WorldWideScience

Sample records for lender risk rating

  1. 75 FR 13145 - SBA Lender Risk Rating System

    Science.gov (United States)

    2010-03-18

    ... SMALL BUSINESS ADMINISTRATION [Docket No. SBA-2010-0004] SBA Lender Risk Rating System AGENCY: Small Business Administration. ACTION: Notice; extension of comment period and correction. SUMMARY: On... of Credit Risk Management, U.S. Small Business Administration, 409 Third Street, SW., 8th Floor...

  2. 75 FR 9257 - SBA Lender Risk Rating System

    Science.gov (United States)

    2010-03-01

    ... Liquidation Rate; 3. Gross Delinquency Rate; 4. Gross Past-Due Rate; 5. Six (6) Month Net Flow Indicator; 6.... The statistical analysis performed showed that incorporating the Portfolio Size/Age component improved...) Month Delinquency Rate; 3. Gross Delinquency Rate; 4. Gross Past-Due Rate; 5. Average Small Business...

  3. 13 CFR 120.1000 - Risk-Based Lender Oversight.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Risk-Based Lender Oversight. 120.1000 Section 120.1000 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Risk-Based Lender Oversight Supervision § 120.1000 Risk-Based Lender Oversight. (a) Risk-Based Lender...

  4. 13 CFR 120.410 - Requirements for all participating Lenders.

    Science.gov (United States)

    2010-01-01

    ... performance, as determined by SBA in its discretion. The 7(a) Lender's Risk Rating, among other factors, will... Lenders. 120.410 Section 120.410 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Lenders Participation Criteria § 120.410 Requirements for all participating Lenders. A Lender must...

  5. 12 CFR 617.7125 - How should a qualified lender determine the effective interest rate?

    Science.gov (United States)

    2010-01-01

    ... effective interest rate? 617.7125 Section 617.7125 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM BORROWER RIGHTS Disclosure of Effective Interest Rates § 617.7125 How should a qualified lender determine the effective interest rate? (a) A qualified lender must calculate the effective interest rate on...

  6. 13 CFR 120.424 - What are the basic conditions a Lender must meet to securitize?

    Science.gov (United States)

    2010-01-01

    ... performance, as determined by SBA in its discretion. The Lender's Risk Rating, among other factors, will be... Lender must meet to securitize? 120.424 Section 120.424 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Lenders Participating Lender Financings § 120.424 What are the basic conditions a...

  7. 13 CFR 120.213 - What fixed interest rates may a Lender charge?

    Science.gov (United States)

    2010-01-01

    ... Lender charge? 120.213 Section 120.213 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION... have a reasonable fixed interest rate. SBA periodically publishes the maximum allowable rate in the... government determines the interest rate on direct loans. SBA publishes the rate periodically in the Federal...

  8. Discharge of residual debt: Do private and institutional lenders differ?

    OpenAIRE

    Kirchkamp, Oliver; Prömpers, Henning

    2013-01-01

    With the help of lab experiments we study the impact of discharging insolvent debtors of their residual debt. We investigate the impact of different participation rules and the impact of different types of lenders. We find that higher participation rates encourage risk taking behaviour of borrowers. Higher participation rates also reduce the amount of moonlighting. Most importantly, institutional lenders can suffer more from moonlighting than private lenders.

  9. 12 CFR 617.7105 - When must a qualified lender disclose the effective interest rate to a borrower?

    Science.gov (United States)

    2010-01-01

    ... effective interest rate to a borrower? 617.7105 Section 617.7105 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM BORROWER RIGHTS Disclosure of Effective Interest Rates § 617.7105 When must a qualified lender disclose the effective interest rate to a borrower? (a) Disclosure to prospective borrowers...

  10. 13 CFR 120.1015 - Risk Rating System.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Risk Rating System. 120.1015 Section 120.1015 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Risk-Based Lender Oversight Supervision § 120.1015 Risk Rating System. (a) Risk Rating. SBA may assign a Risk Rating...

  11. Oil price risk management in the 1990s - issues for producers and lenders

    International Nuclear Information System (INIS)

    Lambert, S.

    1994-01-01

    Oil prices have exhibited considerable volatility over the past five or ten years and the management of oil price risk has become an important factor in underpinning the viability of many oil producing operations from both a lender's and investor's perspective. Various oil based hedging products are now available to protect against such volatility, ranging from products which fix forward prices to option based arrangements which set a floor price but retain some (or all) of the potential upside. These products have particular relevance for petroleum companies with limited financial resources or who are looking to limit recourse to particular assets/cash flows. There are a number of techniques which can be successfully combined to mitigate oil price volatility and the most relevant of these to a producer are discussed. The recent development of the Tapis swap and option markets, which have provided flexibility to Australasian producers, is also discussed. Oil based financial products can also be used as a method of funding (e.g. for a development or acquisition) as an alternative to traditional cash based borrowing structures, thus creating a natural hedge against oil price movements. It is estimated that the use of such structures, coupled with a well structured revenue hedging program, can enhance a project's attractiveness from a lender's perspective (particularly with respect to protection against down side movements in oil price) and/or provide greater certainty of returns to producers. A case study of a recent commodity risk management based financing is presented. 1 fig., 6 tabs

  12. The role of lenders' trust in determining borrowing conditions for sovereign debt: An analysis of one-period government bonds with default risk

    OpenAIRE

    Guo, Yanling

    2015-01-01

    In this paper, the author considers the sovereign debt in the form of one-period government bonds with default risk, which can be purchased by and traded among domestic and foreign investors. She shows that the weight assigned to the lenders' interest by the borrowing government at the time of debt repayment, which captures the lenders' trust in the government's propensity to repay the debt and is denoted as », also determines the default risk: a higher » means a lower default risk ceteris pa...

  13. 7 CFR 762.106 - Preferred and certified lender programs.

    Science.gov (United States)

    2010-01-01

    ... eligible lender under § 762.105; (2) Have a lender loss rate not in excess of the maximum CLP loss rate... loss rate criteria for those lenders whose loss rate was substantially affected by a disaster as... number of guaranteed OL, FO, or Soil and Water (SW) loans established by the Agency and published...

  14. 75 FR 62335 - Federal Housing Administration (FHA) Single Family Lender Insurance Process: Eligibility...

    Science.gov (United States)

    2010-10-08

    ... those lenders with ineffective risk management practices and/or those lenders who have refused to... a marginal impact on those lenders with ineffective risk management practices and who have refused... has any impact, it will be as a consequence of the lender's inability to maintain acceptable risk...

  15. Mortgage lenders and loans

    NARCIS (Netherlands)

    Aalbers, M.B.; Smith, S.J.

    2012-01-01

    This article presents a short historical overview of the different types of lenders that are active in the origination of residential mortgage loans. First, a distinction is made between depository and nondepository lenders. Second, there are two major types of depository lenders: commercial banks,

  16. On the spillover of exchange rate risk into default risk

    Directory of Open Access Journals (Sweden)

    Božović Miloš

    2009-01-01

    Full Text Available In order to reduce the exchange-rate risk, banks in emerging markets are typically denominating their loans in foreign currencies. However, in the event of a substantial depreciation of the local currency, the payment ability of a foreign-currency borrower may be reduced significantly, exposing the lender to additional default risk. This paper analyses how the exchange-rate risk of foreign currency loans spills over into default risk. We show that in an economy where foreign currency loans are a dominant source of financing economic activity, depreciation of the local currency establishes a negative feedback mechanism that leads to higher default probabilities, reduced credit supply, and reduced growth. This finding has some important implications that may be of special interest for regulators and market participants in emerging economies.

  17. 13 CFR 120.441 - How does a Lender become a CLP Lender?

    Science.gov (United States)

    2010-01-01

    ... consider whether the Lender: (1) Has the ability to process, close, service and liquidate loans; (2) Has a... application packages; (3) Has an acceptable SBA purchase rate; and (4) Has shown the ability to work well with... Lender may appeal to the D/FA, whose decision will be final. If SBA grants CLP status, it applies only in...

  18. How strategic environmental assessment can inform lenders about potential environmental risks

    DEFF Research Database (Denmark)

    Banhalmi-Zakar, Zsuzsa; Larsen, Sanne Vammen

    2015-01-01

    at a time when it can be used as an input to bank lending decisions, which can assist banks in making lending decisions with better environmental outcomes. For these reasons, we argue that in some circumstances, and particularly for project finance transactions, SEA may be a more useful environmental......In this paper, we explore the potential for strategic environmental assessment (SEA) to be a useful tool for banks to manage environmental risks and inform lending decisions. SEA is an environmental assessment tool that was developed to assist strategic-level decision-makers, such as policy...

  19. 13 CFR 120.1060 - Confidentiality of Reports, Risk Ratings and related Confidential Information.

    Science.gov (United States)

    2010-01-01

    ... other than SBA's Lender oversight and SBA's portfolio management purposes. An SBA Lender, Intermediary... conjunction with SBA's Lender Oversight Program and SBA's portfolio management (for purposes of this... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Confidentiality of Reports, Risk...

  20. 13 CFR 120.1070 - Lender oversight fees.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Lender oversight fees. 120.1070 Section 120.1070 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Risk-Based... Lender” means a Small Business Lending Company or a Non-Federally Regulated Lender. (2) On-site reviews...

  1. 13 CFR 120.1010 - SBA access to SBA Lender, Intermediary, and NTAP files.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false SBA access to SBA Lender, Intermediary, and NTAP files. 120.1010 Section 120.1010 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Risk-Based Lender Oversight Supervision § 120.1010 SBA access to SBA Lender...

  2. 77 FR 21991 - Federal Housing Administration (FHA): Multifamily Accelerated Processing (MAP)-Lender and...

    Science.gov (United States)

    2012-04-12

    .... This practice would mitigate risk, since MAP lenders and underwriters will now be approved at a tier... Administration (FHA): Multifamily Accelerated Processing (MAP)--Lender and Underwriter Eligibility Criteria and Credit Watch for MAP Lenders AGENCY: Office of the Assistant Secretary for Housing--Federal Housing...

  3. 76 FR 34091 - Notice of Proposed Information Collection for Public Comment; FHA Lender Approval, Annual Renewal...

    Science.gov (United States)

    2011-06-10

    ... managing its financial risks and protect consumers from lender noncompliance with FHA rules and regulations... Information Collection for Public Comment; FHA Lender Approval, Annual Renewal, Periodic Updates and Noncompliance Reporting by FHA Approved Lenders AGENCY: Office of the Assistant Secretary for Housing, HUD...

  4. 12 CFR 617.7130 - What initial disclosures must a qualified lender make to a borrower?

    Science.gov (United States)

    2010-01-01

    ... lender make to a borrower? 617.7130 Section 617.7130 Banks and Banking FARM CREDIT ADMINISTRATION FARM... must a qualified lender make to a borrower? (a) Required disclosures—in general. A qualified lender... certificates that borrowers are required to purchase are at risk and may only be retired at the discretion of...

  5. 7 CFR 2201.13 - Lender.

    Science.gov (United States)

    2010-01-01

    ... guaranteed loans; (4) The performance of the Lender's loan portfolio, including its current delinquency rate... nationally recognized statistical rating organization, as evidenced by written confirmation from the nationally recognized statistical rating organization, subject to updating upon request of the Board; and (ii...

  6. 34 CFR 601.10 - Preferred lender arrangement disclosures.

    Science.gov (United States)

    2010-07-01

    ... Loan (FFEL) Program from any eligible lender the student selects; and (2) On such covered institution's... interest rates, or other terms and conditions or provisions of Title IV, HEA program loans or private... loyalty to compile the preferred lender list under paragraph (d) of this section without prejudice and for...

  7. How SEA can inform lenders

    DEFF Research Database (Denmark)

    Banhalmi-Zakar, Zsuzsa; Larsen, Sanne Vammen

    with identifying the financial incentives that ‘green’ projects attract. Although bank lending decisions apply to projects, examination of the lending practices of an Australian and a Hungarian bank have shown that decisions about the type of projects to target or avoid are also made at strategic level...... to inform bank lending decisions.......SEA can be a powerful tool to improve decision-making for plans, policies and programmes, but it can also be a useful for banks. SEA can help lenders address the reputational risks they are exposed to through financing projects that may have a negative impact on the environment and it can also help...

  8. 13 CFR 120.451 - How does a Lender become a PLP Lender?

    Science.gov (United States)

    2010-01-01

    ... for final decision. (b) In making its decision, SBA considers whether the Lender: (1) Has the required..., historical performance measures (like default rate, purchase rate and loss rate), loan volume to the extent..., policies and procedures. The recertification decision is made by the appropriate Office of Capital Access...

  9. Liquidity Risk and Syndicate Structure

    OpenAIRE

    Evan Gatev; Philip Strahan

    2008-01-01

    We offer a new explanation of loan syndicate structure based on banks' comparative advantage in managing systematic liquidity risk. When a syndicated loan to a rated borrower has systematic liquidity risk, the fraction of passive participant lenders that are banks is about 8% higher than for loans without liquidity risk. In contrast, liquidity risk does not explain the share of banks as lead lenders. Using a new measure of ex-ante liquidity risk exposure, we find further evidence that syndica...

  10. How do mortgage lenders influence neighbourhood dynamics? Redlining and predatory lending

    NARCIS (Netherlands)

    Aalbers, M.B.; van Ham, M.; Manley, D.; Bailey, N.; Simpson, L.; Maclennan, D.

    2013-01-01

    Manuel Aalbers argues that the actions of mortgage lenders can play an important role in understanding the trajectories of some of the most deprived neighbourhoods in Western cities. Mortgage lenders use the notion of the neighbourhood as a means to reduce their risk or to extract profit, and as

  11. HUD Subprime and Manufactured Home Lender List

    Data.gov (United States)

    Department of Housing and Urban Development — The U.S. Department of Housing and Urban Development (HUD) periodically produce its HUD Subprime and Manufactured home Lender List for the lenders who specialize in...

  12. 13 CFR 120.1600 - General procedures for enforcement actions against SBA Lenders, SBA Supervised Lenders, Other...

    Science.gov (United States)

    2010-01-01

    ... Persons, Intermediaries, and NTAPs. 120.1600 Section 120.1600 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Risk-Based Lender Oversight Enforcement Actions § 120.1600 General... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false General procedures for enforcement...

  13. 7 CFR 3565.110 - Insolvency of lender.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Insolvency of lender. 3565.110 Section 3565.110... AGRICULTURE GUARANTEED RURAL RENTAL HOUSING PROGRAM Lender Requirements § 3565.110 Insolvency of lender. The... determination of insolvency by the lender. If the lender fails to transfer a loan when required, the guarantee...

  14. Shopping Center Financing: Pricing Loan Default Risk

    OpenAIRE

    Peter Chinloy; James Musumeci

    1994-01-01

    The financing structure of a shopping center is decomposed into an income security and two put options. These put options are respectively held by the borrower against the lender for default, and by the lender against an insurer or reinsurer. The prices of the put option depend on the loan-to-value ration of the loan and on the risk of the investment. The interest rate charged on the loan is the sum of four components: a riskless rate, lender production costs, and the net price of the put opt...

  15. Management of interest rate risk

    Directory of Open Access Journals (Sweden)

    Šabović Šerif

    2014-01-01

    Full Text Available Interest rate risk is one of the biggest and most dangerous risks that a bank is exposed to. When a change of interest rates occurs, the incomes of a bank based on credits and securities endure significant changes. Banks resources also endure some changes. The change of interest rates changes the value of the assets and liabilities of the bank and it's net and investment worth . The change of interest rates also affects bank's balance sheet, income sheet statement and bank's share capital.

  16. 13 CFR 120.462 - What are SBA's additional requirements on capital maintenance for SBA Supervised Lenders?

    Science.gov (United States)

    2010-01-01

    ... capital that each SBA Supervised Lender must maintain to protect against the credit risk and other general... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What are SBA's additional requirements on capital maintenance for SBA Supervised Lenders? 120.462 Section 120.462 Business Credit and...

  17. Risk, ambiguity and sovereign rating

    OpenAIRE

    Di Caro, Paolo

    2014-01-01

    Decisions of investing in sovereign assets involve both risk and ambiguity. Ambiguity arises from unknown elements characterizing the value of a generic sovereign. In presence of ambiguity, ambiguity-averse investors are prone to pay for obtaining summary information such as ratings which reduces ambiguity. Ambiguity-neutral and ambiguity-averse investors, then, make decisions on the basis of different informative sources. By presenting a simple model of sovereign rating under ambiguity, thre...

  18. 12 CFR 619.9135 - Direct lender.

    Science.gov (United States)

    2010-01-01

    ... and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM DEFINITIONS § 619.9135 Direct lender. The term direct lender refers to Farm Credit banks and associations (production credit associations, agricultural credit associations, and Federal land credit associations) authorized to lend to eligible...

  19. 24 CFR 202.9 - Investing lenders and mortgagees.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Investing lenders and mortgagees... Investing lenders and mortgagees. (a) Definition. An investing lender or mortgagee is an organization that is not approved under any other section of this part. An investing lender or mortgagee may purchase...

  20. 13 CFR 500.211 - Lender responsibilities.

    Science.gov (United States)

    2010-01-01

    ...) Monitoring. In accordance with the Guarantee the Lender shall monitor Borrower's performance under the Loan... borrower, as provided in the Guarantee; (2) Projected balance sheet, income statement, and cash flows for...

  1. 78 FR 13999 - Maximum Interest Rates on Guaranteed Farm Loans

    Science.gov (United States)

    2013-03-04

    ..., cost-plus, flat-rate, or market based) to price guaranteed loans, provided the rates do not exceed the... (LIBOR) or the 5-year Treasury note rate, unless the lender uses a formal written risk-based pricing... cost in the form of a lower interest rate than the borrower would otherwise receive. Therefore, the FSA...

  2. 7 CFR 1980.309 - Lender participation in guaranteed RH loans.

    Science.gov (United States)

    2010-01-01

    ...) Has any change in the Lender name, location, address, or corporate structure; (F) Has become... interests of the Lender and the Government. If the Lender is determined to be no longer eligible, the Lender...

  3. 76 FR 16570 - Interest Rate Risk

    Science.gov (United States)

    2011-03-24

    ... NATIONAL CREDIT UNION ADMINISTRATION 12 CFR Part 741 RIN 3133-AD66 Interest Rate Risk AGENCY... regulations to require Federally insured credit unions to have a written policy addressing interest rate risk... Risk Management for Credit Unions with Large Positions in Fixed Rate Mortgages; 06-CU-16 Inter-Agency...

  4. 24 CFR 232.865 - Election by lender.

    Science.gov (United States)

    2010-04-01

    ... FACILITIES Contract Rights and Obligations Rights and Duties of Lender Under the Contract of Insurance § 232.865 Election by lender. Where a real estate mortgage, or other security instrument has been used to...

  5. 24 CFR 241.865 - Election by the lender.

    Science.gov (United States)

    2010-04-01

    ... Without a HUD-Insured or HUD-Held Mortgage Rights and Duties of Lender Under the Contract of Insurance § 241.865 Election by the lender. Where a real estate mortgage, or other security instrument has been...

  6. 49 CFR 22.27 - Eligible reimbursements to participating lenders.

    Science.gov (United States)

    2010-10-01

    ... reimbursement. Prior written approval from DOT OSDBU is required. Attorney fees will be reimbursed on a pro-rata... 49 Transportation 1 2010-10-01 2010-10-01 false Eligible reimbursements to participating lenders... PROGRAM (STLP) Participating Lenders § 22.27 Eligible reimbursements to participating lenders...

  7. 12 CFR 528.5 - Equal Housing Lender Poster.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Equal Housing Lender Poster. 528.5 Section 528... REQUIREMENTS § 528.5 Equal Housing Lender Poster. (a) Each savings association shall post and maintain one or more Equal Housing Lender Posters, the text of which is prescribed in paragraph (b) of this section, in...

  8. 12 CFR 626.6025 - Equal housing lender poster.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Equal housing lender poster. 626.6025 Section... § 626.6025 Equal housing lender poster. (a) Each Farm Credit institution that makes loans for the... by a dwelling shall post and maintain an Equal Housing Lender Poster in the lobby of each of its...

  9. 7 CFR 762.105 - Eligibility and substitution of lenders.

    Science.gov (United States)

    2010-01-01

    ... from participation in Government contracts or programs or be delinquent on a Government debt. (c... writing by executing a modification of the guarantee to identify the new lender, the amount of debt at the... the loan. (d) Lender name or ownership changes. (1) When a lender begins doing business under a new...

  10. 75 FR 28814 - FHA Lender Approval, Annual Renewal, Periodic Updates and Required Reports From FHA Approved Lenders

    Science.gov (United States)

    2010-05-24

    ... proposal. This information is required for: (1) FHA lender approval, (2) Annual renewal of each FHA lender... following information: Title of Proposal: FHA Lender Approval, Annual Renewal, Periodic Updates and Required... and HUD-92001-C. Description of the Need for the Information and Its Proposed Use: This information is...

  11. 13 CFR 500.201 - Eligible Lender.

    Science.gov (United States)

    2010-01-01

    ...: (1) The Lender's level of regulatory capital, in the case of banking institutions, or net worth, in... eligible to apply to the Board for a Guarantee of a loan must be: (1) A banking institution, such as a commercial bank or trust company, subject to regulation by the Federal banking agencies enumerated in 12 U.S...

  12. 7 CFR 4279.29 - Eligible lenders.

    Science.gov (United States)

    2010-01-01

    ... Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL... have the legal authority to operate a lending program and sufficient lending expertise and financial... consideration to become a guaranteed lender must submit a request in writing to the State Office for the State...

  13. The Determinants of Country Risk Ratings

    OpenAIRE

    Jean-Claude Cosset; Jean Roy

    1991-01-01

    The purpose of this paper is to replicate Euromoney's and Institutional Investor's country risk ratings on the basis of economic and political variables. The evidence reveals that country risk ratings respond to some of the variables suggested by the theory. In particular, both the level of per capita income and propensity to invest affect positively the rating of a country. In addition, high-ranking countries are less indebted than low-ranking countries. It also appears that the ability of t...

  14. Currency Risk Management under Floating Rates

    Directory of Open Access Journals (Sweden)

    Nicu Duret

    2016-09-01

    Full Text Available As for the research into this subject, we find, therefore, that one of the most important indicators that quantify the international competitiveness is the exchange rate, together with other fundamental macroeconomic variables such as the size of the potential GDP, the equilibrium real exchange rate, gives a certain insight into the functioning of the fundamental macroeconomic mechanisms and their regulation. Commercial and financial operations imply relationships between partners from different currency countries or areas that involve conversion operations, of replacement of a currency to another. Exchange rate fluctuations of one currency create currency risk, to the extent that it is used to carry out international transactions. These operations are subjected to currency risk as exchange rates change frequently from one period to another and, on the other hand, speculations in the forex market influence the exchange rate by the interventions of those who perform them.

  15. Remarks on Interest Rate Risk Management

    Directory of Open Access Journals (Sweden)

    Elena-Violeta DRAGOI

    2016-12-01

    Full Text Available Bank interest and interest rate risk management is a contemporary subject and for socio-economic environment of Romania cause serious consequences in the level of economic development. The purpose of this research is to highlight the main indicator that measures the total cost of a loan, namely the annual percentage rate (APR, because if we refer to an interest rate lower, at first glance that loan seems more advantageous, but at a closer look, taking into account the commissions charged by the bank, we see that the loan is more expensive compared to another, whose interest rate is higher.

  16. 12 CFR 560.110 - Most favored lender usury preemption.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Most favored lender usury preemption. 560.110... INVESTMENT Lending and Investment Provisions Applicable to all Savings Associations § 560.110 Most favored... permits its most favored lender to charge late fees, then a savings association located in that state may...

  17. 7 CFR 4287.135 - Substitution of lender.

    Science.gov (United States)

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE SERVICING Servicing Business and Industry Guaranteed... borrower, the proposed substitute lender, and the original lender if still in existence. (b) Where the...

  18. 25 CFR 103.11 - How does BIA approve lenders for the Program?

    Science.gov (United States)

    2010-04-01

    ... opportunities the lender has given to Indian business efforts through the Program; and (5) The lender's... corporate structure; (2) The effective date of a merger between the lender and any other entity, when the... of the lender's assets may be subject to disposition through laws governing bankruptcy, insolvency...

  19. VaR: Exchange Rate Risk and Jump Risk

    Directory of Open Access Journals (Sweden)

    Fen-Ying Chen

    2010-01-01

    Full Text Available Incorporating the Poisson jumps and exchange rate risk, this paper provides an analytical VaR to manage market risk of international portfolios over the subprime mortgage crisis. There are some properties in the model. First, different from past studies in portfolios valued only in one currency, this model considers portfolios not only with jumps but also with exchange rate risk, that is vital for investors in highly integrated global financial markets. Second, in general, the analytical VaR solution is more accurate than historical simulations in terms of backtesting and Christoffersen's independence test (1998 for small portfolios and large portfolios. In other words, the proposed model is reliable not only for a portfolio on specific stocks but also for a large portfolio. Third, the model can be regarded as the extension of that of Kupiec (1999 and Chen and Liao (2009.

  20. 7 CFR 4279.43 - Certified Lender Program.

    Science.gov (United States)

    2010-01-01

    ... guaranteed by any Federal agency, with information on delinquencies and losses and, if applicable, the... lender will provide a written certification to this effect along with a statistical analysis of its...

  1. An Investigation into the Fundamental Drivers of Pricing of Residential Mortgage Products – A Risk Pricing Viewpoint

    Directory of Open Access Journals (Sweden)

    Harry M Karamujic

    2010-12-01

    Full Text Available Residential mortgage products (also known as home loans pricing has been long understood to be something of a ‘dark art’, requiring judgment and experience, rather than being an exact science. In the last decade, a lot has changed in this field and more and more lenders, primarily the larger lenders, are increasingly looking to make their pricing as exact as possible. Even so, inadequate pricing of residential mortgage products (in particular its substandard risk pricing has been seen as one of major causes of the global financial crisis (GFC and subsequent spectacular banking collapses. The underlying theme of the paper is to exhibit how contemporary lenders, in practice, price their residential mortgage products. While discussing elements of the pricing calculation particular attention was given to the exposition of how contemporary lenders price risks involved in providing home loans. Because of the importance of Basel capital accords to how financial institutions assess and quantify their risks, the paper provides an overview of Basel capital accords. The author envisages that the paper will (i help enhance comprehension of the underlying elements of the pricing calculation and the ways in which these elements relate to each other, (ii scrutinize how contemporary lenders identify and quantify risks and (iii improve consciousness of future changes in interest rates

  2. A rating for the risk; Ein Rating fuers Risiko

    Energy Technology Data Exchange (ETDEWEB)

    Faltermeier, Daniel [Meteocontrol GmbH, Augsburg (Germany). Technische Due Diligence PV

    2013-07-01

    The assessment of the quality and risks of the photovoltaics project plays an important role in the investment decision. Especially for very large projects, an extensive risk assessment of yield losses and technical tests are increasingly demanded by independent experts. A new method enables the evaluation of solar energy systems.

  3. 42 CFR 60.43 - Limitation, suspension, or termination of the eligibility of a HEAL lender or holder.

    Science.gov (United States)

    2010-10-01

    ... notice, sent by certified mail, specifying his or her intention to terminate the lender or holder's... that a HEAL lender fails to meet the statutory definition of an “eligible lender.” (d) This section...

  4. Hedging endowment assurance products under interest rate and mortality risk

    NARCIS (Netherlands)

    Chen, A.; Mahayni, A.

    2007-01-01

    This paper analyzes how model misspecification associated with both interest rate and mortality risk influences hedging decisions of insurance companies. For this purpose, diverse risk management strategies which are riskminimizing when model risk is ignored come into consideration. The

  5. 12 CFR 615.5135 - Management of interest rate risk.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Management of interest rate risk. 615.5135... of interest rate risk. The board of directors of each Farm Credit Bank, bank for cooperatives, and agricultural credit bank shall develop and implement an interest rate risk management program as set forth in...

  6. Interbank lending, network structure and default risk contagion

    Science.gov (United States)

    Zhang, Minghui; He, Jianmin; Li, Shouwei

    2018-03-01

    This paper studies the default risk contagion in banking systems based on a dynamic network model with two different kinds of lenders' selecting mechanisms, namely, endogenous selecting (ES) and random selecting (RS). From sensitivity analysis, we find that higher risk premium, lower initial proportion of net assets, higher liquid assets threshold, larger size of liquidity shocks, higher proportion of the initial investments and higher Central Bank interest rates all lead to severer default risk contagion. Moreover, the autocorrelation of deposits and lenders' selecting probability have non-monotonic effects on the default risk contagion, and the effects differ under two mechanisms. Generally, the default risk contagion is much severer under RS mechanism than that of ES, because the multi-money-center structure generated by ES mechanism enables borrowers to borrow from more liquid banks with lower interest rates.

  7. Credit risk migration rates modeling as open systems: A micro-simulation approach

    Science.gov (United States)

    Landini, S.; Uberti, M.; Casellina, S.

    2018-05-01

    for not to predict lenders' bankruptcy by construction; (b) to meet more reliable estimates along with the new regulatory standards, the sample to estimate migration rates matrices for credit risk should include either entries and exits; (c) the static eigen-decomposition standard procedure to forecast migration rates should be replaced with a stochastic process dynamics methodology while conditioning forecasts to macroeconomic scenarios.

  8. 75 FR 12251 - Notice of Proposed Information Collection for Public Comment; FHA Lender Approval, Annual Renewal...

    Science.gov (United States)

    2010-03-15

    ... Lenders. OMB Control Number, if applicable: 2502-0005. Description of the need for the information and proposed use: The information is used by FHA to verify that lenders meet all approval, renewal, update and... Information Collection for Public Comment; FHA Lender Approval, Annual Renewal, Periodic Updates and...

  9. 78 FR 17937 - Notice of Proposed Information Collection for Public Comment; FHA Lender Approval, Annual Renewal...

    Science.gov (United States)

    2013-03-25

    ... Lenders. OMB Control Number, if applicable: 2502-0005. Description of the need for the information and proposed use: The information is used by FHA to verify that lenders meet all approval, renewal, update and... Information Collection for Public Comment; FHA Lender Approval, Annual Renewal, Periodic Updates and...

  10. 78 FR 36560 - 30-Day Notice of Proposed Information Collection: FHA Lender Approval, Annual Renewal, Periodic...

    Science.gov (United States)

    2013-06-18

    ... 92001-C Non-compliances on Title I Lenders Description of the need for the information and proposed use... Information Collection: FHA Lender Approval, Annual Renewal, Periodic Updates and Noncompliance Reporting by FHA Approved Lenders AGENCY: Office of the Chief Information Officer, HUD. ACTION: Notice. SUMMARY...

  11. 77 FR 63323 - Notice of Proposed Information Collection for Public Comment; FHA Lender Approval, Annual Renewal...

    Science.gov (United States)

    2012-10-16

    ... Lenders OMB Control Number, if applicable: 2502-0005. Description of the need for the information and proposed use: The information is used by FHA to verify that lenders meet all approval, renewal, update and... Information Collection for Public Comment; FHA Lender Approval, Annual Renewal, Periodic Updates and...

  12. Exchange rate policy under sovereign default risk

    OpenAIRE

    Schabert, Andreas

    2011-01-01

    We examine monetary policy options for a small open economy where sovereign default might occur due to intertemporal insolvency. Under interest rate policy and floating exchange rates the equilibrium is indetermined. Under a fixed exchange rate the equilibrium is uniquely determined and independent of sovereign default.

  13. Exchange rate risks and their impact upon the energy market

    Directory of Open Access Journals (Sweden)

    Abed Al-Zabidi

    2007-04-01

    Full Text Available The expansion of international business in Slovakia brought not only the opening of markets and expansion of enterprise possibilities but also an increase in the competition and new risks. One of such risks is also the exchange rate risk. The business that realizes a financial transaction exceeding borders of the state or derives his buying or selling prices in Slovak crowns from the foreign currency, is subjected to the exchange rate risks. The exchange rate risks are caused by volatility of exchange courses of Slovak crowns related to foreign currencies. The progress of exchange rates can considerably influence a real result of a transaction negatively; therefore it is important for enterprises to identify possible risks resulting from changes in exchange rates, so they could react accordingly.The proposed article is aimed at the explanation of basic techniques of minimizing exchange rate risks with the use of financial tools available on the financial market.

  14. The Juvenile Addiction Risk Rating: Development and Initial Psychometrics

    Science.gov (United States)

    Powell, Michael; Newgent, Rebecca A.

    2016-01-01

    This article describes the development and psychometrics of the Juvenile Addiction Risk Rating. The Juvenile Addiction Risk Rating is a brief screening of addiction potential based on 10 risk factors predictive of youth alcohol and drug-related problems that assists examiners in more accurate treatment planning when self-report information is…

  15. Interest rate risk of life insurers: Evidence from accounting data

    OpenAIRE

    Möhlmann, Axel

    2017-01-01

    Life insurers are exposed to interest rate risk, and their liability side is typically more sensitive to interest rate changes than their asset side. This paper develops an accounting-based measure of interest rate sensitivity. My approach uses the coexistence of historical cost and market value accounting, which permits the observation of valuations for different discount rates. Using microdata, I show that German life insurers have a significant exposure to interest rate risk. However, ther...

  16. Simplifying cardiovascular risk estimation using resting heart rate.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2010-09-01

    Elevated resting heart rate (RHR) is a known, independent cardiovascular (CV) risk factor, but is not included in risk estimation systems, including Systematic COronary Risk Evaluation (SCORE). We aimed to derive risk estimation systems including RHR as an extra variable and assess the value of this addition.

  17. Exchange rate risk in Central European countries

    Czech Academy of Sciences Publication Activity Database

    Kočenda, Evžen; Poghosyan, T.

    2010-01-01

    Roč. 60, č. 1 (2010), s. 22-39 ISSN 0015-1920 R&D Projects: GA ČR(CZ) GA402/08/1376; GA MŠk LC542 Institutional research plan: CEZ:MSM0021620846 Keywords : foreign exchange risk * time-varying risk premium * stochastic discount factor Subject RIV: AH - Economics Impact factor: 0.278, year: 2010 http://journal.fsv.cuni.cz/storage/1178_str_22_39_-_ko%C4%8Denda.pdf

  18. 7 CFR 3565.304 - Lender loan processing responsibilities.

    Science.gov (United States)

    2010-01-01

    ... application at the feasibility stage or when they request a conditional commitment. (b) Project servicing, management and disposition. Unless otherwise permitted by the Agency, the originating lender must perform all loan functions during the period of the guarantee. These functions include servicing, asset management...

  19. 24 CFR 202.6 - Supervised lenders and mortgagees.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Supervised lenders and mortgagees. 202.6 Section 202.6 Housing and Urban Development Regulations Relating to Housing and Urban... Secretary in the amount of 20 percent of its net worth, up to a maximum liquidity requirement of $100,000...

  20. Interest Rate Risk Management using Duration Gap Methodology

    Directory of Open Access Journals (Sweden)

    Dan Armeanu

    2008-01-01

    Full Text Available The world for financial institutions has changed during the last 20 years, and become riskier and more competitive-driven. After the deregulation of the financial market, banks had to take on extensive risk in order to earn sufficient returns. Interest rate volatility has increased dramatically over the past twenty-five years and for that an efficient management of this interest rate risk is strong required. In the last years banks developed a variety of methods for measuring and managing interest rate risk. From these the most frequently used in real banking life and recommended by Basel Committee are based on: Reprising Model or Funding Gap Model, Maturity Gap Model, Duration Gap Model, Static and Dynamic Simulation. The purpose of this article is to give a good understanding of duration gap model used for managing interest rate risk. The article starts with a overview of interest rate risk and explain how this type of risk should be measured and managed within an asset-liability management. Then the articles takes a short look at methods for measuring interest rate risk and after that explains and demonstrates how can be used Duration Gap Model for managing interest rate risk in banks.The world for financial institutions has changed during the last 20 years, and become riskier and more competitive-driven. After the deregulation of the financial market, banks had to take on extensive risk in order to earn sufficient returns. Interest rate volatility has increased dramatically over the past twenty-five years and for that an efficient management of this interest rate risk is strong required. In the last years banks developed a variety of methods for measuring and managing interest rate risk. From these the most frequently used in real banking life and recommended by Basel Committee are based on: Reprising Model or Funding Gap Model, Maturity Gap Model, Duration Gap Model, Static and Dynamic Simulation. The purpose of this article is to give a

  1. Self-rated health and cancer risk

    DEFF Research Database (Denmark)

    Roelsgaard, Ida Kristiane; Olesen, Anne Marie; Simonsen, Mette Kildevæld

    2016-01-01

    BACKGROUND: Self-rated health (SRH) has been shown to be a strong predictor of mortality from a number of major chronic diseases, however, the association with cancer remains unclear. The aim of this study was to investigate a possible association between change in SRH and cancer incidence...... proportional hazards model with adjustment for age, smoking, alcohol, marital status, physical activity, body mass index and estrogen replacement therapy. RESULTS: No significant association was found between SRH and overall cancer incidence in the age-adjusted Cox proportional hazards model (1.04; 95% CI 0...

  2. Real interest rates, leverage, and bank risk-taking

    NARCIS (Netherlands)

    Dell’Ariccia, G.; Laeven, L.; Marquez, R.

    2014-01-01

    Do low interest rate environments lead to greater bank risk-taking? We show that, when banks can adjust their capital structures, reductions in real interest rates lead to greater leverage and higher risk for any downward sloping loan demand function. However, if the capital structure is fixed, the

  3. Interest Rate Risk Management using Duration Gap Methodology

    Directory of Open Access Journals (Sweden)

    Dan Armeanu

    2008-01-01

    should be measured and managed within an asset-liability management. Then the articles takes a short look at methods for measuring interest rate risk and after that explains and demonstrates how can be used Duration Gap Model for managing interest rate risk in banks.

  4. Credit ratings and CEO risk-taking incentives

    NARCIS (Netherlands)

    Kuang, Y.; Qin, B.

    2013-01-01

    This study examines the sophistication of rating agencies in incorporating managerial risk-taking incentives into their credit risk evaluation. We measure risk-taking incentives using two proxies: the sensitivity of managerial wealth to stock return volatility (vega) and the sensitivity of

  5. Interest Rate Risk Management and the Use of Derivative Securities

    Directory of Open Access Journals (Sweden)

    Ioana-Diana PĂUN

    2013-12-01

    Full Text Available This study aims to demonstrate the utility of derivative financial instruments for the management of interest rate risk that is faced by banks and financial institutions, and to provide an efficient flow of monitoring and control thereof. Banking institutions can now use a combination of balance sheet and off balance sheet measures, i.e. gap method, of interest rate risk management, in order to control exposure of short-term rates and derivatives to control the residual interest rate exposures. The result of the study shows that banks can achieve better diversification and risk management using derivatives.

  6. TECHNICAL RISK RATING OF DOE ENVIRONMENTAL PROJECTS - 9153

    International Nuclear Information System (INIS)

    Cercy, M.; Fayfich, Ronald; Schneider, Steven P.

    2008-01-01

    The U.S. Department of Energy's Office of Environmental Management (DOE-EM) was established to achieve the safe and compliant disposition of legacy wastes and facilities from defense nuclear applications. The scope of work is diverse, with projects ranging from single acquisitions to collections of projects and operations that span several decades and costs from hundreds of millions to billions US$. The need to be able to manage and understand the technical risks from the project to senior management level has been recognized as an enabler to successfully completing the mission. In 2008, DOE-EM developed the Technical Risk Rating as a new method to assist in managing technical risk based on specific criteria. The Technical Risk Rating, and the criteria used to determine the rating, provides a mechanism to foster open, meaningful communication between the Federal Project Directors and DOE-EM management concerning project technical risks. Four indicators (technical maturity, risk urgency, handling difficulty and resolution path) are used to focus attention on the issues and key aspects related to the risks. Pressing risk issues are brought to the forefront, keeping DOE-EM management informed and engaged such that they fully understand risk impact. Use of the Technical Risk Rating and criteria during reviews provides the Federal Project Directors the opportunity to openly discuss the most significant risks and assists in the management of technical risks across the portfolio of DOE-EM projects. Technical Risk Ratings can be applied to all projects in government and private industry. This paper will present the methodology and criteria for Technical Risk Ratings, and provide specific examples from DOE-EM projects

  7. Inappropriate use of payment weights to risk adjust readmission rates.

    Science.gov (United States)

    Fuller, Richard L; Goldfield, Norbert I; Averill, Richard F; Hughes, John S

    2012-01-01

    In this article, the authors demonstrate that the use of relative weights, as incorporated within the National Quality Forum-endorsed PacifiCare readmission measure, is inappropriate for risk adjusting rates of hospital readmission.

  8. Risks and rewards of variable-rate debt.

    Science.gov (United States)

    Jordahl, Eric A

    2012-05-01

    Hospital and health system finance leaders should position their organizations to participate in the variable-rate market. To this end, one important step is to establish the right baseline variable-rate exposure target for the organization based on its credit and risk profile. Leaders also should be thoroughly familiar with the available products and understand the circumstances (pricing, terms, and embedded risk) under which the organization would be willing to deploy them within the overall capital structure.

  9. 25 CFR 103.12 - How does a lender apply for a loan guaranty?

    Science.gov (United States)

    2010-04-01

    ... of the lender's loan guaranty application package, outlining the credit history of the borrower, and... all makers, cosigners and guarantors, maturity dates, payment schedules, uncured delinquencies...

  10. Risk and complication rate of uterine fibroid embolization (UFE)

    International Nuclear Information System (INIS)

    Radeleff, B.; Rimbach, S.; Kauffmann, G.W.; Richter, G.M.

    2003-01-01

    Our goal was to evaluate risks and complication rate of uterine fibroid embolization (UFE). The most frequent complications reported in the literature are associated with angiography procedure, serious complications are extremely infrequent. The embolization of fibroids is a safe angiographic intervention. Nevertheless, the interventional radiologist must be aware of the common risks and complication and the strategies to avoid them. (orig.) [de

  11. College Students' Perceived Disease Risk versus Actual Prevalence Rates

    Science.gov (United States)

    Smith, Matthew Lee; Dickerson, Justin B.; Sosa, Erica T.; McKyer, E. Lisako J.; Ory, Marcia G.

    2012-01-01

    Objective: To compare college students' perceived disease risk with disease prevalence rates. Methods: Data were analyzed from 625 college students collected with an Internet-based survey. Paired t-tests were used to separately compare participants' perceived 10-year and lifetime disease risk for 4 diseases: heart disease, cancer, diabetes, and…

  12. KRW/USD Exchange Rate Volatility and Efficient Risk Management

    OpenAIRE

    Sang-Yong Joo; Chae-Shick Chung; Young-Woo Lee

    1999-01-01

    This thesis analyzes the relationship between the exchange rate of Korean Won and US dollar and the amount of foreign exchange, and studies the direction of the amendment of the risk control of foreign exchange. The GARCH (Generalized Auto Regressive Conditional Heteroscedasticity) model which visually embodies the auto-regress of the wave of exchange rate shows that the amount of trade will enhance the fluidity of the exchange rate, that is, the various expects of the participators of the ma...

  13. 75 FR 80066 - Quality Control Requirements for Direct Endorsement Lenders; Notice of Proposed Information...

    Science.gov (United States)

    2010-12-21

    ... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5380-N-50] Quality Control Requirements... information: Title of Proposal: Quality Control Requirements for Direct Endorsement Lenders. OMB Control... a result, DE lenders will be responsible for conducting quality control on TPO originations of FHA...

  14. 24 CFR 232.520 - Maximum fees and charges by lender.

    Science.gov (United States)

    2010-04-01

    ... HOUSING AND URBAN DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES MORTGAGE INSURANCE FOR NURSING HOMES, INTERMEDIATE CARE FACILITIES, BOARD AND CARE HOMES, AND... of Fire Safety Equipment Fees and Charges § 232.520 Maximum fees and charges by lender. The lender...

  15. 12 CFR 591.4 - Loans originated by lenders other than Federal savings associations.

    Science.gov (United States)

    2010-01-01

    ... Federal savings associations. (a) With regard to any real property loan originated by a lender other than... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Loans originated by lenders other than Federal savings associations. 591.4 Section 591.4 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF...

  16. Failure rate data for fusion safety and risk assessment

    International Nuclear Information System (INIS)

    Cadwallader, L.C.

    1993-01-01

    The Fusion Safety Program (FSP) at the Idaho National Engineering Laboratory (INEL) conducts safety research in materials, chemical reactions, safety analysis, risk assessment, and in component research and development to support existing magnetic fusion experiments and also to promote safety in the design of future experiments. One of the areas of safety research is applying probabilistic risk assessment (PRA) methods to fusion experiments. To apply PRA, we need a fusion-relevant radiological dose code and a component failure rate data base. This paper describes the FSP effort to develop a failure rate data base for fusion-specific components

  17. 77 FR 57990 - Interest Rate Risk Policy and Program

    Science.gov (United States)

    2012-09-19

    ... NATIONAL CREDIT UNION ADMINISTRATION 12 CFR Part 741 RIN 3133-AD66 Interest Rate Risk Policy and Program Correction In rule document 2012-02091, appearing on pages 55155-5167 in the issue of Thursday, February 2, 2012, make the following corrections: 1. On page 5157, in the second column, in the first line...

  18. Government spending shocks, sovereign risk and the exchange rate regime

    NARCIS (Netherlands)

    Bonam, D.; Lukkezen, J.H.J.

    2014-01-01

    Keynesian theory predicts output responses upon a fiscal expansion in a small open economy to be larger under fixed than floating exchange rates. We analyse the effects of fiscal expansions using a New Keynesian model and find that the reverse holds in the presence of sovereign default risk. By

  19. Lender of last resort in a monetary union

    Directory of Open Access Journals (Sweden)

    Gylfi Magnússon

    2014-12-01

    Full Text Available The theory of optimal currency areas was developed during the 1960’s and 1970’s. At that time the international financial system was very different from the current system, banking systems were smaller and the flow of funds across borders limited. Developments in the Eurozone in recent years have shown that when the theory was developed and the decision made to adopt the euro some of the drawbacks of a common currency were not foreseen and important issues were not addressed. This includes the role of a common central bank as a lender of last resort to national governments. In addition, few foresaw how many closely linked financial systems could create problems that are unsolvable without the cooperation of several governments. An adequate framework for dealing with such problems was thus not put in place. The possibility that macro-economic shocks could originate in the financial system was mainly ignored. During the current crisis it has been necessary to address all these issues. It took four years to find a politically viable solution. This involves the redefinition of the role of the European Central Bank, making it a lender of last resort to national governments. This policy change buys time to deal with many fundamental imbalances within the Eurozone but does not in and of itself solve the underlying problems. The delay in implementing this policy was however very costly.

  20. Courting disaster: How diversification rate affects fitness under risk

    Science.gov (United States)

    Ratcliff, William C; Hawthorne, Peter; Libby, Eric

    2015-01-01

    Life is full of risk. To deal with this uncertainty, many organisms have evolved bet-hedging strategies that spread risk through phenotypic diversification. These rates of diversification can vary by orders of magnitude in different species. Here we examine how key characteristics of risk and organismal ecology affect the fitness consequences of variation in diversification rate. We find that rapid diversification is strongly favored when the risk faced has a wide spatial extent, with a single disaster affecting a large fraction of the population. This advantage is especially great in small populations subject to frequent disaster. In contrast, when risk is correlated through time, slow diversification is favored because it allows adaptive tracking of disasters that tend to occur in series. Naturally evolved diversification mechanisms in diverse organisms facing a broad array of environmental risks largely support these results. The theory presented in this article provides a testable ecological hypothesis to explain the prevalence of slow stochastic switching among microbes and rapid, within-clutch diversification strategies among plants and animals. PMID:25410817

  1. Courting disaster: How diversification rate affects fitness under risk.

    Science.gov (United States)

    Ratcliff, William C; Hawthorne, Peter; Libby, Eric

    2015-01-01

    Life is full of risk. To deal with this uncertainty, many organisms have evolved bet-hedging strategies that spread risk through phenotypic diversification. These rates of diversification can vary by orders of magnitude in different species. Here we examine how key characteristics of risk and organismal ecology affect the fitness consequences of variation in diversification rate. We find that rapid diversification is strongly favored when the risk faced has a wide spatial extent, with a single disaster affecting a large fraction of the population. This advantage is especially great in small populations subject to frequent disaster. In contrast, when risk is correlated through time, slow diversification is favored because it allows adaptive tracking of disasters that tend to occur in series. Naturally evolved diversification mechanisms in diverse organisms facing a broad array of environmental risks largely support these results. The theory presented in this article provides a testable ecological hypothesis to explain the prevalence of slow stochastic switching among microbes and rapid, within-clutch diversification strategies among plants and animals. © 2014 The Author(s). Evolution published by Wiley Periodicals, Inc. on behalf of The Society for the Study of Evolution.

  2. KRW/USD Exchange Rate Volatility and Efficient Risk Management

    Directory of Open Access Journals (Sweden)

    Sang-Yong Joo

    1999-03-01

    Full Text Available This thesis analyzes the relationship between the exchange rate of Korean Won and US dollar and the amount of foreign exchange, and studies the direction of the amendment of the risk control of foreign exchange. The GARCH (Generalized Auto Regressive Conditional Heteroscedasticity model which visually embodies the auto-regress of the wave of exchange rate shows that the amount of trade will enhance the fluidity of the exchange rate, that is, the various expects of the participators of the market affect the amount of trade and the fluidity, so in the process of trading, the trader who is in the dry tree of information bears more trading expenditure. It is predicted that the liberalization of foreign exchange rate and fluctuated exchange rate system will jointly bring the enhancement of the fluidity of the exchange rate and the amount of exchange trade. The change of this system will bring the rise of participators in foreign exchange market; meanwhile, it will also initiate superfluous fluidity of foreign exchange market. In order to overcome this problem, the government needs to implement the development strategy of the understructure of the foreign exchange market and the enterprises need to carry through systemic exchange rate risk control.

  3. Abdominoplasty: Risk Factors, Complication Rates, and Safety of Combined Procedures.

    Science.gov (United States)

    Winocour, Julian; Gupta, Varun; Ramirez, J Roberto; Shack, R Bruce; Grotting, James C; Higdon, K Kye

    2015-11-01

    Among aesthetic surgery procedures, abdominoplasty is associated with a higher complication rate, but previous studies are limited by small sample sizes or single-institution experience. A cohort of patients who underwent abdominoplasty between 2008 and 2013 was identified from the CosmetAssure database. Major complications were recorded. Univariate and multivariate analysis was performed evaluating risk factors, including age, smoking, body mass index, sex, diabetes, type of surgical facility, and combined procedures. The authors identified 25,478 abdominoplasties from 183,914 procedures in the database. Of these, 8,975 patients had abdominoplasty alone and 16,503 underwent additional procedures. The number of complications recorded was 1,012 (4.0 percent overall rate versus 1.4 percent in other aesthetic surgery procedures). Of these, 31.5 percent were hematomas, 27.2 percent were infections and 20.2 percent were suspected or confirmed venous thromboembolism. On multivariate analysis, significant risk factors (p procedures (1.5), and procedure performance in a hospital or surgical center versus office-based surgical suite (1.6). Combined procedures increased the risk of complication (abdominoplasty alone, 3.1 percent; with liposuction, 3.8 percent; breast procedure, 4.3 percent; liposuction and breast procedure, 4.6 percent; body-contouring procedure, 6.8 percent; liposuction and body-contouring procedure, 10.4 percent). Abdominoplasty is associated with a higher complication rate compared with other aesthetic procedures. Combined procedures can significantly increase complication rates and should be considered carefully in higher risk patients. Risk, II.

  4. Recovering Risk-Neutral Densities from Brazilian Interest Rate Options

    Directory of Open Access Journals (Sweden)

    José Renato Haas Ornelas

    2011-03-01

    Full Text Available Building Risk-Neutral Density (RND from options data is one useful way for extracting market expectations about a financial variable. For a sample of IDI (Brazilian Interbank Deposit Rate Index options from 1998 to 2009, this paper estimates the option-implied Risk-Neutral Densities for the Brazilian short rate using three methods: Shimko, Mixture of Two Log-Normals and Generalized Beta of Second Kind. Our in-sample goodness-of-fit evaluation shows that the Mixture of Log-Normals method provides better fitting to option’s data than the other two methods. The shape of log-normal distributions seems to fit well to the mean-reversal dynamics of Brazilian interest rates. We have also calculated the RND implied Skewness, showing how it could have provided market early-warning signals of the monetary policy outcomes in 2002 and 2003. Overall, Risk-Neutral Densities implied on IDI options showed to be a useful tool for extracting market expectations about future outcomes of the monetary policy.

  5. Risk Analysis using Corrosion Rate Parameter on Gas Transmission Pipeline

    Science.gov (United States)

    Sasikirono, B.; Kim, S. J.; Haryadi, G. D.; Huda, A.

    2017-05-01

    In the oil and gas industry, the pipeline is a major component in the transmission and distribution process of oil and gas. Oil and gas distribution process sometimes performed past the pipeline across the various types of environmental conditions. Therefore, in the transmission and distribution process of oil and gas, a pipeline should operate safely so that it does not harm the surrounding environment. Corrosion is still a major cause of failure in some components of the equipment in a production facility. In pipeline systems, corrosion can cause failures in the wall and damage to the pipeline. Therefore it takes care and periodic inspections or checks on the pipeline system. Every production facility in an industry has a level of risk for damage which is a result of the opportunities and consequences of damage caused. The purpose of this research is to analyze the level of risk of 20-inch Natural Gas Transmission Pipeline using Risk-based inspection semi-quantitative based on API 581 associated with the likelihood of failure and the consequences of the failure of a component of the equipment. Then the result is used to determine the next inspection plans. Nine pipeline components were observed, such as a straight pipes inlet, connection tee, and straight pipes outlet. The risk assessment level of the nine pipeline’s components is presented in a risk matrix. The risk level of components is examined at medium risk levels. The failure mechanism that is used in this research is the mechanism of thinning. Based on the results of corrosion rate calculation, remaining pipeline components age can be obtained, so the remaining lifetime of pipeline components are known. The calculation of remaining lifetime obtained and the results vary for each component. Next step is planning the inspection of pipeline components by NDT external methods.

  6. 13 CFR 120.1500 - Types of enforcement actions-SBA Lenders.

    Science.gov (United States)

    2010-01-01

    ... general partner, a manager, an employee, an agent or other participant in the affairs of an SBA Lender's... termination. SBA may institute a civil action to terminate the rights, privileges, and franchises of an SBLC...

  7. Basal metabolic rate and risk-taking behaviour in birds.

    Science.gov (United States)

    Møller, A P

    2009-12-01

    Basal metabolic rate (BMR) constitutes the minimal metabolic rate in the zone of thermo-neutrality, where heat production is not elevated for temperature regulation. BMR thus constitutes the minimum metabolic rate that is required for maintenance. Interspecific variation in BMR in birds is correlated with food habits, climate, habitat, flight activity, torpor, altitude, and migration, although the selective forces involved in the evolution of these presumed adaptations are not always obvious. I suggest that BMR constitutes the minimum level required for maintenance, and that variation in this minimum level reflects the fitness costs and benefits in terms of ability to respond to selective agents like predators, implying that an elevated level of BMR is a cost of wariness towards predators. This hypothesis predicts a positive relationship between BMR and measures of risk taking such as flight initiation distance (FID) of individuals approached by a potential predator. Consistent with this suggestion, I show in a comparative analysis of 76 bird species that species with higher BMR for their body mass have longer FID when approached by a potential predator. This effect was independent of potentially confounding variables and similarity among species due to common phylogenetic descent. These results imply that BMR is positively related to risk-taking behaviour, and that predation constitutes a neglected factor in the evolution of BMR.

  8. Multifractality and value-at-risk forecasting of exchange rates

    Science.gov (United States)

    Batten, Jonathan A.; Kinateder, Harald; Wagner, Niklas

    2014-05-01

    This paper addresses market risk prediction for high frequency foreign exchange rates under nonlinear risk scaling behaviour. We use a modified version of the multifractal model of asset returns (MMAR) where trading time is represented by the series of volume ticks. Our dataset consists of 138,418 5-min round-the-clock observations of EUR/USD spot quotes and trading ticks during the period January 5, 2006 to December 31, 2007. Considering fat-tails, long-range dependence as well as scale inconsistency with the MMAR, we derive out-of-sample value-at-risk (VaR) forecasts and compare our approach to historical simulation as well as a benchmark GARCH(1,1) location-scale VaR model. Our findings underline that the multifractal properties in EUR/USD returns in fact have notable risk management implications. The MMAR approach is a parsimonious model which produces admissible VaR forecasts at the 12-h forecast horizon. For the daily horizon, the MMAR outperforms both alternatives based on conditional as well as unconditional coverage statistics.

  9. Worst-Case Portfolio Optimization under Stochastic Interest Rate Risk

    Directory of Open Access Journals (Sweden)

    Tina Engler

    2014-12-01

    Full Text Available We investigate a portfolio optimization problem under the threat of a market crash, where the interest rate of the bond is modeled as a Vasicek process, which is correlated with the stock price process. We adopt a non-probabilistic worst-case approach for the height and time of the market crash. On a given time horizon [0; T], we then maximize the investor’s expected utility of terminal wealth in the worst-case crash scenario. Our main result is an explicit characterization of the worst-case optimal portfolio strategy for the class of HARA (hyperbolic absolute risk aversion utility functions.

  10. Risks to health from radiation at low dose rates

    International Nuclear Information System (INIS)

    Gentner, N.E.; Osborne, R.V.

    1997-01-01

    Our focus is on whether, using a balance-of-evidence approach, it is possible to say that at a low enough dose, or at a sufficiently low dose rate, radiation risk reduces to zero in a population. We conclude that insufficient evidence exists at present to support such a conclusion. In part this reflects statistical limitations at low doses, and in part (although mechanisms unquestionably exist to protect us against much of the damage induced by ionizing radiation) the biological heterogeneity of human populations, which means these mechanisms do not act in all members of the population at all times. If it is going to be possible to demonstrate that low doses are less dangerous than we presently assume, the evidence, paradoxically, will likely come from studies of higher dose and dose rate scenarios than are encountered occupationally. (author)

  11. Modelling Counterparty Credit Risk in Czech Interest Rate Swaps

    Directory of Open Access Journals (Sweden)

    Lenka Křivánková

    2017-01-01

    Full Text Available According to the Basel Committee’s estimate, three quarters of counterparty credit risk losses during the financial crisis in 2008 originate from credit valuation adjustment’s losses and not from actual defaults. Therefore, from 2015, the Third Basel Accord (EU, 2013a and (EU, 2013b instructed banks to calculate the capital requirement for the risk of credit valuation adjustment (CVA. Banks are trying to model CVA to hold the prescribed standards and also reach the lowest possible impact on their profit. In this paper, we try to model CVA using methods that are in compliance with the prescribed standards and also achieve the smallest possible impact on the bank’s earnings. To do so, a data set of interest rate swaps from 2015 is used. The interest rate term structure is simulated using the Hull-White one-factor model and Monte Carlo methods. Then, the probability of default for each counterparty is constructed. A safe level of CVA is reached in spite of the calculated the CVA achieving a lower level than CVA previously used by the bank. This allows a reduction of capital requirements for banks.

