WorldWideScience

Sample records for low-risk drinking guidelines

  1. Lack of international consensus in low-risk drinking guidelines.

    Science.gov (United States)

    Furtwaengler, Nina A F F; de Visser, Richard O

    2013-01-01

    To encourage moderate alcohol consumption, many governments have developed guidelines for alcohol intake, guidelines for alcohol consumption during pregnancy and legislation relating to blood alcohol limits when driving. The aim of this study was to determine the degree of international consensus within such guidelines. Official definitions of standard drinks and consumption guidelines were searched for on government websites, including all 27 European Union Member States and countries from all global geographic regions. There was a remarkable lack of agreement about what constitutes harmful or excessive alcohol consumption on a daily basis, a weekly basis and when driving, with no consensus about the ratios of consumption guidelines for men and women. International consensus in low-risk drinking guidelines is an important--and achievable--goal. Such agreement would facilitate consistent labelling of packaged products and could help to promote moderate alcohol consumption. However, there are some paradoxes related to alcohol content labelling and people's use of such information: although clearer information could increase people's capacity to monitor and regulate their alcohol consumption, not all drinkers are motivated to drink moderately or sensibly, and drinkers who intend to get drunk may use alcohol content labelling to select more alcoholic products. © 2012 Australasian Professional Society on Alcohol and other Drugs.

  2. Do Ontarians drink in moderation? a baseline assessment against Canadian low risk drinking guidelines.

    Science.gov (United States)

    Bondy, S J; Ashley, M J; Rehm, J T; Walsh, G

    1999-01-01

    We used the 1997 Ontario Drug Monitor, a population-based, random-digit dialing survey of 2,776 adults, to obtain a baseline assessment of alcohol drinking by Ontarians against the 1997 low-risk drinking guidelines of the Addiction Research Foundation and the Canadian Centre on Substance Abuse. Average weekly alcohol consumption and the frequency of exceeding the daily limit, estimated using the graduated frequency scale, were determined for the population overall, and by sex and age group (18-44 and 45+ years). Most Ontarians drank alcohol in a pattern associated with a low risk of health consequences. About 10% of women and 25% of men drank in a style associated with some increase in acute or long-term risk. Younger men were most likely to drink in a risky pattern. Most drinkers of middle age or older, for whom cardiovascular disease is a significant health risk, consumed alcohol in a pattern associated with cardiovascular benefit.

  3. Patient perceptions of risky drinking: Knowledge of daily and weekly low-risk guidelines and standard drink sizes.

    Science.gov (United States)

    Sprague, Debra J; Vinson, Daniel C

    2017-01-01

    Effective intervention for risky drinking requires that clinicians and patients know low-risk daily and weekly guidelines and what constitutes a "standard drink." The authors hypothesized that most patients lack this knowledge, and that education is required. Following primary care visits, patients completed anonymous exit questionnaires that included the 3 Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) questions, "How many drinks (containing alcohol) can you safely have in one day?" and questions about size, in ounces, of a standard drink of wine, beer, and liquor. Descriptive analyses were done in Stata. Of 1,331 respondents (60% female, mean age: 49.6, SD = 17.5), 21% screened positive on the AUDIT-C for risky drinking. Only 10% of those accurately estimated daily low-risk limits, with 9% accurate on weekly limits, and half estimated low-risk limits at or below guidelines. Fewer than half who checked "Yes" to "Do you know what a 'standard drink' is?" provided accurate answers for beer, wine, or liquor. Patients with a positive screen were twice as likely to say they knew what a standard drink is, but only a third gave accurate estimates. When asked about plans in the next month regarding change in drinking behavior, 23% with a positive AUDIT-C indicated they were at least considering a change. Most patients in primary care don't know specifics of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines for low-risk drinking. Exploring patient perceptions of low-risk guidelines and current drinking behavior may reveal discrepancies worth discussing. For risky drinkers, most of whom don't know daily and weekly low-risk guidelines or standard drink sizes, education can be vital in intervening. Findings suggest the need for detailed and explicit social marketing and communication on exactly what low-risk drinking entails.

  4. Governmental standard drink definitions and low-risk alcohol consumption guidelines in 37 countries.

    Science.gov (United States)

    Kalinowski, Agnieszka; Humphreys, Keith

    2016-07-01

    One of the challenges of international alcohol research and policy is the variability in and lack of knowledge of how governments in different nations define a standard drink and low-risk drinking. This study gathered such information from governmental agencies in 37 countries. A pool of 75 countries that might have definitions was created using World Health Organization (WHO) information and the authors' own judgement. Structured internet searches of relevant terms for each country were supplemented by efforts to contact government agencies directly and to consult with alcohol experts in the country. Most of the 75 national governments examined were not identified as having adopted a standard drink definition. Among the 37 that were so identified, the modal standard drink size was 10 g pure ethanol, but variation was wide (8-20 g). Significant variability was also evident for low-risk drinking guidelines, ranging from 10-42 g per day for women and 10-56 g per day for men to 98-140 g per week for women and 150-280 g per week for men. Researchers working and communicating across national boundaries should be sensitive to the substantial variability in 'standard' drink definitions and low-risk drinking guidelines. The potential impact of guidelines, both in general and in specific national cases, remains an important question for public health research. © 2016 Society for the Study of Addiction.

  5. Drinking patterns and adherence to "low-risk" guidelines among community-residing older adults.

    Science.gov (United States)

    Lewis, Ben; Garcia, Christian C; Nixon, Sara Jo

    2018-06-01

    Older adults constitute a rapidly expanding proportion of the U.S. Contemporary studies note the increasing prevalence of alcohol consumption in this group. Thus, understanding alcohol effects, consumption patterns, and associated risks in aging populations constitute critical areas of study with increasing public health relevance. Participants (n = 643; 292 women; ages 21-70) were community residing adult volunteers. Primary measures of interest included four patterns of alcohol consumption (average [oz./day]; typical quantity [oz./occasion]; frequency [% drinking days]; and maximal quantity [oz.]). Regression analyses explored associations between these measures, age, and relevant covariates. Subsequent between-group analyses investigated differences between two groups of older adults and a comparator group of younger adults, their adherance to "low-risk" guidelines, and whether alcohol-associated risks differed by age and adherence pattern. Average consumption did not vary by age or differ between age groups. In contrast, markedly higher frequencies and lower quantities of consumption were observed with increasing age. These differences persisted across adherence categories and were evident even in the oldest age group. Exceeding "low-risk" guidelines was associated with greater risk for alcohol-related problems among the older groups. These results emphasize the utility of considering underlying constituent patterns of consumption in older drinkers. Findings highlight difficulties in identifying problem drinking among older adults and contribute to the few characterizations of "risky" drinking patterns in this group. Taken together, our data contribute to literatures of import for the design and enhancement of screening, prevention, and education initiatives directed toward aging adults. Copyright © 2018. Published by Elsevier B.V.

  6. Alcohol consumption and low-risk drinking guidelines among adults: a cross-sectional analysis from Alberta's Tomorrow Project.

    Science.gov (United States)

    Brenner, Darren R; Haig, Tiffany R; Poirier, Abbey E; Akawung, Alianu; Friedenreich, Christine M; Robson, Paula J

    2017-12-01

    Moderate to heavy alcohol consumption is a risk factor for all-cause mortality and cancer incidence. Although cross-sectional data are available through national surveys, data on alcohol consumption in Alberta from a large prospective cohort were not previously available. The goal of these analyses was to characterize the levels of alcohol consumption among adults from the Alberta's Tomorrow Project in the context of cancer prevention guidelines. Furthermore, we conducted analyses to examine the relationships between alcohol consumption and other high-risk or risk-related behaviours. Between 2001 and 2009, 31 072 men and women aged 35 to 69 years were enrolled into Alberta's Tomorrow Project, a large provincial cohort study. Data concerning alcohol consumption in the past 12 months were obtained from 26 842 participants who completed self-administered health and lifestyle questionnaires. We conducted cross-sectional analyses on daily alcohol consumption and cancer prevention guidelines for alcohol use in relation to sociodemographic factors. We also examined the combined prevalence of alcohol consumption and tobacco use, obesity and comorbidities. Approximately 14% of men and 12% of women reported alcohol consumption exceeding recommendations for cancer prevention. Higher alcohol consumption was reported in younger age groups, urban dwellers, those with higher incomes and those who consumed more red meat. Moreover, volume of daily alcohol consumption was positively associated with current tobacco use in both men and women. Overall, men were more likely to fall in the moderate and high-risk behavioural profiles and show higher daily alcohol consumption patterns compared to women. Despite public health messages concerning the adverse impact of alcohol consumption, a sizeable proportion of Alberta's Tomorrow Project participants consumed alcohol in excess of cancer prevention recommendations. Continued strategies to promote low-risk drinking among those who choose to

  7. Life-time risk of mortality due to different levels of alcohol consumption in seven European countries: implications for low-risk drinking guidelines.

    Science.gov (United States)

    Shield, Kevin D; Gmel, Gerrit; Gmel, Gerhard; Mäkelä, Pia; Probst, Charlotte; Room, Robin; Rehm, Jürgen

    2017-09-01

    Low-risk alcohol drinking guidelines require a scientific basis that extends beyond individual or group judgements of risk. Life-time mortality risks, judged against established thresholds for acceptable risk, may provide such a basis for guidelines. Therefore, the aim of this study was to estimate alcohol mortality risks for seven European countries based on different average daily alcohol consumption amounts. The maximum acceptable voluntary premature mortality risk was determined to be one in 1000, with sensitivity analyses of one in 100. Life-time mortality risks for different alcohol consumption levels were estimated by combining disease-specific relative risk and mortality data for seven European countries with different drinking patterns (Estonia, Finland, Germany, Hungary, Ireland, Italy and Poland). Alcohol consumption data were obtained from the Global Information System on Alcohol and Health, relative risk data from meta-analyses and mortality information from the World Health Organization. The variation in the life-time mortality risk at drinking levels relevant for setting guidelines was less than that observed at high drinking levels. In Europe, the percentage of adults consuming above a risk threshold of one in 1000 ranged from 20.6 to 32.9% for women and from 35.4 to 54.0% for men. Life-time risk of premature mortality under current guideline maximums ranged from 2.5 to 44.8 deaths per 1000 women in Finland and Estonia, respectively, and from 2.9 to 35.8 deaths per 1000 men in Finland and Estonia, respectively. If based upon an acceptable risk of one in 1000, guideline maximums for Europe should be 8-10 g/day for women and 15-20 g/day for men. If low-risk alcohol guidelines were based on an acceptable risk of one in 1000 premature deaths, then maximums for Europe should be 8-10 g/day for women and 15-20 g/day for men, and some of the current European guidelines would require downward revision. © 2017 Society for the Study of Addiction.

  8. Alcohol consumption and low-risk drinking guidelines among adults: a cross-sectional analysis from Alberta’s Tomorrow Project

    Science.gov (United States)

    Darren R., Brenner; Tiffany R., Haig; Abbey E, Poirier; Alianu, Akawung; Christine M., Friedenreich; Paula J., Robson

    2017-01-01

    strategies to promote low-risk drinking among those who choose to drink could impact future chronic disease risk in this population. PMID:29236379

  9. Understanding standard drinks and drinking guidelines.

    Science.gov (United States)

    Kerr, William C; Stockwell, Tim

    2012-03-01

    For consumers to follow drinking guidelines and limit their risk of negative consequences they need to track their ethanol consumption. This paper reviews published research on the ability of consumers to utilise information about the alcohol content of beverages when expressed in different forms, for example in standard drinks or units versus percentage alcohol content. A review of the literature on standard drink definitions and consumer understanding of these, actual drink pouring, use of standard drinks in guidelines and consumer understanding and use of these. Standard drink definitions vary across countries and typically contain less alcohol than actual drinks. Drinkers have difficulty defining and pouring standard drinks with over-pouring being the norm such that intake volume is typically underestimated. Drinkers have difficulty using percentage alcohol by volume and pour size information in calculating intake but can effectively utilise standard drink labelling to track intake. Standard drink labelling is an effective but little used strategy for enabling drinkers to track their alcohol intake and potentially conform to safe or low-risk drinking guidelines. © 2011 Australasian Professional Society on Alcohol and other Drugs.

  10. Selection of low-risk design guidelines for energetic events

    International Nuclear Information System (INIS)

    Ferguson, D.; Marchaterre, J.; Graham, J.

    1982-01-01

    This paper recommends the establishment of specific design guidelines for protection against potential, but low-probability, energetic events. These guidelines recognize the plant protective features incorporated to prevent such events, as well as the inherent capability of the plant to accommodate a certain level of energy release. Further, their application is recommended within the context of necessary standardized and agreed-upon acceptance criteria which are less restrictive than ASME code requirements. The paper provides the background upon which the selection of the design is made, including the characterization of energetic events dependent on various core-design parameters, and including the necessity of a low-risk design balanced between prevention of accidents and the mitigation of consequences

  11. [Clinical guideline for management of patients with low risk differentiated thyroid carcinoma].

