WorldWideScience

Sample records for interpret major risk

  1. Majority and minority influence: A dual role interpretation

    OpenAIRE

    de Vries, N.K.; de Dreu, C.; Gordijn, E.; Schuurman, M.

    1996-01-01

    This chapter offers an analysis of majority vs. minority influence using the Heuristic-Systematic Model of persuasion (HSM). We evaluate evidence for and against leading perspectives such as Conversion Theory. Next, research and theory is reviewed suggesting that majority vs. minority influence differentially affect the processing of persuasive arguments. A dual-role interpretation of majority and minority influence is presented. First, numerical support for discrepant messages affects the de...

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

    DEFF Research Database (Denmark)

    Kirkegaard, P.; Edwards, A.; Risor, M. B.

    2013-01-01

    Background: Previous studies have shown the importance of paying attention to lay peoples' interpretations of risk of disease, in order to explain health-related behavior. However, risk interpretations interplay with social context in complex ways. The objective was to explore how asymptomatic...

  3. Risk of the Maritime Supply Chain System Based on Interpretative Structural Model

    Directory of Open Access Journals (Sweden)

    Jiang He

    2017-11-01

    Full Text Available Marine transportation is the most important transport mode of in the international trade, but the maritime supply chain is facing with many risks. At present, most of the researches on the risk of the maritime supply chain focus on the risk identification and risk management, and barely carry on the quantitative analysis of the logical structure of each influencing factor. This paper uses the interpretative structure model to analysis the maritime supply chain risk system. On the basis of comprehensive literature analysis and expert opinion, this paper puts forward 16 factors of maritime supply chain risk system. Using the interpretative structure model to construct maritime supply chain risk system, and then optimize the model. The model analyzes the structure of the maritime supply chain risk system and its forming process, and provides a scientific basis for the controlling the maritime supply chain risk, and puts forward some corresponding suggestions for the prevention and control the maritime supply chain risk.

  4. Imaging defined risk factors in neuroblastoma -guidelines for optimising imaging interpretations

    International Nuclear Information System (INIS)

    Valchev, G.; Balev, B.

    2017-01-01

    Neuroblastoma is the most frequent extracranial tumor in children, arising from the primitive sympathetic cells and the adrenal medulla. Two separate mutually complementing staging systems exist - INSS and INRGSS - one is based on post-operative findings, the other - on pre-treatment imaging. INRGSS consists of a list of 20 separate imaging defined risk factors (IDRF), the presence of which could alter the treatment plan. Radiologists need to be aware of certain intricacies in interpreting the individual IDRFs in order to optimise clinical decision-making. Key words: neuroblastoma. imaging defined risk factors (IDRF). interpretation guidelines [bg

  5. How to interpret safety critical failures in risk and reliability assessments

    International Nuclear Information System (INIS)

    Selvik, Jon Tømmerås; Signoret, Jean-Pierre

    2017-01-01

    Management of safety systems often receives high attention due to the potential for industrial accidents. In risk and reliability literature concerning such systems, and particularly concerning safety-instrumented systems, one frequently comes across the term ‘safety critical failure’. It is a term associated with the term ‘critical failure’, and it is often deduced that a safety critical failure refers to a failure occurring in a safety critical system. Although this is correct in some situations, it is not matching with for example the mathematical definition given in ISO/TR 12489:2013 on reliability modeling, where a clear distinction is made between ‘safe failures’ and ‘dangerous failures’. In this article, we show that different interpretations of the term ‘safety critical failure’ exist, and there is room for misinterpretations and misunderstandings regarding risk and reliability assessments where failure information linked to safety systems are used, and which could influence decision-making. The article gives some examples from the oil and gas industry, showing different possible interpretations of the term. In particular we discuss the link between criticality and failure. The article points in general to the importance of adequate risk communication when using the term, and gives some clarification on interpretation in risk and reliability assessments.

  6. On the Structural Interpretation of the Smets-Wouters “Risk Premium” Shock

    OpenAIRE

    Fisher, Jonas D. M.

    2014-01-01

    This article shows that the "risk premium" shock in Smets and Wouters (2007) can be interpreted as a structural shock to the demand for safe and liquid assets such as short-term US Treasury securities. Several implications of this interpretation are discussed.

  7. Major lipids, apolipoproteins, and risk of vascular disease

    DEFF Research Database (Denmark)

    Collaboration, Emerging Risk Factors; Di Angelantonio, Emanuele; Sarwar, Nadeem

    2009-01-01

    CONTEXT: Associations of major lipids and apolipoproteins with the risk of vascular disease have not been reliably quantified. OBJECTIVE: To assess major lipids and apolipoproteins in vascular risk. DESIGN, SETTING, AND PARTICIPANTS: Individual records were supplied on 302,430 people without...

  8. An Interpreter's Interpretation: Sign Language Interpreters' View of Musculoskeletal Disorders

    National Research Council Canada - National Science Library

    Johnson, William L

    2003-01-01

    Sign language interpreters are at increased risk for musculoskeletal disorders. This study used content analysis to obtain detailed information about these disorders from the interpreters' point of view...

  9. The Impact of Positive and Negative Affect and Issue Framing on Issue Interpretation and Risk Taking.

    Science.gov (United States)

    Mittal; Ross

    1998-12-01

    Two studies examined the influence of transient affective states and issue framing on issue interpretation and risk taking within the context of strategic decision making. In Study 1, participants in whom transient positive or negative affective states were induced by reading a short story showed systematic differences in issue interpretation and risk taking in a strategic decision making context. Compared to negative mood participants, those in a positive mood were more likely to interpret the strategic issue as an opportunity and displayed lower levels of risk taking. Study 2 replicated and extended these results by crossing affective states with threat and opportunity frames. Results showed that framing an issue (as a threat or an opportunity) had a stronger impact on issue interpretation among negative affect participants than among positive affect participants. Affective states also moderated the impact of issue framing on risk taking: the effect of framing on risk-taking was stronger under negative rather than positive affect. These results are interpreted via information-processing and motivational effects of affect on a decision maker. Copyright 1998 Academic Press.

  10. South African farm workers' interpretation of risk assessment data expressed as pictograms on pesticide labels

    International Nuclear Information System (INIS)

    Rother, Hanna-Andrea

    2008-01-01

    Pesticide companies and regulators in developing countries use the United Nations Food and Agricultural Organization (FAO) recommended pictograms on pesticide labels to communicate risk information based on toxicological and environmental risk assessment data. The pesticide label not only is often the only access people have to pesticide risk information, but also in many countries is a legally binding document. As a result of the crucial role pesticide labels play in protecting health and the environment and as a legal instrument, pictograms are used to overcome literacy challenges in transmitting pesticide risk information. Yet, this risk communication tool is often prone to misinterpretations of the risk information which results in hazardous exposures to pesticides for farm workers and end-users generally. In this paper, results are presented from a study with 115 farm workers on commercial vineyards in the Western Cape, South Africa, assessing their interpretations of 10 commonly used pictograms. A standardized questionnaire based on four commonly used pesticide labels was administered. Overall, 50% or more of the study farm workers had misleading, incorrect and critically confused interpretations of the label pictograms. Interpretations often reflected farm workers' social and cultural frames of reference rather than the technically intended risk information. For example, the pictogram indicating a pesticide's toxicity requires boots must be worn, evoked interpretations of 'dangerous to pedestrians' and 'don't walk through pesticides'. Furthermore, there was a gender variation in pictogram comprehension whereby males generally had more correct interpretations than females. This is a result both of a lack of training for women who are assumed to not work with pesticides, as well as a lack of pictograms relevant for female exposures. These findings challenge the viability of the United Nations current initiative to globally harmonize pictograms used on all

  11. Interpretation of Melanoma Risk Feedback in First-Degree Relatives of Melanoma Patients

    International Nuclear Information System (INIS)

    Hay, J. L.; Baguer, C.; Li, Y.; Orlow, I.; Berwick, M.

    2012-01-01

    Little is known about how individuals might interpret brief genetic risk feedback. We examined interpretation and behavioral intentions (sun protection, skin screening) in melanoma first-degree relatives (FDRs) after exposure to brief prototypic melanoma risk feedback. Using a 3 by 2 experimental pre-post design where feedback type (high-risk mutation, gene environment, and nongenetic) and risk level (positive versus negative findings) were systematically varied, 139 melanoma FDRs were randomized to receive one of the six scenarios. All scenarios included an explicit reminder that melanoma family history increased their risk regardless of their feedback. The findings indicate main effects by risk level but not feedback type; positive findings led to heightened anticipated melanoma risk perceptions and anticipated behavioral intentions. Yet those who received negative findings often discounted their family melanoma history. As such, 25%, 30%, and 32% of those who received negative mutation, gene-environment, and nongenetic feedback, respectively, reported that their risk was similar to the general population. Given the frequency with which those who pursue genetic testing may receive negative feedback, attention is needed to identify ideal strategies to present negative genetic findings in contexts such as direct to consumer channels where extensive genetic counseling is not required.

  12. Presentation of laboratory test results in patient portals: influence of interface design on risk interpretation and visual search behaviour.

    Science.gov (United States)

    Fraccaro, Paolo; Vigo, Markel; Balatsoukas, Panagiotis; van der Veer, Sabine N; Hassan, Lamiece; Williams, Richard; Wood, Grahame; Sinha, Smeeta; Buchan, Iain; Peek, Niels

    2018-02-12

    Patient portals are considered valuable instruments for self-management of long term conditions, however, there are concerns over how patients might interpret and act on the clinical information they access. We hypothesized that visual cues improve patients' abilities to correctly interpret laboratory test results presented through patient portals. We also assessed, by applying eye-tracking methods, the relationship between risk interpretation and visual search behaviour. We conducted a controlled study with 20 kidney transplant patients. Participants viewed three different graphical presentations in each of low, medium, and high risk clinical scenarios composed of results for 28 laboratory tests. After viewing each clinical scenario, patients were asked how they would have acted in real life if the results were their own, as a proxy of their risk interpretation. They could choose between: 1) Calling their doctor immediately (high interpreted risk); 2) Trying to arrange an appointment within the next 4 weeks (medium interpreted risk); 3) Waiting for the next appointment in 3 months (low interpreted risk). For each presentation, we assessed accuracy of patients' risk interpretation, and employed eye tracking to assess and compare visual search behaviour. Misinterpretation of risk was common, with 65% of participants underestimating the need for action across all presentations at least once. Participants found it particularly difficult to interpret medium risk clinical scenarios. Participants who consistently understood when action was needed showed a higher visual search efficiency, suggesting a better strategy to cope with information overload that helped them to focus on the laboratory tests most relevant to their condition. This study confirms patients' difficulties in interpreting laboratories test results, with many patients underestimating the need for action, even when abnormal values were highlighted or grouped together. Our findings raise patient safety

  13. Risk of the Maritime Supply Chain System Based on Interpretative Structural Model

    OpenAIRE

    Jiang He; Xiong Wei; Cao Yonghui

    2017-01-01

    Marine transportation is the most important transport mode of in the international trade, but the maritime supply chain is facing with many risks. At present, most of the researches on the risk of the maritime supply chain focus on the risk identification and risk management, and barely carry on the quantitative analysis of the logical structure of each influencing factor. This paper uses the interpretative structure model to analysis the maritime supply chain risk system. On the basis of com...

  14. Risk Interpretation of the CAPM's Beta: Evidence from a New Research Method

    OpenAIRE

    Bilinski, P.; Lyssimachou, D.

    2014-01-01

    This study tests the validity of using the CAPM beta as a risk control in cross-sectional accounting and finance research. We recognize that high-risk stocks should experience either very good or very bad returns more frequently compared to low-risk stocks, that is, high-risk stocks should cluster in the tails of the cross-sectional return distribution. Building on this intuition, we test the risk interpretation of the CAPM's beta by examining if high-beta stocks are more likely than low-beta...

  15. Interpretive Media Study and Interpretive Social Science.

    Science.gov (United States)

    Carragee, Kevin M.

    1990-01-01

    Defines the major theoretical influences on interpretive approaches in mass communication, examines the central concepts of these perspectives, and provides a critique of these approaches. States that the adoption of interpretive approaches in mass communication has ignored varied critiques of interpretive social science. Suggests that critical…

  16. Prospective study of major dietary patterns and colorectal cancer risk in women.

    Science.gov (United States)

    Terry, P; Hu, F B; Hansen, H; Wolk, A

    2001-12-15

    A number of prospective cohort studies have examined the relations of individual dietary variables to risk of colorectal cancer. Few studies have addressed the broader eating patterns that reflect many dietary exposures working together. Using data from a prospective study of 61,463 women, with an average follow-up period of 9.6 years (between 1987 and 1998) and 460 incident cases of colorectal cancer, the authors conducted a factor analysis to identify and examine major dietary patterns in relation to colorectal cancer risk. Using proportional hazards regression to estimate relative risks, the authors found no clear association between a "Western," "healthy," or "drinker" dietary pattern and colorectal cancer risk. However, the data suggested that consuming low amounts of foods that constitute a "healthy" dietary pattern may be associated with increased risks of colon and rectal cancers. An inverse association with the "healthy" dietary pattern was found among women under age 50 years, although the number of cancers in this age group was limited and interpretation of this finding should be cautious. In this age group, relative risks for women in increasing quintiles of the "healthy" dietary pattern, compared with the lowest quintile, were 0.74 (95% confidence interval (CI): 0.41, 1.31), 0.69 (95% CI: 0.39, 1.24), 0.59 (95% CI: 0.32, 1.07), and 0.45 (95% CI: 0.23, 0.88) (p for trend = 0.03). The role of overall eating patterns in predicting colorectal cancer risk requires further investigation.

  17. Global prevalence and major risk factors of diabetic retinopathy

    DEFF Research Database (Denmark)

    Yau, Joanne W Y; Rogers, Sophie L; Kawasaki, Ryo

    2012-01-01

    To examine the global prevalence and major risk factors for diabetic retinopathy (DR) and vision-threatening diabetic retinopathy (VTDR) among people with diabetes.......To examine the global prevalence and major risk factors for diabetic retinopathy (DR) and vision-threatening diabetic retinopathy (VTDR) among people with diabetes....

  18. Intuitive and interpretable visual communication of a complex statistical model of disease progression and risk.

    Science.gov (United States)

    Jieyi Li; Arandjelovic, Ognjen

    2017-07-01

    Computer science and machine learning in particular are increasingly lauded for their potential to aid medical practice. However, the highly technical nature of the state of the art techniques can be a major obstacle in their usability by health care professionals and thus, their adoption and actual practical benefit. In this paper we describe a software tool which focuses on the visualization of predictions made by a recently developed method which leverages data in the form of large scale electronic records for making diagnostic predictions. Guided by risk predictions, our tool allows the user to explore interactively different diagnostic trajectories, or display cumulative long term prognostics, in an intuitive and easily interpretable manner.

  19. Risk Factors to Growth Retardation in Major Thalassemia

    Directory of Open Access Journals (Sweden)

    Riva Uda

    2011-03-01

    Full Text Available The increasing in the life span of patients with major thalassemia should be followed by increased quality of life. There are factors which can affect growth retardation in these patients. The aim of this study was to find out the risk factors for growth retardation in patients with major thalassemia. An analytical study with cross-sectional design was conducted at Pediatric Thalassemia Clinics of Dr.Hasan Sadikin Hospital, Bandung, in June to July 2006. The subjects of this study were patients with major thalassemia. Inclusion criteria’s were age under 14 years old, had no chronic diseases like tuberculosis, cerebral palsy with complete medical records. Risk factors were the timing of diagnosis, initial and dose of deferoxamine, volume of transfused blood, mean pretransfusion hemoglobin level, family income, and age. Antropometric measurement indices were used to assess the growth which expressed in Z score. Growth evaluated based on height/age (H/A and growth retardation if H/A <-2 SD. Risk factors for growth retardation were analyzed separately using chi-square test and odds ratio (OR with 95% confidence interval (CI. Then they were analyzed simultaneously with logistic regression method. Subjects consisted of 152 patients with major thalassemia. Seventy three thalassemia patients were stunted. Analysis showed that age (OR: 5.42, 95% CI:2.32–12.65, p <0.001, dosage of deferoxamine (OR: 4.0, 95% CI: 1.29–12.41, p: 0.016, and family income (OR: 2.32, 95% CI: 1.06–5.06, p: 0.036 were risks factors for growth retardation. Conclusion, risk factors for growth retardation in major thalassemia are age, dosage of deferoxamine, and family income.

  20. Population information on major technological risks and specially on nuclear risk

    International Nuclear Information System (INIS)

    De Choudens, H.

    1992-01-01

    Following Chernobyl accident which has revealed in France a strong need for information on technological risks among population and a lack in its organization, the Mayor of Grenoble City who was also at this time, Environment Minister in French Government had initiated in lsere Region an important operation of consideration of action, which has to been undertaken to correct theses lacks. Among ten actions retained one of them was the creation of an Association for Information of the public for Prevention of major risks. This Association has first initiated a consultation on the perception by the population of the different major risks (Industrial and Naturals) in view of the results of this consultation, Medical Professions were the first concerned and a publication 'Medicine and Nuclear risk' has been elaborated and distributed to all doctors of the Region. A Memento on Nuclear risk as then been written and largely distributed in the region, especially in the medias. A booklet on nuclear risk and behavior in case of nuclear accident has then been realized and distributed to all people around Electronuclear Reactors of the Region and to children in the schools. In complement, public meetings have been organized in these sectors to inform, and discuss with the population. (author)

  1. Gravity Field Interpretation for Major Fault Depth Detection in a Region Located SW- Qa’im / Iraq

    Directory of Open Access Journals (Sweden)

    Wadhah Mahmood Shakir Al-Khafaji

    2017-09-01

    Full Text Available This research deals with the qualitative and quantitative interpretation of Bouguer gravity anomaly data for a region located to the SW of Qa’im City within Anbar province by using 2D- mapping methods. The gravity residual field obtained graphically by subtracting the Regional Gravity values from the values of the total Bouguer anomaly. The residual gravity field processed in order to reduce noise by applying the gradient operator and 1st directional derivatives filtering. This was helpful in assigning the locations of sudden variation in Gravity values. Such variations may be produced by subsurface faults, fractures, cavities or subsurface facies lateral variations limits. A major fault was predicted to extend with the direction NE-SW. This fault is mentioned by previous studies as undefined subsurface fault depth within the sedimentary cover rocks. The results of this research that were obtained by gravity quantitative interpretation find that the depth to this major fault plane center is about 2.4 Km.

  2. Major life events and risk of Parkinson's disease

    DEFF Research Database (Denmark)

    Rod, Naja Hulvej; Hansen, Johnni; Schernhammer, Eva

    2010-01-01

    major life events are risk factors for Parkinson's disease. Between 1986 and 2006, we identified 13,695 patients with a (PD) primary diagnosis of PD in the Danish National Hospital Register. Each case was frequency matched by age and gender to five population controls. Information on major life events...... before onset of PD was ascertained from national registries. Among men, number of life events was associated with risk of Parkinson's disease in an inverse dose-response manner (P ....34-0.99). Life events were not associated with PD in women. In contrast, a higher risk of PD was observed among women who had never been married (1.16; 1.04-1.29) and among men (1.47; 1.18-1.82) and women (1.30; 1.05-1.61) who have never been employees. The lower risk of Parkinson's disease among men who had...

  3. Major Management Challenges and Program Risks: Small Business Administration

    Science.gov (United States)

    2001-01-01

    2001 Major Management Challenges and Program Risks Small Business AdministrationGAO-01-260 Form SF298 Citation Data Report Date ("DD MON YYYY...34) 00JAN2001 Report Type N/A Dates Covered (from... to) ("DD MON YYYY") Title and Subtitle Major Management Challenges and Program Risks Small Business ...Administration (SBA) as it seeks to aid, counsel, assist, and protect the interests of the nations small businesses and help businesses and families

  4. Risk factors for major antenatal depression among low-income African American women.

    Science.gov (United States)

    Luke, Sabrina; Salihu, Hamisu M; Alio, Amina P; Mbah, Alfred K; Jeffers, Dee; Berry, Estrellita Lo; Mishkit, Vanessa R

    2009-11-01

    Data on risk factors for major antenatal depression among African American women are scant. In this study, we seek to determine the prevalence and risk factors for major antenatal depression among low-income African American women receiving prenatal services through the Central Hillsborough Healthy Start (CHHS). Women were screened using the Edinburgh Postnatal Depression Scale (EPDS) with a cutoff of > or =13 as positive for risk of major antenatal depression. In total, 546 African American women were included in the analysis. We used logistic regression to identify risk factors for major antenatal depression. The prevalence of depressive symptomatology consistent with major antenatal depression was 25%. Maternal age was identified as the main risk factor for major antenatal depression. The association between maternal age and risk for major antenatal depression was biphasic, with a linear trend component lasting until age 30, at which point the slope changed markedly tracing a more pronounced likelihood for major depression with advancing age. Women aged > or =30 were about 5 times as likely to suffer from symptoms of major antenatal depression as teen mothers (OR = 4.62, 95% CI 2.23-9.95). The risk for major antenatal depression increases about 5-fold among low-income African American women from age 30 as compared to teen mothers. The results are consistent with the weathering effect resulting from years of cumulative stress burden due to socioeconomic marginalization and discrimination. Older African American mothers may benefit from routine antenatal depression screening for early diagnosis and intervention.

  5. Assessment of major nuclear technologies with decision and risk analysis

    International Nuclear Information System (INIS)

    Winterfeldt, D. von

    1995-01-01

    Selecting technologies for major nuclear programs involves several complexities, including multiple stakeholders, multiple conflicting objectives, uncertainties, and risk. In addition, the programmatic risks related to the schedule, cost, and performance of these technologies often become major issues in the selection process. This paper describes a decision analysis approach for addressing these complexities in a logical manner

  6. Interpretations of alternative uncertainty representations in a reliability and risk analysis context

    International Nuclear Information System (INIS)

    Aven, T.

    2011-01-01

    Probability is the predominant tool used to measure uncertainties in reliability and risk analyses. However, other representations also exist, including imprecise (interval) probability, fuzzy probability and representations based on the theories of evidence (belief functions) and possibility. Many researchers in the field are strong proponents of these alternative methods, but some are also sceptical. In this paper, we address one basic requirement set for quantitative measures of uncertainty: the interpretation needed to explain what an uncertainty number expresses. We question to what extent the various measures meet this requirement. Comparisons are made with probabilistic analysis, where uncertainty is represented by subjective probabilities, using either a betting interpretation or a reference to an uncertainty standard interpretation. By distinguishing between chances (expressing variation) and subjective probabilities, new insights are gained into the link between the alternative uncertainty representations and probability.

  7. Societal risk and major disasters

    International Nuclear Information System (INIS)

    Clement, C.F.

    1989-01-01

    A disaster can be defined as an event, or a series of events, in which a large number of people is adversely affected by a single cause. This definition includes man-made accidents, like that at Chernobyl, as well as the natural disasters that insurance companies are sometimes pleased to describe as Acts of God. In 1986 alone, 12,000 people died and 2.2 million were made homeless by 215 major accidents or disasters. The nature of risk is examined in this paper. (author)

  8. Managing risks in the fisheries supply chain using House of Risk Framework (HOR) and Interpretive Structural Modeling (ISM)

    Science.gov (United States)

    Nguyen, T. L. T.; Tran, T. T.; Huynh, T. P.; Ho, T. K. D.; Le, A. T.; Do, T. K. H.

    2018-04-01

    One of the sectors which contributes importantly to the development of Vietnam economy is fishery industry. However, during recent year, it has been witnessed many difficulties on managing the performance of the fishery supply chain operations as a whole. In this paper, a framework for supply chain risk management (SCRM) is proposed. Initially, all the activities are mapped by using Supply Chain Operations Reference (SCOR) model. Next, the risk ranking is analyzed in House of Risk. Furthermore, interpretive structural modeling (ISM) is used to identify inter-relationships among supply chain risks and to visualize the risks according to their levels. For illustration, the model has been tested in several case studies with fishery companies in Can Tho, Mekong Delta. This study identifies 22 risk events and 20 risk agents through the supply chain. Also, the risk priority could be used for further House of Risk with proactive actions in future studies.

  9. Worldwide incidence of hepatocellular carcinoma cases attributable to major risk factors.

    Science.gov (United States)

    Baecker, Aileen; Liu, Xing; La Vecchia, Carlo; Zhang, Zuo-Feng

    2018-05-01

    To facilitate regionally specific liver cancer prevention and control, this study estimates the fraction of hepatocellular carcinoma (HCC) cases attributable to five major liver cancer risk factors by geographic region. Prevalence estimates of major HCC risk factors, including chronic infection with hepatitis B and hepatitis C, alcohol drinking, tobacco smoking, obesity, and diabetes, were extracted for each country from the literature, along with recent incidence and risk estimate data, to calculate regionally specific population attributable fractions. Overall, 44% of HCC cases worldwide were attributable to chronic hepatitis B infection, with the majority of cases occurring in Asia. Hepatitis C was responsible for 21% of cases. Lifestyle risk factors such as alcohol drinking and obesity were responsible for a larger percentage of cases in North America and Western, Central, and Eastern Europe. In addition, strong sex disparities were observed when looking at lifestyle risk factors, particularly tobacco smoking, in Asia and Africa. Prominent risk factors for HCC vary depending on the region. Our findings provide useful data for developing regionally specific guidelines for liver cancer prevention and control worldwide.

  10. Risk assessment of major hazards and its application in urban planning: a case study.

    Science.gov (United States)

    Zhou, Yafei; Liu, Mao

    2012-03-01

    With the rapid development of industry in China, the number of establishments that are proposed or under construction is increasing year by year, and many are industries that handle flammable, explosive, toxic, harmful, and dangerous substances. Accidents such as fire, explosion, and toxic diffusion inevitably happen. Accidents resulting from these major hazards in cities cause a large number of casualties and property losses. It is increasingly important to analyze the risk of major hazards in cities realistically and to suitably plan and utilize the surrounding land based on the risk analysis results, thereby reducing the hazards. A theoretical system for risk assessment of major hazards in cities is proposed in this article, and the major hazard risk for the entire city is analyzed quantitatively. Risks of various major accidents are considered together, superposition effect is analyzed, individual risk contours of the entire city are drawn out, and the level of risk in the city is assessed using "as low as reasonably practicable" guidelines. After the entire city's individual risk distribution is obtained, risk zones are divided according to corresponding individual risk value of HSE, and land-use planning suggestions are proposed. Finally, a city in China is used as an example to illustrate the risk assessment process of the city's major hazard and its application in urban land-use planning. The proposed method has a certain theoretical and practical significance in establishing and improving risk analysis of major hazard and urban land-use planning. On the one hand, major urban public risk is avoided; further, the land is utilized in the best possible way in order to obtain the maximum benefit from its use. © 2011 Society for Risk Analysis.

  11. Risk factors for and perinatal outcomes of major depression during pregnancy

    DEFF Research Database (Denmark)

    Räisänen, Sari; Lehto, Soili M; Nielsen, Henriette Svarre

    2014-01-01

    was substantial to modest for small-for-gestational age newborn (care associated with major depression, whereas SES made only a minor contribution. CONCLUSIONS: Physician-diagnosed major depression......OBJECTIVES: To identify risk factors for and the consequences (several adverse perinatal outcomes) of physician-diagnosed major depression during pregnancy treated in specialised healthcare. DESIGN: A population-based cross-sectional study. SETTING: Data were gathered from Finnish health registers...... for 1996-2010. PARTICIPANTS: All singleton births (n=511,938) for 2002-2010 in Finland. PRIMARY OUTCOME MEASURES: Prevalence, risk factors and consequences of major depression during pregnancy. RESULTS: Among 511,938 women, 0.8% experienced major depression during pregnancy, of which 46.9% had a history...

  12. Suicide Risk, Aggression and Violence in Major Psychiatric Disorders

    Directory of Open Access Journals (Sweden)

    G Mousavi

    2004-02-01

    Full Text Available Background: Aggression, violence and Suicide are important problems of mental health in our society. They almost always cause disability, death, or other social problems. Appropriate measures can be taken if the distribution of behaviors and suicide risk are well studied in various psychiatric disorders. Methods: This was a cross-sectional study. We studied 801 psychiatric patients who were admitted in a psychiatric emergency unit in Isfahan, Iran, for aggression, violence and risk of suicide. Information was obtained from a 30-item questionnaire, filled by the same physician. Results: About one-third of patients had aggression and/or violence on admission or during hours before it. It was most prevalent in men of 12-26 years old and in bipolar mood disorder patients. "High suicide risk" was markedly found in patients with major depressive disorder. Differences of these phenomena were statistically Conclusion: Our findings show a higher rate of aggression and violence in emergency psychiatric patients than in studies done in other countries. It may be due to higher prevalence of bipolar patients in the study field. The finding of "High suicidal risk" in major depression patients warrent systematic preventive programs. Keywords: Suicide risk, Aggression, Violence

  13. Risk assessment by integrating interpretive structural modeling and Bayesian network, case of offshore pipeline project

    International Nuclear Information System (INIS)

    Wu, Wei-Shing; Yang, Chen-Feng; Chang, Jung-Chuan; Château, Pierre-Alexandre; Chang, Yang-Chi

    2015-01-01

    The sound development of marine resource usage relies on a strong maritime engineering industry. The perilous marine environment poses the highest risk to all maritime work. It is therefore imperative to reduce the risk associated with maritime work by using some analytical methods other than engineering techniques. This study addresses this issue by using an integrated interpretive structure modeling (ISM) and Bayesian network (BN) approach in a risk assessment context. Mitigating or managing maritime risk relies primarily on domain expert experience and knowledge. ISM can be used to incorporate expert knowledge in a systematic manner and helps to impose order and direction on complex relationships that exist among system elements. Working with experts, this research used ISM to clearly specify an engineering risk factor relationship represented by a cause–effect diagram, which forms the structure of the BN. The expert subjective judgments were further transformed into a prior and conditional probability set to be embedded in the BN. We used the BN to evaluate the risks of two offshore pipeline projects in Taiwan. The results indicated that the BN can provide explicit risk information to support better project management. - Highlights: • We adopt an integrated method for risk assessment of offshore pipeline projects. • We conduct semi-structural interview with the experts for risk factor identification. • Interpretive structural modeling helps to form the digraph of Bayesian network (BN) • We perform the risk analysis with the experts by building a BN. • Risk evaluations of two case studies using the BN show effectiveness of the methods

  14. Global risk of radioactive fallout after major nuclear reactor accidents

    International Nuclear Information System (INIS)

    Lelieveld, J.; Kunkel, D.; Lawrence, M.G.

    2012-01-01

    Major reactor accidents of nuclear power plants are rare, yet the consequences are catastrophic. But what is meant by ''rare''? And what can be learned from the Chernobyl and Fukushima incidents? Here we assess the cumulative, global risk of exposure to radioactivity due to atmospheric dispersion of gases and particles following severe nuclear accidents (the most severe ones on the International Nuclear Event Scale, INES 7), using particulate "1"3"7Cs and gaseous "1"3"1I as proxies for the fallout. Our results indicate that previously the occurrence of INES 7 major accidents and the risks of radioactive contamination have been underestimated. Using a global model of the atmosphere we compute that on average, in the event of a major reactor accident of any nuclear power plant worldwide, more than 90% of emitted "1"3"7Cs would be transported beyond 50 km and about 50% beyond 1000 km distance before being deposited. This corroborates that such accidents have large-scale and trans-boundary impacts. Although the emission strengths and atmospheric removal processes of "1"3"7Cs and "1"3"1I are quite different, the radioactive contamination patterns over land and the human exposure due to deposition are computed to be similar. High human exposure risks occur around reactors in densely populated regions, notably in West Europe and South Asia, where a major reactor accident can subject around 30 million people to radioactive contamination. The recent decision by Germany to phase out its nuclear reactors will reduce the national risk, though a large risk will still remain from the reactors in neighbouring countries.

  15. Managing major chemical accidents in China: Towards effective risk information

    International Nuclear Information System (INIS)

    He Guizhen; Zhang Lei; Lu Yonglong; Mol, Arthur P.J.

    2011-01-01

    Chemical industries, from their very inception, have been controversial due to the high risks they impose on safety of human beings and the environment. Recent decades have witnessed increasing impacts of the accelerating expansion of chemical industries and chemical accidents have become a major contributor to environmental and health risks in China. This calls for the establishment of an effective chemical risk management system, which requires reliable, accurate and comprehensive data in the first place. However, the current chemical accident-related data system is highly fragmented and incomplete, as different responsible authorities adopt different data collection standards and procedures for different purposes. In building a more comprehensive, integrated and effective information system, this article: (i) reviews and assesses the existing data sources and data management, (ii) analyzes data on 976 recorded major hazardous chemical accidents in China over the last 40 years, and (iii) identifies the improvements required for developing integrated risk management in China.

  16. The risk of major nuclear accident: calculation and perception of probabilities

    International Nuclear Information System (INIS)

    Leveque, Francois

    2013-01-01

    Whereas before the Fukushima accident, already eight major accidents occurred in nuclear power plants, a number which is higher than that expected by experts and rather close to that corresponding of people perception of risk, the author discusses how to understand these differences and reconcile observations, objective probability of accidents and subjective assessment of risks, why experts have been over-optimistic, whether public opinion is irrational regarding nuclear risk, and how to measure risk and its perception. Thus, he addresses and discusses the following issues: risk calculation (cost, calculated frequency of major accident, bias between the number of observed accidents and model predictions), perceived probabilities and aversion for disasters (perception biases of probability, perception biases unfavourable to nuclear), the Bayes contribution and its application (Bayes-Laplace law, statistics, choice of an a priori probability, prediction of the next event, probability of a core fusion tomorrow)

  17. Living Near Major Traffic Roads and Risk of Deep Vein Thrombosis

    Science.gov (United States)

    Baccarelli, Andrea; Martinelli, Ida; Pegoraro, Valeria; Melly, Steven; Grillo, Paolo; Zanobetti, Antonella; Hou, Lifang; Bertazzi, Pier Alberto; Mannucci, Pier Mannuccio; Schwartz, Joel

    2010-01-01

    Background Particulate air pollution has been consistently linked to increased risk of arterial cardiovascular disease. Few data on air pollution exposure and risk of venous thrombosis are available. We investigated whether living near major traffic roads increases the risk of deep vein thrombosis (DVT), using distance from roads as a proxy for traffic exposure. Methods and Results Between 1995-2005, we examined 663 patients with DVT of the lower limbs and 859 age-matched controls from cities with population>15,000 inhabitants in Lombardia Region, Italy. We assessed distance from residential addresses to the nearest major traffic road using geographic information system methodology. The risk of DVT was estimated from logistic regression models adjusting for multiple clinical and environmental covariates. The risk of DVT was increased (Odds Ratio [OR]=1.33; 95% CI 1.03-1.71; p=0.03 in age-adjusted models; OR=1.47; 95%CI 1.10-1.96; p=0.008 in models adjusted for multiple covariates) for subjects living near a major traffic road (3 meters, 10th centile of the distance distribution) compared to those living farther away (reference distance of 245 meters, 90th centile). The increase in DVT risk was approximately linear over the observed distance range (from 718 to 0 meters), and was not modified after adjusting for background levels of particulate matter (OR=1.47; 95%CI 1.11-1.96; p=0.008 for 10th vs. 90th distance centile in models adjusting for area levels of particulate matter roads is associated with increased risk of DVT. PMID:19506111

  18. Aesthetic Surgical Procedures in Men: Major Complications and Associated Risk Factors.

    Science.gov (United States)

    Kaoutzanis, Christodoulos; Winocour, Julian; Yeslev, Max; Gupta, Varun; Asokan, Ishan; Roostaeian, Jason; Grotting, James C; Higdon, K Kye

    2018-03-14

    The number of men undergoing cosmetic surgery is increasing in North America. To determine the incidence and risk factors of major complications in males undergoing cosmetic surgery, compare the complication profiles between men and women, and identify specific procedures that are associated with higher risk of complications in males. A prospective cohort of patients undergoing cosmetic surgery between 2008 and 2013 was identified from the CosmetAssure database. Gender specific procedures were excluded. Primary outcome was occurrence of a major complication in males requiring emergency room visit, hospital admission, or reoperation within 30 days of the index operation. Univariate and multivariate analysis evaluated potential risk factors for major complications including age, body mass index (BMI), smoking, diabetes, type of surgical facility, type of procedure, and combined procedures. Of the 129,007 patients, 54,927 underwent gender nonspecific procedures, of which 5801 (10.6%) were males. Women showed a higher mean age (46.4 ± 14.1 vs 45.2 ± 16.7 years, P procedures (RR 3.47), and combined procedures (RR 2.56). Aesthetic surgery in men is safe with low major complication rates. Modifiable predictors of complications included BMI and combined procedures.

  19. Anorexia nervosa and major depression: shared genetic and environmental risk factors.

    Science.gov (United States)

    Wade, T D; Bulik, C M; Neale, M; Kendler, K S

    2000-03-01

    The authors sought to derive heritability estimates for anorexia nervosa and to explore the etiology of the comorbid relationship between anorexia nervosa and major depression. They applied bivariate structural equation modeling to a broad definition of anorexia nervosa and lifetime major depression as assessed in a population-based sample of 2,163 female twins. Anorexia nervosa was estimated to have a heritability of 58% (95% confidence interval=33%-84%). The authors were unable to completely rule out a contribution of shared environment. The comorbidity between anorexia nervosa and major depression is likely due to genetic factors that influence the risk for both disorders. Although the study was limited by the small number of affected twins, the results suggest that genetic factors significantly influence the risk for anorexia nervosa and substantially contribute to the observed comorbidity between anorexia nervosa and major depression.

  20. Can subsyndromal manifestations of major depression be identified in children at risk?

    Science.gov (United States)

    Uchida, M; Fitzgerald, M; Lin, K; Carrellas, N; Woodworth, H; Biederman, J

    2017-02-01

    Children of parents with major depression are at significantly increased risk for developing major depression themselves; however, not all children at genetic risk will develop major depressive disorder (MDD). We investigated the utility of subsyndromal scores on the Child Behavior Checklist (CBCL) Anxiety/Depression scale in identifying children at the highest risk for pediatric MDD from among the pool of children of parents with MDD or bipolar disorder. The sample was derived from two previously conducted longitudinal case-control family studies of psychiatrically and pediatrically referred youth and their families. For this study, probands were stratified based on the presence or absence of a parental mood disorder. Subsyndromal scores on the CBCL Anxiety/Depression scale significantly separated the children at high risk for pediatric MDD from those at low risk in a variety of functional areas, including social and academic functioning. Additionally, children at genetic risk without elevated CBCL Anxiety/Depression scale scores were largely indistinguishable from controls. These results suggest that the CBCL Anxiety/Depression scale can help identify children at highest risk for pediatric MDD. If implemented clinically, this scale would cost-effectively screen children and identify those most in need of early intervention resources to impede the progression of depression. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Global prevalence and major risk factors of diabetic retinopathy

    NARCIS (Netherlands)

    J.W.Y. Yau (Joanne W.); S.L. Rogers (Sophie); Y. Kawasaki; E.L. Lamoureux (Ecosse); J.W. Kowalski (Jonathan); T. Bek (Toke); S.-J. Chen (Shih-Jen); J.M. Dekker (Jacqueline); A.E. Fletcher (Astrid E.); J. Grauslund (Jakob); R.C.G. Haffner; U. Hamman (Ute); M.K. Ikram (Kamran); T. Kayama (Takamasa); B.E.K. Klein (Barbara); B.E.K. Klein (Barbara); S. Krishnaiah (Sannapaneni); K. Mayurasakorn (Korapat); J.P. O'Hare (Joseph); T. Orchard; M. Porta; M. Rema (Mohan); M.S. Roy (Monique); T. Sharma (Tarun); S-M. Saw (Seang-Mei); H. Taylor (Hugh); J.M. Tielsch (James); D. Varma (Dhiraj); J.J. Wang (Jie Jin); N. Wang (Ningli); S. West (Sheila); L. Zu (Liang); M. Yasuda (Maya); X. Zhang (Xinzhi); P. Mitchell (Paul); T.Y. Wong (Tien Yin)

    2012-01-01

    textabstractOBJECTIVE - To examine the global prevalence and major risk factors for diabetic retinopathy (DR) and vision-threatening diabetic retinopathy (VTDR) among people with diabetes. RESEARCH DESIGN AND METHODS - A pooled analysis using individual participant data from population-based studies

  2. Value-at-Risk and Expected Shortfall for the major digital currencies

    OpenAIRE

    Stavroyiannis, Stavros

    2017-01-01

    Digital currencies and cryptocurrencies have hesitantly started to penetrate the investors, and the next step will be the regulatory risk management framework. We examine the Value-at-Risk and Expected Shortfall properties for the major digital currencies, Bitcoin, Ethereum, Litecoin, and Ripple. The methodology used is GARCH modelling followed by Filtered Historical Simulation. We find that digital currencies are subject to a higher risk, therefore, to higher sufficient buffer and risk capit...

  3. Majority and minority influence: A dual role interpretation

    NARCIS (Netherlands)

    de Vries, N.K.; de Dreu, C.; Gordijn, E.; Schuurman, M.

    1996-01-01

    This chapter offers an analysis of majority vs. minority influence using the Heuristic-Systematic Model of persuasion (HSM). We evaluate evidence for and against leading perspectives such as Conversion Theory. Next, research and theory is reviewed suggesting that majority vs. minority influence

  4. Functional and structural brain correlates of risk for major depression in children with familial depression

    Directory of Open Access Journals (Sweden)

    Xiaoqian J. Chai

    2015-01-01

    Full Text Available Despite growing evidence for atypical amygdala function and structure in major depression, it remains uncertain as to whether these brain differences reflect the clinical state of depression or neurobiological traits that predispose individuals to major depression. We examined function and structure of the amygdala and associated areas in a group of unaffected children of depressed parents (at-risk group and a group of children of parents without a history of major depression (control group. Compared to the control group, the at-risk group showed increased activation to fearful relative to neutral facial expressions in the amygdala and multiple cortical regions, and decreased activation to happy relative to neutral facial expressions in the anterior cingulate cortex and supramarginal gyrus. At-risk children also exhibited reduced amygdala volume. The extensive hyperactivation to negative facial expressions and hypoactivation to positive facial expressions in at-risk children are consistent with behavioral evidence that risk for major depression involves a bias to attend to negative information. These functional and structural brain differences between at-risk children and controls suggest that there are trait neurobiological underpinnings of risk for major depression.

  5. What lies beneath: Rural landholder interpretation of the risks of aquifer exploitation in Australia

    Science.gov (United States)

    Mendham, Emily; Curtis, Allan

    2014-04-01

    Risks associated with the management of groundwater in farming landscapes are at the forefront of public discourse in Australia and North America. There has been very little social research examining rural landholder attitudes to groundwater use and management. This is an important gap given the critical role social acceptability plays in resource access decisions, the important role groundwater plays in sustaining livelihoods, and the vital role it plays in maintaining groundwater dependent ecosystems. This paper attempts to address that gap by exploring how rural landholders interpret risks associated with groundwater use for irrigated agriculture. We do that by using a case study from south eastern Australia where farmers' livelihoods are increasingly dependent on groundwater. We draw upon spatially referenced survey data to investigate the general extent and nature of concern about risk associated with pumping groundwater. We also explore the factors influencing risk interpretation, including occupational identity and proximity to the aquifer. Survey results suggest that while there is concern about pumping groundwater for irrigated agriculture in the Wimmera region, there is also considerable confidence that negative outcomes can be avoided. The dimension of risk of most concern to respondents was the possibility that the benefits of pumping groundwater would not be shared equitably. Those reporting lower concern about the risks of groundwater pumping were more likely to own properties located above the aquifer, to exhibit a strong business orientation including prioritising economic values compared to environmental values, and to express attitudes indicating they thought private property rights should be protected. A substantial proportion of survey respondents indicated they were 'Unsure' on all the risk items in the survey. It seems the future social acceptability of groundwater exploitation in the Wimmera region will depend on the extent that those 'Unsure

  6. First-Trimester Pregnancy Exposure to Venlafaxine or Duloxetine and Risk of Major Congenital Malformations

    DEFF Research Database (Denmark)

    Lassen, Dorte; Ennis, Zandra Nymand; Damkier, Per

    2016-01-01

    and noradrenaline reuptake inhibitors, SNRIs, significantly less data are available. Following the PRISMA guideline for systematic reviews, we performed a systematic search on the risk of major congenital malformations after first trimester in utero exposure to venlafaxine or duloxetine. We identified eight cohort...... studies reporting on the outcome upon in utero exposure to venlafaxine or duloxetine during the first trimester. The cumulated data for venlafaxine were 3186 exposed infants and 107 major malformations, resulting in a relative risk estimate and 95% confidence interval of 1.12 (0.......92-1.35). The corresponding data for duloxetine were 668 infants and 16 major malformations, resulting in a relative risk estimate and 95% confidence interval of 0.80 (0.46-1.29). First-trimester in utero exposure to venlafaxine is not associated with an increased risk of major congenital malformations. The amount of data...

  7. Suicide risk in placebo-controlled studies of major depression

    NARCIS (Netherlands)

    Storosum, J. G.; van Zwieten, B. J.; van den Brink, W.; Gersons, B. P.; Broekmans, A. W.

    2001-01-01

    The purpose of this study was to determine if fear of an increased risk of attempted suicide in placebo groups participating in placebo-controlled studies is an argument against the performance of placebo-controlled trials in studies of major depression. All short-term and long-term,

  8. Major life events and risk of alcohol use disorders

    DEFF Research Database (Denmark)

    Just-Østergaard, Emilie; Mortensen, Erik L.; Flensborg-Madsen, Trine

    2018-01-01

    , household income, cohabitation status and psychiatric comorbidity. Findings: Serious family conflicts in childhood [hazard ratio (HR) = 1.35; 95% confidence interval (CI) = 1.00, 1.83] and serious economic problems in adult life (HR = 2.22; 95% CI = 1.64, 3.01) were associated significantly with increased......Aims: To estimate associations of individual major life events as well as accumulated major life events in childhood, adult private life and adult work life with risk of alcohol use disorders (AUD). Design: Prospective cohort study with baseline examination in 1991–93 and linkage to national...

  9. Putting risk analysis into perspective: a comparative review of major societal risk studies of nuclear power

    International Nuclear Information System (INIS)

    Dooley, J.E.; Hansson, B.; Kaspersson, R.; ORiordan, T.; Paschen, H.

    1983-04-01

    The emphasis in this final report of the project Evaluation of major Swedish energy risk assessments in an international perspective is shifted towards the comparative aspect. The comprehensive nuclear risk study has been used as an instrument to satisfy many needs simultaneously. The research consisted of an examination of existing risk studies of five nations, namely West Germany, UK, US, Canada and Sweden. The effect of nuclear risk studies on society at large and on public attitude towards nuclear power in particular is discussed. Finally, the effect on the nuclear establishment is analysed. (G.B.)

  10. Misleading reporting and interpretation of results in major infertility journals.

    Science.gov (United States)

    Glujovsky, Demian; Sueldo, Carlos E; Borghi, Carolina; Nicotra, Pamela; Andreucci, Sara; Ciapponi, Agustín

    2016-05-01

    To evaluate the proportion of randomized controlled trials (RCTs) published in top infertility journals indexed on PubMed that reported their results with proper effect estimates and their precision estimation, while correctly interpreting both measures. Cross-sectional study evaluating all the RCTs published in top infertility journals during 2014. Not applicable. Not applicable. Not applicable. Proportion of RCTs that reported both relative and absolute effect size measures and its precision. Among the 32 RCTs published in 2014 in the top infertility journals reviewed, 37.5% (95% confidence interval [CI], 21.1-56.3) did not mention in their abstracts whether the difference among the study arms was statistically or clinically significant, and only 6.3% (95% CI, 0.8-20.8) used a CI of the absolute difference. Similarly, in the results section, these elements were observed in 28.2% (95% CI, 13.7-46.7) and 15.6% (95% CI, 5.3-32.8), respectively. Only one study clearly expressed the minimal clinically important difference in their methods section, but we found related proxies in 53% (95% CI, 34.7-70.9). None of the studies used CIs to draw conclusions about the clinical or statistical significance. We found 13 studies where the interpretation of the findings could be misleading. Recommended reporting items are underused in top infertility journals, which could lead to misleading interpretations. Authors, reviewers, and editorial boards should emphasize their use to improve reporting quality. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2016-09-01

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

  12. Eating disorder risk, exercise dependence, and body weight dissatisfaction among female nutrition and exercise science university majors.

    Science.gov (United States)

    Harris, Natalie; Gee, David; d'Acquisto, Debra; Ogan, Dana; Pritchett, Kelly

    2015-09-01

    Past research has examined eating disorder risk among college students majoring in Nutrition and has suggested an increased risk, while other studies contradict these results. Exercise Science majors, however, have yet to be fully examined regarding their risk for eating disorders and exercise dependence. Based on pressures to fit the image associated with careers related to these two disciplines, research is warranted to examine the potential risk for both eating disorder and exercise dependence. The purpose of this study is to compare eating disorder risk, exercise dependence, and body weight dissatisfaction (BWD) between Nutrition and Exercise Science majors, compared to students outside of these career pathways. Participants (n = 89) were divided into three groups based on major; Nutrition majors (NUTR; n = 31), Exercise Science majors (EXSC; n = 30), and other majors (CON; n = 28). Participants were given the EAT-26 questionnaire and the Exercise Dependence Scale. BWD was calculated as the discrepancy between actual BMI and ideal BMI. The majority of participants expressed a desire to weigh less (83%) and EXSC had significantly (p = .03) greater BWD than NUTR. However, there were no significant differences in eating disorder risk or exercise dependence among majors. This study suggested there was no significant difference in eating disorder risk or exercise dependence between the three groups (NUTR, EXSC, and CON).

  13. Radiologic head CT interpretation errors in pediatric abusive and non-abusive head trauma patients

    International Nuclear Information System (INIS)

    Kralik, Stephen F.; Finke, Whitney; Wu, Isaac C.; Ho, Chang Y.; Hibbard, Roberta A.; Hicks, Ralph A.

    2017-01-01

    patients (41% vs 23%, P=0.02; 26% vs. 12%, P=0.03). The most common findings resulting in major radiologic interpretation errors were fractures and subdural hemorrhage. Differences in the age of the patient and the percentage of patients with hemorrhage were statistically significant between the abusive head trauma versus non-abusive head trauma groups, while no statistical difference was identified for skull fractures, ischemia, head CT radiation dose, or presence of multiplanar or 3-D reformatted images. The second interpretation more frequently indicated potential for abusive head trauma compared to the primary interpretation (P=0.0001). MRI and/or surgical findings were in agreement with the second interpretation in 29/29 (100%) of patients with discrepancies. A high incidence of radiologic interpretation errors may occur in pediatric trauma patients at risk for abusive head trauma who are referred from a community hospital. This suggests value for second interpretations of head CTs at a tertiary pediatric hospital for this patient population. (orig.)

  14. Radiologic head CT interpretation errors in pediatric abusive and non-abusive head trauma patients

    Energy Technology Data Exchange (ETDEWEB)

    Kralik, Stephen F.; Finke, Whitney; Wu, Isaac C.; Ho, Chang Y. [Indiana University School of Medicine, Department of Radiology and Imaging Sciences, Indianapolis, IN (United States); Hibbard, Roberta A.; Hicks, Ralph A. [Indiana University School of Medicine, Department of Pediatrics, Section of Child Protection Programs, Indianapolis, IN (United States)

    2017-07-15

    patients (41% vs 23%, P=0.02; 26% vs. 12%, P=0.03). The most common findings resulting in major radiologic interpretation errors were fractures and subdural hemorrhage. Differences in the age of the patient and the percentage of patients with hemorrhage were statistically significant between the abusive head trauma versus non-abusive head trauma groups, while no statistical difference was identified for skull fractures, ischemia, head CT radiation dose, or presence of multiplanar or 3-D reformatted images. The second interpretation more frequently indicated potential for abusive head trauma compared to the primary interpretation (P=0.0001). MRI and/or surgical findings were in agreement with the second interpretation in 29/29 (100%) of patients with discrepancies. A high incidence of radiologic interpretation errors may occur in pediatric trauma patients at risk for abusive head trauma who are referred from a community hospital. This suggests value for second interpretations of head CTs at a tertiary pediatric hospital for this patient population. (orig.)

  15. Interpreting Impoliteness: Interpreters’ Voices

    Directory of Open Access Journals (Sweden)

    Tatjana Radanović Felberg

    2017-11-01

    Full Text Available Interpreters in the public sector in Norway interpret in a variety of institutional encounters, and the interpreters evaluate the majority of these encounters as polite. However, some encounters are evaluated as impolite, and they pose challenges when it comes to interpreting impoliteness. This issue raises the question of whether interpreters should take a stance on their own evaluation of impoliteness and whether they should interfere in communication. In order to find out more about how interpreters cope with this challenge, in 2014 a survey was sent to all interpreters registered in the Norwegian Register of Interpreters. The survey data were analyzed within the theoretical framework of impoliteness theory using the notion of moral order as an explanatory tool in a close reading of interpreters’ answers. The analysis shows that interpreters reported using a variety of strategies for interpreting impoliteness, including omissions and downtoning. However, the interpreters also gave examples of individual strategies for coping with impoliteness, such as interrupting and postponing interpreting. These strategies border behavioral strategies and conflict with the Norwegian ethical guidelines for interpreting. In light of the ethical guidelines and actual practice, mapping and discussing different strategies used by interpreters might heighten interpreters’ and interpreter-users’ awareness of the role impoliteness can play in institutional interpreter– mediated encounters. 

  16. Major risks and financial guarantees provided by the State in France

    International Nuclear Information System (INIS)

    Brassard, Guy

    2012-01-01

    France's system for indemnifying damage from natural catastrophe is exemplary, whether for floods, storms, or subsidence. However, France is not equipped with the financial capacity to deal with the damage resulting from an exceptional disaster, such as an earthquake on the Mediterranean coast, or a nuclear meltdown. Major catastrophes could be a significant risk to the financial stability of the State today, because the State is in fact the ultimate insurer of its citizens and its institutions. It would be wise to built up reserves in order to enhance the financial resources of the State and to provide a uniform guarantee covering major risks, whatever the cause of the damage may be. (author)

  17. Interpretable functional principal component analysis.

    Science.gov (United States)

    Lin, Zhenhua; Wang, Liangliang; Cao, Jiguo

    2016-09-01

    Functional principal component analysis (FPCA) is a popular approach to explore major sources of variation in a sample of random curves. These major sources of variation are represented by functional principal components (FPCs). The intervals where the values of FPCs are significant are interpreted as where sample curves have major variations. However, these intervals are often hard for naïve users to identify, because of the vague definition of "significant values". In this article, we develop a novel penalty-based method to derive FPCs that are only nonzero precisely in the intervals where the values of FPCs are significant, whence the derived FPCs possess better interpretability than the FPCs derived from existing methods. To compute the proposed FPCs, we devise an efficient algorithm based on projection deflation techniques. We show that the proposed interpretable FPCs are strongly consistent and asymptotically normal under mild conditions. Simulation studies confirm that with a competitive performance in explaining variations of sample curves, the proposed FPCs are more interpretable than the traditional counterparts. This advantage is demonstrated by analyzing two real datasets, namely, electroencephalography data and Canadian weather data. © 2015, The International Biometric Society.

  18. Lost in Interpretation – Communicating Risk to the Public

    International Nuclear Information System (INIS)

    Meschenmoser, P.

    2016-01-01

    Communicating radiation incidents and emergencies to the public always has been challenging. No other type of emergency is related to such disproportional risk perception, so little public knowledge about the subject matter and so many contradicting expert analyses when it comes to public communications. The rise of social media and citizen journalism resulted in a dramatic acceleration of global communications and widespread misinformation. News does not break on television anymore but on Twitter, Facebook & Co. As a consequence, professional communicators not only have to take initiative considerably faster than in the past and deal with rumours. Their message has to be brief and on the point and is sometimes limited to just some 140 characters, the maximum length of a Tweet. More than ever it is essential to timely communicate in plain language and to clearly tell what needs to be done to be safe and to remain safe. Otherwise, the public will be lost in interpretation. (author)

  19. Lost in Interpretation – Communicating Risk to the Public

    International Nuclear Information System (INIS)

    Meschenmoser, P.

    2017-01-01

    Communicating radiation incidents and emergencies to the public always has been challenging. No other type of emergency is related to such disproportional risk perception, so little public knowledge about the subject matter and so many contradicting expert analyses when it comes to public communications. The rise of social media and citizen journalism resulted in a dramatic acceleration of global communications and widespread misinformation. News does not break on television anymore but on Twitter, Facebook & Co. As a consequence, professional communicators not only have to take initiative considerably faster than in the past and deal with rumours. Their message has to be brief and on the point and is sometimes limited to just some 140 characters, the maximum length of a Tweet. More than ever it is essential to timely communicate in plain language and to clearly tell what needs to be done to be safe and to remain safe. Otherwise, the public will be lost in interpretation. (author)

  20. Vigorous-intensity leisure-time physical activity and risk of major chronic disease in men.

    Science.gov (United States)

    Chomistek, Andrea K; Cook, Nancy R; Flint, Alan J; Rimm, Eric B

    2012-10-01

    Although studies have shown health benefits for moderate-intensity physical activity, there is limited evidence to support beneficial effects for high amounts of vigorous activity among middle-age and older men. The objective of this study was to examine the relationship between vigorous-intensity physical activity, compared with moderate-intensity activity, and risk of major chronic disease in men. We prospectively examined the associations between vigorous- and moderate-intensity physical activity and risk of major chronic disease among 44,551 men age 40-75 yr in 1986. Leisure-time physical activity was assessed biennially by questionnaire. During 22 yr of follow-up, we documented 14,162 incident cases of major chronic disease, including 4769 cardiovascular events, 6449 cancer events, and 2944 deaths from other causes. The HR of major chronic disease comparing ≥ 21 to 0 MET.h.wk(-1) of exercise was 0.86 (95% confidence interval (CI), 0.81-0.91) for vigorous-intensity activity and 0.85 (95% CI, 0.80-0.90) for moderate activity. For cardiovascular disease (CVD), the corresponding HRs were 0.78 (95% CI, 0.70-0.86) and 0.80 (95% CI, 0.72-0.88), respectively. When examined separately, running, tennis, and brisk walking were inversely associated with CVD risk. Furthermore, more vigorous activity was associated with lower disease risk; the HR comparing >70 to 0 MET.h.wk(-1) of vigorous-intensity exercise was 0.79 (95% CI, 0.68-0.92; P < 0.0001 for trend) for major chronic disease and 0.73 (95% CI, 0.56-0.96; P < 0.0001 for trend) for CVD. Vigorous- and moderate-intensity physical activities were associated with lower risk of major chronic disease and CVD. Increasing amounts of vigorous activity remained inversely associated with disease risk, even among men in the highest categories of exercise.

  1. Genome-wide association analyses identify 44 risk variants and refine the genetic architecture of major depression.

    Science.gov (United States)

    Wray, Naomi R; Ripke, Stephan; Mattheisen, Manuel; Trzaskowski, Maciej; Byrne, Enda M; Abdellaoui, Abdel; Adams, Mark J; Agerbo, Esben; Air, Tracy M; Andlauer, Till M F; Bacanu, Silviu-Alin; Bækvad-Hansen, Marie; Beekman, Aartjan F T; Bigdeli, Tim B; Binder, Elisabeth B; Blackwood, Douglas R H; Bryois, Julien; Buttenschøn, Henriette N; Bybjerg-Grauholm, Jonas; Cai, Na; Castelao, Enrique; Christensen, Jane Hvarregaard; Clarke, Toni-Kim; Coleman, Jonathan I R; Colodro-Conde, Lucía; Couvy-Duchesne, Baptiste; Craddock, Nick; Crawford, Gregory E; Crowley, Cheynna A; Dashti, Hassan S; Davies, Gail; Deary, Ian J; Degenhardt, Franziska; Derks, Eske M; Direk, Nese; Dolan, Conor V; Dunn, Erin C; Eley, Thalia C; Eriksson, Nicholas; Escott-Price, Valentina; Kiadeh, Farnush Hassan Farhadi; Finucane, Hilary K; Forstner, Andreas J; Frank, Josef; Gaspar, Héléna A; Gill, Michael; Giusti-Rodríguez, Paola; Goes, Fernando S; Gordon, Scott D; Grove, Jakob; Hall, Lynsey S; Hannon, Eilis; Hansen, Christine Søholm; Hansen, Thomas F; Herms, Stefan; Hickie, Ian B; Hoffmann, Per; Homuth, Georg; Horn, Carsten; Hottenga, Jouke-Jan; Hougaard, David M; Hu, Ming; Hyde, Craig L; Ising, Marcus; Jansen, Rick; Jin, Fulai; Jorgenson, Eric; Knowles, James A; Kohane, Isaac S; Kraft, Julia; Kretzschmar, Warren W; Krogh, Jesper; Kutalik, Zoltán; Lane, Jacqueline M; Li, Yihan; Li, Yun; Lind, Penelope A; Liu, Xiaoxiao; Lu, Leina; MacIntyre, Donald J; MacKinnon, Dean F; Maier, Robert M; Maier, Wolfgang; Marchini, Jonathan; Mbarek, Hamdi; McGrath, Patrick; McGuffin, Peter; Medland, Sarah E; Mehta, Divya; Middeldorp, Christel M; Mihailov, Evelin; Milaneschi, Yuri; Milani, Lili; Mill, Jonathan; Mondimore, Francis M; Montgomery, Grant W; Mostafavi, Sara; Mullins, Niamh; Nauck, Matthias; Ng, Bernard; Nivard, Michel G; Nyholt, Dale R; O'Reilly, Paul F; Oskarsson, Hogni; Owen, Michael J; Painter, Jodie N; Pedersen, Carsten Bøcker; Pedersen, Marianne Giørtz; Peterson, Roseann E; Pettersson, Erik; Peyrot, Wouter J; Pistis, Giorgio; Posthuma, Danielle; Purcell, Shaun M; Quiroz, Jorge A; Qvist, Per; Rice, John P; Riley, Brien P; Rivera, Margarita; Saeed Mirza, Saira; Saxena, Richa; Schoevers, Robert; Schulte, Eva C; Shen, Ling; Shi, Jianxin; Shyn, Stanley I; Sigurdsson, Engilbert; Sinnamon, Grant B C; Smit, Johannes H; Smith, Daniel J; Stefansson, Hreinn; Steinberg, Stacy; Stockmeier, Craig A; Streit, Fabian; Strohmaier, Jana; Tansey, Katherine E; Teismann, Henning; Teumer, Alexander; Thompson, Wesley; Thomson, Pippa A; Thorgeirsson, Thorgeir E; Tian, Chao; Traylor, Matthew; Treutlein, Jens; Trubetskoy, Vassily; Uitterlinden, André G; Umbricht, Daniel; Van der Auwera, Sandra; van Hemert, Albert M; Viktorin, Alexander; Visscher, Peter M; Wang, Yunpeng; Webb, Bradley T; Weinsheimer, Shantel Marie; Wellmann, Jürgen; Willemsen, Gonneke; Witt, Stephanie H; Wu, Yang; Xi, Hualin S; Yang, Jian; Zhang, Futao; Arolt, Volker; Baune, Bernhard T; Berger, Klaus; Boomsma, Dorret I; Cichon, Sven; Dannlowski, Udo; de Geus, E C J; DePaulo, J Raymond; Domenici, Enrico; Domschke, Katharina; Esko, Tõnu; Grabe, Hans J; Hamilton, Steven P; Hayward, Caroline; Heath, Andrew C; Hinds, David A; Kendler, Kenneth S; Kloiber, Stefan; Lewis, Glyn; Li, Qingqin S; Lucae, Susanne; Madden, Pamela F A; Magnusson, Patrik K; Martin, Nicholas G; McIntosh, Andrew M; Metspalu, Andres; Mors, Ole; Mortensen, Preben Bo; Müller-Myhsok, Bertram; Nordentoft, Merete; Nöthen, Markus M; O'Donovan, Michael C; Paciga, Sara A; Pedersen, Nancy L; Penninx, Brenda W J H; Perlis, Roy H; Porteous, David J; Potash, James B; Preisig, Martin; Rietschel, Marcella; Schaefer, Catherine; Schulze, Thomas G; Smoller, Jordan W; Stefansson, Kari; Tiemeier, Henning; Uher, Rudolf; Völzke, Henry; Weissman, Myrna M; Werge, Thomas; Winslow, Ashley R; Lewis, Cathryn M; Levinson, Douglas F; Breen, Gerome; Børglum, Anders D; Sullivan, Patrick F

    2018-05-01

    Major depressive disorder (MDD) is a common illness accompanied by considerable morbidity, mortality, costs, and heightened risk of suicide. We conducted a genome-wide association meta-analysis based in 135,458 cases and 344,901 controls and identified 44 independent and significant loci. The genetic findings were associated with clinical features of major depression and implicated brain regions exhibiting anatomical differences in cases. Targets of antidepressant medications and genes involved in gene splicing were enriched for smaller association signal. We found important relationships of genetic risk for major depression with educational attainment, body mass, and schizophrenia: lower educational attainment and higher body mass were putatively causal, whereas major depression and schizophrenia reflected a partly shared biological etiology. All humans carry lesser or greater numbers of genetic risk factors for major depression. These findings help refine the basis of major depression and imply that a continuous measure of risk underlies the clinical phenotype.

  2. Managing major chemical accidents in China: Towards effective risk information

    NARCIS (Netherlands)

    He, G.; Zhang, L.; Lu, Y.; Mol, A.P.J.

    2011-01-01

    Chemical industries, from their very inception, have been controversial due to the high risks they impose on safety of human beings and the environment. Recent decades have witnessed increasing impacts of the accelerating expansion of chemical industries and chemical accidents have become a major

  3. Major bleeding and intracranial hemorrhage risk prediction in patients with atrial fibrillation: Attention to modifiable bleeding risk factors or use of a bleeding risk stratification score? A nationwide cohort study.

    Science.gov (United States)

    Chao, Tze-Fan; Lip, Gregory Y H; Lin, Yenn-Jiang; Chang, Shih-Lin; Lo, Li-Wei; Hu, Yu-Feng; Tuan, Ta-Chuan; Liao, Jo-Nan; Chung, Fa-Po; Chen, Tzeng-Ji; Chen, Shih-Ann

    2018-03-01

    While modifiable bleeding risks should be addressed in all patients with atrial fibrillation (AF), use of a bleeding risk score enables clinicians to 'flag up' those at risk of bleeding for more regular patient contact reviews. We compared a risk assessment strategy for major bleeding and intracranial hemorrhage (ICH) based on modifiable bleeding risk factors (referred to as a 'MBR factors' score) against established bleeding risk stratification scores (HEMORR 2 HAGES, HAS-BLED, ATRIA, ORBIT). A nationwide cohort study of 40,450 AF patients who received warfarin for stroke prevention was performed. The clinical endpoints included ICH and major bleeding. Bleeding scores were compared using receiver operating characteristic (ROC) curves (areas under the ROC curves [AUCs], or c-index) and the net reclassification index (NRI). During a follow up of 4.60±3.62years, 1581 (3.91%) patients sustained ICH and 6889 (17.03%) patients sustained major bleeding events. All tested bleeding risk scores at baseline were higher in those sustaining major bleeds. When compared to no ICH, patients sustaining ICH had higher baseline HEMORR 2 HAGES (p=0.003), HAS-BLED (pbleeding scores, c-indexes were significantly higher compared to MBR factors (pbleeding. C-indexes for the MBR factors score was significantly lower compared to all other scores (De long test, all pbleeding risk scores for major bleeding (all pbleeding risk scores had modest predictive value for predicting major bleeding but the best predictive value and NRI was found for the HAS-BLED score. Simply depending on modifiable bleeding risk factors had suboptimal predictive value for the prediction of major bleeding in AF patients, when compared to the HAS-BLED score. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  4. The association between suicide risk and self-esteem in Japanese university students with major depressive episodes of major depressive disorder.

    Science.gov (United States)

    Mitsui, Nobuyuki; Asakura, Satoshi; Shimizu, Yusuke; Fujii, Yutaka; Toyomaki, Atsuhito; Kako, Yuki; Tanaka, Teruaki; Kitagawa, Nobuki; Inoue, Takeshi; Kusumi, Ichiro

    2014-01-01

    The suicide risk among young adults is related to multiple factors; therefore, it is difficult to predict and prevent suicidal behavior. We conducted the present study to reveal the most important factors relating to suicidal ideation in Japanese university students with major depressive episodes (MDEs) of major depressive disorder (MDD). The subjects were 30 Japanese university students who had MDEs of MDD, and were aged between 18 and 26 years old. They were divided into two groups - without suicide risk group (n=15), and with suicide risk group (n=15) - based on the results of the Mini-International Neuropsychiatric Interview. Additionally, healthy controls were recruited from the same population (n=15). All subjects completed the self-assessment scales including the Beck Depression Inventory 2nd edition (BDI-II), the Beck Hopelessness Scale (BHS), Rosenberg's Self-Esteem Scale (RSES), and SF-36v2™ (The Medical Outcomes Study 36-item short-form health survey version 2), and they were all administered a battery of neuropsychological tests. The RSES score of the suicide risk group was significantly lower than the RSES score of the without suicide risk group, whereas the BDI-II score and the BHS score were not significantly different between the two groups. The mean social functioning score on the SF-36v2 of the with suicide risk group was significantly lower than that of the without suicide risk group. The individual's self-esteem and social functioning may play an important role in suicide risk among young adults with MDEs of MDD.

  5. Aesthetic Breast Surgery and Concomitant Procedures: Incidence and Risk Factors for Major Complications in 73,608 Cases.