  12. Interest rate risk measurement in Brazilian sovereign markets

    Directory of Open Access Journals (Sweden)

    Caio Ibsen Rodrigues de Almeida

    2004-06-01

    Full Text Available Fixed income emerging markets are an interesting investment alternative. Measuring market risks is mandatory in order to avoid unexpected huge losses. The most used market risk measure is the Value at Risk, based on the profit-loss probability distribution of the portfolio under consideration. Estimating this probability distribution requires the prior estimation of the probability distribution of term structures of interest rates. An interesting possibility is to estimate term structures using a decomposition of the spread function into a linear combination of Legendre polynomials. Numerical examples from the Brazilian sovereign fixed income international market illustrate the practical use of the methodology.Os mercados emergentes de renda fixa são alternativas interessantes para investimentos. Devido ao elevado nível de incerteza existente em tais mercados, a mensuração dos riscos de mercado de uma carteira de investimentos é fundamental para que se evite um nível elevado de perdas. Uma das medidas de risco de mercado mais utilizadas é o Value at Risk, baseado na distribuição de probabilidades de perdas-ganhos da carteira sob análise. A estimação desta distribuição requer, no entanto, a estimação prévia da distribuição de pro-babilidades das variações da estrutura a termo da taxa de juros. Uma possibilidade interessante para a estimação de tal distribuição é efetuar uma decomposição da função de spread da estrutura a termo em uma combinação linear de Polinômios de Legendre. Exemplos numéricos do mercado internacional de títulos soberanos brasileiros são apresentados para ilustrar o uso prático desta nova metodologia.

  13. Asset backed securities : risks, ratings and quantitative modelling

    NARCIS (Netherlands)

    Jönsson, B.H.B.; Schoutens, W.

    2009-01-01

    Asset backed securities (ABSs) are structured finance products backed by pools of assets and are created through a securitisation process. The risks in asset backed securities, such as, credit risk, prepayment risk, market risks, operational risk, and legal risks, are directly connected with the

  14. Alarming of exchange rate crisis: A risk management approach

    Directory of Open Access Journals (Sweden)

    Da Zhao

    2016-05-01

    Full Text Available Recently, with increasing volatility of foreign exchange rate, risk management becomes more and more important not only for multinational companies and individuals but also for central governments. This paper attempts to build an econometrics model so as to forecast and manage risks in foreign exchange market, especially during the eve of turbulent periods. By following McNeil and Frey’s (2000 two stage approach called conditional EVT to estimate dynamic VaR commonly used in stock and insurance markets, we extend it by applying a more general asymmetric ARMA-GARCH model to analyze daily foreign exchange dollar-denominated trading data from four countries of different development levels across Asia and Europe for a period of more than 10 years from January 03, 2005 to May 29, 2015, which is certainly representative of global markets. Conventionally, different kinds of backtesting methods are implemented ultimately to evaluate how well the model behaves. Inspiringly, test results show that by taking several specific characteristics (including fat-tails, asymmetry and long-range dependence of the foreign exchange market return data into consideration, the violation ratio of out-of-sample data can be forecasted very well for both fixed and flexible foreign exchange regimes. Moreover, all of the violations are evenly distributed along the whole period which indicates another favorable property of our model. Meanwhile, we find evidence of asymmetry volatility in all of the studied foreign exchange markets even though the magnitudes of the most of them are weak

  15. Injury rates and risk factors in competitive professional boxing.

    Science.gov (United States)

    Zazryn, Tsharni R; McCrory, Paul R; Cameron, Peter A

    2009-01-01

    To determine injury rates and risk factors for injury in a cohort of professional boxers. Retrospective cohort design reporting on data collected for a fight statistics database maintained by the Professional Boxing and Combat Sports Board of Victoria, Australia. Data were extracted for the years January 1997 through June 2005. Victoria, Australia. 545 professional boxers (age, 18 to 43 years) who participated in a total of 907 fights over the study period. Independent variables under investigation included age, gender, weight, bout exposure, and location of the bout (within or outside of the State of Victoria). Physician-reported acute boxing injuries occurring during bouts of any region or nature. 214 injuries were sustained over the 8.5 years, corresponding to an injury rate of 23.6 per 100 professional fights. The majority of these injuries were lacerations to the head and face. An increasing age and an increasing number of fights were both significant predictors of injury. Injury reduction strategies for professional boxing might include restrictions of eligibility to fight based on age and boxing bout exposure. Future research using prospective cohort designs and standardized injury definitions are needed to confirm these results. Greater mechanistic detail and more complete data entry are necessary to ensure that optimal injury prevention strategies can be developed and implemented. Upon confirmation of the results of this study, the Professional Boxing and Combat Sports Board of Victoria may consider different criteria upon which to sanction a fight.

  16. Gambling disorder: estimated prevalence rates and risk factors in Macao.

    Science.gov (United States)

    Wu, Anise M S; Lai, Mark H C; Tong, Kwok-Kit

    2014-12-01

    An excessive, problematic gambling pattern has been regarded as a mental disorder in the Diagnostic and Statistical Manual for Mental Disorders (DSM) for more than 3 decades (American Psychiatric Association [APA], 1980). In this study, its latest prevalence in Macao (one of very few cities with legalized gambling in China and the Far East) was estimated with 2 major changes in the diagnostic criteria, suggested by the 5th edition of DSM (APA, 2013): (a) removing the "Illegal Act" criterion, and (b) lowering the threshold for diagnosis. A random, representative sample of 1,018 Macao residents was surveyed with a phone poll design in January 2013. After the 2 changes were adopted, the present study showed that the estimated prevalence rate of gambling disorder was 2.1% of the Macao adult population. Moreover, the present findings also provided empirical support to the application of these 2 recommended changes when assessing symptoms of gambling disorder among Chinese community adults. Personal risk factors of gambling disorder, namely being male, having low education, a preference for casino gambling, as well as high materialism, were identified.

  17. 25 CFR 103.36 - What options and remedies does the lender have if the borrower defaults on the loan?

    Science.gov (United States)

    2010-04-01

    ... result in the borrower curing the default. (b) The lender may make precautionary advances on the borrower... prospects do not significantly deteriorate. Items for which the lender may make precautionary advances include, for example: (1) Hazard, liability, or key man life insurance premiums; (2) Security measures to...

  18. 12 CFR 617.7315 - What records must the qualified lender maintain on behalf of the CRC?

    Science.gov (United States)

    2010-01-01

    ... on behalf of the CRC? 617.7315 Section 617.7315 Banks and Banking FARM CREDIT ADMINISTRATION FARM... must the qualified lender maintain on behalf of the CRC? A qualified lender must maintain a complete file of all requests for CRC reviews, including participation in state mediation programs, the minutes...

  19. 25 CFR 103.39 - When will BIA refuse to pay all or part of a lender's claim?

    Science.gov (United States)

    2010-04-01

    ... to liquidate loan collateral, and: (1) The lender has not made a reasonable effort to liquidate all... from collateral liquidation proceeds applied to the loan balance; or (e) The lender has otherwise... ACTIVITIES LOAN GUARANTY, INSURANCE, AND INTEREST SUBSIDY Default and Payment by BIA § 103.39 When will BIA...

  20. 25 CFR 103.19 - When must the lender pay BIA the loan guaranty or insurance premium?

    Science.gov (United States)

    2010-04-01

    ... insurance premium? 103.19 Section 103.19 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES LOAN GUARANTY, INSURANCE, AND INTEREST SUBSIDY How a Lender Obtains a Loan Guaranty or Insurance Coverage § 103.19 When must the lender pay BIA the loan guaranty or insurance premium? The premium...

  1. 12 CFR 652.15 - Interest rate risk management and requirements.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Interest rate risk management and requirements... AGRICULTURAL MORTGAGE CORPORATION FUNDING AND FISCAL AFFAIRS Investment Management § 652.15 Interest rate risk... (direction, controls, and supervision) to the interest rate risk management program and must be knowledgeable...

  2. 7 CFR 4279.125 - Interest rates.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Interest rates. 4279.125 Section 4279.125 Agriculture... Interest rates. The interest rate for the guaranteed loan will be negotiated between the lender and the applicant and may be either fixed or variable as long as it is a legal rate. Interest rates will not be more...

  3. 7 CFR 1980.320 - Interest rate.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true Interest rate. 1980.320 Section 1980.320 Agriculture... REGULATIONS (CONTINUED) GENERAL Rural Housing Loans § 1980.320 Interest rate. The interest rate must not... interest rate over the life of the loan. The rate shall be agreed upon by the borrower and the Lender and...

  4. 7 CFR 3575.33 - Interest rates.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Interest rates. 3575.33 Section 3575.33 Agriculture... GENERAL Community Programs Guaranteed Loans § 3575.33 Interest rates. (a) General. Rates will be negotiated between the lender and the borrower. They may be either fixed or variable rates. Interest rates...

  5. 77 FR 5155 - Interest Rate Risk Policy and Program

    Science.gov (United States)

    2012-02-02

    ... directors and management; appropriate IRR measurement and monitoring systems; good internal controls; and... Systems B. Risk Measurement Methods C. Components of IRR Measurement Methods V. Internal Controls VI... risk management and a program to effectively implement that policy, as part of their asset liability...

  6. Essays on long-term mortality and interest rate risk

    NARCIS (Netherlands)

    de Kort, J.P.

    2017-01-01

    This dissertation comprises a study of long-term risks which play a major role in actuarial science. In Part I we analyse long-term mortality risk and its impact on consumption and investment decisions of economic agents, while Part II focuses on the mathematical modelling of long-term interest

  7. Carbon recovery rates following different wildfire risk mitigation treatments

    Science.gov (United States)

    M. Hurteau; M. North

    2010-01-01

    Sequestered forest carbon can provide a climate change mitigation benefit, but in dry temperate forests, wildfire poses a reversal risk to carbon offset projects. Reducing wildfire risk requires a reduction in and redistribution of carbon stocks, the benefit of which is only realized when wildfire occurs. To estimate the time needed to recover carbon removed and...

  8. 12 CFR 614.4155 - Interest rates.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Interest rates. 614.4155 Section 614.4155 Banks... Policies for Banks and Associations § 614.4155 Interest rates. Loans made by each bank and direct lender association shall bear interest at a rate or rates as may be determined by the institution board. The board...

  9. 12 CFR 615.5180 - Interest rate risk management by banks-general.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Interest rate risk management by banks-general... FISCAL AFFAIRS, LOAN POLICIES AND OPERATIONS, AND FUNDING OPERATIONS Risk Assessment and Management § 615.5180 Interest rate risk management by banks—general. The board of directors of each Farm Credit Bank...

  10. 12 CFR 563.176 - Interest-rate-risk-management procedures.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Interest-rate-risk-management procedures. 563... ASSOCIATIONS-OPERATIONS Financial Management Policies § 563.176 Interest-rate-risk-management procedures... association's management of that risk. (b) The board of directors shall formerly adopt a policy for the...

  11. 12 CFR 615.5181 - Bank interest rate risk management program.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Bank interest rate risk management program. 615... FISCAL AFFAIRS, LOAN POLICIES AND OPERATIONS, AND FUNDING OPERATIONS Risk Assessment and Management § 615.5181 Bank interest rate risk management program. (a) The board of directors of each Farm Credit Bank...

  12. 34 CFR 682.411 - Lender due diligence in collecting guaranty agency loans.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Lender due diligence in collecting guaranty agency... due diligence in collecting guaranty agency loans. (a) General. In the event of delinquency on an FFEL... certification. (n) Due diligence for endorsers. (1) Before filing a default claim on a loan with an endorser...

  13. 34 CFR 601.12 - Use of institution and lender name.

    Science.gov (United States)

    2010-07-01

    ... such institution or organization, in the marketing of private education loans to students attending... 34 Education 3 2010-07-01 2010-07-01 false Use of institution and lender name. 601.12 Section 601.12 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF...

  14. 13 CFR 120.460 - What are SBA's additional requirements for SBA Supervised Lenders?

    Science.gov (United States)

    2010-01-01

    ... company and does not have its own board of directors) must adopt an internal control policy which provides... the SBA Supervised Lender regulations that follow. (b) Operations and internal controls. Each SBA... operations, programs, and resources. The internal control policy must, at a minimum: (1) Direct management to...

  15. 75 FR 80516 - Notice of Submission of Proposed Information Collection to OMB; Lender Qualifications for...

    Science.gov (United States)

    2010-12-22

    ... Proposed Information Collection to OMB; Lender Qualifications for Multifamily Accelerated Processing (MAP) AGENCY: Office of the Chief Information Officer, HUD. ACTION: Notice. SUMMARY: The proposed information... Number: 2502-0541. Form Numbers: None. Description of the Need for the Information and Its Proposed Use...

  16. 12 CFR 617.7415 - How does a qualified lender decide to restructure a loan?

    Science.gov (United States)

    2010-01-01

    ... restructure a loan? 617.7415 Section 617.7415 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM BORROWER RIGHTS Distressed Loan Restructuring; State Agricultural Loan Mediation Programs § 617.7415 How... the cost to the lender of restructuring the loan is equal to or less than the cost of foreclosure...

  17. 13 CFR 120.920 - Required participation by the Third Party Lender.

    Science.gov (United States)

    2010-01-01

    ...) Third Party Loan collateral. Third Party Loans usually are collateralized by a first lien on the Project... BUSINESS LOANS Development Company Loan Program (504) Third Party Loans § 120.920 Required participation by the Third Party Lender. (a) Amount of Third Party Loans. A Project financing must include one or more...

  18. 25 CFR 103.17 - Must the lender follow any special procedures to close the loan?

    Science.gov (United States)

    2010-04-01

    ... searches for each asset to be used as loan collateral. (c) At or prior to closing, the lender must obtain recent appraisals for all real property and improvements to be used as collateral for the loan, to the... instruments designed to document the loan, establish the basis for a security interest in loan collateral, and...

  19. Lending Policies of Informal, Formal, and Semi-formal Lenders: Evidence from Vietnam

    NARCIS (Netherlands)

    Lensink, B.W.; Pham, T.T.T.

    2007-01-01

    This paper compares lending policies of formal, informal and semiformal lenders with respect to household lending in Vietnam. The analysis suggests that the probability of using formal or semiformal credit increases if borrowers provide collateral, a guarantor and/or borrow for business-related

  20. Lending policies of informal, formal and semiformal lenders - Evidence from Vietnam

    NARCIS (Netherlands)

    Pham, Thi Thu Tra; Lensink, Robert

    2007-01-01

    This paper compares lending policies of formal, informal and semiformal lenders with respect to household lending in Vietnam. The analysis suggests that the probability of using formal or semiformal credit increases if borrowers provide collateral, a guarantor and/or borrow for business-related

  1. 24 CFR 1007.70 - Disqualification of lenders and civil money penalties.

    Science.gov (United States)

    2010-04-01

    ... civil money penalties. 1007.70 Section 1007.70 Housing and Urban Development Regulations Relating to....70 Disqualification of lenders and civil money penalties. (a) In general—(1) Grounds for action. HUD... or holder that are guaranteed under this part. (b) Civil money penalties for intentional violations...

  2. 76 FR 71329 - Request for Information Regarding Private Education Loans and Private Educational Lenders

    Science.gov (United States)

    2011-11-17

    ... Regarding Private Education Loans and Private Educational Lenders AGENCY: Bureau of Consumer Financial... Justice and the Federal Trade Commission, to prepare a Report on Private Education Loans and Private... Justice and the Federal Trade Commission, to prepare a Report on Private Education Loans and Private...

  3. Crisis management and lender of last resort in the European banking market

    NARCIS (Netherlands)

    Boot, A.W.A.; Marinč, M.

    2008-01-01

    We discuss some key issues related to supervisory arrangements in the Euro-system countries. In particular, we address the lender of last resort (LOLR) structure and the related crisis management framework. We focus on the responsibilities and powers of individual countries (and national central

  4. Crisis management and lender of last resort in the European banking market

    NARCIS (Netherlands)

    Boot, A.W.A.; Marinč, M.; Alessandrini, P.; Fratianni, M.; Zazzaro, A.

    2009-01-01

    We discuss some key issues related to supervisory arrangements in the Euro-system countries. In particular, we address the lender of last resort (LOLR) structure and the related crisis management framework. We focus on the responsibilities and powers of individual countries (and national central

  5. Taming agricultural risks

    OpenAIRE

    Oppedahl, David B.

    2014-01-01

    On November 19, 2013, the Federal Reserve Bank of Chicago held a conference to explore the key risks faced by agricultural producers and lenders, as well as the risk-management tools available to them, in today’s volatile environment.

  6. Agreement in cardiovascular risk rating based on anthropometric parameters

    International Nuclear Information System (INIS)

    Dantas, Endilly Maria da Silva; Pinto, Cristiane Jordânia; Freitas, Rodrigo Pegado de Abreu; Medeiros, Anna Cecília Queiroz de

    2015-01-01

    To investigate the agreement in evaluation of risk of developing cardiovascular diseases based on anthropometric parameters in young adults. The study included 406 students, measuring weight, height, and waist and neck circumferences. Waist-to-height ratio and the conicity index. The kappa coefficient was used to assess agreement in risk classification for cardiovascular diseases. The positive and negative specific agreement values were calculated as well. The Pearson chi-square (χ"2) test was used to assess associations between categorical variables (p<0.05). The majority of the parameters assessed (44%) showed slight (k=0.21 to 0.40) and/or poor agreement (k<0.20), with low values of negative specific agreement. The best agreement was observed between waist circumference and waist-to-height ratio both for the general population (k=0.88) and between sexes (k=0.93 to 0.86). There was a significant association (p<0.001) between the risk of cardiovascular diseases and females when using waist circumference and conicity index, and with males when using neck circumference. This resulted in a wide variation in the prevalence of cardiovascular disease risk (5.5%-36.5%), depending on the parameter and the sex that was assessed. The results indicate variability in agreement in assessing risk for cardiovascular diseases, based on anthropometric parameters, and which also seems to be influenced by sex. Further studies in the Brazilian population are required to better understand this issue

  7. Agreement in cardiovascular risk rating based on anthropometric parameters

    Energy Technology Data Exchange (ETDEWEB)

    Dantas, Endilly Maria da Silva; Pinto, Cristiane Jordânia; Freitas, Rodrigo Pegado de Abreu; Medeiros, Anna Cecília Queiroz de [Universidade Federal do Rio Grande do Norte, Natal, RN (Brazil)

    2015-07-01

    To investigate the agreement in evaluation of risk of developing cardiovascular diseases based on anthropometric parameters in young adults. The study included 406 students, measuring weight, height, and waist and neck circumferences. Waist-to-height ratio and the conicity index. The kappa coefficient was used to assess agreement in risk classification for cardiovascular diseases. The positive and negative specific agreement values were calculated as well. The Pearson chi-square (χ{sup 2}) test was used to assess associations between categorical variables (p<0.05). The majority of the parameters assessed (44%) showed slight (k=0.21 to 0.40) and/or poor agreement (k<0.20), with low values of negative specific agreement. The best agreement was observed between waist circumference and waist-to-height ratio both for the general population (k=0.88) and between sexes (k=0.93 to 0.86). There was a significant association (p<0.001) between the risk of cardiovascular diseases and females when using waist circumference and conicity index, and with males when using neck circumference. This resulted in a wide variation in the prevalence of cardiovascular disease risk (5.5%-36.5%), depending on the parameter and the sex that was assessed. The results indicate variability in agreement in assessing risk for cardiovascular diseases, based on anthropometric parameters, and which also seems to be influenced by sex. Further studies in the Brazilian population are required to better understand this issue.

  8. Risk of solid cancer in low dose-rate radiation epidemiological studies and the dose-rate effectiveness factor.

    Science.gov (United States)

    Shore, Roy; Walsh, Linda; Azizova, Tamara; Rühm, Werner

    2017-10-01

    Estimated radiation risks used for radiation protection purposes have been based primarily on the Life Span Study (LSS) of atomic bomb survivors who received brief exposures at high dose rates, many with high doses. Information is needed regarding radiation risks from low dose-rate (LDR) exposures to low linear-energy-transfer (low-LET) radiation. We conducted a meta-analysis of LDR epidemiologic studies that provide dose-response estimates of total solid cancer risk in adulthood in comparison to corresponding LSS risks, in order to estimate a dose rate effectiveness factor (DREF). We identified 22 LDR studies with dose-response risk estimates for solid cancer after minimizing information overlap. For each study, a parallel risk estimate was derived from the LSS risk model using matching values for sex, mean ages at first exposure and attained age, targeted cancer types, and accounting for type of dosimetric assessment. For each LDR study, a ratio of the excess relative risk per Gy (ERR Gy -1 ) to the matching LSS ERR risk estimate (LDR/LSS) was calculated, and a meta-analysis of the risk ratios was conducted. The reciprocal of the resultant risk ratio provided an estimate of the DREF. The meta-analysis showed a LDR/LSS risk ratio of 0.36 (95% confidence interval [CI] 0.14, 0.57) for the 19 studies of solid cancer mortality and 0.33 (95% CI 0.13, 0.54) when three cohorts with only incidence data also were added, implying a DREF with values around 3, but statistically compatible with 2. However, the analyses were highly dominated by the Mayak worker study. When the Mayak study was excluded the LDR/LSS risk ratios increased: 1.12 (95% CI 0.40, 1.84) for mortality and 0.54 (95% CI 0.09, 0.99) for mortality + incidence, implying a lower DREF in the range of 1-2. Meta-analyses that included only cohorts in which the mean dose was LDR data provide direct evidence regarding risk from exposures at low dose rates as an important complement to the LSS risk estimates used

  9. Bank Credit Risk Management and Rating Migration Analysis on the Business Cycle

    Directory of Open Access Journals (Sweden)

    Dimitris Gavalas

    2014-03-01

    Full Text Available Credit risk measurement remains a critical field of top priority in banking finance, directly implicated in the recent global financial crisis. This paper examines the dynamic linkages between credit risk migration due to rating shifts and prevailing macroeconomic conditions, reflected in alternative business cycle states. An innovative empirical methodology applies to bank internal rating data, under different economic scenarios and investigates the implications of credit risk quality shifts for risk rating transition matrices. The empirical findings are useful and critical for banks to align to Basel guidelines in relation to core capital requirements and risk-weighted assets in the underlying loan portfolio.

  10. 24 CFR 232.560 - Interest rate.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Interest rate. 232.560 Section 232... Equipment Eligible Security Instruments § 232.560 Interest rate. (a) The loan shall bear interest at the rate agreed upon by the lender and the borrower. (b) Interest shall be payable in monthly installments...

  11. Medicine and ionizing rays: a help sheet in analysing risks in high rate curietherapy

    International Nuclear Information System (INIS)

    Gauron, C.

    2009-01-01

    This document proposes a synthesis of useful knowledge for radioprotection in the case of high rate curietherapy. Several aspects are considered: the concerned personnel, the course of treatment procedures, the hazards, the identification of the risk associated with ionizing radiation, the risk assessment and the determination of exposure levels, the strategy to control the risks (reduction of risks, technical measures concerning the installation or the personnel, teaching and information, prevention and medical monitoring), and risk control assessment

  12. Medicine and ionizing rays: a help sheet in analysing risks in pulsed rate curietherapy

    International Nuclear Information System (INIS)

    Gauron, C.

    2009-01-01

    This document proposes a synthesis of useful knowledge for radioprotection in the case of pulsed rate curietherapy. Several aspects are considered: the concerned personnel, the course of treatment procedures, the hazards, the identification of the risk associated with ionizing radiation, the risk assessment and the determination of exposure levels, the strategy to control the risks (reduction of risks, technical measures concerning the installation or the personnel, teaching and information, prevention and medical monitoring), and risk control assessment

  13. Hospital ownership: a risk factor for nosocomial infection rates?

    Science.gov (United States)

    Schröder, C; Behnke, M; Geffers, C; Gastmeier, P

    2018-03-26

    In some countries, a relationship between hospital ownership and the occurrence of healthcare-associated infection (HCAI) rates has been described. To investigate the association between hospital ownership and occurrence of HCAI in Germany. Five different components of the German national nosocomial infection surveillance system were analysed with regard to the influence of hospital ownership in the period 2014-2016. Endpoints included ventilator-associated pneumonia, central-venous-catheter-associated bloodstream infections, urinary-catheter-associated urinary tract infections, surgical site infections (SSI) following hip prosthesis and colon surgery, meticillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile infections (CDI) and hand rub consumption per 1000 patient-days. Three hospital ownership types (public, non-profit and private) were analysed using univariate and multi-variate methods. The distribution of hospitals according to the three ownership types was similar in all components. In total, 661 intensive care units (ICUs), 149 departments performing colon procedures, and 349 departments performing hip prosthesis were included. In addition, 568 hospitals provided their MRSA rates and 236 provided their CDI rates, and 1833 ICUs and 12,934 non-ICUs provided their hand rub consumption data. In general, the differences between the hospital types were rather small and not significant for the ICUs. In the multi-variate analysis, public hospitals had a lower SSI rate following hip prosthesis (odds ratio 0.80, 95% confidence interval 0.65-0.99). Hospital ownership was not found to have a major influence on the incidence of HCAI in Germany. Copyright © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  14. Vaccination rates among the general adult population and high-risk groups in the United States.

    Directory of Open Access Journals (Sweden)

    Kathy Annunziata

    Full Text Available BACKGROUND: In order to adequately assess the effectiveness of vaccination in helping to control vaccine-preventable infectious disease, it is important to identify the adherence and uptake of risk-based recommendations. METHODS: The current project includes data from five consecutive datasets of the National Health and Wellness Survey (NHWS: 2007 through 2011. The NHWS is an annual, Internet-based health questionnaire, administered to a nationwide sample of adults (aged 18 or older which included items on vaccination history as well as high-risk group status. Vaccination rates and characteristics of vaccinees were reported descriptively. Logistic regressions were conducted to predict vaccination behavior from sociodemographics and risk-related variables. RESULTS: The influenza vaccination rate for all adults 18 years and older has increased significantly from 28.0% to 36.2% from 2007 to 2011 (ps<.05. Compared with those not at high risk (25.1%, all high-risk groups were vaccinated at a higher rate, from 36.8% (pregnant women to 69.7% (those with renal/kidney disease; however, considerable variability among high-risk groups was observed. Vaccination rates among high-risk groups for other vaccines varied considerably though all were below 50%, with the exception of immunocompromised respondents (57.5% for the hepatitis B vaccine and 52.5% for the pneumococcal vaccine and the elderly (50.4% for the pneumococcal. Multiple risk factors were associated with increased rate of vaccination for most vaccines. Significant racial/ethnic differences with influenza, hepatitis, and herpes zoster vaccination rates were also observed (ps<.05. CONCLUSIONS: Rates of influenza vaccination have increased over time. Rates varied by high-risk status, demographics, and vaccine. There was a pattern of modest vaccination rate increases for individuals with multiple risk factors. However, there were relatively low rates of vaccination for most risk-based recommendations

  15. Stochastic Discount Factor Approach to International Risk-Sharing: Evidence from Fixed Exchange Rate Episodes

    NARCIS (Netherlands)

    Hadzi-Vaskov, M.; Kool, C.J.M.

    2007-01-01

    This paper presents evidence of the stochastic discount factor approach to international risk-sharing applied to fixed exchange rate regimes. We calculate risk-sharing indices for two episodes of fixed or very rigid exchange rates: the Eurozone before and after the introduction of the Euro, and

  16. Study the rate of fertility and risk factors of schizophrenia in Najaf, Iraq

    African Journals Online (AJOL)

    This study is designed to investigate the main risk factors, which increased the incidence of schizophrenia and the rate of fertility in patients measuring sex hormones (testosterone and estrogen) and prolactin hormone. The aim of study was to evaluate the fertility rate and risk factors of schizophrenia. Blood samples were ...

  17. The impact of the European insolvency regulation on lenders, lending decisions, the structuring of transactions and enforcement of security

    OpenAIRE

    Sharma, R

    2011-01-01

    This Thesis seeks to shed light on the issue of how far secured creditor rights are protected in EU cross-border insolvencies by focusing on the perspective and position of English lenders. The main thread throughout is the legal concerns faced by lenders when lending to a company incorporated in England and Wales which operates across the European Union and has assets and creditors spread across various Member States. The initial stages of the structuring of a cross-border security arrangeme...

  18. Risk of Interest Rates at the Level of Commercial Banks in Romania

    Directory of Open Access Journals (Sweden)

    Sbârcea Ioana Raluca

    2017-12-01

    Full Text Available The banking system in Romania is a banking system under development, subject to fluctuations that exist on the market more than on more developed banking systems, fluctuations that can generate losses for banks if they are not properly managed. The losses that may be generated by these fluctuations, known as market risk, refer to the significant fluctuations in three indicators, namely the interest rate, the exchange rate and the asset price. In this article, I will analyse the interest rate risk from a conceptual point of view and the indicators that mitigate this risk. The analysis also contains a study of this risk among commercial banks in the system to highlight the level of risk and possible effects of its manifestation. I calculated and analysed the interest rate risk indicators, individually for the first three banks in the system, but also to comparatively, in order to highlight the existing differences.

  19. Financing biotechnology projects: lender due diligence requirements and the role of independent technical consultants.

    Science.gov (United States)

    Keller, J B; Plath, P B

    1999-01-01

    An increasing number of biotechnology projects are being brought to commercialization using conventional structured finance sources, which have traditionally only been available to proven technologies and primary industries. Attracting and securing competitive cost financing from mainstream lenders, however, will require the sponsor of a new technology or process to undergo a greater level of due diligence. The specific areas and intensity of investigation, which are typically required by lenders in order to secure long-term financing for biotechnology-based manufacturing systems, is reviewed. The processes for evaluating the adequacy of prior laboratory testing and pilot plant demonstrations is discussed. Particular emphasis is given to scale-up considerations and the ability of the proposed facility design to accommodate significant modifications, in the event that scale-up problems are encountered.

  20. The European central bank and the us federal reserve as lender of last resort

    Directory of Open Access Journals (Sweden)

    Herr Hansjörg

    2014-01-01

    Full Text Available Without a lender of last resort financial stability is not possible and systemic financial crises get out of control. During and after the Great Recession the US Federal Reserve System (Fed and the European Central Bank (ECB took on the role of lender of last resort in a comprehensive way. The Fed stabilised the financial system, including the shadow banking system. However, the chance to fundamentally restructure the financial system was not used. The ECB was confronted with sovereign debt crises and an incomplete integration of the European Monetary Union (EMU. It followed a kind of “muddling through” to keep the Euro area together. In the EMU not only a fundamental restructuring of the financial system is needed but also a deeper economic and political integration. The Fed and the ECB both were the most important institutions to avoid repetition of the 1930s.

  1. Transitional rates, risk and the Ontario wholesale power market

    International Nuclear Information System (INIS)

    Rothman, M.

    2001-01-01

    Navigant Consulting is a large investor-owned management consulting firm specializing in energy-based and other networked and regulated industries across Canada. The company works with clients to create delivery and protect shareholder value in the face of uncertainty and change. This presentation discussed the issue of price volatility in competitive electricity markets. The points to keep in mind for pricing in competitive power markets is that: (1) electricity should be generated simultaneously with use, (2) rates in administered markets are average over some time period, (3) competitive pool markets do not average costs, (4) in competitive pool markets, prices are set in very short (hourly or less) intervals, (5) prices in competitive markets are more volatile than in administered markets for both economic and market structure reasons, and (6) the degree of volatility and price levels can change quickly. The Ontario power market was also discussed with reference to price volatility in Ontario and what this means for electricity customers. tabs., figs

  2. Risk management under a two-factor model of the term structure of interest rates

    OpenAIRE

    Manuel Moreno

    1997-01-01

    This paper presents several applications to interest rate risk management based on a two-factor continuous-time model of the term structure of interest rates previously presented in Moreno (1996). This model assumes that default free discount bond prices are determined by the time to maturity and two factors, the long-term interest rate and the spread (difference between the long-term rate and the short-term (instantaneous) riskless rate). Several new measures of ``generalized duration" are p...

  3. Why borrowers pay premiums to larger lenders: Empirical evidence from sovereign syndicated loans

    OpenAIRE

    Hallak, Issam

    2002-01-01

    All other terms being equal (e.g. seniority), syndicated loan contracts provide larger lending compensations (in percentage points) to institutions funding larger amounts. This paper explores empirically the motivation for such a price design on a sample of sovereign syndicated loans in the period 1990-1997. I find strong evidence that a larger premium is associated with higher renegotiation probability and information asymmetries. It hardly has any impact on the number of lenders though. Thi...

  4. Structuring for technology risk

    International Nuclear Information System (INIS)

    Klapper, M.

    1993-01-01

    The Colver Power Project in Cambria County, PA, looked good in nearly all aspects, but lenders had concerns about startup problems encountered by earlier waste coal circulating fluidized bed projects. Nevertheless, a closer look at the operating history of the earlier plants showed possible risks could be handled

  5. The Exposure of Mortgage Borrowers to Interest Rate Risk, Income Risk and House Price Risk – Evidence from Swiss Loan Application Data

    OpenAIRE

    Guin, Benjamin; Brown, Martin

    2015-01-01

    We study the exposure of mortgage borrowers in Switzerland to interest rate, income and house price risks and examine how the households’ choice of risky mortgages is related to individual interest rate expectations and risk-aversion. Our analysis is based on a unique data set of household mortgage applications from September 2012 until January 2014. Our assessment of risk exposure among mortgage borrowers in Switzerland is highly sensitive to the underlying assumptions on mortgage costs, hou...

  6. Discount rates in risk versus money and money versus money tradeoffs.

    Science.gov (United States)

    Alberini, Anna; Chiabai, Aline

    2007-04-01

    We use data from a survey of residents of five Italian cities conducted in late spring 2004 to estimate the discount rates implicit in (1) money versus future risk reductions and (2) money versus money tradeoffs. We find that the mean personal discount rate is 0.3-1.7% in (1) and 8.7% in (2). The latter is lower than the discount rates estimated in comparable situations in many recent studies, greater than market interest rates in Italy at the time, and exhibits modest variation with age and gender. The discount rate implicit in money versus risk tradeoffs is within the range of estimates from studies in the United States and Europe, and does not depend on observable individual characteristics. We use split samples to investigate whether a completely abstract risk reduction - one where the risk reduction delivery has been stripped of all specifics, so that respondents should focus on the risks without being distracted by details - results in WTP and discount figures comparable to those from an identified delivery mechanism (a medical test). We find that while WTP for an immediate risk reduction is 42-73% higher with the abstract risk reduction, the discount rate in the money versus risk tradeoffs and the variance of the error term in the WTP equation are the same across the two variants of the questionnaire.

  7. Cash Flow and Discount Rate Risk in Up and Down Markets: What is actually priced?

    NARCIS (Netherlands)

    Botshekan, M.; Kraeussl, R.G.W.; Lucas, A.

    2012-01-01

    We test whether asymmetric preferences for losses versus gains affect the prices of cash flow versus discount rate risk. We construct a return decomposition distinguishing cash flow and discount rate betas in up and down markets. Using U.S. data, we find that downside cash flow and discount rate

  8. [C-section rate in low-risk women: a useful indicator to compare hospitals attending deliveries with different risks].

    Science.gov (United States)

    Librero, Julián; Peiró, Salvador; Belda, Ana; Calabuig, Julia

    2014-01-01

    the C-section rate has been criticized as a performance indicator for not considering that different hospitals manage deliveries with diverse risks. In this work we explore the characteristics of a new indicator restricted to low C-section risk deliveries. retrospective cohort of all births (n=214,611) in all public hospitals during 2005-2010 in the Valencia Region, Spain (source: minimum basic dataset). A low-risk subpopulation consisting of women under-35, no history of c-section, between 37 and 41 gestational weeks, and with a single fetus, with cephalic presentation and normal weight (2500-3999 g) was constructed. We analyzed variability in the new indicator, its correlation with the crude indicator and, using multilevel logistic regression models, the presence of residual risks. a total of 117 589 births (58.4% of the whole deliveries) were identified as low C-section risk. The c-section rate in these women was 11.9% (24.4% for all deliveries) ranging between hospitals from 7.0% to 28.9%. The c-section rate in low-risk and total deliveries correlated strongly (r=0.88). The remaining risks in the population of low risk did not alter the hospital effect on the c-section rate. the percentage of C-section in low risk women include a high volume of deliveries, correlated with the crude indicator and residual risks are not differentially influenced by hospitals, being a useful indicator for monitoring the quality of obstetric care in the National Health System.

  9. Information Acquisition and Excessive Risk: Impact of Policy Rate and Market Volatility

    Directory of Open Access Journals (Sweden)

    Volha Audzei

    2015-12-01

    Full Text Available Excessive risk-taking of financial agents drew a lot of attention in the aftermath of the financial crisis. Low interest rates and subdued market volatility during the Great Moderation are sometimes blamed for stimulating risk-taking and leading to the recent financial crisis. In recent years, with many central banks around the world conducting the policy of low interest rates and mitigating market risks, it has been debatable whether this policy contributes to the building up of another credit boom. This paper addresses this issue by focusing on information acquisition by the financial agents. We build a theoretical model which captures excessive risk taking in response to changes in policy rate and market volatility. This excessive risk takes the form of an increased risk appetite of the agents, but also of decreased incentives to acquire information about risky assets. As a result, with market risk being reduced, agents tend to acquire more risk in their portfolios then they would with the higher market risk. The same forces increase portfolio risk when the safe interest rate is falling. The robustness of the results is considered with different learning rules.

  10. The impact of item order on ratings of cancer risk perception.

    Science.gov (United States)

    Taylor, Kathryn L; Shelby, Rebecca A; Schwartz, Marc D; Ackerman, Josh; LaSalle, V Holland; Gelmann, Edward P; McGuire, Colleen

    2002-07-01

    Although perceived risk is central to most theories of health behavior, there is little consensus on its measurement with regard to item wording, response set, or the number of items to include. In a methodological assessment of perceived risk, we assessed the impact of changing the order of three commonly used perceived risk items: quantitative personal risk, quantitative population risk, and comparative risk. Participants were 432 men and women enrolled in an ancillary study of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Three groups of consecutively enrolled participants responded to the three items in one of three question orders. Results indicated that item order was related to the perceived risk ratings of both ovarian (P Perceptions of risk were significantly lower when the comparative rating was made first. The findings suggest that compelling participants to consider their own risk relative to the risk of others results in lower ratings of perceived risk. Although the use of multiple items may provide more information than when only a single method is used, different conclusions may be reached depending on the context in which an item is assessed.

  11. Corporate interest rate risk management with derivatives in Australia: empirical results

    Directory of Open Access Journals (Sweden)

    Luiz Augusto Ferreira Carneiro

    2008-04-01

    Full Text Available Financial and insurance theories explain that large widely-held corporations manage corporate risks if doing so is costective to reduce frictional costs such as taxes, agency costs and financial distress costs. A large number of previous empirical studies, most in the U.S., have tested the hypotheses underlying corporate risk management with financial derivative instruments. In order to quantify corporate hedge demand, most previous studies have used the ratio of principal notional amount of derivatives to company size, although they recognize that company size is not an appropriate proxy for financial risk. This paper analyzes the interest-rate-risk hedge demand by Australian companies, measured through the ratio of principal notional amount of interest rate derivatives to interest-rate-riskbearing liabilities. Modern panel data methods are used, with two panel data sets from 1998 to 2003 (1102 and 465 observations, respectively. Detailed information about interest-rate-risk exposures was available after manual data collection from financial annual reports, which was only possible due to specific reporting requirements in Australian accounting standards. Regarding the analysis of the extent of hedge, our measurement of interest-rate-risk exposures generates some significant results di erent from those found in previous studies. For example, this study shows that total leverage (total debt ratio is not significantly important to interest-rate-risk hedge demand and that, instead, this demand is related to the specific risk exposure in the interest bearing part of the firms liabilities. This study finds significant relations of interest-rate-risk hedge to company size, floating-interest-rate debt ratio, annual log returns, and company industry type (utilities and non-banking financial institutions.

  12. 12 CFR 615.5182 - Interest rate risk management by associations and other Farm Credit System institutions other...

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Interest rate risk management by associations... OPERATIONS, AND FUNDING OPERATIONS Risk Assessment and Management § 615.5182 Interest rate risk management by... shall comply with the requirements of §§ 615.5180 and 615.5181. The interest rate risk management...

  13. The association between social networks and self-rated risk of HIV ...

    African Journals Online (AJOL)

    Elizabeth J. Lyimo

    2014-03-18

    Mar 18, 2014 ... Bonding networks were defined as social groupings of students participating in activities ... bridging social networks and self-rated HIV risk behavior. ...... book for Theory and Research for the Sociology of Education, 241–258.

  14. Explore the Application of Financial Engineering in the Management of Exchange Rate Risk

    Directory of Open Access Journals (Sweden)

    Yang Liu

    2015-01-01

    Full Text Available In the background where the domestic enterprises commonly have a weak protection consciousness against the exchange rate risk, this article makes a deep analysis based on the definition of exchange rate risk and its cause. By comparison of the traditional management method of exchange rate risk with another one based on financial engineering tools, it also deeply analyzes the method to use the financial engineering technology in the management of exchange rate risk, and concludes the primary purpose of exchange rate risk management is for hedging. This article proposes an optimal analysis method in two aspects, namely the minimum risk and maximum efficiency, for the forward-based optimal hedging, and proposes an optimal analysis method of dynamic hedging for the optimal hedging of option-based tools. Based on the description of the application of financial tools in foreign exchange futures, forward contract, currency exchange and foreign exchange option, it makes an empirical analysis on the management of foreign exchange risk by taking an assumed T company as the carrier and based on the trading tools of forward foreign exchange and currency option, which describes the operation procedure of financial tools in a more direct way and proves the efficiency of the optimal analysis method of this article.

  15. Concordance of Motion Sensor and Clinician-Rated Fall Risk Scores in Older Adults.

    Science.gov (United States)

    Elledge, Julie

    2017-12-01

    As the older adult population in the United States continues to grow, developing reliable, valid, and practical methods for identifying fall risk is a high priority. Falls are prevalent in older adults and contribute significantly to morbidity and mortality rates and rising health costs. Identifying at-risk older adults and intervening in a timely manner can reduce falls. Conventional fall risk assessment tools require a health professional trained in the use of each tool for administration and interpretation. Motion sensor technology, which uses three-dimensional cameras to measure patient movements, is promising for assessing older adults' fall risk because it could eliminate or reduce the need for provider oversight. The purpose of this study was to assess the concordance of fall risk scores as measured by a motion sensor device, the OmniVR Virtual Rehabilitation System, with clinician-rated fall risk scores in older adult outpatients undergoing physical rehabilitation. Three standardized fall risk assessments were administered by the OmniVR and by a clinician. Validity of the OmniVR was assessed by measuring the concordance between the two assessment methods. Stability of the OmniVR fall risk ratings was assessed by measuring test-retest reliability. The OmniVR scores showed high concordance with the clinician-rated scores and high stability over time, demonstrating comparability with provider measurements.

  16. [Relationship between performance rating and risk of low back pain in manufacturing line workers].

    Science.gov (United States)

    Higuchi, Yoshiyuki; Funahashi, Atsushi; Izumi, Hiroyuki; Kumashinro, Masaharu

    2012-03-01

    It is possible that the performance rating of line workers is affected by the risk factors for musculoskeletal disorders that are included in their work more so than by the actual takt time. To investigate whether performance rating relates to the risk factors for musculoskeletal disorders, we analyzed a dataset obtained from a self-administered questionnaire answered by assembly line workers (n=1579). As a result, performance rating had a significant association with unsuitable work environments, poor working postures and handling of heavy loads. The workers who reported the fastest rating had a higher exposure than others to the risk factors for occupational low back pain. The results of our study support the effectiveness of performance rating as an index of work burden.

  17. Joint default probabilities and country risk

    NARCIS (Netherlands)

    Scholtens, Bert; Hameeteman, Daphne

    2003-01-01

    The assessment of country risk is of crucial importance for both developing countries and international lenders and investors. Many existing country risk approaches are opaque and heavily rely on subjective choices. In general, they lack a theoretical basis. To assess country risk, we use the Merton

  18. Joint default probabilities and sovereign risk

    NARCIS (Netherlands)

    Scholtens, Bert; Hameeteman, Daphne

    2007-01-01

    The assessment of sovereign risk is of crucial importance for international lenders and investors. Many existing sovereign risk approaches are opaque and heavily rely on subjective choices. In general, they lack a theoretical basis. To assess sovereign risk, we use the Merton model in which a loan

  19. Colleges Scramble to Help Students Find New Lenders

    Science.gov (United States)

    Supiano, Beckie

    2008-01-01

    Recent turbulence in the student-loan business has colleges scrambling to find new loan providers. Financial-aid offices at affected colleges are working hard to get the word out to students. Changes in the loan market have hit community colleges particularly hard because their students tend to have smaller loans and higher default rates than…

  20. Heart rate variability based on risk stratification for type 2 diabetes mellitus.

    Science.gov (United States)

    Silva-E-Oliveira, Julia; Amélio, Pâmela Marina; Abranches, Isabela Lopes Laguardia; Damasceno, Dênis Derly; Furtado, Fabianne

    2017-01-01

    To evaluate heart rate variability among adults with different risk levels for type 2 diabetes mellitus. The risk for type 2 diabetes mellitus was assessed in 130 participants (89 females) based on the questionnaire Finnish Diabetes Risk Score and was classified as low risk (n=26), slightly elevated risk (n=41), moderate risk (n=27) and high risk (n=32). To measure heart rate variability, a heart-rate monitor Polar S810i® was employed to obtain RR series for each individual, at rest, for 5 minutes, followed by analysis of linear and nonlinear indexes. The groups at higher risk of type 2 diabetes mellitus had significantly lower linear and nonlinear heart rate variability indexes. The individuals at high risk for type 2 diabetes mellitus have lower heart rate variability. Avaliar a variabilidade da frequência cardíaca em adultos com diferentes níveis de risco para diabetes mellitus tipo 2. O grau de risco para diabetes mellitus tipo 2 de 130 participantes (41 homens) foi avaliado pelo questionário Finnish Diabetes Risk Score. Os participantes foram classificados em baixo risco (n=26), risco levemente elevado (n=41), risco moderado (n=27) e alto risco (n=32). Para medir a variabilidade da frequência cardíaca, utilizou-se o frequencímetro Polar S810i® para obter séries de intervalo RR para cada indivíduo, em repouso, durante 5 minutos; posteriormente, realizou-se análise por meio de índices lineares e não-lineares. O grupo com maior risco para diabetes mellitus tipo 2 teve uma diminuição significante nos índices lineares e não-lineares da variabilidade da frequência cardíaca. Os resultados apontam que indivíduos com risco alto para diabetes mellitus tipo 2 tem menor variabilidade da frequência cardíaca. To evaluate heart rate variability among adults with different risk levels for type 2 diabetes mellitus. The risk for type 2 diabetes mellitus was assessed in 130 participants (89 females) based on the questionnaire Finnish Diabetes Risk Score

  1. The impact of risk management on internal and sustainable growth rate: Evidence from Tehran Stock Exchange

    Directory of Open Access Journals (Sweden)

    Hamid Reza Vakili Fard

    2014-09-01

    Full Text Available Measuring the relative risk of firms has been an open discussion among researchers. There are many studies on learning how leverage may influence on growth of the firms. This article reviews the relationship between risk management, internal and sustainable growth of accepted companies in Tehran stock exchange. The survey considers three types of risks including operating, financial and compound and investigates their relationships with internal growth rate as well as sustainable growth rate. Using some regression techniques, the study has determined negative and meaningful relationships between different types of leverage on side and internal as well as sustainable growth on the other side.

  2. Risk of inflammatory bowel disease according to self-rated health, pregnancy course, and pregnancy complications

    DEFF Research Database (Denmark)

    Harpsøe, Maria C; Jørgensen, Kristian Tore; Frisch, Morten

    2013-01-01

    Poor self-rated health (SRH) has been connected to immunological changes, and pregnancy complications have been suggested in the etiology of autoimmune diseases including inflammatory bowel disease (IBD). We evaluated the impact of self-rated pre-pregnancy health and pregnancy course, hyperemesis......, gestational hypertension, and preeclampsia on risk of IBD....

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

    Science.gov (United States)

    Turner, Brian; Shinnick, Edward

    2013-04-01

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

  4. Contagion risk in endogenous financial networks

    International Nuclear Information System (INIS)

    Li, Shouwei; Sui, Xin

    2016-01-01

    Highlights: • We propose an endogenous financial network model. • Endogenous networks include interbank networks, inter-firm networks and bank-firm networks. • We investigate contagion risk in endogenous financial networks. - Abstract: In this paper, we investigate contagion risk in an endogenous financial network, which is characterized by credit relationships connecting downstream and upstream firms, interbank credit relationships and credit relationships connecting firms and banks. The findings suggest that: increasing the number of potential lenders randomly selected can lead to an increase in the number of bank bankruptcies, while the number of firm bankruptcies presents a trend of increase after the decrease; after the intensity of choice parameter rises beyond a threshold, the number of bankruptcies in three sectors (downstream firms, upstream firms and banks) shows a relatively large margin of increase, and keeps at a relatively high level; there exists different trends for bankruptcies in different sectors with the change of the parameter of credits’ interest rates.

  5. PERFORMANCE EVALUATION AND RISK AVERSION RATE FOR SEVERAL STOCK INDICES IN INDONESIA STOCK EXCHANGE

    Directory of Open Access Journals (Sweden)

    Robiyanto Robiyanto

    2017-03-01

    Full Text Available There are numerous stock indices in Indonesia Stock Exchange. Several of them are LQ-45, MBX, DBX, JII, SRI-KEHATI, PEFINDO-25, BISNIS-27, IDX-30 and KOMPAS-100. Unfortunately there are limi­ted researches which have been done to measure those indices performance specifically. The same condition also occurs on risk aversion level usage in Indonesia Stock Exchange, only few numbers of researches use this me­a­surement in the portfolio valuation. Based on that, this research measured the performance and risk aversion rate of those indices in Indonesia Stock Exchange. The results of this study were SRI-KEHATI becomes the best performer with the highest risk aversion rate, while Jakarta Islamic Index (JII produces the lowest positive per­formance with the lowest risk aversion rate. This finding shows that sharia stocks’ characters (i.e. usury free could give relieveness and convenience regardless its per­formance.

  6. 25 CFR 103.6 - To what extent will BIA guarantee or insure a loan?

    Science.gov (United States)

    2010-04-01

    ... insurance percentage rate that satisfies the lender's risk management requirements. (d) Absent exceptional... lender has insured under the Program as of the date the lender makes a claim under its insurance coverage... outstanding loans from the same lender to the same borrower; or (2) One loan guaranty under the Program when...

  7. 76 FR 79379 - Risk-Based Capital Guidelines: Market Risk; Alternatives to Credit Ratings for Debt and...

    Science.gov (United States)

    2011-12-21

    ..., China, France, Germany, Hong Kong SAR, India, Indonesia, Italy, Japan, Korea, Luxembourg, Mexico, the..., the legislative history of section 939A focuses on the conflicts of interest of credit rating agencies... illustrates how CDS spreads and CRCs could be used together to assign specific risk-weighting factors. In...

  8. Intertemporal Risk-Return Trade-off in Foreign Exchange Rates

    OpenAIRE

    Christiansen, Charlotte

    2010-01-01

    We investigate the intertemporal risk-return trade-off of foreign ex-change (FX) rates for ten currencies quoted against the USD. For each currency,we use three risk measures simultaneously that pertain to that currency; its re-alized volatility, its realized skewness, and its value-at-risk. We apply monthlyFX excess returns and monthly FX risk measures calculated from daily ob-servations. We find that there is a positive and signi…cant contemporaneousrisk-return trade-off for most currencies...

  9. Global financial crisis, banking crisis and first country risk in the viewpoint of domestic risk rating agencies

    Directory of Open Access Journals (Sweden)

    Dr.Sc. Ingrid Shuli

    2012-06-01

    Full Text Available In a period of dire financial crisis, with which all countries seem to cope, it seemed interesting to analyse the assessment of the risk for our country, viewed from the vantage point of our domestic rating agencies, but also compared to assessments made to our country by international rating agencies, such as Moody’s rating agency, Standard & Poor rating agency, Fitch ratings agency etc. The objective of this study is to recognize indicators and factors affecting the risk assessment and rating of a country, and evaluate whether there has been an impact of the financial crisis faced by other countries in the rating given to Albanian by domestic and foreign agencies. We stopped at the history of earlier financial crisis development to understand bewtter what is happening in this financial crisis. We shall develop upon a wide existing literature, and a range of credible resources such as the IMF, the World Bank, the International Institute of Finance, Economic Intelligence Unit, and local official data sources, eg. The Bank of Albania and INSTAT.

  10. 24 CFR 241.1070 - Agreed interest rate.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Agreed interest rate. 241.1070...-Eligibility Requirements § 241.1070 Agreed interest rate. The equity or acquisition loan shall bear interest at the rate agreed upon by the borrower and the lender. ...

  11. 7 CFR 4287.112 - Interest rate adjustments.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Interest rate adjustments. 4287.112 Section 4287.112... Loans § 4287.112 Interest rate adjustments. (a) Reductions. The borrower, lender, and holder (if any) may collectively initiate a permanent or temporary reduction in the interest rate of the guaranteed...

  12. 24 CFR 241.560 - Agreed interest rate.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Agreed interest rate. 241.560... § 241.560 Agreed interest rate. (a) The mortgage shall bear interest at the rate agreed upon by the lender and the borrower. (b) Interest shall be payable in monthly installments on the principal amount of...

  13. 7 CFR Exhibit B to Subpart F of... - Suggested Outline for Seeking Information From Lenders on Credit Criteria for Graduation of...

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true Suggested Outline for Seeking Information From Lenders... Seeking Information From Lenders on Credit Criteria for Graduation of Single Family Housing Loans Date... (CONTINUED) PROGRAM REGULATIONS (CONTINUED) SERVICING AND COLLECTIONS Analyzing Credit Needs and Graduation...

  14. Evaluating the Impact of Prescription Fill Rates on Risk Stratification Model Performance.

    Science.gov (United States)

    Chang, Hsien-Yen; Richards, Thomas M; Shermock, Kenneth M; Elder Dalpoas, Stacy; J Kan, Hong; Alexander, G Caleb; Weiner, Jonathan P; Kharrazi, Hadi

    2017-12-01

    Risk adjustment models are traditionally derived from administrative claims. Prescription fill rates-extracted by comparing electronic health record prescriptions and pharmacy claims fills-represent a novel measure of medication adherence and may improve the performance of risk adjustment models. We evaluated the impact of prescription fill rates on claims-based risk adjustment models in predicting both concurrent and prospective costs and utilization. We conducted a retrospective cohort study of 43,097 primary care patients from HealthPartners network between 2011 and 2012. Diagnosis and/or pharmacy claims of 2011 were used to build 3 base models using the Johns Hopkins ACG system, in addition to demographics. Model performances were compared before and after adding 3 types of prescription fill rates: primary 0-7 days, primary 0-30 days, and overall. Overall fill rates utilized all ordered prescriptions from electronic health record while primary fill rates excluded refill orders. The overall, primary 0-7, and 0-30 days fill rates were 72.30%, 59.82%, and 67.33%. The fill rates were similar between sexes but varied across different medication classifications, whereas the youngest had the highest rate. Adding fill rates modestly improved the performance of all models in explaining medical costs (improving concurrent R by 1.15% to 2.07%), followed by total costs (0.58% to 1.43%), and pharmacy costs (0.07% to 0.65%). The impact was greater for concurrent costs compared with prospective costs. Base models without diagnosis information showed the highest improvement using prescription fill rates. Prescription fill rates can modestly enhance claims-based risk prediction models; however, population-level improvements in predicting utilization are limited.

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

    Science.gov (United States)

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

    2011-06-01

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

  16. How to Manage the Mortgage Credit Risk in Turkey? Can Dual-indexed Mortgages be a Remedy?

    OpenAIRE

    Ali Alp; M. Mete Doganay

    2009-01-01

    A market-oriented housing finance system has been under discussion in Turkey recently. In this article we analyze different types of mortgages that have been used in developed and developing countries to select the one that is most appropriate for Turkey-one which minimizes risks for both lenders and borrowers. Each type of mortgage presents different risks to borrowers and lenders. After taking into consideration the economic history of Turkey, we conclude that the most appropriate mortgage ...

  17. A statistical modeling approach to build expert credit risk rating systems

    DEFF Research Database (Denmark)

    Waagepetersen, Rasmus

    2010-01-01

    This paper presents an efficient method for extracting expert knowledge when building a credit risk rating system. Experts are asked to rate a sample of counterparty cases according to creditworthiness. Next, a statistical model is used to capture the relation between the characteristics...... of a counterparty and the expert rating. For any counterparty the model can identify the rating, which would be agreed upon by the majority of experts. Furthermore, the model can quantify the concurrence among experts. The approach is illustrated by a case study regarding the construction of an application score...

  18. Risk Management of Interest Rate Derivative Portfolios: A Stochastic Control Approach

    Directory of Open Access Journals (Sweden)

    Konstantinos Kiriakopoulos

    2014-10-01

    Full Text Available In this paper we formulate the Risk Management Control problem in the interest rate area as a constrained stochastic portfolio optimization problem. The utility that we use can be any continuous function and based on the viscosity theory, the unique solution of the problem is guaranteed. The numerical approximation scheme is presented and applied using a single factor interest rate model. It is shown how the whole methodology works in practice, with the implementation of the algorithm for a specific interest rate portfolio. The recent financial crisis showed that risk management of derivatives portfolios especially in the interest rate market is crucial for the stability of the financial system. Modern Value at Risk (VAR and Conditional Value at Risk (CVAR techniques, although very useful and easy to understand, fail to grasp the need for on-line controlling and monitoring of derivatives portfolio. The portfolios should be designed in a way that risk and return be quantified and controlled in every possible state of the world. We hope that this methodology contributes towards this direction.