    Science.gov (United States)

    Díez, Juan José; Oleaga, Amelia; Álvarez-Escolá, Cristina; Martín, Tomás; Galofré, Juan Carlos

    2015-01-01

    Incidence of thyroid cancer is increasing in Spain and worldwide. Overall thyroid cancer survival is very high, and stratification systems to reliably identify patients with worse prognosis have been developed. However, marked differences exist between the different specialists in clinical management of low-risk patients with thyroid carcinoma. Almost half of all papillary thyroid carcinomas are microcarcinomas, and 90% are tumors < 2 cm that have a particularly good prognosis. However, they are usually treated more aggressively than needed, despite the lack of adequate scientific support. Surgery remains the gold standard treatment for these tumors. However, lobectomy may be adequate in most patients, without the need for total thyroidectomy. Similarly, prophylactic lymph node dissection of the central compartment is not required in most cases. This more conservative approach prevents postoperative complications such as hypoparathyroidism or recurrent laryngeal nerve injury. Postoperative radioiodine remnant ablation and strict suppression of serum thyrotropin, although effective for the more aggressive forms of thyroid cancer, have not been shown to be beneficial for the treatment of low risk patients, and may impair their quality of life. This guideline provides recommendations from the task force on thyroid cancer of the Spanish Society of Endocrinology and Nutrition for adequate management of patients with low-risk thyroid cancer. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  12. The selection of low-risk design guidelines for energetic events

    International Nuclear Information System (INIS)

    Fergusson, Donald; Marchaterre, John; Graham, John

    1982-01-01

    This paper recommends the establishment of specific design guidelines for protection against potential, but low probability, energetic events. These guidelines recognize the plant protective features incorporated to prevents such events, as well as the inherent capability of the plant to accommodate a certain level of energy release. Further, their application is recommended within the context of necessary standardized and agreed upon acceptance criteria which are less restrictive than ASME code requirements. The paper provides the background upon which the selection of the design is made, including the characterization of energetic events dependent on various core-design parameters, and including the necessity of a low-risk design balanced between prevention of accidents and the mitigation of consequences

  13. Preventive dentistry: practitioners' recommendations for low-risk patients compared with scientific evidence and practice guidelines.

    Science.gov (United States)

    Frame, P S; Sawai, R; Bowen, W H; Meyerowitz, C

    2000-02-01

    The purpose of this article is to compare published evidence supporting procedures to prevent dental caries and periodontal disease, in low-risk patients, with the actual preventive recommendations of practicing dentists. Methods included (1) a survey questionnaire of general dentists practicing in western New York State concerning the preventive procedures they would recommend and at what intervals for low-risk children, young adults, and older adults; and (2) review of the published, English-language literature for evidence supporting preventive dental interventions. The majority of dentists surveyed recommended semiannual visits for visual examination and probing to detect caries (73% to 79%), and scaling and polishing to prevent periodontal disease (83% to 86%) for low-risk patients of all ages. Bite-wing radiographs were recommended for all age groups at annual or semiannual intervals. In-office fluoride applications were recommended for low-risk children at intervals of 6 to 12 months by 73% of dentists but were recommended for low-risk older persons by only 22% of dentists. Application of sealants to prevent pit and fissure caries was recommended for low-risk children by 22% of dentists. Literature review found no studies comparing different frequencies of dental examinations and bite-wing radiographs to determine the optimal screening interval in low-risk patients. Two studies of the effect of scaling and polishing on the prevention of periodontal disease found no benefit from more frequent than annual treatments. Although fluoride is clearly a major reason for the decline in the prevalence of dental caries, there are no studies of the incremental benefit of in-office fluoride treatments for low-risk patients exposed to fluoridated water and using fluoridated toothpaste. Comparative studies using outcome end points are needed to determine the optimal frequency of dental examinations and bite-wing radiographs for the early detection of caries, and of scaling

  14. “If you drink alcohol, drink sensibly.” Is this guideline still appropriate?

    African Journals Online (AJOL)

    Food-Based Dietary Guidelines for South Africa: “If you drink alcohol, drink sensibly.” - Is this guideline ... alcohol-consumption guideline to be adopted by the general public: “If .... Survey of 20038 and the Youth Risk Behaviour Study of 20029.

  15. Testing the Efficacy of Alcohol Labels with Standard Drink Information and National Drinking Guidelines on Consumers' Ability to Estimate Alcohol Consumption.

    Science.gov (United States)

    Hobin, Erin; Vallance, Kate; Zuo, Fei; Stockwell, Tim; Rosella, Laura; Simniceanu, Alice; White, Christine; Hammond, David

    2018-01-01

    Despite the introduction of national drinking guidelines in Canada, there is limited public knowledge of them and low understanding of 'standard drinks (SDs)' which limits the likelihood of guidelines affecting drinking behaviour. This study tests the efficacy of alcohol labels with SD information and Canada's Low-Risk Drinking Guidelines (LRDGs) as compared to %ABV labels on consumers' ability to estimate alcohol intake. It also examines the label size and format that best supports adults' ability to make informed drinking choices. This research consisted of a between-groups experiment (n = 2016) in which participants each viewed one of six labels. Using an online survey, participants viewed an alcohol label and were asked to estimate: (a) the amount in a SD; (b) the number of SDs in an alcohol container and (c) the number of SDs to consume to reach the recommended daily limit in Canada's LRDG. Results indicated that labels with SD and LRDG information facilitated more accurate estimates of alcohol consumption and awareness of safer drinking limits across different beverage types (12.6% to 58.9% increase in accuracy), and labels were strongly supported among the majority (66.2%) of participants. Labels with SD and LRDG information constitute a more efficacious means of supporting accurate estimates of alcohol consumption than %ABV labels, and provide evidence to inform potential changes to alcohol labelling regulations. Further research testing labels in real-world settings is needed. Results indicate that the introduction of enhanced alcohol labels combining standard drink information and national drinking guidelines may be an effective way to improve drinkers' ability to accurately assess alcohol consumption and monitor intake relative to guidelines. Overall support for enhanced labels suggests probable acceptability of introduction at a population level. © The Author 2017. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  16. High-risk versus low-risk football game weekends: differences in problem drinking and alcohol-related consequences on college campuses in the United States.

    Science.gov (United States)

    Champion, Heather; Blocker, Jill N; Buettner, Cynthia K; Martin, Barbara A; Parries, Maria; Mccoy, Thomas P; Mitra, Ananda; Andrews, David W; Rhodes, Scott D

    2009-01-01

    Collegiate football games provide multiple social opportunities for alcohol use by students over the course of the weekend. The goal of this study was to examine alcohol use and alcohol-related consequences on football game weekends to determine differences based on characteristics of the game. A random sample of students from two large, public universities in the United States completed a survey on the Sunday-Friday following a high-risk weekend (HRW, important, home game) and low-risk weekend (LRW, no home game or game of importance) (N = 3,238 total). The survey measured the number of days students drank (0-3) and got drunk (0-3) over the weekend and whether 1+ consequences were experienced due to one's own drinking (yes/no) and due to others' drinking (yes/no). Ordinal logistic regression analyses revealed greater odds of drinking alcohol (OR = 1.70, CI = 1.46-1.97) and getting drunk (OR = 1.49, CI = 1.27-1.76) on HRW versus LRW. Logistic regression analyses revealed greater odds of experiencing 1+ consequences as a result of one's own drinking (OR = 1.38, CI = 1.16-1.63) and experiencing 1+ consequences as a result of others' drinking (OR = 1.52, CI = 1.30-1.78) on HRW versus LRW. These findings suggest that additional prevention efforts aimed at reducing risky drinking are needed over HRW and have implications for campus administrators, law enforcement, and substance abuse program coordinators.

  17. Commentary: if you drink alcohol, drink sensibly: is this guideline still appropriate?

    Science.gov (United States)

    Jacobs, Liezille; Steyn, Nelia

    2013-01-01

    Alcohol abuse remains one of the most serious substance abuse disorders in South African society, resulting in inordinately large social, economic and health problems at all levels of society. Alcohol consumers in South Africa are estimated to drink 16.6L per annum with a per capita consumption of 7.1L. South Africa has one of the highest rates of death attributable to crime, violence, traffic accidents, and HIV/AIDS in the world. These rates have been directly related to the high prevalence of alcohol abuse and risky drinking patterns. A food-based dietary guideline that encourages alcohol consumption would appear to be not in the nation's best interest. We conducted a search of websites supported by the World Health Organization to find published literature on substance abuse in South Africa and also reviewed the website of the Medical Research Council of South Africa for studies on the social impact of alcohol abuse in humans. We used the search terms alcohol guidelines, alcohol abuse, non-communicable diseases, health benefits of alcohol, moderate drinking, alcohol, and intake patterns and reviewed studies that hade been published between 2002 and the current time. Based on evidence over the past two decades, messages that convey the positive health benefits of moderate alcohol consumption (eg, the increased levels of HDL cholesterol) should be raised and even encouraged for those who are very moderate drinkers (ie, one alcoholic drink/ day for women and a maximum of 2 drinks/day for men). For those who do not consume alcohol at all, even moderate drinking is not encouraged. Nutrition educators should emphasize the negative consequences of alcohol abuse. The current food-based dietary guideline, "If you drink alcohol, drink sensibly," from the South African Department of Health should not remain as is.

  18. Low risk of suicide and lithium in drinking water: A Danish individual-level cohort study using spatial analysis

    DEFF Research Database (Denmark)

    Knudsen, Nikoline Nygård; Schullehner, Jörg; Jørgensen, Lisbeth Flindt

    Importance of the work and objectives: Lithium occurs naturally in drinking water and may have a positive effect on mental health and suicide. In clinical practice, lithium in high therapeutic doses is used as a mood-stabilizer in the treatment of affective disorders. Previous studies performed...... at an ecological level have found an association between lithium in drinking water and risk of suicide. The present study is the first to investigate this association at an individual level considering long-term exposure. Methodologies: The study population consisted of all 3,724,588 Danish adults (≥20 years......) of which 15,370 committed suicide from 1990-2012. Information on suicides was obtained from the nationwide Danish Register of Causes of Death. Data on lithium concentrations were obtained through a nationwide drinking water campaign from 2013 including 151 measurements from waterworks supplying...

  19. Immediate effects on adult drinkers of exposure to alcohol harm reduction advertisements with and without drinking guideline messages: experimental study.

    Science.gov (United States)

    Wakefield, Melanie A; Brennan, Emily; Dunstone, Kimberley; Durkin, Sarah J; Dixon, Helen G; Pettigrew, Simone; Slater, Michael D

    2018-06-01

    To compare the immediate effects on drinkers of television advertisements focusing upon short- versus long-term harms with and without low-risk drinking guidelines. Between-participants on-line experiment, with random assignment to view: (a) alcohol product advertisements (ALC control); (b) advertisements unrelated to alcohol (NON-ALC control); (c) advertisements featuring short-term harms (STH) of alcohol; (d) advertisements featuring STH plus a STH guideline (STH+G); (e) advertisements featuring long-term harms (LTH); or (f) advertisements featuring LTH plus a LTH guideline (LTH+G). Australia, 2016. A total of 3718 drinkers aged 18-64 years (48.5% male). Post-exposure likelihood that participants provided a correct estimate of drinking levels associated with short- and long-term harms; post-exposure intentions to avoid alcohol or reduce consumption. After exposure to STH+G or LTH+G advertisements, participants were more likely to estimate correctly rather than overestimate drinking levels associated with harm, compared with those exposed to STH (P < 0.001) and LTH advertisements without guidelines, respectively (P = 0.019) and ALC control (STH+G, P < 0.001; LTH+G, P < 0.001) and NON-ALC control conditions (STH+G, P < 0.001; LTH+G, P = 0.011). Drinkers exposed to STH conditions were more likely to intend to reduce next-week alcohol consumption than those exposed to ALC control (both P < 0.001) and NON-ALC control conditions (STH, P = 0.001; STH+G, P < 0.001); a similar pattern was observed for intentions to avoid alcohol. Drinkers exposed to LTH conditions were also more likely than drinkers exposed to ALC or NON-ALC controls to intend to avoid and reduce alcohol in the next week. Additionally, drinkers exposed to LTH+G were more likely to intend to reduce drinking than those exposed to LTH advertisements without guidelines (P = 0.022). Response patterns for low- and high-risk drinkers by condition were similar. Alcohol harm television

  20. Predictors of awareness of standard drink labelling and drinking guidelines to reduce negative health effects among Australian drinkers.