    Science.gov (United States)

    Gupta, Varun; Yeslev, Max; Winocour, Julian; Bamba, Ravinder; Rodriguez-Feo, Charles; Grotting, James C; Higdon, K Kye

    2017-05-01

    Major complications following aesthetic breast surgery are uncommon and thus assessment of risk factors is challenging. To determine the incidence and risk factors of major complications following aesthetic breast surgery and concomitant procedures. A prospective cohort of patients who enrolled into the CosmetAssure (Birmingham, AL) insurance program and underwent aesthetic breast surgery between 2008 and 2013 was identified. Major complications (requiring reoperation, readmission, or emergency room visit) within 30 days of surgery were recorded. Risk factors including age, smoking, body mass index (BMI), diabetes, type of surgical facility, and combined procedures were evaluated. Among women, augmentation was the most common breast procedure (n = 41,651, 58.6%) followed by augmentation-mastopexy, mastopexy, and reduction. Overall, major complications occurred in 1.46% with hematoma (0.99%) and infection (0.25%) being most common. Augmentation-mastopexy had a higher risk of complications, particularly infection (relative risk [RR] 1.74, P procedures. Age was the only significant predictor for hematomas (RR 1.01, P procedures or abdominoplasty performed alone. Among men, correction of gynecomastia was the most common breast procedure (n = 1613, 64.6%) with a complication rate of 1.80% and smoking as a risk factor (RR 2.73, P = 0.03). Incidence of major complications after breast cosmetic surgical procedures is low. Risk factors for major complications include increasing age and BMI. Combining abdominoplasty with any breast procedure increases the risk of major complications. 2. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

  6. Cognitive complexity of the medical record is a risk factor for major adverse events.

    Science.gov (United States)

    Roberson, David; Connell, Michael; Dillis, Shay; Gauvreau, Kimberlee; Gore, Rebecca; Heagerty, Elaina; Jenkins, Kathy; Ma, Lin; Maurer, Amy; Stephenson, Jessica; Schwartz, Margot

    2014-01-01

    Patients in tertiary care hospitals are more complex than in the past, but the implications of this are poorly understood as "patient complexity" has been difficult to quantify. We developed a tool, the Complexity Ruler, to quantify the amount of data (as bits) in the patient’s medical record. We designated the amount of data in the medical record as the cognitive complexity of the medical record (CCMR). We hypothesized that CCMR is a useful surrogate for true patient complexity and that higher CCMR correlates with risk of major adverse events. The Complexity Ruler was validated by comparing the measured CCMR with physician rankings of patient complexity on specific inpatient services. It was tested in a case-control model of all patients with major adverse events at a tertiary care pediatric hospital from 2005 to 2006. The main outcome measure was an externally reported major adverse event. We measured CCMR for 24 hours before the event, and we estimated lifetime CCMR. Above empirically derived cutoffs, 24-hour and lifetime CCMR were risk factors for major adverse events (odds ratios, 5.3 and 6.5, respectively). In a multivariate analysis, CCMR alone was essentially as predictive of risk as a model that started with 30-plus clinical factors. CCMR correlates with physician assessment of complexity and risk of adverse events. We hypothesize that increased CCMR increases the risk of physician cognitive overload. An automated version of the Complexity Ruler could allow identification of at-risk patients in real time.

  7. First Trimester Influenza Vaccination and Risks for Major Structural Birth Defects in Offspring.

    Science.gov (United States)

    Kharbanda, Elyse Olshen; Vazquez-Benitez, Gabriela; Romitti, Paul A; Naleway, Allison L; Cheetham, T Craig; Lipkind, Heather S; Klein, Nicola P; Lee, Grace; Jackson, Michael L; Hambidge, Simon J; McCarthy, Natalie; DeStefano, Frank; Nordin, James D

    2017-08-01

    To examine risks for major structural birth defects in infants after first trimester inactivated influenza vaccine (IIV) exposures. In this observational study, we used electronic health data from 7 Vaccine Safety Datalink sites to examine risks for selected major structural defects in infants after maternal IIV exposure. Vaccine exposures for women with continuous insurance enrollment through pregnancy who delivered singleton live births between 2004 and 2013 were identified from standardized files. Infants with continuous insurance enrollment were followed to 1 year of age. We excluded mother-infant pairs with other exposures that potentially increased their background risk for birth defects. Selected cardiac, orofacial or respiratory, neurologic, ophthalmologic or otologic, gastrointestinal, genitourinary and muscular or limb defects were identified from diagnostic codes in infant medical records using validated algorithms. Propensity score adjusted generalized estimating equations were used to estimate prevalence ratios (PRs). We identified 52 856 infants with maternal first trimester IIV exposure and 373 088 infants whose mothers were unexposed to IIV during first trimester. Prevalence (per 100 live births) for selected major structural birth defects was 1.6 among first trimester IIV exposed versus 1.5 among unexposed mothers. The adjusted PR was 1.02 (95% CI 0.94-1.10). Organ system-specific PRs were similar to the overall PR. First trimester maternal IIV exposure was not associated with an increased risk for selected major structural birth defects in this large cohort of singleton live births. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Residential Proximity to Major Roadways and Risk of Type 2 Diabetes Mellitus: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Zhiqing Zhao

    2016-12-01

    Full Text Available Research indicates that higher levels of traffic-related pollution exposure increase the risk of diabetes, but the association between road proximity and diabetes risk remains unclear. To assess and quantify the association between residential proximity to major roadways and type 2 diabetes, a systematic review and meta-analysis was performed. Embase, Medline, and Web of Science were searched for eligible studies. Using a random-effects meta-analysis, the summary relative risks (RRs were calculated. Bayesian meta-analysis was also performed. Eight studies (6 cohort and 2 cross-sectional with 158,576 participants were finally included. The summary unadjusted RR for type 2 diabetes associated with residential proximity to major roadways was 1.24 (95% confidence interval [CI]: 1.07–1.44, p = 0.001, I2 = 48.1%. The summary adjusted RR of type 2 diabetes associated with residential proximity to major roadways was 1.12 (95% CI: 1.03–1.22, p = 0.01, I2 = 17.9%. After excluding two cross-sectional studies, the summary results suggested that residential proximity to major roadways could increase type 2 diabetes risk (Adjusted RR = 1.13; 95% CI: 1.02–1.27, p = 0.025, I2 = 36.6%. Bayesian meta-analysis showed that the unadjusted RR and adjusted RR of type 2 diabetes associated with residential proximity to major roadways were 1.22 (95% credibility interval: 1.06–1.55 and 1.13 (95% credibility interval: 1.01–1.31, respectively. The meta-analysis suggested that residential proximity to major roadways could significantly increase risk of type 2 diabetes, and it is an independent risk factor of type 2 diabetes. More well-designed studies are needed to further strengthen the evidence.

  9. Risk versus benefit in radiology

    International Nuclear Information System (INIS)

    Samuel, E.

    1985-01-01

    The risks of radiology may be grouped into a) those inherent in the use of ionizing radiation which today are well known and b) those associated with the use of any scientific method in medicine. Inherent risks of scientific methods like inadequate examination and the interpretation of results are discussed. Radiology brought major benefits in medical care and some of the newer methods are considered

  10. Cost control and risk mitigation of major projects

    International Nuclear Information System (INIS)

    Caddy, D.G.

    1993-01-01

    In this paper and presentation, the four major types of estimates will be discussed, i.e., capacity factored, equipment factored, semi-detailed and detailed. Key relationships between particular portions of estimates will be discussed such as the relationship between direct field labor and indirect field costs. Having set the basis for developing a project's cost through estimating, the paper will then list and discuss the fifteen key steps which must be followed to control the costs of a project. Next, the subject of allowances and contingency will be discussed and defined and the differences between the two will be highlighted. Having established exactly what contingency is, the subject of risk analysis through RANGE estimating will be discussed. The methods used to establish a precise contingency and probability of an over/under run will be discussed. Finally, the paper will discuss the methods by which a project manager, owner or contractor can mitigate risks; that is to eliminate, transfer or minimize their effect

  11. Robust symptom networks in recurrent major depression across different levels of genetic and environmental risk

    NARCIS (Netherlands)

    van Loo, H.M.; Van Borkulo, C.D.; Peterson, R.E.; Fried, E.I.; Aggen, S.H.; Borsboom, D.; Kendler, K.S.

    BACKGROUND: Genetic risk and environmental adversity-both important risk factors for major depression (MD)-are thought to differentially impact on depressive symptom types and associations. Does heterogeneity in these risk factors result in different depressive symptom networks in patients with MD?

  12. The Art Of Interpretation – Chances And Risks On Interpretation In The Field Of Mobile Testing

    Directory of Open Access Journals (Sweden)

    Palatini Kerstin

    2014-12-01

    Full Text Available Carrying out a usability test is a demanding process per se. Mobile tests raise this claim because they are subject to real usage conditions and therefore unforeseeable factors. On the one hand there are the technical factors like tools, software and laboratory equipment, but on the other hand there are the human beeings with their knowledge and decision-making. They are taking the selection of tools, methods and data, and they decide in every situation of the process of testing. Using a mobile eye-tracking test, the authors will explain where the sources for interpretation are and when misinterpretation become an error. Technology philosophical considerations on interpretation and hermeneutics have to support the recognition of the potential of interpretation. As a result, misinterpretation can be minimized.

  13. Risk Factors as Major Determinants of Resilience: A Replication Study.

    Science.gov (United States)

    Eshel, Yohanan; Kimhi, Shaul; Lahad, Mooli; Leykin, Dmitry; Goroshit, Marina

    2018-03-16

    The present study was conducted in the context of current concerns about replication in psychological research. It claims that risk factors should be regarded as an integral part of the definition of individual resilience, which should be defined in terms of the balance between individual strength or protective factors, and individual vulnerability or risk factors (IND-SVR). Five independent samples, including 3457 Israeli participants, were employed to determine the effects of resilience promoting and resilience suppressing variables on the IND-SVR index of resilience, and on its two components: recovery from adversity, and distress symptoms. Five path analyses were employed for determining the role of distress symptoms as a measure of psychological resilience, as compared to other indices of this resilience. Results indicated the major role of risk factors (distress symptoms) as an integral component of resilience. This role was generally replicated in the five investigated samples. Risk factors are legitimate, valid, and useful parts of the definition of psychological resilience. Resilience research has shifted away from studying individual risk factors to investigating the process through which individuals overcome the hardships they experience. The present data seem to suggest that this shift should be reexamined.

  14. The Burden of Cardiovascular Disease Attributable to Major Modifiable Risk Factors in Indonesia

    Directory of Open Access Journals (Sweden)

    Mohammad Akhtar Hussain

    2016-10-01

    Full Text Available Background: In Indonesia, coronary heart disease (CHD and stroke are estimated to cause more than 470 000 deaths annually. In order to inform primary prevention policies, we estimated the sex- and age-specific burden of CHD and stroke attributable to five major and modifiable vascular risk factors: cigarette smoking, hypertension, diabetes, elevated total cholesterol, and excess body weight. Methods: Population attributable risks for CHD and stroke attributable to these risk factors individually were calculated using summary statistics obtained for prevalence of each risk factor specific to sex and to two age categories (<55 and ≥55 years from a national survey in Indonesia. Age- and sex-specific relative risks for CHD and stroke associated with each of the five risk factors were derived from prospective data from the Asia-Pacific region. Results: Hypertension was the leading vascular risk factor, explaining 20%–25% of all CHD and 36%–42% of all strokes in both sexes and approximately one-third of all CHD and half of all strokes across younger and older age groups alike. Smoking in men explained a substantial proportion of vascular events (25% of CHD and 17% of strokes. However, given that these risk factors are likely to be strongly correlated, these population attributable risk proportions are likely to be overestimates and require verification from future studies that are able to take into account correlation between risk factors. Conclusions: Implementation of effective population-based prevention strategies aimed at reducing levels of major cardiovascular risk factors, especially blood pressure, total cholesterol, and smoking prevalence among men, could reduce the growing burden of CVD in the Indonesian population.

  15. Incorporation of Indigenous Forces in Major Theater War: Advantages, Risks and Considerations

    Science.gov (United States)

    2004-05-03

    training exercises and programs like the International Military Education and Training (IMET) program, to name a few, the United States has a far better...USAWC STRATEGY RESEARCH PROJECT INCORPORATION OF INDIGENOUS FORCES IN MAJOR THEATER WAR: ADVANTAGES , RISKS AND CONSIDERATIONS by Ms. Priscilla... Advantages , Risks and Considerations 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Priscilla Sellers 5d. PROJECT NUMBER

  16. Air Quality Monitoring: Risk-Based Choices

    Science.gov (United States)

    James, John T.

    2009-01-01

    Air monitoring is secondary to rigid control of risks to air quality. Air quality monitoring requires us to target the credible residual risks. Constraints on monitoring devices are severe. Must transition from archival to real-time, on-board monitoring. Must provide data to crew in a way that they can interpret findings. Dust management and monitoring may be a major concern for exploration class missions.

  17. Major stressful life events in adulthood and risk of multiple sclerosis

    DEFF Research Database (Denmark)

    Nielsen, Nete Munk; Bager, Peter; Simonsen, Jacob

    2014-01-01

    It is unclear whether psychological stress is associated with increased risk of multiple sclerosis (MS). We studied the association between major stressful life events and MS in a nationwide cohort study using death of a child or a spouse or marital dissolution as indicators of severe stress....

  18. How to interpret a small increase in AUC with an additional risk prediction marker: decision analysis comes through

    NARCIS (Netherlands)

    Baker, Stuart G.; Schuit, Ewoud; Steyerberg, Ewout W.; Pencina, Michael J.; Vickers, Andrew; Vickers, Andew; Moons, Karel G. M.; Mol, Ben W. J.; Lindeman, Karen S.

    2014-01-01

    An important question in the evaluation of an additional risk prediction marker is how to interpret a small increase in the area under the receiver operating characteristic curve (AUC). Many researchers believe that a change in AUC is a poor metric because it increases only slightly with the

  19. Placenta previa and risk of major congenital malformations among singleton births in Finland.

    Science.gov (United States)

    Kancherla, Vijaya; Räisänen, Sari; Gissler, Mika; Kramer, Michael R; Heinonen, Seppo

    2015-06-01

    Placenta previa has been associated with adverse birth outcomes, but its association with congenital malformations is inconclusive. We examined the association between placenta previa and major congenital malformations among singleton births in Finland. We performed a retrospective population register-based study on all singletons born at or after 22+0 weeks of gestation in Finland during 2000 to 2010. We linked three national health registers: the Finnish Medical Birth Register, the Hospital Discharge Register, and the Register of Congenital Malformations, and examined several demographic and clinical characteristics among women with and without placenta previa, in association with major congenital malformations. We estimated adjusted odds ratios and 95% confidence intervals using multivariable logistic regression models. The prevalence of placenta previa was estimated as 2.65 per 1000 singleton births in Finland (95% confidence interval, 2.53-2.79). Overall, 6.2% of women with placenta previa delivered a singleton infant with a major congenital malformation, compared with 3.8% of unaffected women (p ≤ 0.001). Placenta previa was positively associated with almost 1.6-fold increased risk of major congenital malformations in the offspring, after controlling for maternal age, parity, fetal sex, smoking, socio-economic status, chorionic villus biopsy, In vitro fertilization, pre-existing diabetes, depression, preeclampsia, and prior caesarean section (adjusted odds ratio = 1.55; 95% confidence interval, 1.27-1.90). Using a large population-based study, we found that placenta previa was weakly, but significantly associated with an increased risk of major congenital malformations in singleton births. Future studies should examine the association between placenta previa and individual types of congenital malformations, specifically in high-risk pregnancies. © 2015 Wiley Periodicals, Inc.

  20. Comparison of RISK-PCI, GRACE, TIMI risk scores for prediction of major adverse cardiac events in patients with acute coronary syndrome.

    Science.gov (United States)

    Jakimov, Tamara; Mrdović, Igor; Filipović, Branka; Zdravković, Marija; Djoković, Aleksandra; Hinić, Saša; Milić, Nataša; Filipović, Branislav

    2017-12-31

    To compare the prognostic performance of three major risk scoring systems including global registry for acute coronary events (GRACE), thrombolysis in myocardial infarction (TIMI), and prediction of 30-day major adverse cardiovascular events after primary percutaneous coronary intervention (RISK-PCI). This single-center retrospective study involved 200 patients with acute coronary syndrome (ACS) who underwent invasive diagnostic approach, ie, coronary angiography and myocardial revascularization if appropriate, in the period from January 2014 to July 2014. The GRACE, TIMI, and RISK-PCI risk scores were compared for their predictive ability. The primary endpoint was a composite 30-day major adverse cardiovascular event (MACE), which included death, urgent target-vessel revascularization (TVR), stroke, and non-fatal recurrent myocardial infarction (REMI). The c-statistics of the tested scores for 30-day MACE or area under the receiver operating characteristic curve (AUC) with confidence intervals (CI) were as follows: RISK-PCI (AUC=0.94; 95% CI 1.790-4.353), the GRACE score on admission (AUC=0.73; 95% CI 1.013-1.045), the GRACE score on discharge (AUC=0.65; 95% CI 0.999-1.033). The RISK-PCI score was the only score that could predict TVR (AUC=0.91; 95% CI 1.392-2.882). The RISK-PCI scoring system showed an excellent discriminative potential for 30-day death (AUC=0.96; 95% CI 1.339-3.548) in comparison with the GRACE scores on admission (AUC=0.88; 95% CI 1.018-1.072) and on discharge (AUC=0.78; 95% CI 1.000-1.058). In comparison with the GRACE and TIMI scores, RISK-PCI score showed a non-inferior ability to predict 30-day MACE and death in ACS patients. Moreover, RISK-PCI was the only scoring system that could predict recurrent ischemia requiring TVR.

  1. The risk of a major nuclear accident: calculation and perception of probabilities

    International Nuclear Information System (INIS)

    Leveque, Francois

    2013-07-01

    The accident at Fukushima Daiichi, Japan, occurred on 11 March 2011. This nuclear disaster, the third on such a scale, left a lasting mark in the minds of hundreds of millions of people. Much as Three Mile Island or Chernobyl, yet another place will be permanently associated with a nuclear power plant which went out of control. Fukushima Daiichi revived the issue of the hazards of civil nuclear power, stirring up all the associated passion and emotion. The whole of this paper is devoted to the risk of a major nuclear accident. By this we mean a failure initiating core meltdown, a situation in which the fuel rods melt and mix with the metal in their cladding. Such accidents are classified as at least level 5 on the International Nuclear Event Scale. The Three Mile Island accident, which occurred in 1979 in the United States, reached this level of severity. The explosion of reactor 4 at the Chernobyl plant in Ukraine in 1986 and the recent accident in Japan were classified as class 7, the highest grade on this logarithmic scale. The main difference between the top two levels and level 5 relates to a significant or major release of radioactive material to the environment. In the event of a level-5 accident, damage is restricted to the inside of the plant, whereas, in the case of level-7 accidents, huge areas of land, above or below the surface, and/or sea may be contaminated. Before the meltdown of reactors 1, 2 and 3 at Fukushima Daiichi, eight major accidents affecting nuclear power plants had occurred worldwide. This is a high figure compared with the one calculated by the experts. Observations in the field do not appear to fit the results of the probabilistic models of nuclear accidents produced since the 1970's. Oddly enough the number of major accidents is closer to the risk as perceived by the general public. In general we tend to overestimate any risk relating to rare, fearsome accidents. What are we to make of this divergence? How are we to reconcile

  2. Light water reactor accidents - is there really a major public risk

    Energy Technology Data Exchange (ETDEWEB)

    Levenson, M [Bechtel Power Corp., San Francisco, CA (USA)

    1983-04-01

    During the past decade, a major mismatch has developed between the actual public risk from nuclear power and the public perception of that risk. Extensive analyses have been performed on the probability of accidents at nuclear power plants, but such analyses have used assumed consequences rather than those that have been scientifically derived. The assumed consequences have been overstated and needlessly scare the public or lead to unwarranted evacuations. The 40 years of experience in research, development and testing, and the history of actual accidents, provide a sound basis for assessment-a basis that has not been utilized.

  3. A population-based longitudinal study of risk factors for suicide attempts in major depressive disorder.

    Science.gov (United States)

    Bolton, James M; Pagura, Jina; Enns, Murray W; Grant, Bridget; Sareen, Jitender

    2010-10-01

    No longitudinal study has examined risk factors for future suicide attempts in major depressive disorder in a nationally representative sample. The objective of this study was to investigate baseline sociodemographic characteristics, comorbid mental disorders, specific depressive symptoms, and previous suicidal behavior as potential risk factors for suicide attempts at 3 years follow-up. Data came from the national epidemiologic survey on alcohol and related conditions (NESARC), a large nationally representative longitudinal survey of mental illness in adults [Wave 1 (2001-2002); Wave 2 (2004-2005) n=34,653]. Logistic regression examined associations between risk factors present at Wave 1 and suicide attempts at Wave 2 (n=169) among individuals with major depressive disorder at baseline assessment (n=6004). Risk factors for incident suicide attempts at Wave 2 (n=63) were identified among those with major depressive disorder at Wave 1 and no lifetime history of suicide attempts (n=5170). Results revealed specific comorbid anxiety, personality, and substance use disorders to be associated with incident suicide attempts at Wave 2. Comorbid borderline personality disorder was strongly associated with suicide attempts in all models. Several comorbid disorders were strongly associated with suicide attempts at Wave 2 even after adjusting for previous suicidal behavior, notably posttraumatic stress disorder (adjusted odds ratio (AOR)=2.20; 95% confidence interval (95% CI) 1.27-3.83) and dependent personality disorder (AOR=4.43; 95% CI 1.93-10.18). These findings suggest that mental illness comorbidity confers an increased risk of future suicide attempts in major depressive disorder that is not solely accounted for by past suicidal behavior.

  4. Interpreter-mediated dentistry.

    Science.gov (United States)

    Bridges, Susan; Drew, Paul; Zayts, Olga; McGrath, Colman; Yiu, Cynthia K Y; Wong, H M; Au, T K F

    2015-05-01

    The global movements of healthcare professionals and patient populations have increased the complexities of medical interactions at the point of service. This study examines interpreter mediated talk in cross-cultural general dentistry in Hong Kong where assisting para-professionals, in this case bilingual or multilingual Dental Surgery Assistants (DSAs), perform the dual capabilities of clinical assistant and interpreter. An initial language use survey was conducted with Polyclinic DSAs (n = 41) using a logbook approach to provide self-report data on language use in clinics. Frequencies of mean scores using a 10-point visual analogue scale (VAS) indicated that the majority of DSAs spoke mainly Cantonese in clinics and interpreted for postgraduates and professors. Conversation Analysis (CA) examined recipient design across a corpus (n = 23) of video-recorded review consultations between non-Cantonese speaking expatriate dentists and their Cantonese L1 patients. Three patterns of mediated interpreting indicated were: dentist designated expansions; dentist initiated interpretations; and assistant initiated interpretations to both the dentist and patient. The third, rather than being perceived as negative, was found to be framed either in response to patient difficulties or within the specific task routines of general dentistry. The findings illustrate trends in dentistry towards personalized care and patient empowerment as a reaction to product delivery approaches to patient management. Implications are indicated for both treatment adherence and the education of dental professionals. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. The association between suicide risk and self-esteem in Japanese university students with major depressive episodes of major depressive disorder

    Directory of Open Access Journals (Sweden)

    Mitsui N

    2014-05-01

    Full Text Available Nobuyuki Mitsui,1 Satoshi Asakura,1,2 Yusuke Shimizu,1 Yutaka Fujii,1 Atsuhito Toyomaki,1 Yuki Kako,1 Teruaki Tanaka,1 Nobuki Kitagawa,3 Takeshi Inoue,1 Ichiro Kusumi1 1Department of Psychiatry, Hokkaido University Graduate School of Medicine, 2Health care center of Hokkaido University, Kita-ku, Sapporo, 3Department of Clinical Social Work, Health Sciences University of Hokkaido School of Nursing and Social Services, Tobetsu, Ishikari, Japan Background: The suicide risk among young adults is related to multiple factors; therefore, it is difficult to predict and prevent suicidal behavior. Aim: We conducted the present study to reveal the most important factors relating to suicidal ideation in Japanese university students with major depressive episodes (MDEs of major depressive disorder (MDD. Methods: The subjects were 30 Japanese university students who had MDEs of MDD, and were aged between 18 and 26 years old. They were divided into two groups – without suicide risk group (n=15, and with suicide risk group (n=15 – based on the results of the Mini-International Neuropsychiatric Interview. Additionally, healthy controls were recruited from the same population (n=15. All subjects completed the self-assessment scales including the Beck Depression Inventory 2nd edition (BDI-II, the Beck Hopelessness Scale (BHS, Rosenberg's Self-Esteem Scale (RSES, and SF-36v2TM (The Medical Outcomes Study 36-item short-form health survey version 2, and they were all administered a battery of neuropsychological tests. Results: The RSES score of the suicide risk group was significantly lower than the RSES score of the without suicide risk group, whereas the BDI-II score and the BHS score were not significantly different between the two groups. The mean social functioning score on the SF-36v2 of the with suicide risk group was significantly lower than that of the without suicide risk group. Conclusion: The individual's self-esteem and social functioning may play an

  6. The Regulation of Major Risks in Relation to Large Nuclear Installations in France

    International Nuclear Information System (INIS)

    Phan Van, L.

    1991-01-01

    Recently, major risk prevention has generated legislative and regulatory texts in French law, particularly regarding nuclear installations. This article reviews the context and analyses the scope of the new regulations. They require the nuclear operator to take preventive measures, namely more stringent obligations from the safety viewpoint to inform the public. These include risk assessments and preparing emergency plans in case if accidents. (NEA)

  7. Distribution of major health risks: findings from the Global Burden of Disease study.

    Directory of Open Access Journals (Sweden)

    Anthony Rodgers

    2004-10-01

    Full Text Available Most analyses of risks to health focus on the total burden of their aggregate effects. The distribution of risk-factor-attributable disease burden, for example by age or exposure level, can inform the selection and targeting of specific interventions and programs, and increase cost-effectiveness.For 26 selected risk factors, expert working groups conducted comprehensive reviews of data on risk-factor exposure and hazard for 14 epidemiological subregions of the world, by age and sex. Age-sex-subregion-population attributable fractions were estimated and applied to the mortality and burden of disease estimates from the World Health Organization Global Burden of Disease database. Where possible, exposure levels were assessed as continuous measures, or as multiple categories. The proportion of risk-factor-attributable burden in different population subgroups, defined by age, sex, and exposure level, was estimated. For major cardiovascular risk factors (blood pressure, cholesterol, tobacco use, fruit and vegetable intake, body mass index, and physical inactivity 43%-61% of attributable disease burden occurred between the ages of 15 and 59 y, and 87% of alcohol-attributable burden occurred in this age group. Most of the disease burden for continuous risks occurred in those with only moderately raised levels, not among those with levels above commonly used cut-points, such as those with hypertension or obesity. Of all disease burden attributable to being underweight during childhood, 55% occurred among children 1-3 standard deviations below the reference population median, and the remainder occurred among severely malnourished children, who were three or more standard deviations below median.Many major global risks are widely spread in a population, rather than restricted to a minority. Population-based strategies that seek to shift the whole distribution of risk factors often have the potential to produce substantial reductions in disease burden.

  8. Risk of subsequent dementia among patients with bipolar disorder or major depression: a nationwide longitudinal study in Taiwan.

    Science.gov (United States)

    Chen, Mu-Hong; Li, Cheng-Ta; Tsai, Chia-Fen; Lin, Wei-Chen; Chang, Wen-Han; Chen, Tzeng-Ji; Pan, Tai-Long; Su, Tung-Ping; Bai, Ya-Mei

    2015-06-01

    Both major depression and bipolar disorder are associated with an increased risk of developing dementia. However, the differential risk of dementia between major depression and bipolar disorder is rarely investigated. Using the Taiwan National Health Insurance Research Database, a total of 2291 patients aged ≥ 55 years (major depression: 1946 and bipolar disorder: 345) and 2291 age-and sex-matched controls were enrolled between 1998 and 2008, and followed to the end of 2011. Participants who developed dementia during the follow-up were identified. Both patients with bipolar disorder [hazard ratio (HR) 5.58, 95% confidence interval (CI) 4.26-7.32] and those with major depression (HR 3.02, 95% CI 2.46-3.70) had an increased risk of developing dementia in later life, after adjusting for demographic data and medical comorbidities. The sensitivity tests after excluding the 1-year (bipolar disorder: HR 4.73, 95% CI 3.50-6.35; major depression: HR 2.62, 95% CI 2.11-3.25) and 3-year (HR 3.92, 95% CI 2.78-5.54; HR 2.21, 95% CI 1.73-2.83, respectively) follow-up duration also revealed consistent findings. Furthermore, patients with bipolar disorder were associated with an 87% increased risk (HR 1.87, 95% CI 1.48-2.37) of subsequent dementia compared with patients with major depression. Midlife individuals with bipolar disorder or major depression were associated with an elevated risk of developing dementia in later life. Further studies may be required to clarify the underlying mechanisms among major depression, bipolar disorder, and dementia, and to investigate whether prompt intervention may decrease this risk. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  9. Insight into mental illness and child maltreatment risk among mothers with major psychiatric disorders.

    Science.gov (United States)

    Mullick, M; Miller, L J; Jacobsen, T

    2001-04-01

    This study examined the relationship between insight into mental illness and current child maltreatment risk among mothers who had a major psychiatric disorder and who had lost custody of a child because of abuse, neglect, or having placed the child at risk of harm. Specifically, a measure of insight was examined in relation to systematically observed parenting behaviors known to be correlated with past child maltreatment and in relation to a comprehensive clinical determination of risk. Forty-four mothers who had a major psychiatric disorder were independently rated for their insight into their illness, the quality of mother-child interaction, and the overall clinical risk of maltreatment. Better insight into mental illness was associated with more sensitive mothering behavior and with lower assessed clinical risk of maltreatment. The association remained when mothers with current psychotic symptoms were excluded from the analyses. Better insight did not appear to be associated with past psychotic symptoms, maternal psychiatric diagnosis, or the mother's level of education. Insight into mental illness may function as a protective factor that influences the risk of child maltreatment in mothers with mental illness. Measures of insight could be usefully incorporated into comprehensive parenting assessments for mothers with psychiatric disorders.

  10. Association of ABO blood groups and major ischaemic heart disease risk factors

    International Nuclear Information System (INIS)

    Lutf-Ullah, L.; Akhtar, B.; Noor-Us-Saba; Hanif, A.; Khan, B.Z.; Bukhshi, I.M.

    2010-01-01

    To study the association of ABO blood groups with major ischaemic heart disease risk factors. Setting: Department of Cardiology, Mayo hospital, Lahore over a period of two years from January 2008 to December 2009. Study Design: Analytic comparative study. Subjects and Methods: The study group included 907 patients of ischaemic heart disease (IHD). The distribution of ABO blood groups in IHD patients was compared for presence or absence of major IHD risk factors. Data was analyzed using SPSS 16. ANOVA and Chi-square tests for significance were used. P-value less than 0.05 was taken as significant. Results: In this study, the following pattern of ABO blood groups was observed in IHD patients : blood group A 251 (27.67%); blood group B 329 (36.27%); blood group O 235 (25.91%); blood group AB 92 (10.14%). We found no relation-ship of ABO blood groups with age (p-value = 0.234), gender (p-value = 0.093), hypertension (p-value = 0.230), diabetes mellitus (p-value = 0.801), family history of IHD (p-value = 0.277), transverse ear lobe crease (p-value = 0.231), total cholesterol (p-value = 0.797), triglycerides (p-value = 0.351), low density lipoprotein (p-value = 0.078), high density lipoprotein (p-value = 0.114). Similarly no relationship was found of smoking, weight, height and body mass index with ABO blood groups, p-values 0.428, 0.528, 0.908 and 0.455 respectively. Conclusion: There is no association of ABO blood groups and major ischaemic heart disease risk factors. (author)

  11. "Nudges" to Prevent Behavioral Risk Factors Associated With Major Depressive Disorder.

    Science.gov (United States)

    Woodend, Ashleigh; Schölmerich, Vera; Denktaş, Semiha

    2015-11-01

    Major depressive disorder-colloquially called "depression"-is a primary global cause of disability. Current preventive interventions, such as problem-solving therapy, are effective but also expensive. "Nudges" are easy and cheap interventions for altering behavior. We have explored how nudging can reduce three behavioral risk factors of depression: low levels of physical activity, inappropriate coping mechanisms, and inadequate maintenance of social ties. These nudges use cognitive biases associated with these behavioral risks, such as valuing the present more than the future, following the herd or the norm, making different choices in light of equivalent conditions, and deciding on the basis of salience or attachment to status quo.

  12. Are passive smoking, air pollution and obesity a greater mortality risk than major radiation incidents?

    Directory of Open Access Journals (Sweden)

    Smith Jim T

    2007-04-01

    Full Text Available Abstract Background Following a nuclear incident, the communication and perception of radiation risk becomes a (perhaps the major public health issue. In response to such incidents it is therefore crucial to communicate radiation health risks in the context of other more common environmental and lifestyle risk factors. This study compares the risk of mortality from past radiation exposures (to people who survived the Hiroshima and Nagasaki atomic bombs and those exposed after the Chernobyl accident with risks arising from air pollution, obesity and passive and active smoking. Methods A comparative assessment of mortality risks from ionising radiation was carried out by estimating radiation risks for realistic exposure scenarios and assessing those risks in comparison with risks from air pollution, obesity and passive and active smoking. Results The mortality risk to populations exposed to radiation from the Chernobyl accident may be no higher than that for other more common risk factors such as air pollution or passive smoking. Radiation exposures experienced by the most exposed group of survivors of Hiroshima and Nagasaki led to an average loss of life expectancy significantly lower than that caused by severe obesity or active smoking. Conclusion Population-averaged risks from exposures following major radiation incidents are clearly significant, but may be no greater than those from other much more common environmental and lifestyle factors. This comparative analysis, whilst highlighting inevitable uncertainties in risk quantification and comparison, helps place the potential consequences of radiation exposures in the context of other public health risks.

  13. Comparative risk assessment for electricity generation

    International Nuclear Information System (INIS)

    Thoene, E.; Kallenbach, U.

    1988-01-01

    The following conclusions are drawn: There is no 'zero-risk option' in electricity generation. Risk comparison meets with considerable problems relating to available data and methods. Taking into account the existing uncertainties, technology ranking in terms of risks involved cannot be done, but the major risk elements of the various electricity generating systems can be clearly identified. The risks defined cannot be interpreted so as to lead to an abolishment of certain techniques due to risks involved, particularly if one sees the risks from electricity generation in relation to other health hazards. The use of coal for electricity generation clearly ranks top with regard to occupational risks and hazards to public health. (orig./HP) [de

  14. Using MFM methodology to generate and define major accident scenarios for quantitative risk assessment studies

    DEFF Research Database (Denmark)

    Hua, Xinsheng; Wu, Zongzhi; Lind, Morten

    2017-01-01

    to calculate likelihood of each MAS. Combining the likelihood of each scenario with a qualitative risk matrix, each major accident scenario is thereby ranked for consideration for detailed consequence analysis. The methodology is successfully highlighted using part of BMA-process for production of hydrogen......Generating and defining Major Accident Scenarios (MAS) are commonly agreed as the key step for quantitative risk assessment (QRA). The aim of the study is to explore the feasibility of using Multilevel Flow Modeling (MFM) methodology to formulating MAS. Traditionally this is usually done based...

  15. Abdominal and pelvic computed tomography (CT) interpretation: discrepancy rates among experienced radiologists

    Energy Technology Data Exchange (ETDEWEB)

    Abujudeh, Hani H.; Boland, Giles W.; Kaewlai, Rathachai; Rabiner, Pavel; Thrall, James H. [Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Halpern, Elkarn F.; Gazelle, G.S. [Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Massachusetts General Hospital and Harvard Medical School, Institute for Technology Assessment, Boston, MA (United States)

    2010-08-15

    To assess the discrepancy rate for the interpretation of abdominal and pelvic computed tomography (CT) examinations among experienced radiologists. Ninety abdominal and pelvic CT examinations reported by three experienced radiologists who specialize in abdominal imaging were randomly selected from the radiological database. The same radiologists, blinded to previous interpretation, were asked to re-interpret 60 examinations: 30 of their previous interpretations and 30 interpreted by others. All reports were assessed for the degree of discrepancy between initial and repeat interpretations according to a three-level scoring system: no discrepancy, minor, or major discrepancy. Inter- and intrareader discrepancy rates and causes were evaluated. CT examinations included in the investigation were performed on 90 patients (43 men, mean age 59 years, SD 14, range 19-88) for the following indications: follow-up/evaluation of malignancy (69/90, 77%), pancreatitis (5/90, 6%), urinary tract stone (4/90, 4%) or other (12/90, 13%). Interobserver and intraobserver major discrepancy rates were 26 and 32%, respectively. Major discrepancies were due to missed findings, different opinions regarding interval change of clinically significant findings, and the presence of recommendation. Major discrepancy of between 26 and 32% was observed in the interpretation of abdominal and pelvic CT examinations. (orig.)

  16. Abdominal and pelvic computed tomography (CT) interpretation: discrepancy rates among experienced radiologists

    International Nuclear Information System (INIS)

    Abujudeh, Hani H.; Boland, Giles W.; Kaewlai, Rathachai; Rabiner, Pavel; Thrall, James H.; Halpern, Elkarn F.; Gazelle, G.S.

    2010-01-01

    To assess the discrepancy rate for the interpretation of abdominal and pelvic computed tomography (CT) examinations among experienced radiologists. Ninety abdominal and pelvic CT examinations reported by three experienced radiologists who specialize in abdominal imaging were randomly selected from the radiological database. The same radiologists, blinded to previous interpretation, were asked to re-interpret 60 examinations: 30 of their previous interpretations and 30 interpreted by others. All reports were assessed for the degree of discrepancy between initial and repeat interpretations according to a three-level scoring system: no discrepancy, minor, or major discrepancy. Inter- and intrareader discrepancy rates and causes were evaluated. CT examinations included in the investigation were performed on 90 patients (43 men, mean age 59 years, SD 14, range 19-88) for the following indications: follow-up/evaluation of malignancy (69/90, 77%), pancreatitis (5/90, 6%), urinary tract stone (4/90, 4%) or other (12/90, 13%). Interobserver and intraobserver major discrepancy rates were 26 and 32%, respectively. Major discrepancies were due to missed findings, different opinions regarding interval change of clinically significant findings, and the presence of recommendation. Major discrepancy of between 26 and 32% was observed in the interpretation of abdominal and pelvic CT examinations. (orig.)

  17. Risk factors for suicide completion in major depression: a case-control study of impulsive and aggressive behaviors in men.

    Science.gov (United States)

    Dumais, A; Lesage, A D; Alda, M; Rouleau, G; Dumont, M; Chawky, N; Roy, M; Mann, J J; Benkelfat, C; Turecki, Gustavo

    2005-11-01

    Major depression is a major risk factor for suicide. However, not all individuals with major depression commit suicide. Impulsive and aggressive behaviors have been proposed as risk factors for suicide, but it remains unclear whether their effect on the risk of suicide is at least partly explained by axis I disorders commonly associated with suicide, such as major depression. With a case-control design, a comparison of the level of impulsive and aggressive behaviors and the prevalence of associated psychopathology was carried out with control for the presence of primary psychopathology. One hundred and four male suicide completers who died during an episode of major depression and 74 living depressed male comparison subjects were investigated with proxy-based interviews by using structured diagnostic instruments and personality trait assessments. The authors found that current (6-month prevalence) alcohol abuse/dependence, current drug abuse/dependence, and cluster B personality disorders increased the risk of suicide in individuals with major depression. Also, higher levels of impulsivity and aggression were associated with suicide. An analysis by age showed that these risk factors were more specific to younger suicide victims (ages 18-40). A multivariate analysis indicated that current alcohol abuse/dependence and cluster B personality disorder were two independent predictors of suicide. Impulsive-aggressive personality disorders and alcohol abuse/dependence were two independent predictors of suicide in major depression, and impulsive and aggressive behaviors seem to underlie these risk factors. A developmental hypothesis of suicidal behavior, with impulsive and aggressive behaviors as the starting point, is discussed.

  18. Tokens: Facts and Interpretation.

    Science.gov (United States)

    Schmandt-Besserat, Denise

    1986-01-01

    Summarizes some of the major pieces of evidence concerning the archeological clay tokens, specifically the technique for their manufacture, their geographic distribution, chronology, and the context in which they are found. Discusses the interpretation of tokens as the first example of visible language, particularly as an antecedent of Sumerian…

  19. Do women in major cities experience better health? A comparison of chronic conditions and their risk factors between women living in major cities and other cities in Indonesia.

    Science.gov (United States)

    Christiani, Yodi; Byles, Julie E; Tavener, Meredith; Dugdale, Paul

    2015-01-01

    Inhabitants of rural areas can be tempted to migrate to urban areas for the type and range of facilities available. Although urban inhabitants may benefit from greater access to human and social services, living in a big city can also bring disadvantages to some residents due to changes in social and physical environments. We analysed data from 4,208 women aged >15 years old participating in the fourth wave of the Indonesia Family Life Survey. Chronic condition risk factors - systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI), and tobacco use - among women in four major cities in Indonesia (Jakarta, Surabaya, Medan, and Bandung) were compared against other cities. Fractional polynomial regression models were applied to examine the association between living in the major cities and SBP, DBP, BMI, and tobacco use. The models were also adjusted for age, education, employment status, migration status, ethnic groups, and religion. The patterns of SBP, DBP, and BMI were plotted and contrasted between groups of cities. Chronic condition prevalence was higher for women in major cities than in contrasting cities (p<0.005). Living in major cities increased the risk of having higher SBP, DBP, BMI and being a current smoker. Chronic disease risk factors in major cities were evident from younger ages. Women residing in Indonesia's major cities have a higher risk of developing chronic conditions, starting at younger ages. The findings highlight the challenges inherent in providing long-term healthcare with its associated cost within major Indonesian cities and the importance of chronic disease prevention programmes targeting women at an early age.

  20. Do women in major cities experience better health? A comparison of chronic conditions and their risk factors between women living in major cities and other cities in Indonesia

    Directory of Open Access Journals (Sweden)

    Yodi Christiani

    2015-12-01

    Full Text Available Background: Inhabitants of rural areas can be tempted to migrate to urban areas for the type and range of facilities available. Although urban inhabitants may benefit from greater access to human and social services, living in a big city can also bring disadvantages to some residents due to changes in social and physical environments. Design: We analysed data from 4,208 women aged >15 years old participating in the fourth wave of the Indonesia Family Life Survey. Chronic condition risk factors – systolic and diastolic blood pressure (SBP and DBP, body mass index (BMI, and tobacco use – among women in four major cities in Indonesia (Jakarta, Surabaya, Medan, and Bandung were compared against other cities. Fractional polynomial regression models were applied to examine the association between living in the major cities and SBP, DBP, BMI, and tobacco use. The models were also adjusted for age, education, employment status, migration status, ethnic groups, and religion. The patterns of SBP, DBP, and BMI were plotted and contrasted between groups of cities. Results: Chronic condition prevalence was higher for women in major cities than in contrasting cities (p<0.005. Living in major cities increased the risk of having higher SBP, DBP, BMI and being a current smoker. Chronic disease risk factors in major cities were evident from younger ages. Conclusions: Women residing in Indonesia's major cities have a higher risk of developing chronic conditions, starting at younger ages. The findings highlight the challenges inherent in providing long-term healthcare with its associated cost within major Indonesian cities and the importance of chronic disease prevention programmes targeting women at an early age.

  1. Report by the Delegate for major risks for 2010

    International Nuclear Information System (INIS)

    Michel, Laurent

    2011-01-01

    The first part of this report comments the major natural and industrial disasters which occurred in 2010 in France (Xynthia tempest, flooding, and forest fires) and in other countries. It also proposes some lessons from these disasters. The second part discusses the evolution towards a resilient society by a combined approach of sustainable development, of cultural good safeguarding, and person protection. It also discusses a prospective approach regarding natural hazards and technological accidents, adapted procedures, governance and land planning, the evolution of information and alarm systems, and emerging risks. The third part addresses the adaptation to natural hazards: frameworks and strategies, actions (regulatory prevention, flooding management, safety of hydraulic works, seismic plan). It assesses the financial and budgetary means brought by the State and its partners, and discusses some perspectives. It addresses the technological risks: legal and regulatory evolutions, safety of hazardous industrial installations, consequences of technological accidents. The next part deals with the control of civilian nuclear installations by the ASN. The last part presents the different involved structures and authorities

  2. SU-F-T-243: Major Risks in Radiotherapy. A Review Based On Risk Analysis Literature

    Energy Technology Data Exchange (ETDEWEB)

    López-Tarjuelo, J; Guasp-Tortajada, M; Iglesias-Montenegro, N; Monasor-Denia, P [Servicio de Radiofísica y Protección Radiológica, Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, España/Spain (Spain); Bouché-Babiloni, A; Morillo-Macías, V; Ferrer-Albiach, C [Servicio de Oncología Radioterápica, Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, España/Spain (Spain)

    2016-06-15

    Purpose: We present a literature review of risk analyses in radiotherapy to highlight the most reported risks and facilitate the spread of this valuable information so that professionals can be aware of these major threats before performing their own studies. Methods: We considered studies with at least an estimation of the probability of occurrence of an adverse event (O) and its associated severity (S). They cover external beam radiotherapy, brachytherapy, intraoperative radiotherapy, and stereotactic techniques. We selected only the works containing a detailed ranked series of elements or failure modes and focused on the first fully reported quartile as much. Afterward, we sorted the risk elements according to a regular radiotherapy procedure so that the resulting groups were cited in several works and be ranked in this way. Results: 29 references published between 2007 and February 2016 were studied. Publication trend has been generally rising. The most employed analysis has been the Failure mode and effect analysis (FMEA). Among references, we selected 20 works listing 258 ranked risk elements. They were sorted into 31 groups appearing at least in two different works. 11 groups appeared in at least 5 references and 5 groups did it in 7 or more papers. These last sets of risks where choosing another set of images or plan for planning or treating, errors related with contours, errors in patient positioning for treatment, human mistakes when programming treatments, and planning errors. Conclusion: There is a sufficient amount and variety of references for identifying which failure modes or elements should be addressed in a radiotherapy department before attempting a specific analysis. FMEA prevailed, but other studies such as “risk matrix” or “occurrence × severity” analyses can also lead professionals’ efforts. Risk associated with human actions ranks very high; therefore, they should be automated or at least peer-reviewed.

  3. SU-F-T-243: Major Risks in Radiotherapy. A Review Based On Risk Analysis Literature

    International Nuclear Information System (INIS)

    López-Tarjuelo, J; Guasp-Tortajada, M; Iglesias-Montenegro, N; Monasor-Denia, P; Bouché-Babiloni, A; Morillo-Macías, V; Ferrer-Albiach, C

    2016-01-01

    Purpose: We present a literature review of risk analyses in radiotherapy to highlight the most reported risks and facilitate the spread of this valuable information so that professionals can be aware of these major threats before performing their own studies. Methods: We considered studies with at least an estimation of the probability of occurrence of an adverse event (O) and its associated severity (S). They cover external beam radiotherapy, brachytherapy, intraoperative radiotherapy, and stereotactic techniques. We selected only the works containing a detailed ranked series of elements or failure modes and focused on the first fully reported quartile as much. Afterward, we sorted the risk elements according to a regular radiotherapy procedure so that the resulting groups were cited in several works and be ranked in this way. Results: 29 references published between 2007 and February 2016 were studied. Publication trend has been generally rising. The most employed analysis has been the Failure mode and effect analysis (FMEA). Among references, we selected 20 works listing 258 ranked risk elements. They were sorted into 31 groups appearing at least in two different works. 11 groups appeared in at least 5 references and 5 groups did it in 7 or more papers. These last sets of risks where choosing another set of images or plan for planning or treating, errors related with contours, errors in patient positioning for treatment, human mistakes when programming treatments, and planning errors. Conclusion: There is a sufficient amount and variety of references for identifying which failure modes or elements should be addressed in a radiotherapy department before attempting a specific analysis. FMEA prevailed, but other studies such as “risk matrix” or “occurrence × severity” analyses can also lead professionals’ efforts. Risk associated with human actions ranks very high; therefore, they should be automated or at least peer-reviewed.

  4. Suicidal risk factors of recurrent major depression in Han Chinese women.

    Directory of Open Access Journals (Sweden)

    Yuzhang Zhu

    Full Text Available The relationship between suicidality and major depression is complex. Socio- demography, clinical features, comorbidity, clinical symptoms, and stressful life events are important factors influencing suicide in major depression, but these are not well defined. Thus, the aim of the present study was to assess the associations between the above-mentioned factors and suicide ideation, suicide plan, and suicide attempt in 6008 Han Chinese women with recurrent major depression (MD. Patients with any suicidality had significantly more MD symptoms, a significantly greater number of stressful life events, a positive family history of MD, a greater number of episodes, a significant experience of melancholia, and earlier age of onset. Comorbidity with dysthymia, generalized anxiety disorder (GAD, social phobia, and animal phobia was seen in suicidal patients. The present findings indicate that specific factors act to increase the likelihood of suicide in MD. Our results may help improve the clinical assessment of suicide risk in depressed patients, especially for women.

  5. A Response to Odland et al.'s Misleading, Alarmist Estimates of Risk for Overpathologizing when Interpreting the MMPI-2-RF.

    Science.gov (United States)

    Tarescavage, Anthony M; Ben-Porath, Yossef S

    2015-01-01

    In a recently published article in this journal, Odland, Lammy, Perle, Martin, and Grote report Monte Carlo-simulated normative base rates of scale elevations on the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF). Their primary conclusion--reflected in the title of their article--is that MMPI-2-RF interpretation is associated with "high risk of pathologizing healthy adults" when the 40 substantive scales of the test are simultaneously interpreted. In this paper, we describe how their conclusion follows from several faulty premises, three of which were already debunked in an earlier article and remain false despite counterarguments proposed by Odland and colleagues. We also address these authors' misinterpretation of their analyses and, furthermore, their premise that MMPI-2-RF interpretive guidelines are flawed because they "currently do not account for a basic statistical principle: Type I (or alpha) error inflation" (p. 1). This premise is irrelevant to psychological test interpretation and misaligned with neuropsychological testing literature cited in support of it. Consistent with suggestions by some of the authors they cite, we reiterate MMPI-2-RF interpretive guidelines designed to mitigate the impact of measurement error (not alpha error) by way of a scientific assessment approach that relies on integration of information derived from multiple sources.

  6. Computerized Interpretation of Dynamic Breast MRI

    Science.gov (United States)

    2005-05-01

    The interpretation criteria in the current literature fall Breast MRI has emerged as a promising modality for the into two major categories: 5’ 14...is that theraphy , current interpretation schemes might not be sufficiently ro- Despite its well-recognized advantages, applications of bust. MRI in...postcontrast series For the manual delineation, a radiologist (U.B.), blinded were then taken with a time interval of 60 s. Each series to the histological

  7. Identification of Major Risk Sources for Surface Water Pollution by Risk Indexes (RI) in the Multi-Provincial Boundary Region of the Taihu Basin, China.

    Science.gov (United States)

    Yao, Hong; Li, Weixin; Qian, Xin

    2015-08-21

    Environmental safety in multi-district boundary regions has been one of the focuses in China and is mentioned many times in the Environmental Protection Act of 2014. Five types were categorized concerning the risk sources for surface water pollution in the multi-provincial boundary region of the Taihu basin: production enterprises, waste disposal sites, chemical storage sites, agricultural non-point sources and waterway transportations. Considering the hazard of risk sources, the purification property of environmental medium and the vulnerability of risk receptors, 52 specific attributes on the risk levels of each type of risk source were screened out. Continuous piecewise linear function model, expert consultation method and fuzzy integral model were used to calculate the integrated risk indexes (RI) to characterize the risk levels of pollution sources. In the studied area, 2716 pollution sources were characterized by RI values. There were 56 high-risk sources screened out as major risk sources, accounting for about 2% of the total. The numbers of sources with high-moderate, moderate, moderate-low and low pollution risk were 376, 1059, 101 and 1124, respectively, accounting for 14%, 38%, 5% and 41% of the total. The procedure proposed could be included in the integrated risk management systems of the multi-district boundary region of the Taihu basin. It could help decision makers to identify major risk sources in the risk prevention and reduction of surface water pollution.

  8. Reducing image interpretation errors – Do communication strategies undermine this?

    International Nuclear Information System (INIS)

    Snaith, B.; Hardy, M.; Lewis, E.F.

    2014-01-01

    Introduction: Errors in the interpretation of diagnostic images in the emergency department are a persistent problem internationally. To address this issue, a number of risk reduction strategies have been suggested but only radiographer abnormality detection schemes (RADS) have been widely implemented in the UK. This study considers the variation in RADS operation and communication in light of technological advances and changes in service operation. Methods: A postal survey of all NHS hospitals operating either an Emergency Department or Minor Injury Unit and a diagnostic imaging (radiology) department (n = 510) was undertaken between July and August 2011. The questionnaire was designed to elicit information on emergency service provision and details of RADS. Results: 325 questionnaires were returned (n = 325/510; 63.7%). The majority of sites (n = 288/325; 88.6%) operated a RADS with the majority (n = 227/288; 78.8%) employing a visual ‘flagging’ system as the only method of communication although symbols used were inconsistent and contradictory across sites. 61 sites communicated radiographer findings through a written proforma (paper or electronic) but this was run in conjunction with a flagging system at 50 sites. The majority of sites did not have guidance on the scope or operation of the ‘flagging’ or written communication system in use. Conclusions: RADS is an established clinical intervention to reduce errors in diagnostic image interpretation within the emergency setting. The lack of standardisation in communication processes and practices alongside the rapid adoption of technology has increased the potential for error and miscommunication

  9. Unregulated Autonomy: Uncredentialed Educational Interpreters in Rural Schools.

    Science.gov (United States)

    Fitzmaurice, Stephen

    2017-01-01

    Although many rural Deaf and Hard of Hearing students attend public schools most of the day and use the services of educational interpreters to gain access to the school environment, little information exists on what interpreters are doing in rural school systems in the absence of credentialing requirements. The researcher used ethnographic interviews and field observations of three educational interpreters with no certification or professional assessment to explore how uncredentialed interpreters were enacting their role in a rural high school. The findings indicate that uncredentialed interpreters in rural settings perform four major functions during their school day: preparing the environment, staff, and materials; interpreting a variety of content; interacting with numerous stakeholders; and directly instructing Deaf and Hard of Hearing students. Generally, educational interpreters in rural districts operate with unregulated autonomy, a situation that warrants further research and a national standard for all educational interpreters.

  10. Making sense of climate risk information: The case of future indoor climate risks in Swedish churches

    Directory of Open Access Journals (Sweden)

    Gustaf Leijonhufvud

    2016-01-01

    Full Text Available Organizations and institutions managing built heritage have to make use of increasingly detailed, elaborate and complex climate change impact assessments. It is a challenge to determine how, when and by whom climate predictions should be translated into risk estimates usable for decision-making. In this paper results from the Climate for Culture project are used to study how heritage decision-makers interpret future indoor climate-related risks to Swedish churches. Different sets of risk maps were presented to ten engineers, ten building conservators and five experts on indoor climate related risks. Interviews were used to understand how the interviewees made sense of the presented information and if they associated it with a perceived need for adaptation. The results show that the risks were interpreted and assessed largely dependent on their pre-understanding and familiarity with the individual risks. The magnitude of change and the lack of uncertainty estimates were subordinate to the overall impression of the information as being credible and salient. The major conclusion is that the dissemination of risk information, also from projects which at the outset have aimed at producing knowledge relevant for end-users, should be both customized and tested in collaborative efforts by stakeholders and scientists.

  11. Major upgrade of the reactor dosimetry interpretation methodology used at CEA. Architecture description

    International Nuclear Information System (INIS)

    Gregoire, Gilles; Destouches, Christophe; Beretz, Daniel; Bourganel, Stephane

    2009-01-01

    One of the main objectives of reactor dosimetry is the determination of the physical parameters characterizing the neutron field in which studied samples are irradiated. These values, from neutron spectrum to reaction rates are used on the one hand in experimental reactors to carry out the follow-up of the irradiation and to qualify the neutron calculation (modeling scheme for the experiment) and, on the other hand in power reactors for the follow-up of the damaging of vessel and internals. Neutron parameters are obtained from the treatment of dosimeter's activities which have suitable reactions (response functions and radioactive emissions). Then, activities are analyzed using nuclear data, neutron computation results and data characterizing the conditions of irradiation (temporal and technological data, changes of location...). This current interpretation process presents limitations coming mainly from the calculations tools and the nuclear data knowledge. But nowadays due to, first the improvement of the neutron calculation tools, a full 3D Monte Carlo reactor modeling providing reaction in a point wise format is now possible in a reasonable time, and second, recent releases of the international nuclear data libraries, JEFF3.1, ENDFB7 for transport calculation and IRDF2002 and EAF2007 for dosimetry libraries, a deep renewal of the reactor dosimetry interpretation process has been engaged. In addition, uncertainties associated to the results are derived in a rigorous way using simulation methods. This paper lists the main improvements of the neutron calculation codes and of the international nuclear data libraries. The principle of new interpretation process is then detailed. The general software architecture is then described, especially open-source tools chosen for the implementation. The paper finally analyzes expected improvements. (author)

  12. Perioperative risk factors for postoperative pneumonia after major oral cancer surgery: A retrospective analysis of 331 cases.

    Science.gov (United States)

    Xu, Jieyun; Hu, Jing; Yu, Pei; Wang, Weiwang; Hu, Xingxue; Hou, Jinsong; Fang, Silian; Liu, Xiqiang

    2017-01-01

    Postoperative pneumonia (POP) is common and results in prolonged hospital stays, higher costs, increased morbidity and mortality. However, data on the incidence and risk factors of POP after oral and maxillofacial surgery are rare. This study aims to identify perioperative risk factors for POP after major oral cancer (OC) surgery. Perioperative data and patient records of 331 consecutive subjects were analyzed in the period of April 2014 to March 2016. We individually traced each OC patient for a period to discharge from the hospital or 45 days after surgery, whichever occur later. The incidence of POP after major OC surgery with free flap construction or major OC surgery was 11.6% or 4.5%, respectively. Patient-related risk factors for POP were male sex, T stage, N stage, clinical stage and preoperative serum albumin level. Among the investigated procedure-related variables, incision grade, mandibulectomy, free flap reconstruction, tracheotomy, intraoperative blood loss, and the length of the operation were shown to be associated with the development of POP. Postoperative hospital stay was also significantly related to increased incidence of POP. Using a multivariable logistic regression model, we identified male sex, preoperative serum albumin level, operation time and postoperative hospital stay as independent risk factors for POP. Several perioperative risk factors can be identified that are associated with POP. At-risk oral cancer patients should be subjected to intensified postoperative pulmonary care.

  13. A benefit-risk review of systemic haemostatic agents - Part 1 : In major surgery

    NARCIS (Netherlands)

    Fraser, Ian S.; Porte, Robert J.; Kouides, Peter A.; Lukes, Andrea S.

    2008-01-01

    Systemic haemostatic agents play an important role in the management of blood loss during major surgery where significant blood loss is likely and their use has increased in recent times as a consequence of demand for blood products outstripping supply and the risks associated with transfusions.

  14. Major stressful life events and other risk factors for first admission with mania

    DEFF Research Database (Denmark)

    Kessing, L.V.; Agerbo, E.; Mortensen, P.B.

    2004-01-01

    OBJECTIVES: To investigate whether first admission with mania is associated with the occurrence of death in the family or with major stressful life events and to explore whether the associations change with age. METHODS: Case register study with linkage of the Danish Psychiatric Central Research...... was found on the association between life events and the first admission with mania, totally, or for men or women, separately regarding ageing. CONCLUSIONS: The occurrence of death in the family and the experience of major life events are associated with increased risk of first admission with bipolar...

  15. Sex similarities and differences in risk factors for recurrence of major depression.

    Science.gov (United States)

    van Loo, Hanna M; Aggen, Steven H; Gardner, Charles O; Kendler, Kenneth S

    2017-11-27

    Major depression (MD) occurs about twice as often in women as in men, but it is unclear whether sex differences subsist after disease onset. This study aims to elucidate potential sex differences in rates and risk factors for MD recurrence, in order to improve prediction of course of illness and understanding of its underlying mechanisms. We used prospective data from a general population sample (n = 653) that experienced a recent episode of MD. A diverse set of potential risk factors for recurrence of MD was analyzed using Cox models subject to elastic net regularization for males and females separately. Accuracy of the prediction models was tested in same-sex and opposite-sex test data. Additionally, interactions between sex and each of the risk factors were investigated to identify potential sex differences. Recurrence rates and the impact of most risk factors were similar for men and women. For both sexes, prediction models were highly multifactorial including risk factors such as comorbid anxiety, early traumas, and family history. Some subtle sex differences were detected: for men, prediction models included more risk factors concerning characteristics of the depressive episode and family history of MD and generalized anxiety, whereas for women, models included more risk factors concerning early and recent adverse life events and socioeconomic problems. No prominent sex differences in risk factors for recurrence of MD were found, potentially indicating similar disease maintaining mechanisms for both sexes. Course of MD is a multifactorial phenomenon for both males and females.

  16. Do major depressive disorder and dysthymic disorder confer differential risk for suicide?

    Science.gov (United States)

    Witte, Tracy K; Timmons, Katherine A; Fink, Erin; Smith, April R; Joiner, Thomas E

    2009-05-01

    Although there has been a tremendous amount of research examining the risk conferred for suicide by depression in general, relatively little research examines the risk conferred by specific forms of depressive illness (e.g., dysthymic disorder, single episode versus recurrent major depressive disorder [MDD]). The purpose of the current study was to examine differences in suicidal ideation, clinician-rated suicide risk, suicide attempts, and family history of suicide in a sample of outpatients diagnosed with various forms of depressive illness. To accomplish this aim, we conducted a cluster analysis using the aforementioned suicide-related variables in a sample of 494 outpatients seen between January 2001 and July 2007 at the Florida State University Psychology Clinic. Patients were diagnosed using DSM-IV criteria. Two distinct clusters emerged that were indicative of lower and higher risk for suicide. After controlling for the number of comorbid Axis I and Axis II diagnoses, the only depressive illness that significantly predicted cluster membership was recurrent MDD, which tripled an individual's likelihood of being assigned to the higher risk cluster. The use of a cross-sectional design; the relatively low suicide risk in our sample; the relatively small number of individuals with double depression. Our results demonstrate the importance of both chronicity and severity of depression in terms of predicting increased suicide risk. Among the various forms of depressive illness examined, only recurrent MDD appeared to confer greater risk for suicide.

  17. Incidence and Risk Factors for Major Hematomas in Aesthetic Surgery: Analysis of 129,007 Patients.

    Science.gov (United States)

    Kaoutzanis, Christodoulos; Winocour, Julian; Gupta, Varun; Ganesh Kumar, Nishant; Sarosiek, Konrad; Wormer, Blair; Tokin, Christopher; Grotting, James C; Higdon, K Kye

    2017-10-16

    Postoperative hematomas are one of the most frequent complications following aesthetic surgery. Identifying risk factors for hematoma has been limited by underpowered studies from single institution experiences. To examine the incidence and identify independent risk factors for postoperative hematomas following cosmetic surgery utilizing a prospective, multicenter database. A prospectively enrolled cohort of patients who underwent aesthetic surgery between 2008 and 2013 was identified from the CosmetAssure database. Primary outcome was occurrence of major hematomas requiring emergency room visit, hospital admission, or reoperation within 30 days of the index operation. Univariate and multivariate analysis was used to identify potential risk factors for hematomas including age, gender, body mass index (BMI), smoking, diabetes, type of surgical facility, procedure by body region, and combined procedures. Of 129,007 patients, 1180 (0.91%) had a major hematoma. Mean age (42.0 ± 13.0 years vs 40.9 ± 13.9 years, P hematomas. Males suffered more hematomas than females (1.4% vs 0.9%, P Hematoma rates were higher in patients undergoing combined procedures compared to single procedures (1.1% vs 0.8%, P hematoma included age (Relative Risk [RR] 1.01), male gender (RR 1.98), the procedure being performed in a hospital setting rather than an office-based setting (RR 1.68), combined procedures (RR 1.35), and breast procedures rather than the body/extremity and face procedures (RR 1.81). Major hematoma is the most common complication following aesthetic surgery. Male patients and those undergoing breast or combined procedures have a significantly higher risk of developing hematomas. 2. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

  18. Interpreting the Customary Rules on Interpretation

    NARCIS (Netherlands)

    Merkouris, Panos

    2017-01-01

    International courts have at times interpreted the customary rules on interpretation. This is interesting because what is being interpreted is: i) rules of interpretation, which sounds dangerously tautological, and ii) customary law, the interpretation of which has not been the object of critical

  19. Identification of Major Risk Sources for Surface Water Pollution by Risk Indexes (RI in the Multi-Provincial Boundary Region of the Taihu Basin, China

    Directory of Open Access Journals (Sweden)

    Hong Yao

    2015-08-01

    Full Text Available Environmental safety in multi-district boundary regions has been one of the focuses in China and is mentioned many times in the Environmental Protection Act of 2014. Five types were categorized concerning the risk sources for surface water pollution in the multi-provincial boundary region of the Taihu basin: production enterprises, waste disposal sites, chemical storage sites, agricultural non-point sources and waterway transportations. Considering the hazard of risk sources, the purification property of environmental medium and the vulnerability of risk receptors, 52 specific attributes on the risk levels of each type of risk source were screened out. Continuous piecewise linear function model, expert consultation method and fuzzy integral model were used to calculate the integrated risk indexes (RI to characterize the risk levels of pollution sources. In the studied area, 2716 pollution sources were characterized by RI values. There were 56 high-risk sources screened out as major risk sources, accounting for about 2% of the total. The numbers of sources with high-moderate, moderate, moderate-low and low pollution risk were 376, 1059, 101 and 1124, respectively, accounting for 14%, 38%, 5% and 41% of the total. The procedure proposed could be included in the integrated risk management systems of the multi-district boundary region of the Taihu basin. It could help decision makers to identify major risk sources in the risk prevention and reduction of surface water pollution.

  20. Identification of Major Risk Sources for Surface Water Pollution by Risk Indexes (RI) in the Multi-Provincial Boundary Region of the Taihu Basin, China

    Science.gov (United States)

    Yao, Hong; Li, Weixin; Qian, Xin

    2015-01-01

    Environmental safety in multi-district boundary regions has been one of the focuses in China and is mentioned many times in the Environmental Protection Act of 2014. Five types were categorized concerning the risk sources for surface water pollution in the multi-provincial boundary region of the Taihu basin: production enterprises, waste disposal sites, chemical storage sites, agricultural non-point sources and waterway transportations. Considering the hazard of risk sources, the purification property of environmental medium and the vulnerability of risk receptors, 52 specific attributes on the risk levels of each type of risk source were screened out. Continuous piecewise linear function model, expert consultation method and fuzzy integral model were used to calculate the integrated risk indexes (RI) to characterize the risk levels of pollution sources. In the studied area, 2716 pollution sources were characterized by RI values. There were 56 high-risk sources screened out as major risk sources, accounting for about 2% of the total. The numbers of sources with high-moderate, moderate, moderate-low and low pollution risk were 376, 1059, 101 and 1124, respectively, accounting for 14%, 38%, 5% and 41% of the total. The procedure proposed could be included in the integrated risk management systems of the multi-district boundary region of the Taihu basin. It could help decision makers to identify major risk sources in the risk prevention and reduction of surface water pollution. PMID:26308032

  1. Perceived parenting and risk for major depression in Chinese women.

    Science.gov (United States)

    Gao, J; Li, Y; Cai, Y; Chen, J; Shen, Y; Ni, S; Wei, Y; Qiu, Y; Zhu, X; Liu, Y; Lu, C; Chen, C; Niu, Q; Tang, C; Yang, Y; Wang, Q; Cui, W; Xia, J; Liu, T; Zhang, J; Zhao, B; Guo, Z; Pan, J; Chen, H; Luo, Y; Sun, L; Xiao, X; Chen, Q; Zhao, X; He, F; Lv, L; Guo, L; Liu, L; Li, H; Shi, S; Flint, J; Kendler, K S; Tao, M

    2012-05-01

    In Western countries, a history of major depression (MD) is associated with reports of received parenting that is low in warmth and caring and high in control and authoritarianism. Does a similar pattern exist in women in China? Received parenting was assessed by a shortened version of the Parental Bonding Instrument (PBI) in two groups of Han Chinese women: 1970 clinically ascertained cases with recurrent MD and 2597 matched controls. MD was assessed at personal interview. Factor analysis of the PBI revealed three factors for both mothers and fathers: warmth, protectiveness, and authoritarianism. Lower warmth and protectiveness and higher authoritarianism from both mother and father were significantly associated with risk for recurrent MD. Parental warmth was positively correlated with parental protectiveness and negatively correlated with parental authoritarianism. When examined together, paternal warmth was more strongly associated with lowered risk for MD than maternal warmth. Furthermore, paternal protectiveness was negatively and maternal protectiveness positively associated with risk for MD. Although the structure of received parenting is very similar in China and Western countries, the association with MD is not. High parental protectiveness is generally pathogenic in Western countries but protective in China, especially when received from the father. Our results suggest that cultural factors impact on patterns of parenting and their association with MD.

  2. Birth order and risk taking in athletics: a meta-analysis and study of major league baseball.

    Science.gov (United States)

    Sulloway, Frank J; Zweigenhaft, Richard L

    2010-11-01

    According to expectations derived from evolutionary theory, younger siblings are more likely than older siblings to participate in high-risk activities. The authors test this hypothesis by conducting a meta-analysis of 24 previous studies involving birth order and participation in dangerous sports. The odds of laterborns engaging in such activities were 1.48 times greater than for firstborns (N = 8,340). The authors also analyze performance data on 700 brothers who played major league baseball. Consistent with their greater expected propensity for risk taking, younger brothers were 10.6 times more likely to attempt the high-risk activity of base stealing and 3.2 times more likely to steal bases successfully (odds ratios). In addition, younger brothers were significantly superior to older brothers in overall batting success, including two measures associated with risk taking. As expected, significant heterogeneity among various performance measures for major league baseball players indicated that older and younger brothers excelled in different aspects of the game.

  3. “Nudges” to Prevent Behavioral Risk Factors Associated With Major Depressive Disorder

    Science.gov (United States)

    Schölmerich, Vera; Denktaş, Semiha

    2015-01-01

    Major depressive disorder—colloquially called “depression”—is a primary global cause of disability. Current preventive interventions, such as problem-solving therapy, are effective but also expensive. “Nudges” are easy and cheap interventions for altering behavior. We have explored how nudging can reduce three behavioral risk factors of depression: low levels of physical activity, inappropriate coping mechanisms, and inadequate maintenance of social ties. These nudges use cognitive biases associated with these behavioral risks, such as valuing the present more than the future, following the herd or the norm, making different choices in light of equivalent conditions, and deciding on the basis of salience or attachment to status quo. PMID:26378823

  4. Perioperative risk factors for postoperative pneumonia after major oral cancer surgery: A retrospective analysis of 331 cases.