  19. Default contagion risks in Russian interbank market

    Science.gov (United States)

    Leonidov, A. V.; Rumyantsev, E. L.

    2016-06-01

    Systemic risks of default contagion in the Russian interbank market are investigated. The analysis is based on considering the bow-tie structure of the weighted oriented graph describing the structure of the interbank loans. A probabilistic model of interbank contagion explicitly taking into account the empirical bow-tie structure reflecting functionality of the corresponding nodes (borrowers, lenders, borrowers and lenders simultaneously), degree distributions and disassortativity of the interbank network under consideration based on empirical data is developed. The characteristics of contagion-related systemic risk calculated with this model are shown to be in agreement with those of explicit stress tests.

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

    Science.gov (United States)

    Fan, Qin; Davlasheridze, Meri

    2016-06-01

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

  1. Fracture risk assessed by Fracture Risk Assessment Tool (FRAX) compared with fracture risk derived from population fracture rates

    DEFF Research Database (Denmark)

    Rubin, Katrine Hass; Abrahamsen, Bo; Hermann, Anne Pernille

    2011-01-01

    Purpose: To evaluate the performance of the Swedish version of Fracture Risk Assessment Tool (FRAX)) without bone mass density (BMD) in a Danish population to examine the possibility of applying this version to Danish women. METHODS: From the Danish National Register of social security numbers, we...

  2. Binary Tree Pricing to Convertible Bonds with Credit Risk under Stochastic Interest Rates

    Directory of Open Access Journals (Sweden)

    Jianbo Huang

    2013-01-01

    Full Text Available The convertible bonds usually have multiple additional provisions that make their pricing problem more difficult than straight bonds and options. This paper uses the binary tree method to model the finance market. As the underlying stock prices and the interest rates are important to the convertible bonds, we describe their dynamic processes by different binary tree. Moreover, we consider the influence of the credit risks on the convertible bonds that is described by the default rate and the recovery rate; then the two-factor binary tree model involving the credit risk is established. On the basis of the theoretical analysis, we make numerical simulation and get the pricing results when the stock prices are CRR model and the interest rates follow the constant volatility and the time-varying volatility, respectively. This model can be extended to other financial derivative instruments.

  3. Benchmarking Discount Rate in Natural Resource Damage Assessment with Risk Aversion.

    Science.gov (United States)

    Wu, Desheng; Chen, Shuzhen

    2017-08-01

    Benchmarking a credible discount rate is of crucial importance in natural resource damage assessment (NRDA) and restoration evaluation. This article integrates a holistic framework of NRDA with prevailing low discount rate theory, and proposes a discount rate benchmarking decision support system based on service-specific risk aversion. The proposed approach has the flexibility of choosing appropriate discount rates for gauging long-term services, as opposed to decisions based simply on duration. It improves injury identification in NRDA since potential damages and side-effects to ecosystem services are revealed within the service-specific framework. A real embankment case study demonstrates valid implementation of the method. © 2017 Society for Risk Analysis.

  4. Risk Factors Influencing Conception Rate in Holstein Heifers before Artificial Insemination or Embryo Transfer

    OpenAIRE

    M. Yusuf; T. Nakao; S. T. Long; S. Fujita

    2016-01-01

    The objective of this study was to show the risk factors affecting the conception rate in Holstein heifers after synchronization of estrus. A total of 275 Holstein heifers housed in a free barn were used for the experiment. The herd was visited regularly at four week intervals for synchronization of estrus using Heatsynch and CIDR-Heatsynch protocols. A group of four to 14 animals, depending on the availability, were referred to the experiment at each visit. Estrus induction rates in the two ...

  5. Risk analysis of radioactive waste repository based on the time dependent hazard rate

    International Nuclear Information System (INIS)

    Chang, S.H.; Cho, W.J.

    1984-01-01

    For the probabilistic risk analysis of the radioactive high level waste repository, the simplified method based on the time dependent hazard rate is proposed. The obtained results are compared with those from the time independent hazard rate. The estimation of the failure probability of the waste repository through this method gives more conservative results, especially when the half-life of nuclide is larger and retardation factors of nuclide is smaller. (Auth.)

  6. A NEW LOOK AT THE TRADE VOLUME EFFECTS OF REAL EXCHANGE RATE RISK

    OpenAIRE

    Wang, Kai-Li; Barrett, Christopher B.

    2002-01-01

    This paper takes a new empirical look at the longstanding question of the effect of exchange rate volatility on international trade flows by studying the case of Taiwan's exports to the United States from 1989-1998. In particular, we employ sectoral level, monthly data and a multivariate GARCH-M estimator with corrections for leptokurtic errors that is consistent with the core hypothesis that traders' forward contracting behavior might be affected by exchange rate risk. We find that real exch...

  7. Direct risk standardisation: a new method for comparing casemix adjusted event rates using complex models.

    Science.gov (United States)

    Nicholl, Jon; Jacques, Richard M; Campbell, Michael J

    2013-10-29

    Comparison of outcomes between populations or centres may be confounded by any casemix differences and standardisation is carried out to avoid this. However, when the casemix adjustment models are large and complex, direct standardisation has been described as "practically impossible", and indirect standardisation may lead to unfair comparisons. We propose a new method of directly standardising for risk rather than standardising for casemix which overcomes these problems. Using a casemix model which is the same model as would be used in indirect standardisation, the risk in individuals is estimated. Risk categories are defined, and event rates in each category for each centre to be compared are calculated. A weighted sum of the risk category specific event rates is then calculated. We have illustrated this method using data on 6 million admissions to 146 hospitals in England in 2007/8 and an existing model with over 5000 casemix combinations, and a second dataset of 18,668 adult emergency admissions to 9 centres in the UK and overseas and a published model with over 20,000 casemix combinations and a continuous covariate. Substantial differences between conventional directly casemix standardised rates and rates from direct risk standardisation (DRS) were found. Results based on DRS were very similar to Standardised Mortality Ratios (SMRs) obtained from indirect standardisation, with similar standard errors. Direct risk standardisation using our proposed method is as straightforward as using conventional direct or indirect standardisation, always enables fair comparisons of performance to be made, can use continuous casemix covariates, and was found in our examples to have similar standard errors to the SMR. It should be preferred when there is a risk that conventional direct or indirect standardisation will lead to unfair comparisons.

  8. Rate and Risk Factors for Periprosthetic Joint Infection Among 36,494 Primary Total Hip Arthroplasties.

    Science.gov (United States)

    Triantafyllopoulos, Georgios K; Soranoglou, Vasileios G; Memtsoudis, Stavros G; Sculco, Thomas P; Poultsides, Lazaros A

    2018-04-01

    As periprosthetic joint infections (PJIs) can have tremendous health and socioeconomic implications, recognizing patients at risk before surgery is of great importance. Therefore, we sought to determine the rate of and risk factors for deep PJI in patients undergoing primary total hip arthroplasty (THA). Clinical characteristics of patients treated with primary THA between January 1999 and December 2013 were retrospectively reviewed. These included patient demographics, comorbidities (including the Charlson/Deyo comorbidity index), length of stay, primary diagnosis, total/allogeneic transfusion rate, and in-hospital complications, which were grouped into local and systemic (minor and major). We determined the overall deep PJI rate, as well as the rates for early-onset (occurring within 2 years after index surgery) and late-onset PJI (occurring more than 2 years after surgery). A Cox proportional hazards regression model was constructed to identify risk factors for developing deep PJI. Significance level was set at 0.05. A deep PJI developed in 154 of 36,494 primary THAs (0.4%) during the study period. Early onset PJI was found in 122 patients (0.3%), whereas late PJI occurred in 32 patients (0.1%). Obesity, coronary artery disease, and pulmonary hypertension were identified as independent risk factors for deep PJI after primary THA. The rate of deep PJIs of the hip is relatively low, with the majority occurring within 2 years after THA. If the optimization of modifiable risk factors before THA can reduce the rate of this complication remains unknown, but should be attempted as part of good practice. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. How costly is it to ignore interest rate risk management in your 401(k) plan?

    NARCIS (Netherlands)

    van Bilsen, Servaas; Boelaars, I.; Bovenberg, Lans; Mehlkopf, Roel

    This paper explicitly derives and explores optimal interest rate risk management for lifecycle investors in DC pension plans, and compares our results to the portfolio mix chosen in practice by Target-Date Fund (TDF) managers. We show that investments in long-term bonds play an important role in the

  10. Mapping at-risk-of-poverty rates, household employment, and social spending

    NARCIS (Netherlands)

    Vandenbroucke, F.; Diris, R.; Cantillon, B.; Vandenbroucke, F.

    2014-01-01

    As a first step stylized facts are presented concerning at-risk-of-poverty rates for the non-elderly population, household employment (a concept introduced in this chapter) and social spending in European welfare states. The chapter provides a first exploration of a central theme of the book, which

  11. The ruin probability of a discrete time risk model under constant interest rate with heavy tails

    NARCIS (Netherlands)

    Tang, Q.

    2004-01-01

    This paper investigates the ultimate ruin probability of a discrete time risk model with a positive constant interest rate. Under the assumption that the gross loss of the company within one year is subexponentially distributed, a simple asymptotic relation for the ruin probability is derived and

  12. Hostility Ratings by Parents at Risk for Child Abuse: Impact of Chronic and Temporary Schema Activation

    Science.gov (United States)

    Farc, Maria-Magdalena; Crouch, Julie L.; Skowronski, John J.; Milner, Joel S.

    2008-01-01

    Objective: Two studies examined whether accessibility of hostility-related schema influenced ratings of ambiguous child pictures. Based on the social information processing model of child physical abuse (CPA), it was expected that CPA risk status would serve as a proxy for chronic accessibility of hostile schema, while priming procedures were used…

  13. The association between social networks and self-rated risk of HIV ...

    African Journals Online (AJOL)

    This study describes the social networks of secondary school students in Moshi Municipality, and their association with self-rated risk of human immunodeficiency virus (HIV) infection. A cross-sectional analytical study was conducted among 300 students aged 15–24 years in 5 secondary schools in Moshi, Tanzania.

  14. Genetic loci associated with heart rate variability and their effects on cardiac disease risk

    NARCIS (Netherlands)

    Nolte, Ilja M; Munoz, M Loretto; Tragante, Vinicius; Amare, Azmeraw T; Jansen, Rick; Vaez, Ahmad; von der Heyde, Benedikt; Avery, Christy L; Bis, Joshua C; Dierckx, Bram; van Dongen, Jenny; Gogarten, Stephanie M; Goyette, Philippe; Hernesniemi, Jussi; Huikari, Ville; Hwang, Shih-Jen; Jaju, Deepali; Kerr, Kathleen F; Kluttig, Alexander; Krijthe, Bouwe P; Kumar, Jitender; van der Laan, Sander W; Lyytikäinen, Leo-Pekka; Maihofer, Adam X; Minassian, Arpi; van der Most, Peter J; Müller-Nurasyid, Martina; Nivard, Michel; Salvi, Erika; Stewart, James D; Thayer, Julian F; Verweij, Niek; Wong, Andrew; Zabaneh, Delilah; Zafarmand, Mohammad H; Abdellaoui, Abdel; Albarwani, Sulayma; Albert, Christine; Alonso, Alvaro; Ashar, Foram; Auvinen, Juha; Axelsson, Tomas; Baker, Dewleen G; de Bakker, Paul I W; Barcella, Matteo; Bayoumi, Riad; Bieringa, Rob J; Boomsma, Dorret; Boucher, Gabrielle; Britton, Annie R; Christophersen, Ingrid; Dietrich, Andrea; Ehret, George B; Ellinor, Patrick T; Eskola, Markku; Felix, Janine F; Floras, John S; Franco, Oscar H; Friberg, Peter; Gademan, Maaike G J; Geyer, Mark A; Giedraitis, Vilmantas; Hartman, Catharina A; Hemerich, Daiane; Hofman, Albert; Hottenga, Jouke-Jan; Huikuri, Heikki; Hutri-Kähönen, Nina; Jouven, Xavier; Junttila, Juhani; Juonala, Markus; Kiviniemi, Antti M; Kors, Jan A.; Kumari, Meena; Kuznetsova, Tatiana; Laurie, Cathy C; Lefrandt, Joop D.; Li, Yong; Li, Yun; Liao, Duanping; Limacher, Marian C; Lin, Henry J; Lindgren, Cecilia M; Lubitz, Steven A; Mahajan, Anubha; McKnight, Barbara; Zu Schwabedissen, Henriette Meyer; Milaneschi, Yuri; Mononen, Nina; Morris, Andrew P; Nalls, Mike A; Navis, Gerjan; Neijts, Melanie; Nikus, Kjell; North, Kari E; O'Connor, Daniel T; Ormel, Johan; Perz, Siegfried; Peters, Annette; Psaty, Bruce M; Raitakari, Olli T; Risbrough, Victoria B; Sinner, Moritz F; Siscovick, David; Smit, Johannes H; Smith, Nicholas L; Soliman, Elsayed Z; Sotoodehnia, Nona; Staessen, Jan A; Stein, Phyllis K; Stilp, Adrienne M; Stolarz-Skrzypek, Katarzyna; Strauch, Konstantin; Sundström, Johan; Swenne, Cees A.; Syvänen, Ann-Christine; Tardif, Jean-Claude; Taylor, Kent D; Teumer, Alexander; Thornton, Timothy A; Tinker, Lesley E; Uitterlinden, André G; van Setten, Jessica; Voss, Andreas; Waldenberger, Melanie; Wilhelmsen, Kirk C; Willemsen, Gonneke; Wong, Quenna; Zhang, Zhu-Ming; Zonderman, Alan B; Cusi, Daniele; Evans, Michele K; Greiser, Halina K; van der Harst, Pim; Hassan, Mohammad; Ingelsson, Erik; Järvelin, Marjo-Riitta; Kääb, Stefan; Kähönen, Mika; Kivimaki, Mika; Kooperberg, Charles; Kuh, Diana; Lehtimäki, Terho; Lind, Lars; Nievergelt, Caroline M; O'Donnell, Chris J; Oldehinkel, Albertine J; Penninx, Brenda; Reiner, Alexander P; Riese, Harriëtte; Van Roon, Arie M.; Rioux, John D; Rotter, Jerome I; Sofer, Tamar; Stricker, Bruno H; Tiemeier, Henning; Vrijkotte, Tanja G M; Asselbergs, Folkert W; Brundel, Bianca J J M; Heckbert, Susan R; Whitsel, Eric A; den Hoed, Marcel; Snieder, Harold; de Geus, Eco J C

    2017-01-01

    Reduced cardiac vagal control reflected in low heart rate variability (HRV) is associated with greater risks for cardiac morbidity and mortality. In two-stage meta-analyses of genome-wide association studies for three HRV traits in up to 53,174 individuals of European ancestry, we detect 17

  15. estimated glomerular filtration rate and risk of survival in acute stroke

    African Journals Online (AJOL)

    2014-03-03

    Mar 3, 2014 ... ESTIMATED GLOMERULAR FILTRATION RATE AND RISK OF SURVIVAL IN ACUTE STROKE. E. I. Okaka, MBBS, FWACP, F. A. Imarhiagbe, MBChB, FMCP, F. E. Odiase, MBBS, FMCP, O. C. A. Okoye, MBBS, FWACP,. Department of Medicine, University of Benin Teaching Hospital, Benin City, Nigeria.

  16. 1988 failure rate screening data for fusion reliability and risk analysis

    International Nuclear Information System (INIS)

    Cadwallader, L.C.; Piet, S.J.

    1988-01-01

    This document contains failure rate screening data for application to fusion components. The screening values are generally fission or aerospace industry failure rate estimates that can be extrapolated for use by fusion system designers, reliability engineers and risk analysts. Failure rate estimates for tritium-bearing systems, liquid metal-cooled systems, gas-cooled systems, water-cooled systems and containment systems are given. Preliminary system availability estimates and selected initiating event frequency estimates are presented. This first edition document is valuable to design and safety analysis for the Compact Ignition Tokamak and the International Thermonuclear Experimental Reactor. 20 refs., 28 tabs

  17. Trends in state-level freight accident rates: An enhancement of risk factor development for RADTRAN

    International Nuclear Information System (INIS)

    Saricks, C.; Kvitek, T.

    1991-01-01

    Under the Nuclear Waste Policy Act, the Department of Energy's Office of Civilian Radioactive Waste Management (OCRWM) is concerned with understanding and managing risk as it applies to the shipment of spent commercial nuclear reactor fuel. Understanding risk in relation to mode and geography may provide opportunities to minimize radiological and non-radiological risks of transportation. To enhance such an understanding, a set of state-or waterway-specific accident, fatality, and injury rates (expressed as rates per shipment kilometer) by transportation mode and highway administrative class was developed, using publicly-available data bases. Adjustments made to accommodate miscoded or incomplete information in accident data are described, as well as the procedures for estimating state-level flow data. Results indicate that the shipping conditions under which spent fuel is likely to be transported should be less subject to accidents than the ''average'' shipment within mode. 10 refs., 3 tabs

  18. Risk-free assets: Are they truly risk-free? A comparative study of South African rates and instruments

    Directory of Open Access Journals (Sweden)

    Oosthuizen, A.V.

    2013-10-01

    Full Text Available Determining the price of a financial instrument is something that happens every day in the financial markets. Every price starts off with a spot price adjusted for interest until maturity of the particular instrument. The interest is usually described as risk-free interest. The price so determined is the most basic price that an investor is willing to pay if not risk is involved. Risk-free assets, then, are securities of which the future rates of return are known with certainty. An exceptional degree of confidence in the issuer of the security brings about this certainty. Risk-free assets are normally in the fixed income securities (capital markets investment category or in the liquid money market instruments such as treasury bills, category. This study attempts to determine whether the risk-free rates used by treasury managers and traders in South Africa to formulate their bond yield curves and which are used in valuation models, may be deemed risk-free. The study specifies certain criteria that an asset must satisfy in order to be used as a risk-free asset. Short term and long term South African instruments are compared to the US counterpart instruments, to gain an understanding of the South African instruments relative to the US ones. The behaviour of the risk-free instruments used in South Africa is also compared to the FTSE/JSE All Share Index and gold spot prices, which are perceived to be a risky asset classes. To gain some understanding of the behaviour of these instruments, analyses were done from different angles. The standard deviations of the daily percentage changes of the R157 were significantly lower than that of the ALSI and the gold spot price change. Compared to the ALSI and gold spot price, therefore, the R157 may be deemed a “low risk” instrument. The JIBAR was even less volatile that the R157. Interestingly, the US instruments were substantially more risky than the SA instruments over the analysis period. Also the JIBAR

  19. 7 CFR Appendix H to Subpart E of... - Suggested Format for the Opinion of the Lender's Legal Counsel

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true Suggested Format for the Opinion of the Lender's Legal Counsel H Appendix H to Subpart E of Part 1980 Agriculture Regulations of the Department of Agriculture... Industrial Loan Program Pt. 1980, Subpt. E, App. H Appendix H to Subpart E of Part 1980—Suggested Format for...

  20. 12 CFR 221.119 - Applicability of plan-lender provisions to financing of stock options and stock purchase rights...

    Science.gov (United States)

    2010-01-01

    ... experience that in some nonqualified plans, particularly stock purchase plans, the credit arrangement is... financing of stock options and stock purchase rights qualified or restricted under Internal Revenue Code... PURCHASING OR CARRYING MARGIN STOCK (REGULATION U) Interpretations § 221.119 Applicability of plan-lender...

  1. Suicide rates and risk factors among Korean cancer patients, 1993-2005.

    Science.gov (United States)

    Ahn, Eunmi; Shin, Dong Wook; Cho, Sung-Il; Park, Sohee; Won, Young-Joo; Yun, Young Ho

    2010-08-01

    As the number of cancer survivors increases, suicide risk approaches that of the general population. We therefore investigated suicide rates and risk factors among Korean cancer patients. We observed 816,295 cancer patients for 3,007,294 person-years from 1993 to 2005 through a nationwide cancer registry. We calculated their sex- and age-standardized mortality ratios (SMR) and studied suicide risk factors using rate ratios (RR) based on a log-linear Poisson regression model. Compared with the Korean general population, the suicide rate among cancer patients was high [SMR, 2.00; 95% confidence interval (95% CI), 1.91-2.08]. The rates were highest in the year following the cancer diagnosis (SMR, 3.45; 95% CI, 3.19-3.73) and were still elevated 5 years later (SMR, 1.23; 95% CI, 1.12-1.36). The clinical groups at highest risk were male pancreas cancer patients (SMR, 6.01; 95% CI, 4.33-8.33) and female lung cancer patients (SMR, 3.55; 95% CI, 2.55-4.94). The sociodemographic groups at highest risk were those who had no spouse versus those who were married (RR, 1.50; 95% CI, 1.35-1.68), those who were not employed versus those who were (RR, 1.39; 95% CI, 1.26-1.54), and those who did not have high school education versus those who had (RR, 1.52; 95% CI, 1.30-1.79). Korean cancer patients are at increased risk of suicide. Both clinical and sociodemographic factors play a role. There is a need for social support and suicide prevention strategies for cancer survivors in Korea. (c)2010 AACR.

  2. Risk Factors Influencing Conception Rate in Holstein Heifers before Artificial Insemination or Embryo Transfer

    Directory of Open Access Journals (Sweden)

    M. Yusuf

    2016-12-01

    Full Text Available The objective of this study was to show the risk factors affecting the conception rate in Holstein heifers after synchronization of estrus. A total of 275 Holstein heifers housed in a free barn were used for the experiment. The herd was visited regularly at four week intervals for synchronization of estrus using Heatsynch and CIDR-Heatsynch protocols. A group of four to 14 animals, depending on the availability, were referred to the experiment at each visit. Estrus induction rates in the two protocols were 93.9% and 94.9%, respectively. There was no difference in the conception rate between the two protocols. Conception rate after artificial insemination (AI or embryo transfer (ET were 46.3% and 51.4%, respectively. The risk factors affecting conception rate in heifers were daily weight gain (odds ratio [OR]= 4.673; P= 0.036 and body condition score (BCS (OR= 3.642; P= 0.018. Furthermore, estrus synchronization protocol (OR= 1.774; P= 0.083 and the absence of corpus luteum (CL at the initiation of treatment (OR= 0.512; P= 0.061 had a tendency to affect the conception rate, while age (OR= 0.715; P= 0.008 was a protective factor to conception rate.  In conclusion, positive daily weight gain before AI or ET, higher BCS, younger age, and the presence of CL at the initiation of estrus synchronization in dairy heifers increased the likelihood to conceive.

  3. Rates and risk factors of injury in CrossFitTM: a prospective cohort study.

    Science.gov (United States)

    Moran, Sebastian; Booker, Harry; Staines, Jacob; Williams, Sean

    2017-09-01

    CrossFitTM is a strength and conditioning program that has gained widespread popularity since its inception approximately 15 years ago. However, at present little is known about the level of injury risk associated with this form of training. Movement competency, assessed using the Functional Movement ScreenTM (FMS), has been identified as a risk factor for injury in numerous athletic populations, but its role in CrossFit participants is currently unclear. The aim of this study was to evaluate the level of injury risk associated with CrossFit training, and examine the influence of a number of potential risk factors (including movement competency). A cohort of 117 CrossFit participants were followed prospectively for 12 weeks. Participants' characteristics, previous injury history and training experience were recorded at baseline, and an FMS assessment was conducted. The overall injury incidence rate was 2.10 per 1000 training hours (90% confidence limits: 1.32-3.33). A multivariate Poisson regression model identified males (rate ratio [RR]: 4.44 ×/÷ 3.30, very likely harmful) and those with previous injuries (RR: 2.35 ×/÷ 2.37, likely harmful) as having a higher injury risk. Inferences relating to FMS variables were unclear in the multivariate model, although number of asymmetries was a clear risk factor in a univariate model (RR per two additional asymmetries: 2.62 ×/÷ 1.53, likely harmful). The injury incidence rate associated with CrossFit training was low, and comparable to other forms of recreational fitness activities. Previous injury and gender were identified as risk factors for injury, whilst the role of movement competency in this setting warrants further investigation.

  4. [Injury rate and incidence of accidents with biological risk among infirmary students].

    Science.gov (United States)

    Rodríguez Martín, A; Novalbos Ruiz, J P; Costa Alonso, M J; Zafra Mezcua, J A

    2000-09-09

    A study of the incidence and characteristics of biological accidents among infirmary students during their practicals at the hospital. A retrospective study carried out at five centres by means of two questionnaires, one on the duration of the training and the rate of accidents and the other on the characteristics, precautions and ports exposure behaviour. Out of 397 students, 70,5% had accidents at a rate of 64% (CI 95%, 59-68). Of these, 15% were accidents with biological risk, the majority being jabs (39%) and splashes (32,5%). It is worth note that 49,2% occurred while putting away the material and 58% in the absence of any individual protective measures. One out of 8 accidents implied a biological risk. A very high rate of accidents was observed with important deficiencies in security.

  5. Rates of adult acute inpatients documented as at risk of refeeding syndrome by dietitians.

    Science.gov (United States)

    Owers, Emma L; Reeves, Anneli I; Ko, Susan Y; Ellis, Aleshia K; Huxtable, Shannon L; Noble, Sally A; Porteous, Helen E; Newman, Eli J; Josephson, Christine A; Roth, Rachel A; Byrne, Clare E; Palmer, Michelle A

    2015-02-01

    Identification of Refeeding Syndrome (RFS) is vital for prevention and treatment of metabolic disturbances, yet no information exists that describes identification rates by dietitians in acute care. We aimed to describe rates and demographics of inpatients identified by dietitians as at-risk of RFS and factors associated with electrolyte levels post-dietetic assessment. Eligible participants were adult (≥ 18 yrs) acute care inpatients reviewed by dietitians between March 2012-February 2013 and not admitted to intensive care prior to first dietetic assessment. Patient information was sourced from medical charts. Chi-squared, t-tests and linear regression analyses were conducted. Of 1661 eligible inpatients (55%F, 65 ± 18 yrs), 9% (n = 151) were documented as at-risk of RFS in the first dietetic medical chart entry. On average, patients identified with RFS-risk had four days greater hospital stay, were 13 kg lighter, more likely classified SGA C (36% vs. 7%), and on a modified diet (52% vs. 35%) than non-RFS patients (p < 0.05). Very low and low electrolyte values occurred within seven days post-dietetic assessment in 7% and 52%, respectively, of inpatients with RFS-risk. Regression analysis showed that electrolyte supplementation was positively associated (β = 0.145-0.594), and number of RFS-related risk factors negatively associated (β = -0.044-0.122), with potassium, magnesium and phosphate levels within seven days post-dietetic assessment (p < 0.05). Nine percent of adult inpatients were documented as at-risk of RFS by dietitians. Identification of at-risk patients was in accordance with RFS guidelines. Electrolyte supplementation was positively associated with electrolyte levels post-assessment. Consistency of RFS-risk identification between dietitians requires determination. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Forrest Lianne

    2010-10-01

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

  7. A Comparative Risk Assessment of Extended Integrated Leak Rate Testing Intervals

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Ji Yong; Hwang, Seok Won; Lee, Byung Sik [Korea Hydro and Nuclear Power Co., Daejeon (Korea, Republic of)

    2009-10-15

    This paper presents the risk impacts of extending the Integrated Leak Rate Testing (ILRT) intervals (from five years to ten years) of Yonggwang (YGN) Unit 1 and 2. These risk impacts depended on the annual variances of meteorological data and resident population. Main comparisons were performed between the initial risk assessment (2005) for the purpose of extending ILRT interval and risk reassessment (2009) where the changed plant internal configurations (core inventory and radioisotope release fraction) and plant external alterations (wind directions, rainfall and population distributions) were monitored. The reassessment showed that there was imperceptible risk increase when the ILRT interval was extended compared to the initial risk assessment. In addition, the increased value of the Large Early Release Frequency (LERF) also satisfied the acceptance guideline proposed on Reg. Guide 1.174. The MACCS II code was used for evaluating the offsite consequence analysis. The primary risk index were used as the Probabilistic Population Dose (PPD) by considering the early effects within 80 km. The Probabilistic Safety Assessment (PSA) of YGN 1 and 2 was applied to evaluate the accident frequency of each source term category and the used PSA scope was limited to internal event.

  8. Sovereign ratings in the post-crisis world : an analysis of actual, shadow and relative risk ratings

    OpenAIRE

    Basu, Kaushik; De, Supriyo; Ratha, Dilip; Timmer, Hans

    2013-01-01

    This paper analyzes the evolution of sovereign credit ratings in the wake of the global financial crisis by studying changes in actual, shadow, and relative ratings between 2008 and 2012. For countries that do not have a rating from the major rating agencies, shadow ratings are estimated as a function of macroeconomic, structural, and governance variables. The shadow rating exercise confir...

  9. Association Between NCAP Ratings and Real-World Rear Seat Occupant Risk of Injury.

    Science.gov (United States)

    Metzger, Kristina B; Gruschow, Siobhan; Durbin, Dennis R; Curry, Allison E

    2015-01-01

    Several studies have evaluated the correlation between U.S. or Euro New Car Assessment Program (NCAP) ratings and injury risk to front seat occupants, in particular driver injuries. Conversely, little is known about whether NCAP 5-star ratings predict real-world risk of injury to restrained rear seat occupants. The NHTSA has identified rear seat occupant protection as a specific area under consideration for improvements to its NCAP. In order to inform NHTSA's efforts, we examined how NCAP's current 5-star rating system predicts risk of moderate or greater injury among restrained rear seat occupants in real-world crashes. We identified crash-involved vehicles, model year 2004-2013, in NASS-CDS (2003-2012) with known make and model and nonmissing occupant information. We manually matched these vehicles to their NCAP star ratings using data on make, model, model year, body type, and other identifying information. The resultant linked NASS-CDS and NCAP database was analyzed to examine associations between vehicle ratings and rear seat occupant injury risk; risk to front seat occupants was also estimated for comparison. Data were limited to restrained occupants and occupant injuries were defined as any injury with a maximum Abbreviated Injury Scale (AIS) score of 2 or greater. We linked 95% of vehicles in NASS-CDS to a specific vehicle in NCAP. The 18,218 vehicles represented an estimated 6 million vehicles with over 9 million occupants. Rear seat passengers accounted for 12.4% of restrained occupants. The risk of injury in all crashes for restrained rear seat occupants was lower in vehicles with a 5-star driver rating in frontal impact tests (1.4%) than with 4 or fewer stars (2.6%, P =.015); results were similar for the frontal impact passenger rating (1.3% vs. 2.4%, P =.024). Conversely, side impact driver and passenger crash tests were not associated with rear seat occupant injury risk (driver test: 1.7% for 5-star vs. 1.8% for 1-4 stars; passenger test: 1.6% for 5

  10. Freight-train derailment rates for railroad safety and risk analysis.

    Science.gov (United States)

    Liu, Xiang; Rapik Saat, M; Barkan, Christopher P L

    2017-01-01

    Derailments are the most common type of train accident in the United States. They cause damage to infrastructure, rolling stock and lading, disrupt service, and have the potential to cause casualties, and harm the environment. Train safety and risk analysis relies on accurate assessment of derailment likelihood. Derailment rate - the number of derailments normalized by traffic exposure - is a useful statistic to estimate the likelihood of a derailment. Despite its importance, derailment rate analysis using multiple factors has not been previously developed. In this paper, we present an analysis of derailment rates on Class I railroad mainlines based on data from the U.S. Federal Railroad Administration and the major freight railroads. The point estimator and confidence interval of train and car derailment rates are developed by FRA track class, method of operation and annual traffic density. The analysis shows that signaled track with higher FRA track class and higher traffic density is associated with a lower derailment rate. The new accident rates have important implications for safety and risk management decisions, such as the routing of hazardous materials. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Asymmetry and Risk Premia in the Brazilian Term Structure of Interest Rates

    Directory of Open Access Journals (Sweden)

    Marcelo Ganem

    2011-06-01

    Full Text Available The risk premium in the Brazilian term structure of interest rates is partially driven by some specific defensive behavior following past monetary decisions. Until 2008, the Brazilian Central Bank has primarily dealt with domestic and external crises by raising the short term rate to restrain capital outflows, generating a well-known asymmetry in the market’s response functions to risk aversion. Therefore, the traditional parameterization of risk based on mean and variance estimators fails to capture the market price of risk eventually assigned to higher order moments of bond returns across several maturities. In this paper we propose an arbitrage-free, discrete-time model that provides the form for a lagged endogenous regression which tests the significance and magnitude of the market price of asymmetry in the Brazilian fixed income market. The results are analyzed from a historical perspective, comparing the evolution of the price of asymmetry, the improvement of Brazil’s sovereign risk and the monetary policy conduction from 2003 to 2009.

  12. [Morbidity rate of obesity in children in ukraine. Overweight as noncontagious disease risk factor].

    Science.gov (United States)

    Заболотна, Ірина Е

    The upsurge of prevalence rate of obesity and overweight that in the majority of cases traces back to childhood is a risk factor of the most common noncontagious diseases in adults. The aim was to analyze prevalence of obesity in children in Ukraine and to conduct the pilot study of medical condition of overweight children. Official state statistics of prevalence rate of obesity in kids and screening data of anthropometric characteristics, arterial tension levels, physical performance decrement and medical condition of children (boys - 50, girls - 90, average age - 15,1±0,1 years) was used in research. Data calculation performed by Statistica v. 6.0 software. Over the past few decades, the morbidity rate of obesity in children in Ukraine has greatly increased, especially in year class 15-17. Insufficient diagnosis of obesity in children is the consequence of the inadequacy of the existing system of preventive care and monitoring survey of decease risk factors. Children with body mass index (BMI) above normal have a risk of work decrement in 5,2 times (odds ratio, OR=5,2, CI95%: 1,7-10,6). Such children have higher risk of development of the diseases of the respiratory system (OR=8,1; CI95%: 3,9-13,6) and allergic dermatitis (OR=7,7; CI95%: 3,7-12,9). The odds ratio of arterial hypertension in such children is equal to 3,46±0,3 (95%CI: 2,0-5,9). According to prediction calculations, the situation with the increase of prevalence rate of obesity in children in Ukraine is unfavorable. The introduction of measures aimed at finding children with obesity, their registration and monitoring of patients' health with due regard to decease risk factors at the primary care level would conduce to improving prevention of obesity and prevention of alimentary diseases progression.

  13. Injury rates and injury risk factors among federal bureau of investigation new agent trainees

    Science.gov (United States)

    2011-01-01

    Background A one-year prospective examination of injury rates and injury risk factors was conducted in Federal Bureau of Investigation (FBI) new agent training. Methods Injury incidents were obtained from medical records and injury compensation forms. Potential injury risk factors were acquired from a lifestyle questionnaire and existing data at the FBI Academy. Results A total of 426 men and 105 women participated in the project. Thirty-five percent of men and 42% of women experienced one or more injuries during training. The injury incidence rate was 2.5 and 3.2 injuries/1,000 person-days for men and women, respectively (risk ratio (women/men) = 1.3, 95% confidence interval = 0.9-1.7). The activities most commonly associated with injuries (% of total) were defensive tactics training (58%), physical fitness training (20%), physical fitness testing (5%), and firearms training (3%). Among the men, higher injury risk was associated with older age, slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the physical fitness test (PFT), lower self-rated physical activity, lower frequency of aerobic exercise, a prior upper or lower limb injury, and prior foot or knee pain that limited activity. Among the women higher injury risk was associated with slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the PFT, and prior back pain that limited activity. Conclusion The results of this investigation supported those of a previous retrospective investigation emphasizing that lower fitness and self-reported pain limiting activity were associated with higher injury risk among FBI new agents. PMID:22166096

  14. Association of suicide rates, gun ownership, conservatism and individual suicide risk.

    Science.gov (United States)

    Kposowa, Augustine J

    2013-09-01

    The purpose of the study was to examine the association of suicide rates, firearm ownership, political conservatism, religious integration at the state level, and individual suicide risk. Social structural and social learning and social integration theories were theoretical frameworks employed. It was hypothesized that higher suicide rates, higher state firearm availability, and state conservatism elevate individual suicide risk. Data were pooled from the Multiple Cause of Death Files. Multilevel logistic regression models were fitted to all deaths occurring in 2000 through 2004 by suicide. The state suicide rate significantly elevated individual suicide risk (AOR = 1.042, CI = 1.037, 1.046). Firearm availability at the state level was associated with significantly higher odds of individual suicide (AOR = 1.004, CI = 1.003, 1.006). State political conservatism elevated the odds of individual suicides (AOR = 1.005, CI = 1.003, 1.007), while church membership at the state level reduced individual odds of suicide (AOR = 0.995, CI = 0.993, 0.996). The results held even after controlling for socioeconomic and demographic variables at the individual level. It was concluded that the observed association between individual suicide odds and national suicide rates, and firearm ownership cannot be discounted. Future research ought to focus on integrating individual level data and contextual variables when testing for the impact of firearm ownership. Support was found for social learning and social integration theories.

  15. Low-Dose-Rate Brachytherapy Versus Cryotherapy in Low- and Intermediate-Risk Prostate Cancer

    International Nuclear Information System (INIS)

    Gestaut, Matthew M.; Cai, Wendi; Vyas, Shilpa; Patel, Belur J.; Hasan, Salman A.; MunozMaldonado, Yolanda; Deb, Niloyjyoti; Swanson, Gregory

    2017-01-01

    Purpose: Cryotherapy and brachytherapy are definitive local treatment options for low- to intermediate-risk prostate cancer. There are both prospective and retrospective data for brachytherapy, but the use of cryotherapy has been limited primarily to single-institution retrospective studies. Currently, no published evidence has compared low-dose-rate brachytherapy versus cryotherapy. Methods and Materials: Institutional review board approval was obtained to conduct a retrospective chart review of consecutive patients treated at our institution from 1990 to 2012. For inclusion, patients must have received a prostate cancer diagnosis and have been considered to have low- to intermediate-risk disease according to the National Comprehensive Cancer Network criteria. All patients received brachytherapy or cryotherapy treatment. Disease specifics and failure details were collected for all patients. Failure was defined as prostate-specific antigen nadir +2 ng/mL. Results: A total of 359 patients were analyzed. The groups comprised 50 low-risk cryotherapy (LRC), 92 intermediate-risk cryotherapy (IRC), 133 low-risk brachytherapy (LRB), and 84 intermediate-risk brachytherapy (IRB) patients. The median prostate-specific antigen follow-up periods were 85.6 months (LRC), 59.2 months (IRC), 74.9 months (LRB), and 59.8 months (IRB). The 5-year biochemical progression–free survival (bPFS) rate was 57.9% in the cryotherapy group versus 89.6% in the brachytherapy group (P<.0001). The 5-year bPFS rate was 70.0% (LRC), 51.4% (IRC), 89.4% (LRB), and 89.7% (IRB). The bPFS rate was significantly different between brachytherapy and cryotherapy for low- and intermediate-risk groups (P<.05). The mean nadir temperature reached for cryotherapy patients was −35°C (range, −96°C to −6°C). Cryotherapy used a median of 2 freeze-thaw cycles (range, 2-4 freeze-thaw cycles). Conclusions: Results from this study suggest that cryotherapy is inferior to brachytherapy for patients with

  16. The Credit-Risk Decision Mechanism on Fixed Loan Interest Rate with Imperfect Information

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    In this paper, decision mechanism of credit-risk for banks is studied when the loan interest rate is fixed with asymmetry information in credit market. We give out the designs of rationing and non-rationing on credit risky decision mechanism when collateral value provided by an entrepreneur is not less than the minimum demands of the bank. It shows that under the action of the mechanism, banks could efficiently identify the risk size of the project. Finally, the condition of the project investigation of bank is given over again.

  17. Low-Dose-Rate Brachytherapy Versus Cryotherapy in Low- and Intermediate-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gestaut, Matthew M., E-mail: Matthew.Gestaut@BSWHealth.org [Department of Radiation Oncology, Baylor Scott and White Memorial Hospital, Texas A& M University School of Medicine, Temple, Texas (United States); Cai, Wendi [Department of Biostatistics, Baylor Scott and White Health, Temple, Texas (United States); Vyas, Shilpa [Department of Radiation Oncology, Swedish Cancer Institute, Seattle, Washington (United States); Patel, Belur J. [Department of Urology, Baylor Scott and White Memorial Hospital, Texas A& M University School of Medicine, Temple, Texas (United States); Hasan, Salman A. [Department of Radiation Oncology, Baylor Scott and White Memorial Hospital, Texas A& M University School of Medicine, Temple, Texas (United States); MunozMaldonado, Yolanda [Department of Biostatistics, Baylor Scott and White Health, Temple, Texas (United States); Deb, Niloyjyoti; Swanson, Gregory [Department of Radiation Oncology, Baylor Scott and White Memorial Hospital, Texas A& M University School of Medicine, Temple, Texas (United States)

    2017-05-01

    Purpose: Cryotherapy and brachytherapy are definitive local treatment options for low- to intermediate-risk prostate cancer. There are both prospective and retrospective data for brachytherapy, but the use of cryotherapy has been limited primarily to single-institution retrospective studies. Currently, no published evidence has compared low-dose-rate brachytherapy versus cryotherapy. Methods and Materials: Institutional review board approval was obtained to conduct a retrospective chart review of consecutive patients treated at our institution from 1990 to 2012. For inclusion, patients must have received a prostate cancer diagnosis and have been considered to have low- to intermediate-risk disease according to the National Comprehensive Cancer Network criteria. All patients received brachytherapy or cryotherapy treatment. Disease specifics and failure details were collected for all patients. Failure was defined as prostate-specific antigen nadir +2 ng/mL. Results: A total of 359 patients were analyzed. The groups comprised 50 low-risk cryotherapy (LRC), 92 intermediate-risk cryotherapy (IRC), 133 low-risk brachytherapy (LRB), and 84 intermediate-risk brachytherapy (IRB) patients. The median prostate-specific antigen follow-up periods were 85.6 months (LRC), 59.2 months (IRC), 74.9 months (LRB), and 59.8 months (IRB). The 5-year biochemical progression–free survival (bPFS) rate was 57.9% in the cryotherapy group versus 89.6% in the brachytherapy group (P<.0001). The 5-year bPFS rate was 70.0% (LRC), 51.4% (IRC), 89.4% (LRB), and 89.7% (IRB). The bPFS rate was significantly different between brachytherapy and cryotherapy for low- and intermediate-risk groups (P<.05). The mean nadir temperature reached for cryotherapy patients was −35°C (range, −96°C to −6°C). Cryotherapy used a median of 2 freeze-thaw cycles (range, 2-4 freeze-thaw cycles). Conclusions: Results from this study suggest that cryotherapy is inferior to brachytherapy for patients with

  18. Ischemic risk stratification by means of multivariate analysis of the heart rate variability

    International Nuclear Information System (INIS)

    Valencia, José F; Vallverdú, Montserrat; Caminal, Pere; Porta, Alberto; Voss, Andreas; Schroeder, Rico; Vázquez, Rafael; Bayés de Luna, Antonio

    2013-01-01

    In this work, a univariate and multivariate statistical analysis of indexes derived from heart rate variability (HRV) was conducted to stratify patients with ischemic dilated cardiomyopathy (IDC) in cardiac risk groups. Indexes conditional entropy, refined multiscale entropy (RMSE), detrended fluctuation analysis, time and frequency analysis, were applied to the RR interval series (beat-to-beat series), for single and multiscale complexity analysis of the HRV in IDC patients. Also, clinical parameters were considered. Two different end-points after a follow-up of three years were considered: (i) analysis A, with 151 survivor patients as a low risk group and 13 patients that suffered sudden cardiac death as a high risk group; (ii) analysis B, with 192 survivor patients as a low risk group and 30 patients that suffered cardiac mortality as a high risk group. A univariate and multivariate linear discriminant analysis was used as a statistical technique for classifying patients in risk groups. Sensitivity (Sen) and specificity (Spe) were calculated as diagnostic criteria in order to evaluate the performance of the indexes and their linear combinations. Sen and Spe values of 80.0% and 72.9%, respectively, were obtained during daytime by combining one clinical parameter and one index from RMSE, and during nighttime Sen = 80% and Spe = 73.4% were attained by combining one clinical factor and two indexes from RMSE. In particular, relatively long time scales were more relevant for classifying patients into risk groups during nighttime, while during daytime shorter scales performed better. The results suggest that the left atrial size, indexed to body surface and RMSE indexes are those that allow enhanced classification of ischemic patients in their respective risk groups, confirming that a single measurement is not enough to fully characterize ischemic risk patients and the clinical relevance of HRV complexity measures. (paper)

  19. 13 CFR 120.214 - What conditions apply for variable interest rates?

    Science.gov (United States)

    2010-01-01

    ... interest rates? 120.214 Section 120.214 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Policies Specific to 7(a) Loans Maturities; Interest Rates; Loan and Guarantee Amounts § 120.214 What conditions apply for variable interest rates? A Lender may use a variable rate of interest...

  20. Credit Risk and Financial Performance Assessment of Illinois Farmers: A Comparison of Approaches with Farm Accounting Data

    OpenAIRE

    Zhang, Tianwei; Ellinger, Paul N.

    2006-01-01

    Pro forma financial performance evaluation of agricultural producers is an important issue for lenders, internal management and policy makers. Lenders strive to improve their credit risk management. Internal management is interested in understanding the financial impacts of alternative strategic decisions. And policy makers often assess the magnitude and distributional effects of alternative policies on the future financial performance of farm business. Data limitations are a major impediment...

  1. TARGET2 Imbalances and the ECB as Lender of Last Resort

    Directory of Open Access Journals (Sweden)

    Francesco Purificato

    2015-10-01

    Full Text Available This paper analyses the issue of the dynamics of the TARGET2 system balances during the sovereign debt crisis, when some countries registered a decisive inflow of the central bank liquidity and others showed an outflow. The dynamics in the TARGET2 are here explained as being due to a fall in the level of confidence in the capacity of the Economic and Monetary Union to survive, rather than to disparities in the level of competitiveness among countries of the Eurozone. This crisis of confidence has to be considered as the consequence of the implicit refusal of the European institutions to create a mechanism working as lender of last resort for the euro area member States; indeed, only when the ECB took this responsibility by launching the Outright Monetary Transactions clear signs of improvement were observed in the sovereign debt crisis.

  2. Prior rates of visual field loss and lifetime risk of blindness in glaucomatous patients undergoing trabeculectomy.

    Science.gov (United States)

    Foulsham, W S; Fu, L; Tatham, A J

    2015-10-01

    Trend-based analyses examining rates of visual field (VF) loss in glaucoma are useful for predicting risk of vision-related morbidity. Although patients with faster losses are likely to require treatment escalation, little is known about rates that might trigger a decision to intervene surgically. The aims of this study were to investigate prior rates of VF loss in patients attending for trabeculectomy and to estimate, in the absence of surgical intervention, lifetime risk of visual impairment, and blindness. A retrospective analysis of 117 eyes of 86 consecutive patients with glaucoma attending for trabeculectomy, including 53 patients referred from general ophthalmology clinics and 33 patients from specialist glaucoma clinics. Rates of change in standard automated perimetry mean deviation were examined using linear regression and random coefficient models. Risk of lifetime visual impairment and blindness was calculated using life expectancy data. Mean age at surgery was 71.0±9.7 years. Patients were followed for 10.7±7.5 years prior to surgery with an average of seven useable fields per eye. On average patients referred from general clinics lost 1.04 dB/year compared with 0.77 dB/year in those referred from glaucoma clinics (P=0.070). Patients referred from general clinics had more medication changes prior to surgery (3.4 and 2.6 changes, respectively; P=0.004). Given Scottish life expectancy data, untreated, 61 eyes (52%) would have passed the threshold for visual impairment, whereas 40 (34%) would have passed the threshold demarcating blindness. Patients attending for trabeculectomy had faster average rates of field loss prior to surgery than published values for the general glaucoma population with over one-third of eyes studied predicted to have become blind without intervention. Those managed by glaucoma specialists had fewer changes in medication and tended to slower rates of VF loss, although the latter did not reach statistical significance.

  3. Risk factors and outcomes of high peritonitis rate in continuous ambulatory peritoneal dialysis patients

    Science.gov (United States)

    Tian, Yuanshi; Xie, Xishao; Xiang, Shilong; Yang, Xin; Zhang, Xiaohui; Shou, Zhangfei; Chen, Jianghua

    2016-01-01

    Abstract Peritonitis remains a major complication of peritoneal dialysis (PD). A high peritonitis rate (HPR) affects continuous ambulatory peritoneal dialysis (CAPD) patients’ technique survival and mortality. Predictors and outcomes of HPR, rather than the first peritonitis episode, were rarely studied in the Chinese population. In this study, we examined the risk factors associated with HPR and its effects on clinical outcomes in CAPD patients. This is a single center, retrospective, observational cohort study. A total of 294 patients who developing at least 1 episode of peritonitis were followed up from March 1st, 2002, to July 31, 2014, in our PD center. Multivariate logistic regression was used to determine the factors associated with HPR, and the Cox proportional hazard model was conducted to assess the effects of HPR on clinical outcomes. During the study period of 2917.5 patient-years, 489 episodes of peritonitis were recorded, and the total peritonitis rate was 0.168 episodes per patient-year. The multivariate analysis showed that factors associated with HPR include a quick occurrence of peritonitis after CAPD initiation (shorter than 12 months), and a low serum albumin level at the start of CAPD. In the Cox proportional hazard model, HPR was a significant predictor of technique failure. There were no differences between HPR and low peritonitis rate (LPR) group for all-cause mortality. However, when the peritonitis rate was considered as a continuous variable, a positive correlation was observed between the peritonitis rate and mortality. We found the quick peritonitis occurrence after CAPD and the low serum albumin level before CAPD were strongly associated with an HPR. Also, our results verified that HPR was positively correlated with technique failure. More importantly, the increase in the peritonitis rate suggested a higher risk of all-cause mortality. These results may help to identify and target patients who are at higher risk of HPR at the start

  4. Value at risk using financial copulas: Application to the Mexican exchange rate (2002-2011

    Directory of Open Access Journals (Sweden)

    Tania Nadiezhda Plascencia Cuevas

    2012-12-01

    Full Text Available Nowadays, the volatility of exchange rate is a crucial and a transcendental issue for all transactions, negotiations and operations taking place in foreign currency, being an objective and an accurate prediction the cornerstone. Therefore, the main objective of this research is to analyze whether the Mexican exchange rate market, risk assessment using traditional VaR and VaR with copulas methodologies are more accurate when the estimates are made for a wide historical time-series or two periods for certain, helping it to predict the maximum losses that may be, with the main motivation to have a efficient hedging strategy. The principal conclusion is that assessing risk with these methodologies, the series does not necessarily have to include more than five years, considering that the use of copulas as a dependent measure make that the prediction fits better to the movements of the real returns.

  5. Mechanisms of Protection from Interest Rate Risk with Reference to the Life Insurance Market in Montenegro

    Directory of Open Access Journals (Sweden)

    Burić Milijana Novović

    2018-01-01

    Full Text Available Insurance companies are facing major challenges that point to the need for control process and risk management. Risk management in insurance has a direct impact on solvency, economic security, and overall financial stability of insurance companies. It is very important for insurance companies to adequately calculate risks to which they are exposed. Asset liability management (ALM, as an integrated approach to financial management, requires simultaneous decision-making about categories and values of assets and liabilities in order to establish the optimum volume and the ratio of assets and liabilities, with the understanding of complexity of the financial market in which financial institutions operate. ALM focuses on a significant number of risks, whereby the emphasis in this paper will be on interest rate risk which indicates potential losses that may reflect in a lower interest margin, a lower value of assets or both, in terms of changes in interest rates. In the above context, the aim of this paper is to show how to protect from interest rate changes and how these changes influence the insurance market in Montenegro, both from the theoretical and the practical point of view. The authors consider this to be an interesting and very important topic, especially because the life insurance market in Montenegro is underdeveloped and subject to fluctuations. Also, taking into account the fact that Montenegro is a country that has been making serious efforts to join the EU, it is expected that insurance companies in Montenegro will strengthen their financial position in the market even using the ALM traditional techniques, which is shown in this paper.

  6. Quantification of Gains and Risks of Static Thermal Rating Based on Typical Meteorological Year

    Czech Academy of Sciences Publication Activity Database

    Heckenbergerová, Jana; Musílek, P.; Filimonenkov, K.

    2013-01-01

    Roč. 44, č. 1 (2013), s. 227-235 ISSN 0142-0615 R&D Projects: GA MŠk LD12009 Grant - others:GA AV ČR(CZ) M100300904 Institutional support: RVO:67985807 Keywords : Overhead power transmission lines * Conductor ampacity * Probabilistic static thermal rating * Typical meteorological year * Risk tolerance * Energy throughput Subject RIV: JE - Non-nuclear Energetics, Energy Consumption ; Use Impact factor: 3.432, year: 2012

  7. Political Risk and Foreign Exchange Rates: an Efficient-Market Approach

    OpenAIRE

    Jean-Claude Cosset; Bruno Doutriaux de la Rianderie

    1985-01-01

    This paper examines the reaction of the foreign exchange market to the announcement of changes in the business environment of a country. Our results suggest that sampled political risk news conveys important information about a country's investment climate and causes its currency's exchange rate to vary. It appears, however, that the reaction of the foreign exchange market is more dramatic for unfavorable events than for favorable events. The evidence presented is also consisted with the hypo...

  8. Tobacco, alcohol, and other risk behaviors in film: how well do MPAA ratings distinguish content?

    Science.gov (United States)

    Tickle, Jennifer J; Beach, Michael L; Dalton, Madeline A

    2009-12-01

    To evaluate the usefulness of Motion Picture Association of America (MPAA) ratings for parental selection of appropriate films for children, the 100 top grossing movies each year from 1996 through 2004 (N = 900) were content analyzed to measure risk behaviors in each film. More restrictive MPAA ratings (R and PG-13) were associated with increased mean seconds of portrayals of tobacco use, alcohol use, and sexual content; increased frequency of violent content; and increased salience of drug use. MPAA ratings, however, did not clearly distinguish films based on tobacco or alcohol use. Fifty percent of R-rated movies contained 124 seconds or more of tobacco use, comparable with 26% of PG-13 and 17% of PG movies. Fifty percent of R-rated movies contained 162 seconds or more of alcohol use, comparable with 49% of PG-13 and 25% of PG movies. Because of the high degree of overlap in alcohol and tobacco content between rating categories, the MPAA rating system, as currently defined, is not adequate for parents who wish to limit their children's exposure to tobacco or alcohol content in movies.

  9. Low mortality rates after endovascular aortic repair expand use to high-risk patients.

    Science.gov (United States)

    Adkar, Shaunak S; Turner, Megan C; Leraas, Harold J; Gilmore, Brian F; Nag, Uttara; Turley, Ryan S; Shortell, Cynthia K; Mureebe, Leila

    2018-02-01

    The 2010 endovascular aneurysm repair (EVAR) trial 2 (EVAR 2) reported that patients with comorbidity profiles rendering them unfit for open aneurysm repair who underwent EVAR did not experience a survival advantage compared with those who did not undergo intervention. These patients experienced a 30-day mortality of 7.3%, whereas reports from similar cohorts reported far lower mortality rates. The primary objective of our study was to compare the incidence of 30-day mortality in low- and high-risk patients undergoing EVAR in a contemporary data set, using patient risk stratification criteria from EVAR 2. Secondarily, we sought to identify risk factors associated with a disproportionate contribution to 30-day mortality risk. Data were obtained from the 2005 to 2013 American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Participant Use Data Files (N = 24,813). Patients were included in the high-risk cohort with the presence of renal, respiratory, or cardiac preoperative criteria alone or in combination. Renal impairment criteria were defined as dialysis and creatinine concentration >2.26 mg/dL. Respiratory impairment criteria included history of chronic obstructive pulmonary disease and preoperative ventilator support. Cardiac impairment criteria included history of myocardial infarction, congestive heart failure, angina, and prior coronary intervention. Patient and procedural characteristics and 30-day postoperative outcomes were compared using Pearson χ 2 tests for categorical variables and Wilcoxon rank sum tests for continuous variables. Among 24,813 patients undergoing EVAR, 12,043 (48%) patients were characterized as high risk (at least one impairment criterion); 12,770 (52%) patients were stratified as low risk. The 30-day mortality rate was 1.9% in the high-risk cohort compared with the 7.3% reported by EVAR 2, and it was higher in the high-risk cohort compared with the low-risk cohort (1.9% vs 0.9%; P < .001). Whereas the

  10. Prevalence Rate and Risk Factors of Depression in Outpatients with Premature Ejaculation

    Directory of Open Access Journals (Sweden)

    Xiansheng Zhang

    2013-01-01

    Full Text Available The purpose of this study is to investigate the prevalence rate and risk factors of depression in outpatients who were diagnosed with PE. Therefore, between September 2009 and September 2011, 1801 outpatients at andrology clinics were enrolled and consented to participate in our survey by completed a verbal questionnaire. It included the following: (1 demographic data (e.g., age, body mass index, (2 PE duration, medical history, and sexual history, (3 self-estimated intravaginal ejaculatory latency times, (4 the Zung Self-rating Depression Scale (SDS, and (5 the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI and (6 the International Index of Erectile Function (IIEF-5. The results showed that a total of 1,206 patients were diagnosed with PE. The prevalence rate of depression in these PE patients was 26.78%. Depression was associated with PE duration, NIH-CPSI score, and IIEF-5 score. Risk factors for depression specifically included PE durations for 13–24, 25–60, or ≥61 months, CPSI scores of 15–30 or ≥31, and IIEF-5 scores <22. These findings suggested that several associated factors (PE duration, CPSI scores, and IIEF-5 scores were the risk factors of depression in men with PE.

  11. Consistent high clinical pregnancy rates and low ovarian hyperstimulation syndrome rates in high-risk patients after GnRH agonist triggering and modified luteal support

    DEFF Research Database (Denmark)

    Iliodromiti, Stamatina; Blockeel, Christophe; Tremellen, Kelton P

    2013-01-01

    Are clinical pregnancy rates satisfactory and the incidence of OHSS low after GnRH agonist trigger and modified intensive luteal support in patients with a high risk of ovarian hyperstimulation syndrome (OHSS)?......Are clinical pregnancy rates satisfactory and the incidence of OHSS low after GnRH agonist trigger and modified intensive luteal support in patients with a high risk of ovarian hyperstimulation syndrome (OHSS)?...