    Science.gov (United States)

    Coomber, Kerri; Jones, Sandra C; Martino, Florentine; Miller, Peter G

    2017-03-01

    This study examined rates of awareness of standard drink labelling and drinking guidelines among Australian adult drinkers. Demographic predictors of these two outcomes were also explored. Online survey panel participants aged 18-45 years(n = 1061; mean age = 33.2 years) completed an online survey assessing demographics, alcohol consumption patterns, awareness of standard drink labels and the National Health and Medical Research Council (NHMRC) guidelines, and support for more detailed labels. The majority (80%) of participants had seen standard drink labels on alcohol products; with younger drinkers, those from a regional/rural location and high-risk drinkers significantly more likely to have seen such labelling. Most respondents estimated at or below the maximum number of drinks stipulated in the NHMRC guidelines. However, their estimates of the levels for male drinkers were significantly higher than for female drinkers. High-risk drinkers were significantly less likely to provide accurate estimates, while those who had seen the standard drink logo were significantly more likely to provide accurate estimates of drinking levels to reduce the risk of long-term harms only. Just under three-quarters of respondents supported the inclusion of more information on labels regarding guidelines to reduce negative health effects. The current standard drink labelling approach fails to address high-risk drinkers. The inclusion of information about NHMRC guidelines on alcohol labels, and placing standard drink labelling on the front of products could improve awareness of what constitutes a standard drink and safe levels of consumption among Australian drinkers.[Kerri Coomber, Sandra C. Jones, Florentine Martino, Peter G. Miller. Predictors of awareness of standard drink labelling and drinking guidelines to reduce negative health effects among Australian drinkers. Drug Alcohol Rev 2017;36:200-209]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

  1. Intermittent auscultation of fetal heart rate during labour - a widely accepted technique for low risk pregnancies: but are the current national guidelines robust and practical?

    Science.gov (United States)

    Sholapurkar, S L

    2010-01-01

    Intermittent auscultation of fetal heart rate is an accepted practice in low risk labours in many countries. National guidelines on intrapartum fetal monitoring were critically reviewed regarding timing and frequency of intermittent auscultation. Hypothetical but plausible examples are presented to illustrate that it may be possible to miss significant fetal distress with strict adherence to current guidelines. Opinion is forwarded that intermittent auscultation should be performed for 60 seconds before and after three contractions over about 10 min every half an hour in the first stage of labour. Reasons are put forward to show how this could be more practical and patient friendly and at the same time could improve detection of fetal distress. The current recommendation of intermittent auscultation every 15 min in the first stage is associated with poor compliance and leads to unnecessary burden, stress and medicolegal liability for birth attendants. Modification of current national guidelines would be desirable.

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

    African Journals Online (AJOL)

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

  3. Green tea drinking, high tea temperature and esophageal cancer in high- and low-risk areas of Jiangsu Province, China: a population-based case-control study.

    NARCIS (Netherlands)

    Wu, M.; Liu, A.M.; Kampman, E.; Zhang, Z.F.; Veer, P. van 't; Wu, D.L.; Wang, P.H.; Yang, J.; Qin, Y.; Mu, L.N.; Kok, F.J.; Zhao, J.K.

    2009-01-01

    Epidemiological studies suggested drinking green tea is inversely associated with esophageal cancer but results remain inconclusive. Moreover, inconsistent observations found high temperature drinks are associated with esophageal cancer. A population-based case-control study was conducted in a

  4. Green tea drinking, high tea temperature and esophageal cancer in high and low risk areas of Jiangsu Province, China: a population-based case-control study

    NARCIS (Netherlands)

    Wu, M.; Liu, A.; Kampman, E.; Zhang, Zuo-Feng; Veer, van 't P.; Wu, P.; Wang, P.; Kok, F.J.; Zhao, J.

    2009-01-01

    Epidemiological studies suggested drinking green tea is inversely associated with esophageal cancer but results remain inconclusive. Moreover, inconsistent observations found high temperature drinks are associated with esophageal cancer. A population-based case-control study was conducted in a

  5. “If you drink alcohol, drink sensibly.” Is this guideline still appropriate ...

    African Journals Online (AJOL)

    Background: Alcohol abuse remains one of the most serious substance abuse disorders in South African society, resulting in inordinately large social, economic and health problems at all levels of society. Alcohol consumers in South Africa are estimated to drink 16.6 l per annum, with a per capita consumption of 7.1 l.

  6. Key scientific issues in developing drinking water guidelines for perfluoroalkyl acids: Contaminants of emerging concern.

    Science.gov (United States)

    Post, Gloria B; Gleason, Jessie A; Cooper, Keith R

    2017-12-01

    Perfluoroalkyl acids (PFAAs), a group of synthetic organic chemicals with industrial and commercial uses, are of current concern because of increasing awareness of their presence in drinking water and their potential to cause adverse health effects. PFAAs are distinctive among persistent, bioaccumulative, and toxic (PBT) contaminants because they are water soluble and do not break down in the environment. This commentary discusses scientific and risk assessment issues that impact the development of drinking water guidelines for PFAAs, including choice of toxicological endpoints, uncertainty factors, and exposure assumptions used as their basis. In experimental animals, PFAAs cause toxicity to the liver, the immune, endocrine, and male reproductive systems, and the developing fetus and neonate. Low-dose effects include persistent delays in mammary gland development (perfluorooctanoic acid; PFOA) and suppression of immune response (perfluorooctane sulfonate; PFOS). In humans, even general population level exposures to some PFAAs are associated with health effects such as increased serum lipids and liver enzymes, decreased vaccine response, and decreased birth weight. Ongoing exposures to even relatively low drinking water concentrations of long-chain PFAAs substantially increase human body burdens, which remain elevated for many years after exposure ends. Notably, infants are a sensitive subpopulation for PFAA's developmental effects and receive higher exposures than adults from the same drinking water source. This information, as well as emerging data from future studies, should be considered in the development of health-protective and scientifically sound guidelines for PFAAs in drinking water.

  7. A decision tree approach to screen drinking water contaminants for multiroute exposure potential in developing guideline values.

    Science.gov (United States)

    Krishnan, Kannan; Carrier, Richard

    2017-07-03

    The consideration of inhalation and dermal routes of exposures in developing guideline values for drinking water contaminants is important. However, there is no guidance for determining the eligibility of a drinking water contaminant for its multiroute exposure potential. The objective of the present study was to develop a 4-step framework to screen chemicals for their dermal and inhalation exposure potential in the process of developing guideline values. The proposed framework emphasizes the importance of considering basic physicochemical properties prior to detailed assessment of dermal and inhalation routes of exposure to drinking water contaminants in setting guideline values.

  8. Drinking Levels Defined

    Science.gov (United States)

    ... of Alcohol Consumption Alcohol's Effects on the Body Alcohol Use Disorder Fetal Alcohol Exposure Support & Treatment Alcohol Policy Special ... Definition of Drinking at Low Risk for Developing Alcohol Use Disorder (AUD): For women, low-risk drinking is defined ...

  9. Radium in potable waters from Central Victoria, Australia - an application of the Australian drinking water guidelines

    International Nuclear Information System (INIS)

    Tinker, R.A.; Smith, J.D.

    1998-01-01

    Determinations of 226 Ra and 228 Ra in potable mineral waters from springs located in the Daylesford-Hepburn region of Victoria, Australia are presented. Concentrations ranged from 230-810 mBq L -1 for 226 Ra and 200-800 mBq L -1 for 226 Ra. These levels approach or exceed the guideline limits recommended in the Australian Drinking Water Guidelines. The annual committed effective dose and health risks from radium in potable water is discussed. Assuming consumption of 2 L per day the average annual committed effective dose received from 226 Ra was 0.087 mSv y -1 and from 226 Ra was 0.10 mSv y -1

  10. Urgent need to reevaluate the latest World Health Organization guidelines for toxic inorganic substances in drinking water.

    Science.gov (United States)

    Frisbie, Seth H; Mitchell, Erika J; Sarkar, Bibudhendra

    2015-08-13

    The World Health Organization (WHO) has established guidelines for drinking-water quality that cover biological and chemical hazards from both natural and anthropogenic sources. In the most recent edition of Guidelines for Drinking-water Quality (2011), the WHO withdrew, suspended, did not establish, or raised guidelines for the inorganic toxic substances manganese, molybdenum, nitrite, aluminum, boron, nickel, uranium, mercury, and selenium. In this paper, we review these changes to the WHO drinking-water guidelines, examining in detail the material presented in the WHO background documents for each of these toxic substances. In some cases, these WHO background documents use literature reviews that do not take into account scientific research published within the last 10 or more years. In addition, there are instances in which standard WHO practices for deriving guidelines are not used; for example, rounding and other mathematical errors are made. According to published meeting reports from the WHO Chemical Aspects Working Group, the WHO has a timetable for revising some of its guidelines for drinking-water quality, but for many of these toxic substances the planned changes are minimal or will be delayed for as long as 5 years. Given the limited nature of the planned WHO revisions to the inorganic toxic substances and the extended timetable for these revisions, we suggest that governments, researchers, and other stakeholders might establish independent recommendations for inorganic toxic substances and possibly other chemicals to proactively protect public health, or at the very least, revert to previous editions of the Guidelines for Drinking-water Quality, which were more protective of public health.

  11. The application of national and international guidelines in the assessment of the radiological quality of drinking water

    International Nuclear Information System (INIS)

    Cooper, M.B.

    1998-01-01

    Full text: The World Health Organisation has developed international guidelines for drinking water quality which define acceptable levels of contaminants including radionuclides. These guidelines were the basis for the recent Australian water quality guidelines developed by the National Health and Medical Research Council in conjunction with the Agriculture and Resource Management Council of Australia and New Zealand. This paper highlights some of the practical problems in applying the guidelines in the assessment of groundwater supplies in Australia where the radium content of the water may be significant and the presence of other dissolved minerals can create difficulties in the analytical procedures. Generally, screening methods are based on the determination of gross alpha and beta radioactivity and the limitations of these techniques are discussed. The issue is also addressed as to the appropriate actions in the event of guideline values for specific radionuclides being exceeded

  12. Low Risk Anomalies?

    DEFF Research Database (Denmark)

    Schneider, Paul; Wagner, Christian; Zechner, Josef

    . Empirically, we find that option-implied ex-ante skewness is strongly related to ex-post residual coskewness and alphas. Beta- and volatility-based low risk anomalies are largely driven by a single principal component, which is in turn largely explained by skewness. Controlling for skewness renders the alphas......This paper shows that stocks' CAPM alphas are negatively related to CAPM betas if investors demand compensation for negative skewness. Thus, high (low) beta stocks appear to underperform (outperform). This apparent anomaly merely reflects compensation for residual coskewness ignored by the CAPM...... of betting-against-beta and -volatility insignificant....

  13. Drinking Water Quality Guidelines across Canadian Provinces and Territories: Jurisdictional Variation in the Context of Decentralized Water Governance

    Directory of Open Access Journals (Sweden)

    Gemma Dunn

    2014-04-01

    Full Text Available This article presents the first comprehensive review and analysis of the uptake of the Canadian Drinking Water Quality Guidelines (CDWQG across Canada’s 13 provinces and territories. This review is significant given that Canada’s approach to drinking water governance is: (i highly decentralized and (ii discretionary. Canada is (along with Australia only one of two Organization for Economic Cooperation and Development (OECD member states that does not comply with the World Health Organization’s (WHO recommendation that all countries have national, legally binding drinking water quality standards. Our review identifies key differences in the regulatory approaches to drinking water quality across Canada’s 13 jurisdictions. Only 16 of the 94 CDWQG are consistently applied across all 13 jurisdictions; five jurisdictions use voluntary guidelines, whereas eight use mandatory standards. The analysis explores three questions of central importance for water managers and public health officials: (i should standards be uniform or variable; (ii should compliance be voluntary or legally binding; and (iii should regulation and oversight be harmonized or delegated? We conclude with recommendations for further research, with particular reference to the relevance of our findings given the high degree of variability in drinking water management and oversight capacity between urban and rural areas in Canada.

  14. Drinking Water Quality Guidelines across Canadian provinces and territories: jurisdictional variation in the context of decentralized water governance.

