In; Lee, Chul

2012-12-01

Risk factors for rickets of prematurity have not been re-examined since introduction of high mineral formula, particularly in ELBW infants. We analyzed the incidence and the risk factors of rickets in extremely low birth weight (ELBW) infants. As a retrospective case-control study from 2004 to 2008, risk factors were analyzed in 24 patients with rickets versus 31 patients without. The frequency of rickets in ELBW infants was 24/55 (44%). Infants with rickets were diagnosed at 48.2 ± 16.1 days of age, and improved by 85.3 ± 25.3 days. By radiologic evaluation, 29% were grade 1 rickets, 58% grade 2 and 13% grade 3. In univariate analysis, infants with rickets had significantly higher incidence of patent ductus arteriosus, parenteral nutrition associated cholestasis (PNAC), severe PNAC and moderate/severe bronchopulmonary dysplasia (BPD). In multiple regression analysis, after adjustment for gestation and birth weight, rickets significantly correlated with severe PNAC and with moderate/severe BPD. Serum peak alkaline phosphatase levels were significantly elevated in rickets (P rickets of prematurity remains high and the incidence of severe PNAC and moderate/severe BPD was significantly increased 18 and 3 times, respectively.

Symptomatic heterotopic ossification after very severe traumatic brain injury in 114 patients: incidence and risk factors

DEFF Research Database (Denmark)

Simonsen, Louise Lau; Sonne-Holm, Stig; Krasheninnikoff, Michael

2007-01-01

The incidence of heterotopic ossification (HO) among patients with traumatic brain injury (TBI) varies in the literature from 11 to 73.3%. The aim of this study was to determine the incidence of HO among patients with very severe TBI treated in a new established intensive rehabilitation Brain...... Injury Unit and to list some of the risk-predicting features. The study comprised an approximately complete, consecutive series of 114 adult patients from a well-defined geographical area, and with a posttraumatic amnesia period of at least 28 days, i.e. very severe TBI. Demographic and functional data...... as well as data about trauma severity and hospital stay of these patients have been registered prospectively in a database (Danish National Head Injury database) at the Brain Injury Unit where the sub acute rehabilitation took place. The present study was based retrospectively on this database, combined...

Leflunomide for the treatment of rheumatoid arthritis in clinical practice: Incidence and severity of hepatotoxicity

NARCIS (Netherlands)

Van Roon, Eric N.; Jansen, Tim L.Th.A.; Houtman, Nella M.; Spoelstra, Piet; Brouwers, Jacobus R.B.J.

2004-01-01

Objective: Leflunomide is a novel disease modifying antirheumatic drug (DMARD). Because of reports on possible hepatotoxicity and adaptations in the recommendations for monitoring liver function during leflunomide treatment, we conducted a study to evaluate the incidence and severity of

Analysis of hot leg natural circulation under station blackout severe accident

International Nuclear Information System (INIS)

Deng Jian; Cao Xuewu

2007-01-01

Under severe accidents, natural circulation flows are important to influence the accident progression and result in a pressurized water reactor (PWR). In a station blackout accident with no recovery of steam generator (SG) auxiliary feedwater (TMLB' severe accident scenario), the hot leg countercurrent natural circulation flow is analyzed by using a severe-accident code, to better understand its potential impacts on the creep-rupture timing among the surge line, the hot leg; and SG tubes. The results show that the natural circulation may delay the failure time of the hot leg. The recirculation ratio and the hot mixing factor are also calculated and discussed. (authors)

Multiple epiphyseal dysplasia complicated by severe osteochondritis dissecans of the knee. Incidence in two families

Energy Technology Data Exchange (ETDEWEB)

Versteylen, R.J.; Zwemmer, A.; Lorie, C.A.M.; Schuur, K.H.

1988-09-01

Two families are described which appear to contain examples of multiple epiphyseal dysplasia. In both families a striking incidence of severe osteochondritis of the knees was encountered. It is suggested that this was caused by the fragmented and maldeveloped epiphyses characteristic of epiphyseal dysplasia.

Evaluation of the Incidence and Severity of Olive Leaf Spot caused by Spilocaea oleaginain different olive cultivars in Palestine

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Ruba Abuamsha

2013-12-01

Full Text Available Twelve olive (Olea europaea L. cultivars including Nabali Baladi, Nabali Mohassan, Santa Augustino, Nasohi Jaba`a 1, Nasohi Jaba`a 2, Yunani, Talmasani, Chemlali, Arbequino, Frantoio, Coca and Barouni, were sampled for their susceptibility to Spilocaea oleagina the causal agent for Olive leaf spot (OLS disease on olive trees in Palestine. Investigations were carried out to measure the incidence and severity of the disease at Qabatyia station in Jenin district area Susceptible olive cultivars grown commercially in Palestine include Arbequino, Frantoio and ?Barouni’.The “Nabali” is the most dominant and highly susceptible olive cultivar grown in Palestine. Disease incidence varied greatly among the cultivars F=59.4, df=11, 251, p?0.0001 and was correlated with the severity (y = 0.42x + 9.3, P ? 0.0001, R² = 0.84, y = disease severity and x = disease incidence. Disease severity also varied among different cultivars F=13.9, df=11, 251, p?0.0001. Nabali Mohassan was the most affected susceptible while Barouni was most resistant. Progress of disease severity over time fit the logistic function for all cultivars except for highly susceptible cultivars F=1.56, df=6, 83, p?0.169. The assessment method may be useful to screen olive cultivars for OLS resistance in Palestine.

Incidence and severity of root resorption in orthodontically moved premolars in dogs.

Science.gov (United States)

Maltha, J C; van Leeuwen, E J; Dijkman, G E H M; Kuijpers-Jagtman, A M

2004-05-01

To study treatment-related factors for external root resorption during orthodontic tooth movement. An experimental animal study. Department of Orthodontics and Oral Biology, University Medical Centre Nijmegen, The Netherlands. Twenty-four young adult beagle dogs. Mandibular premolars were bodily moved with continuous or intermittent controlled orthodontic forces of 10, 25, 50, 100, or 200 cN according to standardized protocols. At different points in time histomorphometry was performed to determine the severity of root resorption. Prevalence of root resorptions, defined as microscopically visible resorption lacunae in the dentin. Severity of resorption was defined by the length, relative length, depth, and surface area of each resorption area. The incidence of root resorption increased with the duration of force application. After 14-17 weeks of force application root resorption was found at 94% of the root surfaces at pressure sides. The effect of force magnitude on the severity of root resorption was not statistically significant. The severity of root resorption was highly related to the force regimen. Continuous forces caused significantly more severe root resorption than intermittent forces. A strong correlation (0.60 < r < 0.68) was found between the amount of tooth movement and the severity of root resorption. Root resorption increases with the duration of force application. The more teeth are displaced, the more root resorption will occur. Intermittent forces cause less severe root resorption than continuous forces, and force magnitude is probably not decisive for root resorption.

Open Heart Surgery Does Not Increase the Incidence of Ipsilateral Ischemic Stroke in Patients with Asymptomatic Severe Carotid Stenosis.

Science.gov (United States)

Castaldo, John E; Yacoub, Hussam A; Li, Yuebing; Kincaid, Hope; Jenny, Donna

2017-10-01

We evaluated the incidence of perioperative stroke following the institution's 2007 practice change of discontinuing combined carotid endarterectomy and open heart surgery (OHS) for patients with severe carotid stenosis. In this retrospective cohort study, we compared 113 patients undergoing coronary artery bypass grafting, aortic valve replacement, or both from 2007 to 2011 with data collected from 2001 to 2006 from a similar group of patients. Our aim was to assess whether the practice change led to a greater incidence of stroke. A total of 7350 consecutive patients undergoing OHS during the specified time period were screened. Of these, 3030 had OHS between 2007 and 2011 but none were combined with carotid artery surgery (new cohort). The remaining 4320 had OHS before 2007 and 44 had combined procedures (old cohort). Of patients undergoing OHS during the 10-year period of observation, 230 had severe (>80%) carotid stenosis. In the old cohort (before 2007), carotid stenosis was associated with perioperative stroke in 2.5% of cases. None of the 113 patients having cardiac procedures after 2007 received combined carotid artery surgery; only 1 of these patients harboring severe carotid stenosis had an ischemic stroke (.9%) during the perioperative period. The difference in stroke incidence between the 2 cohorts was statistically significant (P = .002). The incidence of stroke in patients with severe carotid artery stenosis undergoing OHS was lower after combined surgery was discontinued. Combined carotid and OHS itself seems to be an important risk factor for stroke. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Evaluation of High-Pressure RCS Natural Circulations Under Severe Accident Conditions

International Nuclear Information System (INIS)

Lee, Byung Chul; Bang, Young Suk; Suh, Nam Duk

2006-01-01

Since TMI-2 accident, the occurrence of severe accident natural circulations inside RCS during entire in-vessel core melt progressions before the reactor vessel breach had been emphasized and tried to clarify its thermal-hydraulic characteristics. As one of consolidated outcomes of these efforts, sophisticated models have been presented to explain the effects of a variety of engineering and phenomenological factors involved during severe accident mitigation on the integrity of RCS pressure boundaries, i.e. reactor pressure vessel(RPV), RCS coolant pipe and steam generator tubes. In general, natural circulation occurs due to density differences, which for single phase flow, is typically generated by temperature differences. Three natural circulation flows can be formed during severe accidents: in-vessel, hot leg countercurrent flow and flow through the coolant loops. Each of these flows may be present during high-pressure transients such as station blackout (SBO) and total loss of feedwater (TLOFW). As a part of research works in order to contribute on the completeness of severe accident management guidance (SAMG) in domestic plants by quantitatively assessing the RCS natural circulations on its integrity, this study presents basic approach for this work and some preliminary results of these efforts with development of appropriately detailed RCS model using MELCOR computer code

Incidence of severe anorexia nervosa in Switzerland : 40 years of development (vol 35, pg 250, 2004)

NARCIS (Netherlands)

Milos, G; Spindler, A; Schnyder, U; Martz, J; Hoek, HW; Willi, J

Objective: The current study examined the development of the incidence of severe anorexia nervosa with five sampling periods covering the years 1956-1995 in a geographically defined region of Switzerland. Method: Applying the same methodology as in the earlier sampling periods, the medical records

Incidence and risk factors for severe and symptomatic hypoglycemia in type 1 diabetes. Results of the HYPOS-1 study.

Science.gov (United States)

Giorda, Carlo B; Ozzello, Alessandro; Gentile, Sandro; Aglialoro, Alberto; Chiambretti, Anna; Baccetti, Fabio; Gentile, Francesco M; Lucisano, Giuseppe; Nicolucci, Antonio; Rossi, Maria Chiara

2015-10-01

Hypoglycemia is common in type 1 diabetes mellitus (T1DM). We aimed to update the incidence of severe and symptomatic hypoglycemia and investigate several correlated factors. In this multicenter, observational retrospective study, the data of 206 T1DM patients from a sample of 2,229 consecutive patients seen at 18 diabetes clinics were analyzed. Sociodemographic and clinical characteristics, severe hypoglycemia in the past 12 months, and symptomatic hypoglycemia in the past 4 weeks were recorded with a self-report questionnaire and a clinical form during a routine visit. Poisson multivariate models were applied. A minority of patients accounted for the majority of both severe and symptomatic episodes. The incidence rate (IR) of severe hypoglycemia was 0.49 (0.40-0.60) events/person-years. The incidence rate ratio (IRR) was higher in patients with previous severe hypoglycemia (3.71; 2.28-6.04), neuropathy (4.16; 2.14-8.05), long duration (>20 years, 2.96; 1.60-5.45), and on polypharmacy (1.24; 1.13-1.36), but it was lower when a complication was present. The IR of symptomatic hypoglycemia was 53.3 events/person-years, with an IRR significantly higher among women or patients with better education, or shorter duration or on pumps. The IRR was lower in patients with higher BMI or neuropathy or aged more than 50 years. Fewer than 20 % of T1DM patients are free from hypoglycemia, with one in six having experienced at least one severe episode in the last year. The distribution is uneven, with a tendency of episodes to cluster in some patients. Severe and symptomatic episodes have different correlates and reflect different conditions.

Incidence of Severe Malaria Syndromes and Status of Immune Responses among Khat Chewer Malaria Patients in Ethiopia.

Directory of Open Access Journals (Sweden)

Tsige Ketema

Full Text Available Although more emphasis has been given to the genetic and environmental factors that determine host vulnerability to malaria, other factors that might have a crucial role in burdening the disease have not been evaluated yet. Therefore, this study was designed to assess the effect of khat chewing on the incidence of severe malaria syndromes and immune responses during malaria infection in an area where the two problems co-exist. Clinical, physical, demographic, hematological, biochemical and immunological data were collected from Plasmodium falciparum mono-infected malaria patients (age ≥ 10 years seeking medication in Halaba Kulito and Jimma Health Centers. In addition, incidences of severe malaria symptoms were assessed. The data were analyzed using SPSS (version 20 software. Prevalence of current khat chewer malaria patients was 57.38% (95%CI =53-61.56%. Malaria symptoms such as hyperpyrexia, prostration and hyperparasitemia were significantly lower (P0.05, IgG3 antibody was significantly higher (P<0.001 among khat chewer malaria patients. Moreover, IgM, IgG, IgG1and IgG3 antibodies had significant negative association (P<0.001 with parasite burden and clinical manifestations of severe malaria symptoms, but not with severe anemia and hypoglycemia. Additionally, a significant increment (P<0.05 in CD4+ T-lymphocyte population was observed among khat users. Khat might be an important risk factor for incidence of some severe malaria complications. Nevertheless, it can enhance induction of humoral immune response and CD4+ T-lymphocyte population during malaria infection. This calls for further investigation on the effect of khat on parasite or antigen-specifc protective malaria immunity and analysis of cytokines released upon malaria infection among khat chewers.

Incidence and natural history of mucopolysaccharidosis type III in France and comparison with United Kingdom and Greece.

Science.gov (United States)

Héron, Bénédicte; Mikaeloff, Yann; Froissart, Roseline; Caridade, Guillaume; Maire, Irène; Caillaud, Catherine; Levade, Thierry; Chabrol, Brigitte; Feillet, François; Ogier, Hélène; Valayannopoulos, Vassili; Michelakakis, Helen; Zafeiriou, Dimitrios; Lavery, Lucy; Wraith, Ed; Danos, Olivier; Heard, Jean-Michel; Tardieu, Marc

2011-01-01

Sanfilippo syndrome, or mucopolysaccharidosis type III (MPSIII) is a lysosomal storage disease with predominant neurological manifestations in affected children. It is considered heterogeneous with respect to prevalence, clinical presentation, biochemistry (four biochemical forms of the disease referred to as MPSIIIA, B, C, and D are known), and causative mutations. The perspective of therapeutic options emphasizes the need for better knowledge of MPSIII incidence and natural history. We performed parallel retrospective epidemiological studies of patients diagnosed with MSPIII in France (n = 128), UK (n = 126), and Greece (n = 20) from 1990 to 2006. Incidences ranged from 0.68 per 100,000 live-births in France to 1.21 per 100,000 live-births in UK. MPSIIIA, which predominates in France and UK, was absent in Greece, where most patients have MPSIIIB. The study confirmed the large allelic heterogeneity of MPSIIIA and MPSIIIB and detected several yet undescribed mutations. Analysis of clinical manifestations at diagnosis and over a 6-7 years follow-up indicated that almost all patients, whatever the disease subtype, expressed neurological manifestations before the age of 5 years, including language acquisition delay, cognitive delay, and/or abnormal behavior. In contrast to relatively homogeneous early onset manifestations, disease progression showed significant variation depending on subtype and age at diagnosis. Different severities of disease progressions and different allele distribution between France and UK suggested that mutations are not equally deleterious, although genotype-phenotype correlation could not be established. Notwithstanding the rapidity of further clinical deterioration, all MPSIII patients suffer early onset devastating neurological manifestations that deserve early treatment when available. Copyright © 2010 Wiley-Liss, Inc.

Relation between cancer incidence or mortality and external natural background radiation in Japan

International Nuclear Information System (INIS)

Ujeno, Y.

1983-01-01

Analysis was performed on the relationships between the organ dose-equivalent rate due to natural background radiation (mSv/a) and three parameters of cancer risk: the age-adjusted cancer incidence (patients x 10 5 persons x a -1 ) in 13 large areas, the standardized mortality ratio of cancers in 46 large areas, and the cancer mortality in the population aged more than 40 years old (cancer deaths x 10 5 persons x a -1 ) in 649 small areas. The age-adjusted liver cancer incidence in males fitted the exponential model significantly (p<0.01) and the relationship of stomach cancer mortality of aged males in small areas fitted the linear model significantly (p<0.05). No relationship was observed with regard to female cancer in either case. The relationships between the three parameters and various other cancers of both sexes were not statistically significant. (author)

Trends in the incidence and causes of severe visual impairment and blindness in children from Israel.

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Mezer, Eedy; Chetrit, Angela; Kalter-Leibovici, Ofra; Kinori, Michael; Ben-Zion, Itay; Wygnanski-Jaffe, Tamara

2015-06-01

To describe trends in the incidence and causes of legal childhood blindness in Israel, one of the few countries worldwide that maintain a national registry of the blind. We performed a historical cohort study of annual reports of the National Registry of the Blind (NRB) between 1999 and 2013. All data regarding demographic information, year of registration and cause of blindness of children 0-18 years of age registered for blind certification were obtained from the annual reports of the NRB. Causes of legal blindness analyzed were optic atrophy, retinitis pigmentosa, retinopathy of prematurity (ROP), albinism, other retinal disorders, cataract, and glaucoma. The main outcome measure was the incidence of new cases of certified legal blindness. The incidence of newly registered legally blind children in Israel almost halved from 7.7 per 100,000 in 1999 to 3.1 per 100,000 in 2013. The decline was mainly attributable to a decreased incidence of blindness resulting from retinitis pigmentosa and ROP. The incidence of registered cases due to cerebral visual impairment increased. During the past decade the incidence of severe childhood visual impairment and blindness declined in Israel. A continuous decline in consanguineous marriages among the Jewish and Arab populations in Israel may have contributed to the decrease in the rate of vision loss due to retinitis pigmentosa in children. Copyright © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Criminal victimisation in people with severe mental illness: a multi-site prevalence and incidence survey in the Netherlands.

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Astrid M Kamperman

Full Text Available BACKGROUND: Although crime victimisation is as prevalent in psychiatric patients as crime perpetration (and possibly more so, few European figures for it are available. We therefore assessed its one-year prevalence and incident rates in Dutch severely mentally ill outpatients, and compared the results with victimisation rates in the general population. METHOD: This multisite epidemiological survey included a random sample of 956 adult severely mentally ill outpatients. Data on victimisation were obtained using the victimisation scale of the Dutch Crime and Victimisation Survey, which assesses crime victimisation over the preceding 12 months. Comparison data were derived from the nationwide survey on safety and victimisation in the Netherlands. Prevalence and incident rates were weighted for sex, age, ethnicity and socioeconomic status, and compared with a general population sample matched by region (N = 38,227. RESULTS: In the past year, almost half of the severely mentally ill outpatients (47% had been victim of a crime. After control for demographic differences, prevalence rates of overall and specific victimisation measures were significantly higher in severely mentally ill outpatients than in the general population. The relative rates were especially high for personal crimes such as violent threats (RR = 2.12, 95% CI: 1.72-2.61, physical assaults (RR = 4.85, 95% CI: 3.69-6.39 and sexual harassment and assaults (RR = 3.94, 95% CI: 3.05-5.09. In concordance, severely mentally ill outpatients reported almost 14 times more personal crime incidents than persons from the general population (IRR = 13.68, 95% CI: 12.85-14.56. CONCLUSION: Crime victimisation is a serious problem in Dutch severely mentally ill outpatients. Mental-healthcare institutions and clinicians should become aware of their patients' victimisation risk, and should implement structural measures to detect and prevent (re-victimisation.

Contribution of placenta accreta to the incidence of postpartum hemorrhage and severe postpartum hemorrhage.

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Mehrabadi, Azar; Hutcheon, Jennifer A; Liu, Shiliang; Bartholomew, Sharon; Kramer, Michael S; Liston, Robert M; Joseph, K S

2015-04-01

To quantify the contribution of placenta accreta to the rate of postpartum hemorrhage and severe postpartum hemorrhage. All hospital deliveries in Canada (excluding Quebec) for the years 2009 and 2010 (N=570,637) were included in a retrospective cohort study using data from the Canadian Institute for Health Information. Placenta accreta included placental adhesion to the uterine wall, musculature, and surrounding organs (accreta, increta, or percreta). Severe postpartum hemorrhage included postpartum hemorrhage with blood transfusion, hysterectomy, or other procedures to control bleeding (including uterine suturing and ligation or embolization of pelvic arteries). Rates, rate ratios, population-attributable fractions (ie, incidence of postpartum hemorrhage attributable to placenta accreta), and 95% confidence intervals (CIs) were estimated. Logistic regression was used to quantify associations between placenta accreta and risk factors. The incidence of placenta accreta was 14.4 (95% CI 13.4-15.4) per 10,000 deliveries (819 cases among 570,637 deliveries), whereas the incidence of placenta accreta with postpartum hemorrhage was 7.2 (95% CI 6.5-8.0) per 10,000 deliveries. Postpartum hemorrhage among women with placenta accreta was predominantly third-stage hemorrhage (41% of all cases). Although placenta accreta was strongly associated with postpartum hemorrhage (rate ratio 8.3, 95% CI 7.7-8.9), its low frequency resulted in a small population-attributable fraction (1.0%, 95% CI 0.93-1.16). However, the strong association between placenta accreta and postpartum hemorrhage with hysterectomy (rate ratio 286, 95% CI 226-361) resulted in a population-attributable fraction of 29.0% (95% CI 24.3-34.3). Placenta accreta is too infrequent to account for the recent temporal increase in postpartum hemorrhage but contributes substantially to the proportion of postpartum hemorrhage with hysterectomy.

Incidence, trends and severity of primary postpartum haemorrhage in Australia: A population-based study using Victorian Perinatal Data Collection data for 764 244 births.

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Flood, Margaret; McDonald, Susan J; Pollock, Wendy; Cullinane, Fiona; Davey, Mary-Ann

2018-05-22

Increasing incidence and severity of postpartum haemorrhage, together with postpartum haemorrhage-associated morbidities, have been reported in many high-resource countries. In-depth analysis of such factors in Victorian births since 2002 was lacking. Our aim was to determine the incidence and trends for primary postpartum haemorrhage (World Health Organization and International Classification of Diseases 10th revision, Australian Modification definitions) for all confinements in Victoria, Australia, for the years 2003-2013 and the incidence and trends for severe postpartum haemorrhage (≥1500 mL) for 2009-2013. In this population-based cross-sectional study de-identified data from the Victorian Perinatal Data Collection were analysed for confinements (excluding terminations) from 2003 to 2013 (n = 764 244). Perinatal information for all births ≥20 weeks (or of at least 400 g birthweight if gestation was unknown) were prospectively collected. One in five women (21.8%) who gave birth between 2009 and 2013 experienced a primary postpartum haemorrhage and one in 71 women (1.4%) experienced a severe primary postpartum haemorrhage. The increasing trends in incidence of primary postpartum haemorrhage, severe primary postpartum haemorrhage, blood transfusion, admission to an intensive care or high dependency unit and peripartum hysterectomy were significant (P primary postpartum haemorrhage. The highest incidence was experienced by women who had an unplanned caesarean section birth. Women who had a forceps birth had the highest incidence of severe primary postpartum haemorrhage. The incidence of primary postpartum haemorrhage, severe primary postpartum haemorrhage and associated maternal morbidities have increased significantly over time in Victoria. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Loss experience from natural phenomena hazards in the Department of Energy (50 years of natural phenomena hazard losses)

International Nuclear Information System (INIS)

Hill, J.R.

1993-01-01

This paper presents a historical prespective on losses due to natural hazard incidents (1943-1993) at Department of Energy (DOE) and predecessor agencies including the Atomic Energy Commission (AEC) and the Energy Research and Development Agency (ERDA). This paper also demonstrates how an existing DOE resource can be used to gain valuable insight into injury or property damage incidents. That resource is the Computerized Accident/Incident Reporting System (CAIRS) module of DOE's Safety Performance Measurement System. CAIRS data selected the 1981-1991 DOE injury/illness reports, from all the accident reports of the AEC that cited a natural phenomena hazard as either the direct or indirect cause of the injury/property damage. Specifically, injury or property damage reports were selected for analysis if they had a causal factor link to severe weather or natural phenomena hazard categories. Natural phenomena hazard categories are injury/property damage caused by hurricane/tornado, earthquake, lightning, or flood. Severe weather categories are injury/property damage associated with other than normal weather conditions. The lessons learned, as a result of reviewing case histories, are presented, as are suggestions on how to reduce the likelihood of future injuries/property damage as a result of similar events. A significant finding, is that most injuries and property damage were the result of an indirect causal link to a natural phenomena hazard and thus, may be more preventable than previously thought possible. The primary message, however, is that CAIRS and other incident data bases are valuable resources and should be considered for use by those interested in identifying new ways of protecting the health and safety of the worker and for reducing building losses due to the effects of natural phenomena hazards

Incidence of Severe Osteonecrosis Requiring Total Joint Arthroplasty in Children and Young Adults Treated for Leukemia or Lymphoma

DEFF Research Database (Denmark)

Niinimäki, Riitta; Hansen, Lene Mølgaard; Niinimäki, Tuukka

2013-01-01

diagnosis codes given before the age of 40 were also retrieved. Results: The estimated cumulative incidence of TJA was 4.5% at 20 years for patients treated for chronic myeloid leukemia, followed by 2.1% for patients treated for acute myeloid leukemia. It was considerably lower in patients with acute...... the age of 10 (HR=24; 95% CI: 3.1-176 and HR=26; 95% CI: 3.6-192 respectively). Conclusion: The incidence of ON requiring TJA was highest among patients with myeloid leukemias and lowest in patients treated for ALL. Allo-SCT and age ≥10 years at diagnosis were the most important risk factors......Purpose: The population-based incidence of severe osteonecrosis (ON) necessitating total joint arthroplasty (TJA) in patients with hematological cancer is unknown. This study assessed the incidence of ON requiring primary TJA in children and young adults treated for leukemia or lymphoma. Methods...

A comparative study of the incidence of aseptic meningitis in symptomatic natural mumps patients and monovalent mumps vaccine recipients in Japan.

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Nagai, Takao; Okafuji, Teruo; Miyazaki, Chiaki; Ito, Yuhei; Kamada, Makoto; Kumagai, Takuji; Yuri, Kenji; Sakiyama, Hiroshi; Miyata, Akiko; Ihara, Toshiaki; Ochiai, Hitoshi; Shimomura, Kunihisa; Suzuki, Eitaro; Torigoe, Sadayoshi; Igarashi, Masahiro; Kase, Tetsuo; Okuno, Yoshinobu; Nakayama, Tetsuo

2007-03-30

To compare the incidence of aseptic meningitis associated with symptomatic natural mumps infection and in mumps vaccine recipients, we conducted a prospective comparative study. Consecutive samples of 1051 children with mumps were enrolled by 10 pediatricians and 21,465 vaccine recipients by 143 pediatric primary care practitioners, from January 1, 2000 to January 1, 2003. Parents used a daily diary to record symptoms during the period of illness (15 days) or 30-day period following immunization. Mumps infection was confirmed by virus isolation and/or detection of mumps virus genome in salivary and CSF samples. The incidence of aseptic meningitis was 13/1051 (1.24%) in patients with symptomatic natural mumps infection and was estimated to be 0.7-1.1% of overall infection in considering asymptomatic infection, and 10/21,465 (0.05%) in vaccine recipients. Although aseptic meningitis is a clear side effect of the mumps vaccine, the incidence is considerably lower than among those with symptomatic natural infection. Our results provide an informative data for consideration to resume mumps vaccine as a part of routine immunization schedule for Japanese children.

Incidence and severity of coronary artery disease in patients with atrial fibrillation undergoing first-time coronary angiography.

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Stefan Kralev

Full Text Available In standard reference sources, the incidence of coronary artery disease (CAD in patients with atrial fibrillation (AF ranged between 24 and 46.5%. Since then, the incidence of cardiovascular risk factors (CRF has increased and modern treatment strategies ("pill in the pocket" are only applicable to patients without structural heart disease. The aim of this study was to investigate the incidence and severity of CAD in patients with AF.From January 2005 until December 2009, we included 261 consecutive patients admitted to hospital with paroxysmal, persistent or permanent AF in this prospective study. All patients underwent coronary angiography and the Framingham risk score (FRS was calculated. Patients with previously diagnosed or previously excluded CAD were excluded.The overall incidence of CAD in patients presenting with AF was 34%; in patients >70 years, the incidence of CAD was 41%. The incidence of patients undergoing a percutaneous coronary intervention (PCI or coronary artery bypass graft (CABG was 21%. Patients with CAD were older (73±8 years vs 68±10 years, p = 0.001, had significantly more frequent hypercholesterolemia (60% vs 30%, p<0.001, were more frequent smokers (26% vs 13%, p = 0.017 and suffered from angina more often (37% vs 2%, p<0.001. There was a significant linear trend among the FRS categories in percentage and the prevalence of CAD and PCI/CABG (p<0.0001.The overall incidence of CAD in patients presenting with AF was relatively high at 34%; the incidence of PCI/CABG was 21%. Based upon increasing CRF in the western world, we recommend a careful investigation respecting the FRS to either definitely exclude or establish an early diagnosis of CAD--which could contribute to an early and safe therapeutic strategy considering type Ic antiarrhythmics and oral anticoagulation.

Incidence and main causes of severe maternal morbidity in São Luís, Maranhão, Brazil: a longitudinal study

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Ana Paula Pierre Moraes

Full Text Available CONTEXT AND OBJECTIVE: Evaluation of severe maternal morbidity has been used in monitoring of maternal health. The objective of this study was to estimate its incidence and main causes in São Luís, Maranhão, Brazil. DESIGN AND SETTING: Prospective longitudinal study, carried out in two public high-risk maternity hospitals and two public intensive care units (ICUs for referral of obstetric cases from the municipality. METHODS: Between March 1, 2009, and February 28, 2010, all cases of severe maternal morbidity according to the Mantel and Waterstone criteria were identified. The sociodemographic and healthcare characteristics of the extremely severe cases were compared with the less severe cases, using the Fisher, Χ2, Student t and Mann-Whitney tests, with a significance level of < 0.05. RESULTS: 127 cases of severe maternal morbidity were identified among 8,493 deliveries, i.e. an incidence of 15.0/1000 deliveries. Out of 122 cases interviewed, 121 cases were within the Waterstone criteria and 29 were within the Mantel criteria, corresponding to incidences of 14.1/1000 and 3.4/1000 deliveries, respectively. These rates were lower than those described in the literature, possibly due to case loss. The main causes were hypertension during pregnancy, which was more frequent in less severe cases (P = 0.001 and obstetric hemorrhage, which was more common among extremely severe cases (P = 0.01. CONCLUSIONS: Direct obstetric disorders were the main causes of severe maternal morbidity in São Luís, Maranhão. Investigation and monitoring of severe morbidity may contribute towards improving obstetric care in the municipality.

Incidence, severity, aetiology and type of neck injury in men's amateur rugby union: a prospective cohort study

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Pollard Henry P

2010-07-01

Full Text Available Abstract Background There is a paucity of epidemiological data on neck injury in amateur rugby union populations. The objective of this study was to determine the incidence, severity, aetiology and type of neck injury in Australian men's amateur rugby union. Methods Data was collected from a cohort of 262 participants from two Australian amateur men's rugby union clubs via a prospective cohort study design. A modified version of the Rugby Union Injury Report Form for Games and Training was used by the clubs physiotherapist or chiropractor in data collection. Results The participants sustained 90 (eight recurrent neck injuries. Exposure time was calculated at 31143.8 hours of play (12863.8 hours of match time and 18280 hours of training. Incidence of neck injury was 2.9 injuries/1000 player-hours (95%CI: 2.3, 3.6. As a consequence 69.3% neck injuries were minor, 17% mild, 6.8% moderate and 6.8% severe. Neck compression was the most frequent aetiology and was weakly associated with severity. Cervical facet injury was the most frequent neck injury type. Conclusions This is the first prospective cohort study in an amateur men's rugby union population since the inception of professionalism that presents injury rate, severity, aetiology and injury type data for neck injury. Current epidemiological data should be sought when evaluating the risks associated with rugby union football.

Incidence and severity of maxillofacial injuries during the Second Lebanon War among Israeli soldiers and civilians.

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Levin, Liran; Zadik, Yehuda; Peleg, Kobi; Bigman, Galya; Givon, Adi; Lin, Shaul

2008-08-01

To analyze the incidence and severity of maxillofacial injuries in the Second Lebanon War, that occurred during the summer of 2006, among Israeli soldiers and civilians. This is a retrospective cohort study of patients recorded in the Israel National Trauma Registry during the Second Lebanon War. Data refer to all general hospitals throughout the country. Data were analyzed according to the etiology of the injury, severity of trauma using the Injury Severity Score, trauma location, and duration of hospital stay. Cases with multiple injuries that included maxillofacial injuries were separated and further analyzed according to the above parameters. Patients with only dental injuries and superficial facial soft tissue lacerations were excluded because they were referred to the military dental clinics and not to general hospitals. Maxillofacial injuries were found in 36 (6.4%) of the 565 wounded. Patients with maxillofacial injuries ranged in age from 20 to 44 years (mean age, 25.5 +/- 5.7 years). Greater than 50% of the injuries required more than 3 hospitalization days. Mortality rate of the maxillofacial injured was 2.8%. Most of the maxillofacial injuries (33; 91.7%) were combined with other organ injuries; 9 (25%) patients also had dental injuries. In the Second Lebanon War, the incidence and severity of true maxillofacial injuries, without dental injuries alone, were relatively low compared with previous reports of other conflicts. However, because most injuries involved multiple organs, special attention is required when planning and providing emergency, as well as secondary and tertiary medical care to war wounded.

Incidence, risk factors and management of severe post-transsphenoidal epistaxis.

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De Los Reyes, Kenneth M; Gross, Bradley A; Frerichs, Kai U; Dunn, Ian F; Lin, Ning; Rincon-Torroella, Jordina; Annino, Donald J; Laws, Edward R

2015-01-01

Among the major complications of transsphenoidal surgery, less attention has been given to severe postoperative epistaxis, which can lead to devastating consequences. In this study, we reviewed 551 consecutive patients treated over a 4 year period by the senior author to evaluate the incidence, risk factors, etiology and management of immediate and delayed post-transsphenoidal epistaxis. Eighteen patients (3.3%) developed significant postoperative epistaxis - six immediately and 12 delayed (mean postoperative day 10.8). Fourteen patients harbored macroadenomas (78%) and 11 of 18 (61.1%) had complex nasal/sphenoid anatomy. In the immediate epistaxis group, 33% had acute postoperative hypertension. In the delayed group, one had an anterior ethmoidal pseudoaneurysm, and one had restarted anticoagulation on postoperative day 3. We treated the immediate epistaxis group with bedside nasal packing followed by operative re-exploration if conservative measures were unsuccessful. The delayed group underwent bedside nasal hemostasis; if unsuccessful, angiographic embolization was performed. After definitive treatment, no patients had recurrent epistaxis. Copyright © 2014 Elsevier Ltd. All rights reserved.

The ecological importance of mixed-severity fires: Nature's phoenix [Book Review

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Carolyn H. Sieg

2016-01-01

The stated goal of a recent book, The Ecological Importance of Mixed-Severity Fires: Nature’s Phoenix, edited by Dominick A. DellaSala and Chad T. Hansen, is to provide a global reference on the benefits of mixed- and high-severity fires. Note that the goal is not to provide an objective reference on the ecological aspects of mixed- and high-severity fires. Rather, the...

Incidence and severity of scorpion stings in Algeria

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Y Laïd

2012-01-01

Full Text Available Scorpion stings are a public health problem in the Maghreb region. In Algeria, epidemiological data were collected over the past twenty years by the Algerian health authorities. This study is an analysis of morbidity and mortality data collected from 2001 to 2010. Annual incidence and mortality due to scorpion envenoming were 152 ± 3.6 stings and 0.236 ± 0.041 deaths per 100,000 people (95% CI, respectively. The risk of being stung by a scorpion was dramatically higher in southern areas and central highlands due to environmental conditions. Incidence of envenoming was especially higher in the adult population, and among young males. In contrast, mortality was significantly higher among children under 15 years, particularly ages 1-4. Upper limbs were more often affected than lower limbs. Most stings occurred at night, indoors and during the summer. Data collected since 2001 showed a reduction of mortality by nearly 50%, suggesting that the medical care defined by the national anti-scorpion project is bearing fruit.

Risk assessment of several incidents in nuclear waste management facilities

International Nuclear Information System (INIS)

Buetow, E.; Memmert, G.; Storck, R.; Weymann, J.; Matthies, M.; Vogt, K.J.

1981-01-01

Regarding surface facilities two incidents of MAVA (failure of the filter in the exhaust gas system, fire in the bituminization system) and one incident in the Krypton storage and regarding underground systems the water inlet in the pit building have been evaluated. According to the calculations only the two nuclides Tc-99 and J-129 can involve a considerable exposure. The barrier system of overlying rocks and the pit system as a whole is largely redundant and diverse. (DG) [de

The Jarvis gas release incident

International Nuclear Information System (INIS)

Manocha, J.

1992-01-01

On 26 September, 1991, large volumes of natural gas were observed to be leaking from two water wells in the Town of Jarvis. Gas and water were being ejected from a drilled water well, at which a subsequent gas explosion occurred. Measurements of gas concentrations indicated levels far in excess of the lower flammability limit at several locations. Electrical power and natural gas services were cut off, and residents were evacuated. A state of emergency was declared, and gas was found to be flowing from water wells, around building foundations, and through other fractures in the ground. By 27 September the volumes of gas had reduced substantially, and by 30 September all residents had returned to their homes and the state of emergency was cancelled. The emergency response, possible pathways of natural gas into the aquifer, and public relations are discussed. It is felt that the likelihood of a similar incident occurring in the future is high. 11 figs

Severe metabolic or mixed acidemia on intensive care unit admission: incidence, prognosis and administration of buffer therapy. A prospective, multiple-center study.

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Jung, Boris; Rimmele, Thomas; Le Goff, Charlotte; Chanques, Gérald; Corne, Philippe; Jonquet, Olivier; Muller, Laurent; Lefrant, Jean-Yves; Guervilly, Christophe; Papazian, Laurent; Allaouchiche, Bernard; Jaber, Samir

2011-01-01

In this study, we sought describe the incidence and outcomes of severe metabolic or mixed acidemia in critically ill patients as well as the use of sodium bicarbonate therapy to treat these illnesses. We conducted a prospective, observational, multiple-center study. Consecutive patients who presented with severe acidemia, defined herein as plasma pH below 7.20, were screened. The incidence, sodium bicarbonate prescription and outcomes of either metabolic or mixed severe acidemia were analyzed. Among 2, 550 critically ill patients, 200 (8%) presented with severe acidemia, and 155 (6% of the total admissions) met the inclusion criteria. Almost all patients needed mechanical ventilation and vasopressors during their ICU stay, and 20% of them required renal replacement therapy within the first 24 hours of their ICU stay. Severe metabolic or mixed acidemia was associated with a mortality rate of 57% in the ICU. Delay of acidemia recovery as opposed to initial pH value was associated with increased mortality in the ICU. The type of acidemia did not influence the decision to administer sodium bicarbonate. The incidence of severe metabolic or mixed acidemia in critically ill patients was 6% in the present study, and it was associated with a 57% mortality rate in the ICU. In contradistinction with the initial acid-base parameters, the rapidity of acidemia recovery was an independent risk factor for mortality. Sodium bicarbonate prescription was very heterogeneous between ICUs. Further studies assessing specific treatments may be of interest in this population.

Incidence of very mild to severe dementia and Alzheimer's disease in Denmark

DEFF Research Database (Denmark)

Andersen, K; Nielsen, H; Lolk, A

1999-01-01

Calculation of incidence of dementia and AD, including cases in the earliest phases of the diseases.......Calculation of incidence of dementia and AD, including cases in the earliest phases of the diseases....

Spatial variation of natural radiation and childhood leukaemia incidence in Great Britain

International Nuclear Information System (INIS)

Richardson, Sylvia; Monfort, Christine; Green, Martyn; Muirhead, Colin; Draper, Gerald

1995-01-01

This paper describes an analysis of the geographical variation of childhood leukaemia incidence in Great Britain over a 15 year period in relation to natural radiation (gamma and radon). Data at the level of the 459 district level local authorities in England, Wales and regional districts in Scotland are analysed in two complementary ways: first, by Poisson regressions with the inclusion of environmental covariates and a smooth spatial structure; secondly, by a hierarchical Bayesian model in which extra-Poisson variability is modelled explicitly in terms of spatial and non-spatial components. From this analysis, we deduce a strong indication that a main part of the variability is accounted for by a local neighbourhood 'clustering' structure. This structure is furthermore relatively stable over the 15 year period for the lymphocytic leukaemias which make up the majority of observed cases. We found no evidence of a positive association of childhood leukaemia incidence with outdoor or indoor gamma radiation levels. There is no consistent evidence of any association with radon levels. Indeed, in the Poisson regressions, a significant positive association was only observed for one 5-year period, a result which is not compatible with a stable environmental effect. Moreover, this positive association became clearly non-significant when over-dispersion relative to the Poisson distribution was taken into account. (author)

Incidence, nature, and etiology of metabolic alkalosis in dogs and cats.

Science.gov (United States)

Ha, Y-S; Hopper, K; Epstein, S E

2013-01-01

The incidence and causes of metabolic alkalosis in dogs and cats have not been fully investigated. To describe the incidence, nature, and etiology of metabolic alkalosis in dogs and cats undergoing blood gas analysis at a veterinary teaching hospital. Dogs and cats at a veterinary medical teaching hospital. Acid-base and electrolyte results for dogs and cats measured during a 13-month period were retrospectively collected from a computer database. Only the first measured (venous or arterial) blood gas analyzed in a single hospitalization period was included. Animals with a base excess above the reference range for the species were included. A total of 1,805 dogs and cats were included. Of these, 349 (19%) were identified as having an increased standardized base excess, 319 dogs and 30 cats. The mixed acid-base disorder of metabolic alkalosis with respiratory acidosis was the most common abnormality identified in both dogs and cats. Hypokalemia and hypochloremia were more common in animals with metabolic alkalosis compared to animals without metabolic alkalosis. The 4 most commonly identified underlying diseases were respiratory disease, gastrointestinal tract obstruction, furosemide administration, and renal disease. Metabolic alkalosis was less common than metabolic acidosis in the same population of animals. Evidence of contraction alkalosis was present in many patients in this study. Hypokalemia and hypochloremia were more frequent in patients with metabolic alkalosis and suggest the importance of evaluation of acid-base status in conjunction with serum electrolyte concentrations. Copyright © 2013 by the American College of Veterinary Internal Medicine.

Effect of hydro-ethanolic extracts of cinnamon (Cinnamomum zeylanicum Blume and common horsetail (Equisetum arvense L. on incidence and severity of Botrytis cinerea on strawberry

Directory of Open Access Journals (Sweden)

Pazmiño-Miranda Pilar

2017-05-01

Full Text Available The effect of application of three dosages (5, 10 and 15 mL/L and two frequencies (each 6 and 8 days of ethanoic extracts obtained from cinnamon (Cinnamomum zeylanicum Blume and common horsetail (Equisetum arvense L. on incidence and severity of grey mould (Botrytis cinerea on strawberry crop (Fragaria ananassa cv. Albion was evaluated. Experiment was carried out in a randomized block design with factorial arrangement 2 x 3 x 2 + 1, with three replications. Lower incidence and severity percentage in flower and fruit (10.24 and 24.43%, respectively were observed after application of cinnamon extract at 15 mL/L at 6 days interval. Similarly, lower fruit severity (11.86% was observed with the same treatment. In general, reduction in B. cinerea incidence and severity was lower when common horsetail extract was used, compared to cinnamon extracts. According to our results, using of cinnamon hydro-ethanoic extracts could be considered as sustainable alternative for grey mold management in strawberry crops.

RUST INCIDENCE AND SEVERITY IN SUGARCANE CLONES IN THE PARANÁ STATE, BRAZIL INCIDÊNCIA E SEVERIDADE DA FERRUGEM EM CLONES DE CANA-DE-AÇÚCAR NO ESTADO DO PARANÁ

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Oswaldo Teruyo Ido

2007-09-01

Full Text Available

Promising clones in the third selection phase of the sugarcane genetic breeding program in Paraná State, Brazil, were evaluated for the severity of sugarcane rust (Puccinia melanocephala incidence under natural infection. The evaluation was carried out in a sugarcane plant and a sugarcane ratoon cycles, from 1998 to 2000. The assessment of severity identified fifteen clones with rust resistance reaction in the sugarcane plant cycle. Of the 41 evaluated clones, 18.2% presented slightly resistant to susceptible reaction. The highest rust incidence was observed in the early phases of sugarcane crop development, from three to six months. Among the clones with resistance reaction to rust, five were derived from the same female parent (RB855589. This fact demonstrates the good potential of this genotype for crosses looking at clones with rust-resistance reaction.

KEY-WORDS: Saccharum spp.; Puccinia melanocephala; resistance; selection.

Clones promissores do Programa de Melhoramento Genético da Cana-de-Açúcar no Estado do Paraná em terceira fase de seleção foram avaliados quanto à incidência e severidade da ferrugem da cana-de-açúcar (Puccinia melanocephala sob condições de infecção natural. A avaliação foi realizada nos ciclos de cana-planta e cana-soca, entre os anos 1998 e 2000. Os resultados de severidade permitiram agrupar no ciclo de cana-planta, quinze clones com reação resistente a ferrugem. Dos 41 clones avaliados, 18,2% apresentaram reação moderadamente resistente a suscetível. Observou-se a maior incidência da ferrugem nas primeiras fases de desenvolvimento da cana-de-açúcar, entre os três a seis meses. Entre os clones que apresentaram reação resistente, verificou-se que cinco foram oriundos do mesmo genitor feminino (RB855589. Isso demonstra o bom potencial

Severe metabolic or mixed acidemia on intensive care unit admission: incidence, prognosis and administration of buffer therapy. a prospective, multiple-center study

Science.gov (United States)

2011-01-01

Introduction In this study, we sought describe the incidence and outcomes of severe metabolic or mixed acidemia in critically ill patients as well as the use of sodium bicarbonate therapy to treat these illnesses. Methods We conducted a prospective, observational, multiple-center study. Consecutive patients who presented with severe acidemia, defined herein as plasma pH below 7.20, were screened. The incidence, sodium bicarbonate prescription and outcomes of either metabolic or mixed severe acidemia were analyzed. Results Among 2, 550 critically ill patients, 200 (8%) presented with severe acidemia, and 155 (6% of the total admissions) met the inclusion criteria. Almost all patients needed mechanical ventilation and vasopressors during their ICU stay, and 20% of them required renal replacement therapy within the first 24 hours of their ICU stay. Severe metabolic or mixed acidemia was associated with a mortality rate of 57% in the ICU. Delay of acidemia recovery as opposed to initial pH value was associated with increased mortality in the ICU. The type of acidemia did not influence the decision to administer sodium bicarbonate. Conclusions The incidence of severe metabolic or mixed acidemia in critically ill patients was 6% in the present study, and it was associated with a 57% mortality rate in the ICU. In contradistinction with the initial acid-base parameters, the rapidity of acidemia recovery was an independent risk factor for mortality. Sodium bicarbonate prescription was very heterogeneous between ICUs. Further studies assessing specific treatments may be of interest in this population. PMID:21995879

Protecting against natural hazards - Information seeking behaviour in anticipation of severe weather events

NARCIS (Netherlands)

Jeuring, Jelmer

2011-01-01

Protection against natural hazards - Information seeking behaviour in anticipation of severe weather events Severe weather events can have considerable impact on society, including tourism organisations and tourists. Providing accurate and timely information about possible risks due to environmental

Incidence and Severity of Lymphoedema following Limb Salvage of Extremity Soft Tissue Sarcoma

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Daniel Friedmann

2011-01-01

Material and Method. Patient and tumor characteristics, treatment modalities and complications and functional outcomes (MSTS 1987, TESS, and lymphoedema severity (Stern were all collected from prospective databases. Charts were retrospectively abstracted for BMI and comorbidities. Results. There were 289 patients (158 males. Mean age was 53 (16–88. Followup ranged between 12 and 60 months with an average of 35 and a median of 36 months. Mean BMI was 27.4 (15.8–52.1. 72% had lower extremity tumors and 38% upper extremity. Mean tumor size was 8.1 cm (1.0–35.6 cm. 27% had no adjuvant radiation, 62% had 50 Gy, and 11% received 66 Gy. The incidence of lymphoedema was 28.8% (206 none, 58 mild, 22 moderate, 3 severe, and 0 very severe. Mean MSTS score was 32 (11–35 and TESS was 89.4 (32.4–100. Radiation dose was significantly correlated with tumor size>5 cm (P=0.0001 and TESS score (P=0.001, but not MSTS score (P=0.090. Only tumor size>5 cm and depth were found to be independent predictors of significant lymphoedema. Conclusion. Nine percent of STS patients in our cohort developed significant (grade≥2 lymphoedema. Tumor size>5 cm and deep tumors were associated with an increased occurrence of lymphoedema but not radiation dosage.

Medication Incidents Related to Automated Dose Dispensing in Community Pharmacies and Hospitals - A Reporting System Study

Science.gov (United States)

Cheung, Ka-Chun; van den Bemt, Patricia M. L. A.; Bouvy, Marcel L.; Wensing, Michel; De Smet, Peter A. G. M.

2014-01-01

Introduction Automated dose dispensing (ADD) is being introduced in several countries and the use of this technology is expected to increase as a growing number of elderly people need to manage their medication at home. ADD aims to improve medication safety and treatment adherence, but it may introduce new safety issues. This descriptive study provides insight into the nature and consequences of medication incidents related to ADD, as reported by healthcare professionals in community pharmacies and hospitals. Methods The medication incidents that were submitted to the Dutch Central Medication incidents Registration (CMR) reporting system were selected and characterized independently by two researchers. Main Outcome Measures Person discovering the incident, phase of the medication process in which the incident occurred, immediate cause of the incident, nature of incident from the healthcare provider's perspective, nature of incident from the patient's perspective, and consequent harm to the patient caused by the incident. Results From January 2012 to February 2013 the CMR received 15,113 incidents: 3,685 (24.4%) incidents from community pharmacies and 11,428 (75.6%) incidents from hospitals. Eventually 1 of 50 reported incidents (268/15,113 = 1.8%) were related to ADD; in community pharmacies more incidents (227/3,685 = 6.2%) were related to ADD than in hospitals (41/11,428 = 0.4%). The immediate cause of an incident was often a change in the patient's medicine regimen or relocation. Most reported incidents occurred in two phases: entering the prescription into the pharmacy information system and filling the ADD bag. Conclusion A proportion of incidents was related to ADD and is reported regularly, especially by community pharmacies. In two phases, entering the prescription into the pharmacy information system and filling the ADD bag, most incidents occurred. A change in the patient's medicine regimen or relocation was the immediate causes of an incident

Taxonometric Applications in Radiotherapy Incident Analysis

International Nuclear Information System (INIS)

Dunscombe, Peter B.; Ekaette, Edidiong U.; Lee, Robert C.; Cooke, David L.

2008-01-01

Recent publications in both the scientific and the popular press have highlighted the risks to which patients expose themselves when entering a healthcare system. Patient safety issues are forcing us to, not only acknowledge that incidents do occur, but also actively develop the means for assessing and managing the risks of such incidents. To do this, we ideally need to know the probability of an incident's occurrence, the consequences or severity for the patient should it occur, and the basic causes of the incident. A structured approach to the description of failure modes is helpful in terms of communication, avoidance of ambiguity, and, ultimately, decision making for resource allocation. In this report, several classification schemes or taxonomies for use in risk assessment and management are discussed. In particular, a recently developed approach that reflects the activity domains through which the patient passes and that can be used as a basis for quantifying incident severity is described. The estimation of incident severity, which is based on the concept of the equivalent uniform dose, is presented in some detail. We conclude with a brief discussion on the use of a defined basic-causes table and how adding such a table to the reports of incidents can facilitate the allocation of resources

Natural Killer/T-cell Neoplasms: Analysis of Incidence, Patient Characteristics, and Survival Outcomes in the United States.

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Kommalapati, Anuhya; Tella, Sri Harsha; Ganti, Apar Kishore; Armitage, James O

2018-05-04

Limited data are available regarding the incidence, survival patterns, and long-term outcomes of natural killer (NK)/T-cell neoplasms in the United States. We performed a retrospective study of patients with NK/T-cell neoplasms diagnosed from 2001 to 2014 using the Surveillance, Epidemiology, and End Results program database. The Kaplan-Meier method was used to estimate the overall survival difference among the subgroups. Multivariate analyses were used to determine the factors affecting survival. For the 797 patients with NK/T-cell lymphoma, nasal type, the median age at diagnosis was 53 years, and males tended to be younger at diagnosis (P < .0001). The incidence of the disease increased from 0.4 in 2001 to 0.8 in 2014 per 1,000,000 individuals. The incidence was significantly greater in Hispanic patients compared with that in non-Hispanic patients (rate ratio, 3.03; P = .0001). The median overall survival was 20 months (range, 2-73 months) and varied significantly according to the primary site (P < .0001) and the disease stage at diagnosis (P < .0001). NK/T-cell lymphoma patients had an increased risk of acute myeloid leukemia (standardized incidence ratio, 18.77; 95% confidence interval, 2.27-67.81). For the 105 NK/T-cell leukemia patients, the median age at diagnosis was 58 years (range, 4-95 years). The overall incidence of the disease was 0.09 per 1,000,000 individuals and was significantly greater in males (rate ratio, 0.41; P < .0001). Unlike NK/T-cell lymphoma, no racial disparities were found in the incidence. The median overall survival was 17 months (range, 0-36 months). The incidence of NK/T-cell lymphoma, nasal type, in the United States has at least doubled in the past decade, with the greatest predilection among Hispanics. Patients with NK/T-cell lymphoma might have an increased risk of the subsequent development of acute myeloid leukemia. Copyright © 2018 Elsevier Inc. All rights reserved.

Incidence and severity of ocular and adnexal injuries during the Second Lebanon War among Israeli soldiers and civilians.

Science.gov (United States)

Barak, Adiel; Elhalel, Amir; Pikkel, Joseph; Krauss, Eli; Miller, Benjamin

2011-12-01

To analyze the incidence and severity of ocular and adnexal injuries in the Second Lebanon War among Israeli soldiers and civilians. Retrospective cohort study. All patients recorded in the Israeli National Trauma Registry during the Second Lebanon War (July-August, 2006). Retrieval of all data relevant to ocular and adnexal injuries sustained during the study period, and differentiation between those associated with combat/terrorist and other events. Analysis of data according to the severity of trauma , anatomical location of the injury, and whether the patients were military personnel or civilians. A total of 69 war-related ocular trauma patients (58 military personnel and 11 civilians) were registered during the 34 days of war. The injuries involved the anterior segment injury (n = 25), posterior segment (n = 29) and the periocular region (n = 15, all severe). Twenty-seven of the patients had open-globe injuries, of which 18 involved intraocular foreign bodies, and 27 patients had closed-globe injuries. The rate of ocular injuries was 7% among all registered wounded military personnel and 1.2% among all injured civilians. The incidence and severity of ocular and adnexal injuries among military personnel during the Second Lebanon War were consistent with previous reports from American sources of ocular injuries sustained in Iraq and Afghanistan. The rates of ocular injury associated with wartime events sustained by civilians has not been investigated before, and it was relatively low, probably as a result of stringent government-mandated building regulations for passive defense that are discussed.