  12. Short-term versus long-term heart rate variability in ischemic cardiomyopathy risk stratification

    Directory of Open Access Journals (Sweden)

    Andreas eVoss

    2013-12-01

    Full Text Available In industrialized countries with aging populations, heart failure affects 0.3%-2% of the general population. The investigation of 24h-ECG recordings revealed the potential of nonlinear indices of heart rate variability (HRV for enhanced risk stratification in patients with ischemic heart failure (IHF. However, long-term analyses are time-consuming, expensive and delay the initial diagnosis. The objective of this study was to investigate whether 30min short-term HRV analysis is sufficient for comparable risk stratification in IHF in comparison to 24h-HRV analysis. From 256 IHF patients (221 at low risk (IHFLR and 35 at high risk (IHFHR a 24h beat-to-beat time series b the first 30min segment c the 30min most stationary day segment and d the 30min most stationary night segment were investigated. We calculated linear (time and frequency domain and nonlinear HRV analysis indices. Optimal parameter sets for risk stratification in IHF were determined for 24 hours and for each 30min segment by applying discriminant analysis on significant clinical and non-clinical indices. Long- and short-term HRV indices from frequency domain and particularly from nonlinear dynamics revealed high univariate significances (p

  13. Analyse of the prevalence rate and risk factors of pulmonary embolism in the patients with dyspnea

    International Nuclear Information System (INIS)

    Cao Yanxia; Su Jian; Wang Bingsheng; Wu Songhong; Dai Ruiting; Cao Caixia

    2005-01-01

    Objective: To analyse the prevalence rate and risk factors of pulmonary embolism (PE) in patients with dyspnea and to explore the predisposing causes and its early clinical manifestations. Methods: Retrospective analysis was done in 461 patients with dyspnea performed 99 Tc m -macroaggregated albumin (MAA) lung perfusion imaging and 99 Tc m -DTPA ventilation imaging or 99 Tc m -MAA perfusion imaging and chest X-ray examination. Among them, 48 cases without apparent disease were considered as control group, whereas the remaining patients with other underlying illnesses as patients group. PEMS statistics software package was used for estimation of prevalence rate, χ 2 test and PE risk factor analysis. Results: There were 251 PE patients among 461 patients, the prevalence rate [ (π)=95% confidence interval (CI) ] was: lower extremity thrombosis and varicosity (80.79-95.47 ), post cesarean section (55.64-87.12), lower extremity bone surgery or fracture (52.76-87.27 ), cancer operation (52.19-78.19), atrial fibrillation or heart failure (53.30-74.88), obesity (23.14-50.20), post abdominal surgery (20.23-59.43), diabetes (19.12-63.95), chronic bronchitis (1.80-23.06), normal control group (3.47-22.66). Except chronic bronchitis, PE prevalence rate between patients group and control group had significant difference (P 99 Tc m -MAA and DTPA lung imaging should be done as early as possible. (authors)

  14. Modified Exponential (MOE) Models: statistical Models for Risk Estimation of Low dose Rate Radiation

    International Nuclear Information System (INIS)

    Ogata, H.; Furukawa, C.; Kawakami, Y.; Magae, J.

    2004-01-01

    Simultaneous inclusion of dose and dose-rate is required to evaluate the risk of long term irradiation at low dose-rates, since biological responses to radiation are complex processes that depend both on irradiation time and total dose. Consequently, it is necessary to consider a model including cumulative dose,dose-rate and irradiation time to estimate quantitative dose-response relationship on the biological response to radiation. In this study, we measured micronucleus formation and (3H) thymidine uptake in U2OS, human osteosarcoma cell line, as indicators of biological response to gamma radiation. Cells were exposed to gamma ray in irradiation room bearing 50,000 Ci 60Co. After irradiation, they were cultured for 24h in the presence of cytochalasin B to block cytokinesis, and cytoplasm and nucleus were stained with DAPI and propidium iodide. The number of binuclear cells bearing a micronucleus was counted under a florescence microscope. For proliferation inhibition, cells were cultured for 48 h after the irradiation and (3h) thymidine was pulsed for 4h before harvesting. We statistically analyzed the data for quantitative evaluation of radiation risk at low dose/dose-rate. (Author)

  15. Increased fracture rate in women with breast cancer: a review of the hidden risk

    Directory of Open Access Journals (Sweden)

    Body Jean-Jacques

    2011-08-01

    Full Text Available Abstract Background Women with breast cancer, particularly individuals diagnosed at a relatively early age, have an increased incidence of fractures. Fractures can have serious clinical consequences including the need for major surgery, increased morbidity and mortality, increased cost of disease management, and reduced quality of life for patients. The primary cause of the increased fracture risk appears to be an accelerated decrease in bone mineral density (BMD resulting from the loss of estrogenic signaling that occurs with most treatments for breast cancer, including aromatase inhibitors. However, factors other than BMD levels alone may influence treatment decisions to reduce fracture risk in this setting. Our purpose is to review current evidence for BMD loss and fracture risk during treatment for breast cancer and discuss pharmacologic means to reduce this risk. Results Fracture risk during treatment for breast cancer may be influenced by the rate of BMD loss and the consequent rapid alterations in bone microarchitecture, in addition to the established fracture risk factors in postmenopausal osteoporosis. The rapid decrease in BMD during adjuvant chemoendocrine therapy for breast cancer may necessitate more aggressive pharmacotherapy than is indicated for healthy postmenopausal women who develop osteoporosis. Over the last few years, clinical trials have established the effectiveness of bisphosphonates and other antiresorptive agents to preserve BMD during adjuvant therapy for early breast cancer. In addition, some bisphosphonates (eg, zoledronic acid may also delay disease recurrence in women with hormone-responsive tumors, thereby providing an adjuvant benefit in addition to preserving BMD and potentially preventing fractures. Conclusions It is likely that a combined fracture risk assessment (eg, as in the WHO FRAX algorithm will more accurately identify both women with postmenopausal osteoporosis and women with breast cancer who require

  16. State infant mortality: an ecologic study to determine modifiable risks and adjusted infant mortality rates.

    Science.gov (United States)

    Paul, David A; Mackley, Amy; Locke, Robert G; Stefano, John L; Kroelinger, Charlan

    2009-05-01

    To determine factors contributing to state infant mortality rates (IMR) and develop an adjusted IMR in the United States for 2001 and 2002. Ecologic study of factors contributing to state IMR. State IMR for 2001 and 2002 were obtained from the United States linked death and birth certificate data from the National Center for Health Statistics. Factors investigated using multivariable linear regression included state racial demographics, ethnicity, state population, median income, education, teen birth rate, proportion of obesity, smoking during pregnancy, diabetes, hypertension, cesarean delivery, prenatal care, health insurance, self-report of mental illness, and number of in-vitro fertilization procedures. Final risk adjusted IMR's were standardized and states were compared with the United States adjusted rates. Models for IMR in individual states in 2001 (r2 = 0.66, P < 0.01) and 2002 (r2 = 0.81, P < 0.01) were tested. African-American race, teen birth rate, and smoking during pregnancy remained independently associated with state infant mortality rates for 2001 and 2002. Ninety five percent confidence intervals (CI) were calculated around the regression lines to model the expected IMR. After adjustment, some states maintained a consistent IMR; for instance, Vermont and New Hampshire remained low, while Delaware and Louisiana remained high. However, other states such as Mississippi, which have traditionally high infant mortality rates, remained within the expected 95% CI for IMR after adjustment indicating confounding affected the initial unadjusted rates. Non-modifiable demographic variables, including the percentage of non-Hispanic African-American and Hispanic populations of the state are major factors contributing to individual variation in state IMR. Race and ethnicity may confound or modify the IMR in states that shifted inside or outside the 95% CI following adjustment. Other factors including smoking during pregnancy and teen birth rate, which are

  17. Low-Dose-Rate Brachytherapy Versus Cryotherapy in Low- and Intermediate-Risk Prostate Cancer.

    Science.gov (United States)

    Gestaut, Matthew M; Cai, Wendi; Vyas, Shilpa; Patel, Belur J; Hasan, Salman A; MunozMaldonado, Yolanda; Deb, Niloyjyoti; Swanson, Gregory

    2017-05-01

    Cryotherapy and brachytherapy are definitive local treatment options for low- to intermediate-risk prostate cancer. There are both prospective and retrospective data for brachytherapy, but the use of cryotherapy has been limited primarily to single-institution retrospective studies. Currently, no published evidence has compared low-dose-rate brachytherapy versus cryotherapy. Institutional review board approval was obtained to conduct a retrospective chart review of consecutive patients treated at our institution from 1990 to 2012. For inclusion, patients must have received a prostate cancer diagnosis and have been considered to have low- to intermediate-risk disease according to the National Comprehensive Cancer Network criteria. All patients received brachytherapy or cryotherapy treatment. Disease specifics and failure details were collected for all patients. Failure was defined as prostate-specific antigen nadir +2 ng/mL. A total of 359 patients were analyzed. The groups comprised 50 low-risk cryotherapy (LRC), 92 intermediate-risk cryotherapy (IRC), 133 low-risk brachytherapy (LRB), and 84 intermediate-risk brachytherapy (IRB) patients. The median prostate-specific antigen follow-up periods were 85.6 months (LRC), 59.2 months (IRC), 74.9 months (LRB), and 59.8 months (IRB). The 5-year biochemical progression-free survival (bPFS) rate was 57.9% in the cryotherapy group versus 89.6% in the brachytherapy group (Pcryotherapy for low- and intermediate-risk groups (Pcryotherapy patients was -35°C (range, -96°C to -6°C). Cryotherapy used a median of 2 freeze-thaw cycles (range, 2-4 freeze-thaw cycles). Results from this study suggest that cryotherapy is inferior to brachytherapy for patients with low- to intermediate-risk prostate cancer. Patient selection criteria for consideration of cryotherapy and brachytherapy are similar in terms of anesthesia candidacy. Therefore, cryotherapy would not be recommended as a first-line local therapy for this particular

  18. Risk factors in oil and gas lending

    International Nuclear Information System (INIS)

    David, A.; Kipp, J.M.

    1991-01-01

    This paper reports that with the increasing internationalization of the petroleum industry, lenders to the industry must understand and overcome several new credit risk factors. As a result, new financial products are now available to reserve-based borrowers. Traditional project financing now also may include futures hedging, swaps, and collar elements

  19. Credit default swaps and risk-shifting

    NARCIS (Netherlands)

    Campello, M.; Matta, R.

    2012-01-01

    Credit default swaps (CDSs) are thought to ease borrowing by protecting lenders against default. This paper develops a model of the demand for CDS when borrowers choose the riskiness of investment and verification is imperfect. The model shows that CDSs may lead to risk-shifting, increasing the

  20. A real-time heat strain risk classifier using heart rate and skin temperature

    International Nuclear Information System (INIS)

    Buller, Mark J; Latzka, William A; Yokota, Miyo; Tharion, William J; Moran, Daniel S

    2008-01-01

    Heat injury is a real concern to workers engaged in physically demanding tasks in high heat strain environments. Several real-time physiological monitoring systems exist that can provide indices of heat strain, e.g. physiological strain index (PSI), and provide alerts to medical personnel. However, these systems depend on core temperature measurement using expensive, ingestible thermometer pills. Seeking a better solution, we suggest the use of a model which can identify the probability that individuals are 'at risk' from heat injury using non-invasive measures. The intent is for the system to identify individuals who need monitoring more closely or who should apply heat strain mitigation strategies. We generated a model that can identify 'at risk' (PSI ≥ 7.5) workers from measures of heart rate and chest skin temperature. The model was built using data from six previously published exercise studies in which some subjects wore chemical protective equipment. The model has an overall classification error rate of 10% with one false negative error (2.7%), and outperforms an earlier model and a least squares regression model with classification errors of 21% and 14%, respectively. Additionally, the model allows the classification criteria to be adjusted based on the task and acceptable level of risk. We conclude that the model could be a valuable part of a multi-faceted heat strain management system. (note)

  1. Neural Network for Determining Risk Rate of Post-Heart Stroke Patients

    Directory of Open Access Journals (Sweden)

    Oldřich Trenz

    2014-01-01

    Full Text Available The ischemic heart disease presents an important health problem that affects a great part of the population and is the cause of one third of all deaths in the Czech Republic. The availability of data describing the patients’ prognosis enables their further analysis, with the aim of lowering the patients’ risk, by proposing optimum treatment. The main reason for creating the neural network model is not only to automate the process of establishing the risk rate of patients suffering from ischemic heart disease, but also to adapt it for practical use in clinical conditions. Our aim is to identify especially the specific group of risk-rate patients whose well-timed preventive care can improve the quality and prolong the length of their lives.The aim of the paper is to propose a patient-parameter structure, using which we could create a suitable model based on a self-taught neural network. The emphasis is placed on identifying key descriptive parameters (in the form of a reduction of the available descriptive parameters that are crucial for identifying the required patients, and simultaneously to achieve a portability of the model among individual clinical workplaces (availability of parameters.

  2. 77 FR 20890 - Proposed Information Collection (Interest Rate Reduction Refinancing Loan Worksheet) Activity...

    Science.gov (United States)

    2012-04-06

    ... (Interest Rate Reduction Refinancing Loan Worksheet) Activity: Comment Request AGENCY: Veterans Benefits... to determine whether lenders computed the loan amount on interest rate reduction refinancing loans.... Title: Interest Rate Reduction Refinancing Loan Worksheet, VA Form 26-8923. OMB Control Number: 2900...

  3. 77 FR 38397 - Agency Information Collection (Interest Rate Reduction Refinancing Loan Worksheet) Activities...

    Science.gov (United States)

    2012-06-27

    ... . Please refer to ``OMB Control No. 2900- 0386.'' SUPPLEMENTARY INFORMATION: Title: Interest Rate Reduction... guaranty on all interest rate reduction refinancing loan and provide a receipt as proof that the funding... ensure lenders computed the funding fee and the maximum permissible loan amount for interest rate...

  4. 7 CFR 1779.80 - Interest rate changes after loan closing.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false Interest rate changes after loan closing. 1779.80....80 Interest rate changes after loan closing. (a) General. Subject to the restrictions below, the borrower, lender, and holder (if any) may collectively effect a permanent reduction in the interest rate on...

  5. [Sports medical aspects in cardiac risk stratification--heart rate variability and exercise capacity].

    Science.gov (United States)

    Banzer, W; Lucki, K; Bürklein, M; Rosenhagen, A; Vogt, L

    2006-12-01

    The present study investigates the association of the predicted CHD-risk (PROCAM) with the individual endurance capacity and heart rate variability (HRV) in a population-based sample of sedentary elderly. After stratification, in 57 men (48.1+/-9.5 yrs.) with an overall PROCAM-risk or =10% (50.8+/-5.6 points) cycle ergometries and short-term HRV analysis of time (RRMEAN, SDNN, RMSSD) and frequency domain parameters (LF, HF, TP, LF/HF) were conducted. Additionally the autonomic stress index (SI) was calculated. Nonparametric tests were used for statistical correlation analysis (Spearman rho) and group comparisons (Mann-Whitney). For endurance capacity [W/kg] (r=-0.469, pHRV analysis in risk stratification and outline the interrelation of a decreased exercise capacity and autonomic function with a raised individual 10-year cardiac risk. As an independent parameter of the vegetative regulatory state the stress index may contribute to an increased practical relevance of short-time HRV analysis.

  6. FACTORS THAT MAY DETERMINE THE RECOVERY RATE OF FINANCIAL RISK DAMAGES

    Directory of Open Access Journals (Sweden)

    Nicoleta Diana Rosioru

    2015-05-01

    Full Text Available The information about the performance of a company, especially about its profitability, are useful to the consideration of potential changes of the economic resources, which the company might further control and the forecast of the ability to generate treasury flows by the existent resources. Also, based on the performance, judgments are expressed, aiming the efficiency whereof the company may use new resources. The performance of company may be influenced by its financial risk. The financial risk is defined as “variability of result indicators, under the incidence of financial structure of the company” . It is established by “the financing policy of the company, by equity or loans”. The financial risk results by the structure of the company shareholding or by the use method of financial instruments. The financial risks result by different sources, including changes of the interest rate, currency trades, expansions of lending operations, issuance of shares, as well as the use of derived financial instruments (IFD.

  7. Semiparametric accelerated failure time cure rate mixture models with competing risks.

    Science.gov (United States)

    Choi, Sangbum; Zhu, Liang; Huang, Xuelin

    2018-01-15

    Modern medical treatments have substantially improved survival rates for many chronic diseases and have generated considerable interest in developing cure fraction models for survival data with a non-ignorable cured proportion. Statistical analysis of such data may be further complicated by competing risks that involve multiple types of endpoints. Regression analysis of competing risks is typically undertaken via a proportional hazards model adapted on cause-specific hazard or subdistribution hazard. In this article, we propose an alternative approach that treats competing events as distinct outcomes in a mixture. We consider semiparametric accelerated failure time models for the cause-conditional survival function that are combined through a multinomial logistic model within the cure-mixture modeling framework. The cure-mixture approach to competing risks provides a means to determine the overall effect of a treatment and insights into how this treatment modifies the components of the mixture in the presence of a cure fraction. The regression and nonparametric parameters are estimated by a nonparametric kernel-based maximum likelihood estimation method. Variance estimation is achieved through resampling methods for the kernel-smoothed likelihood function. Simulation studies show that the procedures work well in practical settings. Application to a sarcoma study demonstrates the use of the proposed method for competing risk data with a cure fraction. Copyright © 2017 John Wiley & Sons, Ltd.

  8. THE MANAGEMENT OF CREDIT RISK ACCORDING TO INTERNAL RATINGS- BASED APPROACH

    Directory of Open Access Journals (Sweden)

    BOLOCAN DRAGOS-MIHAIL

    2010-12-01

    Full Text Available The internal ratings based approach (IRB Approach was created as part of Basel II replacing the original Basle Accord of 1988 (Basle I in an effort to create a better framework for regulating bank capital. This paper covers the methodology and components of the IRB Approach used to determine capital requirements for credit risk. Such an approach, which relies heavily upon a banks internal assessment of its counterparties and exposures, can secure two key objectives consistent with those which support the wider review of The New Basel Capital Accord.. IRB approach should promote safety and soundness in the financial system and, consistent with providing incentive compatibility, that the structure and requirements of the IRB approach do not impinge upon or undermine banks well-established lending and credit risk management practices

  9. Statistical properties of country risk ratings under oil price volatility: Evidence from selected oil-exporting countries

    International Nuclear Information System (INIS)

    Liu, Chang; Sun, Xiaolei; Chen, Jianming; Li, Jianping

    2016-01-01

    This paper focuses on the application of panel models for identification and analysis of influence of oil price volatility on statistical properties of country risk ratings which stem from uncertainty of macroeconomic fluctuations. Firstly, two statistical properties of country risk ratings, volatility clustering and asymmetrical revision were identified in a theoretical framework based on Cruces (2006). Secondly, considering the oil price volatility, numerical experiments were conducted based on extended models to test and verify specific properties of country risk ratings in selected oil-exporting countries. Empirical results suggest that properties of country risk remain comparatively steady despite oil price volatility. It is also found that the oil price volatility can obviously exaggerate the country risk volatility, as it happened during 2007–2009. Country clustering based on the properties of country risk ratings shows that the selected countries maintain a significant clustering tendency. These features are of great importance for estimating risk exposure of international trade and investments in oil export during extreme situations. - Highlights: •Relationship between oil price volatility and country risk is the focus. •An extended model based on Cruces (2006) is proposed. •Volatility clustering and asymmetrical revision of country risk ratings is explored. •Oil price volatility can obviously exaggerate properties of country risk volatility.

  10. On Value at Risk for Foreign Exchange Rates --- the Copula Approach

    Science.gov (United States)

    Jaworski, P.

    2006-11-01

    The aim of this paper is to determine the Value at Risk (VaR) of the portfolio consisting of long positions in foreign currencies on an emerging market. Basing on empirical data we restrict ourselves to the case when the tail parts of distributions of logarithmic returns of these assets follow the power laws and the lower tail of associated copula C follows the power law of degree 1. We will illustrate the practical usefulness of this approach by the analysis of the exchange rates of EUR and CHF at the Polish forex market.

  11. Dependence and risk assessment for oil prices and exchange rate portfolios: A wavelet based approach

    Science.gov (United States)

    Aloui, Chaker; Jammazi, Rania

    2015-10-01

    In this article, we propose a wavelet-based approach to accommodate the stylized facts and complex structure of financial data, caused by frequent and abrupt changes of markets and noises. Specifically, we show how the combination of both continuous and discrete wavelet transforms with traditional financial models helps improve portfolio's market risk assessment. In the empirical stage, three wavelet-based models (wavelet-EGARCH with dynamic conditional correlations, wavelet-copula, and wavelet-extreme value) are considered and applied to crude oil price and US dollar exchange rate data. Our findings show that the wavelet-based approach provides an effective and powerful tool for detecting extreme moments and improving the accuracy of VaR and Expected Shortfall estimates of oil-exchange rate portfolios after noise is removed from the original data.

  12. NDT method in determining the rate of corrosion applicable to risk based inspection

    International Nuclear Information System (INIS)

    Mohamed Hairul Hasmoni; Mohamad Pauzi Ismail; Ab Razak Hamzah

    2004-01-01

    Corrosion is a major problem in oil and gas industries, refineries and chemical process plants as the equipment is often exposed to corrosive environments or elevated temperature. Important equipment need to operate safely and reliably to avoid injuries to personnel and the public, and to prevent loss time and cost incurred due to loss of production and shutdown. The paper assess the approach in evaluating the technique of non-destructive testing (NDT) using Ultrasonic Testing (UT) in determining the rate of corrosion and remaining life of equipment applicable to Risk Based Inspection (RBI). Methods in determining the corrosion rate are presented using analytical method. Examples and data from MINT chiller water pipeline are presented to illustrate the application of these methods. (Author)

  13. Risk factors for breast cancer in a population with high incidence rates

    International Nuclear Information System (INIS)

    Wrensch, Margaret; Peskin-Mentzer, Roni; Quesenberry, Charles P Jr; Souders-Mason, Virginia; Spence, Linda; Suzuki, Marisa; Gould, Mary; Chew, Terri; Farren, Georgianna; Barlow, Janice; Belli, Flavia; Clarke, Christina; Erdmann, Christine A; Lee, Marion; Moghadassi, Michelle

    2003-01-01

    This report examines generally recognized breast cancer risk factors and years of residence in Marin County, California, an area with high breast cancer incidence and mortality rates. Eligible women who were residents of Marin County diagnosed with breast cancer in 1997–99 and women without breast cancer obtained through random digit dialing, frequency-matched by cases' age at diagnosis and ethnicity, participated in either full in-person or abbreviated telephone interviews. In multivariate analyses, 285 cases were statistically significantly more likely than 286 controls to report being premenopausal, never to have used birth control pills, a lower highest lifetime body mass index, four or more mammograms in 1990–94, beginning drinking after the age of 21, on average drinking two or more drinks per day, the highest quartile of pack-years of cigarette smoking and having been raised in an organized religion. Cases and controls did not significantly differ with regard to having a first-degree relative with breast cancer, a history of benign breast biopsy, previous radiation treatment, age at menarche, parity, use of hormone replacement therapy, age of first living in Marin County, or total years lived in Marin County. Results for several factors differed for women aged under 50 years or 50 years and over. Despite similar distributions of several known breast cancer risk factors, case-control differences in alcohol consumption suggest that risk in this high-risk population might be modifiable. Intensive study of this or other areas of similarly high incidence might reveal other important risk factors proximate to diagnosis

  14. Post-operative high dose rate brachytherapy in patients with low to intermediate risk endometrial cancer

    International Nuclear Information System (INIS)

    Pearcey, R.G.; Petereit, D.G.

    2000-01-01

    This paper investigates the outcome using different dose/fractionation schedules in high dose rate (HDR) post-operative vaginal vault radiotherapy in patients with low to intermediate risk endometrial cancer. The world literature was reviewed and thirteen series were analyzed representing 1800 cases. A total of 12 vaginal vault recurrences were identified representing an overall vaginal control rate of 99.3%. A wide range of dose fractionation schedules and techniques have been reported. In order to analyze a dose response relationship for tumor control and complications, the biologically effective doses to the tumor and late responding tissues were calculated using the linear quadratic model. A threshold was identified for complications, but not vaginal control. While dose fractionation schedules that delivered a biologically effective dose to the late responding tissues in excess of 100 Gy 3 (LQED = 60 Gy) predicted for late complications, dose fractionation schedules that delivered a modest dose to the vaginal surface (50 Gy 10 or LQED = 30 Gy) appeared tumoricidal with vaginal control rates of at least 98%. By using convenient, modest dose fractionation schedules, HDR vaginal vault - brachytherapy yields very high local control and extremely low morbidity rates. (author)

  15. Rates and risk factors of unplanned 30-day readmission following general and thoracic pediatric surgical procedures.

    Science.gov (United States)

    Polites, Stephanie F; Potter, Donald D; Glasgow, Amy E; Klinkner, Denise B; Moir, Christopher R; Ishitani, Michael B; Habermann, Elizabeth B

    2017-08-01

    Postoperative unplanned readmissions are costly and decrease patient satisfaction; however, little is known about this complication in pediatric surgery. The purpose of this study was to determine rates and predictors of unplanned readmission in a multi-institutional cohort of pediatric surgical patients. Unplanned 30-day readmissions following general and thoracic surgical procedures in children readmission per 30 person-days were determined to account for varied postoperative length of stay (pLOS). Patients were randomly divided into 70% derivation and 30% validation cohorts which were used for creation and validation of a risk model for readmission. Readmission occurred in 1948 (3.6%) of 54,870 children for a rate of 4.3% per 30 person-days. Adjusted predictors of readmission included hepatobiliary procedures, increased wound class, operative duration, complications, and pLOS. The predictive model discriminated well in the derivation and validation cohorts (AUROC 0.710 and 0.701) with good calibration between observed and expected readmission events in both cohorts (p>.05). Unplanned readmission occurs less frequently in pediatric surgery than what is described in adults, calling into question its use as a quality indicator in this population. Factors that predict readmission including type of procedure, complications, and pLOS can be used to identify at-risk children and develop prevention strategies. III. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Longitudinal dating violence victimization among Latino teens: Rates, risk factors, and cultural influences.

    Science.gov (United States)

    Sabina, Chiara; Cuevas, Carlos A; Cotignola-Pickens, Heather M

    2016-02-01

    This study uses data from two waves of the Dating Violence Among Latino Adolescents (DAVILA) study and focuses on the 1) rates of dating violence victimization by gender, 2) risk of experiencing dating violence victimization over time, 3) association of dating violence victimization with other forms of victimization, and 4) association of immigrant status, acculturation, and familial support with dating violence victimization over time. A total of 547 Latino adolescents, from across the USA, aged 12-18 at Wave 1 participated in both waves of the study. Rates of dating violence were around 19% across waves. Dating violence at Wave 1 and non-dating violence victimization were associated with an elevated risk of dating violence during Wave 2. Cultural factors did not distinguish between dating violence trajectories, except for immigrant status and familial support being associated with no dating violence victimization. Overall, dating violence affects a large number of Latino teens and tends to continue over time. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  17. Recurrent rates and risk factors associated with recurrent painful bullous keratopathy after primary phototherapeutic keratectomy

    Directory of Open Access Journals (Sweden)

    Kasetsuwan N

    2015-09-01

    Full Text Available Ngamjit Kasetsuwan, Kanokorn Sakpisuttivanit, Usanee Reinprayoon, Vilavun Puangsricharern Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand Objective: To assess the recurrent rate, mean survival time, and risk factors associated with recurrent painful bullous keratopathy (BK after primary treatment with phototherapeutic keratectomy.Methods: Medical records from 72 patients (72 eyes who had phototherapeutic keratectomy for painful BK were evaluated. Data for sex, age, duration of BK, associated ocular and systemic diseases (hypertension, diabetes mellitus, ischemic heart disease, asthma, dyslipidemia, and rheumatoid arthritis, frequency and degree of pain (grade 1–3, visual acuity, corneal thickness, intraocular pressure, and laser setting were extracted and analyzed.Results: The mean age of the patients was 64.2±11.4 years. The mean preoperative duration of BK was 15.0±11.0 months. Most patients had pseudophakic BK (69.40%. Majority of the cases had grade 3 degree of pain (48.60%. Glaucoma and hypertension were markedly found among these patients (51.40% and 19.40%, respectively. Preoperative mean intraocular pressure and corneal thickness were 13.70±4.95 mmHg and 734.1±83.80 µm, respectively. The mean laser diameter and depth were 8.36±1.22 mm and 38.89±8.81 µm, respectively. Systemic disease was significantly associated with the risk for developing recurrent painful BK (P=0.022, hazard ratio [HR] 1.673, 95% confidence interval [CI] 1.08–2.58. The overall recurrent rate was 51%. The average duration time of recurrent painful BK was 17.3±12.9 months (range 1–50 months. The median survival time before recurrence was 29.0±6.6 months.Conclusion: Systemic disease was found to be the only risk factor significantly associated with the development of recurrent painful BK. Low recurrent rate and long mean survival time showed that phototherapeutic

  18. Effects of stochastic interest rates in decision making under risk: A Markov decision process model for forest management

    Science.gov (United States)

    Mo Zhou; Joseph Buongiorno

    2011-01-01

    Most economic studies of forest decision making under risk assume a fixed interest rate. This paper investigated some implications of this stochastic nature of interest rates. Markov decision process (MDP) models, used previously to integrate stochastic stand growth and prices, can be extended to include variable interest rates as well. This method was applied to...

  19. Teaching Exchange Rate Risk Using London's Gherkin Building: How Investors Were in (and out of) a Pickle

    Science.gov (United States)

    Jones, Adam T.; Sackley, William H.; Watson, Ethan D.

    2017-01-01

    In this teaching note, the authors use an iconic London building, the Gherkin, as a motivation to understand exchange rates, cross exchange rates, and unhedged exchange rate risk. The famous tower was constructed in the early 2000s by Swiss Re, an insurance company, and then sold to investors as part of a sale-leaseback deal in early 2007.…

  20. INCLUDING INTANGIBLE ASSETS IN RATES TO ESTIMATE THE RISK OF BANKRUPTCY

    Directory of Open Access Journals (Sweden)

    Eugenia IANCU

    2017-12-01

    Full Text Available The purpose of this paper is to show that an economic entity’s intangible assets play an important role in predicting the risk of bankruptcy of the company and at the same time in its evolution. Based on benchmarking and on appeal to the experience and intuition of available human expert it can be shaped a credible model and, based on this model can be projected the future course of a business organization. Among other issues, we note that the intangible assets of a company can and should be entered into the equation for estimating the risk of bankruptcy whether it avails or not to artificial intelligence (AI techniques to solve this problem (values lead to bankruptcy and the graphics functions differ majorly when the analysis includes the Rhine rate which takes into account intangibles of firms. From the structure of the paper we can see that whatever the type of model used in predicting the risk of bankruptcy at either classic or using artificial intelligence techniques (AI a leading role in the evolution and the value of the company represents intangible.

  1. Observer-rated depression in long-term care: frequency and risk factors.

    Science.gov (United States)

    McCusker, Jane; Cole, Martin G; Voyer, Philippe; Monette, Johanne; Champoux, Nathalie; Ciampi, Antonio; Vu, Minh; Dyachenko, Alina; Belzile, Eric

    2014-01-01

    The objectives of this study were: (1) to describe the prevalence and 6-month incidence of observer-rated depression in residents age 65 and over of long-term care (LTC) facilities; (2) to describe risk factors for depression, at baseline and over time. A multisite, prospective observational study was conducted in residents aged 65 and over of 7 LTC facilities. The Cornell Scale for Depression in Dementia (CSDD) was completed by nurses monthly for 6 months. We measured demographic, medical, and functional factors at baseline and monthly intervals, using data from research assessments, nurse interviews, and chart reviews. 274 residents were recruited and completed baseline depression assessments. The prevalence of depression (CSDD score of 6+) was 19.0%. The incidence of depression among those without prevalent depression was 73.3 per 100 person-years. A delirium diagnosis, pain, and diabetes were independently associated with prevalent depression. CSDD score at baseline and development of severe cognitive impairment at follow-up were independent risk factors for incident depression. A diagnosis of delirium and uncorrected visual impairment at follow-up occurred concurrently with incident depression. The results of this study have implications for the detection and prevention of depression in LTC. Delirium diagnosis, pain and diabetes at baseline were associated with prevalent depression; depression symptoms at baseline and development of severe cognitive impairment at follow-up were risk factors for incident depression. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. THE APPLICATION OF RISK BASED BANK RATING ON BANKRUPTCY PREDICTION OF BANKS IN INDONESIA

    Directory of Open Access Journals (Sweden)

    Evi Sistiyarini

    2017-04-01

    Full Text Available The increase of banking products and services which is more complex will increase the risk to the banks. Therefore, to anticipate the rise of financial difficulties in a bank, the early warning system. This study aimed to find the influence RBBR (Risk Based Bank Rating ratio’s to predict bankruptcy of conventional Banks in Indonesia. Ratio of RBBR consisted of risk profile, Good Corporate Governance, profitability and capital. Independent variables used were NPL, PDN, LDR, GCG, ROA and NIM, and CAR. Dependent variable was bank bankruptcy using dummy variable. The population of this study was all of the conventional banks in Indonesia. The data was a secondary data taken form financial report of conventional bank 2011-2015. Technical sampling used was a purposive sampling method with some criteria. The analysis of this study used logistic regression.The result of the study showed that NPL, PDN, LDR, GCG, ROA and NIM, and CARhad no significant influence to bankruptcy of the bank.

  3. Attenuated Heart Rate Recovery After Exercise Testing and Risk of Incident Hypertension in Men.

    Science.gov (United States)

    Jae, Sae Young; Bunsawat, Kanokwan; Fadel, Paul J; Fernhall, Bo; Choi, Yoon-Ho; Park, Jeong Bae; Franklin, Barry A

    2016-09-01

    Although attenuated heart rate recovery (HRR) and reduced heart rate (HR) reserve to maximal exercise testing are associated with adverse cardiovascular outcomes, their relation to incident hypertension in healthy normotensive populations is unclear. We examined the hypothesis that both attenuated HRR and reduced HR reserve to exercise testing are associated with incident hypertension in men. A total of 1,855 participants were selected comprising of healthy, initially normotensive men who underwent peak or symptom-limited treadmill testing at baseline. HRR was calculated as the difference between peak HR during exercise testing and the HR at 2 minutes after exercise cessation. HR reserve was calculated as the percentage of HR reserve (peak HR - resting HR)/(220 - age - resting HR) × 100. During an average 4-year follow-up, 179 (9.6%) men developed hypertension. Incident hypertension was associated with HRR quartiles (Q1 (57 bpm) 8.3%; P = 0.05 for trend). The relative risk (RR) of the incident hypertension in the slowest HRR quartile vs. the fastest HRR quartile was 1.78 (95% confidence interval (CI): 1.14-2.78) after adjustment for confounders. Every 1 bpm increment in HRR was associated with a 2% (RR 0.98, 95% CI: 0.97-0.99) lower risk of incident hypertension after adjusting for potential confounders. In contrast, reduced HR reserve did not predict the risk of incident hypertension. Slow HRR after exercise testing is independently associated with the development of hypertension in healthy normotensive men. © American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Rates of fetal polydrug exposures in methadone-maintained pregnancies from a high-risk population.

    Directory of Open Access Journals (Sweden)

    Kaitlyn Delano

    Full Text Available Methadone maintenance treatment (MMT is the standard of care during pregnancy for opioid-dependency, showing efficacy in improving prenatal care and reducing risk of relapse. By design, however, MMT is only intended to prevent withdrawal thus facilitating cognitive behavioural interventions. In order to maximize the benefits of MMT, it is essential that methadone is both properly prescribed and that additional addiction treatment is concurrently administered. This study aims to determine the effectiveness of MMT engagement in high-risk pregnant women in reducing polydrug use by objective laboratory examination of neonatal meconium.Over a 29-month period, the Motherisk Laboratory at the Hospital for Sick Children in Toronto analyzed meconium samples as per request by social services and hospitals for drugs of abuse.Of the 904 meconium samples received, 273 were tested for methadone with 164 positive and 109 negative for methadone. Almost half of the methadone positive samples (46.34% were also positive for at least one other opioid compound, which did not differ statistically from the methadone-negative control samples (46.79%; Chi square test, p=0.94. No differences were found between the methadone positive and negative groups in rates of concurrent amphetamines, cocaine, cannabis, and alcohol use indicating a similar risk of polydrug use between pregnant women taking or not taking methadone in this population.The high rates of additional opioid and other drug use in the MMT group, suggest that MMT is failing this population of patients. It is possible that methadone doses during pregnancy are not appropriately adjusted for changes in pharmacokinetic parameters (e.g. blood volume, renal function during the second and third trimesters. This may result in sub-therapeutic dosing creating withdrawal symptoms leading to additional substance use. Alternatively, these results may be demonstrating a substantial lack in delivery of addiction support

  5. Post-crisis Belarus: Marxism and the lender of last resort

    Directory of Open Access Journals (Sweden)

    Heather Bell

    2015-07-01

    Full Text Available Existing literature has examined the predictions and proscriptions of Karl Marx in response to the 2008 global financial crisis. However, the suggestions put forth by the Marxist-leaning literature never took hold and state-level banking and finance policies have remained largely unchanged. While many criticisms of Marxism exist, this paper examines Belarus, a ‘neo-communist’ or ‘market-socialist’ state, to provide a new perspective on the continuation of capitalism in the United States and Europe. In the case of Belarus, the International Monetary Fund and the Eurasian Economic Community's Anti-Crisis Fund provided both the critical liquidity needed to temporarily quell the effects of the financial crisis. Their demands meant that Belarus agreed to speed its move away from the Soviet-era finance and banking policies and more towards its western capitalist neighbors. Its failure to implement these policies further hurt its recovery. Examining Belarus' path to and out of its financial crisis makes apparent that the role of the international lender of last resort (LOLR. The LOLR acts as a key element in protecting states embroiled in the financial crisis from facing the possibility of making the difficult policy changes put forth by the Marxist literature. By ignoring its promises under the loan conditions from its LOLRs, Belarus moved further from the recovery promised by the Marxist suggestions.

  6. Rates and risks for prolonged grief disorder in a sample of orphaned and widowed genocide survivors.

    Science.gov (United States)

    Schaal, Susanne; Jacob, Nadja; Dusingizemungu, Jean-Pierre; Elbert, Thomas

    2010-07-06

    The concept of Prolonged Grief Disorder (PGD) has been defined in recent years by Prigerson and co-workers, who have developed and empirically tested consensus and diagnostic criteria for PGD. Using these most recent criteria defining PGD, the aim of this study was to determine rates of and risks for PGD in survivors of the 1994 Rwandan genocide who had lost a parent and/or the husband before, during or after the 1994 events. The PG-13 was administered to 206 orphans or half orphans and to 194 widows. A regression analysis was carried out to examine risk factors of PGD. 8.0% (n = 32) of the sample met criteria for PGD with an average of 12 years post-loss. All but one person had faced multiple losses and the majority indicated that their grief-related loss was due to violent death (70%). Grief was predicted mainly by time since the loss, by the violent nature of the loss, the severity of symptoms of posttraumatic stress disorder (PTSD) and the importance given to religious/spiritual beliefs. By contrast, gender, age at the time of bereavement, bereavement status (widow versus orphan), the number of different types of losses reported and participation in the funeral ceremony did not impact the severity of prolonged grief reactions. A significant portion of the interviewed sample continues to experience grief over interpersonal losses and unresolved grief may endure over time if not addressed by clinical intervention. Severity of grief reactions may be associated with a set of distinct risk factors. Subjects who lose someone through violent death seem to be at special risk as they have to deal with the loss experience as such and the traumatic aspects of the loss. Symptoms of PTSD may hinder the completion of the mourning process. Religious beliefs may facilitate the mourning process and help to find meaning in the loss. These aspects need to be considered in the treatment of PGD.

  7. Self-rated health among Greenlandic Inuit and Norwegian Sami adolescents: associated risk and protective correlates.

    Science.gov (United States)

    Spein, Anna Rita; Pedersen, Cecilia Petrine; Silviken, Anne Cathrine; Melhus, Marita; Kvernmo, Siv Eli; Bjerregaard, Peter

    2013-01-01

    Self-rated health (SRH) and associated risk and protective correlates were investigated among two indigenous adolescent populations, Greenlandic Inuit and Norwegian Sami. Cross-sectional data were collected from "Well-being among Youth in Greenland" (WBYG) and "The Norwegian Arctic Adolescent Health Study" (NAAHS), conducted during 2003-2005 and comprising 10th and 11th graders, 378 Inuit and 350 Sami. SRH was assessed by one single item, using a 4-point and 5-point scale for NAAHS and WBYG, respectively. Logistic regressions were performed separately for each indigenous group using a dichotomous measure with "very good" (NAAHS) and "very good/good" (WBYG) as reference categories. We simultaneously controlled for various socio-demographics, risk correlates (drinking, smoking, violence and suicidal behaviour) and protective correlates (physical activity, well-being in school, number of close friends and adolescent-parent relationship). A majority of both Inuit (62%) and Sami (89%) youth reported "good" or "very good" SRH. The proportion of "poor/fair/not so good" SRH was three times higher among Inuit than Sami (38% vs. 11%, p≤0.001). Significantly more Inuit females than males reported "poor/fair" SRH (44% vs. 29%, p≤0.05), while no gender differences occurred among Sami (12% vs. 9%, p≤0.08). In both indigenous groups, suicidal thoughts (risk) and physical activity (protective) were associated with poor and good SRH, respectively. In accordance with other studies of indigenous adolescents, suicidal thoughts were strongly associated with poorer SRH among Sami and Inuit. The Inuit-Sami differences in SRH could partly be due to higher "risk" and lower "protective" correlates among Inuit than Sami. The positive impact of physical activity on SRH needs to be targeted in future intervention programs.

  8. Coronary artery bypass graft readmission rates and risk factors - A retrospective cohort study.

    Science.gov (United States)

    Feng, T Robert; White, Robert S; Gaber-Baylis, Licia K; Turnbull, Zachary A; Rong, Lisa Q

    2018-04-17

    Hospital readmissions contribute substantially to the overall healthcare cost. Coronary artery bypass graft (CABG) is of particular interest due to its relatively high short-term readmission rates and mean hospital charges. A retrospective review was performed on 2007-2011 data from California, Florida, and New York from the State Inpatient Databases, Healthcare Cost and Utilization Project. All patients ≥18 years of age who underwent isolated CABG and met inclusion/exclusion criteria were included. Insurance status was categorized by Medicaid, Medicare, Private Insurance, Uninsured, and Other. Primary outcomes were unadjusted rates and adjusted odds of readmission at 30- and 90-days. Secondary outcomes included diagnosis at readmission. A total of 177,229 were included in the analyses after assessing for exclusion criteria. Overall 30-day readmission rate was 16.1%; rates were highest within Medicare (18.4%) and Medicaid (20.2%) groups and lowest in the private insurance group (11.7%; p readmission diagnoses were atrial fibrillation (26.7%), pleural effusion (22.5%), and wound infection (17.7%). Medicare patients had the highest proportion of readmissions with atrial fibrillation (31.7%) and pleural effusions (23.3%), while Medicaid patients had the highest proportion of readmissions with wound infections (21.8%). Similar results were found at 90 days. Risk factors for readmission included non-private insurance, age, female sex, non-white race, low median household income, non-routine discharge, length of stay, and certain comorbidities and complications. CABG readmission rates remain high and are associated with insurance status and racial and socioeconomic markers. Further investigation is necessary to better delineate the underlying factors that relate racial and socioeconomic disparities to CABG readmissions. Understanding these factors will be key to improving healthcare outcomes and expenditure. Copyright © 2018 IJS Publishing Group Ltd. Published by

  9. Pregnancy risk assessment monitoring system in Ireland: methods and response rates

    LENUS (Irish Health Repository)

    O’Keeffe, Linda M.

    2014-06-01

    To describe response rates and characteristics associated with response to the Pregnancy Risk Assessment Monitoring System study in Ireland (PRAMS Ireland). Using hospital discharge records of live births at a large, urban, obstetric hospital, a sampling frame of approximately 2,400 mother-infant pairs were used to alternately sample 1,200 women. Mothers’ information including name, address, parity, age and infant characteristics such as sex and gestational age at delivery were extracted from records. Modes of contact included an invitation letter with option to opt out of the study, three mail surveys, a reminder letter and text message reminder for remaining non-respondents. Sixty-one per cent of women responded to the PRAMS Ireland survey over a 133 day response period. Women aged <30, single women, multiparous women and women with a preterm delivery were less likely to respond. Women participating in PRAMS Ireland were similar to the national birth profile in 2011 which had a mean age of 32, were 40 % primiparous, 33 % single or never married and had a 28 % caesarean section rate. Survey and protocol changes are required to increase response rates above recommended Centers for Disease Control and Prevention (CDC) thresholds of 65 % within the recommended 90 day data collection cycle. Additional efforts such as stratification and over-sampling are required to increase representativeness among hard to reach groups such as younger, single and multiparous women before expanding the project to an ongoing, national surveillance system in Ireland.

  10. Water requirements and drinking rates of homing pigeons: A consideration for exposure risk of migratory birds.

    Science.gov (United States)

    Perez, Cristina R; Moye, John K; Pritsos, Chris A

    2017-09-01

    Access to water along a bird's migratory flyway is essential during the vital process of migration. Because of the scarcity of water in some environments, there is potential for migratory birds to encounter and drink from contaminated bodies of water. Ingestion of contaminated water may cause injury and compromise flying ability, leading to a disruption of migration. To determine injury to birds from potential exposure, it is essential to know not only the concentration of a given contaminant in the water but also the quantity and rate of water consumption by the birds. Homing pigeons (Columba livia) were used in a series of experiments to determine differences in drinking behavior after various flights and after periods of resting. Results from the present study demonstrate that homing pigeons' water consumption is dramatically different when assessed according to activity, flight distance, and time elapsed after flight. This suggests that the drinking rates of birds during migration are extremely important and much greater than estimated using traditional exposure assessment procedures. Thus, exposure to contaminants via drinking water may be greatly underestimated, and the rate of water consumption should be considered when estimating potential exposure risk to avian species. Integr Environ Assess Manag 2017;13:870-876. © 2017 SETAC. © 2017 SETAC.

  11. Penilaian Tingkat Kesehatan Bank Dengan Menggunakan Pendekatan Risiko (Risk-Based Bank Rating

    Directory of Open Access Journals (Sweden)

    Masnawati .

    2016-04-01

    Full Text Available This  study  aimed  to  analyze  techniques  of  the  bank’s  health  assessment  and determine  which  strategies  should  be  done  in  order  to  improve  the  health  of the bank. The method used is the approach of Risk (Risk Based-Bank Rating in accordance with Bank Indonesia Regulation on Rating Bank that PBI Number: 13/1/PBI/2011  which  entered  into  force  on  January  1,  2012.  Bank  health assessment  performed  using  four  (4  factors:  Risk  Profile,  Good  Corporate Governance (GCG, Earning, and Capital. Object  of  this  study  is  PT.  Bank  Pembangunan  Daerah  Kalimantan  Selatan period  2012.  The  results  showed  that  the  health  of  banks  in  PT.  Bank Pembangunan  Daerah  Kalimantan  Selatan  getting  ranked  2,  meaning  can be  categorized  good.  Strategies  to  improve  the  health  value  of  a  bank  is  to improve aspects of Earnings and Capital. Strategis Steps that must to increase credit expansion, improve the quality and quantity of human resources, product innovation, and increase fee-based income. Keywords: Healthy  banks,  Risk  Profile,  Good  Corporate  Governance  (GCG,  Earnings, Capital

  12. A multi-region assessment of population rates of cardiac catheterization and yield of high-risk coronary artery disease

    Directory of Open Access Journals (Sweden)

    Clement Fiona M

    2011-11-01

    Full Text Available Abstract Background There is variation in cardiac catheterization utilization across jurisdictions. Previous work from Alberta, Canada, showed no evidence of a plateau in the yield of high-risk disease at cardiac catheterization rates as high as 600 per 100,000 population suggesting that the optimal rate is higher. This work aims 1 To determine if a previously demonstrated linear relationship between the yield of high-risk coronary disease and cardiac catheterization rates persists with contemporary data and 2 to explore whether the linear relationship exists in other jurisdictions. Methods Detailed clinical information on all patients undergoing cardiac catheterization in 3 Canadian provinces was available through the Alberta Provincial Project for Outcomes Assessment in Coronary Heart (APPROACH disease and partner initiatives in British Columbia and Nova Scotia. Population rates of catheterization and high-risk coronary disease detection for each health region in these three provinces, and age-adjusted rates produced using direct standardization. A mixed effects regression analysis was performed to assess the relationship between catheterization rate and high-risk coronary disease detection. Results In the contemporary Alberta data, we found a linear relationship between the population catheterization rate and the high-risk yield. Although the yield was slightly less in time period 2 (2002-2006 than in time period 1(1995-2001, there was no statistical evidence of a plateau. The linear relationship between catheterization rate and high-risk yield was similarly demonstrated in British Columbia and Nova Scotia and appears to extend, without a plateau in yield, to rates over 800 procedures per 100,000 population. Conclusions Our study demonstrates a consistent finding, over time and across jurisdictions, of linearly increasing detection of high-risk CAD as population rates of cardiac catheterization increase. This internationally-relevant finding

  13. Heart rate variability and increased risk for developing type 2 diabetes mellitus.

    Science.gov (United States)

    Penčić-Popović, Biljana; Ćelić, Vera; Ćosić, Zoran; Pavlović-Kleut, Milena; Čaparević, Zorica; Kostić, Nada; Milovanović, Branislav; Šljivić, Aleksandra; Stojčevski, Biljana

    2014-12-01

    To our knowledge there are no data about the relationship between elevated risk for developing type 2 diabetes mellitus (DM2) and altered cardiac autonomic function. The aim of this study was to evaluate the association between heart rate variability (HRV) and slightly increased risk for DM2. We evaluated 69 subjects (50.0 ± 14.4 years; 30 male) without DM2, coronary artery disease and arrhythmias. The subjects were divided into two groups according to the Finnish Diabetes Risk Score (FINDRISC): group I (n = 39) included subjects with 12 > FINDRISC ≥ 7; group II (n = 30) subjects with FINDRISC power--TP (7.2 ± 0.3 ln/ms2 vs 7.3 ± 0.3 ln/ms2; p = 0.029), and low frequency--LF (5.9 ± 0.4 ln/ms2 vs 6.3 ± 0.6 In/ms2; p = 0.006), over entire 24 h, as well as TP (7.1 ± 0.3 In/ms2 vs 7.3 ± 0.3 In/ms2; p = 0.004), very low frequency (6.2 ± 0.2 In/ms2 vs 6.3 ± 0.2 In/ms2; p = 0.030), LF (5.9 ± 0.4 In/ms2 vs 6.2 ± 0.3 In/ms2; p = 0.000) and high frequency (5.7 ± 0.4 In/ms2 vs 5.9 ± 0.4 In/ms2; p = 0.011) during the daytime compared to the group II. Nocturnal frequency domain analysis was similar between the groups. The low diurnal frequency was independently related to elevated risk for diabetes mellitus (beta = -0,331; p = 0.006). The obtained results suggest that even slightly elevated risk for developing diabetes mellitus may be related to impaired HRV.

  14. The time to ruin in some additive risk models with random premium rates

    DEFF Research Database (Denmark)

    Jacobsen, Martin

    2012-01-01

    to have a Laplace transform that is a rational function. The main results describe the joint Laplace transform of the time at ruin and the deficit at ruin. The method used consists in finding partial eigenfunctions for the generator of the joint process consisting of the Markov process and the accumulated...... of the present value of the Markov process. The intensity for a claim to occur is another nonnegative function of the value of the Markov process. The claim arrival times are the regeneration times for the Markov process. Two-sided claims are allowed, but the distribution of the positive claims is assumed......The risk processes considered in this paper are generated by an underlying Markov process with a regenerative structure and an independent sequence of independent and identically distributed claims. Between the arrivals of claims the process increases at a rate which is a nonnegative function...

  15. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2011-11-15

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  16. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    International Nuclear Information System (INIS)

    Shah, Chirag; Vicini, Frank A.

    2011-01-01

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer–related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2–65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  17. 12 CFR 617.7100 - Who must make and who is entitled to receive an effective interest rate disclosure?

    Science.gov (United States)

    2010-01-01

    ... effective interest rate disclosure? 617.7100 Section 617.7100 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM BORROWER RIGHTS Disclosure of Effective Interest Rates § 617.7100 Who must make and who is entitled to receive an effective interest rate disclosure? (a) A qualified lender must make the...

  18. Comparative rate and risk factors of recurrent urethral stricture during different surgical procedures

    Directory of Open Access Journals (Sweden)

    D. Yu. Pushkar

    2014-11-01

    Full Text Available Objective – to identify the major risk factors leading to worse results of surgical treatment in patients with urethral stricture.Subjects and methods. Two hundred and forty-eight patients with urethral stricture underwent different surgical interventions: internal optical urethrotomy (IOU for strictures of different portions of the urethra in 157 patients (the operation was made once in 121 patients, twice in 24 patients, and thrice or more in 12; replacement urethroplasty using a buccal mucosa graft for strictures of the anterior urethra in 46 patients; Turner-Warwick’s anastomotic urethroplasty modified by Webster for strictures (distraction defects of the posterior urethra in 45 patients. The results of surgical treatment were studied using urethrography, uroflowmetry, urethrocystoscopy, the international prostate symptom score, quality of life (QoL questionnaire, and the international index of erectile function (IIEF questionnaire. The role of risk factors for postoperative recurrent urethral stricture was assessed by univariate and multivariate analyses.Results. The rate of recurrent urethral stricture after IOU was 66.9 % (59.5, 87.5, and 100 % after the first, second, third or more subsequent operations, respectively; 12.1 % after all types of urethroplasty, 15.2 % after augmentation urethroplasty, and 8.9 % after anastomotic urethroplasty. The major risk factors of recurrent urethral stricture after IOU were recognized to be the location of urethral stricture in the penile or bulbomembranous portions, a urethral stricture length of > 1 cm, severe urethral lumen narrowing, and performance of 2 or more operations; those after augmentation urethroplasty were previous ineffective treatment, a stricture length of > 4 cm, lichen sclerosus, and smoking; those after anastomotic urethroplasty were previous ineffective treatment, smoking, and a stricture length of > 4 cm.Conclusion. The results of the investigation have shown that only

  19. Comparative rate and risk factors of recurrent urethral stricture during different surgical procedures

    Directory of Open Access Journals (Sweden)

    D. Yu. Pushkar

    2012-01-01

    Full Text Available Objective – to identify the major risk factors leading to worse results of surgical treatment in patients with urethral stricture.Subjects and methods. Two hundred and forty-eight patients with urethral stricture underwent different surgical interventions: internal optical urethrotomy (IOU for strictures of different portions of the urethra in 157 patients (the operation was made once in 121 patients, twice in 24 patients, and thrice or more in 12; replacement urethroplasty using a buccal mucosa graft for strictures of the anterior urethra in 46 patients; Turner-Warwick’s anastomotic urethroplasty modified by Webster for strictures (distraction defects of the posterior urethra in 45 patients. The results of surgical treatment were studied using urethrography, uroflowmetry, urethrocystoscopy, the international prostate symptom score, quality of life (QoL questionnaire, and the international index of erectile function (IIEF questionnaire. The role of risk factors for postoperative recurrent urethral stricture was assessed by univariate and multivariate analyses.Results. The rate of recurrent urethral stricture after IOU was 66.9 % (59.5, 87.5, and 100 % after the first, second, third or more subsequent operations, respectively; 12.1 % after all types of urethroplasty, 15.2 % after augmentation urethroplasty, and 8.9 % after anastomotic urethroplasty. The major risk factors of recurrent urethral stricture after IOU were recognized to be the location of urethral stricture in the penile or bulbomembranous portions, a urethral stricture length of > 1 cm, severe urethral lumen narrowing, and performance of 2 or more operations; those after augmentation urethroplasty were previous ineffective treatment, a stricture length of > 4 cm, lichen sclerosus, and smoking; those after anastomotic urethroplasty were previous ineffective treatment, smoking, and a stricture length of > 4 cm.Conclusion. The results of the investigation have shown that only

  20. Development of jacket platform tsunami risk rating system in waters offshore North Borneo

    Science.gov (United States)

    Lee, H. E.; Liew, M. S.; Mardi, N. H.; Na, K. L.; Toloue, Iraj; Wong, S. K.

    2016-09-01

    This work details the simulation of tsunami waves generated by seaquakes in the Manila Trench and their effect on fixed oil and gas jacket platforms in waters offshore North Borneo. For this study, a four-leg living quarter jacket platform located in a water depth of 63m is modelled in SACS v5.3. Malaysia has traditionally been perceived to be safe from the hazards of earthquakes and tsunamis. Local design practices tend to neglect tsunami waves and include no such provisions. In 2004, a 9.3 M w seaquake occurred off the northwest coast of Aceh, which generated tsunami waves that caused destruction in Malaysia totalling US 25 million and 68 deaths. This event prompted an awareness of the need to study the reliability of fixed offshore platforms scattered throughout Malaysian waters. In this paper, we present a review of research on the seismicity of the Manila Trench, which is perceived to be high risk for Southeast Asia. From the tsunami numerical model TUNA-M2, we extract computer-simulated tsunami waves at prescribed grid points in the vicinity of the platforms in the region. Using wave heights as input, we simulate the tsunami using SACS v5.3 structural analysis software of offshore platforms, which is widely accepted by the industry. We employ the nonlinear solitary wave theory in our tsunami loading calculations for the platforms, and formulate a platform-specific risk quantification system. We then perform an intensive structural sensitivity analysis and derive a corresponding platform-specific risk rating model.