    Directory of Open Access Journals (Sweden)

    Jieyun Xu

    Full Text Available Postoperative pneumonia (POP is common and results in prolonged hospital stays, higher costs, increased morbidity and mortality. However, data on the incidence and risk factors of POP after oral and maxillofacial surgery are rare. This study aims to identify perioperative risk factors for POP after major oral cancer (OC surgery.Perioperative data and patient records of 331 consecutive subjects were analyzed in the period of April 2014 to March 2016. We individually traced each OC patient for a period to discharge from the hospital or 45 days after surgery, whichever occur later.The incidence of POP after major OC surgery with free flap construction or major OC surgery was 11.6% or 4.5%, respectively. Patient-related risk factors for POP were male sex, T stage, N stage, clinical stage and preoperative serum albumin level. Among the investigated procedure-related variables, incision grade, mandibulectomy, free flap reconstruction, tracheotomy, intraoperative blood loss, and the length of the operation were shown to be associated with the development of POP. Postoperative hospital stay was also significantly related to increased incidence of POP. Using a multivariable logistic regression model, we identified male sex, preoperative serum albumin level, operation time and postoperative hospital stay as independent risk factors for POP.Several perioperative risk factors can be identified that are associated with POP. At-risk oral cancer patients should be subjected to intensified postoperative pulmonary care.

  5. Interactive web visualization tools to the results interpretation of a seismic risk study aimed at the emergency levels definition

    Science.gov (United States)

    Rivas-Medina, A.; Gutierrez, V.; Gaspar-Escribano, J. M.; Benito, B.

    2009-04-01

    Results of a seismic risk assessment study are often applied and interpreted by users unspecialised on the topic or lacking a scientific background. In this context, the availability of tools that help translating essentially scientific contents to broader audiences (such as decision makers or civil defence officials) as well as representing and managing results in a user-friendly fashion, are on indubitable value. On of such tools is the visualization tool VISOR-RISNA, a web tool developed within the RISNA project (financed by the Emergency Agency of Navarre, Spain) for regional seismic risk assessment of Navarre and the subsequent development of emergency plans. The RISNA study included seismic hazard evaluation, geotechnical characterization of soils, incorporation of site effects to expected ground motions, vulnerability distribution assessment and estimation of expected damage distributions for a 10% probability of exceedance in 50 years. The main goal of RISNA was the identification of higher risk area where focusing detailed, local-scale risk studies in the future and the corresponding urban emergency plans. A geographic information system was used to combine different information layers, generate tables of results and represent maps with partial and final results. The visualization tool VISOR-RISNA is intended to facilitate the interpretation and representation of the collection of results, with the ultimate purpose of defining actuation plans. A number of criteria for defining actuation priorities are proposed in this work. They are based on combinations of risk parameters resulting from the risk study (such as expected ground motion and damage and exposed population), as determined by risk assessment specialists. Although the values that these parameters take are a result of the risk study, their distribution in several classes depends on the intervals defined by decision takers or civil defense officials. These criteria provide a ranking of

  6. 76 FR 71465 - Defense Federal Acquisition Regulation Supplement: Management of Manufacturing Risk in Major...

    Science.gov (United States)

    2011-11-18

    ... Government procurement. Mary Overstreet, Editor, Defense Acquisition Regulations System. Interim Rule Adopted... Federal Acquisition Regulation Supplement: Management of Manufacturing Risk in Major Defense Acquisition...). ACTION: Final rule. SUMMARY: DoD is adopting as final, without change, an interim rule amending the...

  7. Risk analysis and evaluation of agricultural drought disaster in the major grain-producing areas, China

    Directory of Open Access Journals (Sweden)

    Zongtang Xie

    2016-09-01

    Full Text Available The analysis and evaluation of agricultural drought risk can assist in reducing regional disasters and agricultural drought losses. Because of the uncertainties and incomplete agricultural drought information, this paper employed an information diffusion technology and information matrix to identify a drought disaster risk distribution and to quantify the relationship between the annual drought-affected rate and the grain production losses in China's major grain-producing areas. From the assessment results, provincial drought disaster risk spatial distribution maps for each major grain-producing area in China were obtained. These risk patterns showed that the probability of drought fell when the annual drought-covered rate and the annual drought-affected rate increased, and that the high risk areas were located primarily in China's northern and central provinces. These results can provide the basis for the development of effective drought mitigation strategies which would be able to inform possible drought situations and allow for easier decision-making on drought resistance strategies. The fuzzy relationship between the annual drought-affected rate and the drought-caused grain production losses provides vital information for the development of disaster compensation plans. Furthermore, the results of this study indicated that the proposed methods had superior detection stability and higher precision. We hope that by conducting such agricultural drought risk analysis, the results are able to provide the basis for the development of drought mitigation strategies to reduce future losses.

  8. Modifiable risk factors predicting major depressive disorder at four year follow-up: a decision tree approach.

    Science.gov (United States)

    Batterham, Philip J; Christensen, Helen; Mackinnon, Andrew J

    2009-11-22

    Relative to physical health conditions such as cardiovascular disease, little is known about risk factors that predict the prevalence of depression. The present study investigates the expected effects of a reduction of these risks over time, using the decision tree method favoured in assessing cardiovascular disease risk. The PATH through Life cohort was used for the study, comprising 2,105 20-24 year olds, 2,323 40-44 year olds and 2,177 60-64 year olds sampled from the community in the Canberra region, Australia. A decision tree methodology was used to predict the presence of major depressive disorder after four years of follow-up. The decision tree was compared with a logistic regression analysis using ROC curves. The decision tree was found to distinguish and delineate a wide range of risk profiles. Previous depressive symptoms were most highly predictive of depression after four years, however, modifiable risk factors such as substance use and employment status played significant roles in assessing the risk of depression. The decision tree was found to have better sensitivity and specificity than a logistic regression using identical predictors. The decision tree method was useful in assessing the risk of major depressive disorder over four years. Application of the model to the development of a predictive tool for tailored interventions is discussed.

  9. Modifiable risk factors predicting major depressive disorder at four year follow-up: a decision tree approach

    Directory of Open Access Journals (Sweden)

    Christensen Helen

    2009-11-01

    Full Text Available Abstract Background Relative to physical health conditions such as cardiovascular disease, little is known about risk factors that predict the prevalence of depression. The present study investigates the expected effects of a reduction of these risks over time, using the decision tree method favoured in assessing cardiovascular disease risk. Methods The PATH through Life cohort was used for the study, comprising 2,105 20-24 year olds, 2,323 40-44 year olds and 2,177 60-64 year olds sampled from the community in the Canberra region, Australia. A decision tree methodology was used to predict the presence of major depressive disorder after four years of follow-up. The decision tree was compared with a logistic regression analysis using ROC curves. Results The decision tree was found to distinguish and delineate a wide range of risk profiles. Previous depressive symptoms were most highly predictive of depression after four years, however, modifiable risk factors such as substance use and employment status played significant roles in assessing the risk of depression. The decision tree was found to have better sensitivity and specificity than a logistic regression using identical predictors. Conclusion The decision tree method was useful in assessing the risk of major depressive disorder over four years. Application of the model to the development of a predictive tool for tailored interventions is discussed.

  10. The impact of risk studies

    International Nuclear Information System (INIS)

    Hansson, B.

    The report is a summary of the reports of various subprojects on nuclear safety. The purpose of the study was to evaluate the role and usefulness of major risk studies in societal opinion forming and decision making processes. The primary research material consisted in seven major risk studies, three of which were concerned with radioactive waste handling, two with reactor safety and two with comparative studies of various sources of energy. Special attention was given to the following four aspects: a) the way in which the studies were interpreted b)the extent to which these studies have clarified the risks they analyse c) the extent to which these studies have narrowed the scientific debate d) the degree to which these studies have actually influenced safety measures and regulatory policy. The picture which emerges is one of success in relation to the effects on the nuclear establishment and largely a failure as attempts at settling disputes and informing the public. (G.B.)

  11. Major bleeding risks of different low-molecular-weight heparin agents: a cohort study in 12 934 patients treated for acute venous thrombosis.

    Science.gov (United States)

    van Rein, N; Biedermann, J S; van der Meer, F J M; Cannegieter, S C; Wiersma, N; Vermaas, H W; Reitsma, P H; Kruip, M J H A; Lijfering, W M

    2017-07-01

    Essentials Low-molecular-weight-heparins (LMWH) kinetics differ which may result in different bleeding risks. A cohort of 12 934 venous thrombosis patients on LMWH was followed until major bleeding. The absolute major bleeding risk was low among patients registered at the anticoagulation clinic. Once-daily dosing was associated with a lower bleeding risk as compared with twice-daily. Background Low-molecular-weight heparins (LMWHs) are considered members of a class of drugs with similar anticoagulant properties. However, pharmacodynamics and pharmacokinetics between LMWHs differ, which may result in different bleeding risks. As these agents are used by many patients, small differences may lead to a large effect on numbers of major bleeding events. Objectives To determine major bleeding risks for different LMWH agents and dosing schedules. Methods A cohort of acute venous thrombosis patients from four anticoagulation clinics who used an LMWH and a vitamin K antagonist were followed until they ceased LMWH treatment or until major bleeding. Exposures were classified according to different types of LMWHs and for b.i.d. and o.d. use. Cumulative incidences for major bleeding per 1000 patients and risk ratios were calculated and adjusted for study center. Results The study comprised 12 934 patients with a mean age of 59 years; 6218 (48%) were men. The cumulative incidence of major bleeding was 2.5 per 1000 patients (95% confidence interval [CI], 1.7-3.5). Enoxaparin b.i.d. or o.d. was associated with a relative bleeding risk of 1.7 (95% CI, 0.2-17.5) compared with nadroparin o.d. In addition, a nadroparin b.i.d. dosing schedule was associated with a 2.0-fold increased major bleeding risk (95% CI, 0.8-5.1) as compared with a nadroparin o.d. dosing schedule. Conclusions Absolute major bleeding rates were low for all LMWH agents and dosing schedules in a large unselected cohort. Nevertheless, twice-daily dosing with nadroparin appeared to be associated with an increased

  12. Perceived parenting and risk for major depression in Chinese women

    Science.gov (United States)

    Gao, J.; Li, Y.; Cai, Y.; Chen, J.; Shen, Y.; Ni, S.; Wei, Y.; Qiu, Y.; Zhu, X.; Liu, Y.; Lu, C.; Chen, C.; Niu, Q.; Tang, C.; Yang, Y.; Wang, Q.; Cui, W.; Xia, J.; Liu, T.; Zhang, J.; Zhao, B.; Guo, Z.; Pan, J.; Chen, H.; Luo, Y.; Sun, L.; Xiao, X.; Chen, Q.; Zhao, X.; He, F.; Lv, L.; Guo, L.; Liu, L.; Li, H.; Shi, S.; Flint, J.; Kendler, K. S.; Tao, M.

    2012-01-01

    Background In Western countries, a history of major depression (MD) is associated with reports of received parenting that is low in warmth and caring and high in control and authoritarianism. Does a similar pattern exist in women in China? Method Received parenting was assessed by a shortened version of the Parental Bonding Instrument (PBI) in two groups of Han Chinese women: 1970 clinically ascertained cases with recurrent MD and 2597 matched controls. MD was assessed at personal interview. Results Factor analysis of the PBI revealed three factors for both mothers and fathers: warmth, protectiveness, and authoritarianism. Lower warmth and protectiveness and higher authoritarianism from both mother and father were significantly associated with risk for recurrent MD. Parental warmth was positively correlated with parental protectiveness and negatively correlated with parental authoritarianism. When examined together, paternal warmth was more strongly associated with lowered risk for MD than maternal warmth. Furthermore, paternal protectiveness was negatively and maternal protectiveness positively associated with risk for MD. Conclusions Although the structure of received parenting is very similar in China and Western countries, the association with MD is not. High parental protectiveness is generally pathogenic in Western countries but protective in China, especially when received from the father. Our results suggest that cultural factors impact on patterns of parenting and their association with MD. PMID:21943491

  13. Interpreting Data: The Hybrid Mind

    Science.gov (United States)

    Heisterkamp, Kimberly; Talanquer, Vicente

    2015-01-01

    The central goal of this study was to characterize major patterns of reasoning exhibited by college chemistry students when analyzing and interpreting chemical data. Using a case study approach, we investigated how a representative student used chemical models to explain patterns in the data based on structure-property relationships. Our results…

  14. Risk analysis and evaluation of agricultural drought disaster in the major grain-producing areas, China

    OpenAIRE

    Zongtang Xie; Jiuping Xu; Yanfei Deng

    2016-01-01

    The analysis and evaluation of agricultural drought risk can assist in reducing regional disasters and agricultural drought losses. Because of the uncertainties and incomplete agricultural drought information, this paper employed an information diffusion technology and information matrix to identify a drought disaster risk distribution and to quantify the relationship between the annual drought-affected rate and the grain production losses in China's major grain-producing areas. From the asse...

  15. Urban-hazard risk analysis: mapping of heat-related risks in the elderly in major Italian cities.

    Science.gov (United States)

    Morabito, Marco; Crisci, Alfonso; Gioli, Beniamino; Gualtieri, Giovanni; Toscano, Piero; Di Stefano, Valentina; Orlandini, Simone; Gensini, Gian Franco

    2015-01-01

    Short-term impacts of high temperatures on the elderly are well known. Even though Italy has the highest proportion of elderly citizens in Europe, there is a lack of information on spatial heat-related elderly risks. Development of high-resolution, heat-related urban risk maps regarding the elderly population (≥ 65). A long time-series (2001-2013) of remote sensing MODIS data, averaged over the summer period for eleven major Italian cities, were downscaled to obtain high spatial resolution (100 m) daytime and night-time land surface temperatures (LST). LST was estimated pixel-wise by applying two statistical model approaches: 1) the Linear Regression Model (LRM); 2) the Generalized Additive Model (GAM). Total and elderly population density data were extracted from the Joint Research Centre population grid (100 m) from the 2001 census (Eurostat source), and processed together using "Crichton's Risk Triangle" hazard-risk methodology for obtaining a Heat-related Elderly Risk Index (HERI). The GAM procedure allowed for improved daytime and night-time LST estimations compared to the LRM approach. High-resolution maps of daytime and night-time HERI levels were developed for inland and coastal cities. Urban areas with the hazardous HERI level (very high risk) were not necessarily characterized by the highest temperatures. The hazardous HERI level was generally localized to encompass the city-centre in inland cities and the inner area in coastal cities. The two most dangerous HERI levels were greater in the coastal rather than inland cities. This study shows the great potential of combining geospatial technologies and spatial demographic characteristics within a simple and flexible framework in order to provide high-resolution urban mapping of daytime and night-time HERI. In this way, potential areas for intervention are immediately identified with up-to-street level details. This information could support public health operators and facilitate coordination for heat

  16. Urban-hazard risk analysis: mapping of heat-related risks in the elderly in major Italian cities.

    Directory of Open Access Journals (Sweden)

    Marco Morabito

    Full Text Available Short-term impacts of high temperatures on the elderly are well known. Even though Italy has the highest proportion of elderly citizens in Europe, there is a lack of information on spatial heat-related elderly risks.Development of high-resolution, heat-related urban risk maps regarding the elderly population (≥ 65.A long time-series (2001-2013 of remote sensing MODIS data, averaged over the summer period for eleven major Italian cities, were downscaled to obtain high spatial resolution (100 m daytime and night-time land surface temperatures (LST. LST was estimated pixel-wise by applying two statistical model approaches: 1 the Linear Regression Model (LRM; 2 the Generalized Additive Model (GAM. Total and elderly population density data were extracted from the Joint Research Centre population grid (100 m from the 2001 census (Eurostat source, and processed together using "Crichton's Risk Triangle" hazard-risk methodology for obtaining a Heat-related Elderly Risk Index (HERI.The GAM procedure allowed for improved daytime and night-time LST estimations compared to the LRM approach. High-resolution maps of daytime and night-time HERI levels were developed for inland and coastal cities. Urban areas with the hazardous HERI level (very high risk were not necessarily characterized by the highest temperatures. The hazardous HERI level was generally localized to encompass the city-centre in inland cities and the inner area in coastal cities. The two most dangerous HERI levels were greater in the coastal rather than inland cities.This study shows the great potential of combining geospatial technologies and spatial demographic characteristics within a simple and flexible framework in order to provide high-resolution urban mapping of daytime and night-time HERI. In this way, potential areas for intervention are immediately identified with up-to-street level details. This information could support public health operators and facilitate coordination for heat

  17. Risk analysis: divergent models and convergent interpretations

    Science.gov (United States)

    Carnes, B. A.; Gavrilova, N.

    2001-01-01

    Material presented at a NASA-sponsored workshop on risk models for exposure conditions relevant to prolonged space flight are described in this paper. Analyses used mortality data from experiments conducted at Argonne National Laboratory on the long-term effects of external whole-body irradiation on B6CF1 mice by 60Co gamma rays and fission neutrons delivered as a single exposure or protracted over either 24 or 60 once-weekly exposures. The maximum dose considered was restricted to 1 Gy for neutrons and 10 Gy for gamma rays. Proportional hazard models were used to investigate the shape of the dose response at these lower doses for deaths caused by solid-tissue tumors and tumors of either connective or epithelial tissue origin. For protracted exposures, a significant mortality effect was detected at a neutron dose of 14 cGy and a gamma-ray dose of 3 Gy. For single exposures, radiation-induced mortality for neutrons also occurred within the range of 10-20 cGy, but dropped to 86 cGy for gamma rays. Plots of risk relative to control estimated for each observed dose gave a visual impression of nonlinearity for both neutrons and gamma rays. At least for solid-tissue tumors, male and female mortality was nearly identical for gamma-ray exposures, but mortality risks for females were higher than for males for neutron exposures. As expected, protracting the gamma-ray dose reduced mortality risks. Although curvature consistent with that observed visually could be detected by a model parameterized to detect curvature, a relative risk term containing only a simple term for total dose was usually sufficient to describe the dose response. Although detectable mortality for the three pathology end points considered typically occurred at the same level of dose, the highest risks were almost always associated with deaths caused by tumors of epithelial tissue origin.

  18. Interpreting major industrial landscapes: Social follow-up on meanings, the case of two aluminium smelters, Alcan (Alma, Canada) and Pechiney (Dunkirk, France)

    International Nuclear Information System (INIS)

    Fortin, Marie-Jose; Gagnon, Christiane

    2006-01-01

    Landscape is becoming an object of growing social concern and, as such, an object of mediation between major industrial producers and local communities. The question of the capacity of environmental assessment to address this issue is thus raised. Until now, landscape studies have focused on visual aspects, although subjective dimensions such as perceptions and meanings have been recognised. The research in this article concerns the subjective dimensions, and is presented with a view to further the understanding of the process of the social interpretation of landscape as it relates to heavy industrial sites. Within a socioconstructivist perspective, two case studies (a longitudinal follow-up and an ex-post) of two aluminum smelters, one in Alma (Quebec, Canada) and the other in Dunkirk (France) were conducted. The results show that nearby residents' interpretations of landscape varied according to three sets of factors related to 1) the dynamics of regional development and the historical place of industry in the community, 2) the relationship between residents and the industry and local governance capacities, and 3) the social impacts experienced. To conclude, three ways of using qualitative methodologies for social and environmental follow-up in a socioconstructivist approach to landscape are proposed

  19. Major dietary patterns and cardiovascular risk factors from childhood to adulthood. The Cardiovascular Risk in Young Finns Study.

    Science.gov (United States)

    Mikkilä, Vera; Räsänen, Leena; Raitakari, Olli T; Marniemi, Jukka; Pietinen, Pirjo; Rönnemaa, Tapani; Viikari, Jorma

    2007-07-01

    Studies on the impact of single nutrients on the risk of CVD have often given inconclusive results. Recent research on dietary patterns has offered promising information on the effects of diet as a whole on the risk of CVD. The Cardiovascular Risk in Young Finns Study is an ongoing, prospective cohort study with a 21-year follow-up to date. The subjects were children and adolescents at baseline (3-18 years, n 1768) and adults at the latest follow-up study (24-39 years, n 1037). We investigated the associations between two major dietary patterns and several risk factors for CVD. In longitudinal analyses with repeated measurements, using multivariate mixed linear regression models, the traditional dietary pattern (characterised by high consumption of rye, potatoes, butter, sausages, milk and coffee) was independently associated with total and LDL cholesterol concentrations, apolipoprotein B and C-reactive protein concentrations among both genders, and also with systolic blood pressure and insulin levels among women and concentrations of homocysteine among men (P health-conscious food choices (such as high consumption of vegetables, legumes and nuts, tea, rye, cheese and other dairy products, and alcoholic beverages) was inversely, but less strongly associated with cardiovascular risk factors. Our results support earlier findings that dietary patterns have a role in the development of CVD.

  20. Tea consumption and the risk of five major cancers: a dose–response meta-analysis of prospective studies

    Science.gov (United States)

    2014-01-01

    Background We conducted a dose–response meta-analysis of prospective studies to summarize evidence of the association between tea consumption and the risk of breast, colorectal, liver, prostate, and stomach cancer. Methods We searched PubMed and two other databases. Prospective studies that reported risk ratios (RRs) with 95% confidence intervals (CIs) of cancer risk for ≥3 categories of tea consumption were included. We estimated an overall RR with 95% CI for an increase of three cups/day of tea consumption, and, usingrestricted cubic splines, we examined a nonlinear association between tea consumption and cancer risk. Results Forty-one prospective studies, with a total of 3,027,702 participants and 49,103 cancer cases, were included. From the pooled overall RRs, no inverse association between tea consumption and risk of five major cancers was observed. However, subgroup analysis showed that increase in consumption of three cups of black tea per day was a significant risk factor for breast cancer (RR, 1.18; 95% CI, 1.05-1.32). Conclusion Ourresults did not show a protective role of tea in five major cancers. Additional large prospective cohort studies are needed to make a convincing case for associations. PMID:24636229

  1. A clinical risk stratification tool for predicting treatment resistance in major depressive disorder.

    Science.gov (United States)

    Perlis, Roy H

    2013-07-01

    Early identification of depressed individuals at high risk for treatment resistance could be helpful in selecting optimal setting and intensity of care. At present, validated tools to facilitate this risk stratification are rarely used in psychiatric practice. Data were drawn from the first two treatment levels of a multicenter antidepressant effectiveness study in major depressive disorder, the STAR*D (Sequenced Treatment Alternatives to Relieve Depression) cohort. This cohort was divided into training, testing, and validation subsets. Only clinical or sociodemographic variables available by or readily amenable to self-report were considered. Multivariate models were developed to discriminate individuals reaching remission with a first or second pharmacological treatment trial from those not reaching remission despite two trials. A logistic regression model achieved an area under the receiver operating characteristic curve exceeding .71 in training, testing, and validation cohorts and maintained good calibration across cohorts. Performance of three alternative models with machine learning approaches--a naïve Bayes classifier and a support vector machine, and a random forest model--was less consistent. Similar performance was observed between more and less severe depression, men and women, and primary versus specialty care sites. A web-based calculator was developed that implements this tool and provides graphical estimates of risk. Risk for treatment resistance among outpatients with major depressive disorder can be estimated with a simple model incorporating baseline sociodemographic and clinical features. Future studies should examine the performance of this model in other clinical populations and its utility in treatment selection or clinical trial design. Copyright © 2013 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  2. How to take deontological concerns seriously in risk-cost-benefit analysis: a re-interpretation of the precautionary principle.

    Science.gov (United States)

    John, S D

    2007-04-01

    In this paper the coherence of the precautionary principle as a guide to public health policy is considered. Two conditions that any account of the principle must meet are outlined, a condition of practicality and a condition of publicity. The principle is interpreted in terms of a tripartite division of the outcomes of action (good outcomes, normal bad outcomes and special bad outcomes). Such a division of outcomes can be justified on either "consequentialist" or "deontological" grounds. In the second half of the paper, it is argued that the precautionary principle is not necessarily opposed to risk-cost-benefit analysis, but, rather, should be interpreted as suggesting a lowering of our epistemic standards for assessing evidence that there is a link between some policy and "special bad" outcomes. This suggestion is defended against the claim that it mistakes the nature of statistical testing and against the charge that it is unscientific or antiscientific, and therefore irrational.

  3. Objective interpretation as conforming interpretation

    Directory of Open Access Journals (Sweden)

    Lidka Rodak

    2011-12-01

    Full Text Available The practical discourse willingly uses the formula of “objective interpretation”, with no regards to its controversial nature that has been discussed in literature.The main aim of the article is to investigate what “objective interpretation” could mean and how it could be understood in the practical discourse, focusing on the understanding offered by judicature.The thesis of the article is that objective interpretation, as identified with textualists’ position, is not possible to uphold, and should be rather linked with conforming interpretation. And what this actually implies is that it is not the virtue of certainty and predictability – which are usually associated with objectivity- but coherence that makes the foundation of applicability of objectivity in law.What could be observed from the analyses, is that both the phenomenon of conforming interpretation and objective interpretation play the role of arguments in the interpretive discourse, arguments that provide justification that interpretation is not arbitrary or subjective. With regards to the important part of the ideology of legal application which is the conviction that decisions should be taken on the basis of law in order to exclude arbitrariness, objective interpretation could be read as a question “what kind of authority “supports” certain interpretation”? that is almost never free of judicial creativity and judicial activism.One can say that, objective and conforming interpretation are just another arguments used in legal discourse.

  4. Practical guide to interpretive near-infrared spectroscopy

    CERN Document Server

    Workman, Jr, Jerry

    2007-01-01

    Containing focused, comprehensive coverage, Practical Guide to Interpretive Near-Infrared Spectroscopy gives you the tools necessary to interpret NIR spectra. The authors present extensive tables, charts, and figures with NIR absorption band assignments and structural information for a broad range of functional groups, organic compounds, and polymers. They include visual spectral representation of all major compound functional groupings and NIR frequency ranges. Organized by functional group type and chemical structure, based on standard compound classification, the chapters are easy to

  5. Risk of major depression in patients with chronic renal failure on different treatment modalities: A matched-cohort and population-based study in Taiwan.

    Science.gov (United States)

    Chen, Shih-Feng; Wang, I-Jen; Lang, Hui-Chu

    2016-01-01

    The influence of different treatment modalities on the risk of developing major depression in patients with chronic renal failure (CRF) is not well understood. We aimed to explore the incidence of major depression among patients with CRF who were on different dialysis modalities, who had received renal transplantation (RT), and those who had not yet received any of the aforementioned renal replacement therapies. We conducted a population-based retrospective cohort study using a national health insurance research database. This study investigated 89,336 study controls, 17,889 patients with chronic kidney disease on conservative treatment, 3823 patients on hemodialysis (HD), 351 patients on peritoneal dialysis (PD), and 322 patients who had RT. We followed all individuals until the occurrence of major depression or the date of loss to follow-up. The PD group had the highest risk (hazard ratio [HR] 2.43; 95% confidence interval [CI] 1.26-4.69), whereas the RT group had the lowest risk (HR 0.18; 95% CI 0.03-1.29) of developing major depression compared with the control group. Patients initiated on PD had a higher risk of developing major depression than patients initiated on HD (pairwise comparison: HR 2.20; 95% CI 1.09-4.46). Different treatment modalities are associated with different risks of developing major depression in patients with CRF. Among renal replacement therapies, patients who have had RT have the lowest risk of developing major depression. Patients who initiate renal therapy on PD may have a higher risk of major depression compared with patients who initiate renal therapy on HD. © 2015 International Society for Hemodialysis.

  6. Drug safety in pregnancy: utopia or achievable prospect? Risk information, risk research and advocacy in Teratology Information Services.

    Science.gov (United States)

    Schaefer, Christof

    2011-03-01

    Even though from preclinical testing to drug risk labeling, the situation with drugs in pregnancy has improved substantially since the thalidomide scandal, there is still an increasing need to provide healthcare professionals and patients with updated individualized risk information for clinical decision making. For the majority of drugs, clinical experience is still insufficient with respect to their safety in pregnancy. There is often uncertainty in how to interpret the available scientific data. Based on 20 years of experience with Teratology Information Services (TIS) cooperating in the European Network of Teratology Information Services (ENTIS) methods of risk interpretation, follow-up of exposed pregnancies through the consultation process and their evaluation is discussed. Vitamin K antagonists, isotretinoin and angiotensin (AT) II-receptor-antagonists are presented as examples of misinterpretation of drug risks and subjects of research based on observational clinical data recorded in TIS. As many TIS are poorly funded, advocacy is necessary by establishing contacts with decision makers in health politics and administration, informing them of the high return in terms of health outcomes and cost savings provided by TIS as reference institutions in clinical teratology. © 2011 The Author. Congenital Anomalies © 2011 Japanese Teratology Society.

  7. How to interpret a small increase in AUC with an additional risk prediction marker: decision analysis comes through.

    Science.gov (United States)

    Baker, Stuart G; Schuit, Ewoud; Steyerberg, Ewout W; Pencina, Michael J; Vickers, Andrew; Vickers, Andew; Moons, Karel G M; Mol, Ben W J; Lindeman, Karen S

    2014-09-28

    An important question in the evaluation of an additional risk prediction marker is how to interpret a small increase in the area under the receiver operating characteristic curve (AUC). Many researchers believe that a change in AUC is a poor metric because it increases only slightly with the addition of a marker with a large odds ratio. Because it is not possible on purely statistical grounds to choose between the odds ratio and AUC, we invoke decision analysis, which incorporates costs and benefits. For example, a timely estimate of the risk of later non-elective operative delivery can help a woman in labor decide if she wants an early elective cesarean section to avoid greater complications from possible later non-elective operative delivery. A basic risk prediction model for later non-elective operative delivery involves only antepartum markers. Because adding intrapartum markers to this risk prediction model increases AUC by 0.02, we questioned whether this small improvement is worthwhile. A key decision-analytic quantity is the risk threshold, here the risk of later non-elective operative delivery at which a patient would be indifferent between an early elective cesarean section and usual care. For a range of risk thresholds, we found that an increase in the net benefit of risk prediction requires collecting intrapartum marker data on 68 to 124 women for every correct prediction of later non-elective operative delivery. Because data collection is non-invasive, this test tradeoff of 68 to 124 is clinically acceptable, indicating the value of adding intrapartum markers to the risk prediction model. Copyright © 2014 John Wiley & Sons, Ltd.

  8. New information on decabromodiphenyl ether and how it changes our interpretations of risk

    Energy Technology Data Exchange (ETDEWEB)

    Hays, S.; Pleus, R. [Intertox, Seattle, WA (United States); Belzer, R. [Regulatory Checkbook, Mt. Vernon, OH (United States)

    2004-09-15

    Decabromodiphenyl ether (DBDPE), the most highly brominated of the polybrominated diphenyl ethers (PBDPEs), is the most widely used brominated flame retardant in the United States. It is used predominantly in hard plastic electronic consumer products and in flame-retarded backing on textiles for furniture. Several U.S. and international organizations have formally evaluated the human health and environmental risks associated with the use of the major BFRs for consumer applications and for DBDPE specifically. These risk assessments have found DBDPE to be safe in its' current use. Most recently, DBDPE underwent an evaluation under the Voluntary Children's Chemical Evaluation Program (VCCEP) and was found to pose negligible health risks for children and is currently undergoing a formal risk assessment within the European Union. Most of these risk assessments have had to rely on extrapolations to estimate exposures among the general population. Most uncertain has been the indirect methods that have had to be used to estimate infants' exposures via potential presence in breast milk. However, newly published data on levels of DBDPE in human milk volunteers in the U.S. provide a better means for calculating infants' exposures. This new data is used to put the previously conducted DBDPE VCCEP risk assessment in perspective and to help assess whether a different conclusion about risks is warranted, what new data gaps and data needs warrant further attention, and some conclusions about risks and benefits of DBDPE and how these new findings change the balance between risks and benefits of the use of DBDPE to protect consumer products. In the VCCEP risk assessment, children's potential exposures to DBDPE from all sources (including electronics, upholstery, breast milk, and the general environment) were characterized using data from published literature, agency reports, and information from manufacturers. An extensive literature search had indicated

  9. Urban-Hazard Risk Analysis: Mapping of Heat-Related Risks in the Elderly in Major Italian Cities

    Science.gov (United States)

    Morabito, Marco; Crisci, Alfonso; Gioli, Beniamino; Gualtieri, Giovanni; Toscano, Piero; Di Stefano, Valentina; Orlandini, Simone; Gensini, Gian Franco

    2015-01-01

    Background Short-term impacts of high temperatures on the elderly are well known. Even though Italy has the highest proportion of elderly citizens in Europe, there is a lack of information on spatial heat-related elderly risks. Objectives Development of high-resolution, heat-related urban risk maps regarding the elderly population (≥65). Methods A long time-series (2001–2013) of remote sensing MODIS data, averaged over the summer period for eleven major Italian cities, were downscaled to obtain high spatial resolution (100 m) daytime and night-time land surface temperatures (LST). LST was estimated pixel-wise by applying two statistical model approaches: 1) the Linear Regression Model (LRM); 2) the Generalized Additive Model (GAM). Total and elderly population density data were extracted from the Joint Research Centre population grid (100 m) from the 2001 census (Eurostat source), and processed together using “Crichton’s Risk Triangle” hazard-risk methodology for obtaining a Heat-related Elderly Risk Index (HERI). Results The GAM procedure allowed for improved daytime and night-time LST estimations compared to the LRM approach. High-resolution maps of daytime and night-time HERI levels were developed for inland and coastal cities. Urban areas with the hazardous HERI level (very high risk) were not necessarily characterized by the highest temperatures. The hazardous HERI level was generally localized to encompass the city-centre in inland cities and the inner area in coastal cities. The two most dangerous HERI levels were greater in the coastal rather than inland cities. Conclusions This study shows the great potential of combining geospatial technologies and spatial demographic characteristics within a simple and flexible framework in order to provide high-resolution urban mapping of daytime and night-time HERI. In this way, potential areas for intervention are immediately identified with up-to-street level details. This information could support public

  10. Risk factors of major noncommunicable diseases in Bahrain. The need for a surveillance system.

    Science.gov (United States)

    Hamadeh, Randah R

    2004-09-01

    Noncommunicable diseases NCDs are the major cause of morbidity and mortality in Bahrain. The review examines the prevalence of risk factors of major NCDs from the available literature and determines the impact of the rapid socio economic changes on their burden. It further recommends ways of improving their reporting and monitoring. Smoking, obesity, diabetes, hypertension, hyperlipidemia, physical activity and nutrition are considered. The review points out that data on some of the factors is available but deficient for others. The call for the establishment of an integrated surveillance system using the World Health Organization STEPwise approach is stressed.

  11. Major air pollutants and risk of COPD exacerbations: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Li JH

    2016-12-01

    Full Text Available Jinhui Li,1,2 Shengzhi Sun,1,2 Robert Tang,1,2 Hong Qiu,2 Qingyuan Huang,3 Tonya G Mason,2 Linwei Tian1,2 1Shenzhen Institute of Research and Innovation, Nanshan, The University of Hong Kong, Shenzhen, People’s Republic of China; 2School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region; 3Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Minhang, Shanghai, People’s Republic of China Background: Short-term exposure to major air pollutants (O3, CO, NO2, SO2, PM10, and PM2.5 has been associated with respiratory risk. However, evidence on the risk of chronic obstructive pulmonary disease (COPD exacerbations is still limited. The present study aimed at evaluating the associations between short-term exposure to major air pollutants and the risk of COPD exacerbations.Methods: After a systematic search up until March 30, 2016, in both English and Chinese electronic databases such as PubMed, EMBASE, and CNKI, the pooled relative risks and 95% confidence intervals were estimated by using the random-effects model. In addition, the population-attributable fractions (PAFs were also calculated, and a subgroup analysis was conducted. Heterogeneity was assessed by I2.Results: In total, 59 studies were included. In the single-pollutant model, the risks of COPD were calculated by each 10 µg/m3 increase in pollutant concentrations, with the exception of CO (100 µg/m3. There was a significant association between short-term exposure and COPD exacerbation risk for all the gaseous and particulate pollutants. The associations were strongest at lag0 and lag3 for gaseous and particulate air pollutants, respectively. The subgroup analysis not only further confirmed the overall adverse effects but also reduced the heterogeneities obviously. When 100% exposure was assumed, PAFs ranged from 0.60% to 4.31%, depending on the pollutants. The adverse health effects of SO2 and NO2

  12. Parenting Practices, Interpretive Biases, and Anxiety in Latino Children

    Science.gov (United States)

    Varela, R. Enrique; Niditch, Laura A.; Hensley-Maloney, Lauren; Moore, Kathryn W.; Creveling, C. Christiane

    2013-01-01

    A number of factors are believed to confer risk for anxiety development in children; however, cultural variation of purported risk factors remains unclear. We examined relations between controlling and rejecting parenting styles, parental modeling of anxious behaviors, child interpretive biases, and child anxiety in a mixed clinically anxious (n = 27) and non-clinical (n = 20) sample of Latino children and at least one of their parents. Families completed discussion-based tasks and questionnaires in a lab setting. Results indicated that child anxiety was: linked with parental control and child interpretative biases; associated with parental modeling of anxious behaviors at a trend level; and not associated with low parental acceptance. Findings that controlling parenting and child interpretive biases were associated with anxiety extend current theories of anxiety development to the Latino population. We speculate that strong family ties may buffer Latino children from detrimental effects of perceived low parental acceptance. PMID:23434545

  13. The incidence and risk factors of meningitis after major craniotomy in China: a retrospective cohort study.

    Science.gov (United States)

    Chen, Chen; Zhang, Bingyan; Yu, Shenglei; Sun, Feng; Ruan, Qiaoling; Zhang, Wenhong; Shao, Lingyun; Chen, Shu

    2014-01-01

    Meningitis after neurosurgery can result in severe morbidity and high mortality. Incidence varies among regions and limited data are focused on meningitis after major craniotomy. This retrospective cohort study aimed to determine the incidence, risk factors and microbiological spectrum of postcraniotomy meningitis in a large clinical center of Neurosurgery in China. Patients who underwent neurosurgeries at the Department of Neurosurgery in Huashan Hospital, the largest neurosurgery center in Asia and the Pacific, between 1st January and 31st December, 2008 were selected. Individuals with only shunts, burr holes, stereotactic surgery, transsphenoidal or spinal surgery were excluded. The complete medical records of each case were reviewed, and data on risk factors were extracted and evaluated for meningitis. A total of 65 meningitides were identified among 755 cases in the study, with an incidence of 8.60%. The risk of meningitis was increased by the presence of diabetes mellitus (odds ratio [OR], 6.27; P = 0.009), the use of external ventricular drainage (OR, 4.30; P = 0.003) and the use of lumbar drainage (OR, 17.23; PMeningitis remains an important source of morbidity and mortality after major craniotomy. Diabetic patients or those with cerebral spinal fluid shunts carry significant high risk of infection. Thus, identification of the risk factors as soon as possible will help physicians to improve patient care.

  14. [Blood representations associated to chronic transfused patients: Symbolic interpretations and ethical perspectives].

    Science.gov (United States)

    Petermann, R; Pêchard, M; Gesbert, C; Assez, N

    2016-09-01

    Since the beginning of the 20th century, major technological developments have been made in blood transfusion. Although numerous sociological studies have been conducted on donors, few have highlighted transfused patients, and in this case, the attention has almost exclusively been focused on transfusion risks in patients. Conversely, blood representations associated with the chronically transfused patients have not really been explored in the literature. Based on interviews conducted among chronically transfused patients (patients with hemoglobinopathy, malignant hemopathy or cancer), this present study enables to understand their needs and their expectations through their symbolic representations and their interpretations of blood transfusion, raising tensions as well ethical perspectives. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  15. Predictive Value of C-Reactive Protein for Major Complications after Major Abdominal Surgery: A Systematic Review and Pooled-Analysis.

    Directory of Open Access Journals (Sweden)

    Jennifer Straatman

    Full Text Available Early diagnosis and treatment of complications after major abdominal surgery can decrease associated morbidity and mortality. Postoperative CRP levels have shown a strong correlation with complications. Aim of this systematic review and pooled-analysis was to assess postoperative values of CRP as a marker for major complications and construct a prediction model.A systematic review was performed for CRP levels as a predictor for complications after major abdominal surgery (MAS. Raw data was obtained from seven studies, including 1427 patients. A logit regression model assessed the probability of major complications as a function of CRP levels on the third postoperative day. Two practical cut-offs are proposed: an optimal cut-off for safe discharge in a fast track protocol and another for early identification of patients with increased risk for major complications.A prediction model was calculated for major complications as a function of CRP levels on the third postoperative day. Based on the model several cut-offs for CRP are proposed. For instance, a two cut-off system may be applied, consisting of a safe discharge criterion with CRP levels below 75 mg/L, with a negative predictive value of 97.2%. A second cut-off is set at 215 mg/L (probability 20% and serves as a predictor of complications, indicating additional CT-scan imaging.The present study provides insight in the interpretation of CRP levels after major abdominal surgery, proposing a prediction model for major complications as a function of CRP on postoperative day 3. Cut-offs for CRP may be implemented for safe early-discharge in a fast-track protocol and, secondly as a threshold for additional examinations, such as CT-scan imaging, even in absence of clinical signs, to confirm or exclude major complications. The prediction model allows for setting a cut-off at the discretion of individual surgeons or surgical departments.

  16. COMPARING THE COMPETITIVENESS BETWEEN BRAZILIAN AND EUROPEAN FOOTBALL (SOCCER (G-5 – INTERPRETATIONS AND SUGGESTIONS

    Directory of Open Access Journals (Sweden)

    Cláudio Vicente di Gioia F. Silva

    2013-11-01

    Full Text Available World sport has been seen as a growing industry, generating revenues of roughly US$ 1 trillion a year. Playing a major role in this industry, football (soccer is accountable for an annual turnover of approximately US$ 250 billion – Brazil’s share being approximately 1% of that amount. The growing marketing and globalization of football has brought up new topics such as: the risks associated with competitiveness; the need for professional management; creating corporate teams; sports strategies and marketing; accounting; accountability.This paper aims at: i understanding the risks associated with the competitiveness of football leagues; ii comparing the competitive balance in the five largest European football markets (Germany, Spain, France, England and Italy in relation with Brazilian football and; iii interpreting these results in view of the literature concerning sports administration.

  17. Spine-hip T-score difference predicts major osteoporotic fracture risk independent of FRAX(®): a population-based report from CAMOS.

    Science.gov (United States)

    Leslie, William D; Kovacs, Christopher S; Olszynski, Wojciech P; Towheed, Tanveer; Kaiser, Stephanie M; Prior, Jerilynn C; Josse, Robert G; Jamal, Sophie A; Kreiger, Nancy; Goltzman, David

    2011-01-01

    The WHO fracture risk assessment tool (FRAX(®)) estimates an individual's 10-yr major osteoporotic and hip fracture probabilities. When bone mineral density (BMD) is included in the FRAX calculation, only the femoral neck measurement can be used. Recently, a procedure was reported for adjusting major osteoporotic fracture probability from FRAX with femoral neck BMD based on the difference (offset) between the lumbar spine and the femoral neck T-score values. The objective of the current analysis was to independently evaluate this algorithm in a population-based cohort of 4575 women and 1813 men aged 50 yr and older from the Canadian Multicentre Osteoporosis Study. For women and men combined, there was a 15% (95% confidence interval 7-24%) increase in major osteoporotic fracture risk for each offset T-score after adjusting for FRAX probability calculated with femoral neck BMD. The effect was stronger in women than men, but a significant sex interaction was not detected. Among the full cohort, 5.5% had their risk category reclassified after using the offset adjustment. Sex- and age-dependent offsets (equivalent to an offset based on Z-scores) showed improved risk classification among individuals designated to be at moderate risk with the conventional FRAX probability measurement. In summary, the T-score difference between the lumbar spine and femoral neck is an independent risk factor for major osteoporotic fractures that is independent of the FRAX probability calculated with femoral neck BMD. Copyright © 2011 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

  18. Parenting practices, interpretive biases, and anxiety in Latino children.

    Science.gov (United States)

    Varela, R Enrique; Niditch, Laura A; Hensley-Maloney, Lauren; Moore, Kathryn W; Creveling, C Christiane

    2013-03-01

    A number of factors are believed to confer risk for anxiety development in children; however, cultural variation of purported risk factors remains unclear. We examined relations between controlling and rejecting parenting styles, parental modeling of anxious behaviors, child interpretive biases, and child anxiety in a mixed clinically anxious (n=27) and non-clinical (n=20) sample of Latino children and at least one of their parents. Families completed discussion-based tasks and questionnaires in a lab setting. Results indicated that child anxiety was: linked with parental control and child interpretative biases, associated with parental modeling of anxious behaviors at a trend level, and not associated with low parental acceptance. Findings that controlling parenting and child interpretive biases were associated with anxiety extend current theories of anxiety development to the Latino population. We speculate that strong family ties may buffer Latino children from detrimental effects of perceived low parental acceptance. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Betel nut usage is a major risk factor for coronary artery disease.

    Science.gov (United States)

    Khan, Muhammad Shahzeb; Bawany, Faizan Imran; Ahmed, Muhammad Umer; Hussain, Mehwish; Khan, Asadullah; Lashari, Muhammad Nawaz

    2013-12-27

    The objective of our study was to assess betel nut usage as one of the major risk factors associated with coronary artery disease. This case control study consisted of 300 controls and 300 cases. A structured questionnaire was administered to the participants to assess consumption of betel nut and confounding variables. A respondent was considered a regular consumer of betel nut if he/she consumed one or more pieces of betel nut every day for a period of greater than 6 months. About 8 in 10 betel nut chewers developed coronary artery disease. After adjusting for diabetes and hypertension, the odds ratio analysis depicted 7.72 times greater likelihood for coronary artery disease in patients who chewed betel nut for more than 10 years. Our study concludes that betel nut chewing is a significant risk factor leading to the development of coronary artery disease.

  20. Obesity as a Major Risk Factor for Cancer

    Directory of Open Access Journals (Sweden)

    Giovanni De Pergola

    2013-01-01

    Full Text Available The number of cancer cases caused by being obese is estimated to be 20% with the increased risk of malignancies being influenced by diet, weight change, and body fat distribution together with physical activity. Reports from the International Agency for Research into Cancer and the World Cancer Research Fund (WCRF have shown that the strongest evidence exists for an association of obesity with the following cancer types: endometrial, esophageal adenocarcinoma, colorectal, postmenopausal breast, prostate, and renal, whereas the less common malignancies are leukemia, non-Hodgkin’s lymphoma, multiple myeloma, malignant melanoma, and thyroid tumours. To be able to develop novel methods in prevention and treatment, we first must understand the underlying processes which link cancer to obesity. Four main systems have been identified as potential producers of cancer in obesity: insulin, insulin-like growth factor-I, sex steroids, and adipokines. Various novel candidate mechanisms have been proposed: chronic inflammation, oxidative stress, crosstalk between tumour cells and surrounding adipocytes, migrating adipose stromal cells, obesity-induced hypoxia, shared genetic susceptibility, and the functional defeat of immune function. Herein, we review the major pathogenic links between obesity and susceptibility to cancer.

  1. The incidence and risk factors of meningitis after major craniotomy in China: a retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Chen Chen

    Full Text Available BACKGROUND: Meningitis after neurosurgery can result in severe morbidity and high mortality. Incidence varies among regions and limited data are focused on meningitis after major craniotomy. AIM: This retrospective cohort study aimed to determine the incidence, risk factors and microbiological spectrum of postcraniotomy meningitis in a large clinical center of Neurosurgery in China. METHODS: Patients who underwent neurosurgeries at the Department of Neurosurgery in Huashan Hospital, the largest neurosurgery center in Asia and the Pacific, between 1st January and 31st December, 2008 were selected. Individuals with only shunts, burr holes, stereotactic surgery, transsphenoidal or spinal surgery were excluded. The complete medical records of each case were reviewed, and data on risk factors were extracted and evaluated for meningitis. RESULTS: A total of 65 meningitides were identified among 755 cases in the study, with an incidence of 8.60%. The risk of meningitis was increased by the presence of diabetes mellitus (odds ratio [OR], 6.27; P = 0.009, the use of external ventricular drainage (OR, 4.30; P = 0.003 and the use of lumbar drainage (OR, 17.23; P<0.001. The isolated microorganisms included Acinetobacter baumannii, Enterococcus sp, Streptococcus intermedius and Klebsiella pneumonia. CONCLUSIONS: Meningitis remains an important source of morbidity and mortality after major craniotomy. Diabetic patients or those with cerebral spinal fluid shunts carry significant high risk of infection. Thus, identification of the risk factors as soon as possible will help physicians to improve patient care.

  2. Representations and Techniques for 3D Object Recognition and Scene Interpretation

    CERN Document Server

    Hoiem, Derek

    2011-01-01

    One of the grand challenges of artificial intelligence is to enable computers to interpret 3D scenes and objects from imagery. This book organizes and introduces major concepts in 3D scene and object representation and inference from still images, with a focus on recent efforts to fuse models of geometry and perspective with statistical machine learning. The book is organized into three sections: (1) Interpretation of Physical Space; (2) Recognition of 3D Objects; and (3) Integrated 3D Scene Interpretation. The first discusses representations of spatial layout and techniques to interpret physi

  3. Interpreting radiographs. 4. The carpus

    International Nuclear Information System (INIS)

    Burguez, P.N.

    1984-01-01

    The complexity of the carpus which has three major joints, seven or eight carpal bones and five adjacent bones, each of which articulates with one or more of the carpal elements, necessitates good quality radiographs for definitive radiographic interpretation may be extremely difficult because of the disparity between radiographic changes and obvious clinical signs and, therefore, must be discussed in the light of a thorough clinical assessment

  4. Risk of major congenital malformations in relation to maternal overweight and obesity severity: cohort study of 1.2 million singletons.

    Science.gov (United States)

    Persson, Martina; Cnattingius, Sven; Villamor, Eduardo; Söderling, Jonas; Pasternak, Björn; Stephansson, Olof; Neovius, Martin

    2017-06-14

    Objective  To estimate the risks of major congenital malformations in the offspring of mothers who are underweight (body mass index (BMI) malformation, and subgroups of organ specific malformations diagnosed during the first year of life. Risk ratios were estimated using generalised linear models adjusted for maternal factors, sex of offspring, and birth year. Results  A total of 43 550 (3.5%) offspring had any major congenital malformation, and the most common subgroup was for congenital heart defects (n=20 074; 1.6%). Compared with offspring of normal weight mothers (risk of malformations 3.4%), the proportions and adjusted risk ratios of any major congenital malformation among the offspring of mothers with higher BMI were: overweight, 3.5% and 1.05 (95% confidence interval 1.02 to 1.07); obesity class I, 3.8% and 1.12 (1.08 to 1.15), obesity class II, 4.2% and 1.23 (1.17 to 1.30), and obesity class III, 4.7% and 1.37 (1.26 to 1.49). The risks of congenital heart defects, malformations of the nervous system, and limb defects also progressively increased with BMI from overweight to obesity class III. The largest organ specific relative risks related to maternal overweight and increasing obesity were observed for malformations of the nervous system. Malformations of the genital and digestive systems were also increased in offspring of obese mothers. Conclusions  Risks of any major congenital malformation and several subgroups of organ specific malformations progressively increased with maternal overweight and increasing severity of obesity. For women who are planning pregnancy, efforts should be encouraged to reduce adiposity in those with a BMI above the normal range. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. [Major nutrition-related risk factors of ischemic heart disease: dyslipoproteinemia, obesity, hypertension, glucose intolerance].

    Science.gov (United States)

    Pados, G

    1999-07-11

    Of the major risk factors of coronary heart disease dyslipoproteinemia, obesity, hypertension, and diabetes are nutrition related and can be considered of metabolic origin. Dyslipoproteinemia affects 2/3 of the adult population. The risk of coronary heart disease can be decreased 2-5 fold by lowering hypercholesterinemia; atherosclerosis in the coronaries may regress and total mortality may decrease. Atherogenic dyslipidemia (i.e. hypertriglyceridaemia, low HDL cholesterol levels, elevated concentrations of small dense LDL) increases the risk as part of the metabolic syndrome. Obesity is already highly prevalent, and it is affecting ever growing proportions of the adult population. Abdominal obesity furthermore predisposes patients to complications. No effective therapy is available for obesity. 3/4 of hypertensive patients are obese and more than half of them have insulin resistance. By decreasing blood pressure, the risk of stroke decreases by about 40%, that of coronary heart disease by 14-30%. Slimming cures are the most important non-pharmacological way of treating hypertension. 5% of the population has diabetes mellitus, and a further 5% has impaired glucose tolerance. Type 2 diabetes predisposes patients to macrovascular complications. The risk of coronary heart disease can be decreased by controlling diabetes by e.g. metformin.

  6. Risk of developing major depression and bipolar disorder among adolescents with atopic diseases: A nationwide longitudinal study in Taiwan.

    Science.gov (United States)

    Wei, Han-Ting; Lan, Wen-Hsuan; Hsu, Ju-Wei; Huang, Kai-Lin; Su, Tung-Ping; Li, Cheng-Ta; Lin, Wei-Chen; Chen, Tzeng-Ji; Bai, Ya-Mei; Chen, Mu-Hong

    2016-10-01

    Previous studies have found an increased prevalence of atopic diseases among patients with major depression and bipolar disorder. But the temporal association between atopic diseases in adolescence and the subsequent risk of developing mood disorders has been rarely investigated. Using the Taiwan National Health Insurance Research Databases, 5075 adolescents with atopic diseases (atopic cohort) and 44,729 without (non-atopic cohort) aged between 10 and 17 in 2000 were enrolled into our study and followed to the end of 2010. Subjects who developed major depression or bipolar disorder during the follow-up were identified. The atopic cohort had an increased risk of developing major depression (HR: 2.45, 95% CI: 1.93~3.11) and bipolar disorder (HR: 2.51, 95% CI: 1.71~3.67) compared to the non-atopic cohort, with a dose-dependent relationship between having a greater number of atopic comorbidities and a greater likelihood of major depression (1 atopic disease: HR: 1.80, 95% CI: 1.29~2.50; 2 atopic comorbidities: HR: 2.42, 95% CI: 1.93~3.04;≥3 atopic comorbidities: HR: 3.79, 95% CI: 3.05~4.72) and bipolar disorder (HR: 1.40, 95% CI: 0.57~3.44; HR: 2.81, 95% CI: 1.68~4.68; HR: 3.02, 95% CI: 1.69~5.38). Having atopic diseases in adolescence increased the risk of developing major depression and bipolar disorder in later life. Further studies may be required to clarify the underlying mechanism between atopy and mood disorders, and to investigate whether prompt intervention may decrease the risk of subsequent mood disorders. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. The ambiguity of ethnicity as risk factor of vitamin D deficiency--a case study of Danish vitamin D policy documents

    DEFF Research Database (Denmark)

    Mygind, Anna; Traulsen, Janine Morgall; Nørgaard, Lotte Stig

    2011-01-01

    of interpretative flexibility regarding how ethnic minorities are constructed as a risk group for vitamin D deficiency. The ten documents analysed revealed eight different constructions of the ethnic minorities groups at risk. A low degree of interpretative flexibility was found regarding the importance of skin...... colour and skin covering. Major disagreements were found regarding the importance attributed to the Islamic religion, other traditions, immigration, gender and age, and use of an evolutionary explanation for the increased risk. CONCLUSIONS: Ethnic minorities at risk of vitamin D deficiency......OBJECTIVES: To explore how ethnic minorities at risk of vitamin D deficiency are constructed in Danish policy documents (current as of April 2009), regarding vitamin D supplementation. METHODS: Ten policy documents were analysed through content analysis, focusing on definitions and explanations...

  8. Longitudinal social-interpersonal functioning among higher-risk responders to acute-phase cognitive therapy for recurrent major depressive disorder.

    Science.gov (United States)

    Vittengl, Jeffrey R; Clark, Lee Anna; Thase, Michael E; Jarrett, Robin B

    2016-07-15

    Social-interpersonal dysfunction increases disability in major depressive disorder (MDD). Here we clarified the durability of improvements in social-interpersonal functioning made during acute-phase cognitive therapy (CT), whether continuation CT (C-CT) or fluoxetine (FLX) further improved functioning, and relations of functioning with depressive symptoms and relapse/recurrence. Adult outpatients (N=241) with recurrent MDD who responded to acute-phase CT with higher risk of relapse (due to unstable or partial remission) were randomized to 8 months of C-CT, FLX, or pill placebo plus clinical management (PBO) and followed 24 additional months. We analyzed repeated measures of patients' social adjustment, interpersonal problems, dyadic adjustment, depressive symptoms, and major depressive relapse/recurrence. Large improvements in social-interpersonal functioning occurring during acute-phase CT (median d=1.4) were maintained, with many patients (median=66%) scoring in normal ranges for 32 months. Social-interpersonal functioning did not differ significantly among C-CT, FLX, and PBO arms. Beyond concurrently measured residual symptoms, deterioration in social-interpersonal functioning preceded and predicted upticks in depressive symptoms and major depressive relapse/recurrence. Results may not generalize to other patient populations, treatment protocols, or measures of social-interpersonal functioning. Mechanisms of risk connecting poorer social-interpersonal functioning with depression were not studied. Average improvements in social-interpersonal functioning among higher-risk responders to acute phase CT are durable for 32 months. After acute-phase CT, C-CT or FLX may not further improve social-interpersonal functioning. Among acute-phase CT responders, deteriorating social-interpersonal functioning provides a clear, measurable signal of risk for impending major depressive relapse/recurrence and opportunity for preemptive intervention. Copyright © 2016 Elsevier B

  9. Facts and interpretation on the subject of nuclear energy

    International Nuclear Information System (INIS)

    Kleinrath, H.

    1977-01-01

    This report analyses facts and their interpretations on nuclear-energy. Due to the fact that the discussion on nuclear energy was very controversial in the 1970s in Austria, there were various opinions. This report includes always two interpretations for each fact. Content overview: How high is the risk of the operation of nuclear-power-plants compared to other possibilities to produce electricity? How dangerous is the nuclear waste, which is produced during the operation of nuclear-power-plants? Which risks entail reprocessing-plants? How far is the question of final repository of nuclear waste solved? Is there any sense for Austria to do without nuclear-power-plants? Is electricity generated by nuclear power cheap? Are there alternatives in the generation of electricity to nuclear-power-plants? Does a waiver of nuclear-power-plants mean a social risk – hazard of our economic stability, hazard of jobs? Literature(kancsar)

  10. Female Gender and Acne Disease Are Jointly and Independently Associated with the Risk of Major Depression and Suicide: A National Population-Based Study

    Directory of Open Access Journals (Sweden)

    Yi-Chien Yang

    2014-01-01

    Full Text Available Acne is a common disease in adolescence with female preponderance. It could cause poor self-esteem and social phobia. Previous studies based on questionnaires from several thousands of adolescents showed that acne is associated with major depression and suicide. However, the gender- and age-specific risk of depression and suicide in patients with acne remain largely unknown. Using a database from the National Health Insurance, which included 98% of the population of Taiwan in 2006, we identified patients of acne, major depression, and suicide based on ICD-9-CM codes. Totally 47111 patients with acne were identified (16568 males and 30543 females from 1 million subjects. The youths of 7–12 years had the highest prevalence of acne (14.39%. Major depression was more common in those with acne (0.77% than controls (0.56% , P < 0.0001 regardless of gender. Multiple logistic regression showed an increased risk of major depression in women without acne (OR = 1.85, 95% CI 1.75–1.96. The risk is additive in women with acne (OR = 2.78, 95% CI 2.43–3.17. Similar additive risk of suicide was noticed in women with acne. In conclusion, acne and gender, independently and jointly, are associated with major depression and suicide. Special medical support should be warranted in females with acne for the risk of major depression and suicide.

  11. Meat consumption is a major risk factor for hepatitis E virus infection.

    Directory of Open Access Journals (Sweden)

    Ed Slot

    Full Text Available The incidence of autochthonous hepatitis E virus genotype 3 (HEV gt3 infections in Western Europe is high. Although pigs are a major reservoir of the virus, the exact sources and transmission route(s of HEV gt3 to humans remain unclear.To determine the role of meat consumption at a population level, the seroprevalence of anti-HEV IgG antibodies was compared between Dutch blood donors with a vegetarian lifestyle and donors who consume meat on a daily basis.The age-weighted anti-HEV IgG seroprevalence among donors not eating meat was significantly lower than among meat-eating donors (12.4% vs 20.5%, p = 0.002. For both groups the prevalence strongly increased with age and the difference in prevalence was apparent for all age groups.Compared with meat-eating donors, the incidence of HEV infection is significantly lower among donors not eating meat, indicating that meat consumption is a major risk factor for HEV infection.

  12. Built Environment, Selected Risk Factors and Major Cardiovascular Disease Outcomes: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Pasmore Malambo

    Full Text Available Built environment attributes have been linked to cardiovascular disease (CVD risk. Therefore, identifying built environment attributes that are associated with CVD risk is relevant for facilitating effective public health interventions.To conduct a systematic review of literature to examine the influence of built environmental attributes on CVD risks.Multiple database searches including Science direct, CINAHL, Masterfile Premier, EBSCO and manual scan of reference lists were conducted.Studies published in English between 2005 and April 2015 were included if they assessed one or more of the neighborhood environmental attributes in relation with any major CVD outcomes and selected risk factors among adults.Author(s, country/city, sex, age, sample size, study design, tool used to measure neighborhood environment, exposure and outcome assessments and associations were extracted from eligible studies.Eighteen studies met the inclusion criteria. Most studies used both cross-sectional design and Geographic Information System (GIS to assess the neighborhood environmental attributes. Neighborhood environmental attributes were significantly associated with CVD risk and CVD outcomes in the expected direction. Residential density, safety from traffic, recreation facilities, street connectivity and high walkable environment were associated with physical activity. High walkable environment, fast food restaurants, supermarket/grocery stores were associated with blood pressure, body mass index, diabetes mellitus and metabolic syndrome. High density traffic, road proximity and fast food restaurants were associated with CVDs outcomes.This study confirms the relationship between neighborhood environment attributes and CVDs and risk factors. Prevention programs should account for neighborhood environmental attributes in the communities where people live.

  13. Interpretation in reproductive genetic counseling: a methodological framework.

    Science.gov (United States)

    Tóth, Adél; Szeverényi, Péter

    2007-09-01

    In case of genetic risk, parents are often faced with reproductive decisions affecting their life essentially, so it is advisable to pursue careful deliberation. For this reason, the genetic counselor is expected to help the counselee make well-informed and well-considered decisions, which requires the understanding of the patient as an individual. To reach emphatic understanding, physicians can use the results of the Gadamerian theory of interpretation that contains the idea -- as it has been summarized by V. Arnason -- that four aspects of openness are necessary to fully understand the other, such as openness to oneself, to the other, to the subject matter and to tradition. In our paper, we are applying the four-openness model of interpretation to genetic consultation, and we argue that during counseling double interpretation takes place: the physician interprets the patient, and the patient interprets the physician. Double interpretation leads to the clarification of those factors which influence the patient's decision-making: the counselor's attitude and prejudices, the counselee's values and needs, the medical, social, and moral implications of the genetic disease, and the social expectations. By adopting the theory of interpretation, counselors can also advance the provision of emotional support patients need in hard situations.

  14. Heritage Interpretation and Presentation Practices in Tigray, Northern Ethiopia: Cases from the Wukro Tourism Cluster

    Directory of Open Access Journals (Sweden)

    Gebrekiros Welegebriel Asfaw

    2016-12-01

    Full Text Available Interpretation and presentation of heritage is becoming a major challenge as important elements of human culture are misinterpreted and vanishing throughout the globe. It is only when the heritages are sustainably interpreted that tourism can be developed in a sustainable manner. The major purpose of this study is to investigate the practices of heritage interpretation and presentation in Tigray with a case from Wukro Tourism Cluster. Descriptive type of research design inculcating both quantitative and qualitative research methods was employed for empirical investigation. Questionnaire, interview and observation were the main instruments of primary data collections. Primary data was collected from 134 respondents (120 questionnaires and 14 interviews. Findings of the study reveal that the practices of heritage interpretation and presentation in Wukro Cluster are embedded with different pitfalls. A lot of unfavorable factors like limited capacity of heritage interpreters, scant attention to community based heritage interpretation, problems in variety and quality of visitor experiences, problems with stakeholder cooperation, lack of organized interpretation and presentation, problems in the adequacy and quality of interpretation infrastructures and others. Developing appropriate interpretation system, preparing different interpretation and presentation infrastructures and introducing common practices of visitor management can be good remedies.

  15. Radiographer involvement in mammography image interpretation: A survey of United Kingdom practice

    International Nuclear Information System (INIS)

    Culpan, A.M.

    2016-01-01

    Breast cancer is most often diagnosed using x-ray mammography. Traditionally mammography images have been interpreted and reported by medically qualified practitioners – radiologists. Due to radiologist workforce shortages in recent years some non-medical practitioners, radiographers, now interpret and report mammography images. The aims of this survey were to describe the characteristics and practices of radiographers who interpret and report mammography images in NHS hospitals in the UK, and in particular to establish the extent of their practice beyond low-risk asymptomatic screening cases. This service evaluation demonstrated that UK radiographers are interpreting and reporting images across the full spectrum of clinical indications for mammography including: low-risk population screening, symptomatic, annual surveillance, family history and biopsy/surgical cases. The survey revealed that radiographers are involved in a diverse range of single and double reading practices where responsibility for diagnostic decision making is shared or transferred between radiologists and/or other radiographers. Comparative analysis of sub-group data suggested that there might be differences in the characteristics and practices of radiographers who interpret only low-risk screening mammograms and those who interpret and report a wider range of cases. The findings of this survey provide a platform for further research to investigate how and why the roles and responsibilities of radiographers who interpret and report mammograms vary between organisations, between practitioners and across different examinations. Further research is also needed to explore the implications of variation in practice for patients, practitioners and service providers. - Highlights: • UK radiographers interpret mammograms across the full spectrum of clinical indications. • UK radiographers are involved in a wide range of single/double mammography reading practices. • Characteristics required for

  16. The NVL gene confers risk for both major depressive disorder and schizophrenia in the Han Chinese population.

    Science.gov (United States)

    Wang, Meng; Chen, Jianhua; He, Kuanjun; Wang, Qingzhong; Li, Zhiqiang; Shen, Jiawei; Wen, Zujia; Song, Zhijian; Xu, Yifeng; Shi, Yongyong

    2015-10-01

    NVL (nuclear VCP (valosin containing protein)/p97-Like), a member of the AAA-ATPase (ATPases associated with various cellular activities) family, encodes a novel hTERT (human telomerase reverse transcriptase)-interacting protein NVL2 which is a telomerase component essential for holoenzyme assembly. Previous researches have reported the impacts of telomerase activity on mental illness and the potential association between NVL and major depressive disorder. To validate the susceptibility of NVL to major depressive disorder, and to investigate the overlapping risk conferred by NVL for both major depressive disorder and schizophrenia, we analyzed 9 tag single nucleotide polymorphisms (tag SNPs) using TaqMan® technology, in 1045 major depressive disorder patients, 1235 schizophrenia patients and 1235 normal controls of Han Chinese origin. We found that rs10916583 (P(allele) = 0.020, P(genotype) = 0.028, OR = 1.156) and rs16846649 (adjusted P(allele) = 0.014, P(genotype) = 0.007, OR = 0.718) were associated with major depressive disorder, while rs10916583 (adjusted P(allele) = 1.08E-02, OR = 1.213), rs16846649 (adjusted P(allele) = 7.40E-06, adjusted P(genotype) = 8.07E-05, OR = 0.598) and rs10799541 (adjusted P(allele) = 8.10E-03, adjusted P(genotype) = 0.049, OR= 0.826) showed statistically significant association with schizophrenia after Bonferroni correction. Furthermore, rs10916583 (adjusted P(allele) = 9.00E-03, adjusted P(genotype) = 3.15E-02, OR = 1.187) and rs16846649 (adjusted P(allele) = 8.92E-06, adjusted P(genotype) = 8.84E-05, OR = 0.653) remained strongly associated with the analysis of combined cases of major depressive disorder and schizophrenia after Bonferroni correction. Our results indicated that the NVL gene may contain overlapping common genetic risk factors for major depressive disorder and schizophrenia in the Han Chinese population. The roles of NVL in telomerase biogenesis were also highlighted in psychiatric pathogenesis. The study on

  17. Identification and risk assessment of unknown contaminants migrating from Food Contact Materials

    DEFF Research Database (Denmark)

    Pieke, Eelco Nicolaas

    The exposure of humans to possibly thousands of chemical compounds through food poses a health risk that is questioning our ability to ensure high standards for food safety. Food contact materials (FCM) are a major source of extraneous chemical compounds in food, yet not much knowledge is available...... interpretations. Risk prioritization is successful in classifying estimated risk based on predicted exposure and predicted hazard, and is valuable for to preliminary RA studies. The overarching strategy in this study shows that explorative techniques are valuable tools to help ensure food safety in the future...

  18. Interpreters, Interpreting, and the Study of Bilingualism.

    Science.gov (United States)

    Valdes, Guadalupe; Angelelli, Claudia

    2003-01-01

    Discusses research on interpreting focused specifically on issues raised by this literature about the nature of bilingualism. Suggests research carried out on interpreting--while primarily produced with a professional audience in mind and concerned with improving the practice of interpreting--provides valuable insights about complex aspects of…

  19. Major hazard risk indicators for monitoring of trends in the Norwegian offshore petroleum sector

    International Nuclear Information System (INIS)

    Vinnem, Jan Erik; Aven, Terje; Husebo, Torleif; Seljelid, Jorunn; Tveit, Odd J.