    Science.gov (United States)

    Dunn, Gemma; Bakker, Karen; Harris, Leila

    2014-04-25

    This article presents the first comprehensive review and analysis of the uptake of the Canadian Drinking Water Quality Guidelines (CDWQG) across Canada's 13 provinces and territories. This review is significant given that Canada's approach to drinking water governance is: (i) highly decentralized and (ii) discretionary. Canada is (along with Australia) only one of two Organization for Economic Cooperation and Development (OECD) member states that does not comply with the World Health Organization's (WHO) recommendation that all countries have national, legally binding drinking water quality standards. Our review identifies key differences in the regulatory approaches to drinking water quality across Canada's 13 jurisdictions. Only 16 of the 94 CDWQG are consistently applied across all 13 jurisdictions; five jurisdictions use voluntary guidelines, whereas eight use mandatory standards. The analysis explores three questions of central importance for water managers and public health officials: (i) should standards be uniform or variable; (ii) should compliance be voluntary or legally binding; and (iii) should regulation and oversight be harmonized or delegated? We conclude with recommendations for further research, with particular reference to the relevance of our findings given the high degree of variability in drinking water management and oversight capacity between urban and rural areas in Canada.

  15. Drinking Water Quality Guidelines across Canadian Provinces and Territories: Jurisdictional Variation in the Context of Decentralized Water Governance

    Science.gov (United States)

    Dunn, Gemma; Bakker, Karen; Harris, Leila

    2014-01-01

    This article presents the first comprehensive review and analysis of the uptake of the Canadian Drinking Water Quality Guidelines (CDWQG) across Canada’s 13 provinces and territories. This review is significant given that Canada’s approach to drinking water governance is: (i) highly decentralized and (ii) discretionary. Canada is (along with Australia) only one of two Organization for Economic Cooperation and Development (OECD) member states that does not comply with the World Health Organization’s (WHO) recommendation that all countries have national, legally binding drinking water quality standards. Our review identifies key differences in the regulatory approaches to drinking water quality across Canada’s 13 jurisdictions. Only 16 of the 94 CDWQG are consistently applied across all 13 jurisdictions; five jurisdictions use voluntary guidelines, whereas eight use mandatory standards. The analysis explores three questions of central importance for water managers and public health officials: (i) should standards be uniform or variable; (ii) should compliance be voluntary or legally binding; and (iii) should regulation and oversight be harmonized or delegated? We conclude with recommendations for further research, with particular reference to the relevance of our findings given the high degree of variability in drinking water management and oversight capacity between urban and rural areas in Canada. PMID:24776725

  16. Exposure to revised drinking guidelines and 'COM-B' determinants of behaviour change: descriptive analysis of a monthly cross-sectional survey in England.

    Science.gov (United States)

    Stevely, Abigail K; Buykx, Penny; Brown, Jamie; Beard, Emma; Michie, Susan; Meier, Petra S; Holmes, John

    2018-02-14

    January 2016 saw the publication of proposed revisions to the UK's lower risk drinking guidelines but no sustained promotional activity. This paper aims to explore the impact of publishing guidelines without sustained promotional activity on reported guideline exposure and determinants of behaviour (capability, opportunity and motivation) proposed by the COM-B model. Data were collected by a monthly repeat cross-sectional survey of adults (18+) resident in England over 15 months between November 2015 and January 2017 from a total of 16,779 drinkers, as part of the Alcohol Toolkit Study. Trends and associated 95% confidence intervals were described in the proportion of reported exposure to guidelines in the past month and measures of the capability, opportunity and motivation to consume alcohol within drinking guidelines. There was a rise in reported exposure to drinking guidelines in January 2016 (57.6-80.6%) which did not reoccur in January 2017. Following the increase in January 2016, reported exposure reduced slowly but remained significantly higher than in December 2015. In February 2016, there was an increase in measures of capability (31.1% reported tracking units of alcohol consumption and 87.8% considered it easier to drink safely) and opportunity (84.0% perceived their lifestyle as conducive to drinking within guidelines). This change was not maintained in subsequent months. Other measures showed marginal changes between January and February 2016 with no evidence of change in subsequent months. Following the publication of revised drinking guideline in January 2016, there was a transient increase in exposure to guidelines, and capability and opportunity to drink within the guidelines that diminished over time. The transience and size of the changes indicate that behaviour change is unlikely. Well-designed, theory-based promotional campaigns may be required for drinking guidelines to be an effective public health intervention.

  17. Low Risk Anomalies?

    DEFF Research Database (Denmark)

    Schneider, Paul; Wagner, Christian; Zechner, Josef

    This paper shows theoretically and empirically that beta- and volatility-based low risk anomalies are driven by return skewness. The empirical patterns concisely match the predictions of our model that endogenizes the role of skewness for stock returns through default risk. With increasing downside...... risk, the standard capital asset pricing model (CAPM) increasingly overestimates expected equity returns relative to firms' true (skew-adjusted) market risk. Empirically, the profitability of betting against beta/volatility increases with firms' downside risk, and the risk-adjusted return differential...... of betting against beta/volatility among low skew firms compared to high skew firms is economically large. Our results suggest that the returns to betting against beta or volatility do not necessarily pose asset pricing puzzles but rather that such strategies collect premia that compensate for skew risk...

  18. Drinking water guideline for ethylene thiourea, a metabolite of ethylene bisdithiocarbamate fungicides

    International Nuclear Information System (INIS)

    Frakes, R.A.

    1988-01-01

    The ethylene bisdithiocarbamate fungicides are the most heavily used pesticides in Maine. Ethylene thiourea (ETU) is a metabolite and environmental decomposition product of these compounds, is highly water soluble, and has been detected in groundwater in the state. ETU is a recognized animal carcinogen and teratogen. When administered in the diet, ETU produced a significant increase in thyroid carcinomas in rats in two studies. Two strains of mice fed ETU in the diet developed an increased incidence of hepatomas and a slight increase in lymphomas. Application of the linearized multistage model resulted in virtually safe doses (10(-5) lifetime cancer risk) of 0.25 to 1.6 micrograms/kg/day. The major teratologic effect has been the development of hydrocephalus and other CNS defects postnatally, resulting in a high mortality rate among the offspring. The NOEL for this effect was 5 mg/kg in a single oral dose. Retarded parietal ossification was observed at 5 mg/kg/day. Serious nononcogenic thyroid effects, such as goiter, decreased 131I uptake, and reduced thyroxine production, have been observed. Thyroid hyperplasia was produced at doses as low as 0.3 mg/kg/day ETU ingested in the diet. Based on protection against thyroid and/or liver tumors and alteration in thyroid function, the recommended Drinking Water Guideline for ETU is determined to be 3 ppb. This will also provide protection against developmental effects, since these occur at doses that are one to two orders of magnitude higher. 37 references

  19. Development of a shower exposure model for benzene : background work for potential recommended update to the recently derived drinking water guidelines

    International Nuclear Information System (INIS)

    Knafla, A.L.; Carey, J.

    2009-01-01

    Chloroform exposure was first identified in showers. Shower exposures were then examined for other volatile substances. This presentation discussed the development of a shower exposure model for benzene and included background work for potential recommended updates to the recently derived drinking water guidelines. Specifically, the presentation addressed the relevance for oil and gas sites and the influence on the drinking water guideline. Issues and limitation with Health Canada's Khrisnan model were identified. The advantages of an alternate model development were also presented. Model structure was examined with particular reference to how model exposures are modelled and the risk associated with taking showers with impacted water. Two general types of models were discussed, notably the simple model used to estimate exposures and the integrated physiologically-based pharmacokinetic model. The relevance of the drinking water guideline revision to the petroleum industry was addressed. It was concluded that future water quality guidelines will likely incorporate shower exposures. tabs., figs.

  20. Further European initiatives and regulations concerning radiation protection: drinking water guideline, maximum permissible contamination in food products and feeding stuff

    International Nuclear Information System (INIS)

    Mundigl, Stefan

    2013-01-01

    The radiation protection community has observed intensively the development of basic safety standards concerning protection against hazards of ionizing radiation. The new core part of the European radiation protection legislation is complemented by several specialized regulations relevant for radiation protection. Besides the existing regulations in the field of emergency protection the European Commission initiated a drinking water guideline that will be published in the near future. Furthermore the European commission approved a revised regulation concerning the maximum permissible contamination limits for food products and feeding stuff in case of a future nuclear accident. Together with the new radiation protection basic standards a new complete, coherent and modernized European regulation package will be accomplished.

  1. Adherence to Eating and Drinking Guidelines for Adults with Intellectual Disabilities and Dysphagia.

    Science.gov (United States)

    Chadwick, Darren D.; Jolliffe, Jane; Goldbart, Juliet

    2003-01-01

    The extent to which 40 individuals with intellectual disorders and dysphagia and their caregivers adhered to speech and language pathology dysphagia guidelines was evaluated across four settings. Although adherence was generally high, there were significant differences across settings, type of guidelines, and between people who were fed by…

  2. Long-term risks of metal contaminants in drinking water: a critical appraisal of guideline values for arsenic and vanadium

    Directory of Open Access Journals (Sweden)

    Riccardo Crebelli

    2012-12-01

    Full Text Available Metal contaminants in drinking water represent a relevant health issue in several areas of the world. In Italy, because of the geological features of the territory, high arsenic and vanadium are frequently reported in ground waters in concentrations above current guideline values. The implications for public health of the presence of contaminants above their legal limit are directly related to the biological basis of the guideline value. In the case of arsenic there are still major uncertainties in the mechanism of carcinogenesis which prevent a precise evaluation of long-term risks. Thus, the guideline value endorsed in the European Community (10 µg/L has to be considered as a pragmatic tool rather than a quality objective, bearing in mind that "every effort should be made to keep concentrations as low as reasonably possible" (WHO, 2011. A reverse situation holds for vanadium, for which a strict national limit (50 µg/L was previously proposed in consideration of data gaps, and for which new evidence indicated a less stringent health-based limit.

  3. Drink lots of clean, safe water”: A food-based dietary guideline for ...

    African Journals Online (AJOL)

    The purpose of this review is to summarise the literature that supports the importance of the food-based dietary guideline on water consumption. General recommendations for total daily water intake are between 2 and 3.7 l for women and men, 0.7 l for infants aged 0-6 months, 0.8 l for infants aged 7-12 months, 1.3 l for ...

  4. Drinking Water

    Science.gov (United States)

    This encyclopedic entry deals with various aspects of microbiology as it relates to drinking water treatment. The use of microbial indicators for assessing fecal contamination is discussed as well as current national drinking water regulations (U.S. EPA) and guidelines proposed ...

  5. Guideline for the assessment of radioactive substances in drinking water in the frame of the implementation of the drinking water regulation. Recommendation by BMUB, BfS, UBA and the responsible state authorities and DVGW and BDFW; Leitfaden zur Untersuchung und Bewertung von radioaktiven Stoffen im Trinkwasser bei der Umsetzung der Trinkwasserverordnung. Empfehlung von BMUB, BMG, BfS, UBA und den zustaendigen Landesbehoerden sowie DVGW und BDEW

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2017-01-15

    The guidelines on the assessment of radioactive substances in drinking water cover the following issues: terms, symbols and units concerning radioactivity, radioactivity in the drinking water and radiation exposure, requirements for drinking water with respect to radioactive substances, fundamentals of the assessment concept according to the drinking water regulation, practical application of the assessment concept, analytical determination of radioactivity related parameters.

  6. View the label before you view the movie: A field experiment into the impact of Portion size and Guideline Daily Amounts labelling on soft drinks in cinemas

    Directory of Open Access Journals (Sweden)

    de Boer Michiel

    2011-06-01

    Full Text Available Abstract Background Large soft drink sizes increase consumption, and thereby contribute to obesity. Portion size labelling may help consumers to select more appropriate food portions. This study aimed to assess the effectiveness of portion size and caloric Guidelines for Daily Amounts (GDA labelling on consumers' portion size choices and consumption of regular soft drinks. Methods A field experiment that took place on two subsequent evenings in a Dutch cinema. Participants (n = 101 were asked to select one of five different portion sizes of a soft drink. Consumers were provided with either portion size and caloric GDA labelling (experimental condition or with millilitre information (control condition. Results Labelling neither stimulated participants to choose small portion sizes (OR = .75, p = .61, CI: .25 - 2.25, nor did labelling dissuade participants to choose large portion sizes (OR = .51, p = .36, CI: .12 - 2.15. Conclusions Portion size and caloric GDA labelling were found to have no effect on soft drink intake. Further research among a larger group of participants combined with pricing strategies is required. The results of this study are relevant for the current public health debate on food labelling.

  7. Assessment of the chemical toxicity of long-lived radionuclides on the basis of Who guidelines for drinking-water quality

    International Nuclear Information System (INIS)

    Renaud-Salis, V.; Menetrier, F.; Leudet, A.; Flury-Herard, A.