  1. The impact of macroeconomic variables on the evolution of the credit risk rate

    Directory of Open Access Journals (Sweden)

    Luminița Gabriela Istrate

    2018-03-01

    Full Text Available The dynamics of the real economy is a major driver of the evolution of arrears at the level of the pool of loans granted to non-financial companies, completed by the financial pressure induced by the monetary conditions. Lending allows on the one hand providing resources for companies that need financing for investment projects, on the other hand, it supports the fund holders to place resources for obtaining profit. The role of the lending policy in the activity of commercial banks is very important, as it may influence both the cost of credits and the loan portfolio quality in the future. The purpose of this research is to find the macroeconomic variables that significantly influence credit risk and to develop a statistical model for predicting the doubtful and non-performing loans rate. Thus, it is envisaged the research of mechanisms by which the dynamics of the real economy and the money market conditions influence the evolution of the credit risk in different business sectors.

  2. Impact of Race/Ethnicity and Socioeconomic Status on Risk-Adjusted Hospital Readmission Rates Following Hip and Knee Arthroplasty.

    Science.gov (United States)

    Martsolf, Grant R; Barrett, Marguerite L; Weiss, Audrey J; Kandrack, Ryan; Washington, Raynard; Steiner, Claudia A; Mehrotra, Ateev; SooHoo, Nelson F; Coffey, Rosanna

    2016-08-17

    Readmission rates following total hip arthroplasty (THA) and total knee arthroplasty (TKA) are increasingly used to measure hospital performance. Readmission rates that are not adjusted for race/ethnicity and socioeconomic status, patient risk factors beyond a hospital's control, may not accurately reflect a hospital's performance. In this study, we examined the extent to which risk-adjusting for race/ethnicity and socioeconomic status affected hospital performance in terms of readmission rates following THA and TKA. We calculated 2 sets of risk-adjusted readmission rates by (1) using the Centers for Medicare & Medicaid Services standard risk-adjustment algorithm that incorporates patient age, sex, comorbidities, and hospital effects and (2) adding race/ethnicity and socioeconomic status to the model. Using data from the Healthcare Cost and Utilization Project, 2011 State Inpatient Databases, we compared the relative performances of 1,194 hospitals across the 2 methods. Addition of race/ethnicity and socioeconomic status to the risk-adjustment algorithm resulted in (1) little or no change in the risk-adjusted readmission rates at nearly all hospitals; (2) no change in the designation of the readmission rate as better, worse, or not different from the population mean at >99% of the hospitals; and (3) no change in the excess readmission ratio at >97% of the hospitals. Inclusion of race/ethnicity and socioeconomic status in the risk-adjustment algorithm led to a relative-performance change in readmission rates following THA and TKA at socioeconomic status in risk-adjusted THA and TKA readmission rates used for hospital accountability, payment, and public reporting. Prognostic Level III. See instructions for Authors for a complete description of levels of evidence. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

  3. The Performance Of Alternative Interest Rate Risk Measures And Immunization Strategies Under A Heath-Jarrow-Morton Framework

    OpenAIRE

    Agca, Senay

    2002-01-01

    The Heath-Jarrow-Morton (HJM) model represents the latest in powerful arbitrage-free technology for modeling the term structure and managing interest rate risk. Yet risk management strategies in the form of immunization portfolios using duration, convexity, and M-square are still widely used in bond portfolio management today. This study addresses the question of how traditional risk measures and immunization strategies perform when the term structure evolves in the HJM manner. Using Monte Ca...

  4. A remote sensing-assisted risk rating study to predict oak decline and recovery in the Missouri Ozark Highlands, USA

    Science.gov (United States)

    Cuizhen Wang; Hong S. He; John M. Kabrick

    2008-01-01

    Forests in the Ozark Highlands underwent widespread oak decline affected by severe droughts in 1999-2000. In this study, the differential normalized difference water index was calculated to detect crown dieback. A multi-factor risk rating system was built to map risk levels of stands. As a quick response to drought, decline in 2000 mostly occurred in stands at low to...

  5. A risk microbiological profile of the Australian red meat industry: risk ratings of hazard-product pairings.

    Science.gov (United States)

    Sumner, John; Ross, Tom; Jenson, Ian; Pointon, Andrew

    2005-11-25

    A risk profile of microbial hazards across the supply continuum for the beef, sheep and goat meat industries was developed using both a qualitative tool and a semi-quantitative, spreadsheet tool, Risk Ranger. The latter is useful for highlighting factors contributing to food safety risk and for ranking the risk of various product/pathogen combinations. In the present profile the qualitative tool was used as a preliminary screen for a wide range of hazard-product pairings while Risk Ranger was used to rank in order of population health risk pairings for which quantitative data were available and for assessing the effect of hypothetical scenarios. 'High' risk hazard-product pairings identified were meals contaminated with Clostridium perfringens provided by caterers which have not implemented HACCP; kebabs cross-contaminated by Salmonella present in drip trays or served undercooked; meals served in the home cross-contaminated with Salmonella. 'Medium' risk hazard-product pairings identified were ready-to-eat meats contaminated with Listeria monocytogenes and which have extended shelf life; Uncooked Comminuted Fermented Meat (UCFM)/Salami contaminated with Enterohaemorrhagic E. coli (EHEC) and Salmonella; undercooked hamburgers contaminated with EHEC; kebabs contaminated by Salmonella under normal production or following final "flash" heating. Identified 'low' risk hazard-product pairings included cooked, ready-to-eat sausages contaminated with Salmonella; UCFM/Salami contaminated with L. monocytogenes; well-cooked hamburgers contaminated with EHEC. The risk profile provides information of value to Australia's risk managers in the regulatory, processing and R&D sectors of the meat and meat processing industry for the purposes of identifying food safety risks in the industry and for prioritising risk management actions.

  6. The modified "Rockfall Hazard Rating System": a new tool for roads risk assessment

    Science.gov (United States)

    Budetta, P.

    2003-04-01

    This paper contains a modified method for the analysis of rockfall hazard along roads and motorways. The method is derived from that one developed by Pierson et alii at the Oregon State Highway Division. The Rockfall Hazard Rating System (RHRS) provides a rational way to make informed decisions on where and how to spend construction funds. An exponential scoring graph is used to represent the increase in hazard that is reflected in the nine categories forming the classification (slope height, ditch effectiveness, average vehicle risk, percent of decision site distance, roadway width, geological character, quantity of rockfall/event, climate and rock fall history). The resulting total score contains the essential elements regarding the evaluation of the consequences ("cost of failure"). In the modified method, the rating for the categories "ditch effectiveness", "decision sight distance", "rodway width", "geologic characteristic" and "climate and water circulation" have been rendered more easy and objective. The main modifications regard the introduction of the Romana's Slope Mass Rating improving the estimate of the geologic characteristics, of the volume of the potentially unstable blocks and underground water circulation. Other modifications regard the scoring determination for the categories "decision sight distance" and "road geometry". For these categories, the Italian National Council's standards (CNR) have been used. The method must be applied in both the traffic directions because the percentage of reduction in the "decision sight distance" greatly affects the results. An application of the method to a 2-km-long section of the Sorrentine road (n° 145) in Southern Italy was pointed out. A high traffic intensity affects the entire section of the road and rockfalls periodically cause casualties, as well as a large amount of damage and traffic interruptions. The method was applied on seven cross section traces of slopes adjacent to the Sorrentine road and the

  7. Prevalence rates and epidemiological risk factors for astigmatism in Singapore school children.

    Science.gov (United States)

    Tong, Louis; Saw, Seang-Mei; Carkeet, Andrew; Chan, Wai-Ying; Wu, Hui-Min; Tan, Donald

    2002-09-01

    This study examined the prevalence rate of astigmatism and its epidemiological risk factors in Singapore school children. In a study of school children aged 7 to 9 years old in two schools in Singapore in 1999, a detailed questionnaire was administered to parents regarding reading or close-work habits, past history of close-work, family history, and socioeconomic factors. Cycloplegic refraction was performed five times in each eye. Defining astigmatism as worse than or equal to 0.5, 0.75, and 1 D cylinder in the right eye, the prevalence of astigmatism was calculated. The study population consisted of 1028 children. The prevalence rate of astigmatism (worse than or equal to 1 D cylinder) was 19.2% (95% confidence interval, 16.8 to 21.6). This was not different between genders, ethnic groups, or age (p > 0.05). With-the-rule astigmatism was more common than against-the-rule astigmatism. The prevalence of astigmatism and myopia was 9.8% (95% confidence interval, 8.0 to 11.6). A high AC/A ratio was associated (p = 0.003) with astigmatism, even after exclusion of myopic children. On vectorial analysis, J0 and J45 were associated with the number of hours of playing video games, whereas J45 was also associated with computer use. Only J45 was associated to male gender, a high AC/A ratio, and a family history of myopia. The prevalence rate of astigmatism (> or = 1 D) was 19%. Playing video games and computer use may be associated with astigmatism severity, although the presence of astigmatism (> or = 1 D) was not associated with any nearwork factors. A family history of myopia was associated with oblique astigmatism severity. A high AC/A ratio is associated with astigmatism, and this requires further investigation.

  8. [Do laymen understand information about hospital quality? An empirical verification using risk-adjusted mortality rates as an example].

    Science.gov (United States)

    Sander, Uwe; Kolb, Benjamin; Taheri, Fatemeh; Patzelt, Christiane; Emmert, Martin

    2017-11-01

    The effect of public reporting to improve quality in healthcare is reduced by the limited intelligibility of information about the quality of healthcare providers. This may result in worse health-related choices especially for older people and those with lower levels of education. There is, as yet, little information as to whether laymen understand the concepts behind quality comparisons and if this comprehension is correlated with hospital choices. An instrument with 20 items was developed to analyze the intelligibility of five technical terms which were used in German hospital report cards to explain risk-adjusted death rates. Two online presentations of risk-adjusted death rates for five hospitals in the style of hospital report cards were developed. An online survey of 353 volunteers tested the comprehension of the risk-adjusted mortality rates and included an experimental hospital choice. The intelligibility of five technical terms was tested: risk-adjusted, actual and expected death rate, reference range and national average. The percentages of correct answers for the five technical terms were in the range of 75.0-60.2%. Between 23.8% and 5.1% of the respondents were not able to answer the question about the technical term itself. The least comprehensible technical terms were "risk-adjusted death rate" and "reference range". The intelligibility of the 20 items that were used to test the comprehension of the risk-adjusted mortality was between 89.5% and 14.2%. The two items that proved to be least comprehensible were related to the technical terms "risk-adjusted death rate" and "reference range". For all five technical terms it was found that a better comprehension correlated significantly with better hospital choices. We found a better than average intelligibility for the technical terms "actual and expected death rate" and for "national average". The least understandable were "risk-adjusted death rate" and "reference range". Since the self

  9. Accounting for Risk of Non-Completion in Private and Social Rates of Return to Higher Education

    Science.gov (United States)

    Toutkoushian, Robert K.; Shafiq, M. Najeeb; Trivette, Michael J.

    2013-01-01

    Conventional studies of the private and social rates of return to a Bachelor's degree focus on the earnings difference between Bachelor degree holders and high school graduates, and find that there are large rates of return for degree recipients. The estimates in these studies, however, do not take into account the risk of not completing a degree.…

  10. Energy-efficient mortgages and home energy rating systems: A report on the nation`s progress

    Energy Technology Data Exchange (ETDEWEB)

    Farhar, B.C.; Eckert, J.

    1993-09-01

    This report summarizes progress throughout the nation in establishing voluntary programs linking home energy rating systems (HERS) and energy-efficient mortgages (EEMs). These programs use methods for rating the energy efficiency of new and existing homes and predicting energy cost savings so lenders can factor in energy cost savings when underwriting mortgages. The programs also encourage lenders to finance cost-effective energy-efficiency improvements to existing homes with low-interest mortgages or other instruments. The money saved on utility bills over the long term can more than offset the cost of such energy-efficiency improvements. The National Collaborative on HERS and EEMs recommended that this report be prepared.

  11. Association between Carotid Intima Media Thickness and Heart Rate Variability in Adults at Increased Cardiovascular Risk

    Directory of Open Access Journals (Sweden)

    Ovidiu C. Baltatu

    2017-04-01

    Full Text Available Background: Atherosclerotic carotid intima-media thickness (IMT may be associated with alterations in the sensitivity of carotid baroreceptors. The aim of this study was to investigate the association between carotid IMT and the autonomic modulation of heart rate variability (HRV.Methods: A total of 101 subjects were enrolled in this prospective observational study. The carotid IMT was determined by duplex ultrasonography. The cardiac autonomic function was determined through HRV measures during the Deep Breathing Test. Linear regression models, adjusted for demographics, comorbidities, body mass index, waist-hip-ratio, and left ventricular ejection fraction were used to evaluate the association between HRV parameters and carotid IMT.Results: Participants had a mean age of 60.4 ± 13.4 years and an estimated 10-year atherosclerotic cardiovascular disease (ASCVD risk score (using the Pooled Cohort Equations of 16.4 ± 17. The mean carotid media thickness was highest (0.90 ± 0.19 mm in the first quartile of the standard deviation of all RR intervals (SDNN (19.7 ± 5.1 ms and progressively declined in each subsequent quartile to 0.82 ± 0.21 mm, 0.81 ± 0.16 mm, and 0.68 ± 0.19 in quartiles 2 (36.5 ± 5.9 ms, 3 (57.7 ± 6.2 ms and 4 (100.9 ± 22.2 ms, respectively. In multivariable adjusted models, there was a statistical significant association between SDNN and carotid IMT (OR −0.002; 95%CI −0.003 to −0.001, p = 0.005. The same significant association was found between carotid IMT and other measures of HRV, including coefficient of variation of RR intervals (CV and dispersion of points along the line of identity (SD2.Conclusions: In a cohort of individuals at increased cardiovascular risk, carotid IMT as a marker of subclinical atherosclerosis was associated with alterations of HRV indicating an impaired cardiac autonomic control, independently of other cardiovascular risk factors.

  12. DIGITAL FLOOD INSURANCE RATE MAP DATABASE, DODGE COUNTY, WISCONSIN, USA - MIP Dodge Portion Upper Rock River Watershed RiskMap DFIRM Update

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The Digital Flood Insurance Rate Map (DFIRM) Database depicts flood risk information and supporting data used to develop the risk data. The primary risk;...

  13. DIGITAL FLOOD INSURANCE RATE MAP DATABASE, COLUMBIA COUNTY, WISCONSIN, USA - MIP Columbia Portion Baraboo River Watershed RiskMap DFIRM Update

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The Digital Flood Insurance Rate Map (DFIRM) Database depicts flood risk information and supporting data used to develop the risk data. The primary risk;...

  14. Business travel and self-rated health, obesity, and cardiovascular disease risk factors.

    Science.gov (United States)

    Richards, Catherine A; Rundle, Andrew G

    2011-04-01

    To assess associations between extent of travel for business and health. Associations between business travel and cardiovascular disease risk factors were assessed using medical record data from 13,057 patients provided by EHE International, Inc. Compared with light travelers (1 to 6 nights per month), nontravelers were more likely to report poor/fair health (odds ratio = 1.58; 95% confidence interval [CI]: 1.33 to 1.87) and the odds ratios increased with increasing travel, reaching 2.61 (95% CI: 1.57 to 4.33) among extensive travelers (>20 nights per month). Compared with light travelers, the odds ratios for obesity were highest among nontravelers (odds ratio = 1.33; 95% CI: 1.18 to 1.50) and extensive travelers (odds ratio = 1.92; 95% CI: 1.25 to 2.94). Although the differences were small, nontravelers and extensive travelers had the highest diastolic blood pressure and lowest high-density lipoprotein cholesterol levels. Poor self-rated health and obesity are associated with extensive business travel.

  15. The rate of endophthalmitis after pars plana vitrectomy and its risk factors.

    Science.gov (United States)

    Tabatabaei, Seyed Ali; Soleimani, Mohammad; Vakili, Hadi; Naderan, Morteza; Lashay, Alireza; Faghihi, Houshang; Yaseri, Mehdi

    2018-05-11

    To study the incidence of endophthalmitis after pars plana vitrectomy, its causative organisms, and visual acuity outcomes. In this retrospective, comparative study, the medical records of patients with acute-onset postoperative endophthalmitis after pars plana vitrectomy at Farabi Eye Hospital, Tehran, Iran, during a 12-year period between January 2004 and November 2015 were reviewed. To compare the endophthalmitis patients with other cases who underwent pars plana vitrectomy at the same day and also the same operating room, a control group was developed by gathering the data from surgical records. In the present study, the incidence rate of pos- vitrectomy endophthalmitis was 0.04% (16/39783). The organisms identified in aqueous or vitreous cultures (culture positive 44%) included Streptococcus pneumoniae (two patients, 12.5%), Pseudomonas aeruginosa (two patients, 12.5%), fungi (two patients, 12.5%), and Streptococcus viridans (one patient, 6.25%). Visual acuity after treatment for endophthalmitis ranged from light perception (7 eyes) to hand motion (1 eye), and evisceration was performed in 8 eyes (50%). When comparing the cases (patients developing endophthalmitis) and controls (patients with no complications operated in the same day and place of operation with the case group), only not using tamponade showed a statistically significant relation with the occurrence of endophthalmitis (p = 0.034). Our results indicated low incidence of endophthalmitis after pars plana vitrectomy comparable to previous studies which resulted in poor visual acuity. It seems that not using tamponade might increase the risk of endophthalmitis among these patients.

  16. Lifetime radiation risks from low-dose rate radionuclides in beagles

    International Nuclear Information System (INIS)

    Goldman, M.; Rosenblatt, L.S.

    1985-01-01

    One of the largest, long-term (25-yr) animal studies on the effects of low-dose internal irradiation is almost completed. Some 335 beagles were given continuous exposure to graded 90 Sr [low linear energy transfer (LET)] in their diets (D-dogs) through adulthood. A second group (R-dogs) was given fractionated doses of 225 Ra (high LET) as young adults. A third group of 44 was given a single injection of 90 Sr as adults (S-dogs) to compare single to continuous dosages. All dogs were followed through their lifetimes. Only one of the 848 dogs is still alive. The animals were whole-body counted over their entire life span and were examined frequently for assessment of medical status. There were no acute radiation lethalities. Analyses of the large data base from these dogs have begun and preliminary indications are that 90 Sr, which was tested over a 1500-fold skeletal dose rate range, does not cause significant life shortening at average accumulation skeletal doses of ∼2500 rads (25 Gy) and that a curvilinear dose response curve for life shortening was seen at higher accumulation doses. The data will be discussed in terms of modern epidemiological concepts and quantifications will be related to certain parameters of human risk from acute or chronic radiation exposures

  17. Rate of Corneal Collagen Crosslinking Redo in Private Practice: Risk Factors and Safety

    Directory of Open Access Journals (Sweden)

    Joelle Antoun

    2015-01-01

    Full Text Available Objective. To report the rate of progression of keratectasia after primary crosslinking (CXL and evaluate the safety and efficiency of CXL redo. Materials and Methods. We conducted a retrospective analysis of the patients who underwent CXL between 2010 and 2013 at the Beirut Eye Specialist Hospital, Lebanon. Progression of keratectasia was based on the presence of an increase in maximum keratometry of 1.00 D, a change in the map difference between two consecutive topographies of 1.00 D, a deterioration of visual acuity, or any change in the refraction. Primary and redo CXL were done using the same protocol. Results. Among the 221 eyes of 130 patients who underwent CXL, 7 eyes (3.17% of five patients met the criteria of progression. All patients reported a history of allergic conjunctivitis and eye rubbing and progressed within 9 to 48 months. No complications were noted and all patients were stable 1 year after CXL redo. Conclusion. Allergic conjunctivitis and eye rubbing were the only risk factors associated with keratoconus progression after CXL. A close followup is thus mandatory, even years after the procedure. CXL redo seems to be a safe and efficient technique to halt the progression after a primary CXL.

  18. School burnout and heart rate variability: risk of cardiovascular disease and hypertension in young adult females.

    Science.gov (United States)

    May, Ross W; Seibert, Gregory S; Sanchez-Gonzalez, Marcos A; Fincham, Frank D

    2018-05-01

    Emerging research documents the relationship between school burnout and some indicators of increased cardiovascular risk. Indicators of cardiovascular functioning assessed via ambulatory blood pressure and heart rate variability (HRV) have not been thoroughly explored in this research domain. Therefore, the current study examined relationships between school burnout and indicators of cardiac functioning via 24 h ambulatory blood pressure (BP) and electrocardiogram monitoring in a sample of young adult female undergraduates (N = 88). Two hypotheses were tested: (1) that independent of related negative affective symptomology (depression and anxiety), increased school burnout would be related to greater systolic and diastolic BP, higher low frequency (LF) HRV and lower very low frequency (VLF) HRV, and (2) that lower VLF would be related to greater school burnout independently of LF HRV. Hierarchical multiple regression analyzes showed that school burnout was significantly related to elevated ambulatory BP (systolic and diastolic) and HRV markers of increased cardiac sympathovagal tone. These findings support the hypotheses and suggest that school burnout might be implicated in the development of pre-hypertension or early cardiovascular disease. Study limitations and the need for future longitudinal research are discussed.

  19. Statewide prevalence of school children at risk of anaphylaxis and rate of adrenaline autoinjector activation in Victorian government schools, Australia.

    Science.gov (United States)

    Loke, Paxton; Koplin, Jennifer; Beck, Cara; Field, Michael; Dharmage, Shyamali C; Tang, Mimi L K; Allen, Katrina J

    2016-08-01

    The prevalence of school students at risk of anaphylaxis in Victoria is unknown and has not been previously studied. Similarly, rates of adrenaline autoinjector usage in the school environment have yet to be determined given increasing prescription rates. We sought to determine time trends in prevalence of school children at risk of anaphylaxis across all year levels and the annual usage rate of adrenaline autoinjectors in the school setting relative to the number of students at risk of anaphylaxis. Statewide surveys from more than 1,500 government schools including more than 550,000 students were used and prevalence rates (%) with 95% CIs were calculated. The overall prevalence of students at risk of anaphylaxis has increased 41% from 0.98% (95% CI, 0.95-1.01) in 2009 to 1.38% (95% CI, 1.35-1.41) in 2014. There was a significant drop in reporting of anaphylaxis risk with transition from the final year of primary school to the first year of secondary school, suggesting a change in parental reporting of anaphylaxis risk among secondary school students. The number of adrenaline autoinjectors activated per 1000 students at risk of anaphylaxis ranged from 6 to 8 per year, with consistently higher activation use in secondary school students than in primary school students. Statewide prevalence of anaphylaxis risk has increased in children attending Victorian government schools. However, adrenaline autoinjector activation has remained fairly stable despite known increase in the rates of prescription. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  20. Relationship Between the Urine Flow Rate and Risk of Contrast-Induced Nephropathy After Emergent Percutaneous Coronary Intervention.

    Science.gov (United States)

    Liu, Yong; Lin, Lixia; Li, Yun; Li, Hualong; Wu, Deng-Xuan; Zhao, Jian-bin; Lian, Dan; Zhou, Yingling; Liu, Yuanhui; Ye, Piao; Ran, Peng; Duan, Chongyang; Chen, Shiqun; Chen, Pingyan; Xian, Ying; Chen, Jiyan; Tan, Ning

    2015-12-01

    A low urine flow rate is a marker of acute kidney injury. However, it is unclear whether a high urine flow rate is associated with a reduced risk of contrast-induced nephropathy (CIN) in high-risk patients. We conducted this study to evaluate the predictive value of the urine flow rate for the risk of CIN following emergent percutaneous coronary intervention (PCI). We prospectively examined 308 patients undergoing emergent PCI who provided consent. The predictive value of the 24-hour postprocedural urine flow rate, adjusted by weight (UR/W, mL/kg/h) and divided into quartiles, for the risk of CIN was assessed using multivariate logistic regression analysis. The cumulative incidence of CIN was 24.4%. In particular, CIN was observed in 29.5%, 19.5%, 16.7%, and 32.0% of cases in the UR/W quartile (Q)-1 (≤0.94  mL/kg/h), Q2 (0.94-1.30  mL/kg/h), Q3 (1.30-1.71  mL/kg/h), and Q4 (≥1.71  mL/kg/h), respectively. Moreover, in-hospital death was noted in 7.7%, 3.9%, 5.1%, and 5.3% of patients in Q1, Q2, Q3, and Q4, respectively. After adjusting for potential confounding predictors, multivariate analysis indicated that compared with the moderate urine flow rate quartiles (Q2 + Q3), a high urine flow rate (Q4) (odds ratio [OR], 2.69; 95% confidence interval [CI], 1.27-5.68; P = 0.010) and low urine flow rate (Q1) (OR, 2.23; 95% CI, 1.03-4.82; P = 0.041) were significantly associated with an increased risk of CIN. Moreover, a moderate urine flow rate (0.94-1.71  mL/kg/h) was significantly associated with a decreased risk of mortality. Our data suggest that higher and lower urine flow rates were significantly associated with an increased risk of CIN after emergent PCI, and a moderate urine flow rate (0.94-1.71  mL/kg/h) may be associated with a decreased risk of CIN with a good long-term prognosis after emergent PCI.

  1. Expert ratings of job demand and job control as predictors of injury and musculoskeletal disorder risk in a manufacturing cohort.

    Science.gov (United States)

    Cantley, Linda F; Tessier-Sherman, Baylah; Slade, Martin D; Galusha, Deron; Cullen, Mark R

    2016-04-01

    To examine associations between workplace injury and musculoskeletal disorder (MSD) risk and expert ratings of job-level psychosocial demand and job control, adjusting for job-level physical demand. Among a cohort of 9260 aluminium manufacturing workers in jobs for which expert ratings of job-level physical and psychological demand and control were obtained during the 2 years following rating obtainment, multivariate mixed effects models were used to estimate relative risk (RR) of minor injury and minor MSD, serious injury and MSD, minor MSD only and serious MSD only by tertile of demand and control, adjusting for physical demand as well as other recognised risk factors. Compared with workers in jobs rated as having low psychological demand, workers in jobs with high psychological demand had 49% greater risk of serious injury and serious MSD requiring medical treatment, work restrictions or lost work time (RR=1.49; 95% CI 1.10 to 2.01). Workers in jobs rated as having low control displayed increased risk for minor injury and minor MSD (RR=1.45; 95% CI 1.12 to 1.87) compared with those in jobs rated as having high control. Using expert ratings of job-level exposures, this study provides evidence that psychological job demand and job control contribute independently to injury and MSD risk in a blue-collar manufacturing cohort, and emphasises the importance of monitoring psychosocial workplace exposures in addition to physical workplace exposures to promote worker health and safety. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Radioablation of liver malignancies with interstitial high-dose-rate brachytherapy. Complications and risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Mohnike, Konrad; Wolf, Steffen; Damm, Robert; Seidensticker, Max; Seidensticker, Ricarda; Fischbach, Frank; Pech, Maciej; Ricke, Jens [Otto-von-Guericke-Universitaet, Klinik fuer Radiologie und Nuklearmedizin, Universitaetsklinikum Magdeburg A.oe.R., Magdeburg (Germany); Peters, Nils; Hass, Peter; Gademann, Guenther [Otto-von-Guericke-Universitaet, Klinik fuer Strahlentherapie, Universitaetsklinikum Magdeburg A.oe.R., Magdeburg (Germany)

    2016-05-15

    To evaluate complications and identify risk factors for adverse events in patients undergoing high-dose-rate interstitial brachytherapy (iBT). Data from 192 patients treated in 343 CT- or MRI-guided interventions from 2006-2009 at our institution were analyzed. In 41 %, the largest tumor treated was ≥ 5 cm, 6 % of the patients had tumors ≥ 10 cm. Prior to iBT, 60 % of the patients had chemotherapy, 22 % liver resection, 19 % thermoablation or transarterial chemoembolization (TACE). Safety was the primary endpoint; survival data were obtained as the secondary endpoints. During follow-up, MRI or CT imaging was performed and clinical and laboratory parameters were obtained. The rate of major complications was below 5 %. Five major bleedings (1.5 %) occurred. The frequency of severe bleeding was significantly higher in patients with advanced liver cirrhosis. One patient developed signs of a nonclassic radiation-induced liver disease. In 3 patients, symptomatic gastrointestinal (GI) ulcers were detected. A dose exposure to the GI wall above 14 Gy/ml was a reliable threshold to predict ulcer formation. A combination of C-reactive protein ≥ 165 mg/l and/or leukocyte count ≥ 12.7 Gpt/l on the second day after the intervention predicted infection (sensitivity 90.0 %; specificity 92.8 %.) Two patients (0.6 %) died within 30 days. Median overall survival after the first liver treatment was 20.1 months for all patients and the local recurrence-free surviving proportion was 89 % after 12 months. Image-guided iBT yields a low rate of major complications and is effective. (orig.) [German] Evaluierung der Komplikationsrate und Identifizierung von Risikofaktoren fuer Komplikationen und Nebenwirkungen bei Patienten mit Lebermalignomen, die mit der hochdosierten interstitiellen Brachytherapie (iBT) behandelt wurden. Von 2006 bis 2009 wurden 192 Patienten in 343 CT- oder MRT-gefuehrten Interventionen behandelt und deren Daten ausgewertet. Der groesste behandelte Tumor war in

  3. Reduced glomerular filtration rate and its association with clinical outcome in older patients at risk of vascular events: secondary analysis.

    LENUS (Irish Health Repository)

    Ford, Ian

    2009-01-20

    Reduced glomerular filtration rate (GFR) is associated with increased cardiovascular risk in young and middle aged individuals. Associations with cardiovascular disease and mortality in older people are less clearly established. We aimed to determine the predictive value of the GFR for mortality and morbidity using data from the 5,804 participants randomized in the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER).

  4. Risk premium shocks, monetary policy and exchange rate pass-through in the Czech Republic, Hungary and Poland

    OpenAIRE

    Vonnák, Balázs

    2010-01-01

    This paper investigates the role of monetary policy in a small open economy, where exchange rate shocks are important. VAR models are estimated for the Czech Republic, Hungary and Poland. Contemporaneous and sign restrictions are imposed in order to identify the effect of monetary policy and risk premium shocks. Estimates from the same model for Canada, Sweden and the UK are used as benchmark for developed economies with low inflation. The results suggest that the typical size a of risk premi...

  5. 13 CFR 120.434 - What are SBA's requirements for loan pledges?

    Science.gov (United States)

    2010-01-01

    ... satisfactory SBA performance, as determined by SBA in its discretion. The Lender's Risk Rating, among other... BUSINESS LOANS Lenders Other Conveyances § 120.434 What are SBA's requirements for loan pledges? (a) Except... 7(a) loan, which consent SBA may withhold in its sole discretion; (b) The Lender must be in good...

  6. On the rate of return and risk factors to international oil companies in Iran's buy-back service contracts

    International Nuclear Information System (INIS)

    Ghandi, Abbas; Lin Lawell, C.-Y. Cynthia

    2017-01-01

    We analyze the rate of return (ROR) and risk factors faced by Shell Exploration, an international oil company (IOC), in its Soroosh and Nowrooz buy-back service contract in Iran. In particular, based on our models of cash flow, we analyze the buy-back contract specific risk factors that can contribute to a reduction in the rate of return for the international oil company. Our cash flow models resemble the cash flow of buy-back service contracts before the Iranian government changed the way it determined the capital cost ceiling and pre-defined the oil price in these contracts in 2008–2009. Our actual and contractual cash flow models reveal that Shell Exploration's actual ROR was much lower than the contractual level. Furthermore, we find that among the risk factors that we considered, a capital cost overrun has the greatest negative effect on the IOC's ROR. Moreover, we show that there is a potential for modifying the contracts in order for the IOC to face an actual ROR closer to the contractual ROR even if the contract faces cost overrun or delay, without exceeding the maximum contractual ROR that the National Iranian Oil Company is willing to give. - Highlights: • Buy-back contract specific risk factors can reduce the rate of return. • Shell Exploration's actual ROR was much lower than the contractual level. • A capital cost overrun has the greatest negative effect on the rate of return. • Contracts can be modified to better share the risk.

  7. Rates of Delirium Diagnosis Do Not Improve with Emergency Risk Screening: Results of the Emergency Department Delirium Initiative Trial.

    Science.gov (United States)

    Arendts, Glenn; Love, Jennefer; Nagree, Yusuf; Bruce, David; Hare, Malcolm; Dey, Ian

    2017-08-01

    To determine whether a bundled risk screening and warning or action card system improves formal delirium diagnosis and person-centered outcomes in hospitalized older adults. Prospective trial with sequential introduction of screening and interventional processes. Two tertiary referral hospitals in Australia. Individuals aged 65 and older presenting to the emergency department (ED) and not requiring immediate resuscitation (N = 3,905). Formal ED delirium screening algorithm and use of a risk warning card with a recommended series of actions for the prevention and management of delirium during the subsequent admission MEASUREMENTS: Delirium diagnosis at hospital discharge, proportion discharged to new assisted living arrangements, in-hospital complications (use of sedation, falls, aspiration pneumonia, death), hospital length of stay. Participants with a positive risk screen were significantly more likely (relative risk = 6.0, 95% confidence interval = 4.9-7.3) to develop delirium, and the proportion of at-risk participants with a positive screen was constant across three study phases. Delirium detection rate in participants undergoing the final intervention (Phase 3) was 12.1% (a 2% absolute and 17% relative increase from the baseline rate) but this was not statistically significant (P = .29), and a similar relative increase was seen over time in participants not receiving the intervention CONCLUSION: A risk screening and warning or action card intervention in the ED did not significantly improve rates of delirium detection or other important outcomes. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  8. Self-rated Health and Internet Addiction in Iranian Medical Sciences Students; Prevalence, Risk Factors and Complications

    OpenAIRE

    Mohammadbeigi, Abolfazl; Valizadeh, Farzaneh; Mirshojaee, Seyede Roqaie; Ahmadli, Robabeh; Mokhtari, Mohsen; Ghaderi, Ebrahim; Ahmadi, Ali; Rezaei, Heshmatollah; Ansari, Hossein

    2016-01-01

    Introduction: Self-rated health is a brief measure for general health. It is a comprehensive and sensitive index for prediction of health in future. Due to the high internet usage in medical students, the current study designed to evaluate the self-rated health (SRH) in relationship with internet addiction risk factors in medical students. Methods: This cross sectional study conducted on 254 students of Qom University of Medical Sciences 2014. Participants selected by two stage sampling metho...

  9. Comparing variation in hospital rates of cesarean delivery among low-risk women using 3 different measures.

    Science.gov (United States)

    Armstrong, Joanne C; Kozhimannil, Katy B; McDermott, Patricia; Saade, George R; Srinivas, Sindhu K

    2016-02-01

    This report describes the development of a measure of low-risk cesarean delivery by the Society for Maternal-Fetal Medicine (SMFM). Safely lowering the cesarean delivery rate is a priority for maternity care clinicians and health care delivery systems. Therefore, hospital quality assurance programs are increasingly tracking cesarean delivery rates among low-risk pregnancies. Two commonly used definitions of "low risk" are available, the Joint Commission (JC) and the Agency for Healthcare Research and Quality (AHRQ) measures, but these measures are not clinically comprehensive. We sought to refine the definition of the low-risk cesarean delivery rate to enhance the validity of the metric for quality measurement. We created this refined definition-called the SMFM definition-and compared it to the JC and AHRQ measures using claims-based data from the 2011 Nationwide Inpatient Sample of >863,000 births in 612 hospitals. Using these definitions, we calculated means and interquartile ranges (25th-75th percentile range) for hospital low-risk cesarean delivery rates, stratified by hospital size, teaching status, urban/rural location, and payer mix. Across all hospitals, the mean low-risk cesarean delivery rate was lowest for the SMFM definition (12.65%), but not substantially different from the JC and AHRQ measures (13.12% and 13.29%, respectively). We empirically examined the SMFM definition to ensure its validity and utility. This refined definition performs similarly to existing measures and has the added advantage of clinical perspective, enhanced face validity, and ease of use. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Risk transfer via energy-savings insurance

    International Nuclear Information System (INIS)

    Mills, Evan

    2003-01-01

    Among the key barriers to investment in energy efficiency are uncertainties about attaining projected energy savings and potential disputes over stipulated savings. The fields of energy management and risk management are thus intertwined. While many technical methods have emerged to manage performance risks (e.g. building diagnostics and commissioning), financial methods are less developed in the energy management arena than in other segments of the economy. Energy-savings insurance (ESI) - formal insurance of predicted energy savings - transfers and spreads both types of risk over a larger pool of energy efficiency projects and reduces barriers to market entry of smaller energy service firms who lack sufficiently strong balance sheets to self-insure the savings. ESI encourages those implementing energy-saving projects to go beyond standard measures and thereby achieve more significant levels of energy savings. Insurance providers are proponents of improved savings measurement and verification techniques, as well as maintenance, thereby contributing to national energy-saving objectives. If properly applied, ESI can potentially reduce the net cost of energy-saving projects by reducing the interest rates charged by lenders, and by increasing the level of savings through quality control. Governmental agencies have been pioneers in the use of ESI and could continue to play a role

  11. The influence of maternity units' intrapartum intervention rates and midwives' risk perception for women suitable for midwifery-led care.

    Science.gov (United States)

    Mead, Marianne M P; Kornbrot, Diana

    2004-03-01

    to test the hypothesis that midwives working in higher intervention units would have a higher perception of risk for the intrapartum care of women suitable for midwifery-led care than midwives working in lower intervention units. an initial retrospective analysis of the computerised records of 9887 healthy Caucasian women in spontaneous labour enabled the categorisation of 11 units as either 'lower intrapartum intervention' or 'higher intrapartum intervention' units. A survey of the midwives involved in intrapartum care in these 11 units, using standardised scenario questionnaires, was used to investigate midwives' options for intrapartum interventions, their perceptions of intrapartum risk and the accuracy of these perceptions in the light of actual maternity outcomes. midwives working in maternity units that had a higher level of intervention generally perceived intrapartum risks to be higher than midwives working in lower intervention units. However, midwives generally underestimated the ability of women to progress normally and overestimated the advantages of technological interventions, in particular epidural analgesia. variations in intrapartum care cannot be solely explained by the characteristics of the women. The influence of the workplace culture plays a significant role in shaping midwives' perceptions of risk, but it seems even more likely that the medicalisation of childbirth has had an influence on midwives' appreciation of intrapartum risks. Intervention rates for low-risk births are often higher than recommended by research. The level of interventions varies across hospitals and higher rates are associated with higher perception of risk by midwives. Attention needs to be given to the influence the workplace plays in shaping midwives' perception of risk; and to the effect of organisational culture on intervention rates.

  12. Relationship of detection rate of PET cancer screening examinees and risk factors. Analysis of background of examinees

    International Nuclear Information System (INIS)

    Shibata, Koji; Uno, Kimiichi; Arai, Masami; Matsuura, Masaaki; Yoshida, Teruhiko; Momose, Toshimitsu; Ohtomo, Kuni

    2011-01-01

    Positron emission tomography (PET) cancer screening is performed widely in Japan as opportunistic screening, but no study has focused on the correlation with various cancer risk factors and the seeking bias of examinees and cancer detection rate. Analyzing our large series of PET cancer screening data, correlations with cancer detection rates according to general cancer risk factors and PET detection survey were reviewed, and the selection bias of the medical examinees was determined. 19189 examinees who underwent PET cancer screening were enrolled. Using logistic-regression analysis, we analyzed correlations between smoking history/drinking history/cancer family history and detection rates of thyroid cancer/breast cancer/colorectal cancer/lung cancer, which are the main malignancies detected in PET cancer screening. In addition, we evaluated seeking bias of examinees, analyzing correlations between the presence of cancer risk factors and prior screening checkups at other institutions to our PET cancer screening using a matched case-control study. Cancer detection rates by FDG-PET were 1.17% (224/19189), being much higher than those of standard cancer mass screenings. In males, statistically significant correlations were seen between lung cancer and smoking, and between prostate cancer and a family history of prostate cancer, but not between the detection rates of three other types of cancer (thyroid cancer/lung cancer/colorectal cancer) and other cancer risk factors. In females, detection rates of four types of cancer (thyroid cancer/lung cancer/colorectal cancer/breast cancer) were significantly higher in the examinees without cancer risks, and subgroup analysis according to types of cancer did not indicate significant correlations either. The matched case-control study evaluating seeking bias indicated that a significant proportion of the examinees with cancer risks had undergone prior cancer screening at other institutions. Our study indicated that there was

  13. Implications of supermarket access, neighbourhood walkability and poverty rates for diabetes risk in an employee population.

    Science.gov (United States)

    Herrick, Cynthia J; Yount, Byron W; Eyler, Amy A

    2016-08-01

    Diabetes is a growing public health problem, and the environment in which people live and work may affect diabetes risk. The goal of the present study was to examine the association between multiple aspects of environment and diabetes risk in an employee population. This was a retrospective cross-sectional analysis. Home environment variables were derived using employees' zip code. Descriptive statistics were run on all individual- and zip-code-level variables, stratified by diabetes risk and worksite. A multivariable logistic regression analysis was then conducted to determine the strongest associations with diabetes risk. Data were collected from employee health fairs in a Midwestern health system, 2009-2012. The data set contains 25 227 unique individuals across four years of data. From this group, using an individual's first entry into the database, 15 522 individuals had complete data for analysis. The prevalence of high diabetes risk in this population was 2·3 %. There was significant variability in individual- and zip-code-level variables across worksites. From the multivariable analysis, living in a zip code with higher percentage of poverty and higher walk score was positively associated with high diabetes risk, while living in a zip code with higher supermarket density was associated with a reduction in high diabetes risk. Our study underscores the important relationship between poverty, home neighbourhood environment and diabetes risk, even in a relatively healthy employed population, and suggests a role for the employer in promoting health.

  14. A multicriteria approach for rating the credit risk of financial institutions

    NARCIS (Netherlands)

    Baourakis, G.; Conisescu, M.; Dijk, van G.; Pardalos, P.M.; Zopounidis, C.

    2009-01-01

    Within the new bank regulatory context, the assessment of the credit risk of financial institutions is an important issue for supervising authorities and investors. This study explores the possibility of a developing risk assessment model for financial institutions using a multicriteria

  15. 12 CFR 617.7410 - When and how does a qualified lender notify a borrower of the right to seek loan restructuring?

    Science.gov (United States)

    2010-01-01

    ... borrower of the right to seek loan restructuring? 617.7410 Section 617.7410 Banks and Banking FARM CREDIT... Mediation Programs § 617.7410 When and how does a qualified lender notify a borrower of the right to seek... been identified as distressed and that the borrower has the right to request a restructuring of the...

  16. Small Businesses Save Big: A Guide to Help SBA Lenders Understand and Communicate the Value of Energy Efficiency Investments (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2015-01-01

    Dollars saved through energy efficiency can directly impact your bottom line. Whether you are planning for a major renovation or upgrading individual pieces of building equipment, these improvements can help reduce operating costs, save on utility bills, and boost profits. This fact sheet provides guidelines for SBA lenders to understand the value of financing energy efficiency investments.

  17. 25 CFR 103.37 - What must the lender do to collect payment under its loan guaranty certificate or loan insurance...

    Science.gov (United States)

    2010-04-01

    ... collateral securing the loan under § 103.36(d)(2), and has a residual loss after doing so, it must send BIA... principal collateral securing the loan; or (iii) One hundred eighty calendar days after the date of the default. (b) For insured loans, after liquidating all loan collateral, the lender must submit a claim for...

  18. Pitfalls and Precautions When Using Predicted Failure Data for Quantitative Analysis of Safety Risk for Human Rated Launch Vehicles

    Science.gov (United States)

    Hatfield, Glen S.; Hark, Frank; Stott, James

    2016-01-01

    Launch vehicle reliability analysis is largely dependent upon using predicted failure rates from data sources such as MIL-HDBK-217F. Reliability prediction methodologies based on component data do not take into account system integration risks such as those attributable to manufacturing and assembly. These sources often dominate component level risk. While consequence of failure is often understood, using predicted values in a risk model to estimate the probability of occurrence may underestimate the actual risk. Managers and decision makers use the probability of occurrence to influence the determination whether to accept the risk or require a design modification. The actual risk threshold for acceptance may not be fully understood due to the absence of system level test data or operational data. This paper will establish a method and approach to identify the pitfalls and precautions of accepting risk based solely upon predicted failure data. This approach will provide a set of guidelines that may be useful to arrive at a more realistic quantification of risk prior to acceptance by a program.

  19. The Relationship between the Risk of a Change of the Interest Rate and the Age of Entrepreneurs among Slovak SMEs

    Directory of Open Access Journals (Sweden)

    Sobeková Majková Monika

    2016-09-01

    Full Text Available Young entrepreneurs and start-up founders are considered to be a drivers of innovation which is an important element of knowledge economy and competitiveness of each country. But their early age could be perceived as a factor causing the increasing impact of the credit risk because young entrepreneurs usually have a short company history, weak capital power and a lack of the guarantees. The main objective of this paper is to bring scientific evidence that the age of the entrepreneur should be considered as a factor with the significant impact on one part of the credit risk of a company– the risk of a change of the interest rate. The research was carried out among 438 Slovak companies in 2016. Based on Pearson´s chi-square analysis of the results of our research, we bring statistical evidence that age has a significant impact on the ability of the company to protect the firm against the change of the interest rate. We also found out that there is dependence between the age of the owner and the opinion that SMEs in the other EU countries have better loan conditions, especially lower interest rates, than Slovak SMEs. Research findings indicate that young entrepreneurs have problems with obtaining capital and increasing interest rates and collaterals because of their higher risk profile. But effective state support of young and innovative companies through venture financing can lead to increasing global competitiveness of the Slovak Republic.

  20. Standardized error severity score (ESS) ratings to quantify risk associated with child restraint system (CRS) and booster seat misuse.

    Science.gov (United States)

    Rudin-Brown, Christina M; Kramer, Chelsea; Langerak, Robin; Scipione, Andrea; Kelsey, Shelley

    2017-11-17

    Although numerous research studies have reported high levels of error and misuse of child restraint systems (CRS) and booster seats in experimental and real-world scenarios, conclusions are limited because they provide little information regarding which installation issues pose the highest risk and thus should be targeted for change. Beneficial to legislating bodies and researchers alike would be a standardized, globally relevant assessment of the potential injury risk associated with more common forms of CRS and booster seat misuse, which could be applied with observed error frequency-for example, in car seat clinics or during prototype user testing-to better identify and characterize the installation issues of greatest risk to safety. A group of 8 leading world experts in CRS and injury biomechanics, who were members of an international child safety project, estimated the potential injury severity associated with common forms of CRS and booster seat misuse. These injury risk error severity score (ESS) ratings were compiled and compared to scores from previous research that had used a similar procedure but with fewer respondents. To illustrate their application, and as part of a larger study examining CRS and booster seat labeling requirements, the new standardized ESS ratings were applied to objective installation performance data from 26 adult participants who installed a convertible (rear- vs. forward-facing) CRS and booster seat in a vehicle, and a child test dummy in the CRS and booster seat, using labels that only just met minimal regulatory requirements. The outcome measure, the risk priority number (RPN), represented the composite scores of injury risk and observed installation error frequency. Variability within the sample of ESS ratings in the present study was smaller than that generated in previous studies, indicating better agreement among experts on what constituted injury risk. Application of the new standardized ESS ratings to installation

  1. Mandatory Disclosure and Operational Risk: Evidence from Hedge Fund Registration

    OpenAIRE

    Stephen Brown; William Goetzmann; Bing Liang; Christopher Schwarz

    2006-01-01

    Mandatory disclosure is a regulatory tool intended to allow market participants to assess operational risk. We examine the value of disclosure through the controversial SEC requirement, since overturned, which required major hedge funds to register as investment advisors and file Form ADV disclosures. Leverage and ownership structures suggest that lenders and equity investors were already aware of operational risk. However, operational risk does not mediate flow-performance relationships. Inv...

  2. A new way to ask the experts: Rating radioactive waste risks

    International Nuclear Information System (INIS)

    Kerr, R.A.

    1996-01-01

    The possible risks of a proposed nuclear waste repository at Yucca Mountain include the dozen or more young volcanos near by. Now some earth scientists have a new approach to evaluating hazards accounting for uncertainty at every step - 'expert elicitation.' This pulls together a panel of experts, carefully assesses the uncertainties of each of their views then mathematically combines their risk estimates along with the accompanying uncertainties. The article goes on to describe just such a panel which considered seismic hazards to Yucca Mountain, how they came to their conclusions, the arguments about the conclusions, and the future of expert elicitation in evaluating the risks of nuclear waste disposal

  3. Risk-based approach in valuation of workplace injury rate for transportation and construction industry

    Science.gov (United States)

    Pykhtin, Kirill; Simankina, Tatiana; Sharmanov, Vladimir; Kopytova, Anna

    2017-10-01

    The danger of injuries and accidents in various industries such as transportation and construction urges the government to control the occupational health and safety more strictly. However, in order to do so with the minimal costs modern risk management tools, have to be implemented. Risk-based approach is an essential tool for competent risk- assessment and used in a great variety of other countries, demonstrating great results in providing of safe working environment. The article describes the problems that the implementation of the method faces in Russia and suggests certain ways to resolve them.

  4. ARIES Oxide Production Program Assessment of Risk to Long-term Sustainable Production Rate

    Energy Technology Data Exchange (ETDEWEB)

    Whitworth, Julia [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Lloyd, Jane Alexandria [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Majors, Harry W. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-05-04

    This report describes an assessment of risks and the development of a risk watch list for the ARIES Oxide Production Program conducted in the Plutonium Facility at LANL. The watch list is an active list of potential risks and opportunities that the management team periodically considers to maximize the likelihood of program success. The initial assessments were made in FY 16. The initial watch list was reviewed in September 2016. The initial report was not issued. Revision 1 has been developed based on management review of the original watch list and includes changes that occurred during FY-16.

  5. Mortality and recurrence rates among systemically untreated high risk breast cancer patients included in the DBCG 77 trials

    DEFF Research Database (Denmark)

    Jensen, Maj Britt; Nielsen, Torsten O.; Knoop, Ann S.

    2018-01-01

    Background: Following loco-regional treatment for early breast cancer accurate prognostication is essential for communicating benefits of systemic treatment. The aim of this study was to determine time to recurrence and long-term mortality rates in high risk patients according to patient characte......Background: Following loco-regional treatment for early breast cancer accurate prognostication is essential for communicating benefits of systemic treatment. The aim of this study was to determine time to recurrence and long-term mortality rates in high risk patients according to patient...... and EGFR positive. Multivariate categorical and fractional polynomials (MFP) models were used to construct prognostic subsets by clinicopathologic characteristics. Results: In a multivariate model, mortality rate was significantly associated with age, tumor size, nodal status, invasion, histological type...

  6. Ratings of Sovereign Risk and the Macroeconomics Fundamentals of the countries: a Study Using Artificial Neural Networks

    Directory of Open Access Journals (Sweden)

    Osvaldo Cândido da Silva Filho

    2009-05-01

    Full Text Available To minimize the consequences of asymmetric information, the sovereign risk ratings are instruments that constitute a key piece in the determination of credit market conditions, essential to the growth of developing countries like Brazil. In the present work we studied based on macroeconomics foundations, a classification to sovereign risk ratings realized by the ratings agencies finding the classification using Artificial Neural Networks. We observed homogeneity degree between the attributions of agencies and macroeconomics foundations in the countries of sample which four of foundations seem to be more directly connected with these attributions. After, in a comparative static exercise, we use the model to make simulations of scenarios of the credit external conditions for the Brazilian economy, changing the macroeconomics foundations which we noted that agencies expected for more per capita income increasing and decrease of public debt. (Full article in Portuguese only

  7. Individual and Population Level Impact of Key HIV Risk Factors on HIV Incidence Rates in Durban, South Africa.

    Directory of Open Access Journals (Sweden)

    Gita Ramjee

    Full Text Available We aimed to estimate the individual and joint impact of age, marital status and diagnosis with sexually transmitted infections (STIs on HIV acquisition among young women at a population level in Durban, KwaZulu-Natal, South Africa. A total of 3,978 HIV seronegative women were recruited for four biomedical intervention trials from 2002-2009. Point and interval estimates of partial population attributable risk (PAR were used to quantify the proportion of HIV seroconversions which can be prevented if a combination of risk factors is eliminated from a target population. More than 70% of the observed HIV acquisitions were collectively attributed to the three risk factors: younger age (<25 years old, unmarried and not cohabiting with a stable/regular partner and diagnosis with STIs. Addressing these risks requires targeted structural, behavioural, biomedical and cultural interventions in order to impact on unacceptably high HIV incidence rates among young women and the population as a whole.

  8. Rates and risk factors of injury in CrossFit:A prospective cohort study

    OpenAIRE

    Moran, Sebastian; Booker, Harry; Staines, Jacob; Williams, Sean

    2017-01-01

    BACKGROUNDː CrossFit is a strength and conditioning programme that has gained widespread popularity since its inception approximately 15 years ago. However, at present little is known about the level of injury risk associated with this form of training. Movement competency, assessed using the Functional Movement Screen (FMS), has been identified as a risk factor for injury in numerous athletic populations, but its role in CrossFit participants is currently unclear. The aim of this study was t...

  9. Rating agencies: role and influence of their sovereign credit risk assessment in the Euro area

    OpenAIRE

    Sibert, Anne

    2012-01-01

    Credit ratings have a huge impact on the access to and costs of funding, regardless whether the rated entity is a private enterprise or a sovereign borrower. Since the beginning of the financial crisis there has been a vivid and controversial debate about methods, timing and procedures used by these agencies. In this compilation of five notes provided by members of the Monetary Expert Panel the role of the rating agencies and their influence on the euro area is discussed in more detail.

  10. Modeling and estimating the jump risk of exchange rates: Applications to RMB

    Science.gov (United States)

    Wang, Yiming; Tong, Hanfei

    2008-11-01

    In this paper we propose a new type of continuous-time stochastic volatility model, SVDJ, for the spot exchange rate of RMB, and other foreign currencies. In the model, we assume that the change of exchange rate can be decomposed into two components. One is the normally small-cope innovation driven by the diffusion motion; the other is a large drop or rise engendered by the Poisson counting process. Furthermore, we develop a MCMC method to estimate our model. Empirical results indicate the significant existence of jumps in the exchange rate. Jump components explain a large proportion of the exchange rate change.

  11. Rating agencies : Role and influence of their sovereign credit risk assessment in the Eurozone

    NARCIS (Netherlands)

    Eijffinger, S.C.W.

    2012-01-01

    In this article, the role of credit rating agencies (CRAs) during the 2010–11 EU sovereign debt crisis is assessed. It is concluded that rating agencies lag behind markets, that their business model is flawed, and that the lack of competition renders the big three CRAs with too strong a market

  12. ARE SMES MORE CONFORTABLE WITH SMALL DOMESTIC LENDERS? (II –EVIDENCE FOR ROMANIAN SMES

    Directory of Open Access Journals (Sweden)

    Badulescu Daniel

    2012-12-01

    Full Text Available Based on a consistent literature presented in the previous part of our paper, and analysing our research results, carried out on a significant number of SMEs from Romania in 2011, the purpose of this paper is to examine how SMEs are affected and how they perceive the bank involvement in financing SMEs needs, in terms of the nature and characteristics of organizational structure of these lenders. We have found that, despite of the recent development of the crisis and the decision of the most of important European banks to reduce theirs involvement in Central and Eastern Europe, the mostly of the Romanian SMEs considered they are not ignored or under-privileged by large, international banks operating in Romania.

  13. Recruitment Methods and Show Rates to a Prostate Cancer Early Detection Program for High-Risk Men: A Comprehensive Analysis

    Science.gov (United States)

    Giri, Veda N.; Coups, Elliot J.; Ruth, Karen; Goplerud, Julia; Raysor, Susan; Kim, Taylor Y.; Bagden, Loretta; Mastalski, Kathleen; Zakrzewski, Debra; Leimkuhler, Suzanne; Watkins-Bruner, Deborah

    2009-01-01

    Purpose Men with a family history (FH) of prostate cancer (PCA) and African American (AA) men are at higher risk for PCA. Recruitment and retention of these high-risk men into early detection programs has been challenging. We report a comprehensive analysis on recruitment methods, show rates, and participant factors from the Prostate Cancer Risk Assessment Program (PRAP), which is a prospective, longitudinal PCA screening study. Materials and Methods Men 35–69 years are eligible if they have a FH of PCA, are AA, or have a BRCA1/2 mutation. Recruitment methods were analyzed with respect to participant demographics and show to the first PRAP appointment using standard statistical methods Results Out of 707 men recruited, 64.9% showed to the initial PRAP appointment. More individuals were recruited via radio than from referral or other methods (χ2 = 298.13, p < .0001). Men recruited via radio were more likely to be AA (p<0.001), less educated (p=0.003), not married or partnered (p=0.007), and have no FH of PCA (p<0.001). Men recruited via referrals had higher incomes (p=0.007). Men recruited via referral were more likely to attend their initial PRAP visit than those recruited by radio or other methods (χ2 = 27.08, p < .0001). Conclusions This comprehensive analysis finds that radio leads to higher recruitment of AA men with lower socioeconomic status. However, these are the high-risk men that have lower show rates for PCA screening. Targeted motivational measures need to be studied to improve show rates for PCA risk assessment for these high-risk men. PMID:19758657

  14. The impact of lifestyle risk factors on the rate of infection after surgery for a fracture of the ankle

    DEFF Research Database (Denmark)

    Olsen, L L; Møller, A M; Brorson, S

    2017-01-01

    .PATIENTS AND METHODS: We retrospectively reviewed all patients who underwent internal fixation of a fracture of the ankle between 2008 and 2013. The primary outcome was the rate of deep infection and the secondary outcome was any surgical site infection (SSI). Associations with the risk factors and possible.......032) in all analyses. Alcohol overuse was similarly associated, though significant only in unadjusted analyses. Surprisingly, smoking did not yield statistically significant associations with infections.CONCLUSION: These findings suggest that obesity and possibly alcohol overuse are independent risk factors...

  15. Risk Assessment of Diabetes Mellitus by Chaotic Globals to Heart Rate Variability via Six Power Spectra

    Directory of Open Access Journals (Sweden)

    Garner David M.

    2017-09-01

    Full Text Available Background: The priniciple objective here is to analyze cardiovascular dynamics in diabetic subjects by actions related to heart rate variability (HRV. The correlation of chaotic globals is vital to evaluate the probability of dynamical diseases.

  16. Tax Rates Effects on the Risk Level of Listed Viet Nam Wholesale ...

    African Journals Online (AJOL)

    user

    The emerging stock market in Viet Nam has been developed since 2006 and was affected ... positive relationship with the increasing levels of tax rate. Finally, this ... Hypothesis 1: because tax may strongly affect business returns, changing tax.

  17. Resting Heart Rate Is Not a Good Predictor of a Clustered Cardiovascular Risk Score in Adolescents: The HELENA Study.