    2006-01-01

    The Petroleum Safety Authority Norway (PSA, formerly Norwegian Petroleum Directorate) took in 1999 the initiative to develop a method in order to assess trends and status for the risk levels in the Norwegian offshore petroleum industry. A method was developed, and a pilot study report was issued in April 2001, covering the period 1996-2000. Annual updates have been performed since then, and the latest report covers the period 1996-2004. The statistical approach is based on recording occurrence of near misses and relevant incidents, performance of barriers and results from risk assessments. Of similar importance is an evaluation of safety culture, motivation, communication and perceived risk. This is covered through the use of social science methods, such as questionnaire surveys and a number of interviews, audit and inspection reports as well as accident and incident investigations. There are also indicators for occupational accidents and occupational illness/-physical working environment factors. The focus is on the major hazard risk components for personnel staying on the offshore installations. An overview of the indicators used to illustrate these risk aspects is presented, followed by a discussion of the analytical approach used for these indicators. Results from the risk assessment for the Norwegian Continental Shelf in the period 1996-2004 are used throughout for illustration, and discussion of challenges

  20. Exposure Estimation and Interpretation of Occupational Risk: Enhanced Information for the Occupational Risk Manager

    Science.gov (United States)

    Waters, Martha; McKernan, Lauralynn; Maier, Andrew; Jayjock, Michael; Schaeffer, Val; Brosseau, Lisa

    2015-01-01

    The fundamental goal of this article is to describe, define, and analyze the components of the risk characterization process for occupational exposures. Current methods are described for the probabilistic characterization of exposure, including newer techniques that have increasing applications for assessing data from occupational exposure scenarios. In addition, since the probability of health effects reflects variability in the exposure estimate as well as the dose-response curve—the integrated considerations of variability surrounding both components of the risk characterization provide greater information to the occupational hygienist. Probabilistic tools provide a more informed view of exposure as compared to use of discrete point estimates for these inputs to the risk characterization process. Active use of such tools for exposure and risk assessment will lead to a scientifically supported worker health protection program. Understanding the bases for an occupational risk assessment, focusing on important sources of variability and uncertainty enables characterizing occupational risk in terms of a probability, rather than a binary decision of acceptable risk or unacceptable risk. A critical review of existing methods highlights several conclusions: (1) exposure estimates and the dose-response are impacted by both variability and uncertainty and a well-developed risk characterization reflects and communicates this consideration; (2) occupational risk is probabilistic in nature and most accurately considered as a distribution, not a point estimate; and (3) occupational hygienists have a variety of tools available to incorporate concepts of risk characterization into occupational health and practice. PMID:26302336

  1. Interpreting XML documents via an RDF schema

    NARCIS (Netherlands)

    Klein, Michel; Handschuh, Siegfried; Staab, Steffen

    2003-01-01

    One of the major problems in the realization of the vision of the ``Semantic Web''; is the transformation of existing web data into sources that can be processed and used by machines. This paper presents a procedure that can be used to turn XML documents into knowledge structures, by interpreting

  2. Geothermal well log interpretation state of the art. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Sanyal, S.K.; Wells, L.E.; Bickham, R.E.

    1980-01-01

    An in-depth study of the state of the art in Geothermal Well Log Interpretation has been made encompassing case histories, technical papers, computerized literature searches, and actual processing of geothermal wells from New Mexico, Idaho, and California. A classification scheme of geothermal reservoir types was defined which distinguishes fluid phase and temperature, lithology, geologic province, pore geometry, salinity, and fluid chemistry. Major deficiencies of Geothermal Well Log Interpretation are defined and discussed with recommendations of possible solutions or research for solutions. The Geothermal Well Log Interpretation study and report has concentrated primarily on Western US reservoirs. Geopressured geothermal reservoirs are not considered.

  3. Randomized controlled psychotherapy trials in eating disorders: Improving their conduct, interpretation and usefulness.

    Science.gov (United States)

    Wade, Tracey D; Johnson, Catherine; Byrne, Susan M

    2018-04-25

    While randomized controlled trials (RCTs) inform the efficacy and effectiveness of treatments, we need to understand that even RCTs can be associated with sub-optimal execution. This is of special pertinence to eating disorders given the majority of treatment studies involving cognitive behaviour therapy are of poor quality with respect to managing risk of bias adequately. The current paper outlines the components of a good RCT for psychotherapy, and examines ways to improve the conduct, interpretation, and usefulness of RCTs. This includes managing reporting bias, recognizing the limits of randomization, applicability, and ethical considerations. We highlight a number of strategies for future research, including issues related to utilizing a variety of designs to examine treatment outcomes, integrity, openness and reproducibility. © 2018 Wiley Periodicals, Inc.

  4. Technical risk audit method (tram): development and application to the auditing of major hazard sites

    International Nuclear Information System (INIS)

    Maddison, T.; Kirk, P.; Stansfield, R.

    1998-01-01

    The Technical Risk Audit Method (TRAM) has been developed by the UK Health and Safety Executive (UK HSE) as a risk-based auditing and inspection tool for application to Major Hazard process plant covered by the Seveso-I/Seveso-II directives. The objective of TRAM is to provide a framework in which plant inspection or audit can be undertaken and results collated. TRAM comprises a paper audit procedure and a software tool which is used to analyse the results. TRAM includes a semi-quantitative risk model, which may be used to rank risks both within and between similar facilities, using qualitative data collected during the inspection. The results of this qualitative analysis may be used to identify where inspector resources would be best deployed. To date, TRAM has been applied to a number of LPG storage and processing facilities in the UK, and the lessons learnt are being used to develop a robust version suitable for use by inspectors. The methodology will be made consistent with the risk model included in IEC 61508 'Functional safety of electrical/electronic/programmable electronic safety-related systems' to permit its application to a wide range of process plant and other hazardous facilities. (authors)

  5. Thermal conductivity of carbon foams. Measurements and interpretation; Conductivite thermique de mousses de carbone. Mesures et interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Bourret, F.; Fort, C.; Duffa, G. [CEA CESTA, 33 - Le Barp (France)

    1996-12-31

    This paper describes thermal diffusivity measurements performed with the flash method on carbon foams with open porosity at ambient and higher temperatures. The influence of gas inclusions in the pores has been studied too. In this type of highly insulating material, radiant heat transfer plays a major role. The experiments carried out are interpreted in terms of equivalent thermal conductivity and show the difficulties encountered, in particular the dependence with sample thickness. An interpretation based on a direct simulation with an equivalent periodical material is given with an estimation of the gaseous conductivity based on the kinetics theory of gases. This study demonstrates that the notion of equivalent thermal conductivity is not applicable to all experiments. (J.S.) 10 refs.

  6. Caesarean Section at Full Dilatation and Risk of Major Obstetric Haemorrhage

    LENUS (Irish Health Repository)

    O’Dwyer, V

    2018-03-01

    The purpose of the study was to examine the risk factors for caesarean section (CS) at full dilatation and to assess the risk and management of haemorrhage. The study took place in a tertiary referral maternity hospital. Women who had a CS at full dilatation were included. Clinical and demographic details were recorded. There were 199 cases. The average age was 30.3 years and average BMI was 25.8kg\\/m2. There were 79.9 % (159) primigravidas and 20.1% (40) multigravidas. The average gestation at delivery was 39.4 weeks. Labour was induced in 46.9 % (92) and spontaneous in 53.8% (107). Oxytocin was used in 67.8 % (135). An instrumental delivery was attempted in 46.7 % (93). The rate of malposition was 46.5 % (92). The average birthweight was 3,629g and 9 babies weighed ≥4.5kg. The average estimated blood loss (EBL) was 665mls and 34 had EBL>1L. Most had an oxytocin infusion (141). Other uterotonic agents were used in 70 women. Seven women had blood transfusions. The highest rate of CS at full dilatation was in primigravidas due to malposition. There was a low rate of major obstetric haemorrhage.

  7. The risk of major and any (non-hip) fragility fracture after hip fracture in the United Kingdom : 2000-2010

    NARCIS (Netherlands)

    Gibson-Smith, D; Klop, C; Elders, P J M; Welsing, P M J; van Schoor, N; Leufkens, H G M; Harvey, N C; van Staa, T P; de Vries, F

    2014-01-01

    UNLABELLED: The risk of a subsequent major or any fracture after a hip fracture and secular trends herein were examined. Within 1 year, 2.7 and 8.4% of patients sustained a major or any (non-hip) fracture, which increased to 14.7 and 32.5% after 5 years. Subsequent fracture rates increased during

  8. Obesity genes and risk of major depressive disorder in a multiethnic population: a cross-sectional study.

    Science.gov (United States)

    Samaan, Zainab; Lee, Yvonne K; Gerstein, Hertzel C; Engert, James C; Bosch, Jackie; Mohan, Viswanathan; Diaz, Rafael; Yusuf, Salim; Anand, Sonia S; Meyre, David

    2015-12-01

    Observational studies have shown a positive association between obesity (body mass index [BMI] ≥ 30 kg/m2) and depression. Around 120 obesity-associated loci have been identified, but genetic variants associated with depression remain elusive. Recently, our team reported that the fat mass and obesity-associated (FTO) gene rs9939609 obesity-risk variant is paradoxically inversely associated with the risk of depression. This finding raises the question as to whether other obesity-associated genetic variants are also associated with depression. Twenty-one obesity gene variants other than FTO were selected from a custom ∼50,000 single-nucleotide polymorphisms (SNPs) genotyping array (ITMAT-Broad-CARe array). Associations of these 21 SNPs and an unweighted genotype score with BMI and major depressive disorder (determined using the DSM-IV diagnostic criteria) were tested in 3,209 cases and 14,195 noncases, using baseline data collected from July 2001 to August 2003 from the multiethnic EpiDREAM study. Body mass index was positively associated with depression status (odds ratio [OR] = 1.02; 95% CI, 1.02-1.03 per BMI unit; P = 2.9 × 10(-12), adjusted for age, sex, and ethnicity). Six of 21 genetic variants (rs1514176 [TNN13K], rs2206734 [CDKAL1], rs11671664 [GIPR], rs2984618 [TAL1], rs3824755 [NT5C2], and rs7903146 [TCF7L2]) and the genotype score were significantly associated with BMI (1.47 × 10(-14) ≤ P ≤ .04). Of the 21 SNPs, TAL1 rs2984618 obesity-risk allele was associated with a higher risk of major depressive disorder (P = 1.79 × 10(-4), adjusted for age, sex, BMI, and ethnicity), and BDNF rs1401635 demonstrated significant ethnic-dependent association with major depressive disorder (OR = 0.88; 95% CI, 0.80-0.97; P = .01 in non-Europeans and OR = 1.11; 95% CI, 1.02-1.20; P = .02 in Europeans; Pinteraction = 2.73 × 10(-4)). The genotype score, calculated with or without FTO rs9939609, and adjusted for the same covariates, was not associated with

  9. High risk for major nonlimb anomalies associated with lower-limb deficiency: a population-based study.

    Science.gov (United States)

    Syvänen, Johanna; Nietosvaara, Yrjänä; Ritvanen, Annukka; Koskimies, Eeva; Kauko, Tommi; Helenius, Ilkka

    2014-11-19

    The aims of this study were to determine the prevalence of congenital lower-limb reduction defects and associated mortality, to evaluate lower-limb deficiencies by type of reduction, and to identify patterns of associated anomalies. We conducted a population-based study with use of data from the Finnish Register of Congenital Malformations and Care Register for Health Care. All cases of lower-limb deficiency among live births, stillbirths, spontaneous abortions, and terminations of pregnancy due to fetal anomalies from 1993 to 2008 were included. We analyzed medical records and classified lower-limb reduction defects. Associated major anomalies were recorded, and perinatal mortality and infant mortality were calculated. Two hundred and sixty-six cases with lower-limb deficiency were identified, with a total prevalence of 2.8 per 10,000 births, a birth prevalence of 2.2 per 10,000 births, and a live-birth prevalence of 2.1 per 10,000 live births. Terminal transverse limb reductions accounted for 44.7% of the cases; longitudinal reductions, 22.9%; intercalary reductions, 7.9%; multiple reductions, 8.3%; and split-foot malformations, 4.5%. In addition to lower-limb deficiency, 47.7% of the cases had other major anomalies; anomalies of internal organs were noted in 26.3% of the cases, anomalies of the axial skeleton in 13.5% of cases, and central nervous system anomalies in 12.8%. Upper-limb reductions were observed in 32.0% of the cases. The relative risk (RR) for associated major anomalies was 12.54 (95% confidence interval [CI], 11.06 to 14.23) compared with the general figures for major congenital anomalies in Finland. The RR for associated anomalies was higher (1.75; 95% CI, 1.20 to 2.53) for longitudinal preaxial lower-limb deficiencies than for the other types of lower-limb reductions. Perinatal mortality was seventy-eight per 1000 births. All infant deaths were associated with chromosomal abnormalities, other known syndromes, or additional congenital

  10. The excess risk of major osteoporotic fractures in hypothyroidism is driven by cumulative hyperthyroid as opposed to hypothyroid time

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Jørgensen, Henrik L; Laulund, Anne Sofie

    2015-01-01

    was not associated with an increased risk of hip fracture (HR 0.90; 95% CI, 0.80 to 1.02) or major osteoporotic fractures (HR 0.97; 95% CI, 0.90 to 1.05), nor was subsequent thyroxine prescription predictive of increased risk of fractures. The number of subsequent 6-month periods with low TSH-suggesting excessive...

  11. A Novel Approach to Asynchronous MVP Data Interpretation Based on Elliptical-Vectors

    Science.gov (United States)

    Kruglyakov, M.; Trofimov, I.; Korotaev, S.; Shneyer, V.; Popova, I.; Orekhova, D.; Scshors, Y.; Zhdanov, M. S.

    2014-12-01

    We suggest a novel approach to asynchronous magnetic-variation profiling (MVP) data interpretation. Standard method in MVP is based on the interpretation of the coefficients of linear relation between vertical and horizontal components of the measured magnetic field.From mathematical point of view this pair of linear coefficients is not a vector which leads to significant difficulties in asynchronous data interpretation. Our approach allows us to actually treat such a pair of complex numbers as a special vector called an ellipse-vector (EV). By choosing the particular definitions of complex length and direction, the basic relation of MVP can be considered as the dot product. This considerably simplifies the interpretation of asynchronous data. The EV is described by four real numbers: the values of major and minor semiaxes, the angular direction of the major semiaxis and the phase. The notation choice is motivated by historical reasons. It is important that different EV's components have different sensitivity with respect to the field sources and the local heterogeneities. Namely, the value of major semiaxis and the angular direction are mostly determined by the field source and the normal cross-section. On the other hand, the value of minor semiaxis and the phase are responsive to local heterogeneities. Since the EV is the general form of complex vector, the traditional Schmucker vectors can be explicitly expressed through its components.The proposed approach was successfully applied to interpretation the results of asynchronous measurements that had been obtained in the Arctic Ocean at the drift stations "North Pole" in 1962-1976.

  12. HUMAN MILK BIOMONITORING DATA: INTERPRETATION AND RISK ASSESSMENT ISSUES

    Science.gov (United States)

    Biomonitoring data can, under certain conditions, be used to describe potential risks to human health (for example, blood lead levels used to determine children's neurodevelopmental risk). At present, there are very few chemical exposures at low levels for which sufficient data ...

  13. Association of major dietary patterns with obesity risk among Mongolian men and women.

    Science.gov (United States)

    Dugee, Otgontuya; Khor, Geok Lin; Lye, Munn-Sann; Luvsannyam, Lhagva; Janchiv, Oyunbileg; Jamyan, Batjargal; Esa, Norhaizan

    2009-01-01

    Mongolia is experiencing changes in its unique nomadic lifestyle and dietary habits in the last two decades with accompanying increase in obesity rate. The dietary pattern approach, which investigates the overall diet in relation to obesity risks, has become appealing in nutrition epidemiology. The aim of this study was to identify major dietary patterns of the Mongolian adults in relation to the risk of having obesity. Dietary intake of a total 418 adults aged ? 25 years was assessed by using a food frequency questionnaire with 68 items. An exploratory factor analysis resulted in three dietary patterns: transitional high in processed meat and potato, traditional rich in whole milk, fats and oils and healthy with greater intake of whole grains, mixed vegetables and fruits. Individuals in the upper quintile of the transitional pattern had significantly greater risk of obesity (BMI > or =25 kg/m2: OR=2.47; 95% CI=1.04-5.86) while subjects in the highest quintile of the healthy dietary pattern were found to have significantly decreased risk of obesity (OR: 0.49; 95% CI=0.25-0.95). Men in the highest quintile of the transitional pattern had greater risk of abdominal obesity WC > or =90 cm: OR= 4.08; 95% CI=1.11-14.97) than those in the lowest quintile. Women in the top quintile of the traditional pattern had a greater odds of having abdominal obesity (WC > or =80 cm: OR=4.59; 95% CI=1.58-13.30) than those in the lowest quintile. The study suggests that public health efforts be targeted at adults in Mongolia to address the undesirable aspects of the transitional and the traditional dietary patterns.

  14. Why style matters - uncertainty and structural interpretation in thrust belts.

    Science.gov (United States)

    Butler, Rob; Bond, Clare; Watkins, Hannah

    2016-04-01

    Structural complexity together with challenging seismic imaging make for significant uncertainty in developing geometric interpretations of fold and thrust belts. Here we examine these issues and develop more realistic approaches to building interpretations. At all scales, the best tests of the internal consistency of individual interpretations come from structural restoration (section balancing), provided allowance is made for heterogeneity in stratigraphy and strain. However, many existing balancing approaches give misleading perceptions of interpretational risk - both on the scale of individual fold-thrust (trap) structures and in regional cross-sections. At the trap-scale, idealised models are widely cited - fault-bend-fold, fault-propagation folding and trishear. These make entirely arbitrary choices for fault localisation and layer-by-layer deformation: precise relationships between faults and fold geometry are generally invalidated by real-world conditions of stratigraphic variation and distributed strain. Furthermore, subsurface predictions made using these idealisations for hydrocarbon exploration commonly fail the test of drilling. Rarely acknowledged, the geometric reliability of seismic images depends on the assigned seismic velocity model, which in turn relies on geological interpretation. Thus iterative approaches are required between geology and geophysics. The portfolio of commonly cited outcrop analogues is strongly biased to examples that simply conform to idealised models - apparently abnormal structures are rarely described - or even photographed! Insight can come from gravity-driven deep-water fold-belts where part of the spectrum of fold-thrust complexity is resolved through seismic imaging. This imagery shows deformation complexity in fold forelimbs and backlimbs. However, the applicability of these, weakly lithified systems to well-lithified successions (e.g. carbonates) of many foreland thrust belts remains conjectural. Examples of

  15. A review of the role of social cognition in major depressive disorder.

    Science.gov (United States)

    Weightman, Michael James; Air, Tracy Michele; Baune, Bernhard Theodor

    2014-01-01

    Social cognition - the ability to identify, perceive, and interpret socially relevant information - is an important skill that plays a significant role in successful interpersonal functioning. Social cognitive performance is recognized to be impaired in several psychiatric conditions, but the relationship with major depressive disorder is less well understood. The aim of this review is to characterize the current understanding of: (i) the different domains of social cognition and a possible relationship with major depressive disorder, (ii) the clinical presentation of social cognition in acute and remitted depressive states, and (iii) the effect of severity of depression on social cognitive performance. Electronic databases were searched to identify clinical studies investigating social cognition in a major depressive disorder population, yielding 31 studies for this review. Patients with major depressive disorder appear to interpret social cognitive stimuli differently to healthy controls: depressed individuals may interpret emotion through a mood-congruent bias and have difficulty with cognitive theory of mind tasks requiring interpretation of complex mental states. Social cognitive performance appears to be inversely associated with severity of depression, whilst the bias toward negative emotions persists even in remission. Some deficits may normalize following effective pharmacotherapy. The difficulties with social interaction observed in major depressive disorder may, at least in part, be due to an altered ability to correctly interpret emotional stimuli and mental states. These features seem to persist even in remission, although some may respond to intervention. Further research is required in this area to better understand the functional impact of these findings and the way in which targeted therapy could aid depressed individuals with social interactions.

  16. A Review of the Role of Social Cognition in Major Depressive Disorder

    Science.gov (United States)

    Weightman, Michael James; Air, Tracy Michele; Baune, Bernhard Theodor

    2014-01-01

    Background: Social cognition – the ability to identify, perceive, and interpret socially relevant information – is an important skill that plays a significant role in successful interpersonal functioning. Social cognitive performance is recognized to be impaired in several psychiatric conditions, but the relationship with major depressive disorder is less well understood. The aim of this review is to characterize the current understanding of: (i) the different domains of social cognition and a possible relationship with major depressive disorder, (ii) the clinical presentation of social cognition in acute and remitted depressive states, and (iii) the effect of severity of depression on social cognitive performance. Methods: Electronic databases were searched to identify clinical studies investigating social cognition in a major depressive disorder population, yielding 31 studies for this review. Results: Patients with major depressive disorder appear to interpret social cognitive stimuli differently to healthy controls: depressed individuals may interpret emotion through a mood-congruent bias and have difficulty with cognitive theory of mind tasks requiring interpretation of complex mental states. Social cognitive performance appears to be inversely associated with severity of depression, whilst the bias toward negative emotions persists even in remission. Some deficits may normalize following effective pharmacotherapy. Conclusions: The difficulties with social interaction observed in major depressive disorder may, at least in part, be due to an altered ability to correctly interpret emotional stimuli and mental states. These features seem to persist even in remission, although some may respond to intervention. Further research is required in this area to better understand the functional impact of these findings and the way in which targeted therapy could aid depressed individuals with social interactions. PMID:25566100

  17. A review of the role of social cognition in major depressive disorder

    Directory of Open Access Journals (Sweden)

    Michael James Weightman

    2014-12-01

    Full Text Available Background: Social cognition – the ability to identify, perceive and interpret socially-relevant information – is an important skill that plays a significant role in successful interpersonal functioning. Social cognitive performance is recognised to be impaired in several psychiatric conditions, but the relationship with major depressive disorder is less well understood. The aim of this review is to characterise the current understanding of (i the different domains of social cognition and a possible relationship with major depressive disorder, (ii the clinical presentation of social cognition in acute and remitted depressive states, and (iii the effect of severity of depression on social cognitive performance.Methods: Electronic databases were searched to identify clinical studies investigating social cognition in a major depressive disorder population, yielding 31 studies for this review.Results: Patients with major depressive disorder appear to interpret social cognitive stimuli differently to healthy controls: depressed individuals may interpret emotion through a mood-congruent bias and have difficulty with cognitive theory of mind tasks requiring interpretation of complex mental states. Social cognitive performance appears to be inversely associated with severity of depression, whilst the bias toward negative emotions persists even in remission. Some deficits may normalise following effective pharmacotherapy.Conclusions: The difficulties with social interaction observed in major depressive disorder may, at least in part, be due to an altered ability to correctly interpret emotional stimuli and mental states. These features seem to persist even in the remitted state, although some may respond to intervention. Further research is required in this area to better understand the functional impact of these findings and the way in which targeted therapy could aid depressed individuals with social interactions.

  18. South Asian Ethnicity as a Risk Factor for Major Adverse Cardiovascular Events after Renal Transplantation

    Science.gov (United States)

    Vangala, Sai K.; Silver, Samuel A.; Wong, Steven C.W.; Huang, Michael; Rapi, Lindita; Nash, Michelle M.; Zaltzman, Jeffrey S.

    2011-01-01

    Summary Background and objectives South Asians (SAs) comprise 25% of all Canadian visible minorities. SAs constitute a group at high risk for cardiovascular disease in the general population, but the risk in SA kidney transplant recipients has never been studied. Design, setting, participants, & measurements In a cohort study of 864 kidney recipients transplanted from 1998 to 2007 and followed to June 2009, we identified risk factors including ethnicity associated with major cardiac events (MACEs, a composite of nonfatal myocardial infarction, coronary intervention, and cardiac death) within and beyond 3 months after transplant. Kaplan-Meier methodology and multivariate Cox regression analysis were used to determine risk factors for MACEs. Results There was no difference among SAs (n = 139), whites (n = 550), blacks (n = 65), or East Asians (n = 110) in baseline risk, including pre-existing cardiac disease. Post-transplant MACE rate in SAs was 4.4/100 patient-years compared with 1.31, 1.16, and 1.61/100 patient-years in whites, blacks, and East Asians, respectively (P diabetes, systolic BP, and prior cardiac disease. SAs also experienced more MACEs within 3 months after transplant compared with whites (P < 0.0001), blacks (P = 0.04), and East Asians (P = 0.006). However, graft and patient survival was similar to other groups. Conclusions SA ethnicity is an independent risk factor for post-transplant cardiac events. Further study of this high-risk group is warranted. PMID:20884776

  19. Neuroticism Predicts Subsequent Risk of Major Depression for Whites but Not Blacks

    Directory of Open Access Journals (Sweden)

    Shervin Assari

    2017-09-01

    Full Text Available Cultural and ethnic differences in psychosocial and medical correlates of negative affect are well documented. This study aimed to compare blacks and whites for the predictive role of baseline neuroticism (N on subsequent risk of major depressive episodes (MDD 25 years later. Data came from the Americans’ Changing Lives (ACL Study, 1986–2011. We used data on 1219 individuals (847 whites and 372 blacks who had data on baseline N in 1986 and future MDD in 2011. The main predictor of interest was baseline N, measured using three items in 1986. The main outcome was 12 months MDD measured using the Composite International Diagnostic Interview (CIDI at 2011. Covariates included baseline demographics (age and gender, socioeconomics (education and income, depressive symptoms [Center for Epidemiologic Studies Depression Scale (CES-D], stress, health behaviors (smoking and driking, and physical health [chronic medical conditions, obesity, and self-rated health (SRH] measured in 1986. Logistic regressions were used to test the predictive role of baseline N on subsequent risk of MDD 25 years later, net of covariates. The models were estimated in the pooled sample, as well as blacks and whites. In the pooled sample, baseline N predicted subsequent risk of MDD 25 years later (OR = 2.23, 95%CI = 1.14–4.34, net of covariates. We also found a marginally significant interaction between race and baseline N on subsequent risk of MDD (OR = 0.37, 95% CI = 0.12–1.12, suggesting a stronger effect for whites compared to blacks. In race-specific models, among whites (OR = 2.55; 95% CI = 1.22–5.32 but not blacks (OR = 0.90; 95% CI = 0.24–3.39, baseline N predicted subsequent risk of MDD. Black-white differences in socioeconomics and physical health could not explain the racial differences in the link between N and MDD. Blacks and whites differ in the salience of baseline N as a psychological determinant of MDD risk over a long period of time. This finding

  20. The Risk Implications of Globalisation: An Exploratory Analysis of 105 Major Industrial Incidents (1971-2010).

    Science.gov (United States)

    Beck, Matthias

    2016-03-10

    This paper revisits work on the socio-political amplification of risk, which predicts that those living in developing countries are exposed to greater risk than residents of developed nations. This prediction contrasts with the neoliberal expectation that market driven improvements in working conditions within industrialising/developing nations will lead to global convergence of hazard exposure levels. It also contradicts the assumption of risk society theorists that there will be an ubiquitous increase in risk exposure across the globe, which will primarily affect technically more advanced countries. Reviewing qualitative evidence on the impact of structural adjustment reforms in industrialising countries, the export of waste and hazardous waste recycling to these countries and new patterns of domestic industrialisation, the paper suggests that workers in industrialising countries continue to face far greater levels of hazard exposure than those of developed countries. This view is confirmed when a data set including 105 major multi-fatality industrial disasters from 1971 to 2000 is examined. The paper concludes that there is empirical support for the predictions of socio-political amplification of risk theory, which finds clear expression in the data in a consistent pattern of significantly greater fatality rates per industrial incident in industrialising/developing countries.

  1. 31 CFR Appendix C to Part 103 - Interpretive Rules

    Science.gov (United States)

    2010-07-01

    ...-money laundering programs. See 31 CFR 103.125. Specifically, this Interpretive Guidance clarifies that the anti-money laundering program regulation requires Money Services Businesses to establish adequate and appropriate policies, procedures, and controls commensurate with the risks of money laundering and...

  2. The ARIPAR project: analysis of the major accident risks connected with industrial and transportation activities in the Ravenna area

    International Nuclear Information System (INIS)

    Egidi, Demetrio; Foraboschi, Franco P.; Spadoni, Gigliola; Amendola, Aniello

    1995-01-01

    The paper describes the ARIPAR project aimed at the assessment of the major accident risks connected with storage, process and transportation of dangerous substances in the densely populated Ravenna area in Italy, which includes a large complex of chemical and petrochemical plants and minor industries, essentially distributed around an important commercial port. Large quantities of dangerous goods are involved in various transportation forms connected with the industrial and commercial activity of the port. The project started by making a complete inventory of fixed installations and transportation activities capable of provoking major fire, explosion and toxic release events; then relevant accident scenarios were developed for the single hazard sources; probabilities were assigned to the events and consequences were evaluated; finally iso-risk contours and F-N diagrams were evaluated both for the single sources and for the overall area. This required the development of a particular methodology for analysis of area risk and of associated software packages which allowed examination of the relative importance of the different activities and typologies of materials involved. The methodological approach and the results have proved to be very useful for the priority-ranking of risk mitigating interventions and physical planning in a complex area

  3. The GSK3B gene confers risk for both major depressive disorder and schizophrenia in the Han Chinese population.

    Science.gov (United States)

    Chen, Jianhua; Wang, Meng; Waheed Khan, Raja Amjad; He, Kuanjun; Wang, Qingzhong; Li, Zhiqiang; Shen, Jiawei; Song, Zhijian; Li, Wenjin; Wen, Zujia; Jiang, Yiwen; Xu, Yifeng; Shi, Yongyong; Ji, Weidong

    2015-10-01

    Glycogen synthease kinase-3B is a key gene encoding a protein kinase which is abundant in brain, and is involved in signal transduction cascades of neuronal cell development and energy metabolism. Previous researches proposed GSK3B as a potential region for schizophrenia. To validate the susceptibility of GSK3B to major depressive disorder, and to investigate the overlapping risk conferred by GSK3B for mental disorders, we performed a large-scale case-control study, analyzed 6 tag single nucleotide polymorphisms using TaqMan® technology in 1,045 major depressive disorder patients, 1,235 schizophrenia patients and 1,235 normal controls of Han Chinese origin. We found rs334535 (Pallele=2.79E-03, Pgenotype=5.00E-03, OR=1.429) and rs2199503 (Pallele=0.020, Pgenotype= 0.040, OR=1.157) showed association with major depressive disorder before Bonferroni correction. rs6771023 (adjusted Pallele=1.64E-03, adjusted Pgenotype=6.00E-03, OR=0.701) and rs2199503 (adjusted Pallele=0.001, adjusted Pgenotype=0.002, OR=1.251) showed significant association with schizophrenia after Bonferroni correction. rs2199503 (adjusted Pallele=1.70E-03, adjusted Pgenotype=0.006, OR=1.208) remained to be significant in the combined cases of major depressive disorder and schizophrenia after Bonferroni correction. Further validations of our findings in samples with larger scale are suggested, and functional genomic study is needed to elucidate the role of GSK3B in signal pathway and psychiatric disorders. Our results provide evidence that the GSK3B gene could be a promising region which contains genetic risk for both major depressive disorder and schizophrenia in the Han Chinese population. The study on variants conferring overlapping risk for multiple psychiatric disorders could be tangible pathogenesis support and clinical or diagnostic references. Copyright © 2015. Published by Elsevier B.V.

  4. Re-Interpreting the "Chinese miracle"

    DEFF Research Database (Denmark)

    Feng, Xingyuan; Ljungwall, Christer; Guo, Sujian

    2011-01-01

    The rapid economic development and transformation of Chinese society over the past three decades has, by a large mass of analysts, been called a "Miracle." This paper not only addresses the shortcomings of existing interpretations but also develops a new multi-dimensional framework based on North......'s theory of institutional change and Hayek's theory of institutional evolution to explain China's miraculous growth. Our analysis shows that both Hayekian spontaneous order and Popper's "piecemeal social engineering" played a major role in attaining China's miraculous growth....

  5. The impact of chronic kidney disease as a predictor of major cardiac events in patients with no evidence of coronary artery disease

    International Nuclear Information System (INIS)

    Furuhashi, Tatsuhiko; Moroi, Masao; Joki, Nobuhiko; Hase, Hiroki; Masai, Hirofumi; Kunimasa, Taeko; Nakazato, Ryo; Fukuda, Hiroshi; Sugi, Kaoru

    2010-01-01

    Normal stress myocardial perfusion images (MPI) generally show good prognosis for cardiovascular events. However, chronic kidney disease (CKD) is one of the important risk factors for coronary artery disease (CAD), and the interpretation of normal stress MPI has not been well established in CKD patients with no evidence of CAD. The purpose of this study was to evaluate the long-term prognostic value of stress MPI in CKD patients with no evidence of myocardial ischemia or infarction. Patients who had no history but were suspected of CAD and had normal stress MPI (n=307, male=208, age=67 years, CKD/non-CKD=46/261) were followed-up for 4.5 years. CKD was defined as a glomerular filtration ratio of 2 and/or persistent proteinuria. Cardiac death, non-fatal myocardial infarction, and unstable angina requiring hospitalization were defined as major cardiac events. Major cardiac events were observed in 3 of 261 (1.1%) non-CKD patients and 6 of 46 (13%) CKD patients (p<0.001, with log-rank test). CKD was an independent risk factor for major cardiac events (hazard ratio=13.1, p<0.001, multivariate Cox regression analysis). Normal stress MPI does not always promise a good prognosis for major cardiac events. Even in patients with no evidence of CAD from stress MPI, CKD can be an independent and significant risk factor for major cardiac events. (author)

  6. Bacterial genus is a risk factor for major amputation in patients with diabetic foot.

    Science.gov (United States)

    Cardoso, Natália Anício; Cisneiros, Lígia DE Loiola; Machado, Carla Jorge; Cenedezi, Juliana Merlin; Procópio, Ricardo Jayme; Navarro, Túlio Pinho

    2017-01-01

    to evaluate whether bacterial genus is a risk factor for major amputation in patients with diabetic foot and infected ulcer. we conducted a case-control, observational study of 189 patients with infected ulcers in diabetic feet admitted to the Vascular Surgery Service of the Risoleta Tolentino Neves Hospital, from January 2007 to December 2012. The bacteriological evaluation was performed in deep tissue cultures from the lesions and amputation was considered major when performed above the foot'smiddle tarsus. the patients'mean age was 61.9±12.7 years; 122 (64.6%) were men. The cultures were positive in 86.8%, being monomicrobial in 72% of the cases. In patients with major amputation, Acinetobacter spp. (24.4%), Morganella spp. (24.4%), Proteus spp. (23.1%) and Enterococcus spp. (19.2%) were the most frequent types of bacteria. The most commonly isolated species were Acinetobacter baumannii, Morganella morganii, Pseudomonas aeruginosa and Proteus mirabilis. As predictors of major amputation, we identified the isolation of the generaAcinetobacter spp. and Klebsiella spp., serum creatinine ≥1.3mg/dl and hemoglobin creatinina ≥1,3mg/dl e de hemoglobina <11g/dl. os gêneros bacterianos Acinetobacter spp. e Klebsiella spp. identificados nas úlceras infectadas dos pacientes com pé diabético associaram-se a maior incidência de amputação maior.

  7. Development of Screening Tools for the Interpretation of Chemical Biomonitoring Data

    Directory of Open Access Journals (Sweden)

    Richard A. Becker

    2012-01-01

    Full Text Available Evaluation of a larger number of chemicals in commerce from the perspective of potential human health risk has become a focus of attention in North America and Europe. Screening-level chemical risk assessment evaluations consider both exposure and hazard. Exposures are increasingly being evaluated through biomonitoring studies in humans. Interpreting human biomonitoring results requires comparison to toxicity guidance values. However, conventional chemical-specific risk assessments result in identification of toxicity-based exposure guidance values such as tolerable daily intakes (TDIs as applied doses that cannot directly be used to evaluate exposure information provided by biomonitoring data in a health risk context. This paper describes a variety of approaches for development of screening-level exposure guidance values with translation from an external dose to a biomarker concentration framework for interpreting biomonitoring data in a risk context. Applications of tools and concepts including biomonitoring equivalents (BEs, the threshold of toxicologic concern (TTC, and generic toxicokinetic and physiologically based toxicokinetic models are described. These approaches employ varying levels of existing chemical-specific data, chemical class-specific assessments, and generic modeling tools in response to varying levels of available data in order to allow assessment and prioritization of chemical exposures for refined assessment in a risk management context.

  8. Epidemiology, major risk factors and genetic predisposition for breast cancer in the Pakistani population.

    Science.gov (United States)

    Shaukat, Uzma; Ismail, Muhammad; Mehmood, Nasir

    2013-01-01

    Occurrence of breast cancer is related to genetic as well as cultural, environmental and life-style factors. Variations in diversity of these factors among different ethnic groups and geographical areas emphasize the immense need for studies in all racial-ethnic populations. The incidence of breast cancer in Pakistan is highest in Asians after Jews in Israel and 2.5 times higher than that in neighboring countries like Iran and India, accounting for 34.6% of female cancers. The Pakistani population is deficient in information regarding breast cancer etiology and epidemiology, but efforts done so far had suggested consanguinity as a major risk factor for frequent mutations leading to breast cancer and has also shed light on genetic origins in different ethnic groups within Pakistan. World-wide research efforts on different ethnicities have enhanced our understanding of genetic predisposition to breast cancer but despite these discoveries, 75% of the familial risk of breast cancer remains unexplained, highlighting the fact that the majority of breast cancer susceptibility genes remain unidentified. For this purpose Pakistani population provides a strong genetic pool to elucidate the genetic etiology of breast cancer because of cousin marriages. In this review, we describe the known breast cancer predisposition factors found in the local Pakistani population and the epidemiological research work done to emphasize the importance of exploring factors/variants contributing to breast cance, in order to prevent, cure and decrease its incidence in our country.

  9. Visual Perspectives on Majority-World Adolescent Thriving

    Science.gov (United States)

    Cameron, Catherine Ann; Theron, Linda; Tapanya, Sombat; Li, Chun; Lau, Cindy; Liebenberg, Linda; Ungar, Michael

    2013-01-01

    This paper offers socio-ecological, situated perspectives on adolescent resilience derived from an application of interpretive visual methodologies to deepen understanding of adaptive youth development in diverse majority-world cultural contexts (South Africa, Thailand, China, Mexican migration to Canada). The research is not…

  10. Background risk information to assist in risk management decision making

    International Nuclear Information System (INIS)

    Hammonds, J.S.; Hoffman, F.O.; White, R.K.; Miller, D.B.

    1992-10-01

    The evaluation of the need for remedial activities at hazardous waste sites requires quantification of risks of adverse health effects to humans and the ecosystem resulting from the presence of chemical and radioactive substances at these sites. The health risks from exposure to these substances are in addition to risks encountered because of the virtually unavoidable exposure to naturally occurring chemicals and radioactive materials that are present in air, water, soil, building materials, and food products. To provide a frame of reference for interpreting risks quantified for hazardous waste sites, it is useful to identify the relative magnitude of risks of both a voluntary and involuntary nature that are ubiquitous throughout east Tennessee. In addition to discussing risks from the ubiquitous presence of background carcinogens in the east Tennessee environment, this report also presents risks resulting from common, everyday activities. Such information should, not be used to discount or trivialize risks from hazardous waste contamination, but rather, to create a sensitivity to general risk issues, thus providing a context for better interpretation of risk information

  11. Application of risk assessment techniques to 'major hazard' pipelines

    Energy Technology Data Exchange (ETDEWEB)

    Cox, R A

    1982-12-01

    A risk analysis for a hazardous-material pipeline (carrying LPG, ammonia, or high-pressure gas) is presented. The analysis gives results in a form that will assist the decisionmaker in pipeline planning and route selection. The large inventory of hazardous materials in such pipelines means that risks exist even though the accident record of pipeline transportation compares favorably with that for competing modes of transport. Risk analysis techniques - commonly used in the civil aviation, nuclear, and process industries - can be equally well applied to pipelines and can produce results that not only give a measure of the risk but also indicate the principal sources of risk and possible areas for improvement. A number of pipeline risk analyses have demonstrated the viability of the technique and its usefulness as an aid to practical engineering in design, planning, and maintenance/repair phases.

  12. Changes in geriatric nutritional risk index and risk of major adverse cardiac and cerebrovascular events in incident peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Mi Jung Lee

    2017-12-01

    Full Text Available Background: Geriatric nutritional risk index (GNRI is a validated nutritional assessment method, and lower GNRI values are closely associated with adverse clinical outcomes in dialysis patients. This study investigated the impact of changes in GNRI during the first year of dialysis on cardiovascular outcomes in incident peritoneal dialysis (PD patients. Methods: We reviewed medical records in 133 incident PD patients to determine GNRI at the start of PD and after 12 months. Patients were categorized into improved (delta GNRI > 0 and worsening/stationary (delta GNRI ≤ 0 groups. The primary outcome was major adverse cardiac and cerebrovascular events (MACCEs. Results: During a mean follow-up of 51.1 months, the primary outcome was observed in 42 patients (31.6%. The baseline GNRI at PD initiation was not significantly associated with MACCEs (log-rank test, P = 0.40. However, the cumulative event-free rate was significantly lower in the worsening or stationary GNRI group than in the improved group (log-rank test, P = 0.004. Multivariate Cox analysis revealed that a worsening or stationary GNRI was independently associated with higher risk for MACCEs (hazard ratio, 2.47; 95% confidence interval, 1.15–5.29; P = 0.02. In subgroup analysis, patients with worsening or stationary GNRI were at significantly greater risk for MACCEs in both the lower (P = 0.04 and higher (P = 0.01 baseline GNRI groups. Conclusion: Baseline GNRI was not associated with MACCEs, but patients with deteriorating or stationary nutritional status were at significantly greater risk for MACCEs, suggesting that serial monitoring of nutritional status is important to stratify cardiovascular risk in incident PD patients.

  13. Structural interpretation of seismic data and inherent uncertainties

    Science.gov (United States)

    Bond, Clare

    2013-04-01

    associated further interpretation and analysis of the techniques and strategies employed. This resource will be of use to undergraduate, post-graduate, industry and academic professionals seeking to improve their seismic interpretation skills, develop reasoning strategies for dealing with incomplete datasets, and for assessing the uncertainty in these interpretations. Bond, C.E. et al. (2012). 'What makes an expert effective at interpreting seismic images?' Geology, 40, 75-78. Bond, C. E. et al. (2011). 'When there isn't a right answer: interpretation and reasoning, key skills for 21st century geoscience'. International Journal of Science Education, 33, 629-652. Bond, C. E. et al. (2008). 'Structural models: Optimizing risk analysis by understanding conceptual uncertainty'. First Break, 26, 65-71. Bond, C. E. et al., (2007). 'What do you think this is?: "Conceptual uncertainty" In geoscience interpretation'. GSA Today, 17, 4-10.

  14. Quantifying and predicting interpretational uncertainty in cross-sections

    Science.gov (United States)

    Randle, Charles; Bond, Clare; Monaghan, Alison; Lark, Murray

    2015-04-01

    Cross-sections are often constructed from data to create a visual impression of the geologist's interpretation of the sub-surface geology. However as with all interpretations, this vision of the sub-surface geology is uncertain. We have designed and carried out an experiment with the aim of quantifying the uncertainty in geological cross-sections created by experts interpreting borehole data. By analysing different attributes of the data and interpretations we reflect on the main controls on uncertainty. A group of ten expert modellers at the British Geological Survey were asked to interpret an 11.4 km long cross-section from south-east Glasgow, UK. The data provided consisted of map and borehole data of the superficial deposits and shallow bedrock. Each modeller had a unique set of 11 boreholes removed from their dataset, to which their interpretations of the top of the bedrock were compared. This methodology allowed quantification of how far from the 'correct answer' each interpretation is at 11 points along each interpreted cross-section line; through comparison of the interpreted and actual bedrock elevations in the boreholes. This resulted in the collection of 110 measurements of the error to use in further analysis. To determine the potential control on uncertainty various attributes relating to the modeller, the interpretation and the data were recorded. Modellers were asked to fill out a questionnaire asking for information; such as how much 3D modelling experience they had, and how long it took them to complete the interpretation. They were also asked to record their confidence in their interpretations graphically, in the form of a confidence level drawn onto the cross-section. Initial analysis showed the majority of the experts' interpreted bedrock elevations within 5 metres of those recorded in the withheld boreholes. Their distribution is peaked and symmetrical about a mean of zero, indicating that there was no tendency for the experts to either under

  15. Interpretative commenting.

    Science.gov (United States)

    Vasikaran, Samuel

    2008-08-01

    * Clinical laboratories should be able to offer interpretation of the results they produce. * At a minimum, contact details for interpretative advice should be available on laboratory reports.Interpretative comments may be verbal or written and printed. * Printed comments on reports should be offered judiciously, only where they would add value; no comment preferred to inappropriate or dangerous comment. * Interpretation should be based on locally agreed or nationally recognised clinical guidelines where available. * Standard tied comments ("canned" comments) can have some limited use.Individualised narrative comments may be particularly useful in the case of tests that are new, complex or unfamiliar to the requesting clinicians and where clinical details are available. * Interpretative commenting should only be provided by appropriately trained and credentialed personnel. * Audit of comments and continued professional development of personnel providing them are important for quality assurance.

  16. Genome-wide association study identifies HLA 8.1 ancestral haplotype alleles as major genetic risk factors for myositis phenotypes.

    Science.gov (United States)

    Miller, F W; Chen, W; O'Hanlon, T P; Cooper, R G; Vencovsky, J; Rider, L G; Danko, K; Wedderburn, L R; Lundberg, I E; Pachman, L M; Reed, A M; Ytterberg, S R; Padyukov, L; Selva-O'Callaghan, A; Radstake, T R; Isenberg, D A; Chinoy, H; Ollier, W E R; Scheet, P; Peng, B; Lee, A; Byun, J; Lamb, J A; Gregersen, P K; Amos, C I

    2015-10-01

    Autoimmune muscle diseases (myositis) comprise a group of complex phenotypes influenced by genetic and environmental factors. To identify genetic risk factors in patients of European ancestry, we conducted a genome-wide association study (GWAS) of the major myositis phenotypes in a total of 1710 cases, which included 705 adult dermatomyositis, 473 juvenile dermatomyositis, 532 polymyositis and 202 adult dermatomyositis, juvenile dermatomyositis or polymyositis patients with anti-histidyl-tRNA synthetase (anti-Jo-1) autoantibodies, and compared them with 4724 controls. Single-nucleotide polymorphisms showing strong associations (Pmyositis phenotypes together, as well as for the four clinical and autoantibody phenotypes studied separately. Imputation and regression analyses found that alleles comprising the human leukocyte antigen (HLA) 8.1 ancestral haplotype (AH8.1) defined essentially all the genetic risk in the phenotypes studied. Although the HLA DRB1*03:01 allele showed slightly stronger associations with adult and juvenile dermatomyositis, and HLA B*08:01 with polymyositis and anti-Jo-1 autoantibody-positive myositis, multiple alleles of AH8.1 were required for the full risk effects. Our findings establish that alleles of the AH8.1 comprise the primary genetic risk factors associated with the major myositis phenotypes in geographically diverse Caucasian populations.

  17. Intersectional identities and dilemmas in interactions with healthcare professionals: an interpretative phenomenological analysis of British Muslim gay men.

    Science.gov (United States)

    Semlyen, Joanna; Ali, Atif; Flowers, Paul

    2017-12-22

    Individual interviews were conducted with six self-identified Muslim gay men living in London focusing on their experience of health service use. Transcripts were analysed using interpretative phenomenological analysis. Analysis identified two major themes: the close(d) community and self-management with healthcare professionals, detailing participants' concerns regarding the risks of disclosing sexuality; and the authentic identity - 'you're either a Muslim or you're gay, you can't be both' - which delineated notions of incommensurate identity. Analysis highlights the need for health practitioners to have insight into the complexity of intersectional identities, identity disclosure dynamics and the negative consequences of assumptions made, be these heteronormative or faith-related.

  18. Building interpretable predictive models for pediatric hospital readmission using Tree-Lasso logistic regression.

    Science.gov (United States)

    Jovanovic, Milos; Radovanovic, Sandro; Vukicevic, Milan; Van Poucke, Sven; Delibasic, Boris

    2016-09-01

    Quantification and early identification of unplanned readmission risk have the potential to improve the quality of care during hospitalization and after discharge. However, high dimensionality, sparsity, and class imbalance of electronic health data and the complexity of risk quantification, challenge the development of accurate predictive models. Predictive models require a certain level of interpretability in order to be applicable in real settings and create actionable insights. This paper aims to develop accurate and interpretable predictive models for readmission in a general pediatric patient population, by integrating a data-driven model (sparse logistic regression) and domain knowledge based on the international classification of diseases 9th-revision clinical modification (ICD-9-CM) hierarchy of diseases. Additionally, we propose a way to quantify the interpretability of a model and inspect the stability of alternative solutions. The analysis was conducted on >66,000 pediatric hospital discharge records from California, State Inpatient Databases, Healthcare Cost and Utilization Project between 2009 and 2011. We incorporated domain knowledge based on the ICD-9-CM hierarchy in a data driven, Tree-Lasso regularized logistic regression model, providing the framework for model interpretation. This approach was compared with traditional Lasso logistic regression resulting in models that are easier to interpret by fewer high-level diagnoses, with comparable prediction accuracy. The results revealed that the use of a Tree-Lasso model was as competitive in terms of accuracy (measured by area under the receiver operating characteristic curve-AUC) as the traditional Lasso logistic regression, but integration with the ICD-9-CM hierarchy of diseases provided more interpretable models in terms of high-level diagnoses. Additionally, interpretations of models are in accordance with existing medical understanding of pediatric readmission. Best performing models have

  19. ISM Approach to Model Offshore Outsourcing Risks

    Directory of Open Access Journals (Sweden)

    Sunand Kumar

    2014-07-01

    Full Text Available In an effort to achieve a competitive advantage via cost reductions and improved market responsiveness, organizations are increasingly employing offshore outsourcing as a major component of their supply chain strategies. But as evident from literature number of risks such as Political risk, Risk due to cultural differences, Compliance and regulatory risk, Opportunistic risk and Organization structural risk, which adversely affect the performance of offshore outsourcing in a supply chain network. This also leads to dissatisfaction among different stake holders. The main objective of this paper is to identify and understand the mutual interaction among various risks which affect the performance of offshore outsourcing.  To this effect, authors have identified various risks through extant review of literature.  From this information, an integrated model using interpretive structural modelling (ISM for risks affecting offshore outsourcing is developed and the structural relationships between these risks are modeled.  Further, MICMAC analysis is done to analyze the driving power and dependency of risks which shall be helpful to managers to identify and classify important criterions and to reveal the direct and indirect effects of each criterion on offshore outsourcing. Results show that political risk and risk due to cultural differences are act as strong drivers.

  20. Chinese Registry of rheumatoid arthritis (CREDIT): II. prevalence and risk factors of major comorbidities in Chinese patients with rheumatoid arthritis.

    Science.gov (United States)

    Jin, Shangyi; Li, Mengtao; Fang, Yongfei; Li, Qin; Liu, Ju; Duan, Xinwang; Liu, Yi; Wu, Rui; Shi, Xiaofei; Wang, Yongfu; Jiang, Zhenyu; Wang, Yanhong; Yu, Chen; Wang, Qian; Tian, Xinping; Zhao, Yan; Zeng, Xiaofeng

    2017-11-15

    Rheumatoid arthritis patients are at higher risk of developing comorbidities. The main objective of this study was to evaluate the prevalence of major comorbidities in Chinese rheumatoid arthritis patients. We also aimed to identify factors associated with these comorbidities. Baseline demographic, clinical characteristics and comorbidity data from RA patients enrolled in the Chinese Registry of rhEumatoiD arthrITis (CREDIT) from Nov 2016 to August 2017 were presented and compared with those from five other registries across the world. Possible factors related to three major comorbidities (cardiovascular disease, fragility fracture and malignancy) were identified using multivariate logistic regression analyses. A total of 13,210 RA patients were included (80.6% female, mean age 52.9 years and median RA duration 4.0 years). Baseline prevalence rates of major comorbidities were calculated: CVD, 2.2% (95% CI 2.0-2.5%); fragility fracture, 1.7% (95% CI 1.5-1.9%); malignancy, 0.6% (95% CI 0.5-0.7%); overall major comorbidities, 4.2% (95% CI 3.9-4.6%). Advanced age was associated with all comorbidities. Male gender and disease duration were positively related to CVD. Female sex and longer disease duration were potential risk factors for fragility fractures. Ever use of methotrexate (MTX) was negatively related to baseline comorbidities. Patients with rheumatoid arthritis in China have similar prevalence of comorbidities with other Asian countries. Advanced age and long disease duration are possible risk factors for comorbidities. On the contrary, MTX may protect RA patients from several major comorbidities, supporting its central role in the management of rheumatoid arthritis.

  1. Major depressive disorder and suicidality in early HIV infection and its association with risk factors and negative outcomes as seen in semi-urban and rural Uganda.

    Science.gov (United States)

    Kinyanda, Eugene; Nakasujja, Noeline; Levin, Jonathan; Birabwa, Harriet; Mpango, Richard; Grosskurth, Heiner; Seedat, Soraya; Patel, Vikram

    2017-04-01

    There is a paucity of research into the psychiatric problems associated with early stage HIV clinical disease in sub-Saharan Africa. A cross sectional study was undertaken among 899 adult ART naïve persons in early stage HIV clinical disease (participants with CD4≥250 and who were at WHO clinical Stage I or II) attending a semi-urban and a rural clinic in Uganda. The prevalence of major depressive disorder in this study was 14.0% [95% CI 11.7-6.3%] while that of 'moderate to high risk for suicidality' was 2.8% [95% CI 1.7%; 3.9%]. Multivariable analyses found that factors in the socio-demographic, vulnerability/protective and stress (only for major depressive disorder) domains were significantly associated with both major depressive disorder and 'moderate to high risk for suicidality'. Major depressive disorder but not 'moderate to high risk for suicidality' was significantly associated with impaired psychosocial functioning, greater utilisation of health services and non-adherence to septrin/dasone. Neither major depressive disorder nor 'moderate to high risk for suicidality' was associated with CD4 counts, risky sexual behaviour nor with non-utilisation of condoms. The bidirectional nature of some of the relationships between the investigated psychiatric problems, risk factors and outcomes in this cross sectional study makes it difficult to elucidate the actual direction of causality. Early stage HIV clinical disease is associated with considerable major depressive disorder and 'moderate to high risk for suicidality'. Therefore there is a need to integrate mental health into HIV interventions that target early stage HIV disease. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. The Risk Implications of Globalisation: An Exploratory Analysis of 105 Major Industrial Incidents (1971–2010)

    Science.gov (United States)

    Beck, Matthias

    2016-01-01

    This paper revisits work on the socio-political amplification of risk, which predicts that those living in developing countries are exposed to greater risk than residents of developed nations. This prediction contrasts with the neoliberal expectation that market driven improvements in working conditions within industrialising/developing nations will lead to global convergence of hazard exposure levels. It also contradicts the assumption of risk society theorists that there will be an ubiquitous increase in risk exposure across the globe, which will primarily affect technically more advanced countries. Reviewing qualitative evidence on the impact of structural adjustment reforms in industrialising countries, the export of waste and hazardous waste recycling to these countries and new patterns of domestic industrialisation, the paper suggests that workers in industrialising countries continue to face far greater levels of hazard exposure than those of developed countries. This view is confirmed when a data set including 105 major multi-fatality industrial disasters from 1971 to 2000 is examined. The paper concludes that there is empirical support for the predictions of socio-political amplification of risk theory, which finds clear expression in the data in a consistent pattern of significantly greater fatality rates per industrial incident in industrialising/developing countries. PMID:26978378

  3. How normative interpretations of climate risk assessment affect local decision-making: an exploratory study at the city scale in Cork, Ireland

    Science.gov (United States)

    McDermott, T. K. J.; Surminski, S.

    2018-06-01

    Urban areas already suffer substantial losses in both economic and human terms from climate-related disasters. These losses are anticipated to grow substantially, in part as a result of the impacts of climate change. In this paper, we investigate the process of translating climate risk data into action for the city level. We apply a commonly used decision-framework as our backdrop and explore where in this process climate risk assessment and normative political judgements intersect. We use the case of flood risk management in Cork city in Ireland to investigate what is needed for translating risk assessment into action at the local city level. Evidence presented is based on focus group discussions at two stakeholder workshops, and a series of individual meetings and phone-discussions with stakeholders involved in local decision-making related to flood risk management and adaptation to climate change, in Ireland. Respondents were chosen on the basis of their expertise or involvement in the decision-making processes locally and nationally. Representatives of groups affected by flood risk and flood risk management and climate adaptation efforts were also included. The Cork example highlights that, despite ever more accurate data and an increasing range of theoretical approaches available to local decision-makers, it is the normative interpretation of this information that determines what action is taken. The use of risk assessments for decision-making is a process that requires normative decisions, such as setting `acceptable risk levels' and identifying `adequate' protection levels, which will not succeed without broader buy-in and stakeholder participation. Identifying and embracing those normative views up-front could strengthen the urban adaptation process-this may, in fact, turn out to be the biggest advantage of climate risk assessment: it offers an opportunity to create a shared understanding of the problem and enables an informed evaluation and discussion of

  4. How normative interpretations of climate risk assessment affect local decision-making: an exploratory study at the city scale in Cork, Ireland.

    Science.gov (United States)

    McDermott, T K J; Surminski, S

    2018-06-13

    Urban areas already suffer substantial losses in both economic and human terms from climate-related disasters. These losses are anticipated to grow substantially, in part as a result of the impacts of climate change. In this paper, we investigate the process of translating climate risk data into action for the city level. We apply a commonly used decision-framework as our backdrop and explore where in this process climate risk assessment and normative political judgements intersect. We use the case of flood risk management in Cork city in Ireland to investigate what is needed for translating risk assessment into action at the local city level. Evidence presented is based on focus group discussions at two stakeholder workshops, and a series of individual meetings and phone-discussions with stakeholders involved in local decision-making related to flood risk management and adaptation to climate change, in Ireland. Respondents were chosen on the basis of their expertise or involvement in the decision-making processes locally and nationally. Representatives of groups affected by flood risk and flood risk management and climate adaptation efforts were also included. The Cork example highlights that, despite ever more accurate data and an increasing range of theoretical approaches available to local decision-makers, it is the normative interpretation of this information that determines what action is taken. The use of risk assessments for decision-making is a process that requires normative decisions, such as setting 'acceptable risk levels' and identifying 'adequate' protection levels, which will not succeed without broader buy-in and stakeholder participation. Identifying and embracing those normative views up-front could strengthen the urban adaptation process-this may, in fact, turn out to be the biggest advantage of climate risk assessment: it offers an opportunity to create a shared understanding of the problem and enables an informed evaluation and discussion of

  5. Human health risks associated with asbestos abatement.

    Science.gov (United States)

    Chrostowski, P C; Foster, S A; Anderson, E L

    1991-09-01

    Upperbound lifetime excess cancer risks were calculated for activities associated with asbestos abatement using a risk assessment framework developed for EPA's Superfund program. It was found that removals were associated with cancer risks to workers which were often greater than the commonly accepted cancer risk of 1 x 10(-6), although lower than occupational exposure limits associated with risks of 1 x 10(-3). Removals had little effect in reducing risk to school populations. Risks to teachers and students in school buildings containing asbestos were approximately the same as risks associated with exposure to ambient asbestos by the general public and were below the levels typically of concern to regulatory agencies. During abatement, however, there were increased risks to both workers and nearby individuals. Careless, everyday building maintenance generated the greatest risk to workers followed by removals and encapsulation. If asbestos abatement was judged by the risk criteria applied to EPA's Superfund program, the no-action alternative would likely be selected in preference to removal in a majority of cases. These conclusions should only be interpreted within the context of an overall asbestos risk management program, which includes consideration of specific fiber types and sizes, sampling and analytical limitations, physical condition of asbestos-containing material, episodic peak exposures, and the number of people potentially exposed.

  6. Penultimate interpretation.

    Science.gov (United States)

    Neuman, Yair

    2010-10-01

    Interpretation is at the center of psychoanalytic activity. However, interpretation is always challenged by that which is beyond our grasp, the 'dark matter' of our mind, what Bion describes as ' O'. O is one of the most central and difficult concepts in Bion's thought. In this paper, I explain the enigmatic nature of O as a high-dimensional mental space and point to the price one should pay for substituting the pre-symbolic lexicon of the emotion-laden and high-dimensional unconscious for a low-dimensional symbolic representation. This price is reification--objectifying lived experience and draining it of vitality and complexity. In order to address the difficulty of approaching O through symbolization, I introduce the term 'Penultimate Interpretation'--a form of interpretation that seeks 'loopholes' through which the analyst and the analysand may reciprocally save themselves from the curse of reification. Three guidelines for 'Penultimate Interpretation' are proposed and illustrated through an imaginary dialogue. Copyright © 2010 Institute of Psychoanalysis.

  7. Interobserver agreement in interpretation of radiographic pulmonary changes in dogs in relation to radiology training

    Directory of Open Access Journals (Sweden)

    Tilde Rodrigues Froes

    2014-09-01

    Full Text Available Interpretation of pulmonary radiographs is one of the most difficult aspects of radiology and interobserver variability is high. The aim of this study was to assess variations in interpretation of pulmonary pathology amongst Brazilian veterinarians with different levels of training and experience, using the interpretation by American board-certified radiologists as a reference. We identified areas where interpretation is particularly challenging. Sixty digital canine thoracic radiographic examinations were interpreted by four groups of three Brazilian observers, each group being defined by different levels of training and experience. The radiographic findings of the 4 groups of observers in the study were compared to a reference interpretation established from the findings of three ACVR board-certified radiologists. The degree of discrepancy for each list between each group and the reference interpretation was assessed according to a three-level scoring system: no discrepancy, minor discrepancy, or major discrepancy. Data was analyzed using a Kappa and Cochran-Mantel-Haenszel tests. Brazilian veterinarians with the most training and experience showed the least interobserver variation and best performance when compared to the reference interpretation, followed by those with practical training, but with little work experience in professional practice. The radiographic patterns that were associated with the highest interobserver variability were the vascular, unstructured interstitial and bronchial patterns. Interobserver major discrepancies occurred in all groups, but is more evident in groups with the least training (44.4% and the general practitioners (26.7% group. It can be concluded that training positively influences the accuracy of radiographic interpretation and is recommended to reduce erroneous diagnoses.

  8. Concept of risk: risk assessment and nuclear safety

    International Nuclear Information System (INIS)

    Thompson, P.B.

    1980-01-01

    The dissertation is a critical examination of risk assessment and its role in public policy. Nuclear power safety safety issues are selected as the primary source of illustrations and examples. The dissertation examines how risk assessment studies develop a concept of risk which becomes decisive for policy choices. Risk-assessment techniques are interpreted as instruments which secure an evaluation of risk which, in turn, figures prominently in technical reports on nuclear power. The philosophical critique is mounted on two levels. First, an epistemological critique surveys distinctions between the technical concept of risk and more familiar senses of risk. The critique shows that utilization of risk assessment re-structures the concept of risk. The technical concept is contrasted to the function of risk within a decision-maker's conceptual agenda and hierarchy of values. Second, an ethical critique exposes the value commitments of risk assessment recommendations. Although some of these values might be defended for policy decisions, the technical character of risk assessment obfuscates normative issues. Risk assessment is shown to be a form of factual enquiry which, nonetheless, represents a commitment to a specific selection of ethical and social values. Risk assessment should not be interpreted as a primary guide to decision unless the specific values incorporated into its concept of risk are stated explicitly and justified philosophically. Such a statement would allow value questions which have been sublimated by the factual tone of the analytic techniques to be debated on clear, social and ethical grounds

  9. Cognitive Artificial Intelligence Method for Interpreting Transformer Condition Based on Maintenance Data

    Directory of Open Access Journals (Sweden)

    Karel Octavianus Bachri

    2017-07-01

    Full Text Available A3S(Arwin-Adang-Aciek-Sembiring is a method of information fusion at a single observation and OMA3S(Observation Multi-time A3S is a method of information fusion for time-series data. This paper proposes OMA3S-based Cognitive Artificial-Intelligence method for interpreting Transformer Condition, which is calculated based on maintenance data from Indonesia National Electric Company (PLN. First, the proposed method is tested using the previously published data, and then followed by implementation on maintenance data. Maintenance data are fused to obtain part condition, and part conditions are fused to obtain transformer condition. Result shows proposed method is valid for DGA fault identification with the average accuracy of 91.1%. The proposed method not only can interpret the major fault, it can also identify the minor fault occurring along with the major fault, allowing early warning feature. Result also shows part conditions can be interpreted using information fusion on maintenance data, and the transformer condition can be interpreted using information fusion on part conditions. The future works on this research is to gather more data, to elaborate more factors to be fused, and to design a cognitive processor that can be used to implement this concept of intelligent instrumentation.

  10. Quantifying risk: the role of absolute and relative measures in interpreting risk of adverse reactions from product labels of antipsychotic medications.

    Science.gov (United States)

    Citrome, Leslie

    2009-09-01

    Pharmaceutical product labeling as approved by regulatory agencies include statements of adverse event risk. Product labels include descriptive statements such as whether events are uncommon or rare, as well as percentage occurrence for more common events. In addition tables are provided with the frequencies of the latter events for both product and placebo as observed in clinical trials. Competing products are not mentioned in a specific drug's product labeling but indirect comparisons can be made using the corresponding label information for the alternate product. Two types of tools are easily used for this purpose: absolute measures such as number needed to harm (NNH), and relative measures such as relative risk increase (RRI). The calculations for both of these types of quantitative measures are presented using as examples the oral first-line second-generation antipsychotic medications. Among three sample outcomes selected a priori, akathisia, weight gain, and discontinuation from a clinical trial because of an adverse reaction, there appears to be differences among the different antipsychotics versus placebo. Aripiprazole was associated with the highest risk for akathisia, particularly when used as adjunctive treatment of major depressive disorder (NNH 5, 95% CI 4-7; RRI 525%, 95% CI 267%-964%). Although insufficient information was available in product labeling to calculate the CI, olanzapine was associated with the highest risk for weight gain of at least 7% from baseline (NNH 6, RRI 640% for adults; NNH 4, RRI 314% for adolescents), and quetiapine for the indication of bipolar depression was associated with the highest risk of discontinuation from a clinical trial because of an adverse reaction (NNH 8, RRI 265% for 600 mg/d; NNH 15, RRI 137% for 300 mg/d). In conclusion, with certain limitations, it is possible for the clinician to extract information from medication product labeling regarding the frequency with which certain adverse reactions can be

  11. Exponentially increasing incidences of cutaneous malignant melanoma in Europe correlate with low personal annual UV doses and suggests 2 major risk factors.

    Science.gov (United States)

    Merrill, Stephen J; Ashrafi, Samira; Subramanian, Madhan; Godar, Dianne E

    2015-01-01

    For several decades the incidence of cutaneous malignant melanoma (CMM) steadily increased in fair-skinned, indoor-working people around the world. Scientists think poor tanning ability resulting in sunburns initiate CMM, but they do not understand why the incidence continues to increase despite the increased use of sunscreens and formulations offering more protection. This paradox, along with lower incidences of CMM in outdoor workers, although they have significantly higher annual UV doses than indoor workers have, perplexes scientists. We found a temporal exponential increase in the CMM incidence indicating second-order reaction kinetics revealing the existence of 2 major risk factors. From epidemiology studies, we know one major risk factor for getting CMM is poor tanning ability and we now propose the other major risk factor may be the Human Papilloma Virus (HPV) because clinicians find β HPVs in over half the biopsies. Moreover, we uncovered yet another paradox; the increasing CMM incidences significantly correlate with decreasing personal annual UV dose, a proxy for low vitamin D3 levels. We also discovered the incidence of CMM significantly increased with decreasing personal annual UV dose from 1960, when it was almost insignificant, to 2000. UV and other DNA-damaging agents can activate viruses, and UV-induced cytokines can hide HPV from immune surveillance, which may explain why CMM also occurs in anatomical locations where the sun does not shine. Thus, we propose the 2 major risk factors for getting CMM are intermittent UV exposures that result in low cutaneous levels of vitamin D3 and possibly viral infection.

  12. Surgery and Anesthesia Exposure Is Not a Risk Factor for Cognitive Impairment After Major Noncardiac Surgery and Critical Illness

    NARCIS (Netherlands)

    Hughes, Christopher G; Patel, Mayur B; Jackson, James C; Girard, Timothy D; Geevarghese, Sunil K; Norman, Brett C; Thompson, Jennifer L; Chandrasekhar, Rameela; Brummel, Nathan E; May, Addison K; Elstad, Mark R; Wasserstein, Mitzi L; Goodman, Richard B; Moons, Karel G; Dittus, Robert S; Ely, E Wesley; Pandharipande, Pratik P; MIND-ICU, BRAIN-ICU investigators

    OBJECTIVE: The aim of this study was to determine whether surgery and anesthesia exposure is an independent risk factor for cognitive impairment after major noncardiac surgery associated with critical illness. SUMMARY OF BACKGROUND DATA: Postoperative cognitive impairment is a prevalent individual

  13. Liberating burdensomeness of suicide survivorship loss: A Critical Interpretive Synthesis.

    Science.gov (United States)

    Talseth, Anne-Grethe; Gilje, Fredricka L

    2017-12-01

    What is an interpreted and synthesised understanding of responses of survivors to a suicide death of a close person? It is well known that survivors of suicide loss who are in a close relationship with the deceased are at high risk for suicidality and health conditions. Nurses in various settings need evidenced-informed approaches to encounter these vulnerable persons and support their healing journey from postvention to prevention. The design is reflexive and iterative. A Critical Interpretive Synthesis comprised of six phases: formulating the review question; searching literature; sampling; determining quality; extracting data; interpretive synthesis. Qualitative content analysis was also. Based on a sample of 15 published full-text qualitative and quantitative nursing research studies published between 1990 and 2016, an aggregated, interpreted and synthesised understanding of responses of survivors of suicide loss to the suicide death of a close person emerged. Four synthesised concepts were: dreading burden of suicide risk and stigma; facing burdensomeness in the aftermath of suicide death; enduring being burdened-unburdened, striving to invest in living; and liberating burdensomeness, journeying toward healing. Contextually, geo-cultural gaps exist in published nursing studies. Most studies were from North American and a few from Asia. The reported suicide deaths occurred over a wide range of time. Conceptually, four synthesised concepts can be viewed as a process of moving from burdensomeness to liberating burdensomeness. Methodologically, a small body of knowledge that met quality appraisal was interpreted and synthesised into an understanding of an evidenced-informed approach to guide nurses' encounters with survivors of suicide loss. The results contribute to an evidenced-informed approach for nurses in practice to support survivors of suicide loss journeying from burdensomeness to liberating burdensomeness. Results also serve as a foundation for further

  14. Adverse Childhood Experiences and Risk for First-Episode Major Depression During the Menopause Transition.

    Science.gov (United States)

    Epperson, C Neill; Sammel, Mary D; Bale, Tracy L; Kim, Deborah R; Conlin, Sarah; Scalice, Stephanie; Freeman, Katharine; Freeman, Ellen W

    2017-03-01

    Stress exposures may have a differential impact on risk and resilience for depression depending on their timing across development. We sought to determine whether adverse childhood experiences (ACEs) and their onset with respect to puberty contribute to the increased risk observed in first-episode major depressive disorder (MDD) during the menopause transition. Participants were from the Penn Ovarian Aging Study cohort, which is composed of women from Philadelphia County, Pennsylvania, who underwent behavioral, cognitive, and endocrine evaluations approximately yearly from 1996 to 2012 and completed the Adverse Childhood Experiences Questionnaire at study end point (n = 243). ACEs that first occurred 2 or more years before menarche were considered prepubertal. Incident menopause MDD was defined as first observed onset of the disorder in the perimenopause to postmenopause transition using the Structured Clinical Interview for DSM-III-R and the Primary Care Evaluation of Mental Disorders. Incident menopause MDD occurred in 48% of the 100 women who reported lifetime MDD. Women reporting ≥ 2 total ACEs were at significantly greater risk for lifetime MDD (adjusted odds ratio [aOR] = 2.05, P = .034) and incident menopause MDD (aOR = 2.58, P = .03) compared to those reporting 0 ACEs; women with ≥ 2 postpubertal ACEs were 2.3 times more likely to experience incidence menopause MDD (P = .024) after controlling for race, smoking, body mass index, and employment. Experiencing only 1 ACE in the prepubertal window, regardless of additional ACEs in postpuberty, was associated with reduced risk for lifetime and incident menopause MDD. Timing and number of adverse experiences with respect to puberty differentially impacted risk and resilience for MDD across the female life span and during the menopause transition in this community cohort. © Copyright 2017 Physicians Postgraduate Press, Inc.