    2003-01-01

    The current assessment of health risks related to long lived radionuclides waste management is not complete if accounting only for radiological toxicity aspects. Although such an approach is justified for a large number of radionuclides of concern, it nevertheless cannot be exclusive and generalised: the chemical toxicity should be considered for radionuclides with a radioactive half-life exceeding 10 5 years. When assessing the chemical or radiological toxicity of a radionuclide, a reference dose applied to drinking water consumption (0.1 mSv/year) can be compared to existing toxicological data. Such an approach has been used by the World Health Organization for natural uranium, for which a guideline value in drinking water derived from its chemical toxicity (2 μg/l) is recommended. WHO's approach is used here for illustrating that the potential chemical toxicity of an element is to be considered for assessing health risks related to long-lived radionuclides. (authors)

  8. Problem drinking and exceeding guidelines for 'sensible' alcohol consumption in Scottish men: associations with life course socioeconomic disadvantage in a population-based cohort study

    Directory of Open Access Journals (Sweden)

    Benzeval Michaela

    2008-09-01

    Full Text Available Abstract Background With surveys suggesting that exceeding guidelines for 'sensible' alcohol intake is commonplace, the health and social impact of modifying intake on a population level is potentially considerable. If public health interventions are to be successfully implemented, it is first important to identify correlates of such behaviours, including socioeconomic disadvantage. This was the aim of the present study. Methods Population-representative cohort study of 576 men from the West of Scotland. Data on life course socioeconomic position were collected in 1988 (at around 55 years of age. Alcohol consumption patterns (detailed seven day recall and problem drinking (CAGE questionnaire were ascertained in 1990/2 (at around 59 years of age. A relative index of inequality was computed to explore the comparative strength of different indicators of social circumstances from different periods of the life course. Results Socioeconomic adversity in both early life and in adulthood was related to an increased risk of exceeding the weekly and daily alcohol guidelines, with adult indicators of socioeconomic position revealing the strongest associations. Of these, material indicators of socioeconomic deprivation in adulthood – car ownership, housing tenure – were marginally more strongly related to heavy alcohol intake and problem drinking than education, income and occupational social class. A substantial proportion of the influence of early life deprivation on alcohol intake was mediated via adult socioeconomic position. Similar results were apparent when problem drinking was the outcome of interest. Conclusion In men in this cohort, exposure to disadvantaged social circumstances across the lifecourse, but particularly in adulthood, is associated with detrimental patterns of alcohol consumption and problem drinking in late middle age.

  9. A critical evaluation of two point-of-use water treatment technologies: can they provide water that meets WHO drinking water guidelines?

    Science.gov (United States)

    Murphy, Heather M; McBean, Edward A; Farahbakhsh, Khosrow

    2010-12-01

    Point-of-use (POU) technologies have been proposed as solutions for meeting the Millennium Development Goal (MDG) for safe water. They reduce the risk of contamination between the water source and the home, by providing treatment at the household level. This study examined two POU technologies commonly used around the world: BioSand and ceramic filters. While the health benefits in terms of diarrhoeal disease reduction have been fairly well documented for both technologies, little research has focused on the ability of these technologies to treat other contaminants that pose health concerns, including the potential for formation of contaminants as a result of POU treatment. These technologies have not been rigorously tested to see if they meet World Health Organization (WHO) drinking water guidelines. A study was developed to evaluate POU BioSand and ceramic filters in terms of microbiological and chemical quality of the treated water. The following parameters were monitored on filters in rural Cambodia over a six-month period: iron, manganese, fluoride, nitrate, nitrite and Escherichia coli. The results revealed that these technologies are not capable of consistently meeting all of the WHO drinking water guidelines for these parameters.

  10. Does the risk of childhood diabetes mellitus require revision of the guideline values for nitrate in drinking water?

    NARCIS (Netherlands)

    Maanen, J.M.S. van; Albering, H.J.; Kok, T.M.C.M. de; Breda, S.G.J. van; Curfs, D.M.J.; Vermeer, I.T.M.; Ambergen, A.W.; Wolffenbuttel, B.H.R.; Kleinjans, J.C.S.; Reeser, H.M.

    2000-01-01

    In recent years, several studies have addressed a possible relationship between nitrate exposure and childhood type 1 insulin-dependent diabetes mellitus. The present ecologic study describes a possible relation between the incidence of type 1 diabetes and nitrate levels in drinking water in The

  11. The development of a web-based brief alcohol intervention in reducing heavy drinking among college students: an Intervention Mapping approach.

    Science.gov (United States)

    Voogt, Carmen V; Poelen, Evelien A P; Kleinjan, Marloes; Lemmers, Lex A C J; Engels, Rutger C M E

    2014-12-01

    In the Netherlands, young adults' drinking practices have become an issue of public concern since their drinking levels are high. Heavy drinking can place young adults at an increased risk for developing short- and long-term health-related problems. Current national alcohol prevention programmes focus mainly on adolescents and their parents and paying less systematic attention to young adults. The present study describes the theory and evidence-based development of a web-based brief alcohol intervention entitled What Do You Drink (WDYD). We applied the Intervention Mapping (IM) protocol to combine theory and evidence in the development and implementation of WDYD. The WDYD intervention aims to detect and reduce heavy drinking of young adults who are willing to decrease their alcohol consumption, preferably below the Dutch guidelines of low-risk drinking. According to the IM protocol, the development of WDYD resulted in a structured intervention. Reducing heavy drinking to low-risk drinking was proposed as the behavioural outcome. Motivational interviewing principles and parts of the I-Change Model were used as methods in the development of WDYD, whereas computer tailoring was selected as main strategy. An effect and a process evaluation of the intervention will be conducted. IM was found to be a practical instrument for developing the WDYD intervention tailored to a specific target population in the area of alcohol prevention. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Determinants for hospitalization in " low-risk" community acquired pneumonia

    Directory of Open Access Journals (Sweden)

    Aliyu Muktar H

    2003-06-01

    Full Text Available Abstract Background A variable decision in managing community acquired pneumonia (CAP is the initial site of care; in-patient versus outpatient. These variations persist despite comprehensive practice guidelines. Patients with a Pneumonia Severity Index (PSI score lower than seventy have low risk for complications and outpatient antibiotic management is recommended in this group. These patients are generally below the age of fifty years, non-nursing home residents, HIV negative and have no major cardiac, hepatic, renal or malignant diseases. Methods A retrospective analysis of 296 low-risk CAP patients evaluated within a year one period at St. Agnes Hospital, Baltimore, Maryland was undertaken. All patients were assigned a PSI score. 208 (70% were evaluated and discharged from the emergency department (E.D. to complete outpatient antibiotic therapy, while 88 (30% were hospitalized. Patients were sub-stratified into classes I-V according to PSI. A comparison of demographic, clinical, social and financial parameters was made between the E.D. discharged and hospitalized groups. Results Statistically significant differences in favor of the hospitalized group were noted for female gender (CI: 1.46-5.89, p= 0.0018, African Americans (CI: 0.31-0.73, p= 0.004, insurance coverage (CI: 0.19-0.63, p= 0.0034, temperature (CI: 0.04-0.09, p= 0.0001 and pulse rate (CI: 0.03-0.14, p= 0.0001. No statistically significant differences were observed between the two groups for altered mental status, hypotension, tachypnea, laboratory/radiological parameters and social indicators (p>0.05. The average length of stay for in-patients was 3.5 days at about eight time's higher cost than outpatient management. There was no difference in mortality or treatment failures between the two groups. The documentation rate and justifications for hospitalizing low risk CAP patients by admitting physicians was less than optimal. Conclusions High fever, tachycardia, female gender

  13. Low-Risk Investing without Industry Bets

    DEFF Research Database (Denmark)

    Asness, Clifford S.; Frazzini, Andrea; Heje Pedersen, Lasse

    2014-01-01

    The strategy of buying safe low-beta stocks while shorting (or underweighting) riskier high-beta stocks (“betting against beta”) has been shown to deliver significant risk-adjusted returns. Some have suggested, however, that such “low-risk investing” delivers high returns primarily because...... of industry bets that favor a slowly changing set of stodgy, stable industries. The authors refute this notion by showing that a strategy of betting against beta has delivered positive returns both as an industry-neutral bet within each industry and as a pure bet across industries....

  14. Has there been an increase in the frequency with which people who drink in a risky fashion receive advice to cut down on their drinking from 1998 to 2015?

    Science.gov (United States)

    Cunningham, John A; Chaiton, Michael

    2018-03-13

    To assess whether there has been an increase over time in the proportion of people who drink in a risky fashion, who receive expressions of concern about their drinking or advice to cut down. Secondary analysis of the Centre for Addiction and Mental Health (CAMH) Monitor population survey, conducted annually in Ontario (participants: 18 or older) and with relevant data available from 1998 to 2015 (N = 48,124). The proportions of participants who drank above weekly low-risk drinking levels (approximated as 15 or more drinks for males and 11 or more for females) who reported receiving expressions of concern about their drinking or advice to cut down were compared between the time periods 1998-2004, 2005-2010, and 2011-2015. Further, proportions were broken down by age group and participant sex. Overall, there were low rates of participants who reported receiving advice about their drinking (16.8% of those drinking above weekly drinking levels) and no evidence of an increase across time, except among males, 34 years and under. Females drinking beyond recommended weekly guidelines were less likely than males to receive advice (11.7% versus 19.3%, respectively; P fashion receive advice to cut down.

  15. Content analysis of UK newspaper and online news representations of women's and men's 'binge' drinking: a challenge for communicating evidence-based messages about single-episodic drinking?

    Science.gov (United States)

    Patterson, C; Emslie, C; Mason, O; Fergie, G; Hilton, S

    2016-12-27

    In the UK, men's alcohol-related morbidity and mortality still greatly exceeds women's, despite an increase in women's alcohol consumption in recent decades. New UK alcohol guidelines introduce gender-neutral low-risk alcohol consumption guidance. This study explores how UK newspaper and online news represent women's and men's 'binge' drinking to identify opportunities to better align reporting of harmful drinking with evidence. Quantitative and qualitative content analysis of 308 articles published in 7 UK national newspapers and the BBC News website between 1 January 2012 and 31 December 2013. Articles associated women with 'binge' drinking more frequently than men, and presented women's drinking as more problematic. Men were more frequently characterised as violent or disorderly, while women were characterised as out of control, putting themselves in danger, harming their physical appearance and burdening men. Descriptions of female 'binge' drinkers' clothing and appearance were typically moralistic. The UK news media's disproportionate focus on women's 'binge' drinking is at odds with epidemiological evidence, may reproduce harmful gender stereotypes and may obstruct public understandings of the gender-neutral weekly consumption limits in newly proposed alcohol guidelines. In order to better align reporting of harmful drinking with current evidence, public health advocates may engage with the media with a view to shifting media framing of 'binge' drinking away from specific groups (young people; women) and contexts (public drinking) and towards the health risks of specific drinking behaviours, which affect all groups regardless of context. 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/.

  16. Quality of drinking water in Italy in relation to WHO guidelines and European community and national regulations; Stato di qualita` delle acque potabili in Italia in relazione alle linee guida dell`Organizzazione Mondiale della Sanita` e alla normativa comunitaria e nazionale

    Energy Technology Data Exchange (ETDEWEB)

    Funari, E [Istituto Superiore di Sanita` , Rome (Italy). Lab. di Igiene Ambientale

    1995-09-01

    The causes and processes of contamination, as well as the possible human health implications for the main contaminants of drinking water are described. The quality of drinking water in Italy is defined through the comparison of the pollutant levels with the World Health Organization guidelines published in 1993 and the USEPA HAs (Health Advisories) of 1994 (annexed to the report).

  17. Responsible drinking

    Science.gov (United States)

    Alcohol use disorder - responsible drinking; Drinking alcohol responsibly; Drinking in moderation; Alcoholism - responsible drinking ... 2016. National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder. www.niaaa.nih.gov/alcohol-health/overview-alcohol- ...

  18. Further European initiatives and regulations concerning radiation protection: drinking water guideline, maximum permissible contamination in food products and feeding stuff; Weitere europaeische Initiativen und Regelungen im Strahlenschutz. Trinkwasserrichtlinie, maximal zulaessige Kontaminationswerte in Nahrungs- und Futtermitteln

    Energy Technology Data Exchange (ETDEWEB)

    Mundigl, Stefan [Europaeische Kommission, Generaldirektion Energie, Luxemburg (Luxembourg). Abt. D3 - Strahlenschutz, EUFO 4150

    2013-07-01

    The radiation protection community has observed intensively the development of basic safety standards concerning protection against hazards of ionizing radiation. The new core part of the European radiation protection legislation is complemented by several specialized regulations relevant for radiation protection. Besides the existing regulations in the field of emergency protection the European Commission initiated a drinking water guideline that will be published in the near future. Furthermore the European commission approved a revised regulation concerning the maximum permissible contamination limits for food products and feeding stuff in case of a future nuclear accident. Together with the new radiation protection basic standards a new complete, coherent and modernized European regulation package will be accomplished.