    Directory of Open Access Journals (Sweden)

    Augusto César Ferreira de Moraes

    Full Text Available Resting heart rate (RHR reflects sympathetic nerve activity a significant association between RHR and all-cause and cardiovascular mortality has been reported in some epidemiologic studies.To analyze the predictive power and accuracy of RHR as a screening measure for individual and clustered cardiovascular risk in adolescents. The study comprised 769 European adolescents (376 boys participating in the HELENA cross-sectional study (2006-2008 were included in this study. Measurements on systolic blood pressure, HOMA index, triglycerides, TC/HDL-c, VO2máx and the sum of four skinfolds were obtained, and a clustered cardiovascular disease (CVD risk index was computed. The receiver operating characteristics curve was applied to calculate the power and accuracy of RHR to predict individual and clustered CVD risk factors.RHR showed low accuracy for screening CVD risk factors in both sexes (range 38.5%-54.4% in boys and 45.5%-54.3% in girls. Low specificity's (15.6%-19.7% in boys; 18.1%-20.0% in girls were also found. Nevertheless, the sensitivities were moderate-to-high (61.4%-89.1% in boys; 72.9%-90.3% in girls.RHR is a poor predictor of individual CVD risk factors and of clustered CVD and the estimates based on RHR are not accurate. The use of RHR as an indicator of CVD risk in adolescents may produce a biased screening of cardiovascular health in both sexes.

  18. estimated glomerular filtration rate and risk of survival in acute stroke

    African Journals Online (AJOL)

    2014-03-03

    Mar 3, 2014 ... Design: A prospective observational cross-sectional study. Setting: Medical ... stroke sub-type, blood sugar, serum creatinine, serum urea and ... history of hypertension and diabetes mellitus, history of alcohol ... Declining renal function takes its toll on homeostasis .... risk of stroke: meta-analysis. BMJ 2010 ...

  19. A simultaneous approach to the estimation of risk aversion and the subjective time discount rate

    NARCIS (Netherlands)

    Booij, A.S.; van Praag, B.M.S.

    2009-01-01

    In this paper we analyze a sample of 1832 individuals who responded to six randomly generated lottery questions that differ with respect to chance, prize and the timing of the draw. Using a model that explicitly allows for consumption smoothing, we obtain an estimate of relative risk aversion of 82.

  20. Child maltreatment in numbers : a multimethod study of year prevalence rates and risk factors

    NARCIS (Netherlands)

    Euser, Saskia

    2013-01-01

    How often does child maltreatment occur in the Netherlands and which factors increase the risk of child maltreatment? In this thesis we describe the findings of two epidemiological studies aimed at answering these questions. First, in the Netherlands’ Prevalence study on Maltreatment of children and

  1. American Indians, hunting and fishing rates, risk, and the Idaho National Engineering and Environmental Laboratory

    International Nuclear Information System (INIS)

    Burger, J.

    1999-01-01

    Hunting, fishing, and recreational rates of 276 American Indians attending a festival at Fort Hall, near the Idaho National Engineering and Environmental Laboratory (INEEL), were examined. Nearly half of the sample lived on the Fort Hall Reservation, and half were American Indians from elsewhere in the western United States. An additional 44 White people attending the festival were also interviewed. The hypothesis that there are differences in hunting, fishing, and recreational rates as a function of tribal affiliation, educational level, gender, and age was examined. Information on hunting and fishing rates are central for understanding potential exposure scenarios for American Indians if the Department of Energy's INEEL lands are ever opened to public access, and the data are important because of the existence of tribal treaties that govern the legal and cultural rights of the Shoshone-Bannock regarding INEEL lands. Variations in hunting, fishing, and photography rates were explained by tribal affiliation (except fishing), gender, age, and schooling. Hunting rates were significantly higher for Indians (both those living on Fort Hall and others) than Whites. Men engaged in significantly higher rates of outdoor activities than women (except for photography). Potential and current hunting and fishing on and adjacent to INEEL was more similar among the local Whites and Fort Hall Indians than between these two groups and other American Indians

  2. Premorbid teacher-rated social functioning predicts adult schizophrenia-spectrum disorder: A high-risk prospective investigation

    DEFF Research Database (Denmark)

    Tsuji, Thomas; Kline, Emily; Sorensen, Holger J.

    2013-01-01

    Social functioning deficits are a core component of schizophrenia spectrum disorders, and may emerge years prior to the onset of diagnosable illness. The current study prospectively examines the relation between teacher-rated childhood social dysfunction and later mental illness among participants...... who were at genetic high-risk for schizophrenia and controls (n=244). The teacher-rated social functioning scale significantly predicted psychiatric outcomes (schizophrenia-spectrum vs. other psychiatric disorder vs. no mental illness). Poor premorbid social functioning appears to constitute a marker...

  3. Incident rate and risk factors for tuberculosis among patients with type 2 diabetes: retrospective cohort study in Shanghai, China.

    Science.gov (United States)

    Qiu, Hanbo; Shi, Yan; Li, Yanyun; Shen, Xin; Li, Rui; Yang, Qundi; Pan, Qichao; Yan, Fei

    2017-07-01

    To examine the incident rate of tuberculosis (TB) and its associates among adults with type 2 diabetes in Shanghai, China. We conducted a retrospective cohort study among 170 399 patients with type 2 diabetes aged ≥18 years who were registered in Shanghai community-based diabetes management system between 2004 and 2009. Their TB status was tracked until 31 December 2014. Cox regression was performed to identify the risk factors for TB. We documented 785 new TB cases during 654 977 person-years of follow-up. The incident rate of TB was 224.20 (206.69, 243.16) per 100 000 person-years among men and 51.34 (44.75, 58.92) per 100 000 person-years among women. A 1-unit increase of BMI was associated with a risk reduction in 16% (P < 0.01) for men and a 14% (P < 0.01) reduction for women. TB cases were more likely to be insulin-dependent [men: hazard ratio = 2.13 (1.29, 3.53); women: 3.28 (1.28, 8.39)] and had a poor glucose level initially [men: 1.21 (1.15, 1.27); women: 1.27 (1.18, 1.37)]. The risk factor for TB specific to men was a young age at diagnosis of diabetes, and the protective factor specific to women was actively engaging in physical activity. TB incident rate among patients with type 2 diabetes was substantially higher among men than among women. The risk of TB was reversely associated with initial BMI. The severity of poor glucose control among patients with diabetes was also linearly associated with the risk of TB. © 2017 John Wiley & Sons Ltd.

  4. Changing rates of suicide ideation and attempts among Inuit youth: a gender-based analysis of risk and protective factors.

    Science.gov (United States)

    Fraser, Sarah L; Geoffroy, Dominique; Chachamovich, Eduardo; Kirmayer, Laurence J

    2015-04-01

    Inuit in Canada currently suffer from one of the highest rates of suicide in the world. The objective of this study was to explore the prevalence of suicide ideations and attempts among 15-24 year olds living in Nunavik, Québec, and to explore risk and protective factors of suicide attempts as a function of gender. A cross-sectional survey was conducted in 2004 across Nunavik. Univariate and multivariate logistic regressions were conducted. A total of 22% of young males and 39% of females adults reported past suicidal attempts. Gender differences were observed in relation to associated risk and protective factors as well as degree of exposure to risk factors. Suicide prevention must include alcohol and drug prevention programs and rehabilitation services, interventions to reduce physical and sexual violence and their long-term impacts on Inuit youth, as well as exposure to culturally meaningful activities. © 2014 The American Association of Suicidology.

  5. Funding Liquidity Risk and Deviations from Interest-Rate Parity During the Financial Crisis of 2007-2009

    OpenAIRE

    Cho-Hoi Hui; Hans Genberg; Tsz-Kin Chung

    2009-01-01

    Significant deviations from covered interest parity were observed during the financial crisis of 2007-2009. This paper finds that before the failure of Lehman Brothers the market-wide funding liquidity risk was the main determinant of these deviations in terms of the premiums on swap-implied US dollar interest rates for the euro, British pound, Hong Kong dollar, Japanese yen, Singapore dollar and Swiss Franc. This suggests that the deviations can be explained by the existence and nature of li...

  6. Foreign exchange risk management : how are the largest non-financial companies in Norway managing their foreign exchange rate exposure?

    OpenAIRE

    Eriksen, Krister; Wedøe, Ola

    2010-01-01

    The purpose of this thesis is to investigate how the largest non-financial companies in Norway manage their foreign exchange rate exposure. This is investigated through the use of a survey distributed to a sample the largest non-financial firms in Norway. According to our results, the largest non-financial companies in Norway have a predefined strategy for managing foreign exchange risk, which is defined by the board of directors or by the management in the organisation. The companies’ mai...

  7. Evaluation of a consumer-oriented internet health care report card: the risk of quality ratings based on mortality data.

    Science.gov (United States)

    Krumholz, Harlan M; Rathore, Saif S; Chen, Jersey; Wang, Yongfei; Radford, Martha J

    2002-03-13

    Health care "report cards" have attracted significant consumer interest, particularly publicly available Internet health care quality rating systems. However, the ability of these ratings to discriminate between hospitals is not known. To determine whether hospital ratings for acute myocardial infarction (AMI) mortality from a prominent Internet hospital rating system accurately discriminate between hospitals' performance based on process of care and outcomes. Data from the Cooperative Cardiovascular Project, a retrospective systematic medical record review of 141 914 Medicare fee-for-service beneficiaries 65 years or older hospitalized with AMI at 3363 US acute care hospitals during a 4- to 8-month period between January 1994 and February 1996 were compared with ratings obtained from HealthGrades.com (1-star: worse outcomes than predicted, 5-star: better outcomes than predicted) based on 1994-1997 Medicare data. Quality indicators of AMI care, including use of acute reperfusion therapy, aspirin, beta-blockers, angiotensin-converting enzyme inhibitors; 30-day mortality. Patients treated at higher-rated hospitals were significantly more likely to receive aspirin (admission: 75.4% 5-star vs 66.4% 1-star, P for trend =.001; discharge: 79.7% 5-star vs 68.0% 1-star, P =.001) and beta-blockers (admission: 54.8% 5-star vs 35.7% 1-star, P =.001; discharge: 63.3% 5-star vs 52.1% 1-star, P =.001), but not angiotensin-converting enzyme inhibitors (59.6% 5-star vs 57.4% 1-star, P =.40). Acute reperfusion therapy rates were highest for patients treated at 2-star hospitals (60.6%) and lowest for 5-star hospitals (53.6% 5-star, P =.008). Risk-standardized 30-day mortality rates were lower for patients treated at higher-rated than lower-rated hospitals (21.9% 1-star vs 15.9% 5-star, P =.001). However, there was marked heterogeneity within rating groups and substantial overlap of individual hospitals across rating strata for mortality and process of care; only 3.1% of comparisons

  8. County-Level Climate Uncertainty for Risk Assessments: Volume 26 Appendix Y - Historical Ridging Rate.

    Energy Technology Data Exchange (ETDEWEB)

    Backus, George A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lowry, Thomas Stephen [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Jones, Shannon M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Walker, La Tonya Nicole [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Roberts, Barry L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Malczynski, Leonard A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-05-01

    This report uses the CMIP5 series of climate model simulations to produce country- level uncertainty distributions for use in socioeconomic risk assessments of climate change impacts. It provides appropriate probability distributions, by month, for 169 countries and autonomous-areas on temperature, precipitation, maximum temperature, maximum wind speed, humidity, runoff, soil moisture and evaporation for the historical period (1976-2005), and for decadal time periods to 2100. It also provides historical and future distributions for the Arctic region on ice concentration, ice thickness, age of ice, and ice ridging in 15-degree longitude arc segments from the Arctic Circle to 80 degrees latitude, plus two polar semicircular regions from 80 to 90 degrees latitude. The uncertainty is meant to describe the lack of knowledge rather than imprecision in the physical simulation because the emphasis is on unfalsified risk and its use to determine potential socioeconomic impacts. The full report is contained in 27 volumes.

  9. County-Level Climate Uncertainty for Risk Assessments: Volume 27 Appendix Z - Forecast Ridging Rate.

    Energy Technology Data Exchange (ETDEWEB)

    Backus, George A.; Lowry, Thomas Stephen; Jones, Shannon M; Walker, La Tonya Nicole; Roberts, Barry L; Malczynski, Leonard A.

    2017-06-01

    This report uses the CMIP5 series of climate model simulations to produce country- level uncertainty distributions for use in socioeconomic risk assessments of climate change impacts. It provides appropriate probability distributions, by month, for 169 countries and autonomous-areas on temperature, precipitation, maximum temperature, maximum wind speed, humidity, runoff, soil moisture and evaporation for the historical period (1976-2005), and for decadal time periods to 2100. It also provides historical and future distributions for the Arctic region on ice concentration, ice thickness, age of ice, and ice ridging in 15-degree longitude arc segments from the Arctic Circle to 80 degrees latitude, plus two polar semicircular regions from 80 to 90 degrees latitude. The uncertainty is meant to describe the lack of knowledge rather than imprecision in the physical simulation because the emphasis is on unfalsified risk and its use to determine potential socioeconomic impacts. The full report is contained in 27 volumes.

  10. Rates and risks for co-morbid depression in patients with Type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Pouwer, F; Beekman, Aartjan T F; Nijpels, G

    2003-01-01

    factors of co-morbid depression in a community-based sample of older adults, comparing Type 2 diabetic patients with healthy control subjects. METHODS: A large (n=3107) community-based study in Dutch adults (55-85 years of age) was conducted. Pervasive depression was defined as a CES-D score greater than...... could play an essential role in the development of depression in Type 2 diabetes. These findings can enable clinicians and researchers to identify high-risk groups and set up prevention and treatment programs.......AIMS/HYPOTHESIS: There is accumulating evidence that depression is common in people with Type 2 diabetes. However, most prevalence-studies are uncontrolled and could also be inaccurate from selection-bias, as they are conducted in specialized treatment settings. We studied the prevalence and risk...

  11. Effect of Birth Cohort on Risk of Hip Fracture: Age-Specific Incidence Rates in the Framingham Study

    Science.gov (United States)

    Samelson, Elizabeth J.; Zhang, Yuqing; Kiel, Douglas P.; Hannan, Marian T.; Felson, David T.

    2002-01-01

    Objectives. This study examined the effect of birth cohort on incidence rates of hip fracture among women and men in the Framingham Study. Methods. Age-specific incidence rates of first hip fracture were presented according to tertile of year of birth for 5209 participants of the Framingham Study, a population-based cohort followed since 1948. Sex-specific incidence rate ratios were calculated by Cox regression to assess the relation between birth cohort and hip fracture incidence. Results. An increasing trend in hip fracture incidence rates was observed with year of birth for women (trend, P = .05) and men (trend, P = .03). Relative to those born from 1887 to 1900 (incidence rate ratio [IRR] = 1.0), age-specific incidence rates were greatest in the most recent birth cohort, born from 1911 to 1921 (IRR = 1.4 for women, IRR = 2.0 for men), and intermediate in those born from 1901 to 1910 (IRR = 1.2 for women, IRR = 1.5 for men). Conclusions. Results suggest risk of hip fracture is increasing for successive birth cohorts. Projections that fail to account for the increase in rates associated with birth cohort underestimate the future public health impact of hip fracture in the United States. PMID:11988460

  12. High-Dose-Rate Brachytherapy Alone for Localized Prostate Cancer in Patients at Moderate or High Risk of Biochemical Recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Hoskin, Peter [Cancer Centre, Mount Vernon Hospital, Northwood, Middlesex (United Kingdom); Rojas, Ana, E-mail: arc03@btconnect.com [Cancer Centre, Mount Vernon Hospital, Northwood, Middlesex (United Kingdom); Lowe, Gerry; Bryant, Linda; Ostler, Peter; Hughes, Rob; Milner, Jessica; Cladd, Helen [Cancer Centre, Mount Vernon Hospital, Northwood, Middlesex (United Kingdom)

    2012-03-15

    Purpose: To evaluate genitourinary (GU) and gastrointestinal (GI) morbidity and biochemical control of disease in patients with localized prostate adenocarcinoma treated with escalating doses per fraction of high-dose rate brachytherapy alone. Methods and Materials: A total of 197 patients were treated with 34 Gy in four fractions, 36 Gy in four fractions, 31.5 Gy in three fractions, or 26 Gy in two fractions. Median follow-up times were 60, 54, 36, and 6 months, respectively. Results: Incidence of early Grade {>=} 3 GU morbidity was 3% to 7%, and Grade 4 was 0% to 4%. During the first 12 weeks, the highest mean International Prostate Symptom Score (IPSS) value was 14, and between 6 months and 5 years it was 8. Grade 3 or 4 early GI morbidity was not observed. The 3-year actuarial rate of Grade 3 GU was 3% to 16%, and was 3% to 7% for strictures requiring surgery (4-year rate). An incidence of 1% Grade 3 GI events was seen at 3 years. Late Grade 4 GU or GI events were not observed. At 3 years, 99% of patients with intermediate-risk and 91% with high-risk disease were free of biochemical relapse (log-rank p = 0.02). Conclusions: There was no significant difference in urinary and rectal morbidity between schedules. Biochemical control of disease in patients with intermediate and high risk of relapse was good.

  13. FACTORS THAT MAY DETERMINE THE RECOVERY RATE OF FINANCIAL RISK DAMAGES

    OpenAIRE

    Nicoleta Diana Rosioru

    2015-01-01

    The information about the performance of a company, especially about its profitability, are useful to the consideration of potential changes of the economic resources, which the company might further control and the forecast of the ability to generate treasury flows by the existent resources. Also, based on the performance, judgments are expressed, aiming the efficiency whereof the company may use new resources. The performance of company may be influenced by its financial risk. The financial...

  14. The Dynamics of Foreign Exchange Rate Risk Management in Different Enterprises

    OpenAIRE

    Khaldoun M. Al-Qaisi

    2012-01-01

    Foreign currency exchange management is very crucial in firms with foreign deals. The objective of this research was to study the management practices in Jordanian firms of foreign exchange management and its risk on these firms. A questionnaire was used to collect data using a stratified random sample. The results show that the firms interested with foreign currency exchange management as it forms more that 50% of its deals. Most of firms indicated that they have a policy for foreign exchang...

  15. A longitudinal study investigating neural processing of speech envelope modulation rates in children with (a family risk for) dyslexia.

    Science.gov (United States)

    De Vos, Astrid; Vanvooren, Sophie; Vanderauwera, Jolijn; Ghesquière, Pol; Wouters, Jan

    2017-08-01

    Recent evidence suggests that a fundamental deficit in the synchronization of neural oscillations to temporal information in speech may underlie phonological processing problems in dyslexia. Since previous studies were performed cross-sectionally in school-aged children or adults, developmental aspects of neural auditory processing in relation to reading acquisition and dyslexia remain to be investigated. The present longitudinal study followed 68 children during development from pre-reader (5 years old) to beginning reader (7 years old) and more advanced reader (9 years old). Thirty-six children had a family risk for dyslexia and 14 children eventually developed dyslexia. EEG recordings of auditory steady-state responses to 4 and 20 Hz modulations, corresponding to syllable and phoneme rates, were collected at each point in time. Our results demonstrate an increase in neural synchronization to phoneme-rate modulations around the onset of reading acquisition. This effect was negatively correlated with later reading and phonological skills, indicating that children who exhibit the largest increase in neural synchronization to phoneme rates, develop the poorest reading and phonological skills. Accordingly, neural synchronization to phoneme-rate modulations was found to be significantly higher in beginning and more advanced readers with dyslexia. We found no developmental effects regarding neural synchronization to syllable rates, nor any effects of a family risk for dyslexia. Altogether, our findings suggest that the onset of reading instruction coincides with an increase in neural responsiveness to phoneme-rate modulations, and that the extent of this increase is related to (the outcome of) reading development. Hereby, dyslexic children persistently demonstrate atypically high neural synchronization to phoneme rates from the beginning of reading acquisition onwards. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Resting heart rate and risk of adverse cardiovascular outcomes in asymptomatic aortic stenosis

    DEFF Research Database (Denmark)

    Greve, Anders M; Bang, Casper N; Berg, Ronan M G

    2015-01-01

    BACKGROUND: An elevated resting heart rate (RHR) may be an early sign of cardiac failure, but its prognostic value during watchful waiting in asymptomatic aortic stenosis (AS) is largely unknown. METHODS: RHR was determined by annual ECGs in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS)...

  17. 77 FR 5416 - Financial Derivatives Transactions To Offset Interest Rate Risk; Investment and Deposit Activities

    Science.gov (United States)

    2012-02-03

    ... manage derivatives. First, an FCU would need to demonstrate relevant IRR exposure. One of the motivations... in ANPR I, the Board is considering whether to limit the types of derivatives instruments that some... considers it appropriate to limit the types of derivatives that an FCU may transact to interest rate...

  18. 76 FR 37030 - Financial Derivatives Transactions To Offset Interest Rate Risk; Investment and Deposit Activities

    Science.gov (United States)

    2011-06-24

    ..., with certain exceptions, are financial derivatives such as futures, options, interest rate swaps and... to evaluate any hedge transaction using derivatives must include the ability to capture all options... NATIONAL CREDIT UNION ADMINISTRATION 12 CFR Part 703 Financial Derivatives Transactions To Offset...

  19. Assessing the influence of risk factors on rates and dynamics of peripheral vein phlebitis: an observational cohort study.

    Science.gov (United States)

    Mestre Roca, Gabriel; Berbel Bertolo, Cristina; Tortajada Lopez, Purificación; Gallemi Samaranch, Gema; Aguilar Ramirez, Mari Carmen; Caylà Buqueras, Joan; Rodríguez-Baño, Jesús; Martinez, José Antonio

    2012-07-21

    To assess the influence of risk factors on the rates and kinetics of peripheral vein phlebitis (PVP) development and its theoretical influence in absolute PVP reduction after catheter replacement. All peripheral short intravenous catheters inserted during one month were included (1201 catheters and 967 patients). PVP risk factors were assessed by a Cox proportional hazard model. Cumulative probability, conditional failure of PVP and theoretical estimation of the benefit from replacement at different intervals were performed. Female gender, catheter insertion at the emergency or medical-surgical wards, forearm site, amoxicillin-clavulamate or aminoglycosides were independent predictors of PVP with hazard ratios (95 confidence interval) of 1.46 (1.09-2.15), 1.94 (1.01-3.73), 2.51 (1.29-4.88), 1.93 (1.20-3.01), 2.15 (1.45-3.20) and 2.10 (1.01-4.63), respectively. Maximum phlebitis incidence was reached sooner in patients with ≥2 risk factors (days 3-4) than in those with phlebitis/one catheter-day for devices with ≤1 risk factors to 0.26 for those with ≥3. The greatest benefit of routine catheter exchange was obtained by replacement every 60h. However, this benefit differed according to the number of risk factors: 24.8% reduction with ≥3, 13.1% with 2, and 9.2% with ≤1. PVP dynamics is highly influenced by identifiable risk factors which may be used to refine the strategy of catheter management. Routine replacement every 72h seems to be strictly necessary only in high-risk catheters. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  20. PERFORMANCE EVALUATION AND RISK AVERSION RATE FOR SEVERAL STOCK INDICES IN INDONESIA STOCK EXCHANGE

    OpenAIRE

    Robiyanto Robiyanto

    2017-01-01

    There are numerous stock indices in Indonesia Stock Exchange. Several of them are LQ-45, MBX, DBX, JII, SRI-KEHATI, PEFINDO-25, BISNIS-27, IDX-30 and KOMPAS-100. Unfortunately there are limi­ted researches which have been done to measure those indices performance specifically. The same condition also occurs on risk aversion level usage in Indonesia Stock Exchange, only few numbers of researches use this me­a­surement in the portfolio valuation. Based on that, this research measured the perfor...

  1. Stroke subtypes, risk factors and mortality rate in northwest of Iran

    DEFF Research Database (Denmark)

    Farhoudi, Mehdi; Mehrvar, Kaveh; Sadeghi-Bazargani, Homayoun

    2017-01-01

    Background: Stroke is the second most common cause of death and first cause of disability in adults in the world. About 80% of all stroke deaths occur in developing countries. So far, the data on stroke epidemiology have been limited in Iran. Therefore, this study was focused on stroke demographic...... data, risk factors, types and mortality. Methods: A retrospective study was done in two university tertiary referral hospitals in Tabriz, northwest of Iran, from March 2008 to April 2013. Patients diagnosed with stroke were enrolled in the study. Demographic data, stroke subtypes, duration...

  2. Estimation of value at risk in currency exchange rate portfolio using asymmetric GJR-GARCH Copula

    Science.gov (United States)

    Nurrahmat, Mohamad Husein; Noviyanti, Lienda; Bachrudin, Achmad

    2017-03-01

    In this study, we discuss the problem in measuring the risk in a portfolio based on value at risk (VaR) using asymmetric GJR-GARCH Copula. The approach based on the consideration that the assumption of normality over time for the return can not be fulfilled, and there is non-linear correlation for dependent model structure among the variables that lead to the estimated VaR be inaccurate. Moreover, the leverage effect also causes the asymmetric effect of dynamic variance and shows the weakness of the GARCH models due to its symmetrical effect on conditional variance. Asymmetric GJR-GARCH models are used to filter the margins while the Copulas are used to link them together into a multivariate distribution. Then, we use copulas to construct flexible multivariate distributions with different marginal and dependence structure, which is led to portfolio joint distribution does not depend on the assumptions of normality and linear correlation. VaR obtained by the analysis with confidence level 95% is 0.005586. This VaR derived from the best Copula model, t-student Copula with marginal distribution of t distribution.

  3. Decreasing the infusion rate reduces the proarrhythmic risk of NS-7

    DEFF Research Database (Denmark)

    Detre, Elke; Thomsen, Morten Bækgaard; Beekman, Jet D

    2005-01-01

    1 The rate of infusion has been suggested to be important for drug-induced torsades de pointes (TdP) arrhythmias. We investigated the repolarisation-prolonging effects and proarrhythmic properties of NS-7, a neuroprotective drug in development, using two different infusion rates. 2 A fast (5 min...... intravenously (i.v.)) escalating dosing regimen (0.3 and 3.0 mg kg(-1), n=4) of NS-7 was investigated in anaesthetised control dogs in sinus rhythm (SR). This was compared to a slow infusion (60 min i.v.) of one dose (3.0 mg kg(-1), n=4) NS-7. The similar dosing regimens were investigated in anaesthetised dogs...... with chronic, complete AV block (CAVB), an animal model of TdP (n=6). 3 No electrophysiological effects were seen after 0.3 mg kg(-1) NS-7. Fast infusion of 3.0 mg kg(-1) caused prolongation of repolarisation, for example, heart rate corrected QT interval (QT(c)): in SR: 6+/-1%; in CAVB: 10+/-7%, which...

  4. Sensitivity analysis of the leaching rate parameter in assessing the environmental risk of phosphogypsum application in sanitary landfills

    Energy Technology Data Exchange (ETDEWEB)

    Marchesi, Marcos Vinicius A.; Hama, Naruhiko; Jacomino, Vanusa M.F.; Ladeira, Ana Claudia Q.; Cota, Stela D.S., E-mail: mvmarchesi@hotmail.com, E-mail: sdsc@cdtn.br, E-mail: vmfj@cdtn.br, E-mail: ana.ladeira@cdtn.br, E-mail: naruhikohama@hotmail.com [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2013-07-01

    The attack with sulfuric acid to phosphate rock produces both phosphoric acid, basic raw material in the manufacture of fertilizers, as a by-product called phosphogypsum. Phosphogypsum is composed mostly of calcium sulfate dihydrated, but may have high levels of impurities from the phosphate rock matrix as a series of natural radionuclides, and heavy metals (e.g. Cd, Zn) and metalloids (e.g. , As and Se). Although it is used for agricultural purposes and more recently in construction, in Brazil the generation rate estimated at six million tons per year is much higher than the amount spent on existing alternatives, and therefore mostly deposited in piles in the same place production, causing thereby the risk of contamination of soil and water resources of the region and providing risk to human health. Taken into account the need to find alternative arrangements for phosphogypsum and reduce the impact generated by its contaminants, this study aims to analyze the sensitivity of the leaching rate parameter in the environmental risk evaluation of the application of phosphogypsum in landfills through mathematical modeling, where it is evaluated the concentration of heavy metals and radionuclides in the layer of the soil under the clay layer of the landfill.

  5. Risk of radiation-induced cancer at low doses and low dose rates for radiation protection purposes

    International Nuclear Information System (INIS)

    1995-01-01

    The aim of this report is to provide an updated, comprehensive review of the data available for assessing the risk of radiation-induced cancer for radiation protection purposes. Particular emphasis is placed on assessing risks at low doses and low dose rates. The review brings together the results of epidemiological investigations and fundamental studies on the molecular and cellular mechanisms involved in radiation damage. Additionally, this information is supplemented by studies with experimental animals which provide further guidance on the form of the dose-response relationship for cancer induction, as well as on the effect of dose rate on the tumour yield. The emphasis of the report is on cancer induction resulting from exposure to radiations with a low linear energy transfer (LET). The work was performed under contract for the Institut de Protection et de Surete Nucleaire, Fontenay-aux-Roses, Paris, France, whose agreement to publish is gratefully ackowledged. It extends the advice on radiation risks given in Documents of the NRPB, 4 No. 4 (1993). (Author)

  6. Sensitivity analysis of the leaching rate parameter in assessing the environmental risk of phosphogypsum application in sanitary landfills

    International Nuclear Information System (INIS)

    Marchesi, Marcos Vinicius A.; Hama, Naruhiko; Jacomino, Vanusa M.F.; Ladeira, Ana Claudia Q.; Cota, Stela D.S.

    2013-01-01

    The attack with sulfuric acid to phosphate rock produces both phosphoric acid, basic raw material in the manufacture of fertilizers, as a by-product called phosphogypsum. Phosphogypsum is composed mostly of calcium sulfate dihydrated, but may have high levels of impurities from the phosphate rock matrix as a series of natural radionuclides, and heavy metals (e.g. Cd, Zn) and metalloids (e.g. , As and Se). Although it is used for agricultural purposes and more recently in construction, in Brazil the generation rate estimated at six million tons per year is much higher than the amount spent on existing alternatives, and therefore mostly deposited in piles in the same place production, causing thereby the risk of contamination of soil and water resources of the region and providing risk to human health. Taken into account the need to find alternative arrangements for phosphogypsum and reduce the impact generated by its contaminants, this study aims to analyze the sensitivity of the leaching rate parameter in the environmental risk evaluation of the application of phosphogypsum in landfills through mathematical modeling, where it is evaluated the concentration of heavy metals and radionuclides in the layer of the soil under the clay layer of the landfill

  7. Assessing Drawdown-at-Risk in Brazilian Real Foreign Exchange Rates

    Directory of Open Access Journals (Sweden)

    Vinicius Ratton Brandi

    2004-12-01

    Full Text Available The investigation of the stochastic behavior of financial series has become widespread over the literature. There is empirical and theoretical evidence that the total stock price change over a long period is usually concentrated in the a few hectic runs of trading days. The drawdown is a random variable which provides information on alternative characteristics of market behavior during these periods. In this work, we use distributions from extreme value theory to model the severity of drawdowns and drawups. We illustrate using nine currency exchange rates and gold.

  8. Benefits and risks of using smart pumps to reduce medication error rates: a systematic review.

    Science.gov (United States)

    Ohashi, Kumiko; Dalleur, Olivia; Dykes, Patricia C; Bates, David W

    2014-12-01

    Smart infusion pumps have been introduced to prevent medication errors and have been widely adopted nationally in the USA, though they are not always used in Europe or other regions. Despite widespread usage of smart pumps, intravenous medication errors have not been fully eliminated. Through a systematic review of recent studies and reports regarding smart pump implementation and use, we aimed to identify the impact of smart pumps on error reduction and on the complex process of medication administration, and strategies to maximize the benefits of smart pumps. The medical literature related to the effects of smart pumps for improving patient safety was searched in PUBMED, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) (2000-2014) and relevant papers were selected by two researchers. After the literature search, 231 papers were identified and the full texts of 138 articles were assessed for eligibility. Of these, 22 were included after removal of papers that did not meet the inclusion criteria. We assessed both the benefits and negative effects of smart pumps from these studies. One of the benefits of using smart pumps was intercepting errors such as the wrong rate, wrong dose, and pump setting errors. Other benefits include reduction of adverse drug event rates, practice improvements, and cost effectiveness. Meanwhile, the current issues or negative effects related to using smart pumps were lower compliance rates of using smart pumps, the overriding of soft alerts, non-intercepted errors, or the possibility of using the wrong drug library. The literature suggests that smart pumps reduce but do not eliminate programming errors. Although the hard limits of a drug library play a main role in intercepting medication errors, soft limits were still not as effective as hard limits because of high override rates. Compliance in using smart pumps is key towards effectively preventing errors. Opportunities for improvement include upgrading drug

  9. A TWO-WAY ROAD: RATES OF HIV INFECTION AND BEHAVIORAL RISK FACTORS AMONG DEPORTED MEXICAN LABOR MIGRANTS

    Science.gov (United States)

    Rangel, M. Gudelia; Martinez-Donate, Ana P.; Hovell, Melbourne; Sipan, Carol L.; Zellner, Jennifer A.; Gonzalez-Fagoaga, Eduardo; Kelley, Norma J.; Asadi-Gonzalez, Ahmed; Amuedo-Dorantes, Catalina; Magis-Rodriguez, Carlos

    2012-01-01

    A large number of Mexican migrants are deported to Mexico and released in the North Mexican border region every year. Despite their volume and high vulnerability, little is known about the level of HIV infection and related risk behaviors among this hard-to-reach population. We conducted a cross-sectional, probability survey with deported Mexican migrants in Tijuana, Mexico (N=693) and estimated levels of HIV infection and behavioral risk factors among this migrant flow. The sample and population estimated rates of HIV for deported males were 1.23% and 0.80%, respectively. No positive cases were found among the female sample. We found high lifetime rates of reported sexually transmitted infections (22.3%) and last 12-months rates of unprotected sex (63.0%), sex with multiple sexual partners (18.1%), casual partners (25.7%), and sex workers (8.6%), compared to U.S. and Mexico adults. HIV prevention, testing, and treatment programs for this large, vulnerable, and transnational population need to be implemented in both the U.S. and Mexico. PMID:22562390

  10. Risk factors and outcomes of high peritonitis rate in continuous ambulatory peritoneal dialysis patients: A retrospective study.

    Science.gov (United States)

    Tian, Yuanshi; Xie, Xishao; Xiang, Shilong; Yang, Xin; Zhang, Xiaohui; Shou, Zhangfei; Chen, Jianghua

    2016-12-01

    Peritonitis remains a major complication of peritoneal dialysis (PD). A high peritonitis rate (HPR) affects continuous ambulatory peritoneal dialysis (CAPD) patients' technique survival and mortality. Predictors and outcomes of HPR, rather than the first peritonitis episode, were rarely studied in the Chinese population. In this study, we examined the risk factors associated with HPR and its effects on clinical outcomes in CAPD patients.This is a single center, retrospective, observational cohort study. A total of 294 patients who developing at least 1 episode of peritonitis were followed up from March 1st, 2002, to July 31, 2014, in our PD center. Multivariate logistic regression was used to determine the factors associated with HPR, and the Cox proportional hazard model was conducted to assess the effects of HPR on clinical outcomes.During the study period of 2917.5 patient-years, 489 episodes of peritonitis were recorded, and the total peritonitis rate was 0.168 episodes per patient-year. The multivariate analysis showed that factors associated with HPR include a quick occurrence of peritonitis after CAPD initiation (shorter than 12 months), and a low serum albumin level at the start of CAPD. In the Cox proportional hazard model, HPR was a significant predictor of technique failure. There were no differences between HPR and low peritonitis rate (LPR) group for all-cause mortality. However, when the peritonitis rate was considered as a continuous variable, a positive correlation was observed between the peritonitis rate and mortality.We found the quick peritonitis occurrence after CAPD and the low serum albumin level before CAPD were strongly associated with an HPR. Also, our results verified that HPR was positively correlated with technique failure. More importantly, the increase in the peritonitis rate suggested a higher risk of all-cause mortality.These results may help to identify and target patients who are at higher risk of HPR at the start of CAPD and to

  11. High dose rate brachytherapy for carcinoma of the cervix: risk factors for late rectal complications

    International Nuclear Information System (INIS)

    Uno, Takashi; Itami, Jun; Aruga, Moriyo; Kotaka, Kikuo; Fujimoto, Hajime; Minoura, Shigeki

    1996-01-01

    Purpose/Objective: To determine the incidence of late rectal complications in patients treated with high dose rate brachytherapy for FIGO stage IIB, IIIB carcinoma of the uterine cervix, and to evaluate the treatment factors associated with an increased probability of treatment complications. Materials and Methods: Records of 100 patients with FIGO IIB or IIIB cervical carcinoma treated with definitive irradiation using high dose rate intracavitary brachytherapy (HDR-ICR) between 1977 and 1994 were retrospectively reviewed. For each HDR-ICR session, 6 Gy isodose volume was reconstructed three dimensionally and the following three parameters were determined to represent this isodose volume, length (L); maximum longitudinal distance of 6 Gy isodose area in an oblique frontal plane containing the intrauterine applicator, width (W); maximum width of 6 Gy isodose area in the same plane, height (H); maximum dimension of 6 Gy isodose area perpendicular to the intrauterine applicator determined in the oblique sagittal plane. Point P/Q (2 cm ventral/dorsal from the proximal retention point of the intrauterine source) and point R/S (2 cm ventral/dorsal from the midpoint of the ovoid sources) were also defined retrospectively and HDR-ICR dose at these points were calculated. Statistical analyses were performed to determine the treatment factors predictive of late rectal complications. Results: The 5-year cumulative cause-specific disease-free survival rate was 50% for all, 74% for Stage IIB, and 38% for Stage IIIB, with a significant difference between two FIGO Stages (p=0.0004). Of patients treated for both stages, 30% and 36% had experienced moderate to severe (Grade 2-4) complications at 3 and 5 years, respectively. Average H value (p=0.013) and cumulative point S dose by HDR-ICR (p=0.020) were significantly correlated with the incidence of late rectal complications (Student's t-test), whereas these factors did not significantly affect the probability of pelvic control. No

  12. Effect of heart rate correction on pre- and post-exercise heart rate variability to predict risk of mortality – an experimental study on the FINCAVAS cohort

    Directory of Open Access Journals (Sweden)

    Paruthi ePradhapan

    2014-06-01

    Full Text Available The non-linear inverse relationship between RR-intervals and heart rate (HR contributes significantly to the heart rate variability (HRV parameters and their performance in mortality prediction. To determine the level of influence HR exerts over HRV parameters’ prognostic power, we studied the predictive performance for different HR levels by applying eight correction procedures, multiplying or dividing HRV parameters by the mean RR-interval (RRavg to the power 0.5-16. Data collected from 1288 patients in The Finnish Cardiovascular Study (FINCAVAS, who satisfied the inclusion criteria, was used for the analyses. HRV parameters (RMSSD, VLF Power and LF Power were calculated from 2-minute segment in the rest phase before exercise and 2-minute recovery period immediately after peak exercise. Area under the receiver operating characteristic curve (AUC was used to determine the predictive performance for each parameter with and without HR corrections in rest and recovery phases. The division of HRV parameters by segment’s RRavg to the power 2 (HRVDIV-2 showed the highest predictive performance under the rest phase (RMSSD: 0.67/0.66; VLF Power: 0.70/0.62; LF Power: 0.79/0.65; cardiac mortality/non-cardiac mortality with minimum correlation to HR (r = -0.15 to 0.15. In the recovery phase, Kaplan-Meier (KM survival analysis revealed good risk stratification capacity at HRVDIV-2 in both groups (cardiac and non-cardiac mortality. Although higher powers of correction (HRVDIV-4 and HRVDIV-8 improved predictive performance during recovery, they induced an increased positive correlation to HR. Thus, we inferred that predictive capacity of HRV during rest and recovery is augmented when its dependence on HR is weakened by applying appropriate correction procedures.

  13. How the growth rate of host cells affects cancer risk in a deterministic way

    Science.gov (United States)

    Draghi, Clément; Viger, Louise; Denis, Fabrice; Letellier, Christophe

    2017-09-01

    It is well known that cancers are significantly more often encountered in some tissues than in other ones. In this paper, by using a deterministic model describing the interactions between host, effector immune and tumor cells at the tissue level, we show that this can be explained by the dependency of tumor growth on parameter values characterizing the type as well as the state of the tissue considered due to the "way of life" (environmental factors, food consumption, drinking or smoking habits, etc.). Our approach is purely deterministic and, consequently, the strong correlation (r = 0.99) between the number of detectable growing tumors and the growth rate of cells from the nesting tissue can be explained without evoking random mutation arising during DNA replications in nonmalignant cells or "bad luck". Strategies to limit the mortality induced by cancer could therefore be well based on improving the way of life, that is, by better preserving the tissue where mutant cells randomly arise.

  14. Modeling Fuel Treatment Leverage: Encounter Rates, Risk Reduction, and Suppression Cost Impacts

    Directory of Open Access Journals (Sweden)

    Matthew P. Thompson

    2017-11-01

    Full Text Available The primary theme of this study is the cost-effectiveness of fuel treatments at multiple scales of investment. We focused on the nexus of fuel management and suppression response planning, designing spatial fuel treatment strategies to incorporate landscape features that provide control opportunities that are relevant to fire operations. Our analysis explored the frequency and magnitude of fire-treatment encounters, which are critical determinants of treatment efficacy. Additionally, we examined avoided area burned, avoided suppression costs, and avoided damages, and combined all three under the umbrella of leverage to explore multiple dimensions with which to characterize return on investment. We chose the Sierra National Forest, California, USA, as our study site, due to previous work providing relevant data and analytical products, and because it has the potential for large, long-duration fires and corresponding potential for high suppression expenditures. Modeling results generally confirmed that fire-treatment encounters are rare, such that median suppression cost savings are zero, but in extreme years, savings can more than offset upfront investments. Further, reductions in risk can expand areas where moderated suppression response would be appropriate, and these areas can be mapped in relation to fire control opportunities.

  15. Normal overall mortality rate in Addison's disease, but young patients are at risk of premature death.

    Science.gov (United States)

    Erichsen, Martina M; Løvås, Kristian; Fougner, Kristian J; Svartberg, Johan; Hauge, Erik R; Bollerslev, Jens; Berg, Jens P; Mella, Bjarne; Husebye, Eystein S

    2009-02-01

    Primary adrenal insufficiency (Addison's disease) is a rare autoimmune disease. Until recently, life expectancy in Addison's disease patients was considered normal. To determine the mortality rate in Addison's disease patients. i) Patients registered with Addison's disease in Norway during 1943-2005 were identified through search in hospital diagnosis registries. Scrutiny of the medical records provided diagnostic accuracy and age at diagnosis. ii) The patients who had died were identified from the National Directory of Residents. iii) Background mortality data were obtained from Statistics Norway, and standard mortality rate (SMR) calculated. iv) Death diagnoses were obtained from the Norwegian Death Cause Registry. Totally 811 patients with Addison's disease were identified, of whom 147 were deceased. Overall SMR was 1.15 (95% confidence intervals (CI) 0.96-1.35), similar in females (1.18 (0.92-1.44)) and males (1.10 (0.80-1.39)). Patients diagnosed before the age of 40 had significantly elevated SMR at 1.50 (95% CI 1.09-2.01), most pronounced in males (2.03 (1.19-2.86)). Acute adrenal failure was a major cause of death; infection and sudden death were more common than in the general population. The mean ages at death for females (75.7 years) and males (64.8 years) were 3.2 and 11.2 years less than the estimated life expectancy. Addison's disease is still a potentially lethal condition, with excess mortality in acute adrenal failure, infection, and sudden death in patients diagnosed at young age. Otherwise, the prognosis is excellent for patients with Addison's disease.

  16. Cancer risk of low dose/low dose rate radiation: a meta-analysis of cancer data of mammals exposed to low doses of radiation

    International Nuclear Information System (INIS)

    Ogata, Hiromitsu; Magae, Junji

    2008-01-01

    Full text: Linear No Threshold (LNT) model is a basic theory for radioprotection, but the adaptability of this hypothesis to biological responses at low doses or at low dose rates is not sufficiently investigated. Simultaneous consideration of the cumulative dose and the dose rate is necessary for evaluating the risk of long-term exposure to ionizing radiation at low dose. This study intends to examine several numerical relationships between doses and dose rates in biological responses to gamma radiation. Collected datasets on the relationship between dose and the incidence of cancer in mammals exposed to low doses of radiation were analysed using meta-regression models and modified exponential (MOE) model, which we previously published, that predicts irradiation time-dependent biological response at low dose rate ionizing radiation. Minimum doses of observable risk and effective doses with a variety of dose rates were calculated using parameters estimated by fitting meta-regression models to the data and compared them with other statistical models that find values corresponding to 'threshold limits'. By fitting a weighted regression model (fixed-effects meta-regression model) to the data on risk of all cancers, it was found that the log relative risk [log(RR)] increased as the total exposure dose increased. The intersection of this regression line with the x-axis denotes the minimum dose of observable risk. These estimated minimum doses and effective doses increased with decrease of dose rate. The goodness of fits of MOE-model depended on cancer types, but the total cancer risk is reduced when dose rates are very low. The results suggest that dose response curve for cancer risk is remarkably affected by dose rate and that dose rate effect changes as a function of dose rate. For scientific discussion on the low dose exposure risk and its uncertainty, the term 'threshold' should be statistically defined, and dose rate effects should be included in the risk

  17. Success rate and risk factors of failure of the induced membrane technique in children: a systematic review.

    Science.gov (United States)

    Aurégan, Jean-Charles; Bégué, Thierry; Rigoulot, Guillaume; Glorion, Christophe; Pannier, Stéphanie

    2016-12-01

    The induced membrane technique was designed by Masquelet et al. to address segmental bone defects of critical size in adults. It has been used after bone defects of traumatic, infectious and tumoral origin with satisfactory results. Recently, it has been used in children but, after an initial enthusiasm, several cases of failure have been reported. The purpose of this study was to assess the success rate and the risk factors of failure of the induced membrane for children. We conducted a systematic review of all the studies reporting the results of the induced membrane technique to address bone defects of critical size in children. Our primary outcome was the success rate of the technique defined as a bone union before any iterative surgery. Our secondary outcomes were the complications and the risk factors of failure. We searched Medline via Pubmed, EMBASE and the Cochrane Library. Twelve studies, including 69 patients, met the inclusion criteria. There were 41 boys and 28 girls. Mean age at surgery was 10 years. Mean size of resection was 12.38 cm and the mean time between the two stages was 5.86 months. Mean rate of bone union after the two stages of the induced membrane technique was 58% (40/69) but this rate increased to 87% after revision surgeries (60/69). Main complications were non-unions (19/69), lysis of the graft (6/69) and fractures of the bone graft (6/69). Only 1/69 deep infection was reported. Other non specific complications were regularly reported such limb length discrepancies, joint stiffness and protruding wires. Risk factor of failure that could be suspected comprised the resection of a malignant tumour, a bone defect located at the femur, a wide resection, a long time between the two stages, an unstable osteosynthesis and a bone graft associating autograft to other graft materials. The induced membrane technique is suitable for bone defects of critical size in children. It is a reliable technique with no need of micro vascular surgery

  18. Emotional stress and heart rate variability measures associated with cardiovascular risk in relocated Katrina survivors.

    Science.gov (United States)

    Tucker, Phebe; Pfefferbaum, Betty; Jeon-Slaughter, Haekyung; Khan, Qaiser; Garton, Theresa

    2012-01-01

    To explore the effects of hurricane exposure and forced relocation on the mind and body, we compared psychiatric diagnoses and symptoms with heart rate variability (HRV) for 34 relocated Katrina survivors and 34 demographically matched controls. All participants were healthy and free of psychiatric and cardiovascular medications. We measured symptoms of posttraumatic stress disorder (PTSD) (Clinician-Administered PTSD Scale 1) and depression (Beck Depression Inventory), Axis I psychiatric diagnoses (Structured Clinical Interview for DSM-IV), psychosocial disability (Sheehan Disability Scale), and power spectral analysis HRV reactivity to trauma reminders. Katrina-related PTSD occurred in 38% of survivors and 12% of controls. Survivors reported higher levels of PTSD and depression symptoms, within diagnostic ranges, and greater psychosocial disability than controls. Survivors had higher resting heart rate (80.82 [standard deviation = 13.60] versus 74.85 [10.67], p = .05), lower parasympathetic (high-frequency [HF] normalized unit) baseline HRV activity (40.14 [23.81] versus 50.67 [19.93], p = .04) and less reactivity with trauma cues (-2.63 [20.70] versus -11.96 [15.84], p = .04), and higher baseline sympathovagal activity (low frequency/HF ratio) (2.84 [3.08] versus 1.35 [1.08], p = .04) than controls. Survivors with depression (n = 12) and with depression and PTSD combined (n = 7), but not those with PTSD (n = 13), had flattened parasympathetic responsiveness to trauma cues. HRV indices correlated with depressive (low frequency/HF, p = .01; HF normalized unit, p = .046) but not PTSD symptoms (p values > .05). Results showed this multilayer trauma's impact on emotional health and HRV-based measures of autonomic nervous system dysregulation. Specifically, dysregulation of depressed survivors' HRV in response to trauma reminders supports more autonomic involvement in traumatic loss/depression than in PTSD. Diagnostic criteria for PTSD include physiologic reactivity

  19. Maternal depression in the United States: nationally representative rates and risks.

    Science.gov (United States)

    Ertel, Karen A; Rich-Edwards, Janet W; Koenen, Karestan C

    2011-11-01

    To examine the public health burden of major depressive disorder (MDD) among mothers: its prevalence and sociodemographic patterns; associated functioning, comorbidities, and adversities; and racial/ethnic disparities. This was a cross-sectional analysis of 8916 mothers in the National Epidemiologic Survey of Alcohol and Related Conditions, a nationally representative survey of the civilian U.S. population in 2001?2002. Past-year MDD was assessed with a structured interview protocol. Ten percent of mothers experienced depression in the past year. White and Native American women, those with low education or income, and those not married had high rates of depression. Depression was not strongly patterned by number of or age of children. Depressed mothers experienced more adversities (poverty, separation or divorce, unemployment, financial difficulties) and had worse functioning. Half of depressed mothers received services for their depression. Black and Hispanic depressed mothers were more likely to experience multiple adversities and less likely to receive services than white depressed mothers. Maternal depression is a major public health problem in the United States, with an estimated 1 in 10 children experiencing a depressed mother in any given year. Professionals who work with mothers and children should be aware of its prevalence and its detrimental effects.

  20. Trends of increases in potential risk factors and prevalence rates of diabetes mellitus in Thailand.

    Science.gov (United States)

    Chavasit, V; Kriengsinyos, W; Photi, J; Tontisirin, K

    2017-07-01

    Over the past three decades, undernutrition in Thailand has drastically reduced by over seven times. However, since 1995 the number of patients afflicted with non-communicable diseases, such as diabetes mellitus, has rapidly increased, even among the young. Unhealthy life styles due to urbanization are a major reason for this increase. Less physical activity and low consumption of fruits and vegetables, as well as high consumption of added free sugar, are common. Every year, the Thai people increase their consumption of energy from fat and protein, while lowering their intake of energy from complex carbohydrates. Per capita and on average, a Thai individual consumes up to 20% of total energy from added free sugar. Barker's hypothesis and Developmental Origins of Health and Disease hypothesis (DOHaD) can partially explain the increase in diabetes mellitus at this rapid rate. To alleviate the problem, the main strategy has been consumer education to reduce diabetes mellitus prevalence. Sugar elimination from infant formula is mandatory and sugar taxation is being considered. Simplified nutrition labeling is voluntarily as part of consumer education, as well as encouraging food industries to produce healthier food products. Currently, a multi-sectoral approach is used for alleviating diabetes mellitus in Thailand.

  1. Sick leave during pregnancy: a longitudinal study of rates and risk factors in a Norwegian population.

    Science.gov (United States)

    Dørheim, S K; Bjorvatn, B; Eberhard-Gran, M

    2013-04-01

    To describe the prevalence of, reasons given for, and factors associated with sick leave during pregnancy. Longitudinal, population-based descriptive study. Akershus University Hospital, Norway. All women scheduled to give birth at the hospital (November 2008 to April 2010). Consenting women were handed a questionnaire at the routine ultrasound check at 17 weeks of gestation. Women returning this questionnaire received a second questionnaire at 32 weeks of gestation. Multiple logistic regression analyses were performed to examine associations with somatic, psychiatric and social factors. Rates and duration of sick leave. By 32 weeks of gestation, 63.2% of the 2918 women included were on sick leave, and 75.3% had been on sick leave at some point during their pregnancy. Pelvic girdle pain and fatigue/sleep problems were the main reasons given for sick leave. Being on sick leave in all trimesters was strongly associated with hyperemesis, exercising less than weekly, chronic pain before or during pregnancy, infertility treatment (all P workplace (both P pregnancy, but sick leave might not be caused by pregnancy alone. Previous medical and psychiatric history, work conditions and socio-economic factors need to be addressed to understand sick leave during pregnancy. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

  2. Estimation of outdoor and indoor effective dose and excess lifetime cancer risk from Gamma dose rates in Gonabad, Iran

    Energy Technology Data Exchange (ETDEWEB)

    Jafaria, R.; Zarghania, H.; Mohammadia, A., E-mail: rvzreza@gmail.com [Paramedical faculty, Birjand University of Medical Sciences, Birjand (Iran, Islamic Republic of)

    2017-07-01

    Background gamma irradiation in the indoor and outdoor environments is a major concern in the world. The study area was Gonabad city. Three stations and buildings for background radiation measurement of outdoor and indoor were randomly selected and the Geiger-Muller detector (X5C plus) was used. All dose rates on display of survey meter were recorded and mean of all data in each station and buildings was computed and taken as measured dose rate of that particular station. The average dose rates of background radiation were 84.2 nSv/h for outdoor and 108.6 nSv/h for indoor, maximum and minimum dose rates were 88.9 nSv/h and 77.7 nSv/h for outdoor measurements and 125.4 nSv/h and 94.1 nSv/h for indoor measurements, respectively. Results show that the annual effective dose is 0.64 mSv, which compare to global level of the annual effective dose 0.48 mSv is high. Estimated excess lifetime cancer risk was 2.24×10{sup -3} , indicated that it is large compared to the world average value of 0.25×10{sup -3}. (author)

  3. Heart Rate Variability: New Perspectives on Physiological Mechanisms, Assessment of Self-regulatory Capacity, and Health risk.

    Science.gov (United States)

    McCraty, Rollin; Shaffer, Fred

    2015-01-01

    Heart rate variability, the change in the time intervals between adjacent heartbeats, is an emergent property of interdependent regulatory systems that operates on different time scales to adapt to environmental and psychological challenges. This article briefly reviews neural regulation of the heart and offers some new perspectives on mechanisms underlying the very low frequency rhythm of heart rate variability. Interpretation of heart rate variability rhythms in the context of health risk and physiological and psychological self-regulatory capacity assessment is discussed. The cardiovascular regulatory centers in the spinal cord and medulla integrate inputs from higher brain centers with afferent cardiovascular system inputs to adjust heart rate and blood pressure via sympathetic and parasympathetic efferent pathways. We also discuss the intrinsic cardiac nervous system and the heart-brain connection pathways, through which afferent information can influence activity in the subcortical, frontocortical, and motor cortex areas. In addition, the use of real-time HRV feedback to increase self-regulatory capacity is reviewed. We conclude that the heart's rhythms are characterized by both complexity and stability over longer time scales that reflect both physiological and psychological functional status of these internal self-regulatory systems.

  4. Ultrasound-guided fine needle aspiration versus core needle biopsy: comparison of post-biopsy hematoma rates and risk factors.

    Science.gov (United States)

    Chae, In Hye; Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Park, Vivian Y; Kwak, Jin Young

    2017-07-01

    To compare post-biopsy hematoma rates between ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy, and to investigate risk factors for post-biopsy hematoma. A total of 5304 thyroid nodules which underwent ultrasound guided biopsy were included in this retrospective study. We compared clinical and US features between patients with and without post-biopsy hematoma. Associations between these features and post-biopsy hematoma were analyzed. Post-biopsy hematoma rate was 0.8% (43/5121) for ultrasound guided-fine needle aspiration and 4.9% (9/183) for ultrasound guided-core needle biopsy (P core needle biopsy (9/179, 5.0%) than with ultrasound guided-fine needle aspiration (9/1138, 0.8%) (P core needle biopsy was the only significant risk factor for post-biopsy hematoma (adjusted Odds Ratio, 6.458, P core needle biopsy than in ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy was the only independent factor of post-biopsy hematoma in thyroid nodules.

  5. Quantification of lung cancer risk after low radon exposure and low exposure rate: synthesis from epidemiological and experimental data

    International Nuclear Information System (INIS)

    Timarche, M.

    2004-03-01

    Radon is a radioactive gas produced during the decay of uranium 238 that is present in soil. It was classified as a human lung carcinogen in 1988, based on evidence both from animal studies and from human studies of miners with high levels of radon exposure. Radon is present everywhere; therefore the quantification of the risk associated with exposure to it is a key public health issue. The project aimed to analyse the risk associated with radon inhalation at low doses and at low rates of exposure. It involved researchers from three different fields: epidemiology, animal experiments and mechanistic modelling and provided a unique opportunity to study the influence of dose rate, mainly in the range of low daily exposures over long periods, by analysing in parallel results from both animal and epidemiological studies. The project comprised 6 work packages (W.P.). Firstly, the partners involved in epidemiology and animal experiments worked on the validation and the analysis of the data. Secondly, the data from W.P.1 and W.P.4 were transferred to the partners involved in W.P.5 for the application of mechanistic models. In the final step a synthesis of the results was prepared. (N.C)

  6. Quantification of lung cancer risk after low radon exposure and low exposure rate: synthesis from epidemiological and experimental data

    Energy Technology Data Exchange (ETDEWEB)

    Timarche, M

    2004-03-15

    Radon is a radioactive gas produced during the decay of uranium 238 that is present in soil. It was classified as a human lung carcinogen in 1988, based on evidence both from animal studies and from human studies of miners with high levels of radon exposure. Radon is present everywhere; therefore the quantification of the risk associated with exposure to it is a key public health issue. The project aimed to analyse the risk associated with radon inhalation at low doses and at low rates of exposure. It involved researchers from three different fields: epidemiology, animal experiments and mechanistic modelling and provided a unique opportunity to study the influence of dose rate, mainly in the range of low daily exposures over long periods, by analysing in parallel results from both animal and epidemiological studies. The project comprised 6 work packages (W.P.). Firstly, the partners involved in epidemiology and animal experiments worked on the validation and the analysis of the data. Secondly, the data from W.P.1 and W.P.4 were transferred to the partners involved in W.P.5 for the application of mechanistic models. In the final step a synthesis of the results was prepared. (N.C)

  7. High-Dose-Rate Brachytherapy as a Monotherapy for Favorable-Risk Prostate Cancer: A Phase II Trial

    International Nuclear Information System (INIS)

    Barkati, Maroie; Williams, Scott G.; Foroudi, Farshad; Tai, Keen Hun; Chander, Sarat; Dyk, Sylvia van; See, Andrew; Duchesne, Gillian M.