  15. Data analysis and interpretation for environmental surveillance

    International Nuclear Information System (INIS)

    1992-06-01

    The Data Analysis and Interpretation for Environmental Surveillance Conference was held in Lexington, Kentucky, February 5--7, 1990. The conference was sponsored by what is now the Office of Environmental Compliance and Documentation, Oak Ridge National Laboratory. Participants included technical professionals from all Martin Marietta Energy Systems facilities, Westinghouse Materials Company of Ohio, Pacific Northwest Laboratory, and several technical support contractors. Presentations at the conference ranged the full spectrum of issues that effect the analysis and interpretation of environmental data. Topics included tracking systems for samples and schedules associated with ongoing programs; coalescing data from a variety of sources and pedigrees into integrated data bases; methods for evaluating the quality of environmental data through empirical estimates of parameters such as charge balance, pH, and specific conductance; statistical applications to the interpretation of environmental information; and uses of environmental information in risk and dose assessments. Hearing about and discussing this wide variety of topics provided an opportunity to capture the subtlety of each discipline and to appreciate the continuity that is required among the disciplines in order to perform high-quality environmental information analysis

  16. Melancholic features and hostility are associated with suicidality risk in Asian patients with major depressive disorder.

    Science.gov (United States)

    Jeon, Hong Jin; Peng, Daihui; Chua, Hong Choon; Srisurapanont, Manit; Fava, Maurizio; Bae, Jae-Nam; Man Chang, Sung; Hong, Jin Pyo

    2013-06-01

    Suicide rates are higher in East-Asians than other populations, and especially high in Koreans. However, little is known about suicidality risk and melancholic features in Asian patients with major depressive disorder (MDD). Drug-free MDD outpatients were included from 13 centers across five ethnicities consisting of Chinese (n=290), Korean (n=101), Thai (n=102), Indian (n=27), and Malay (n=27). All were interviewed using the Mini-International Neuropsychiatric Interview (M.I.N.I.), the Montgomery-Åsberg Depression Rating Scale (MADRS), and the Symptoms Checklist 90-Revised (SCL-90-R). Of 547 subjects, 177 MDD patients showed melancholic features (32.4%). These melancholic MDD patients revealed significantly higher suicidality risk (pdepression (pdifference in higher hostility. Adjusted odds ratios of melancholic features and hostility for moderate to high suicidality risk were 1.79 (95% CI=1.15-2.79) and 2.45 (95% CI=1.37-4.38), after adjusting for age, sex, education years, and depression severity. Post-hoc analyses showed that suicidality risk was higher in Korean and Chinese than that of Thai, Indian and Malay in MDD subjects with melancholic features, although depression severity showed no significant differences among the ethnicities. Suicidality risk is associated with both melancholic features and hostility and it shows cross-ethnic differences in Asian MDD patients, independent of depression severity. Copyright © 2013 Elsevier B.V. All rights reserved.

  17. On court interpreters' visibility

    DEFF Research Database (Denmark)

    Dubslaff, Friedel; Martinsen, Bodil

    of the service they receive. Ultimately, the findings will be used for training purposes. Future - and, for that matter, already practising - interpreters as well as the professional users of interpreters ought to take the reality of the interpreters' work in practice into account when assessing the quality...... on the interpreter's interpersonal role and, in particular, on signs of the interpreter's visibility, i.e. active co-participation. At first sight, the interpreting assignment in question seems to be a short and simple routine task which would not require the interpreter to deviate from the traditional picture...

  18. Do Interpreters Indeed Have Superior Working Memory in Interpreting

    Institute of Scientific and Technical Information of China (English)

    于飞

    2012-01-01

    With the frequent communications between China and western countries in the field of economy,politics and culture,etc,Inter preting becomes more and more important to people in all walks of life.This paper aims to testify the author’s hypothesis "professional interpreters have similar short-term memory with unprofessional interpreters,but they have superior working memory." After the illustration of literatures concerning with consecutive interpreting,short-term memory and working memory,experiments are designed and analysis are described.

  19. Major dust events in Europe during marine isotope stage 5 (130–74 ka: a climatic interpretation of the "markers"

    Directory of Open Access Journals (Sweden)

    D.-D. Rousseau

    2013-09-01

    Full Text Available At present, major dust storms are occurring at mid-latitudes in the Middle East and Asia, as well as at low latitudes in Northern Africa and in Australia. Western Europe, though, does not experience such dramatic climate events, except for some African dust reaching it from the Sahara. This modern situation is of particular interest, in the context of future climate projections, since the present interglacial is usually interpreted, in this context, as an analog of the warm Eemian interval. European terrestrial records show, however, major dust events during the penultimate interglacial and early glacial. These events are easily observed in loess records by their whitish-color deposits, which lie above and below dark chernozem paleosols in Central European records of Marine Isotope Stage (MIS 5 age. We describe here the base of the Dolni Vestonice (DV loess sequence, Czech Republic, as the reference of such records. The dust is deposited during intervals that are characterized by poor vegetation – manifested by high δ13C values and low magnetic susceptibility – while the fine sand and clay in the deposits shows grain sizes that are clearly different from the overlying pleniglacial loess deposits. Some of these dust events have been previously described as "Markers" or Marker Silts (MS by one of us (G. Kukla, and are dated at about 111–109 ka and 93–92 ka, with a third and last one slightly visible at about 75–73 ka. Other events correspond to the loess material of Kukla's cycles, and are described as eolian silts (ES; they are observed in the same DV sequence and are dated at about 106–105 ka, 88–86 ka, and 78.5–77 ka. These dates are determined by considering the OSL ages with their errors measured on the studied sequence, and the comparison with Greenland ice-core and European speleothem chronologies. The fine eolian deposits mentioned above, MS as well as ES, correspond to short events that lasted about 2 ka; they are

  20. Laboratory test result interpretation for primary care doctors in South Africa

    Directory of Open Access Journals (Sweden)

    Naadira Vanker

    2017-03-01

    Full Text Available Background: Challenges and uncertainties with test result interpretation can lead to diagnostic errors. Primary care doctors are at a higher risk than specialists of making these errors, due to the range in complexity and severity of conditions that they encounter. Objectives: This study aimed to investigate the challenges that primary care doctors face with test result interpretation, and to identify potential countermeasures to address these. Methods: A survey was sent out to 7800 primary care doctors in South Africa. Questionnaire themes included doctors’ uncertainty with interpreting test results, mechanisms used to overcome this uncertainty, challenges with appropriate result interpretation, and perceived solutions for interpreting results. Results: Of the 552 responses received, the prevalence of challenges with result interpretation was estimated in an average of 17% of diagnostic encounters. The most commonly-reported challenges were not receiving test results in a timely manner (51% of respondents and previous results not being easily available (37%. When faced with diagnostic uncertainty, 84% of respondents would either follow-up and reassess the patient or discuss the case with a specialist, and 67% would contact a laboratory professional. The most useful test utilisation enablers were found to be: interpretive comments (78% of respondents, published guidelines (74%, and a dedicated laboratory phone line (72%. Conclusion: Primary care doctors acknowledge uncertainty with test result interpretation. Potential countermeasures include the addition of patient-specific interpretive comments, the availability of guidelines or algorithms, and a dedicated laboratory phone line. The benefit of enhanced test result interpretation would reduce diagnostic error rates.

  1. Interpretation bias in Cluster-C and borderline personality disorders.

    Science.gov (United States)

    Arntz, Arnoud; Weertman, Anoek; Salet, Sjoerd

    2011-08-01

    Cognitive therapy (CT) assumes that personality disorders (PDs) are characterized by interpretational biases that maintain the disorder. Changing interpretations is therefore a major aim of CT of PDs. This study tested whether Borderline PD (BPD), Avoidant and Dependent PD (AV/DEPD), and Obsessive-Compulsive PD (OCPD) are characterized by specific interpretations. Among the 122 participants there were 55 PD patients (17 BPD, 30 AV/DEPD, 29 OCPD diagnoses), 26 axis-1 patients, and 41 nonpatients. Participants put themselves into 10 scripts of negative events and noted feelings, thoughts and behaviors that came to mind. Next, they chose between hypothesized BPD-specific, AV/DEPD-specific, and OCPD-specific interpretations of each event (forced choice). Lastly, participants rated belief in each interpretation. Regression analyses revealed that forced choices and belief ratings supported the CT-model of BPD and AV/DEP: interpretations were specific. The alleged OCPD-beliefs were however not specifically related to OCPD, with relatively high popularity in axis-1 patients and nonpatients. The open responses were classified by judges blind for diagnoses, with the following results. BPD was characterized by low levels of solution-focused and healthy-flexible/accepting responses, and higher levels of criticizing others and malevolent interpretations of others. AV/DEPD was characterized by lower levels of solution-focused responses, and higher levels of self-criticism, negative emotions, guilt and fear of judgment, as well as lower levels of other-criticism. OCPD only showed trends for lower healthy responses, and higher compulsiveness and worry. It is concluded that the assumptions of CT are supported for BPD and AV/DEPD, but not - at least not on the explicit interpretational level - for OCPD. CT of OCPD might need a slightly different approach. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Act No. 87-565 of 22 July 1987 on the organization of public safety measures, forestry protection against fires and the prevention of major risks

    International Nuclear Information System (INIS)

    1987-01-01

    As defined by this Act, the objective of the public safety measures is to prevent all types of major risks and to protect persons, property and the environment, including forests, against accidents, disasters and catastrophes. It deals with the conditions for preparing preventive measures and for implementing necessary measures in case of major risks or accidents. The preparation and organization of assistance are determined within the framework of ORSEC (ORganisation des SECours) plans and emergency plans; the first assess the possibilities for facing up to disasters while the latter provide for measures and means to overcome a particular risk [fr

  3. Female gender and acne disease are jointly and independently associated with the risk of major depression and suicide: a national population-based study.

    Science.gov (United States)

    Yang, Yi-Chien; Tu, Hung-Pin; Hong, Chien-Hui; Chang, Wei-Chao; Fu, Hung-Chun; Ho, Ji-Chen; Chang, Wei-Pin; Chuang, Hung-Yi; Lee, Chih-Hung

    2014-01-01

    Acne is a common disease in adolescence with female preponderance. It could cause poor self-esteem and social phobia. Previous studies based on questionnaires from several thousands of adolescents showed that acne is associated with major depression and suicide. However, the gender- and age-specific risk of depression and suicide in patients with acne remain largely unknown. Using a database from the National Health Insurance, which included 98% of the population of Taiwan in 2006, we identified patients of acne, major depression, and suicide based on ICD-9-CM codes. Totally 47111 patients with acne were identified (16568 males and 30543 females) from 1 million subjects. The youths of 7-12 years had the highest prevalence of acne (14.39%). Major depression was more common in those with acne (0.77%) than controls (0.56% , P suicide was noticed in women with acne. In conclusion, acne and gender, independently and jointly, are associated with major depression and suicide. Special medical support should be warranted in females with acne for the risk of major depression and suicide.

  4. Genre and Interpretation

    DEFF Research Database (Denmark)

    Auken, Sune

    2015-01-01

    Despite the immensity of genre studies as well as studies in interpretation, our understanding of the relationship between genre and interpretation is sketchy at best. The article attempts to unravel some of intricacies of that relationship through an analysis of the generic interpretation carrie...

  5. Major Risk Factors for Heart Disease: Overweight and Obesity

    Science.gov (United States)

    ... we spend more time in front of computers, video games, TV, and other electronic pastimes, we have fewer ... no other risk factors. Overweight and obesity also increase the risks for diabetes, high blood pressure, high ...

  6. Analysis of major risk factors affecting those working in the agrarian sector (based on a sociological survey).

    Science.gov (United States)

    Krekoten, Olena M; Dereziuk, Anatolii V; Ihnaschuk, Olena V; Holovchanska, Svitlana E

    Issues related to labour potential, its state and problems have consistently been a focus of attention for the International Labour Organisation (ILO). Its respective analysis shows that labour potential problems remain unresolved in many countries of the world. According to the World Health Organisation (WHO), adverse working conditions are among major factors of occupational disease development in Europe and the reason for disabilities of economically active population during 2.5% of their lifetime. The aim of the present study is to identify and analyse major risk factors, which have a bearing on people working in agriculture in the course of exercising their occupation, with account of forms of ownership of agricultural enterprises. Carried out was a cross-sectional study involving a sociological survey of 412 respondents - those working in agriculture - who made up the primary group and the control group. The study revealed 21 risk factors, 9 of which were work-related. A modified elementary cybernetic model of studying impact efficiency was developed with the view of carrying out a structural analysis of the sample group and choosing relevant methodological approaches. It has been established that harmful factors related to working environment and one's lifestyle are decisive in the agrarian sector, particularly for workers of privately owned businesses. For one out of three respondents harmful working conditions manifested themselves as industrial noise (31.7±3.4), vibration (29.0±2.1) trunk bending and constrained working posture (36.6±3.4). The vast majority of agricultural workers (91.6±2.5) admitted they could not afford proper rest during their annual leave; male respondents abused alcohol (70.6±3.0) and smoking (41.4±2.0 per 100 workers). The research established the structure of risk factors, which is sequentially represented by the following groups: behavioral (smoking, drinking of alcohol, rest during annual leave, physical culture), working

  7. Engineering Definitional Interpreters

    DEFF Research Database (Denmark)

    Midtgaard, Jan; Ramsay, Norman; Larsen, Bradford

    2013-01-01

    A definitional interpreter should be clear and easy to write, but it may run 4--10 times slower than a well-crafted bytecode interpreter. In a case study focused on implementation choices, we explore ways of making definitional interpreters faster without expending much programming effort. We imp...

  8. Cardiac imaging: working towards fully-automated machine analysis & interpretation.

    Science.gov (United States)

    Slomka, Piotr J; Dey, Damini; Sitek, Arkadiusz; Motwani, Manish; Berman, Daniel S; Germano, Guido

    2017-03-01

    Non-invasive imaging plays a critical role in managing patients with cardiovascular disease. Although subjective visual interpretation remains the clinical mainstay, quantitative analysis facilitates objective, evidence-based management, and advances in clinical research. This has driven developments in computing and software tools aimed at achieving fully automated image processing and quantitative analysis. In parallel, machine learning techniques have been used to rapidly integrate large amounts of clinical and quantitative imaging data to provide highly personalized individual patient-based conclusions. Areas covered: This review summarizes recent advances in automated quantitative imaging in cardiology and describes the latest techniques which incorporate machine learning principles. The review focuses on the cardiac imaging techniques which are in wide clinical use. It also discusses key issues and obstacles for these tools to become utilized in mainstream clinical practice. Expert commentary: Fully-automated processing and high-level computer interpretation of cardiac imaging are becoming a reality. Application of machine learning to the vast amounts of quantitative data generated per scan and integration with clinical data also facilitates a move to more patient-specific interpretation. These developments are unlikely to replace interpreting physicians but will provide them with highly accurate tools to detect disease, risk-stratify, and optimize patient-specific treatment. However, with each technological advance, we move further from human dependence and closer to fully-automated machine interpretation.

  9. Directionality effects in simultaneous language interpreting: the case of sign language interpreters in The Netherlands.

    Science.gov (United States)

    Van Dijk, Rick; Boers, Eveline; Christoffels, Ingrid; Hermans, Daan

    2011-01-01

    The quality of interpretations produced by sign language interpreters was investigated. Twenty-five experienced interpreters were instructed to interpret narratives from (a) spoken Dutch to Sign Language of The Netherlands (SLN), (b) spoken Dutch to Sign Supported Dutch (SSD), and (c) SLN to spoken Dutch. The quality of the interpreted narratives was assessed by 5 certified sign language interpreters who did not participate in the study. Two measures were used to assess interpreting quality: the propositional accuracy of the interpreters' interpretations and a subjective quality measure. The results showed that the interpreted narratives in the SLN-to-Dutch interpreting direction were of lower quality (on both measures) than the interpreted narratives in the Dutch-to-SLN and Dutch-to-SSD directions. Furthermore, interpreters who had begun acquiring SLN when they entered the interpreter training program performed as well in all 3 interpreting directions as interpreters who had acquired SLN from birth.

  10. Mammographic interpretation

    International Nuclear Information System (INIS)

    Tabor, L.

    1987-01-01

    For mammography to be an effective diagnostic method, it must be performed to a very high standard of quality. Otherwise many lesions, in particular cancer in its early stages, will simply not be detectable on the films, regardless of the skill of the mammographer. Mammographic interpretation consists of two basic steps: perception and analysis. The process of mammographic interpretation begins with perception of the lesion on the mammogram. Perception is influenced by several factors. One of the most important is the parenchymal pattern of the breast tissue, detection of pathologic lesions being easier with fatty involution. The mammographer should use a method for the systematic viewing of the mammograms that will ensure that all parts of each mammogram are carefully searched for the presence of lesions. The method of analysis proceeds according to the type of lesion. The contour analysis of primary importance in the evaluation of circumscribed tumors. After having analyzed the contour and density of a lesion and considered its size, the mammographer should be fairly certain whether the circumscribed tumor is benign or malignant. Fine-needle puncture and/or US may assist the mammographer in making this decision. Painstaking analysis is required because many circumscribed tumors do not need to be biopsied. The perception of circumscribed tumors seldom causes problems, but their analysis needs careful attention. On the other hand, the major challenge with star-shaped lesions is perception. They may be difficult to discover when small. Although the final diagnosis of a stellate lesion can be made only with the help of histologic examination, the preoperative mammorgraphic differential diagnosis can be highly accurate. The differential diagnostic problem is between malignant tumors (scirrhous carcinoma), on the one hand, and traumatic fat necrosis as well as radial scars on the other hand

  11. Cardiovascular risk factors are major determinants of thrombotic risk in patients with the lupus anticoagulant.

    Science.gov (United States)

    Posch, Florian; Gebhart, Johanna; Rand, Jacob H; Koder, Silvia; Quehenberger, Peter; Pengo, Vittorio; Ay, Cihan; Pabinger, Ingrid

    2017-03-10

    Patients with the lupus anticoagulant (LA) are at an increased risk of thrombotic events, which in turn increase the risk of death. Understanding the determinants of thrombotic risk in patients with LA may pave the way towards targeted thromboprophylaxis. In the Vienna Lupus Anticoagulant and Thrombosis Study (LATS), we systematically evaluate risk factors for thrombotic events in patients with LA. We followed 150 patients (mean age: 41.3 years, female gender: n = 122 (81.3%), history of thrombosis or pregnancy complications: n = 111 (74.0%)), who tested repeatedly positive for LA until development of thrombosis, death, or censoring. The primary endpoint was a composite of arterial or venous thrombotic events (TEs). During a median follow-up of 9.5 years (range: 12 days-13.6 years) and 1076 person-years, 32 TEs occurred (arterial: n = 16, venous: n = 16; cumulative 10-year TE incidence: 24.3%). A prolonged lupus-sensitive activated partial thromboplastin time (aPTT-LA) (adjusted subdistribution hazard ratio (SHR) = 2.31, 95% CI: 1.07--5.02), diabetes (adjusted SHR = 4.39, 95% CI: 1.42-13.57), and active smoking (adjusted SHR = 2.31, 95% CI: 1.14-5.02) emerged as independent risk factors of both arterial and venous thrombotic risk. A risk model that includes a prolonged lupus-sensitive aPTT, smoking, and diabetes enabled stratification of LA patients into subgroups with a low, intermediate, and high risk of thrombosis (5-year TE risk of 9.7% (n = 77), 30.9% (n = 51), and 56.8% (n = 22). Long-term thrombotic risk in patients with LA is clustered within subjects harboring typical cardiovascular risk factors in addition to a prolonged lupus-sensitive aPTT, whereas patients with none of these risk factors represent a large subgroup with a low risk of thrombosis.

  12. Major depression as a risk factor for high blood pressure: epidemiologic evidence from a national longitudinal study.

    Science.gov (United States)

    Patten, Scott B; Williams, Jeanne V A; Lavorato, Dina H; Campbell, Norman R C; Eliasziw, Michael; Campbell, Tavis S

    2009-04-01

    To determine whether major depression (MD) leads to an increased risk of new-onset high blood pressure diagnoses. The data source was the Canadian National Population Health Survey (NPHS). The NPHS included a short-form version of the Composite International Diagnostic Interview (CIDI-SF) to assess MD and collected self-report data about professionally diagnosed high blood pressure and the use of antihypertensive medications. The analysis included 12,270 respondents who did not report high blood pressure or the use of antihypertensive medications at a baseline interview conducted in 1994. Proportional hazards models were used to compare the incidence of high blood pressure in respondents with and without MD during 10 years of subsequent follow-up. After adjustment for age, the risk of developing high blood pressure was elevated in those with MD. The hazard ratio was 1.6 (95% Confidence Interval = 1.2-2.1), p = .001, indicating a 60% increase in risk. Adjustment for additional covariates did not alter the association. MD may be a risk factor for new-onset high blood pressure. Epidemiologic data cannot definitely confirm a causal role, and the association may be due to shared etiologic factors. However, the increased risk may warrant closer monitoring of blood pressure in people with depressive disorders.

  13. Effect of Tryptophan Hydroxylase-2 rs7305115 SNP on suicide attempts risk in major depression

    Directory of Open Access Journals (Sweden)

    Zhang Yuqi

    2010-08-01

    Full Text Available Abstract Background Suicide and major depressive disorders (MDD are strongly associated, and genetic factors are responsible for at least part of the variability in suicide risk. We investigated whether variation at the tryptophan hydroxylase-2 (TPH2 gene rs7305115 SNP may predispose to suicide attempts in MDD. Methods We genotyped TPH2 gene rs7305115 SNP in 215 MDD patients with suicide and matched MDD patients without suicide. Differences in behavioral and personality traits according to genotypic variation were investigated by logistic regression analysis. Results There were no significant differences between MDD patients with suicide and controls in genotypic (AG and GG frequencies for rs7305115 SNP, but the distribution of AA genotype differed significantly (14.4% vs. 29.3%, p p p Conclusions The study suggested that hopelessness, negative life events and family history of suicide were risk factors of attempted suicide in MDD while the TPH2 rs7305115A remained a significant protective predictor of suicide attempts.

  14. Equestrian injuries: incidence, injury patterns, and risk factors for 10 years of major traumatic injuries.

    Science.gov (United States)

    Ball, Chad G; Ball, Jill E; Kirkpatrick, Andrew W; Mulloy, Robert H

    2007-05-01

    Horseback riding is more dangerous than motorcycle riding, skiing, football, and rugby. The purpose of this study was to identify the incidence and injury patterns, as well as risk factors associated with severe equestrian trauma. All patients with major equestrian injuries (injury severity score > or = 12) admitted between 1995 and 2005 were reviewed. A 46-question survey outlining potential rider, animal, and environmental risk factors was administered. Among 7941 trauma patients, 151 (2%) were injured on horseback (mean injury severity score, 20; mortality rate, 7%). Injuries included the chest (54%), head (48%), abdomen (22%), and extremities (17%). Forty-five percent required surgery. Survey results (55%) indicated that riders and horses were well trained, with a 47% recidivism rate. Only 9% of patients wore helmets, however, 64% believed the accident was preventable. Chest trauma previously has been underappreciated. This injury pattern may be a result of significant rider experience. Helmet and vest use will be targeted in future injury prevention strategies.

  15. Financial risks in major investment projects

    International Nuclear Information System (INIS)

    Segelod, Esbjoern

    2006-01-01

    We have probably all read about large projects which proved far more expensive than anticipated, projects such as the Channel tunnel which cost 80% more than planned, and the oil pipeline between the oil field in Prudhoe Bay in Northern Alaska and the oil terminal in Vadez in the south which overran its budget by 1,000%. The purpose of this paper is to summarise our knowledge of the risk of cost escalation. Which projects are more likely than others to be hit by cost escalation, and why

  16. Specificity of interpretation and judgemental biases in social phobia versus depression.

    Science.gov (United States)

    Voncken, M J; Bögels, S M; Peeters, F

    2007-09-01

    A body of studies shows that social phobia is characterized by content specific interpretation and judgmental biases. That is, they show bias in social situations but not in non-social situations. Comorbid depression, one of the major comorbid disorders in social phobia, might account for these biases in social phobia since depression also is characterized by cognitive distortions in social situations. This study hypothesized that, despite comorbid depression, patients with social phobia would suffer from contentspecific biases. Participants filled out the Interpretation and Judgmental Questionnaire (IJQ) to assess interpretation bias (using open-ended responses and forced-interpretations) and judgmental bias in social and non-social situations. Four groups participated: social phobic patients with high (N=38) and low (N=47) depressive symptoms, depressed patients (N=22) and normal controls (N=33). We found both social phobic groups to interpret social situations more negatively and judge social situations as more threatening than non-social situations relative to depressed patients and normal controls. As expected, depressive symptoms related to increased general interpretation and judgmental biases across social and non-social situations. In contrast to expectations, we did not find these patterns for the open-ended measure of interpretation bias. The content-specific biases for social situations distinguished social phobic patients from depressive patients. This speaks for the importance of establishing the primary diagnosis in patients with mixed depression and social anxiety complaints.

  17. [Incidence and risk factors of venous thromboembolism in major spinal surgery with no chemical or mechanical prophylaxis].

    Science.gov (United States)

    Rojas-Tomba, F; Gormaz-Talavera, I; Menéndez-Quintanilla, I E; Moriel-Durán, J; García de Quevedo-Puerta, D; Villanueva-Pareja, F

    2016-01-01

    To evaluate the incidence of venous thromboembolism in spine surgery with no chemical and mechanical prophylaxis, and to determine the specific risk factors for this complication. A historical cohort was analysed. All patients subjected to major spinal surgery, between January 2010 and September 2014, were included. No chemical or mechanical prophylaxis was administered in any patient. Active mobilisation of lower limbs was indicated immediately after surgery, and early ambulation started in the first 24-48 hours after surgery. Clinically symptomatic cases were confirmed by Doppler ultrasound of the lower limbs or chest CT angiography. A sample of 1092 cases was studied. Thromboembolic events were observed in 6 cases (.54%); 3 cases (.27%) with deep venous thrombosis and 3 cases (.27%) with pulmonary thromboembolism. A lethal case was identified (.09%). There were no cases of major bleeding or epidural haematoma. The following risk factors were identified: a multilevel fusion at more than 4 levels, surgeries longer than 130 minutes, patients older than 70 years of age, hypertension, and degenerative scoliosis. There is little scientific evidence on the prevention of thromboembolic events in spinal surgery. In addition to the disparity of prophylactic methods indicated by different specialists, it is important to weigh the risk-benefit of intra- and post-operative bleeding, and even the appearance of an epidural haematoma. Prophylaxis should be assessed in elderly patients over 70 years old, who are subjected to surgeries longer than 130 minutes, when 4 or more levels are involved. Copyright © 2015 SECOT. Published by Elsevier Espana. All rights reserved.

  18. High resolution esophageal manometry--the switch from "intuitive" visual interpretation to Chicago classification.

    Science.gov (United States)

    Srinivas, M; Balakumaran, T A; Palaniappan, S; Srinivasan, Vijaya; Batcha, M; Venkataraman, Jayanthi

    2014-03-01

    High resolution esophageal manometry (HREM) has been interpreted all along by visual interpretation of color plots until the recent introduction of Chicago classification which categorises HREM using objective measurements. It compares HREM diagnosis of esophageal motor disorders by visual interpretation and Chicago classification. Using software Trace 1.2v, 77 consecutive tracings diagnosed by visual interpretation were re-analyzed by Chicago classification and findings compared for concordance between the two systems of interpretation. Kappa agreement rate between the two observations was determined. There were 57 males (74 %) and cohort median age was 41 years (range: 14-83 years). Majority of the referrals were for gastroesophageal reflux disease, dysphagia and achalasia. By "intuitive" visual interpretation, the tracing were reported as normal in 45 (58.4 %), achalasia 14 (18.2 %), ineffective esophageal motility 3 (3.9 %), nutcracker esophagus 11 (14.3 %) and nonspecific motility changes 4 (5.2 %). By Chicago classification, there was 100 % agreement (Kappa 1) for achalasia (type 1: 9; type 2: 5) and ineffective esophageal motility ("failed peristalsis" on visual interpretation). Normal esophageal motility, nutcracker esophagus and nonspecific motility disorder on visual interpretation were reclassified as rapid contraction and esophagogastric junction (EGJ) outflow obstruction by Chicago classification. Chicago classification identified distinct clinical phenotypes including EGJ outflow obstruction not identified by visual interpretation. A significant number of unclassified HREM by visual interpretation were also classified by it.

  19. Patients' Experience of therapeutic footwear whilst living at risk of neuropathic diabetic foot ulceration: an interpretative phenomenological analysis (IPA).

    Science.gov (United States)

    Paton, Joanne S; Roberts, Anne; Bruce, Graham K; Marsden, Jonathan

    2014-02-22

    Previous work has found that people with diabetes do not wear their therapeutic footwear as directed, but the thinking behind this behaviour is unclear. Adherence to therapeutic footwear advice must improve in order to reduce foot ulceration and amputation risk in people with diabetes and neuropathy. Therefore this study aimed to explore the psychological influences and personal experiences behind the daily footwear selection of individuals with diabetes and neuropathy. An interpretative phenomenological analysis (IPA) approach was used to explore the understanding and experience of therapeutic footwear use in people living at risk of diabetic neuropathic foot ulceration. This study benefited from the purposive selection of a small sample of four people and used in-depth semi structured interviews because it facilitated the deep and detailed examination of personal thoughts and feelings behind footwear selection. Four overlapping themes that interact to regulate footwear choice emerged from the analyses: a) Self-perception dilemma; resolving the balance of risk experienced by people with diabetes and neuropathy day to day, between choosing to wear footwear to look and feel normal and choosing footwear to protect their feet from foot ulceration; b) Reflective adaption; The modification and individualisation of a set of values about footwear usage created in the minds of people with diabetes and neuropathy; c) Adherence response; The realignment of footwear choice with personal values, to reinforce the decision not to change behaviour or bring about increased footwear adherence, with or without appearance management; d) Reality appraisal; A here and now appraisal of the personal benefit of footwear choice on emotional and physical wellbeing, with additional consideration to the preservation of therapeutic footwear. For some people living at risk of diabetic neuropathic foot ulceration, the decision whether or not to wear therapeutic footwear is driven by the

  20. Patients’ Experience of therapeutic footwear whilst living at risk of neuropathic diabetic foot ulceration: an interpretative phenomenological analysis (IPA)

    Science.gov (United States)

    2014-01-01

    Background Previous work has found that people with diabetes do not wear their therapeutic footwear as directed, but the thinking behind this behaviour is unclear. Adherence to therapeutic footwear advice must improve in order to reduce foot ulceration and amputation risk in people with diabetes and neuropathy. Therefore this study aimed to explore the psychological influences and personal experiences behind the daily footwear selection of individuals with diabetes and neuropathy. Methods An interpretative phenomenological analysis (IPA) approach was used to explore the understanding and experience of therapeutic footwear use in people living at risk of diabetic neuropathic foot ulceration. This study benefited from the purposive selection of a small sample of four people and used in-depth semi structured interviews because it facilitated the deep and detailed examination of personal thoughts and feelings behind footwear selection. Findings Four overlapping themes that interact to regulate footwear choice emerged from the analyses: a) Self-perception dilemma; resolving the balance of risk experienced by people with diabetes and neuropathy day to day, between choosing to wear footwear to look and feel normal and choosing footwear to protect their feet from foot ulceration; b) Reflective adaption; The modification and individualisation of a set of values about footwear usage created in the minds of people with diabetes and neuropathy; c) Adherence response; The realignment of footwear choice with personal values, to reinforce the decision not to change behaviour or bring about increased footwear adherence, with or without appearance management; d) Reality appraisal; A here and now appraisal of the personal benefit of footwear choice on emotional and physical wellbeing, with additional consideration to the preservation of therapeutic footwear. Conclusion For some people living at risk of diabetic neuropathic foot ulceration, the decision whether or not to wear

  1. Left atrial enlargement increases the risk of major adverse cardiac events independent of coronary vasodilator capacity

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Angela S. [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); National Heart Centre Singapore, Singapore (Singapore); Murthy, Venkatesh L.; Sitek, Arkadiusz; Gayed, Peter; Bruyere, John; Di Carli, Marcelo F. [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); Wu, Justina [Brigham and Women' s Hospital, Division of Cardiology, Department of Medicine, and the Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Boston, MA (United States); Dorbala, Sharmila [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); Brigham and Women' s Hospital, Department of Radiology and the Division of Cardiology, Noninvasive Cardiovascular Imaging Section, Boston, MA (United States)

    2015-09-15

    Longstanding uncontrolled atherogenic risk factors may contribute to left atrial (LA) hypertension, LA enlargement (LAE) and coronary vascular dysfunction. Together they may better identify risk of major adverse cardiac events (MACE). The aim of this study was to test the hypothesis that chronic LA hypertension as assessed by LAE modifies the relationship between coronary vascular function and MACE. In 508 unselected subjects with a normal clinical {sup 82}Rb PET/CT, ejection fraction ≥40 %, no prior coronary artery disease, valve disease or atrial fibrillation, LAE was determined based on LA volumes estimated from the hybrid perfusion and CT transmission scan images and indexed to body surface area. Absolute myocardial blood flow and global coronary flow reserve (CFR) were calculated. Subjects were systematically followed-up for the primary end-point - MACE - a composite of all-cause death, myocardial infarction, hospitalization for heart failure, stroke, coronary artery disease progression or revascularization. During a median follow-up of 862 days, 65 of the subjects experienced a composite event. Compared with subjects with normal LA size, subjects with LAE showed significantly lower CFR (2.25 ± 0.83 vs. 1.95 ± 0.80, p = 0.01). LAE independently and incrementally predicted MACE even after accounting for clinical risk factors, medication use, stress left ventricular ejection fraction, stress left ventricular end-diastolic volume index and CFR (chi-squared statistic increased from 30.9 to 48.3; p = 0.001). Among subjects with normal CFR, those with LAE had significantly worse event-free survival (risk adjusted HR 5.4, 95 % CI 2.3 - 12.8, p < 0.0001). LAE and reduced CFR are related but distinct cardiovascular adaptations to atherogenic risk factors. LAE is a risk marker for MACE independent of clinical factors and left ventricular volumes; individuals with LAE may be at risk of MACE despite normal coronary vascular function. (orig.)

  2. Theoretical interpretation of high-energy nuclear collisions

    International Nuclear Information System (INIS)

    Fai, G.

    1992-06-01

    Nuclear collisions are interpreted theoretically. The nuclear equation of state is studied in a wide energy range. Subnucleonic degrees of freedom are invoked at high energy densities and at short length-scales. Questions of dynamical collision simulations are investigated. Direct support is provided for experiment in the form of collaborative projects. The major objective of this nuclear theory program is a better understanding of the properties of strongly interacting matter on the nuclear energy scale, as manifested in high-energy heavy-ion collisions

  3. Localized Smart-Interpretation

    Science.gov (United States)

    Lundh Gulbrandsen, Mats; Mejer Hansen, Thomas; Bach, Torben; Pallesen, Tom

    2014-05-01

    The complex task of setting up a geological model consists not only of combining available geological information into a conceptual plausible model, but also requires consistency with availably data, e.g. geophysical data. However, in many cases the direct geological information, e.g borehole samples, are very sparse, so in order to create a geological model, the geologist needs to rely on the geophysical data. The problem is however, that the amount of geophysical data in many cases are so vast that it is practically impossible to integrate all of them in the manual interpretation process. This means that a lot of the information available from the geophysical surveys are unexploited, which is a problem, due to the fact that the resulting geological model does not fulfill its full potential and hence are less trustworthy. We suggest an approach to geological modeling that 1. allow all geophysical data to be considered when building the geological model 2. is fast 3. allow quantification of geological modeling. The method is constructed to build a statistical model, f(d,m), describing the relation between what the geologists interpret, d, and what the geologist knows, m. The para- meter m reflects any available information that can be quantified, such as geophysical data, the result of a geophysical inversion, elevation maps, etc... The parameter d reflects an actual interpretation, such as for example the depth to the base of a ground water reservoir. First we infer a statistical model f(d,m), by examining sets of actual interpretations made by a geological expert, [d1, d2, ...], and the information used to perform the interpretation; [m1, m2, ...]. This makes it possible to quantify how the geological expert performs interpolation through f(d,m). As the geological expert proceeds interpreting, the number of interpreted datapoints from which the statistical model is inferred increases, and therefore the accuracy of the statistical model increases. When a model f

  4. The YWHAE gene confers risk to major depressive disorder in the male group of Chinese Han population.

    Science.gov (United States)

    Liu, Jie; Zhang, Hong-Xin; Li, Zhi-Qiang; Li, Tao; Li, Jun-Yan; Wang, Ti; Li, You; Feng, Guo-Yin; Shi, Yong-Yong; He, Lin

    2017-07-03

    Schizophrenia and major depressive disorder are two major psychiatric illnesses that may share specific genetic risk factors to a certain extent. Increasing evidence suggests that the two disorders might be more closely related than previously considered. To investigate whether YWHAE gene plays a significant role in major depressive disorder in Han Chinese population, we recruited 1135 unrelated major depressive disorder patients (485 males, 650 females) and 989 unrelated controls (296 males, 693 females) of Chinese Han origin. Eleven common SNPs were genotyped using TaqMan® technology. In male-group, the allele and genotype frequencies of rs34041110 differed significantly between patients and control (P allele =0.036486, OR[95%CI]: 1.249442(1.013988-1.539571); P genotype =0.045301). Also in this group, allele and genotype frequencies of rs1532976 differed significantly (P allele =0.013242, OR[95%CI]: 1.302007(1.056501-1.604563); genotype: P=0.039152). Haplotype-analyses showed that, in male-group, positive association with major depressive disorder was found for the A-A-C-G haplotype of rs3752826-rs2131431-rs1873827-rs12452627 (χ 2 =20.397, P=6.38E-06, OR[95%CI]: 7.442 [2.691-20.583]), its C-A-C-G haplotype (χ 2 =19.122, P=1.24E-05, OR and 95%CI: 0.402 [0.264-0.612]), its C-C-T-G haplotype (χ 2 =9.766, P=0.001785, OR[95%CI]: 5.654 [1.664-19.211]). In female-group, positive association was found for the A-A-C-G haplotype of rs3752826-rs2131431-rs1873827-rs12452627 (χ 2 =78.628, P=7.94E-19, OR[95%CI]: 50.043 [11.087-225.876]), its A-C-T-G haplotype (χ 2 =38.806, P=4.83E-10, OR[95%CI]: 0.053 [0.015-0.192]), the C-A-C-G haplotype (χ 2 =18.930, P=1.37E-05, OR[95%CI]: 0.526 [0.392-0.705]), and the C-C-T-G haplotype (χ 2 =38.668, P=5.18E-10, OR[95%CI]: 6.130 [3.207-11.716]). Our findings support YWHAE being a risk gene for Major Depressive Disorder in the Han Chinese population. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Interpretation of Coronary Angiograms Recorded Using Google Glass: A Comparative Analysis.

    Science.gov (United States)

    Duong, Thao; Wosik, Jedrek; Christakopoulos, Georgios E; Martínez Parachini, José Roberto; Karatasakis, Aris; Tarar, Muhammad Nauman Javed; Resendes, Erica; Rangan, Bavana V; Roesle, Michele; Grodin, Jerrold; Abdullah, Shuaib M; Banerjee, Subhash; Brilakis, Emmanouil S

    2015-10-01

    Google Glass (Google, Inc) is a voice-activated, hands-free, optical head-mounted display device capable of taking pictures, recording videos, and transmitting data via wi-fi. In the present study, we examined the accuracy of coronary angiogram interpretation, recorded using Google Glass. Google Glass was used to record 15 angiograms with 17 major findings and the participants were asked to interpret those recordings on: (1) an iPad (Apple, Inc); or (2) a desktop computer. Interpretation was compared with the original angiograms viewed on a desktop. Ten physicians (2 interventional cardiologists and 8 cardiology fellows) participated. One point was assigned for each correct finding, for a maximum of 17 points. The mean angiogram interpretation score for Google Glass angiogram recordings viewed on an iPad or a desktop vs the original angiograms viewed on a desktop was 14.9 ± 1.1, 15.2 ± 1.8, and 15.9 ± 1.1, respectively (P=.06 between the iPad and the original angiograms, P=.51 between the iPad and recordings viewed on a desktop, and P=.43 between the recordings viewed on a desktop and the original angiograms). In a post-study survey, one of the 10 physicians (10%) was "neutral" with the quality of the recordings using Google Glass, 6 physicians (60%) were "somewhat satisfied," and 3 physicians (30%) were "very satisfied." This small pilot study suggests that the quality of coronary angiogram video recordings obtained using Google Glass may be adequate for recognition of major findings, supporting its expanding use in telemedicine.

  6. Major malformation risk, pregnancy outcomes, and neurodevelopmental outcomes associated with metformin use during pregnancy.

    Science.gov (United States)

    Andrade, Chittaranjan

    2016-04-01

    There are several reasons why metformin treatment may be considered for women in neuropsychiatric practice. These include prevention or attenuation of antipsychotic-associated weight gain, prevention or treatment of gestational diabetes mellitus (GDM), treatment of type 2 diabetes mellitus, and improvement of conception chances and pregnancy outcomes in the presence of polycystic ovarian disease (PCOD). This article examines the benefits and risks associated with metformin use during pregnancy. The available data suggest that metformin exposure during the first trimester is not associated with major congenital malformations; that metformin reduces the risk of early pregnancy loss, preeclampsia, preterm delivery, and GDM in women with PCOD; that metformin is associated with at least comparable benefits relative to insulin treatment in women with mild GDM; and that neurodevelopmental outcomes at age 1.5-2.5 years are comparable after gestational exposure to metformin and insulin. Whereas study designs were not always ideal and sample sizes were mostly small to modest, the study findings are more encouraging than discouraging and can guide shared decision-making in women who are receiving or may need metformin during pregnancy. © Copyright 2016 Physicians Postgraduate Press, Inc.

  7. Constructing identities in the media: newspaper coverage analysis of a major UK Clostridium difficile outbreak.

    Science.gov (United States)

    Burnett, Emma; Johnston, Bridget; Corlett, Joanne; Kearney, Nora

    2014-07-01

    To examine how a major Clostridium difficile outbreak in the UK was represented in the media. Clostridium difficile is a serious health care-associated infection with significant global prevalence. As major outbreaks have continued to occur worldwide over the last few decades, it has also resulted in increasing media coverage. Newspaper journalists are, however, frequently criticized for sensationalized and inaccurate reporting and alarming the public. Despite such criticisms, nothing is known about how the media frame Clostridium difficile related coverage. Qualitative interpretive descriptive study. An interpretive analysis of newspaper articles from the national press that reported about the outbreak from the first day of coverage over 3 weeks (12 June-3 July 2008). Twenty-eight newspaper articles were included in the study from tabloids, broadsheets, a regional and a Sunday newspaper. Monster and war metaphors were frequently adopted to portray the severity of Clostridium difficile and the impact it can have on patient safety. In addition, the positioning of the affected patients, their families, healthcare professionals and the Government produced representations of victims, villains and heroes. This subsequently evoked notions of vulnerability, blame and conflict. The media are and will remain critical convectors of public information and, as such, are hugely influential in risk perceptions and responses. Rather than simply dismissing media coverage, further understanding around how such stories in specific contexts are constructed and represented is needed so that it can help inform future communication and management strategies. © 2013 John Wiley & Sons Ltd.

  8. Risk factors for postoperative delirium in patients undergoing major head and neck cancer surgery: a meta-analysis.

    Science.gov (United States)

    Zhu, Yun; Wang, Gangpu; Liu, Shengwen; Zhou, Shanghui; Lian, Ying; Zhang, Chenping; Yang, Wenjun

    2017-06-01

    Postoperative delirium is common after extensive surgery. This study aimed to collate and synthesize published literature on risk factors for delirium in patients with head and neck cancer surgery. Three databases were searched (MEDLINE, Embase, and Cochrane Library) between January 1987 and July 2016. The Newcastle Ottawa Scale (NOS) was adopted to evaluate the study quality. Pooled odds ratios or mean differences for individual risk factors were estimated using the Mantel-Haenszel and inverse-variance methods. They provided a total of 1940 patients (286 with delirium and 1654 without), and predominantly included patients undergoing head and neck cancer surgery. The incidence of postoperative delirium ranged from 11.50% to 36.11%. Ten statistically significant risk factors were identified in pooled analysis. Old age, age >70 years, male sex, duration of surgery, history of hypertension, blood transfusions, tracheotomy, American Society of Anesthesiologists physical status grade at least III, flap reconstruction and neck dissection were more likely to sustain delirium after head and neck cancer surgery. Delirium is common in patients undergoing major head neck cancer surgery. Several risk factors were consistently associated with postoperative delirium. These factors help to highlight patients at risk of developing delirium and are suitable for preventive action. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  9. Managing Complex Environmental Risks

    Energy Technology Data Exchange (ETDEWEB)

    Karlsson, Mikael [Karlstad Univ. (Sweden). Dept. of Environmental Sciences

    2006-09-15

    Environmental and public health risks are often handled in a process in which experts, and sometimes policy makers, try their best to quantitatively assess, evaluate and manage risks. This approach harmonises with mainstream interpretations of sustainable development, which aim at defining a desirable relationship between human and natural systems, for instance by policies that define limit values of different forms of disturbances. However, under conditions of high scientific incertitude, diverging values and distrust, this approach is far from satisfactory. The use of cell phones, hazardous chemicals, nuclear or fossil energy systems, and modern biotechnology are examples of activities causing such risks with high complexity. Against this background, a complementary interpretation of the concept of sustainable development is suggested. This interpretation is operationalised through new formulations of three common principles for public risk management; the precautionary principle, the polluter pays principle and the principle of public participation. Implementation of these reformulated principles would challenge some foundations of present mainstream views on environmental decision-making, but would on the other hand contribute to improved practices for long-term human welfare and planetary survival (full text of contribution)

  10. Managing Complex Environmental Risks

    International Nuclear Information System (INIS)

    Karlsson, Mikael

    2006-01-01

    Environmental and public health risks are often handled in a process in which experts, and sometimes policy makers, try their best to quantitatively assess, evaluate and manage risks. This approach harmonises with mainstream interpretations of sustainable development, which aim at defining a desirable relationship between human and natural systems, for instance by policies that define limit values of different forms of disturbances. However, under conditions of high scientific incertitude, diverging values and distrust, this approach is far from satisfactory. The use of cell phones, hazardous chemicals, nuclear or fossil energy systems, and modern biotechnology are examples of activities causing such risks with high complexity. Against this background, a complementary interpretation of the concept of sustainable development is suggested. This interpretation is operationalised through new formulations of three common principles for public risk management; the precautionary principle, the polluter pays principle and the principle of public participation. Implementation of these reformulated principles would challenge some foundations of present mainstream views on environmental decision-making, but would on the other hand contribute to improved practices for long-term human welfare and planetary survival (full text of contribution)

  11. Interpreting and communicating risk of medications in pregnancy, using SSRIs as an example

    NARCIS (Netherlands)

    Reefhuis, Jennita; Bobo, William; Van Puijenbroek, Eugene; Sahin, Leyla

    2013-01-01

    Background: Often we consider publishing our research as the last step in the process. However, women considering pregnancy, women who are pregnant and health care providers caring for these women need to be able to interpret and use our research to make treatment decisions for their health and the

  12. Major life events and development of major depression in Parkinson's disease patients

    DEFF Research Database (Denmark)

    Rod, Naja Hulvej; Bordelon, Y; Thompson, A

    2012-01-01

    BACKGROUND AND PURPOSE: Non-motor symptoms including depression are important features of Parkinson's disease (PD). We aim to address the relationship between major life events and depression amongst PD patients free of depressive symptoms at baseline. METHODS: New-onset PD patients from California...... were recruited in 2001-2007 and followed up for 3-4 years. The participants (n = 221) were examined by neurologists and responded to comprehensive interviews that included major life events, social support, and coping measures from validated scales. Major depression was assessed using the Structured...... Clinical Interview for the DSM-IV depression module (SCID). RESULTS: More than half of all patients had experienced major life events since diagnosed with PD, and 22 patients developed a major depression. The number of life events was associated with risk of depression in an exposure-dependent manner...

  13. PBPK and population modelling to interpret urine cadmium concentrations of the French population

    Energy Technology Data Exchange (ETDEWEB)

    Béchaux, Camille, E-mail: Camille.bechaux@anses.fr [ANSES, French Agency for Food, Environmental and Occupational Health Safety, 27-31 Avenue du Général Leclerc, 94701 Maisons-Alfort (France); Bodin, Laurent [ANSES, French Agency for Food, Environmental and Occupational Health Safety, 27-31 Avenue du Général Leclerc, 94701 Maisons-Alfort (France); Clémençon, Stéphan [Telecom ParisTech, 46 rue Barrault, 75634 Paris Cedex 13 (France); Crépet, Amélie [ANSES, French Agency for Food, Environmental and Occupational Health Safety, 27-31 Avenue du Général Leclerc, 94701 Maisons-Alfort (France)

    2014-09-15

    As cadmium accumulates mainly in kidney, urinary concentrations are considered as relevant data to assess the risk related to cadmium. The French Nutrition and Health Survey (ENNS) recorded the concentration of cadmium in the urine of the French population. However, as with all biomonitoring data, it needs to be linked to external exposure for it to be interpreted in term of sources of exposure and for risk management purposes. The objective of this work is thus to interpret the cadmium biomonitoring data of the French population in terms of dietary and cigarette smoke exposures. Dietary and smoking habits recorded in the ENNS study were combined with contamination levels in food and cigarettes to assess individual exposures. A PBPK model was used in a Bayesian population model to link this external exposure with the measured urinary concentrations. In this model, the level of the past exposure was corrected thanks to a scaling function which account for a trend in the French dietary exposure. It resulted in a modelling which was able to explain the current urinary concentrations measured in the French population through current and past exposure levels. Risk related to cadmium exposure in the general French population was then assessed from external and internal critical values corresponding to kidney effects. The model was also applied to predict the possible urinary concentrations of the French population in 2030 assuming there will be no more changes in the exposures levels. This scenario leads to significantly lower concentrations and consequently lower related risk. - Highlights: • Interpretation of urine cadmium concentrations in France • PBPK and Bayesian population modelling of cadmium exposure • Assessment of the historic time-trend of the cadmium exposure in France • Risk assessment from current and future external and internal exposure.

  14. PBPK and population modelling to interpret urine cadmium concentrations of the French population

    International Nuclear Information System (INIS)

    Béchaux, Camille; Bodin, Laurent; Clémençon, Stéphan; Crépet, Amélie

    2014-01-01

    As cadmium accumulates mainly in kidney, urinary concentrations are considered as relevant data to assess the risk related to cadmium. The French Nutrition and Health Survey (ENNS) recorded the concentration of cadmium in the urine of the French population. However, as with all biomonitoring data, it needs to be linked to external exposure for it to be interpreted in term of sources of exposure and for risk management purposes. The objective of this work is thus to interpret the cadmium biomonitoring data of the French population in terms of dietary and cigarette smoke exposures. Dietary and smoking habits recorded in the ENNS study were combined with contamination levels in food and cigarettes to assess individual exposures. A PBPK model was used in a Bayesian population model to link this external exposure with the measured urinary concentrations. In this model, the level of the past exposure was corrected thanks to a scaling function which account for a trend in the French dietary exposure. It resulted in a modelling which was able to explain the current urinary concentrations measured in the French population through current and past exposure levels. Risk related to cadmium exposure in the general French population was then assessed from external and internal critical values corresponding to kidney effects. The model was also applied to predict the possible urinary concentrations of the French population in 2030 assuming there will be no more changes in the exposures levels. This scenario leads to significantly lower concentrations and consequently lower related risk. - Highlights: • Interpretation of urine cadmium concentrations in France • PBPK and Bayesian population modelling of cadmium exposure • Assessment of the historic time-trend of the cadmium exposure in France • Risk assessment from current and future external and internal exposure

  15. Higher risk of developing major depression and bipolar disorder in later life among adolescents with asthma: a nationwide prospective study.

    Science.gov (United States)

    Chen, Mu-Hong; Su, Tung-Ping; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Chang, Wen-Han; Chen, Tzeng-Ji; Bai, Ya-Mei

    2014-02-01

    Previous studies have suggested an immunological dysfunction in mood disorders, but rarely have investigated the temporal association between allergic diseases and mood disorders. Using the Taiwan National Health Insurance Research Database, we attempted to investigate the association between asthma in early adolescence and the risk of unipolar depression and bipolar disorder in later life. In all, 1453 adolescents with asthma aged between 10 and 15 years and 5812 age-/gender-matched controls were selected in 1998-2000. Subjects with unipolar depression and bipolar disorder that occurred up to the end of follow-up (December 31 2010) were identified. Adolescents with asthma had a higher incidence of major depression (2.8% vs. 1.1%, p bipolar disorder (1.0% vs. 0.3%, p adolescence was associated with an increased risk of developing major depression (hazard ratio [HR]: 1.81, 95% confidence interval [CI]: 1.14-2.89), any depressive disorder (HR: 1.74, 95% CI: 1.27-2.37), and bipolar disorder (HR: 2.27, 95% CI: 1.01-5.07), after adjusting for demographic data and comorbid allergic diseases. Adolescents with asthma had an elevated risk of developing mood disorders in later life. Further studies would be required to investigate the underlying mechanisms for this comorbid association and elucidate whether prompt intervention for asthma would decrease the risk of developing mood disorders. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Major national human biomonitoring programs in chemical exposure assessment

    Directory of Open Access Journals (Sweden)

    Judy Choi

    2015-07-01

    Full Text Available Human biomonitoring (HBM programs have been established in several countries around the world in order to monitor the levels of chemical exposures in the general population and qualify health risk assessment of national and international interest. Study design, population, sample collection, and chemical analysis must be considered when comparing and interpreting the results. In this review, the objectives and brief descriptions of the major national HBM programs in North America, Europe, and Asia are provided. Similarities and differences observed from a comparative analysis among these programs, including the stratification of data according to age, sex, socioeconomic background, etc. as well as the identification of chemical exposure associated with food intake, are discussed. Overall, although there are some discrepancies in the study designs among the reviewed national HBM programs, results from the programs can provide useful information such as chemical levels found within the general population of a country that can be compared. Furthermore, the results can be used by regulatory authorities or the government to enforce legislations in order to reduce the exposure of chemicals into the human body.

  17. Major League pitching workload after primary ulnar collateral ligament reconstruction and risk for revision surgery.

    Science.gov (United States)

    Keller, Robert A; Mehran, Nima; Marshall, Nathan E; Okoroha, Kelechi R; Khalil, Lafi; Tibone, James E; Moutzouros, Vasilios

    2017-02-01

    Literature has attempted to correlate pitching workload with risk of ulnar collateral ligament (UCL) injury; however, limited data are available in evaluating workload and its relationship with the need for revision reconstruction in Major League Baseball (MLB) pitchers. We identified 29 MLB pitchers who underwent primary UCL reconstruction surgery and subsequently required revision reconstruction and compared them with 121 MLB pitchers who underwent primary reconstruction but did not later require revision surgery. Games pitched, pitch counts, and innings pitched were evaluated and compared for the seasons after returning from primary reconstruction and for the last season pitched before undergoing revision surgery. The difference in workload between pitchers who did and did not require revision reconstruction was not statistically significant in games pitched, innings pitched, and MLB-only pitch counts. The one significant difference in workload was in total pitch counts (combined MLB and minor league), with the pitchers who required revision surgery pitching less than those who did not (primary: 1413.6 pitches vs. revision: 959.0 pitches, P = .04). In addition, pitchers who required revision surgery underwent primary reconstruction at an early age (22.9 years vs. 27.3 years, P risk for injury after primary UCL reconstruction. However, correlations of risk may be younger age and less MLB experience at the time of the primary reconstruction. Copyright © 2017. Published by Elsevier Inc.

  18. Decree no 90-918 of 11 october 1990 on exercising rights to information on major risks, in implementation of Section 21 of act no 87-565 of 22 july 1987 on the organisation of public safety measures, forestry protection against fires and prevention of major risks

    International Nuclear Information System (INIS)

    1990-01-01

    This Decree specifies the content and type of information to which persons likely to be exposed to major risks must have access, in accordance with the 1987 Act. These provisions apply in the communes for which a special action plan has been prepared. The information includes a description of the risks and their foreseeable consequences for persons, property and the environment, and a statement on the preventive measures to limit their effects. A summary record of this information is established [fr

  19. Psychoanalytical interpretations of prejudices with emphasis on prejudices towards persons with disabilities

    Directory of Open Access Journals (Sweden)

    Dimoski Sanja

    2012-01-01

    Full Text Available This paper deals with interpretations of prejudices and specifically, prejudices towards people with disabilities, from the perspective of one of the many theoretical approaches. Psychoanalytic theoretical point of view interpret prejudices through the personality of the individual. The study and interpretation of prejudices towards people with disabilities is one of the major themes of modern social model of disability. Psychoanalytic interpretations determine prejudices, as well as prejudices towards people with disabilities, as a result of defense mechanisms, especially projection. This paper discusses the emotional component of attitude, based on its predominance in prejudices, as a extreme attitudes. In this analysis we have taken into account the emotional and unconscious reactions that can compose an emotional ambivalence in relation to the object of an attitude. Prejudice towards people with disabilities were brought in connection with the irrational and emotional reactions and unconscious fantasies related to the object of an attitude.

  20. Applying total interpretive structural modeling to study factors affecting construction labour productivity

    Directory of Open Access Journals (Sweden)

    Sayali Shrikrishna Sandbhor

    2014-03-01

    Full Text Available Construction sector has always been dependent on manpower. Most of the activities carried out on any construction site are labour intensive. Since productivity of any project depends directly on productivity of labour, it is a prime responsibility of the employer to enhance labour productivity. Measures to improve the same depend on analysis of positive and negative factors affecting productivity. Major attention should be given to factors that decrease the productivity of labour. Factor analysis thus is an integral part of any study aiming to improve productivity.  Interpretive structural modeling is a methodology for identifying and summarizing relationships among factors which define an issue or problem. It provides a means to arrange the factors in an order as per their complexity. This study attempts to use the latest version of interpretive structural modeling i.e. total interpretive structural modeling to analyze factors negatively affecting construction labour productivity. It establishes interpretive relationship among these factors facilitating improvement in the overall productivity of construction site.

  1. Knowledge, attitudes, and practices toward malaria risk and prevention among frequent business travelers of a major oil and gas company.

    Science.gov (United States)

    Berg, Johannes; Breederveld, Daan; Roukens, Anna H; Hennink, Yvonne; Schouten, Marjolijn; Wendt, Judy K; Visser, Leo G

    2011-01-01

    Despite significant morbidity and mortality among business travelers due to malaria, very little has been published on knowledge, attitudes, and practices (KAP) toward malaria risk. The aim of this study was to assess KAP among frequent international business travelers (FBT) and to identify recommendations for improving malaria prevention that could be applied to the wider FBT community in occupational health. A retrospective web-based survey was conducted in 2005 among self-registered FBT of an oil and gas company based in the Netherlands. The survey was completed by 328 of the 608 self-registered FBT (54%). Fifty-four percent of respondents had visited a high-risk area for malaria. Most respondents (96%) were experienced travelers; the majority (71%) sought health advice before their trip and made use of a company health resource. Fever was recognized as a malaria symptom by all FBT; travel to high-risk malaria areas was correctly identified by 96%, and 99% of these travelers adhered to use of adequate personal protective measures. The proportion of travelers carrying appropriate anti-malaria drug regimen was positively associated with receiving company advice among FBT traveling to high-risk destinations (RR = 2.10, 95% CI: 1.21-3.67), but not for those traveling to low- or no-risk destinations. Only 8% (14) of those going to a high-risk area were not carrying malaria prophylaxis. One in five of FBT traveling to no-risk areas were unnecessarily carrying malaria prophylaxis. The majority of KAP results were excellent. We postulate that a company culture with a strong focus on health, safety, security, and environment can positively contribute to high KAP scores. Notwithstanding the excellent findings, this study also provides a cautionary tale for company health functions against overprescribing of malaria prophylaxis. It demonstrates the need for constant review and audit of adherence to quality criteria. © 2011 International Society of Travel Medicine.

  2. A resilience engineering approach to assess major accident risks

    DEFF Research Database (Denmark)

    Hollnagel, E.

    2013-01-01

    This chapter describes how the principles of Resilience Engineering can be used to make a risk assessment of an Integrated Operations (IO) scenario. It refers to the case study provided in Chapter 12.......This chapter describes how the principles of Resilience Engineering can be used to make a risk assessment of an Integrated Operations (IO) scenario. It refers to the case study provided in Chapter 12....

  3. The Oft-Neglected Role of Parietal EEG Asymmetry and Risk for Major Depressive Disorder

    Science.gov (United States)

    Stewart, Jennifer L.; Towers, David N.; Coan, James A.; Allen, John J.B.

    2010-01-01

    Relatively less right parietal activity may reflect reduced arousal and signify risk for major depressive disorder (MDD). Inconsistent findings with parietal electroencephalographic (EEG) asymmetry, however, suggest issues such as anxiety comorbidity and sex differences have yet to be resolved. Resting parietal EEG asymmetry was assessed in 306 individuals (31% male) with (n = 143) and without (n = 163) a DSM-IV diagnosis of lifetime MDD and no comorbid anxiety disorders. Past MDD+ women displayed relatively less right parietal activity than current MDD+ and MDD- women, replicating prior work. Recent caffeine intake, an index of arousal, moderated the relationship between depression and EEG asymmetry for women and men. Findings suggest that sex differences and arousal should be examined in studies of depression and regional brain activity. PMID:20525011

  4. Operating performance and environmental and safety risks: A preliminary comparison of majors and independents

    International Nuclear Information System (INIS)

    Pulsipher, A.G.; Iledare, W.O.; Baumann, R.H.; Mesyanzhinov, D.

    1995-01-01

    The objective is to compare the safety and environmental records of oil and gas companies operating on the OCS in the Gulf of Mexico over the past decade. The reason for doing so is to help inform public sector policy-makers and private sector decision-makers about the potential safety and environmental risks associated with the expected increased presence of smaller independents in the domestic oil and gas industry in general and on the federal OCS in particular. The preliminary conclusion is that although independents have had a modestly high incidence of fires and explosions than the majors, the difference is not significant statistically and is largely attributable to a few ''bad actors'' rather than demonstrably poorer practice by the group as a whole

  5. Schrodinger's mechanics interpretation

    CERN Document Server

    Cook, David B

    2018-01-01

    The interpretation of quantum mechanics has been in dispute for nearly a century with no sign of a resolution. Using a careful examination of the relationship between the final form of classical particle mechanics (the Hamilton–Jacobi Equation) and Schrödinger's mechanics, this book presents a coherent way of addressing the problems and paradoxes that emerge through conventional interpretations.Schrödinger's Mechanics critiques the popular way of giving physical interpretation to the various terms in perturbation theory and other technologies and places an emphasis on development of the theory and not on an axiomatic approach. When this interpretation is made, the extension of Schrödinger's mechanics in relation to other areas, including spin, relativity and fields, is investigated and new conclusions are reached.

  6. Reaffirming normal: the high risk of pathologizing healthy adults when interpreting the MMPI-2-RF.

    Science.gov (United States)

    Odland, Anthony P; Lammy, Andrew B; Perle, Jonathan G; Martin, Phillip K; Grote, Christopher L

    2015-01-01

    Monte Carlo simulations were utilized to determine the proportion of the normal population expected to have scale elevations on the MMPI-2-RF when multiple scores are interpreted. Results showed that when all 40 MMPI-2-RF scales are simultaneously considered, approximately 70% of normal adults are likely to have at least one scale elevation at or above 65 T, and as many as 20% will have five or more elevated scales. When the Restructured Clinical (RC) Scales are under consideration, 34% of normal adults have at least one elevated score. Interpretation of the Specific Problem Scales and Personality Psychopathology Five Scales--Revised also yielded higher than expected rates of significant scores, with as many as one in four normal adults possibly being miscategorized as having features of a personality disorder by the latter scales. These findings are consistent with the growing literature on rates of apparently abnormal scores in the normal population due to multiple score interpretation. Findings are discussed in relation to clinical assessment, as well as in response to recent work suggesting that the MMPI-2-RF's multiscale composition does not contribute to high rates of elevated scores.

  7. Assessing the contribution of borderline personality disorder and features to suicide risk in psychiatric inpatients with bipolar disorder, major depression and schizoaffective disorder.

    Science.gov (United States)

    Zeng, Ruifan; Cohen, Lisa J; Tanis, Thachell; Qizilbash, Azra; Lopatyuk, Yana; Yaseen, Zimri S; Galynker, Igor

    2015-03-30

    Suicidal behavior often accompanies both borderline personality disorder (BPD) and severe mood disorders, and comorbidity between the two appears to further increase suicide risk. The current study aims to quantify the risk of suicidality conferred by comorbid BPD diagnosis or features in three affective disorders: major depressive disorder (MDD), bipolar disorder (BP) and schizoaffective disorder. One hundred forty-nine (149) psychiatric inpatients were assessed by SCID I and II, and the Columbia Suicide Severity Rating Scale. Logistic regression analyses investigated the associations between previous suicide attempt and BPD diagnosis or features in patients with MDD, BP, and schizoaffective disorder, as well as a history of manic or major depressive episodes, and psychotic symptoms. Comorbid BPD diagnosis significantly increased suicide risk in the whole sample, and in those with MDD, BP, and history of depressive episode or psychotic symptoms. Each additional borderline feature also increased risk of past suicide attempt in these same groups (excepting BP) and in those with a previous manic episode. Of the BPD criteria, only unstable relationships and impulsivity independently predicted past suicide attempt. Overall, among patients with severe mood disorders, the presence of comorbid BPD features or disorder appears to substantially increase the risk of suicide attempts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. A microseismic workflow for managing induced seismicity risk as CO2 storage projects

    Energy Technology Data Exchange (ETDEWEB)

    Matzel, E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Morency, C. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Pyle, M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Templeton, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); White, J. A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2015-10-27

    It is well established that fluid injection has the potential to induce earthquakes—from microseismicity to large, damaging events—by altering state-of-stress conditions in the subsurface. While induced seismicity has not been a major operational issue for carbon storage projects to date, a seismicity hazard exists and must be carefully addressed. Two essential components of effective seismic risk management are (1) sensitive microseismic monitoring and (2) robust data interpretation tools. This report describes a novel workflow, based on advanced processing algorithms applied to microseismic data, to help improve management of seismic risk. This workflow has three main goals: (1) to improve the resolution and reliability of passive seismic monitoring, (2) to extract additional, valuable information from continuous waveform data that is often ignored in standard processing, and (3) to minimize the turn-around time between data collection, interpretation, and decision-making. These three objectives can allow for a better-informed and rapid response to changing subsurface conditions.

  9. Theoretical interpretation of high-energy nuclear collisions

    International Nuclear Information System (INIS)

    Fai, G.

    1991-07-01

    Nuclear collision data are interpreted theoretically. The nuclear equation of state is investigated with particular emphasis on momentum-dependent mean field effects. Subnucleonic degrees of freedom are invoked at high energies and densities, and a short length-scales. A nontopological soliton model for baryons is studied in which effective meson fields are generated from extended quark-antiquark pairs. The major objective of this nuclear theory project is a better understanding of the properties of strongly interacting matter on the nuclear energy scale, as manifested in high-energy heavy-ion collisions

  10. Left atrial enlargement increases the risk of major adverse cardiac events independent of coronary vasodilator capacity.

    Science.gov (United States)

    Koh, Angela S; Murthy, Venkatesh L; Sitek, Arkadiusz; Gayed, Peter; Bruyere, John; Wu, Justina; Di Carli, Marcelo F; Dorbala, Sharmila

    2015-09-01

    Longstanding uncontrolled atherogenic risk factors may contribute to left atrial (LA) hypertension, LA enlargement (LAE) and coronary vascular dysfunction. Together they may better identify risk of major adverse cardiac events (MACE). The aim of this study was to test the hypothesis that chronic LA hypertension as assessed by LAE modifies the relationship between coronary vascular function and MACE. In 508 unselected subjects with a normal clinical (82)Rb PET/CT, ejection fraction ≥40 %, no prior coronary artery disease, valve disease or atrial fibrillation, LAE was determined based on LA volumes estimated from the hybrid perfusion and CT transmission scan images and indexed to body surface area. Absolute myocardial blood flow and global coronary flow reserve (CFR) were calculated. Subjects were systematically followed-up for the primary end-point - MACE - a composite of all-cause death, myocardial infarction, hospitalization for heart failure, stroke, coronary artery disease progression or revascularization. During a median follow-up of 862 days, 65 of the subjects experienced a composite event. Compared with subjects with normal LA size, subjects with LAE showed significantly lower CFR (2.25 ± 0.83 vs. 1.95 ± 0.80, p = 0.01). LAE independently and incrementally predicted MACE even after accounting for clinical risk factors, medication use, stress left ventricular ejection fraction, stress left ventricular end-diastolic volume index and CFR (chi-squared statistic increased from 30.9 to 48.3; p = 0.001). Among subjects with normal CFR, those with LAE had significantly worse event-free survival (risk adjusted HR 5.4, 95 % CI 2.3 - 12.8, p < 0.0001). LAE and reduced CFR are related but distinct cardiovascular adaptations to atherogenic risk factors. LAE is a risk marker for MACE independent of clinical factors and left ventricular volumes; individuals with LAE may be at risk of MACE despite normal coronary vascular function.