Risks to offshore installations in Europe due to natural hazards

Science.gov (United States)

Necci, Amos; Krausmann, Elisabeth

2017-04-01

Natural hazards, such as storms, earthquakes, or lightning are a major threat to industry. In particular, chemical plants, storage facilities, pipelines, and offshore oil and gas facilities are vulnerable to natural events which can cause hazardous materials releases and thereby endanger workers, the population and the environment. These technological accidents are commonly referred to as Natech accidents. Recent events have increased concerns about safety in the offshore oil and gas sector, and the need for improving knowledge on the matter has become evident. With those premises, we analyzed accidents, near misses and accident precursors at offshore facilities in Europe caused by natural events using both a statistical and a qualitative approach. For this purpose, we screened the World Offshore Accident Database (WOAD) to identify all incidents that featured natural events as causes or aggravating factors. A dataset of 1,085 global Natech events was built for the statistical analysis. Among those, a subset composed of 303 European records was selected. The results of the analysis showed that offshore Natech events in Europe are frequent; they resulted, however, in low consequences. The main threat to offshore facilities resulted from bad weather, such as strong winds and heavy seas. Storms can put intense loads on the structural parts of offshore installations, eventually exceeding design resistance specifications. Several incidents triggered by lightning strikes and earthquakes were also recorded. Substantial differences in terms of vulnerability, damage modality and consequences emerged between fixed and floating offshore structures. The main damage mode for floating structures was the failure of station keeping systems due to the rupture of mooring or anchors, mainly caused by adverse meteorological conditions. Most of the incidents at fixed offshore structures in Europe involved falling loads for both metal jacket and concrete base platforms due to storms. In

Effects of plant conduction systems and organic fertilizer management on disease incidence and severity in ‘Osiana’ and ‘Carola’ roses

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Márcia de Nazaré Oliveira Ribeiro

2015-04-01

Full Text Available Conventional pruning is a very common practice for pruning rose cultivars in Brazil. However, few Brazilian producers known any other efficient plant training method for roses, namely “lateral stem bending” or “arching technique”, which involves bending the branches of the rosebush in order to increase the photosynthetic rate of the plant. As well as plant training, the use of fertilizers must also be done carefully in order to obtain high quality roses. Biofertilizers are recommended because of their multiple effects: fertilizer, protein synthesis stimulant, insect repellent, and disease controller. The aim of this study was to assess the plant training system and management of organic fertilizer on the incidence and severity of disease in the ‘Osiana’ and ‘Carola’ roses. The ‘Osiana’ rosebushes received three concentrations (0%, 5%, and 15% of foliar biofertilizer applied monthly to the leaves together with two plant conduction methods (conventional pruning and lateral stem bending. ‘Carola’ roses were treated with three types of fertilizer (chemical fertilizer on the soil + bokashi on the soil, chemical fertilizer on the soil + foliar FishfertilÒand chemical fertilization on the soil without applying organic fertilizers every two weeks, together with 2 plant conduction systems (conventional pruning and lateral stem bending. The additional treatments in ‘Carola’ roses were composed of two organic fertilizers (Bokashi and foliar Fishfertil® and chemical fertilization with lateral pruning. The incidence and severity of disease in these plants during the experiment were assessed over 5 months. For the ‘Osiana’ rose, the incidence and severity of disease were not influenced by fertilizer management or plant training methods. For the ‘Carola’ roses, the different types of fertilizer caused different responses according to the plant training system used, with the biofertilizer Fishfertil® reducing the incidence

Incidência e severidade do "furo de bala" em folhas da ameixeira sob doses de nitrogênio e potássio Incidence and severity of 'shot hole' in plum´s leaves related into nitrogen and potassium doses

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Inês Tutida

2007-10-01

plum (Prunus salicina. In this paper, the incidence and severity of this disease were investigated by using combined doses of nitrogen and potassium fertilizer in a commercial plum orchard, cv Reubennel in Araucária (PR. The treatments consisted of combinations of five doses of nitrogen (40, 80, 120, 160 and 200kg ha-1year-1 and two doses of potassium rates (55 and 110kg ha-1year-1. The incidence and severity of "shot hole" disease were evaluated at 20 days intervals during the period of November/2004 to March/2005, and once during October/2006. The first harvest´s data were integrated in time to produce the area under the disease progress curve (AUDPC of the incidence and severity and all data were analyzed statistically using generalized linear models in longitudinal data theory. The disease severity was higher in the second year of the study with the maxima being 0.70 and 2.25 in the first and second year, respectively. The incidence and severity was highest in 160 and 200kg nitrogen ha-1year-1 treatments. Potassium does not interfere in the incidence and severity of the disease due to the high content found in the soil and plant.

Incidence of influenza-like illness and severe acute respiratory infection during three influenza seasons in Bangladesh, 2008–2010

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Alamgir, ASM; Rahman, Mustafizur; Homaira, Nusrat; Sohel, Badrul Munir; Sharker, MA Yushuf; Zaman, Rashid Uz; Dee, Jacob; Gurley, Emily S; Al Mamun, Abdullah; Mah-E-Muneer, Syeda; Fry, Alicia M; Widdowson, Marc-Alain; Bresee, Joseph; Lindstrom, Stephen; Azim, Tasnim; Brooks, Abdullah; Podder, Goutam; Hossain, M Jahangir; Rahman, Mahmudur; Luby, Stephen P

2012-01-01

Abstract Objective To determine how much influenza contributes to severe acute respiratory illness (SARI), a leading cause of death in children, among people of all ages in Bangladesh. Methods Physicians obtained nasal and throat swabs to test for influenza virus from patients who were hospitalized within 7 days of the onset of severe acute respiratory infection (SARI) or who consulted as outpatients for influenza-like illness (ILI). A community health care utilization survey was conducted to determine the proportion of hospital catchment area residents who sought care at study hospitals and calculate the incidence of influenza using this denominator. Findings The estimated incidence of SARI associated with influenza in children < 5 years old was 6.7 (95% confidence interval, CI: 0–18.3); 4.4 (95% CI: 0–13.4) and 6.5 per 1000 person–years (95% CI: 0–8.3/1000) during the 2008, 2009 and 2010 influenza seasons, respectively. The incidence of SARI in people aged ≥ 5 years was 1.1 (95% CI: 0.4–2.0) and 1.3 (95% CI: 0.5–2.2) per 10 000 person–years during 2009 and 2010, respectively. The incidence of medically attended, laboratory-confirmed seasonal influenza in outpatients with ILI was 10 (95% CI: 8–14), 6.6 (95% CI: 5–9) and 17 per 100 person–years (95% CI: 13–22) during the 2008, 2009 and 2010 influenza seasons, respectively. Conclusion Influenza-like illness is a frequent cause of consultation in the outpatient setting in Bangladesh. Children aged less than 5 years are hospitalized for influenza in greater proportions than children in other age groups. PMID:22271960

[Decreased consciousness of hypoglycaemia and the incidence of severe hypoglycaemia in children and adolescents with diabetes type 1].

Science.gov (United States)

Peczyńska, Jadwiga; Urban, Mirosława; Głowińska, Barbara; Florys, Bozena

2002-01-01

Maintaining good metabolic control is connected with an increasing risk of hypoglycaemia, which is the most frequent and most dangerous side effect of intensive insulin therapy. The results of the DCCT trial revealed that the intensification in insulin therapy increases three-fold the risk of severe hypoglycaemia. Severe hypoglycaemia was defined by loose of consciousness, coma and/or convulsions. Feeling the state of hypoglycaemia is the basic defensive mechanism in patients with diabetes type 1, making possible to start the self treatment. The decreased consciousness of hypoglycaemia makes limitations to the intensive insulin- therapy, the main aim of which is to stop later complications. The aim of the study was to evaluate the incidence of severe hypoglycaemia during a 5 yrs period, the attempt to find the reason and correlations between severe hypoglycaemia and decreased consciousness of feeling this state in children and adolescents with diabetes type 1. The study was carried out on 280 patients aged x=13.1 yrs (2.2-18.6), suffering from diabetes, mean duration 7 yrs (2.0-13.9). The study was retrospective, taking into consideration the period from 1.01.1995 to 31.12.2000. During the analysed period we noticed 48 cases of severe hypoglycaemia in 31 patients (21 boys and 10 girls), mean age 13.8 yrs, with diabetes duration about 7 yrs. Every tenth patient had severe hypoglycaemia. Mean level of HbA1c was little lower in children with episode of severe hypoglycaemia (7.2%) than in patients without it (7.9%). The frequency of episodes of severe hypoglycaemia increased with the duration of the disease. The dose of insulin per day did not differ between groups. In patients with severe hypoglicaemias only 5 were treated with use of Humalog. In 38 (81%), severe hypoglycaemias occurred between 1-3 o'clock a.m., 4 (1.9%) in the early morning and 6 (2.88%) in late evening hours. Only in 9 cases the reason for severe hypoglycaemia was found. 11 patients had at least

Incidence of severe work-related injuries among young adult workers in Brazil: analysis of compensation data.

Science.gov (United States)

Sousa Santana, Vilma; Villaveces, Andrés; Bangdwala, Shrikant L; Runyan, Carol W; Albuquerque Oliveira, Paulo Rogerio

2012-08-01

To obtain national estimates of the annual cumulative incidence and incidence density of severe non-fatal injuries using compensation benefits data from the Brazilian National Social Security Institute (INSS), and to describe their sociodemographic distribution among workers aged under 25 years. Data are records of health-related compensation benefits from the Ministry of Social Insurance's information system of compensation benefits of the INSS recorded in 2006. Injuries were cases classified under chapter XIX, ICD-10. The assessment of their relation with work was made by INSS's occupational physician experts. The study population comprised young workers aged 16-24 years. 59,381 workers received compensation benefits for injuries in the study year. Among them 14,491 (24.4%) were work related, 12,501 (86.3%) were male and 1990 were female workers (13.7%). The annual cumulative incidence rate of work-related injuries (ACI-WI) was 2.9×1000 workers, higher among men (4.2×1000) than women (1.0×1000). The incidence density rate (IDR-WI) was 0.7/1000 full-time equivalent (FTE), higher for men (0.97/1000 FTE) than women (0.24/1000 FTE). Both morbidity measures were higher in the younger group (16-19 years), and inversely related to wage, especially for women in the younger group. Logging, extraction, food/beverage and construction industries had higher ACI-WI and IDR-WI for adolescents and young adult workers of both sex groups. These findings suggest that the Brazilian labour laws limiting young adult workers in hazardous settings need to be expanded, adding occupations in other extractive industries and certain types of work in the food/beverage manufacturing industries. Social inequalities associated with sex need to be examined further with more detailed data.

Experiments on natural circulation during PWR severe accidents and their analysis

International Nuclear Information System (INIS)

Sehgal, B.R.; Stewart, W.A.; Sha, W.T.

1988-01-01

Buoyancy-induced natural circulation flows will occur during the early-part of PWR high pressure accident scenarios. These flows affect several key parameters; in particular, the course of such accidents will most probably change due to local failures occurring in the primary coolant system (CS) before substantial core degradation. Natural circulation flow patterns were measured in a one-seventh scale PWR PCS facility at Westinghouse RandD laboratories. The measured flow and temperature distributions are report in this paper. The experiments were analyzed with the COMMIX code and good agreement was obtained between data and calculations. 10 refs., 8 figs., 2 tabs

Targeting safety improvements through identification of incident origination and detection in a near-miss incident learning system

International Nuclear Information System (INIS)

Novak, Avrey; Nyflot, Matthew J.; Ermoian, Ralph P.; Jordan, Loucille E.; Sponseller, Patricia A.; Kane, Gabrielle M.; Ford, Eric C.; Zeng, Jing

2016-01-01

Purpose: Radiation treatment planning involves a complex workflow that has multiple potential points of vulnerability. This study utilizes an incident reporting system to identify the origination and detection points of near-miss errors, in order to guide their departmental safety improvement efforts. Previous studies have examined where errors arise, but not where they are detected or applied a near-miss risk index (NMRI) to gauge severity. Methods: From 3/2012 to 3/2014, 1897 incidents were analyzed from a departmental incident learning system. All incidents were prospectively reviewed weekly by a multidisciplinary team and assigned a NMRI score ranging from 0 to 4 reflecting potential harm to the patient (no potential harm to potential critical harm). Incidents were classified by point of incident origination and detection based on a 103-step workflow. The individual steps were divided among nine broad workflow categories (patient assessment, imaging for radiation therapy (RT) planning, treatment planning, pretreatment plan review, treatment delivery, on-treatment quality management, post-treatment completion, equipment/software quality management, and other). The average NMRI scores of incidents originating or detected within each broad workflow area were calculated. Additionally, out of 103 individual process steps, 35 were classified as safety barriers, the process steps whose primary function is to catch errors. The safety barriers which most frequently detected incidents were identified and analyzed. Finally, the distance between event origination and detection was explored by grouping events by the number of broad workflow area events passed through before detection, and average NMRI scores were compared. Results: Near-miss incidents most commonly originated within treatment planning (33%). However, the incidents with the highest average NMRI scores originated during imaging for RT planning (NMRI = 2.0, average NMRI of all events = 1.5), specifically

Targeting safety improvements through identification of incident origination and detection in a near-miss incident learning system

Energy Technology Data Exchange (ETDEWEB)

Novak, Avrey; Nyflot, Matthew J.; Ermoian, Ralph P.; Jordan, Loucille E.; Sponseller, Patricia A.; Kane, Gabrielle M.; Ford, Eric C.; Zeng, Jing, E-mail: jzeng13@uw.edu [Department of Radiation Oncology, University of Washington Medical Center, 1959 NE Pacific Street, Campus Box 356043, Seattle, Washington 98195 (United States)

2016-05-15

Purpose: Radiation treatment planning involves a complex workflow that has multiple potential points of vulnerability. This study utilizes an incident reporting system to identify the origination and detection points of near-miss errors, in order to guide their departmental safety improvement efforts. Previous studies have examined where errors arise, but not where they are detected or applied a near-miss risk index (NMRI) to gauge severity. Methods: From 3/2012 to 3/2014, 1897 incidents were analyzed from a departmental incident learning system. All incidents were prospectively reviewed weekly by a multidisciplinary team and assigned a NMRI score ranging from 0 to 4 reflecting potential harm to the patient (no potential harm to potential critical harm). Incidents were classified by point of incident origination and detection based on a 103-step workflow. The individual steps were divided among nine broad workflow categories (patient assessment, imaging for radiation therapy (RT) planning, treatment planning, pretreatment plan review, treatment delivery, on-treatment quality management, post-treatment completion, equipment/software quality management, and other). The average NMRI scores of incidents originating or detected within each broad workflow area were calculated. Additionally, out of 103 individual process steps, 35 were classified as safety barriers, the process steps whose primary function is to catch errors. The safety barriers which most frequently detected incidents were identified and analyzed. Finally, the distance between event origination and detection was explored by grouping events by the number of broad workflow area events passed through before detection, and average NMRI scores were compared. Results: Near-miss incidents most commonly originated within treatment planning (33%). However, the incidents with the highest average NMRI scores originated during imaging for RT planning (NMRI = 2.0, average NMRI of all events = 1.5), specifically

Comparative study on aerosol removal by natural processes in containment in severe accident for AP1000 reactor

International Nuclear Information System (INIS)

Sun, Xiaohui; Cao, Xinrong; Shi, Xingwei; Yan, Jin

2017-01-01

Highlights: • Characteristics of aerosol distribution in containment are obtained. • Aerosol removal by natural processes is comparative studied by two methods. • Traditional rapid assessment method is conservative and can be applied in AP1000 reactor. - Abstract: Focusing on aerosol removal by naturally occurring processes in containment in severe accident for AP1000, integral severe accident code MELCOR and rapid assessment method mentioned in NUREG/CR-6189 are utilized to study aerosol removal by natural processes, respectively. Three typical severe accidents, induced by large break loss of coolant accident (LBLOCA), small break loss of coolant accident (SBLOCA) and steam generator tube rupture (SGTR), respectively, are selected for the study. The results obtained by two methods were further compared in the following several aspects: efficiency of aerosol removal by natural processes, peak time of aerosol suspended in containment atmosphere, peak amount of aerosol suspended in containment atmosphere, time when aerosol removal efficiency by natural processes is up to 99.9%. It was further concluded that results obtained by rapid assessment with shorter calculation process are more conservative. The analysis results provide reference to assessment method selection of severe accident source term for AP1000 nuclear emergency.

Behavior of obliquely incident vector Bessel beams at planar interfaces

KAUST Repository

Salem, Mohamed; Bagci, Hakan

2013-01-01

We investigate the behavior of full-vector electromagnetic Bessel beams obliquely incident at an interface between two electrically different media. We employ a Fourier transform domain representation of Bessel beams to determine their behavior upon reflection and transmission. This transform, which is geometric in nature, consists of elliptical support curves with complex weighting associated with them. The behavior of the scattered field at an interface is highly complex, owing to its full-vector nature; nevertheless, this behavior has a straightforward representation in the transform domain geometry. The analysis shows that the reflected field forms a different vector Bessel beam, but in general, the transmitted field cannot be represented as a Bessel beam. Nevertheless, using this approach, we demonstrate a method to propagate a Bessel beam in the refractive medium by launching a non- Bessel beam at the interface. Several interesting phenomena related to the behavior of Bessel beams are illustrated, such as polarized reflection at Brewster's angle incidence, and the Goos-Hänchen and Imbert-Federov shifts in the case of total reflection. © 2013 Optical Society of America.

Behavior of obliquely incident vector Bessel beams at planar interfaces

KAUST Repository

Salem, Mohamed

2013-01-01

We investigate the behavior of full-vector electromagnetic Bessel beams obliquely incident at an interface between two electrically different media. We employ a Fourier transform domain representation of Bessel beams to determine their behavior upon reflection and transmission. This transform, which is geometric in nature, consists of elliptical support curves with complex weighting associated with them. The behavior of the scattered field at an interface is highly complex, owing to its full-vector nature; nevertheless, this behavior has a straightforward representation in the transform domain geometry. The analysis shows that the reflected field forms a different vector Bessel beam, but in general, the transmitted field cannot be represented as a Bessel beam. Nevertheless, using this approach, we demonstrate a method to propagate a Bessel beam in the refractive medium by launching a non- Bessel beam at the interface. Several interesting phenomena related to the behavior of Bessel beams are illustrated, such as polarized reflection at Brewster\\'s angle incidence, and the Goos-Hänchen and Imbert-Federov shifts in the case of total reflection. © 2013 Optical Society of America.

Urinary and anal incontinence during pregnancy and postpartum: incidence, severity, and risk factors.

Science.gov (United States)

Solans-Domènech, Maite; Sánchez, Emília; Espuña-Pons, Montserrat

2010-03-01

To estimate frequency and severity and to identify risk factors of urinary incontinence (UI) and anal incontinence during pregnancy and after delivery in previously continent nulliparous women. We designed a cohort study of healthy, continent, nulliparous pregnant women attending public health care services. The field work was conducted during the control visits of the three trimesters of pregnancy, at the time of delivery, and postpartum. A self-administered questionnaire was used to assess UI (validated and adapted) and anal incontinence. Frequency of UI and anal incontinence and their confidence intervals (95% CIs) were calculated. The correlations between the severity of UI and the degree of effect on daily life were also estimated. Multivariable Cox models were applied to estimate hazard ratios for both incontinences (urinary/anal) during pregnancy and postpartum. The cumulative incidence rate during pregnancy was 39.1% (95% CI 36.3-41.9) for UI and 10.3% (95% CI 8.3-12.3) for anal incontinence. The correlation between severity of UI and effect on daily life was moderate. Age, baseline body mass index, and family history of UI were significantly associated with the occurrence of UI during pregnancy, while age and excess weight gain during pregnancy were associated with the occurrence of anal incontinence during pregnancy. Postpartum, the identified risk factors for both incontinences were incontinence during pregnancy and vaginal delivery. The occurrence of UI and anal incontinence during the postpartum period is related to the presence of incontinence in pregnancy, and vaginal delivery increases the risk of persistent incontinence. Some risk factors for both incontinences during pregnancy and postpartum are related to lifestyles and obstetric practices.

Germination of several groundnut cultivars in relation to incidence of ...

African Journals Online (AJOL)

This experiment is concerned with the germination of nine cultivars of groundnut grown in Nigeria in relation to incidence of fungi. The cultivars were NHK 5V8, NUTII 288, Samnut 10, 11, 21, 22, 23, 24 and MK 373. Germination potential was assessed after 10 days of planting in petri-dishes. Parameters such as seedling ...

Neutron scattering on natural iron at incident energies between 9.4 and 15.2 MeV

International Nuclear Information System (INIS)

Schmidt, D.; Mannhart, W.; Klein, H.; Nolte, R.

1994-11-01

Neutrons were scattered on a sample of natural iron at 12 incident energies in the range between 9.4 MeV and 15.2 MeV. Differential cross sections of the elastic scattering (natural iron) and of the inelastic scattering to the first excited level of 56 Fe (Q=-0.847 MeV) were determined for angles between 12.5 deg and 160 deg with total uncertainties between of 3% and 10%. Legendre polynomial least-squares fits resulted in integrated cross sections with uncertainties of 2% (elastic data) and 7% (inelastic data). The cross sections obtained in this work were compared with data from the literature. Inelastic scattering cross sections were determined within the scope of a pseudolevel analysis up to excitation energies of nearly 5.5 MeV. At higher excitation energies the scattering spectrum is contaminated by scattered breakup neutrons from the D+d source used hampering an analysis of the data. (orig.) [de

The Influence of Safety, Efficacy, and Medical Condition Severity on Natural versus Synthetic Drug Preference.

Science.gov (United States)

Meier, Brian P; Lappas, Courtney M

2016-11-01

Research indicates that there is a preference for natural v. synthetic products, but the influence of this preference on drug choice in the medical domain is largely unknown. We present 5 studies in which participants were asked to consider a hypothetical situation in which they had a medical issue requiring pharmacological therapy. Participants ( N = 1223) were asked to select a natural, plant-derived, or synthetic drug. In studies 1a and 1b, approximately 79% of participants selected the natural v. synthetic drug, even though the safety and efficacy of the drugs were identical. Furthermore, participants rated the natural drug as safer than the synthetic drug, and as that difference increased, the odds of choosing the natural over synthetic drug increased. In studies 2 and 3, approximately 20% of participants selected the natural drug even when they were informed that it was less safe (study 2) or less effective (study 3) than the synthetic drug. Finally, in study 4, approximately 65% of participants chose a natural over synthetic drug regardless of the severity of a specific medical condition (mild v. severe hypertension), and this choice was predicted by perceived safety and efficacy differences. Overall, these data indicate that there is a bias for natural over synthetic drugs. This bias could have implications for drug choice and usage. © The Author(s) 2015.

Incidence of neural tube defects in the natural radiation coastal areas of Kerala

International Nuclear Information System (INIS)

Jaikrishan, G.; Sudheer, K.R.; Andrews, V.J.; Koya, P.K.M.; Cheriyan, V.D.; Seshadri, M.

2010-01-01

All consecutive births in selected government hospitals in and around the high level natural background radiation areas (HLNRA) of Kerala were monitored for congenital malformations observable at birth since 1995. The HLNR area, a coastal strip of land about 55 km in length and 0.5 km in breadth from Purakkad in the north in Alleppey district to Sakthikulangara in the south of Quilon district, stands out among the most prominent background radiation areas of the world. Natural deposit of monazite sand, containing Thorium (8-10%), Uranium (0.3%) and corresponding decay products, is the source of elevated background radiation, ranging from < 1 to 45 mGy/year. Wide variation in dose, due to the patchy and non-uniform distribution of Monazite sand, enables in built controls. High population density, limited migration, ethnic diversity, good literacy, health awareness, institutionalized births and acceptance of small family norm are some of the key features of the population. Areas with a mean radiation dose of more than 1.5 mGy/year were treated as HLNR areas and areas with a dose level of 1.5 mGy/year or less were treated as normal level radiation (NLNR) areas. The study carried out since 1995 does not seem to implicate HLNR in the incidence of neural tube defects among newborns

Relationship between seasonal weather changes, risk of dehydration, and incidence of severe bradyarrhythmias requiring urgent temporary transvenous cardiac pacing in an elderly population

Science.gov (United States)

Palmisano, Pietro; Accogli, Michele; Zaccaria, Maria; Vergari, Alessandra; De Luca De Masi, Gabriele; Negro, Luca; De Blasi, Sergio

2014-09-01

There is little information on any seasonal variations or meteorological factors associated with symptomatic bradyarrhythmias requiring cardiac pacing. The aim of this single-center study was to investigate the seasonal distribution of the incidence of severe, life-threatening bradyarrhythmias requiring urgent temporary transvenous cardiac pacing in an elderly population. Consecutive patients who underwent urgent temporary transvenous cardiac pacing between 2007 and 2012 were enrolled. The baseline characteristics of the patients and some meteorological parameters, including the calculation the daily heat index (HI), were recorded. During the study period, 79 consecutive patients (mean age 82 ± 8 years, 41 % male) underwent urgent temporary transvenous cardiac pacing, mainly for third-degree atrioventricular block (79 %). The incidence of bradyarrhythmias was significantly higher in summer than in the other seasons ( P 90 °F for >3 h per day for at least 10 days ( P renal function impairment and hyperkalemia (all P < 0.05). This study showed an increased incidence of severe bradyarrhythmias in an elderly population during the hottest months of the year. In these months, in subjects characterized by increased susceptibility to dehydration, the risk of developing bradyarrhythmias was increased significantly.

Prostate cancer incidence and tumor severity in Georgia: descriptive epidemiology, racial disparity, and geographic trends.

Science.gov (United States)

Wagner, Sara E; Bauer, Sarah E; Bayakly, A Rana; Vena, John E

2013-01-01

Limited research has been conducted to describe the geographical clustering and distribution of prostate cancer (PrCA) incidence in Georgia (GA). This study describes and compares the temporal and geographic trends of PrCA incidence in GA with a specific focus on racial disparities. GA Comprehensive Cancer Registry PrCA incidence data were obtained for 1998-2008. Directly standardized age-adjusted PrCA incidence rates per 100,000 were analyzed by race, stage, grade, and county. County-level hotspots of PrCA incidence were analyzed with the Getis-Ord Gi* statistic in a geographic information system; a census tract-level cluster analysis was performed with a Discrete Poisson model and implemented in SaTScan(®) software. Significant (p incidence were observed in nine southwestern counties and six centrally located counties among men of both races. Six significant (p incidence rates were detected for men of both races in north and northwest central Georgia. When stratified by race, clusters among white and black men were similar, although centroids were slightly shifted. Most notably, a large (122 km radius) cluster in northwest central Georgia was detected only in whites, and two smaller clusters (0-32 km radii) were detected in Southwest Georgia only in black men. Clusters of high-grade and late-stage tumors were identified primarily in the northern portion of the state among men of both races. This study revealed a pattern of higher incidence and more advanced disease in northern and northwest central Georgia, highlighting geographic patterns that need more research and investigation of possible environmental determinants.

Natural circulation under severe accident conditions

International Nuclear Information System (INIS)

Pafford, D.J.; Hanson, D.J.; Tung, V.X.; Chmielewski, S.V.

1992-01-01

Research is being conducted to better understand natural circulation phenomena in mixtures of steam and noncondensibles and its influence on the temperature of the vessel internals and the hot leg, pressurizer surge line, and steam generator tubes. The temperature of these structures is important because their failure prior to reactor vessel lower head failure could reduce the likelihood of containment failure as a result of direct containment heating. Computer code calculations (MELPROG, SCDAP/RELAP5/MOD3) predict high fluid temperatures in the upper plenum resulting from in-vessel natural circulation. Using a simple model for the guide tube phenomena, high upper plenum temperatures are shown to be consistent with the relatively low temperatures that were deduced metallurgically from leadscrews removed from the TMI-2 upper plenum. Evaluation of the capabilities of the RELAP5/MOD3 computer code to predict natural circulation behavior was also performed. The code was used to model the Westinghouse natural circulation experimental facility. Comparisons between code calculations and results from experiments show good agreement

Incidence and Nature of Medical Attendance Injuries in English Community Rugby Union

Science.gov (United States)

Roberts, Simon P.; Trewartha, Grant; England, Mike; Stokes, Keith A.

2014-01-01

Background: Previous research has identified injury patterns during community-level rugby union match play, but none have investigated the frequency and reasons for on-field injury management. Purpose: To establish the frequency, reasons, and patterns of on-field injury management in English community rugby, including differences between different levels of play. Study Design: Descriptive epidemiology study. Methods: Over 3 seasons, injury information was collected from 46 (2009-2010), 67 (2010-2011), and 76 (2011-2012) English community clubs (Rugby Football Union [RFU] levels 3-9). Club injury management staff reported information for all medical attendances during match play, including details on the injury site and type, playing position (seasons 2010-2011 and 2011-2012 only), and whether the player was removed from play. Clubs were subdivided into groups A (RFU levels 3 and 4 [mainly semiprofessional]; n = 39), B (RFU levels 5 and 6 [mainly amateur]; n = 71), and C (RFU levels 7-9 [social and recreational]; n = 79) to differentiate playing levels. Results: The overall medical attendance incidence was 229 per 1000 player-match hours (95% CI, 226-232), with 45 players removed per 1000 player-match hours (95% CI, 44-46). Attendance incidence for group A (294 per 1000 player-match hours; 95% CI, 287-301) was higher compared with group B (213; 95% CI, 208-218; P < .001) and C (204; 95% CI, 200-209; P < .001). There was a higher incidence of attendances to forwards (254; 95% CI, 249-259) compared with backs (191; 95% CI, 187-196; P < .001). The head was the most common specific site of injury (55 per 1000 player-match hours; 95% CI, 53-57) but the lower limb region overall accounted for most attendances (87; 95% CI, 85-89) and the greatest chance of removal from the pitch (22; 95% CI, 21-23). Conclusion: With the likelihood of 1 injury for each team per match severe enough for the player to leave the pitch and with at least 1 attendance for a head injury per match

Can Angiotensin-Converting Enzyme Inhibitors Reduce the Incidence, Severity, and Duration of Radiation Proctitis?

International Nuclear Information System (INIS)

Alashkham, Abduelmenem; Paterson, Catherine; Rauchhaus, Petra; Nabi, Ghulam

2016-01-01

Purpose: To determine whether participants taking angiotensin-converting enzyme inhibitors (ACEIs) and treated with radical radiation therapy with neoadjuvant/adjuvant hormone therapy have less incidence, severity, and duration of radiation proctitis. Methods and Materials: A propensity score analysis of 817 patients who underwent radical radiation therapy with neoadjuvant or adjuvant hormone therapy as primary line management in a cohort study during 2009 to 2013 was conducted. Patients were stratified as follows: group 1, hypertensive patients taking ACEIs (as a study group); group 2, nonhypertensive patients not taking ACEIs; and group 3, hypertensive patients not taking ACEIs (both as control groups). The incidence, severity, and duration of proctitis were the main outcome. χ"2 tests, Mann-Whitney U tests, analysis of variance, risk ratio (RR), confidence interval (CI), Kaplan-Meier plots, and log-rank tests were used. Results: The mean age of the participants was 68.91 years, with a follow-up time of 3.38 years. Based on disease and age-matched comparison, there was a statistically significant difference of proctitis grading between the 3 groups: χ"2 (8, n=308) = 72.52, P<.001. The Mann-Whitney U test indicated that grades of proctitis were significantly lower in hypertensive patients taking ACEIs than in nonhypertensive patients not taking ACEIs and hypertensive patients not taking ACEIs (P<.001). The risk ratio (RR) of proctitis in hypertensive patients taking ACEIs was significantly lower than in hypertensive patients not taking ACEIs (RR 0.40, 95% CI 0.30-0.53, P<.001) and in nonhypertensive patients not taking ACEIs (RR 0.58, 95% CI 0.44-0.77, P<.001). Time to event analysis revealed that hypertensive patients taking ACEIs were significantly different from the control groups (P<.0001). Furthermore, hypertensive patients taking ACEIs had significantly faster resolution of proctitis (P<.0001). Conclusion: Patients who were taking ACEIs were

Can Angiotensin-Converting Enzyme Inhibitors Reduce the Incidence, Severity, and Duration of Radiation Proctitis?

Energy Technology Data Exchange (ETDEWEB)

Alashkham, Abduelmenem, E-mail: alashkham@yahoo.com [Academic Section of Urology, Division of Cancer Research, School of Medicine, University of Dundee, Scotland (United Kingdom); Paterson, Catherine [Academic Section of Urology, Division of Cancer Research, School of Medicine, University of Dundee, Scotland (United Kingdom); Rauchhaus, Petra [Tayside Clinical Trials Unit, School of Medicine, University of Dundee, Scotland (United Kingdom); Nabi, Ghulam [Academic Section of Urology, Division of Cancer Research, School of Medicine, University of Dundee, Scotland (United Kingdom)

2016-01-01

Purpose: To determine whether participants taking angiotensin-converting enzyme inhibitors (ACEIs) and treated with radical radiation therapy with neoadjuvant/adjuvant hormone therapy have less incidence, severity, and duration of radiation proctitis. Methods and Materials: A propensity score analysis of 817 patients who underwent radical radiation therapy with neoadjuvant or adjuvant hormone therapy as primary line management in a cohort study during 2009 to 2013 was conducted. Patients were stratified as follows: group 1, hypertensive patients taking ACEIs (as a study group); group 2, nonhypertensive patients not taking ACEIs; and group 3, hypertensive patients not taking ACEIs (both as control groups). The incidence, severity, and duration of proctitis were the main outcome. χ{sup 2} tests, Mann-Whitney U tests, analysis of variance, risk ratio (RR), confidence interval (CI), Kaplan-Meier plots, and log-rank tests were used. Results: The mean age of the participants was 68.91 years, with a follow-up time of 3.38 years. Based on disease and age-matched comparison, there was a statistically significant difference of proctitis grading between the 3 groups: χ{sup 2} (8, n=308) = 72.52, P<.001. The Mann-Whitney U test indicated that grades of proctitis were significantly lower in hypertensive patients taking ACEIs than in nonhypertensive patients not taking ACEIs and hypertensive patients not taking ACEIs (P<.001). The risk ratio (RR) of proctitis in hypertensive patients taking ACEIs was significantly lower than in hypertensive patients not taking ACEIs (RR 0.40, 95% CI 0.30-0.53, P<.001) and in nonhypertensive patients not taking ACEIs (RR 0.58, 95% CI 0.44-0.77, P<.001). Time to event analysis revealed that hypertensive patients taking ACEIs were significantly different from the control groups (P<.0001). Furthermore, hypertensive patients taking ACEIs had significantly faster resolution of proctitis (P<.0001). Conclusion: Patients who were taking ACEIs were

The definition and natural history of severe exacerbation of hepatitis B

Directory of Open Access Journals (Sweden)

GUO Wei

2014-10-01

Full Text Available Despite different opinions on its definition and classification in the past, a consensus has gradually been reached regarding the naming, classification, and clinical diagnosis of liver failure. The classification of liver failure is described, and the definition and natural history of severe exacerbation of hepatitis B are summarized. Antiviral treatment and artificial liver support in the early stage are beneficial for clinical outcomes and prognosis.

Chronic Hepatitis B with Spontaneous Severe Acute Exacerbation

Directory of Open Access Journals (Sweden)

Wei-Lun Tsai

2015-11-01

Full Text Available Chronic hepatitis B virus (HBV infection is a major global health problem with an estimated 400 million HBV carriers worldwide. In the natural history of chronic hepatitis B (CHB, spontaneous acute exacerbation (AE is not uncommon, with a cumulative incidence of 10%–30% every year. While exacerbations can be mild, some patients may develop hepatic decompensation and even die. The underlying pathogenesis is possibly related to the activation of cytotoxic T lymphocyte-mediated immune response against HBV. An upsurge of serum HBV DNA usually precedes the rise of alanine aminotransferase (ALT and bilirubin. Whether antiviral treatment can benefit CHB with severe AE remains controversial, but early nucleos(tide analogues treatment seemed to be associated with an improved outcome. There has been no randomized study that compared the effects of different nucleos(tide analogues (NA in the setting of CHB with severe AE. However, potent NAs with good resistance profiles are recommended. In this review, we summarized current knowledge regarding the natural history, pathogenetic mechanisms, and therapeutic options of CHB with severe AE.

Managing Materials and Wastes for Homeland Security Incidents

Science.gov (United States)

To provide information on waste management planning and preparedness before a homeland security incident, including preparing for the large amounts of waste that would need to be managed when an incident occurs, such as a large-scale natural disaster.

Natural history of severe atheromatous disease of the thoracic aorta: a transesophageal echocardiographic study.

Science.gov (United States)

Montgomery, D H; Ververis, J J; McGorisk, G; Frohwein, S; Martin, R P; Taylor, W R

1996-01-01

This study sought to prospectively observe the morphologic and clinical natural history of severe atherosclerotic disease of the thoracic aorta as defined by transesophageal echocardiography. Atherosclerosis of the thoracic aorta has been shown to be highly associated with risk for embolic events in transesophageal studies, but the natural history of the disease under clinical conditions has not been reported. During a 20-month period, 191 of 264 patients undergoing transesophageal echocardiography had adequate visualization of the aorta to allow atherosclerotic severity to be graded as follows: grade I = normal (44 patients); grade II = intimal thickening (52 patients); grade III = atheroma or = 5 mm (19 patients); grade V = mobile lesion (14 patients). All available patients with grades IV (8 patients) and V (10 patients) disease as well as a subgroup of 12 patients with grade III disease had follow-up transesophageal echocardiographic studies (mean [+/- SD] 11.7 +/- 0.9 months, range 6 to 22). Of 30 patients undergoing follow-up transesophageal echocardiographic studies, 20 (66%) had no change in atherosclerotic severity grade. Of the remaining 10 patients, atherosclerotic severity progressed one grade in 7 and decreased in 3 with resolved mobile lesions. Of 18 patients with grade IV or V disease of the aorta who underwent a follow-up study, 11 (61%) demonstrated formation of new mobile lesions. Of 10 patients with grade V disease on initial study who underwent follow-up study, 7 (70%) demonstrated resolution of a specific previously documented mobile lesion. However, seven patients (70%) with grade V disease also demonstrated development of a new mobile lesion. Of 33 patients with grade IV or V disease, 8 (24%) died during the study period, and 1 (3%) had a clinical embolic event. The presence of severe atherosclerotic disease of the thoracic aorta as defined by transesophageal echocardiography is associated with a high mortality rate. Although the morphologic

Incomplete fissures in severe emphysematous patients evaluated with MDCT: Incidence and interobserver agreement among radiologists and pneumologists

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Koenigkam-Santos, Marcel, E-mail: marcelk46@yahoo.com.br [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Neuenheimer Feld 110, 69120 Heidelberg (Germany); Chest Clinic (Thoraxklinik), University of Heidelberg, Amalienstr. 5,69126 Heidelberg (Germany); Department of Radiology, University Hospital of the School of Medicine of Ribeirao Preto - University of Sao Paulo, Av. Bandeirantes 3900, Campus Universitario Monte Alegre, 14048 900 Ribeirao Preto, SP (Brazil); Puderbach, Michael [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Neuenheimer Feld 110, 69120 Heidelberg (Germany); Chest Clinic (Thoraxklinik), University of Heidelberg, Amalienstr. 5,69126 Heidelberg (Germany); Gompelmann, Daniela; Eberhardt, Ralf; Herth, Felix [Chest Clinic (Thoraxklinik), University of Heidelberg, Amalienstr. 5,69126 Heidelberg (Germany); Kauczor, Hans-Ulrich [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Neuenheimer Feld 110, 69120 Heidelberg (Germany); Heussel, Claus Peter [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Neuenheimer Feld 110, 69120 Heidelberg (Germany); Chest Clinic (Thoraxklinik), University of Heidelberg, Amalienstr. 5,69126 Heidelberg (Germany)

2012-12-15

Objective: Pulmonary fissures completeness predicts efficacy in endobronchial valves (EBV) implantation, a new lobar volume reduction therapy for severe emphysematous patients. We assessed the incidence of incomplete fissures and the interobserver agreement in its evaluation with MDCT, in severe emphysematous patients prior to EBV implantation. Materials and Methods: Volumetric thin-section CT scans of 35 patients (CODP GOLD 3/4, heterogeneous emphysema) were retrospectively reviewed by 2 pneumologists, 1 general and 2 experienced chest radiologists, independently and blinded for treatment outcome, and the pulmonary fissures were classified as either complete or incomplete. Interobserver agreement was assessed with Kappa index (KI). Results: Agreement between all readers for the left oblique, right oblique and horizontal fissure was, respectively, moderate (KI = 0.53), fair (KI = 0.37) and moderate (KI = 0.42). Highest agreement (99/105 fissures) was observed among experienced radiologists, being for left oblique, right oblique and horizontal, respectively, almost perfect (KI = 0.79), perfect (KI = 1.0) and moderate (KI = 0.52). These 2 reviewers found that all of 35 patients had at least one incomplete fissure, with a proportion of incomplete fissures assigned as 74/65%, 85/85% and 91/88%, respectively for the left oblique, right oblique and horizontal fissures. Conclusions: Pneumologists and radiologists agreed fairly to moderately in fissures analysis, while the experienced chest radiologists reached the highest clinically adequate agreement of 94%. We believe that clinical routine visual analysis of the fissures integrity can be done with a good degree of confidence in MDCT images, and experienced readers might be required. Also, a higher than expected incidence of incomplete fissures was described in our studied population.

Incomplete fissures in severe emphysematous patients evaluated with MDCT: Incidence and interobserver agreement among radiologists and pneumologists

International Nuclear Information System (INIS)

Koenigkam-Santos, Marcel; Puderbach, Michael; Gompelmann, Daniela; Eberhardt, Ralf; Herth, Felix; Kauczor, Hans-Ulrich; Heussel, Claus Peter

2012-01-01

Objective: Pulmonary fissures completeness predicts efficacy in endobronchial valves (EBV) implantation, a new lobar volume reduction therapy for severe emphysematous patients. We assessed the incidence of incomplete fissures and the interobserver agreement in its evaluation with MDCT, in severe emphysematous patients prior to EBV implantation. Materials and Methods: Volumetric thin-section CT scans of 35 patients (CODP GOLD 3/4, heterogeneous emphysema) were retrospectively reviewed by 2 pneumologists, 1 general and 2 experienced chest radiologists, independently and blinded for treatment outcome, and the pulmonary fissures were classified as either complete or incomplete. Interobserver agreement was assessed with Kappa index (KI). Results: Agreement between all readers for the left oblique, right oblique and horizontal fissure was, respectively, moderate (KI = 0.53), fair (KI = 0.37) and moderate (KI = 0.42). Highest agreement (99/105 fissures) was observed among experienced radiologists, being for left oblique, right oblique and horizontal, respectively, almost perfect (KI = 0.79), perfect (KI = 1.0) and moderate (KI = 0.52). These 2 reviewers found that all of 35 patients had at least one incomplete fissure, with a proportion of incomplete fissures assigned as 74/65%, 85/85% and 91/88%, respectively for the left oblique, right oblique and horizontal fissures. Conclusions: Pneumologists and radiologists agreed fairly to moderately in fissures analysis, while the experienced chest radiologists reached the highest clinically adequate agreement of 94%. We believe that clinical routine visual analysis of the fissures integrity can be done with a good degree of confidence in MDCT images, and experienced readers might be required. Also, a higher than expected incidence of incomplete fissures was described in our studied population.

Classification of medication incidents associated with information technology.

Science.gov (United States)

Cheung, Ka-Chun; van der Veen, Willem; Bouvy, Marcel L; Wensing, Michel; van den Bemt, Patricia M L A; de Smet, Peter A G M

2014-02-01

Information technology (IT) plays a pivotal role in improving patient safety, but can also cause new problems for patient safety. This study analyzed the nature and consequences of a large sample of IT-related medication incidents, as reported by healthcare professionals in community pharmacies and hospitals. The medication incidents submitted to the Dutch central medication incidents registration (CMR) reporting system were analyzed from the perspective of the healthcare professional with the Magrabi classification. During classification new terms were added, if necessary. The principal source of the IT-related problem, nature of error. Additional measures: consequences of incidents, IT systems, phases of the medication process. From March 2010 to February 2011 the CMR received 4161 incidents: 1643 (39.5%) from community pharmacies and 2518 (60.5%) from hospitals. Eventually one of six incidents (16.1%, n=668) were related to IT; in community pharmacies more incidents (21.5%, n=351) were related to IT than in hospitals (12.6%, n=317). In community pharmacies 41.0% (n=150) of the incidents were about choosing the wrong medicine. Most of the erroneous exchanges were associated with confusion of medicine names and poor design of screens. In hospitals 55.3% (n=187) of incidents concerned human-machine interaction-related input during the use of computerized prescriber order entry. These use problems were also a major problem in pharmacy information systems outside the hospital. A large sample of incidents shows that many of the incidents are related to IT, both in community pharmacies and hospitals. The interaction between human and machine plays a pivotal role in IT incidents in both settings.

Incidence, nature, and etiology of metabolic acidosis in dogs and cats.

Science.gov (United States)

Hopper, K; Epstein, S E

2012-01-01

Metabolic acidosis is an important abnormality in ill and injured dogs and cats. To describe the incidence, nature, and etiology of metabolic acidosis in dogs and cats that had arterial or venous blood gases measured for any reason at a university teaching hospital. Dogs and cats at the Veterinary Medical Teaching Hospital. Acid base parameters and electrolyte and lactate concentrations in dogs and cats measured during a 13-month period were retrospectively retrieved from a computer database. Metabolic acidosis was defined as a standardized base excess (SBE) in dogs of acidosis (753 dogs and 134 cats). Primary metabolic acidosis was the most common disorder in dogs, whereas mixed acid base disorder of metabolic acidosis and respiratory acidosis was most common in cats. Hyperchloremic metabolic acidosis was more common than a high anion gap (AG) metabolic acidosis; 25% of dogs and 34% of cats could not be classified as having either a hyperchloremic metabolic acidosis or a high AG metabolic acidosis. Metabolic acidosis was found commonly in this patient population and was associated with a wide variety of disease processes. Mixed acid base disorders occur frequently and routine categorization of metabolic acidosis based on the presence of high AG or hyperchloremia may be misleading in a large proportion of cases. Copyright © 2012 by the American College of Veterinary Internal Medicine.

Baseline incidence and severity of renal insufficiency evaluated by estimated glomerular filtration rates in patients scheduled for contrast-enhanced CT

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Utsunomiya, Daisuke; Yanaga, Yumi; Oda, Seitaro; Namimoto, Tomohiro; Yamashita, Yasuyuki (Dept. of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto Univ., Kumamoto (Japan)), email: utsunomi@kumamoto-u.ac.jp; Awai, Kazuo (Dept. of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima Univ., Hiroshima (Japan)); Funama, Yoshinori (Dept. of Medical Physics, Faculty of Life Sciences, Kumamoto Univ., Kumamoto (Japan))

2011-06-15

Background Although pre-existing renal insufficiency (RI) is the most important risk factor for contrast-induced nephropathy (CIN), the background distribution of baseline renal function has not been investigated thoroughly in patients scheduled for contrast-enhanced CT. Purpose To investigate the incidence and severity of baseline RI evaluated by estimated glomerular filtration rates (eGFR) in patients who underwent contrast-enhanced CT at an academic center. Material and Methods A total of 6586 patients (3630 men and 2956 women; mean age 57.0 +- 11.9 years) who underwent contrast-enhanced CT between January and December 2008 were retrospectively studied. Of these, 829 had cardiovascular diseases (CVD), 5116 had oncologic diseases, 178 had diabetes mellitus (DM), and 1572 had chronic liver disease (CLD). The eGFR (mL/min/1.73 m2) was calculated from their serum creatinine level. Mild, moderate-a, moderate-b, and severe RI were recorded at 60 < =eGFR < 90, 45 < =eGFR < 60, 30 < =eGFR < 45 and eGFR < 30, respectively. Results Of the 6586 patients, 1.6%, 3.7%, 13.7%, and 54.2% were judged to present with severe, moderate-b, moderate-a, and mild RI, respectively. While moderate-b-to-severe RI was recorded in 133 (3.2%) of 4161 patients aged 70 years or less, it was observed in 218 (9.0%) of the 2425 patients who were 71 years or older. Among the 829 CVD patients, 9.9% manifested moderate-b-to-severe- and 73.0% mild-to-moderate-a RI. The corresponding rates were 4.4% and 68.9% for oncologic disease, 16.9% and 61.2% for DM, and 4.8% and 71.5% for CLD patients. By univariate analysis, there was a significant association between moderate-b-to-severe RI and the advanced age, CVD, DM, and non-oncologic disease. Multivariate analysis showed that the advanced age, DM, and non-oncologic disease were statistically associated with moderate-b-to-severe RI. Conclusion The incidence of RI of eGFR < 45mL/min/1.73 m2 at baseline was high in patients with advanced age, CVD and DM and

Epidemiological studies on disturbances of human fetal development in areas with various doses of natural background radiation. I. Relationship between incidences of Down's syndrome or visible malformation and gonad dose equivalent rate of natural background radiation

International Nuclear Information System (INIS)

Ujeno, Y.

1985-01-01

The relationship between environmental radiation to the gonads and incidences of Down's syndrome and visible malformation was analyzed using Kendall's rank correlation method. The subjects, studied during a 3-yr period (1979-1981), were inhabitants of 46 prefectures in Japan that had various dose rates of natural background ionizing radiation. Results showed that the natural background very low-dose radiation rate was not a predominant factor responsible for inducing Down's syndrome or other visible malformations

In-flight medical emergencies during airline operations: a survey of physicians on the incidence, nature, and available medical equipment

Directory of Open Access Journals (Sweden)

Hinkelbein J

2017-02-01

Full Text Available Jochen Hinkelbein,1,2 Christopher Neuhaus,2,3 Lennert Böhm,1 Steffen Kalina,1 Stefan Braunecker1,2 1Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, 2Working group “Emergency Medicine and Air Rescue”, German Society for Aviation and Space Medicine (DGLRM, Munich, 3Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany Background: Data on the incidence of in-flight medical emergencies on-board civil aircraft are uncommon and rarely published. Such data could provide information regarding required medical equipment on-board aircraft and requisite training for cabin crew. The aim of the present study was to gather data on the incidences, nature, and medical equipment for in-flight medical emergencies by way of a survey of physician members of a German aerospace medical society.Materials and methods: Using unipark.de (QuestBack GmbH, Cologne, Germany, an online survey was developed and used to gather specific information. Members of the German Society for Aviation and Space Medicine (Deutsche Gesellschaft für Luft- und Raumfahrtmedizin e.V.; DGLRM were invited to participate in the survey during a 4-week period (21 March 2015 to 20 April 2015. Chi-square test was used for statistical analysis (p<0.05 was considered significant.Results: Altogether, 121 members of the society responded to the survey (n=335 sent out. Of the 121 respondents, n=54 (44.6% of the participants (89.9% male and 10.1% female; mean age, 54.1 years; n=121 were involved in at least one in-flight medical emergency. Demographic parameters in this survey were in concordance with the society members’ demographics. The mean duration of flights was 5.7 hours and the respondents performed 7.1 airline flights per year (median. Cardiovascular (40.0% and neurological disorders (17.8% were the most frequent diagnoses. The medical equipment (78.7% provided was sufficient. An emergency diversion was

Temporal characterisation of soil-plant natural recovery related to fire severity in burned Pinus halepensis Mill. forests.

Science.gov (United States)

Moya, D; González-De Vega, S; García-Orenes, F; Morugán-Coronado, A; Arcenegui, V; Mataix-Solera, J; Lucas-Borja, M E; De Las Heras, J

2018-05-28

Despite Mediterranean ecosystems' high resilience to fire, both climate and land use change, and alterations in fire regimes increase their vulnerability to fire by affecting the long-term natural recovery of ecosystem services. The objective of this work is to study the effects of fire severity on biochemical soil indicators, such as chemical composition or enzymatic activity, related to time after fire and natural vegetation recovery (soil-plant interphase). Soil samples from three wildfires occurring 3, 15 and 21 years ago were taken in the south-eastern Iberian Peninsula (semiarid climate). Sampling included three fire severity levels in naturally regenerated (and changing to shrublands) Pinus halepensis Mill. forests. In the short-term post-fire period, phosphorus concentration, electrical conductivity and urease activity were positively linked to fire severity, and also influenced β-glucosidade activity in a negative relationship. During the 15-21-year post-fire period, the effects related to medium-high fire severity were negligible and soil quality indicators were linked to natural regeneration success. The results showed that most soil properties recovered in the long term after fire (21 years). These outcomes will help managers and stakeholders to implement management tools to stabilise soils and to restore burned ecosystems affected by medium-high fire severity. Such knowledge can be considered in adaptive forest management to reduce the negative effects of wildfires and desertification, and to improve the resilience of vulnerable ecosystems in a global change scenario. Copyright © 2018 Elsevier B.V. All rights reserved.

The Incidence and Severity of Physical Pain Symptoms in Marfan Syndrome: A Survey of 993 Patients.

Science.gov (United States)

Nelson, Ariana M; Walega, David R; McCarthy, Robert J

2015-12-01

To characterize the incidence, severity, quality, and treatment of pain in a large cohort of Marfan patients. A web-based survey was distributed to all individuals on the Marfan Foundation listserv. Respondents who endorsed a diagnosis of Marfan syndrome were queried as to the presence, frequency, severity, location, and quality of their pain and were asked to describe the specific treatments used to manage pain. The primary outcome was the presence of pain symptoms in respondents during the 7-day period preceding completion of the survey. Of the 993 patients with a verified diagnosis of Marfan syndrome, 67% (95% confidence interval, 64%-69%) reported pain in the preceding 7 days. Median (interquartile range) "average daily pain" was 4 (3 to 5) on the numeric rating scale; "worst pain" was 7 (5 to 8). "Worst pain experienced" was ≥4 in 93% of respondents. Analgesic use to control pain related to Marfan syndrome was reported in 56% of respondents with 55% reporting Marfan patients are underestimated and likely undertreated. We propose a need for improved patient and medical provider awareness of pain management options in this population, including the development of effective algorithms to treat pain in Marfan patients.

System Safety Assessment Based on Past Incidents in Oil and Gas Industries: A Focused Approach in Forecasting of Minor, Severe, Critical, and Catastrophic Incidents, 2010–2015

Directory of Open Access Journals (Sweden)

Praveen Patel

2016-01-01

Full Text Available Accident in an occupation which occurred due to series of repetitive minor incidents within the working environment. This work demonstrates the critical system safety assessment based on various incidents that took place to the different system and subsystem of two Indian oil refineries in five years of span 2010 to 2015. The categorization of incidents and hazard rate function of each incident category were classified and calculated. The result of Weibull analysis estimators in the form of scale and shape parameters provides useful information of incidents forecasting and their patterns in a particular time.

Proposed classification scale for radiological incidents and accidents; Elaboration d'une echelle de classement des incidents et accidents radiologiques

Energy Technology Data Exchange (ETDEWEB)

NONE

2003-04-15

The scale proposed in this report is intended to facilitate communication concerning the severity of incidents and accidents involving the exposure of human beings to ionising radiations. Like the INES, it comprises eight levels of severity and uses the same terms (accident, incident, anomaly, serious and major) for keeping the public and the media informed. In a radiological protection context, the severity of an event is considered as being directly proportional to the risk run by an individual (the probability of developing fatal or non-fatal health effects) following exposure to ionising radiation in an incident or accident situation. However for society, other factors have to be taken into account to determine severity. The severity scale proposed is therefore based on assessment of the individual radiological risk. A severity level corresponding to exposure of a member of the public in an incident or accident situation is determined on the basis of risk assessment concepts and methods derived from international consensus on dose/effect relationships for both stochastic and deterministic effects. The severity of all the possible exposure situations - worker exposure, collective exposure, potential exposure - is determined using a system of weighting in relation to situations involving members of the public. In the case of this scale, to indicate the severity of an event, it is proposed to make use of the most penalizing level of severity, comparing: - the severity associated with the probability of occurrence of deterministic effects and the severity associated with the probability of occurrence of stochastic effects, when the event gives rise to both types of risk; - the severity for members of the public and the severity for exposed workers, when both categories of individuals are involved; - the severity on the proposed radiological protection scale and that obtained using the INES, when radiological protection and nuclear safety aspects are associated with

Urinary Incontinence During Pregnancy and Postpartum Incidence, Severity and Risk Factors in Alzahra and Taleqani Hospitals in Tabriz , Iran, 2011-2012

OpenAIRE

Fatemeh Mallah; Parinaz Tasbihi; Nazli Navali; Azadeh Azadi

2014-01-01

Objectives: This is a cohort study that investigated the incidence, severity and risk factors of Urinary Incontinence during pregnancy and postpartum in nulliparous women. Materials and Methods: In this cohort study, 441 nulliparous women were studied. The women were followed up from the beginning of pregnancy until the postpartum period. The prevalence of urinary incontinence was determined among them. Risk factors that could play a significant role were analyzed using questionnaires. ...

Efficacy of polyethylene glycol-conjugated bovine granulocyte colony-stimulating factor for reducing the incidence of naturally occurring clinical mastitis in periparturient dairy cows and heifers.

Science.gov (United States)

Hassfurther, Renee L; TerHune, Terry N; Canning, Peter C

2015-03-01

To evaluate effects of various doses of polyethylene glycol (PEG)-conjugated bovine granulocyte colony-stimulating factor (bG-CSF) on the incidence of naturally occurring clinical mastitis in periparturient dairy cattle. 211 periparturient Holstein cows and heifers. Approximately 7 days before the anticipated date of parturition (day of parturition = day 0), healthy cattle received SC injections of sterile saline (0.9% NaCl) solution (control treatment) or PEG-bG-CSF at 5, 10, or 20 μg/kg. Cattle were commingled and housed in a pen with dirt flooring, which was kept wet to maximize the incidence of naturally occurring clinical mastitis. Within 24 hours after parturition, each animal again received the assigned treatment. Mammary glands and milk were visually scored for abnormalities twice daily for 28 days after parturition. Milk samples were aseptically collected from mammary glands with an abnormal appearance or abnormal milk and submitted for microbial culture. Daily milk production was recorded, and milk composition was assessed on days 3, 5, 7, and 10. Cattle treated with PEG-bG-CSF at 10 and 20 μg/kg had significantly fewer cases of clinical mastitis (9/54 and 5/53, respectively), compared with control cattle (18/53). Administration of PEG -bG-CSF did not significantly affect daily milk production or milk composition. Results suggested that PEG-bG-CSF was effective for reducing the incidence of naturally occurring clinical mastitis in periparturient dairy cattle. Further investigations of the use of PEG-bG-CSF as a potential preventative intervention should be conducted.

78 FR 14877 - Pipeline Safety: Incident and Accident Reports

Science.gov (United States)

2013-03-07

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket ID PHMSA-2013-0028] Pipeline Safety: Incident and Accident Reports AGENCY: Pipeline and Hazardous Materials... PHMSA F 7100.2--Incident Report--Natural and Other Gas Transmission and Gathering Pipeline Systems and...

Oil Spill Incident Tracking [ds394

Data.gov (United States)

California Natural Resource Agency — The Office of Spill Prevention and Response (OSPR) Incident Tracking Database is a statewide oil spill tracking information system. The data are collected by OSPR...