    2012-01-01

    Purpose: There are multiple treatment options for favorable-risk prostate cancer. High-dose-rate (HDR) brachytherapy as a monotherapy is appealing, but its use is still investigational. A Phase II trial was undertaken to explore the value of such treatment in low-to-intermediate risk prostate cancer. Methods and Materials: This was a single-institution, prospective study. Eligible patients had low-risk prostate cancer features but also Gleason scores of 7 (51% of patients) and stage T2b to T2c cancer. Treatment with HDR brachytherapy with a single implant was administered over 2 days. One of four fractionation schedules was used in a dose escalation study design: 3 fractions of 10, 10.5, 11, or 11.5 Gy. Patients were assessed with the Common Terminology Criteria for Adverse Events version 2.0 for urinary toxicity, the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer scoring schema for rectal toxicity, and the Expanded Prostate Cancer Index Composite (EPIC) questionnaire to measure patient-reported health-related quality of life. Biochemical failure was defined as a prostate-specific antigen (PSA) nadir plus 2 ng/ml. Results: Between 2003 and 2008, 79 patients were enrolled. With a median follow-up of 39.5 months, biochemical relapse occurred in 7 patients. Three- and 5-year actuarial biochemical control rates were 88.4% (95% confidence interval [CI], 78.0-96.2%) and 85.1% (95% CI, 72.5-94.5%), respectively. Acute grade 3 urinary toxicity was seen in only 1 patient. There was no instance of acute grade 3 rectal toxicity. Rates of late grade 3 rectal toxicity, dysuria, hematuria, urinary retention, and urinary incontinence were 0%, 10.3%, 1.3%, 9.0%, and 0%, respectively. No grade 4 or greater toxicity was recorded. Among the four (urinary, bowel, sexual, and hormonal) domains assessed with the EPIC questionnaire, only the sexual domain did not recover with time. Conclusions: HDR brachytherapy as a monotherapy for favorable-risk

  8. High-Dose-Rate Brachytherapy as a Monotherapy for Favorable-Risk Prostate Cancer: A Phase II Trial

    Energy Technology Data Exchange (ETDEWEB)

    Barkati, Maroie [Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne (Australia); Williams, Scott G., E-mail: scott.williams@petermac.org [Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne (Australia); Department of Pathology, University of Melbourne, Melbourne (Australia); Foroudi, Farshad; Tai, Keen Hun; Chander, Sarat [Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne (Australia); Department of Pathology, University of Melbourne, Melbourne (Australia); Dyk, Sylvia van [Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne (Australia); See, Andrew [Ballarat Austin Radiation Oncology Centre, Ballarat (Australia); Duchesne, Gillian M. [Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne (Australia); Department of Pathology, University of Melbourne, Melbourne (Australia)

    2012-04-01

    Purpose: There are multiple treatment options for favorable-risk prostate cancer. High-dose-rate (HDR) brachytherapy as a monotherapy is appealing, but its use is still investigational. A Phase II trial was undertaken to explore the value of such treatment in low-to-intermediate risk prostate cancer. Methods and Materials: This was a single-institution, prospective study. Eligible patients had low-risk prostate cancer features but also Gleason scores of 7 (51% of patients) and stage T2b to T2c cancer. Treatment with HDR brachytherapy with a single implant was administered over 2 days. One of four fractionation schedules was used in a dose escalation study design: 3 fractions of 10, 10.5, 11, or 11.5 Gy. Patients were assessed with the Common Terminology Criteria for Adverse Events version 2.0 for urinary toxicity, the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer scoring schema for rectal toxicity, and the Expanded Prostate Cancer Index Composite (EPIC) questionnaire to measure patient-reported health-related quality of life. Biochemical failure was defined as a prostate-specific antigen (PSA) nadir plus 2 ng/ml. Results: Between 2003 and 2008, 79 patients were enrolled. With a median follow-up of 39.5 months, biochemical relapse occurred in 7 patients. Three- and 5-year actuarial biochemical control rates were 88.4% (95% confidence interval [CI], 78.0-96.2%) and 85.1% (95% CI, 72.5-94.5%), respectively. Acute grade 3 urinary toxicity was seen in only 1 patient. There was no instance of acute grade 3 rectal toxicity. Rates of late grade 3 rectal toxicity, dysuria, hematuria, urinary retention, and urinary incontinence were 0%, 10.3%, 1.3%, 9.0%, and 0%, respectively. No grade 4 or greater toxicity was recorded. Among the four (urinary, bowel, sexual, and hormonal) domains assessed with the EPIC questionnaire, only the sexual domain did not recover with time. Conclusions: HDR brachytherapy as a monotherapy for favorable-risk

  9. A proposed structural, risk-informed approach to the periodicity of CANDU-6 nuclear containment integrated leak rate testing

    Energy Technology Data Exchange (ETDEWEB)

    Saliba, N. [McGill Univ., Dept. of Civil Engineering and Applied Mechanics, Montreal, Quebec (Canada); Komljenovic, D. [Hydro-Quebec, Gentilly-2 Nuclear Power Plant, Becancour, Quebec (Canada); Chouinard, L. [McGill Univ., Dept. of Civil Engineering and Applied Mechanics, Montreal, Quebec (Canada); Vaillancourt, R.; Chretien, G. [Hydro-Quebec, Gentilly-2 Nuclear Power Plant, Becancour, Quebec (Canada); Gocevski, V. [Hydro-Quebec Equipements, Montreal, Quebec (Canada)

    2010-07-01

    As ultimate lines of defense against leakage of large amounts of radioactive material to the environment in case of major reactor accidents, containments have been monitored through well designed periodic tests to ensure their proper performance. Regulatory organizations have imposed types and frequencies of containment tests based on highly-conservative deterministic approaches, and judgments of knowledgeable experts. Recent developments in the perception and methods of risk evaluation have been applied to rationalize the leakage-rate testing frequencies while maintaining risks within acceptable levels, preserving the integrity of containments, and respecting the defense-in-depth philosophy. The objective of this paper is to introduce a proposed risk-informed decision making framework on the periodicity of nuclear containment ILRTs for CANDU-6 nuclear power plants based on five main decision criteria, namely: 1) the containment structural integrity; 2) inputs from PSA Level-2; 3) the requirements of deterministic safety analyses and defense-in-depth concepts; 4- the obligations under regulatory and standard requirements; and 5) the return of experience from nuclear containments historic performance. The concepts of dormant reliability and structural fragility will guide the assessment of the containment structural integrity, within the general context of a global containment life cycle management program. This study is oriented towards the requirements of CANDU-6 reactors, in general, and Hydro-Quebec's Gentilly-2 nuclear power plant, in particular. The present article is the first part in a series of papers that will comprehensively detail the proposed research. (author)

  10. [Study on the detection rate and risk factors regarding non-suicidal self-injurious behavior in middle school students].

    Science.gov (United States)

    Yan, Jing; Zhu, Cui-zhen; Situ, Ming-jing; DU, Na; Huang, Yi

    2012-01-01

    To understand the prevalence and risk factors of non-suicidal self-injury in middle school students. 1312 middle school students of Pengzhou and Santai were selected to fill in a Risky Behavior Questionnaire for Adolescence (RBQ-A), Family Environment Scale (FES), Center for Epidemiological Survey, Depression Scale (CES-D), Adolescent Self-Rating Life Events Check List (ASLEC), Social Support Scale for Adolescents (SSSA) and self-administered questionnaire. In all the research subjects, 1288 were qualified for the study in April 2011 before the risk factors for non-suicidal self-injury were identified by logistic regression. In 1288 middle school students, 22.67% had a history of non-suicidal self-injury, with 22.70% in boys and 22.64% in girls. 63.36% of students had injured themselves through variously ways, more seen in boys (26.88%) than in girls (11.36%) who cut or burnt themselves. The scores of ASLEC and CES-D in non-suicidal self-injury group appeared higher than that in the control group and the score of SSSA was found higher in the control group. The main risk factors for non-suicidal self-injuries were family conflict, depressive emotion, negative life events and receiving less social support. The prevalence of non-suicidal self-injury among middle school students in Pengzhou was high, which called for more attention.

  11. Uranium in soil and gamma dose rate as proxies for the indoor radon risk: situation in Belgium

    International Nuclear Information System (INIS)

    Tondeur, F.; Cinelli, G.; Dehandschutter, B.

    2017-01-01

    Radon risk maps are usually based either on indoor radon data, or on measurements of soil gas radon and soil permeability. If these data are not available or not sufficient, it was suggested that other data could be used as an approximate substitute (a proxy) to the missing information, like the concentration of 238 U or 226 Ra in soils or the terrestrial gamma dose rate (TGDR). We examine here the correlation between airborne measurements of soil U and indoor radon, and between airborne U and TGDR, and their link with affected/unaffected areas. No clear correlation is found between airborne U and affected areas, as strongly affected areas are not characterised by a higher U level. Only the moderately affected area of Condroz can be connected to a higher U level, related to a few U anomalies. TGDR shows a rather good correlation with airborne U, but its relation with radon risk is less clear. Soil uranium and TGDR may help to screen out areas with very low U and very low TGDR, which have a low indoor radon risk, but they cannot be considered as good proxies for predicting radon-affected areas in Belgium. (authors)

  12. A proposed structural, risk-informed approach to the periodicity of CANDU-6 nuclear containment integrated leak rate testing

    International Nuclear Information System (INIS)

    Saliba, N.; Komljenovic, D.; Chouinard, L.; Vaillancourt, R.; Chretien, G.; Gocevski, V.

    2010-01-01

    As ultimate lines of defense against leakage of large amounts of radioactive material to the environment in case of major reactor accidents, containments have been monitored through well designed periodic tests to ensure their proper performance. Regulatory organizations have imposed types and frequencies of containment tests based on highly-conservative deterministic approaches, and judgments of knowledgeable experts. Recent developments in the perception and methods of risk evaluation have been applied to rationalize the leakage-rate testing frequencies while maintaining risks within acceptable levels, preserving the integrity of containments, and respecting the defense-in-depth philosophy. The objective of this paper is to introduce a proposed risk-informed decision making framework on the periodicity of nuclear containment ILRTs for CANDU-6 nuclear power plants based on five main decision criteria, namely: 1) the containment structural integrity; 2) inputs from PSA Level-2; 3) the requirements of deterministic safety analyses and defense-in-depth concepts; 4- the obligations under regulatory and standard requirements; and 5) the return of experience from nuclear containments historic performance. The concepts of dormant reliability and structural fragility will guide the assessment of the containment structural integrity, within the general context of a global containment life cycle management program. This study is oriented towards the requirements of CANDU-6 reactors, in general, and Hydro-Quebec's Gentilly-2 nuclear power plant, in particular. The present article is the first part in a series of papers that will comprehensively detail the proposed research. (author)

  13. Using data to help increase STEM retention rates for at-risk students; Student expectations and skill building

    Science.gov (United States)

    Reed, D. E.; Jones, G.; Heaney, A.

    2013-12-01

    Retention in the STEM fields is often a focus for higher education due to a shortage of trained workforce members. In particular, much effort has been spent on first year retention rates and introductory level courses under the assumption that students are more likely to drop out of STEM majors early in their higher education degree progress. While the retention rates of women, minorities, and low income students have been a priority by both the National Science Foundation and the private sector, we are interested in at-risk first year students for this study. The University of Wyoming Synergy Program's goal is to promote academic success and retention for underprepared and at-risk students by creating a series of first semester curricula as theme-based college transition skills courses that are paired with English courses. This creates a cohort group of courses for the students with increased communication between instructors at the same time allowing greater development of student social networks. In this study we are highlighting the results of the STEM students as compared with other at-risk participants in the program. The Synergy Program enrolls approximately 144 students each year with pre- and post-course surveys that directly measure which college skills students select as important as well as student expectations of the amount of time required for STEM courses. Follow-up surveys track the same queries for students who persist to their junior and senior year. In addition, instructors complete a summative survey about skills they find important to student success and individual student's challenges and successes with a variety of skills. Our results show a large gap in skills between those identified as important by students and those identified by their instructors. Expectations for the amount of time required to complete work for STEM courses and the reported time spent on course work are not constant when progressing throughout college. This analysis

  14. Reduction in acute myocardial infarction mortality in the United States: risk-standardized mortality rates from 1995-2006.

    Science.gov (United States)

    Krumholz, Harlan M; Wang, Yun; Chen, Jersey; Drye, Elizabeth E; Spertus, John A; Ross, Joseph S; Curtis, Jeptha P; Nallamothu, Brahmajee K; Lichtman, Judith H; Havranek, Edward P; Masoudi, Frederick A; Radford, Martha J; Han, Lein F; Rapp, Michael T; Straube, Barry M; Normand, Sharon-Lise T

    2009-08-19

    During the last 2 decades, health care professional, consumer, and payer organizations have sought to improve outcomes for patients hospitalized with acute myocardial infarction (AMI). However, little has been reported about improvements in hospital short-term mortality rates or reductions in between-hospital variation in short-term mortality rates. To estimate hospital-level 30-day risk-standardized mortality rates (RSMRs) for patients discharged with AMI. Observational study using administrative data and a validated risk model to evaluate 3,195,672 discharges in 2,755,370 patients discharged from nonfederal acute care hospitals in the United States between January 1, 1995, and December 31, 2006. Patients were 65 years or older (mean, 78 years) and had at least a 12-month history of fee-for-service enrollment prior to the index hospitalization. Patients discharged alive within 1 day of an admission not against medical advice were excluded, because it is unlikely that these patients had sustained an AMI. Hospital-specific 30-day all-cause RSMR. At the patient level, the odds of dying within 30 days of admission if treated at a hospital 1 SD above the national average relative to that if treated at a hospital 1 SD below the national average were 1.63 (95% CI, 1.60-1.65) in 1995 and 1.56 (95% CI, 1.53-1.60) in 2006. In terms of hospital-specific RSMRs, a decrease from 18.8% in 1995 to 15.8% in 2006 was observed (odds ratio, 0.76; 95% CI, 0.75-0.77). A reduction in between-hospital heterogeneity in the RSMRs was also observed: the coefficient of variation decreased from 11.2% in 1995 to 10.8%, the interquartile range from 2.8% to 2.1%, and the between-hospital variance from 4.4% to 2.9%. Between 1995 and 2006, the risk-standardized hospital mortality rate for Medicare patients discharged with AMI showed a significant decrease, as did between-hospital variation.

  15. The Influence of Base Rate and Case Information on Health-Risk Perceptions: A Unified Model of Self-Positivity and Self-Negativity

    OpenAIRE

    Dengfeng Yan; Jaideep Sengupta

    2013-01-01

    This research examines how consumers use base rate (e.g., disease prevalence in a population) and case information (e.g., an individual's disease symptoms) to estimate health risks. Drawing on construal level theory, we propose that consumers' reliance on base rate (case information) will be enhanced (weakened) by psychological distance. A corollary of this premise is that self-positivity (i.e., underestimating self-risk vs. other-risk) is likely when the disease base rate is high but the cas...

  16. Turkish assessment of SURF (SUrvey of Risk Factor Management) study: Control rates of cardiovascular risk factors derived from databases of 15 different levels of health centers in Turkey.

    Science.gov (United States)

    Tokgözoğlu, Lale; Oğuz, Aytekin; Balcı, Mustafa Kemal; Temizhan, Ahmet; Güldal Altunoğlu, Esma; Bektaş, Osman; Aslan, Güler; Iyigün, Özgün; Kara, Ahmet; Tanrıverdi Pınar, Handan; Yavuz, Saffet; Tekin, Murat; Ercan, Saffet; Çelik, Selda; Sezgin Meriçliler, Özlem; Bozkurt Çakır, İrem

    2017-07-01

    The aim of this study was to evaluate the adherence to recommendations for secondary prevention and the achievement of treatment targets for the control of risk factors in patients with established coronary heart disease (CHD) who were followed-up at various healthcare facilities in Turkey. According to the protocol of the international Survey of Risk Factor Management study, questionnaire forms were completed and demographic, anthropometric, and laboratory data of CHD patients who were followed-up at a total of 15 selected primary, secondary, and tertiary healthcare centers were recorded. Among a total of 724 CHD patients (69.8% male; mean age: 63.3±10.7 years) included in the study, 18.4% were current smokers, only 19.1% had normal body mass index, and 22.1% had waist circumference below the limit of abdominal obesity. Physical activity was insufficient in 53% of the patients, 47.3% had low high-density lipoprotein cholesterol value, 46% had triglyceride level above 150 mg/dL, and 67% had glycated hemoglobin value of 6.5% or above. Of all the patients, 88.1% were using antiplatelet drugs, 71.4% were using beta-blockers, 55.7% were using statins, and 41.9% were using angiotensin-converting enzyme inhibitors/angiotensin receptor blockers. Blood pressure was under control in 56.7% of the hypertensive patients using antihypertensive drugs, and the proportion of diabetic patients who reached glycemic control targets using antidiabetic drugs was 35.9%. Low-density lipoprotein cholesterol was below 70 mg/dL in 12.2% of the patients using statins. According to the data obtained, among Turkish CHD patients, the control rate of cardiovascular risk factors is low, and implementation of the recommendations regarding lifestyle modification and medication use for secondary prevention in the current guidelines are insufficient.

  17. Potential risk of weed outbreak by increasing biochar's application rates in slow-growth legume, lentil (Lens culinaris Medik.).

    Science.gov (United States)

    Safaei Khorram, Mahdi; Fatemi, Akram; Khan, Md Asaduzzaman; Kiefer, Rudolf; Jafarnia, Sasan

    2018-04-01

    Biochar amendment is a promising tool to improve the soil quality and, consequently, higher crop yield has received more attention during last decades. The positive effects of biochar have been attracting more attention especially in the areas with low precipitation rates, such as the Middle East, due to low soil organic carbon content, higher drought intensity, and increasing demands for food production. However, biochar can lead to lower herbicide efficacy, resulting in higher consumption of herbicides. In this study, the impact of two biochars on soil properties, plant growth, and fomesafen efficacy under rain-fed condition was investigated. Biochar amendment at the rate of 5 t ha -1 improved soil quality and plant growth by 40-200% and 46-57%, respectively, compared to the control. The increase of biochar application rate from 5 t ha -1 to 15 t ha -1 showed small additional positive effects on soil and lentil as the tested crop plant, whereas the growth of weeds elevated by 200% in this case. Albeit biochar application could be an effective way to improve the soil fertility, the potential risk of weed outbreak in the long term should be evaluated carefully before the use of biochar amendment at field scale. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  18. The rate of depression and its risk stratification in patients with differentiated thyroid cancers treated with radioactive iodine

    International Nuclear Information System (INIS)

    Eftekhari, M.; Fallahi, B.; Ansari, S.; Izadian, E.S.; Esfahani, A.F.; Beiki, D.; Saghari, M.

    2005-01-01

    Full text: Depression is a common disease in general population and may be more frequent in the cases of malignant diseases. Diagnosis and treatment of depressions in such patients may improve the quality of life. The aim of this study was to determine the risk of depression in patients diagnosed as differentiated thyroid cancers (DTC) and treated with radioactive iodine ( 131 I). In a historical Cohort study, 390 DTC patients, 312 female and 78 male, 18-68 years with median age of 41 years who were treated with 131 I and 390 control cases selected from the patients' relatives and matched with DTC cases by age, sex, wedding state and socioeconomic status were entered the study. Each patient and his/her control were concurrently assessed with Beck's questionnaire for diagnosis of depression. The data was analyzed to detect the rate, severity and relative risk of depression and the effect of some variables on the severity of depression in these patients. Of 390 patients, 179(45.9%) showed some degree of depression, 20.3% mild, 14.1% moderate, 11% partially severe and 0.5% severe according to Beck score, while the proportional frequency of different grades of depression among the control group was 15.5% and overall relative risk of depression in DTC patients was 2.96. The frequency of depression in female patients, 47.8% was lesser than male, 38.5% (p=0.013) and in married female (46.2%) was greater than single (14.3%) but lesser than divorced or widow female patients (82.4%), (p<0.0001). Depression was more prevalent and more severe in cases of papillary, 47.9% than follicular carcinoma, 33.3% (p=0.014) and also was more predominant in less-educated than in high-educated patients (p<0.0001). In DTC patients with history of radio-iodine therapy, the rate of depression is almost three times of the general population, so screening and treatment of depression especially in high risk patients like married or divorced female and less-educated patients may be of great

  19. Low Nicotine Content Descriptors Reduce Perceived Health Risks and Positive Cigarette Ratings in Participants Using Very Low Nicotine Content Cigarettes.

    Science.gov (United States)

    Denlinger-Apte, Rachel L; Joel, Danielle L; Strasser, Andrew A; Donny, Eric C

    2017-10-01

    Understanding how smokers perceive reduced nicotine content cigarettes will be important if the FDA and global regulatory agencies implement reduced nicotine product standards for cigarettes. Prior research has shown that some smokers incorrectly believe "light" cigarettes are less harmful than regular cigarettes. Similar misunderstandings of health risk could also apply to reduced nicotine cigarettes. To date, most studies of reduced nicotine cigarettes have blinded subjects to the nicotine content. Therefore, little is known about how smokers experience reduced nicotine content cigarettes when they are aware of the reduced content, and how use may be impacted. The present study was a within-subjects experiment with 68 adult daily smokers who smoked two identical very low nicotine content Quest 3 (0.05 mg nicotine yield) cigarettes. Subjects were told that one cigarette contained "average" nicotine content, and the other contained "very low" nicotine content. After smoking each cigarette, subjects completed subjective measures about their smoking experience. Subjects rated the "very low" nicotine cigarette as less harmful to their health overall compared to the "average" nicotine cigarette; this effect held true for specific smoking-related diseases. Additionally, they rated the "very low" nicotine cigarette as having less desirable subjective effects than the "average" nicotine cigarette and predicted having greater interest in quitting smoking in the future if only the "very low" nicotine cigarette was available. Explicit knowledge of very low nicotine content changes smokers' perceptions of very low nicotine content cigarettes, resulting in reduced predicted harm, subjective ratings and predicted future use. Before a reduced nicotine product standard for cigarettes can be implemented, it is important to understand how product information impacts how smokers think about and experience very low nicotine content cigarettes. Prior research has shown that smokers

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

    OpenAIRE

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

  2. 24 CFR 202.3 - Approval status for lenders and mortgagees.

    Science.gov (United States)

    2010-04-01

    ... own portfolio or the portfolios of other mortgagees with which it has a servicing contract. (d... by the Secretary and signed by the mortgagee; (ii) Be accompanied by an independent analysis of the... and claim rate. The independent analysis must be prepared by an independent Certified Public...

  3. Trends in Respiratory Syncytial Virus and Bronchiolitis Hospitalization Rates in High-Risk Infants in a United States Nationally Representative Database, 1997-2012.

    Directory of Open Access Journals (Sweden)

    Abigail Doucette

    Full Text Available Respiratory syncytial virus (RSV causes significant pediatric morbidity and is the most common cause of bronchiolitis. Bronchiolitis hospitalizations declined among US infants from 2000‒2009; however, rates in infants at high risk for RSV have not been described. This study examined RSV and unspecified bronchiolitis (UB hospitalization rates from 1997‒2012 among US high-risk infants.The Kids' Inpatient Database (KID infant annual RSV (ICD-9 079.6, 466.11, 480.1 and UB (ICD-9 466.19, 466.1 hospitalization rates were estimated using weighted counts. Denominators were based on birth hospitalizations with conditions associated with high-risk for RSV: chronic perinatal respiratory disease (chronic lung disease [CLD]; congenital airway anomalies (CAA; congenital heart disease (CHD; Down syndrome (DS; and other genetic, metabolic, musculoskeletal, and immunodeficiency conditions. Preterm infants could not be identified. Hospitalizations were characterized by mechanical ventilation, inpatient mortality, length of stay, and total cost (2015$. Poisson and linear regression were used to test statistical significance of trends.RSV and UB hospitalization rates were substantially elevated for infants with higher-risk CHD, CLD, CAA and DS without CHD compared with all infants. RSV rates declined by 47.0% in CLD and 49.7% in higher-risk CHD infants; no other declines in high-risk groups were observed. UB rates increased in all high-risk groups except for a 22.5% decrease among higher-risk CHD. Among high-risk infants, mechanical ventilation increased through 2012 to 20.4% and 13.5% of RSV and UB hospitalizations; geometric mean cost increased to $31,742 and $25,962, respectively, and RSV mortality declined to 0.9%.Among high-risk infants between 1997 and 2012, RSV hospitalization rates declined among CLD and higher-risk CHD infants, coincident with widespread RSV immunoprophylaxis use in these populations. UB hospitalization rates increased in all high-risk

  4. Infection after pacemaker implantation: infection rates and risk factors associated with infection in a population-based cohort study of 46299 consecutive patients

    DEFF Research Database (Denmark)

    Johansen, Jens Brock; Jørgensen, Ole Dan; Møller, Mogens

    2011-01-01

    Infection is a serious complication of pacemaker (PM) systems. Although the rate of infection has been debated, the figures are largely unknown. We therefore studied the incidence of PM infection and its associated risk factors in the Danish population....

  5. The analysis of hyper-homocysteine incidence rate and multi-risk factors in 200 patients with cerebral stroke

    International Nuclear Information System (INIS)

    Ding Xiudong; Yang Jianghui; Huo Aimei; Wang Yan; Chu Yanchuang; Dong Mei

    2009-01-01

    To investigate the hyperhomocysteine incidence rate and clinical significance in 200 patients with cerebral stroke, the serum homocysteine, fibrinogen, C-reaction protein, cholesterol, triglyceride, LDL-cholesterol and HDL-cholesterol levels in 200 patients with cerebral stroke and 100 normal healthy controls were detected. The results showed that both serum homocysteine and plasma FIB levels in patients with cerebral infarction and intracerebral hemorrhage were significantly higher than those in controls (P 0.05). The hyper-homocysteinemia is an independent risk factor for cerebral stoke, and hyperhomocysteine may lead to the increase of Fibrinogen level, which is one of the important reasons for the high blood viscosity in the cerebral infarction patients. (authors)

  6. Rate Your Risk Quiz

    Science.gov (United States)

    ... Cares Peers Support Ask the Doctor My Food Coach Nutrition Dialysis Patient & Family Resources Emergency Resources A ... State Charity Registration Disclosures © 2017 National Kidney Foundation, Inc., 30 East 33rd Street, New York, NY 10016, ...

  7. A Multicountry Ecological Study of Cancer Incidence Rates in 2008 with Respect to Various Risk-Modifying Factors

    Directory of Open Access Journals (Sweden)

    William B. Grant

    2013-12-01

    Full Text Available Observational and ecological studies are generally used to determine the presence of effect of cancer risk-modifying factors. Researchers generally agree that environmental factors such as smoking, alcohol consumption, poor diet, lack of physical activity, and low serum 25-hdyroxyvitamin D levels are important cancer risk factors. This ecological study used age-adjusted incidence rates for 21 cancers for 157 countries (87 with high-quality data in 2008 with respect to dietary supply and other factors, including per capita gross domestic product, life expectancy, lung cancer incidence rate (an index for smoking, and latitude (an index for solar ultraviolet-B doses. The factors found to correlate strongly with multiple types of cancer were lung cancer (direct correlation with 12 types of cancer, energy derived from animal products (direct correlation with 12 types of cancer, inverse with two, latitude (direct correlation with six types, inverse correlation with three, and per capita gross national product (five types. Life expectancy and sweeteners directly correlated with three cancers, animal fat with two, and alcohol with one. Consumption of animal products correlated with cancer incidence with a lag time of 15–25 years. Types of cancer which correlated strongly with animal product consumption, tended to correlate weakly with latitude; this occurred for 11 cancers for the entire set of countries. Regression results were somewhat different for the 87 high-quality country data set and the 157-country set. Single-country ecological studies have inversely correlated nearly all of these cancers with solar ultraviolet-B doses. These results can provide guidance for prevention of cancer.

  8. Depression, comorbid anxiety disorders, and heart rate variability in physically healthy, unmedicated patients: implications for cardiovascular risk.

    Science.gov (United States)

    Kemp, Andrew H; Quintana, Daniel S; Felmingham, Kim L; Matthews, Slade; Jelinek, Herbert F

    2012-01-01

    There is evidence that heart rate variability (HRV) is reduced in major depressive disorder (MDD), although there is debate about whether this effect is caused by medication or the disorder per se. MDD is associated with a two to fourfold increase in the risk of cardiac mortality, and HRV is a robust predictor of cardiac mortality; determining a direct link between HRV and not only MDD, but common comorbid anxiety disorders, will point to psychiatric indicators for cardiovascular risk reduction. To determine in physically healthy, unmedicated patients whether (1) HRV is reduced in MDD relative to controls, and (2) HRV reductions are driven by MDD alone, comorbid generalized anxiety disorder (GAD, characterized by anxious anticipation), or comorbid panic and posttraumatic stress disorders (PD/PTSD, characterized by anxious arousal). A case-control study in 2006 and 2007 on 73 MDD patients, including 24 without anxiety comorbidity, 24 with GAD, and 14 with PD/PTSD. Seventy-three MDD and 94 healthy age- and sex-matched control participants were recruited from the general community. Participants had no history of drug addiction, alcoholism, brain injury, loss of consciousness, stroke, neurological disorder, or serious medical conditions. There were no significant differences between the four groups in age, gender, BMI, or alcohol use. HRV was calculated from electrocardiography under a standardized short-term resting state condition. HRV was reduced in MDD relative to controls, an effect associated with a medium effect size. MDD participants with comorbid generalized anxiety disorder displayed the greatest reductions in HRV relative to controls, an effect associated with a large effect size. Unmedicated, physically healthy MDD patients with and without comorbid anxiety had reduced HRV. Those with comorbid GAD showed the greatest reductions. Implications for cardiovascular risk reduction strategies in otherwise healthy patients with psychiatric illness are discussed.

  9. Potential side effects of unhealthy lifestyle choices and health risks on basal and reactive heart rate variability in college drinkers.

    Science.gov (United States)

    Udo, Tomoko; Mun, Eun-Young; Buckman, Jennifer F; Vaschillo, Evgeny G; Vaschillo, Bronya; Bates, Marsha E

    2013-09-01

    Emerging adults often begin making independent lifestyle choices during college, yet the association of these choices with fundamental indicators of health and adaptability is unclear. The present study examined the relationship between health risks and neurocardiac function in college drinkers. Heart rate variability (HRV) was assessed at baseline and in reaction to a paced breathing challenge in 212 college drinkers (53.8% women). Basal HRV served as a general indicator of health. Reactive HRV (during paced breathing) was used as a marker of an individual's adaptability to challenge. The relationship of HRV to alcohol use, cigarette use, exercise, sleep, and body mass index (BMI) was assessed. Greater alcohol use and less exercise were associated with lower basal HRV. BMI was unrelated to basal HRV but was negatively associated with reactive HRV during the breathing challenge. High levels of alcohol use and lack of exercise are negative correlates of cardiovascular and general health, even in apparently healthy college drinkers. The negative relationship between BMI and reactive HRV suggests that overweight individuals have reduced ability to psychophysiologically adapt to challenges; understanding the temporal course of this relationship is needed. This study highlights the importance of examining HRV at baseline and in response to a challenge to capture the active neurocardiac processes that contribute to health and adaptive responding. The suppressive effects of health risks on HRV are modifiable; thus, HRV may be useful in evaluating the health benefits of lifestyle change and in promoting change behaviors in college drinkers.

  10. Pyrosequencing as a tool for the detection of Phytophthora species: error rate and risk of false Molecular Operational Taxonomic Units.

    Science.gov (United States)

    Vettraino, A M; Bonants, P; Tomassini, A; Bruni, N; Vannini, A

    2012-11-01

    To evaluate the accuracy of pyrosequencing for the description of Phytophthora communities in terms of taxa identification and risk of assignment for false Molecular Operational Taxonomic Units (MOTUs). Pyrosequencing of Internal Transcribed Spacer 1 (ITS1) amplicons was used to describe the structure of a DNA mixture comprising eight Phytophthora spp. and Pythium vexans. Pyrosequencing resulted in 16 965 reads, detecting all species in the template DNA mixture. Reducing the ITS1 sequence identity threshold resulted in a decrease in numbers of unmatched reads but a concomitant increase in the numbers of false MOTUs. The total error rate was 0·63% and comprised mainly mismatches (0·25%) Pyrosequencing of ITS1 region is an efficient and accurate technique for the detection and identification of Phytophthora spp. in environmental samples. However, the risk of allocating false MOTUs, even when demonstrated to be low, may require additional validation with alternative detection methods. Phytophthora spp. are considered among the most destructive groups of invasive plant pathogens, affecting thousands of cultivated and wild plants worldwide. Simultaneous early detection of Phytophthora complexes in environmental samples offers an unique opportunity for the interception of known and unknown species along pathways of introduction, along with the identification of these organisms in invaded environments. © 2012 The Authors Letters in Applied Microbiology © 2012 The Society for Applied Microbiology.

  11. Desiccation as a mitigation tool to manage biofouling risks: trials on temperate taxa to elucidate factors influencing mortality rates.

    Science.gov (United States)

    Hopkins, Grant A; Prince, Madeleine; Cahill, Patrick L; Fletcher, Lauren M; Atalah, Javier

    2016-01-01

    The desiccation tolerance of biofouling taxa (adults and early life-stages) was determined under both controlled and 'realistic' field conditions. Adults of the ascidian Ciona spp. died within 24 h. Mortality in the adult blue mussel Mytilus galloprovincialis occurred within 11 d under controlled conditions, compared with 7 d when held outside. The Pacific oyster Crassostrea gigas was the most desiccation-tolerant taxon tested (up to 34 d under controlled conditions). Biofouling orientated to direct sunlight showed faster mortality rates for all the taxa tested. Mortality in Mytilus juveniles took up to 24 h, compared with 8 h for Ciona, with greater survival at the higher temperature (18.5°C) and humidity (~95% RH) treatment combination. This study demonstrated that desiccation can be an effective mitigation method for a broad range of fouling taxa, especially their early life-stages. Further work is necessary to assess risks from other high-risk species such as algae and cyst forming species.

  12. Outcomes Associated With 3 Treatment Schedules of High-Dose-Rate Brachytherapy Monotherapy for Favorable-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Jawad, Maha Saada; Dilworth, Joshua T.; Gustafson, Gary S.; Ye, Hong; Wallace, Michelle [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Martinez, Alvaro [Michigan HealthCare Professionals/21" s" t Century Oncology, Farmington Hills, Michigan (United States); Chen, Peter Y. [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Krauss, Daniel J., E-mail: DKrauss@beaumont.edu [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States)

    2016-03-15

    Purpose: We report the outcomes associated with 3 high-dose-rate (HDR) brachytherapy regimens used as monotherapy for favorable-risk prostate cancer. Methods and Materials: Four hundred ninety-four patients with stage ≤T2b prostate cancer, Gleason score ≤7, and prostate-specific antigen levels ≤15 ng/mL underwent HDR brachytherapy as monotherapy. Of those, 319 received 38 Gy in 4 fractions, 79 received 24 Gy in 2 fractions, and 96 received 27 Gy in 2 fractions. Acute and chronic genitourinary (GU) and gastrointestinal (GI) toxicities were defined as side effects occurring ≤6 and >6 months, respectively, after radiation therapy (RT) and were graded according to the Common Terminology Criteria for Adverse Events version 3.0. The time to toxicity was calculated from the date of RT completion. Variables were analyzed with χ{sup 2} test. P values <.05 were considered significant. Results: The median overall follow-up time was 4 years (range, 5.5, 3.5, and 2.5 years for 38 Gy, 24 Gy, and 27 Gy, respectively, P<.001). Acute and chronic grade ≥2 GU and GI toxicity profiles were similar among groups. Acceptable rates of grade 2 GU toxicities were seen with overall acute/chronic frequency/urgency, dysuria, retention, incontinence, and hematuria rates of 14%/20%, 6%/7%, 7%/4%, 1.5%/2%, and 1.5%/7%, respectively. Minimal grade 3 and no grade 4 or 5 toxicities were seen. Grade 1, 2, and 3 chronic urethral stricture rates were 0.3%, 2%, and 1%, respectively. All GI toxicities were similar between groups, with overall rates of acute/chronic grade 2 diarrhea, rectal pain/tenesmus, rectal bleeding, and proctitis of 1%/1%, <1%/0.5%, 0%/2%, and <1%/1%, respectively. No grade 3, 4, or 5 toxicities were seen. All comparisons were similar for hormone-naïve patients. The median time to maximal GU/GI toxicity was similar between groups, ranging from 1 to 1.6 to 0.9 to 1.2 years, respectively. There were no differences in clinical outcomes between the 3 groups at 5

  13. Guidelines for estimating blowout rates and duration for environmental risk analysis purposes; Retningslinjer for beregning av utblaasningsrater og -varighet til bruk ved analyse av miljoerisiko

    Energy Technology Data Exchange (ETDEWEB)

    Nilsen, Thomas

    2007-01-15

    Risk assessment in relation to possible blowouts of oil and condensate is the main topic in this analysis. The estimated risk is evaluated against criteria for acceptable risk and is part of the foundation for dimensioning in oil spill preparedness. The report aims to contribute to the standardisation of the terminology, methodology and documentation for estimations of blowout rates, and thus to simplify communication of the analysis results and strengthen the decision makers' trust in these (ml)

  14. Federal Reserve Swap Lines – International Lender of the Last Resort

    Directory of Open Access Journals (Sweden)

    Miroslav Titze

    2016-08-01

    Full Text Available After 2007, financial market turmoil began and shortage of dollar funding liquidity disrupted not only the US dollar funding market but also overseas. To address the shortage of dollar liquidity, the FED introduced swap lines with systematic important central banks, including emerging markets. The paper discusses the main feature of the FED’s swap lines in the context of the funding pressures on the FX swap market. The main objective of the paper is to reveal technical aspects and effectiveness of the swap lines. The paper explains connectivity between un/secured money markets and the FX swap market during the financial and debt crises. The FX swap market was hit significantly. During the liquidity crisis of 2007–2010, the main driver of the deviation from covered interest parity was a shortage of dollar liquidity jointly with counterparty risk. During the debt crisis, the main driver was counterparty risk of the euro zone banks and sovereigns. The FED swap lines were used as a liquidity backstop. The paper concludes that the swap lines were an effective tool of cooperation between central banks and significantly alleviated the pressure on the FX swap market. In addition, the swap lines were flexible, supported financial stability, no losses were recorded, the problem of adverse selection was avoided and exit was successful. Finally, the swap lines have become a permanent tool for solving temporary shortages of foreign currency liquidity in national banking systems.

  15. An analysis of the effects of smoking and other cardiovascular risk factors on obliteration rates after arteriovenous malformation radiosurgery

    International Nuclear Information System (INIS)

    Bhatnagar, Ajay; Flickinger, John C.; Kondziolka, Douglas; Niranjan, Ajay; Lunsford, L. Dade

    2001-01-01

    Purpose: To assess the relationships of smoking and other cardiovascular disease risk factors (hypertension, diabetes, hypercholesterolemia, and gender) to rates of radiosurgery-induced obliteration of arteriovenous malformations (AVM). Methods and Materials: We evaluated follow-up imaging and clinical data in 329 AVM patients who received gamma knife radiosurgery at the University of Pittsburgh between 1987 and 1994. There were 113 smokers, 29 hypertensives, 5 diabetics, 4 hypercholesterolemics, 159 male patients, and 170 female patients. All patients had regular clinical or imaging follow-up for a minimum of 3 years after radiosurgery. Results: Multivariate analysis showed that smoking had no effect on AVM obliteration (p>0.43). Hypertension, diabetes, and hypercholesterolemia had no discernible effect on AVM obliteration in this study (p>0.78). However, females aged 12-49 had a statistically significant lower in-field obliteration rate than males (78% vs. 89%, p=0.0102). Conclusion: Smoking has no effect on AVM obliteration. Hypertension, diabetes, and hypercholesterolemia had no discernible effect in this study. Further study is needed to establish whether estrogen has a vascular protective effect that could partially limit radiosurgical AVM obliteration, as suggested by this study

  16. International hedging under concurrent risks of input/output prices and exchange rate : The case of Korean oil refinery

    Energy Technology Data Exchange (ETDEWEB)

    Yun, W C; Kim, S D [Korea Energy Economics Institute, Euiwang (Korea, Republic of)

    1997-11-01

    This study develops an international hedging model which accounts for the multiple risks of input and output prices and exchange rates. Considering a fixed production technology, we formulize simultaneous minimum variance hedge ratios, which reflects inter correlations among prices. To utilize the dynamic nature of prices, time-varying conditional procedures are specified to estimate the relevant variance and covariance matrix. The time-varying representations of the variance and covariance matrix are statistically appropriate, in general. The separate hedge ratios are similar to the simultaneous hedge ratios for alternative procedures. The ex post hedging effectiveness indicate that there are substantial reduction in the variance of returns for all the procedures. The contribution of foreign currency futures is minimal due to the low correlation between commodities and exchange rates. Based on the traditional definition of hedging effectiveness, the time-varying conditional procedure provide little gain to the hedgers over a constant procedure in terms of the mean and the variance reduction. However, the performance of conditional procedures could be improved by accounting for the potential problems: mis specification problem, inappropriate definition of hedging effectiveness, and conflicts between theoretical derivation and estimation of hedge ratios. (author). 39 refs., 6 tabs.

  17. Analysis of empirical determinants of credit risk in the banking sector of the Republic of Serbia

    Directory of Open Access Journals (Sweden)

    Račić Željko

    2016-01-01

    Full Text Available The aim of this paper is the detection and analysis of empirical determinants of credit risk in the banking sector of the Republic of Serbia. The paper is based on an analysis of results of the application of the linear regression model, during the period from the third quarter of 2008 to the third quarter of 2014. There are three main findings. Firstly, the higher lending activity of banks contributes to the increasing share of high-risk loans in the total withdrawn loans (delayed effect of 3 years. Secondly, the growth of loans as opposed to deposits contributes to the increased exposure of banks to credit risk. Thirdly, the factors that reduce the exposure of banks to credit risk increase profitability, growth of interest rate spread and real GDP growth. Bearing in mind the overall market conditions and dynamics of the economic recovery of the country, there is a general conclusion based on the results that in the coming period the question of non-performing loans (NPLs in the Republic of Serbia will present a challenge for both lenders and borrowers.

  18. Using Cutting-Edge Tree-Based Stochastic Models to Predict Credit Risk

    Directory of Open Access Journals (Sweden)

    Khaled Halteh

    2018-05-01

    Full Text Available Credit risk is a critical issue that affects banks and companies on a global scale. Possessing the ability to accurately predict the level of credit risk has the potential to help the lender and borrower. This is achieved by alleviating the number of loans provided to borrowers with poor financial health, thereby reducing the number of failed businesses, and, in effect, preventing economies from collapsing. This paper uses state-of-the-art stochastic models, namely: Decision trees, random forests, and stochastic gradient boosting to add to the current literature on credit-risk modelling. The Australian mining industry has been selected to test our methodology. Mining in Australia generates around $138 billion annually, making up more than half of the total goods and services. This paper uses publicly-available financial data from 750 risky and not risky Australian mining companies as variables in our models. Our results indicate that stochastic gradient boosting was the superior model at correctly classifying the good and bad credit-rated companies within the mining sector. Our model showed that ‘Property, Plant, & Equipment (PPE turnover’, ‘Invested Capital Turnover’, and ‘Price over Earnings Ratio (PER’ were the variables with the best explanatory power pertaining to predicting credit risk in the Australian mining sector.

  19. A Reactive Balance Rating Method that Correlates with Kinematics after Trip-Like Perturbations on a Treadmill and Fall Risk Among Residents of Older Adult Congregate Housing.

    Science.gov (United States)

    Madigan, Michael L; Aviles, Jessica; Allin, Leigh J; Nussbaum, Maury A; Alexander, Neil B

    2018-04-16

    A growing number of studies are using modified treadmills to train reactive balance after trip-like perturbations that require multiple steps to recover balance. The goal of this study was thus to develop and validate a low-tech reactive balance rating method in the context of trip-like treadmill perturbations to facilitate the implementation of this training outside the research setting. Thirty-five residents of five senior congregate housing facilities participated in the study. Subjects completed a series of reactive balance tests on a modified treadmill from which the reactive balance rating was determined, along with a battery of standard clinical balance and mobility tests that predict fall risk. We investigated the strength of correlation between the reactive balance rating and reactive balance kinematics. We compared the strength of correlation between the reactive balance rating and clinical tests predictive of fall risk, with the strength of correlation between reactive balance kinematics and the same clinical tests. We also compared the reactive balance rating between subjects predicted to be at a high or low risk of falling. The reactive balance rating was correlated with reactive balance kinematics (Spearman's rho squared = .04 - .30), exhibited stronger correlations with clinical tests than most kinematic measures (Spearman's rho squared = .00 - .23), and was 42-60% lower among subjects predicted to be at a high risk for falling. The reactive balance rating method may provide a low-tech, valid measure of reactive balance kinematics, and an indicator of fall risk, after trip-like postural perturbations.

  20. Reexamining the Empirical Relation between Loan Risk and Collateral : The Role of the Economic Characteristics of Collateral

    OpenAIRE

    Berger, A.N.; Frame, W.S.; Ioannidou, V.

    2012-01-01

    Abstract: This paper offers a possible explanation for the conflicting results in the literature concerning the empirical relation between collateral and loan risk. We posit that certain economic characteristics of collateral may be associated with the empirical dominance of different risk-collateral channels implied by economic theory, namely the “lender selection,” “borrower selection,” “risk-shifting,” and “loss mitigation” channels. Each of these four channels has different predictions re...

  1. Anterior disc displacement with reduction and symptomatic hypermobility in the human temporomandibular joint : Prevalence rates and risk factors in children and teenagers

    NARCIS (Netherlands)

    Slater, James J. R. Huddleston; Lobbezoo, Frank; Onland-Moret, N. Charlotte; Naeije, Machiel

    2007-01-01

    Aims: To assess the prevalence rates and risk factors of anterior disc displacement with reduction (ADDR) and symptomatic hypermobility in a large sample of children and teenagers. Prevalence rates were also established in samples of young adults and adults. Methods: Children from 7 Dutch primary

  2. Permanent interstitial low-dose-rate brachytherapy for patients with low risk prostate cancer. An interim analysis of 312 cases

    Energy Technology Data Exchange (ETDEWEB)

    Badakhshi, Harun; Graf, Reinhold; Budach, Volker; Wust, Peter [University Hospital Berlin, Department for Radiation Oncology of Charite School of Medicine, Berlin (Germany)

    2015-04-01

    The biochemical relapse-free survival (bRFS) rate after treatment with permanent iodine-125 seed implantation (PSI) or combined seeds and external beam radiotherapy (COMB) for clinical stage T1-T2 localized prostate cancer is a clinically relevant endpoint. The goal of this work was to evaluate the influence of relevant patient- and treatment-related factors. The study population comprised 312 consecutive patients treated with permanent seed implantation. All patients were evaluable for analysis of overall survival (OS) and disease-specific survival (DSS), 230 for bRFS, of which 192 were in the PSI group and 38 in the COMB group. The prescribed minimum peripheral dose was 145 Gy for PSI, for COMB 110 Gy implant and external beam radiotherapy of 45 Gy. The median follow-up time was 33 months (range 8-66 months). bRFS was defined as a serum prostate-specific antigen (PSA) level ≤ 0.2 ng/ml at last follow-up. Overall, the actuarial bRFS at 50 months was 88.4 %. The 50-month bRFS rate for PSI and COMB was 90.9 %, and 77.2 %, respectively. In the univariate analysis, age in the categories ≤ 63 and > 63 years (p < 0.00), PSA nadir (≤ 0.5 ng/ml and > 0.5 ng/ml) and PSA bounce (yes/no) were the significant predicting factors for bRFS. None of the other patient and treatment variables (treatment modality, stage, PSA, Gleason score, risk group, number of risk factors, D90 and various other dose parameters) were found to be a statistically significant predictor of 50-month bRFS. The biochemical failure rates were low in this study. As a proof of principle, our large monocenteric analysis shows that low-dose-rate brachytherapy is an effective and safe procedure for patients with early stage prostate cancer. (orig.) [German] Das biochemisch rezidivfreie Ueberleben (bRFS) nach der Brachytherapie mit permanenter Iod-125-Seed-Implantation (PSI) oder in Kombination mit externer Radiotherapie (COMB) ist beim Patienten mit fruehem Prostatakarzinom (T1/T2) ein relevanter

  3. Flood Risk Management: Exploring the Impacts of the Community Rating System Program on Poverty and Income Inequality.

    Science.gov (United States)

    Noonan, Douglas S; Sadiq, Abdul-Akeem A

    2018-03-01

    Flooding remains a major problem for the United States, causing numerous deaths and damaging countless properties. To reduce the impact of flooding on communities, the U.S. government established the Community Rating System (CRS) in 1990 to reduce flood damages by incentivizing communities to engage in flood risk management initiatives that surpass those required by the National Flood Insurance Program. In return, communities enjoy discounted flood insurance premiums. Despite the fact that the CRS raises concerns about the potential for unevenly distributed impacts across different income groups, no study has examined the equity implications of the CRS. This study thus investigates the possibility of unintended consequences of the CRS by answering the question: What is the effect of the CRS on poverty and income inequality? Understanding the impacts of the CRS on poverty and income inequality is useful in fully assessing the unintended consequences of the CRS. The study estimates four fixed-effects regression models using a panel data set of neighborhood-level observations from 1970 to 2010. The results indicate that median incomes are lower in CRS communities, but rise in floodplains. Also, the CRS attracts poor residents, but relocates them away from floodplains. Additionally, the CRS attracts top earners, including in floodplains. Finally, the CRS encourages income inequality, but discourages income inequality in floodplains. A better understanding of these unintended consequences of the CRS on poverty and income inequality can help to improve the design and performance of the CRS and, ultimately, increase community resilience to flood disasters. © 2017 Society for Risk Analysis.

  4. Sexual victimization of youth with a physical disability: an examination of prevalence rates, and risk and protective factors.

    Science.gov (United States)

    Mueller-Johnson, Katrin; Eisner, Manuel P; Obsuth, Ingrid

    2014-11-01

    Children with disabilities have been shown to be at greater risk of victimization than those without. Although much of the research combines disability of any type into a single disability category, recent evidence suggests that not all types of disabilities are equally associated with victimization. To date, little knowledge exists about the victimization of youth with physical disabilities. This study used data from a national school-based survey of adolescents (n = 6,749, mean age = 15.41, SD = .66) in Switzerland to investigate sexual victimization (SV) among physically disabled youth. Two subtypes of SV were differentiated: contact SV, including penetration or touching/kissing, and non-contact SV, such as exhibitionism, verbal harassment, exposure to sexual acts, or cyber SV. A total of 360 (5.1%) youth self-identified as having a physical disability. Lifetime prevalence rates for contact SV were 25.95% for girls with a physical disability (odds ratio [OR] = 1.29 compared with able-bodied girls), 18.50% for boys with physical disability (OR = 2.78 compared with able-bodied boys), and 22.35% for the total sample with physical disability (OR = 1.74 compared with able-bodied youth). For non-contact SV, the lifetime prevalence was 48.11% for girls with a physical disability (OR = 1.44 compared with able-bodied girls), 31.76% for boys with physical disability (OR = 1.95 compared with able-bodied boys), and 40.28% for the total sample with physical disability (OR = 1.67 compared with able-bodied youth). After controlling for other risk factors, physical disability was a significant predictor of contact and non-contact SV for boys, but not for girls. © The Author(s) 2014.

  5. Rates of trauma spectrum disorders and risks of posttraumatic stress disorder in a sample of orphaned and widowed genocide survivors

    Directory of Open Access Journals (Sweden)

    Susanne Schaal

    2011-06-01

    Full Text Available During the Rwandan genocide of 1994, nearly one million people were killed within a period of 3 months.The objectives of this study were to investigate the levels of trauma exposure and the rates of mental health disorders and to describe risk factors of posttraumatic stress reactions in Rwandan widows and orphans who had been exposed to the genocide.Trained local psychologists interviewed orphans (n=206 and widows (n=194. We used the PSS-I to assess posttraumatic stress disorder (PTSD, the Hopkins Symptom Checklist to assess depression and anxiety symptoms, and the M.I.N.I. to assess risk of suicidality.Subjects reported having been exposed to a high number of different types of traumatic events with a mean of 11 for both groups. Widows displayed more severe mental health problems than orphans: 41% of the widows (compared to 29% of the orphans met symptom criteria for PTSD and a substantial proportion of widows suffered from clinically significant depression (48% versus 34% and anxiety symptoms (59% versus 42% even 13 years after the genocide. Over one-third of respondents of both groups were classified as suicidal (38% versus 39%. Regression analysis indicated that PTSD severity was predicted mainly by cumulative exposure to traumatic stressors and by poor physical health status. In contrast, the importance given to religious/spiritual beliefs and economic variables did not correlate with symptoms of PTSD.While a significant portion of widows and orphans continues to display severe posttraumatic stress reactions, widows seem to constitute a particularly vulnerable survivor group. Our results point to the chronicity of mental health problems in this population and show that PTSD may endure over time if not addressed by clinical intervention. Possible implications of poor mental health and the need for psychological intervention are discussed.

  6. Decline in estimated glomerular filtration rate and subsequent risk of end-stage renal disease and mortality.

    Science.gov (United States)

    Coresh, Josef; Turin, Tanvir Chowdhury; Matsushita, Kunihiro; Sang, Yingying; Ballew, Shoshana H; Appel, Lawrence J; Arima, Hisatomi; Chadban, Steven J; Cirillo, Massimo; Djurdjev, Ognjenka; Green, Jamie A; Heine, Gunnar H; Inker, Lesley A; Irie, Fujiko; Ishani, Areef; Ix, Joachim H; Kovesdy, Csaba P; Marks, Angharad; Ohkubo, Takayoshi; Shalev, Varda; Shankar, Anoop; Wen, Chi Pang; de Jong, Paul E; Iseki, Kunitoshi; Stengel, Benedicte; Gansevoort, Ron T; Levey, Andrew S

    2014-06-25

    The established chronic kidney disease (CKD) progression end point of end-stage renal disease (ESRD) or a doubling of serum creatinine concentration (corresponding to a change in estimated glomerular filtration rate [GFR] of −57% or greater) is a late event. To characterize the association of decline in estimated GFR with subsequent progression to ESRD with implications for using lesser declines in estimated GFR as potential alternative end points for CKD progression. Because most people with CKD die before reaching ESRD, mortality risk also was investigated. Individual meta-analysis of 1.7 million participants with 12,344 ESRD events and 223,944 deaths from 35 cohorts in the CKD Prognosis Consortium with a repeated measure of serum creatinine concentration over 1 to 3 years and outcome data. Transfer of individual participant data or standardized analysis of outputs for random-effects meta-analysis conducted between July 2012 and September 2013, with baseline estimated GFR values collected from 1975 through 2012. End-stage renal disease (initiation of dialysis or transplantation) or all-cause mortality risk related to percentage change in estimated GFR over 2 years, adjusted for potential confounders and first estimated GFR. The adjusted hazard ratios (HRs) of ESRD and mortality were higher with larger estimated GFR decline. Among participants with baseline estimated GFR of less than 60 mL/min/1.73 m2, the adjusted HRs for ESRD were 32.1 (95% CI, 22.3-46.3) for changes of −57% in estimated GFR and 5.4 (95% CI, 4.5-6.4) for changes of −30%. However, changes of −30% or greater (6.9% [95% CI, 6.4%-7.4%] of the entire consortium) were more common than changes of −57% (0.79% [95% CI, 0.52%-1.06%]). This association was strong and consistent across the length of the baseline period (1 to 3 years), baseline estimated GFR, age, diabetes status, or albuminuria. Average adjusted 10-year risk of ESRD (in patients with a baseline estimated GFR of 35 mL/min/1.73 m2

  7. Fetal heart rate abnormalities during and after external cephalic version: Which fetuses are at risk and how are they delivered?

    Science.gov (United States)

    Kuppens, Simone M; Smailbegovic, Ida; Houterman, Saskia; de Leeuw, Ingrid; Hasaart, Tom H

    2017-10-17

    Fetal heart rate abnormalities (FHR) during and after external cephalic version (ECV) are relatively frequent. They may raise concern about fetal wellbeing. Only occasionally they may lead to an emergency cesarean section. Prospective cohort study in 980 women (> 34 weeks gestation) with a singleton fetus in breech presentation. During and after external cephalic version (ECV) FHR abnormalities were recorded. Obstetric variables and delivery outcome were evaluated. Primary outcome was to identify which fetuses are at risk for FHR abnormalities. Secondary outcome was to identify a possible relationship between FHR abnormalities during and after ECV and mode of delivery and fetal distress during subsequent labor. The overall success rate of ECV was 60% and in 9% of the attempts there was an abnormal FHR pattern. In two cases FHR abnormalities after ECV led to an emergency CS. Estimated fetal weight per 100 g (OR 0.90, CI: 0.87-0.94) and longer duration of the ECV-procedure (OR 1.13, CI: 1.05-1.21) were factors significantly associated with the occurrence of FHR abnormalities. FHR abnormalities were not associated with the mode of delivery or the occurrence of fetal distress during subsequent labor. FHR abnormalities during and after ECV are more frequent with lower estimated fetal weight and longer duration of the procedure. FHR abnormalities during and after ECV have no consequences for subsequent mode of delivery. They do not predict whether fetal distress will occur during labor. The Eindhoven Breech Intervention Study, NCT00516555 . Date of registration: August 13, 2007.