  11. Paracetamol, Ibuprofen, and Recurrent Major Cardiovascular and Major Bleeding Events in 19 120 Patients With Recent Ischemic Stroke.

    Science.gov (United States)

    Gonzalez-Valcarcel, Jaime; Sissani, Leila; Labreuche, Julien; Bousser, Marie-Germaine; Chamorro, Angel; Fisher, Marc; Ford, Ian; Fox, Kim M; Hennerici, Michael G; Mattle, Heinrich P; Rothwell, Peter M; Steg, Philippe Gabriel; Vicaut, Eric; Amarenco, Pierre

    2016-04-01

    The presumed safety of paracetamol in high-cardiovascular risk patients has been questioned. We determined whether paracetamol or ibuprofen use is associated with major cardiovascular events (MACE) or major bleeding in 19 120 patients with recent ischemic stroke or transient ischemic attack of mainly atherothrombotic origin included in the Prevention of cerebrovascular and cardiovascular events of ischemic origin with terutroban in patients with a history of ischemic stroke or transient ischemic attack (PERFORM) trial. We performed 2 nested case-control analysis (2153 cases with MACE during trial follow-up and 4306 controls matched on Essen stroke risk score; 809 cases with major bleeding matched with 1616 controls) and a separate time-varying analysis. 12.3% were prescribed paracetamol and 2.5% ibuprofen. Median duration of treatment was 14 (interquartile range 5-145) days for paracetamol and 9 (5-30) days for ibuprofen. Paracetamol, but not ibuprofen, was associated with increased risk of MACE (odds ratio 1.21, 95% confidence interval [CI] 1.04-1.42) or a major bleeding (odds ratio 1.60, 95% CI 1.26-2.03), with no impact of daily dose and duration of paracetamol treatment. Time-varying analysis found an increased risk of MACE with both paracetamol (hazard ratio 1.22, 95% CI 1.05-1.43) and ibuprofen (hazard ratio 1.47, 95% CI 1.06-2.03) and of major bleeding with paracetamol (hazard ratio 1.95, 95% CI 1.45-2.62). There was a weak and inconsistent signal for association between paracetamol or ibuprofen and MACE or major bleeding, which may be related to either a genuine but modest effect of these drugs or to residual confounding. http://www.isrctn.com. Unique identifier: ISRCTN66157730. © 2016 American Heart Association, Inc.

  12. S -ketamine compared to etomidate during electroconvulsive therapy in major depression.

    Science.gov (United States)

    Zavorotnyy, Maxim; Kluge, Ina; Ahrens, Kathrin; Wohltmann, Thomas; Köhnlein, Benjamin; Dietsche, Patricia; Dannlowski, Udo; Kircher, Tilo; Konrad, Carsten

    2017-12-01

    Objective of the study was to compare two commonly used anesthetic drugs, S-ketamine and etomidate, regarding their influence on seizure characteristics, safety aspects, and outcome of electroconvulsive therapy (ECT) in major depression. Treatment data of 60 patients who underwent a total number of 13 ECTs (median) because of the severe or treatment-resistant major depressive disorder (DSM-IV) were analyzed. Etomidate, mean dosage (SD) = 0.25 (0.04) mg/kg, was used for anesthesia in 29 participants; 31 patients received S-ketamine, mean dosage (SD) = 0.96 (0.26) mg/kg. Right unilateral brief pulse ECTs were performed. The number of ECTs was individually adjusted to clinical needs, mean (SD) = 13.0 (4.3). Seizure characteristics, adverse events, and the clinical global impression (CGI) scores were compared between the both groups during ECT series. In the S-ketamine group, a lower initial seizure threshold (p = 0.014), stimulation charge (p ketamine might hold a potential to become a clinically favorable anesthetic agent during ECT. However, the current findings should be interpreted with caution, and further prospective randomized clinical trials are required. Also, specific adverse effects profile of S-ketamine, especially with regard to the cardiovascular risk, needs to be taken into account.

  13. A mathematical model for interpretable clinical decision support with applications in gynecology.

    Directory of Open Access Journals (Sweden)

    Vanya M C A Van Belle

    Full Text Available Over time, methods for the development of clinical decision support (CDS systems have evolved from interpretable and easy-to-use scoring systems to very complex and non-interpretable mathematical models. In order to accomplish effective decision support, CDS systems should provide information on how the model arrives at a certain decision. To address the issue of incompatibility between performance, interpretability and applicability of CDS systems, this paper proposes an innovative model structure, automatically leading to interpretable and easily applicable models. The resulting models can be used to guide clinicians when deciding upon the appropriate treatment, estimating patient-specific risks and to improve communication with patients.We propose the interval coded scoring (ICS system, which imposes that the effect of each variable on the estimated risk is constant within consecutive intervals. The number and position of the intervals are automatically obtained by solving an optimization problem, which additionally performs variable selection. The resulting model can be visualised by means of appealing scoring tables and color bars. ICS models can be used within software packages, in smartphone applications, or on paper, which is particularly useful for bedside medicine and home-monitoring. The ICS approach is illustrated on two gynecological problems: diagnosis of malignancy of ovarian tumors using a dataset containing 3,511 patients, and prediction of first trimester viability of pregnancies using a dataset of 1,435 women. Comparison of the performance of the ICS approach with a range of prediction models proposed in the literature illustrates the ability of ICS to combine optimal performance with the interpretability of simple scoring systems.The ICS approach can improve patient-clinician communication and will provide additional insights in the importance and influence of available variables. Future challenges include extensions of the

  14. A pragmatic multi-centre randomised controlled trial of fluid loading and level of dependency in high-risk surgical patients undergoing major elective surgery: trial protocol

    Directory of Open Access Journals (Sweden)

    Norrie John

    2010-04-01

    Full Text Available Abstract Background Patients undergoing major elective or urgent surgery are at high risk of death or significant morbidity. Measures to reduce this morbidity and mortality include pre-operative optimisation and use of higher levels of dependency care after surgery. We propose a pragmatic multi-centre randomised controlled trial of level of dependency and pre-operative fluid therapy in high-risk surgical patients undergoing major elective surgery. Methods/Design A multi-centre randomised controlled trial with a 2 * 2 factorial design. The first randomisation is to pre-operative fluid therapy or standard regimen and the second randomisation is to routine intensive care versus high dependency care during the early post-operative period. We intend to recruit 204 patients undergoing major elective and urgent abdominal and thoraco-abdominal surgery who fulfil high-risk surgical criteria. The primary outcome for the comparison of level of care is cost-effectiveness at six months and for the comparison of fluid optimisation is the number of hospital days after surgery. Discussion We believe that the results of this study will be invaluable in determining the future care and clinical resource utilisation for this group of patients and thus will have a major impact on clinical practice. Trial Registration Trial registration number - ISRCTN32188676

  15. Interpreting land records

    CERN Document Server

    Wilson, Donald A

    2014-01-01

    Base retracement on solid research and historically accurate interpretation Interpreting Land Records is the industry's most complete guide to researching and understanding the historical records germane to land surveying. Coverage includes boundary retracement and the primary considerations during new boundary establishment, as well as an introduction to historical records and guidance on effective research and interpretation. This new edition includes a new chapter titled "Researching Land Records," and advice on overcoming common research problems and insight into alternative resources wh

  16. Scrutinizing screening: a critical interpretive review of primary care provider perspectives on mammography decision-making with average-risk women.

    Science.gov (United States)

    Siedlikowski, Sophia; Ells, Carolyn; Bartlett, Gillian

    2018-01-01

    A decision to undertake screening for breast cancer often takes place within the primary care setting, but current controversies such as overdiagnosis and inconsistent screening recommendations based on evolving evidence render this a challenging process, particularly for average-risk women. Given the responsibility of primary care providers in counseling women in this decision-making process, it is important to understand their thoughts on these controversies and how they manage uncertainty in their practice. To review the perspectives and approaches of primary care providers regarding mammography decision-making with average-risk women. This study is a critical interpretive review of peer-review literature that reports primary care provider perspectives on mammography screening decision-making. Ovid MEDLINE®, Ovid PsycInfo, and Scopus databases were searched with dates from 2002 to 2017 using search terms related to mammography screening, uncertainty, counseling, decision-making, and primary health care providers. Nine articles were included following a review process involving the three authors. Using an inductive and iterative approach, data were grouped into four thematic categories: (1) perceptions on the effectiveness of screening, screening initiation age, and screening frequency; (2) factors guiding primary care providers in the screening decision-making process, including both provider and patient-related factors, (3) uncertainty faced by primary care providers regarding guidelines and screening discussions with their patients; and (4) informed decision-making with average-risk women, including factors that facilitate and hinder this process. The discussion of results addresses several factors about the diversity of perspectives and practices of physicians counseling average-risk women regarding breast cancer screening. This has implications for the challenge of understanding and explaining evidence, what should be shared with average-risk women

  17. The Interpretive Function

    DEFF Research Database (Denmark)

    Agerbo, Heidi

    2017-01-01

    Approximately a decade ago, it was suggested that a new function should be added to the lexicographical function theory: the interpretive function(1). However, hardly any research has been conducted into this function, and though it was only suggested that this new function was relevant...... to incorporate into lexicographical theory, some scholars have since then assumed that this function exists(2), including the author of this contribution. In Agerbo (2016), I present arguments supporting the incorporation of the interpretive function into the function theory and suggest how non-linguistic signs...... can be treated in specific dictionary articles. However, in the current article, due to the results of recent research, I argue that the interpretive function should not be considered an individual main function. The interpretive function, contrary to some of its definitions, is not connected...

  18. The book sealed with seven seals (Revelation 5. 1: three remarkable patristic interpretations

    Directory of Open Access Journals (Sweden)

    Veronika Androsova

    2013-02-01

    Full Text Available This article examines various interpretations regarding the book written inside and out and sealed with seven seals (Revelation 5,1 which appears as the central symbol of the fifth chapter of the Revelation of Saint John. The fi gure of the book continues to be of great interest to commentators who find ever new interpretations of the passage. The author of this article has tried to collect these various interpretations and order them into three major groups. At the same time, the author was guided in her choice of these interpretations by the factor of their presence in the patristic tradition. The fi rst group of interpretations points to the Old Testament. The meaning of the Old Testament is opened by Christ and through the figure of Christ becomes understandable. The second group of interpretations envisages the book as holding those things which pertain to the fi nal fate of the world given over to Christ who appears as the fulfi llment of God’s plan of salvation and the master of destiny. In the third interpretation, the sealed book represents the divine testament which is inherited by Christ who accepts death for mankind. The author wishes to highlight a certain chain of borrowings linking the various interpretations as well as a certain planned inter-coordination of all these interpretations of the passage. The author concludes that in spite of the apparent diff erences between the various interpretations, they nevertheless share some common points which result from their thematic intertwining

  19. Public views on drinking water standards as risk indicators.

    Science.gov (United States)

    Johnson, Branden B

    2008-12-01

    Government agencies often compare contaminant levels to standards and other regulatory benchmarks to convey relative risk to public audiences, as well as for enforcement. Yet we know little of how citizens interpret these risk indicators or factors influencing interpretations. Owners of private residential wells in New Jersey were surveyed by mail. A majority appreciated this comparison, trusted the standard, and could effectively compare the contaminant level to the standard. Most people who recalled that their own well water quality was unsatisfactory simply installed treatment systems. However, there was also a surprising amount of inability to tell whether pollution levels were better or worse than the standard, perhaps exacerbated by confusing institutional language to summarize the comparison (e.g., pollution "exceeds" or is "less than" the standard) and innumeracy. There was also substantial skepticism about the degree to which pollution levels below, or (to a lesser extent) above, the standard are harmless or harmful, respectively. Skepticism was variously due to distrust of standards, disbelief in thresholds for health effects, inability to accurately compare standards and contaminant levels, information processing, and demographics. Discontinuity in reactions below versus above the standard did not exist in the aggregate, and rarely among individuals, contrary to some previous findings. At identical standards and contaminant levels, familiar toxins (mercury, arsenic, lead) elicited higher risk ratings than less familiar ones. Given the wide institutional use of this risk indicator, further research on how to improve the design and use of this indicator, and consideration of alternatives, is warranted.

  20. Polygenic Scores for Major Depressive Disorder and Risk of Alcohol Dependence.

    Science.gov (United States)

    Andersen, Allan M; Pietrzak, Robert H; Kranzler, Henry R; Ma, Li; Zhou, Hang; Liu, Xiaoming; Kramer, John; Kuperman, Samuel; Edenberg, Howard J; Nurnberger, John I; Rice, John P; Tischfield, Jay A; Goate, Alison; Foroud, Tatiana M; Meyers, Jacquelyn L; Porjesz, Bernice; Dick, Danielle M; Hesselbrock, Victor; Boerwinkle, Eric; Southwick, Steven M; Krystal, John H; Weissman, Myrna M; Levinson, Douglas F; Potash, James B; Gelernter, Joel; Han, Shizhong

    2017-11-01

    Major depressive disorder (MDD) and alcohol dependence (AD) are heritable disorders with significant public health burdens, and they are frequently comorbid. Common genetic factors that influence the co-occurrence of MDD and AD have been sought in family, twin, and adoption studies, and results to date have been promising but inconclusive. To examine whether AD and MDD overlap genetically, using a polygenic score approach. Association analyses were conducted between MDD polygenic risk score (PRS) and AD case-control status in European ancestry samples from 4 independent genome-wide association study (GWAS) data sets: the Collaborative Study on the Genetics of Alcoholism (COGA); the Study of Addiction, Genetics, and Environment (SAGE); the Yale-Penn genetic study of substance dependence; and the National Health and Resilience in Veterans Study (NHRVS). Results from a meta-analysis of MDD (9240 patients with MDD and 9519 controls) from the Psychiatric Genomics Consortium were applied to calculate PRS at thresholds from P men; mean [SD] age, 38.2 [10.8] years) and 522 controls (151 [28.9.%] men; age [SD], 43.9 [11.6] years) from COGA; 631 cases (333 [52.8%] men; age [SD], 35.0 [7.7] years) and 756 controls (260 [34.4%] male; age [SD] 36.1 [7.7] years) from SAGE; 2135 cases (1375 [64.4%] men; age [SD], 39.4 [11.5] years) and 350 controls (126 [36.0%] men; age [SD], 43.5 [13.9] years) from Yale-Penn; and 317 cases (295 [93.1%] men; age [SD], 59.1 [13.1] years) and 1719 controls (1545 [89.9%] men; age [SD], 64.5 [13.3] years) from NHRVS. Higher MDD PRS was associated with a significantly increased risk of AD in all samples (COGA: best P = 1.7 × 10-6, R2 = 0.026; SAGE: best P = .001, R2 = 0.01; Yale-Penn: best P = .035, R2 = 0.0018; and NHRVS: best P = .004, R2 = 0.0074), with stronger evidence for association after meta-analysis of the 4 samples (best P = 3.3 × 10-9). In analyses adjusted for MDD status in 3 AD GWAS data

  1. Evaluation of staff performance and interpretation of the screening program for prevention of thalassemia.

    Science.gov (United States)

    Prommetta, Simaporn; Sanchaisuriya, Kanokwan; Fucharoen, Goonnapa; Yamsri, Supawadee; Chaiboonroeng, Attawut; Fucharoen, Supan

    2017-06-15

    Thalassemia screening program has been implemented for years in Southeast Asia, but no external quality assessment program has been established. We have developed and initiated the proficiency testing (PT) program for the first time in Thailand with the aim to assess the screening performance of laboratory staff and their competency in interpretation of the screening results. Three PT cycles per year were organized. From the first to the third cycle of the PT scheme, a total number of participant laboratories increased from 59 to 67. In each cycle, 2 PT items (assigned as blood samples of the couple) were provided. Performance evaluation was based on the accuracy of screening results, i.e . mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and the dichlorophenolindophenol (DCIP) test for haemoglobin E, including the competency in interpretation of screening results and assessment of foetal risk. Performance was assessed by comparing the participants' result against the assigned value. Of all 3 cycles, most laboratories reported acceptable MCV and MCH values. From the first to the third cycle, incorrect DCIP test and misinterpretation rates were decreased while incorrect risk assessment varied by cycle to cycle. Combining the accuracy of thalassemia screening and the competency in interpretation and risk assessment, approximately half of participants showed excellent performance. Improved performance observed in many laboratories reflects the achievement and benefit of the PT program which should be regularly provided.

  2. Confusing Relative Risk with Absolute Risk Is Associated with More Enthusiastic Beliefs about the Value of Cancer Screening.

    Science.gov (United States)

    Caverly, Tanner J; Prochazka, Allan V; Binswanger, Ingrid A; Kutner, Jean S; Matlock, Daniel D

    2014-07-01

    Reviews of how data are presented in medical literature document that the benefit from an intervention is often exaggerated relative to the harm (e.g., relative risk for benefit and absolute risk for harm). Such mismatched presentations may create unwarranted enthusiasm, especially among those who misinterpret the statistics presented. The objective was to determine whether misinterpretation of risk data predicts enthusiasm for cancer screening. The authors administered a survey with 14 items assessing beliefs about cancer screening and 6 items measuring data interpretation ability. Multiple linear regression was used to evaluate the association between data interpretation and enthusiasm for cancer screening, with adjustment for gender and year graduated from medical school. Eighty-eight of 139 physicians at a state-wide professional meeting returned completed surveys (63% response rate). Lower data interpretation scores were associated with higher enthusiasm for cancer screening scores (P = 0.004) in the adjusted primary analysis. Confusing relative risk with absolute risk appeared to drive the overall association. Biased presentations of risk data could affect general beliefs about the value of cancer screening, especially among physicians who uncritically accept mismatched presentations of data. © The Author(s) 2014.

  3. [Lead poisoning: towards a paleo-epidemiologic re-interpretation?].

    Science.gov (United States)

    Bourdieu, Anne

    2014-01-01

    Lead is a major public health issue. Its use has been increasing since Neolithic times, climaxing in the Ancient Rome and the nineteenth century. Defining the frequency of plumbism before modern times proves to be a difficult matter because of its various and delayed symptoms, and of diagenetic processes affecting bones. After reviewing various methods of lead measurement in bone and tooth, we will expose ways to ascertain lead measurement interpretation in order to estimate the epidemiology of plumbism in ancient times.

  4. Risk, Affect and Emotion

    Directory of Open Access Journals (Sweden)

    Jens O. Zinn

    2006-01-01

    Full Text Available For a long time theorising has underestimated the importance of affect and emotion in decision making and the management of risk and uncertainty. In relatively one-sided interpretations emotions were often interpreted as threats for rational decision making, and could be triggered by uncertainties, which would go along with social change. Recent interdisciplinary research has shown the importance to acknowledge the more complex link between reasoning and emotions. The article outlines different perspectives on emotion in risk research of economics, psychology and sociology and argues for further research. URN: urn:nbn:de:0114-fqs0601293

  5. Association between influenza vaccination and reduced risks of major adverse cardiovascular events in elderly patients.

    Science.gov (United States)

    Chiang, Ming-Hsien; Wu, Hau-Hsin; Shih, Chia-Jen; Chen, Yung-Tai; Kuo, Shu-Chen; Chen, Te-Li

    2017-11-01

    This study was conducted to determine the protective effect of influenza vaccine against primary major adverse cardiovascular events (MACEs) in elderly patients, especially those with influenza-like illness (ILI). This retrospective, population-based case-control study of an elderly population (age≥65 years) was conducted using Taiwan's National Health Insurance Research Database (2000-2013). One control was selected for each MACE case (n=80,363 each), matched according to age, year of study entry, and predisposing factors for MACEs. ILI and MACEs (myocardial infarction [MI] and ischemic stroke) were defined according to the International Classification of Diseases, Ninth Revision, Clinical Modification. Odds ratios (ORs) were calculated for the association between MACEs and vaccination. Influenza vaccination received in the previous year was associated with reduced risks of primary MACEs overall (adjusted OR [aOR] 0.80, 95% CI 0.78-0.82, Prisks of MACEs (aOR 1.24, 95% CI 1.18-1.29, PVaccination attenuated the heightened risks associated with ILI (MACEs: aOR 0.99, 95% CI 0.92-1.07, P=.834; MI: aOR 1.05, 95% CI 0.92-1.21, P=.440; ischemic stroke: aOR 0.96, 95% CI 0.89-1.05, P=.398). Results of this study suggest that influenza vaccination is associated with reduced primary MACE risks in the elderly population, including those with ILI. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Revenue Risk Modelling and Assessment on BOT Highway Project

    Science.gov (United States)

    Novianti, T.; Setyawan, H. Y.

    2018-01-01

    The infrastructure project which is considered as a public-private partnership approach under BOT (Build-Operate-Transfer) arrangement, such as a highway, is risky. Therefore, assessment on risk factors is essential as the project have a concession period and is influenced by macroeconomic factors and consensus period. In this study, pre-construction risks of a highway were examined by using a Delphi method to create a space for offline expert discussions; a fault tree analysis to map intuition of experts and to create a model from the underlying risk events; a fuzzy logic to interpret the linguistic data of risk models. The loss of revenue for risk tariff, traffic volume, force majeure, and income were then measured. The results showed that the loss of revenue caused by the risk tariff was 10.5% of the normal total revenue. The loss of revenue caused by the risk of traffic volume was 21.0% of total revenue. The loss of revenue caused by the force majeure was 12.2% of the normal income. The loss of income caused by the non-revenue events was 6.9% of the normal revenue. It was also found that the volume of traffic was the major risk of a highway project because it related to customer preferences.

  7. Exploring the uncertainties in cancer risk assessment using the integrated probabilistic risk assessment (IPRA) approach.

    Science.gov (United States)

    Slob, Wout; Bakker, Martine I; Biesebeek, Jan Dirk Te; Bokkers, Bas G H

    2014-08-01

    Current methods for cancer risk assessment result in single values, without any quantitative information on the uncertainties in these values. Therefore, single risk values could easily be overinterpreted. In this study, we discuss a full probabilistic cancer risk assessment approach in which all the generally recognized uncertainties in both exposure and hazard assessment are quantitatively characterized and probabilistically evaluated, resulting in a confidence interval for the final risk estimate. The methodology is applied to three example chemicals (aflatoxin, N-nitrosodimethylamine, and methyleugenol). These examples illustrate that the uncertainty in a cancer risk estimate may be huge, making single value estimates of cancer risk meaningless. Further, a risk based on linear extrapolation tends to be lower than the upper 95% confidence limit of a probabilistic risk estimate, and in that sense it is not conservative. Our conceptual analysis showed that there are two possible basic approaches for cancer risk assessment, depending on the interpretation of the dose-incidence data measured in animals. However, it remains unclear which of the two interpretations is the more adequate one, adding an additional uncertainty to the already huge confidence intervals for cancer risk estimates. © 2014 Society for Risk Analysis.

  8. 38 CFR 41.520 - Major program determination.

    Science.gov (United States)

    2010-07-01

    ... major programs. This risk-based approach shall include consideration of: Current and prior audit... of prior audit findings under § 41.510(a)(7) do not preclude the Type A program from being low-risk... this section), except this paragraph (e)(2)(i)(A) does not require the auditor to audit more high-risk...

  9. A modified fetal heart rate tracing interpretation system for prediction of cesarean section

    Science.gov (United States)

    Schnettler, William T.; Rogers, Jennifer; Barber, Rachel E.; Hacker, Michele R.

    2013-01-01

    Objective To investigate whether a modified version of the 2008 National Institute of Child Health and Human Development (NICHD) interpretation system upon admission decreases cesarean delivery risk. Methods This retrospective cohort study ascribed a modified category to the first 30 min of fetal heart rate (FHR) tracings in labor. Category I was divided into two subsets (Ia and Ib) by the presence of accelerations. Category II was divided into four subsets (IIa–IId) based on baseline FHR, variability, response to stimulation and decelerations. Log-binomial regression was used to calculate risk ratios (RR) and 95% confidence intervals (CI). Results A category was ascribed to 910 women. Most FHR tracings were Category Ia (65.8%), Ib (7.7%), IIb (11.8%) and IId (14.0%). Category Ib tracings (fewer than two accelerations) were 2.26 (95% CI: 1.13–4.52) times more likely to result in cesarean delivery for abnormal FHR tracing than Category Ia tracings. A similar increase in risk was seen when comparing Category IIb and Category IId with Category Ia. Conclusion Application of a modified version of the 2008 NICHD FHR interpretation system to the initial 30 min of labor can identify women at increased risk of cesarean delivery for abnormal FHR tracing. PMID:21942513

  10. Increasing risk of compound flooding from storm surge and rainfall for major US coastal cities

    Science.gov (United States)

    Wahl, Thomas; Jain, Shaleen; Bender, Jens; Meyers, Steven; Luther, Mark

    2016-04-01

    Flood risk is a well-known facet of natural hazards along the US coastline where nearly 40% of the population resides in coastal counties. Given the heavy reliance on the coastal zone for natural resources and economic activity, flood preparedness and safety is a key element of long-term resilience. A clear understanding of the various flood types and changes in the frequency of their occurrence is critical towards reliable estimates of vulnerability and potential impacts in the near-term as well as into the future. When the two main flood drivers for coastal areas storm surge and heavy precipitation occur in tandem the potential for significant flooding is much greater than from either in isolation. Exploring the probability of these 'compound events' and understanding the processes driving them is essential to mitigate the associated high impact risks. For the contiguous US the likelihood of the joint occurrence of the two phenomena is largely unknown. Here we show - using storm surge and precipitation records spanning the last century - that the risk of compound flooding is higher for the US east and Gulf coasts, relative to the west coast. We also show that the number of compound events has increased significantly over the last century along large coastline stretches including many of the major coastal cities. For New York City - as an example - this increase is attributed to a shift towards storm surge weather patterns also favouring high precipitation. Preliminary analyses reveal that these synoptic scale changes are closely linked to large scale and low frequency climate variations. Our results demonstrate the importance of assessing the risk of compound flooding within the design process of coastal and urban infrastructure in a non-stationary framework and to explore the potential effects of climate change on these high impact events.

  11. Gender-specific suicide risk factors: a case-control study of individuals with major depressive disorder.

    Science.gov (United States)

    Dalca, Ioana Mioara; McGirr, Alexander; Renaud, Johanne; Turecki, Gustavo

    2013-12-01

    Available information on risk for suicide completion in females is limited and often extrapolated from studies conducted in males. However, the validity of extending to females risk factors identified among male suicide cases is unclear. In this study, we aimed to investigate clinical and behavioral risk factors for suicide among female depressed patients and compare them to similar factors among male depressed patients. We identified 201 suicide completers (160 male and 41 female) who died during an episode of major depressive disorder (MDD). Cases were compared to 127 living patients with MDD (88 male and 39 female). All subjects were characterized for Axis I and II diagnoses using the Structured Clinical Interview for DSM-IV Axis I Disorders and Structured Clinical Interview for DSM-IV Axis II Personality Disorders according to the DSM-IV, as well as behavioral and temperament dimensions using proxy-based interviews. The primary outcome was measures of impulsive and impulsive-aggressive behaviors. Compared to controls, male, but not female suicide cases had higher levels of impulsive aggression (P suicide cases from controls. However, nonimpulsive aggression and impulsive aggression were correlated constructs in males (r = 0.297; P suicide, such as alcohol and substance dependence, cluster B disorders, and elevated hostility and aggression, were replicated in the pooled-sex analyses, and, though not statistically significant in discriminating between suicide cases and controls by gender, maintained strong group differences. Males and females share many risk factors for suicide in MDD, yet alcohol dependence is much more specific though less sensitive among depressed females. Nonimpulsive aggression is part of a diathesis for suicide in females, which is distinct from the well-characterized impulsive aggression that is consistently reported in a portion of male suicide cases. © Copyright 2013 Physicians Postgraduate Press, Inc.

  12. Objectives and Design of BLEEDS: A Cohort Study to Identify New Risk Factors and Predictors for Major Bleeding during Treatment with Vitamin K Antagonists.

    Science.gov (United States)

    van Rein, Nienke; Lijfering, Willem M; Bos, Mettine H A; Herruer, Martien H; Vermaas, Helga W; van der Meer, Felix J M; Reitsma, Pieter H

    2016-01-01

    Risk scores for patients who are at high risk for major bleeding complications during treatment with vitamin K antagonists (VKAs) do not perform that well. BLEEDS was initiated to search for new biomarkers that predict bleeding in these patients. To describe the outline and objectives of BLEEDS and to examine whether the study population is generalizable to other VKA treated populations. A cohort was created consisting of all patients starting VKA treatment at three Dutch anticoagulation clinics between January-2012 and July-2014. We stored leftover plasma and DNA following analysis of the INR. Of 16,706 eligible patients, 16,570 (99%) were included in BLEEDS and plasma was stored from 13,779 patients (83%). Patients had a mean age of 70 years (SD 14), 8713 were male (53%). The most common VKA indications were atrial fibrillation (10,876 patients, 66%) and venous thrombosis (3920 patients, 24%). 326 Major bleeds occurred during 17,613 years of follow-up (incidence rate 1.85/100 person years, 95%CI 1.66-2.06). The risk for major bleeding was highest in the initial three months of VKA treatment and increased when the international normalized ratio increased. These results and characteristics are in concordance with results from other VKA treated populations. BLEEDS is generalizable to other VKA treated populations and will permit innovative and unbiased research of biomarkers that may predict major bleeding during VKA treatment.

  13. Interpretation of drinking water quality guidelines – The case of arsenic

    African Journals Online (AJOL)

    ... both in the creation of sound drinking water quality guidelines or standards, and in the problem of how to interpret the risk to human health when guideline values are exceeded. In this paper this problem is discussed using the case of arsenic, where the definition of the boundaries of the grey area is particularly uncertain.

  14. Major League Baseball pitch velocity and pitch type associated with risk of ulnar collateral ligament injury.

    Science.gov (United States)

    Keller, Robert A; Marshall, Nathan E; Guest, John-Michael; Okoroha, Kelechi R; Jung, Edward K; Moutzouros, Vasilios

    2016-04-01

    The number of Major League Baseball (MLB) pitchers requiring ulnar collateral ligament (UCL) reconstructions is increasing. Recent literature has attempted to correlate specific stresses placed on the throwing arm to risk for UCL injury, with limited results. Eighty-three MLB pitchers who underwent primary UCL reconstruction were evaluated. Pitching velocity and percent of pitch type thrown (fastball, curve ball, slider, and change-up) were evaluated 2 years before and after surgery. Data were compared with control pitchers matched for age, position, size, innings pitched, and experience. The evaluation of pitch velocity compared with matched controls found no differences in pre-UCL reconstruction pitch velocities for fastballs (91.5 vs. 91.2 miles per hour [mph], P = .69), curveballs (78.2 vs. 77.9 mph, P = .92), sliders (83.3 vs. 83.5 mph, P = .88), or change-ups (83.9 vs. 83.8 mph, P = .96). When the percentage of pitches thrown was evaluated, UCL reconstructed pitchers pitch significantly more fastballs than controls (46.7% vs. 39.4%, P = .035). This correlated to a 2% increase in risk for UCL injury for every 1% increase in fastballs thrown. Pitching more than 48% fastballs was a significant predictor of UCL injury, because pitchers over this threshold required reconstruction (P = .006). MLB pitchers requiring UCL reconstruction do not pitch at higher velocities than matched controls, and pitch velocity does not appear to be a risk factor for UCL reconstruction. However, MLB pitchers who pitch a high percentage of fastballs may be at increased risk for UCL injury because pitching a higher percent of fastballs appears to be a risk factor for UCL reconstruction. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  15. Risk of stroke/systemic embolism, major bleeding and associated costs in non-valvular atrial fibrillation patients who initiated apixaban, dabigatran or rivaroxaban compared with warfarin in the United States Medicare population.

    Science.gov (United States)

    Amin, Alpesh; Keshishian, Allison; Trocio, Jeffrey; Dina, Oluwaseyi; Le, Hannah; Rosenblatt, Lisa; Liu, Xianchen; Mardekian, Jack; Zhang, Qisu; Baser, Onur; Vo, Lien

    2017-09-01

    To compare the risk and cost of stroke/systemic embolism (SE) and major bleeding between each direct oral anticoagulant (DOAC) and warfarin among non-valvular atrial fibrillation (NVAF) patients. Patients (≥65 years) initiating warfarin or DOACs (apixaban, rivaroxaban, and dabigatran) were selected from the Medicare database from 1 January 2013 to 31 December 2014. Patients initiating each DOAC were matched 1:1 to warfarin patients using propensity score matching to balance demographics and clinical characteristics. Cox proportional hazards models were used to estimate the risks of stroke/SE and major bleeding of each DOAC vs. warfarin. Two-part models were used to compare the stroke/SE- and major-bleeding-related medical costs between matched cohorts. Of the 186,132 eligible patients, 20,803 apixaban-warfarin pairs, 52,476 rivaroxaban-warfarin pairs, and 16,731 dabigatran-warfarin pairs were matched. Apixaban (hazard ratio [HR] = 0.40; 95% confidence interval [CI] 0.31, 0.53) and rivaroxaban (HR = 0.72; 95% CI 0.63, 0.83) were significantly associated with lower risk of stroke/SE compared to warfarin. Apixaban (HR = 0.51; 95% CI 0.44, 0.58) and dabigatran (HR = 0.79; 95% CI 0.69, 0.91) were significantly associated with lower risk of major bleeding; rivaroxaban (HR = 1.17; 95% CI 1.10, 1.26) was significantly associated with higher risk of major bleeding compared to warfarin. Compared to warfarin, apixaban ($63 vs. $131) and rivaroxaban ($93 vs. $139) had significantly lower stroke/SE-related medical costs; apixaban ($292 vs. $529) and dabigatran ($369 vs. $450) had significantly lower major bleeding-related medical costs. Among the DOACs in the study, only apixaban is associated with a significantly lower risk of stroke/SE and major bleeding and lower related medical costs compared to warfarin.

  16. Internet-based control recruitment for a case-control study of major risk factors for stroke in Korea: lessons from the experience.

    Science.gov (United States)

    Park, Jong-Moo; Cho, Yong-Jin; Lee, Kyung Bok; Park, Tai Hwan; Lee, Soo Joo; Han, Moon-Ku; Ko, Youngchai; Lee, Jun; Cha, Jae-Kwan; Lee, Byung-Chul; Yu, Kyung-Ho; Oh, Mi-Sun; Lee, Ji Sung; Lee, Juneyoung; Bae, Hee-Joon

    2014-01-01

    This study aimed to estimate the population-attributable risks (PARs) of 9 major risk factors for stroke in Korea through a case-control study and to test the feasibility and validity of internet-based control recruitment. From April 2008 to September 2009, controls were enrolled via internet after providing consent for participation through a web-based survey. The cases included patients who were admitted to the participating centers due to acute stroke or transient ischemic attack within 7 days of onset during the study period. Each control was age- and sex-matched with 2 cases. Adjusted odd ratios, age-standardized prevalence, and PARs were estimated for the 9 major risk factors using the prevalence of risk factors in the control group and the age and sex characteristics from Korea's national census data. In total, 1041 controls were matched to 2082 stroke cases. Because of a shortage of elderly controls in the internet-based recruitment, 248 controls were recruited off-line. The PARs were 23.44%, 10.95%, 51.32%, and 6.35% for hypertension, diabetes, smoking, and stroke history, respectively. Hypercholesterolemia, atrial fibrillation, obesity, coronary heart disease, and a family history of stroke were not associated with stroke. Comparison with education and religion of the control group with that mentioned in the national census data showed a notable difference. The study results imply that internet-based control recruitment for a case-control study requires careful selection of risk factors with high self-awareness and effective strategies to facilitate the recruitment of elderly participants. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  17. 3D quantitative interpretation of archaeo-magnetic data: Adaptation of aero-magnetic interpretation techniques for archaeological purposes

    Science.gov (United States)

    Cheyney, S.; Hill, I. A.; Linford, N.; Fishwick, S.; Leech, C.

    2011-12-01

    information from Euler deconvolution can also be obtained, but is highly dependent on selecting an appropriate structural index. We demonstrate that results from both the edge-detection methods and Euler deconvolution can be used to constrain an inversion. Such results can be determined simply, automatically and objectively using few user-derived assumptions or constraints. Initial estimates of subsurface structure can then used to create an initial reference model, or to constrain the depth weighting of the inversion. This increases confidence in the final result. Greater interpretation of the magnetic data will aid the planning of higher resolution surveys such as GPR or resistivity, or to position targeted excavations. In some situations the detailed 3D geophysical model may supply sufficient archaeological information to avoid excavation, thus reducing cost and risk to the archaeological material.

  18. Major depressive disorder and suicide risk among adult outpatients at several general hospitals in a Chinese Han population.

    Science.gov (United States)

    Li, Haiyan; Luo, Xinni; Ke, Xiaoyin; Dai, Qing; Zheng, Wei; Zhang, Chanjuan; Cassidy, Ryan M; Soares, Jair C; Zhang, XiangYang; Ning, Yuping

    2017-01-01

    Somatic complaints are often the presenting symptoms of major depressive disorder (MDD) in the outpatient context, because this may go unrecognized. It is well understood that MDD carries an increased risk of suicide. This study aimed to identify the risk factors and association with both MDD and suicidality among Han Chinese outpatients. A multicenter study was carried out in 5189 outpatient adults (≥18 years old) in four general hospitals in Guangzhou, China. The 1392 patients who had the Patient Health Questionnaire-9 (PHQ-9) score ≥ 5, indicating depressive symptoms were offered an interview with a psychiatrist by the Mini International Neuropsychiatric Interview (MINI); 819 patients consented and completed the MINI interview. MINI module B was used to assess suicidality. Stepwise binary logistic models were used to estimate the relationship between a significant risk factor and suicide or MDD. According to with or without MDD, the secondary analysis was performed using the logistic regression model for the risk of suicidility. The current prevalence of MDD and the one month prevalence of suicidality were 3.7% and 2.3% respectively. The odds ratio of suicidality in women was more than twice that in men (OR = 2.62; 95% CI 1.45-4.76). Other risk factors which were significantly associated with suicidality were: living alone, higher education, self-reported depression, getting psychiatric diagnoses (MDD, anxiety disorders, and bipolar disorders). Significant risk factors for MDD were also noticed, such as comorbid anxiety disorders, self-reported anxiety, insomnia, suicidal ideation. It's a cross-sectional study in outpatient clinics using self-report questionnaires. This study provides valuable data about the risk factors and association of MDD and suicide risk in adult outpatients in Han Chinese. Those factors allow better the employment of preventative measures.

  19. Outcome of intraoperative goal-directed therapy using Vigileo/FloTrac in high-risk patients scheduled for major abdominal surgeries: A prospective randomized trial

    Directory of Open Access Journals (Sweden)

    Mohammed A. Elgendy

    2017-07-01

    Conclusion: The applied protocol for intraoperative GDT provided significant reduction of PO morbidities, ICU and hospital LOS but couldn‘t significantly reduce mortality rates in high risk patients scheduled for major abdominal surgeries.

  20. Risk of developing major depressive disorder and anxiety disorders among adolescents and adults with atopic dermatitis: a nationwide longitudinal study.

    Science.gov (United States)

    Cheng, Chih-Ming; Hsu, Ju-Wei; Huang, Kai-Lin; Bai, Ya-Mei; Su, Tung-Ping; Li, Cheng-Ta; Yang, Albert C; Chang, Wen-Han; Chen, Tzeng-Ji; Tsai, Shih-Jen; Chen, Mu-Hong

    2015-06-01

    Previous cross-sectional studies have suggested a comorbid association between atopic dermatitis (AD) and depressive disorder as well as anxiety disorders, but the temporal relationship was not determined. Using the Taiwan National Health Insurance Research Database, 8208 AD patients aged 12 and older without psychiatric history and age-/sex-matched (1:1) controls between 1998 and 2008 were enrolled in our study and followed to the end of 2011. Subjects who developed major depression, any depressive disorder, and anxiety disorders during the follow-up were identified. The Cox regression analysis after adjusting for demographic data and atopic comorbidities demonstrated that patients with AD had an elevated risk of developing major depression (hazard ratio [HR]: 6.56, 95% confidence interval [CI]: 3.64-11.84), any depressive disorder (HR: 5.44, 95% CI: 3.99-7.44), and anxiety disorders (HR: 3.57, 95% CI: 2.55-4.98). Stratified by age group, both adolescents and adults with AD were prone to developing major depression (HR: 4.26, 95% CI: 1.39-13.13; HR: 7.56, 95% CI: 3.75-15.23), any depressive disorder (HR: 4.38, 95% CI: 2.09-9.18; HR: 5.66, 95% CI: 4.01-7.99), and anxiety disorders (HR: 5.40, 95% CI: 2.02-14.39; HR: 3.36, 95% CI: 2.38-4.80). AD in both adolescence and adulthood increased the risk of developing major depression, any depressive disorder, and anxiety disorders in later life. Further studies would be required to clarify the possible underlying mechanism between AD and depression as well as anxiety disorders. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Developing an Interpretive Structural Modeling(ISM in order to Achieve Agility via Information Technology in Manufacturing Organization

    Directory of Open Access Journals (Sweden)

    Ali Mohammadi

    2012-12-01

    Full Text Available Agility is considered the ability to respond quickly to changes and a major factor for success and survival in today's business. The purpose of this research is to offer a conceptual model using Interpretive Structural Modeling(ISM. To this end after reviewing literature and theoretical background, the indices related to achieving agility via information technology (IT have been identified and then the Interpretive Structural Model in four levels has been represented. Findings show that tendency and commitment of top managers, organizational climate and strategic planning alignment with information technology planning is the major factors affecting agility achievement via information technology (IT.

  2. Medical interpreters as tools: dangers and challenges in the utilitarian approach to interpreters' roles and functions.

    Science.gov (United States)

    Hsieh, Elaine; Kramer, Eric Mark

    2012-10-01

    This study explores the tensions, challenges, and dangers when a utilitarian view of interpreter is constructed, imposed, and/or reinforced in health care settings. We conducted in-depth interviews and focus groups with 26 medical interpreters from 17 different languages and cultures and 39 providers of five specialties. Grounded theory was used for data analysis. The utilitarian view to interpreters' roles and functions influences providers in the following areas: (a) hierarchical structure and unidirectional communication, (b) the interpreter seen as information gatekeeper, (c) the interpreter seen as provider proxy, and (d) interpreter's emotional support perceived as tools. When interpreters are viewed as passive instruments, a utilitarian approach may compromise the quality of care by silencing patients' and interpreters' voice, objectifying interpreters' emotional work, and exploiting patients' needs. Providers need to recognize that a utilitarian approach to the interpreter's role and functions may create interpersonal and ethical dilemmas that compromise the quality of care. By viewing interpreters as smart technology (rather than passive instruments), both providers and interpreters can learn from and co-evolve with each other, allowing them to maintain control over their expertise and to work as collaborators in providing quality care. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  3. Report by the Delegate for major risks for 2010; Rapport 2010 du delegue aux risques majeurs

    Energy Technology Data Exchange (ETDEWEB)

    Michel, Laurent [Ministere de l' Ecologie, du Developpement durable, des Transports et du Logement, Grande Arche, Tour Pascal A et B, 92055 La Defense Cedex (France)

    2011-07-01

    The first part of this report comments the major natural and industrial disasters which occurred in 2010 in France (Xynthia tempest, flooding, and forest fires) and in other countries. It also proposes some lessons from these disasters. The second part discusses the evolution towards a resilient society by a combined approach of sustainable development, of cultural good safeguarding, and person protection. It also discusses a prospective approach regarding natural hazards and technological accidents, adapted procedures, governance and land planning, the evolution of information and alarm systems, and emerging risks. The third part addresses the adaptation to natural hazards: frameworks and strategies, actions (regulatory prevention, flooding management, safety of hydraulic works, seismic plan). It assesses the financial and budgetary means brought by the State and its partners, and discusses some perspectives. It addresses the technological risks: legal and regulatory evolutions, safety of hazardous industrial installations, consequences of technological accidents. The next part deals with the control of civilian nuclear installations by the ASN. The last part presents the different involved structures and authorities

  4. Risk-based approach for bioremediation of fuel hydrocarbons at a major airport

    International Nuclear Information System (INIS)

    Wiedemeier, T.H.; Guest, P.R.; Blicker, B.R.

    1994-01-01

    This paper describes a risk-based approach for bioremediation of fuel-hydrocarbon-contaminated soil and ground water at a major airport in Colorado. In situ bioremediation pilot testing, natural attenuation modeling, and full-scale remedial action planning and implementation for soil and ground water contamination has conducted at four airport fuel farms. The sources of fuel contamination were leaking underground storage tanks (USTs) or pipelines transporting Jet A fuel and aviation gasoline. Continuing sources of contamination were present in several small cells of free-phase product and in fuel residuals trapped within the capillary fringe at depths 15 to 20 feet below ground surface. Bioventing pilot tests were conducted to assess the feasibility of using this technology to remediate contaminated soils. The pilot tests included measurement of initial soil gas chemistry at the site, determination of subsurface permeability, and in situ respiration tests to determine fuel biodegradation rates. A product recovery test was also conducted. ES designed and installed four full-scale bioventing systems to remediate the long-term sources of continuing fuel contamination. Benzene, toluene, ethylbenzene, and xylenes (BTEX) and total petroleum hydrocarbons (TPH) were detected in ground water at concentrations slightly above regulatory guidelines

  5. Standardizing terms, definitions and concepts for describing and interpreting unwanted immunogenicity of biopharmaceuticals

    DEFF Research Database (Denmark)

    Rup, B; Pallardy, M; Sikkema, D

    2015-01-01

    scientists are involved in: interpretation and management of clinical and biological outcomes of BP immunogenicity, improvement of methods for describing, predicting and mitigating immunogenicity risk and elucidation of underlying causes. Collaboration and alignment of efforts across these communities...... the Risk; www.abirisk.eu] was formed by leading clinicians, academic scientists and EFPIA (European Federation of Pharmaceutical Industries and Associations) members to elucidate underlying causes, improve methods for immunogenicity prediction and mitigation and establish common definitions around terms...

  6. The Nirex Sellafield site investigation: the role of geophysical interpretation

    International Nuclear Information System (INIS)

    Muir Wood, R.; Woo, G.; MacMillan, G.

    1992-01-01

    This report reviews the methods by which geophysical data are interpreted, and used to characterize the 3-D geology of a site for potential storage of radioactive waste. The report focuses on the NIREX site investigation at Sellafield, for which geophysical observations provide a significant component of the structural geological understanding. In outlining the basic technical principles of seismic data processing and interpretation, and borehole logging, an attempt has been made to identify errors, uncertainties, and the implicit use of expert judgement. To enhance the reliability of a radiological probabilistic risk assessment, recommendations are proposed for independent use of the primary NIREX geophysical site investigation data in characterizing the site geology. These recommendations include quantitative procedures for undertaking an uncertainty audit using a combination of statistical analysis and expert judgement. (author)

  7. Distortion product otoacoustic emissions in college music majors and nonmusic majors

    Directory of Open Access Journals (Sweden)

    Rebecca L. Warner Henning

    2016-01-01

    Full Text Available The presence and absence of distortion product otoacoustic emissions (DPOAEs as well as DPOAE amplitudes were compared between college music majors and a control group of nonmusic majors. Participants included 28 music majors and 35 nonmusic majors enrolled at a university with ages ranging from 18-25 years. DPOAEs and hearing thresholds were measured bilaterally on all the participants. DPOAE amplitudes were analyzed at the following f2 frequencies: 1,187 Hz, 1,500 Hz, 1,906 Hz, 2,531 Hz, 3,031 Hz, 3812 Hz, 4,812 Hz, and 6,031 Hz. Significantly more music majors (7/28 than nonmusic majors (0/35 exhibited absent DPOAEs for at least one frequency in at least one ear. Both groups of students reported similar histories of recreational and occupational noise exposures that were unrelated to studying music, and none of the students reported high levels of noise exposure within the previous 48 h. There were no differences in audiometric thresholds between the groups at any frequency. At DPOAE f2 frequencies from 3,031 Hz to 6,031 Hz, nonsignificantly lower amplitudes of 2-4 dB were seen in the right ears of music majors versus nonmajors, and in the right ears of music majors playing brass instruments compared to music majors playing nonbrass instruments. Given the greater prevalence of absent DPOAEs in university music majors compared to nonmusic majors, it appears that early stages of cochlear damage may be occurring in this population. Additional research, preferably longitudinal and across multiple colleges/universities, would be beneficial to more definitively determine when the music students begin to show signs of cochlear damage, and to identify whether any particular subgroups of music majors are at a greater risk of cochlear damage.

  8. Interpretation of the Haestholmen in situ state of stress based on core damage observations

    International Nuclear Information System (INIS)

    Hakala, M.

    2000-01-01

    At the Haestholmen investigation site, direct in situ stress measurements, overcoring and hydraulic fracturing have been unsuccessful because of ring disking and horizontal hydraulic fracturing. Prior to this study, a detailed study on both core disking and ring disking was made, and based on those results an in situ state of stress interpretation method was developed. In this work this method is applied to the Haestholmen site. The interpretation is based on disk fracture type, spacing and shape. Also, the Hoek-Brown strength envelope and Poisson's ratio of intact rock are needed. The interpretation result is most reliable if both core disking and ring disking information at the same depth levels is available. A detailed core logging showed that ring disking is systematic below the -365 m level in the vertical overcoring stress measurement hole, HH-KR6. On the other hand, no representative core disking exists except for two points in two differently oriented subvertical boreholes HH-KR2 and HHKR7. Because the interpretation has to be based on ring disking only, upper and lower estimates for the vertical stress were set. These were gravitational and 67% of gravitational. Furthermore, the in situ stress state was assumed to be in horizontal and vertical planes, because the disking in vertical borehole HH-KR6 was not inclined. The interpretation resulted in a good estimate for the major horizontal stress but none of the horizontal stress rations ( 0.25, 0.5, 0.75 and 1.0 ) or vertical stress assumptions studied are clearly more probable the others. At the 500 m level the resulting maximum horizontal stress is 41 MPa. If a linear fit through the zero depth and zero stress point is applied, the maximum horizontal stress gradient is 0.0818 z MPa/m with a standard deviation between 5 and 12 per cent. The orientation of the major horizontal stress is 108 with standard deviation of 21 degrees. The interpreted major horizontal stress state also indicated that systematic

  9. Risk assessment of major hazards: Hazardous materials transportation in urban areas

    Energy Technology Data Exchange (ETDEWEB)

    Hubert, Ph; Pages, P

    1988-02-01

    There is no doubt that, thanks to the pioneering studies of the late seventies and the early eighties, a methodology has been made available that allows risk management of hazardous transportation in urban areas. This approach can easily be extended to the management of other similar risks (storages and to some extent natural hazards). The methodology is both technically available and affordable. The insertion within the decision making processes deserves still some efforts. It has be seen that the applications are broad and numerous. They range from route selection to emergency preparedness, with some insights into acceptability considerations. One limit to the use of such studies, aiming to an objective assessment of the risk, is the complexity of the decision problems, where many factors are to be considered, the most subtle being the one linked to acceptability. However, as such studies develop, those factors start to be clarified, and decision makers learn how to use risk indices in this context. So at the present time it can be said that risk analyses are a valuable input into the decision making process in most cases. And, as more experience is acquired the uses are broader. As any technical innovation risk assessment modifies the approaches to the questions it is dealing with. It seems impossible now to treat those kinds of risks as was done ten years ago.

  10. Risk assessment of major hazards: Hazardous materials transportation in urban areas

    International Nuclear Information System (INIS)

    Hubert, Ph.; Pages, P.

    1988-02-01

    There is no doubt that, thanks to the pioneering studies of the late seventies and the early eighties, a methodology has been made available that allows risk management of hazardous transportation in urban areas. This approach can easily be extended to the management of other similar risks (storages and to some extent natural hazards). The methodology is both technically available and affordable. The insertion within the decision making processes deserves still some efforts. It has be seen that the applications are broad and numerous. They range from route selection to emergency preparedness, with some insights into acceptability considerations. One limit to the use of such studies, aiming to an objective assessment of the risk, is the complexity of the decision problems, where many factors are to be considered, the most subtle being the one linked to acceptability. However, as such studies develop, those factors start to be clarified, and decision makers learn how to use risk indices in this context. So at the present time it can be said that risk analyses are a valuable input into the decision making process in most cases. And, as more experience is acquired the uses are broader. As any technical innovation risk assessment modifies the approaches to the questions it is dealing with. It seems impossible now to treat those kinds of risks as was done ten years ago

  11. Novel variants in the PRDX6 Gene and the risk of Acute Lung Injury following major trauma

    Directory of Open Access Journals (Sweden)

    Localio A Russell

    2011-05-01

    Full Text Available Abstract Background Peroxiredoxin 6 (PRDX6 is involved in redox regulation of the cell and is thought to be protective against oxidant injury. Little is known about genetic variation within the PRDX6 gene and its association with acute lung injury (ALI. In this study we sequenced the PRDX6 gene to uncover common variants, and tested association with ALI following major trauma. Methods To examine the extent of variation in the PRDX6 gene, we performed direct sequencing of the 5' UTR, exons, introns and the 3' UTR in 25 African American cases and controls and 23 European American cases and controls (selected from a cohort study of major trauma, which uncovered 80 SNPs. In silico modeling was performed using Patrocles and Transcriptional Element Search System (TESS. Thirty seven novel and tagging SNPs were tested for association with ALI compared with ICU at-risk controls who did not develop ALI in a cohort study of 259 African American and 254 European American subjects that had been admitted to the ICU with major trauma. Results Resequencing of critically ill subjects demonstrated 43 novel SNPs not previously reported. Coding regions demonstrated no detectable variation, indicating conservation of the protein. Block haplotype analyses reveal that recombination rates within the gene seem low in both Caucasians and African Americans. Several novel SNPs appeared to have the potential for functional consequence using in silico modeling. Chi2 analysis of ALI incidence and genotype showed no significant association between the SNPs in this study and ALI. Haplotype analysis did not reveal any association beyond single SNP analyses. Conclusions This study revealed novel SNPs within the PRDX6 gene and its 5' and 3' flanking regions via direct sequencing. There was no association found between these SNPs and ALI, possibly due to a low sample size, which was limited to detection of relative risks of 1.93 and above. Future studies may focus on the role of

  12. Apolipoprotein E e4 allele does not increase the risk of early postoperative delirium after major surgery.

    Science.gov (United States)

    Abelha, Fernando José; Fernandes, Vera; Botelho, Miguela; Santos, Patricia; Santos, Alice; Machado, J C; Barros, Henrique

    2012-02-01

    BACKGROUND: A relationship between patients with a genetic predisposition to and those who develop postoperative delirium has not been yet determined. The aim of this study was to determine whether there is an association between apolipoprotein E epsilon 4 allele (APOE4) and delirium after major surgery. METHODS: Of 230 intensive care patients admitted to the post anesthesia care unit (PACU) over a period of 3 months, 173 were enrolled in the study. Patients' demographics and intra- and postoperative data were collected. Patients were followed for the development of delirium using the Intensive Care Delirium Screening Checklist, and DNA was obtained at PACU admission to determine apolipoprotein E genotype. RESULTS: Fifteen percent of patients developed delirium after surgery. Twenty-four patients had one copy of APOE4. The presence of APOE4 was not associated with an increased risk of early postoperative delirium (4% vs. 17%; P = 0.088). The presence of APOE4 was not associated with differences in any studied variables. Multivariate analysis identified age [odds ratio (OR) 9.3, 95% confidence interval (CI) 2.0-43.0, P = 0.004 for age ≥65 years), congestive heart disease (OR 6.2, 95% CI 2.0-19.3, P = 0.002), and emergency surgery (OR 59.7, 95% CI 6.7-530.5, P < 0.001) as independent predictors for development of delirium. The Simplified Acute Physiology Score II (SAPS II) and The Acute Physiology and Chronic Health Evaluation II (APACHE II) were significantly higher in patients with delirium (P < 0.001 and 0.008, respectively). Hospital mortality rates of these patients was higher and they had a longer median PACU stay. CONCLUSIONS: Apolipoprotein e4 carrier status was not associated with an increased risk for early postoperative delirium. Age, congestive heart failure, and emergency surgery were independent risk factors for the development of delirium after major surgery.

  13. Major depressive disorder with religious struggle and completed suicide after hair transplantation

    Directory of Open Access Journals (Sweden)

    Mehmet Emin Ceylan

    2017-03-01

    Full Text Available Objectives: Psychological outcomes of aesthetic surgical procedures like hair transplantation are mostly positive including decreased anxiety, depression and social phobia and increased general well-being, self-efficacy and self-esteem. However, some patients may suffer from post-surgical depression and post-surgical increased suicide rates have been reported for breast augmentation patients. Difficulty adapting to the new image, unfulfilled psychological needs expected to be met by the surgery, side effects of the surgery like tissue swelling or bruising, uncontrolled pain, presence of body dysmorphic disorder and previous history of mood disorder may be some of the risk factors for post-surgical depression. Methods: Here, we present a case without prior psychiatric history who developed major depressive disorder after hair transplantation and died of suicide. Results: He started experiencing religious struggle related to his decision about the hair transplant which he interpreted as acting against God’s will. While religious involvement has been reported to be a protective factor against depression, spiritual struggle, which includes religious guilt, has been described as an important risk factor for depression, hopelessness and suicidality which might explain the severity of depression in our patient. Conclusions: This case highlights the importance of a detailed psychiatric evaluation and exploration of religious concerns of any patient before any type of aesthetic surgery. Major depressive disorder is a treatable condition; however, mild depression can go unnoticed. Religious belief and related religious practices affect an individual’s personal health attitudes; therefore, we think that every physician is needed to explore the religious concerns of any patient during any medical examination or surgical procedure. Relevant religious authorities should be consulted when necessary.

  14. Major depressive disorder with religious struggle and completed suicide after hair transplantation.

    Science.gov (United States)

    Ceylan, Mehmet Emin; Önen Ünsalver, Barış; Evrensel, Alper

    2017-01-01

    Psychological outcomes of aesthetic surgical procedures like hair transplantation are mostly positive including decreased anxiety, depression and social phobia and increased general well-being, self-efficacy and self-esteem. However, some patients may suffer from post-surgical depression and post-surgical increased suicide rates have been reported for breast augmentation patients. Difficulty adapting to the new image, unfulfilled psychological needs expected to be met by the surgery, side effects of the surgery like tissue swelling or bruising, uncontrolled pain, presence of body dysmorphic disorder and previous history of mood disorder may be some of the risk factors for post-surgical depression. Here, we present a case without prior psychiatric history who developed major depressive disorder after hair transplantation and died of suicide. He started experiencing religious struggle related to his decision about the hair transplant which he interpreted as acting against God's will. While religious involvement has been reported to be a protective factor against depression, spiritual struggle, which includes religious guilt, has been described as an important risk factor for depression, hopelessness and suicidality which might explain the severity of depression in our patient. This case highlights the importance of a detailed psychiatric evaluation and exploration of religious concerns of any patient before any type of aesthetic surgery. Major depressive disorder is a treatable condition; however, mild depression can go unnoticed. Religious belief and related religious practices affect an individual's personal health attitudes; therefore, we think that every physician is needed to explore the religious concerns of any patient during any medical examination or surgical procedure. Relevant religious authorities should be consulted when necessary.

  15. REQUIREMENTS FOR A GENERAL INTERPRETATION THEORY

    Directory of Open Access Journals (Sweden)

    Anda Laura Lungu Petruescu

    2013-06-01

    Full Text Available Time has proved that Economic Analysis is not enough as to ensure all the needs of the economic field. The present study wishes to propose a new approach method of the economic phenomena and processes based on the researches made outside the economic space- a new general interpretation theory- which is centered on the human being as the basic actor of economy. A general interpretation theory must assure the interpretation of the causalities among the economic phenomena and processes- causal interpretation; the interpretation of the correlations and dependencies among indicators- normative interpretation; the interpretation of social and communicational processes in economic organizations- social and communicational interpretation; the interpretation of the community status of companies- transsocial interpretation; the interpretation of the purposes of human activities and their coherency – teleological interpretation; the interpretation of equilibrium/ disequilibrium from inside the economic systems- optimality interpretation. In order to respond to such demands, rigor, pragmatism, praxiology and contextual connectors are required. In order to progress, the economic science must improve its language, both its syntax and its semantics. The clarity of exposure requires a language clarity and the scientific theory progress asks for the need of hypotheses in the building of the theories. The switch from the common language to the symbolic one means the switch from ambiguity to rigor and rationality, that is order in thinking. But order implies structure, which implies formalization. Our paper should be a plea for these requirements, requirements which should be fulfilled by a modern interpretation theory.

  16. How accessible are interpreter services to dialysis patients of Non-English Speaking background?

    Directory of Open Access Journals (Sweden)

    Edward Zimbudzi

    2010-03-01

    Full Text Available Benefits of utilising professional interpreters in clinicalsettings have been well documented. However, not manystudies have focused on use of professional interpreters bydialysis patients of Non-English Speaking Background (NESBwho are in the clinical settings every second day of their lives.The underlying question for this research was to determinethe level of interpreter utilisation by dialysis patients of NESBat a major urban teaching hospital.MethodA multi-method approach was used involving (a in-depthinterviews of health care professionals working with dialysispatients to elicit their views regarding interpreter access anduse by dialysis patients of NESB, (b observations ofinteractions between staff and dialysis patients of NESB and(c review of medical records belonging to dialysis patients ofNESB who were admitted 24 months prior to the study.ResultsInterviews revealed that only 50% of Health Care Workers(HCWs had accessed an interpreter for dialysis patients ofNESB over a period of six months. Observations of staff/NESBpatient interactions showed that professional interpreterswere used in only 25% of the observed occasions. Thereview of medical records revealed that there was noevidence of interpreter use in 32% of the recordsbelonging to dialysis patients of NESB. The study alsoshowed that non-compliance with dialysis treatmentregime was more likely to occur among patients who hadlimited access to interpreters.ConclusionThe study demonstrated a suboptimal utilisation ofinterpreter services by dialysis patients of NESB. Severalbarriers to inaccessibility and underutilisation ofprofessional interpreters were identified.Recommendations to improve communication betweenHCWs and dialysis patients of NESB are suggested.

  17. Interpreting Physics

    CERN Document Server

    MacKinnon, Edward

    2012-01-01

    This book is the first to offer a systematic account of the role of language in the development and interpretation of physics. An historical-conceptual analysis of the co-evolution of mathematical and physical concepts leads to the classical/quatum interface. Bohrian orthodoxy stresses the indispensability of classical concepts and the functional role of mathematics. This book analyses ways of extending, and then going beyond this orthodoxy orthodoxy. Finally, the book analyzes how a revised interpretation of physics impacts on basic philosophical issues: conceptual revolutions, realism, and r

  18. Antidepressant use during pregnancy and the risk of major congenital malformations in a cohort of depressed pregnant women: an updated analysis of the Quebec Pregnancy Cohort.

    Science.gov (United States)

    Bérard, Anick; Zhao, Jin-Ping; Sheehy, Odile

    2017-01-12

    Antidepressant use during gestation has been associated with risk of major congenital malformations but estimates can lack statistical power or be confounded by maternal depression. We aimed to determine the association between first-trimester exposure to antidepressants and the risk of major congenital malformations in a cohort of depressed/anxious women. Data were obtained from the Quebec Pregnancy Cohort (QPC). All pregnancies with a diagnosis of depression or anxiety, or exposed to antidepressants in the 12 months before pregnancy, and ending with a live-born singleton were included. Antidepressant classes (selective serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors (SNRI), tricyclic antidepressants (TCA) and other antidepressants) and types were individually compared with non-exposure during the first trimester (depressed untreated). Major congenital malformations overall and organ-specific malformations in the first year of life were identified. 18 487 pregnant women were included. When looking at the specific types of antidepressant used during the first trimester, only citalopram was increasing the risk of major congenital malformations (adjusted OR, (aOR) 1.36, 95% CI 1.08 to 1.73; 88 exposed cases), although there was a trend towards increased risk for the most frequently used antidepressants. Antidepressants with serotonin reuptake inhibition effect (SSRI, SNRI, amitriptyline (the most used TCA)) increased the risk of certain organ-specific defects: paroxetine increased the risk of cardiac defects (aOR 1.45, 95% CI 1.12 to 1.88), and ventricular/atrial septal defects (aOR 1.39, 95% CI 1.00 to 1.93); citalopram increased the risk of musculoskeletal defects (aOR 1.92, 95% CI 1.40 to 2.62), and craniosynostosis (aOR 3.95, 95% CI 2.08 to 7.52); TCA was associated with eye, ear, face and neck defects (aOR 2.45, 95% CI 1.05 to 5.72), and digestive defects (aOR 2.55, 95% CI 1.40 to 4.66); and venlafaxine was associated with

  19. Protection goals in environmental risk assessment: a practical approach.

    Science.gov (United States)

    Garcia-Alonso, Monica; Raybould, Alan

    2014-12-01

    Policy protection goals are set up in most countries to minimise harm to the environment, humans and animals caused by human activities. Decisions on whether to approve new agricultural products, like pesticides or genetically modified (GM) crops, take into account these policy protection goals. To support decision-making, applications for approval of commercial uses of GM crops usually comprise an environmental risk assessment (ERA). These risk assessments are analytical tools, based on science, that follow a conceptual model that includes a problem formulation step where policy protection goals are considered. However, in most countries, risk assessors face major problems in that policy protection goals set in the legislation are stated in very broad terms and are too ambiguous to be directly applicable in ERAs. This means that risk assessors often have to interpret policy protection goals without clear guidance on what effects would be considered harmful. In this paper we propose a practical approach that may help risk assessors to translate policy protection goals into unambiguous (i.e., operational) protection goals and to establish relevant assessment endpoints and risk hypotheses that can be used in ERAs. Examples are provided to show how this approach can be applied to two areas of environmental concern relevant to the ERAs of GM crops.

  20. Major salt beds of the Palo Duro and Dalhart Basins, Texas

    International Nuclear Information System (INIS)

    1983-12-01

    Major salt beds are defined as salt intervals at least 75 feet thick that contain no interbeds greater than 10 feet thick and include no more than 15 percent non-salt interbeds. Maps based on the interpretation of geophysical logs from hundreds of oil and gas exploration wells reveal seven major salt beds in the Palo Duro Basin and one major salt bed in the Dalhart Basin. The most extensive major salt beds are in the central and northern Palo Duro Basin, in the Upper San Andres Formation and the Lower San Andres Formation Units 4 and 5. Of these, the major salt bed within the Lower San Andres Formation Unit 4 is the most widespread and generally the thickest. 7 references, 15 figures, 2 tables

  1. Automated, computer interpreted radioimmunoassay results

    International Nuclear Information System (INIS)

    Hill, J.C.; Nagle, C.E.; Dworkin, H.J.; Fink-Bennett, D.; Freitas, J.E.; Wetzel, R.; Sawyer, N.; Ferry, D.; Hershberger, D.

    1984-01-01

    90,000 Radioimmunoassay results have been interpreted and transcribed automatically using software developed for use on a Hewlett Packard Model 1000 mini-computer system with conventional dot matrix printers. The computer program correlates the results of a combination of assays, interprets them and prints a report ready for physician review and signature within minutes of completion of the assay. The authors designed and wrote a computer program to query their patient data base for radioassay laboratory results and to produce a computer generated interpretation of these results using an algorithm that produces normal and abnormal interpretives. Their laboratory assays 50,000 patient samples each year using 28 different radioassays. Of these 85% have been interpreted using our computer program. Allowances are made for drug and patient history and individualized reports are generated with regard to the patients age and sex. Finalization of reports is still subject to change by the nuclear physician at the time of final review. Automated, computerized interpretations have realized cost savings through reduced personnel and personnel time and provided uniformity of the interpretations among the five physicians. Prior to computerization of interpretations, all radioassay results had to be dictated and reviewed for signing by one of the resident or staff physicians. Turn around times for reports prior to the automated computer program generally were two to three days. Whereas, the computerized interpret system allows reports to generally be issued the day assays are completed

  2. Use of an Integrated Tool for Interpretation of Blood Glucose Data Improves Correctness of Glycemic Risk Assessment in Individuals With Type 1 and Type 2 Diabetes.

    Science.gov (United States)

    Parkin, Christopher G; Schwenke, Stephanie; Ossege, Anna Katharina; Gruchmann, Torsten

    2017-01-01

    Manufacturers now incorporate blood glucose (bG) value interpretation tools into their monitoring systems; however, usability of these support tools has not been well studied. We evaluated the utility and perceived benefits of support tool use by individuals with type 1 (T1D) and type 2 diabetes (T2D). This 3-arm, randomized, simulation study assessed the impact of use of bG value interpretation support tools on participants' ability to correctly interpret bG values, using 1 of 3 tools: a new tool that uses colored scales with target range indicator (TRI), Colors and Smiley icons (already available). Participants assessed 50 bG values without use of any tool and repeated the assessment using 1 of the 3 tool configurations. Changes in percentage of correct responses when using a support tool and user perceptions were assessed. Data sets from 140 participants were analyzed. Increases in correct responses were seen in all study groups but most notably in the TRI group (26%, P .627). Most TRI users felt confident (94%), agreed the tool will help them identify high and low values (96%) and will help them to make correct insulin dosage decisions (80%). Use of the TRI significantly increases users' ability to correctly and confidently determine their glycemic risk when self-monitoring bG levels. This suggests the tool may offer clinical value to individuals with T1D and T2D.

  3. Normative interpretations of diversity

    DEFF Research Database (Denmark)

    Lægaard, Sune

    2009-01-01

    Normative interpretations of particular cases consist of normative principles or values coupled with social theoretical accounts of the empirical facts of the case. The article reviews the most prominent normative interpretations of the Muhammad cartoons controversy over the publication of drawings...... of the Prophet Muhammad in the Danish newspaper Jyllands-Posten. The controversy was seen as a case of freedom of expression, toleration, racism, (in)civility and (dis)respect, and the article notes different understandings of these principles and how the application of them to the controversy implied different...... social theoretical accounts of the case. In disagreements between different normative interpretations, appeals are often made to the ‘context', so it is also considered what roles ‘context' might play in debates over normative interpretations...