Very high coronary artery calcium score with normal myocardial perfusion SPECT imaging is associated with a moderate incidence of severe coronary artery disease

Energy Technology Data Exchange (ETDEWEB)

Yuoness, Salem A.; Goha, Ahmed M.; Romsa, Jonathan G.; Akincioglu, Cigdem; Warrington, James C.; Datta, Sudip; Gambhir, Sanjay; Urbain, Jean-Luc C.; Vezina, William C. [London Health Sciences Centre, Department of Nuclear Medicine, London, ON (Canada); Massel, David R. [London Health Sciences Centre, Division of Cardiology, London, ON (Canada); Martell, Rafael [Private Practice, London, ON (Canada)

2015-09-15

Myocardial perfusion imaging (MPI) has limitations in the presence of balanced multivessel disease (MVD) and left main (LM) coronary artery disease, occasionally resulting in false-normal results despite the high cardiovascular risk associated with this condition. The purpose of this study was to assess the incidence of severe coronary artery disease (CAD) in the presence of a very high Agatston coronary artery calcium (CAC) score (>1,000) in stable symptomatic patients without known CAD but with normal MPI results. A total of 2,659 prospectively acquired consecutive patients were referred for MPI and evaluation of CAC score by CT. Of this patient population, 8 % (222/2,659) had ischemia without myocardial infarction (MI) on MPI and 11 % (298/2,659) had abnormal MPI (MI and/or ischemia). On presentation 1 % of the patients (26/2,659) were symptomatic, had a CAC score >1,000 and normal MPI results. The definition of normal MPI was strict and included a normal hemodynamic response without ischemic ECG changes and normal imaging, particularly absence of transient ischemic dilation. All of these 26 patients with a CAC score >1,000 and normal MPI findings underwent cardiac catheterization. Of these 26 patients, 58 % (15/26) had severe disease (≥70 % stenosis) leading to revascularization. Of this group, 47 % (7/15) underwent percutaneous intervention, and 53 % (8/15) underwent coronary artery bypass grafting. All of these 15 patients had either MVD (14/15) or LM coronary artery disease (1/15), and represented 0.6 % (15/2,659) of all referred patients (95 % CI 0.3 - 0.9 %). The majority, 90 % (8/9), had severe CAD with typical chest pain. A very high CAC score (>1,000) with normal MPI in a small subset of symptomatically stable patients was associated with a moderate incidence of severe CAD (95 % CI 37 - 77 %). Larger studies and/or a meta-analysis of small studies are needed to more precisely estimate the incidence of CAD in this population. This study also supports

Hepatitis B prevalence and incidence in Greenland

DEFF Research Database (Denmark)

Børresen, Malene Landbo; Andersson, Mikael; Wohlfahrt, Jan

2015-01-01

Greenland remains a highly endemic area for hepatitis B virus (HBV) infection. This is in sharp contrast to other modern societies, such as Denmark. To address this discrepancy, we investigated the natural history of HBV infection in Greenland by estimating the age-specific incidence of HBV...... from all available HBV registries in Greenland to determine changes in HBV status over time. Incidence rates of HBV infection and hepatitis B surface antigen seroclearance were estimated after taking into account interval censoring. The incidence of HBV infection in 5-14-year-old subjects was less than...

Precursor incident program at EDF

International Nuclear Information System (INIS)

Fourest, B.; Maliverney, B.; Rozenholc, M.; Piovesan, C.

1998-01-01

The precursor program was started by EDF in 1994, after an investigation of the US NRC's Accident Sequence Precursor Program. Since then, reported operational events identified as Safety Outstanding Events have been analyzed whenever possible using probabilistic methods based on PSAs. Analysis provides an estimate of the remaining protection against core damage at the time the incident occurred. Measuring the incidents' severity enables to detect incidents important regarding safety. Moreover, the most efficient feedback actions can be derived from the main accident sequences identified through the analysis. Therefore, incident probabilistic analysis provides a way to assess priorities in terms of treatment and resource allocation, and so, to implement countermeasures preventing further occurrence and development of the most significant incidents. As some incidents cannot be analyzed using this method, probabilistic analysis can only be one among the methods used to assess the nuclear power plants' safety level. Nevertheless, it provides an interesting complement to classical methods of deterministic studies. (author)

Proposed classification scale for radiological incidents and accidents

International Nuclear Information System (INIS)

2003-04-01

The scale proposed in this report is intended to facilitate communication concerning the severity of incidents and accidents involving the exposure of human beings to ionising radiations. Like the INES, it comprises eight levels of severity and uses the same terms (accident, incident, anomaly, serious and major) for keeping the public and the media informed. In a radiological protection context, the severity of an event is considered as being directly proportional to the risk run by an individual (the probability of developing fatal or non-fatal health effects) following exposure to ionising radiation in an incident or accident situation. However for society, other factors have to be taken into account to determine severity. The severity scale proposed is therefore based on assessment of the individual radiological risk. A severity level corresponding to exposure of a member of the public in an incident or accident situation is determined on the basis of risk assessment concepts and methods derived from international consensus on dose/effect relationships for both stochastic and deterministic effects. The severity of all the possible exposure situations - worker exposure, collective exposure, potential exposure - is determined using a system of weighting in relation to situations involving members of the public. In the case of this scale, to indicate the severity of an event, it is proposed to make use of the most penalizing level of severity, comparing: - the severity associated with the probability of occurrence of deterministic effects and the severity associated with the probability of occurrence of stochastic effects, when the event gives rise to both types of risk; - the severity for members of the public and the severity for exposed workers, when both categories of individuals are involved; - the severity on the proposed radiological protection scale and that obtained using the INES, when radiological protection and nuclear safety aspects are associated with

Effects of neurosurgical treatment and severity of head injury on cognitive functioning, general health and incidence of mental disorders in patients with traumatic brain injury.

Science.gov (United States)

Rezaei, Sajjad; Asgari, Karim; Yousefzadeh, Shahrokh; Moosavi, Heshmat-Allah; Kazemnejad, Ehsan

2012-01-01

Neurosurgical treatment and the severity of head injury (HI) can have remarkable effect on patients' neuropsychiatric outcomes. This research aimed to study the effect of these factors on cognitive functioning, general health and incidence of mental disorders in patients with a traumatic brain injury (TBI). In this descriptive, longitudinal study, 206 TBI patients entered the study by consecutive sampling; they were then compared according to neurosurgery status and severity of their HI. Both groups underwent neurosurgical and psychological examinations. The mini mental state examination (MMSE) and general health questionnaire-28 items (GHQ-28) were administered to the study participants. At follow-up, four months later, the groups underwent a structured clinical interview by a psychiatrist based on the diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV) diagnostic criteria regarding the presence of mental disorders. Analysis of covariance (ANCOVA) and multivariate analysis of covariance (MANCOVA) were performed and adjusted for the effect of confounding variables (age, gender, Glasgow outcome scale (GOS) , and level of education). The severity of HI had the most significant effect for the following variables; cognitive functioning and physical symptoms (P < 0.05). The effect of the neurosurgical treatment factor was not significant; however, the interaction effect of the two variables on social dysfunction, and total score of the GHQ-28 questionnaire appeared to be significant (P < 0.05). Fisher's exact test indicated that after a four month follow-up period, no significant differences were seen between the two groups (with or without neurosurgery) in the incidence of mental disorders, while χ(2) Test showed that having a more severe HI is significantly correlated with the incidence of mental disorders (P < 0.01). The implications of this study should be discussed with an emphasis on negative, effective factors on the cognitive

Predicting incident size from limited information

International Nuclear Information System (INIS)

Englehardt, J.D.

1995-01-01

Predicting the size of low-probability, high-consequence natural disasters, industrial accidents, and pollutant releases is often difficult due to limitations in the availability of data on rare events and future circumstances. When incident data are available, they may be difficult to fit with a lognormal distribution. Two Bayesian probability distributions for inferring future incident-size probabilities from limited, indirect, and subjective information are proposed in this paper. The distributions are derived from Pareto distributions that are shown to fit data on different incident types and are justified theoretically. The derived distributions incorporate both inherent variability and uncertainty due to information limitations. Results were analyzed to determine the amount of data needed to predict incident-size probabilities in various situations. Information requirements for incident-size prediction using the methods were low, particularly when the population distribution had a thick tail. Use of the distributions to predict accumulated oil-spill consequences was demonstrated

Incidence of and risk factors for severe maternal complications associated with hypertensive disorders after 36 weeks' gestation in uncomplicated twin pregnancies: A prospective cohort study.

Science.gov (United States)

Yamamoto, Ryo; Ishii, Keisuke; Muto, Haruka; Ota, Shiyo; Kawaguchi, Haruna; Hayashi, Shusaku; Mitsuda, Nobuaki

2018-04-19

To elucidate the incidence of and risk factors for severe hypertensive disorders (HD) and related maternal complications in uncomplicated twin pregnancies that reached 36 weeks' gestation. We conducted a prospective cohort study of twin pregnancies delivered after 36 weeks' gestation. Cases of twin-twin transfusion syndrome, twin anemia-polycythemia sequence, malformed fetuses, monoamniotic twins, selective reduction, fetal therapy and HD or fetal death before 35 weeks' gestation were excluded. The study's primary outcome was the incidence of severe maternal complications, including severe HD, eclampsia, placental abruption, HELLP (hemolysis, elevated liver enzyme and low platelet) syndrome, pulmonary edema and cerebrovascular disease. Perinatal factors associated with the primary outcome were identified using a multivariate logistic regression model. In 330 enrolled women, the number of cases with the primary outcome was 28 (8.5%; 95% confidence interval 5.9-12.0), including 25 cases of severe HD and each one case of placental abruption, HELLP syndrome and eclampsia. The rate of severe maternal complications significantly increased with gestational age, demonstrating 1.2% at 36 weeks, 3.9% at 37 weeks and 6.4% at 38 weeks. Only gestational proteinuria was identified as the independent risk factor for severe maternal complications (adjusted odds ratio 17.1 [95% confidence interval 6.71-45.4]). Severe maternal HD and related complications increased from late preterm to early term; particularly, patients with gestational proteinuria were at high risk. © 2018 Japan Society of Obstetrics and Gynecology.

Dietary Natural Products for Prevention and Treatment of Breast Cancer

OpenAIRE

Li, Ya; Li, Sha; Meng, Xiao; Gan, Ren-You; Zhang, Jiao-Jiao; Li, Hua-Bin

2017-01-01

Breast cancer is the most common cancer among females worldwide. Several epidemiological studies suggested the inverse correlation between the intake of vegetables and fruits and the incidence of breast cancer. Substantial experimental studies indicated that many dietary natural products could affect the development and progression of breast cancer, such as soy, pomegranate, mangosteen, citrus fruits, apple, grape, mango, cruciferous vegetables, ginger, garlic, black cumin, edible macro-fungi...

Detecting inpatient falls by using natural language processing of electronic medical records

Directory of Open Access Journals (Sweden)

Toyabe Shin-ichi

2012-12-01

Full Text Available Abstract Background Incident reporting is the most common method for detecting adverse events in a hospital. However, under-reporting or non-reporting and delay in submission of reports are problems that prevent early detection of serious adverse events. The aim of this study was to determine whether it is possible to promptly detect serious injuries after inpatient falls by using a natural language processing method and to determine which data source is the most suitable for this purpose. Methods We tried to detect adverse events from narrative text data of electronic medical records by using a natural language processing method. We made syntactic category decision rules to detect inpatient falls from text data in electronic medical records. We compared how often the true fall events were recorded in various sources of data including progress notes, discharge summaries, image order entries and incident reports. We applied the rules to these data sources and compared F-measures to detect falls between these data sources with reference to the results of a manual chart review. The lag time between event occurrence and data submission and the degree of injury were compared. Results We made 170 syntactic rules to detect inpatient falls by using a natural language processing method. Information on true fall events was most frequently recorded in progress notes (100%, incident reports (65.0% and image order entries (12.5%. However, F-measure to detect falls using the rules was poor when using progress notes (0.12 and discharge summaries (0.24 compared with that when using incident reports (1.00 and image order entries (0.91. Since the results suggested that incident reports and image order entries were possible data sources for prompt detection of serious falls, we focused on a comparison of falls found by incident reports and image order entries. Injury caused by falls found by image order entries was significantly more severe than falls detected by

[Diabetes care and incidence of severe hypoglycemia in nursing home facilities and nursing services: The Heidelberg Diabetes Study].

Science.gov (United States)

Bahrmann, A; Wörz, E; Specht-Leible, N; Oster, P; Bahrmann, P

2015-04-01

The goal of this study was to perform a structured analysis of the treatment quality and acute complications of geriatric patients with diabetes mellitus (DM) cared for by nursing services and nursing home facilities. Secondly, structural problems and potentials for improvement in the care of multimorbid older people with DM treated by nursing homes and nursing services were analysed from the viewpoint of geriatric nurses, managers of nursing homes and general practitioners. In all, 77 older persons with DM from 13 nursing homes and 3 nursing services were included in the analysis (76.6% female, HbA1c 6.9 ± 1.4%, age 81.6 ± 9.9 years). Structural problems and potentials for improvement were collected from 95 geriatric nurses, 9 managers of nursing homes and 6 general practitioners using semistandardized questionnaires. Metabolic control was too strict in care-dependent older people with DM (mean HbA1c value: 6.9 ± 1.4 %; recommended by guidelines: 7-8%). The measurement of HbA1c was performed in 16 of 77 people (20.8%) within the last year despite a high visitation frequency of the general practitioners (12.7 ± 7.7 within the last 6 months). The incidence of severe hypoglycemia was 7.8%/patient/year. Regarding the management in case of diabetes-related acute complications 33 geriatric nurses (34.7%) stated not having any written standard (nursing home 39%, geriatric services 16.7%). Complex insulin therapies are still used in older people with DM with the consequence of a high incidence of severe hypoglycemia. Concrete management standards in the case of diabetes-related acute complications for geriatric nurses are lacking for more than one third of the nursing services.

A review of football injuries on third and fourth generation artificial turfs compared with natural turf.

Science.gov (United States)

Williams, Sean; Hume, Patria A; Kara, Stephen

2011-11-01

Football codes (rugby union, soccer, American football) train and play matches on natural and artificial turfs. A review of injuries on different turfs was needed to inform practitioners and sporting bodies on turf-related injury mechanisms and risk factors. Therefore, the aim of this review was to compare the incidence, nature and mechanisms of injuries sustained on newer generation artificial turfs and natural turfs. Electronic databases were searched using the keywords 'artificial turf', 'natural turf', 'grass' and 'inj*'. Delimitation of 120 articles sourced to those addressing injuries in football codes and those using third and fourth generation artificial turfs or natural turfs resulted in 11 experimental papers. These 11 papers provided 20 cohorts that could be assessed using magnitude-based inferences for injury incidence rate ratio calculations pertaining to differences between surfaces. Analysis showed that 16 of the 20 cohorts showed trivial effects for overall incidence rate ratios between surfaces. There was increased risk of ankle injury playing on artificial turf in eight cohorts, with incidence rate ratios from 0.7 to 5.2. Evidence concerning risk of knee injuries on the two surfaces was inconsistent, with incidence rate ratios from 0.4 to 2.8. Two cohorts showed beneficial inferences over the 90% likelihood value for effects of artificial surface on muscle injuries for soccer players; however, there were also two harmful, four unclear and five trivial inferences across the three football codes. Inferences relating to injury severity were inconsistent, with the exception that artificial turf was very likely to have harmful effects for minor injuries in rugby union training and severe injuries in young female soccer players. No clear differences between surfaces were evident in relation to training versus match injuries. Potential mechanisms for differing injury patterns on artificial turf compared with natural turf include increased peak torque and

Incidence of a New Pest, the Cotton Mealybug Phenacoccus solenopsis Tinsley, on Sesame in North Ethiopia

Directory of Open Access Journals (Sweden)

Zenawi Gebregergis

2018-01-01

Full Text Available Sesame (Sesamum indicum is one of the most important cash crops grown extensively for its seeds in Ethiopia. Production of sesame in the country is very crucial in many aspects, but the invasion of the cotton mealybug, Phenacoccus solenopsis Tinsley, is becoming a big deal in its production. A survey for mealybug infestation was conducted during 2016 production season in 15 localities of “Kafta Humera” district so as to assess the incidence and severity of the pest. In each locality 2 sesame farms have been selected and 6 samples per farm (2 samples from the road sides, 2 from camp surrounding, and 2 from the central part of the farms have been checked. During the survey, “Bowal” and “Sherif Hamad” have scored the higher incidence and severity of mealybugs. Road sides and camp surrounding of the farms were shown to have severe infestation. Stony and oxen plowed farms were also intensively invaded with cotton mealybugs. The pest has different natural means to infest new areas; thus its control measure has to be developing timely.

Napier grass stunt disease prevalence, incidence, severity and genetic variability of the associated phytoplasma in Uganda

DEFF Research Database (Denmark)

Kawube, Geofrey; Talwana, Herbert; Nicolaisen, Mogens

2015-01-01

The prevalence, incidence and severity of Napier grass stunt disease (NGSD) caused by phytoplasma on Pennisetum purpureum, the main fodder for livestock under intensive and semi-intensive management systems in Uganda were determined following a field survey carried out in 17 districts. A total...... of 298 Napier grass fields were visited and NGSD status visually assessed and 1192 samples collected for identification and confirmation of the phytoplasma by polymerase chain reaction (PCR) assays using universal primers P1/P6 nested with R16F2n/R16R2n and, tuf primers 890/340 nested with 835 and 400....... From these, 221 PCR products were sequenced and sequences aligned. Napier grass stunt disease is widely spread at an epidemic proportion, with the districts at different risk levels. The most affected districts are in central, East and North parts of the country while those in the west are least...

Incidence of severe combined immunodeficiency through newborn screening in a Chinese population

Directory of Open Access Journals (Sweden)

Yin-Hsiu Chien

2015-01-01

Conclusion: Newborn screening to measure the number of TREC copies successfully identifies newborns with T-cell lymphopenia, 22q11.2 microdeletion syndrome, and other high-risk conditions. Taken together, the incidence of T-cell lymphopenia in apparently healthy newborns is more than 1 in 11,821, and further attention to their immune functions is warranted.

Modelling of the relation of natural disasters and the economic ...

African Journals Online (AJOL)

It is obvious that economy and production and commerce ability of the countries are also under the influence of natural changes. But when the changes and natural challenges finds a high speed or volume, they are called natural incident or natural disaster. Natural incidents, in addition to damages to life and emotion that ...

Hardware-related infections after deep brain stimulation surgery: review of incidence, severity and management in 212 single-center procedures in the first year after implantation.

Science.gov (United States)

Piacentino, Massimo; Pilleri, Manuela; Bartolomei, Luigi

2011-12-01

Device-related infection is a common occurrence after deep brain stimulation (DBS) surgery, and may result in additional interventions and a loss of efficacy of therapy. This retrospective review aimed to evaluate the incidence, severity and management of device-related infections in 212 DBS procedures performed in our institute. Data on 106 patients, in whom 212 DBS procedures were performed between 2001 and 2011 at our institute by a single neurosurgeon (M.P.), were reviewed to assess the incidence, severity, management and clinical characteristics of infections in the first year after the implantation of a DBS system. Infections occurred in 8.5% of patients and 4.2% of procedures. Of the nine infections, eight involved the neurostimulator and extensions, and one the whole system. The infections occurred 30.7 days after implantation: 7 within 30 days and 2 within 6 months. Infected and uninfected patients were comparable in terms of age, sex, indication for DBS implantation and neurostimulator location. In eight cases, the system components involved were removed and re-implanted after 3 months, while in one case the complete hardware was removed and not re-implanted. The overall incidence of postoperative infections after DBS system implantation was 4.2%; this rate decreased over time. All infections required further surgery. Correct and timely management of partial infections may result in successful salvage of part of the system.

Passive decay heat removal by natural air convection after severe accidents

Energy Technology Data Exchange (ETDEWEB)

Erbacher, F.J.; Neitzel, H.J. [Forschungszentrum Karlsruhe Institut fur Angewandte Thermo- und Fluiddynamik, Karlsruhe (Germany); Cheng, X. [Technische Universitaet Karlsruhe Institut fur Stroemungslehre und Stroemungsmaschinen, Karlsruhe (Germany)

1995-09-01

The composite containment proposed by the Research Center Karlsruhe and the Technical University Karlsruhe is to cope with severe accidents. It pursues the goal to restrict the consequences of core meltdown accidents to the reactor plant. One essential of this new containment concept is its potential to remove the decay heat by natural air convection and thermal radiation in a passive way. To investigate the coolability of such a passive cooling system and the physical phenomena involved, experimental investigations are carried out at the PASCO test facility. Additionally, numerical calculations are performed by using different codes. A satisfying agreement between experimental data and numerical results is obtained.

Consumption tax incidence: evidence from natural experiment in the Czech Republic

Czech Academy of Sciences Publication Activity Database

Zápal, Jan

2014-01-01

Roč. 8, č. 2 (2014), s. 149-166 ISSN 1802-792X Institutional support: PRVOUK-P23 Keywords : tax incidence * value added tax * difference-in-differences estimation Subject RIV: AH - Economics http://www.vsfs.cz/periodika/acta-2014-02.pdf

Consumption tax incidence: evidence from natural experiment in the Czech Republic

Czech Academy of Sciences Publication Activity Database

Zápal, Jan

2014-01-01

Roč. 8, č. 2 (2014), s. 149-166 ISSN 1802-792X Institutional support: RVO:67985998 Keywords : tax incidence * value added tax * difference-in-differences estimation Subject RIV: AH - Economics http://www.vsfs.cz/periodika/acta-2014-02.pdf

Pilot program: NRC severe reactor accident incident response training manual: Severe reactor accident overview

International Nuclear Information System (INIS)

McKenna, T.J.; Martin, J.A.; Miller, C.W.; Hively, L.M.; Sharpe, R.W.; Giitter, J.G.; Watkins, R.M.

1987-02-01

This pilot training manual has been written to fill the need for a general text on NRC response to reactor accidents. The manual is intended to be the foundation for a course for all NRC response personnel. Severe Reactor Accident Overview is the second in a series of volumes that collectively summarize the US Nuclear Regulatory Commission (NRC) emergency response during severe power reactor accidents and provide necessary background information. This volume describes elementary perspectives on severe accidents and accident assesment. Each volume serves, respectively, as the text for a course of instruction in a series of courses. Each volume is accompanied by an appendix of slides that can be used to present this material. The slides are called out in the text

Incidence and course of child malnutrition according to clinical or anthropometrical assessment: a longitudinal study from rural DR Congo

Science.gov (United States)

2014-01-01

Background Longitudinal studies describing incidence and natural course of malnutrition are scarce. Studies defining malnutrition clinically [moderate clinical malnutrition (McM) marasmus, kwashiorkor] rather than anthropometrically are rare. Our aim was to address incidence and course of malnutrition among pre-schoolers and to compare patterns and course of clinically and anthropometrically defined malnutrition. Methods Using a historical, longitudinal study from Bwamanda, DR Congo, we studied incidence of clinical versus anthropometrical malnutrition in 5 657 preschool children followed 3-monthly during 15 months. Results Incidence rates were highest in the rainy season for all indices except McM. Incidence rates of McM and marasmus tended to be higher for boys than for girls in the dry season. Malnutrition rates increased from the 0–5 to the 6 – 11 months age category. McM and marasmus had in general a higher incidence at all ages than their anthropometrical counterparts, moderate and severe wasting. Shifts back to normal nutritional status within 3 months were more frequent for clinical than for anthropometrical malnutrition (62.2-80.3% compared to 3.4-66.4.5%). Only a minority of moderately stunted (30.9%) and severely stunted children (3.4%) shifted back to normal status. Alteration from severe to mild malnutrition was more characteristic for anthropometrically than for clinically defined malnutrition. Conclusions Our data on age distribution of incidence and course of malnutrition underline the importance of early life intervention to ward off malnutrition. In principle, looking at incidence may yield different findings from those obtained by looking at prevalence, since incidence and prevalence differ approximately differ by a factor “duration”. Our findings show the occurrence dynamics of general malnutrition, demonstrating that patterns can differ according to nutritional assessment method. They suggest the importance of applying a mix of clinical

Incidence and course of child malnutrition according to clinical or anthropometrical assessment: a longitudinal study from rural DR Congo.

Science.gov (United States)

Kismul, Hallgeir; Schwinger, Catherine; Chhagan, Meera; Mapatano, Mala; Van den Broeck, Jan

2014-01-28

Longitudinal studies describing incidence and natural course of malnutrition are scarce. Studies defining malnutrition clinically [moderate clinical malnutrition (McM) marasmus, kwashiorkor] rather than anthropometrically are rare. Our aim was to address incidence and course of malnutrition among pre-schoolers and to compare patterns and course of clinically and anthropometrically defined malnutrition. Using a historical, longitudinal study from Bwamanda, DR Congo, we studied incidence of clinical versus anthropometrical malnutrition in 5,657 preschool children followed 3-monthly during 15 months. Incidence rates were highest in the rainy season for all indices except McM. Incidence rates of McM and marasmus tended to be higher for boys than for girls in the dry season. Malnutrition rates increased from the 0-5 to the 6 - 11 months age category. McM and marasmus had in general a higher incidence at all ages than their anthropometrical counterparts, moderate and severe wasting. Shifts back to normal nutritional status within 3 months were more frequent for clinical than for anthropometrical malnutrition (62.2-80.3% compared to 3.4-66.4.5%). Only a minority of moderately stunted (30.9%) and severely stunted children (3.4%) shifted back to normal status. Alteration from severe to mild malnutrition was more characteristic for anthropometrically than for clinically defined malnutrition. Our data on age distribution of incidence and course of malnutrition underline the importance of early life intervention to ward off malnutrition. In principle, looking at incidence may yield different findings from those obtained by looking at prevalence, since incidence and prevalence differ approximately differ by a factor "duration". Our findings show the occurrence dynamics of general malnutrition, demonstrating that patterns can differ according to nutritional assessment method. They suggest the importance of applying a mix of clinical and anthropometric methods for assessing

Quantifying the Impact of Natural Immunity on Rotavirus Vaccine Efficacy Estimates: A Clinical Trial in Dhaka, Bangladesh (PROVIDE) and a Simulation Study.

Science.gov (United States)

Rogawski, Elizabeth T; Platts-Mills, James A; Colgate, E Ross; Haque, Rashidul; Zaman, K; Petri, William A; Kirkpatrick, Beth D

2018-03-05

The low efficacy of rotavirus vaccines in clinical trials performed in low-resource settings may be partially explained by acquired immunity from natural exposure, especially in settings with high disease incidence. In a clinical trial of monovalent rotavirus vaccine in Bangladesh, we compared the original per-protocol efficacy estimate to efficacy derived from a recurrent events survival model in which children were considered naturally exposed and potentially immune after their first rotavirus diarrhea (RVD) episode. We then simulated trial cohorts to estimate the expected impact of prior exposure on efficacy estimates for varying rotavirus incidence rates and vaccine efficacies. Accounting for natural immunity increased the per-protocol vaccine efficacy estimate against severe RVD from 63.1% (95% confidence interval [CI], 33.0%-79.7%) to 70.2% (95% CI, 44.5%-84.0%) in the postvaccination period, and original year 2 efficacy was underestimated by 14%. The simulations demonstrated that this expected impact increases linearly with RVD incidence, will be greatest for vaccine efficacies near 50%, and can reach 20% in settings with high incidence and low efficacy. High rotavirus incidence leads to predictably lower vaccine efficacy estimates due to the acquisition of natural immunity in unvaccinated children, and this phenomenon should be considered when comparing efficacy estimates across settings. NCT01375647.

Safety and Health Standard 110: Incident/accident reporting and investigation

Energy Technology Data Exchange (ETDEWEB)

Sones, K. [West Kootenay Power, BC (Canada)

1999-10-01

Incident/accident reporting requirements in effect at West Kootenay Power are discussed. Details provided include definitions of low risk, high risk, and critical events, the incidents to be reported, the nature of the reports, the timelines, the investigation to be undertaken for each type of incident/accident, counselling services available to employees involved in serious incidents, and the procedures to be followed in accidents involving serious injury to non-employees. The emphasis is on the `critical five` high risk events and the procedures relating to them.

The incidence of hospital-treated occupational hand injuries

DEFF Research Database (Denmark)

Skov, O

1994-01-01

Previous studies have shown that young men have the highest frequency of occupational hand injuries. This study investigated their incidence and severity in relation to age and sex. For occupational hand injuries in general the estimated incidence rate was 17.1 per 1,000 person years. The incidence...... was found to be higher among men than women in all age groups below 60 years. The incidence for minor injuries declines with increasing age, but the rates for significant injuries are independent of age. The higher incidence rate for minor injuries among young patients could be real, but it could also...

Incident wave run-up into narrow sloping bays and estuaries

Science.gov (United States)

Sinan Özeren, M.; Postacioglu, Nazmi; Canlı, Umut

2015-04-01

The problem is investigated using Carrier Greenspan hodograph transformations.We perform a quasi-one-dimensional solution well into the bay, far enough of the mouth of the bay. The linearized boundary conditions at the mouth of the bay lead to an integral equation for 2-D geometry. A semi analytical optimization method has been developed to solve this integral equation. When the wavelength of the incident wave is much larger than the width of the bay, the conformalmapping of the bay and the semi infinite sea onto upper complex plane provides a solution of the integral equation in closed form. Particular emphasis is placed on the case where the frequency of the incident waves matches the real-part of the natural frequency of the oscillation of the bay. These natural frequencies are complex because of the radiation conditions imposed at the mouth of the bay. It is found that the complex part of these natural frequencies decreases with decreasing width of the bay. Thus the trapping of the waves in narrower bays leads to a strong resonance phenomenon when the frequency of the incident wave is equal to the real part of the natural frequency.

The incidence and severity of errors in pharmacist-written discharge medication orders

OpenAIRE

Onatade, Raliat; Sawieres, Sara; Veck, Alexandra; Smith, Lindsay; Gore, Shivani; Al-Azeib, Sumiah

2017-01-01

Background Errors in discharge prescriptions are problematic. When hospital pharmacists write discharge prescriptions improvements are seen in the quality and efficiency of discharge. There is limited information on the incidence of errors in pharmacists’ medication orders. Objective To investigate the extent and clinical significance of errors in pharmacist-written discharge medication orders. Setting 1000-bed teaching hospital in London, UK. Method Pharmacists in this London hospital routin...

Incidence, causes, severity and treatment of throat discomfort: a four-region online questionnaire survey.

Science.gov (United States)

Addey, Dilys; Shephard, Adrian

2012-08-10

Acute sore throat is commonly associated with viral infections. Consumers typically rely on over-the-counter treatments and other remedies to treat symptoms; however, limited information is available regarding consumer perceptions of sore throat or treatment needs. The aim of this study was to investigate perceptions of throat discomfort and how these influence attitudes and consumer behaviour with regard to treatment. Online consumer surveys were completed by participants invited by email between 2003 and 2004 in four markets: the UK, France, Poland, and Malaysia. The questionnaire consisted of 24 questions that covered key issues surrounding throat discomfort including incidence in the past 12 months, causes, severity, effects on functionality and quality of life, actions taken to relieve throat discomfort, the efficacy of these approaches and the reasons behind using specific products. In total, 6465 men and women aged ≥18 years were surveyed, identifying 3514 participants who had suffered throat discomfort/irritation in the past 12 months (response rate of 54%). These participants completed the full survey. The breakdown of throat discomfort sufferers was: UK, 912; France, 899; Poland, 871; Malaysia, 832. A high proportion of respondents experienced one or more instances of throat discomfort in the previous 12 months, with an overall incidence of 54%. Infections including the common cold/influenza and other bacteria/viruses were commonly perceived causes of throat discomfort (72% and 46%, respectively). Physical and environmental factors were also perceived to be causative, including airborne pollution (28%), smoking (23%), and air conditioning (31%). Symptoms perceived to be caused by an infection were associated with a higher degree of suffering (mean degree of suffering for bacteria/virus and common cold/influenza; 3.4 and 3.0, respectively). Medicinal products were used for all perceived causes, but more commonly for sore throats thought to be caused by

Incidence, causes, severity and treatment of throat discomfort: a four-region online questionnaire survey

Directory of Open Access Journals (Sweden)

Addey Dilys

2012-08-01

Full Text Available Abstract Background Acute sore throat is commonly associated with viral infections. Consumers typically rely on over-the-counter treatments and other remedies to treat symptoms; however, limited information is available regarding consumer perceptions of sore throat or treatment needs. The aim of this study was to investigate perceptions of throat discomfort and how these influence attitudes and consumer behaviour with regard to treatment. Methods Online consumer surveys were completed by participants invited by email between 2003 and 2004 in four markets: the UK, France, Poland, and Malaysia. The questionnaire consisted of 24 questions that covered key issues surrounding throat discomfort including incidence in the past 12 months, causes, severity, effects on functionality and quality of life, actions taken to relieve throat discomfort, the efficacy of these approaches and the reasons behind using specific products. Results In total, 6465 men and women aged ≥18 years were surveyed, identifying 3514 participants who had suffered throat discomfort/irritation in the past 12 months (response rate of 54%. These participants completed the full survey. The breakdown of throat discomfort sufferers was: UK, 912; France, 899; Poland, 871; Malaysia, 832. A high proportion of respondents experienced one or more instances of throat discomfort in the previous 12 months, with an overall incidence of 54%. Infections including the common cold/influenza and other bacteria/viruses were commonly perceived causes of throat discomfort (72% and 46%, respectively. Physical and environmental factors were also perceived to be causative, including airborne pollution (28%, smoking (23%, and air conditioning (31%. Symptoms perceived to be caused by an infection were associated with a higher degree of suffering (mean degree of suffering for bacteria/virus and common cold/influenza; 3.4 and 3.0, respectively. Medicinal products were used for all perceived causes, but more

Application Study of Fire Severity Classification

International Nuclear Information System (INIS)

Kim, In Hwan; Kim, Hyeong Taek; Jee, Moon Hak; Kim, Yun Jung

2013-01-01

This paper introduces the Fire Incidents Severity Classification Method for Korean NPPs that may be derived directly from the data fields and feasibility study for domestic uses. FEDB was characterized in more detail and assessed based on the significance of fire incidents in the updated database and five fire severity categories were defined. The logical approach to determine the fire severity starts from the most severe characteristics, namely challenging fires, and continues to define the less challenging and undetermined categories in progress. If the FEDB is utilized for Korean NPPs, the ways of Fire Severity Classification suggested in 2.4 above can be utilized for the quantitative fire risk analysis in future. The Fire Events Database (FEDB) is the primary source of fire data which are used for fire frequency in Fire PSA (Probabilistic Safety Assessment). The purpose of its development is to calculate the quantitative fire frequency at the comprehensive and consolidated source derived from the fire incident information available for Nuclear Power Plants (NPPs). Recently, the Fire Events Database (FEDB) was updated by Electric Power Research Institute (EPRI) and Nuclear Regulatory Commission (NRC) in U. S. The FEDB is intended to update the fire event history up to 2009. A significant enhancement to it is the reorganization and refinement of the database structure and data fields. It has been expanded and improved data fields, coding consistency, incident detail, data review fields, and reference data source traceability. It has been designed to better support several Fire PRA uses as well

Incidence and severity of gingival invaginations associated with early versus late initiation of orthodontic space closure after tooth extraction : A multicenter pilot and randomized controlled trial.

Science.gov (United States)

Reichert, Christoph; Kutschera, Eric; Plötz, Christina; Scharf, Sven; Gölz, Lina; Fimmers, Rolf; Fuhrmann, Christine; Wahl, Gerhard; Braumann, Bert; Jäger, Andreas

2017-09-01

Gingival invaginations are a common side effect of orthodontic extraction-space closure. The timing of initiating the closure of an extraction space varies greatly in clinical practice. In this multicenter pilot and randomized controlled trial, we prospectively investigated whether initiating space closure in the early stage of wound healing would benefit the incidence and severity of invaginations developing in the extraction sites. A total of 368 patients were screened for indications to extract at least one mandibular premolar. Those recruited were randomly assigned to one of two treatment arms: initiation of space closure either 2-4 weeks (arm A) or ≥12 weeks (arm B) after tooth extraction. Clinical data regarding treatment process and periodontal tissue response were recorded during and after space closure and analyzed by a specialized biometrics unit. The study was performed under continuous surveillance by an independent study control center. A total of 74 extraction sites were analyzed. Regarding the incidence of gingival invaginations, there were no significant intergroup differences [p = 0.13; group A comprising 37/44 (84.1%) and group B 29/30 (96.7%) invaginated sites]. The same was true based on either maxillary (p = 0.52) or mandibular (p = 0.21) sites only, and the severity of the invaginations did not differ between the treatment arms. As to the incidence and severity of gingival invaginations, we did not notice any statistically significant differences between the two timeframes. Our data do, however, provide a basis to identify additional confounders and to improve the accuracy of case-load estimations for future trials.

Prevention and treatment of traumatic brain injury due to rapid-onset natural disasters

Directory of Open Access Journals (Sweden)

James L. Regens

2014-04-01

Full Text Available The prevention and treatment of traumatic brain injury (TBI attributable to rapid-onset natural disasters is a major challenge confronting disaster preparedness planners and emergency medical personnel responding to those incidents. The kinetic energy released by rapid-onset natural disasters such as earthquakes, hurricanes or typhoons, and tornadoes can cause mild, moderate or severe TBIs. As a result, neurotrauma is a major risk factor for mortality and morbidity outcomes within the spatial domain impacted by a rapid-onset natural disaster. This review article elucidates major challenges associated with immediate emergency medical response, long-term care, and prevention of post-event increases in pediatric TBIs because of child abuse when rapid-onset natural disasters occur.

Natural course and predictors of severe disability and death in Thai patients with dementia.

Science.gov (United States)

Dharmasaroja, Pornpatr A; Lolekha, Praween; Kulkantrakorn, Kongkiat; Charernboon, Thammanard; Watcharakorn, Arvemas; Piyabhan, Pritsana

2017-12-01

More than half of patients with dementia lived in countries with low and middle incomes. However, there have been few studies on the natural course of disease in these countries. The purpose of this study was to study the natural course and the predictive factors of advanced stage and death in Thai patients with dementia. Patients with dementia who were treated in neurologic and psychiatric clinic from September 2004 to February 2016, were included. Data about natural course of diseases, behavioral and psychological symptoms in dementia (BPSD) and complications were studied. 207 patients were included. Mean age was 77years old. Mean Thai Mental State Examination (TMSE) was 17.5. Alzheimer's disease was the most common cause of dementia (55%). With the mean follow-up of 39months (range from 2 to 126months), 64% of the patients had BPSD. Sixty-two patients (30%) had complications required admission. Seven patients died. Fifty-four patients (29%) ended in the advanced stage of dementia. Mean duration from diagnosis to the advanced stage was 49months. Complications that required admission usually occurred in moderate to severe dementia and were strongly associated with the advanced stage or death (OR 6.1, 95%CI 2.57-14.49, p-valuedementia in the study. Most demented patients presented in moderate severity of dementia. Mean duration from diagnosis to the advanced stage of dementia was approximate 4-5years. Complications required admissions related to the progression to advanced stage or death. Copyright © 2017 Elsevier Ltd. All rights reserved.

Parameters affecting of Akkuyu's safety assessment for severe core damages

Science.gov (United States)

Kavun, Yusuf; Karasulu, Muzaffer

2015-07-01

We have looked at all past core meltdowns (Three Mile Island, Chernobyl and Fukushima incidents) and postulated the fourth one might be taking place in the future most probably in a newly built reactors anywhere of the earth in any type of NPP. The probability of this observation is high considering the nature of the machine and human interaction. Operation experience is a very significant parameter as well as the safety culture of the host nation. The concerns is not just a lack of experience with industry with the new comers, but also the infrastructure and established institutions who will be dealing with the Emergencies. Lack of trained and educated Emergency Response Organizations (ERO) is a major concern. The culture on simple fire drills even makes the difference when a severe condition occurs in the industry. The study assumes the fourth event will be taking place at the Akkuyu NGS and works backwards as required by the "what went wrong " scenarios and comes up with interesting results. The differences studied in depth to determine the impact to the severe accidents. The all four design have now core catchers. We have looked at the operator errors'like in TMI); Operator errors combined with design deficiencies(like in Chernobyl) and natural disasters( like in Fukushima) and found operator errors to be more probable event on the Akkuyu's postulated next incident. With respect to experiences of the operators we do not have any data except for long and successful operating history of the Soviet design reactors up until the Chernobyl incident. Since the Akkuyu will be built, own and operated by the Russians we have found no alarming concerns at the moment. At the moment, there is no body be able to operate those units in Turkey. Turkey is planning to build the required manpower during the transition period. The resolution of the observed parameters lies to work and educate, train of the host nation and exercise together.

Incidence and outcomes of bulimia nervosa : a nationwide population-based study

NARCIS (Netherlands)

Keski-Rahkonen, A.; Hoek, H. W.; Linna, M. S.; Raevuori, A.; Sihvola, E.; Bulik, C. M.; Rissanen, A.; Kaprio, J.

Background. Little is known about the epidemiology of bulimia nervosa outside clinical settings. We report the incidence, prevalence and outcomes of bulimia nervosa using for the first time a nationwide Study design. Method. To assess the incidence and natural course and outcomes of DSM-IV bulimia

Natural Disasters under the Form of Severe Storms in Europe: the Cause-Effect Analysis

Directory of Open Access Journals (Sweden)

Virginia Câmpeanu

2009-07-01

Full Text Available For more than 100 years, from 1900 to 2008, there were almost 400 storms natural disasters in Europe, 40% of which occurred in the 1990s. The international prognoses for the world weather suggest a tendency toward increasing in frequency and intensity of the severe storms as the climate warms. In these circumstances, for a researcher in the field of Environmental Economics, a natural question occurs, on whether people can contribute to reducing the frequency and the magnitude of severe storms that produce disastreous social and economic effects, by acting on their causes. In researching an answer to support the public policies in the field, a cause-effect analysis applied to Europe might make a contribution to the literature in the field. This especially considering the fact that international literature regarding the factors influencing global warming contains certainties in regard to the natural factors of influence, but declared incertitudes or skepticism in regard to anthropogenic ones. Skepticism, and even tension arised during the international negotiations in Copenhagen (December 2009 in regard to the agreement for limiting global warming, with doubts being raised about the methods used by experts of the International Climate Experts Group (GIEC, and thus the results obtained, which served as a basis for the negotiations. The object of critics was in regard to the form, and at times in regard to the content. It was not about contesting the phenomenon of Global warming during the negotiations, but the methods of calculation. The methodology relies on qualitative (type top down and quantitative (type correlations bottom up cause-effect analysis of the storm disasters in Europe. Based on the instruments used, we proposed a dynamic model of association of the evolution of storm disasters in Europe with anthropogenic factors, with 3 variants. Results: The diagram cause-effect (Ishikawa or fishbone diagram and quantitative correlation of sub

Shoulder injuries in rugby: Report of its incidence and severity in a group of Portuguese male players during a season

Directory of Open Access Journals (Sweden)

E. Cruz-Ferreira

2018-04-01

Full Text Available Objective: Rugby union is a fast growing sport all over the world, due to its nature as a contact sport it is frequent for players to sustain injuries, more specifically on the shoulder joint, were the injuries occur with greater severity. Method: The authors present a cohort prospective study focusing on the incidence and severity of shoulder injuries in a population of 51 male of top-tier Portuguese Rugby Union players aiming, to characterize relevant epidemiological aspects, conducted between September 2013 and May 2014. All data was collected and recorded according to the consensus statement for epidemiological studies in Rugby Union. Results: A total injury incidence rate of 23.68 per 1000 player match-hours was found with a mean severity of injuries of 34.22, a value higher than expected when comparing with previous studies. New and recurrent injuries occurred in a 7:2 ratio. Reported mean severity of 41.57 days in new injuries versus 8.50 days. Conclusion: The proportion of recurrent injuries alerts us for the importance of preventing measures. Poor physical condition of the players seems to have contributed to the increased number of shoulder injuries of our target population. Specific training programs to improve muscle strength and directed training to improve correct technical aspects of the tackling engagement during the fatigue periods of the game could be very important in the prevention of shoulder injuries. Resumen: Objetivo: El rugby es un deporte de rápido crecimiento en todo el mundo, debido a su naturaleza, tratándose de un deporte de contacto es frecuente que los jugadores sufran lesiones, más específicamente en la articulación del hombro, donde las lesiones suceden con mayor severidad. Método: Los autores presentan un estudio de cohorte prospectivo centrado en la incidencia y la gravedad de las lesiones de hombro en una población de 51 jugadores de primer nivel de Rugby de la liga portuguesa, caracterizando aspectos

Prevalence, severity, and natural history of jack jumper ant venom allergy in Tasmania.

Science.gov (United States)

Brown, Simon G A; Franks, Rodney W; Baldo, Brian A; Heddle, Robert J

2003-01-01

The jack jumper ant (Myrmecia pilosula) is responsible for greater than 90% of Australian ant venom allergy. However, deaths have only been recorded in the island of Tasmania. We sought to determine the prevalence, clinical features, natural history, and predictors of severity of M pilosula sting allergy in Tasmania. We performed a random telephone survey supported by serum venom-specific IgE analysis, review of emergency department presentations, and follow-up of allergic volunteers. M pilosula, honeybee (Apis mellifera), and yellow jacket wasp (Vespula germanica) sting allergy prevalences were 2.7%, 1.4%, and 0.6% compared with annual sting exposure rates of 12%, 7%, and 2%, respectively. Similarly, emergency department presentations with anaphylaxis to M pilosula were double those for honeybee. M pilosula allergy prevalence increased with age of 35 years or greater (odds ratio [OR], 2.4) and bee sting allergy (OR, 16.9). Patients 35 years of age or older had a greater risk of hypotensive reactions (OR, 2.9). Mueller reaction grades correlated well with adrenaline use. During follow-up, 79 (70%) of 113 jack jumper stings caused anaphylaxis. Prior worst reaction severity predicted the likelihood and severity of follow-up reactions; only 3 subjects had more severe reactions. Venom-specific IgE levels and other clinical features, including comorbidities, were not predictive of severity. Sting allergy prevalence is determined by age and exposure rate. M pilosula sting exposure in Tasmania is excessive compared with that found in mainland Australia, and there is a high systemic reaction risk in allergic people on re-sting. Prior worst reaction severity (Mueller grade) and age predict reaction severity and might be used to guide management.

Epidemiology and incidence of acute and chronic Post-Surgical pain.

Science.gov (United States)

Sansone, Pasquale; Pace, Maria Caterina; Passavanti, Maria Beatrice; Pota, Vincenzo; Colella, Umberto; Aurilio, Caterina

2015-01-01

Post Surgical Pain (PSP) treatment represents a significant aspect of management of surgical patients. Incidence of severe PSP, with significant functional deficit is estimated at 5-10%. Most studies include a limited number of patients and this is a factor which affects power of results. Aims of our prospective observational study was to evaluate the incidence and characteristics of acute and chronic PSP in patients undergoing surgery at the university hospital of second university of naples. After Ethics Committee approval and written informed consent, the PSP acute on first day (at least 6 hours after surgery) through the International Pain Outcomes questionnaire was rated. Subsequently, patients were followed-up at 6 and 12 months; data collection took place by e-mail or phone and the Brief Pain Inventory and the DN4 were administered. We enrolled 235 patients, 219 performed the follow-up to 6months, 195 even that to 12 The incidence of CPSP at 6 months was of 45.2% for mild pain, 15.9% for moderate pain and of 2.7% for severe pain while the incidence of CPSP at 12 months was 35.9%, 11.8% and 2.5% respectively for the pain mild, moderate and severe. Neuropathic pain occurred in 40.3% of patients who CPSP moderate at 12 months compared with 31.9% of the patients interviewed at 6 months. Incidence and characteristics of PSP varied, often considerably, depending on the type of surgery, gender, age of the patient and the presence of PSP severe in the 24 hours following surgery. The incidence of CPSP 12 months after surgery must be improved in the next future. Preoperative pain and the percentage of time with severe pain during the first 24 hours after surgery seem to be CPSP predictors.

Updated estimates of the proportion of childhood leukaemia incidence in Great Britain that may be caused by natural background ionising radiation

International Nuclear Information System (INIS)

Little, Mark P; Wakeford, Richard; Kendall, Gerald M

2009-01-01

The aetiology of childhood leukaemia remains generally unknown, although exposure to moderate and high levels of ionising radiation, such as was experienced during the atomic bombings of Japan or from radiotherapy, is an established cause. Risk models based primarily upon studies of the Japanese A-bomb survivors imply that low-level exposure to ionising radiation, including to ubiquitous natural background radiation, also raises the risk of childhood leukaemia. In a recent paper (Wakeford et al 2009 Leukaemia 23 770-6) we estimated the proportion of childhood leukaemia incidence in Great Britain attributable to natural background radiation to be about 20%. In this paper we employ the two sets of published leukaemia risk models used previously, but use recently published revised estimates of natural background radiation doses received by the red bone marrow of British children to update the previous results. Using the newer dosimetry we calculate that the best estimate of the proportion of cases of childhood leukaemia in Great Britain predicted to be attributable to this source of exposure is 15-20%, although the uncertainty associated with certain stages in the calculation (e.g. the nature of the transfer of risk between populations and the pertinent dose received from naturally occurring alpha-particle-emitting radionuclides) is significant. The slightly lower attributable proportions compared with those previously derived by Wakeford et al (Leukaemia 2009 23 770-6) are largely due to the lower doses (and in particular lower high LET doses) for the first year of life.

Effect of weight loss on the severity of psoriasis

DEFF Research Database (Denmark)

Jensen, P; Zachariae, Claus; Christensen, R

2013-01-01

Psoriasis is associated with adiposity and weight gain increases the severity of psoriasis and the risk of incident psoriasis. Therefore, we aimed to measure the effect of weight reduction on the severity of psoriasis in obese patients with psoriasis.......Psoriasis is associated with adiposity and weight gain increases the severity of psoriasis and the risk of incident psoriasis. Therefore, we aimed to measure the effect of weight reduction on the severity of psoriasis in obese patients with psoriasis....

Grazing Incidence X-ray Scattering and Diffraction

Indian Academy of Sciences (India)

IAS Admin

several materials as a function of angle of incidence, αi with X-rays of wavelength ..... are several advantages of using this formulation for the description of surface ..... print of the surface (as shown at the botton of Figure. 5). A Soller collimator ...

Alcohol-use disorder severity predicts first-incidence of depressive disorders

NARCIS (Netherlands)

Boschloo, L.; van den Brink, W.; Penninx, B.W.J.H.; Wall, M.M.; Hasin, D.S.

2012-01-01

Background Previous studies suggest that alcohol-use disorder severity, defined by the number of criteria met, provides a more informative phenotype than dichotomized DSM-IV diagnostic measures of alcohol use disorders. Therefore, this study examined whether alcohol-use disorder severity predicted

Alcohol-use disorder severity predicts first-incidence of depressive disorders

NARCIS (Netherlands)

Boschloo, L.; van den Brink, W.; Penninx, B. W. J. H.; Wall, M. M.; Hasin, D. S.

2012-01-01

Background. Previous studies suggest that alcohol-use disorder severity, defined by the number of criteria met, provides a more informative phenotype than dichotomized DSM-IV diagnostic measures of alcohol use disorders. Therefore, this study examined whether alcohol-use disorder severity predicted

Natural gas jet flames. Topical report, January 1994-August 1995

Energy Technology Data Exchange (ETDEWEB)

Atallah, S.; Saxena, S.K.

1995-08-15

Several incidents have been reported where high pressure natural gas transmission pipelines were ruptured and the escaping gas jet ignited. It was desired to estimate the length of the ensuing jet flame. Data on large scale jet fires were collected from accidents investigated by the National Transportation Safety Board, large-scale experiments on natural gas and LPG and from observations made during the Kuwaiti oil well fires. Analytical models which predict the size of jet flames were assembled and each model was evaluated against these data. A theoretical model developed by Kalghatgi at Shell, which most closely predicted the collected data, was selected and programmed for use on a PC. In addition, a simple empirical correlation similar to API`s flare correlation was developed by the authors for application to natural gas jet flames.

The Association Between Pitch Conditions and the Incidence of ...

African Journals Online (AJOL)

shown to influence incidence of rugby injuries. Harsh weather conditions and detrimental effect on poor Kenyan rugby pitches create a unique environment for injury exposure. We conducted a whole population prospective cohort study to determine the association of pitch conditions with injury incidence and severity.

Extended incident-angle dependence formula of sputter yield

International Nuclear Information System (INIS)

Ono, T.; Shibata, K.; Muramoto, T.; Kenmotsu, T.; Li Z.; Kawamura, T.

2006-06-01

We extend a new semi-empirical formula for incident-angle dependence of normalized sputter yield that includes the contribution to sputter yield from the direct knock-out process that was not considered in the previously proposed one. Three parameters included in the new one are estimated for data calculated with ACAT code for D + ions incident obliquely on C, Fe and W materials in incident-energy regions from several tens of eV to 10 keV. Then, the parameters are expressed with functions of incident energy. The formula with the functions derived well reproduces that using the ACAT data in the whole energy range. (author)

Incidence of traumatic carotid and vertebral artery dissections: results of cervical vessel computed tomography angiogram as a mandatory scan component in severely injured patients

Directory of Open Access Journals (Sweden)

Schicho A

2018-01-01

Full Text Available Andreas Schicho,1 Lukas Luerken,1 Ramona Meier,1 Antonio Ernstberger,2 Christian Stroszczynski,1 Andreas Schreyer,1 Lena-Marie Dendl,1 Stephan Schleder1 1Department of Radiology, 2Department of Trauma Surgery, University Medical Center, Regensburg, Germany Purpose: The aim of this study was to evaluate the true incidence of cervical artery dissections (CeADs in trauma patients with an Injury Severity Score (ISS of ≥16, since head-and-neck computed tomography angiogram (CTA is not a compulsory component of whole-body trauma computed tomography (CT protocols. Patients and methods: A total of 230 consecutive trauma patients with an ISS of ≥16 admitted to our Level I trauma center during a 24-month period were prospectively included. Standardized whole-body CT in a 256-detector row scanner included a head-and-neck CTA. Incidence, mortality, patient and trauma characteristics, and concomitant injuries were recorded and analyzed retrospectively in patients with carotid artery dissection (CAD and vertebral artery dissection (VAD. Results: Of the 230 patients included, 6.5% had a CeAD, 5.2% had a CAD, and 1.7% had a VAD. One patient had both CAD and VAD. For both, CAD and VAD, mortality is 25%. One death was caused by fatal cerebral ischemia due to high-grade CAD. A total of 41.6% of the patients with traumatic CAD and 25% of the patients with VAD had neurological sequelae. Conclusion: Mandatory head-and-neck CTA yields higher CeAD incidence than reported before. We highly recommend the compulsory inclusion of a head-and-neck CTA to whole-body CT routines for severely injured patients. Keywords: polytrauma, carotid artery, vertebral artery, dissection, blunt trauma, computed tomography angiogram

Incidence and severity of head and neck injuries in victims of road traffic crashes: In an economically developed country.

Science.gov (United States)

Bener, Abdulbari; Rahman, Yassir S Abdul; Mitra, Biswadev

2009-01-01

Head and neck injuries following the road traffic crashes (RTCs) are the most common cause of morbidity and mortality in most developed and developing countries and may also result in temporary or permanent disability. The aim of this study was to determine the incidence pattern of head and neck injuries, investigate its trend and identify the severity of injuries involved with road traffic crashes (RTCs) during the period 2001-2006. This is a retrospective descriptive hospital based study. The patients with head and neck injuries were seen and treated in the Accident and Emergency Department of the Hamad General Hospital and other Trauma Centers of the Hamad Medical Corporation following the road traffic crashes during the period 2001-2006. This study is a retrospective analysis of 6709 patients attended and treated at the Accident and Emergency and Trauma centers for head and neck injuries over a 6 year period. Head and neck injuries were determined according to the ICD 10 criteria. Of these, 3013 drivers, 2502 passengers, 704 pedestrians and 490 two wheel riders (motor bike and cyclists). Details of all the road traffic crash patients were compiled in the database of the Emergency Medical Services (EMS), and the data of patients with head and neck injuries were extracted from this database. A total of 6709 patients with head and neck injuries was reported during the study period. Majority of the victims were non-Qataris (68.7%), men (85.9%) and in the age group 20-44 years (68.5%). There were statistical significant differences in relation to age, nationality, gender, and accident during week ends for head and neck injuries (pQatar from road traffic crashes. The incidence of head and neck injuries is still very high in Qatar, but the severity of injury was mild in most of the victims. The findings of the study highlighted the need for taking urgent steps for safety of people especially drivers and passengers.

Serum 25(OH)D and incident type 2 diabetes

DEFF Research Database (Denmark)

Husemoen, L L N; Skaaby, T; Thuesen, B H

2012-01-01

Mild to moderate vitamin D insufficiency has been proposed as a risk factor for several common chronic diseases including type 2 diabetes. This study aimed to examine the association between serum 25-hydroxy vitamin D (25(OH)D) and incident diabetes.......Mild to moderate vitamin D insufficiency has been proposed as a risk factor for several common chronic diseases including type 2 diabetes. This study aimed to examine the association between serum 25-hydroxy vitamin D (25(OH)D) and incident diabetes....

Comparative assessment of severe accident risks in the coal, oil and natural gas chains

International Nuclear Information System (INIS)

Burgherr, Peter; Eckle, Petrissa; Hirschberg, Stefan

2012-01-01

This study compared severe accident risks of fossil energy chains (coal, oil and natural gas), based on the historical experience contained in the comprehensive database ENSAD. Considered risk indicators focused on human health impacts, i.e., fatality rates and maximum consequences were calculated for a broad range of country groups. Generally, expected fatality rates were lowest for natural gas, intermediate for oil and highest for coal. Concerning maximum consequences of a single accident, natural gas also performed best, followed by coal, whereas accidents in the oil chain can claim significantly more fatalities. In general, OECD and EU 27 ranked top, while non-OECD countries and China in the case of coal were worst. The consideration of numerous additional country groups enabled a more detailed differentiation within the main bounding groups. Furthermore, differences among country groups are distinctly decreasing from coal to oil and natural gas, both for fatality rates and maximum consequences. The use of import adjusted-fatality rates indicates that fatality risks in supply countries are an essential aspect to understand how specific risk reduction strategies may affect other components of energy security, and thus tradeoffs and compromises are necessary. Finally, the proposed fatality risk score for fossil chains (FRS F ) allows a comparison of the combined accident risk for the considered fossil energy chains across individual countries, which can be visualized using risk mapping.