  8. Self-rated Health and Internet Addiction in Iranian Medical Sciences Students; Prevalence, Risk Factors and Complications.

    Science.gov (United States)

    Mohammadbeigi, Abolfazl; Valizadeh, Farzaneh; Mirshojaee, Seyede Roqaie; Ahmadli, Robabeh; Mokhtari, Mohsen; Ghaderi, Ebrahim; Ahmadi, Ali; Rezaei, Heshmatollah; Ansari, Hossein

    2016-06-01

    Self-rated health is a brief measure for general health. It is a comprehensive and sensitive index for prediction of health in future. Due to the high internet usage in medical students, the current study designed to evaluate the self-rated health (SRH) in relationship with internet addiction risk factors in medical students. This cross sectional study conducted on 254 students of Qom University of Medical Sciences 2014. Participants selected by two stage sampling method including stratified and simple random sampling. The Young's questionnaire of internet addiction and SRH question used for data collection. Chi-square, t-test, and logistic regression used in data analysis. More than 79.9% of students reported their general health good and very good. The student's mean score of general health was higher than the average. In addition, the prevalence of internet addiction was 28.7%. An inverse significant correlation observed between SRH and internet addiction score (r=-0.198, p=0.002). Using internet for Entertainment, using private Email and chat rooms were the most important predictors of affecting to internet addiction. Moreover, internet addiction is the most predictors of SRH and increased the odds of bad SRH. The good SRH of medical students was higher than general population but in health faculty' students were lower than others. Due to the effect of internet addiction on SRH and increasing trend of internet use in medical students, as well as low age of participants, attention to psychological aspects and the job expectancy in future, can effective on increasing the good SRH.

  9. Cardiovascular risk rate in hypertensive patients attended in primary health care units: the influence of pharmaceutical care

    Directory of Open Access Journals (Sweden)

    Paulo Yuri Milen Firmino

    2015-09-01

    Full Text Available Cardiovascular complications are relevant due to their frequency and severity on the hypertension scenario. Studies refer Pharmaceutical Care (PC as capable of decreasing cardiovascular risk rate (%CVR on hypertensive patients. This study aimed to investigate, through a randomized clinical assay, the influence of PC service on the %CVR of hypertensive patients assisted in a health primary care unit from Fortaleza-Ceará. Two study groups were formed: i. Intervention Group (IG, which received orientation about taking medicines, actions aiming to prevent/solve medicine interactions and adverse effects and non-pharmacological interventions for 9 months and, ii. Control Group (CG, which received traditional assistance of the unit and was monitored during the same period. It was observed a statistically significant reduction on %CVR (10.76 to 7.86; p=0.04 and systolic blood pressure levels (SBP (137.69 to 131.54; p<0.01 in the IG, while, in the CG, there was no significant alteration. 151 Drug Related Problem (DRP were identified and it was realized 124 pharmaceutical interventions, with 89.2% of them resulting on solution/prevention of the problem. Our findings indicated that the inclusion of the PC service in the hypertensive health assistance was more effective at the %CVR and the SBP reduction in comparison to the traditional assistance offered.

  10. Human chorionic gonadotrophin regression rate as a predictive factor of postmolar gestational trophoblastic neoplasm in high-risk hydatidiform mole: a case-control study.

    Science.gov (United States)

    Kim, Bo Wook; Cho, Hanbyoul; Kim, Hyunki; Nam, Eun Ji; Kim, Sang Wun; Kim, Sunghoon; Kim, Young Tae; Kim, Jae-Hoon

    2012-01-01

    The aim of this study was early prediction of postmolar gestational trophoblastic neoplasm (GTN) after evacuation of high-risk mole, by comparison of human chorionic gonadotrophin (hCG) regression rates. Fifty patients with a high-risk mole initially and spontaneously regressing after molar evacuation were selected from January 1, 1996 to May 31, 2010 (spontaneous regression group). Fifty patients with a high-risk mole initially and progressing to postmolar GTN after molar evacuation were selected (postmolar GTN group). hCG regression rates represented as hCG/initial hCG were compared between the two groups. The sensitivity and specificity of these rates for prediction of postmolar GTN were assessed using receiver operating characteristic curves. Multivariate analyses of associations between risk factors and postmolar GTN progression were performed. The mean regression rate of hCG between the two groups was compared. hCG regression rates represented as hCG/initial hCG (%) were 0.36% in the spontaneous regression group and 1.45% in the postmolar GTN group in the second week (p=0.003). Prediction of postmolar GTN by hCG regression rate revealed a sensitivity of 48.0% and specificity of 89.5% with a cut-off value of 0.716% and area under the curve (AUC) of 0.759 in the 2nd week (pfactor for postmolar GTN. Crown Copyright © 2011. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Effect of Contract Compliance Rate to a Fourth-Generation Telehealth Program on the Risk of Hospitalization in Patients With Chronic Kidney Disease: Retrospective Cohort Study.

    Science.gov (United States)

    Hung, Chi-Sheng; Lee, Jenkuang; Chen, Ying-Hsien; Huang, Ching-Chang; Wu, Vin-Cent; Wu, Hui-Wen; Chuang, Pao-Yu; Ho, Yi-Lwun

    2018-01-24

    Chronic kidney disease (CKD) is prevalent in Taiwan and it is associated with high all-cause mortality. We have shown in a previous paper that a fourth-generation telehealth program is associated with lower all-cause mortality compared to usual care with a hazard ratio of 0.866 (95% CI 0.837-0.896). This study aimed to evaluate the effect of renal function status on hospitalization among patients receiving this program and to evaluate the relationship between contract compliance rate to the program and risk of hospitalization in patients with CKD. We retrospectively analyzed 715 patients receiving the telehealth care program. Contract compliance rate was defined as the percentage of days covered by the telehealth service before hospitalization. Patients were stratified into three groups according to renal function status: (1) normal renal function, (2) CKD, or (3) end-stage renal disease (ESRD) and on maintenance dialysis. The outcome measurements were first cardiovascular and all-cause hospitalizations. The association between contract compliance rate, renal function status, and hospitalization risk was analyzed with a Cox proportional hazards model with time-dependent covariates. The median follow-up duration was 694 days (IQR 338-1163). Contract compliance rate had a triphasic relationship with cardiovascular and all-cause hospitalizations. Patients with low or very high contract compliance rates were associated with a higher risk of hospitalization. Patients with CKD or ESRD were also associated with a higher risk of hospitalization. Moreover, we observed a significant interaction between the effects of renal function status and contract compliance rate on the risk of hospitalization: patients with ESRD, who were on dialysis, had an increased risk of hospitalization at a lower contract compliance rate, compared with patients with normal renal function or CKD. Our study showed that there was a triphasic relationship between contract compliance rate to the

  12. Elevated resting heart rate is associated with greater risk of cardiovascular and all-cause mortality in current and former smokers

    DEFF Research Database (Denmark)

    Jensen, Magnus T; Marott, Jacob L; Jensen, Gorm B

    2010-01-01

    . Current and former smokers had, irrespective of tobacco consumption, greater relative risk of elevated RHR compared to never smokers. The relative risk of all-cause mortality per 10bpm increase in RHR was (95% CI): 1.06 (1.01-1.10) in never smokers, 1.11 (1.07-1.15) in former smokers, 1.13 (1......BACKGROUND: Elevated resting heart rate is associated with mortality in general populations. Smokers may be at particular risk. The association between resting heart rate (RHR), smoking status and cardiovascular and total mortality was investigated in a general population. METHODS: Prospective.......09-1.16) in moderate smokers, and 1.13 (1.10-1.16) in heavy smokers. There was no gender difference. The risk estimates for cardiovascular and all-cause mortality were essentially similar. In univariate analyses, the difference in survival between a RHR in the highest (>80bpm) vs lowest quartile (...

  13. Elevated resting heart rate is associated with greater risk of cardiovascular and all-cause mortality in current and former smokers

    DEFF Research Database (Denmark)

    Jensen, Magnus T; Marott, Jacob L; Jensen, Gorm B

    2010-01-01

    BACKGROUND: Elevated resting heart rate is associated with mortality in general populations. Smokers may be at particular risk. The association between resting heart rate (RHR), smoking status and cardiovascular and total mortality was investigated in a general population. METHODS: Prospective....... Current and former smokers had, irrespective of tobacco consumption, greater relative risk of elevated RHR compared to never smokers. The relative risk of all-cause mortality per 10bpm increase in RHR was (95% CI): 1.06 (1.01-1.10) in never smokers, 1.11 (1.07-1.15) in former smokers, 1.13 (1.......09-1.16) in moderate smokers, and 1.13 (1.10-1.16) in heavy smokers. There was no gender difference. The risk estimates for cardiovascular and all-cause mortality were essentially similar. In univariate analyses, the difference in survival between a RHR in the highest (>80bpm) vs lowest quartile (...

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

    Science.gov (United States)

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

    2013-12-01

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

  15. Time-driven activity-based costing of low-dose-rate and high-dose-rate brachytherapy for low-risk prostate cancer.

    Science.gov (United States)

    Ilg, Annette M; Laviana, Aaron A; Kamrava, Mitchell; Veruttipong, Darlene; Steinberg, Michael; Park, Sang-June; Burke, Michael A; Niedzwiecki, Douglas; Kupelian, Patrick A; Saigal, Christopher

    Cost estimates through traditional hospital accounting systems are often arbitrary and ambiguous. We used time-driven activity-based costing (TDABC) to determine the true cost of low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy for prostate cancer and demonstrate opportunities for cost containment at an academic referral center. We implemented TDABC for patients treated with I-125, preplanned LDR and computed tomography based HDR brachytherapy with two implants from initial consultation through 12-month followup. We constructed detailed process maps for provision of both HDR and LDR. Personnel, space, equipment, and material costs of each step were identified and used to derive capacity cost rates, defined as price per minute. Each capacity cost rate was then multiplied by the relevant process time and products were summed to determine total cost of care. The calculated cost to deliver HDR was greater than LDR by $2,668.86 ($9,538 vs. $6,869). The first and second HDR treatment day cost $3,999.67 and $3,955.67, whereas LDR was delivered on one treatment day and cost $3,887.55. The greatest overall cost driver for both LDR and HDR was personnel at 65.6% ($4,506.82) and 67.0% ($6,387.27) of the total cost. After personnel costs, disposable materials contributed the second most for LDR ($1,920.66, 28.0%) and for HDR ($2,295.94, 24.0%). With TDABC, the true costs to deliver LDR and HDR from the health system perspective were derived. Analysis by physicians and hospital administrators regarding the cost of care afforded redesign opportunities including delivering HDR as one implant. Our work underscores the need to assess clinical outcomes to understand the true difference in value between these modalities. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  16. Gender differences in the predictive role of self-rated health on short-term risk of mortality among older adults

    Directory of Open Access Journals (Sweden)

    Shervin Assari

    2016-09-01

    Full Text Available Objectives: Despite the well-established association between self-rated health and mortality, research findings have been inconsistent regarding how men and women differ on this link. Using a national sample in the United States, this study compared American male and female older adults for the predictive role of baseline self-rated health on the short-term risk of mortality. Methods: This longitudinal study followed 1500 older adults (573 men (38.2% and 927 women (61.8% aged 66 years or older for 3 years from 2001 to 2004. The main predictor of interest was self-rated health, which was measured using a single item in 2001. The outcome was the risk of all-cause mortality during the 3-year follow-up period. Demographic factors (race and age, socio-economic factors (education and marital status, and health behaviors (smoking and drinking were covariates. Gender was the focal moderator. We ran logistic regression models in the pooled sample and also stratified by gender, with self-rated health treated as either nominal variables, poor compared to other levels (i.e. fair, good, or excellent or excellent compared to other levels (i.e. good, fair, or poor, or an ordinal variable. Results: In the pooled sample, baseline self-rated health predicted mortality risk, regardless of how the variable was treated. We found a significant interaction between gender and poor self-rated health, indicating a stronger effect of poor self-rated health on mortality risk for men compared to women. Gender did not interact with excellent self-rated health on mortality. Conclusion: Perceived poor self-rated health better reflects risk of mortality over a short period of time for older men compared to older women. Clinicians may need to take poor self-rated health of older men very seriously. Future research should test whether the differential predictive validity of self-rated health based on gender is due to a different meaning of poor self-rated health for older men

  17. Determining the Relationship between U.S. County-Level Adult Obesity Rate and Multiple Risk Factors by PLS Regression and SVM Modeling Approaches

    Directory of Open Access Journals (Sweden)

    Chau-Kuang Chen

    2015-02-01

    Full Text Available Data from the Center for Disease Control (CDC has shown that the obesity rate doubled among adults within the past two decades. This upsurge was the result of changes in human behavior and environment. Partial least squares (PLS regression and support vector machine (SVM models were conducted to determine the relationship between U.S. county-level adult obesity rate and multiple risk factors. The outcome variable was the adult obesity rate. The 23 risk factors were categorized into four domains of the social ecological model including biological/behavioral factor, socioeconomic status, food environment, and physical environment. Of the 23 risk factors related to adult obesity, the top eight significant risk factors with high normalized importance were identified including physical inactivity, natural amenity, percent of households receiving SNAP benefits, and percent of all restaurants being fast food. The study results were consistent with those in the literature. The study showed that adult obesity rate was influenced by biological/behavioral factor, socioeconomic status, food environment, and physical environment embedded in the social ecological theory. By analyzing multiple risk factors of obesity in the communities, may lead to the proposal of more comprehensive and integrated policies and intervention programs to solve the population-based problem.

  18. Rates and predictors of consideration for adjuvant radiotherapy among high-risk breast cancer patients: a cohort study.

    Science.gov (United States)

    Krotneva, Stanimira; Reidel, Kristen; Nassif, Mohammed; Trabulsi, Nora; Mayo, Nancy; Tamblyn, Robyn; Meguerditchian, Ari N

    2013-07-01

    Radiotherapy (RT) after breast conserving surgery (BCS) represents the standard for local control of breast cancer (BC). However, variations in practice persist. We aimed to characterize the rate of RT consideration (or referral) after BCS and identify predictors in Quebec, Canada, where universal health insurance is in place. A historical prospective cohort study using the provincial hospital discharge and medical services databases was conducted. All women with incident, non-metastatic BC (stages I-III) undergoing BCS (1998-2005) were identified. Odds ratios (ORs) and 95 % confidence intervals (CIs) for RT consideration were estimated with a generalized estimating equations regression model, adjusting for clustering of patients within physicians. Of the 27,483 women selected, 90 % were considered for RT and 84 % subsequently received it. Relative to women 50-69 years old, younger and older women were less likely to be considered: ORs of 0.82 (95 % CI 0.73-0.93) and 0.10 (0.09-0.12), respectively. Emergency room visits and hospitalizations unrelated to BC were associated with decreased odds of RT consideration: 0.85 (0.76-0.94) and 0.83 (0.71-0.97). Women with regional BC considered for chemotherapy were more likely to be considered for RT: 3.41 (2.83-4.11). RT consideration odds increased by 7 % (OR of 1.07, 95 % CI 1.03-1.10) for every ten additional BCSs performed by the surgeon in the prior year. Social isolation, comorbidities, and greater distance to a referral center lowered the odds. Demographic and clinical patient-related risk factors, health service use, gaps in other aspects of BC management, and surgeon's experience predicted RT consideration.

  19. Albuminuria and neck circumference are determinate factors of successful accurate estimation of glomerular filtration rate in high cardiovascular risk patients.

    Directory of Open Access Journals (Sweden)

    Po-Jen Hsiao

    Full Text Available Estimated glomerular filtration rate (eGFR is used for diagnosis of chronic kidney disease (CKD. The eGFR models based on serum creatinine or cystatin C are used more in clinical practice. Albuminuria and neck circumference are associated with CKD and may have correlations with eGFR.We explored the correlations and modelling formulates among various indicators such as serum creatinine, cystatin C, albuminuria, and neck circumference for eGFR.Cross-sectional study.We reviewed the records of patients with high cardiovascular risk from 2010 to 2011 in Taiwan. 24-hour urine creatinine clearance was used as the standard. We utilized a decision tree to select for variables and adopted a stepwise regression method to generate five models. Model 1 was based on only serum creatinine and was adjusted for age and gender. Model 2 added serum cystatin C, models 3 and 4 added albuminuria and neck circumference, respectively. Model 5 simultaneously added both albuminuria and neck circumference.Total 177 patients were recruited in this study. In model 1, the bias was 2.01 and its precision was 14.04. In model 2, the bias was reduced to 1.86 with a precision of 13.48. The bias of model 3 was 1.49 with a precision of 12.89, and the bias for model 4 was 1.74 with a precision of 12.97. In model 5, the bias could be lower to 1.40 with a precision of 12.53.In this study, the predicting ability of eGFR was improved after the addition of serum cystatin C compared to serum creatinine alone. The bias was more significantly reduced by the calculation of albuminuria. Furthermore, the model generated by combined albuminuria and neck circumference could provide the best eGFR predictions among these five eGFR models. Neck circumference can be investigated potentially in the further studies.

  20. The association between social networks and self-rated risk of HIV infection among secondary school students in Moshi Municipality, Tanzania

    DEFF Research Database (Denmark)

    Lyimo, Elizabeth; Todd, Jim; Richey, Lisa Ann

    2013-01-01

    This study describes the social networks of secondary school students in Moshi Municipality, and their association with self-rated risk of human immunodeficiency virus (HIV) infection. A cross-sectional analytical study was conducted among 300 students aged 15–24 years in 5 secondary schools...... participation in bonding and bridging social networks and self-rated HIV risk behavior. More participants participated in bonding networks (72%) than in bridging networks (29%). Participation in bridging networks was greater among females (25%) than males (12%, p 

  1. [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.

  2. Reexamining the empirical relation between loan risk and collateral:the roles of collateral liquidity and types

    OpenAIRE

    Berger, Allen N.; Frame, W. Scott; Ioannidou, Vasso

    2016-01-01

    This paper offers a possible explanation for the conflicting results in the literature concerning the empirical relation between collateral and loan risk. We posit that differences in collateral characteristics, such as liquidity, may be associated with the empirical dominance of different risk-collateral relations implied by economic theory. Using credit registry data and a novel identification strategy to control for borrower and lender selection effects allows us to differentiate between t...

  3. The At Issue Maturity of Corporate Bonds: The Influence of Credit Rating, Security Level, Duration and Macreoconomic Conditions

    OpenAIRE

    Geetajali Bali; Frank Skinner

    2003-01-01

    We examine the determinants of the at issue time to maturity of corporate bonds. We find evidence that corporations partly determine the at issue maturity of bonds by responding to economic conditions. They also appear to immunize by matching the maturity of assets with the at issue maturity of bonds regardless of credit quality. Finally, we find evidence that the security level (our proxy for the recovery rate) is inversely related to the at issue time to maturity. This suggests that lenders...

  4. Risk

    Science.gov (United States)

    Cole, Stephen R.; Hudgens, Michael G.; Brookhart, M. Alan; Westreich, Daniel

    2015-01-01

    The epidemiologist primarily studies transitions between states of health and disease. The purpose of the present article is to define a foundational parameter for such studies, namely risk. We begin simply and build to the setting in which there is more than 1 event type (i.e., competing risks or competing events), as well as more than 1 treatment or exposure level of interest. In the presence of competing events, the risks are a set of counterfactual cumulative incidence functions for each treatment. These risks can be depicted visually and summarized numerically. We use an example from the study of human immunodeficiency virus to illustrate concepts. PMID:25660080

  5. Traditional risk factors as determinants of heart rate recovery in patients with diabetes mellitus type 2 without known coronary artery disease

    Science.gov (United States)

    Silaban, Sanny; Afif Siregar, A.; Hasan, H.; Aryfa Andra, C.

    2018-03-01

    The impact of Traditional risk factors on heart rate recovery (HRR) has not been studied in patients Diabetes Mellitus type 2 without known coronary artery disease (CAD). For this reason, we sought to determine the association between HRR as cardiac autonomic dysfunction marker and traditonal risk factors. The study was conducted with a cross-sectional study involving 89 patients with Type 2 Diabetes Mellitus without known having coronary artery disease. The data was taken through anamnese and laboratory tests, and subjects who met the criteria were tested for a treadmill exercise to assess heart rate recovery in the first minute. In bivariate analysis Dyslipidemia, Hypertension, smoker, age, duration of DM≥ 5 years, HbA1C ≥7.5, Peak Heart rate, functional capacity and ST depression ischemic have an association with heart rate recovery. In multivariate analysis patients with hyper triglyceride, smoker, overweight, duration of diabetes ≥ five years and HbA1C ≥ 7,5 have lower heart rate recovery significantly. Traditional risk factors are determinant factors for heart rate recovery in patients with Diabetes Mellitus type 2 without known coronary artery disease.

  6. Using non-performing loan ratios as default rates in the estimation of credit losses and macroeconomic credit risk stress testing: A case from Turkey

    Directory of Open Access Journals (Sweden)

    Guray Kucukkocaoglu

    2016-02-01

    Full Text Available In this study, inspired by the Credit Portfolio View approach, we intend to develop an econometric credit risk model to estimate credit loss distributions of Turkish Banking System under baseline and stress macro scenarios, by substituting default rates with non-performing loan (NPL ratios. Since customer number based historical default rates are not available for the whole Turkish banking system’s credit portfolio, we used NPL ratios as dependent variable instead of default rates, a common practice for many countries where historical default rates are not available. Although, there are many problems in using NPL ratios as default rates such as underestimating portfolio losses as a result of totally non-homogeneous total credit portfolios and transferring non-performing loans to asset management companies from banks’ balance sheets, our aim is to underline and limit some ignored problems using accounting based NPL ratios as default rates in macroeconomic credit risk modeling. Developed models confirm the strong statistical relationship between systematic component of credit risk and macroeconomic variables in Turkey. Stress test results also are compatible with the past experiences

  7. 12 CFR Appendix C to Part 567 - Risk-Based Capital Requirements-Internal-Ratings-Based and Advanced Measurement Approaches

    Science.gov (United States)

    2010-01-01

    .... Exchange rate derivative contract means a cross-currency interest rate swap, forward foreign-exchange contract, currency option purchased, or any other instrument linked to exchange rates that gives rise to...) Equity securities that are publicly traded; (vi) Convertible bonds that are publicly traded; (vii) Money...

  8. 'Prostate Cancer Risk Calculator' mobile applications (Apps): a systematic review and scoring using the validated user version of the Mobile Application Rating Scale (uMARS).

    Science.gov (United States)

    Adam, Ahmed; Hellig, Julian C; Perera, Marlon; Bolton, Damien; Lawrentschuk, Nathan

    2018-04-01

    The use of mobile phone applications (Apps) has modernised the conventional practice of medicine. The diagnostic ability of the current Apps in prostate specific antigen monitoring, and its diagnostic ability within prostate cancer (PCa) risk calculators have not yet been appraised. We aimed to review, rate and assess the everyday functionality, and utility of all the currently available PCa risk calculator Apps. A systematic search on iTunes, Google Play Store, Blackberry World and Windows Apps Store, was performed on 23/11/2017, using the search term 'prostate cancer risk calculator'. After applying the exclusion criteria, each App was individually assessed and rated using pre-set criteria and grading was performed using the validated uMARS scale. In total, 83 Apps were retrieved. After applying our exclusion criteria, only 9 Apps were relevant, with 2 duplicated, and the remaining 7 were suitable for critical review. Data sizes ranged from 414 kb to 10.1 Mb. The cost of the Apps ranged from South African rand (ZAR) 0.00 to ZAR 29.99. The overall mean category uMARS scores ranged from 2.8/5 to 4.5/5. Apps such as Rotterdam Prostate Cancer Risk Calculator, Coral-Prostate Cancer Nomogram Calculator and CPC Risk Calculator, performed the best. The current PCa risk calculator mobile Apps available may be beneficial in counselling the concerned at risk patient. These Apps have potential to assist both the patient and the urologist alike. The PCa risk calculator App 'predictability' may be further enhanced by the incorporation of newly validated risk factors and predictors for PCa.

  9. Cardiovascular disease (CVD) and chronic kidney disease (CKD) event rates in HIV-positive persons at high predicted CVD and CKD risk

    DEFF Research Database (Denmark)

    Boyd, Mark A; Mocroft, Amanda; Ryom, Lene

    2017-01-01

    BACKGROUND: The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study has developed predictive risk scores for cardiovascular disease (CVD) and chronic kidney disease (CKD, defined as confirmed estimated glomerular filtration rate [eGFR] ≤ 60 ml/min/1.73 m2) events in HIV...

  10. Approximation for the Finite-Time Ruin Probability of a General Risk Model with Constant Interest Rate and Extended Negatively Dependent Heavy-Tailed Claims

    Directory of Open Access Journals (Sweden)

    Yang Yang

    2011-01-01

    Full Text Available We propose a general continuous-time risk model with a constant interest rate. In this model, claims arrive according to an arbitrary counting process, while their sizes have dominantly varying tails and fulfill an extended negative dependence structure. We obtain an asymptotic formula for the finite-time ruin probability, which extends a corresponding result of Wang (2008.

  11. Quantifying Risk of Financial Incapacity and Financial Exploitation in Community-dwelling Older Adults: Utility of a Scoring System for the Lichtenberg Financial Decision-making Rating Scale.

    Science.gov (United States)

    Lichtenberg, Peter A; Gross, Evan; Ficker, Lisa J

    2018-06-08

    This work examines the clinical utility of the scoring system for the Lichtenberg Financial Decision-making Rating Scale (LFDRS) and its usefulness for decision making capacity and financial exploitation. Objective 1 was to examine the clinical utility of a person centered, empirically supported, financial decision making scale. Objective 2 was to determine whether the risk-scoring system created for this rating scale is sufficiently accurate for the use of cutoff scores in cases of decisional capacity and cases of suspected financial exploitation. Objective 3 was to examine whether cognitive decline and decisional impairment predicted suspected financial exploitation. Two hundred independently living, non-demented community-dwelling older adults comprised the sample. Participants completed the rating scale and other cognitive measures. Receiver operating characteristic curves were in the good to excellent range for decisional capacity scoring, and in the fair to good range for financial exploitation. Analyses supported the conceptual link between decision making deficits and risk for exploitation, and supported the use of the risk-scoring system in a community-based population. This study adds to the empirical evidence supporting the use of the rating scale as a clinical tool assessing risk for financial decisional impairment and/or financial exploitation.

  12. Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative meta-analysis of high-risk population cohorts

    NARCIS (Netherlands)

    van der Velde, Marije; Matsushita, Kunihiro; Coresh, Josef; Astor, Brad C.; Woodward, Mark; Levey, Andrew S.; de Jong, Paul E.; Gansevoort, Ron T.

    Screening for chronic kidney disease is recommended in people at high risk, but data on the independent and combined associations of estimated glomerular filtration rate (eGFR) and albuminuria with all-cause and cardiovascular mortality are limited. To clarify this, we performed a collaborative

  13. What is the empirical evidence that hospitals with higher-risk adjusted mortality rates provide poorer quality care? A systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Mohammed Mohammed A

    2007-06-01

    Full Text Available Abstract Background Despite increasing interest and publication of risk-adjusted hospital mortality rates, the relationship with underlying quality of care remains unclear. We undertook a systematic review to ascertain the extent to which variations in risk-adjusted mortality rates were associated with differences in quality of care. Methods We identified studies in which risk-adjusted mortality and quality of care had been reported in more than one hospital. We adopted an iterative search strategy using three databases – Medline, HealthSTAR and CINAHL from 1966, 1975 and 1982 respectively. We identified potentially relevant studies on the basis of the title or abstract. We obtained these papers and included those which met our inclusion criteria. Results From an initial yield of 6,456 papers, 36 studies met the inclusion criteria. Several of these studies considered more than one process-versus-risk-adjusted mortality relationship. In total we found 51 such relationships in a widen range of clinical conditions using a variety of methods. A positive correlation between better quality of care and risk-adjusted mortality was found in under half the relationships (26/51 51% but the remainder showed no correlation (16/51 31% or a paradoxical correlation (9/51 18%. Conclusion The general notion that hospitals with higher risk-adjusted mortality have poorer quality of care is neither consistent nor reliable.

  14. Döviz Kuru Riski Yönetimi: Türkiye Tütün Endüstrisi Örneği (Exchange Rate Risk Management: The Case Of Turkish Tobacco Industry

    Directory of Open Access Journals (Sweden)

    Murat DOĞANAY

    2016-03-01

    Full Text Available The exchange rate movements, along with globalization, have become more important not only for financial institutions but also for real sector companies. Also exchange rate risk is important for non-financial companies regards to both assets and liabilities. Management of this exchange rate risk exposure has an impact on competitiveness of these companies. This paper reviews the impact level of exchange rate movements, determination of the structure of exchange rate risk position on the basis of currency and also determination of the approaches to exchange rate risk management in the tobacco industry which has very high concentration level. It’s found that the firms want to hedge against the exchange rate risk particularly in the export transactions. A significant number of firms don’t use exchange rate risk management systematically. The firms prefer operational hedging much more than financial hedging. The primarily reasons of not using financial tools in the exchange rate risk management are the presence of import transactions and the expectation of exchange rate increase. Finally, it’s concluded that the firms use foreign currency loans as a tool for exchange rate risk management in order to balance their exchange rate risk position.

  15. Customers and Markets: Both are Essential to Credit-Risk Measurement

    Directory of Open Access Journals (Sweden)

    David E. Allen

    2011-03-01

    Full Text Available This paper compares credit models that incorporate a market component to those that are solely customerbased. We found that customer-only models understated credit risk during the Global Financial Crisis (GFCand do not adequately differentiate between industries. Models that focus too heavily on the market canoverstate credit risk in times of high volatility. We recommend a two-factor modelling approach thatincorporates both customer and market risk to improve the accuracy of credit-risk measurement as well asassist lenders with early risk detection.

  16. Risk of inflammatory bowel disease according to self-rated health, pregnancy course, and pregnancy complications: a study within the Danish National Birth Cohort.

    Directory of Open Access Journals (Sweden)

    Maria C Harpsøe

    Full Text Available BACKGROUND: Poor self-rated health (SRH has been connected to immunological changes, and pregnancy complications have been suggested in the etiology of autoimmune diseases including inflammatory bowel disease (IBD. We evaluated the impact of self-rated pre-pregnancy health and pregnancy course, hyperemesis, gestational hypertension, and preeclampsia on risk of IBD. METHODS: Information was collected by questionnaires from The Danish National Birth Cohort (enrolment 1996-2002 at 16(th and 30(th week of pregnancy and 6 months postpartum. A total of 55,699 women were followed from childbirth until development of IBD (using validated National Hospital Discharge Register diagnoses, emigration, death, or end of follow-up, 31(st of October, 2011. Hazard ratios (HR with 95% confidence intervals (CI were calculated using Cox proportional hazards models adjusting for age and evaluating pre-pregnancy BMI, parity, alcohol and tobacco consumption, and socio-occupational status as potential confounders. RESULTS: Risk of IBD increased with decreasing level of self-rated pre-pregnancy health (p = 0.002 and was elevated in women with poor self-rated pregnancy course (HR, 1.61, 95% CI 1.22-2.12. Associations persisted for more than 5 years postpartum. Hyperemesis and preeclampsia were not significantly associated with risk of IBD. CONCLUSIONS: This is the first prospective observational study to suggest that poor self-rated health--in general and in relation to pregnancy--is associated with increased risk of IBD even in the long term though results needs further confirmation. Symptoms of specific pregnancy complications were, on the other hand, not significantly associated with risk of IBD.

  17. Risk

    Science.gov (United States)

    Barshi, Immanuel

    2016-01-01

    Speaking up, i.e. expressing ones concerns, is a critical piece of effective communication. Yet, we see many situations in which crew members have concerns and still remain silent. Why would that be the case? And how can we assess the risks of speaking up vs. the risks of keeping silent? And once we do make up our minds to speak up, how should we go about it? Our workshop aims to answer these questions, and to provide us all with practical tools for effective risk assessment and effective speaking-up strategies..

  18. Re-resection rates and risk characteristics following breast conserving surgery for breast cancer and carcinoma in situ

    DEFF Research Database (Denmark)

    Kryh, C G; Pietersen, C A; Rahr, Hans

    2014-01-01

    OBJECTIVES: To examine the frequency of re-resections and describe risk characteristics: invasive carcinoma or carcinoma in situ (CIS), palpability of the lesion, and neoadjuvant chemotherapy. RESULTS: 1703 breast conserving surgeries were performed: 1575 primary breast conserving surgeries (BCS...

  19. Increased risk of long-term sickness absence, lower rate of return to work, and higher risk of unemployment and disability pensioning for thyroid patients

    DEFF Research Database (Denmark)

    Nexo, M A; Watt, T; Pedersen, J

    2014-01-01

    CONTEXT: Little is known about how thyroid diseases affect work ability. OBJECTIVE: The objective of this study was to evaluate the risk of work disability for patients with thyroid disease compared with the general population. DESIGN, SETTING, AND PARTICIPANTS: In a longitudinal register study, ...

  20. Risk Balancing of Cold Ischemic Time against Night Shift Surgery Possibly Reduces Rates of Reoperation and Perioperative Graft Loss

    Directory of Open Access Journals (Sweden)

    Nikos Emmanouilidis

    2017-01-01

    Full Text Available Background. This retrospective cohort study evaluates the advantages of risk balancing between prolonged cold ischemic time (CIT and late night surgery. Methods. 1262 deceased donor kidney transplantations were analyzed. Multivariable regression was used to determine odds ratios (ORs for reoperation, graft loss, delayed graft function (DGF, and discharge on dialysis. CIT was categorized according to a forward stepwise pattern ≤1h/>1h, ≤2h/>2h, ≤3h/>3h,…, ≤nh/>nh. ORs for DGF were plotted against CIT and a nonlinear regression function with best R2 was identified. First and second derivative were then implemented into the curvature formula k(x=f′′(x/(1+f′x23/2 to determine the point of highest CIT-mediated risk acceleration. Results. Surgery between 3 AM and 6 AM is an independent risk factor for reoperation and graft loss, whereas prolonged CIT is only relevant for DGF. CIT-mediated risk for DGF follows an exponential pattern fx=A·(1+k·eI·x with a cut-off for the highest risk increment at 23.5 hours. Conclusions. The risk of surgery at 3 AM–6 AM outweighs prolonged CIT when confined within 23.5 hours as determined by a new mathematical approach to calculate turning points of nonlinear time related risks. CIT is only relevant for the endpoint of DGF but had no impact on discharge on dialysis, reoperation, or graft loss.

  1. Relationship between Credit Recovery Programs and Graduation Rates for At-Risk Students on the Navajo Indian Reservation

    Science.gov (United States)

    Fahey, John M.

    2010-01-01

    Low graduation rates of high school students are a problem for the Native American community. One possible solution for low graduation rates is a credit recovery program that may assist Native American students to recover credit not earned in their early high school years. The purpose of this study was to examine the effectiveness of a credit…

  2. Glomerular filtration rate, cardiovascular risk factors and insulin resistance Filtrado glomerular, riesgo cardiovascular y resistencia a la insulina

    Directory of Open Access Journals (Sweden)

    Martín R. Salazar

    2009-10-01

    Full Text Available The aim of this paper was to study the estimated glomerular filtration rate (eGFR, its changes with age, and its association with systolic blood pressure (SBP and diastolic BP (DBP, indicators of obesity, dyslipemia, insulin resistance and inflammation on a random population sample. BP, weight, size and waist circumference (WC were recorded at home. Fasting morning blood samples were analysed. The eGFR was calculated with MDRD (eGFR-MDRD, Cockroft-Gault (eGFR-CG adjusted to 1.73 m² and reciprocal of serum creatinine (100/serum cretinine. A total of 1016 individuals, 722 females (41.97 ± 0.66 years old and 294 males (42.06 ± 0.99 years old, completed the laboratory tests. The mean of 100/Scr was 115.13 ± 0.60 (dl/mg, the mean eGFR-CG was 98.48 ± 0.82 ml/min/1.73 m²; the mean eGFR-MDRD was 85.15 ± 0.58 ml/min/1.73 m². The eGFR-MDRD decreased with age and with the number of risk factors in both sexes. The eGFR-MDRD El objetivo fue evaluar en una muestra poblacional aleatoria el filtrado glomerular estimado (FGe, sus cambios con la edad y su asociación con presión arterial sistólica (PAS y diastólica (PAD, indicadores de obesidad, dislipemia, resistencia a la insulina e inflamación. En cada domicilio fueron medidos presión arterial, peso y talla y perímetro de la cintura (PC. Se analizaron muestras de sangre en ayunas y fue calculado el FGe usando las fórmulas de MDRD (FGe-MDRD y Cockroft-Gault (FGe-CG ajustado a 1.73 m², y la inversa de la creatinina sérica (100/CrS. Completaron el protocolo de laboratorio 1016 sujetos, 722 mujeres (41.97 ± 0.66 años y 294 varones (42.06 ± 0.99 años. La media de 100/Crs fue 115.13 ± 0.60 (dl/mg, la del FGe-CG 98.48 ± 0.82 ml/min/1.73 m² y la del FGe-MDRD 85.15 ± 0.58 ml/min/1.73 m² (CI 95% 84.00-86.29. El FGe-MDRD disminuyó con la edad y con el número de factores de riesgo cardiovascular en ambos sexos. La prevalecencia ajustada de FGe-MDRD < 60 ml/min/1.73 m² fue 6.2 por 100

  3. Preliminary study on the rate of broncho-pulmonary cancer in a Romanian department (Bihor) for the estimation of radon risk exposure

    International Nuclear Information System (INIS)

    Vaida, T.; Maghiar, F.; Cosma, C.; Ristoiu, D.; Ramboiu, S.; Pacurar, V.; Poffijn, A.

    1996-01-01

    The purpose of this paper is a retrospective estimation on the rate of lung cancer at the population in the Bihor district (Romania) in two years (1993 -1994) and the potential bronchopulmonary cancer risk from indoor radon. In this time were found 473 cases with primary bronchopulmonary cancer: 400 men (84.5%) and 73 women (15.4%). Most cases ( 64.4%) were from rural environment while the other 35.5% were from urban environment. Preliminary study on the potential lung cancer risk from indoor radon encompassed 40 cases and 66 non-cancer controls in the period March-July 1995. (author)

  4. Perinatal Risks in "Late Motherhood" Defined Based On Parity and Preterm Birth Rate - an Analysis of the German Perinatal Survey (20th Communication).

    Science.gov (United States)

    Schure, V; Voigt, M; Schild, R L; Hesse, V; Carstensen, M; Schneider, K T M; Straube, S

    2012-01-01

    Aim: "Late motherhood" is associated with greater perinatal risks but the term lacks precise definition. We present an approach to determine what "late motherhood" associated with "high risk" is, based on parity and preterm birth rate. Materials and Methods: Using data from the German Perinatal Survey of 1998-2000 we analysed preterm birth rates in women with zero, one, or two previous live births. We compared groups of "late" mothers (with high preterm birth rates) with "control" groups of younger women (with relatively low preterm birth rates). Data of 208 342 women were analysed. For women with zero (one; two) previous live births, the "control" group included women aged 22-26 (27-31; 29-33) years. Women in the "late motherhood" group were aged > 33 (> 35; > 38) years. Results: The "late motherhood" groups defined in this way were also at higher risk of adverse perinatal events other than preterm birth. For women with zero (one; two) previous live births, normal cephalic presentation occurred in 89 % (92.7 %; 93.3 %) in the "control" group, but only in 84.5 % (90 %; 90.4 %) in the "late motherhood" group. The mode of delivery was spontaneous or at most requiring manual help in 71.3 % (83.4 %; 85.8 %) in the "control" group, but only in 51.4 % (72.2 %; 76.4 %) in the "late motherhood" group. Five-minute APGAR scores were likewise worse for neonates of "late" mothers and the proportion with a birth weight ≤ 2499 g was greater. Conclusion: "Late motherhood" that is associated with greater perinatal risks can be defined based on parity and preterm birth rate.

  5. Treatment Results of Postoperative Radiotherapy on Squamous Cell Carcinoma of the Oral Cavity: Coexistence of Multiple Minor Risk Factors Results in Higher Recurrence Rates

    International Nuclear Information System (INIS)

    Fan, Kang-Hsing; Wang, Hung-Ming; Kang, Chung-Jan

    2010-01-01

    Purpose: The aim of this study was to investigate the treatment results of postoperative radiotherapy (PORT) on squamous cell carcinoma of the oral cavity (OSCC). Materials and Methods: This study included 302 OSCC patients who were treated by radical surgery and PORT. Indications for PORT include Stage III or IV OSCC according to the 2002 criteria of the American Joint Committee on Cancer, the presence of perineural invasion or lymphatic invasion, the depth of tumor invasion, or a close surgical margin. Patients with major risk factors, such as multiple nodal metastases, a positive surgical margin, or extracapsular spreading, were excluded. The prescribed dose of PORT ranged from 59.4 to 66.6Gy (median, 63Gy). Results: The 3-year overall and recurrence-free survival rates were 73% and 70%, respectively. Univariate analysis revealed that differentiation, perineural invasion, lymphatic invasion, bone invasion, location (hard palate and retromolar trigone), invasion depths ≥10mm, and margin distances ≤4mm were significant prognostic factors. The presence of multiple significant factors of univariate analysis correlated with disease recurrence. The 3-year recurrence-free survival rates were 82%, 76%, and 45% for patients with no risk factors, one or two risk factors, and three or more risk factors, respectively. After multivariate analysis, the number of risk factors and lymphatic invasion were significant prognostic factors. Conclusion: PORT may be an adequate adjuvant therapy for OSCC patients with one or two risk factors of recurrence. The presence of multiple risk factors and lymphatic invasion correlated with poor prognosis, and more aggressive treatment may need to be considered.

  6. ICU Acquisition Rate, Risk Factors, and Clinical Significance of Digestive Tract Colonization With Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Detsis, Marios; Karanika, Styliani; Mylonakis, Eleftherios

    2017-04-01

    To evaluate the acquisition rate, identify risk factors, and estimate the risk for subsequent infection, associated with the colonization of the digestive tract with extended-spectrum beta-lactamase-producing Enterobacteriaceae during ICU-hospitalization. PubMed, EMBASE, and reference lists of all eligible articles. Included studies provided data on ICU-acquired colonization with extended-spectrum beta-lactamase-producing Enterobacteriaceae in previously noncolonized and noninfected patients and used the double disk synergy test for extended-spectrum beta-lactamase-producing Enterobacteriaceae phenotypic confirmation. Studies reporting extended-spectrum beta-lactamase-producing Enterobacteriaceae outbreaks or data on pediatric population were excluded. Two authors independently assessed study eligibility and performed data extraction. Thirteen studies (with 15,045 ICUs-patients) were evaluated using a random-effect model and a meta-regression analysis. The acquisition rate of digestive tract colonization during ICU stay was 7% (95% CI, 5-10) and it varies from 3% (95% CI, 2-4) and 4% (95% CI, 2-6) in the Americas and Europe to 21% (95% CI, 9-35) in the Western Pacific region. Previous hospitalization (risk ratio, 1.57 [95% CI, 1.07-2.31]) or antibiotic use (risk ratio, 1.65 [95% CI, 1.15-2.37]) and exposure to beta-lactams/beta-lactamase inhibitors (risk ratio, 1.78 [95% CI, 1.24-2.56]) and carbapenems (risk ratio, 2.13 [95% CI, 1.49-3.06]) during the ICU stay were independent risk factors for ICU-acquired colonization. Importantly, colonized patients were more likely to develop an extended-spectrum beta-lactamase-producing Enterobacteriaceae infection (risk ratio, 49.62 [95% CI, 20.42-120.58]). The sensitivity and specificity of prior colonization to predict subsequent extended-spectrum beta-lactamase-producing Enterobacteriaceae infection were 95.1% (95% CI, 54.7-99.7) and 89.2% (95% CI, 77.2-95.3), respectively. The ICU acquisition rate of extended-spectrum beta

  7. Combination of pegylated IFN-α2b with imatinib increases molecular response rates in patients with low- or intermediate-risk chronic myeloid leukemia

    DEFF Research Database (Denmark)

    Simonsson, Bengt; Gedde-Dahl, Tobias; Markevärn, Berit

    2011-01-01

    Biologic and clinical observations suggest that combining imatinib with IFN-a may improve treatment outcome in chronic myeloid leukemia (CML). We randomized newly diagnosed chronic-phase CML patients with a low or intermediate Sokal risk score and in imatinib-induced complete hematologic remission......%) discontinued imatinib treatment (1 because of blastic transformation in imatinib arm). In addition, in the combination arm, 34 patients (61%) discontinued Peg-IFN-a2b, most because of toxicity. The MMR rate at 12 months was significantly higher in the imatinib plus Peg-IFN-a2b arm (82%) compared...... with the imatinib monotherapy arm (54%; intention-to-treat, P = .002). The MMR rate increased with the duration of Peg-IFN-a2b treatment ( 12-week MMR rate 91%). Thus, the addition of even relatively short periods of Peg-IFN-a2b to imatinib markedly increased the MMR rate at 12 months...

  8. Colleges with High Default Rates on Guaranteed Loans Given 3 Years to Cut Them or Risk Losing Student Aid.

    Science.gov (United States)

    Palmer, Stacy E.; Wilson, Robin

    1987-01-01

    Colleges and universities will be held directly responsible for loan repayments by their former students. Most postsecondary institutions with default rates of more than 20% are for-profit trade schools, community colleges, or historically Black colleges. (MLW)

  9. Average County-Level IQ Predicts County-Level Disadvantage and Several County-Level Mortality Risk Rates

    Science.gov (United States)

    Barnes, J. C.; Beaver, Kevin M.; Boutwell, Brian B.

    2013-01-01

    Research utilizing individual-level data has reported a link between intelligence (IQ) scores and health problems, including early mortality risk. A growing body of evidence has found similar associations at higher levels of aggregation such as the state- and national-level. At the same time, individual-level research has suggested the…

  10. Psychometric Adaptation of the Beck Hopelessness Scale as a Self-Rated Suicide Risk Screening Instrument Among Nigerian University Students.

    Science.gov (United States)

    Aloba, Olutayo; Awe, Oluwatosin; Adelola, Aderopo; Olatunji, Philemon; Aloba, Tolulope

    2018-03-01

    Globally, suicide is the most important cause of mortality among adolescents and young adults. The factor that correlates most significantly with suicide is hopelessness. The aim is to explore the psychometric adaptation of the Beck Hopelessness Scale (BHS) as a suicide risk evaluation tool among Nigerian university students. A total of 554 Nigerian students completed the BHS and the Depression Anxiety Stress Scale (DASS). Suicide risk level among them was determined by interviewing them with the Mini International Neuropsychiatric Interview Suicidality module. Cronbach's alpha for the 16-item BHS was 0.87. It exhibited satisfactory concurrent validity with the Mini International Neuropsychiatric Interview (MINI) Suicidality module and the subscales of the DASS among the students. The 2-factor model of the BHS-16 exhibited satisfactory indices of fitness (goodness of fit index = 0.930; parsimonious goodness of fit index = 0.601; comparative fit index = 0.934; incremental fit index = 0.936; Tucker-Lewis index = 0.910; root mean square error of approximation = 0.059; χ 2 / df = 1.9). Receiver operating characteristics curve indicated that the best cutoff score for those categorized as high suicide risk was 7 (sensitivity 0.700, specificity 0.908, AUC = 0.897). The BHS has satisfactory psychometric properties as a suicide risk screening tool among Nigerian university students.

  11. The Effect of Graduation Coaches and Credit Recovery Programs on the Dropout Rate of At-Risk Grade 9 Students

    Science.gov (United States)

    Bowling, Jan

    2013-01-01

    The objective of this study was to identify the characteristics of effective graduation coaches (GCs) and credit recovery programs and explain the influence of a GC and a credit recovery program on Grade 9 students at risk of dropping out. The purpose of this study was to determine whether a high school GC and enrollment in a credit recovery…

  12. Psychometric Evaluation of a Brief Parent- and Teacher-Rated Screen for Children at Risk of Conduct Disorder

    Science.gov (United States)

    Duncombe, Melissa E.; Havighurst, Sophie S.; Holland, Kerry A.; Frankling, Emma J.

    2012-01-01

    This study examined the psychometric properties of the Conduct Problems Risk Screen (CPRS), a seven-item screen derived from DSM-IV-TR criteria that can be completed by parents or teachers. The sample consisted of 4,752 Australian five- to nine-year-old primary school children. The results showed the parent and teacher screens had very good…

  13. Increased Saccadic Rate during Smooth Pursuit Eye Movements in Patients at Ultra High Risk for Developing a Psychosis

    Science.gov (United States)

    van Tricht, M. J.; Nieman, D. H.; Bour, L. J.; Boeree, T.; Koelman, J. H. T. M.; de Haan, L.; Linszen, D. H.

    2010-01-01

    Abnormalities in eye tracking are consistently observed in schizophrenia patients and their relatives and have been proposed as an endophenotype of the disease. The aim of this study was to investigate the performance of patients at Ultra High Risk (UHR) for developing psychosis on a task of smooth pursuit eye movement (SPEM). Forty-six UHR…

  14. An Inverse Problem Study: Credit Risk Ratings as a Determinant of Corporate Governance and Capital Structure in Emerging Markets: Evidence from Chinese Listed Companies

    Directory of Open Access Journals (Sweden)

    ManYing Kang

    2017-11-01

    Full Text Available Credit risk rating is shown to be a relevant determinant in order to estimate good corporate governance and to self-optimize capital structure. The conclusion is argued from a study on a selected (and justified sample of (182 companies listed on the Shanghai Stock Exchange (SHSE and the Shenzhen Stock Exchange (SZSE and which use the same Shanghai Brilliance Credit Rating & Investors Service Company (SBCR assessment criteria, for their credit ratings, from 2010 to 2015. Practically, 3 debt ratios are examined in terms of 11 characteristic variables. Moreover, any relationship between credit rating and corporate governance can be thought to be an interesting finding. The relationship we find between credit rating and leverage is not as evident as that found by other researchers for different countries; it is significantly positively related to the outside director, firm size, tangible assets and firm age, and CEO and chairman office plurality. However, leverage is found to be negatively correlated with board size, profitability, growth opportunity, and non-debt tax shield. Credit rating is positively associated with leverage, but in a less significant way. CEO-Board chairship duality is insignificantly related to leverage. The non-debt tax shield is significantly correlated with leverage. The correlation coefficient between CEO duality and auditor is positive but weakly significant, but seems not consistent with expectations. Finally, profitability cause could be regarded as an interesting finding. Indeed, there is an inverse correlation between profitability and total debt (Notice that the result supports the pecking order theory. In conclusion, it appears that credit rating has less effect on the so listed large Chinese companies than in other countries. Nevertheless, the perspective of assessing credit risk rating by relevant agencies is indubitably a recommended time dependent leverage determinant.

  15. Rates and predictors of colorectal cancer screening by race among motivated men participating in a prostate cancer risk assessment program

    Science.gov (United States)

    Hall, Michael J.; Ruth, Karen; Giri, Veda N.

    2011-01-01

    Background Screening by fecal occult blood test and lower endoscopy have lowered colorectal cancer (CRC) mortality, but compliance gaps persist. Of concern are possible disparities in uptake of CRC screening between White and African American (AA) men. Our goal was to assess for disparities in uptake of CRC screening among men participating in a high-risk prostate cancer clinic. If present, such disparities could support hypotheses for further research examining racial differences in awareness and patient preferences in undergoing CRC screening. Methods Baseline data on a racially diverse cohort of men age 50–69 at increased risk of prostate cancer collected via the prostate cancer risk assessment program (PRAP) at Fox Chase Cancer Center were analyzed. Predictors of uptake of CRC screening were assessed using multivariable logistic regression. Results Compared to Whites, AA men had statistically significantly lower uptake of fecal occult blood testing (AA 49.0% vs White 60.7%, p=0.035), lower endoscopy (AA 44.1% vs White 58.5%, p=0.011), and any CRC screening (AA 66.2% vs White 76.3%, p=0.053). Predictors of uptake of lower endoscopy among AA men included older age (OR 3.61, 95% CI 1.87–6.97), family history of CRC (OR 3.47, 95% CI 1.30–9.25), and insurance status (OR 1.90, 95% CI 1.04–3.46). Conclusion Despite awareness of cancer risk and motivation to seek prostate cancer screening through a specialized prostate cancer risk assessment program, evidence supporting compliance gaps with CRC screening among men was found. Tailored messages to younger AA men with and without a family history of CRC are needed. PMID:21751189

  16. Cholestasis sepsis at neonatology ward and neonatal Intensive Care Unit Cipto Mangunkusumo Hospital 2007 : incidence, mortality rate and associated risk factors

    Directory of Open Access Journals (Sweden)

    Kadim S. Bachtiar

    2008-06-01

    Full Text Available Cholestatic jaundice represents serious pathological condition. Septic-cholestasis is a kind of hepato-cellular cholestasis that occured during or after sepsis caused by biliary flow obstruction. This is a cohort study from February to June 2007 on neonatal sepsis patients at Neonatology ward Department of Child Health Faculty of Medicine University of Indonesia-Cipto Mangunkusumo General National Hospital. Aim of this study is to find out the incidence of intrahepatic cholestasis in neonatal sepsis, associated risk factors, and mortality rate in neonatal cholestasis-sepsis. From 138 neonatal sepsis patients, the incidence of intrahepatic cholestasis is 65.9%. None of the risk factors tested in this study showed statistically significant result. Mortality rate of neonatal cholestasis-sepsis is 52.8%. (Med J Indones 2008; 17: 107-13Keywords: cholestasis intrahepatic, neonatal sepsis, cholestasis sepsis, conjugated hyperbilirubinemia

  17. Combined heart rate- and accelerometer-assessed physical activity energy expenditure and associations with glucose homeostasis markers in a population at high risk of developing diabetes

    DEFF Research Database (Denmark)

    Hansen, Anne-Louise Smidt; Carstensen, Bendix; Helge, Jørn Wulff

    2013-01-01

    OBJECTIVE: Regular physical activity (PA) reduces the risk of developing type 2 diabetes, and different subtypes of dysglycemia have shown different associations with PA. To better understand the associations of PA and glucose homeostasis, we examined the association of objectively measured PA...... energy expenditure (PAEE) with detailed measures of glucose homeostasis. RESEARCH DESIGN AND METHODS: In 1,531 men and women, with low to high risk of developing type 2 diabetes, we measured 7 days of PAEE using a combined accelerometry and heart rate monitor (ActiHeart). Measures and indices of glucose...... of PAEE slightly in an entire population at risk for developing type 2 diabetes may be a realistic and worthwhile goal to reach in order to achieve beneficial effect in terms of glucose metabolism....

  18. Symptom assessment in early psychosis: The use of well-established rating scales in clinical high-risk and recent-onset populations

    OpenAIRE

    Fulford, Daniel; Pearson, Rahel; Stuart, Barbara K.; Fisher, Melissa; Mathalon, Daniel H.; Vinogradov, Sophia; Loewy, Rachel L.

    2014-01-01

    Symptom assessment in early psychosis research typically relies on scales validated in chronic schizophrenia samples. Our goal was to inform investigators who are selecting symptom scales for early psychosis research. We described measure characteristics, baseline scores, and scale inter-relationships in clinical high-risk (CHR) and recent-onset psychotic disorder (RO) samples using the Positive and Negative Syndrome Scale, Brief Psychiatric Rating Scale, Scale for the Assessment of Positive ...

  19. Classification of radiation-hazardous objects by the ecological risk rate, based on the concept of the International Nuclear Event Scale (INES)

    International Nuclear Information System (INIS)

    Vetrov, V.A.

    2003-01-01

    The principal categories of the radiation-hazardous objects (RHO) (nuclear fuel cycle plants (NFC including NPP); ships with nuclear engine units and appropriate service facilities; units related with nuclear weapons (design, manufacture, storage, etc.); contaminated territories in the result nuclear accidents and nuclear facilities tests; civil enterprises using the radioactive sources) with real accident risk from radioactive substances (RS) release into environment are considered. For assessment of the ecological risk rate from RHO the International Nuclear Event Scale implemented by IAEA for NPP use is suggested. By opinion of the specialists the INES criteria could be used for radiation events assessment to other RHO that gives possibility for RHO arrangement by the potential hazard rate for environment in the case of accident. For RHO qualitative classification the main parameters assessment influencing on radioactive release risk (amount (total activity) of radioactive substances; possibility of chain reaction development; strength of technological parameters, etc.) was suggested. On the base of the INES all above-listed RHO kinds in the case of accident could be conditionally separated into three categories: 1. most radiation dangerous objects, on which could be severe and serious radiation accidents (corresponding to 4-7 INES levels); 2. RHO on which there is risk for accidents accompanying with RS release (accidents up to 4 INES level). 3. RHO without practical possibility for event (incidents - not higher 3 INES level). Introduction of suggested classification gives possibility for RHO safety control requirements rationalizing to radiation monitoring purposes for both RHO and the local systems

  20. Are there risk factors that increase the rate of staple line leakage in patients undergoing primary sleeve gastrectomy for morbid obesity?

    Science.gov (United States)

    Benedix, Frank; Benedix, Diana D; Knoll, Christian; Weiner, Rudolf; Bruns, Christiane; Manger, Thomas; Stroh, Christine

    2014-10-01

    Laparoscopic sleeve gastrectomy (LSG) is currently being performed with increasing frequency worldwide. It offers an excellent weight loss and resolution of comorbidities in the short term with a very low incidence of complications. However, the ever present risk of a staple line leak is still a major concern. Since 2005, data from obese patients that undergo bariatric procedures in Germany are prospectively registered in an online database and analyzed at the Institute of Quality Assurance in Surgical Medicine. For the current analysis, all patients that had undergone primary sleeve gastrectomy for morbid obesity within a 7-year period were considered. Using the GBSR, data from 5.400 LSGs were considered for analysis. Staple line leak rate decreased during the study period from 6.5 to 1.4 %. Male gender, higher BMI, concomitant sleep apnea, conversion to laparotomy, longer operation time, use of both buttresses and oversewing, and the occurrence of intraoperative complications were associated with a significantly higher leakage rate. On multivariate analysis, operation time and year of procedure only had a significant impact on staple line leak rate. The results of the current study demonstrated that there are factors that increase the risk of a leakage which would enable surgeons to define risk groups, to more carefully select patients, and to offer a closer follow-up during the postoperative course with early recognition and adequate treatment. All future efforts should be focused on a further reduction of serious complications to make the LSG a widely accepted and safer procedure.