  4. Barak’s Purposive Interpretation in Law as a Pattern of Constitutional Interpretative Fidelity

    Directory of Open Access Journals (Sweden)

    Marinković Tanasije

    2016-12-01

    Full Text Available Political jurisprudence points out that constitutional court judges sometimes act like political actors, and that their decisions are a function of strategic and ideological as much as legal considerations. Consequently, the proper role of the courts, notably in exercising their review of constitutionality, has been one of the most debated issues in modern political and legal theory. Part of the controversy is also how to measure the interpretative fidelity of judges to the constitutional texts, or conversely, the level of their political engagement. This paper argues for the reconsideration of Aharon Barak’s Purposive Interpretation in Law in that light. Barak’s work was intended to provide, in the first place, judges and other lawyers with a sort of judicial philosophy – a holistic system of legal reasoning, applying both to the interpretation of will, contract, statute and constitution. Nevertheless, these conventions of legal reasoning, modified and readapted, could well be used also as heuristic tools by the academics in measuring the interpretative fidelity of judges to various sources of law. Accordingly, this paper clings closely to the presentation of Barak’s precepts for the purposive interpretation of constitutions, by focusing on the notions of subjective and objective purpose in interpreting constitutions, and how the potential conflicts between these purposes are resolved.

  5. Major Management Challenges and Program Risks. Department of Labor

    National Research Council Canada - National Science Library

    2001-01-01

    This report addresses the major performance and accountability challenges facing the Department of Labor as it seeks to promote the welfare and economic security of the nations work force and ensure...

  6. Childhood leukaemia and low-level radiation - are we underestimating the risk?

    International Nuclear Information System (INIS)

    Wakeford, R.

    1996-01-01

    The Seascale childhood leukaemia 'cluster' can be interpreted as indicating that the risk of childhood leukaemia arising from low-level exposure to ionising radiation has been underestimated. Indeed, several variants of such an interpretation have been advanced. These include exposure to particular radionuclides, an underestimation of the radiation risk coefficient for childhood leukaemia, and the existence of a previously unrecognized risk of childhood leukaemia from the preconceptional irradiation of fathers. However, the scientific assessment of epidemiological associations is a complex matter, and such associations must be interpreted with caution. It would now seem most likely that the Seascale 'cluster' does not represent an unanticipated effect of the exposure to ionising radiation, but rather the effect of unusual population mixing generated by the Sellafield site which has produced an increase in the infection-based risk of childhood leukaemia. This episode in the history of epidemiological research provides a timely reminder of the need for great care in the interpretation-of novel statistical associations. (author)

  7. Accumulation of Major Life Events in Childhood and Adult Life and Risk of Type 2 Diabetes Mellitus.

    Directory of Open Access Journals (Sweden)

    Jolene Masters Pedersen

    Full Text Available The aim of the study was to estimate the effect of the accumulation of major life events (MLE in childhood and adulthood, in both the private and working domains, on risk of type 2 diabetes mellitus (T2DM. Furthermore, we aimed to test the possible interaction between childhood and adult MLE and to investigate modification of these associations by educational attainment.The study was based on 4,761 participants from the Copenhagen City Heart Study free of diabetes at baseline and followed for 10 years. MLE were categorized as 0, 1, 2, 3 or more events. Multivariate logistic regression models adjusted for age, sex, education and family history of diabetes were used to estimate the association between MLE and T2DM.In childhood, experiencing 3 or more MLE was associated with a 69% higher risk of developing T2DM (Odds Ratio (OR 1.69; 95% Confidence Interval (CI 1.60, 3.27. The accumulation of MLE in adult private (p-trend = 0.016 and work life (p-trend = 0.049 was associated with risk of T2DM in a dose response manner. There was no evidence that experiencing MLE in both childhood and adult life was more strongly associated with T2DM than experiencing events at only one time point. There was some evidence that being simultaneously exposed to childhood MLE and short education (OR 2.28; 95% C.I. 1.45, 3.59 and work MLE and short education (OR 2.86; 95% C.I. 1.62, 5.03 was associated with higher risk of T2DM, as the joint effects were greater than the sum of their individual effects.Findings from this study suggest that the accumulation of MLE in childhood, private adult life and work life, respectively, are risk factors for developing T2DM.

  8. Court Interpreting in Denmark - the role of court interpreters in Danish courtrooms

    DEFF Research Database (Denmark)

    Jacobsen, Bente

    1999-01-01

    Court interpreters in Denmark are expected to follow the guidelines laid down in the document Instructions for Interpreters, which was published in 1994, and which deals with four principal areas: accuracy and completeness, impartiality, confidentiality and conflict of interest. This paper contends...

  9. A pragmatic multi-centre randomised controlled trial of fluid loading in high-risk surgical patients undergoing major elective surgery--the FOCCUS study.

    Science.gov (United States)

    Cuthbertson, Brian H; Campbell, Marion K; Stott, Stephen A; Elders, Andrew; Hernández, Rodolfo; Boyers, Dwayne; Norrie, John; Kinsella, John; Brittenden, Julie; Cook, Jonathan; Rae, Daniela; Cotton, Seonaidh C; Alcorn, David; Addison, Jennifer; Grant, Adrian

    2011-01-01

    Fluid strategies may impact on patient outcomes in major elective surgery. We aimed to study the effectiveness and cost-effectiveness of pre-operative fluid loading in high-risk surgical patients undergoing major elective surgery. This was a pragmatic, non-blinded, multi-centre, randomised, controlled trial. We sought to recruit 128 consecutive high-risk surgical patients undergoing major abdominal surgery. The patients underwent pre-operative fluid loading with 25 ml/kg of Ringer's solution in the six hours before surgery. The control group had no pre-operative fluid loading. The primary outcome was the number of hospital days after surgery with cost-effectiveness as a secondary outcome. A total of 111 patients were recruited within the study time frame in agreement with the funder. The median pre-operative fluid loading volume was 1,875 ml (IQR 1,375 to 2,025) in the fluid group compared to 0 (IQR 0 to 0) in controls with days in hospital after surgery 12.2 (SD 11.5) days compared to 17.4 (SD 20.0) and an adjusted mean difference of 5.5 days (median 2.2 days; 95% CI -0.44 to 11.44; P = 0.07). There was a reduction in adverse events in the fluid intervention group (P = 0.048) and no increase in fluid based complications. The intervention was less costly and more effective (adjusted average cost saving: £2,047; adjusted average gain in benefit: 0.0431 quality adjusted life year (QALY)) and has a high probability of being cost-effective. Pre-operative intravenous fluid loading leads to a non-significant reduction in hospital length of stay after high-risk major surgery and is likely to be cost-effective. Confirmatory work is required to determine whether these effects are reproducible, and to confirm whether this simple intervention could allow more cost-effective delivery of care. Prospective Clinical Trials, ISRCTN32188676.

  10. Risk-adjusted econometric model to estimate postoperative costs: an additional instrument for monitoring performance after major lung resection.

    Science.gov (United States)

    Brunelli, Alessandro; Salati, Michele; Refai, Majed; Xiumé, Francesco; Rocco, Gaetano; Sabbatini, Armando

    2007-09-01

    The objectives of this study were to develop a risk-adjusted model to estimate individual postoperative costs after major lung resection and to use it for internal economic audit. Variable and fixed hospital costs were collected for 679 consecutive patients who underwent major lung resection from January 2000 through October 2006 at our unit. Several preoperative variables were used to develop a risk-adjusted econometric model from all patients operated on during the period 2000 through 2003 by a stepwise multiple regression analysis (validated by bootstrap). The model was then used to estimate the postoperative costs in the patients operated on during the 3 subsequent periods (years 2004, 2005, and 2006). Observed and predicted costs were then compared within each period by the Wilcoxon signed rank test. Multiple regression and bootstrap analysis yielded the following model predicting postoperative cost: 11,078 + 1340.3X (age > 70 years) + 1927.8X cardiac comorbidity - 95X ppoFEV1%. No differences between predicted and observed costs were noted in the first 2 periods analyzed (year 2004, $6188.40 vs $6241.40, P = .3; year 2005, $6308.60 vs $6483.60, P = .4), whereas in the most recent period (2006) observed costs were significantly lower than the predicted ones ($3457.30 vs $6162.70, P model may be used as a methodologic template for economic audit in our specialty and complement more traditional outcome measures in the assessment of performance.

  11. Pharmacogenetics-based warfarin dosing algorithm decreases time to stable anticoagulation and the risk of major hemorrhage: an updated meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Wang, Zhi-Quan; Zhang, Rui; Zhang, Peng-Pai; Liu, Xiao-Hong; Sun, Jian; Wang, Jun; Feng, Xiang-Fei; Lu, Qiu-Fen; Li, Yi-Gang

    2015-04-01

    Warfarin is yet the most widely used oral anticoagulant for thromboembolic diseases, despite the recently emerged novel anticoagulants. However, difficulty in maintaining stable dose within the therapeutic range and subsequent serious adverse effects markedly limited its use in clinical practice. Pharmacogenetics-based warfarin dosing algorithm is a recently emerged strategy to predict the initial and maintaining dose of warfarin. However, whether this algorithm is superior over conventional clinically guided dosing algorithm remains controversial. We made a comparison of pharmacogenetics-based versus clinically guided dosing algorithm by an updated meta-analysis. We searched OVID MEDLINE, EMBASE, and the Cochrane Library for relevant citations. The primary outcome was the percentage of time in therapeutic range. The secondary outcomes were time to stable therapeutic dose and the risks of adverse events including all-cause mortality, thromboembolic events, total bleedings, and major bleedings. Eleven randomized controlled trials with 2639 participants were included. Our pooled estimates indicated that pharmacogenetics-based dosing algorithm did not improve percentage of time in therapeutic range [weighted mean difference, 4.26; 95% confidence interval (CI), -0.50 to 9.01; P = 0.08], but it significantly shortened the time to stable therapeutic dose (weighted mean difference, -8.67; 95% CI, -11.86 to -5.49; P pharmacogenetics-based algorithm significantly reduced the risk of major bleedings (odds ratio, 0.48; 95% CI, 0.23 to 0.98; P = 0.04), but it did not reduce the risks of all-cause mortality, total bleedings, or thromboembolic events. Our results suggest that pharmacogenetics-based warfarin dosing algorithm significantly improves the efficiency of International Normalized Ratio correction and reduces the risk of major hemorrhage.

  12. Serum levels of nerve growth factor (NGF) in patients with major depression disorder and suicide risk.

    Science.gov (United States)

    Wiener, Carolina David; de Mello Ferreira, Sharon; Pedrotti Moreira, Fernanda; Bittencourt, Guilherme; de Oliveira, Jacqueline Flores; Lopez Molina, Mariane; Jansen, Karen; de Mattos Souza, Luciano Dias; Rizzato Lara, Diogo; Portela, Luiz Valmor; da Silva, Ricardo Azevedo; Oses, Jean Pierre

    2015-09-15

    Nerve growth factor (NGF) is an important member of the neurotrophins group and their involvement in the pathophysiology of major depression disorder (MDD) and suicide risk (SR) has been recently suggested. The aim of this study is to evaluate the changes in NGF serum levels in individuals with MDD and with or without risk of suicide, in subjects from a young population-based sample. This is a paired cross-sectional study nested in a population-based study. Individuals were rated for MDD and SR by a diagnostic interview--Mini International Neuropsychiatric Interview (M.I.N.I). The total population of the sample was comprised of 141 subjects distributed in three groups: 47 healthy controls, 47 subjects with current depressive episode without SR (MDD) and 47 subjects with current depressive episode and with SR (MDD + SR). NGF serum levels were significantly reduced in the MDD and MDD + SR groups when compared with controls (p ≤ 0.001). However, there were no differences in NGF levels between the MDD and MDD + SR groups (p = 1.000). These results suggest that reduced NGF serum levels can be a possible biomarker of MDD. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. The mismatch between bioaccumulation in field and laboratory environments: Interpreting the differences for metals in benthic bivalves

    International Nuclear Information System (INIS)

    Belzunce-Segarra, Maria J.; Simpson, Stuart L.; Amato, Elvio D.; Spadaro, David A.; Hamilton, Ian L.; Jarolimek, Chad V.; Jolley, Dianne F.

    2015-01-01

    Laboratory-based bioaccumulation and toxicity bioassays are frequently used to predict the ecological risk of contaminated sediments in the field. This study investigates the bioassay conditions most relevant to achieving environmentally relevant field exposures. An identical series of metal-contaminated marine sediments were deployed in the field and laboratory over 31 days. Changes in metal concentrations and partitioning in both sediments and waters were used to interpret differences in metal exposure and bioaccumulation to the benthic bivalve Tellina deltoidalis. Loss of resuspended sediments and deposition of suspended particulate matter from the overlying water resulted in the concentrations of Cu, Pb and Zn (major contaminants) becoming lower in the 1-cm surface layer of field-deployed sediments. Lower exchange rates of overlying waters in the laboratory resulted in higher dissolved metal exposures. The prediction of metal bioaccumulation by the bivalves in field and laboratory was improved by considering the metal partitioning within the surface sediments. - Highlights: • Particulate metals are the dominant metal exposure route in laboratory and field tests (87). • There is an over-representation of the dissolved metal exposure in the laboratory (81). • Laboratory bioassays result in higher bioaccumulation of major metals, Cu, Pb, Zn (82). • Differences in exposure must be considered for a proper sediment quality evaluation (83). • Traditional measurements are not sufficient to explain bioaccumulation results (79). - To improve the value of field- and laboratory-based sediment bioassays in ecological risk assessments, it is necessary to create exposure conditions that resemble those in the field

  14. A one-size-fits-all HIV prevention and education approach?: Analyzing and interpreting divergent HIV risk perceptions between African American and East African immigrant women in Washington, DC

    Science.gov (United States)

    De Jesus, Maria; Taylor, Juanita; Maine, Cathleen; Nalls, Patricia

    2015-01-01

    Background To date, there are very few comparative US studies and none in DC that distinguish between US-born and foreign-born Black women to examine and compare their perceptions of HIV risk. This qualitative study, therefore, analyzes African American and East African women’s perceptions of HIV risk in the Washington DC Metropolitan area, which has the highest AIDS rate in the US. Methods Forty in-depth, semi-structured interviews and 10 cognitive interviews were conducted among a sample of 25 African American women and 25 East African born women between October 2012 and March 2013 to examine perceptions regarding HIV risk. The in-depth semi-structured interviews were preceded by the cognitive interviews and accompanying survey. Study protocol was reviewed and approved by the American University Institutional Review Board. Results Adopting Boerma and Weir’s Proximate Determinants conceptual framework to interpret the data, the results of the study demonstrate that African American and East African immigrant women have divergent perceptions of HIV risk. While African American women ascribe HIV risk to individual-level behaviors and choices such as unprotected sex, East African women attribute HIV risk to conditions of poverty and survival. Conclusions Study findings suggest that addressing HIV prevention and education among Black women in DC will require distinct and targeted strategies that are culturally and community-centered in order to resonate with these different audiences. PMID:26766523

  15. Prevalence and risk factors of major depressive disorder in HIV/AIDS as seen in semi-urban Entebbe district, Uganda

    Directory of Open Access Journals (Sweden)

    Kinyanda Eugene

    2011-12-01

    Full Text Available Abstract Background Not much is known about the risk factors of major depressive disorder (MDD in HIV/AIDS in the African socio-cultural context. Therefore a study was undertaken to examine the prevalence and risk factors of MDD in HIV/AIDS in semi-urban Uganda. Methods A cross-sectional study was undertaken among 618 respondents attending two HIV clinics in Uganda. Results Prevalence of MDD was 8.1%. Factors associated with MDD at univariate analysis only were female gender, family history of mental illness, negative coping style, alcohol dependency disorder, food insecurity and stress; not associated with MDD were social support, neurocognitive impairment, CD4 counts and BMI. Factors independently associated with MDD were psychosocial impairment, adverse life events, post traumatic stress disorder, generalised anxiety disorder and life-time attempted suicide. Conclusion Psychological and social factors were the main risk factors of MDD among ambulatory HIV positive persons with no evidence for the role of the neurotoxic effects of HIV. Treatment approaches for MDD in this patient group should be modeled on those used among non-HIV groups.

  16. Previously known and newly diagnosed atrial fibrillation: a major risk indicator after a myocardial infarction complicated by heart failure or left ventricular dysfunction

    DEFF Research Database (Denmark)

    Køber, Lars; Swedberg, Karl; McMurray, John J V

    2006-01-01

    AIMS: To characterize the relationship between known and newly diagnosed atrial fibrillation (AF) and the risk of death and major cardiovascular (CV) events in patients with acute myocardial infarction (MI) complicated by heart failure (HF) and/or left ventricular systolic dysfunction (LVSD). MET...

  17. What Makes Children Defy Majorities? The Role of Dissenters in Chinese and Spanish Preschoolers' Social Judgments.

    Science.gov (United States)

    Enesco, Ileana; Sebastián-Enesco, Carla; Guerrero, Silvia; Quan, Siyu; Garijo, Sonia

    2016-01-01

    When many people say the same thing, the individual is more likely to endorse this information than when just a single person says the same. Yet, the influence of consensus information may be modulated by many personal, contextual and cultural variables. Here, we study the sensitivity of Chinese ( N = 68) and Spanish ( N = 82) preschoolers to consensus in social decision making contexts. Children faced two different types of peer-interaction events, which involved (1) uncertain or ambiguous scenarios open to interpretation (social interpretation context), and (2) explicit scenarios depicting the exclusion of a peer (moral judgment context). Children first observed a video in which a group of teachers offered their opinion about the events, and then they were asked to evaluate the information provided. Participants were assigned to two conditions that differed in the type of consensus: Unanimous majority ( non-dissenter condition) and non-unanimous majority ( dissenter condition). In the dissenter condition, we presented the conflicting opinions of three teachers vs. one teacher. In the non-dissenter condition, we presented the unanimous opinion of three teachers. The general results indicated that children's sensitivity to consensus varies depending both on the degree of ambiguity of the social events and the presence or not of a dissenter: (1) Children were much more likely to endorse the majority view when they were uncertain (social interpretation context), than when they already had a clear interpretation of the situation (moral judgment context); (2) The presence of a dissenter resulted in a significant decrease in children's confidence in majority. Interestingly, in the moral judgment context, Chinese and Spanish children differed in their willingness to defy a majority whose opinion run against their own. While Spanish children maintained their own criteria regardless of the type of condition, Chinese children did so when an "allied" dissenter was present

  18. What makes children defy majorities? The role of dissenters in Chinese and Spanish preschoolers’ social judgments.

    Directory of Open Access Journals (Sweden)

    Ileana Enesco

    2016-10-01

    Full Text Available When many people say the same thing, the individual is more likely to endorse this information than when just a single person says the same. Yet, the influence of consensus information may be modulated by many personal, contextual and cultural variables. Here, we study the sensitivity of Chinese (N = 68 and Spanish (N = 82 preschoolers to consensus in social decision making contexts. Children faced two different types of peer-interaction events, which involved (1 uncertain or ambiguous scenarios open to interpretation (social interpretation context, and (2 explicit scenarios depicting the exclusion of a peer (moral judgment context. Children first observed a video in which a group of teachers offered their opinion about the events, and then they were asked to evaluate the information provided. Participants were assigned to two conditions that differed in the type of consensus: Unanimous majority (non-dissenter condition and non-unanimous majority (dissenter condition. In the dissenter condition, we presented the conflicting opinions of three teachers vs. one teacher. In the non-dissenter condition, we presented the unanimous opinion of three teachers. The general results indicated that children’s sensitivity to consensus varies depending both on the degree of ambiguity of the social events and the presence or not of a dissenter: 1 Children were much more likely to endorse the majority view when they were uncertain (social interpretation context, than when they already had a clear interpretation of the situation (moral judgment context; 2 The presence of a dissenter resulted in a significant decrease in children’s confidence in majority. Interestingly, in the moral judgment context, Chinese and Spanish children differed in their willingness to defy a majority whose opinion run against their own. While Spanish children maintained their own criteria regardless of the type of condition, Chinese children did so when an allied dissenter was

  19. The interpretation of administrative contracts

    Directory of Open Access Journals (Sweden)

    Cătălin-Silviu SĂRARU

    2014-06-01

    Full Text Available The article analyzes the principles of interpretation for administrative contracts, in French law and in Romanian law. In the article are highlighted derogations from the rules of contract interpretation in common law. Are examined the exceptions to the principle of good faith, the principle of common intention (willingness of the parties, the principle of good administration, the principle of extensive interpretation of the administrative contract. The article highlights the importance and role of the interpretation in administrative contracts.

  20. Endometriosis: a high-risk population for major chronic diseases?

    Science.gov (United States)

    Kvaskoff, Marina; Mu, Fan; Terry, Kathryn L.; Harris, Holly R.; Poole, Elizabeth M.; Farland, Leslie; Missmer, Stacey A.

    2015-01-01

    BACKGROUND Despite an estimated prevalence of 10% in women, the etiology of endometriosis remains poorly understood. Over recent decades, endometriosis has been associated with risk of several chronic diseases, such as cancer, autoimmune diseases, asthma/atopic diseases and cardiovascular diseases. A deeper understanding of these associations is needed as they may provide new leads into the causes or consequences of endometriosis. This review summarizes the available epidemiological findings on the associations between endometriosis and other chronic diseases and discusses hypotheses for underlying mechanisms, potential sources of bias and methodological complexities. METHODS We performed a comprehensive search of the PubMed/Medline and ISI Web of Knowledge databases for all studies reporting on the associations between endometriosis and other diseases published in English through to May 2014, using numerous search terms. We additionally examined the reference lists of all identified papers to capture any additional articles that were not identified through computer searches. RESULTS We identified 21 studies on the associations between endometriosis and ovarian cancer, 14 for breast cancer, 8 for endometrial cancer, 4 for cervical cancer, 12 for cutaneous melanoma and 3 for non-Hodgkin's lymphoma, as well as 9 on the links between endometriosis and autoimmune diseases, 6 on the links with asthma and atopic diseases, and 4 on the links with cardiovascular diseases. Endometriosis patients were reported to be at higher risk of ovarian and breast cancers, cutaneous melanoma, asthma, and some autoimmune, cardiovascular and atopic diseases, and at decreased risk of cervical cancer. CONCLUSIONS Increasing evidence suggests that endometriosis patients are at higher risk of several chronic diseases. Although the underlying mechanisms are not yet understood, the available data to date suggest that endometriosis is not harmless with respects to women's long-term health. If

  1. The framing of two major flood episodes in the Irish print news media: Implications for societal adaptation to living with flood risk.

    Science.gov (United States)

    Devitt, Catherine; O'Neill, Eoin

    2017-10-01

    Societal adaptation to flooding is a critical component of contemporary flood policy. Using content analysis, this article identifies how two major flooding episodes (2009 and 2014) are framed in the Irish broadsheet news media. The article considers the extent to which these frames reflect shifts in contemporary flood policy away from protection towards risk management, and the possible implications for adaptation to living with flood risk. Frames help us make sense of the social world, and within the media, framing is an essential tool for communication. Five frames were identified: flood resistance and structural defences, politicisation of flood risk, citizen as risk manager, citizen as victim and emerging trade-offs. These frames suggest that public debates on flood management do not fully reflect shifts in contemporary flood policy, with negative implications for the direction of societal adaptation. Greater discussion is required on the influence of the media on achieving policy objectives.

  2. Discourse on risks: The definition of risks as a matter of debate in society

    International Nuclear Information System (INIS)

    Lau, C.

    1989-01-01

    The article deals with a certain aspect of a sociological interpretation of the complex subject of risks to be accepted by a society, i.e. with the problem of the implications and impacts of acceptable risk definition becoming a topic of social conflict. The author assumes that the novel conflicts arising from effects of risks and costs of risks are beginning to superimpose upon the traditional conflict patterns of an industrial society. Characteristic features of conflicts about risks, resulting consequences, and three types of risk are discussed. (DG) [de

  3. Interpretation of risk significance of passive component aging using probabilistic structural analysis

    International Nuclear Information System (INIS)

    Phillips, J.H.; Atwood, C.L.

    1993-01-01

    The probabilistic risk assessments (PRAs) being developed at most nuclear power plants to calculate the risk of core damage generally focus on the possible failure of active components. Except as initiating events, the possible failure of passive components is given little consideration. The NRC is sponsoring a project at INEL to investigate the risk significance of passive components as they age. For this project, we developed a technique to calculate the failure probability of passive components over time, and demonstrated the technique by applying it to a weld in the auxiliary feedwater (AFW) system. A decreasing yearly rupture rate for this weld was calculated instead of the increasing rupture rate trend one might expect. We attribute this result to infant mortality; that is, most of those initial flaws that will eventually lead to rupture will do so early in life. This means that although each weld in a population may be wearing out, the population as a whole can exhibit a decreasing rupture rate. This observation has implications for passive components in commercial nuclear plants and other facilities where aging is a concern. For the population of passive components that exhibit a decreasing failure rate, risk increase is not a concern. The next step of the work is to identify the attributes that contribute to this decreasing rate, and to determine any attributes that would contribute to an increasing failure rate and thus to an increased risk

  4. Heuristics structure and pervade formal risk assessment.

    Science.gov (United States)

    MacGillivray, Brian H

    2014-04-01

    Lay perceptions of risk appear rooted more in heuristics than in reason. A major concern of the risk regulation literature is that such "error-strewn" perceptions may be replicated in policy, as governments respond to the (mis)fears of the citizenry. This has led many to advocate a relatively technocratic approach to regulating risk, characterized by high reliance on formal risk and cost-benefit analysis. However, through two studies of chemicals regulation, we show that the formal assessment of risk is pervaded by its own set of heuristics. These include rules to categorize potential threats, define what constitutes valid data, guide causal inference, and to select and apply formal models. Some of these heuristics lay claim to theoretical or empirical justifications, others are more back-of-the-envelope calculations, while still more purport not to reflect some truth but simply to constrain discretion or perform a desk-clearing function. These heuristics can be understood as a way of authenticating or formalizing risk assessment as a scientific practice, representing a series of rules for bounding problems, collecting data, and interpreting evidence (a methodology). Heuristics are indispensable elements of induction. And so they are not problematic per se, but they can become so when treated as laws rather than as contingent and provisional rules. Pitfalls include the potential for systematic error, masking uncertainties, strategic manipulation, and entrenchment. Our central claim is that by studying the rules of risk assessment qua rules, we develop a novel representation of the methods, conventions, and biases of the prior art. © 2013 Society for Risk Analysis.

  5. Interpretive Medicine

    Science.gov (United States)

    Reeve, Joanne

    2010-01-01

    Patient-centredness is a core value of general practice; it is defined as the interpersonal processes that support the holistic care of individuals. To date, efforts to demonstrate their relationship to patient outcomes have been disappointing, whilst some studies suggest values may be more rhetoric than reality. Contextual issues influence the quality of patient-centred consultations, impacting on outcomes. The legitimate use of knowledge, or evidence, is a defining aspect of modern practice, and has implications for patient-centredness. Based on a critical review of the literature, on my own empirical research, and on reflections from my clinical practice, I critique current models of the use of knowledge in supporting individualised care. Evidence-Based Medicine (EBM), and its implementation within health policy as Scientific Bureaucratic Medicine (SBM), define best evidence in terms of an epistemological emphasis on scientific knowledge over clinical experience. It provides objective knowledge of disease, including quantitative estimates of the certainty of that knowledge. Whilst arguably appropriate for secondary care, involving episodic care of selected populations referred in for specialist diagnosis and treatment of disease, application to general practice can be questioned given the complex, dynamic and uncertain nature of much of the illness that is treated. I propose that general practice is better described by a model of Interpretive Medicine (IM): the critical, thoughtful, professional use of an appropriate range of knowledges in the dynamic, shared exploration and interpretation of individual illness experience, in order to support the creative capacity of individuals in maintaining their daily lives. Whilst the generation of interpreted knowledge is an essential part of daily general practice, the profession does not have an adequate framework by which this activity can be externally judged to have been done well. Drawing on theory related to the

  6. The BRCA1 c. 5096G>A p.Arg1699Gln (R1699Q) intermediate risk variant

    DEFF Research Database (Denmark)

    Moghadasi, Setareh; Meeks, Huong D.; Vreeswijk, Maaike Pg

    2018-01-01

    studied families, to further define cancer risks and to propose adjusted clinical management of female BRCA1*R1699Q carriers. METHODS: Data were collected from 129 BRCA1*R1699Q families ascertained internationally by ENIGMA (Evidence-based Network for the Interpretation of Germline Mutant Alleles......BACKGROUND: We previously showed that the BRCA1 variant c.5096G>A p.Arg1699Gln (R1699Q) was associated with an intermediate risk of breast cancer (BC) and ovarian cancer (OC). This study aimed to assess these cancer risks for R1699Q carriers in a larger cohort, including follow-up of previously......) consortium members. A modified segregation analysis was used to calculate BC and OC risks. Relative risks were calculated under both monogenic model and major gene plus polygenic model assumptions. RESULTS: In this cohort the cumulative risk of BC and OC by age 70 years was 20% and 6%, respectively...

  7. [Prediction value of deceleration capacity of rate and GRACE risk score on major adverse cardiac events in patients with acute myocardial infarction].

    Science.gov (United States)

    Gao, L; Chen, Y D; Shi, Y J; Xue, H; Wang, J L

    2016-07-24

    To investigate the prediction value of deceleration capacity of rate (DC) and GRACE risk score for cardiovascular events in AMI patients. Consecutive AMI patients with sinus rhythm hospitalized in our department during August 2012 to August 2013 were included in this prospective study. 24-hour ECG Holter monitoring was performed within 1 week, and the DC value was analyzed, GRACE risk score was acquired with the application of GRACE risk score calculator. Patients were followed up for more than 1 year and major adverse cardiac events (MACE) were obtained. Analysised the Kaplan Meier survival according to DC and GRACE score risk stratification respectively. A total of 157 patients were enrolled in the study (average age: (58.9±12.7)years old). The average follow-up was (20.54±2.85) months. Mortality during follow-up was significantly higher in patients with DC>2.5 compared to patients with DC≤2.5 (Prisk stratification was 0.898 (95%CI 0.840-0.940, Prisk stratification was 0.786 (95%CI 0.714-0.847, Prisk stratification was 0.708 (95%CI 0.652-0.769, Prisk patients than those with intermediate and low risk patients according to DC risk stratification in intermediate and low risk patients by GRACE risk stratification (Prisk stratification is superior to GRACE risk score on outcome assessment in this AMI patient cohort.

  8. A Multi-Breed Genome-Wide Association Analysis for Canine Hypothyroidism Identifies a Shared Major Risk Locus on CFA12.

    Directory of Open Access Journals (Sweden)

    Matteo Bianchi

    Full Text Available Hypothyroidism is a complex clinical condition found in both humans and dogs, thought to be caused by a combination of genetic and environmental factors. In this study we present a multi-breed analysis of predisposing genetic risk factors for hypothyroidism in dogs using three high-risk breeds--the Gordon Setter, Hovawart and the Rhodesian Ridgeback. Using a genome-wide association approach and meta-analysis, we identified a major hypothyroidism risk locus shared by these breeds on chromosome 12 (p = 2.1x10(-11. Further characterisation of the candidate region revealed a shared ~167 kb risk haplotype (4,915,018-5,081,823 bp, tagged by two SNPs in almost complete linkage disequilibrium. This breed-shared risk haplotype includes three genes (LHFPL5, SRPK1 and SLC26A8 and does not extend to the dog leukocyte antigen (DLA class II gene cluster located in the vicinity. These three genes have not been identified as candidate genes for hypothyroid disease previously, but have functions that could potentially contribute to the development of the disease. Our results implicate the potential involvement of novel genes and pathways for the development of canine hypothyroidism, raising new possibilities for screening, breeding programmes and treatments in dogs. This study may also contribute to our understanding of the genetic etiology of human hypothyroid disease, which is one of the most common endocrine disorders in humans.

  9. Dementia, post-traumatic stress disorder and major depressive disorder: a review of the mental health risk factors for dementia in the military veteran population.

    Science.gov (United States)

    Rafferty, L A; Cawkill, P E; Stevelink, S A M; Greenberg, K; Greenberg, N

    2018-07-01

    Dementia is currently incurable, irreversible and a major cause of disability for the world's older population. The association between mental health difficulties, such as post-traumatic stress disorder (PTSD) and major depressive disorder (MDD), and dementia has a long history within the civilian population. Despite the increased importance of this link within the military veteran population, who suffer a greater propensity of mental health difficulties and consist largely of over 65s, attention is only recently being paid to the salience of such an association for this group. This paper aims to explore the relationship between PTSD and MDD with dementia within the military veteran population. A systematic review was conducted on articles from 1990 to July 2016 on MEDLINE, EMBASE, EBSCO and Web of Science electronic databases with an update conducted in February 2017. Six empirical studies were identified from the review, the majority of which originated from the USA. Five of the studies asserted that veterans with a diagnosis of either PTSD or MDD are at a significantly greater risk of developing dementia than 'healthy' controls. The final study, conducted in Australia, found only a small, but non-significant, correlation between earlier MDD and future dementia, but no concurrent correlation. While causality cannot be determined, it is likely that PTSD and depressive disorders are related to an increased risk of dementia in military veterans. Potential pathological explanations and risk factors are reviewed and the clinical and neuroscience implications of these findings are explored.

  10. Application of Demand-Control Theory to Sign Language Interpreting: Implications for Stress and Interpreter Training.

    Science.gov (United States)

    Dean, Robyn K.; Pollard, Robert Q., Jr.

    2001-01-01

    This article uses the framework of demand-control theory to examine the occupation of sign language interpreting. It discusses the environmental, interpersonal, and intrapersonal demands that impinge on the interpreter's decision latitude and notes the prevalence of cumulative trauma disorders, turnover, and burnout in the interpreting profession.…

  11. Combined Risk Measures: Representation Results and Applications

    NARCIS (Netherlands)

    Göttsche, O.E.

    2014-01-01

    The analysis and interpretation of risk play a crucial role in different areas of modern finance. This includes pricing of financial products, capital allocation and derivation of economic capital. Key to this analysis is the quantification of the risk via risk measures. A promising approach is to

  12. Clinical features of and risk factors for major depression with history of postpartum episodes in Han Chinese women: A retrospective study.

    Science.gov (United States)

    Yang, Fuzhong; Gardner, Charles O; Bigdeli, Tim; Gao, Jingfang; Zhang, Zhen; Tao, Ming; Liu, Ying; Li, Youhui; Wang, Gang; Shi, Jianguo; Gao, Chengge; Zhang, Kerang; Li, Kan; Wang, Xumei; Liu, Lanfen; Sun, Jing; Du, Bo; Shi, Shenxun; Zhang, Jingbei; Wu, Wenyuan; Wang, Xueyi; Shen, Jianhua; Liu, Tiebang; Gu, Danhua; Liang, Wei; Deng, Hong; Pan, Jiyang; Yang, Lijun; Jian, Hu; Jiang, Guoqin; Meng, Huaqing; Miao, Guodong; Li, Yi; Hu, Chunmei; Huang, Guoping; Zhang, Yutang; Chen, Yunchun; Ha, Baowei; Gao, Shu; Fang, Xiang; Mei, Qiyi; Hong, Xiaohong; Yang, Donglin; Liu, Tieqiao; Fengyu, Yu; Zhong, Hui; Sang, Hong; Chen, Guibing; Cai, Min; Song, Yan; Dong, Jicheng; Shen, Zhenmin; Zhang, Wei; Wang, Xiaoping; Pan, Runde; Liu, Xiaojuan; Li, Yi; Liu, Zhengrong; Zhang, Qiwen; Li, Gongying; Flint, Jonathan; Kendler, Kenneth S

    2015-09-01

    We sought to investigate the clinical features of and risk factors for recurrent major depression (MD) with history of postpartum episodes (PPD) in Han Chinese women and the differences between first-onset postpartum MD (MD that has its first lifetime depressive episode in the postpartum period) and first-onset non-postpartum MD (MD with history of PPD and has its first lifetime depressive episode in a period other than postpartum). Data were derived from the China, Oxford and Virginia Commonwealth University Experimental Research on Genetic Epidemiology (CONVERGE) study (N=6017 cases) and analyzed in two steps. We first examined the clinical features of and risk factors for MD patients with (N=981) or without (N=4410) a history of PPD. We then compared the differences between first-onset postpartum MD (N=583) and first-onset non-postpartum MD (N=398) in those with a history of PPD. Linear, logistic and multinomial logistic models were employed to measure the associations. A history of PPD was associated with more guilt feelings, greater psychiatric comorbidity, higher neuroticism, earlier onset and more chronicity (OR 0.2-2.8). Severe premenstrual symptoms (PMS) and more childbirths increased the risk of PPD, as did a family history of MD, childhood sexual abuse, stressful life events and lack of social support (OR 1.1-1.3). In the MD with history of PPD subsample, first-onset postpartum MD was associated with fewer recurrent major depressive episodes, less psychiatric comorbidity, lower neuroticism, less severe PMS and fewer disagreements with their husbands (OR 0.5-0.8), but more childbirths (OR 1.2). Data were obtained retrospectively through interview and recall bias may have affected the results. MD with history of PPD in Han Chinese women is typically chronic and severe, with particular risk factors including severe PMS and more childbirths. First-onset postpartum MD and first-onset non-postpartum MD can be partly differentiated by their clinical features

  13. The impact of working memory on interpreting

    Institute of Scientific and Technical Information of China (English)

    白云安; 张国梅

    2016-01-01

    This paper investigates the roles of working memory in interpreting process. First of all, it gives a brief introduction to interpreting. Secondly, the paper exemplifies the role of working memory in interpreting. The result reveals that the working memory capacity of interpreters is not adsolutely proportional to the quality of interpreting in the real interpreting conditions. The performance of an interpreter with well-equipped working memory capacity will comprehensively influenced by various elements.

  14. Interval Coded Scoring: a toolbox for interpretable scoring systems

    Directory of Open Access Journals (Sweden)

    Lieven Billiet

    2018-04-01

    Full Text Available Over the last decades, clinical decision support systems have been gaining importance. They help clinicians to make effective use of the overload of available information to obtain correct diagnoses and appropriate treatments. However, their power often comes at the cost of a black box model which cannot be interpreted easily. This interpretability is of paramount importance in a medical setting with regard to trust and (legal responsibility. In contrast, existing medical scoring systems are easy to understand and use, but they are often a simplified rule-of-thumb summary of previous medical experience rather than a well-founded system based on available data. Interval Coded Scoring (ICS connects these two approaches, exploiting the power of sparse optimization to derive scoring systems from training data. The presented toolbox interface makes this theory easily applicable to both small and large datasets. It contains two possible problem formulations based on linear programming or elastic net. Both allow to construct a model for a binary classification problem and establish risk profiles that can be used for future diagnosis. All of this requires only a few lines of code. ICS differs from standard machine learning through its model consisting of interpretable main effects and interactions. Furthermore, insertion of expert knowledge is possible because the training can be semi-automatic. This allows end users to make a trade-off between complexity and performance based on cross-validation results and expert knowledge. Additionally, the toolbox offers an accessible way to assess classification performance via accuracy and the ROC curve, whereas the calibration of the risk profile can be evaluated via a calibration curve. Finally, the colour-coded model visualization has particular appeal if one wants to apply ICS manually on new observations, as well as for validation by experts in the specific application domains. The validity and applicability

  15. Interpretable Active Learning

    OpenAIRE

    Phillips, Richard L.; Chang, Kyu Hyun; Friedler, Sorelle A.

    2017-01-01

    Active learning has long been a topic of study in machine learning. However, as increasingly complex and opaque models have become standard practice, the process of active learning, too, has become more opaque. There has been little investigation into interpreting what specific trends and patterns an active learning strategy may be exploring. This work expands on the Local Interpretable Model-agnostic Explanations framework (LIME) to provide explanations for active learning recommendations. W...

  16. Comparative risk of major bleeding with new oral anticoagulants (NOACs) and phenprocoumon in patients with atrial fibrillation: a post-marketing surveillance study.

    Science.gov (United States)

    Hohnloser, Stefan H; Basic, Edin; Nabauer, Michael

    2017-08-01

    Non-vitamin K antagonist oral anticoagulants (NOACs) are at least as effective and safe as vitamin K antagonists (VKAs) for stroke prevention in atrial fibrillation (AF). All pivotal trials have compared NOACs to warfarin. However, other VKAs are commonly used, for instance phenprocoumon. A retrospective cohort study using a German claims database assessed the comparative risks of bleeding leading to hospitalization during therapy with NOACs and phenprocoumon in AF patients. Endpoints consisted of major bleeding, gastrointestinal bleeding, and any bleeding. Data were collected from January 1, 2013 to March 31, 2015. Patients newly initiated on dabigatran, apixaban, rivaroxaban, or phenprocoumon were included. Hazard Ratios for bleeding events were derived from Cox proportional hazard models, adjusting for differences in baseline characteristics. Propensity score matching was performed as a sensitivity analysis. A total of 35,013 patients were identified, including 3138 on dabigatran, 3633 on apixaban, 12,063 on rivaroxaban, and 16,179 on phenprocoumon. Patients prescribed apixaban or phenprocoumon were older compared to those on dabigatran or rivaroxaban and had a higher CHA 2 DS 2 -VASc score. After adjusting for baseline confounders, apixaban was associated with lower risks of major bleeding (HR 0.68, 95% CI 0.51-0.90, p = 0.008), gastrointestinal bleeding (HR 0.53, 95% CI 0.39-0.72, p similar to that of phenprocoumon but bleeding risk with rivaroxaban was higher.

  17. Interpreter in Criminal Cases: Allrounders First!

    Science.gov (United States)

    Frid, Arthur

    1974-01-01

    The interpreter in criminal cases generally has had a purely linguistic training with no difference from the education received by his colleague interpreters. The position of interpreters in criminal cases is vague and their role depends to a large extent on individual interpretation of officials involved in the criminal procedure. Improvements on…

  18. Mind, Matter, Information and Quantum Interpretations

    Directory of Open Access Journals (Sweden)

    Reza Maleeh

    2015-07-01

    Full Text Available In this paper I give a new information-theoretic analysis of the formalisms and interpretations of quantum mechanics (QM in general, and of two mainstream interpretations of quantum mechanics in particular: The Copenhagen interpretation and David Bohm’s interpretation of quantum mechanics. Adopting Juan G. Roederer’s reading of the notion of pragmatic information, I argue that pragmatic information is not applicable to the Copenhagen interpretation since the interpretation is primarily concerned with epistemology rather than ontology. However it perfectly fits Bohm’s ontological interpretation of quantum mechanics in the realms of biotic and artificial systems. Viewing Bohm’s interpretation of QM in the context of pragmatic information imposes serious limitations to the qualitative aspect of such an interpretation, making his extension of the notion active information to every level of reality illegitimate. Such limitations lead to the idea that, contrary to Bohm’s claim, mind is not a more subtle aspect of reality via the quantum potential as active information, but the quantum potential as it affects particles in the double-slit experiment represents the non-algorithmic aspect of the mind as a genuine information processing system. This will provide an information-based ground, firstly, for refreshing our views on quantum interpretations and secondly, for a novel qualitative theory of the relationship of mind and matter in which mind-like properties are exclusive attributes of living systems. To this end, I will also take an information-theoretic approach to the notion of intentionality as interpreted by John Searle.

  19. Interpretation of computed tomographic images

    International Nuclear Information System (INIS)

    Stickle, R.L.; Hathcock, J.T.

    1993-01-01

    This article discusses the production of optimal CT images in small animal patients as well as principles of radiographic interpretation. Technical factors affecting image quality and aiding image interpretation are included. Specific considerations for scanning various anatomic areas are given, including indications and potential pitfalls. Principles of radiographic interpretation are discussed. Selected patient images are illustrated

  20. Excess risk of major vascular diseases associated with airflow obstruction: a 9-year prospective study of 0.5 million Chinese adults

    Directory of Open Access Journals (Sweden)

    Kurmi OP

    2018-03-01

    Full Text Available Om P Kurmi,1 Liming Li,2 Kourtney J Davis,3 Jenny Wang,1 Derrick A Bennett,1 Ka Hung Chan,1 Ling Yang,1 Yiping Chen,1 Yu Guo,4 Zheng Bian,4 Junshi Chen,5 Liuping Wei,6 Donghui Jin,7 Rory Collins,1 Richard Peto,1 Zhengming Chen1 On behalf of the China Kadoorie Biobank collaborative group 1Clinical Trial Service and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; 2Department of Epidemiology, School of Public Health, Peking University Health Science Center, Beijing, China; 3Real World Evidence and Epidemiology, GlaxoSmithKline, Collegeville, PA, USA; 4Chinese Academy of Medical Sciences, Beijing China; 5China National Center for Food Safety Risk Assessment, Beijing, China; 6NCDs Prevention and Control Department, Liuzhou CDC, Liuzhou, China; 7NCDs Prevention and Control Department, Hunan CDC, Changsha, China Background: China has high COPD rates, even among never-regular smokers. Little is known about nonrespiratory disease risks, especially vascular morbidity and mortality after developing airflow obstruction (AFO in Chinese adults. Objective: We aimed to investigate the prospective association of prevalent AFO with major vascular morbidity and mortality. Materials and methods: In 2004–2008, a nationwide prospective cohort study recruited 512,891 men and women aged 30–79 years from 10 diverse localities across China, tracking cause-specific mortality and coded episodes of hospitalization for 9 years. Cox regression yielded adjusted HRs for vascular diseases comparing individuals with spirometry-defined prevalent AFO at baseline to those without. Results: Of 489,382 participants with no vascular disease at baseline, 6.8% had AFO, with prevalence rising steeply with age. Individuals with prevalent AFO had significantly increased vascular mortality (n=1,429, adjusted HR 1.29, 95% CI 1.21–1.36. There were also increased risks of hemorrhagic stroke (n=823, HR 1.18, 95% CI 1.09–1

  1. Informal interpreting in general practice: Are interpreters' roles related to perceived control, trust, and satisfaction?

    Science.gov (United States)

    Zendedel, Rena; Schouten, Barbara C; van Weert, Julia C M; van den Putte, Bas

    2018-06-01

    The aim of this observational study was twofold. First, we examined how often and which roles informal interpreters performed during consultations between Turkish-Dutch migrant patients and general practitioners (GPs). Second, relations between these roles and patients' and GPs' perceived control, trust in informal interpreters and satisfaction with the consultation were assessed. A coding instrument was developed to quantitatively code informal interpreters' roles from transcripts of 84 audio-recorded interpreter-mediated consultations in general practice. Patients' and GPs' perceived control, trust and satisfaction were assessed in a post consultation questionnaire. Informal interpreters most often performed the conduit role (almost 25% of all coded utterances), and also frequently acted as replacers and excluders of patients and GPs by asking and answering questions on their own behalf, and by ignoring and omitting patients' and GPs' utterances. The role of information source was negatively related to patients' trust and the role of GP excluder was negatively related to patients' perceived control. Patients and GPs are possibly insufficiently aware of the performed roles of informal interpreters, as these were barely related to patients' and GPs' perceived trust, control and satisfaction. Patients and GPs should be educated about the possible negative consequences of informal interpreting. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Objective interpretation as conforming interpretation

    OpenAIRE

    Lidka Rodak

    2011-01-01

    The practical discourse willingly uses the formula of “objective interpretation”, with no regards to its controversial nature that has been discussed in literature.The main aim of the article is to investigate what “objective interpretation” could mean and how it could be understood in the practical discourse, focusing on the understanding offered by judicature.The thesis of the article is that objective interpretation, as identified with textualists’ position, is not possible to uphold, and ...

  3. Herbicides and forest ecosystems - approaches to risk communication

    Science.gov (United States)

    Charles K. McMahon

    1992-01-01

    Abstract.It has become apparent to many risk experts that without good communication, risk assessment and risk management efforts may be largely in vain. For the public, perception is reality when it comes to the interpretation of risk information and the shaping of regulatory policy. The findings of several- risk communication experts are reviewed...

  4. Risk in technical and scientific studies: general introduction to uncertainty management and the concept of risk

    International Nuclear Information System (INIS)

    Apostolakis, G.E.

    2004-01-01

    George Apostolakis (MIT) presented an introduction to the concept of risk and uncertainty management and their use in technical and scientific studies. He noted that Quantitative Risk Assessment (QRA) provides support to the overall treatment of a system as an integrated socio-technical system. Specifically, QRA aims to answer the questions: - What can go wrong (e.g., accident sequences or scenarios)? - How likely are these sequences or scenarios? - What are the consequences of these sequences or scenarios? The Quantitative Risk Assessment deals with two major types of uncertainty. An assessment requires a 'model of the world', and this preferably would be a deterministic model based on underlying processes. In practice, there are uncertainties in this model of the world relating to variability or randomness that cannot be accounted for directly in a deterministic model and that may require a probabilistic or aleatory model. Both deterministic and aleatory models of the world have assumptions and parameters, and there are 'state-of-knowledge' or epistemic uncertainties associated with these. Sensitivity studies or eliciting expert opinion can be used to address the uncertainties in assumptions, and the level of confidence in parameter values can be characterised using probability distributions (pdfs). Overall, the distinction between aleatory and epistemic uncertainties is not always clear, and both can be treated mathematically in the same way. Lessons on safety assessments that can be learnt from experience at nuclear power plants are that beliefs about what is important can be wrong if a risk assessment is not performed. Also, precautionary approaches are not always conservative if failure modes are not identified. Nevertheless, it is important to recognize that uncertainties will remain despite a quantitative risk assessment: e.g., is the scenario list complete, are the models accepted as reasonable, and are parameter probability distributions representative of

  5. The cancer precision medicine knowledge base for structured clinical-grade mutations and interpretations

    Science.gov (United States)

    Huang, Linda; Fernandes, Helen; Zia, Hamid; Tavassoli, Peyman; Rennert, Hanna; Pisapia, David; Imielinski, Marcin; Sboner, Andrea; Rubin, Mark A; Kluk, Michael

    2017-01-01

    Objective: This paper describes the Precision Medicine Knowledge Base (PMKB; https://pmkb.weill.cornell.edu), an interactive online application for collaborative editing, maintenance, and sharing of structured clinical-grade cancer mutation interpretations. Materials and Methods: PMKB was built using the Ruby on Rails Web application framework. Leveraging existing standards such as the Human Genome Variation Society variant description format, we implemented a data model that links variants to tumor-specific and tissue-specific interpretations. Key features of PMKB include support for all major variant types, standardized authentication, distinct user roles including high-level approvers, and detailed activity history. A REpresentational State Transfer (REST) application-programming interface (API) was implemented to query the PMKB programmatically. Results: At the time of writing, PMKB contains 457 variant descriptions with 281 clinical-grade interpretations. The EGFR, BRAF, KRAS, and KIT genes are associated with the largest numbers of interpretable variants. PMKB’s interpretations have been used in over 1500 AmpliSeq tests and 750 whole-exome sequencing tests. The interpretations are accessed either directly via the Web interface or programmatically via the existing API. Discussion: An accurate and up-to-date knowledge base of genomic alterations of clinical significance is critical to the success of precision medicine programs. The open-access, programmatically accessible PMKB represents an important attempt at creating such a resource in the field of oncology. Conclusion: The PMKB was designed to help collect and maintain clinical-grade mutation interpretations and facilitate reporting for clinical cancer genomic testing. The PMKB was also designed to enable the creation of clinical cancer genomics automated reporting pipelines via an API. PMID:27789569

  6. Smoking and Pregnancy — A Review on the First Major Environmental Risk Factor of the Unborn

    Directory of Open Access Journals (Sweden)

    Mathias Mund

    2013-11-01

    Full Text Available Smoking cigarettes throughout pregnancy is one of the single most important avoidable causes of adverse pregnancy outcomes and it represents the first major environmental risk of the unborn. If compared with other risk factors in the perinatal period, exposure to tobacco smoke is considered to be amongst the most harmful and it is associated with high rates of long and short term morbidity and mortality for mother and child. A variety of adverse pregnancy outcomes are linked with cigarette consumption before and during pregnancy. Maternal prenatal cigarette smoke disturbs the equilibrium among the oxidant and antioxidant system, has negative impact on the genetic and cellular level of both mother and fetus and causes a large quantity of diseases in the unborn child. These smoking-induced damages for the unborn offspring manifest themselves at various times in life and for most only a very limited range of causal treatment exists. Education, support and assistance are of high importance to decrease maternal and fetal morbidity and mortality, as there are few other avoidable factors which influence a child’s health that profoundly throughout its life. It is imperative that smoking control should be seen as a public health priority.

  7. Society-ethics-risk

    International Nuclear Information System (INIS)

    Ruh, H.; Seiler, H.

    1993-01-01

    The aim of the workshops which was reported in this volume, was the interpretation and evaluation of catastrophic risks for society in an interdisciplinary dialogue between representation of society, ethics, as well as natural science and technology. (author) figs., tabs., refs

  8. A robust interpretation of duration calculus

    DEFF Research Database (Denmark)

    Franzle, M.; Hansen, Michael Reichhardt

    2005-01-01

    We transfer the concept of robust interpretation from arithmetic first-order theories to metric-time temporal logics. The idea is that the interpretation of a formula is robust iff its truth value does not change under small variation of the constants in the formula. Exemplifying this on Duration...... Calculus (DC), our findings are that the robust interpretation of DC is equivalent to a multi-valued interpretation that uses the real numbers as semantic domain and assigns Lipschitz-continuous interpretations to all operators of DC. Furthermore, this continuity permits approximation between discrete...

  9. Atmospheric Gas Tracers in Groundwater: Theory, Sampling. Measurement and Interpretation

    International Nuclear Information System (INIS)

    Bayari, C.S.

    2002-01-01

    Some of the atmospheric gasses posses features that are sought in an environmental tracer of hydrogeologic interest. Among these, chlorofluorocarbons, sulfur hegzafluoride, carbon tetrachloride, methyl chloroform, krypton-85 etc. have found increasing use in groundwater age dating studies during the last ten years. This paper explains the theory of their use as tracer and discusses the major concerns as related to their sampling and analyses. Factors affecting their applicability and the approach to interpret tracer gas data is briefly outlined

  10. A lifestyle intervention program for successfully addressing major cardiometabolic risks in persons with SCI: a three-subject case series.

    Science.gov (United States)

    Bigford, Gregory E; Mendez, Armando J; Betancourt, Luisa; Burns-Drecq, Patricia; Backus, Deborah; Nash, Mark S

    2017-01-01

    This study is a prospective case series analyzing the effects of a comprehensive lifestyle intervention program in three patients with chronic paraplegia having major risks for the cardiometabolic syndrome (CMS). Individuals underwent an intense 6-month program of circuit resistance exercise, nutrition using a Mediterranean diet and behavioral support, followed by a 6-month extension (maintenance) phase involving minimal support. The primary goal was a 7% reduction of body mass. Other outcomes analyzed insulin resistance using the HOMA-IR model, and plasma levels of fasting triglycerides and high-density lipoprotein cholesterol. All participants achieved the goal for 7% reduction of body mass and maintained the loss after the MP. Improvements were observed in 2/3 subjects for HOMA-IR and high-density lipoprotein cholesterol. All participants improved their risk for plasma triglycerides. We conclude, in a three-person case series of persons with chronic paraplegia, a lifestyle intervention program involving circuit resistance training, a calorie-restrictive Mediterranean-style diet and behavioral support, results in clinically significant loss of body mass and effectively reduced component risks for CMS and diabetes. These results were for the most part maintained after a 6-month MP involving minimal supervision.

  11. Toward Establishing the Validity of the Resource Interpreter's Self-Efficacy Instrument

    Science.gov (United States)

    Smith, Grant D.

    Interpretive rangers serve as one of the major educational resources that visitors may encounter during their visit to a park or other natural area, yet our understanding of their professional growth remains limited. This study helps address this issue by developing an instrument that evaluates the beliefs of resource interpreters regarding their capabilities of communicating with the public. The resulting 11-item instrument was built around the construct of Albert Bandura's self-efficacy theory (Bandura, 1977, 1986, 1997), used guidelines and principles developed over the course of 30 years of teacher efficacy studies (Bandura, 2006; Gibson & Dembo, 1984; Riggs & Enochs, 1990; Tschannen-Moran & Hoy, 2001; Tschannen-Moran, Hoy, & Hoy, 1998), and probed areas of challenge that are unique to the demands of resource interpretation (Brochu & Merriman, 2002; Ham, 1992; Knudson, Cable, & Beck, 2003; Larsen, 2003; Tilden, 1977). A voluntary convenience sample of 364 National Park Service rangers was collected in order to conduct the statistical analyses needed to winnow the draft instrument down from 47 items in its original form to 11 items in its final state. Statistical analyses used in this process included item-total correlation, index of discrimination, exploratory factor analysis, and confirmatory factor analysis.

  12. Uses of risk importance measures

    International Nuclear Information System (INIS)

    Mankamo, T.; Poern, K.; Holmberg, J.

    1991-05-01

    Risk importance measures provide an understandable and practical way of presenting probabilistic safety analysis results which too often tend to remain abstract numbers without real insight into the content. The report clarifies the definitions, relationships and interpretations of the three most basic measures: Risk increase factor, risk decrease factor, and fractional contribution. The above three measures already cover the main types of risk importance measures. Many other importance measures presented in literature are close variants to some of these three measures. They are related in many cases so that, for a technical system considered, the two other measures can be derived from the one calculated first. However, the practical interpretations are different, and hence each three measures have their own uses and rights to existence. The fundamental aspect of importance measures is, that they express some specific influence of a basic event on the total risk. The basic failure or error events are the elements from which the reliability and risk models are constituted. The importance measures are relative, which is an advantage compared to absolute risk numbers, due to insensitivity with respect to quantification uncertainties. Therefore they are particularly adapted to give first hand guidance where to focus main interest from the system's risk and reliability point of view and wherefrom to continue the analysis with more sophisticated methods requiring more effort

  13. Interpreting the Bible in the 'new' South Africa: Remarks on some problems and challenges

    Directory of Open Access Journals (Sweden)

    D. J. Human

    1997-12-01

    Full Text Available Interpreting the Bible in the 'new' South Africa DJ Human Department of Biblical Studies (Sec B University of Pretoria The Bible plays an important role in South African society. The interpretation of this book within or outside the Christian community has become an increaslingly major source of debate. It has been used and misused in several spheres of society. This article does not intend providing an extensive and composite picture of the problems and character of biblical hermeneutics. Nor will it attempt to elaborate on or explain the origins, development and influences of all the different her-meneutical approaches. Rather, it poses to be an introduction to a few of the problem(s encountered in the attempt to understand the Bible, especially in terms of the 'new' South Africa. Within the framework of this scope, remarks will be made regarding the challenges involved in interpreting the Bible, the role of the interpreter in the interpretation process, the varied forms of literature to be found in Scripture, and in the last instance, to take cognisance of a few methodological approaches to the text analysis of the Bible.

  14. Risk prediction models for major adverse cardiac event (MACE) following percutaneous coronary intervention (PCI): A review

    Science.gov (United States)

    Manan, Norhafizah A.; Abidin, Basir

    2015-02-01

    Five percent of patients who went through Percutaneous Coronary Intervention (PCI) experienced Major Adverse Cardiac Events (MACE) after PCI procedure. Risk prediction of MACE following a PCI procedure therefore is helpful. This work describes a review of such prediction models currently in use. Literature search was done on PubMed and SCOPUS database. Thirty literatures were found but only 4 studies were chosen based on the data used, design, and outcome of the study. Particular emphasis was given and commented on the study design, population, sample size, modeling method, predictors, outcomes, discrimination and calibration of the model. All the models had acceptable discrimination ability (C-statistics >0.7) and good calibration (Hosmer-Lameshow P-value >0.05). Most common model used was multivariate logistic regression and most popular predictor was age.

  15. Risk in pediatric anesthesia.

    Science.gov (United States)

    Paterson, Neil; Waterhouse, Peter

    2011-08-01

    Risk in pediatric anesthesia can be conveniently classified as minor or major. Major morbidity includes cardiac arrest, brain damage and death. Minor morbidity can be assessed by clinical audits with small patient samples. Major morbidity is rare. It is best assessed by very large clinical studies and by review of closed malpractice claims. Both minor and major morbidity occur most commonly in infants and children under three, especially those with severe co-morbidities. Knowledge of risk profiles in pediatric anesthesia is a starting point for the reduction of risk. © 2010 Blackwell Publishing Ltd.

  16. Hypertriglyceridemia: a too long unfairly neglected major cardiovascular risk factor.

    Science.gov (United States)

    Tenenbaum, Alexander; Klempfner, Robert; Fisman, Enrique Z

    2014-12-04

    The existence of an independent association between elevated triglyceride (TG) levels, cardiovascular (CV) risk and mortality has been largely controversial. The main difficulty in isolating the effect of hypertriglyceridemia on CV risk is the fact that elevated triglyceride levels are commonly associated with concomitant changes in high density lipoprotein (HDL), low density lipoprotein (LDL) and other lipoproteins. As a result of this problem and in disregard of the real biological role of TG, its significance as a plausible therapeutic target was unfoundedly underestimated for many years. However, taking epidemiological data together, both moderate and severe hypertriglyceridaemia are associated with a substantially increased long term total mortality and CV risk. Plasma TG levels partially reflect the concentration of the triglyceride-carrying lipoproteins (TRL): very low density lipoprotein (VLDL), chylomicrons and their remnants. Furthermore, hypertriglyceridemia commonly leads to reduction in HDL and increase in atherogenic small dense LDL levels. TG may also stimulate atherogenesis by mechanisms, such excessive free fatty acids (FFA) release, production of proinflammatory cytokines, fibrinogen, coagulation factors and impairment of fibrinolysis. Genetic studies strongly support hypertriglyceridemia and high concentrations of TRL as causal risk factors for CV disease. The most common forms of hypertriglyceridemia are related to overweight and sedentary life style, which in turn lead to insulin resistance, metabolic syndrome (MS) and type 2 diabetes mellitus (T2DM). Intensive lifestyle therapy is the main initial treatment of hypertriglyceridemia. Statins are a cornerstone of the modern lipids-modifying therapy. If the primary goal is to lower TG levels, fibrates (bezafibrate and fenofibrate for monotherapy, and in combination with statin; gemfibrozil only for monotherapy) could be the preferable drugs. Also ezetimibe has mild positive effects in lowering TG

  17. Membrane omega-3 Fatty Acid deficiency as a preventable risk factor for comorbid coronary heart disease in major depressive disorder.

    Science.gov (United States)

    McNamara, Robert K

    2009-01-01

    Major depression disorder (MDD) significantly increases the risk for coronary heart disease (CHD) which is a leading cause of mortality in patients with MDD. Moreover, depression is frequently observed in a subset of patients following acute coronary syndrome (ACS) and increases risk for mortality. Here evidence implicating omega-3 (n-3) fatty acid deficiency in the pathoaetiology of CHD and MDD is reviewed, and the hypothesis that n-3 fatty acid deficiency is a preventable risk factor for CHD comorbidity in MDD patients is evaluated. This hypothesis is supported by cross-national and cross-sectional epidemiological surveys finding an inverse correlation between n-3 fatty acid status and prevalence rates of both CHD and MDD, prospective studies finding that lower dietary or membrane EPA+DHA levels increase risk for both MDD and CHD, case-control studies finding that the n-3 fatty acid status of MDD patients places them at high risk for emergent CHD morbidity and mortality, meta-analyses of controlled n-3 fatty acid intervention studies finding significant advantage over placebo for reducing depression symptom severity in MDD patients, and for secondary prevention of cardiac events in CHD patients, findings that n-3 fatty acid status is inversely correlated with other documented CHD risk factors, and patients diagnosed with MDD after ACS exhibit significantly lower n-3 fatty acid status compared with nondepressed ACS patients. This body of evidence provides strong support for future studies to evaluate the effects of increasing dietary n-3 fatty acid status on CHD comorbidity and mortality in MDD patients.

  18. Interpreting Electromagnetic Reflections In Glaciology

    Science.gov (United States)

    Eisen, O.; Nixdorf, U.; Wilhelms, F.; Steinhage, D.; Miller, H.

    Electromagnetic reflection (EMR) measurements are active remote sensing methods that have become a major tool for glaciological investigations. Although the basic pro- cesses are well understood, the unambiguous interpretation of EMR data, especially internal layering, still requires further information. The Antacrtic ice sheet provides a unique setting for investigating the relation between physical­chemical properties of ice and EMR data. Cold ice, smooth surface topography, and low accumulation facilitates matters to use low energy ground penetrating radar (GPR) devices to pene- trate several tens to hundreds of meters of ice, covering several thousands of years of snow deposition history. Thus, sufficient internal layers, primarily of volcanic origin, are recorded to enable studies on a local and regional scale. Based on dated ice core records, GPR measurements at various frequencies, and airborne radio-echo sound- ing (RES) from Dronning Maud Land (DML), Antarctica, combined with numerical modeling techniques, we investigate the influence of internal layering characteristics and properties of the propagating electromagnetic wave on EMR data.

  19. Minerals in thalassaemia major patients: An overview.

    Science.gov (United States)

    Ozturk, Zeynep; Genc, Gizem Esra; Gumuslu, Saadet

    2017-05-01

    Thalassaemia major (TM) is a hereditary blood disease characterised by reduced or absent production of beta globin chains. Erythrocyte transfusions are given to raise the haemoglobin level in patients with thalassaemia major. However, transfusions have been related to increased risk of iron overload and tissue damage related to excess iron. Both elevated oxidative stress due to iron overload and increased hemolysis lead to over utilisation of minerals required for antioxidant enzymes activities. Iron chelators have been used to prevent iron overload in thalassaemia major patients, but these chelators have the possibility of removing minerals from the body. Thalassaemia patients are more at risk for mineral deficiency because of increased oxidative stress and iron chelation therapies. Growth and maturational delay, cardiomyopathy, endocrinopathies and osteoporosis are the complications of thalassaemia. Minerals may play a particular role to prevent these complications. In the current review, we provide an overview of minerals including zinc (Zn), copper (Cu), selenium (Se), magnesium (Mg) and calcium (Ca) in thalassaemia major patients. We, also, underline that some complications of thalassaemia can be caused by an increased need for minerals or lack of the minerals. Copyright © 2017 Elsevier GmbH. All rights reserved.

  20. The effects of a novel hostile interpretation bias modification paradigm on hostile interpretations, mood, and aggressive behavior.

    Science.gov (United States)

    AlMoghrabi, Nouran; Huijding, Jorg; Franken, Ingmar H A

    2018-03-01

    Cognitive theories of aggression propose that biased information processing is causally related to aggression. To test these ideas, the current study investigated the effects of a novel cognitive bias modification paradigm (CBM-I) designed to target interpretations associated with aggressive behavior. Participants aged 18-33 years old were randomly assigned to either a single session of positive training (n = 40) aimed at increasing prosocial interpretations or negative training (n = 40) aimed at increasing hostile interpretations. The results revealed that the positive training resulted in an increase in prosocial interpretations while the negative training seemed to have no effect on interpretations. Importantly, in the positive condition, a positive change in interpretations was related to lower anger and verbal aggression scores after the training. In this condition, participants also reported an increase in happiness. In the negative training no such effects were found. However, the better participants performed on the negative training, the more their interpretations were changed in a negative direction and the more aggression they showed on the behavioral aggression task. Participants were healthy university students. Therefore, results should be confirmed within a clinical population. These findings provide support for the idea that this novel CBM-I paradigm can be used to modify interpretations, and suggests that these interpretations are related to mood and aggressive behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Posttraumatic stress disorder increases risk for suicide attempt in adults with recurrent major depression.

    Science.gov (United States)

    Stevens, Daniel; Wilcox, Holly C; MacKinnon, Dean F; Mondimore, Francis M; Schweizer, Barbara; Jancic, Dunya; Coryell, William H; Weissman, Myrna M; Levinson, Douglas F; Potash, James B

    2013-10-01

    Genetics of Recurrent Early-Onset Depression study (GenRED II) data were used to examine the relationship between posttraumatic stress disorder (PTSD) and attempted suicide in a population of 1,433 individuals with recurrent early-onset major depressive disorder (MDD). We tested the hypothesis that PTSD resulting from assaultive trauma increases risk for attempted suicide among individuals with recurrent MDD. Data on lifetime trauma exposures and clinical symptoms were collected using the Diagnostic Interview for Genetic Studies version 3.0 and best estimate diagnoses of MDD, PTSD, and other DSM-IV Axis I disorders were reported with best estimated age of onset. The lifetime prevalence of suicide attempt in this sample was 28%. Lifetime PTSD was diagnosed in 205 (14.3%) participants. We used discrete time-survival analyses to take into account timing in the PTSD-suicide attempt relationship while adjusting for demographic variables (gender, race, age, and education level) and comorbid diagnoses prior to trauma exposure. PTSD was an independent predictor of subsequent suicide attempt (HR = 2.5, 95% CI: 1.6, 3.8; P < .0001). Neither assaultive nor nonassaultive trauma without PTSD significantly predicted subsequent suicide attempt after Bonferroni correction. The association between PTSD and subsequent suicide attempt was driven by traumatic events involving assaultive violence (HR = 1.7, 95% CI: 1.3, 2.2; P< .0001). Among those with recurrent MDD, PTSD appears to be a vulnerability marker of maladaptive responses to traumatic events and an independent risk factor for attempted suicide. Additional studies examining differences between those with and without PTSD on biological measures might shed light on this potential vulnerability. © 2013 Wiley Periodicals, Inc.

  2. Genetic and Environmental Risk for Chronic Pain and the Contribution of Risk Variants for Major Depressive Disorder: A Family-Based Mixed-Model Analysis.