Parameters affecting of Akkuyu’s safety assessment for severe core damages

Directory of Open Access Journals (Sweden)

Kavun Yusuf

2015-01-01

Full Text Available We have looked at all past core meltdowns (Three Mile Island, Chernobyl and Fukushima incidents and postulated the fourth one might be taking place in the future most probably in a newly built reactors anywhere of the earth in any type of NPP. The probability of this observation is high considering the nature of the machine and human interaction. Operation experience is a very significant parameter as well as the safety culture of the host nation. The concerns is not just a lack of experience with industry with the new comers, but also the infrastructure and established institutions who will be dealing with the Emergencies. Lack of trained and educated Emergency Response Organizations (ERO is a major concern. The culture on simple fire drills even makes the difference when a severe condition occurs in the industry. The study assumes the fourth event will be taking place at the Akkuyu NGS and works backwards as required by the “what went wrong ” scenarios and comes up with interesting results. The differences studied in depth to determine the impact to the severe accidents. The all four design have now core catchers. We have looked at the operator errors’like in TMI; Operator errors combined with design deficiencies(like in Chernobyl and natural disasters( like in Fukushima and found operator errors to be more probable event on the Akkuyu’s postulated next incident. With respect to experiences of the operators we do not have any data except for long and successful operating history of the Soviet design reactors up until the Chernobyl incident. Since the Akkuyu will be built, own and operated by the Russians we have found no alarming concerns at the moment. At the moment, there is no body be able to operate those units in Turkey. Turkey is planning to build the required manpower during the transition period. The resolution of the observed parameters lies to work and educate, train of the host nation and exercise together.

Natural Ventilation Driven by Wind and Temperature Difference

DEFF Research Database (Denmark)

Larsen, Tine Steen

Natural ventilation is a commonly used principle when buildings are being ventilated. It can be controlled by openings in the building envelope, which open or close depending on the need of air inside the building. It can also be the simple action of just opening a door or a window to let the fresh...... driving forces are still wind pressure and temperature differences as with cross-ventilation, but here the turbulence in the wind and the pulsating flow near the opening also affect the flow through the opening. From earlier work, some design expressions already exist, but none of these include...... the incidence angle of the wind, which is an important parameter in this type of ventilation. Several wind tunnel experiments are made and from the results of these, a new design expression is made which includes the wind pressure, temperature difference, incidence angle of the wind and the fluctuations...

Baseline incidence and severity of renal insufficiency evaluated by estimated glomerular filtration rates in patients scheduled for contrast-enhanced CT

International Nuclear Information System (INIS)

Utsunomiya, Daisuke; Yanaga, Yumi; Oda, Seitaro; Namimoto, Tomohiro; Yamashita, Yasuyuki; Awai, Kazuo; Funama, Yoshinori

2011-01-01

Background Although pre-existing renal insufficiency (RI) is the most important risk factor for contrast-induced nephropathy (CIN), the background distribution of baseline renal function has not been investigated thoroughly in patients scheduled for contrast-enhanced CT. Purpose To investigate the incidence and severity of baseline RI evaluated by estimated glomerular filtration rates (eGFR) in patients who underwent contrast-enhanced CT at an academic center. Material and Methods A total of 6586 patients (3630 men and 2956 women; mean age 57.0 ± 11.9 years) who underwent contrast-enhanced CT between January and December 2008 were retrospectively studied. Of these, 829 had cardiovascular diseases (CVD), 5116 had oncologic diseases, 178 had diabetes mellitus (DM), and 1572 had chronic liver disease (CLD). The eGFR (mL/min/1.73 m 2 ) was calculated from their serum creatinine level. Mild, moderate-a, moderate-b, and severe RI were recorded at 60 2 at baseline was high in patients with advanced age, CVD and DM and in patients without oncologic disease

The association between childhood sexual and physical abuse with incident adult severe obesity across 13 years of the National Longitudinal Study of Adolescent Health

Science.gov (United States)

Richardson, Andrea S.; Dietz, William H.; Gordon-Larsen, Penny

2013-01-01

Background Severe obesity has increased yet childhood antecedents of adult severe obesity are not well understood. Objective Estimate adult-onset severe obesity risk in individuals with history of childhood physical and/or sexual abuse compared to those who did not report abuse. Methods Longitudinal analysis of participants from the U.S. National Longitudinal Study of Adolescent Health (N=10,774) Wave II (1996; aged 12–22 years) followed through Wave IV (2008–09; aged 24–34 years). New cases of adult-onset severe obesity (BMI≥40 kg/m2 using measured height and weight) in individuals followed over 13 years who were not severely obese during adolescence (BMI childhood was associated with an increased risk of incident severe obesity in adulthood in non-minority females (Hazard Ratio=2.5; 1.3, 4.8) and males (Hazard Ratio=3.6; 1.5, 8.5) compared to individuals with no history of abuse. Conclusion In addition to other social and emotional risks, exposure to sexual and physical abuse during childhood may increase risk of severe obesity later in life. Consideration of the confluence of childhood abuse might be considered as part of preventive and therapeutic approaches to address severe obesity. PMID:24115589

The incidence of severe hypoglycaemia in pregnant women with type 1 diabetes mellitus can be reduced with unchanged HbA1c levels and pregnancy outcomes in a routine care setting

DEFF Research Database (Denmark)

Ringholm, Lene; Secher, A L; Pedersen-Bjergaard, U

2013-01-01

To investigate whether the incidence of severe hypoglycaemia in pregnant women with type 1 diabetes can be reduced without deteriorating HbA1c levels or pregnancy outcomes in a routine care setting....

The effect of crop protection strategy on pest and beneficials incidence in protected crops.

Science.gov (United States)

Lourenço, I; Rodrigues, S; Figueiredo, E; Godinho, M C; Marques, C; Amaro, F; Mexia, A

2002-01-01

This study took place in the Oeste region from 1996-1999 and it intended to analyse if the crop protection strategy followed by the farmer influenced the arthropod incidence and the natural control in protected vegetable crops under Mediterranean conditions. The observations were made fortnightly (Autumn/Winter) or weekly (Spring/Summer) in 30-60 plants/parcel (1 plant/35 m2) in order to evaluate incidences. Samples of pests and natural enemies were collected for systematic identification in two greenhouses for each protection strategy (traditional chemical control (TCC), integrated pest management (IPM) and pest control allowed in organic farming (OF)) in lettuce, tomato, green beans and cucumber. Data on incidence of mites, aphids, caterpillars, leafminers, whiteflies, thrips and respective natural enemies were registered as well as phytosanitary treatments performed (farmers' information and/or in loco traces). The leafminers were the pest whose incidence more often presented significant statistical differences between the studied protection strategies. In relation to this pest, the main results obtained were: a higher feeding punctures incidence in TCC than in IPM; higher incidence of adults, mines and feeding punctures in TCC than in OF; and a higher mines' incidence in IPM than in OF. Both in TCC and IPM high percentages of plants with mines were found although without an adult proportional presence. In the first case this was due to the repeatedly phytosanitary treatments applied; in the second case it was due to the natural control, since in IPM and OF greenhouses the collected larvae were mostly parasitized or dead. In spite of the fact these two strategies have as final result a similar mines and adults incidence, their production and environmental costs are quite different. Significant differences at the beneficials' population level between TCC greenhouses and IPM or OF greenhouses were found. As the farmers did no biological treatments these

Incident Duration Modeling Using Flexible Parametric Hazard-Based Models

Directory of Open Access Journals (Sweden)

Ruimin Li

2014-01-01

Full Text Available Assessing and prioritizing the duration time and effects of traffic incidents on major roads present significant challenges for road network managers. This study examines the effect of numerous factors associated with various types of incidents on their duration and proposes an incident duration prediction model. Several parametric accelerated failure time hazard-based models were examined, including Weibull, log-logistic, log-normal, and generalized gamma, as well as all models with gamma heterogeneity and flexible parametric hazard-based models with freedom ranging from one to ten, by analyzing a traffic incident dataset obtained from the Incident Reporting and Dispatching System in Beijing in 2008. Results show that different factors significantly affect different incident time phases, whose best distributions were diverse. Given the best hazard-based models of each incident time phase, the prediction result can be reasonable for most incidents. The results of this study can aid traffic incident management agencies not only in implementing strategies that would reduce incident duration, and thus reduce congestion, secondary incidents, and the associated human and economic losses, but also in effectively predicting incident duration time.

Security incidents on the Internet, 1989--1995

Energy Technology Data Exchange (ETDEWEB)

Howard, J.D.

1995-12-31

This paper presents an analysis of trends in Internet security based on an investigation of 4,299 Internet security-related incidents reported to the CERT{reg_sign} Coordination Center (CERT{reg_sign}/CC) from 1989 through 1995. Prior to this research, knowledge of actual Internet security incidents was limited and primarily anecdotal. This research: (1) developed a taxonomy to classify Internet attacks and incidents, (2) organized, classified, and analyzed CERT{reg_sign}/CC incident records, (3) summarized the relative frequency of the use of tools and vulnerabilities, success in achieving access, and results of attacks, (4) estimated total Internet incident activity, (5) developed recommendations for Internet users and suppliers, and (6) developed recommendations for future research. With the exception of denial-of-service attacks, security incidents were found to be increasing at a rate less than Internet growth. Estimates showed that most, if not all, severe incidents were reported to the CERT{reg_sign}/CC, and that more than one out of three above average incidents (in terms of duration and number of sites) were reported. Estimates also indicated that a typical Internet site was involved in, at most, around one incident (of any kind) per year, and a typical Internet host in, at most, around one incident in 45 years. The probability of unauthorized privileged access was around an order of magnitude less likely. As a result, simple and reasonable security precautions should be sufficient for most Internet users.

Review article: the incidence and prevalence of colorectal cancer in inflammatory bowel disease

DEFF Research Database (Denmark)

Munkholm, P

2003-01-01

Although colorectal cancer (CRC), complicating ulcerative colitis and Crohn's disease, only accounts for 1-2% of all cases of CRC in the general population, it is considered a serious complication of the disease and accounts for approximately 15% of all deaths in inflammatory bowel disease (IBD...... of symptoms, and extent of the disease, with pancolitis having a more severe inflammation burden and risk of the dysplasia-carcinoma cascade. Considering the chronic nature of the disease, it is remarkable that there is such a low incidence of CRC in some of the population-based studies, and possible...... in Crohn's disease, the number was significantly increased in relation to the expected number....

Incidence of dementia and major subtypes in Europe

DEFF Research Database (Denmark)

Fratiglioni, L; Launer, L J; Andersen, K

2000-01-01

The authors examined the association of incident dementia and subtypes with age, sex, and geographic area in Europe. Incidence data from eight population-based studies carried out in seven European countries were compared and pooled. The pooled data included 835 mild to severe dementia cases and 42......,996 person-years of follow-up. In all studies a higher proportion of cases were diagnosed with AD (60 to 70% of all demented cases) than vascular dementia (VaD). The incidence of dementia and AD continued to increase with age up to age 85 years, after which rates increased in women but not men....... There was a large variation in VaD incidence across studies. In the pooled analysis, the incidence rates increased with age without any substantial difference between men and women. Surprisingly, higher incidence rates of dementia and AD were found in the very old in northwest countries than in southern countries...

Two year reduction in sleep apnea symptoms and associated diabetes incidence after weight loss in severe obesity.

Science.gov (United States)

Grunstein, Ronald R; Stenlöf, Kaj; Hedner, Jan A; Peltonen, Markku; Karason, Kristjan; Sjöström, Lars

2007-06-01

To evaluate the effect of bariatric surgery on sleep apnea symptoms and obesity-associated morbidity in patients with severe obesity. Prospective study. University hospitals and community centers in Sweden. We investigated the influence of weight loss surgery (n=1729) on sleep apnea symptoms and obesity-related morbidity using a conservatively treated group (n=1748) as a control. Baseline BMI in surgical group (42.2+/-4.4 kg/m(2)) and control group (40.1+/-4.6 kg/m(2)) changed -9.7+/-5 kg/m(2) and 0+/-3 kg/m(2), respectively, at 2-year follow-up. In the surgery group, there was a marked improvement in all obstructive sleep apnea (OSA) symptoms compared with the control group (P sleep apnea symptoms at 2 years. Despite adjustment for weight change and baseline central obesity, subjects reporting loss of OSA symptoms had a lower 2-year incidence of diabetes and hypertriglyceridemia. Improvement in OSA in patients losing weight may provide health benefits in addition to weight loss alone.

Analysis of a molten pool natural convection in the APR1400 RPV at a severe accident

International Nuclear Information System (INIS)

Kim, Jong Tae; Park, Rae Joon; Kim, Sang Baik

2005-01-01

During a hypothetical severe accident, reactor fuel rods and structures supporting them are melted and relocated in the lower head of the reactor vessel. These relocated molten materials could be separated by their density difference and construct metal/oxide stratified pools in the lower head. A decay heat generated from the fuel material is transferred to the vessel wall and upper structures remaining in the reactor vessel by natural convection. As shown in Fig. 1 two-layered stratified molten pool is developed in the reactor lower vessel. The oxidic pool usually constructed by the mixture of uranium oxide and zirconium oxide. The melting temperature of the oxidic material is very high compared to the steel vessel and metallic layer. And highly turbulent natural convection generated by the decay heat enhances heat transfer to the boundary of the oxidic pool. By this thermal mechanism, oxide curst is developed around the oxidic layer as shown in Fig. 1. The oxidic pool is bounded thermally and fluid-dynamically by the developed crust. By this boundedness, the heat transfer structure in the stratified oxidic/metallic pool can be solved separately. The thermal boundary condition of the oxidic pool is isothermal with constant melting temperature of the oxidic material. The decay heat is transfer to side wall and upper interface between oxidic and metallic layer. Turbulent natural convection is dominant heat transfer mechanism in the oxidic pool. The heat transferred from the bottom oxidic layer is imposed to the upper metallic layer. This transferred heat in the metallic pool is removed through side and upper surface, which is augmented also by natural convection developed in the pool. In this study, a molten pool natural convection in the APR1400 RPV during a severe accident is simulated using the Lilac code and the calculated heat flux distribution on the reactor vessel wall is compared with a lumped-parameter (LP) prediction

The effect of magnesium sulphate infusion on the incidence and severity of emergence agitation in children undergoing adenotonsillectomy using sevoflurane anaesthesia.

Science.gov (United States)

Abdulatif, M; Ahmed, A; Mukhtar, A; Badawy, S

2013-10-01

This randomised, controlled, double-blind study investigated the effects of intra-operative magnesium sulphate administration on the incidence of emergence agitation in children undergoing adenotonsillectomy using sevoflurane anaesthesia. Seventy children were randomly allocated to receive a 30 mg.kg(-1) bolus of intravenous magnesium sulphate after induction of anaesthesia followed by a continuous infusion of 10 mg.kg(-1).h(-1) or an equal volume of saline 0.9%. All children received titrated sevoflurane anaesthesia adjusted to maintain haemodynamic stability. The Pediatric Anesthesia Emergence Delirium scale and the Children's Hospital of Eastern Ontario Score were used for the assessment of postoperative emergence agitation and pain, respectively. Emergence agitation was more common in the control group than in the magnesium group (23 (72%) and 12 (36%), respectively (p = 0.004)), with a relative risk of 0.51 (95% CI 0.31-0.84), an absolute risk reduction of 0.35 (95% CI 0.10-0.54), and number needed to treat of 3 (95% CI 2-9). Postoperative pain scores were comparable in the two groups. Magnesium sulphate reduces the incidence and severity of emergence agitation in children undergoing adenotonsillectomy using sevoflurane anaesthesia and is not associated with increased postoperative side-effects or delayed recovery. © 2013 The Association of Anaesthetists of Great Britain and Ireland.

Dysphonia in preterm children: assessing incidence and response to treatment.

Science.gov (United States)

Reynolds, Victoria; Meldrum, Suzanne; Simmer, Karen; Vijayasekaran, Shyan; French, Noel P

2014-03-01

Mild dysphonia in childhood is surprisingly common, yet moderate to severe dysphonia is rare. The latter has been associated with complex medical conditions and congenital abnormalities. Intubation injury has also been documented as a cause of childhood dysphonia. Children born very preterm may be intubated as part of the intensive care administered in the perinatal and neonatal periods, yet there are few studies investigating dysphonia in this population. This study will be the first to: use an objective acoustic voice assessment in a paediatric study, document the incidence of dysphonia in very preterm children at school age, and conduct a controlled trial of behavioural voice therapy in this population. This study will consist of three phases: assessment of voice quality and its impact on quality of life in up to 200 children born at less than 32 weeks' gestation: assessment of the nature and extent of laryngeal pathology in children with moderate to severe dysphonia; and a non-blinded, randomised controlled trial of behavioural voice therapy in children with moderate to severe dysphonia. This study will be the first to use clinical assessment to examine the voice quality of very preterm children, and to use fibre optic endoscopic evaluation of laryngeal function to determine the nature and extent of any laryngeal pathology in such children. Those participants with significant voice difficulties will be randomised to receive treatment immediately or after the eight week assessment. This study is registered on the Australian New Zealand Clinical Trials Registry (ACTRN12613001015730/ACTRN12613001012763). Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Femoral head retroposition as a potential compensatory mechanism in patients with a severe mismatch between pelvic incidence and lumbar lordosis.

Science.gov (United States)

Cheng, Xiaofei; Zhang, Kai; Sun, Xiaojiang; Zhao, Changqing; Li, Hua; Zhao, Jie

2017-12-01

Severe mismatch between pelvic incidence (PI) and lumbar lordosis (LL) leads to extra anterior displacement of the gravity line. The objective of this study is to investigate whether femoral head retroposition is a separate compensatory mechanism responsible for the extra anterior displacement. Based on the values of PI and LL, 94 patients were divided into the PI-LL match group (PI-LL ≤ 0°), the mild PI-LL mismatch group (20°> PI-LL >0°), and the severe PI-LL mismatch group (PI-LL ≥ 20°). A series of parameters including PI, LL, PI-LL, thoracic kyphosis (TK), pelvic tilt (PT), sacral slope (SS), knee flexion angle (KFA), tibial obliquity angle (TOA), sagittal vertical axis (SVA), S1 overhang, femoral head shift (FHS), and pelvic shift (PS) were measured and compared among the three groups. The severe PI-LL mismatch group exhibited significantly greater PI, PI-LL, PT, KFA, SVA, PS, and FHS, and less LL and TK, compared with the control and mild PI-LL mismatch group. The mild PI-LL mismatch group had significantly greater PI-LL, PT, KFA, TOA, and S1 overhang, and less LL and SS than the control group. SS, TOA, and S1 overhang in the severe PI-LL mismatch group differed significantly from that in the control group, but did not differ significantly from that in the mild PI-LL mismatch group. Femoral head retroposition is an entirely separate compensatory mechanism and, in this study, participated in the compensation for the anterior displacement of the gravity line induced by extra-sagittal spinal malalignment in patients with severe PI-LL mismatch.

Incidence of injury in elite junior Rugby Union: a prospective descriptive study.

Science.gov (United States)

McManus, A; Cross, D S

2004-12-01

The high incidence of injury in Rugby Union is well documented, particularly at elite levels of competition. This article describes the incidence and nature of all injuries sustained by elite Western Australian junior Rugby Union players during the 26 weeks up to and including the 1997 National Championship campaign. Informed consent was gained for each participant (n = 44) prior to completion of an extensive baseline questionnaire. Exposure and injury data were collected at each training session and game. The injury incidence rate over the 26 week period was 13.26/1000 player hours. Injury data were analysed by phase of play, position, severity and if occurred at games or training. The incidence of injury was significantly associated with the position played (chi2 = 67.49, p value = 0.008) and the phase of play in which the injury occurred (chi2 = 8.07, p value = 0.042). Tackling was the most dangerous phase of play (52% of injuries) and the most common site of injury was the lower limb (37%). Most injuries occurred during games (56%) and the flanker was the position most at risk of injury (12%). Further research is needed to identify the aetiology of injury at all levels of competition and to use these findings to develop effective injury prevention strategies in this sport. Position-specific risk factors should also be investigated, as should the mechanism of injury associated with tackling which is the phase of play in which significantly more injuries occur in rugby.

Radiological incidents in industrial gamma radiography in the Philippines, 1979-1993

International Nuclear Information System (INIS)

Borras, A.M.

1994-01-01

Among the many practices of radiation sources, the practice of industrial gamma radiography in the country has the most number of reported radiological incidents. During the past fourteen (14) years, from 1979-1993, twenty (20) incidents that have occurred were reported to the Institute. This paper presents the nature and extent of the 20 reported incidents as well as the results of the analysis of why these incidents happened. The results of the analysis showed that the causes of these incidents are mainly human error and equipment failure. Hence, the factors that can minimize or prevent the chance of occurrence and/or recurrence of incidents and in minimizing the hazard in case of radiological incidents are: a) proper training and re-training of personnel; b) proper and regular inspection and maintenance of equipment; c) adequate radiation survey; and d) proper storage and inventory of the radiography sealed sources. (author). 3 refs.; 5 figs.; 1 tab

Thrombocytopenia in neonatal sepsis: Incidence, severity and risk factors

NARCIS (Netherlands)

Ree, Isabelle M. C.; Fustolo-Gunnink, Suzanne F.; Bekker, Vincent; Fijnvandraat, Karin J.; Steggerda, Sylke J.; Lopriore, Enrico

2017-01-01

Thrombocytopenia is a frequent problem in neonatal sepsis and is among the most predictive, independent risk factors for sepsis-associated mortality. This study aims to clarify the occurrence, severity and duration of thrombocytopenia in neonatal sepsis. A cohort study was carried out among all

Qualitative analysis of factors leading to clinical incidents.

Science.gov (United States)

Smith, Matthew D; Birch, Julian D; Renshaw, Mark; Ottewill, Melanie

2013-01-01

The purpose of this paper is to evaluate the common themes leading or contributing to clinical incidents in a UK teaching hospital. A root-cause analysis was conducted on patient safety incidents. Commonly occurring root causes and contributing factors were collected and correlated with incident timing and severity. In total, 65 root-cause analyses were reviewed, highlighting 202 factors implicated in the clinical incidents and 69 categories were identified. The 14 most commonly occurring causes (encountered in four incidents or more) were examined as a key-root or contributory cause. Incident timing was also analysed; common factors were encountered more frequently during out-hours--occurring as contributory rather than a key-root cause. In total, 14 commonly occurring factors were identified to direct interventions that could prevent many clinical incidents. From these, an "Organisational Safety Checklist" was developed to involve departmental level clinicians to monitor practice. This study demonstrates that comprehensively investigating incidents highlights common factors that can be addressed at a local level. Resilience against clinical incidents is low during out-of-hours periods, where factors such as lower staffing levels and poor service provision allows problems to escalate and become clinical incidents, which adds to the literature regarding out-of-hours care provision and should prove useful to those organising hospital services at departmental and management levels.

Severe street and mountain bicycling injuries in adults: a comparison of the incidence, risk factors and injury patterns over 14 years.

Science.gov (United States)

Roberts, Derek J; Ouellet, Jean-Francois; Sutherland, Francis R; Kirkpatrick, Andrew W; Lall, Rohan N; Ball, Chad G

2013-06-01

Street and mountain bicycling are popular recreational activities and prevalent modes of transportation with the potential for severe injury. The purpose of this investigation was to compare the incidence, risk factors and injury patterns among adults with severe street versus mountain bicycling injuries. We conducted a retrospective cohort study using the Southern Alberta Trauma Database of all adults who were severely injured (injury severity score [ISS] ≥ 12) while street or mountain bicycling between Apr. 1, 1995, and Mar. 31, 2009. Among 11 772 severely injured patients, 258 (2.2%) were injured (mean ISS 17, hospital stay 6 d, mortality 7%) while street (n = 209) or mountain bicycling (n = 49). Street cyclists were often injured after being struck by a motor vehicle, whereas mountain bikers were frequently injured after faulty jump attempts, bike tricks and falls (cliffs, roadsides, embankments). Mountain cyclists were admitted more often on weekends than weekdays (61.2% v. 45.0%, p = 0.040). Injury patterns were similar for both cohorts (all p > 0.05), with trauma to the head (67.4%), extremities (38.4%), chest (34.1%), face (26.0%) and abdomen (10.1%) being common. Spinal injuries, however, were more frequent among mountain cyclists (65.3% v. 41.1%, p = 0.003). Surgical intervention was required in 33.3% of patients (9.7% open reduction internal fixation, 7.8% spinal fixation, 7.0% craniotomy, 5.8% facial repair and 2.7% laparotomy). With the exception of spine injuries, severely injured cyclists display similar patterns of injury and comparable outcomes, regardless of style (street v. mountain). Helmets and thoracic protection should be advocated for injury prevention.

DISTRIBUTION AND INCIDENCE LEAF DISEASES OF BANANA IN SEVERAL BANANA PRODUCTION CENTERS IN NORTH SUMATRA, WEST SUMATRA BENGKULU AND WEST JAVA

Directory of Open Access Journals (Sweden)

Sahlan

2011-06-01

Full Text Available The research was aimed to determine the type, the distribution and the incidence of banana leaf diseases in several production centers in West Sumatra, Bengkulu, North Sumatra and West Java. Direct observations on banana orchards were conducted in some districts in Simalungun, Deli Serdang and Medan (North Sumatra, Tanah Datar, Limapuluh Kota, Agam, Pariaman and Pasaman (West Sumatra, Rejang Lebong and Kepahyang (Bengkulu, Sukabumi, Purwakarta and Subang (West Java from November to December 2006. Two banana orchards were randomly selected in each district. Plant population at the selected orchard was at least 100 plants. From each sampled orchard, if banana population consisted of similar or only one variety, 10 plants were randomly chosen according to wind direction. Meanwhile, when the banana varieties were varied, five plants were randomly selected. The result showed that Black Sigatoka and Eumusae leaf spot were found in West Sumatra, Bengkulu and North Sumatra at severity level of between 15 % to 62.31%, whilst speckle disease was mainly found in North Sumatra and in parts of West Sumatra at severity level of between 72,72% to 100% and 15 to 30%, respectively. Banana varieties that were primarily attacked by leaf diseases were Cavendish, Telor, Barangan and Emas.

The incidence and course of depression in bereaved youth 21 months after the loss of a parent to suicide, accident, or sudden natural death.

Science.gov (United States)

Brent, David; Melhem, Nadine; Donohoe, M Bertille; Walker, Monica

2009-07-01

This study examined effects of bereavement 21 months after a parent's death, particularly death by suicide. The participants were 176 offspring, ages 7-25, of parents who died by suicide, accident, or sudden natural death. They were assessed 9 and 21 months after the death, along with 168 nonbereaved subjects. Major depression and alcohol or substance abuse 21 months after the parent's death were more common among bereaved youth than among comparison subjects. Offspring with parental suicide or accidental death had higher rates of depression than comparison subjects; those with parental suicide had higher rates of alcohol or substance abuse. Youth with parental suicide had a higher incidence of depression than those bereaved by sudden natural death. Bereavement and a past history of depression increased depression risk in the 9 months following the death, which increased depression risk between 9 and 21 months. Losing a mother, blaming others, low self-esteem, negative coping, and complicated grief were associated with depression in the second year. Youth who lose a parent, especially through suicide, are vulnerable to depression and alcohol or substance abuse during the second year after the loss. Depression risk in the second year is mediated by the increased incidence of depression within the first 9 months. The most propitious time to prevent or attenuate depressive episodes in bereaved youth may be shortly after the parent's death. Interventions that target complicated grief and blaming of others may also improve outcomes in symptomatic youth with parental bereavement.

Medication incidents reported to an online incident reporting system.

LENUS (Irish Health Repository)

Alrwisan, Adel

2011-01-15

AIMS: Approximately 20% of deaths from adverse events are related to medication incidents, costing the NHS an additional £500 million annually. Less than 5% of adverse events are reported. This study aims to assess the reporting rate of medication incidents in NHS facilities in the north east of Scotland, and to describe the types and outcomes of reported incidents among different services. Furthermore, we wished to quantify the proportion of reported incidents according to the reporters\\' profession. METHODS: A retrospective description was made of medication incidents reported to an online reporting system (DATIX) over a 46-month-period (July 2005 to April 2009). Reports originated from acute and community hospitals, mental health, and primary care facilities. RESULTS: Over the study period there were 2,666 incidents reported with a mean monthly reporting rate of 78.2\\/month (SD±16.9). 6.1% of all incidents resulted in harm, with insulin being the most commonly implicated medication. Nearly three-quarters (74.2%, n=1,978) of total incidents originated from acute hospitals. Administration incidents were implicated in the majority of the reported medication incidents (59%), followed by prescribing (10.8%) and dispensing (9.9%), while the nondescript "other medication incidents" accounted for 20.3% of total incidents. The majority of reports were made by nursing and midwifery staff (80%), with medical and dental professionals reporting the lowest number of incidents (n=56, 2%). CONCLUSIONS: The majority of medication incidents in this study were reported by nursing and midwifery staff, and were due to administration incidents. There is a clear need to elucidate the reasons for the limited contribution of the medical and dental professionals to reporting medication incidents.

The Incidence of Posttraumatic Stress Disorder After Floods: A Meta-Analysis.

Science.gov (United States)

Chen, Long; Liu, Aizhong

2015-06-01

This study analyzes the incidence of posttraumatic stress disorder (PTSD) among flood victims, between different flood intensities, and between different time points after a flood. A search of several electronic literature databases was conducted to collect data on the incidence of PTSD after a flood. Loney criteria for research quality were used to evaluate the quality of selected search results. The combined incidence of PTSD was estimated using the Freeman-Tukey double arcsine transformation method. Subgroup analyses were conducted on different trauma intensities and different time points after a flood. Sensitivity analysis was performed to evaluate the impact of research quality. Fourteen articles were included in this meta-analysis, including a total of 40 600 flood victims; 3862 victims were diagnosed with PTSD. The combined incidence of PTSD was 15.74%. The subgroup analyses showed that the incidence of PTSD in victims who experienced severe and moderate flood intensity was higher than that in victims who experienced mild flood intensity. The incidence of PTSD was lower at 6 or more months after a flood (11.45%) than within 6 months (16.01%) of a flood. In conclusion, the incidence of PTSD among floods of different trauma intensities was statistically significant.

Incidence, patterns and severity of reported unintentional injuries in Pakistan for persons five years and older: results of the National Health Survey of Pakistan 1990–94

Directory of Open Access Journals (Sweden)

Qureshi Huma I

2007-07-01

Full Text Available Abstract Background National level estimates of injuries are not readily available for developing countries. This study estimated the annual incidence, patterns and severity of unintentional injuries among persons over five years of age in Pakistan. Methods National Health Survey of Pakistan (NHSP 1990–94 is a nationally representative survey of the household. Through a two-stage stratified design, 18, 315 persons over 5 years of age were interviewed to estimate the overall annual incidence, patterns and severity of unintentional injuries for males and females in urban and rural areas over the preceding one year. Weighted estimates were computed adjusting for complex survey design using surveyfreq and surveylogistic option of SAS 9.1 software. Results The overall annual incidence of all unintentional injuries was 45.9 (CI: 39.3–52.5 per 1000 per year; 59.2 (CI: 49.2–69.2 and 33.2 (CI: 27.0–39.4 per 1000 per year among males and females over five years of age, respectively. An estimated 6.16 million unintentional injuries occur in Pakistan annually among persons over five years of age. Urban and rural injuries were 55.9 (95% CI: 48.1–63.7 and 41.2 (95% CI: 32.2–50.0 per 1000 per year, respectively. The annual incidence of injuries due to falls were 22.2 (95% CI: 18.0–26.4, poisoning 3.3 (95%CI: 0.5–6.1 and burn was 1.5 (95%CI: 0.9–2.1 per 1000 per year. The majority of injuries occurred at home 19.2 (95%CI: 16.0–22.4 or on the roads 17.0 (95%CI: 13.8–20.2. Road traffic/street, school and urban injuries were more likely to result in handicap. Conclusion There is high burden of unintentional injuries among persons over five years of age in Pakistan. These results are useful to plan further studies and prioritizing prevention programs on injuries nationally and other developing countries with similar situation.

Naturally Occurring Peer Support through Social Media: The Experiences of Individuals with Severe Mental Illness Using YouTube

NARCIS (Netherlands)

Naslund, J.A.; Grande, S.W.; Aschbrenner, K.A.; Elwyn, G.

2014-01-01

Increasingly, people with diverse health conditions turn to social media to share their illness experiences or seek advice from others with similar health concerns. This unstructured medium may represent a platform on which individuals with severe mental illness naturally provide and receive peer

A critical incident reporting system in anaesthesia.

Science.gov (United States)

Madzimbamuto, F D; Chiware, R

2001-01-01

To audit the recently established Critical Incident Reporting System in the Department of Anaesthesia and Critical Care Medicine, University of Zimbabwe Medical School. The system was set up with the purpose of improving the quality of care delivered by the department. Cross sectional study. A critical incident was defined as 'any adverse and reversible event in theatre, during or immediately after surgery that if it persisted without correction would cause harm to the patient'. The anaesthetic or recovery room staff filled a critical incident form anonymously. Data was collected from critical incident reporting forms for analysis. The anaesthetic service in the two teaching hospitals of Harare Central and Parirenyatwa General Hospitals. Between May and October 2000, 62 completed critical incident forms were collected. The nature of the incident and the monitoring used were recorded, the cause was classified as human, equipment or monitoring failure and the outcome for each patient reported. There was no formal system for reminding staff to fill in their critical incident forms. A total of 14,165 operations were performed over the reporting period: 62 critical incident forms were collected, reporting 130 incidents, giving a rate of 0.92% (130/14,165). Of these, 42 patients were emergencies and 20 elective. The incidents were hypotension, hypoxia, bradycardia, ECG changes, aspiration, laryngospasm, high spinal, and cardiac arrest. Monitoring present on patients who had critical incidents was: capnography 57%, oxymetry 90% and ECG 100%. Other monitors are not reported. Human error contributed in 32/62 of patients and equipment failure in 31/62 of patients. Patient outcome showed 15% died, 23% were unplanned admissions to HDU while 62% were discharged to the ward with little or no adverse outcome. Despite some under reporting, the critical incident rate was within the range reported in the literature. Supervision of juniors is not adequate, especially on call. The

Naturally Occurring Peer Support through Social Media: The Experiences of Individuals with Severe Mental Illness Using YouTube

Science.gov (United States)

Naslund, John A.; Grande, Stuart W.; Aschbrenner, Kelly A.; Elwyn, Glyn

2014-01-01

Increasingly, people with diverse health conditions turn to social media to share their illness experiences or seek advice from others with similar health concerns. This unstructured medium may represent a platform on which individuals with severe mental illness naturally provide and receive peer support. Peer support includes a system of mutual giving and receiving where individuals with severe mental illness can offer hope, companionship, and encouragement to others facing similar challenges. In this study we explore the phenomenon of individuals with severe mental illness uploading videos to YouTube, and posting and responding to comments as a form of naturally occurring peer support. We also consider the potential risks and benefits of self-disclosure and interacting with others on YouTube. To address these questions, we used qualitative inquiry informed by emerging techniques in online ethnography. We analyzed n = 3,044 comments posted to 19 videos uploaded by individuals who self-identified as having schizophrenia, schizoaffective disorder, or bipolar disorder. We found peer support across four themes: minimizing a sense of isolation and providing hope; finding support through peer exchange and reciprocity; sharing strategies for coping with day-to-day challenges of severe mental illness; and learning from shared experiences of medication use and seeking mental health care. These broad themes are consistent with accepted notions of peer support in severe mental illness as a voluntary process aimed at inclusion and mutual advancement through shared experience and developing a sense of community. Our data suggest that the lack of anonymity and associated risks of being identified as an individual with severe mental illness on YouTube seem to be overlooked by those who posted comments or uploaded videos. Whether or not this platform can provide benefits for a wider community of individuals with severe mental illness remains uncertain. PMID:25333470

Naturally occurring peer support through social media: the experiences of individuals with severe mental illness using YouTube.

Directory of Open Access Journals (Sweden)

John A Naslund

Full Text Available Increasingly, people with diverse health conditions turn to social media to share their illness experiences or seek advice from others with similar health concerns. This unstructured medium may represent a platform on which individuals with severe mental illness naturally provide and receive peer support. Peer support includes a system of mutual giving and receiving where individuals with severe mental illness can offer hope, companionship, and encouragement to others facing similar challenges. In this study we explore the phenomenon of individuals with severe mental illness uploading videos to YouTube, and posting and responding to comments as a form of naturally occurring peer support. We also consider the potential risks and benefits of self-disclosure and interacting with others on YouTube. To address these questions, we used qualitative inquiry informed by emerging techniques in online ethnography. We analyzed n = 3,044 comments posted to 19 videos uploaded by individuals who self-identified as having schizophrenia, schizoaffective disorder, or bipolar disorder. We found peer support across four themes: minimizing a sense of isolation and providing hope; finding support through peer exchange and reciprocity; sharing strategies for coping with day-to-day challenges of severe mental illness; and learning from shared experiences of medication use and seeking mental health care. These broad themes are consistent with accepted notions of peer support in severe mental illness as a voluntary process aimed at inclusion and mutual advancement through shared experience and developing a sense of community. Our data suggest that the lack of anonymity and associated risks of being identified as an individual with severe mental illness on YouTube seem to be overlooked by those who posted comments or uploaded videos. Whether or not this platform can provide benefits for a wider community of individuals with severe mental illness remains uncertain.

Naturally occurring peer support through social media: the experiences of individuals with severe mental illness using YouTube.

Science.gov (United States)

Naslund, John A; Grande, Stuart W; Aschbrenner, Kelly A; Elwyn, Glyn

2014-01-01

Increasingly, people with diverse health conditions turn to social media to share their illness experiences or seek advice from others with similar health concerns. This unstructured medium may represent a platform on which individuals with severe mental illness naturally provide and receive peer support. Peer support includes a system of mutual giving and receiving where individuals with severe mental illness can offer hope, companionship, and encouragement to others facing similar challenges. In this study we explore the phenomenon of individuals with severe mental illness uploading videos to YouTube, and posting and responding to comments as a form of naturally occurring peer support. We also consider the potential risks and benefits of self-disclosure and interacting with others on YouTube. To address these questions, we used qualitative inquiry informed by emerging techniques in online ethnography. We analyzed n = 3,044 comments posted to 19 videos uploaded by individuals who self-identified as having schizophrenia, schizoaffective disorder, or bipolar disorder. We found peer support across four themes: minimizing a sense of isolation and providing hope; finding support through peer exchange and reciprocity; sharing strategies for coping with day-to-day challenges of severe mental illness; and learning from shared experiences of medication use and seeking mental health care. These broad themes are consistent with accepted notions of peer support in severe mental illness as a voluntary process aimed at inclusion and mutual advancement through shared experience and developing a sense of community. Our data suggest that the lack of anonymity and associated risks of being identified as an individual with severe mental illness on YouTube seem to be overlooked by those who posted comments or uploaded videos. Whether or not this platform can provide benefits for a wider community of individuals with severe mental illness remains uncertain.

Desfolha, população de plantas e precocidade do milho afetam a incidência e a severidade de podridões de colmo Defoliation, plant population, and earliness of maize affect the incidence and severity of stalk rots

Directory of Open Access Journals (Sweden)

Luiz Eduardo Bassay Blum

2003-10-01

Full Text Available As relações entre fonte e dreno interferem sobre a ocorrência de podridões de colmo na cultura do milho (Zea mays. O estudo foi conduzido em Lages, SC, para avaliar o efeito da desfolha, população de plantas e híbridos sobre as podridões do colmo do milho. O delineamento experimental foi de blocos ao acaso com parcelas sub-subdivididas e três repetições. Os híbridos P32R21 (superprecoce, Premium (precoce e C333B (tardio foram testados sem desfolha e com 50% de desfolha no estágio de espigamento nas populações de 25.000, 50.000, 75.000 e 100.000 plantas ha-1. Avaliaram-se a incidência e a severidade das podridões do colmo causadas por Colletotrichum graminicola, Diplodia maydis e Fusarium moniliforme. O híbrido P32R21 foi o mais afetado pelos fungos causadores de podridões. Nos híbridos P32R21 e Premium, as plantas desfolhadas foram mais severamente infectadas pelos patógenos do que as intactas. O aumento da população de plantas aumentou a intensidade (incidência ou severidade de podridões de colmo nas plantas intactas e diminuiu a ocorrência nas desfolhadas.The relationship between source and sink interferes on maize (Zea mays stalk rot occurrence. This study was conducted in Lages, SC, Brazil, to evaluate the effect of defoliation, plant population, and hybrids on the intensity (incidence or severity of maize stalk rots. The experiment was set in a randomized complete block design (three replications with a split-split-plot arrangement. The hybrids P32R21 (very early, Premium (early and C333B (late were tested without defoliation and with 50% defoliation on ear formation stage at plant populations of 25,000, 50,000, 75,000, and 100,000 plants ha-1. The incidence and severity of Colletotrichum graminicola, Diplodia maydis and Fusarium moniliforme stalk rots were evaluated. The hybrid P32R21 was the most affected by stalk rots. Defoliation enhanced rots on P32R21 and Premium. Enhancements in plant population increased

Analysis of contributing factors associated to related patients safety incidents in Intensive Care Medicine.

Science.gov (United States)

Martín Delgado, M C; Merino de Cos, P; Sirgo Rodríguez, G; Álvarez Rodríguez, J; Gutiérrez Cía, I; Obón Azuara, B; Alonso Ovies, Á

2015-01-01

To explore contributing factors (CF) associated to related critical patients safety incidents. SYREC study pos hoc analysis. A total of 79 Intensive Care Departments were involved. The study sample consisted of 1.017 patients; 591 were affected by one or more incidents. The CF were categorized according to a proposed model by the National Patient Safety Agency from United Kingdom that was modified. Type, class and severity of the incidents was analyzed. A total 2,965 CF were reported (1,729 were associated to near miss and 1,236 to adverse events). The CF group more frequently reported were related patients factors. Individual factors were reported more frequently in near miss and task related CF in adverse events. CF were reported in all classes of incidents. The majority of CF were reported in the incidents classified such as less serious, even thought CF patients factors were associated to serious incidents. Individual factors were considered like avoidable and patients factors as unavoidable. The CF group more frequently reported were patient factors and was associated to more severe and unavoidable incidents. By contrast, individual factors were associated to less severe and avoidable incidents. In general, CF most frequently reported were associated to near miss. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

Azathioprine-induced Acute Pancreatitis in Patients with Inflammatory Bowel Diseases—A Prospective Study on Incidence and Severity

Science.gov (United States)

Mohl, Wolfgang; Bokemeyer, Bernd; Bündgens, Burkhard; Büning, Jürgen; Miehlke, Stephan; Hüppe, Dietrich; Maaser, Christian; Klugmann, Tobias; Kruis, Wolfgang; Siegmund, Britta; Helwig, Ulf; Weismüller, Joseph; Drabik, Attyla; Stallmach, Andreas

2016-01-01

Background and Aims: Azathioprine [AZA] is recommended for maintenance of steroid-free remission in inflammatory bowel disease IBD. The aim of this study has been to establish the incidence and severity of AZA-induced pancreatitis, an idiosyncratic and major side effect, and to identify specific risk factors. Methods: We studied 510 IBD patients [338 Crohn’s disease, 157 ulcerative colitis, 15 indeterminate colitis] with initiation of AZA treatment in a prospective multicentre registry study. Acute pancreatitis was diagnosed in accordance with international guidelines. Results: AZA was continued by 324 [63.5%] and stopped by 186 [36.5%] patients. The most common cause of discontinuation was nausea [12.2%]. AZA-induced pancreatitis occurred in 37 patients [7.3%]. Of these: 43% were hospitalised with a median inpatient time period of 5 days; 10% had peripancreatic fluid collections; 24% had vomiting; and 14% had fever. No patient had to undergo nonsurgical or surgical interventions. Smoking was the strongest risk factor for AZA-induced acute pancreatitis [p pancreatitis is a common adverse event in IBD patients, but in this study had a mild course in all patients. Smoking is the most important risk factor. PMID:26468141

The association between childhood sexual and physical abuse with incident adult severe obesity across 13 years of the National Longitudinal Study of Adolescent Health.

Science.gov (United States)

Richardson, A S; Dietz, W H; Gordon-Larsen, P

2014-10-01

Severe obesity has increased, yet childhood antecedents of adult severe obesity are not well understood. Estimate adult-onset severe obesity risk in individuals with history of childhood physical and/or sexual abuse compared with those who did not report abuse. Longitudinal analysis of participants from the US National Longitudinal Study of Adolescent Health (n = 10,774) wave II (1996; aged 12-22 years) followed through wave IV (2008-2009; aged 24-34 years). New cases of adult-onset severe obesity (body mass index [BMI] ≥ 40 kg/m2 using measured height and weight) in individuals followed over 13 years who were not severely obese during adolescence (BMI childhood was associated with an increased risk of incident severe obesity in adulthood in non-minority females (hazard ratio [HR; 95% Confidence Interval] = 2.5; 1.3, 4.8) and males (HR = 3.6; 1.5, 8.5) compared with individuals with no history of abuse. In addition to other social and emotional risks, exposure to sexual and physical abuse during childhood may increase risk of severe obesity later in life. Consideration of the confluence of childhood abuse might be considered as part of preventive and therapeutic approaches to address severe obesity. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

Mapping Prevalence and Incidence of Coral Disease in reef-building corals at two Natural Reserves of the Southwest Puerto Rico

Science.gov (United States)

Sanchez Viruet, I.; Irizarry-Soto, E.; Ruiz-Valentín, I.

2016-02-01

Coral diseases seems to be the main cause of coral reef decline in the Caribbean. Before the bleaching event of 2005, coral reefs in Puerto Rico were dominated by the reef-building taxa: Orbicella annularis, Porites astreoides, Montastrea cavernosa, Agaricia agaracites and Colpophyllia natans. After the event, live-coral cover significantly declined and more than 90% of the scleractinian corals in the U.S. Virgin Islands and Puerto Rico showed signals of thermal stressors. The prevalence of coral diseases in five reef-building coral (Orbicella annularis, Orbicella franksi, Orbicella faveolata, Porites porites and Pseudiploria strigosa) species was assessed by tagging, photographing, and mapping all diseased and healthy colonies within 10 permanent 40m2 band transects at each inshore and mid-shelf reefs of Belvedere and Punta Guaniquilla Natural Reserves using a random stratified sampling method. Maximum and perpendicular diameter was used to assess coral size using Coral Point Count with Excel Extension. Corals were classified into three size class populations (class I: 0-50cm, class II: 50-100cm and class III: >100 cm). Data was used to develop a GIS-based map containing coral species, size and disease presence. Preliminary results of the inshore area showed a higher disease prevalence in Belvedere natural reserve and for P. strigosa (17.1%) and O. annularis (9.3%). Frequency distribution analysis showed a dominance of O. faveolata at Punta Guaniquilla and Belvedere (127 and 88 individuals respectively). Size class I dominates the distribution of each species within the natural reserves with a higher disease prevalence. Future work include continue prevalence surveys of the outer reef shelf on both natural reserves, monitoring and GIS-based mapping of incidence and resilience through time. This study will help in the assessment of the status of the coral reef of the southwest insular platform.

Incidence of severe hypoglycemia in children with type 1 diabetes in the Nordic countries in the period 2008-2012

DEFF Research Database (Denmark)

Birkebaek, N H; Drivvoll, A K; Aakeson, K

2017-01-01

of hemoglobin A1c (HbA1c) and treatment modalities on the frequency of SH; particularly, to explore if a HbA1c target ≤6.7% (50 mmol/mol) is feasible. RESEARCH DESIGN AND METHODS: Data on children below 15 years with a diabetes duration more than 1 year, registered in the national childhood diabetes databases......OBJECTIVE: Treatment of type 1 diabetes has been intensified aiming at normalizing blood glucose, which may increase the risk of severe hypoglycemia (SH). We aimed to compare the incidence of SH events in the four Nordic countries Denmark, Iceland, Norway and Sweden, and to assess the influence...... in the four Nordic countries from 2008 to 2012, were compiled. Data completeness was more than 95%. RESULTS: Totally 8806 (48% females) patients with 29 715 person years were included, mean age and diabetes duration were 11 years and 5.1 years, respectively. The overall rate of SH was 6.0 per 100 patient...

[Severe hypertension: definition and patients profiles].

Science.gov (United States)

Mourad, Jean-Jacques

2013-05-01

Severe arterial hypertension gathers relatively different clinical situations explained by the heterogeneity of the definitions of this clinical setting. From a medical point of view, severe hypertension is a short course situation defined by very high values of blood pressure corresponding to grade 3 hypertension. In France, until 2011, the social security also included in the definition of severe HTA chronic situations characterized by moderate blood pressure values requiring at least triple anthihypertensive therapies associated with a clinical or infraclinical target organ damages. These clinical profiles, much more frequent than grade 3 hypertension, allowed the full reimbursement of care costs for these patients. In France, it is estimated that 10% of hypertensive patients present a severe form with an annual incidence of 50,000 patients. The patients with severe hypertension have an increased cardiovascular morbidity justifying a closer clinical monitoring. From an economic point of view, these severe forms of hypertension have a higher cost of care, explained primarily by a more frequent need of specialized referrals, radiological exams and hospitalizations. This excess cost justified the existence of a full coverage of induced costs by the social security, since the incidence of severe hypertension is more frequent in the low social categories, and in patients with economic fragility.

Incidence of rheumatoid arthritis from 1995 to 2001

DEFF Research Database (Denmark)

Pedersen, Jens; Kjær, Niels; Svendsen, Anders

2009-01-01

The aim of this study was to describe the mean incidence rate of rheumatoid arthritis over a 7-year period from 1995 to 2001 in a population in the southern part of Denmark, using the data from several sources. Cases fulfilling the 1987 American College of Rheumatology criteria for rheumatoid...... from general practice and referral centres, the estimated incidence was 35/100,000 person-years (95% confidence interval 32-38). We suggest that the estimated rate should be viewed as a plausible upper limit for the incidence of rheumatoid arthritis in the southern part of Denmark....... arthritis were identified at hospitals and private practising rheumatologists (referral centres), and in general practice. The observed incidence was 32/100,000 person-years (95% confidence interval 29-35). Using the ratio between the number of cases known only from general practice and the number known...

Incidence of Poverty and the Role of Non-Farm Activities

International Nuclear Information System (INIS)

Fatima, A.

2015-01-01

The incidence of poverty, poverty gap and the severity of poverty for the nine agro-climatic zones of the country (rice/wheat Punjab, mixed Punjab, cotton/wheat Punjab, low intensity Punjab, Barani Punjab, cotton/wheat Sindh, rice other Sindh, Khyber Pakhtunkhwa and Balochistan) were calculated for farming and non-farming households. The indices of poverty were also measured for households that only did farming, undertook farming and non-farm activities and those that did no farming in the various agro-climatic zones. Finally, incidence and severity of poverty as well as the spread of income among the poor for non-farm wage earners, farm wage earners, non-farm self-employed and the crop cultivators in the nine agro-climatic zones of rural Pakistan was also carried out. The relationship between incidence of poverty and non-farm activities is ambivalent with non-farm households being better off in regions that are less fertile. The incidence of poverty was highest amongst farm wage workers, followed by non-farm wage workers, non-farm self-employed and lastly crop cultivators. (author)

Standardization of natural phenomena risk assessment methodology at the Savannah River Plant

International Nuclear Information System (INIS)

Huang, J.C.; Hsu, Y.S.

1985-01-01

Safety analyses at the Savannah River Plant (SRP) normally require consideration of the risks of incidents caused by natural events such as high-velocity straight winds, tornadic winds, and earthquakes. The probabilities for these events to occur at SRP had been studied independently by several investigators, but the results of their studies were never systematically evaluated. As part of the endeavor to standardize our environmental risk assessment methodology, these independent studies have been thoroughly reviewed and critiqued, and appropriate probability models for these natural events have been selected. The selected probability models for natural phenomena, high-velocity straight winds and tornadic winds in particular, are in agreement with those being used at other DOE sites, and have been adopted as a guide for all safety studies conducted for SRP operations and facilities. 7 references, 3 figures

The Role of the MAPK Signaling, Topoisomerase and Dietary Bioactives in Controlling Cancer Incidence

Directory of Open Access Journals (Sweden)

Khaled A. Selim

2017-04-01

Full Text Available Reactive oxygen species (ROS are common products of mitochondrial oxidative phosphorylation, xenobiotics metabolism and are generated in response to several environmental stress conditions. Some of them play important biochemical roles in cellular signal transduction and gene transcription. On the other hand, ROS are known to be involved in a wide range of human diseases, including cancer. The excessive production of such ROS together with disruption of homeostasis detoxifying mechanisms can mediate a series of cellular oxidative stresses. The oxidative stress of redundant free radicals production can lead to oxidative denaturation of cellular macromolecules including proteins, lipids and DNA. Moreover, oxidative damage is one of the major causes of DNA mutations, replication errors and genomic abnormalities which result in either inhibition or induction of transcription, and end with the disturbance of signal transduction pathways. Among affected signaling pathways are redox-sensitive kinases. The stimulation of these kinases induces several transcription factors through the phosphorylation of their module proteins. The activation of such pathways induces proliferation and cellular transformation. A diet rich in antioxidant compounds has potential health benefits, and there is a growing interest in the role of natural antioxidants in nutrition for prevention and cure of cancer diseases. A controversy has risen regarding the relation between antioxidants and the significant decrease in the risk of cancer incidence. In this review, we will focus on redox-sensitive kinases signaling pathways, highlighting the effects of dietary antioxidant on the prevention, incidence, prognosis or even treatment of human cancers. In addition, we will place emphasis on the chemical classes of pterocarpans as natural anti-oxidants/cancers as well as their underlying mechanisms of action, including their effects on MAPKs and topoisomerase activities.

Constitution of an incident database suited to statistical analysis and examples

International Nuclear Information System (INIS)

Verpeaux, J.L.

1990-01-01

The Nuclear Protection and Safety Institute (IPSN) has set up and is developing an incidents database, which is used for the management and analysis of incidents encountered in French PWR plants. IPSN has already carried out several incidents or safety important events statistical analysis, and is improving its database on the basis of the experience it gained from this various studies. A description of the analysis method and of the developed database is presented

IRID: specifications for the Ionising Radiations Incident Database

International Nuclear Information System (INIS)

Thomas, G.O.; Croft, J.R.; Williams, M.K.; McHugh, J.O.

1996-01-01

Technologies that make use of ionising radiations are widespread. They provide many benefits but, as with other technologies, the use of ionising radiations carries with it the potential for incidents and accidents. Their severity can vary from the trivial to the fatal and may involve substantial economic penalties. In order to minimise the number of incidents and their consequences it is important that there is a mechanism to learn the lessons from those that do occur. To help pursue this objective the National Radiological Protection Board, the Health and Safety Executive and the Environment Agency have established a national Ionising Radiations Incident Database (IRID) to cover radiation incidents in industry, medicine, research and teaching. This publication details the specifications for IRID and its methods of operation. All information in the database will be unattributable and names of persons or organisations will not be included. It is a personal computer based system with 24 fields to categorise an incident, including a text field that will provide a description of the incident giving the causes, consequences, follow-up actions and lessons to be learned. These descriptions will be used in subsequent publications to provide feedback to the users. (UK)

Natural History of Helicobacter pylori Infection in Mexican Schoolchildren: Incidence and Spontaneous Clearance

Science.gov (United States)

Duque, Ximena; Vilchis, Jenny; Mera, Robertino; Trejo-Valdivia, Belem; Goodman, Karen J.; Mendoza, Maria-Eugenia; Navarro, Fabiola; Roque, Victoria; Moran, Segundo; Torres, Javier; Correa, Pelayo

2013-01-01

Objectives The aim of the present study was to estimate the incidence and spontaneous clearance rate of Helicobacter pylori infection and the effect of some variables on these outcomes in schoolchildren. Methods From May 2005 to December 2010, 718 schoolchildren enrolled in 3 public boarding schools in Mexico City participated in the follow-up. At the beginning of the study and every 6 months thereafter, breath samples were taken to detect H pylori infection; blood samples and anthropometric measurements were taken to evaluate nutritional status. Data on sociodemographic characteristics were collected. Results The prevalence of H pylori infection was 38%. The incidence rate was 6.36%/year. Schoolchildren with anemia or iron deficiency at the beginning of the study (who received iron supplements) showed a higher infection acquisition rate than those with normal iron nutritional status, hazard ratio (HR) 12.52 (95% confidence interval [CI] 4.01%–39.12%), P <0.001 and HR 2.05 (95% CI 1.09%–3.87%), P = 0.027, respectively. The spontaneous clearance rate of the infection was 4.74%/year. The spontaneous clearance rate was higher in children who had iron deficiency (who received iron supplements), HR 5.02 (95% CI 1.33%–18.99%), P = 0.017, compared with those with normal nutritional iron status. It was lower in schoolchildren with ≥2 siblings compared with schoolchildren with 1 or no siblings, HR 0.23 (95% CI 0.08%–0.63%), P = 0.004. Conclusions H pylori infection status is dynamic in schoolchildren. Variables related to health status and infection transmission, such as iron status and number of siblings, are important for the incidence and spontaneous clearance of H pylori infection. PMID:22227999

Multi-step polynomial regression method to model and forecast malaria incidence.