  19. Drinking motives

    NARCIS (Netherlands)

    Jacob Rosendahl; Lenka van Riemsdijk; Klaus Grunert; Johan van Berkel

    2013-01-01

    Chapter 8 in Comsumption Culture in Europe. This chapter presents an analysis of what consumer in Europe drink and why they drink what they drink. The concept of drinking motives is developed and defined, and analysis of data on drinking motives shows that these can be grouped into two major

  20. Energy Drinks

    Science.gov (United States)

    ... R S T U V W X Y Z Energy Drinks Share: © Thinkstock Energy drinks are widely promoted as products that increase ... people has been quite effective. Next to multivitamins, energy drinks are the most popular dietary supplement consumed ...

  1. Binge Drinking

    Medline Plus

    Full Text Available ... prepared for different audiences including, children, parents, and public health professionals. More > Binge Drinking (4:23) Recommend on ... More Information Vital Signs Binge Drinking Information Alcohol & Public Health Binge Drinking Factsheet Effective Prevention Strategies Send Us ...

  2. Ethnic Drinking Culture, Acculturation, and Enculturation in Relation to Alcohol Drinking Behavior Among Marriage-Based Male Immigrants in Taiwan.

    Science.gov (United States)

    Chen, Hung-Hui; Chien, Li-Yin

    2018-04-01

    Drinking behavior among immigrants could be influenced by drinking-related cultural norms in their country of origin and host country. This study examined the association of ethnic drinking culture, acculturation, and enculturation with alcohol drinking among male immigrants in Taiwan. This cross-sectional survey recruited 188 male immigrants. Ethnic drinking culture was divided into dry and wet according to per capita alcohol consumption and abstinent rate in the countries of origin in reference to that in Taiwan. A scale, Bidimensional Acculturation Scale for Marriage-Based Immigrants, was developed to measure acculturation (adaptation to the host culture) and enculturation (maintenance of the original culture). Drinking patterns (abstinent, low-risk drinking, and hazardous drinking) were determined by scores on the Alcohol Use Disorder Identification Test. There was a significant interaction between ethnic drinking culture and enculturation/acculturation on drinking patterns. Multinomial logistic regression models identified that for those from dry ethnic drinking cultures, a high level of acculturation was associated with increased low-risk drinking, while a high level of enculturation was associated with decreased low-risk drinking. For those from wet ethnic drinking cultures, a low level of acculturation and high level of enculturation were associated with increased hazardous drinking. High family socioeconomic status was associated with increased drinking, while perceived insufficient family income was positively associated with hazardous use. To prevent hazardous use of alcohol, health education should be targeted at immigrant men who drink, especially among those who have economic problems, are from wet ethnic drinking cultures, and demonstrate low adaptation to the host culture.

  3. Different pituitary. beta. -endorphin and adrenal cortisol response to ethanol in individuals with high and low risk for future development of alcoholism

    Energy Technology Data Exchange (ETDEWEB)

    Gianoulakis, C.G.; Beliveau, D.; Angelogianni, P.; Meaney, M.; Thavundayil, J.; Tawar, V.; Dumas, M. (McGill Univ., Quebec (Canada))

    1989-01-01

    The purpose of the present studies was to investigate the activity of the adrenal gland and the pituitary {beta}-endorphin system in individuals from families with a 3 generation history of alcoholism, High Risk group, or from families without history of alcoholism, Low Risk group. On the day of testing, blood sample was taken at 9:00 a.m., then the subject drank a placebo drink or an ethanol solution. Additional blood samples were taken at 15, 45 and 120 minutes post-drink. Results indicated that individuals of the High Risk group had lower basal levels of {beta}-endorphin like immunoreactivity ({beta}-EPLIR) than individuals of the Low Risk group. The dose of 0.5 g ethanol/kg B.Wt. induced an induce an increase in the plasma content of {beta}-EPLIR of the High Risk group, but not of the Low Risk group. In the Low Risk group ethanol did not induce an increase above the 9:00 a.m. levels, however, it attenuated the {beta}-endorphin decrease overtime, observed following the placebo drink. Analysis of {beta}-endorphin-like peptides in the plasma of the High Risk group, with Sephadex G-75 chromatography indicated that the major component of the plasma {beta}-EPLIR was {beta}-lipotropin. Plasma cortisol levels, following ethanol intake, presented a small increase in the High Risk group but not in the Low Risk group.

  4. Underage Drinking

    Science.gov (United States)

    ... 10/17. Drinking patterns vary by age and gender As adolescents get older, they tend to drink ... in risky behavior, including drinking and driving, sexual activity (such as unprotected ... the risk of physical and sexual assault Underage youth who drink are ...

  5. [Postoperative radioiodine ablation in patients with low risk differentiated thyroid carcinoma].

    Science.gov (United States)

    Díez, Juan J; Grande, Enrique; Iglesias, Pedro

    2015-01-06

    Most patients with newly diagnosed differentiated thyroid carcinoma have tumors with low risk of mortality and recurrence. Standard therapy has been total or near total thyroidectomy followed by postoperative radioiodine remnant ablation (RRA). Although RRA provides benefits, current clinical guidelines do not recommend it universally, since an increase in disease-free survival or a decrease in mortality in low risk patients has not been demonstrated so far. Advancements in our understanding of the biological behavior of thyroid cancer have been translated into the clinic in a personalized approach to the patients based on their individual risk of recurrence and mortality. Current evidence suggests that RRA is not indicated in most low-risk patients, especially those with papillary carcinomas smaller than 1cm, without extrathyroidal extension, unfavorable histology, lymph node involvement or distant metastases. Follow-up of these patients with serial measurements of serum thyroglobulin and neck ultrasound is adequate. Careful evaluation of all risk factors of clinical relevance will allow a more realistic assessment of each individual patient. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  6. Multi-Barrier Protection of Drinking Water Systems in Ontario: A Comparison of First Nation and Non-First Nation Communities

    Directory of Open Access Journals (Sweden)

    Budhendra Singh

    2012-11-01

    Full Text Available In some way or another, all levels of government in Canada and First Nations share responsibility to implement multi-barrier protection of drinking water. The goal is to protect water from source to tap to minimize risk so that people have access to adequate and safe drinking water. The federal government has committed to assist First Nations achieve comparable levels of service standards available to non-First Nation communities. However, several recent reports on the status of drinking water services standards in First Nations indicate that people in these communities often experience greater health risks than those living off reserves. Using the federal drinking water risk evaluation guidelines, the capacities of First Nations and non-First Nations in Ontario to implement multi-barrier protection of their drinking water systems are compared. The Risk Level Evaluation Guidelines for Water and Wastewater Treatment in First Nation Communities rank drinking water systems as low, medium, or high risk based on information about source water, system design, system operation, reporting, and operator expertise. The risk evaluation scores for First Nations drinking water systems were obtained from Aboriginal Affairs and Northern Development Canada. A survey based on the federal Risk Level Evaluation Guidelines was sent to non-First Nation communities throughout Ontario with 54 communities responding. The capacity among First Nations was variable throughout the province, whereas all of the municipalities were in the low risk category, even small and northern non-First Nation community water systems. It is clear that the financial and technological capacity issues should be addressed regardless of the legislative and regulatory regime that is established. The current governance and management structure does not appear to be significantly reducing the gap in service standards despite financial investment. Exploring social or other underlying determinants

  7. Drinking Level, Drinking Pattern, and Twenty-Year Total Mortality Among Late-Life Drinkers.

    Science.gov (United States)

    Holahan, Charles J; Schutte, Kathleen K; Brennan, Penny L; Holahan, Carole K; Moos, Rudolf H

    2015-07-01

    Research on moderate drinking has focused on the average level of drinking. Recently, however, investigators have begun to consider the role of the pattern of drinking, particularly heavy episodic drinking, in mortality. The present study examined the combined roles of average drinking level (moderate vs. high) and drinking pattern (regular vs. heavy episodic) in 20-year total mortality among late-life drinkers. The sample comprised 1,121 adults ages 55-65 years. Alcohol consumption was assessed at baseline, and total mortality was indexed across 20 years. We used multiple logistic regression analyses controlling for a broad set of sociodemographic, behavioral, and health status covariates. Among individuals whose high level of drinking placed them at risk, a heavy episodic drinking pattern did not increase mortality odds compared with a regular drinking pattern. Conversely, among individuals who engage in a moderate level of drinking, prior findings showed that a heavy episodic drinking pattern did increase mortality risk compared with a regular drinking pattern. Correspondingly, a high compared with a moderate drinking level increased mortality risk among individuals maintaining a regular drinking pattern, but not among individuals engaging in a heavy episodic drinking pattern, whose pattern of consumption had already placed them at risk. Findings highlight that low-risk drinking requires that older adults drink low to moderate average levels of alcohol and avoid heavy episodic drinking. Heavy episodic drinking is frequent among late-middle-aged and older adults and needs to be addressed along with average consumption in understanding the health risks of late-life drinkers.

  8. 40 CFR 266.109 - Low risk waste exemption.

    Science.gov (United States)

    2010-07-01

    ... MANAGEMENT FACILITIES Hazardous Waste Burned in Boilers and Industrial Furnaces § 266.109 Low risk waste exemption. (a) Waiver of DRE standard. The DRE standard of § 266.104(a) does not apply if the boiler or... 99.9 percent destruction and removal efficiency. That is, assume that 0.1 percent of the mass weight...

  9. Contemporary management of low-risk bladder cancer

    NARCIS (Netherlands)

    Falke, J.; Witjes, J.A.

    2011-01-01

    Bladder cancer comprises a heterogeneous group of tumors, the majority of which are non-muscle-invasive bladder cancer (NMIBC) at initial presentation. Low-risk bladder cancer--defined as pTa low-grade papillary tumors--is the type of NMIBC with the most favorable oncologic outcome. Although the

  10. Toxicological relevance of emerging contaminants for drinking water quality

    OpenAIRE

    Schriks, M.; Heringa, M.B.; van der Kooij, M.M.E.; de Voogt, P.; van Wezel, A.P.

    2010-01-01

    The detection of many new compounds in surface water, groundwater and drinking water raises considerable public concern, especially when human health based guideline values are not available it is questioned if detected concentrations affect human health. In an attempt to address this question, we derived provisional drinking water guideline values for a selection of 50 emerging contaminants relevant for drinking water and the water cycle. For only 10 contaminants, statutory guideline values ...

  11. Time to improve statin prescription guidelines in low-risk patients?

    NARCIS (Netherlands)

    Balder, Jan W.; de Vries, Jeroen K.; Mulder, Douwe J.; Kamphuisen, Pieter W.

    Background The challenge of the primary prevention of cardiovascular disease (CVD) is to identify patients who would benefit from treatment with statins. Statins are currently prescribed to many patients, even those at a low 10-year risk of CVD. These latter patients may not be eligible for statins

  12. Determinants of low risk of asthma exacerbation during pregnancy

    DEFF Research Database (Denmark)

    Ali, Z; Nilas, L; Ulrik, C S

    2018-01-01

    of Asthma during Pregnancy (MAP) programme at Hvidovre Hospital since 2007. Assessment of asthma control, adjustment of treatment, spirometry and measurement of exhaled nitric oxide (FENO) were performed, and baseline characteristics and exacerbation history were collected at enrolment. Determinants of low......: Clinically stable asthma at enrolment, together with no history of previous exacerbations and no prescribed controller medication, is a determinant of low risk of an asthma exacerbation during pregnancy, which may guide clinicians in individualizing surveillance of asthma during pregnancy.......BACKGROUND: Assessment of asthma control every 4-6 weeks during pregnancy is recommended to reduce risk of exacerbation, and by that improve outcome. OBJECTIVE: To identify determinants of pregnancies with low risk of asthma exacerbation. METHODS: All pregnant women enrolled into the Management...

  13. Emergency caesarean section in low risk nulliparous women

    DEFF Research Database (Denmark)

    Haerskjold, Ann; Hegaard, H K; Kjaergaard, H

    2012-01-01

    and identifies maternal and fetal risk factors associated with ECS. We included 2,748 low-risk women and 8.7% had ECS. Failure-to-progress (FTP) accounted for 68.3% of the ECS and 30.4% were performed due to suspected fetal distress (SFD). Multivariate logistic regression analyses were done to estimate.......26-3.20) were associated with increased risk of ECS due to FTP....

  14. Drinking Motives

    DEFF Research Database (Denmark)

    Grunert, Klaus G; Rosendahl, Jacob; Andronikidis, Andreas I.

    2013-01-01

    . This distinction is universal and henceapplies across Europe. However, the importance of self-expressive as compared to functional motives, as well as the way in which these relate to different beverages, does differ across Europe. Both dimensions are relevant for the motives for drinking non-alcoholic drinks...