    Science.gov (United States)

    McIntosh, Andrew M; Hall, Lynsey S; Zeng, Yanni; Adams, Mark J; Gibson, Jude; Wigmore, Eleanor; Hagenaars, Saskia P; Davies, Gail; Fernandez-Pujals, Ana Maria; Campbell, Archie I; Clarke, Toni-Kim; Hayward, Caroline; Haley, Chris S; Porteous, David J; Deary, Ian J; Smith, Daniel J; Nicholl, Barbara I; Hinds, David A; Jones, Amy V; Scollen, Serena; Meng, Weihua; Smith, Blair H; Hocking, Lynne J

    2016-08-01

    Chronic pain is highly prevalent and a significant source of disability, yet its genetic and environmental risk factors are poorly understood. Its relationship with major depressive disorder (MDD) is of particular importance. We sought to test the contribution of genetic factors and shared and unique environment to risk of chronic pain and its correlation with MDD in Generation Scotland: Scottish Family Health Study (GS:SFHS). We then sought to replicate any significant findings in the United Kingdom Biobank study. Using family-based mixed-model analyses, we examined the contribution of genetics and shared family environment to chronic pain by spouse, sibling, and household relationships. These analyses were conducted in GS:SFHS (n = 23,960), a family- and population-based study of individuals recruited from the Scottish population through their general practitioners. We then examined and partitioned the correlation between chronic pain and MDD and estimated the contribution of genetic factors and shared environment in GS:SFHS. Finally, we used data from two independent genome-wide association studies to test whether chronic pain has a polygenic architecture and examine whether genomic risk of psychiatric disorder predicted chronic pain and whether genomic risk of chronic pain predicted MDD. These analyses were conducted in GS:SFHS and repeated in UK Biobank, a study of 500,000 from the UK population, of whom 112,151 had genotyping and phenotypic data. Chronic pain is a moderately heritable trait (heritability = 38.4%, 95% CI 33.6% to 43.9%) that is significantly concordant in spouses (variance explained 18.7%, 95% CI 9.5% to 25.1%). Chronic pain is positively correlated with depression (ρ = 0.13, 95% CI 0.11 to 0.15, p = 2.72x10-68) and shows a tendency to cluster within families for genetic reasons (genetic correlation = 0.51, 95%CI 0.40 to 0.62, p = 8.24x10-19). Polygenic risk profiles for pain, generated using independent GWAS data, were associated with

  3. Genetic and Environmental Risk for Chronic Pain and the Contribution of Risk Variants for Major Depressive Disorder: A Family-Based Mixed-Model Analysis.

    Directory of Open Access Journals (Sweden)

    Andrew M McIntosh

    2016-08-01

    Full Text Available Chronic pain is highly prevalent and a significant source of disability, yet its genetic and environmental risk factors are poorly understood. Its relationship with major depressive disorder (MDD is of particular importance. We sought to test the contribution of genetic factors and shared and unique environment to risk of chronic pain and its correlation with MDD in Generation Scotland: Scottish Family Health Study (GS:SFHS. We then sought to replicate any significant findings in the United Kingdom Biobank study.Using family-based mixed-model analyses, we examined the contribution of genetics and shared family environment to chronic pain by spouse, sibling, and household relationships. These analyses were conducted in GS:SFHS (n = 23,960, a family- and population-based study of individuals recruited from the Scottish population through their general practitioners. We then examined and partitioned the correlation between chronic pain and MDD and estimated the contribution of genetic factors and shared environment in GS:SFHS. Finally, we used data from two independent genome-wide association studies to test whether chronic pain has a polygenic architecture and examine whether genomic risk of psychiatric disorder predicted chronic pain and whether genomic risk of chronic pain predicted MDD. These analyses were conducted in GS:SFHS and repeated in UK Biobank, a study of 500,000 from the UK population, of whom 112,151 had genotyping and phenotypic data. Chronic pain is a moderately heritable trait (heritability = 38.4%, 95% CI 33.6% to 43.9% that is significantly concordant in spouses (variance explained 18.7%, 95% CI 9.5% to 25.1%. Chronic pain is positively correlated with depression (ρ = 0.13, 95% CI 0.11 to 0.15, p = 2.72x10-68 and shows a tendency to cluster within families for genetic reasons (genetic correlation = 0.51, 95%CI 0.40 to 0.62, p = 8.24x10-19. Polygenic risk profiles for pain, generated using independent GWAS data, were associated

  4. 18 CFR 385.1901 - Interpretations and interpretative rules under the NGPA (Rule 1901).

    Science.gov (United States)

    2010-04-01

    ... to requests for interpretations to prospective, existing or completed facts, acts, or transactions..., knowledge, and belief there is no untrue statement of a material or relevant fact and there is no omission... misrepresented or omitted or if any material or relevant fact changes after an interpretation is issued or if the...

  5. Rethinking the relationship between flood risk perception and flood management.

    Science.gov (United States)

    Birkholz, S; Muro, M; Jeffrey, P; Smith, H M

    2014-04-15

    Although flood risk perceptions and their concomitant motivations for behaviour have long been recognised as significant features of community resilience in the face of flooding events, there has, for some time now, been a poorly appreciated fissure in the accompanying literature. Specifically, rationalist and constructivist paradigms in the broader domain of risk perception provide different (though not always conflicting) contexts for interpreting evidence and developing theory. This contribution reviews the major constructs that have been applied to understanding flood risk perceptions and contextualises these within broader conceptual developments around risk perception theory and contemporary thinking around flood risk management. We argue that there is a need to re-examine and re-invigorate flood risk perception research, in a manner that is comprehensively underpinned by more constructivist thinking around flood risk management as well as by developments in broader risk perception research. We draw attention to an historical over-emphasis on the cognitive perceptions of those at risk to the detriment of a richer understanding of a wider range of flood risk perceptions such as those of policy-makers or of tax-payers who live outside flood affected areas as well as the linkages between these perspectives and protective measures such as state-supported flood insurance schemes. Conclusions challenge existing understandings of the relationship between risk perception and flood management, particularly where the latter relates to communication strategies and the extent to which those at risk from flooding feel responsible for taking protective actions. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Linguistics in Text Interpretation

    DEFF Research Database (Denmark)

    Togeby, Ole

    2011-01-01

    A model for how text interpretation proceeds from what is pronounced, through what is said to what is comunicated, and definition of the concepts 'presupposition' and 'implicature'.......A model for how text interpretation proceeds from what is pronounced, through what is said to what is comunicated, and definition of the concepts 'presupposition' and 'implicature'....

  7. Symptoms of major depressive disorder subsequent to child maltreatment: Examining change across multiple levels of analysis to identify transdiagnostic risk pathways.

    Science.gov (United States)

    Shenk, Chad E; Griffin, Amanda M; O'Donnell, Kieran J

    2015-11-01

    Major depressive disorder (MDD) is a prevalent psychiatric condition in the child maltreatment population. However, not all children who have been maltreated will develop MDD or MDD symptoms, suggesting the presence of unique risk pathways that explain how certain children develop MDD symptoms when others do not. The current study tested several candidate risk pathways to MDD symptoms following child maltreatment: neuroendocrine, autonomic, affective, and emotion regulation. Female adolescents (N = 110; age range = 14-19) were recruited into a substantiated child maltreatment or comparison condition and completed a laboratory stressor, saliva samples, and measures of emotion regulation, negative affect, and MDD symptoms. MDD symptoms were reassessed 18 months later. Mediational modeling revealed that emotion regulation was the only significant indirect effect of the relationship between child maltreatment and subsequent MDD symptoms, demonstrating that children exposed to maltreatment had greater difficulties managing affective states that in turn led to more severe MDD symptoms. These results highlight the importance of emotion dysregulation as a central risk pathway to MDD following child maltreatment. Areas of future research and implications for optimizing prevention and clinical intervention through the direct targeting of transdiagnostic risk pathways are discussed.

  8. Symptoms of Major Depressive Disorder Subsequent to Child Maltreatment: Examining Change across Multiple Levels of Analysis to Identify Transdiagnostic Risk Pathways

    Science.gov (United States)

    Shenk, Chad E.; Griffin, Amanda M.; O’Donnell, Kieran J.

    2016-01-01

    Major depressive disorder (MDD) is a prevalent psychiatric condition in the child maltreatment population. However, not all children who have been maltreated will develop MDD or MDD symptoms, suggesting the presence of unique risk pathways that explain how certain children develop MDD symptoms when others do not. The current study tested several candidate risk pathways to MDD symptoms following child maltreatment: 1) neuroendocrine, 2) autonomic, 3) affective, and 4) emotion regulation. Female adolescents (N=110; Age range: 14–19) were recruited into a substantiated child maltreatment or comparison condition and completed a laboratory stressor, saliva samples, and measures of emotion regulation, negative affect, and MDD symptoms. MDD symptoms were reassessed eighteen months later. Mediational modeling revealed that emotion regulation was the only significant indirect effect of the relationship between child maltreatment and subsequent MDD symptoms, demonstrating that children exposed to maltreatment had greater difficulties managing affective states that in turn led to more severe MDD symptoms. These results highlight the importance of emotion dysregulation as a central risk pathway to MDD following child maltreatment. Areas of future research and implications for optimizing prevention and clinical intervention through the direct targeting of transdiagnostic risk pathways are discussed. PMID:26535940

  9. What do men understand about lifetime risk following genetic testing? The effect of context and numeracy.

    Science.gov (United States)

    Rolison, Jonathan J; Hanoch, Yaniv; Miron-Shatz, Talya

    2012-07-01

    Genetic testing for gene mutations associated with specific cancers provides an opportunity for early detection, surveillance, and intervention (Smith, Cokkinides, & Brawley, 2008). Lifetime risk estimates provided by genetic testing refer to the risk of developing a specific disease within one's lifetime, and evidence suggests that this is important for the medical choices people make, as well as their future family and financial plans. The present studies tested whether adult men understand the lifetime risks of prostate cancer informed by genetic testing. In 2 experiments, adult men were asked to interpret the lifetime risk information provided in statements about risks of prostate cancer. Statement format was manipulated such that the most appropriate interpretation of risk statements referred to an absolute risk of cancer in experiment 1 and a relative risk in experiment 2. Experiment 1 revealed that few men correctly interpreted the lifetime risks of cancer when these refer to an absolute risk of cancer, and numeracy levels positively predicted correct responding. The proportion of correct responses was greatly improved in experiment 2 when the most appropriate interpretation of risk statements referred instead to a relative rather than an absolute risk, and numeracy levels were less involved. Understanding of lifetime risk information is often poor because individuals incorrectly believe that these refer to relative rather than absolute risks of cancer.

  10. Modular interpreters with implicit context propagation

    NARCIS (Netherlands)

    P.A. Inostroza Valdera (Pablo); T. van der Storm (Tijs)

    2017-01-01

    textabstractModular interpreters are a crucial first step towards component-based language development: instead of writing language interpreters from scratch, they can be assembled from reusable, semantic building blocks. Unfortunately, traditional language interpreters can be hard to extend because

  11. Interpretation of Whorf from Different Perspectives

    Directory of Open Access Journals (Sweden)

    Yanlong Wang

    2016-02-01

    Full Text Available The paper interprets Whorf’s notion by turning to his original writings.  Specifically, the paper makes a detailed analysis of Whorf’s notion from anthropological linguistics, which largely deals with his famous distinction between overt category and covert category and his detailed description of the American Indian language Hopi; contrastive linguistics, which implies Whorf’s research pedagogy by which the major differences between Hopi and English were found; and psycholinguistics which shows that Whorf would like to explore the deeper internalized meaning of language so as to uncover the true nature of language in the process of thinking.   Therefore, the writer aims to have access to Whorf by rereading his original works and demonstrates what he has actually done in relation with those disciplines mentioned above. Keywords: Whorf, anthropological linguistics, contrastive linguistics, psycholinguistics

  12. Two-year prospective study of major depressive disorder in HIV-infected men.

    Science.gov (United States)

    Atkinson, J Hampton; Heaton, Robert K; Patterson, Thomas L; Wolfson, Tanya; Deutsch, Reena; Brown, Stephen J; Summers, J; Sciolla, A; Gutierrez, R; Ellis, Ronald J; Abramson, Ian; Hesselink, John R; McCutchan, J Allen; Grant, Igor

    2008-06-01

    The risks and factors contributing to major depressive episodes in HIV infection remain unclear. This 2-year prospective study compared cumulative rates and predictors of a major depressive episode in HIV-infected (HIV+) men (N=297) and uninfected (HIV-) risk-group controls (N=90). By design participants at entry were without current major depression, substance dependence or major anxiety disorder. Standardized neuromedical, neuropsychological, neuroimaging, life events, and psychiatric assessments (Structured Clinical Interview for DSM III-R) were conducted semi-annually for those with AIDS, and annually for all others. Lifetime prevalence of major depression or other psychiatric disorder did not differ at baseline between HIV+ men and controls. On a two-year follow-up those with symptomatic HIV disease were significantly more likely to experience a major depressive episode than were asymptomatic HIV+ individuals and HIV-controls (pdepression. After baseline disease stage and medical variables associated with HIV infection were controlled, a lifetime history of major depression, or of lifetime psychiatric comorbidity (two or more psychiatric disorders), predicted subsequent major depressive episode (pdepressive episode. Research cohort of men examined before era of widespread use of advanced anti-HIV therapies. Symptomatic HIV disease, but not HIV infection itself, increases intermediate-term risk of major depression. Prior psychiatric history most strongly predicted future vulnerability.

  13. Environmental cancer risks

    Science.gov (United States)

    Bell, Peter M.

    In a long-awaited report (‘Assessment of Technologies for Determining Cancer Risks From the Environment’), the U.S. Office of Technology Assessment (OTA) has evaluated the role of environmental factors in cancer diseases. Environment is interpreted broadly as encompassing anything that interacts with humans, including the natural environment, food, radiation, the workplace, etc. Geologic factors range from geographic location to radiation and specific minerals. The report, however, is based on an inadequate data base in most instances, and its major recommendations are related to the establishment of a national cancer registry to record cancer statistics, as is done for many other diseases. Presently, hard statistics are lacking in the establishment of some association between the cause-effect relationship of most environmental factors and most carcinogens. Of particular interest, but unfortunately based on unreliable data, are the effects of mineral substances such as ‘asbestos.’ USGS mineralogist Malcolm Ross will review asbestos and its effects on human health in the forthcoming Mineralogical Society of America's Short Course on the Amphiboles (Reviews in Mineralogy, 9, in press, 1981).

  14. Prediction of Major Vascular Events after Stroke

    DEFF Research Database (Denmark)

    Ovbiagele, Bruce; Goldstein, Larry B.; Amarenco, Pierre

    2014-01-01

    BACKGROUND: Identifying patients with recent stroke or transient ischemic attack (TIA) at high risk of major vascular events (MVEs; stroke, myocardial infarction, or vascular death) may help optimize the intensity of secondary preventive interventions. We evaluated the relationships between...... the baseline Framingham Coronary Risk Score (FCRS) and a novel risk prediction model and with the occurrence of MVEs after stroke or TIA in subjects enrolled in the Stroke Prevention by Aggressive Reduction in Cholesterol Level (SPARCL) trial. METHODS: Data from the 4731 subjects enrolled in the SPARCL study...... were analyzed. Hazard ratios (HRs) from Cox regression models were used to determine the risk of subsequent MVEs based on the FCRS predicting 20% or more 10-year coronary heart disease risk. The novel risk model was derived based on multivariable modeling with backward selection. Model discrimination...

  15. Efficacy of Chinese herbal medicine for stroke modifiable risk factors: a systematic review.

    Science.gov (United States)

    Peng, Wenbo; Lauche, Romy; Ferguson, Caleb; Frawley, Jane; Adams, Jon; Sibbritt, David

    2017-01-01

    The vast majority of stroke burden is attributable to its modifiable risk factors. This paper aimed to systematically summarise the evidence of Chinese herbal medicine (CHM) interventions on stroke modifiable risk factors for stroke prevention. A literature search was conducted via the MEDLINE, CINAHL/EBSCO, SCOPUS, and Cochrane Database from 1996 to 2016. Randomised controlled trials or cross-over studies were included. Risk of bias was assessed according to the Cochrane Risk of Bias tool. A total of 46 trials (6895 participants) were identified regarding the use of CHM interventions in the management of stroke risk factors, including 12 trials for hypertension, 10 trials for diabetes, eight trials for hyperlipidemia, seven trials for impaired glucose tolerance, three trials for obesity, and six trials for combined risk factors. Amongst the included trials with diverse study design, an intervention of CHM as a supplement to biomedicine and/or a lifestyle intervention was found to be more effective in lowering blood pressure, decreasing blood glucose level, helping impaired glucose tolerance reverse to normal, and/or reducing body weight compared to CHM monotherapy. While no trial reported deaths amongst the CHM groups, some papers do report moderate adverse effects associated with CHM use. However, the findings of such beneficial effects of CHM should be interpreted with caution due to the heterogeneous set of complex CHM studied, the various control interventions employed, the use of different participants' inclusion criteria, and low methodological quality across the published studies. The risk of bias of trials identified was largely unclear in the domains of selection bias and detection bias across the included studies. This study showed substantial evidence of varied CHM interventions improving the stroke modifiable risk factors. More rigorous research examining the use of CHM products for sole or multiple major stroke risk factors are warranted.

  16. Risk analysis of Odelouca cofferdam

    OpenAIRE

    Pimenta, L.; Caldeira, L.; Maranha das Neves, E.

    2009-01-01

    In this paper we present the risk analysis of Odelouca Cofferdam, using an event tree analysis. The initializing events, failure modes and analysed limit states are discussed based on an influence diagram. The constructed event trees and their interpretation are presented. The obtained risk values are represented in an FN plot superimposed to the acceptability and tolerability risk limits proposed for Portuguese dams. Initially, particular emphasis is placed on the main characteristic...

  17. DISC1 pathway in brain development: exploring therapeutic targets for major psychiatric disorders

    Directory of Open Access Journals (Sweden)

    Atsushi eKamiya

    2012-03-01

    Full Text Available Genetic risk factors for major psychiatric disorders play key roles in neurodevelopment. Thus, exploring the molecular pathways of risk genes is important not only for understanding the molecular mechanisms underlying brain development, but also to decipher how genetic disturbances affect brain maturation and functioning relevant to major mental illnesses. During the last decade, there has been significant progress in determining the mechanisms whereby risk genes impact brain development. Nonetheless, given that the majority of psychiatric disorders have etiological complexities encompassing multiple risk genes and environmental factors, the biological mechanisms of these diseases remain poorly understood. How can we move forward in our research for discovery of the biological markers and novel therapeutic targets for major mental disorders? Here we review recent progress in the neurobiology of Disrupted in schizophrenia 1 (DISC1, a major risk gene for major mental disorders, with a particular focus on its roles in cerebral cortex development. Convergent findings implicate DISC1 as part of a large, multi-step pathway implicated in various cellular processes and signal transduction. We discuss links between the DISC1 pathway and environmental factors, such as immune/inflammatory responses, which may suggest novel therapeutic targets. Existing treatments for major mental disorders are hampered by a limited number of pharmacological targets. Consequently, elucidation of the DISC1 pathway, and its association with neuropsychiatric disorders, may offer hope for novel treatment interventions.

  18. The interrelation between premenstrual syndrome and major depression: Results from a population-based sample

    Directory of Open Access Journals (Sweden)

    Weiss Carine

    2011-10-01

    Full Text Available Abstract Background Research about the relationship between premenstrual syndrome (PMS and major depression is limited. This study examined the relationship between moderate to severe PMS and major depression in a population-based sample of women of reproductive age. The objectives of the study were to assess the association between premenstrual syndrome and major depression, to analyse how PMS and major depression differ and to characterise the group of women who report both PMS and major depression. Methods Data were obtained from the Swiss Health Survey 2007. Included in the analysis was data from women under the age of 55 without hysterectomy and who answered the questions on PMS symptoms. The population-based sample consisted of 3518 women. Weighted prevalence rates were calculated and relative risk ratios for PMS, major depression and women who reported both PMS and major depression, were calculated with logistic multinominal logit regression. Results The prevalence of major depression was 11.3% in women screening positive for moderate PMS and 24.6% in women screening positive for severe PMS. Compared to women without any of these conditions, women who reported moderate to severe alcohol consumption had a lower risk for PMS. Women reporting use of antidepressants, and use of oral contraceptives had a higher risk for major depression compared to women without any of these conditions. Women reporting work dissatisfaction had a higher risk for PMS. A higher relative risk to report both PMS and major depression compared to women without PMS or major depression was related to factors such as high psychological distress, low mastery, psychotropic drug consumption, and low self-rated health. Conclusions The results suggested that women who suffer from both PMS and major depression are more impaired compared to women with only one disorder. The results further indicated that PMS and major depression are different disorders that can, however, co-occur.

  19. Interpreting Sustainability for Urban Forests

    Directory of Open Access Journals (Sweden)

    Camilo Ordóñez

    2010-06-01

    Full Text Available Incisive interpretations of urban-forest sustainability are important in furthering our understanding of how to sustain the myriad values associated with urban forests. Our analysis of earlier interpretations reveals conceptual gaps. These interpretations are attached to restrictive definitions of a sustainable urban forest and limited to a rather mechanical view of maintaining the biophysical structure of trees. The probing of three conceptual domains (urban forest concepts, sustainable development, and sustainable forest management leads to a broader interpretation of urban-forest sustainability as the process of sustaining urban forest values through time and across space. We propose that values—and not services, benefits, functions or goods—is a superior concept to refer to what is to be sustained in and by an urban forest.

  20. Gender Differences in Somatic Symptoms and Current Suicidal Risk in Outpatients with Major Depressive Disorder.

    Science.gov (United States)

    Jeon, Hong Jin; Woo, Jong-Min; Kim, Hyo-Jin; Fava, Maurizio; Mischoulon, David; Cho, Seong Jin; Chang, Sung Man; Park, Doo-Heum; Kim, Jong Woo; Yoo, Ikki; Heo, Jung-Yoon; Hong, Jin Pyo

    2016-11-01

    Although somatic symptoms are common complaints of patients with major depressive disorder (MDD), their associations with suicide are still unclear. A total of 811 MDD outpatients of aged between 18 to 64 years were enrolled nationwide in Korea with the suicidality module of the Mini-International Neuropsychiatric Interview (MINI) and the Depression and Somatic Symptom Scale (DSSS). On stepwise regression analysis, current suicidality scores were most strongly associated with chest pain in men, and neck or shoulder pain in women. Severe chest pain was associated with higher current suicidality scores in men than in women, whereas severe neck or shoulder pain showed no significant differences between the genders. In conclusion, MDD patients of both sexes with suicidal ideation showed significantly more frequent and severe somatic symptoms than those without. Current suicidal risk was associated with chest pain in men, and neck or shoulder pain in women. We suggest that clinicians pay attention to patients' somatic symptoms in real world practice.

  1. Clinical features and risk factors for post-partum depression in a large cohort of Chinese women with recurrent major depressive disorder.

    Science.gov (United States)

    Tian, Tian; Li, Yihan; Xie, Dong; Shen, Yifeng; Ren, Jianer; Wu, Wenyuan; Guan, Chengbin; Zhang, Zhen; Zhang, Danning; Gao, Chengge; Zhang, Xiaoming; Wu, Jinbo; Deng, Hong; Wang, Gang; Zhang, Yunshu; Shao, Yun; Rong, Han; Gan, Zhaoyu; Sun, Yan; Hu, Bin; Pan, Jiyang; Li, Yi; Sun, Shufan; Song, Libo; Fan, Xuesheng; Li, Yi; Zhao, Xiaochuan; Yang, Bin; Lv, Luxian; Chen, Yunchun; Wang, Xiaoli; Ning, Yuping; Shi, Shenxun; Chen, Yiping; Kendler, Kenneth S; Flint, Jonathan; Tian, Hongjun

    2012-02-01

    Post partum depression (PPD) is relatively common in China but its clinical characteristics and risk factors have not been studied. We set out to investigate whether known risk factors for PPD could be found in Chinese women. A case control design was used to determine the impact of known risk factors for PPD in a cohort of 1970 Chinese women with recurrent DSM-IV major depressive disorder (MDD). In a within-case design we examined the risk factors for PPD in patients with recurrent MDD. We compared the clinical features of MDD in cases with PPD to those without MDD. Odds ratios were calculated using logistic and ordinal regression. Lower occupational and educational statuses increased the risk of PPD, as did a history of pre-menstrual symptoms, stressful life events and elevated levels of the personality trait of neuroticism. Patients with PPD and MDD were more likely to experience a comorbid anxiety disorder, had a younger age of onset of MDD, have higher levels of neuroticism and dysthymia. Results obtained in this clinical sample may not be applicable to PPD within the community. Data were obtained retrospectively and we do not know whether the correlations we observe have the same causes as those operating in other populations. Our results are consistent with the hypothesis that the despite cultural differences between Chinese and Western women, the phenomenology and risk factors for PPD are very similar. Copyright © 2011 Elsevier B.V. All rights reserved.

  2. Long noncoding RNA expression in peripheral blood mononuclear cells and suicide risk in Chinese patients with major depressive disorder.

    Science.gov (United States)

    Cui, Xuelian; Niu, Wei; Kong, Lingming; He, Mingjun; Jiang, Kunhong; Chen, Shengdong; Zhong, Aifang; Li, Wanshuai; Lu, Jim; Zhang, Liyi

    2017-06-01

    WHO stated that nearly one million people commit suicide every year worldly, and 40% of the suicide completer suffered from depression. The primary aim of this study was to explore the association between long noncoding RNAs (lncRNAs) expression in peripheral blood mononuclear cells (PBMCs) and suicide risk of patients with major depressive disorder (MDD). Using Human LncRNA 3.0 microarray profiling which includes 30,586 human lncRNAs and RT-PCR, six down-regulated lncRNAs were identified differentially expressed in MDD patients. According to suicidal ideation and suicidal attempt, the suicide risk of MDD patients was classified into suicidal ideation versus no suicidal ideation groups, and past attempt versus no past attempt groups, respectively. The expression of six lncRNAs in MDD patients and controls were examined by RT-PCR. The expression of six lncRNAs had significant differences between no suicidal ideation, suicidal ideation, and controls; corresponding lncRNAs associated with suicidal attempt had remarkable differences between no past attempt, past attempt, and controls. Additionally, only the expression of lncRNAs in suicidal ideation group and past attempt group markedly declined compared with controls. This study indicated that the expression of six down-regulated lncRNAs had a negative association with suicide risk in MDD patients, and the expression of lncRNAs in PBMCs could have the potential to help clinician judge the suicide risk of MDD patients to provide timely treatment and prevent suicide.

  3. Time-dependent changes in mortality and transformation risk in MDS.

    Science.gov (United States)

    Pfeilstöcker, Michael; Tuechler, Heinz; Sanz, Guillermo; Schanz, Julie; Garcia-Manero, Guillermo; Solé, Francesc; Bennett, John M; Bowen, David; Fenaux, Pierre; Dreyfus, Francois; Kantarjian, Hagop; Kuendgen, Andrea; Malcovati, Luca; Cazzola, Mario; Cermak, Jaroslav; Fonatsch, Christa; Le Beau, Michelle M; Slovak, Marilyn L; Levis, Alessandro; Luebbert, Michael; Maciejewski, Jaroslaw; Machherndl-Spandl, Sigrid; Magalhaes, Silvia M M; Miyazaki, Yasushi; Sekeres, Mikkael A; Sperr, Wolfgang R; Stauder, Reinhard; Tauro, Sudhir; Valent, Peter; Vallespi, Teresa; van de Loosdrecht, Arjan A; Germing, Ulrich; Haase, Detlef; Greenberg, Peter L

    2016-08-18

    In myelodysplastic syndromes (MDSs), the evolution of risk for disease progression or death has not been systematically investigated despite being crucial for correct interpretation of prognostic risk scores. In a multicenter retrospective study, we described changes in risk over time, the consequences for basal prognostic scores, and their potential clinical implications. Major MDS prognostic risk scoring systems and their constituent individual predictors were analyzed in 7212 primary untreated MDS patients from the International Working Group for Prognosis in MDS database. Changes in risk of mortality and of leukemic transformation over time from diagnosis were described. Hazards regarding mortality and acute myeloid leukemia transformation diminished over time from diagnosis in higher-risk MDS patients, whereas they remained stable in lower-risk patients. After approximately 3.5 years, hazards in the separate risk groups became similar and were essentially equivalent after 5 years. This fact led to loss of prognostic power of different scoring systems considered, which was more pronounced for survival. Inclusion of age resulted in increased initial prognostic power for survival and less attenuation in hazards. If needed for practicability in clinical management, the differing development of risks suggested a reasonable division into lower- and higher-risk MDS based on the IPSS-R at a cutoff of 3.5 points. Our data regarding time-dependent performance of prognostic scores reflect the disparate change of risks in MDS subpopulations. Lower-risk patients at diagnosis remain lower risk whereas initially high-risk patients demonstrate decreasing risk over time. This change of risk should be considered in clinical decision making. © 2016 by The American Society of Hematology.

  4. Report from risk communication practice

    International Nuclear Information System (INIS)

    Kanda, Reiko

    2011-01-01

    National Institute of Radiological Sciences (NIRS) set up a phone consulting service early after Fukushima Nuclear Power Plant Accident and inquiries to the service attained over 14,000 at August end, 2011. This paper describes the process, present state and future view of the risk communication based on experiences through the service. The communication is classified in 3 stages of consensus/care in peacetime, crisis, and consensus/care post disaster. The first one contains the consensus of atomic power policy and provision of its information; the second, of evacuation/indoor evacuation and indication of restricted water and food intake; and the third, communication for changes and standard of radiation related matters. Initial inquiries to the NIRS service were many concerning examinations of radiation screening, decontamination and internal exposure, from inside and outside of Fukushima Prefecture, suggesting the concern had been spread to remote area from the Prefecture. Then, the time needed per inquiry/consultation prolonged, implying the wish for solving the concern. The risk communication and consideration for realizing radiation risk at peacetime might have rather unrealistic, which was thought to be the major cause of problems at crisis. In addition, interpretation of various values relating to radiation had been apparently different from expert to expert, and findings by radiation effects and rules of radiation protection had been confusedly understood, which probably influenced on people's correct understanding. However, it is conceivably a fruit of taken risk communication that the past understanding ''radiation, unseeable, is terrible'' has changed to the current understanding ''protection can be done through risk assessment of radiation, measurable''. Hereafter, important are the practical use of various numerical values officially informed and realization of dose through exposure routes, and dispatch of their integrated information to lessen the

  5. The longitudinal joint effect of obesity and major depression on work performance impairment.

    Science.gov (United States)

    Nigatu, Yeshambel T; Reijneveld, Sijmen A; Penninx, Brenda W J H; Schoevers, Robert A; Bültmann, Ute

    2015-05-01

    We examined the longitudinal effect of obesity, major depression, and their combination on work performance impairment (WPI). We collected longitudinal data (2004-2013) on 1726 paid employees from the Netherlands Study of Depression and Anxiety at baseline and 2-, 4-, and 6-year follow-up. We defined obesity with body mass index and waist circumference. We diagnosed major depression with the Composite International Diagnostic Interview 2.1. We assessed work performance impairment with a questionnaire for illness-associated costs. We used generalized estimating equations for modeling, and estimated interaction on the additive scale. Obesity, abdominal obesity, and major depression were longitudinally associated with increased risk of high WPI. The combinations of obesity and major depression, and of abdominal obesity and major depression were associated with increased risk of high WPI (odds ratios of 2.36 [95% confidence interval = 1.61, 3.44] and 1.88 [95% confidence interval = 1.40, 2.53], respectively), but the relative excess risks attributable to interaction were nonsignificant. The longitudinal joint effect of obesity and major depression on high WPI implies that obesity intervention may be more beneficial for individuals with major depression than those without regarding risk of high WPI, if confirmed in a large, representative sample.

  6. Diagnostic errors in interpretation of pediatric musculoskeletal radiographs at common injury sites

    International Nuclear Information System (INIS)

    Bisset, George S.; Crowe, James

    2014-01-01

    Extremity pain represents one of the most common reasons for obtaining conventional radiographs in childhood. Despite the frequency of these examinations little is known about the incidence of diagnostic errors by interpreting pediatric radiologists. The purpose of this study was to develop a standard error rate of pediatric radiologists by double-reading of extremity radiographs (elbow, wrists, knees and ankles) in children presenting with a history of trauma or pain. During a 6-month period all major extremity radiographs (excluding digits) obtained at a large pediatric referral hospital for evaluation of pain or trauma were reviewed by two senior pediatric radiologists and compared to the official interpretation. All radiographs were interpreted initially by a board-certified pediatric radiologist with a Certificate of Added Qualification (CAQ). We reviewed 3,865 radiographic series in children and young adults 2-20 years of age. We tabulated misses and overcalls. We did not assess the clinical significance of the errors. There were 61 miss errors and 44 overcalls in 1,235 abnormal cases and 2,630 normal cases, for a 1.6% miss rate and a 1.1% overcall rate. Misses and overcalls were most common in the ankle. Interpretive errors by pediatric radiologists reviewing certain musculoskeletal radiographs are relatively infrequent. Diagnostic errors in the form of a miss or overcall occurred in 2.7% of the radiographs. (orig.)

  7. Working memory and simultaneous interpreting

    OpenAIRE

    Timarova, Sarka

    2009-01-01

    Working memory is a cognitive construct underlying a number of abilities, and it has been hypothesised for many years that it is crucial for interpreting. A number of studies have been conducted with the aim to support this hypothesis, but research has not yielded convincing results. Most researchers focused on studying working memory differences between interpreters and non-interpreters with the rationale that differences in working memory between the two groups would provide evidence of wor...

  8. Interpretation of food risks by mothers of kindergarten children in St.Petersburg, Russia, and their strategies of risk handling

    NARCIS (Netherlands)

    Gromasheva, O.

    2012-01-01

    This study discusses different types of food risks and different strategies of risk handling as conceived by mothers of kindergarten children in Russia. The research includes an analysis of Internet forum discussions and semi-structured interviews; it mainly used data from well-educated,

  9. Assessment and management of cancer risks from radiological and chemical hazards

    International Nuclear Information System (INIS)

    1998-01-01

    A Joint Working Group was established in April 1995 by the President of the Atomic Energy Control Board (AECB) and the Assistant Deputy Minister of the Health Protection Branch of Health Canada to examine the similarities, disparities and inconsistencies between the levels of risk considered acceptable for regulating ionizing radiation and those considered acceptable for regulating chemical and microbiological hazards. During the process of collecting, analysing and interpreting information, the Joint Working Group realized that its terms of reference as written presented a major difficulty because of the lack of consensus on acceptable levels of risk. Consequently it decided that the most reasonable way to proceed was to compare the risk assessment and management processes used to protect the public from radiation, chemicals and microbiological hazards. This report concentrates on the assessment and management of ionizing radiation and genotoxic chemicals (which both cause cancer by damaging the DNA in cells) and pays less attention to non-genotoxic effects and microbiological hazards. The report also examines public more than occupational exposures and exposures from man-made rather than naturally occurring agents. (author)

  10. [Risk sharing methods in middle income countries].

    Science.gov (United States)

    Inotai, András; Kaló, Zoltán

    2012-01-01

    The pricing strategy of innovative medicines is based on the therapeutic value in the largest pharmaceutical markets. The cost-effectiveness of new medicines with value based ex-factory price is justifiable. Due to the international price referencing and parallel trade the ex-factory price corridor of new medicines has been narrowed in recent years. Middle income countries have less negotiation power to change the narrow drug pricing corridor, although their fair intention is to buy pharmaceuticals at lower price from their scarce public resources compared to higher income countries. Therefore the reimbursement of new medicines at prices of Western-European countries may not be justifiable in Central-Eastern European countries. Confidential pricing agreements (i.e. confidential price discounts, claw-back or rebate) in lower income countries of the European Union can alleviate this problem, as prices of new medicines can be adjusted to local purchasing power without influencing the published ex-factory price and so the accessibility of patients to these drugs in other countries. In order to control the drug budget payers tend to apply financial risk sharing agreements for new medicines in more and more countries to shift the consequences of potential overspending to pharmaceutical manufacturers. The major paradox of financial risk-sharing schemes is that increased mortality, poor persistence of patients, reduced access to healthcare providers, and no treatment reduce pharmaceutical spending. Consequently, payers have started to apply outcome based risk sharing agreements for new medicines recently to improve the quality of health care provision. Our paper aims to review and assess the published financial and outcome based risk sharing methods. Introduction of outcome based risk-sharing schemes can be a major advancement in the drug reimbursement strategy of payers in middle income countries. These schemes can help to reduce the medical uncertainty in coverage

  11. Major Accidents (Gray Swans) Likelihood Modeling Using Accident Precursors and Approximate Reasoning.

    Science.gov (United States)

    Khakzad, Nima; Khan, Faisal; Amyotte, Paul

    2015-07-01

    Compared to the remarkable progress in risk analysis of normal accidents, the risk analysis of major accidents has not been so well-established, partly due to the complexity of such accidents and partly due to low probabilities involved. The issue of low probabilities normally arises from the scarcity of major accidents' relevant data since such accidents are few and far between. In this work, knowing that major accidents are frequently preceded by accident precursors, a novel precursor-based methodology has been developed for likelihood modeling of major accidents in critical infrastructures based on a unique combination of accident precursor data, information theory, and approximate reasoning. For this purpose, we have introduced an innovative application of information analysis to identify the most informative near accident of a major accident. The observed data of the near accident were then used to establish predictive scenarios to foresee the occurrence of the major accident. We verified the methodology using offshore blowouts in the Gulf of Mexico, and then demonstrated its application to dam breaches in the United Sates. © 2015 Society for Risk Analysis.

  12. The joint impact of cognitive performance in adolescence and familial cognitive aptitude on risk for major psychiatric disorders: a delineation of four potential pathways to illness.

    Science.gov (United States)

    Kendler, K S; Ohlsson, H; Keefe, R S E; Sundquist, K; Sundquist, J

    2018-04-01

    How do joint measures of premorbid cognitive ability and familial cognitive aptitude (FCA) reflect risk for a diversity of psychiatric and substance use disorders? To address this question, we examined, using Cox models, the predictive effects of school achievement (SA) measured at age 16 and FCA-assessed from SA in siblings and cousins, and educational attainment in parents-on risk for 12 major psychiatric syndromes in 1 140 608 Swedes born 1972-1990. Four developmental patterns emerged. In the first, risk was predicted jointly by low levels of SA and high levels of FCA-that is a level of SA lower than would be predicted from the FCA. This pattern was strongest in autism spectrum disorders and schizophrenia, and weakest in bipolar illness. In these disorders, a pathologic process seems to have caused cognitive functioning to fall substantially short of familial potential. In the second pattern, seen in the internalizing conditions of major depression and anxiety disorders, risk was associated with low SA but was unrelated to FCA. Externalizing disorders-drug abuse and alcohol use disorders-demonstrated the third pattern, in which risk was predicted jointly by low SA and low FCA. The fourth pattern, seen in eating disorders, was directly opposite of that observed in externalizing disorders with risk associated with high SA and high FCA. When measured together, adolescent cognitive ability and FCA identified four developmental patterns leading to diverse psychiatric disorders. The value of cognitive assessments in psychiatric research can be substantially increased by also evaluating familial cognitive potential.

  13. Epidemiology of major depressive disorder

    NARCIS (Netherlands)

    Stegenga, B.T.

    2011-01-01

    Major depressive disorder (MDD) is a serious health problem and will be the second leading cause of burden of disease worldwide by 2030. To be able to prevent MDD, insight into risk factors for the onset of MDD is of clear importance. On the other hand, if onset of MDD has occurred, one may argue

  14. Significance of earthquake risk in nuclear power plant probabilistic risk assessments

    International Nuclear Information System (INIS)

    Sues, R.H.; Amico, P.J.; Campbell, R.D.

    1990-01-01

    During the last eight years, approximately 25 utility-sponsored probabilistic risk assessments (PRAs) have been conducted for US nuclear reactors. Of these, ten have been published, seven of which have included complete seismic risk assessment. The results of the seven published PRAs are reviewed here in order to ascertain the significance of the risk due to earthquake initiating events. While PRA methodology has been in a state of development over the past seven years, and the results are subject to interpretation (as discussed in the paper), from the review conducted it is clear that earthquake-induced initiating events are important risk contributors. It is concluded that earthquake initiating events should not be dismissed, a priori, in any nuclear plant risk assessment. (orig.)

  15. Epigenomic annotation-based interpretation of genomic data: from enrichment analysis to machine learning.

    Science.gov (United States)

    Dozmorov, Mikhail G

    2017-10-15

    One of the goals of functional genomics is to understand the regulatory implications of experimentally obtained genomic regions of interest (ROIs). Most sequencing technologies now generate ROIs distributed across the whole genome. The interpretation of these genome-wide ROIs represents a challenge as the majority of them lie outside of functionally well-defined protein coding regions. Recent efforts by the members of the International Human Epigenome Consortium have generated volumes of functional/regulatory data (reference epigenomic datasets), effectively annotating the genome with epigenomic properties. Consequently, a wide variety of computational tools has been developed utilizing these epigenomic datasets for the interpretation of genomic data. The purpose of this review is to provide a structured overview of practical solutions for the interpretation of ROIs with the help of epigenomic data. Starting with epigenomic enrichment analysis, we discuss leading tools and machine learning methods utilizing epigenomic and 3D genome structure data. The hierarchy of tools and methods reviewed here presents a practical guide for the interpretation of genome-wide ROIs within an epigenomic context. mikhail.dozmorov@vcuhealth.org. Supplementary data are available at Bioinformatics online. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  16. Impact of educational intervention on the inter-rater agreement of nasal endoscopy interpretation

    Science.gov (United States)

    Colley, Patrick; Mace, Jess C.; Schaberg, Madeleine R.; Smith, Timothy L.; Tabaee, Abtin

    2015-01-01

    OBJECTIVE Nasal endoscopy is integral to the evaluation of sinonasal disorders. However, prior studies have shown significant variability in the inter-rater agreement of nasal endoscopy interpretation amongst practicing rhinologists. The objective of the current study is to evaluate the inter-rater agreement of nasal endoscopy amongst otolaryngology residents from a single training program at baseline and following an educational intervention. METHODS 11 otolaryngology residents completed nasal endoscopy grading forms for 8 digitally recorded nasal endoscopic examinations. An instructional lecture reviewing nasal endoscopy interpretation was subsequently provided. The residents then completed grading forms for 8 different nasal endoscopic examinations. Inter-rate agreement amongst residents for the pre- and post-lecture videos was calculated using the unweighted Fleiss’ kappa statistic (Kf) and intra-class correlation agreement (ICC). RESULTS Inter-rater agreement improved from a baseline level of fair (Kf range 0.268–0.383) to a post-educational level of moderate (Kf range 0.401–0.547) for nasal endoscopy findings of middle meatus mucosa, middle turbinate mucosa, middle meatus discharge, sphenoethmoid recess mucosa, sphenoethmoid recess discharge and atypical lesions (ICC, pendoscopy interpretation amongst otolaryngology residents. The inter-rater agreement for the majority of the characteristics that were evaluated improved after educational intervention. Further study is needed to improve nasal endoscopy interpretation. PMID:25781864

  17. Interpreter services in emergency medicine.

    Science.gov (United States)

    Chan, Yu-Feng; Alagappan, Kumar; Rella, Joseph; Bentley, Suzanne; Soto-Greene, Marie; Martin, Marcus

    2010-02-01

    Emergency physicians are routinely confronted with problems associated with language barriers. It is important for emergency health care providers and the health system to strive for cultural competency when communicating with members of an increasingly diverse society. Possible solutions that can be implemented include appropriate staffing, use of new technology, and efforts to develop new kinds of ties to the community served. Linguistically specific solutions include professional interpretation, telephone interpretation, the use of multilingual staff members, the use of ad hoc interpreters, and, more recently, the use of mobile computer technology at the bedside. Each of these methods carries a specific set of advantages and disadvantages. Although professionally trained medical interpreters offer improved communication, improved patient satisfaction, and overall cost savings, they are often underutilized due to their perceived inefficiency and the inconclusive results of their effect on patient care outcomes. Ultimately, the best solution for each emergency department will vary depending on the population served and available resources. Access to the multiple interpretation options outlined above and solid support and commitment from hospital institutions are necessary to provide proper and culturally competent care for patients. Appropriate communications inclusive of interpreter services are essential for culturally and linguistically competent provider/health systems and overall improved patient care and satisfaction. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  18. Semantic interpretation of search engine resultant

    Science.gov (United States)

    Nasution, M. K. M.

    2018-01-01

    In semantic, logical language can be interpreted in various forms, but the certainty of meaning is included in the uncertainty, which directly always influences the role of technology. One results of this uncertainty applies to search engines as user interfaces with information spaces such as the Web. Therefore, the behaviour of search engine results should be interpreted with certainty through semantic formulation as interpretation. Behaviour formulation shows there are various interpretations that can be done semantically either temporary, inclusion, or repeat.

  19. Who can monitor the court interpreter's performance?

    DEFF Research Database (Denmark)

    Martinsen, Bodil

    2009-01-01

    and the conflict about her competence was negotiated. Because of this unusual constellation, combined with a multi-method approach, this single case study can shed some light on the question of the participants' ability to monitor the interpreter's performance. Legal professional users of interpreters tend......  Who can monitor the court interpreter's performance? Results of a case study This paper presents the results of a case study of an unusual interpreting event in a Danish courtroom setting. During the trial, the interpreter's non-normative performance was explicitly criticised by the audience...... are far less transparent for the legal participants than they normally assume. This problem, in turn, stresses the importance of a) the interpreter's competence and self-awareness and b) the use of check interpreters.  ...

  20. [Control of major cardiovascular risk factors of ischemic heart disease in secondary prevention in Aragón: COCINA study].

    Science.gov (United States)

    Cucalon Arenal, J M; Buisac Ramón, C; Marin Ibáñez, A; Castan Ruiz, S; Blay Cortes, M G; Barrasa Villar, J I

    2016-01-01

    Ischemic heart disease remains a leading cause of death in Spain. According to the American Heart Association/American College of Cardiology (AHA/ACC) and European national societies, secondary prevention for these patients consists of control of major cardiovascular risk factors (CVRF) and suitable lifestyle habits. To determine the degree of control of CVRF in the Aragonese population in secondary prevention. Cross-sectional study of a sample of 705 patients of Aragon who had suffered a cardiac event, selected opportunistically in consultations of family physicians participating in the 3 provinces of Aragon. The study was conducted in the second half of 2012. To measure the degree of control of different FRVC and lifestyle habits in this population. Anthropometric, different cardiovascular risk factors, treatment and lifestyle. 58% of men and 52% of women met criteria for monitoring of measured variables. The best result was obtained with smoking cessation and the worst with BMI. Hypertension, Dyslipidemia and Diabetes Mellitus achieve poor control results. The results show that the degree of control of CVRF is still low, especially in variables such as dyslipidemia and Diabetes Mellitus. Only 16.5% of control patients met criteria given the pharmacologically-modifiable cardiovascular risk factors. Copyright © 2015 SEHLELHA. Published by Elsevier España, S.L.U. All rights reserved.

  1. Disordered Eating Behaviors and Food Addiction among Nutrition Major College Students.

    Science.gov (United States)

    Yu, Zhiping; Tan, Michael

    2016-10-26

    Evidence of whether nutrition students are free from food-related issues or at higher risk for eating disorders is inconsistent. This study aimed to assess disordered eating behaviors and food addiction among nutrition and non-nutrition major college students. Students ( n = 967, ages 18-25, female 72.7%, white 74.8%) enrolled at a public university completed online demographic characteristics surveys and validated questionnaires measuring specific disordered eating behaviors. Academic major category differences were compared. Additionally, high risk participants were assessed by weight status and academic year. Overall, 10% of respondents were a high level of concern for developing eating disorders. About 10.3% of respondents met criteria for food addiction. In addition, 4.5% of respondents had co-occurrence of eating disorder risk and food addiction risk out of total respondents. There were no significant differences in level of concern for developing an eating disorder, eating subscales, or food addiction among academic majors. The percentage of high risk participants was lower in the underweight/normal weight group than in the overweight/obese group in health-related non-nutrition major students but not in nutrition students. Early screening, increasing awareness, and promoting healthy eating habits could be potential strategies to help treat and prevent the development of disorders or associated health conditions in nutrition as well as non-nutrition students.

  2. Disordered Eating Behaviors and Food Addiction among Nutrition Major College Students

    Science.gov (United States)

    Yu, Zhiping; Tan, Michael

    2016-01-01

    Evidence of whether nutrition students are free from food-related issues or at higher risk for eating disorders is inconsistent. This study aimed to assess disordered eating behaviors and food addiction among nutrition and non-nutrition major college students. Students (n = 967, ages 18–25, female 72.7%, white 74.8%) enrolled at a public university completed online demographic characteristics surveys and validated questionnaires measuring specific disordered eating behaviors. Academic major category differences were compared. Additionally, high risk participants were assessed by weight status and academic year. Overall, 10% of respondents were a high level of concern for developing eating disorders. About 10.3% of respondents met criteria for food addiction. In addition, 4.5% of respondents had co-occurrence of eating disorder risk and food addiction risk out of total respondents. There were no significant differences in level of concern for developing an eating disorder, eating subscales, or food addiction among academic majors. The percentage of high risk participants was lower in the underweight/normal weight group than in the overweight/obese group in health-related non-nutrition major students but not in nutrition students. Early screening, increasing awareness, and promoting healthy eating habits could be potential strategies to help treat and prevent the development of disorders or associated health conditions in nutrition as well as non-nutrition students. PMID:27792162

  3. Disordered Eating Behaviors and Food Addiction among Nutrition Major College Students

    Directory of Open Access Journals (Sweden)

    Zhiping Yu

    2016-10-01

    Full Text Available Evidence of whether nutrition students are free from food-related issues or at higher risk for eating disorders is inconsistent. This study aimed to assess disordered eating behaviors and food addiction among nutrition and non-nutrition major college students. Students (n = 967, ages 18–25, female 72.7%, white 74.8% enrolled at a public university completed online demographic characteristics surveys and validated questionnaires measuring specific disordered eating behaviors. Academic major category differences were compared. Additionally, high risk participants were assessed by weight status and academic year. Overall, 10% of respondents were a high level of concern for developing eating disorders. About 10.3% of respondents met criteria for food addiction. In addition, 4.5% of respondents had co-occurrence of eating disorder risk and food addiction risk out of total respondents. There were no significant differences in level of concern for developing an eating disorder, eating subscales, or food addiction among academic majors. The percentage of high risk participants was lower in the underweight/normal weight group than in the overweight/obese group in health-related non-nutrition major students but not in nutrition students. Early screening, increasing awareness, and promoting healthy eating habits could be potential strategies to help treat and prevent the development of disorders or associated health conditions in nutrition as well as non-nutrition students.

  4. Abstract Interpretation and Attribute Gramars

    DEFF Research Database (Denmark)

    Rosendahl, Mads

    The objective of this thesis is to explore the connections between abstract interpretation and attribute grammars as frameworks in program analysis. Abstract interpretation is a semantics-based program analysis method. A large class of data flow analysis problems can be expressed as non-standard ...... is presented in the thesis. Methods from abstract interpretation can also be used in correctness proofs of attribute grammars. This proof technique introduces a new class of attribute grammars based on domain theory. This method is illustrated with examples....

  5. On improvement in ejection fraction with iron chelation in thalassemia major and the risk of future heart failure

    Directory of Open Access Journals (Sweden)

    Carpenter JP

    2011-09-01

    Full Text Available Abstract Background Trials of iron chelator regimens have increased the treatment options for cardiac siderosis in beta-thalassemia major (TM patients. Treatment effects with improved left ventricular (LV ejection fraction (EF have been observed in patients without overt heart failure, but it is unclear whether these changes are clinically meaningful. Methods This retrospective study of a UK database of TM patients modelled the change in EF between serial scans measured by cardiovascular magnetic resonance (CMR to the relative risk (RR of future development of heart failure over 1 year. Patients were divided into 2 strata by baseline LVEF of 56-62% (below normal for TM and 63-70% (lower half of the normal range for TM. Results A total of 315 patients with 754 CMR scans were analyzed. A 1% absolute increase in EF from baseline was associated with a statistically significant reduction in the risk of future development of heart failure for both the lower EF stratum (EF 56-62%, RR 0.818, p Conclusion These data show that during treatment with iron chelators for cardiac siderosis, small increases in LVEF in TM patients are associated with a significantly reduced risk of the development of heart failure. Thus the iron chelator induced improvements in LVEF of 2.6% to 3.1% that have been observed in randomized controlled trials, are associated with risk reductions of 25.5% to 46.4% for the development of heart failure over 12 months, which is clinically meaningful. In cardiac iron overload, heart mitochondrial dysfunction and its relief by iron chelation may underlie the changes in LV function.

  6. A functional programming interpreter. M.S. Thesis

    Science.gov (United States)

    Robison, Arch Douglas

    1987-01-01

    Functional Programming (FP) sup BAC87 is an alternative to conventional imperative programming languages. This thesis describes an FP interpreter implementation. Superficially, FP appears to be a simple, but very inefficient language. Its simplicity, however, allows it to be interpreted quickly. Much of the inefficiency can be removed by simple interpreter techniques. This thesis describes the Illinois Functional Programming (IFP) interpreter, an interactive functional programming implementation which runs under both MS-DOS and UNIX. The IFP interpreter allows functions to be created, executed, and debugged in an environment very similar to UNIX. IFP's speed is competitive with other interpreted languages such as BASIC.

  7. Behavior is a major determinant of predation risk in zooplankton

    DEFF Research Database (Denmark)

    Almeda, Rodrigo; van Someren Gréve, Hans; Kiørboe, Thomas

    2017-01-01

    as prey for different predatory copepods. Copepods with “active” feeding behaviors (feeding-current and cruising feeders) showed significantly higher mortality from predation (~2–8 times) than similarly sized copepods with low motility feeding behavior (ambush feeders). Copepod males, which have a more...... active motile behavior than females (mate-seeking behavior), suffered a higher predation mortality than females in most of the experiments. However, the predation risk for mate-searching behavior in copepods varied depending on feeding behavior with ambush feeders consistently having the greatest......Zooplankton exhibit different small-scale motile behaviors related to feeding and mating activities. These different motile behaviors may result in different levels of predation risk, which may partially determine the structure of planktonic communities. Here, we experimentally determined predation...

  8. Dialectica Interpretation with Marked Counterexamples

    Directory of Open Access Journals (Sweden)

    Trifon Trifonov

    2011-01-01

    Full Text Available Goedel's functional "Dialectica" interpretation can be used to extract functional programs from non-constructive proofs in arithmetic by employing two sorts of higher-order witnessing terms: positive realisers and negative counterexamples. In the original interpretation decidability of atoms is required to compute the correct counterexample from a set of candidates. When combined with recursion, this choice needs to be made for every step in the extracted program, however, in some special cases the decision on negative witnesses can be calculated only once. We present a variant of the interpretation in which the time complexity of extracted programs can be improved by marking the chosen witness and thus avoiding recomputation. The achieved effect is similar to using an abortive control operator to interpret computational content of non-constructive principles.

  9. Interpreting outcome following foot surgery in people with rheumatoid arthritis.

    Science.gov (United States)

    Backhouse, Michael R; Vinall-Collier, Karen A; Redmond, Anthony C; Helliwell, Philip S; Keenan, Anne-Maree

    2016-01-01

    Foot surgery is common in RA but the current lack of understanding of how patients interpret outcomes inhibits evaluation of procedures in clinical and research settings. This study aimed to explore which factors are important to people with RA when they evaluate the outcome of foot and ankle surgery. Semi structured interviews with 11 RA participants who had mixed experiences of foot surgery were conducted and analysed using thematic analysis. Responses showed that while participants interpreted surgical outcome in respect to a multitude of factors, five major themes emerged: functional ability, participation, appearance of feet and footwear, surgeons' opinion, and pain. Participants interpreted levels of physical function in light of other aspects of their disease, reflecting on relative change from their preoperative state more than absolute levels of ability. Appearance was important to almost all participants: physical appearance, foot shape, and footwear were closely interlinked, yet participants saw these as distinct concepts and frequently entered into a defensive repertoire, feeling the need to justify that their perception of outcome was not about cosmesis. Surgeons' post-operative evaluation of the procedure was highly influential and made a lasting impression, irrespective of how the outcome compared to the participants' initial goals. Whilst pain was important to almost all participants, it had the greatest impact upon them when it interfered with their ability to undertake valued activities. People with RA interpret the outcome of foot surgery using multiple interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than anticipated. These factors can help clinicians in discussing surgical options in patients.

  10. 5 A study analysing the diagnostic performance of ECG interpretation for 30-day major cardiac events in the emergency department.

    Science.gov (United States)

    Morris, Niall; Body, Rick

    2017-12-01

    This study evaluates the diagnostic accuracy of an Emergency Medicine (EM) clinician at identifying ischaemia on an ECG using 30-day major adverse cardiac events (MACE) as the primary outcome. This is a secondary analysis of a prospective, multi-centre, observational cohort at 14 centres: the Bedside Evaluation of Sensitive Troponin study. All fourteen Emergency Departments were based in the United Kingdom. Emergency physicians' assessments of the ECG were collected using a standardised form. Clinicians were asked to judge whether the ECG demonstrated ischaemia, the presence of ST depression (STD) and if there was abnormal T wave inversion (ATWI). Patients provided written informed consent and underwent serial high sensitivity troponin testing. 30 day follow-up was performed by research nurses using a standardised form via telephone. The primary outcome was 30-day major adverse cardiac events, defined as acute myocardial infarction, any cause of death and coronary revascularisation. In total, 756 patients were included in the analysis. Clinicians' ECG diagnosis of ischaemia for 30-day MACE: ECG ischaemia produces a sensitivity (Sn) of 19.54% (95% CI:11.81% to 29.43%), specificity (Sp) of 93.27% (95% CI:91.10% to 95.05%), positive predictive value (PPV) of 27.42% (95% CI:18.47% to 38.65%) and negative predictive value (NPV) of 89.91% (95%CI 88.92% to 90.83%). ECG ST depression produces Sn of 16.09% (9.09% to 25.52%), Sp of 89.69% (87.13% to 91.89%), PPV 16.87 (10.68% to 25.62%), and NPV 89.15% (88.19% to 90.04%). ECG ATWI produces Sn of 4.60% (1.27% to 11.36%), Sp of 91.63% (89.27% to 93.62%), PPV of 6.67% (2.59% to 16.12%) and NPV of 88.07% (87.52% to 88.6). This is the first prospective, multi-centre cohort study, that assess the diagnostic performance of EM clinician's ECG interpretation, with 30-day MACE as the primary outcome. The findings are highly relevant to EM as they represent the ECG terms used by popular acute coronary syndrome clinical decision rules

  11. Working with interpreters in cross-cultural qualitative research in the context of a developing country: systematic literature review.

    Science.gov (United States)

    Shimpuku, Yoko; Norr, Kathleen F

    2012-08-01

    This article is a report of a systematic literature review describing how cross-cultural researchers conducted qualitative studies with interpreters in Tanzania. The purpose was to draw methodological implications for working with interpreters within the context of developing countries. In a growing number of cross-cultural nursing studies in developing countries, interpreters play a crucial role for imparting verbal and cultural understanding. In many studies, however, the interpreters' role and their influences on the findings are not adequately described, and therefore the study credibility is weakened. Cross-cultural qualitative studies conducted with interpreters in Tanzania were searched in four databases. Meeting our inclusion criteria were 20 studies published from 1994-2009. We used Garrard's Matrix Method following Wallin and Ahlström's framework to analyse how cross-cultural researchers described the role of interpreters. We identified three major patterns of how researchers worked with interpreters: (i) invisible assistance, (ii) independent fieldwork and (iii) integrated collaboration. In many studies, interpreters' information was limited. They were often asked to collect data in the field without the presence of the researcher. They were integrated into the research process beyond data collection, such as subject recruitment, review of interviews, transcription and translation and analysis. From planning of research to dissemination of the findings, nurse researchers should carefully consider interpreters' influences on the findings. They may use a set of questions we developed for working with interpreters in developing countries to systematically describe the interpreter's role and maximize their research credibility. © 2012 Blackwell Publishing Ltd.

  12. Balancing Life with an Increased Risk of Cancer

    DEFF Research Database (Denmark)

    Petersen, Helle Vendel; Nilbert, Mef; Bernstein, Inge

    2014-01-01

    led us to explore lived experiences in healthy mutation carriers with Lynch syndrome. Individual interviews were subjected to descriptive phenomenological analysis. Four constitutions, namely, family context, interpretation and transformation, approach to risk and balancing life at risk were...

  13. Risk-benefit assessment of cold-smoked salmon: microbial risk versus nutritional benefit

    DEFF Research Database (Denmark)

    Berjia, Firew Lemma; Hoekstra, Jeljer; Andersen, Rikke

    2012-01-01

    Heart Disease (CHD) mortality and stroke, as well as enhanced cognitive (IQ) development of unborns following maternal intake, are identified as the main health benefits of omega-3 fatty acid from CSS. Contrary, risk of meningitis, septicemia and abortion/stillborn are identified as a major health risk......The objective of the study is to perform an integrated analysis of microbiological risks and nutritional benefits in a fish product, Cold Smoked Salmon (CSS). Literature study identified the major health risks and benefits in connection with CSS consumption. The reduction of the risk of Coronary...

  14. Nuclear arbitration: Interpreting non-proliferation agreements

    International Nuclear Information System (INIS)

    Tzeng, Peter

    2015-01-01

    At the core of the nuclear non-proliferation regime lie international agreements. These agreements include, inter alia, the Nuclear Non-proliferation Treaty, nuclear co-operation agreements and nuclear export control agreements.1 States, however, do not always comply with their obligations under these agreements. In response, commentators have proposed various enforcement mechanisms to promote compliance. The inconvenient truth, however, is that states are generally unwilling to consent to enforcement mechanisms concerning issues as critical to national security as nuclear non-proliferation.3 This article suggests an alternative solution to the non-compliance problem: interpretation mechanisms. Although an interpretation mechanism does not have the teeth of an enforcement mechanism, it can induce compliance by providing an authoritative interpretation of a legal obligation. Interpretation mechanisms would help solve the non-compliance problem because, as this article shows, in many cases of alleged non-compliance with a non-proliferation agreement, the fundamental problem has been the lack of an authoritative interpretation of the agreement, not the lack of an enforcement mechanism. Specifically, this article proposes arbitration as the proper interpretation mechanism for non-proliferation agreements. It advocates the establishment of a 'Nuclear Arbitration Centre' as an independent branch of the International Atomic Energy Agency (IAEA), and recommends the gradual introduction of arbitration clauses into the texts of non-proliferation agreements. Section I begins with a discussion of international agreements in general and the importance of interpretation and enforcement mechanisms. Section II then discusses nuclear non-proliferation agreements and their lack of interpretation and enforcement mechanisms. Section III examines seven case studies of alleged non-compliance with non-proliferation agreements in order to show that the main problem in many cases

  15. Scanning Tunneling Microscopy - image interpretation

    International Nuclear Information System (INIS)

    Maca, F.

    1998-01-01

    The basic ideas of image interpretation in Scanning Tunneling Microscopy are presented using simple quantum-mechanical models and supplied with examples of successful application. The importance is stressed of a correct interpretation of this brilliant experimental surface technique

  16. Image interpretation performance: A longitudinal study from novice to professional

    International Nuclear Information System (INIS)

    Wright, C.; Reeves, P.

    2017-01-01

    Purpose: Universities need to deliver educational programmes that create radiography graduates who are ready and able to participate in abnormality detection schemes, ultimately delivering safe and reliable performance because junior doctors are exposed to the risk of misdiagnosis if unsupported by other healthcare professionals. Radiographers are ideally suited to this role having the responsibility for conducting the actual X-ray examination. Method: The image interpretation performance of one cohort of student radiographers was measured upon enrolment from UCAS in the first week of university education and then again prior to graduation using RadBench (n = 23). Results: The results identified that novices have a range of natural image interpretation skills; accuracy 35–85%, sensitivity 45–100%, specificity 15–85%, mean ROC 0.691. Graduates presented a narrower range; accuracy 60–90%, sensitivity 40–100%, specificity 60–90%, mean ROC 0.841. The positive shift in graduate mean accuracy (+16%) was driven by increases in specificity (+27%) rather than sensitivity (+5%). No statistically significant differences (ANOVA) could be found between age group, gender and previous education however trends were identified. 56.5% of the population (n = 13) met a benchmark accurate standard of 80%, including one graduate who met 90%. Conclusion: Image interpretation testing at the point of UCAS entry is a useful indicator of future performance and is a recommended factor for consideration as part of the selection process. Whilst image interpretation now forms an integral part of undergraduate radiography programmes, new graduates may not necessary possess the reliability in decision making to justify participation in abnormality detection schemes, highlighting the need for continuous professional development. - Highlights: • Some novices appear to have inherent skills in fracture identification. • RadBench testing as part of the UCAS selection process

  17. US and MR Imaging of Pectoralis Major Injuries.

    Science.gov (United States)

    Lee, Yauk K; Skalski, Matt R; White, Eric A; Tomasian, Anderanik; Phan, Diane D; Patel, Dakshesh B; Matcuk, George R; Schein, Aaron J

    2017-01-01

    During the past 2 decades, the frequency of pectoralis major muscle injuries has increased in association with the increased popularity of bench press exercises. Injury of the pectoralis major can occur at the muscle origin, muscle belly, musculotendinous junction, intratendinous region, and/or humeral insertion-with or without bone avulsion. The extent of the tendon injury ranges from partial to complete tears. Treatment may be surgical or conservative, depending on the clinical scenario and anatomic characteristics of the injury. The radiologist has a critical role in the patient's treatment-first in detecting and then in characterizing the injury. In this article, the authors review the normal anatomy and anatomic variations of the pectoralis major muscle, classifications and typical patterns of pectoralis major injuries, and associated treatment considerations. The authors further provide an instructive guide for ultrasonographic (US) and magnetic resonance (MR) imaging evaluation of pectoralis major injuries, with emphasis on a systematic approach involving the use of anatomic landmarks. After reviewing this article, the reader should have an understanding of how to perform-and interpret the findings of-US and MR imaging of the pectoralis major. The reader should also understand how to classify pectoralis major injuries, with emphasis on the key findings used to differentiate injuries for which surgical management is required from those for which nonsurgical management is required. Familiarity with the normal but complex anatomy of the pectoralis major is crucial for performing imaging-based evaluation and understanding the injury findings. © RSNA, 2017 Online supplemental material is available for this article.

  18. Critical Assessment of Metagenome Interpretation

    DEFF Research Database (Denmark)

    Sczyrba, Alexander; Hofmann, Peter; Belmann, Peter

    2017-01-01

    Methods for assembly, taxonomic profiling and binning are key to interpreting metagenome data, but a lack of consensus about benchmarking complicates performance assessment. The Critical Assessment of Metagenome Interpretation (CAMI) challenge has engaged the global developer community to benchma...

  19. Common pitfalls in statistical analysis: Absolute risk reduction, relative risk reduction, and number needed to treat

    Science.gov (United States)

    Ranganathan, Priya; Pramesh, C. S.; Aggarwal, Rakesh

    2016-01-01

    In the previous article in this series on common pitfalls in statistical analysis, we looked at the difference between risk and odds. Risk, which refers to the probability of occurrence of an event or outcome, can be defined in absolute or relative terms. Understanding what these measures represent is essential for the accurate interpretation of study results. PMID:26952180

  20. Cling - The LLVM-based C++ Interpreter

    CERN Multimedia

    CERN. Geneva

    2012-01-01

    Cling (http://cern.ch/cling) is a C++ interpreter, built on top of clang (http://clang.llvm.org) and LLVM (http://llvm.org). Like its predecessor CINT, cling offers an interactive, terminal-like prompt. It enables exploratory programming with rapid edit / run cycles. The ROOT team has more than 15 years of experience with C++ interpreters, and this has been fully exploited in the design of cling. However, matching the concepts of an interpreter to a compiler library is a non-trivial task; we will explain how this is done for cling, and how we managed to implement cling as a small (10,000 lines of code) extension to the clang and llvm libraries. The resulting features clearly show the advantages of basing an interpreter on a compiler. Cling uses clang's praised concise and easy to understand diagnostics. Building an interpreter on top of a compiler library makes the transition between interpreted and compiled code much easier and smoother. We will present the design, e.g. how cling treats the C++ extensions ...

  1. Alcohol screening and risk of postoperative complications in male VA patients undergoing major non-cardiac surgery.

    Science.gov (United States)

    Bradley, Katharine A; Rubinsky, Anna D; Sun, Haili; Bryson, Chris L; Bishop, Michael J; Blough, David K; Henderson, William G; Maynard, Charles; Hawn, Mary T; Tønnesen, Hanne; Hughes, Grant; Beste, Lauren A; Harris, Alex H S; Hawkins, Eric J; Houston, Thomas K; Kivlahan, Daniel R

    2011-02-01

    Patients who misuse alcohol are at increased risk for surgical complications. Four weeks of preoperative abstinence decreases the risk of complications, but practical approaches for early preoperative identification of alcohol misuse are needed. To evaluate whether results of alcohol screening with the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) questionnaire-up to a year before surgery-were associated with the risk of postoperative complications. This is a cohort study. Male Veterans Affairs (VA) patients were eligible if they had major noncardiac surgery assessed by the VA's Surgical Quality Improvement Program (VASQIP) in fiscal years 2004-2006, and completed the AUDIT-C alcohol screening questionnaire (0-12 points) on a mailed survey within 1 year before surgery. One or more postoperative complication(s) within 30 days of surgery based on VASQIP nurse medical record reviews. Among 9,176 eligible men, 16.3% screened positive for alcohol misuse with AUDIT-C scores ≥ 5, and 7.8% had postoperative complications. Patients with AUDIT-C scores ≥ 5 were at significantly increased risk for postoperative complications, compared to patients who drank less. In analyses adjusted for age, smoking, and days from screening to surgery, the estimated prevalence of postoperative complications increased from 5.6% (95% CI 4.8-6.6%) in patients with AUDIT-C scores 1-4, to 7.9% (6.3-9.7%) in patients with AUDIT-Cs 5-8, 9.7% (6.6-14.1%) in patients with AUDIT-Cs 9-10 and 14.0% (8.9-21.3%) in patients with AUDIT-Cs 11-12. In fully-adjusted analyses that included preoperative covariates potentially in the causal pathway between alcohol misuse and complications, the estimated prevalence of postoperative complications increased significantly from 4.8% (4.1-5.7%) in patients with AUDIT-C scores 1-4, to 6.9% (5.5-8.7%) in patients with AUDIT-Cs 5-8 and 7.5% (5.0-11.3%) among those with AUDIT-Cs 9-10. AUDIT-C scores of 5 or more up to a year before surgery were

  2. Interpretation of illness in cancer survivors is associated with health-related variables and adaptive coping styles

    Directory of Open Access Journals (Sweden)

    Fischer Julia

    2009-01-01

    Full Text Available Abstract Background A patient's interpretation of illness may have an influence on the choice of coping strategies