Directory of Open Access Journals (Sweden)

Chandrajit Chatterjee

Full Text Available Malaria is one of the most severe problems faced by the world even today. Understanding the causative factors such as age, sex, social factors, environmental variability etc. as well as underlying transmission dynamics of the disease is important for epidemiological research on malaria and its eradication. Thus, development of suitable modeling approach and methodology, based on the available data on the incidence of the disease and other related factors is of utmost importance. In this study, we developed a simple non-linear regression methodology in modeling and forecasting malaria incidence in Chennai city, India, and predicted future disease incidence with high confidence level. We considered three types of data to develop the regression methodology: a longer time series data of Slide Positivity Rates (SPR of malaria; a smaller time series data (deaths due to Plasmodium vivax of one year; and spatial data (zonal distribution of P. vivax deaths for the city along with the climatic factors, population and previous incidence of the disease. We performed variable selection by simple correlation study, identification of the initial relationship between variables through non-linear curve fitting and used multi-step methods for induction of variables in the non-linear regression analysis along with applied Gauss-Markov models, and ANOVA for testing the prediction, validity and constructing the confidence intervals. The results execute the applicability of our method for different types of data, the autoregressive nature of forecasting, and show high prediction power for both SPR and P. vivax deaths, where the one-lag SPR values plays an influential role and proves useful for better prediction. Different climatic factors are identified as playing crucial role on shaping the disease curve. Further, disease incidence at zonal level and the effect of causative factors on different zonal clusters indicate the pattern of malaria prevalence in the city

Encounters of aircraft with volcanic ash clouds; A compilation of known incidents, 1953-2009

Science.gov (United States)

Guffanti, Marianne; Casadevall, Thomas J.; Budding, Karin

2010-01-01

Information about reported encounters of aircraft with volcanic ash clouds from 1953 through 2009 has been compiled to document the nature and scope of risks to aviation from volcanic activity. The information, gleaned from a variety of published and other sources, is presented in database and spreadsheet formats; the compilation will be updated as additional encounters occur and as new data and corrections come to light. The effects observed by flight crews and extent of aircraft damage vary greatly among incidents, and each incident in the compilation is rated according to a severity index. Of the 129 reported incidents, 94 incidents are confirmed ash encounters, with 79 of those having various degrees of airframe or engine damage; 20 are low-severity events that involve suspected ash or gas clouds; and 15 have data that are insufficient to assess severity. Twenty-six of the damaging encounters involved significant to very severe damage to engines and (or) airframes, including nine encounters with engine shutdown during flight. The average annual rate of damaging encounters since 1976, when reporting picked up, has been approximately 2 per year. Most of the damaging encounters occurred within 24 hours of the onset of ash production or at distances less than 1,000 kilometers from the source volcanoes. The compilation covers only events of relatively short duration for which aircraft were checked for damage soon thereafter; documenting instances of long-term repeated exposure to ash (or sulfate aerosols) will require further investigation. Of 38 source volcanoes, 8 have caused 5 or more encounters, of which the majority were damaging: Augustine (United States), Chaiten (Chile), Mount St. Helens (United States), Pacaya (Guatemala), Pinatubo (Philippines), Redoubt (United States), Sakura-jima (Japan), and Soufriere Hills (Montserrat, Lesser Antilles, United Kingdom). Aircraft have been damaged by eruptions ranging from small, recurring episodes to very large

The MentDis_ICF65+ study protocol: prevalence, 1-year incidence and symptom severity of mental disorders in the elderly and their relationship to impairment, functioning (ICF) and service utilisation.

Science.gov (United States)

Andreas, Sylke; Härter, Martin; Volkert, Jana; Hausberg, Maria; Sehner, Susanne; Wegscheider, Karl; Rabung, Sven; Ausín, Berta; Canuto, Alessandra; Da Ronch, Chiara; Grassi, Luigi; Hershkovitz, Yael; Lelliott, Paul; Muñoz, Manuel; Quirk, Alan; Rotenstein, Ora; Santos-Olmo, Ana Belén; Shalev, Arieh; Siegert, Jens; Weber, Kerstin; Wittchen, Hans-Ulrich; Koch, Uwe; Schulz, Holger

2013-02-18

The EU currently lacks reliable data on the prevalence and incidence of mental disorders in older people. Despite the availability of several national and international epidemiological studies, the size and burden of mental disorders in the elderly remain unclear due to various reasons. Therefore, the aims of the MentDis_ICF65+ study are (1) to adapt existing assessment instruments, and (2) to collect data on the prevalence, the incidence, and the natural course and prognosis of mental disorders in the elderly. Using a cross-sectional and prospective longitudinal design, this multi-centre study from six European countries and associated states (Germany, Great Britain, Israel, Italy, Spain, and Switzerland) is based on age-stratified, random samples of elderly people living in the community. The study program consists of three phases: (1) a methodological phase devoted primarily to the adaptation of age- and gender-specific assessment tools for older people (e.g., the Composite International Diagnostic Interview, CIDI) as well as psychometric evaluations including translation, back translation; (2) a baseline community study in all participating countries to assess the lifetime, 12 month and 1 month prevalence and comorbidity of mental disorders, including prior course, quality of life, health care utilization and helpseeking, impairments and participation and, (3) a 12 month follow-up of all baseline participants to monitor course and outcome as well as examine predictors. The study is an essential step forward towards the further development and improvement of harmonised instruments for the assessment of mental disorders as well as the evaluation of activity impairment and participation in older adults. This study will also facilitate the comparison of cross-cultural results. These results will have bearing on mental health care in the EU and will offer a starting point for necessary structural changes to be initiated for mental health care policy at the level of

Incidents/accidents classification and reporting in Statoil.

Science.gov (United States)

Berentsen, Rune; Holmboe, Rolf H

2004-07-26

Based on requirements in the new petroleum regulations from Norwegian Petroleum Directorate (NPD) and the realisation of a need to improve and rationalise the routines for reporting and follow up of incidents, Statoil Exploration & Production Norway (Statoil E&P Norway) has formulated a new strategy and process for handling of incidents/accidents. The following past experiences serve as basis for the changes made to incident reporting in Statoil E&P Norway; too much resources were spent on a comprehensive handling and analysis of a vast amount of incidents with less importance for the safety level, taking the focus away from the more severe and important issues at hand, the assessment of "Risk Factor", i.e. the combination of recurrence frequency and consequence, was difficult to use. The high degree of subjectivity involved in the determination of the "Risk Factor" (in particular the estimation of the recurrence frequency) resulted in poor data quality and lack of consistency in the data material. The new system for categorisation and handling of undesirable incidents was established in January 2002. The intention was to get a higher degree of focus on serious incidents (injuries, damages, loss and near misses), with a thorough handling and follow-up. This is reflected throughout the handling of the serious incidents, all the way from immediate notification of the incident, through investigation and follow-up of corrective and preventive actions. Simultaneously, it was also an objective to rationalise/simplify the handling of less serious incidents. These incidents are, however, subjected to analyses twice a year in order to utilize the learning opportunity that they also provide. A year after the introduction of this new system for categorisation and follow-up of undesirable incidents, Statoil's experiences are predominantly good; the intention to get a higher degree of focus on serious incidents (injuries, damages, loss and near misses), has been met, the data

Attitudes and perceived barriers influencing incident reporting by nurses and their correlation with reported incidents: A systematic review.

Science.gov (United States)

Fung, Wing Mei; Koh, Serena Siew Lin; Chow, Yeow Leng

Clinical incident reporting is an integral feature of risk management system in the healthcare sector. By reporting clinical incidents, nurses allow for learning from errors, identification of error patterns and development of error preventive strategies. The need to understand attitudes to reporting, perceived barriers and incident reporting patterns by nurses are the core highlights of this review. INCLUSION CRITERIA: This review considered descriptive quantitative studies that examined nurses' attitudes or perceived barriers towards incident reporting.The participants in this review were nurses working in acute care settings or step-down care settings. Studies that included non-nursing healthcare personnel were excluded.This review considered studies which examined nurses' attitudes towards incident reporting, perceived barriers and incident reporting practices.The outcomes of interest were the attitudes that nurses have towards incident reporting, perceived barriers and the types of reported incidents in correlation with nurses' attitudes and barriers. A three-step search strategy was utilised in this review. An initial limited search of CINAHL and MEDLINE was undertaken. Search strategies were then developed using identified keywords and index terms. Lastly, the reference lists of all identified articles were examined. All searches were limited to studies published in English, between 1991 and 2010. The studies were independently assessed by two reviewers using the Joanna Briggs Institute Critical Appraisal Checklist for Descriptive/ Case Series studies. The reviewers extracted data independently from included studies using the Joanna Briggs Institute Data Extraction Form for Descriptive/ Case Series studies. Due to the descriptive nature of the study designs, statistical pooling was not possible. Therefore, the findings of this systematic review are presented in a narrative summary. Fifty-five papers were identified from the searches based on their titles and

Pipework failures - a review of historical incidents

International Nuclear Information System (INIS)

Blything, K.W.; Parry, S.T.

1988-01-01

A description is presented of the gathering of historical pipework incident data and its analysis to determine the causes and underlying reasons for failure. The following terms of reference were agreed: (a) To review data on failures associated with pipework to establish the principal causes of failure. This should include not only rupture of the pipe itself, but also pipework induced failures, such as severe flange leaks and excessive strains resulting in failure of connected equipment. (b) To suggest an incident classification for pipework systems which will alert design, construction, maintenance, and operating personnel to the need for special care. (c) To advise non-piping specialists of the type of situation which could result in failure if not allowed for in the design, e.g. dynamic and transient conditions. (d) To recommend, possibly as the result of (a) above, areas where present procedures and codes of practice may require amplification. Brief descriptions are given of selected incidents where the consequences are considered to be serious in terms of damage and financial loss. For consequence analysis, the release rate is an important parameter and, where possible, the proportion of incidents in the failure mode categories, leaks, ''ruptures/severances'' are given. Although not one of the agreed objectives, the determination of failure rates was recognised as an important requirement in the risk assessment of pipework systems. The quality of data gathered however was found to be inadequate for any statistical analysis and no failure rate values are given in this report. (author)

Shift within age-groups of mumps incidence, hospitalizations and severe complications in a highly vaccinated population. Spain, 1998-2014.

Science.gov (United States)

López-Perea, Noemí; Masa-Calles, Josefa; Torres de Mier, María de Viarce; Fernández-García, Aurora; Echevarría, Juan E; De Ory, Fernando; Martínez de Aragón, María Victoria

2017-08-03

The mumps vaccine (Jeryl-Lynn-strain) was introduced in Spain in 1981, and a vaccination policy which included a second dose was added in 1995. From 1992-1999, a Rubini-strain based vaccine was administered in many regions but later withdrawn due to lack of effectiveness. Despite high levels of vaccination coverage, epidemics have continued to appear. We characterized the three epidemic waves of mumps between 1998 and 2014, identifying major changes in susceptible populations using Poisson regression. For the period 1998-2003 (P1), the most affected group was from 1 to 4years old (y) [Incidence Rate (IR)=71.7 cases/100,000 population]; in the periods 2004-2009 (P2) and 2010-2014 (P3) IR ratio (IRR) increased among 15-24y (P2=1.46; P3=2.68) and 25-34y (P2=2.17; P3=4.05). Hospitalization rate (HR), complication rate (CR) and neurological complication rate (NR) among hospitalized subjects decreased across the epidemics, except for 25-34y which increased: HR ratio (HRR) (P2=2.18; P3=2.16), CRR (P3=2.48), NRR (P3=2.41). In Spain mumps incidence increased, while an overall decrease of hospitalizations and severe complications occurred across the epidemics. Cohorts born during periods of low vaccination coverage and those vaccinated with Rubini-strain were the most affected populations, leading to a shift in mumps cases from children to adolescents and young adults; this also reveals the waning immunity provided by the mumps vaccine. Despite not preventing all mumps cases, the vaccine appears to prevent serious forms of the disease. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

The management of radiation treatment error through incident learning

International Nuclear Information System (INIS)

Clark, Brenda G.; Brown, Robert J.; Ploquin, Jodi L.; Kind, Anneke L.; Grimard, Laval

2010-01-01

Purpose: To assess efficacy of an incident learning system in the management of error in radiation treatment. Materials and methods: We report an incident learning system implementation customized for radiation therapy where any 'unwanted or unexpected change from normal system behaviour that causes or has the potential to cause an adverse effect to persons or equipment' is reported, investigated and learned from. This system thus captures near-miss (potential) and actual events. Incidents are categorized according to severity, type and origin. Results: Our analysis spans a period of 3 years with an average accrual of 11.6 incidents per week. We found a significant reduction in actual incidents of 28% and 47% in the second and third year when compared to the first year (p < 0.001), which we attribute to the many interventions prompted by the analysis of incidents reported. We also saw a similar significant reduction in incidents generated at the treatment unit correlating with the introduction of direct treatment parameter transfer and electronic imaging (p < 0.001). Conclusions: Implementation of an incident learning system has helped us to establish a just environment where all staff members report deviations from normal system behaviour and thus generate evidence to initiate safety improvements.

Incidence of severe capsular contracture following implant-based immediate breast reconstruction with or without postoperative chest wall radiotherapy using 40 Gray in 15 fractions

International Nuclear Information System (INIS)

Whitfield, Gillian A.; Horan, Gail; Irwin, Michael S.; Malata, Charles M.; Wishart, Gordon C.; Wilson, Charles B.

2009-01-01

Purpose: To determine the incidence of capsular contracture (CC) requiring revisional surgery in patients receiving postoperative radiotherapy (RT) or no RT following mastectomy and immediate breast reconstruction. Material and methods: One hundred and seventy-eight immediate breast reconstructions performed at the Cambridge Breast Unit between 1.1.2001 and 31.12.2005 were identified. RT was delivered using a standard UK scheme of 40 Gray in 15 fractions over 3 weeks. The influence of hormones and chemotherapy as well as postoperative RT on time to development of severe CC after implant-based reconstruction was explored in univariate and multivariate analysis. Results: One hundred and ten patients had implant-based reconstructions with a median follow-up of 51 months. In the RT group (41 patients), there were 8 patients with severe CC requiring revisional surgery, a crude rate of 19.5%, with actuarial rates of 0%, 5%, 5%, 21%, 30% and 30% at 1, 2, 3, 4, 5 and 6 years follow-up. In the unirradiated group, there were no cases of severe CC. This difference is highly significant (p < 0.001). Hormones and chemotherapy were not significantly associated with severe CC. Conclusions: This series showed a significantly higher rate of severe CC with postoperative RT. This finding has important clinical implications, when counselling patients for immediate breast reconstruction

Natures and incidences of each normal variations on I.V.P. series of 1000 Korean females

International Nuclear Information System (INIS)

Shin, Ok Ja; Chin, Soo Yil

1980-01-01

Each organ of body has many normal variation and/or abnormal developments from fetus to adult, especially urogenital system is very complex and markedly abnormal. The authors attempt to analyze the natures, incidences and differences of each normal variations based on I.V.P. series of 1000 Korean females and the review of literatures were carried out. The results are as follows: 1. The normal variations of urinary tracts are about 30 kinds as follows; Aphasia 0/1000 (0%), Hypoplasia 4/1000 (0.4%), Atrophic kidney 0/1000 (0%), Hyperplasia 0/1000 (0%), Hypertrophied kidney 0/1000 (0%), Supernumerary kidney 0/1000 (0%), Pelvic kidney 0/1000 (0%), Wandering kidney 7/1000 (7%), Horseshoe kidney 2/1000 (2%), Nephroptosis 6/1000 (0.6%), Malroated kidney 0/1000 (0%), Crossed ecotopic kidney 0/1000 (0%), Ureteral kingking 440/1000 (44.0%), Short ureter 3/1000 (0.3%), Long ureter 49/1000 (4.9%), Retrocaval ureter 0/1000 (0%), Retroiliac ureter 0/1000 (0%), Mega-ureter 0/1000 (0%), Aberrant vessel in ureter 79/1000 (7.9%), Congenital ureteral valves 0/1000 (0%), Anomalous ureteral orifices 0/1000 (0%), Double ureter 22/1000 (2.2%), Ureteral diverticulum 0/1000 (0%), Extrarenal pelvis 170/1000 (17.0%), Intrarenal pelvis 830/1000 (83.0%), Supernumerary pelvis 55/1000 (55%), Renal backflow 2/1000 0.2%), Multiple calyces 0/1000 (0.1%), Calyceal diverticulum 2/1000 (0.2%), Unilateral fused kidney 0/1000 (0%), Polar enlarged kidney 0/1000 (0%). 2. The order of incidence of common variations in Korean females are as follows: 1. Intrarenal pelvis 2. Ureteral kingking 3. Extrarenal pelvis 4. Aberrant vessel in ureter 5. Double pelvis 6. Long ureter 7. Double ureter 8. Wandering Kidney 9. Nephrotosis 10. Hypoplasia 11. Short ureter 12. Horseshoe kidney 13. Renal backflow 14. Calyceal diverticulum 15. Supernumerary calyces. 3. The most common variations in Korean females are intrarenal pelvis, extrarenal pelvis, aberrant vessel in ureters and most of them are acquired origin. Contrary

Neuromuscular exercises prevent severe knee injury in adolescent team handball players.

Science.gov (United States)

Achenbach, Leonard; Krutsch, Volker; Weber, Johannes; Nerlich, Michael; Luig, Patrick; Loose, Oliver; Angele, Peter; Krutsch, Werner

2017-10-20

Team handball is associated with a high risk of severe knee injury that needs to be reduced, particularly at the youth level. The purpose of this study was to show how an injury-prevention programme effectively reduces severe knee injury in adolescent team handball players. Of 23 adolescent handball teams of both sexes, 13 were randomly allocated into the intervention group (168 players) and 10 into the control group (111 players). Players of the intervention group regularly participated in an injury-prevention programme for one season. Handball exposure and sustained injuries were documented for both groups on a monthly basis. The primary outcome parameter of the injury-prevention programme was the incidence of severe knee injury. Of the 279 included players, 68 (24%) sustained 82 injuries yielding an overall incidence of 1.85 injuries per 1000 h handball exposure (intervention group: 50 injuries/incidence: 1.90/1000 h; control group: 32 injuries/incidence: 1.78/1000 h). Knee injury was the second most frequent injury in adolescent team handball. The primary outcome parameter, severe knee injury occurred significantly more often in the control group [mean age (SD) 15.1 (1.0), injury incidence 0.33/1000 h] than in the intervention group [mean age (SD) 14.9 (0.9), injury incidence 0.04/1000 h]. The odds ratio was 0.11 (95% CI 0.01-0.90), p = 0.019. Other injuries to the lower extremities showed no significant difference between the two groups. Frequent neuromuscular exercises prevent severe knee injury in adolescent team handball players and should thus be included in the practical routine as well as in the education of team coaches.

Early enteral nutrition prevents intra-abdominal hypertension and reduces the severity of severe acute pancreatitis compared with delayed enteral nutrition: a prospective pilot study.

Science.gov (United States)

Sun, Jia-Kui; Li, Wei-Qin; Ke, Lu; Tong, Zhi-Hui; Ni, Hai-Bin; Li, Gang; Zhang, Lu-Yao; Nie, Yao; Wang, Xin-Ying; Ye, Xiang-Hong; Li, Ning; Li, Jie-Shou

2013-09-01

To investigate the effects of early enteral nutrition (EEN) on intra-abdominal pressure (IAP) and disease severity in patients with severe acute pancreatitis (SAP). Enteral nutrition (EN) was started within 48 h after admission in the EEN group and from the 8th day in the delayed enteral nutrition (DEN) group. The IAP and intra-abdominal hypertension (IAH) incidence were recorded for 2 weeks. The caloric intake and feeding intolerance (FI) incidence were recorded daily after EN was started. The severity markers and clinical outcome variables were also recorded. Sixty patients were enrolled to this study. No difference about IAP was found. The IAH incidence of the EEN group was significantly lower than that of the DEN group from the 9th day (8/30 versus 18/30; P = 0.009) after admission. The FI incidence of the EEN group was higher than that of the DEN group during the initial 3 days of feeding (25/30 versus 12/30; P = 0.001; 22/30 versus 9/30; P = 0.001; 15/30 versus 4/30; P = 0.002). Patients with an IAP FI incidence than those with an IAP ≥15 mmHg on the 1st day (20/22 versus 17/38; P < 0.001), the 3rd day (11/13 versus 8/47; P < 0.001), and the 7th day (3/5 versus 3/55; P = 0.005) of feeding. The severity markers and clinical outcome variables of the EEN group were significantly improved. Early enteral nutrition did not increase IAP. In contrast, it might prevent the development of IAH. In addition, EEN might be not appropriate during the initial 3-4 days of SAP onset. Moreover, EN might be of benefit to patients with an IAP <15 mmHg. Early enteral nutrition could improve disease severity and clinical outcome, but did not decrease mortality of SAP.

Correlation of Steam Generator Mixing Parameters for Severe Accident Hot-Leg Natural Circulation

Energy Technology Data Exchange (ETDEWEB)

Liao, Yehong; Guentay, Salih [Paul Scherrer Institut, Villigen PSI, CH-5232 (Switzerland)

2008-07-01

Steam generator inlet plenum mixing phenomenon with hot-leg counter-current natural circulation during a PWR station blackout severe accident is one of the important processes governing which component will fail first as a result of thermal challenge from the circulating gas with high temperature and pressure. Since steam generator tube failure represents bypass release of fission product from the reactor to environment, study of inlet plenum mixing parameters is important to risk analysis. Probability distribution functions of individual mixing parameter should be obtained from experiments or calculated by analysis. In order to perform sensitivity studies of the synergetic effects of all mixing parameters on the severe accident-induced steam generator tube failure, the distribution and correlation of these mixing parameters must be known to remove undue conservatism in thermal-hydraulic calculations. This paper discusses physical laws governing three mixing parameters in a steady state and setups the correlation among these mixing parameters. The correlation is then applied to obtain the distribution of one of the mixing parameters that has not been given in the previous CFD analysis. Using the distributions and considering the inter-dependence of the three mixing parameters, three sensitivity cases enveloping the mixing parameter uncertainties are recommended for the plant analysis. (authors)

Natural killer (NK)-cell activity in sorted subsets of peripheral blood mononuclear cells from patients with severe combined immunodeficiency

NARCIS (Netherlands)

ten Berge, R. J.; Schellekens, P. T.; Budding-Koppenol, A.; Dooren, L. J.; Vossen, J. M.

1987-01-01

Natural killer-cell activity for K562 target cells was measured in 13 patients with severe combined immunodeficiency before bone marrow transplantation. Both unseparated peripheral blood mononuclear cells and sorted cell subsets (B73.1 positive, B73.1 negative, OKT3 positive, OKT3 negative) were

Incidence and Trends in Psychopathology Symptoms over Time in Adults with Severe to Profound Intellectual Disability

Science.gov (United States)

Horovitz, Max; Matson, Johnny L.; Sipes, Megan; Shoemaker, Mary; Belva, Brian; Bamburg, Jay W.

2011-01-01

Individuals with intellectual disability (ID) have a high risk for developing comorbid psychopathology. While researchers have shown that symptoms of psychopathology remain relatively stable in children with ID over time, little research has been conducted to demonstrate symptom stability for adults with ID. Incidence of psychopathology symptoms…

Surviving severe traumatic brain injury in Denmark

DEFF Research Database (Denmark)

Odgaard, Lene; Poulsen, Ingrid; Kammersgaard, Lars Peter

2015-01-01

PURPOSE: To identify all hospitalized patients surviving severe traumatic brain injury (TBI) in Denmark and to compare these patients to TBI patients admitted to highly specialized rehabilitation (HS-rehabilitation). PATIENTS AND METHODS: Patients surviving severe TBI were identified from...... severe TBI were admitted to HS-rehabilitation. Female sex, older age, and non-working status pre-injury were independent predictors of no HS-rehabilitation among patients surviving severe TBI. CONCLUSION: The incidence rate of hospitalized patients surviving severe TBI was stable in Denmark...

Newborn Screening for Severe Combined Immunodeficiency in Israel

Directory of Open Access Journals (Sweden)

Erez Rechavi

2017-06-01

Full Text Available Newborn screening (NBS programs for severe combined immunodeficiency (SCID, the most severe type of primary immunodeficiency, are being implemented in more and more countries with every passing year. Since October 2015, SCID screening via T cell receptor excision circle (TREC quantification in dried blood spots (DBS has been part of the Israeli NBS program. As an NBS program in its infancy, SCID screening is still evolving, making gathering input from the various programs crucial for compiling an ideal screening algorithm. The relatively high rate of consanguineous marriages in Israel, especially among non-Jews, correlates with an increased incidence of SCID. The Israeli algorithm uses a commercial kit and consists of a two-Guthrie card confirmation system prior to referral to a national immunology center. Preliminary data from the first year and a half of SCID screening in Israel has identified a surprisingly high prevalence of DNA cross-link repair protein 1c (DCLRE1C; ARTEMIS mutations as the cause of SCID in Israel. The clinically unbiased nature of SCID screening helps unearth mild/leaky SCID phenotypes, resulting in a better understanding of true SCID prevalence and etiology.

Analysis of a Natural Circulation in the Reactor Coolant System Following a High Pressure Severe Accident at APR1400

International Nuclear Information System (INIS)

Kim, Han Chul; Cho, Yong Jin; Park, Jae Hong; Cho, Song Won

2011-01-01

Under a high temperature and pressure condition during a severe accident, hot leg pipes or steam generator tubes could fail due to creep rupture following natural circulation in the Reactor Coolant System (RCS) unless depressurization of the system is performed at a proper time. Natural circulation in the RCS can be a multi-dimensional circulation in the reactor vessel, a partial loop circulation of two-phase flow from the core up to steam generators (SGs), or circulation in the total loop. It can delay the reactor vessel failure time by removing heat from the reactor core. This natural phenomenon can be hardly simulated with a single flow path model for the hot spots of the RCS, since it cannot deal with the counter-current flow. Thus it may estimate accident progression faster than reality, which may cause troubles for optimized implementation of severe accident management strategies. An earlier damage in the RCS other than the reactor pressure vessel may make subsequent behaviors of hydrogen or fission products in the containment quite different from the single reactor vessel failure. Therefore, a RCS model which treats natural circulation is needed to evaluate the RCS response and the safety depressurization strategy in a best-estimate way. The aim of this study is to develop a detailed model which allows natural circulation between the reactor vessel and steam generators through hot legs, based on the existing APR1400 RCS model. The station blackout sequence was selected to be the representative high-pressure scenario. Sensitivity study on the effect of node configuration of the upper plenum and addition of cross flow paths from the upper plenum to the hot legs were carried out. This model is described herein and representative calculation results are presented

Relación entre Incidencia y Severidad de la Roya Asiática de la Soya Causada por Phakopsora pachyrhizi Sydow & Sydow Relationship Between Incidence and Severity of Asian Soybean Rust Caused by Phakopsora pachyrhizi Sydow & Sydow

Directory of Open Access Journals (Sweden)

Felipe Rafael Garcés Fiallos

2011-12-01

Full Text Available Se relaciona la incidencia con la severidad de la roya asiática de la soya, donde los valores generados por las ecuaciones pueden ser usados en cualquier estudio de este patosistema, proporcionando una herramienta para evaluar la incidencia como también la severidad. Se generaron gradientes de la enfermedad mediante el uso de fungicidas y momentos de aplicación, de manera preventiva y curativa. El experimento de campo con el cultivar Nidera 5909 RG, fue distribuido en bloques completos al azar. La intensidad de la roya asiática fue medida en los estratos inferior, medio y superior de la planta, a través de diferentes conteos de incidencia (porcentaje y severidad (lesiones cm-2, urédias cm-2 y porcentaje en folíolos. Las regresiones realizadas, presentaron una correlación significativa entre incidencia y severidad a 1% de probabilidad. Con los datos obtenidos, el evaluador puede escoger el método de cuantificación mas razonable o confiable a su criterio para otros trabajos de investigación o aplicar un determinado control de la enfermedad, utilizando las ecuaciones lineales generadas, facilitando el trabajo de cuantificar la roya asiática, bien se busque medir la incidencia (% o el número de lesiones cm-2, urédias cm-2 o severidad (%.Incidence is related to severity of the Asian soybean rust, where values generated by the equations can be used in any study of this pathosystem, providing a tool to evaluate incidence as well severity. Gradients of the disease were generated by means of the use of fungicides and moments of application, in a preventive and curative way. The field experiment with the cultivar Nidera RG 5909, was distributed in a randomized complete block. The intensity of Asian rust layers was measured in the lower, middle and top of the plant, through various counts of incidence (percentage and severity (lesions cm-2, uredinia cm-2 and percentage in leaflets. The regressions showed a significant correlation between

Regional geographic variations in kidney cancer incidence rates in European countries.

Science.gov (United States)

Li, Peng; Znaor, Ariana; Holcatova, Ivana; Fabianova, Eleonora; Mates, Dana; Wozniak, Magdalena B; Ferlay, Jacques; Scelo, Ghislaine

2015-06-01

Marked unexplained national variations in incidence rates of kidney cancer have been observed for decades in Europe. To investigate geographic variations at the regional level and identify European regions with high incidence rates of kidney cancer. Regional- and national-level incidence data were extracted from the Cancer Incidence in Five Continents databases, local cancer registry databases, and local published reports. World population age-standardised rates (ASRs) were calculated for the periods 2003-2007 and 1988-1992. Rates by period and sex were compared using map visualisation. During 2003-2007, the highest ASR was found in the Plzen region, Czech Republic (31.4/100,000 person-years in men). Other regions of the Czech Republic had ASRs of 18.6-27.5/100,000 in men, with a tendency for higher rates in regions south of Prague. Surrounding regions, including eastern Germany and regions of Slovakia and Austria, had medium-to-high incidence rates (13.0-16.8/100,000 in men). Three other areas in Europe showed higher incidence rates in men compared with the rest of the continent: Lithuania, Estonia, Latvia, and Belarus (15.0-17.6/100,000); Iceland (13.5/100,000), and northern Italy (up to 16.0/100,000). Similar regional differences were observed among women, with rates approximately half of those observed in men in the same region. In general, these regional geographic variations remained stable over the periods 1988-1992 and 2003-2007, although higher incidence rates were detected in the Baltic countries in 2003-2007. Several European regions show particularly high rates of kidney cancer incidence. Large variations were observed within countries covered by national health-care systems, implying that overdetection is not the major factor. We present regional geographic variations in kidney cancer incidence rates in Europe. We highlight several regions with high incidence rates where further studies should be conducted for cancer control and prevention. Copyright �

Critical incidents and the impact of satisfaction on customer share

NARCIS (Netherlands)

van Doorn, J.; Verhoef, P.C.

In business markets, the long-term nature of relationships may prompt parties to conduct "business as usual," but negative critical incidents (CIs) can cause a destabilization of these long-term relationships. The authors develop a comprehensive dynamic model of customer loyalty to account for the

Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases

Science.gov (United States)

Gabriel, Sherine E; Michaud, Kaleb

2009-01-01

Epidemiology is the study of the distribution and determinants of disease in human populations. Over the past decade there has been considerable progress in our understanding of the fundamental descriptive epidemiology (levels of disease frequency: incidence and prevalence, comorbidity, mortality, trends over time, geographic distributions, and clinical characteristics) of the rheumatic diseases. This progress is reviewed for the following major rheumatic diseases: rheumatoid arthritis (RA), juvenile rheumatoid arthritis, psoriatic arthritis, osteoarthritis, systemic lupus erythematosus, giant cell arteritis, polymyalgia rheumatica, gout, Sjögren's syndrome, and ankylosing spondylitis. These findings demonstrate the dynamic nature of the incidence and prevalence of these conditions – a reflection of the impact of genetic and environmental factors. The past decade has also brought new insights regarding the comorbidity associated with rheumatic diseases. Strong evidence now shows that persons with RA are at a high risk for developing several comorbid disorders, that these conditions may have atypical features and thus may be difficult to diagnose, and that persons with RA experience poorer outcomes after comorbidity compared with the general population. Taken together, these findings underscore the complexity of the rheumatic diseases and highlight the key role of epidemiological research in understanding these intriguing conditions. PMID:19519924

Natural agents: cellular and molecular mechanisms of photoprotection.

Science.gov (United States)

Afaq, Farrukh

2011-04-15

The skin is the largest organ of the body that produces a flexible and self-repairing barrier and protects the body from most common potentially harmful physical, environmental, and biological insults. Solar ultraviolet (UV) radiation is one of the major environmental insults to the skin and causes multi-tiered cellular and molecular events eventually leading to skin cancer. The past decade has seen a surge in the incidence of skin cancer due to changes in life style patterns that have led to a significant increase in the amount of UV radiation that people receive. Reducing excessive exposure to UV radiation is desirable; nevertheless this approach is not easy to implement. Therefore, there is an urgent need to develop novel strategies to reduce the adverse biological effects of UV radiation on the skin. A wide variety of natural agents have been reported to possess substantial skin photoprotective effects. Numerous preclinical and clinical studies have elucidated that natural agents act by several cellular and molecular mechanisms to delay or prevent skin cancer. In this review article, we have summarized and discussed some of the selected natural agents for skin photoprotection. Copyright © 2010 Elsevier Inc. All rights reserved.

Influence of positions of the incidence and severity of maxillofacial ...

African Journals Online (AJOL)

The most common vehicle involved in RTA was the mini bus, 34.3% followed by motorcycle, 26.5%. Middle seat passengers, drivers and motorcycle passengers and riders sustained more and severe injuries during crashes. The mandible was more frequently fractured at the symphysis (24.6%) than at any other site while ...

Variation in interpretation and counselling of blood exposure incidents by different medical practitioners.

NARCIS (Netherlands)

Wijk, P.T.L. van; Pelk-Jongen, M; Wijkmans, C.J.; Voss, A.; Timen, A.; Schneeberger, P.M.

2008-01-01

BACKGROUND: Blood exposure incidents pose a risk for transmission of bloodborne pathogens for both health care workers and public health. Despite several national and international guidelines, counsellors have often different opinions about the risks caused by these incidents. Little is known about

The child sexual abuse epidemic in addis ababa: some reflections on reported incidents, psychosocial consequences and implications.

Science.gov (United States)

Jemal, Jibril

2012-03-01

Though child sexual abuse is a universal phenomenon, only reported cases of the incidence are common source of information to get insight on how to understand the problem. Besides, investigating complaints presented by victims themselves would be a stepping stone for designing prevention and rehabilitation programs. The objective of this study was to identify the nature of sexual incidence and experience victims face. The research was conducted by collecting reported child sexual abuse cases from Child Protection Units of Addis Ababa Police Commission and three selected non-governmental organizations working for the welfare of sexually abused children in Addis Ababa. 64 selected samples of victim children were included from the three organizations. They completed a semi-structured questionnaire and data were analyzed. Of the total reported crime cases committed against children (between July 2005 and December 2006), 23% of them were child sexual victimization. On average, 21 children were reported to be sexually abused each month where majority of the sexual abuse incidence were committed against female children in their own home by someone they closely know. The psychological trauma and physical complaints presented by victims include symptoms of anxiety and depression. It was found out that child sexual abuse cases presented to the legal office was not properly managed. Female children appear to be more prone to sexual abuse than their male counterparts. By virtue of their nature, many children are at risk of sexual victimization by people they truest. Based on the findings, several implications are made, which includes the importance of nation-wide study to formulate a comprehensive policy guideline for protection and criminalization of child sexual abuse in Ethiopia.

Integrating incident investigation into the management system

International Nuclear Information System (INIS)

Peterson, E.E.

1992-01-01

In the last 10 yr, the size and frequency of incidents affecting the communities and environment surrounding chemical processing facilities has increased. The chemical process industry, which has always concerned itself with the safety of its facilities, has responded by committing to stricter standards of operation and management. A critical element of these management practices is the use of a structured incident investigation program. Many facilities have implemented and disciplined themselves to perform good investigation of incidents. However, most of these facilities maintain incident investigation as part of their safety management programs. This allows the process to be disconnected from the management system that deals with the day-to-day business of the facility. The first step of integration is understanding the objectives and functions of the management system into which the integration is to occur. To begin, a common definition of management is needed. Management, for the purposes of this discussion, is defined as the system of activities used to control, coordinate, and improve the flow of work within a facility or organization. This definition refers to several concepts that need further development in order to understand how incident investigation can be integrated into a management system, including (a) flow of work, (b) control, and (c) improvement. Application can be made to the nuclear industry

[Nature and severity of oppositional defiant disorder and conduct disorder as they occur together or separately in children].

Science.gov (United States)

Lapalme, Mélanie; Déry, Michèle

2009-09-01

Co-occurring oppositional defiant disorder and conduct disorder symptoms are particularly common, which could be related to the greater severity (number and nature of symptoms) of each disorder. Our study aims to determine if oppositional defiant disorder and conduct disorder symptoms vary when they occur together or separately in children. Our study was conducted with 406 children (aged 6 to 13 years) divided in 4 groups (oppositional disorder only, conduct disorder only, oppositional disorder and conduct disorder, control) with no age or sex difference. Structured diagnostic interviews conducted with one parent and each child separately led to assessing the average number of symptoms for each disorder as well as the onset frequency of each symptom. When occurring together, oppositional disorder and conduct disorder appear more severe than when they occur separately, considering the number and nature of symptoms shown. Further, children with an oppositional disorder only or a conduct disorder only also have more frequent symptoms of the other disorder, compared with children in the control group. These results suggest taking into account, at the time of assessment and potential intervention, the presence of both disorders.

Incidence Rate of Community-Acquired Sepsis Among Hospitalized Acute Medical Patients-A Population-Based Survey

DEFF Research Database (Denmark)

Henriksen, Daniel Pilsgaard; Laursen, Christian B; Jensen, Thøger Gorm

2015-01-01

to the hospital. DESIGN:: Population-based survey. SETTING:: Medical emergency department from September 1, 2010, to August 31, 2011. PATIENTS:: All patients were manually reviewed using a structured protocol in order to identify the presence of infection. Vital signs and laboratory values were collected...... to define the presence of systemic inflammatory response syndrome and organ dysfunction. MEASUREMENTS AND MAIN RESULTS:: Incidence rate of sepsis of any severity. Among 8,358 admissions to the medical emergency department, 1,713 patients presented with an incident admission of sepsis of any severity, median...... on symptoms and clinical findings at arrival, incidence rates of patients admitted to a medical emergency department with sepsis and severe sepsis are more frequent than previously reported based on discharge diagnoses....

An incident command system in practice and reality

International Nuclear Information System (INIS)

Spitzer, J.D.

1992-01-01

The basic organizational problems and options for forming a pollution response organization are described. Problems with multi-agency response organizations include poor coordination and lack of accountability. Alternatives to autonomous organizations operating with minimal coordination are the multi-agency/organization teams working under a controlling organization, and organizations formed into a single response organization (the incident command system or ICS). Design criteria for an ICS include flexibility as to the jurisdiction and agency, adaptable organizational structure, capability to expand in a logical manner, and uniform elements in terminology, organization, and procedures. ICS in practice is illustrated both by the CANUSLAK exercise undertaken in August 1990 and a real incident that occurred several days after the exercise was finished. CANUSLAK involved the US Coast Guard and its Canadian and Michigan counterparts in a simulated incident in the St. Clair river. The real incident was the explosion of the gasoline-carrying tank vessel Jupiter in the Saginaw River. In both instances, ICS combined many organizations into one team with a single incident commander. The eight basic components of ICS are common terminology, modular organization, integrated communications, unified command structure, consolidated action plan, manageable span of control, designated incident facilities, and comprehensive resource management. ICS has been tailored to a wide range of applications and is not only used in major disasters but as a part of routine operations. 18 refs., 5 figs

Probabilities of Natural Events Occurring at Savannah River Plant

Energy Technology Data Exchange (ETDEWEB)

Huang, J.C.

2001-07-17

This report documents the comprehensive evaluation of probability models of natural events which are applicable to Savannah River Plant. The probability curves selected for these natural events are recommended to be used by all SRP/SRL safety analysts. This will ensure a consistency in analysis methodology for postulated SAR incidents involving natural phenomena.

Dietary Natural Products for Prevention and Treatment of Breast Cancer.

Science.gov (United States)

Li, Ya; Li, Sha; Meng, Xiao; Gan, Ren-You; Zhang, Jiao-Jiao; Li, Hua-Bin

2017-07-08

Breast cancer is the most common cancer among females worldwide. Several epidemiological studies suggested the inverse correlation between the intake of vegetables and fruits and the incidence of breast cancer. Substantial experimental studies indicated that many dietary natural products could affect the development and progression of breast cancer, such as soy, pomegranate, mangosteen, citrus fruits, apple, grape, mango, cruciferous vegetables, ginger, garlic, black cumin, edible macro-fungi, and cereals. Their anti-breast cancer effects involve various mechanisms of action, such as downregulating ER-α expression and activity, inhibiting proliferation, migration, metastasis and angiogenesis of breast tumor cells, inducing apoptosis and cell cycle arrest, and sensitizing breast tumor cells to radiotherapy and chemotherapy. This review summarizes the potential role of dietary natural products and their major bioactive components in prevention and treatment of breast cancer, and special attention was paid to the mechanisms of action.

Severe hyperbilirubinaemia and kernicterus: more caution is needed in newborn jaundice surveillance.

LENUS (Irish Health Repository)

Allen, N M

2012-02-01

Since the 1990s, there has been a re-emergence of cases of severe hyperbilirubinaemia and kernicterus. The current UK incidence of bilirubin encephalopathy is 0.9\\/100,000 with a higher reported incidence in some countries. Three otherwise healthy newborn infants, who presented with severe hyperbilirubinaemia, including one who developed kernicterus, are reported here. Some of the current challenges in newborn jaundice surveillance are highlighted.

A spatial generalized ordered response model to examine highway crash injury severity.

Science.gov (United States)

Castro, Marisol; Paleti, Rajesh; Bhat, Chandra R

2013-03-01

This paper proposes a flexible econometric structure for injury severity analysis at the level of individual crashes that recognizes the ordinal nature of injury severity categories, allows unobserved heterogeneity in the effects of contributing factors, as well as accommodates spatial dependencies in the injury severity levels experienced in crashes that occur close to one another in space. The modeling framework is applied to analyze the injury severity sustained in crashes occurring on highway road segments in Austin, Texas. The sample is drawn from the Texas Department of Transportation (TxDOT) crash incident files from 2009 and includes a variety of crash characteristics, highway design attributes, driver and vehicle characteristics, and environmental factors. The results from our analysis underscore the value of our proposed model for data fit purposes as well as to accurately estimate variable effects. The most important determinants of injury severity on highways, according to our results, are (1) whether any vehicle occupant is ejected, (2) whether collision type is head-on, (3) whether any vehicle involved in the crash overturned, (4) whether any vehicle occupant is unrestrained by a seat-belt, and (5) whether a commercial truck is involved. Copyright © 2012 Elsevier Ltd. All rights reserved.

Diet, occupational exposure and early asthma incidence among bakers, pastry makers and hairdressers.

Science.gov (United States)

Rémen, Thomas; Acouetey, Dovi-Stéphanie; Paris, Christophe; Zmirou-Navier, Denis

2012-05-29

The natural history of occupational asthma (OA) is influenced by many determinants. This study aims to assess the combined roles of personal characteristics, including occupational exposure and nutritional habits, on the incidence of OA during the first years at work. A nested case-control study was conducted within a retrospective cohort of young workers in the bakery, pastry-making and hairdressing sectors. Cases were subjects diagnosed as 'confirmed' or 'probable' OA consecutively to a medical visit (N = 31). Controls were subjects without OA (N = 196). Atopy was defined after blood specific IgE analysis, based on the PhadiatopTM test. Occupational exposure was characterized by standardized questionnaires and diet patterns by a food frequency questionnaire. Among bakers and pastry-makers, only atopy is an independent risk factor of OA (OR = 10.07 95%CI [2.76 - 36.65]). Among hairdressers, several variables are associated with OA. Body mass index (unit OR = 1.24 [1.03 - 1.48]) and the score of exposure intensity (unit OR = 1.79 [1.05 - 3.05]) are independent predictors of OA, but the role of atopy is weak (OR = 4.94 [0.66 - 36.75]). Intake of vitamin A is higher among hairdressers cases (crude p = 0.002, adjusted p = 0.01 after control for body mass index and atopy); the same observation is made for vitamin D (crude p = 0.004, adjusted p = 0.01). This study suggests that the influence of several factors on the incidence of OA, including dietary vitamins, might vary across exposure settings.

Comprehensive Oral Health Care to Reduce the Incidence of Severe Early Childhood Caries (s-ECC) in Urban China.

Science.gov (United States)

Si, Yan; Guo, Yan; Yuan, Chao; Xu, Tao; Zheng, Shu Guo

2016-03-01

To explore the effectiveness of comprehensive oral health care to reduce the caries incidence for children with severe early childhood caries (s-ECC) in an urban area in China. A total of 357 children aged 3 to 4 years old and diagnosed with s-ECC were recruited in this randomised controlled, single-blinded clinical trial for 1 year. Children of two different kindergarten classes were enrolled in this study and randomly divided into a test group (205 children) and a control group (152 children). The test group received comprehensive oral health care, which included: oral health examination, oral health education, topical fluoride application and dental treatment, and the children in the control group only received the oral health examination. The evaluation of the oral health questionnaire for parents was also performed. An evaluation was carried out at the time of recruitment and 1 year later to explore the effectiveness of the comprehensive oral health care model. The differences in decayed teeth (dt), decayed tooth surfaces (ds), filled teeth (ft), filled tooth surfaces (fs) and the ratio of ft /(dt + ft) between the two groups were statistically significant (P comprehensive oral health care program reduces and prevents caries amongst children with s-ECC.

E-Community: Mobile application for reporting incidents of public services of a city

OpenAIRE

Jaime Suárez; Elvia Aispuro; Mónica Carreño; Andrés Sandoval; Italia Estrada; Jesús Hernández; Javier Aguilar; Yoshio Valles; Emma Ibarra

2013-01-01

This paper reports the mobile application call E-Community, an application of a social nature with the objective that the civilian population in the city of La Paz, Baja California Sur, Mexico, have an alternative to report incidents that deal with services public. Generally, citizens reported by telephone different types of incidents such as traffic accidents, water leaks, lighting shabby, fire, garbage collection, however sometimes the phone is not attended for various reasons so regularly ...

Incidence and public health burden of sunburn among ...

Science.gov (United States)

Sunburn, a preventable skin condition, is a major risk factor for skin cancer. Severe burns can result in emergency department visits and in some cases hospitalization. Many people spend hours in direct sunlight while at the beach, which could lead to sunburn. We pooled data from 13 prospective cohorts of beachgoers in the United States (n=84,411) to describe incidence of sunburn, risk factors associated with an increased risk of sunburn, and the health burden resulting from time lost from work or school, visits to the doctor, and medication use. The incidence of sunburn in this population in the 10-12 days after the beach visit was 14% (n=9,882), excluding those with sunburn at enrollment. Sunburn incidence increased with greater time spent in the sun. Approximately 8% of beachgoers only exposed for sunburn, whereas almost 20% spending ≥5 hours in the sun reported sunburn (psunburn (15% versus 11%, psunburns (17%) or freckles when in the sun (13%) compared to 11% who typically get dark tans. The incidence of sunburn varied considerably by age group. Children ages sunburn (2%) whereas adults between the ages of 19-35 had the highest incidence of sunburn (18%). Preliminary analyses indicate t

Depression and incident dementia. An 8-year population-based prospective study.

Science.gov (United States)

Luppa, Melanie; Luck, Tobias; Ritschel, Franziska; Angermeyer, Matthias C; Villringer, Arno; Riedel-Heller, Steffi G

2013-01-01

The aim of the study was to investigate the impact of depression (categorical diagnosis; major depression, MD) and depressive symptoms (dimensional diagnosis and symptom patterns) on incident dementia in the German general population. Within the Leipzig Longitudinal Study of the Aged (LEILA 75+), a representative sample of 1,265 individuals aged 75 years and older were interviewed every 1.5 years over 8 years (mean observation time 4.3 years; mean number of visits 4.2). Cox proportional hazards and binary logistic regressions were used to estimate the effect of baseline depression and depressive symptoms on incident dementia. The incidence of dementia was 48 per 1,000 person-years (95% confidence interval (CI) 45-51). Depressive symptoms (Hazard ratio HR 1.03, 95% CI 1.01-1.05), and in particular mood-related symptoms (HR 1.08, 95% CI 1.03-1.14), showed a significant impact on the incidence of dementia only in univariate analysis, but not after adjustment for cognitive and functional impairment. MD showed only a significant impact on incidence of dementia in Cox proportional hazards regression, but not in binary logistic regression models. The present study using different diagnostic measures of depression on future dementia found no clear significant associations of depression and incident dementia. Further in-depth investigation would help to understand the nature of depression in the context of incident dementia.

Social determinants and inequalities in tuberculosis incidence in Latin America and the Caribbean

Directory of Open Access Journals (Sweden)

César V. Munayco

2015-09-01

Full Text Available OBJECTIVE: To identify key social determinants of tuberculosis (TB incidence among countries in Latin America and the Caribbean (LAC, a geographic area regarded as one of the most socioeconomically unequal in the world METHODS: An ecological study was conducted at the country level. Data were obtained from several institutional-based sources. Random-effects regression modeling was used to explore the relationship between several social determinants indicators and TB incidence rates in 20 LAC countries in 1995-2012. Standard gap and gradient metrics of social inequality in TB incidence among countries in 2000, 2005, and 2010 were then calculated. RESULTS: TB incidence rate trends were significantly associated with health expenditure per capita and access to improved sanitation facilities, as well as with life expectancy at birth and TB detection rate, after adjusting for other socioeconomic, demographic, and health services variables. Absolute and relative inequality in TB incidence remained mostly unchanged: countries at the bottom 20% of both health expenditure and sanitation coverage distributions concentrated up to 40% of all TB incident cases, despite a considerable decline in the overall TB incidence mean rate during the period assessed. CONCLUSIONS: Along with the intensity of TB control (reflected by TB detection rate, both access to sanitation (as a proxy of quality of living conditions and health expenditure per capita (either as an indicator of the level of resources and/or commitment to health care appear to be key determinants of TB incidence trends in LAC countries. Inequalities in both health expenditure per capita and access to sanitation seem to define profound and persistent inverse gradients in TB incidence among LAC countries.

Learning from radiation incidents: the new OTHEA website

International Nuclear Information System (INIS)

Shaw, P V; Ely, S Y; Croueail, P; Bataille, C

2010-01-01

OTHEA is the name of a new website (www.othea.net), created by the Health Protection Agency (UK) and the Centre d'etude sur l'evaluation de la protection dans le domaine nucleaire (CEPN, France), and supported by several other stakeholders including national societies and associations. The website is bi-lingual (French and English) and the purpose is to share the lessons learnt from radiological incidents that have occurred in the industrial, medical, research and teaching, and other non-nuclear sectors. OTHEA contains a collection of incident reports, categorised according to the sector and the type of application, and a search facility. The reports can be freely downloaded and printed, for example for use in radiation protection training activities. To encourage dissemination, the incident reports have been made anonymous, i.e. any information that could identify a particular individual, organisation or site has been removed. Each report contains a brief summary of the incident, the radiological consequences, and the lessons learnt. The aim is not to capture every single incident, but to provide a range of reports selected according to the value of the lessons learnt. For OTHEA to be a long-term success, it needs to be sustained with new reports. Therefore users are encouraged to submit incident reports that can be considered for inclusion in OTHEA. This note summarises the background to OTHEA, and provides a description of the operating features and content at its launch in summer 2010. (note)

Improvement in operating incident experience at the Savannah River Burial Ground

International Nuclear Information System (INIS)

Cornman, W.R.

1979-01-01

Low-level radioactive wastes generated at the Savannah River Plant and Laboratory are stored at the Savannah River burial ground. These wastes have accumulated from >20 years of reprocessing nuclear fuels and materials for defense programs at the Savannah River Plant. Burial in earthen trenches and aboveground storage for transuranic materials are the principal modes of storage. The infrequent operating incidents that have occurred during the 20-year period have been analyzed. The incidents can be categorized as those causing airborne contamination, waterborne contamination, or vegetation contamination through penetration of plant roots into contaminated soil. Contamination was generally confined to the immediate area of the burial ground. Several incidents occurred because of unintentional burial or exhumation of material. The frequency of operating incidents decreased with operating experience of the burial ground, averaging only about two incidents per year during the last six years of operation

Severe adverse events related to tattooing: An retrospective analysis of 11 years

Directory of Open Access Journals (Sweden)

Uwe Wollina

2012-01-01

Full Text Available Background: The incidence of tattoos has been increased markedly during the last 20 years. Aims: To analyze the patient files for severe adverse medical reactions related to tattooing. Settings: Academic Teaching Hospital in South-East Germany. Materials and Methods: Retrospective investigation from March 2001 to May 2012. Results: The incidence of severe adverse medical reactions has been estimated as 0.02%. Infectious and non-infectious severe reactions have been observed. The consequences were medical drug therapies and surgery. Conclusions: Tattooing may be associated with severe adverse medical reactions with significant morbidity. Regulations, education and at least hygienic controls are tools to increase consumer safety.

Incidence of bacterial diseases associated with irrigation methods on onions (Allium cepa).

Science.gov (United States)

Chorolque, A; Pozzo Ardizzi, C; Pellejero, G; Aschkar, G; García Navarro, F J; Jiménez Ballesta, R

2018-04-24

In the last decade, diseases of bacterial origin in onions have increased and this has led to significant losses in production. These diseases are currently observed in both the Old and New Worlds. The aim of the experimental work reported here was to evaluate whether the irrigation method influences the incidence of diseases of bacterial origin. In cases where the inoculum was natural, the initial incidence of Soft Bacterial Rot was not manifested in any treatment in the first year, whereas at the end of the conservation period all treatments had increased incidences of infection. Sprinkler irrigation (8%) was statistically differentiated from the other treatments, for which the final incidence was similar (4.5%). For all irrigation treatments, the final incidence of Bacterial Soft Rot decreased or remained stable towards the end of the cycle, with the exception of sprinkler irrigation in 2015, which increased. It can be inferred from the results that the irrigation method does have an influence on the incidence of diseases of bacterial origin in the post-harvest stage for onions. This article is protected by copyright. All rights reserved.

Rural and urban distribution of trauma incidents in Scotland.

Science.gov (United States)

Morrison, J J; McConnell, N J; Orman, J A; Egan, G; Jansen, J O

2013-02-01

Trauma systems reduce mortality and improve functional outcomes from injury. Regional trauma networks have been established in several European regions to address longstanding deficiencies in trauma care. A perception of the geography and population distribution as challenging has delayed the introduction of a trauma system in Scotland. The characteristics of trauma incidents attended by the Scottish Ambulance Service were analysed, to gain a better understanding of the geospatial characteristics of trauma in Scotland. Data on trauma incidents collected by the Scottish Ambulance Service between November 2008 and October 2010 were obtained. Incident location was analysed by health board region, rurality and social deprivation. The results are presented as number of patients, average annual incidence rates and relative risks. Of the 141,668 incidents identified, 72·1 per cent occurred in urban regions. The risk of being involved in an incident was similar across the most populous regions, and decreased slightly with increasing rurality. Social deprivation was associated with greater numbers and risk. A total of 53·1 per cent of patients were taken to a large general hospital, and 38·6 per cent to a teaching hospital; the distribution was similar for the subset of incidents involving patients with physiological derangements. The majority of trauma incidents in Scotland occur in urban and deprived areas. A regionalized system of trauma care appears plausible, although the precise configuration of such a system requires further study. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Computer incident response and forensics team management conducting a successful incident response

CERN Document Server

Johnson, Leighton

2013-01-01

Computer Incident Response and Forensics Team Management provides security professionals with a complete handbook of computer incident response from the perspective of forensics team management. This unique approach teaches readers the concepts and principles they need to conduct a successful incident response investigation, ensuring that proven policies and procedures are established and followed by all team members. Leighton R. Johnson III describes the processes within an incident response event and shows the crucial importance of skillful forensics team management, including when and where the transition to forensics investigation should occur during an incident response event. The book also provides discussions of key incident response components. Provides readers with a complete handbook on computer incident response from the perspective of forensics team management Identify the key steps to completing a successful computer incident response investigation Defines the qualities necessary to become a succ...

Estimating the impact of natural and technogenic factors on the incidence of malignant neoplasms in Altai krai

Science.gov (United States)

Romanov, A. N.; Kovrigin, A. O.; Lazarev, A. F.; Lubennikov, V. A.

2016-12-01

Air pollution by industry and motor vehicles, the use of coal ash for the construction of residential and nonresidential buildings, and the presence of dead zones in the residential sector are the main factors of carcinogenic risk to human health. Natural factors (such as topography and prevailing wind directions) can weaken or strengthen technogenic factors. Based on the estimate of pollutant concentrations in the snow cover of Barnaul, we reveal residential areas that are located at the crossroads of atmospheric transport of carcinogenic substances and characterized by concentrations considerably exceeding the maximum allowable concentration. These areas are characterized by the integral accumulation of carcinogenic substances concurrently from multiple sources; for almost any wind rose, the impact of one of the pollution sources is observed throughout the year. The assessment of the carcinogenic risk for a territory depends much on the correlation between local topography and the height of apartments above ground level. Using cancer register data for Barnaul, we reveal an increased level of the incidence of malignant neoplasms in people living in high-rise buildings located in areas with a sharp change in topography (such as ledges, hills, and lowlands). This may occur due to stagnant zones and wind shadows; under certain correlation between topography and the height and shape of buildings, carcinogenic substances accumulate maximally.

The incidence and clinical presentation of infantile rotavirus ...