  15. Binge Drinking

    Centers for Disease Control (CDC) Podcasts

    This podcast is based on the October, 2010 CDC Vital Signs report which indicates that drinking too much, including binge drinking, causes more than 79,000 deaths in the U.S. each year and is the third leading preventable cause of death.

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

    Science.gov (United States)

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

    2015-07-01

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

  17. Does nitrite and nitrate levels in drinking water impact the health of people in Dakahlia governorate, Egypt?

    Science.gov (United States)

    Mortada, Wael I; Shokeir, Ahmed A

    2018-05-07

    A total of 1291 drinking water samples were examined for nitrite and nitrate during 6 months from December, 2015 to May, 2016 at 17 cities of Dakahlia governorate (Nile Delta, north of Egypt), and the results were utilized for assessment of health risk of the exposure from drinking water by calculating average daily intake (ADI), hazard quotient (HQ), and the hazard index (HI). The nitrite and nitrate in drinking water had a concentration range of 0.030-0.113 and 2.41-8.70 mg L -1 , with mean values of 0.059 ± 0.014 and 5.25 ± 1.61 mg L -1 , respectively. Nitrite and nitrate levels in rural areas and ground water samples were significantly higher than that in the urban ones. None of the analyzed samples exceeded WHO guideline values that set out to prevent methemoglobinemia. The values of HQ and HI for all age groups do not exceed unity indicating a low risk of methaemoglobinaemia for the population in this area. Results of the present study indicate that there is no health risk of residents from nitrite and nitrate through drinking water in the studied area. However, the other sources of exposure to nitrite and nitrate should be investigated in further studies.

  18. Development of quality indicators for low-risk labor care provided by midwives using a RAND-modified Delphi method.

    Science.gov (United States)

    Ueda, Kayo; Ohtera, Shosuke; Kaso, Misato; Nakayama, Takeo

    2017-09-22

    In childbirth, most deliveries are low-risk, defined as spontaneous labor at full term without special high-risk facts or complications, especially in high-resource countries where maternal and perinatal mortality rates are very low. Indeed, the majority of mothers and infants have no serious conditions during labor. However, the quality of care provided is not assured, and performance may vary by birthing facility and provider. The overuse of technology in childbirth in some parts of the world is almost certainly based on assumptions like, "something can go wrong at any minute." There is a need to assess the quality of care provided for mothers and infants in low-risk labor. We aimed to develop specific quality indicators for low-risk labor care provided primarily by midwives in Japan. We used a RAND-modified Delphi method, which integrates evidence review with expert consensus development. The procedure comprises five steps: (1) literature review, including clinical practice guidelines, to extract and develop quality indicator candidates; (2) formation of a multidisciplinary panel; (3) independent panel ratings (Round 1); (4) panel meeting and independent panel ratings (Round 2); and (5) independent panel ratings (Round 3). The three independent panel ratings (Rounds 1-3) were held between July and December 2012. The assembled multidisciplinary panel comprised eight clinicians (two pediatricians, three obstetricians, and three midwives) and three mothers who were nonclinicians. Evidentiary review extracted 166 key recommendations from 32 clinical practice guidelines, and 31 existing quality indicators were added. After excluding duplicate recommendations and quality indicators, the panel discussed 25 candidate indicators. Of these, 18 were adopted, one was modified, six were not adopted, and four were added during the meeting, respectively. We established 23 quality indicators for low-risk labor care provided by midwives in labor units in Japan.

  19. Low Risk of Cervical Cancer/Precancer Among Most Women Under Surveillance Postcolposcopy.

    Science.gov (United States)

    Demarco, Maria; Cheung, Li C; Kinney, Walter K; Wentzensen, Nicolas; Lorey, Thomas S; Fetterman, Barbara; Poitras, Nancy E; Befano, Brian; Castle, Philip E; Schiffman, Mark

    2018-04-01

    To inform impending postcolposcopy guidelines, this analysis examined the subsequent risk of CIN 3+ among women with a grade lower than CIN 2 (< CIN 2) colposcopy results, taking into account the referring results that brought them to colposcopy and cotest results postcolposcopy. We analyzed 107,005 women from 25 to 65 years old, recommended for colposcopy at Kaiser Permanente Northern California. We estimated absolute risks of CIN 3+ among women: (1) recommended for colposcopy (precolposcopy), (2) following colposcopy and with histology results < CIN 2 (postcolposcopy), and (3) with cotest results 12 months after a < CIN 2 colposcopy (return cotest). After colposcopy showing < CIN 2 (n = 69,790; 87% of the women at colposcopy), the 1-year risk of CIN 3+ was 1.2%, compared with 6.3% at the time of colposcopy recommendation. Negative cotest results 1 year after colposcopy identified a large group (37.1%) of women whose risk of CIN 3+ (i.e., <0.2% at 3 years after postcolposcopy cotest) was comparable with women with normal cytology in the screening population. These risks are consistent with current guidelines recommending repeat cotesting 12 months after colposcopy < CIN 2 and a 3-year return for women with a negative postcolposcopy cotest. Most women are at low risk of subsequent CIN 3+ after a colposcopy showing < CIN 2, especially those who are human papillomavirus-negative postcolposcopy, consistent with current management guidelines for repeat testing intervals. Before the finalizing the upcoming guidelines, we will consider additional rounds of postcolposcopy cotesting.

  20. Comparison between visual and computerized cardiotocography in low risk pregnancy

    International Nuclear Information System (INIS)

    Mirghani, Hisham M.; Khair, Howaida

    2005-01-01

    To compare between visual and computerized cardiotocography (cCTG) in low-risk pregnant women in predicting pregnancy outcome. One hundred and fifty-three consecutive computerized fetal heart tracings were recorded from non-laboring pregnant women at >/- 30 weeks gestation. All traces were reviewed by 2 experienced obstetricians. The study was carried out at Al-Ain Medical District, United Arab Emirates, between August 2004 and December 2004. Of the 153 pregnant women, 11 (7.2%) were delivered by cesarean section. The interobserver agreement was 0.60. The observers cCTG agreement were 0.48 and 0.45. The difference in cesarean section rate was not statistically significant. Observers interpretation and cCTG did not correlate well with Apgar score at 5 minutes and admission to special care baby unit. Computerized CTG has little advantage over conventional CTG in the prediction of Apgar score and need for neonatal intensive care unit admission in a low-risk population. (author)

  1. Binge Drinking

    Medline Plus

    Full Text Available ... Please Parents Want To Do What′s Best The Obesity Epidemic Outbreaks CDC: Protecting Americans through Global Health ... captioning. Videos are prepared for different audiences including, children, parents, and public health professionals. More > Binge Drinking ( ...

  2. Binge Drinking

    Science.gov (United States)

    ... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & ... period of uncontrolled overeating). Today the generally accepted definition of binge drinking in the United States is ...

  3. Binge Drinking

    Medline Plus

    Full Text Available ... Break the Silence: Stop the Violence Injury Prevention Research In the Swim of Things Safe Teen Drivers ... Binge Drinking A Time To Act Injury Prevention Research In the Swim of Things Safe Teen Drivers ...

  4. Underage Drinking

    Science.gov (United States)

    ... Organization Budget History NIH Almanac Public Involvement Outreach & Education Visitor Information RePORT ... Since Colonial times, drinking alcohol has been part of American culture and its use by young people has been accepted by many as part ...

  5. Binge Drinking

    Centers for Disease Control (CDC) Podcasts

    2010-10-05

    This podcast is based on the October, 2010 CDC Vital Signs report which indicates that drinking too much, including binge drinking, causes more than 79,000 deaths in the U.S. each year and is the third leading preventable cause of death.  Created: 10/5/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 10/5/2010.

  6. Drinking water quality assessment.

    Science.gov (United States)

    Aryal, J; Gautam, B; Sapkota, N

    2012-09-01

    Drinking water quality is the great public health concern because it is a major risk factor for high incidence of diarrheal diseases in Nepal. In the recent years, the prevalence rate of diarrhoea has been found the highest in Myagdi district. This study was carried out to assess the quality of drinking water from different natural sources, reservoirs and collection taps at Arthunge VDC of Myagdi district. A cross-sectional study was carried out using random sampling method in Arthunge VDC of Myagdi district from January to June,2010. 84 water samples representing natural sources, reservoirs and collection taps from the study area were collected. The physico-chemical and microbiological analysis was performed following standards technique set by APHA 1998 and statistical analysis was carried out using SPSS 11.5. The result was also compared with national and WHO guidelines. Out of 84 water samples (from natural source, reservoirs and tap water) analyzed, drinking water quality parameters (except arsenic and total coliform) of all water samples was found to be within the WHO standards and national standards.15.48% of water samples showed pH (13) higher than the WHO permissible guideline values. Similarly, 85.71% of water samples showed higher Arsenic value (72) than WHO value. Further, the statistical analysis showed no significant difference (Pwater for collection taps water samples of winter (January, 2010) and summer (June, 2010). The microbiological examination of water samples revealed the presence of total coliform in 86.90% of water samples. The results obtained from physico-chemical analysis of water samples were within national standard and WHO standards except arsenic. The study also found the coliform contamination to be the key problem with drinking water.

  7. Low-risk diet for colorectal cancer in Italy.

    Science.gov (United States)

    Calza, S; Ferraroni, M; La Vecchia, C; Franceschi, S; Decarli, A

    2001-12-01

    An innovative approach was used to define a low-risk diet for colorectal cancer from a multicentric case-control study of 1953 incident cases and 4154 hospital controls from Italy. A logistic regression model was fitted on the reported intake of five macronutrients, and the estimated coefficients were used to compute a diet-related logistic risk score (LRS). The mean of LRS within risk decile ranged from 0.89 to 1.86. Total energy intake and absolute consumption of each macronutrient increased with increasing LRS. In relative terms, however, starch intake showed an almost threefold increase across subsequent score levels, while a decline was observed for unsaturated fat, sugar and protein. Saturated fat consumption remained fairly stable in relative terms. When food groups were considered, bread and cereals dishes, cakes and desserts and refined sugar were positively associated, while the consumption of vegetables, fruit, fish, poultry and olive oils was inversely associated with LRS.

  8. Older adults' alcohol consumption and late-life drinking problems: a 20-year perspective.

    Science.gov (United States)

    Moos, Rudolf H; Schutte, Kathleen K; Brennan, Penny L; Moos, Bernice S

    2009-08-01

    The aim of this study was to identify changes in patterns of alcohol consumption over a 20-year interval among older women and men, and to examine the associations between guideline-defined excessive drinking and late-life drinking problems. DESIGN, PARTICIPANTS AND MEASURES: A community sample of 719 adults between 55 and 65 years of age who consumed alcohol at or prior to baseline participated in a survey of alcohol consumption and drinking problems and was followed 10 years and 20 years later. The likelihood of excessive drinking declined over the 20-year interval as adults matured into their 70s and 80s. However, at ages 75-85, 27.1% of women and 48.6% of men consumed more than two drinks per day or seven drinks per week. At comparable guideline levels of alcohol consumption, older men were more likely to have drinking problems than were older women. Consumption of more than two drinks per day or seven drinks per week was identified as a potential conservative guideline for identifying excessive drinking associated with an elevated likelihood of drinking problems. A substantial percentage of older adults who consume alcohol engage in guideline-defined excessive drinking and incur drinking problems. The finding that older men may be more likely than older women to experience problems when they drink beyond guideline levels suggests that alcohol guidelines for men should not be set higher than those for women.

  9. Older Adults’ Alcohol Consumption and Late-Life Drinking Problems: A 20-Year Perspective

    Science.gov (United States)

    Moos, Rudolf H.; Schutte, Kathleen K.; Brennan, Penny L.; Moos, Bernice S.