African Journals Online (AJOL)

Objectives. An effective vaccine is needed to protect against severe rotavirus disease, an important cause of gastroenteritis. Since there are no data on the incidence and antigenic diversity of rotavirus infection in Sierra Leone, we studied its epidemiology to enable an effective vaccine strategy to be designed. Methods.

Prevalence, incidence and molecular identification of root-knot ...

African Journals Online (AJOL)

Tomato is a widely grown vegetable in Pakistan. However, its production is severely constrained by root knot nematodes (RKNs). Accurate identification of RKNs is essential for an appropriate control program. The current study evaluated the prevalence, incidence and diversity of RKNs of tomato crops grown in the Khyber ...

Natural and technologic hazardous material releases during and after natural disasters: a review.

Science.gov (United States)

Young, Stacy; Balluz, Lina; Malilay, Josephine

2004-04-25

Natural disasters may be powerful and prominent mechanisms of direct and indirect hazardous material (hazmat) releases. Hazardous materials that are released as the result of a technologic malfunction precipitated by a natural event are referred to as natural-technologic or na-tech events. Na-tech events pose unique environmental and human hazards. Disaster-associated hazardous material releases are of concern, given increases in population density and accelerating industrial development in areas subject to natural disasters. These trends increase the probability of catastrophic future disasters and the potential for mass human exposure to hazardous materials released during disasters. This systematic review summarizes direct and indirect disaster-associated releases, as well as environmental contamination and adverse human health effects that have resulted from natural disaster-related hazmat incidents. Thorough examination of historic disaster-related hazmat releases can be used to identify future threats and improve mitigation and prevention efforts.

Community pharmacy incident reporting: a new tool for community pharmacies in Canada.

Science.gov (United States)

Ho, Certina; Hung, Patricia; Lee, Gary; Kadija, Medina

2010-01-01

Incident reporting offers insight into a variety of intricate processes in healthcare. However, it has been found that medication incidents are under reported in the community pharmacy setting. The Community Pharmacy Incident Reporting (CPhIR) program was created by the Institute for Safe Medication Practices Canada specifically for incident reporting in the community pharmacy setting in Canada. The initial development of key elements for CPhIR included several focus-group teleconferences with pharmacists from Ontario and Nova Scotia. Throughout the development and release of the CPhIR pilot, feedback from pharmacists and pharmacy technicians was constantly incorporated into the reporting program. After several rounds of iterative feedback, testing and consultation with community pharmacy practitioners, a final version of the CPhIR program, together with self-directed training materials, is now ready to launch. The CPhIR program provides users with a one-stop platform to report and record medication incidents, export data for customized analysis and view comparisons of individual and aggregate data. These unique functions allow for a detailed analysis of underlying contributing factors in medication incidents. A communication piece for pharmacies to share their experiences is in the process of development. To ensure the success of the CPhIR program, a patient safety culture must be established. By gaining a deeper understanding of possible causes of medication incidents, community pharmacies can implement system-based strategies for quality improvement and to prevent potential errors from occurring again in the future. This article highlights key features of the CPhIR program that will assist community pharmacies to improve their drug distribution system and, ultimately, enhance patient safety.

Novel targets for natural killer/T-cell lymphoma immunotherapy.

Science.gov (United States)

Kumai, Takumi; Kobayashi, Hiroya; Harabuchi, Yasuaki

2016-01-01

Extranodal natural killer/T-cell lymphoma, nasal type (NKTL) is a rare but highly aggressive Epstein-Barr virus-related malignancy, which mainly occurs in nasopharyngeal and nasal/paranasal areas. In addition to its high prevalence in Asian, Central American and South American populations, its incidence rate has been gradually increasing in Western countries. The current mainstay of treatment is a combination of multiple chemotherapies and irradiation. Although chemoradiotherapy can cure NKTL, it often causes severe and fatal adverse events. Because a growing body of evidence suggests that immunotherapy is effective against hematological malignancies, this treatment could provide an alternative to chemoradiotherapy for treatment of NKTL. In this review, we focus on how recent findings could be used to develop efficient immunotherapies against NKTL.

Severe Intellectual Disability: Systematic Review of the Prevalence and Nature of Presentation of Unipolar Depression.

Science.gov (United States)

Walton, Catherine; Kerr, Mike

2016-09-01

The diagnosis of depression in severe and profound intellectual disability is challenging. Without adequate skills in verbal self-expression, standardized diagnostic criteria cannot be used with confidence. The purpose of this systematic review was to investigate the assessment and diagnosis of unipolar depression in severe and profound intellectual disability. The review aimed to examine the methods used to assess for depression. The secondary aim was to explore the frequency and symptoms of depression. The PRISMA (2009) Checklist for systematic review was followed, and a search of electronic databases was undertaken. Nine studies were included in the qualitative synthesis from over 2000 records identified. The quality of the studies was assessed and scored, with a wide range of results. Individual studies scored between 2 and 7 of a maximum possible score of 8. The diagnostic tools utilized by each of the studies were assessed and compared. In terms of the methods used to assess for depression, results were varied. This was due to the heterogeneous nature of the individual study designs. The Aberrant Behaviour Checklist consistently showed promise, in particular when combined with other instruments or clinical examination. Qualitative analysis of the selected studies has shown a wide variation in the quality of primary research in this field, with more required to make firm conclusions regarding the diagnosis, frequency and presentation of depression in severe and profound intellectual disability. © 2015 John Wiley & Sons Ltd.

Epidemiology of biological-exposure incidents among Spanish healthcare workers.

Science.gov (United States)

Monge, V; Mato, G; Mariano, A; Fernández, C; Fereres, J

2001-12-01

To determine the frequency and the epidemiological characteristics of biological-exposure incidents occurring among healthcare personnel. Prospective surveillance study. Participating Spanish primary-care and specialty centers from January 1994 to December 1997. 70 centers in 1994, 87 in 1995, 97 in 1996, and 104 in 1997. Absolute and relative frequencies were calculated for several variables (position held, area of care, type of injuring object, activity, etc) and for the different categories of each variable. There were 20,235 registered incidents. Annual incidence rates were as follows: 1994, 51 per 1,000; 1995, 58 per 1,000, 1996, 54 per 1,000; and 1997, 59 per 1,000. Mean age of accident victims was as follows: 1994, 35.68 (standard deviation [SD], 16.26); 1995, 33.6 (SD, 11.9); 1996,38.2 (SD, 17.27); and 1997, 36.7 (SD, 16.33) years. Of the 20,235 incidents, 15,860 (80.7%) occurred to women; 50% (9,833) accidents were among nursing staff. The type of incident most frequently reported was percutaneous injury (81.1%). The highest frequency of accidents was seen in medical and surgical areas (28% and 25.6%, respectively). Blood and blood products were the most commonly involved material (87.6%). Administration of intramuscular or intravenous medication was the activity associated with the highest accident rate (20.3%). The most frequent immediate action in response was rinsing and disinfecting (65.6%). The incident registry was highly stable in terms of incidence rates over the observation period and served to highlight the large number of incidents recorded each year. The potential implications of the results are the need to explore reasons for increased exposures in certain areas, with the aim of focusing prevention efforts, and, similarly, to establish the factors associated with diminished incidence rates to model successful measures.

Psychiatric disease incidence among Danish Seventh-day Adventists and Baptists.

Science.gov (United States)

Thygesen, Lau Caspar; Dalton, Susanne Oksbjerg; Johansen, Christoffer; Ross, Lone; Kessing, Lars Vedel; Hvidt, Niels Christian

2013-10-01

Previous studies suggest that religious practice can have a positive effect on mental health, but may also have potential for harm. In Denmark, unique possibilities are available for studying the influence of religious practice on mental health: Denmark is characterized as a secular society and it is possible to follow members of religious societies in nationwide registers. In this study, we follow a cohort of Danish Seventh-day Adventists (SDA) and Baptists in a nationwide psychiatry register and compare the incidence in this cohort with the general population. We followed a cohort of 5,614 SDA and 3,663 Baptists in the Danish Psychiatric Central Register, which contained information on psychiatric hospitalizations from 1970 to 2009. Psychiatric disease incidence in the cohort was compared with that in the general Danish population as standardized incidence ratios and within-cohort comparisons were made with a Cox model. The cohort had decreased incidence of abuse disorders compared to the general population. Furthermore, among Baptists, decreased incidence of unipolar disorders among men and decreased incidence of schizophrenia among women were observed. Surprisingly, we observed an increased incidence rate of unipolar disorder among women. In this nationwide cohort study with 40 years of follow-up, we observed increased incidence rates of unipolar disorders among women and decreased rates of alcohol- and drug-related psychiatric disorders compared to the general Danish population. We have no mechanistic explanation for the increased incidence of unipolar disorders among women, but discuss several hypotheses that could explain this observation.

Incidence of cutaneous adverse drug reactions among medical inpatients of Sultanah Aminah Hospital Johor Bahru.

Science.gov (United States)

Latha, S; Choon, S E

2017-06-01

Cutaneous adverse drug reactions (cADRs) are common. There are only few studies on the incidence of cADRs in Malaysia. To determine the incidence, clinical features and risk factors of cADRs among hospitalized patients. A prospective study was conducted among medical inpatients from July to December 2014. A total of 43 cADRs were seen among 11 017 inpatients, yielding an incidence rate of 0.4%. cADR accounted for hospitalization in 26 patients. Previous history of cADR was present in 14 patients, with 50% exposed to the same drug taken previously. Potentially lifethreatening severe cutaneous adverse reactions (SCAR), namely drug reaction with eosinophilia and systemic symptoms (DRESS: 14 cases) and Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN: 6 cases) comprise almost 50% of cADRs. The commonest culprit drug group was antibiotics (37.2%), followed by anticonvulsants (18.6%). Cotrimoxazole, phenytoin and rifampicin were the main causative drugs for DRESS. Anticonvulsants were most frequently implicated in SJS/TEN (66.7%). Most cases had "probable" causality relationship with suspected drug (69.8%). The majority of cases were of moderate severity (65.1%), while 18.6% had severe reaction with 1 death recorded. Most cases were not preventable (76.7%). Older age (> 60 years) and mucosal involvement were significantly associated with a more severe reaction. The incidence of cADRs was 0.4%, with most cases classified as moderate severity and not preventable. The commonest reaction pattern was DRESS, while the main culprit drug group was antibiotics. Older age and mucosal membrane involvement predicts a severe drug reaction.

Epidemiology of Eating Disorders : Incidence, Prevalence and Mortality Rates

NARCIS (Netherlands)

Smink, Frederique R. E.; van Hoeken, Daphne; Hoek, Hans W.

Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms

Scrutinizing incident reporting in anaesthesia: why is an incident perceived as critical?

DEFF Research Database (Denmark)

Maaløe, R; la Cour, M; Hansen, A

2006-01-01

The purpose of the present study was to measure the incidence and type of incidents that occurred in relation to anaesthesia and surgery during a 1-year period in six Danish hospitals. Furthermore, we wanted to identify risk factors for incidents, as well as risk factors for incidents being deeme...... critical....

Cancer incidence among Nordic airline cabin crew.

Science.gov (United States)

Pukkala, Eero; Helminen, Mika; Haldorsen, Tor; Hammar, Niklas; Kojo, Katja; Linnersjö, Anette; Rafnsson, Vilhjálmur; Tulinius, Hrafn; Tveten, Ulf; Auvinen, Anssi

2012-12-15

Airline cabin crew are occupationally exposed to cosmic radiation and jet lag with potential disruption of circadian rhythms. This study assesses the influence of work-related factors in cancer incidence of cabin crew members. A cohort of 8,507 female and 1,559 male airline cabin attendants from Finland, Iceland, Norway and Sweden was followed for cancer incidence for a mean follow-up time of 23.6 years through the national cancer registries. Standardized incidence ratios (SIRs) were defined as ratios of observed and expected numbers of cases. A case-control study nested in the cohort (excluding Norway) was conducted to assess the relation between the estimated cumulative cosmic radiation dose and cumulative number of flights crossing six time zones (indicator of circadian disruption) and cancer risk. Analysis of breast cancer was adjusted for parity and age at first live birth. Among female cabin crew, a significantly increased incidence was observed for breast cancer [SIR 1.50, 95% confidence interval (95% CI) 1.32-1.69], leukemia (1.89, 95% CI 1.03-3.17) and skin melanoma (1.85, 95% CI 1.41-2.38). Among men, significant excesses in skin melanoma (3.00, 95% CI 1.78-4.74), nonmelanoma skin cancer (2.47, 95% CI 1.18-4.53), Kaposi sarcoma (86.0, 95% CI 41.2-158) and alcohol-related cancers (combined SIR 3.12, 95% CI 1.95-4.72) were found. This large study with complete follow-up and comprehensive cancer incidence data shows an increased incidence of several cancers, but according to the case-control analysis, excesses appear not to be related to the cosmic radiation or circadian disruptions from crossing multiple time zones. Copyright © 2012 UICC.

The natural history of substance use disorders.

Science.gov (United States)

Sarvet, Aaron L; Hasin, Deborah

2016-07-01

Illicit drugs, alcohol, and tobacco use disorders contribute substantially to the global burden of disease. Knowledge about the major elements of the natural history of substance use disorders (incidence, remission, persistence, and relapse) is crucial to a broader understanding of the course and outcomes of substance use disorders. Prospective cohort studies in nonclinical samples indicate that externalizing psychopathology in earlier life, including early disordered substance use, delinquency, and personality disorders, are related to substance use disorders later in life and chronic course. Externalizing psychopathology may be initiated by early adverse experiences, for example, childhood maltreatment and stressful life events. After controlling for confounders, 'age at first use' as a causal factor for alcohol use disorder later in life and the 'drug substitution' hypothesis are not supported in general population data. Future research should focus on elaborating the causal framework that leads to the development and persistence of severe substance use disorders, with an emphasis on identifying modifiable factors for intervention by policy makers or health professionals. More research is needed on the natural history of substance use disorders in low-income and middle-income countries.

The incidence of torpor in winter and summer in the Angolan free ...

African Journals Online (AJOL)

The incidence of torpor during summer and winter in response to cold exposure in Mops condylurus was studied in a subtropical environment. Body temperature changes under natural roosting conditions during winter and summer were monitored using bats fitted with temperature-sensitive radio transmitters.

Nursing care of children after a traumatic incident.

Science.gov (United States)

Mulvihill, Deanna

2007-01-01

The objective of this study was to describe the nursing interventions with children and their parents to reduce the impact of a traumatic incident. A traumatic incident can be a natural disaster, a plane or car accident, or child abuse. The author has conducted an interdisciplinary integrative review of the research literature on the health impact of childhood trauma. This research is summarized and the results are synthesized and presented in a diagram that demonstrates the strong relationships that trauma has to both short and long-term health status. The impact of post-traumatic stress disorder (PTSD) and interventions to reduce its impact are described. Predictability and continuity in nursing care grounded in both routine and personnel are important. Nurses can teach self-soothing techniques and coping skills prior to using exploratory dialogue to assist the child and the parent in reviewing the traumatic incident. Nurses can also act as advocates for unsafe situations and practices, such as corporal punishment. Assessment of children for history of trauma is indicated, especially children who exhibit signs of short-term health effects. Areas for health education and future research are also presented.

Reproducibility of The Random Incidence Absorption Coefficient Converted From the Sabine Absorption Coefficient

DEFF Research Database (Denmark)

Jeong, Cheol-Ho; Chang, Ji-ho

2015-01-01

largely depending on the test room. Several conversion methods for porous absorbers from the Sabine absorption coefficient to the random incidence absorption coefficient were suggested by considering the finite size of a test specimen and non-uniformly incident energy onto the specimen, which turned out...... resistivity optimization outperforms the surface impedance optimization in terms of the reproducibility....

Historical analysis of US pipeline accidents triggered by natural hazards

Science.gov (United States)

Girgin, Serkan; Krausmann, Elisabeth

2015-04-01

Natural hazards, such as earthquakes, floods, landslides, or lightning, can initiate accidents in oil and gas pipelines with potentially major consequences on the population or the environment due to toxic releases, fires and explosions. Accidents of this type are also referred to as Natech events. Many major accidents highlight the risk associated with natural-hazard impact on pipelines transporting dangerous substances. For instance, in the USA in 1994, flooding of the San Jacinto River caused the rupture of 8 and the undermining of 29 pipelines by the floodwaters. About 5.5 million litres of petroleum and related products were spilled into the river and ignited. As a results, 547 people were injured and significant environmental damage occurred. Post-incident analysis is a valuable tool for better understanding the causes, dynamics and impacts of pipeline Natech accidents in support of future accident prevention and mitigation. Therefore, data on onshore hazardous-liquid pipeline accidents collected by the US Pipeline and Hazardous Materials Safety Administration (PHMSA) was analysed. For this purpose, a database-driven incident data analysis system was developed to aid the rapid review and categorization of PHMSA incident reports. Using an automated data-mining process followed by a peer review of the incident records and supported by natural hazard databases and external information sources, the pipeline Natechs were identified. As a by-product of the data-collection process, the database now includes over 800,000 incidents from all causes in industrial and transportation activities, which are automatically classified in the same way as the PHMSA record. This presentation describes the data collection and reviewing steps conducted during the study, provides information on the developed database and data analysis tools, and reports the findings of a statistical analysis of the identified hazardous liquid pipeline incidents in terms of accident dynamics and

Sexual cannibalism: high incidence in a natural population with benefits to females.

Directory of Open Access Journals (Sweden)

Rubén Rabaneda-Bueno

Full Text Available Sexual cannibalism may be a form of extreme sexual conflict in which females benefit more from feeding on males than mating with them, and males avoid aggressive, cannibalistic females in order to increase net fitness. A thorough understanding of the adaptive significance of sexual cannibalism is hindered by our ignorance of its prevalence in nature. Furthermore, there are serious doubts about the food value of males, probably because most studies that attempt to document benefits of sexual cannibalism to the female have been conducted in the laboratory with non-natural alternative prey. Thus, to understand more fully the ecology and evolution of sexual cannibalism, field experiments are needed to document the prevalence of sexual cannibalism and its benefits to females.We conducted field experiments with the Mediterranean tarantula (Lycosa tarantula, a burrowing wolf spider, to address these issues. At natural rates of encounter with males, approximately a third of L. tarantula females cannibalized the male. The rate of sexual cannibalism increased with male availability, and females were more likely to kill and consume an approaching male if they had previously mated with another male. We show that females benefit from feeding on a male by breeding earlier, producing 30% more offspring per egg sac, and producing progeny of higher body condition. Offspring of sexually cannibalistic females dispersed earlier and were larger later in the season than spiderlings of non-cannibalistic females.In nature a substantial fraction of female L. tarantula kill and consume approaching males instead of mating with them. This behaviour is more likely to occur if the female has mated previously. Cannibalistic females have higher rates of reproduction, and produce higher-quality offspring, than non-cannibalistic females. Our findings further suggest that female L. tarantula are nutrient-limited in nature and that males are high-quality prey. The results of these

Diet, occupational exposure and early asthma incidence among bakers, pastry makers and hairdressers

Directory of Open Access Journals (Sweden)

Rémen Thomas

2012-05-01

Full Text Available Abstract Background The natural history of occupational asthma (OA is influenced by many determinants. This study aims to assess the combined roles of personal characteristics, including occupational exposure and nutritional habits, on the incidence of OA during the first years at work. Methods A nested case–control study was conducted within a retrospective cohort of young workers in the bakery, pastry-making and hairdressing sectors. Cases were subjects diagnosed as ‘confirmed’ or ‘probable’ OA consecutively to a medical visit (N = 31. Controls were subjects without OA (N = 196. Atopy was defined after blood specific IgE analysis, based on the PhadiatopTM test. Occupational exposure was characterized by standardized questionnaires and diet patterns by a food frequency questionnaire. Results Among bakers and pastry-makers, only atopy is an independent risk factor of OA (OR = 10.07 95%CI [2.76 – 36.65]. Among hairdressers, several variables are associated with OA. Body mass index (unit OR = 1.24 [1.03 – 1.48] and the score of exposure intensity (unit OR = 1.79 [1.05 – 3.05] are independent predictors of OA, but the role of atopy is weak (OR = 4.94 [0.66 – 36.75]. Intake of vitamin A is higher among hairdressers cases (crude p = 0.002, adjusted p = 0.01 after control for body mass index and atopy; the same observation is made for vitamin D (crude p = 0.004, adjusted p = 0.01. Conclusion This study suggests that the influence of several factors on the incidence of OA, including dietary vitamins, might vary across exposure settings.

Incidence Rates of Clinical Mastitis among Canadian Holsteins Classified as High, Average, or Low Immune Responders

Science.gov (United States)

Miglior, Filippo; Mallard, Bonnie A.

2013-01-01

The objective of this study was to compare the incidence rate of clinical mastitis (IRCM) between cows classified as high, average, or low for antibody-mediated immune responses (AMIR) and cell-mediated immune responses (CMIR). In collaboration with the Canadian Bovine Mastitis Research Network, 458 lactating Holsteins from 41 herds were immunized with a type 1 and a type 2 test antigen to stimulate adaptive immune responses. A delayed-type hypersensitivity test to the type 1 test antigen was used as an indicator of CMIR, and serum antibody of the IgG1 isotype to the type 2 test antigen was used for AMIR determination. By using estimated breeding values for these traits, cows were classified as high, average, or low responders. The IRCM was calculated as the number of cases of mastitis experienced over the total time at risk throughout the 2-year study period. High-AMIR cows had an IRCM of 17.1 cases per 100 cow-years, which was significantly lower than average and low responders, with 27.9 and 30.7 cases per 100 cow-years, respectively. Low-AMIR cows tended to have the most severe mastitis. No differences in the IRCM were noted when cows were classified based on CMIR, likely due to the extracellular nature of mastitis-causing pathogens. The results of this study demonstrate the desirability of breeding dairy cattle for enhanced immune responses to decrease the incidence and severity of mastitis in the Canadian dairy industry. PMID:23175290

Critical analysis of major incidents risks in civil nuclear energy

International Nuclear Information System (INIS)

2000-09-01

The differences existing between the PWR type reactors and the RBMK type reactors are explained as well as the risk associated to each type when it exists. The Ines scale, tool to give the level of an accident gravity comprises seven levels, the number seven is the most serious and corresponds to the Chernobyl accident; The number zero is of no consequence but must be mentioned as a matter of form. The incidents from 1 to 3 concern increasing incidents, affecting the nuclear power plant but not the external public. The accidents from 4 to 7 have a nature to affect the nuclear power plant and the environment. An efficient tool exists between nuclear operators it is made of the reports on incidents encountered by close reactors. Two others type reactors are coming, the high temperature type reactors and the fast neutrons reactors. different risks are evoked, terrorism, proliferation, transport and radioactive wastes. (N.C.)

Incidence of rotavirus gastroenteritis by age in African, Asian and European children: Relevance for timing of rotavirus vaccination

Science.gov (United States)

Steele, A. Duncan; Madhi, Shabir A.; Cunliffe, Nigel A.; Vesikari, Timo; Phua, Kong Boo; Lim, Fong Seng; Nelson, E. Anthony S.; Lau, Yu-Lung; Huang, Li-Min; Karkada, Naveen; Debrus, Serge; Han, Htay Htay; Benninghoff, Bernd

2016-01-01

ABSTRACT Variability in rotavirus gastroenteritis (RVGE) epidemiology can influence the optimal vaccination schedule. We evaluated regional trends in the age of RVGE episodes in low- to middle- versus high-income countries in three continents. We undertook a post-hoc analysis based on efficacy trials of a human rotavirus vaccine (HRV; Rotarix™, GSK Vaccines), in which 1348, 1641, and 5250 healthy infants received a placebo in Europe (NCT00140686), Africa (NCT00241644), and Asia (NCT00197210, NCT00329745). Incidence of any/severe RVGE by age at onset was evaluated by active surveillance over the first two years of life. Severity of RVGE episodes was assessed using the Vesikari-scale. The incidence of any RVGE in Africa was higher than in Europe during the first year of life (≤2.78% vs. ≤2.03% per month), but much lower during the second one (≤0.86% versus ≤2.00% per month). The incidence of severe RVGE in Africa was slightly lower than in Europe during the first year of life. Nevertheless, temporal profiles for the incidence of severe RVGE in Africa and Europe during the first (≤1.00% and ≤1.23% per month) and second (≤0.53% and ≤1.13% per month) years of life were similar to those of any RVGE. Any/severe RVGE incidences peaked at younger ages in Africa vs. Europe. In high-income Asian regions, severe RVGE incidence (≤0.31% per month) remained low during the study. The burden of any RVGE was higher earlier in life in children from low- to middle- compared with high-income countries. Differing rotavirus vaccine schedules are likely warranted to maximize protection in different settings. PMID:27260009

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

Science.gov (United States)

Cavallini, Simona; Bisogni, Fabio; Mastroianni, Marco

2014-12-01

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

Review of the prevalence and incidence of eating disorders

NARCIS (Netherlands)

Hoek, HW; van Hoeken, D

2003-01-01

Objective: To review the literature on the incidence and prevalence of eating disorders. Methods: We searched Medline using several key terms relating to epidemiology and eating disorders and we checked the reference lists of the articles that we found. Special attention has been paid to

Perioperative incidents associated with internal maxillary distraction osteogenesis: a retrospective study of 20 patients.

Science.gov (United States)

Kristian, Andersen; Erik, Nørholt Sven; Annelise, Küseler; John, Jensen; Klit, Pedersen Thomas

2012-12-01

This retrospective study aimed to assess the frequency and distribution of incidents encountered during the perioperative period of maxillary distraction with internal devices. The perioperative period was defined as the period between device placement and removal. Records of 20 patients treated during 2004-2011 with internal maxillary distraction osteogenesis were examined. Incidents were registered in terms of severity and need of intervention. Eighty percent of the patients experienced minor incidents, of which the most frequent were pain during activation and infections; 80% of these experienced ≥1 hard and soft tissue-related incidents, and 20% ≥1 device-related incidents. All incidents were solved with minimal or no intervention. Maxillary distraction using internal devices is a safe treatment with only minor incidents in the perioperative period. Preoperative planning and good cooperation are essential for preventing postoperative incidents. Prophylactic antibiotic treatment during the distraction period may be indicated. Copyright © 2012 Elsevier Inc. All rights reserved.

Prevalence of very mild to severe dementia in Denmark

DEFF Research Database (Denmark)

Andersen, K; Lolk, A; Nielsen, H

1997-01-01

The prevalence of dementia has been estimated in several countries and a meta-analysis has shown moderate and severe dementia in people aged 65 years and older to be between 4% and 6%. The Odense study is aiming to estimate the prevalence and incidence of dementia and to identify risk factors....

Estimated HIV incidence in the United States, 2006-2009.

Directory of Open Access Journals (Sweden)

Joseph Prejean

Full Text Available BACKGROUND: The estimated number of new HIV infections in the United States reflects the leading edge of the epidemic. Previously, CDC estimated HIV incidence in the United States in 2006 as 56,300 (95% CI: 48,200-64,500. We updated the 2006 estimate and calculated incidence for 2007-2009 using improved methodology. METHODOLOGY: We estimated incidence using incidence surveillance data from 16 states and 2 cities and a modification of our previously described stratified extrapolation method based on a sample survey approach with multiple imputation, stratification, and extrapolation to account for missing data and heterogeneity of HIV testing behavior among population groups. PRINCIPAL FINDINGS: Estimated HIV incidence among persons aged 13 years and older was 48,600 (95% CI: 42,400-54,700 in 2006, 56,000 (95% CI: 49,100-62,900 in 2007, 47,800 (95% CI: 41,800-53,800 in 2008 and 48,100 (95% CI: 42,200-54,000 in 2009. From 2006 to 2009 incidence did not change significantly overall or among specific race/ethnicity or risk groups. However, there was a 21% (95% CI:1.9%-39.8%; p = 0.017 increase in incidence for people aged 13-29 years, driven by a 34% (95% CI: 8.4%-60.4% increase in young men who have sex with men (MSM. There was a 48% increase among young black/African American MSM (12.3%-83.0%; p<0.001. Among people aged 13-29, only MSM experienced significant increases in incidence, and among 13-29 year-old MSM, incidence increased significantly among young, black/African American MSM. In 2009, MSM accounted for 61% of new infections, heterosexual contact 27%, injection drug use (IDU 9%, and MSM/IDU 3%. CONCLUSIONS/SIGNIFICANCE: Overall, HIV incidence in the United States was relatively stable 2006-2009; however, among young MSM, particularly black/African American MSM, incidence increased. HIV continues to be a major public health burden, disproportionately affecting several populations in the United States, especially MSM and racial and

All-Cause Hospital Admissions Among Older Adults After a Natural Disaster.

Science.gov (United States)

Bell, Sue Anne; Abir, Mahshid; Choi, HwaJung; Cooke, Colin; Iwashyna, Theodore

2017-08-05

We characterize hospital admissions among older adults for any cause in the 30 days after a significant natural disaster in the United States. The main outcome was all-cause hospital admissions in the 30 days after natural disaster. Separate analyses were conducted to examine all-cause hospital admissions excluding the 72 hours after the disaster, ICU admissions, all-cause inhospital mortality, and admissions by state. A self-controlled case series analysis using the 2011 Medicare Provider and Analysis Review was conducted to examine exposure to natural disaster by elderly adults located in zip codes affected by tornadoes during the 2011 southeastern superstorm. Spatial data of tornado events were obtained from the National Oceanic and Atmospheric Administration's Severe Report database, and zip code data were obtained from the US Census Bureau. All-cause hospital admissions increased by 4% for older adults in the 30 days after the April 27, 2011, tornadoes (incidence rate ratio 1.04; 95% confidence interval 1.01 to 1.07). When the first 3 days after the disaster that may have been attributed to immediate injuries were excluded, hospitalizations for any cause also remained higher than when compared with the other 11 months of the year (incidence rate ratio 1.04; 95% confidence interval 1.01 to 1.07). There was no increase in ICU admissions or inhospital mortality associated with the natural disaster. When data were examined by individual states, Alabama, which had the highest number of persons affected, had a 9% increase in both hospitalizations and ICU admissions. When all time-invariant characteristics were controlled for, this natural disaster was associated with a significant increase in all-cause hospitalizations. This analysis quantifies acute care use after disasters through examining all-cause hospitalizations and represents an important contribution to building models of resilience-the ability to recover from a disaster-and hospital surge capacity

Incidence, risk factors, etiology, severity and short-term outcome of non-traumatic intracerebral hemorrhage in young adults.

Science.gov (United States)

Koivunen, R-J; Satopää, J; Meretoja, A; Strbian, D; Haapaniemi, E; Niemelä, M; Tatlisumak, T; Putaala, J

2015-01-01

Intracerebral hemorrhage (ICH) is a common and severe form of stroke but is scarcely studied in young adults. Our aim was to study risk factors, clinical presentation and early mortality of ICH in the young and compare these features with older patients. All consecutive patients aged between 16 and 49 diagnosed with a first-ever ICH at the Departments of Neurology or Neurosurgery of the Helsinki University Central Hospital between January 2000 and March 2010 (n = 336) were analyzed retrospectively. Comparisons were performed amongst demographic subgroups and with patients over 49 years of age enrolled between January 2005 and March 2010 (n = 921). In the young patients, median age was 42 years (interquartile range 34-47), 59.5% were male, and annual incidence was 4.9 (95% confidence interval 4.5-5.3) per 100 000. The most prevalent risk factors were hypertension (29.8%) and smoking (22.3%). Compared with older patients hypertensive microangiopathy was less common (25.0% vs. 34.3%, P = 0.002) and structural lesions more common (25.0% vs. 4.9%, P young patients and in 22.5% of those who underwent magnetic resonance imaging and any angiography (n = 89, P = 0.023). Three-month mortality rate was lower in young patients compared with older ones (17.0% vs. 32.7%, P ages (P = 0.324) and independently predicted mortality in older patients but not in the young. Intracerebral hemorrhage (ICH) in the young appears less fatal and has a different spectrum of causes and factors associated with short-term mortality than for the elderly. © 2014 EAN.

Case studies of hydrogen sulphide occupational exposure incidents in the UK.

Science.gov (United States)

Jones, Kate

2014-12-15

The UK Health and Safety Executive has investigated several incidents of workplace accidents involving hydrogen sulphide exposure in recent years. Biological monitoring has been used in some incidents to determine the cause of unconsciousness resulting from these incidents and as a supporting evidence in regulatory enforcement. This paper reports on three case incidents and discusses the use of biological monitoring in such cases. Biological monitoring has a role in identifying hydrogen sulphide exposure in incidents, whether these are occupational or in the wider environment. Sample type, time of collection and sample storage are important factors in the applicability of this technique. For non-fatal incidents, multiple urine samples are recommended at two or more time points between the incident and 15 h post-exposure. For routine occupational monitoring, post-shift samples should be adequate. Due to endogenous levels of urinary thiosulphate, it is likely that exposures in excess of 12 ppm for 30 min (or 360 ppm/min equivalent) would be detectable using biological monitoring. This is within the Acute Exposure Guideline Level 2 (the level of the chemical in air at or above which there may be irreversible or other serious long-lasting effects or impaired ability to escape) for hydrogen sulphide. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

Incidence and injury characteristics of traumatic brain injury: Comparison between children, adults and seniors in Israel.

Science.gov (United States)

Siman-Tov, Maya; Radomislensky, Irina; Knoller, Nachshon; Bahouth, Hany; Kessel, Boris; Klein, Yoram; Michaelson, Moshe; Avraham Rivkind, Bala Miklosh; Shaked, Gad; Simon, Daniel; Soffer, Dror; Stein, Michael; Jeroukhimov, Igor; Peleg, Kobi

2016-01-01

To assess the incidence and injury characteristics of hospitalized trauma patients diagnosed with TBI. A retrospective study of all injured hospitalized patients recorded in the National Trauma Registry at 19 trauma centres in Israel between 2002-2011. Incidence and injury characteristics were examined among children, adults and seniors. The annual incidence rate of hospitalized TBI for the Israeli population in 2011 was 31.8/100,000. Age-specific incidence was highest among seniors with a dramatic decrease in TBI-related mortality rate among them. Adults, in comparison to children and seniors, had higher rates of severe TBI, severe and critical injuries, more admission to the intensive care unit, underwent surgery, were hospitalization for more than 2 weeks and were discharged to rehabilitation. After adjusting for age, gender, ethnicity, mechanism of injury and injury severity score, TBI-related in-hospital mortality was higher among seniors and adults compared to children. Seniors are at high risk for TBI-related in-hospital mortality, although adults had more severe and critical injuries and utilized more hospital resources. However, seniors showed the most significant reduction in mortality rate during the study period. Appropriate intervention programmes should be designed and implemented, targeted to reduce TBI among high risk groups.

Risk Insights Gained from Fire Incidents

International Nuclear Information System (INIS)

Kazarians, Mardy; Nowlen, Steven P.

1999-01-01

There now exist close to 20 years of history in the application of Probabilistic Risk Assessment (PRA) for the analysis of fire risk at nuclear power plants. The current methods are based on various assumptions regarding fire phenomena, the impact of fire on equipment and operator response, and the overall progression of a fire event from initiation through final resolution. Over this same time period, a number of significant fire incidents have occurred at nuclear power plants around the world. Insights gained from US experience have been used in US studies as the statistical basis for establishing fire initiation frequencies both as a function of the plant area and the initiating fire source.To a lesser extent, the fire experience has also been used to assess the general severity and duration of fires. However, aside from these statistical analyses, the incidents have rarely been scrutinized in detail to verify the underlying assumptions of fire PRAs. This paper discusses an effort, under which a set of fire incidents are being reviewed in order to gain insights directly relevant to the methods, data, and assumptions that form the basis for current fire PRAs. The paper focuses on the objectives of the effort, the specific fire events being reviews methodology, and anticipated follow-on activities

Adverse incidents resulting in exposure to body fluids at a UK dental teaching hospital over a 6-year period

Directory of Open Access Journals (Sweden)

Hughes A

2012-10-01

Full Text Available A Hughes,1 L Davies,1 R Hale,1 JE Gallagher21Kings College Hospital NHS Foundation Trust, 2King's College London Dental Institute, London, United KingdomBackground: The safety and protection of patients and health care workers is of paramount importance in dentistry, and this includes students in training who provide clinical care. Given the nature of dental care, adverse incidents can and do occur, exposing health care workers to body fluids and putting them at risk of infection, including contracting a blood-borne virus. The aim of this research was to analyze trends in the volume, rate, nature, management, and outcome of adverse incidents reported at one dental teaching hospital from 2005 to 2010.Methods: Descriptive analysis of trends in the volume, rate, nature, management, and outcome of adverse incidents reported at one dental teaching hospital over a six-year period was undertaken in relation to the level of outpatient and day surgery activity.Results: In total, 287 incidents were reported over a six-year period, which amounted to 0.039% of outpatient or day surgery appointments. Nearly three quarters of all the incidents (n = 208, 72% took place during treatment or whilst clearing away after the appointment. The most frequent incidents were associated with administration of local anesthetic (n = 63, 22%, followed by burs used in dental hand pieces (n = 51, 18%.Conclusion: This research confirms that adverse incidents are a feature of dental hospitals and reports the common sources. The importance of accurate and consistent reporting of data to ensure that these issues are monitored to inform action and reduce risks to staff, students, and patients are highlighted.Keywords: risk management, blood-borne virus, dental hospital, body fluids exposure, adverse event reporting

Pancreatic hyperamylasemia during acute gastroenteritis: incidence and clinical relevance

Directory of Open Access Journals (Sweden)

Pignattari Elena

2001-09-01

Full Text Available Abstract Background Many case reports of acute pancreatitis have been reported but, up to now, pancreatic abnormalities during acute gastroenteritis have not been studied prospectively. Objectives To evaluate the incidence and the clinical significance of hyperamylasemia in 507 consecutive adult patients with acute gastroenteritis. Methods The clinical significance of hyperamylasemia, related predisposing factors and severity of gastroenteritis were assessed. Results Hyperamylasemia was detected in 10.2 % of patients studied. Although amylasemia was found over four times the normal values in three cases, the clinical features of acute pancreatitis were recorded in only one case (0.1%. Hyperamylasemia was more likely (17% where a microorganism could be identified in the stools (p Salmonella spp. and in particular S. enteritidis, was the microorganism most frequently associated with hyperamylasemia [17/84 (20.2 % and 10/45 (22.2%, respectively], followed by Rotavirus, Clostridium difficile and Campylobacter spp. Patients with hyperamylasemia had more severe gastroenteritis with an increased incidence of fever (80 % vs 50.6 %, O.R. 3.0; P Conclusions Hyperamylasemia is relatively frequent, and is associated with severe gastroenteritis. However, acute pancreatitis in the setting of acute gastroenteritis, is a rare event.

Incidents with hazardous radiation sources

International Nuclear Information System (INIS)

Schoenhacker, Stefan

2016-01-01

Incidents with hazardous radiation sources can occur in any country, even those without nuclear facilities. Preparedness for such incidents is supposed to fulfill globally agreed minimum standards. Incidents are categorized in incidents with licensed handling of radiation sources as for material testing, transport accidents of hazardous radiation sources, incidents with radionuclide batteries, incidents with satellites containing radioactive inventory, incidents wit not licensed handling of illegally acquired hazardous radiation sources. The emergency planning in Austria includes a differentiation according to the consequences: incidents with release of radioactive materials resulting in restricted contamination, incidents with release of radioactive materials resulting in local contamination, and incidents with the hazard of e@nhanced exposure due to the radiation source.

Incidents analysis

International Nuclear Information System (INIS)

Francois, P.

1996-01-01

We undertook a study programme at the end of 1991. To start with, we performed some exploratory studies aimed at learning some preliminary lessons on this type of analysis: Assessment of the interest of probabilistic incident analysis; possibility of using PSA scenarios; skills and resources required. At the same time, EPN created a working group whose assignment was to define a new approach for analysis of incidents on NPPs. This working group gave thought to both aspects of Operating Feedback that EPN wished to improve: Analysis of significant incidents; analysis of potential consequences. We took part in the work of this group, and for the second aspects, we proposed a method based on an adaptation of the event-tree method in order to establish a link between existing PSA models and actual incidents. Since PSA provides an exhaustive database of accident scenarios applicable to the two most common types of units in France, they are obviously of interest for this sort of analysis. With this method we performed some incident analyses, and at the same time explores some methods employed abroad, particularly ASP (Accident Sequence Precursor, a method used by the NRC). Early in 1994 EDF began a systematic analysis programme. The first, transient phase will set up methods and an organizational structure. 7 figs

Incidents analysis

Energy Technology Data Exchange (ETDEWEB)

Francois, P

1997-12-31

We undertook a study programme at the end of 1991. To start with, we performed some exploratory studies aimed at learning some preliminary lessons on this type of analysis: Assessment of the interest of probabilistic incident analysis; possibility of using PSA scenarios; skills and resources required. At the same time, EPN created a working group whose assignment was to define a new approach for analysis of incidents on NPPs. This working group gave thought to both aspects of Operating Feedback that EPN wished to improve: Analysis of significant incidents; analysis of potential consequences. We took part in the work of this group, and for the second aspects, we proposed a method based on an adaptation of the event-tree method in order to establish a link between existing PSA models and actual incidents. Since PSA provides an exhaustive database of accident scenarios applicable to the two most common types of units in France, they are obviously of interest for this sort of analysis. With this method we performed some incident analyses, and at the same time explores some methods employed abroad, particularly ASP (Accident Sequence Precursor, a method used by the NRC). Early in 1994 EDF began a systematic analysis programme. The first, transient phase will set up methods and an organizational structure. 7 figs.

Incidence of dentinal defects after preparation of severely curved root canals using the Reciproc single-file system with and without prior creation of a glide path.

Science.gov (United States)

Saber, S E D M; Schäfer, E

2016-11-01

To investigate the incidence of dentinal defects after preparation of severely curved root canals using the Reciproc single-file system with and without prior creation of a glide path. Mesial roots from extracted mandibular first molars were collected and scanned with CBCT to assess the morphology of the root canal systems. Three groups of 20 anatomically comparable specimens were generated. The control group was left unprepared, whilst the experimental groups were prepared with Reciproc R25 with and without a glide path (groups RG and R, respectively). Roots were then sectioned perpendicular to the long axis at 2, 4, 6, 8 and 10 mm from the apex, and coloured photographs of the sections at 40× were obtained. Two blinded examiners registered the presence of dentinal defects twice at 2-week interval. Data were statistically analysed using the Fisher exact and Cochran's Q tests. No defects were observed in the control group. The overall incidence of dentinal defects was 26% in group R and 24% in group RG, with no significant differences between them (P > 0.05). Dentinal defects occurred significantly more often in the middle and coronal thirds compared to the apical third of the canals (P files. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Heterogeneity in Trajectories of Child Maltreatment Severity: A Two-Part Growth Mixture Model

Science.gov (United States)

Yampolskaya, Svetlana; Greenbaum, Paul E.; Brown, C. Hendricks; Armstrong, Mary I.

2016-01-01

This study examined the trajectories of maltreatment severity and substantiation over a 24-month period among children (N = 82,396) with repeated maltreatment reports. Findings revealed two different longitudinal patterns. The first pattern, Elevated Severity, showed a higher level of maltreatment during the initial incident and increased maltreatment severity during subsequent incidents but the substantiation rates for this class decreased over time. The second pattern, Lowered Severity, showed a much lower level of severity, but the likelihood of substantiation increased over time. The Elevated Severity class was comprised of children with an elevated risk profile due to both individual and contextual risk factors including older age, female gender, caregivers’ substance use problems, and a higher number of previous maltreatment reports. Implications of the findings are discussed. PMID:26300381

Incidence of hyperthyroidism in Slovenia since improved iodine supply

International Nuclear Information System (INIS)

Zaletel, K.; Gaberscek, S.; Pirnat, E.; Hojker, S.

2002-01-01

Full text: Since the year 1953, when iodine prophylaxis was introduced in Slovenia, several epidemiological studies confirmed the existence of mild iodine deficiency on the whole territory of Slovenia. In January 1999 the implementation of higher iodine content (25 mg of KI or 32 mg of KIO 3 ) was recommended and since then the increased incidence of thyrotoxicosis was observed. Here we present 5-year follow-up data of the incidence of hyperthyroidism due to thyroid autonomy and Graves' disease. We estimated incidence rates from 1997 to 2001 for hyperthyroidism due to thyroid autonomy and Graves' disease among 1000000 people, living in the area of Ljubljana. We assumed that most cases were seen and treated in the Outpatient Department for thyroid diseases of Department for Nuclear Medicine of University Medical Centre Ljubljana. Immediately after correction of iodine deficiency, the incidence of hyperthyroidism due to thyroid autonomy rose almost twice in 1999 (320 cases in 1999 compared to 173 cases in 1997), but afterwards the incidence slightly decreased (240 cases in 2000). Similarly, the incidence of Graves' disease rose in 1999 (267 cases in 1999 compared to 237 in 1997) and in contrast to thyroid autonomy the incidence further increased in the following years (337 in 2000 and 246 in the first half of 2001). The increased incidence of hyperthyroidism due to thyroid autonomy and Graves' disease after elevation of iodine prophylaxis in Slovenia is comparable with data in some other endemic areas. Those data indicate that stepwise supplementation is preferable to immediate corrections. However, we believe that iodine prophylaxis is reasonable and justified and to reassess the iodine nutrition status we plan a follow up evaluation in year 2002. (author)

Natural hazards and motivation for mitigation behavior: people cannot predict the affect evoked by a severe flood.

Science.gov (United States)

Siegrist, Michael; Gutscher, Heinz

2008-06-01

Past research indicates that personal flood experience is an important factor in motivating mitigation behavior. It is not fully clear, however, why such experience is so important. This study tested the hypothesis that people without flooding experience underestimate the negative affect evoked by such an event. People who were affected by a severe recent flood disaster were compared with people who were not affected, but who also lived in flood-prone areas. Face-to-face interviews with open and closed questions were conducted (n= 201). Results suggest that people without flood experience envisaged the consequences of a flood differently from people who had actually experienced severe losses due to a flood. People who were not affected strongly underestimated the negative affect associated with a flood. Based on the results, it can be concluded that risk communication must not focus solely on technical aspects; in order to trigger motivation for mitigation behavior, successful communication must also help people to envisage the negative emotional consequences of natural disasters.

MO-G-BRE-06: Metrics of Success: Measuring Participation and Attitudes Related to Near-Miss Incident Learning Systems

Energy Technology Data Exchange (ETDEWEB)

Nyflot, MJ; Kusano, AS; Zeng, J; Carlson, JC; Novak, A; Sponseller, P; Jordan, L; Kane, G; Ford, EC [University of Washington, Seattle, WA (United States)

2014-06-15

Purpose: Interest in incident learning systems (ILS) for improving safety and quality in radiation oncology is growing, as evidenced by the upcoming release of the national ILS. However, an institution implementing such a system would benefit from quantitative metrics to evaluate performance and impact. We developed metrics to measure volume of reporting, severity of reported incidents, and changes in staff attitudes over time from implementation of our institutional ILS. Methods: We analyzed 2023 incidents from our departmental ILS from 2/2012–2/2014. Incidents were prospectively assigned a near-miss severity index (NMSI) at multidisciplinary review to evaluate the potential for error ranging from 0 to 4 (no harm to critical). Total incidents reported, unique users reporting, and average NMSI were evaluated over time. Additionally, departmental safety attitudes were assessed through a 26 point survey adapted from the AHRQ Hospital Survey on Patient Safety Culture before, 12 months, and 24 months after implementation of the incident learning system. Results: Participation in the ILS increased as demonstrated by total reports (approximately 2.12 additional reports/month) and unique users reporting (0.51 additional users reporting/month). Also, the average NMSI of reports trended lower over time, significantly decreasing after 12 months of reporting (p<0.001) but with no significant change at months 18 or 24. In survey data significant improvements were noted in many dimensions, including perceived barriers to reporting incidents such as concern of embarrassment (37% to 18%; p=0.02) as well as knowledge of what incidents to report, how to report them, and confidence that these reports were used to improve safety processes. Conclusion: Over a two-year period, our departmental ILS was used more frequently, incidents became less severe, and staff confidence in the system improved. The metrics used here may be useful for other institutions seeking to create or evaluate

MO-G-BRE-06: Metrics of Success: Measuring Participation and Attitudes Related to Near-Miss Incident Learning Systems

International Nuclear Information System (INIS)

Nyflot, MJ; Kusano, AS; Zeng, J; Carlson, JC; Novak, A; Sponseller, P; Jordan, L; Kane, G; Ford, EC

2014-01-01

Purpose: Interest in incident learning systems (ILS) for improving safety and quality in radiation oncology is growing, as evidenced by the upcoming release of the national ILS. However, an institution implementing such a system would benefit from quantitative metrics to evaluate performance and impact. We developed metrics to measure volume of reporting, severity of reported incidents, and changes in staff attitudes over time from implementation of our institutional ILS. Methods: We analyzed 2023 incidents from our departmental ILS from 2/2012–2/2014. Incidents were prospectively assigned a near-miss severity index (NMSI) at multidisciplinary review to evaluate the potential for error ranging from 0 to 4 (no harm to critical). Total incidents reported, unique users reporting, and average NMSI were evaluated over time. Additionally, departmental safety attitudes were assessed through a 26 point survey adapted from the AHRQ Hospital Survey on Patient Safety Culture before, 12 months, and 24 months after implementation of the incident learning system. Results: Participation in the ILS increased as demonstrated by total reports (approximately 2.12 additional reports/month) and unique users reporting (0.51 additional users reporting/month). Also, the average NMSI of reports trended lower over time, significantly decreasing after 12 months of reporting (p<0.001) but with no significant change at months 18 or 24. In survey data significant improvements were noted in many dimensions, including perceived barriers to reporting incidents such as concern of embarrassment (37% to 18%; p=0.02) as well as knowledge of what incidents to report, how to report them, and confidence that these reports were used to improve safety processes. Conclusion: Over a two-year period, our departmental ILS was used more frequently, incidents became less severe, and staff confidence in the system improved. The metrics used here may be useful for other institutions seeking to create or evaluate

Incidence of call stone in liver cirrhosis patients: comparison with genera population

International Nuclear Information System (INIS)

Kim, Chul Jjoong; Park, Cheol Min; Park, Seung Chul; Chung, Kyoo Byung; Suh, Won Hyuck

1994-01-01

We investigated the incidence of gallstone detected by ultrasound in cirrhotic patients, and it was compared with that of the general population. One hundred and seventy seven patients with proven or suspected liver cirrhosis were evaluated sonographic ally to determine the presence of gallstone. We classified 177 cirrhotic patients into A,B, and C by Child classification and investigated the incidence of gallstone for each class. The control group was 363 general population with age distribution and sex-ratio similar to cirrhotic patients.Gallstone was visualized by ultrasound in 32(18.1%) of 177 cirrhotic patients. The incidence of gallstone was 13.1% in Child A, 21.0% in child B, and 20.0% in Child C cirrhotic patients. Overall incidence of gallstone was 3.9% in 363 general population. In summary, the incidence of gallstone was significantly higher in cirrhosis patients than in general population(p<0.01). The patients with moderate and severe cirrhosis showed higher incidence of gallstone than the patients with mild cirrhosis(20.5% vs 13.1%)

Adapting Cognitive Task Analysis to Investigate Clinical Decision Making and Medication Safety Incidents.

Science.gov (United States)

Russ, Alissa L; Militello, Laura G; Glassman, Peter A; Arthur, Karen J; Zillich, Alan J; Weiner, Michael

2017-05-03

Cognitive task analysis (CTA) can yield valuable insights into healthcare professionals' cognition and inform system design to promote safe, quality care. Our objective was to adapt CTA-the critical decision method, specifically-to investigate patient safety incidents, overcome barriers to implementing this method, and facilitate more widespread use of cognitive task analysis in healthcare. We adapted CTA to facilitate recruitment of healthcare professionals and developed a data collection tool to capture incidents as they occurred. We also leveraged the electronic health record (EHR) to expand data capture and used EHR-stimulated recall to aid reconstruction of safety incidents. We investigated 3 categories of medication-related incidents: adverse drug reactions, drug-drug interactions, and drug-disease interactions. Healthcare professionals submitted incidents, and a subset of incidents was selected for CTA. We analyzed several outcomes to characterize incident capture and completed CTA interviews. We captured 101 incidents. Eighty incidents (79%) met eligibility criteria. We completed 60 CTA interviews, 20 for each incident category. Capturing incidents before interviews allowed us to shorten the interview duration and reduced reliance on healthcare professionals' recall. Incorporating the EHR into CTA enriched data collection. The adapted CTA technique was successful in capturing specific categories of safety incidents. Our approach may be especially useful for investigating safety incidents that healthcare professionals "fix and forget." Our innovations to CTA are expected to expand the application of this method in healthcare and inform a wide range of studies on clinical decision making and patient safety.

Wheelchair incidents

NARCIS (Netherlands)

Drongelen AW van; Roszek B; Hilbers-Modderman ESM; Kallewaard M; Wassenaar C; LGM

2002-01-01

This RIVM study was performed to gain insight into wheelchair-related incidents with powered and manual wheelchairs reported to the USA FDA, the British MDA and the Dutch Center for Quality and Usability Research of Technical Aids (KBOH). The data in the databases do not indicate that incidents with

Unravelling the incidence and etiology of chronic idiopathic axonal polyneuropathy

NARCIS (Netherlands)

Visser, N.A.

2016-01-01

Chronic idiopathic axonal polyneuropathy (CIAP) is a sensory or sensorimotor polyneuropathy that has a slowly progressive course without severe disability. CIAP is diagnosed in a significant proportion of patients with polyneuropathy, but precise figures on the incidence of polyneuropathy and CIAP

Criteria for classification and reporting of fire incidences in nuclear power plants of India

International Nuclear Information System (INIS)

Kapoor, R.K.

1998-01-01

Is is important that all fires in and around fire effective neighbourhood of Nuclear Power Plant (NPP) should be promptly reported (Reportable fires) and investigated. However, the depth of investigation and the range of authorities to whom the individual fire incidence need to be reported depends upon the severity of fire. In case of conventional non-chemical industries, the severity of fire depends mainly on the extent of loss caused by fire on property and the burn injury to persons. In case of NPP, two additional losses viz, release of radioactivity to working/public environment and the risk to safety related systems of NPP due to fire assume greater importance. This paper describes the criteria used in NPPs of India for classification of reportable fire incidences into four categories, viz. Insignificant, small, medium and large fires. It also gives the level of investigation depending upon the severity of fire. The fire classification scheme is explained in this paper with the help of worked out examples and two incidences of fire in Indian NPPs. (author)

The Role of Compounds Derived from Natural Supplement as Anticancer Agents in Renal Cell Carcinoma: A Review.

Science.gov (United States)

Haque, Inamul; Subramanian, Arvind; Huang, Chao H; Godwin, Andrew K; Van Veldhuizen, Peter J; Banerjee, Snigdha; Banerjee, Sushanta K

2017-12-31

Renal Cell Carcinoma (RCC) is the most prominent kidney cancer derived from renal tubules and accounts for roughly 85% of all malignant kidney cancer. Every year, over 60,000 new cases are registered, and about 14,000 people die from RCC. The incidence of this has been increasing significantly in the U.S. and other countries. An increased understanding of molecular biology and the genomics of RCC has uncovered several signaling pathways involved in the progression of this cancer. Significant advances in the treatment of RCC have been reported from agents approved by the Food and Drug Administration (FDA) that target these pathways. These agents have become drugs of choice because they demonstrate clinical benefit and increased survival in patients with metastatic disease. However, the patients eventually relapse and develop resistance to these drugs. To improve outcomes and seek approaches for producing long-term durable remission, the search for more effective therapies and preventative strategies are warranted. Treatment of RCC using natural products is one of these strategies to reduce the incidence. However, recent studies have focused on these chemoprevention agents as anti-cancer therapies given they can inhibit tumor cell grow and lack the severe side effects common to synthetic compounds. This review elaborates on the current understanding of natural products and their mechanisms of action as anti-cancer agents. The present review will provide information for possible use of these products alone or in combination with chemotherapy for the prevention and treatment of RCC.

Moments of sorrow and joy : an empirical assessment of the complementary value of critical incidents in understanding customer service evaluations

NARCIS (Netherlands)

Odekerken-Schröder, G.; Birgelen, van M.; Lemmink, J.G.A.M.; Ruyter, de J.C.; Wetzels, M.G.M.

2000-01-01

It is commonly acknowledged that service quality can be measured by using attribute-based and incident-based measurements. Both methods are distinct in nature, but can be used complementarily. However, in the literature a simultaneous empirical investigation of the power of critical incidents in

Incidence and Prevalence of Musculoskeletal Injury in Ballet

Science.gov (United States)

Smith, Preston J.; Gerrie, Brayden J.; Varner, Kevin E.; McCulloch, Patrick C.; Lintner, David M.; Harris, Joshua D.

2015-01-01

Background Most published studies on injuries in the ballet dancer focus on the lower extremity. The rigors of this activity require special training and care. By understanding prevalence and injury pattern to the musculoskeletal system, targeted prevention and treatment for this population can be developed. Purpose To determine the incidence and prevalence of musculoskeletal injuries in ballet. Study Design Systematic review; Level of evidence, 4. Methods A systematic review registered with PROSPERO was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Level 1 through 4 evidence studies reporting incidence of musculoskeletal injuries in male and female ballet dancers were included, with the numbers and types of injuries extracted from each. Injury rates were recorded and calculated based on professional status, sex, and nature of injury. Incidence was defined as number of injuries sustained over a specific time. Prevalence was defined as proportion of subjects with an injury at a given point in time. Results The studies analyzed reported injury incidence or prevalence in more than 1365 amateur and 900 professional dancers. The mean age was 16.2 years among amateur and 27.0 years among professional dancers. The incidence of injury among amateur dancers was 0.99 and 1.09 injuries per 1000 dance hours in males and females, respectively; 75% of injuries were overuse, with similar rates among males and females. In professional dancers, the incidence of injury was 1.06 and 1.46 injuries per 1000 dance hours in males and females, respectively, and 64% of female injuries were overuse, compared with 50% in males (P ballet dancers is 0.97 and 1.24 injuries per 1000 dance hours, respectively. The majority are overuse in both amateur and professional dancers, with amateur ballet dancers showing a higher proportion of overuse injuries than professionals (P < .001). Male professional dancers show a higher proportion of

PPO.02 Severe maternal morbidity in Ireland

NARCIS (Netherlands)

Manning, E.; Lutomski, J.E.; O'Connor, L.; Corcoran, P.; Greene, R.

2014-01-01

OBJECTIVE: To assess the incidence of severe maternal morbidity (SMM) and examine associated factors in Ireland. METHODS: In 2011, 67,806 maternities were reported from 19 maternity units, representing 93% of maternities in Ireland. SMM was classified as the presence of one or more of 15 categories

Naturalisms and religion

NARCIS (Netherlands)

Drees, Willem

1997-01-01

Such terms as materialism, naturalism, and near synonyms evoke strong negative reactions among many believers. However, the notion of naturalism has various meanings; implications for religion differ for the several varieties of naturalism. In this paper I analyze epistemological and ontological

Reporting Severe Hypoglycemia in Type 1 Diabetes

DEFF Research Database (Denmark)

Pedersen-Bjergaard, Ulrik; Thorsteinsson, Birger

2017-01-01

PURPOSE OF REVIEW: To describe potential factors influencing reporting of severe hypoglycemia in adult patients with type 1 diabetes and to analyze their effect on reported rates of severe hypoglycemia. RECENT FINDINGS: Reported rates of severe hypoglycemia defined as need for third party...... by partners report higher rates of severe hypoglycemia. There is a large variation between studies reporting incidence and prevalence of severe hypoglycemia in patients with type 1 diabetes, mainly explained by definition of severity, methods of reporting, and patient selection. These findings call...... hypoglycemia are 0.02-0.5 events per patient-year and 1-29%, respectively. When subjects with recurrent severe hypoglycemia in the past or suffering from impaired hypoglycemia awareness are excluded from participation in studies, lower rates are reported. Studies applying anonymous reporting or reporting...

Tracking Traffickers. The IAEA Incident and Trafficking Database

International Nuclear Information System (INIS)

Webb, Greg

2013-01-01

Radioactive material is missing from a hospital. Contaminated metal is found in a scrap yard. Smugglers try to peddle nuclear- weapon-usable material. These different scenarios illustrate the risks that these materials can pose to human safety and security. To assess those risks and to develop strategies to reduce them, States must understand the implications and the scope of such incidents that are occurring around the world. To better understand and respond to these events, the IAEA maintains an Incident and Trafficking Database (ITDB) which collects information from 122 participating States and some select international organizations. They are asked to share data on a voluntary basis about incidents in which nuclear and other radioactive material has fallen ''out of regulatory control.'' This could mean reporting cases of material that has gone missing, or discoveries of material where none was expected. The cases range from the innocent misplacement of industrial radioactive sources to criminal smuggling efforts which could aid terrorist acts. This information is shared among ITDB participants, and IAEA analysts try to identify trends and characteristics that could help prevent the misuse of these potentially dangerous materials. ''The ITDB has become an internationally recognized tool for States to study the extent and nature of these incidents,'' said John Hilliard, head of the Information Management and Coordination Section that administers the database. ''We've learned a lot by studying them, and we hope the information helps us prevent accidents or crimes in the future.'' The IAEA established the database in 1995 after States became alarmed by a growing number of trafficking incidents in the early 1990s. The service was originally operated by the Department of Safeguards, but later moved to the Department of Nuclear Safety and Security, where the Office of Nuclear Security now administers all the data collection and analysis

The impact of normal saline on the incidence of exposure keratopathy in patients hospitalized in intensive care units

Directory of Open Access Journals (Sweden)

Zohreh Davoodabady

2018-01-01

Full Text Available Background: Patients in the intensive care unit (ICU have impaired ocular protective mechanisms that lead to an increased risk of ocular surface diseases including exposure keratopathy (EK. This study was designed to evaluate the effect of normal saline (NS on the incidence and severity of EK in critically ill patients. Materials and Methods: This single-blind randomized controlled trial was conducted on 50 patients admitted to ICUs. The participants were selected through purposive sampling. One eye of each patient, randomly was allocated to intervention group (standard care with NS and the other eye to control group (standard care. In each patient, one eye (control group randomly received standard care and the other eye (intervention group received NS every 6 h in addition to standard care. The presence and severity of keratopathy was assessed daily until day 7 of hospitalization using fluorescein and an ophthalmoscope with cobalt blue filter. Chi-square test was used for statistical analysis in SPSS software. Results: Before the study ( first day there were no statistically significant differences in the incidence and severity of EK between groups. Although, the incidence and severity of EK after the study (7th day was higher in the intervention group compared to the control group, their differences were not statistically significant. Although, the incidence and severity of EK, from the 1st day until the 7th, increased within both groups, this increase was statistically significant only in the intervention (NS group. Conclusions: The use of NS as eye care in patients hospitalized in ICUs can increase the incidence and severity of EK and is not recommended.

Severe idiosyncratic drug reactions with epidermal necrolysis: A 5-year study

Directory of Open Access Journals (Sweden)

I O Fadeyibi

2011-01-01

Full Text Available Introduction: Idiosyncratic drug reactions (IDRs are unexpected responses to a drug. The spectrums of severe cutaneous reactions include Stevens-Johnson Syndrome (SJS, SJS/Lyell Syndrome and Toxic Epidermal Necrolysis (TEN. The conditions are associated with high mortality. This study was designed to determine the causal agents, patterns of presentations, review the management and make recommendations to reduce the incidence and mortality of this class of drug reactions. Materials and Methods: A retrospective study was made of patients seen with IDR in the Lagos State University Teaching Hospital, LASUTH, between January, 2004 and December, 2008. They were cases admitted with bullous skin eruptions with associated systemic symptoms. Results: Sixty-seven patients were seen, with 45 (67.2% satisfying the inclusion criteria. Fifteen males and 30 females were involved, giving a male to female (M:F ratio of 1:2. Their ages ranged from 7 to 79 years (mean, 40.02 ± 17.89 years. Peak incidences occurred among the 20-24 and 30-34 year age groups. The causal agents were antibiotics (48.89%, sulphonamides (24.44%, herbal preparations (17.78% and artemisinin drugs (8.89%. Conclusions: The age groups with the peak incidence are the most likely to indulge more in drug abuse in environments with poor drug control. Diagnosis of SJS, SJS/TEN and TEN were missed in many patients at first contact due to the progressive nature of the conditions. Patients needed reviews at regular intervals when IDR was suspected. Health education to prevent drug abuse is important and herbal preparations should be scientifically studied to determine the efficacy and side-effects.

Endodontic interappointment flare-ups: a prospective study of incidence and related factors.

Science.gov (United States)

Walton, R; Fouad, A

1992-04-01

Severe pain and/or swelling following a root canal treatment appointment are serious sequelae. Information varies or is incomplete as to the incidence of these conditions and related factors. In this study, data were collected at root canal treatment appointments on demographics, pulp/periapical diagnoses, presenting symptoms, treatment procedures, and number of appointments. Patients that then experienced a flare-up (a severe problem requiring an unscheduled visit and treatment) had the correlating factors examined. Statistical determinations were by chi-square analysis with significance at 0.05 or less. Nine hundred forty-six visits resulted in an incidence of 3.17% flare-ups. Flare-ups were positively correlated with more severe presenting symptoms, pulp necrosis with painful apical pathosis, and patients on analgesics. Fewer flare-ups occurred in undergraduate patients and following obturation procedures. There was no correlation between patient demographics or systemic conditions, number of appointments, treatment procedures, or taking antibiotics.

Recent Vegetation Fire Incidence in Russia

OpenAIRE

Hayasaka, Hiroshi

2011-01-01

MODIS hotspot data from NASA have now become a standard means of evaluating vegetation fires worldwide. Remote sensing is the most effective tool for large countries like Russia because it is hard to obtain exact, detailed forest fire data. Accumulated MODIS hotspot data of the nine years from 2002 to 2010 may allow us to assess recent changes in the vegetation fire incidence in Russia. This kind of analysis using various satellites is useful in estimating fire intensity and sever...

The distributional incidence of the gasoline tax in Chile

International Nuclear Information System (INIS)

Agostini, Claudio A.; Jiménez, Johanna

2015-01-01

This paper analyzes the distributional incidence of the excise tax on gasoline in Chile using Household Budget Surveys. The incidence is calculated with respect to both income and expenditure distributions in order to consider the potential differences between transitory and permanent income. The Suits Index is estimated as a measure of the degree of progressivity of the tax, and confidence intervals are calculated using a bootstrap methodology to statistically compare changes in the incidence given changes in the tax. The results show that the tax, contrary to the evidence for several developed countries, is slightly or moderately progressive, with a lower degree of progressivity observed in the calculations based on income than those based on expenditure. The simulation of the 25% reduction in the tax rate implemented in 2008 shows that, in terms of incidence, its effect is to reduce the progressivity of the gasoline tax, which is the opposite of what was sought by the government with this policy. -- Highlights: •Gasoline tax is an optimal tax and is a significant instrument of climate policy. •Despite its benefits, it faces political economy challenges in its implementation. •In the public discussion in developing countries the tax is considered regressive. •The estimation of the distributional incidence shows that it is slightly progressive. •Increases in gasoline taxes can reduce both negative externalities and inequality

[Mineral waters from several Brazilian natural sources].

Science.gov (United States)

Rebelo, M A; Araujo, N C

1999-01-01

To divulge information on the chemical composition and physical-chemical features of some mineral waters from Brazilian natural sources that will be of useful protocol investigation and patient advice. The survey was based on bottle labels of non-gaseous mineral waters commercially available in the city of Rio de Janeiro. The íon concentration of each mineral was calculated from the salt content. 36 springs were enralled from different states of the country. The pH (25 degrees C), 4.1 to 9.3, varied on dependence of the source and it was linearey correlated with the cations calcium, magnesium and sodium and the anion bicarbonate. It was atributed to high alkalinity (about 70% of bicarbonate in the molecula-gram) of these salts. The calcium (0.3 to 42 mg/l), magnesium (0.0 to 18 mg/l) and bicarbonate (4 to 228 mg/l) contents are relatively low. The mineral content of the Brazilian springs enrolled in this survey is low; about 70% of the sources having calcium and magnesium less than 10 mg/l and 1.0 mg/l, respectively, similar to local tap water.

15-year incidence of diabetic ketoacidosis at onset of type 1 diabetes in children from a regional setting (Auckland, New Zealand).

Science.gov (United States)

Jefferies, Craig; Cutfield, Samuel W; Derraik, José G B; Bhagvandas, Jignal; Albert, Benjamin B; Hofman, Paul L; Gunn, Alistair J; Cutfield, Wayne S

2015-05-19

We assessed the incidence of diabetic ketoacidosis (DKA) in children aged Auckland Region (New Zealand) in 1999-2013, in a retrospective review of a complete regional cohort. DKA and its severity were classified according to ISPAD 2014 guidelines. Of 730 children presenting with new-onset T1DM over the 15-year time period, 195 cases had DKA of any severity (27%). There was no change in the incidence of DKA or the proportion of children with severe DKA at presentation. The incidence of DKA among children aged Auckland Region over time. Thus, it is important to explore ways to reduce DKA risk.

Is Global Warming likely to cause an increased incidence of Malaria?

Science.gov (United States)

Nabi, SA; Qader, SS

2009-01-01

The rise in the average temperature of earth has been described as global warming which is mainly attributed to the increasing phenomenon of the greenhouse effect. It is believed that global warming can have several harmful effects on human health, both directly and indirectly. Since malaria is greatly influenced by climatic conditions because of its direct relationship with the mosquito population, it is widely assumed that its incidence is likely to increase in a future warmer world. This review article discusses the two contradictory views regarding the association of global warming with an increased incidence of malaria. On one hand, there are many who believe that there is a strong association between the recent increase in malaria incidence and global warming. They predict that as global warming continues, malaria is set to spread in locations where previously it was limited, due to cooler climate. On the other hand, several theories have been put forward which are quite contrary to this prediction. There are multiple other factors which are accountable for the recent upsurge of malaria: for example drug resistance, mosquito control programs, public health facilities, and living standards. PMID:21483497

Fire and explosion incident at bituminization demonstration facility of PNC Tokai works, on march 11, 1997

International Nuclear Information System (INIS)

Miura, A.; Sato, Y.; Koyama, T.; Omori, E.; Kato, Y.; Suzuki, H.; Norjiri, I.; Yamanouchi, T.

2001-01-01

On March 11, a fire and explosion incident occurred at the Bituminization Demonstration Facility (BDF) of Tokai Reprocessing Plant in Power Reactor and Nuclear Fuel Development Corporation (PNC). Soon after the incident, PNC (now reorganized to JNC) started to investigate the facility damage, operational records around the incident, technical notes including facility design and reviews of R and D results, operators witness and to perform several analysis, tests and calculations. This paper describes outline and cause of the incident which were concluded based on the results of continuous serious investigation, analysis and calculation. (author)

Key Planning Factors for Recovery from a Radiological Terrorism Incident

Science.gov (United States)

2012-09-01

measurements are made, these are collected electronically4 and automatically exported to local operation centers and incident command posts where the...economic, natural and built environments and a move to self-sufficiency, sustainability and resilience.” As can be seen in Figure 3-11, some long-term...Transportation and access routes Bridges Streets and thoroughfares Sidewalks and walkways Release of property from radiologically controlled areas

Major Incident Hospital: Development of a Permanent Facility for Management of Incident Casualties.

Science.gov (United States)

Marres, Geertruid; Bemelman, Michael; van der Eijk, John; Leenen, Luke

2009-06-01

Preparation is essential to cope with the challenge of providing optimal care when there is a sudden, unexpected surge of casualties due to a disaster or major incident. By definition, the requirements of such cases exceed the standard care facilities of hospitals in qualitative or quantitative respects and interfere with the care of regular patients. To meet the growing demands to be prepared for disasters, a permanent facility to provide structured, prepared relief in such situations was developed. A permanent but reserved Major Incident Hospital (MIH) has been developed through cooperation between a large academic medical institution, a trauma center, a military hospital, and the National Poison Information Centre (NVIC). The infrastructure, organization, support systems, training and systematic working methods of the MIH are designed to create order in a chaotic, unexpected situation and to optimize care and logistics in any possible scenario. Focus points are: patient flow and triage, registration, communication, evaluation and training. Research and the literature are used to identify characteristic pitfalls due to the chaos associated with and the unexpected nature of disasters, and to adapt our organization. At the MIH, the exceptional has become the core business, and preparation for disaster and large-scale emergency care is a daily occupation. An Emergency Response Protocol enables admittance to the normally dormant hospital of up to 100 (in exceptional cases even 300) patients after a start-up time of only 15 min. The Patient Barcode Registration System (PBR) with EAN codes guarantees quick and adequate registration of patient data in order to facilitate good medical coordination and follow-up during a major incident. The fact that the hospital is strictly reserved for this type of care guarantees availability and minimizes impact on normal care. When it is not being used during a major incident, there is time to address training and research

Police Response to Children Present at Domestic Violence Incidents.

Science.gov (United States)

Swerin, Danielle D; Bostaph, Lisa Growette; King, Laura L; Gillespie, Lane Kirkland

2018-01-01

Police response to domestic violence (DV) has continued to change and expand over the past several decades. Although DV was originally considered a private matter, it now represents one of the most common calls for service received by police agencies. While police response to DV incidents has improved substantially, intervention when children are present remains an undeveloped area of research and practice. The present study examined 345 police reports from an agency in the Northwestern United States to explore police response to DV incidents when children are present. Regression analyses indicated that child presence was a statistically significant predictor of victim-directed intervention, victim-directed follow-up, and arrest although in differing directions. While child presence increased the odds of victim-directed intervention and victim-directed follow-up, it decreased the odds of arrest. Findings further indicated that the frequency of police interaction with children present at DV incidents was minimal. Based on these findings, recommendations for policy and practice are discussed.

Long term consumption of mineral spring water containing natural radium-226

International Nuclear Information System (INIS)

Aulenbach, D.B.; Davis, R.E.

1976-01-01

The presence of naturally occurring 226 radium in several of the spring waters of Saratoga Springs, New York has been known for some time. However, recently the recommended maximum acceptable limit for consumption of water containing radium has been lowered to the point that the limits are now lower than the concentration of radium observed in several of the wells. A survey was made of 27 individuals who have consumed water from the Hathorn No. 1 Spring for periods varying from 5-65 years. A calculation was made of the 226 radium body burden from equations provided in the literature. The calcium concentration of the springs was determined in consideration of the still unknown comparative selectivity of the body between radium and calcium. Waters from two of the springs were analzyed for 226 radium using the radon emanation method. No adverse effects of consuming the mineral water were observed in the individuals interviewed nor were there any increased incidences of broken or brittle bones among these individuals

Asymmetric valley-resolved beam splitting and incident modes in slanted graphene junctions

International Nuclear Information System (INIS)

Hsieh, S. H.; Chu, C. S.

2016-01-01

Electron injection into a graphene sheet through a slanted armchair graphene nanoribbon (AGNR) is investigated. An incident mode, or subband, in the AGNR is valley-unpolarized. Our attention is on the valley-resolved nature of the injected electron beams and its connection to the incident mode. It is known for a normal injection that an incident mode will split symmetrically into two valley-resolved beams of equal intensity. We show, in contrast, that slanted injections result in asymmetric valley-resolved beam splitting. The most asymmetric beam splitting cases, when one of the valley-resolved beams has basically disappeared, are found and the condition derived. This is shown not due to trigonal warping because it holds even in the low incident energy regime, as long as collimation allows. These most asymmetric beam splitting cases occur at energies within an energy interval near and include the subband edge of an incident mode. The physical picture is best illustrated by a projection of the slanted AGNR subband states onto that of the 2D graphene sheet. It follows that the disappearing of a valley-resolved beam coincides with the situation that the group velocities of the projected states in the corresponding valley are in backward directions

Job strain and the risk of severe asthma exacerbations

DEFF Research Database (Denmark)

Heikkilä, K; Madsen, I E H; Nyberg, S T

2014-01-01

BACKGROUND: Many patients and healthcare professionals believe that work-related psychosocial stress, such as job strain, can make asthma worse, but this is not corroborated by empirical evidence. We investigated the associations between job strain and the incidence of severe asthma exacerbations...... in working-age European men and women. METHODS: We analysed individual-level data, collected between 1985 and 2010, from 102 175 working-age men and women in 11 prospective European studies. Job strain (a combination of high demands and low control at work) was self-reported at baseline. Incident severe...... asthma exacerbations were ascertained from national hospitalization and death registries. Associations between job strain and asthma exacerbations were modelled using Cox regression and the study-specific findings combined using random-effects meta-analyses. RESULTS: During a median follow-up of 10 years...

INCIDENCE OF AMPUTATION IN EMERGENCY

Directory of Open Access Journals (Sweden)

K. Rojaramani Kumbha

2016-08-01

Full Text Available Advanced Technology and early detection of disease by recent improvements in investigation modalities lead to decreased incidents of amputations while Road Traffic Accidents (RTA increase. Furthermore, it leads to variation and decreased morbidity, mortality and accidents (crush injuries, and better equipped and trained staff, specialist services, diabetic food, rehabilitation centres, and giving good support physically and psychologically for Amputated patients. OBJECTIVE To know incidence rates of Emergency Amputation who attended causality with advanced disease and severe Trauma. METHODOLOGY The study is done over a period of one year i.e. between June 2015 to June 2016 who attended causality with advanced and severe disease affecting the limbs either due to diabetes, trauma or vascular diseases. RESULTS During one-year period, total 6,371 patients attended for general surgery OP. In those, 187 patients needed emergency surgery which included both major and minor operations. Among those, 81 patients were amputated. CONCLUSION As per our available records and observation, even though there is increased literacy and access to advanced technology, there is still increased incidence of patients undergoing amputations due to diseases. Therefore, there is a need to improve awareness and importance of early detection of diabetes, hazards of smoking, and regular general health checkups for patients at root level. With that we can treat diabetes and/or any disease in time. So there must be awareness in peripheral health staff i.e. PHC, subcentres, and community health centres about early detection of disease which in turn improves the quality of life of the patient. Due to diabetes slight injury to the glucose laden tissue may cause chronic infection and ulcer formation.(1 The tumours are seen commonly in the age group of 20-40 years after bone fusion, bones affected commonly are those around the knee (lower end of knee, upper end of tibia. A lytic

Incident Information Management Tool

CERN Document Server

Pejovic, Vladimir

2015-01-01

Flaws of\tcurrent incident information management at CMS and CERN\tare discussed. A new data\tmodel for future incident database is\tproposed and briefly described. Recently developed draft version of GIS-­‐based tool for incident tracking is presented.

Severe obesity, heart disease, and death among white, African American, and Hispanic postmenopausal women.

Science.gov (United States)

McTigue, Kathleen M; Chang, Yue-Fang; Eaton, Charles; Garcia, Lorena; Johnson, Karen C; Lewis, Cora E; Liu, Simin; Mackey, Rachel H; Robinson, Jennifer; Rosal, Milagros C; Snetselaar, Linda; Valoski, Alice; Kuller, Lewis H

2014-03-01

To compare mortality, nonfatal coronary heart disease (CHD), and congestive heart failure (CHF) risk across BMI categories in white, African American, and Hispanic women, with a focus on severe obesity (BMI ≥ 40), and examine heterogeneity in weight-related CHD risk. Among 156,775 Women's Health Initiative observational study and clinical trial participants (September 1993-12 September 2005), multivariable Cox models estimated relative risk for mortality, CHD, and CHF. CHD incidence was calculated by anthropometry, race, and cardiovascular risk factors (CVRF). Mortality, nonfatal CHD, and CHF incidence generally rose with BMI category. For severe obesity versus normal BMI, hazard ratios (HRs, 95% confidence interval) for mortality were 1.97 (1.77-2.20) in white, 1.55 (1.20-2.00) in African American, and 2.59 (1.55-4.31) in Hispanic women; for CHD, HRs were 2.05 (1.80-2.35), 2.24 (1.57-3.19), and 2.95 (1.60-5.41) respectively; for CHF, HRs were 5.01 (4.33-5.80), 3.60 (2.30-5.62), and 6.05 (2.49-14.69). CVRF variation resulted in substantial variation in CHD rates across BMI categories, even in severe obesity. CHD incidence was similar by race/ethnicity when differences in BMI or CVRF were accounted for. Severe obesity increases mortality, nonfatal CHD, and CHF risk in women of diverse race/ethnicity. CVRF heterogeneity contributes to variation in CHD incidence even in severe obesity. Copyright © 2012 The Obesity Society.

Identifying Predictive Factors for Incident Reports in Patients Receiving Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Elnahal, Shereef M., E-mail: selnaha1@jhmi.edu [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Blackford, Amanda [Department of Oncology Biostatistics, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Smith, Koren; Souranis, Annette N.; Briner, Valerie; McNutt, Todd R.; DeWeese, Theodore L.; Wright, Jean L.; Terezakis, Stephanie A. [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States)

2016-04-01

Purpose: To describe radiation therapy cases during which voluntary incident reporting occurred; and identify patient- or treatment-specific factors that place patients at higher risk for incidents. Methods and Materials: We used our institution's incident learning system to build a database of patients with incident reports filed between January 2011 and December 2013. Patient- and treatment-specific data were reviewed for all patients with reported incidents, which were classified by step in the process and root cause. A control group of patients without events was generated for comparison. Summary statistics, likelihood ratios, and mixed-effect logistic regression models were used for group comparisons. Results: The incident and control groups comprised 794 and 499 patients, respectively. Common root causes included documentation errors (26.5%), communication (22.5%), technical treatment planning (37.5%), and technical treatment delivery (13.5%). Incidents were more frequently reported in minors (age <18 years) than in adult patients (37.7% vs 0.4%, P<.001). Patients with head and neck (16% vs 8%, P<.001) and breast (20% vs 15%, P=.03) primaries more frequently had incidents, whereas brain (18% vs 24%, P=.008) primaries were less frequent. Larger tumors (17% vs 10% had T4 lesions, P=.02), and cases on protocol (9% vs 5%, P=.005) or with intensity modulated radiation therapy/image guided intensity modulated radiation therapy (52% vs 43%, P=.001) were more likely to have incidents. Conclusions: We found several treatment- and patient-specific variables associated with incidents. These factors should be considered by treatment teams at the time of peer review to identify patients at higher risk. Larger datasets are required to recommend changes in care process standards, to minimize safety risks.

Identifying Predictive Factors for Incident Reports in Patients Receiving Radiation Therapy

International Nuclear Information System (INIS)

Elnahal, Shereef M.; Blackford, Amanda; Smith, Koren; Souranis, Annette N.; Briner, Valerie; McNutt, Todd R.; DeWeese, Theodore L.; Wright, Jean L.; Terezakis, Stephanie A.

2016-01-01

Purpose: To describe radiation therapy cases during which voluntary incident reporting occurred; and identify patient- or treatment-specific factors that place patients at higher risk for incidents. Methods and Materials: We used our institution's incident learning system to build a database of patients with incident reports filed between January 2011 and December 2013. Patient- and treatment-specific data were reviewed for all patients with reported incidents, which were classified by step in the process and root cause. A control group of patients without events was generated for comparison. Summary statistics, likelihood ratios, and mixed-effect logistic regression models were used for group comparisons. Results: The incident and control groups comprised 794 and 499 patients, respectively. Common root causes included documentation errors (26.5%), communication (22.5%), technical treatment planning (37.5%), and technical treatment delivery (13.5%). Incidents were more frequently reported in minors (age <18 years) than in adult patients (37.7% vs 0.4%, P<.001). Patients with head and neck (16% vs 8%, P<.001) and breast (20% vs 15%, P=.03) primaries more frequently had incidents, whereas brain (18% vs 24%, P=.008) primaries were less frequent. Larger tumors (17% vs 10% had T4 lesions, P=.02), and cases on protocol (9% vs 5%, P=.005) or with intensity modulated radiation therapy/image guided intensity modulated radiation therapy (52% vs 43%, P=.001) were more likely to have incidents. Conclusions: We found several treatment- and patient-specific variables associated with incidents. These factors should be considered by treatment teams at the time of peer review to identify patients at higher risk. Larger datasets are required to recommend changes in care process standards, to minimize safety risks.

An Evaluation of Departmental Radiation Oncology Incident Reports: Anticipating a National Reporting System

Energy Technology Data Exchange (ETDEWEB)

Terezakis, Stephanie A., E-mail: stereza1@jhmi.edu [Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Harris, Kendra M. [Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Ford, Eric [Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Department of Radiation Oncology, University of Washington, Seattle, Washington (United States); Michalski, Jeff [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); DeWeese, Theodore [Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Santanam, Lakshmi; Mutic, Sasa; Gay, Hiram [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States)

2013-03-15

Purpose: Systems to ensure patient safety are of critical importance. The electronic incident reporting systems (IRS) of 2 large academic radiation oncology departments were evaluated for events that may be suitable for submission to a national reporting system (NRS). Methods and Materials: All events recorded in the combined IRS were evaluated from 2007 through 2010. Incidents were graded for potential severity using the validated French Nuclear Safety Authority (ASN) 5-point scale. These incidents were categorized into 7 groups: (1) human error, (2) software error, (3) hardware error, (4) error in communication between 2 humans, (5) error at the human-software interface, (6) error at the software-hardware interface, and (7) error at the human-hardware interface. Results: Between the 2 systems, 4407 incidents were reported. Of these events, 1507 (34%) were considered to have the potential for clinical consequences. Of these 1507 events, 149 (10%) were rated as having a potential severity of ≥2. Of these 149 events, the committee determined that 79 (53%) of these events would be submittable to a NRS of which the majority was related to human error or to the human-software interface. Conclusions: A significant number of incidents were identified in this analysis. The majority of events in this study were related to human error and to the human-software interface, further supporting the need for a NRS to facilitate field-wide learning and system improvement.

An Evaluation of Departmental Radiation Oncology Incident Reports: Anticipating a National Reporting System

International Nuclear Information System (INIS)

Terezakis, Stephanie A.; Harris, Kendra M.; Ford, Eric; Michalski, Jeff; DeWeese, Theodore; Santanam, Lakshmi; Mutic, Sasa; Gay, Hiram

2013-01-01

Purpose: Systems to ensure patient safety are of critical importance. The electronic incident reporting systems (IRS) of 2 large academic radiation oncology departments were evaluated for events that may be suitable for submission to a national reporting system (NRS). Methods and Materials: All events recorded in the combined IRS were evaluated from 2007 through 2010. Incidents were graded for potential severity using the validated French Nuclear Safety Authority (ASN) 5-point scale. These incidents were categorized into 7 groups: (1) human error, (2) software error, (3) hardware error, (4) error in communication between 2 humans, (5) error at the human-software interface, (6) error at the software-hardware interface, and (7) error at the human-hardware interface. Results: Between the 2 systems, 4407 incidents were reported. Of these events, 1507 (34%) were considered to have the potential for clinical consequences. Of these 1507 events, 149 (10%) were rated as having a potential severity of ≥2. Of these 149 events, the committee determined that 79 (53%) of these events would be submittable to a NRS of which the majority was related to human error or to the human-software interface. Conclusions: A significant number of incidents were identified in this analysis. The majority of events in this study were related to human error and to the human-software interface, further supporting the need for a NRS to facilitate field-wide learning and system improvement

The Effects of Floods on the Incidence of Bacillary Dysentery in Baise (Guangxi Province, China) from 2004 to 2012.

Science.gov (United States)

Liu, Xuena; Liu, Zhidong; Zhang, Ying; Jiang, Baofa

2017-02-12

Research shows potential effects of floods on intestinal infections. Baise, a city in Guangxi Province (China) had experienced several floods between 2004 and 2012 due to heavy and constant precipitation. This study aimed to examine the relationship between floods and the incidence of bacillary dysentery in Baise. A mixed generalized additive model and Spearman correlation were applied to analyze the relationship between monthly incidence of bacillary dysentery and 14 flood events with two severity levels. Data collected from 2004 to 2010 were utilized to estimate the parameters, whereas data from 2011 to 2012 were used to validate the model. There were in total 9255 cases of bacillary dysentery included in our analyses. According to the mixed generalized additive model, the relative risks (RR) of moderate and severe floods on the incidence of bacillary dysentery were 1.40 (95% confidence interval (CI): 1.16-1.69) and 1.78 (95% CI: 1.61-1.97), respectively. The regression analysis also indicated that the flood duration was negatively associated with the incidence of bacillary dysentery (with RR: 0.57, 95% CI: 0.40-0.86). Therfore, this research suggests that floods exert a significant part in enhancing the risk of bacillary dysentery in Baise. Moreover, severe floods have a higher proportional contribution to the incidence of bacillary dysentery than moderate floods. In addition, short-term floods may contribute more to the incidence of bacillary dysentery than a long-term flood. The findings from this research will provide more evidence to reduce health risks related to floods.

The Effects of Floods on the Incidence of Bacillary Dysentery in Baise (Guangxi Province, China from 2004 to 2012

Directory of Open Access Journals (Sweden)

Xuena Liu

2017-02-01

Full Text Available Research shows potential effects of floods on intestinal infections. Baise, a city in Guangxi Province (China had experienced several floods between 2004 and 2012 due to heavy and constant precipitation. This study aimed to examine the relationship between floods and the incidence of bacillary dysentery in Baise. A mixed generalized additive model and Spearman correlation were applied to analyze the relationship between monthly incidence of bacillary dysentery and 14 flood events with two severity levels. Data collected from 2004 to 2010 were utilized to estimate the parameters, whereas data from 2011 to 2012 were used to validate the model. There were in total 9255 cases of bacillary dysentery included in our analyses. According to the mixed generalized additive model, the relative risks (RR of moderate and severe floods on the incidence of bacillary dysentery were 1.40 (95% confidence interval (CI: 1.16–1.69 and 1.78 (95% CI: 1.61–1.97, respectively. The regression analysis also indicated that the flood duration was negatively associated with the incidence of bacillary dysentery (with RR: 0.57, 95% CI: 0.40–0.86. Therfore, this research suggests that floods exert a significant part in enhancing the risk of bacillary dysentery in Baise. Moreover, severe floods have a higher proportional contribution to the incidence of bacillary dysentery than moderate floods. In addition, short-term floods may contribute more to the incidence of bacillary dysentery than a long-term flood. The findings from this research will provide more evidence to reduce health risks related to floods.

Best practices in incident investigation in the chemical process industries with examples from the industry sector and specifically from Nova Chemicals

International Nuclear Information System (INIS)

Morrison, Lisa M.

2004-01-01

This paper will summarize best practices in incident investigation in the chemical process industries and will provide examples from both the industry sector and specifically from NOVA Chemicals. As a sponsor of the Center for Chemical Process Safety (CCPS), an industry technology alliance of the American Institute of Chemical Engineers, NOVA Chemicals participates in a number of working groups to help develop best practices and tools for the chemical process and associated industries in order to advance chemical process safety. A recent project was to develop an update on guidelines for investigating chemical process incidents. A successful incident investigation management system must ensure that all incidents and near misses are reported, that root causes are identified, that recommendations from incident investigations identify appropriate preventive measures, and that these recommendations are resolved in a timely manner. The key elements of an effective management system for incident investigation will be described. Accepted definitions of such terms as near miss, incident, and root cause will be reviewed. An explanation of the types of incident classification systems in use, along with expected levels of follow-up, will be provided. There are several incident investigation methodologies in use today by members of the CCPS; most of these methodologies incorporate the use of several tools. These tools include: timelines, sequence diagrams, causal factor identification, brainstorming, checklists, pre-defined trees, and team-defined logic trees. Developing appropriate recommendations and then ensuring their resolution is the key to prevention of similar events from recurring, along with the sharing of lessons learned from incidents. There are several sources of information on previous incidents and lessons learned available to companies. In addition, many companies in the chemical process industries use their own internal databases to track recommendations from

Radiological incidents in radiotherapy

International Nuclear Information System (INIS)

Hobzova, L.; Novotny, J.

2008-01-01

In many countries a reporting system of radiological incidents to national regulatory body exists and providers of radiotherapy treatment are obliged to report all major and/or in some countries all incidents occurring in institution. State Office for Nuclear Safety (SONS) is providing a systematic guidance for radiotherapy departments from 1997 by requiring inclusion of radiation safety problems into Quality assurance manual, which is the basic document for obtaining a license of SONS for handling with sources of ionizing radiation. For that purpose SONS also issued the recommendation 'Introduction of QA system for important sources in radiotherapy-radiological incidents' in which the radiological incidents are defined and the basic guidance for their classification (category A, B, C, D), investigation and reporting are given. At regular periods the SONS in co-operation with radiotherapy centers is making a survey of all radiological incidents occurring in institutions and it is presenting obtained information in synoptic communication (2003 Motolske dny, 2005 Novy Jicin). This presentation is another summary report of radiological incidents that occurred in our radiotherapy institutions during last 3 years. Emphasis is given not only to survey and statistics, but also to analysis of reasons of the radiological incidents and to their detection and prevention. Analyses of incidents in radiotherapy have led to a much broader understanding of incident causation. Information about the error should be shared as early as possible during or after investigation by all radiotherapy centers. Learning from incidents, errors and near misses should be a part of improvement of the QA system in institutions. Generally, it is recommended that all radiotherapy facilities should participate in the reporting, analyzing and learning system to facilitate the dissemination of knowledge throughout the whole country to prevent errors in radiotherapy.(authors)

15-year incidence of diabetic ketoacidosis at onset of type 1 diabetes in children from a regional setting (Auckland, New Zealand)

Science.gov (United States)

Jefferies, Craig; Cutfield, Samuel W.; Derraik, José G. B.; Bhagvandas, Jignal; Albert, Benjamin B.; Hofman, Paul L.; Gunn, Alistair J.; Cutfield, Wayne S.

2015-01-01

We assessed the incidence of diabetic ketoacidosis (DKA) in children aged Auckland Region (New Zealand) in 1999–2013, in a retrospective review of a complete regional cohort. DKA and its severity were classified according to ISPAD 2014 guidelines. Of 730 children presenting with new-onset T1DM over the 15-year time period, 195 cases had DKA of any severity (27%). There was no change in the incidence of DKA or the proportion of children with severe DKA at presentation. The incidence of DKA among children aged Auckland Region over time. Thus, it is important to explore ways to reduce DKA risk. PMID:25989414

The selective metabotropic glutamate receptor 5 antagonist mavoglurant (AFQ056) reduces the incidence of reflux episodes in dogs and patients with moderate to severe gastroesophageal reflux disease.

Science.gov (United States)

Rouzade-Dominguez, M-L; Pezous, N; David, O J; Tutuian, R; Bruley des Varannes, S; Tack, J; Malfertheiner, P; Allescher, H-D; Ufer, M; Rühl, A

2017-08-01

Transient lower esophageal sphincter relaxations (TLESRs) induced by gastric distension are modulated by the metabotropic glutamate receptor 5 (mGluR5) that influences the vagal reflex loop. We therefore aimed to examine the effects of the selective mGluR5 antagonist mavoglurant (AFQ056) on the number of TLESRs in dogs and reflux episodes in patients with gastroesophageal reflux disease (GERD). In a dog model, the number of meal-induced TLESRs was determined after intravenous (0.03, 0.1, 0.3, and 1 mg kg -1 ) and oral (1, 3, and 10 mg kg -1 ) doses of mavoglurant with reference to vehicle. In a multicenter, randomized, double-blind, placebo-controlled, three-period crossover study, the incidence of meal-induced reflux episodes was assessed by esophageal impedance monitoring after single, oral doses of mavoglurant (50 and 400 mg) or baclofen (40 mg) in 30 patients with moderate to severe GERD. In dogs, mavoglurant reduced the number of TLESRs after intravenous and oral administration. In patients with GERD, the incidence of postprandial reflux episodes was significantly lower at a dose of 400 mg mavoglurant (-37.5% ; 90% confidence interval [CI]: -57.8, -17.2), whereas there was no significant difference at 50 mg of mavoglurant compared to placebo. A significantly lower incidence of reflux episodes was also noted with the active comparator baclofen (-50.3%; 90% CI: -66.2, -34.3), thereby validating this study. These data suggest a potential clinical benefit of mGluR5 antagonists such as mavoglurant in patients with GERD, particularly in those with persisting symptoms despite treatment with proton pump inhibitors. © 2017 John Wiley & Sons Ltd.

Early Detection and Localization of Downhole Incidents in Managed Pressure Drilling

DEFF Research Database (Denmark)

Willersrud, Anders; Imsland, Lars; Blanke, Mogens

2015-01-01

Downhole incidents such as kick, lost circulation, pack-off, and hole cleaning issues are important contributors to downtime in drilling. In managed pressure drilling (MPD), operations margins are typically narrower, implying more frequent incidents and more severe consequences. Detection...... and handling of symptoms of downhole drilling contingencies at an early stage are therefore crucial for the reliability and safety of MPD operations. In this paper we describe a method for early detection and localization of such incidents, based on a fit for purpose model of the downhole pressure hydraulics...... successfully been tested on experimental data from a medium-scale horizontal flow loop in Sta- vanger, Norway. The flow loop represents a 700 m borehole with emulation of the following downhole contingencies: drillstring washout, drill bit nozzle plugging, gas influx and fluid loss. In the tests...

Increasing Incidence of Canine Leptospirosis in Switzerland

Directory of Open Access Journals (Sweden)

Andrea Major

2014-07-01

Full Text Available A marked increase in canine leptospirosis was observed in Switzerland over 10 years with a peak incidence of 28.1 diagnosed cases/100,000 dogs/year in the most affected canton. With 95% affected dogs living at altitudes <800 m, the disease presented a seasonal pattern associated with temperature (r2 0.73 and rainfall (r2 0.39, >90% cases being diagnosed between May and October. The increasing yearly incidence however was only weakly correlated with climatic data including number of summer (r2 0.25 or rainy days (r2 0.38. Serovars Australis and Bratislava showed the highest seropositivity rates with 70.5% and 69.1%, respectively. Main clinical manifestations included renal (99.6%, pulmonary (76.7%, hepatic (26.0%, and hemorrhagic syndromes (18.2%, leading to a high mortality rate (43.3%. Similar to the human disease, liver involvement had the strongest association with negative outcome (OR 16.3. Based on these data, canine leptospirosis presents similar features and severity as the human infection for which it therefore can be considered a model. Its re-emergence in a temperate country with very high incidence rates in canines should thus be viewed as a warning and emphasize the need for increased awareness in other species.

Regulation Plans on Severe Accidents developed by KINS Severe Accident Regulation Preparation TFT

International Nuclear Information System (INIS)

Kim, Kyun Tae; Chung, Ku Young; Na, Han Bee

2016-01-01

Some nuclear power plants in Fukushima Daiichi site had lost their emergency reactor cooling function for long-time so the fuels inside the reactors were molten, and the integrity of containment was damaged. Therefore, large amount of radioactive material was released to environment. Because the social and economic effects of severe accidents are enormous, Korean Government already issued 'Severe Accident Policy' in 2001 which requires nuclear power plant operators to set up 'Quantitative Safety Goal', to do 'Probabilistic Safety Analysis', to install 'Severe Accident Countermeasures' and to make 'Severe Accident Management Plan'. After the Fukushima disaster, a Special Safety Inspection was performed for all operating nuclear power plants of Korea. The inspection team from industry, academia, and research institutes assessed Korean NPPs capabilities to cope with or respond to severe accidents and emergency situation caused by natural disasters such as a large earthquake or tsunami. As a result of the special inspection, about 50 action items were identified to increase the capability to cope with natural disaster and severe accidents. Nuclear Safety Act has been amended to require NPP operators to submit Accident Management Plant as part of operating license application. The KINS Severe Accident Regulation Preparation TFT had first investigated oversea severe accident regulation trend before and after the Fukushima accident. Then, the TFT has developed regulation draft for severe accidents such as Severe accident Management Plans, the required design features for new NPPs to prevent severe accident against multiple failures and beyond-design external events, countermeasures to mitigate severe accident and to keep the integrity of containment, and assessment methodology on safety assessment plan and probabilistic safety assessment

Sustainable development through natural resource development in Dir Kohistan North West Frontier Province Pakistan

International Nuclear Information System (INIS)

Khan, S. E.mail: erp@brain.net.pk

2005-01-01

Up to the middle of the past century it was possible to prevent the depletion of natural resources though good governance and the effective enforcement of the prevailing land tenure by legal and social control. This is no longer so, far several reasons. Both governance and social control have greatly deteriorated. Land tenure has not kept pace with rapid increase in population and the incidence of poverty and landlessness. Not finding redress in the established legal and social orders the landless and the poor have taken resource to illicit use for subsistence and eking out a living. Thus sustainable management of natural resources has become a daunting challenge in an era of declining resources, increasing demand, deteriorating governance and eroding social control. Recent experimental endeavors are attempting to develop flexible model of collaborative management, which could be applied successfully in the immensely variable socio-economic milieus of the countryside. Issues of resource degradation and regeneration is intimately linked to questions of power, poverty, institutions, livelihoods and culture. Natural Resource Management must become integral part of overall development strategies. (author)

Relating coccidioidomycosis (valley fever) incidence to soil moisture conditions.

Science.gov (United States)

Coopersmith, E J; Bell, J E; Benedict, K; Shriber, J; McCotter, O; Cosh, M H

2017-04-17

Coccidioidomycosis (also called Valley fever) is caused by a soilborne fungus, Coccidioides spp. , in arid regions of the southwestern United States. Though some who develop infections from this fungus remain asymptomatic, others develop respiratory disease as a consequence. Less commonly, severe illness and death can occur when the infection spreads to other regions of the body. Previous analyses have attempted to connect the incidence of coccidioidomycosis to broadly available climatic measurements, such as precipitation or temperature. However, with the limited availability of long-term, in situ soil moisture data sets, it has not been feasible to perform a direct analysis of the relationships between soil moisture levels and coccidioidomycosis incidence on a larger temporal and spatial scale. Utilizing in situ soil moisture gauges throughout the southwest from the U.S. Climate Reference Network and a model with which to extend those estimates, this work connects periods of higher and lower soil moisture in Arizona and California between 2002 and 2014 to the reported incidence of coccidioidomycosis. The results indicate that in both states, coccidioidomycosis incidence is related to soil moisture levels from previous summers and falls. Stated differently, a higher number of coccidioidomycosis cases are likely to be reported if previous bands of months have been atypically wet or dry, depending on the location.

The benefits and risks of bacille Calmette-Guérin vaccination among infants at high risk for both tuberculosis and severe combined immunodeficiency: assessment by Markov model

Directory of Open Access Journals (Sweden)

Cameron D William

2006-03-01

Full Text Available Abstract Background Bacille Calmette-Guérin (BCG vaccine is given to Canadian Aboriginal neonates in selected communities. Severe reactions and deaths associated with BCG have been reported among infants born with immunodeficiency syndromes. The main objective of this study was to estimate threshold values for severe combined immunodeficiency (SCID incidence, above which BCG is associated with greater risk than benefit. Methods A Markov model was developed to simulate the natural histories of tuberculosis (TB and SCID in children from birth to 14 years. The annual risk of tuberculous infection (ARI and SCID incidence were varied in analyses. The model compared a scenario of no vaccination to intervention with BCG. Appropriate variability and uncertainty analyses were conducted. Outcomes included TB incidence and quality-adjusted life years (QALYs. Results In sensitivity analyses, QALYs were lower among vaccinated infants if the ARI was 0.1% and the rate of SCID was higher than 4.2 per 100,000. Assuming an ARI of 1%, this threshold increased to 41 per 100,000. In uncertainty analyses (Monte Carlo simulations which assumed an ARI of 0.1%, QALYs were not significantly increased by BCG unless SCID incidence is 0. With this ARI, QALYs were significantly decreased among vaccinated children if SCID incidence exceeds 23 per 100,000. BCG is associated with a significant increase in QALYs if the ARI is 1%, and SCID incidence is below 5 per 100,000. Conclusion The possibility that Canadian Aboriginal children are at increased risk for SCID has serious implications for continued BCG use in this population. In this context, enhanced TB Control – including early detection and treatment of infection – may be a safer, more effective alternative.

Validating FMEA output against incident learning data: A study in stereotactic body radiation therapy.

Science.gov (United States)

Yang, F; Cao, N; Young, L; Howard, J; Logan, W; Arbuckle, T; Sponseller, P; Korssjoen, T; Meyer, J; Ford, E

2015-06-01

Though failure mode and effects analysis (FMEA) is becoming more widely adopted for risk assessment in radiation therapy, to our knowledge, its output has never been validated against data on errors that actually occur. The objective of this study was to perform FMEA of a stereotactic body radiation therapy (SBRT) treatment planning process and validate the results against data recorded within an incident learning system. FMEA on the SBRT treatment planning process was carried out by a multidisciplinary group including radiation oncologists, medical physicists, dosimetrists, and IT technologists. Potential failure modes were identified through a systematic review of the process map. Failure modes were rated for severity, occurrence, and detectability on a scale of one to ten and risk priority number (RPN) was computed. Failure modes were then compared with historical reports identified as relevant to SBRT planning within a departmental incident learning system that has been active for two and a half years. Differences between FMEA anticipated failure modes and existing incidents were identified. FMEA identified 63 failure modes. RPN values for the top 25% of failure modes ranged from 60 to 336. Analysis of the incident learning database identified 33 reported near-miss events related to SBRT planning. Combining both methods yielded a total of 76 possible process failures, of which 13 (17%) were missed by FMEA while 43 (57%) identified by FMEA only. When scored for RPN, the 13 events missed by FMEA ranked within the lower half of all failure modes and exhibited significantly lower severity relative to those identified by FMEA (p = 0.02). FMEA, though valuable, is subject to certain limitations. In this study, FMEA failed to identify 17% of actual failure modes, though these were of lower risk. Similarly, an incident learning system alone fails to identify a large number of potentially high-severity process errors. Using FMEA in combination with incident learning may

Economically motivated adulteration (EMA) of food: common characteristics of EMA incidents.

Science.gov (United States)

Everstine, Karen; Spink, John; Kennedy, Shaun

2013-04-01

Economically motivated adulteration (EMA) of food, also known as food fraud, is the intentional adulteration of food for financial advantage. A common form of EMA, undeclared substitution with alternative ingredients, is usually a health concern because of allergen labeling requirements. As demonstrated by the nearly 300,000 illnesses in China from melamine adulteration of infant formula, EMA also has the potential to result in serious public health consequences. Furthermore, EMA incidents reveal gaps in quality assurance testing methodologies that could be exploited for intentional harm. In contrast to foodborne disease outbreaks, EMA incidents present a particular challenge to the food industry and regulators because they are deliberate acts that are intended to evade detection. Large-scale EMA incidents have been described in the scientific literature, but smaller incidents have been documented only in media sources. We reviewed journal articles and media reports of EMA since 1980. We identified 137 unique incidents in 11 food categories: fish and seafood (24 incidents), dairy products (15), fruit juices (12), oils and fats (12), grain products (11), honey and other natural sweeteners (10), spices and extracts (8), wine and other alcoholic beverages (7), infant formula (5), plant-based proteins (5), and other food products (28). We identified common characteristics among the incidents that may help us better evaluate and reduce the risk of EMA. These characteristics reflect the ways in which existing regulatory systems or testing methodologies were inadequate for detecting EMA and how novel detection methods and other deterrence strategies can be deployed. Prevention and detection of EMA cannot depend on traditional food safety strategies. Comprehensive food protection, as outlined by the Food Safety Modernization Act, will require innovative methods for detecting EMA and for targeting crucial resources toward the riskiest food products.

Israeli hospital preparedness for terrorism-related multiple casualty incidents: can the surge capacity and injury severity distribution be better predicted?

Science.gov (United States)

Kosashvili, Yona; Aharonson-Daniel, L; Daniel, Limor A; Peleg, Kobi; Horowitz, Ariel; Laor, Danny; Blumenfeld, Amir

2009-07-01

The incidence of large-scale urban attacks on civilian populations has significantly increased across the globe over the past decade. These incidents often result in Hospital Multiple Casualty Incidents (HMCI), which are very challenging to hospital teams. 15 years ago the Emergency and Disaster Medicine Division in the Israeli Ministry of Health defined a key of 20 percent of each hospital's bed capacity as its readiness for multiple casualties. Half of those casualties are expected to require immediate medical treatment. This study was performed to evaluate the efficacy of the current readiness guidelines based on the epidemiology of encountered HMCIs. A retrospective study of HMCIs was recorded in the Israeli Defense Force (IDF) home front command and the Israeli National Trauma Registry (ITR) between November 2000 and June 2003. An HMCI is defined by the Emergency and Disaster Medicine Division in the Israeli Ministry of Health as >or=10 casualties or >or=4 suffering from injuries with an ISS>or=16 arriving to a single hospital. The study includes a total of 32 attacks, resulting in 62 HMCIs and 1292 casualties. The mean number of arriving casualties to a single hospital was 20.8+/-13.3 (range 4-56, median 16.5). In 95% of the HMCIs the casualty load was concept may improve the utilisation of national emergency health resources both in the preparation phase and on real time.

Cardiac arrest upon induction of anesthesia in children with cardiomyopathy: an analysis of incidence and risk factors.

LENUS (Irish Health Repository)

Lynch, Johanne

2012-02-01

INTRODUCTION: It is thought that patients with cardiomyopathy have an increased risk of cardiac arrest on induction of anesthesia, but there is little available data. The purpose of this study was to identify the incidence and potential risk factors for cardiac arrest upon induction of anesthesia in children with cardiomyopathy in our institution. METHODS: A retrospective chart review was performed. Eligible patients included patients admitted between 1998 and 2008 with the International Statistical Classification of Disease code for cardiomyopathy (ICD-9 code 425) who underwent airway intervention for sedation or general anesthesia in the operating room, cardiac diagnostic and interventional unit (CDIU) or intensive care unit. Patients undergoing emergency airway intervention following cardiovascular collapse were excluded. For each patient, we recorded patient demographics, disease severity, anesthesia location, and anesthetic technique. RESULTS: One hundred and twenty-nine patients with cardiomyopathy underwent a total of 236 anesthetic events, and four cardiac arrests were identified. One was related to bradycardia (HR<60), two were attributed to bradycardia in association with severe hypotension (systolic blood pressure<45), and the fourth arrest was related to isolated severe hypotension. Two occurred in the operating suite and two in the CDIU. There was no resulting mortality. One patient progressed to heart transplantation. Multiple combinations of anesthetic drugs were used for induction of anesthesia. CONCLUSION: We performed a review of the last 10 years of anesthesia events in children with cardiomyopathy. We report four cardiac arrests in two patients and 236 anesthetic events (1.7%). To the best of our knowledge, this is the largest review of these patients to date but is limited by its retrospective nature. The low cardiac arrest incidence prevents the identification of risk factors and the development of a cardiac arrest risk predictive clinical

The Role of Compounds Derived from Natural Supplement as Anticancer Agents in Renal Cell Carcinoma: A Review

Science.gov (United States)

Haque, Inamul; Subramanian, Arvind; Huang, Chao H.; Godwin, Andrew K.; Van Veldhuizen, Peter J.; Banerjee, Snigdha; Banerjee, Sushanta K.

2017-01-01

Renal Cell Carcinoma (RCC) is the most prominent kidney cancer derived from renal tubules and accounts for roughly 85% of all malignant kidney cancer. Every year, over 60,000 new cases are registered, and about 14,000 people die from RCC. The incidence of this has been increasing significantly in the U.S. and other countries. An increased understanding of molecular biology and the genomics of RCC has uncovered several signaling pathways involved in the progression of this cancer. Significant advances in the treatment of RCC have been reported from agents approved by the Food and Drug Administration (FDA) that target these pathways. These agents have become drugs of choice because they demonstrate clinical benefit and increased survival in patients with metastatic disease. However, the patients eventually relapse and develop resistance to these drugs. To improve outcomes and seek approaches for producing long-term durable remission, the search for more effective therapies and preventative strategies are warranted. Treatment of RCC using natural products is one of these strategies to reduce the incidence. However, recent studies have focused on these chemoprevention agents as anti-cancer therapies given they can inhibit tumor cell grow and lack the severe side effects common to synthetic compounds. This review elaborates on the current understanding of natural products and their mechanisms of action as anti-cancer agents. The present review will provide information for possible use of these products alone or in combination with chemotherapy for the prevention and treatment of RCC. PMID:29301217

Cancer incidence following long-term consumption of drinking water with high inorganic selenium content.

Science.gov (United States)

Vinceti, Marco; Vicentini, Massimo; Wise, Lauren A; Sacchettini, Claudio; Malagoli, Carlotta; Ballotari, Paola; Filippini, Tommaso; Malavolti, Marcella; Rossi, Paolo Giorgi

2018-04-16

Selenium, a trace element to which humans are exposed mainly through diet, has been involved in the etiology of human cancer. We investigated the long-term effects of selenium exposure on cancer incidence using data from a natural experiment in Northern Italy. During the 1970s-1980s, in a part of the Italian municipality of Reggio Emilia, residents were inadvertently exposed to unusually high levels of inorganic hexavalent selenium (selenate) through drinking water. We followed the exposed residents for 28years, generating data on incidence (when available) and mortality rates for selected cancer sites; the remaining municipal residents comprised the unexposed (reference) group. We observed no substantial difference in overall cancer incidence comparing exposed and unexposed cohorts. We detected, however, a higher incidence of cancer at some sites, and for a few of them, namely cancers of the buccal cavity and pharynx, melanoma, urinary tract and lymphoid tissue, the excess incidence was particularly evident in the first period of follow-up but decreased over time. Overall, these results suggest that consumption of water with levels of selenium in its inorganic hexavalent form close to the European standard, 10μg/L, may have unfavourable effects on cancer incidence. Copyright © 2018 Elsevier B.V. All rights reserved.

Noticeable rise in incidence of Hurthle cell carcinoma - Are we paying the Chernobyl toll ?

International Nuclear Information System (INIS)

Vojicic, J.; Popadic, S.; Malesevic, M.; Kermeci, K.; Peter, A.

2004-01-01

Full text: The Institute of Oncology in Sremska Kamenica is a reference centre for radioiodine treatment of different thyroid cancer (DTC) in our country. The majority of patients operated for DTC throughout the country are sent to us for further diagnostics and/or therapy. In our practice, we noticed a rising incidence of Hurthle cell cancer (HCC) during the past several years. We wanted to determine if there is statistically significant difference in the incidence of Hurthle cell cancer between several previous years. Data from the patients referred to our institution for 131-I whole body scanning and/or therapy between January 1998 and August 2003 were used to determine the incidence of HCC, which was presented as the percentage of total number of patients who were diagnosed to have DTC in the specific year. χ 2 test was used to test for significance of differences between the years. In the aforementioned period, there was a total number of 394 DTC patients among whom 17 with follicular carcinoma of oxyphyllic type (so called Hurthle cell carcinoma). Presented in percentage, the distribution of HCC throughout the years is as follows: 1998-0%; 1999-0%; 2000-3.85%; 2001-4.55%; 2002-5.3%; 2003-7.6%. We found significant difference (p<0.05 or less) between the incidence of HCC in year 2003 and all the previous years; also between years 1998 and 1999 and year of 2002 (p<0.05). These results show a rising incidence of Hurthle cell carcinoma over the past several years, with a significant peak in the year of 2003. Since these tumors also tend to show more aggressive clinical behaviour than they used to, our belief is that we might now be paying the toll of the Chernobyl accident. (author)

Bayesian geostatistical modeling of leishmaniasis incidence in Brazil.

Directory of Open Access Journals (Sweden)

Dimitrios-Alexios Karagiannis-Voules

Full Text Available BACKGROUND: Leishmaniasis is endemic in 98 countries with an estimated 350 million people at risk and approximately 2 million cases annually. Brazil is one of the most severely affected countries. METHODOLOGY: We applied Bayesian geostatistical negative binomial models to analyze reported incidence data of cutaneous and visceral leishmaniasis in Brazil covering a 10-year period (2001-2010. Particular emphasis was placed on spatial and temporal patterns. The models were fitted using integrated nested Laplace approximations to perform fast approximate Bayesian inference. Bayesian variable selection was employed to determine the most important climatic, environmental, and socioeconomic predictors of cutaneous and visceral leishmaniasis. PRINCIPAL FINDINGS: For both types of leishmaniasis, precipitation and socioeconomic proxies were identified as important risk factors. The predicted number of cases in 2010 were 30,189 (standard deviation [SD]: 7,676 for cutaneous leishmaniasis and 4,889 (SD: 288 for visceral leishmaniasis. Our risk maps predicted the highest numbers of infected people in the states of Minas Gerais and Pará for visceral and cutaneous leishmaniasis, respectively. CONCLUSIONS/SIGNIFICANCE: Our spatially explicit, high-resolution incidence maps identified priority areas where leishmaniasis control efforts should be targeted with the ultimate goal to reduce disease incidence.

Extracting classification rules from an informatic security incidents repository by genetic programming

Directory of Open Access Journals (Sweden)

Carlos Javier Carvajal Montealegre

2015-04-01

Full Text Available This paper describes the data mining process to obtain classification rules over an information security incident data collection, explaining in detail the use of genetic programming as a mean to model the incidents behavior and representing such rules as decision trees. The described mining process includes several tasks, such as the GP (Genetic Programming approach evaluation, the individual's representation and the algorithm parameters tuning to upgrade the performance. The paper concludes with the result analysis and the description of the rules obtained, suggesting measures to avoid the occurrence of new informatics attacks. This paper is a part of the thesis work degree: Information Security Incident Analytics by Data Mining for Behavioral Modeling and Pattern Recognition (Carvajal, 2012.

The Nature of the Bioterrorism Threat

Energy Technology Data Exchange (ETDEWEB)

Regens, J. L.

2003-02-25

This analysis provides an overview of the nature of the bioterrorism threat. It identifies potential CDC Class A biological agents that are likely candidates for use in a terrorist incident and describes the known sources of vulnerability. The paper also summarizes S&T resources/needs and assesses response options for achieving effective biodefense against terrorist threats.

Incidence of Schizophrenia Among Second-Generation Immigrants in the Jerusalem Perinatal Cohort

Science.gov (United States)

Corcoran, Cheryl; Perrin, Mary; Harlap, Susan; Deutsch, Lisa; Fennig, Shmuel; Manor, Orly; Nahon, Daniella; Kimhy, David; Malaspina, Dolores; Susser, Ezra

2009-01-01

Objective: Increased incidence of schizophrenia is observed among some immigrant groups in Europe, with the offspring of immigrants, ie “second-generation” immigrants particularly vulnerable. Few contemporary studies have evaluated the risk of schizophrenia among second-generation immigrants in other parts of the world. Methods: We studied the incidence of schizophrenia in relation to parental immigrant status in a population-based cohort of 88 829 offspring born in Jerusalem in 1964–1976. Parental countries of birth were obtained from birth certificates and grouped together as (1) Israel, (2) Other West Asia, (3) North Africa, and (4) Europe and industrialized countries. Cox proportional hazards methods were used in adjusting for sex, parents’ ages, maternal education, social class, and birth order. Results: Linkage with Israel's Psychiatric Registry identified 637 people admitted to psychiatric care facilities with schizophrenia-related diagnoses, before 1998. Incidence of schizophrenia was not increased among second-generation immigrants in this birth cohort, neither overall nor by specific group. Conclusions: The difference in risk of schizophrenia among second-generation immigrants in Europe and in this Israeli birth cohort suggests that the nature of the immigration experience may be relevant to risk, including reasons for migration, the nature of entry, and subsequent position in the host country for immigrants and their offspring. Minority status may be of importance as, in later studies, immigrants to Israel from Ethiopia had increased risk of schizophrenia. PMID:18648022

Analysis of recent incidents of on-field violence in sport: legal decisions and additional considerations from psychology.

Science.gov (United States)

Kerr, John H

2009-01-01

This article focuses on two recent incidents of serious on-field violence in sports and the legal consequences for those involved. The two incidents occurred in Dutch football (soccer) and became infamous owing to the nature of the violent incidents and widespread media coverage. The legal outcomes of these two incidents are described, and some of the difficulties that legal authorities face in considering assaults on the sports field are discussed. A new way of categorizing such violent incidents and the motivation behind them, based on an established psychological theory [reversal theory, Apter, 1982, 2001] is proposed. Taken along with the other points made in this article, being aware of when and how individuals cross the boundaries between play and anger, power or thrill violence may provide an additional perspective to making informed decisions about illegal violent acts on the sports field. Copyright 2008 Wiley-Liss, Inc.

Arrival time and incidence angle distributions of extensive air showers (EAS) muons

International Nuclear Information System (INIS)

Brancus, I.M.; Duma, M.; Vulpescu, B.; Foeller, M.; Rebel, H.; Voelker, G.; Chilingarian, A.A.

1995-01-01

The arrival time distributions of the muons can be related to the longitudinal EAS development and may provide additional information about the nature of the primary. Based on EAS simulations using the Monte-Carlo code CORSIKA, the correlations between arrival time and incidence angle distributions have been investigated in a case of a set of ideal detectors (10 m x 10 m) placed at various distances from the shower core. Applying advanced statistical techniques based on Bayes decision rule and non-parametric multivariate analysing methods it turns out that the correlations of muon arrival time and incidence angle at various separating distances of about 50 m exhibit promising features for mass discrimination (author)

Regulation Plans on Severe Accidents developed by KINS Severe Accident Regulation Preparation TFT

Energy Technology Data Exchange (ETDEWEB)

Kim, Kyun Tae; Chung, Ku Young; Na, Han Bee [KINS, Daejeon (Korea, Republic of)

2016-05-15

Some nuclear power plants in Fukushima Daiichi site had lost their emergency reactor cooling function for long-time so the fuels inside the reactors were molten, and the integrity of containment was damaged. Therefore, large amount of radioactive material was released to environment. Because the social and economic effects of severe accidents are enormous, Korean Government already issued 'Severe Accident Policy' in 2001 which requires nuclear power plant operators to set up 'Quantitative Safety Goal', to do 'Probabilistic Safety Analysis', to install 'Severe Accident Countermeasures' and to make 'Severe Accident Management Plan'. After the Fukushima disaster, a Special Safety Inspection was performed for all operating nuclear power plants of Korea. The inspection team from industry, academia, and research institutes assessed Korean NPPs capabilities to cope with or respond to severe accidents and emergency situation caused by natural disasters such as a large earthquake or tsunami. As a result of the special inspection, about 50 action items were identified to increase the capability to cope with natural disaster and severe accidents. Nuclear Safety Act has been amended to require NPP operators to submit Accident Management Plant as part of operating license application. The KINS Severe Accident Regulation Preparation TFT had first investigated oversea severe accident regulation trend before and after the Fukushima accident. Then, the TFT has developed regulation draft for severe accidents such as Severe accident Management Plans, the required design features for new NPPs to prevent severe accident against multiple failures and beyond-design external events, countermeasures to mitigate severe accident and to keep the integrity of containment, and assessment methodology on safety assessment plan and probabilistic safety assessment.

Liver dysfunction in patients with severe anorexia nervosa.

Science.gov (United States)

Rosen, Elissa; Sabel, Allison L; Brinton, John T; Catanach, Brittany; Gaudiani, Jennifer L; Mehler, Philip S

2016-02-01

Evaluation of liver dysfunction in patients with severe anorexia nervosa (AN) has typically been limited to small case series. We report an investigation into the admission characteristics and clinical outcomes associated with liver dysfunction in a large cohort of adults hospitalized for medical stabilization of severe AN. We retrospectively evaluated electronic medical records to quantify the cumulative incidence of elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT). We compared mean (±SD), frequencies (%), and median (IQR) values of clinical covariates of interest by incidence of liver enzyme elevation. The study included 181 adults, admitted for medical stabilization of AN, from October 1, 2008 to December 31, 2013. AST and ALT were mildly elevated in 27.6% of patients and severely elevated (more than three times the upper limit of normal) in 35.4% of patients. On admission, patients with severely elevated liver enzymes had a lower body mass index (BMI) (11.9 ± 1.8 kg/m(2) vs.13.3 ± 1.7 kg/m(2)), lower percentage ideal body weight (56.5% ± 7.7% vs. 63.5% ± 8.3%), and lower prealbumin (64% vs. 37%) compared with the rest of the cohort (p < 0.001). While hospitalized, patients with severely elevated liver enzymes more often developed hypoglycemia, hypophosphatemia, and experienced longer lengths of stay (p < 0.001). Elevated liver enzymes are common in our patient population with severe AN. Liver enzymes reached near normal values by the time of discharge. Severely elevated liver enzymes were associated with a lower BMI and the development of hypoglycemia. © 2015 Wiley Periodicals, Inc.

Sports injuries: population based representative data on incidence, diagnosis, sequelae, and high risk groups.

Science.gov (United States)

Schneider, S; Seither, B; Tönges, S; Schmitt, H

2006-04-01

To generate national representative data on the incidence, diagnosis, severity, and nature of medically treated sports injuries and to identify high risk groups. The first national health survey for the Federal Republic of Germany, conducted in the format of a standardised, written, cross sectional survey in the period October 1997 to March 1999, gathered data on the incidence of accident and injury and information on social demographics, injury related disability/time off work, and injury location/setting. The net sample comprised 7124 people aged 18-79. 3.1% of adult Germans said they sustained a sports injury during the previous year, corresponding to an annual injury rate of 5.6% among those engaging in regular recreational physical activity and ranking sports injuries as the second most common type of accident. About 62% of all sports injuries result in time taken off work. The period of occupational disability is 14 days or less in around two thirds of these cases. The occupational disability rate after occupational and traffic accidents is much higher by comparison. Dislocations, distortions, and/or torn ligaments make up 60% of all sports injuries, followed by fractures (18%), contusions, surface wounds, or open wounds (12%). Three out of four sports injury casualties are male. The incidence declines noticeably in higher age groups. Future injury prevention measures should focus on the high risk group of young male recreational athletes. The data indicate that the fear of damage to health and injury, believed to be significant internal psychological barriers to participation in sports, is largely unwarranted for the female population and/or older age groups. Sporting injuries are a marginal phenomenon among the female population and mobile seniors actively engaged in sports.

Interference in a thick plate at large angle of incidence

International Nuclear Information System (INIS)

Tavassoli, M.T.; Shah Shehany, F.

1991-01-01

A new approach to the interference in a plane parallel plate is introduced which is valid for any angle of incidence and any thickness. It is shown that the interference in a plate can be interpreted as the interference in a double-slit and the corresponding parameters are derived. It is also shown that for a particular angle of incidence, which depends only on the refractive index, the interfringes are minimum. It is proved theoretically and verified experimentally that the interference around this particular angle of incidence has several exploitable features which include: a) In thick plates large numbers of equidistant fringes are formed which are very adequate for producing interference gratings. b) It provides, in comparison to the conventional interferometric methods, an easier and more accurate means for direct measurement of wave-length. c) Multiple-beam interference at this particular angle improve the accuracy of the measurement of the fine structures of the atomic spectra, compared to other interferometric methods. (author). 4 refs, 4 figs

Medical treatment of radiation damages and medical emergency planning in case of nuclear power plant incidents and accidents

International Nuclear Information System (INIS)

Ohlenschlaeger, L.

1981-03-01

Medical measures in case of radiation damages are discussed on the basis of five potential categories of radiation incidents and accidents, respectively, viz. contaminations, incorporations, external local and general radiation over-exposures, contaminated wounds, and combinations of radiation damages and conventional injuries. Considerations are made for diagnostic and therapeutic initial measures especially in case of minor and moderate radiation accidents. The medical emergency planning is reviewed by means of definations used in the practical handling of incidents or accidents. The parameters are: extent of the incident or accident, number of persons involved, severity of radiation damage. Based on guiding symptoms the criteria for the classification into minor, moderate or severe radiation accidents are discussed. Reference is made to the Medical Radiation Protection Centers existing in the Federal Republic of Germany and the possibility of getting advices in case of radiation incidents and accidents. (orig.) [de

A Natural Language Architecture

OpenAIRE

Sodiya, Adesina Simon

2007-01-01

Natural languages are the latest generation of programming languages, which require processing real human natural expressions. Over the years, several groups or researchers have trying to develop widely accepted natural language languages based on artificial intelligence (AI). But no true natural language has been developed. The goal of this work is to design a natural language preprocessing architecture that identifies and accepts programming instructions or sentences in their natural forms ...

Influence of knee flexion and atraumatic mobilisation of infrapatellar fat pad on incidence and severity of anterior knee pain after tibial nailing.

Science.gov (United States)

Jankovic, Andrija; Korac, Zelimir; Bozic, Nenad-Bozo; Stedul, Ivan

2013-09-01

We evaluated the incidence and aetiology of anterior knee pain (AKP) in a series of patients that underwent intramedullary nailing for stabilisation of tibial fractures. During the preparation of the entry site no excision of the infrapatellar fat was allowed and electrical haemostasis was kept at the lowest level. Medullary canal was reamed and the nails inserted in position of knee flexion over 100 degrees. All fractures were fixed using medial paratendinous approach. Functional outcome was measured using Lysholm knee score. The knee range of movement and return to previous level of activity were also documented and analysed. Mean follow up was 38.9 months (range 12-84 months). In total 60 patients with 62 tibial shaft fractures were analysed. The mean age at the time of final follow up was 49.4 years (range 20-87). In 22 (35.5%) a newly developed and persisting pain in the anterior region of the operated knee was reported. According to VAP scale, the pain was mild (VAS 1-3) in 12 cases (19.4%) and moderate (VAS 4-6) in 10 (16.1%). In 16 cases (73%) the pain was noticed 6-12 months after injury and subjectively related to return to full range of working and recreational activities. The mean Lysholm knee score in the group without AKP was 90.8. In the AKP group with mild pain it was 88.4 and in the group with moderate AKP it was 79.9. Complete return to previous professional and recreational activities occurred in 49/60 patients (81.7%). Content with the treatment regarding expectations in recovery dynamics and return to desired level of activity was present in 98.3% of patients; one patient was unsatisfied with the treatment. Our results indicate that respecting the physiological motion of Hoffa pad and menisci during knee flexion, accompanied with atraumatic mobilisation of retrotendinous fat, reduces incidence and severity of anterior knee pain following intramedullary fixation of tibial shaft fractures. Copyright © 2013 Elsevier Ltd. All rights reserved.

[A Method Research on Environmental Damage Assessment of a Truck Rollover Pollution Incident].

Science.gov (United States)

Cai, Feng; Zhao, Shi-ho; Chen, Gang-cai; Xian, Si-shu; Yang, Qing-ling; Zhou, Xian-jie; Yu, Hai

2015-05-01

With high occurrence of sudden water pollution incident, China faces an increasingly severe situation of water environment. In order to deter the acts of environmental pollution, ensure the damaged resources of environment can be restored and compensated, it is very critical to quantify the economic losses caused by the sudden water pollution incident. This paper took truck rollover pollution incidents in Chongqing for an example, established a set of evaluation method for quantifying the environmental damage, and then assessed the environmental damage by the method from four aspects, including the property damage, ecological environment and resources damages, the costs of administrative affairs in emergency disposal, and the costs of investigation and evaluation.

Savannah River experience using a Cause Coding Tree to identify the root cause of an incident

International Nuclear Information System (INIS)

Paradies, M.W.; Busch, D.A.

1986-01-01

Incidents (or near misses) provide important information about plant performance and ways to improve that performance. Any particular incident may have several ''root causes'' that need to be addressed to prevent recurrence of the incident and thereby improve the safety of the plant. Also, by reviewing a large number of these incidents, one can identify trends in the root causes and generic concerns. A method has been developed at Savannah River Plant to systematically evaluate incidents, identify their root causes, record these root causes, and analyze the trends of these causes. By providing a systematic method to identify correctable root causes, the system helps the incident investigator to ask the right questions during the investigation. It also provides the independent safety analysis group and management with statistics that indicate existing and developing trouble sports. This paper describes the Savannah River Plant (SRP) Cause Coding Tree, and the differences between the SRP Tree and other systems used to analyze incidents. 2 refs., 14 figs

Thyroid cancer incidence in the Ukraine after the Chernobyl accident: comparison with spontaneous incidences

International Nuclear Information System (INIS)

Sobolev, B.; Kairo, I.; Likhtarev, I.; Heidenreich, W.F.; Jacob, P.; Goulko, G.

1997-01-01

The thyroid cancer incidence in the Ukraine among those born in the period 1968-1986 was analyzed with the aim to identify the enhancement due to the Chernobyl accident. Since any Ukrainian data referring to the time period before the accident are scarce and the variation of spontaneous incidences in other countries is immense, the Ukrainian incidences in the period 1986-1989 were used to estimate the baseline risk. Following 1990, the incidence in the southern part of the Ukraine increased by about 30%, independent of age. In the other parts the increase of the incidence depended on age at exposure. In the age group of 9-year-old children, the incidences in three regions defined as the 'high-dose area', the northern, and the middle oblasts, increased by factors of 50, 20, and 6, respectively. These rates (1991-1995) are well above spontaneous rates in other countries. In the age group of 17-year-old juveniles, the incidence increased by a factor of 6 for the 'high dose area' and in the three northern oblasts, whereas in the nine 'middle' oblasts it was similar to the incidence of the 'southern' Ukraine. These rates are within the range found in other countries. (orig.)

Association between chronic azotemic kidney disease and the severity of periodontal disease in dogs.

Science.gov (United States)

Glickman, Lawrence T; Glickman, Nita W; Moore, George E; Lund, Elizabeth M; Lantz, Gary C; Pressler, Barrak M

2011-05-01

Naturally occurring periodontal disease affects >75% of dogs and has been associated with cardiac lesions and presumptive endocarditis. However, the relationships between periodontal disease and chronic kidney disease (CKD) in dogs have not been studied. In a retrospective longitudinal study the incidence of azotemic CKD was compared between a cohort of 164,706 dogs with periodontal disease and a cohort of age-matched dogs with no periodontal disease from a national primary care practice. These dogs contributed 415,971 dog-years of follow-up from 2002 to 2008. Hazard ratios and 95% confidence intervals from Cox regression were used to compare the incidence of azotemic CKD in dogs with stage 1, 2, or 3/4 periodontal disease to dogs with no periodontal disease. The hazard ratio for azotemic CKD increased with increasing severity of periodontal disease (stage 1 hazard ratio=1.8, 95% confidence interval: 1.6, 2.1; stage 2 hazard ratio=2.0, 95% confidence interval: 1.7, 2.3; stage 3/4 hazard ratio=2.7, 95% confidence interval: 2.3, 3.0; P(trend)=periodontal disease was also associated with serum creatinine >1.4 mg/dl and blood urea nitrogen >36 mg/dl, independent of a veterinarian's clinical diagnosis of CKD. Copyright © 2011 Elsevier B.V. All rights reserved.

Incidence and Symptoms of High Altitude Illness in South Pole Workers: Antarctic Study of Altitude Physiology (ASAP

Directory of Open Access Journals (Sweden)

Paul J. Anderson

2011-01-01

Full Text Available Introduction Each year, the US Antarctic Program rapidly transports scientists and support personnel from sea level (SL to the South Pole (SP, 2835 m providing a unique natural laboratory to quantify the incidence of acute mountain sickness (AMS, patterns of altitude related symptoms and the field effectiveness of acetazolamide in a highly controlled setting. We hypothesized that the combination of rapid ascent (3 hr, accentuated hypobarism (relative to altitude, cold, and immediate exertion would increase altitude illness risk. Methods Medically screened adults (N = 246, age = 37 ± 11 yr, 30% female, BMI = 26 ± 4 kg/m 2 were recruited. All underwent SL and SP physiological evaluation, completed Lake Louise symptom questionnaires (LLSQ, to define AMS, and answered additional symptom related questions (eg, exertional dyspnea, mental status, cough, edema and general health, during the 1st week at altitude. Acetazolamide, while not mandatory, was used by 40% of participants. Results At SP, the barometric pressure resulted in physiological altitudes that approached 3400 m, while T ° C averaged -42, humidity 0.03%. Arterial oxygen saturation averaged 89% ± 3%. Overall, 52% developed LLSQ defined AMS. The most common symptoms reported were exertional dyspnea-(87%, sleeping difficulty-(74%, headache-(66%, fatigue-(65%, and dizziness/lightheadedness-(46%. Symptom severity peaked on days 1-2, yet in >20% exertional dyspnea, fatigue and sleep problems persisted through day 7. AMS incidence was similar between those using acetazolamide and those abstaining (51 vs. 52%, P = 0.87. Those who used acetazolamide tended to be older, have less altitude experience, worse symptoms on previous exposures, and less SP experience. Conclusion The incidence of AMS at SP tended to be higher than previously reports in other geographic locations at similar altitudes. Thus, the SP constitutes a more intense altitude exposure than might be expected considering physical

Incidence de la taxation selon le sexe : améliorer la production de ...

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

Incidence de la taxation selon le sexe : améliorer la production de revenus et la ... et de réduire la pauvreté, il est essentiel de comprendre la nature des réformes fiscales ... Le CRDI félicite la première cohorte de chercheuses en science des ...

Tax incidence on services rendered on the high seas; Incidencia de ISS sobre servicos prestados em aguas maritimas

Energy Technology Data Exchange (ETDEWEB)

Paco, Daniel Hora do; Giamattey, Ricardo Henrique Dionisio; Miranda, Thales Ribamar [PETROBRAS S.A., Rio de Janeiro, RJ (Brazil)

2008-07-01

This paper analyze the legal aspects of the incidence of ISSQN tax (Tax on Services of any Nature), on the services provide on the high seas. Also comment the controversy surrounding the active tax competency (municipality who may be due to the tax) for the charging of the incident ISSQN on the services provided on the high seas, if overcome the arguments in favor of non-levy of the tax.

Measurable improvement in patient safety culture: A departmental experience with incident learning.

Science.gov (United States)

Kusano, Aaron S; Nyflot, Matthew J; Zeng, Jing; Sponseller, Patricia A; Ermoian, Ralph; Jordan, Loucille; Carlson, Joshua; Novak, Avrey; Kane, Gabrielle; Ford, Eric C

2015-01-01

Rigorous use of departmental incident learning is integral to improving patient safety and quality of care. The goal of this study was to quantify the impact of a high-volume, departmental incident learning system on patient safety culture. A prospective, voluntary, electronic incident learning system was implemented in February 2012 with the intent of tracking near-miss/no-harm incidents. All incident reports were reviewed weekly by a multiprofessional team with regular department-wide feedback. Patient safety culture was measured at baseline with validated patient safety culture survey questions. A repeat survey was conducted after 1 and 2 years of departmental incident learning. Proportional changes were compared by χ(2) or Fisher exact test, where appropriate. Between 2012 and 2014, a total of 1897 error/near-miss incidents were reported, representing an average of 1 near-miss report per patient treated. Reports were filed by a cross section of staff, with the majority of incidents reported by therapists, dosimetrists, and physicists. Survey response rates at baseline and 1 and 2 years were 78%, 80%, and 80%, respectively. Statistically significant and sustained improvements were noted in several safety metrics, including belief that the department was openly discussing ways to improve safety, the sense that reports were being used for safety improvement, and the sense that changes were being evaluated for effectiveness. None of the surveyed dimensions of patient safety culture worsened. Fewer punitive concerns were noted, with statistically significant decreases in the worry of embarrassment in front of colleagues and fear of getting colleagues in trouble. A comprehensive incident learning system can identify many areas for improvement and is associated with significant and sustained improvements in patient safety culture. These data provide valuable guidance as incident learning systems become more widely used in radiation oncology. Copyright © 2015

An International Comparison of the Instigation and Design of Health Registers in the Epidemiological Response to Major Environmental Health Incidents.

Science.gov (United States)

Behbod, Behrooz; Leonardi, Giovanni; Motreff, Yvon; Beck, Charles R; Yzermans, Joris; Lebret, Erik; Muravov, Oleg I; Bayleyegn, Tesfaye; Wolkin, Amy Funk; Lauriola, Paolo; Close, Rebecca; Crabbe, Helen; Pirard, Philippe

Epidemiological preparedness is vital in providing relevant, transparent, and timely intelligence for the management, mitigation, and prevention of public health impacts following major environmental health incidents. A register is a set of records containing systematically collected, standardized data about individual people. Planning for a register of people affected by or exposed to an incident is one of the evolving tools in the public health preparedness and response arsenal. We compared and contrasted the instigation and design of health registers in the epidemiological response to major environmental health incidents in England, France, Italy, the Netherlands, and the United States. Consultation with experts from the 5 nations, supplemented with a review of gray and peer-reviewed scientific literature to identify examples where registers have been used. Populations affected by or at risk from major environmental health incidents in England, France, Italy, the Netherlands, and the United States. Nations were compared with respect to the (1) types of major incidents in their remit for considering a register; (2) arrangements for triggering a register; (3) approaches to design of register; (4) arrangements for register implementation; (5) uses of registers; and (6) examples of follow-up studies. Health registers have played a key role in the effective public health response to major environmental incidents, including sudden chemical, biological, radiological, or nuclear, as well as natural, more prolonged incidents. Value has been demonstrated in the early and rapid deployment of health registers, enabling the capture of a representative population. The decision to establish a health register must ideally be confirmed immediately or soon after the incident using a set of agreed criteria. The establishment of protocols for the instigation, design, and implementation of health registers is recommended as part of preparedness activities. Key stakeholders must be

Grazing incidence beam expander

Energy Technology Data Exchange (ETDEWEB)

Akkapeddi, P.R.; Glenn, P.; Fuschetto, A.; Appert, Q.; Viswanathan, V.K.

1985-01-01

A Grazing Incidence Beam Expander (GIBE) telescope is being designed and fabricated to be used as an equivalent end mirror in a long laser resonator cavity. The design requirements for this GIBE flow down from a generic Free Electron Laser (FEL) resonator. The nature of the FEL gain volume (a thin, pencil-like, on-axis region) dictates that the output beam be very small. Such a thin beam with the high power levels characteristic of FELs would have to travel perhaps hundreds of meters or more before expanding enough to allow reflection from cooled mirrors. A GIBE, on the other hand, would allow placing these optics closer to the gain region and thus reduces the cavity lengths substantially. Results are presented relating to optical and mechanical design, alignment sensitivity analysis, radius of curvature analysis, laser cavity stability analysis of a linear stable concentric laser cavity with a GIBE. Fabrication details of the GIBE are also given.

Exposures to natural radiation in Switzerland

International Nuclear Information System (INIS)

Murith, Ch.; Gurtner, A.

1999-01-01

The exposure of human beings to ionising radiation from natural sources is a continuing and inescapable feature of life on earth. There are two main sources that contribute to this exposure: high-energy cosmic-ray particles incident to the earth's atmosphere and radioactive nuclides that originated in the earth's crust and are present everywhere in the environment, including human body itself. Both external and internal exposures to humans arise from these sources. Exposures to natural radiation sources in Switzerland and some of their variations are here summarised and the resulting effective doses are compared to those from man-made sources exposures. It results that the natural background exposures are more significant for the population than most exposures to man-made sources. (authors)

Alzheimer's-related cortical atrophy is associated with postoperative delirium severity in persons without dementia.

Science.gov (United States)

Racine, Annie M; Fong, Tamara G; Travison, Thomas G; Jones, Richard N; Gou, Yun; Vasunilashorn, Sarinnapha M; Marcantonio, Edward R; Alsop, David C; Inouye, Sharon K; Dickerson, Bradford C

2017-11-01

Patients with dementia due to Alzheimer's disease (AD) have increased risk of developing delirium. This study investigated the relationship between a magnetic resonance imaging (MRI)-derived biomarker associated with preclinical AD and postoperative delirium. Participants were older adults (≥70 years) without dementia who underwent preoperative MRI and elective surgery. Delirium incidence and severity were evaluated daily during hospitalization. Cortical thickness was averaged across a published set of a priori brain regions to derive a measure known as the "AD signature." Logistic and linear regression was used, respectively, to test whether the AD signature was associated with delirium incidence in the entire sample (N = 145) or with the severity of delirium among those who developed delirium (N = 32). Thinner cortex in the AD signature did not predict incidence of delirium (odds ratio = 1.15, p = 0.38) but was associated with greater delirium severity among those who developed delirium (b = -1.2, p = 0.014). These results suggest that thinner cortices, perhaps reflecting underlying neurodegeneration due to preclinical AD, may serve as a vulnerability factor that increases severity once delirium occurs. Copyright © 2017 Elsevier Inc. All rights reserved.

Cancer incidence among waiters

DEFF Research Database (Denmark)

Reijula, Jere; Kjaerheim, Kristina; Lynge, Elsebeth

2015-01-01

AIMS: To study cancer risk patterns among waiters in the Nordic countries. METHODS: We identified a cohort of 16,134 male and 81,838 female waiters from Denmark, Finland, Iceland, Norway and Sweden. During the follow-up period from 1961 to 2005, we found that 19,388 incident cancer cases were...... diagnosed. Standardised incidence ratio (SIR) was defined as the observed number of cancer cases divided by the expected number, based on national age, time period and gender-specific cancer incidence rates in the general population. RESULTS: The SIR of all cancers in waiters, in the five countries combined...... INCIDENCE IN SOME CANCER SITES CAN LIKELY BE EXPLAINED BY HIGHER ALCOHOL CONSUMPTION, THE PREVALENCE OF SMOKING AND OCCUPATIONAL EXPOSURE TO TOBACCO SMOKE HOPEFULLY, THE INCIDENCE OF CANCER AMONG WAITERS WILL DECREASE IN THE FUTURE, DUE TO THE BANNING OF TOBACCO SMOKING IN RESTAURANTS AND BARS IN THE NORDIC...

Critical incidents and critical incident stress management (CISM) - an employee assistance programme (EAP) perspective

OpenAIRE

Terblanche, Lourie; van Wyk, André

2014-01-01

Employees are increasingly becoming victims of critical incidents. From a systems theory point of view, it is necessary to acknowledge the impact of critical incidents not only on the personal life of the employee, but on the workplace itself. Employees respond differently to critical incidents, which makes it even more complicated when this reaches the point of requiring therapeutic intervention. The most common response to critical incidents may be the risk of developing post-traumatic s...

[Notification of incidents related to patient safety in hospitals in Catalonia, Spain during the period 2010-2013].

Science.gov (United States)

Oliva, Glòria; Alava, Fernando; Navarro, Laura; Esquerra, Miquel; Lushchenkova, Oksana; Davins, Josep; Vallès, Roser

2014-07-01

The aim of this paper is to discover the aggregated results of a general notification system for incidents related to patient safety implemented in Catalan hospitals from 2010 to 2013. Observational study describing the incidents notified from January 2010 to December 2013 from all hospitals in Catalonia forming part of the project to create operational patient safety management units. The Patient Safety Notification and Learning System (SiNASP) was used. This makes it possible to classify incidents depending on the area where they occur, the type of incident notified, the consequences, the seriousness according to the Severity Assessment Code (SAC) and the profession of the notifying party, as the principal variables. The system was accessed via the Internet (SiNASP portal). Access was voluntary and anonymous or with a name given and later removed. During the study period, notification of a total of 5,948 incidents came from 22-29 hospitals. 5,244 of the incidents were handled by the centres and these are the ones analysed in the study. 64% (3,380) affected patients, 18% (950) created a situation capable of causing an incident and 18% (914) did not affect patients. 26% of incidents that affected patients (864) caused some kind of harm. Most incidents occurred during hospitalisation (54%) and in casualty (15%), followed by the ICU (9%) and the surgical block (8%). The most frequent notifying parties were nurses (71%) followed by doctors (15%) and pharmacists (9%). In terms of severity, most incidents were classified as low-risk (37%) or incidents that did not affect the patient (36%). However, 40 cases (0.76%) of extreme risk should be highlighted. In terms of the types of incident notified, most were due to a medication error (26.8%), followed by falls (16.3%) and patient identification (10.6%). The majority of notifications were incidents that affected patients and, of these, 26% caused harm. In general, they occurred in hospitalisation units and notification was

Incidence, types and characteristics of aggressive behaviour in treatment facilities for adults with mild intellectual disability and severe challenging behaviour

NARCIS (Netherlands)

Tenneij, N.H.; Koot, H.M.

2008-01-01

Background: Inpatient aggression in treatment facilities for persons with intellectual disability (ID) can have aversive consequences, for co-clients and staff, but also for the aggressors themselves. To manage and eventually prevent inpatient aggressive incidents, more knowledge about their types

The “true” incidence of surgically treated deep prosthetic joint infection after 32,896 primary total hip arthroplasties

Science.gov (United States)

Gundtoft, Per Hviid; Overgaard, Søren; Schønheyder, Henrik Carl; Møller, Jens Kjølseth; Kjærsgaard-Andersen, Per; Pedersen, Alma Becic

2015-01-01

Background and purpose It has been suggested that the risk of prosthetic joint infection (PJI) in patients with total hip arthroplasty (THA) may be underestimated if based only on arthroplasty registry data. We therefore wanted to estimate the “true” incidence of PJI in THA using several data sources. Patients and methods We searched the Danish Hip Arthroplasty Register (DHR) for primary THAs performed between 2005 and 2011. Using the DHR and the Danish National Register of Patients (NRP), we identified first revisions for any reason and those that were due to PJI. PJIs were also identified using an algorithm incorporating data from microbiological, prescription, and clinical biochemistry databases and clinical findings from the medical records. We calculated cumulative incidence with 95% confidence interval. Results 32,896 primary THAs were identified. Of these, 1,546 had first-time revisions reported to the DHR and/or the NRP. For the DHR only, the 1- and 5-year cumulative incidences of PJI were 0.51% (0.44–0.59) and 0.64% (0.51–0.79). For the NRP only, the 1- and 5-year cumulative incidences of PJI were 0.48% (0.41–0.56) and 0.57% (0.45–0.71). The corresponding 1- and 5-year cumulative incidences estimated with the algorithm were 0.86% (0.77–0.97) and 1.03% (0.87–1.22). The incidences of PJI based on the DHR and the NRP were consistently 40% lower than those estimated using the algorithm covering several data sources. Interpretation Using several available data sources, the “true” incidence of PJI following primary THA was estimated to be approximately 40% higher than previously reported by national registries alone. PMID:25637247

Incidence and risk factors for exacerbations of asthma during pregnancy

Directory of Open Access Journals (Sweden)

Ali Z

2013-05-01

Full Text Available Zarqa Ali, Charlotte Suppli UlrikDepartment of Pulmonary Medicine, Hvidovre Hospital and University of Copenhagen, Copenhagen, DenmarkBackground: Asthma is one of the most common chronic diseases among pregnant women. Acute exacerbations of asthma during pregnancy have an unfavorable impact on pregnancy outcome. This review provides an overview of current knowledge of incidence, mechanisms, and risk factors for acute exacerbations of asthma during pregnancy.Methods: A narrative literature review was carried out using the PubMed database.Results: During pregnancy, up to 6% of women with asthma are hospitalized for an acute exacerbation. The maternal immune system is characterized by a very high T-helper-2:T-helper-1 cytokine ratio during pregnancy and thereby provides an environment essential for fetal survival but one that may aggravate asthma. Cells of the innate immune system such as monocytes and neutrophils are also increased during pregnancy, and this too can exacerbate maternal asthma. Severe or difficult-to-control asthma appears to be the major risk factor for exacerbations during pregnancy, but studies also suggest that nonadherence with controller medication and viral infections are important triggers of exacerbations during pregnancy. So far, inconsistent findings have been reported regarding the effect of fetal sex on exacerbations during pregnancy. Other risk factors for exacerbation during pregnancy include obesity, ethnicity, and reflux, whereas atopy does not appear to be a risk factor.Discussion: The incidence of asthma exacerbations during pregnancy is disturbingly high. Severe asthma – better described as difficult-to-control asthma – nonadherence with controller therapy, viral infections, obesity, and ethnicity are likely to be important risk factors for exacerbations of asthma during pregnancy, whereas inconsistent findings have been reported with regard to the importance of sex of the fetus.Keywords: acute exacerbations

A five-year history of hazardous materials incidents in Chester County, PA

International Nuclear Information System (INIS)

Shorten, C.V.; McNamara, J.

1993-01-01

The Emergency Planning and Community Right-to-Know Act (EPCRA) of 1986 established Local Emergency Planning Committees (LEPCs) to oversee emergency response planning at the community level. In Pennsylvania, each county was assigned its own LEPC, and Chester County held its first LEPC meeting on October 15, 1987. From the data of that meeting through September 1992, 300 hazardous materials incidents have been reported. The majority of these incidents were met with fire department response, but several warranted response by hazardous materials teams. This report presents an analysis of the database of reported hazardous materials incidents in Chester County, including chemical identification, amount released, type of response, location, and trends. Over 235 of the reported spills were either gasoline, diesel fuel, home heating oil, or kerosene, often in five to 50 gallon amounts from transportation accidents. A number of extremely hazardous substance (EHS) incidents were reported, however, including sulfuric acid, chlorine, ammonia, phosphorus, formaldehyde, bromine, methyl mercaptan, and hydrofluoric acid. The most commonly released EHS's were ammonia and chlorine. The number of hazardous materials incidents reported in Chester County increased from only 14 in 1988 to 95 in 1991, with 67 in 1992 through September. This dramatic increase is attributable to both increased reporting and an increased number of incidents. This database clearly indicates both the success of EPCRA reporting system and the magnitude of hazardous materials incidents in this part of Pennsylvania

Incidence and risk factors for post-ERCP pancreatitis in chronic pancreatitis.

Science.gov (United States)

Zhao, Zhen-Hua; Hu, Liang-Hao; Ren, Hong-Bo; Zhao, An-Jing; Qian, Yang-Yang; Sun, Xiao-Tian; Su, Song; Zhu, Shu-Guang; Yu, Jin; Zou, Wen-Bin; Guo, Xiao-Rong; Wang, Lei; Li, Zhao-Shen; Liao, Zhuan

2017-09-01

Almost all studies on post-ERCP pancreatitis (PEP) have mainly involved patients with biliary diseases rather than chronic pancreatitis (CP), and the concept that CP seems to be a protective factor associated with PEP has not been studied in detail. The aim of this study was to determine the incidence of PEP in patients with CP at different clinical stages and to identify the predictive and protective factors of PEP in a large cohort. In this observational cohort study, medical records of patients with CP (CP group) and biliary diseases (BD group) in a tertiary hospital from January 2011 to May 2015 were examined. The difference in the incidence of PEP between CP group and BD group and the risk of PEP at different clinical stages of CP were calculated by the χ 2 test or the Fisher exact test. The predictive and protective factors for PEP were investigated by univariate and multivariate analysis. In total, 2028 ERCP procedures were performed in 1301 patients with CP and 2000 procedures in 1655 patients with BD. The overall incidence of PEP in CP group (4.5%) was similar to that in the BD group (4.8%; P = .747). However, CP patients had significantly lower rates of moderate and severe attacks (0% vs 1.3%, P pancreatitis, and prior PEP were independent risk factors of PEP, whereas extracorporeal shock wave lithotripsy was a protective factor. Compared with BD patients, CP patients had similar incidence of PEP overall but lower grades of severity. The incidence of PEP in CP patients decreased significantly with disease progression. (Clinical trial registration number: NCT02781987.). Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Serum calcium and incident diabetes: an observational study and meta-analysis.

Science.gov (United States)

Sing, C W; Cheng, V K F; Ho, D K C; Kung, A W C; Cheung, B M Y; Wong, I C K; Tan, K C B; Salas-Salvadó, J; Becerra-Tomas, N; Cheung, C L

2016-05-01

The study aimed to prospectively evaluate if serum calcium is related to diabetes incidence in Hong Kong Chinese. The results showed that serum calcium has a significant association with increased risk of diabetes. The result of meta-analysis reinforced our findings. This study aimed to evaluate the association of serum calcium, including serum total calcium and albumin-corrected calcium, with incident diabetes in Hong Kong Chinese. We conducted a retrospective cohort study in 6096 participants aged 20 or above and free of diabetes at baseline. Serum calcium was measured at baseline. Incident diabetes was determined from several electronic databases. We also searched relevant databases for studies on serum calcium and incident diabetes and conducted a meta-analysis using fixed-effect modeling. During 59,130.9 person-years of follow-up, 631 participants developed diabetes. Serum total calcium and albumin-corrected calcium were associated with incident diabetes in the unadjusted model. After adjusting for demographic and clinical variables, the association remained significant only for serum total calcium (hazard ratio (HR), 1.32 (95 % confidence interval (CI), 1.02-1.70), highest vs. lowest quartile). In a meta-analysis of four studies including the current study, both serum total calcium (pooled risk ratio (RR), 1.38 (95 % CI, 1.15-1.65); I (2) = 5 %, comparing extreme quantiles) and albumin-corrected calcium (pooled RR, 1.29 (95 % CI, 1.03-1.61); I (2) = 0 %, comparing extreme quantiles) were associated with incident diabetes. Penalized regression splines showed that the association of incident diabetes with serum total calcium and albumin-correlated calcium was non-linear and linear, respectively. Elevated serum calcium concentration is associated with incident diabetes. The mechanism underlying this association warrants further investigation.

In situ simulation: Taking reported critical incidents and adverse events back to the clinic

DEFF Research Database (Denmark)

Juul, Jonas; Paltved, Charlotte; Krogh, Kristian

2014-01-01

for content analysis4 and thematic analysis5. Medical experts and simulation faculty will design scenarios for in situ simulation training based on the analysis. Short-term observations using time logs will be performed along with interviews with key informants at the departments. Video data will be collected...... improve patient safety if coupled with training and organisational support2. Insight into the nature of reported critical incidents and adverse events can be used in writing in situ simulation scenarios and thus lead to interventions that enhance patient safety. The patient safety literature emphasises...... well-developed non-technical skills in preventing medical errors3. Furthermore, critical incidents and adverse events reporting systems comprise a knowledgebase to gain in-depth insights into patient safety issues. This study explores the use of critical incidents and adverse events reports to inform...

Environmental consequences of postulate plutonium releases from Atomics International's Nuclear Materials Development Facility (NMDF), Santa Susana, California, as a result of severe natural phenomena

International Nuclear Information System (INIS)

Jamison, J.D.; Watson, E.C.

1982-02-01

Potential environmental consequences in terms of radiation dose to people are presented for postulated plutonium releases caused by severe natural phenomena at the Atomics International's Nuclear Materials Development Facility (NMDF), in the Santa Susana site, California. The severe natural phenomena considered are earthquakes, tornadoes, and high straight-line winds. Plutonium deposition values are given for significant locations around the site. All important potential exposure pathways are examined. The most likely 50-year committed dose equivalents are given for the maximum-exposed individual and the population within a 50-mile radius of the plant. The maximum plutonium deposition values likely to occur offsite are also given. The most likely calculated 50-year collective committed dose equivalents are all much lower than the collective dose equivalent expected from 50 years of exposure to natural background radiation and medical x-rays. The most likely maximum residual plutonium contamination estimated to be deposited offsite following the earthquake, and the 150-mph and 170-mph tornadoes are above the Environmental Protection Agency's (EPA) proposed guideline for plutonium in the general environment of 0.2 μCi/m 2 . The deposition values following the 110-mph and the 130-mph tornadoes are below the EPA proposed guideline

Histopathological and parasitological investigations of ear healthy skin of dogs naturally and experimentally infected with Leishmania (Leishmania) chagasi.

Science.gov (United States)

Figueiredo, Maria Marta; Moura, Eliane Perlatto; Costa, Miriam Maria; Ribeiro, Vitor Marcio; Michalick, Marilene Suzan; Tafuri, Washington Luiz; Tafuri, Wagner Luiz

2010-07-01

Although 90% of clinical cases of American visceral leishmaniasis (AVL) occur in the northeastern region of Brazil, the incidence of cases in recent years has increased in southeastern states such as Minas Gerais (MG), where the disease has been reported in several cities, including Belo Horizonte, the state capital. Some studies have shown a strong correlation between the incidence of AVL and canine visceral leishmaniasis (CVL) in Belo Horizonte. A study of 108 dogs with parasite Leishmania chagasi detected by immuno-histochemistry in healthy ear skin was obtained from two distinct geographical areas: 55 from a metropolitan area of the municipality (Santa Luzia, MG) and 53 dogs from a central area of Belo Horizonte. In parallel, a group of 10 beagles were experimentally infected with L. chagasi. Considering the clinical aspects of all naturally infected dogs, symptomatic dogs were more frequent than asymptomatic ones, especially animals from the metropolitan area compared with the central area (79.6% and 20.3%, respectively). A chronic exudate was observed in the ear of 51 out of 55 dogs naturally infected from the metropolitan area (92.7%) and 45 out of 53 dogs naturally infected from the central area (84.9%). Importantly, asymptomatic dogs from the central area harbor more parasites in the skin than the asymptomatic ones from the metropolitan area. In addition, a profound difference was noted in the intensity of the inflammatory reaction and parasite load in the skin of experimental infected dogs.

Ex Vivo Spleen and Kidney Absorption of Xenoreactive Natural Antibodies Decreases Severity of Hyperacute Rejection in Pig-to-dog Renal Xenotransplantation

OpenAIRE

Nitta, Kohsaku

1996-01-01

The severe hyperacute rejection in pig-to-dog renal xenotransplantation is mainly caused by xenoreactive natural antibodies (NAb). Organ absorption (ex vivo perfusion of spleen and kidney of donor species) was performed to remove xenoreactive NAb. A pig-to-dog renal transplantation model was used for discordant combination xenografting. The experimental animals were divided into 4 groups: group 1, control; group 2, recipients splenectomized prior to renal xenografting; group 3, splenectomy al...

Formal analysis of empirical traces in incident management

International Nuclear Information System (INIS)

Hoogendoorn, Mark; Jonker, Catholijn M.; Maanen, Peter-Paul van; Sharpanskykh, Alexei

2008-01-01

Within the field of incident management split second decisions have to be made, usually on the basis of incomplete and partially incorrect information. As a result of these conditions, errors occur in such decision processes. In order to avoid repetition of such errors, historic cases, disaster plans, and training logs need to be thoroughly analysed. This paper presents a formal approach for such an analysis that pays special attention to spatial and temporal aspects, to information exchange, and to organisational structure. The formal nature of the approach enables automation of analysis, which is illustrated by case studies of two disasters

Dry Eye Disease Incidence Associated with Chronic Graft-Host Disease: Nonconcurrent Cohort Study (An American Ophthalmological Society Thesis)

Science.gov (United States)

Mian, Shahzad I.; De la Parra-Colín, Paola; De Melo-Franco, Rafael; Johnson, Christopher; Barrientos-Gutierrez, Tonatiuh

2015-01-01

Purpose: To determine if chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (HSCT) is associated with stable or progressive dry eye disease and to determine the true incidence in patients with no prior history of dry eye disease. Methods: A nonconcurrent cohort study at a single institution with 136 patients who had no previous history of dry eye disease before HSCT. Survival analysis was used to estimate dry eye disease incidence. The incidence rate was calculated using life tables as the number of observed dry eye disease cases divided by the person-time at risk accumulated by the cohort. Transition probabilities were calculated from time of transplant to time of diagnosis, and then to last recorded visit. Results: Incidence rate was 0.8 cases of dry eye disease per person-year, and half of the population at risk developed dry eye disease during the first 10 months post transplant. Time to develop dry eye disease was 2.5 months for mild dry eye disease, 9.6 months for moderate dry eye disease, and 13.2 months for severe dry eye disease. In terms of cumulative incidence, 73% of subjects developed dry eye disease (50% mild, 16% moderate, and 7% severe) at the time of diagnosis. Conclusions: Our findings suggest that dry eye disease associated with cGVHD is an extremely frequent event and shows a wide spectrum of severity, with a mild form presenting early and a moderate to severe form presenting later after HSCT. These findings need to be studied further to elucidate if these are two different pathophysiological entities or just different expressions of the same pathology. PMID:27507907

The Initial Purging Policies after the 1965 Incident at Lubang Buaya

Directory of Open Access Journals (Sweden)

Yosef Djakababa

2013-01-01

Full Text Available After the Lubang Buaya incident on 1 October 1965 in which six top Indonesian Army generals and a lieutenant were killed, the Army began to implement a nationwide purging campaign with the assistance of civilian anti-communist groups. Thousands of PKI members, supporters and pro-Sukarno groups/individuals immediately became the target of this purge. For organisational purposes, several purging policies were released and then strictly enforced. The official purging policies that are highlighted in this paper are a series of initial directives that were released within days of the generals’ executions. They do not explicitly translate into orders to kill, but are more of a guideline to help anti-communist officials classify and contain communists and other PKI followers. This article attempts to show how these initial directives evolved and also discusses competing purge policies from non-military sources. The co-existence and overlapping nature of the various directives indicate that a power struggle existed between the anti-communist group led by General Soeharto and the presidium of the Dwikora Cabinet who were loyal to President Soekarno.

FEMA's Earthquake Incident Journal: A Web-Based Data Integration and Decision Support Tool for Emergency Management

Science.gov (United States)

Jones, M.; Pitts, R.

2017-12-01

For emergency managers, government officials, and others who must respond to rapidly changing natural disasters, timely access to detailed information related to affected terrain, population and infrastructure is critical for planning, response and recovery operations. Accessing, analyzing and disseminating such disparate information in near real-time are critical decision support components. However, finding a way to handle a variety of informative yet complex datasets poses a challenge when preparing for and responding to disasters. Here, we discuss the implementation of a web-based data integration and decision support tool for earthquakes developed by the Federal Emergency Management Agency (FEMA) as a solution to some of these challenges. While earthquakes are among the most well- monitored and measured of natural hazards, the spatially broad impacts of shaking, ground deformation, landslides, liquefaction, and even tsunamis, are extremely difficult to quantify without accelerated access to data, modeling, and analytics. This web-based application, deemed the "Earthquake Incident Journal", provides real-time access to authoritative and event-specific data from external (e.g. US Geological Survey, NASA, state and local governments, etc.) and internal (FEMA) data sources. The journal includes a GIS-based model for exposure analytics, allowing FEMA to assess the severity of an event, estimate impacts to structures and population in near real-time, and then apply planning factors to exposure estimates to answer questions such as: What geographic areas are impacted? Will federal support be needed? What resources are needed to support survivors? And which infrastructure elements or essential facilities are threatened? This presentation reviews the development of the Earthquake Incident Journal, detailing the data integration solutions, the methodology behind the GIS-based automated exposure model, and the planning factors as well as other analytical advances that

Incidence of dengue virus infections in febrile episodes in Ile-Ife ...

African Journals Online (AJOL)

While dengue infection is accompanied by little or no subclinical signs in many, about 1-2% may produce clinically severe Dengue Haemorrhagic Fever/Dengue Shock Syndrome. Early recognition, appropriate treatment and elimination of mosquito vectors will help control it. The study is aimed at determining the incidence ...

An update in international trends in incidence rates of thyroid cancer, 1973-2007.

Science.gov (United States)

James, Benjamin C; Mitchell, Janeil M; Jeon, Heedo D; Vasilottos, Nektarios; Grogan, Raymon H; Aschebrook-Kilfoy, Briseis

2018-05-01

Over the past several decades, there has been a reported increase in the incidence of thyroid cancer in many countries. We previously reported an increase in thyroid cancer incidence across continents between 1973 and 2002. Here, we provide an update on the international trends in thyroid cancer between 2003 and 2007. We examined thyroid cancer incidence data from the Cancer Incidence in Five Continents (CI5) database for the period between 1973 and 2007 from 24 populations in the Americas, Asia, Europe, Africa and Oceania, and report on the time trends as well as the distribution by histologic type and gender worldwide. The incidence of thyroid cancer increased during the period from 1998-2002 to 2003-2007 in the majority of populations examined, with the highest rates observed among women, most notably in Israel and the United States SEER registry, at over 14 per 100,000 people. This update suggests that incidence is rising in a similar fashion across all regions of the world. The histologic and gender distributions in the updated CI5 are consistent with the previous report. Our analysis of the published CI5 data illustrates that the incidence of thyroid cancer increased between 1998-2002 and 2003-2007 in most populations worldwide, and rising rates continue in all regions of the world.

Data study of death rate and cancer incidence among Thule workers, 2005; Registerundersoegelse af doedelighed og kraeftforekomst blandt Thulearbejdere, 2005

Energy Technology Data Exchange (ETDEWEB)

Juel, K. [Statens Insti. for Folkesundhed, Copenhagen (Denmark); Engholm, G.; Storm, H. [Kraeftens Bekaempelse, Copenhagen (Denmark)

2005-12-01

January 21st, 1968, an American B52 bomber with nuclear weapons aboard crashed close to the Thule air-base in Greenland. In 1986 suspicions arose that there might be increased disease incidences and death rate among the employees at the base that were involved in the clearing operations. During 1986 - 1995, several health studies were made of the Thule workers. These studies of death rate, cancer, hospitalization, and fertility did not show any differences between the Thule workers from the clearing operations and those not involved in the clearing. The present study shows no difference in total death rate among the clearing workers compared to other workers. The same results were found for cancer mortality, circulatory diseases, pulmonary diseases, natural causes, and accidents. As the previous studies showed, the present study shows that there were a slightly less number of suicides among the clearing workers. The data analyses show with great certainty that the Thule workers as a group do not have a great excessive mortality or an increased cancer incidence caused by the aircraft crash. Thus, the present results fall in line with the previous investigations. (ln)

Incidence of pterygium in patients admitted to a university hospital

Directory of Open Access Journals (Sweden)

Fethiye Gülden Turgut

2013-12-01

Full Text Available Objectives: This study aimed to investigate the incidence of pterygium in a particular district of Istanbul, its association with age, and gender, and the severity of the disease. Methods: All patients aged ≥ 30 years referred to our outpatient clinics between January 2009 and December 2009 were included in this retrospective study. Age, gender, anterior segment photos, and findings of biomicroscopic eye examination were evaluated. Results: The incidence of pterygium for all age groups was 2.91% (male 1.75%, female 3.67% with an increasing incidence with age. A significant difference was detected in its incidence favoring female patients in 40-49, and 70-79, and male patients in ≥ 80 age groups, respectively. In addition, pterygium was seen in one (75.4% or both eyes (24.6% preferring right or left eye in 50.7%, and 49.3% of the patients, respectively. Pterygium was in nasal or temporal region in 98%, and 2% of the patients, respectively. The disease state in 59.9% of the patients was consistent with Stage 2 pterygium. The distance of pterygium from limbus was observed greatest in 60-69, and at a minimum in 40-49 age groups. No relationship was found between eye colour and development of pterygium. Conclusion: The incidence of pterygium increases with age. Incidence of pterygium differs between genders but without any significant difference. Its occurrence in one or both eyes and in right and left eyes was not influenced by gender of the patients. A statistically significant impact of eye colour of the patient on the development of pterygium was not disclosed. J Clin Exp Invest 2013; 4 (4: 436-442

[Incidence of fetal macrosomia: maternal and fetal morbidity].

Science.gov (United States)

Rodríguez-Rojas, R R; Cantú-Esquivel, M G; Benavides-de la Garza, L; Benavides-de Anda, L

1996-06-01

The macrosomia is an obstetric eventuality associated to high maternal-fetal morbidity-mortality. This assay was planned in order to know the incidence of macrosomia in our institution, the relation between vaginal and abdominal deliveries and the fetal-maternal morbidity we reviewed 3590 records and we found 5.6% incidence of macrosomia in the global obstetric population. There was 58% of vaginal deliveries, 68% of the newborn were male. The main complications were in the C. sections, 2 laceration of the hysterectomy, and 2 peroperative atonias. In the vaginal deliveries, the lacerations of III and IV grade were 9 of each grade. The main fetal complications were 5 slight to severe asphyxia and 4 shoulder dystocias. This assay concludes that the macrosomia in our service is similar to the already published ones, a 42% were C. section and the maternal-fetal morbidity was low.

Surface Movement Incidents Reported to the NASA Aviation Safety Reporting System

Science.gov (United States)

Connell, Linda J.; Hubener, Simone

1997-01-01

Increasing numbers of aircraft are operating on the surface of airports throughout the world. Airport operations are forecast to grow by more that 50%, by the year 2005. Airport surface movement traffic would therefore be expected to become increasingly congested. Safety of these surface operations will become a focus as airport capacity planning efforts proceed toward the future. Several past events highlight the prevailing risks experienced while moving aircraft during ground operations on runways, taxiways, and other areas at terminal, gates, and ramps. The 1994 St. Louis accident between a taxiing Cessna crossing an active runway and colliding with a landing MD-80 emphasizes the importance of a fail-safe system for airport operations. The following study explores reports of incidents occurring on an airport surface that did not escalate to an accident event. The Aviation Safety Reporting System has collected data on surface movement incidents since 1976. This study sampled the reporting data from June, 1993 through June, 1994. The coding of the data was accomplished in several categories. The categories include location of airport, phase of ground operation, weather /lighting conditions, ground conflicts, flight crew characteristics, human factor considerations, and airport environment. These comparisons and distributions of variables contributing to surface movement incidents can be invaluable to future airport planning, accident prevention efforts, and system-wide improvements.

MO-G-BRE-09: Validating FMEA Against Incident Learning Data: A Study in Stereotactic Body Radiation Therapy