    2009-01-01

    Aims The aim was to identify changes in patterns of alcohol consumption over a 20-year interval among older women and men, and to examine the associations between guideline-defined excessive drinking and late-life drinking problems. Design, Participants, and Measures A community sample of 719 adults between 55 and 65 years of age who consumed alcohol at or prior to baseline participated in a survey of alcohol consumption and drinking problems and was followed 10 years and 20 years later. Findings The likelihood of excessive drinking declined over the 20-year interval as adults matured into their 70s and 80s. However, at ages 75–85, 27% of women and 49% of men consumed more than 2 drinks per day or 7 drinks per week. At comparable guideline levels of alcohol consumption, older men were more likely to have drinking problems than were older women. Consumption of more than 2 drinks per day or 7 drinks per week was identified as a potential conservative guideline for identifying excessive drinking associated with an elevated likelihood of drinking problems. Conclusions A substantial percentage of older adults who consume alcohol engage in guideline-defined excessive drinking and incur drinking problems. The finding that older men may be more likely than older women to experience problems when they drink beyond guideline levels suggests that alcohol guidelines for men should not be set higher than those for women. PMID:19438836

  10. Are energy Drinks Scapegoats? Decomposing Teenagers' Caffeine intake from Energy Drinks and Soda Beverages.

    Science.gov (United States)

    Turel, Ofir

    2018-02-22

    Energy drinks have been repeatedly blamed for contributing to caffeine intake among teenagers. This study aimed to estimate and compare the caffeine intake of US teenagers from soda drinks versus energy drinks and shots. Data were taken from a 2015 nationally representative survey (Monitoring the Future) of 8th and 10th graders in the US (47.2% 8th grade; 51.1% female). Participants reported their numbers of consumed sodas, diet sodas, energy drinks, and energy shots per day. These were converted into mg caffeine/day and were contrasted with common guidelines for healthy caffeine intake, stratified by age group and sex. Error-bar charts, ANOVA and ROC curves were used for contrasting caffeine intake from soda drinks and energy drinks, as well as their contribution to exceeding recommended caffeine intake cutoffs. First, in both sexes and grades the intake from soda drinks was significantly higher than the intake from energy drinks. The soda and energy drink intake for males was higher than the intake for females; intake for 8th graders was higher than this of 10th graders. Second, caffeine intake from soda drinks was significantly higher even in those who exceeded the recommended maximum caffeine intake. Third, caffeine intakes from soda and energy drinks were efficacious in explaining the exceeding of the recommended threshold for daily caffeine intake, but the explanatory power of soda drinks was larger. From a caffeine consumption standpoint, health professionals should emphasize reduction in both soda and energy drinks.

  11. 38 CFR 41.530 - Criteria for a low-risk auditee.

    Science.gov (United States)

    2010-07-01

    ... low-risk auditee and be eligible for reduced audit coverage in accordance with § 41.520: (a) Single... entity that has biennial audits does not qualify as a low-risk auditee, unless agreed to in advance by... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Criteria for a low-risk...

  12. Heavy metal pollution in drinking water - a global risk for the human ...

    African Journals Online (AJOL)

    Fabian Fernandez

    parts of the world heavy metal (HM) concentrations in drinking water are higher than some international guideline values. ..... become the basis for several drinking water treatment approaches ...... physiological and hygienic needs. Monitoring ...

  13. Low-risk diet for breast cancer in Italy.

    Science.gov (United States)

    Franceschi, S; La Vecchia, C; Russo, A; Negri, E; Favero, A; Decarli, A

    1997-11-01

    To define a low-risk diet for breast cancer in Italy, a multicentric case-control study of 2569 incident cases of breast cancer and 2588 controls from Italy was analyzed. A logistic regression model was applied to the estimated intake of five macronutrients and used to compute a diet-related risk score (RS). The pattern of macronutrient and food group intake across RS deciles was defined. The mean of diet-related RSs across subsequent risk deciles ranged from 0.83 to 1.44. Total energy intake first decreased slightly, from the first to the second decile, and then increased, mostly in the last three risk deciles. Intake of starch increased in absolute and relative terms, whereas saturated fat intake rose in absolute terms but remained stable as a proportion. A relative decline was observed for unsaturated fat and sugars, with a hint, however, of U-shape effect. From a food group viewpoint, there was a marked increase in the intake of bread and cereal dishes, cakes and desserts, and refined sugar across subsequent deciles, whereas the consumption of vegetables, olive and seed oils, and fruit decreased.

  14. Binge Drinking

    Centers for Disease Control (CDC) Podcasts

    2010-04-13

    This podcast explores the health risks of binge drinking and discusses effective community strategies to prevent it.  Created: 4/13/2010 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/13/2010.

  15. Radon in private drinking water wells

    International Nuclear Information System (INIS)

    Otahal, P.; Merta, J.; Burian, I.

    2014-01-01

    At least 10 % of inhabitants in the Czech Republic are supplied with water from private sources (private wells, boreholes). With the increasing cost of water, the number of people using their own sources of drinking water will be likely to increase. According to the Decree of the State Office for Nuclear Safety about the Radiation Protection 307/2002 as amended by Decree 499/2005, the guideline limit for the supplied drinking water ('drinking water for public supply') for radon concentration is 50 Bq.l -1 . This guideline does not apply to private sources of drinking water. Radon in water influences human health by ingestion and also by inhalation when radon is released from water during showering and cooking. This paper presents results of measurements of radon concentrations in water from private wells in more than 300 cases. The gross concentration of alpha-emitting radionuclides and the concentrations of radium and uranium were also determined. (authors)

  16. Quality Guidelines

    Science.gov (United States)

    ... this page: https://medlineplus.gov/criteria.html MedlinePlus Quality Guidelines To use the sharing features on this ... materials must also meet our existing quality guidelines. Quality, authority and accuracy of health content The organization's ...

  17. Oxytocin and dystocia as risk factors for adverse birth outcomes: a cohort of low-risk nulliparous women.

    Science.gov (United States)

    Bernitz, Stine; Øian, Pål; Rolland, Rune; Sandvik, Leiv; Blix, Ellen

    2014-03-01

    augmented and not augmented women without dystocia were compared to investigate associations between oxytocin and adverse birth outcomes. Augmented women with and without dystocia were compared, to investigate associations between dystocia and adverse birth outcomes. a cohort of low-risk nulliparous women originally included in a randomised controlled trial. the Department of Obstetrics and Gynaecology, Østfold Hospital Trust, Norway. the study population consists of 747 well defined low-risk women. incidence of oxytocin augmentation, and associations between dystocia and augmentation, and mode of delivery, transfer of newborns to the intensive care unit, episiotomy and postpartum haemorrhage. of all participants 327 (43.8%) were augmented with oxytocin of which 139 (42.5%) did not fulfil the criteria for dystocia. Analyses adjusted for possible confounders found that women without dystocia had an increased risk of instrumental vaginal birth (OR 3.73, CI 1.93-7.21) and episiotomy (OR 2.47, CI 1.38-4.39) if augmented with oxytocin. Augmented women had longer active phase if vaginally delivered and longer labours if delivered by caesarean section if having dystocia. Among women without dystocia, those augmented had higher body mass index, gave birth to heavier babies, had longer labours if vaginally delivered and had epidural analgesia more often compared to women not augmented. in low-risk nulliparous without dystocia, we found an association between the use of oxytocin and an increased risk of instrumental vaginal birth and episiotomy. careful attention should be paid to criteria for labour progression and guidelines for oxytocin augmentation to avoid unnecessary use. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Home birth or short-stay hospital birth in a low risk population in The Netherlands.

    NARCIS (Netherlands)

    Wiegers, T.A.; Zee, J. van der; Kerssens, J.J.; Keirse, M.J.N.C.

    1998-01-01

    In the Netherlands women with low risk pregnancies can choose whether they want to give birth at home or in hospital, under the care of their own primary caregiver. The majority of these women prefer to give birth at home, but over the last few decades an increasing number of low risk women have

  19. Alcohol Energy Drinks

    Science.gov (United States)

    ... Home / About Addiction / Alcohol / Alcohol Energy Drinks Alcohol Energy Drinks Read 33960 times font size decrease font size increase font size Print Email Alcohol energy drinks (AEDs) or Caffeinated alcoholic beverages (CABs) are ...

  20. Benefit of early discharge among patients with low-risk pulmonary embolism.

    Directory of Open Access Journals (Sweden)

    Li Wang

    Full Text Available Clinical guidelines recommend early discharge of patients with low-risk pulmonary embolism (LRPE. This study measured the overall impact of early discharge of LRPE patients on clinical outcomes and costs in the Veterans Health Administration population. Adult patients with ≥1 inpatient diagnosis for pulmonary embolism (PE (index date between 10/2011-06/2015, continuous enrollment for ≥12 months pre- and 3 months post-index date were included. PE risk stratification was performed using the simplified Pulmonary Embolism Stratification Index. Propensity score matching (PSM was used to compare 90-day adverse PE events (APEs [recurrent venous thromboembolism, major bleed and death], hospital-acquired complications (HACs, healthcare utilization, and costs among short (≤2 days versus long length of stay (LOS. Net clinical benefit was defined as 1 minus the combined rate of APE and HAC. Among 6,746 PE patients, 95.4% were men, 22.0% were African American, and 1,918 had LRPE. Among LRPE patients, only 688 had a short LOS. After 1:1 PSM, there were no differences in APE, but short LOS had fewer HAC (1.5% vs 13.3%, 95% CI: 3.77-19.94 and bacterial pneumonias (5.9% vs 11.7%, 95% CI: 1.24-3.23, resulting in better net clinical benefit (86.9% vs 78.3%, 95% CI: 0.84-0.96. Among long LOS patients, HACs (52 exceeded APEs (14 recurrent DVT, 5 bleeds. Short LOS incurred lower inpatient ($2,164 vs $5,100, 95% CI: $646.8-$5225.0 and total costs ($9,056 vs $12,544, 95% CI: $636.6-$6337.7. LRPE patients with short LOS had better net clinical outcomes at lower costs than matched LRPE patients with long LOS.

  1. Health risk assessment for exposure to nitrate in drinking water from village wells in Semarang, Indonesia.

    Science.gov (United States)

    Sadler, Ross; Maetam, Brooke; Edokpolo, Benjamin; Connell, Des; Yu, Jimmy; Stewart, Donald; Park, M-J; Gray, Darren; Laksono, Budi

    2016-09-01

    The levels of nitrate in 52 drinking water wells in rural Central Java, Indonesia were evaluated in April 2014, and the results were used for a health risk assessment for the local populations by using probabilistic techniques. The concentrations of nitrate in drinking water had a range of 0.01-84 mg/L, a mean of 20 mg/L and a medium of 14 mg/L. Only two of the 52 samples exceeded the WHO guideline values of 50 mg/L for infant methaemoglobinaemia. The hazard quotient values as evaluated against the WHO guideline value at the 50 and 95 percentile points were HQ50 at 0.42 and HQ95 at 1.2, respectively. These indicated a low risk of infant methaemoglobinaemia for the whole population, but some risk for the sensitive portion of the population. The HQ50 and HQ95 values based on WHO acceptable daily intake dose for adult male and female were 0.35 and 1.0, respectively, indicating a generally a low level of risk. A risk characterisation linking birth defects to nitrate levels in water consumed during the first three months of pregnancy resulted in a HQ50/50 values of 1.5 and a HQ95/5 value of 65. These HQ values indicated an elevated risk for birth defects, in particular for the more sensitive population. A sanitation improvement program in the study area had a positive effect in reducing nitrate levels in wells and the corresponding risk for public health. For example, the birth defect HQ50/50 values for a subset of wells surveyed in both 2014 and 2015 was reduced from 1.1 to 0.71. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Types of drinkers and drinking settings: an application of a mathematical model.

    Science.gov (United States)

    Mubayi, Anuj; Greenwood, Priscilla; Wang, Xiaohong; Castillo-Chávez, Carlos; Gorman, Dennis M; Gruenewald, Paul; Saltz, Robert F

    2011-04-01

    US college drinking data and a simple population model of alcohol consumption are used to explore the impact of social and contextual parameters on the distribution of light, moderate and heavy drinkers. Light drinkers become moderate drinkers under social influence, moderate drinkers may change environments and become heavy drinkers. We estimate the drinking reproduction number, R(d) , the average number of individual transitions from light to moderate drinking that result from the introduction of a moderate drinker in a population of light drinkers. Ways of assessing and ranking progression of drinking risks and data-driven definitions of high- and low-risk drinking environments are introduced. Uncertainty and sensitivity analyses, via a novel statistical approach, are conducted to assess R(d) variability and to analyze the role of context on drinking dynamics. Our estimates show R(d) well above the critical value of 1. R(d) estimates correlate positively with the proportion of time spent by moderate drinkers in high-risk drinking environments. R(d) is most sensitive to variations in local social mixing contact rates within low-risk environments. The parameterized model with college data suggests that high residence times of moderate drinkers in low-risk environments maintain heavy drinking. With regard to alcohol consumption in US college students, drinking places, the connectivity (traffic) between drinking venues and the strength of socialization in local environments are important determinants in transitions between light, moderate and heavy drinking as well as in long-term prediction of the drinking dynamics. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

  3. Drinking Coffee

    DEFF Research Database (Denmark)

    Strøbæk, Pernille Solveig

    2015-01-01

    The chapter explores how coffee is an integral part of our daily life. Focusing on coffee drinking at home, at work, and on the go I show that coffee consumption is a social practice. The chapter illustrates through everyday examples that coffee is more than a caffeine drug. Coffee, with or without...... caffeine, is a social lubricant. We talk to each other and share emotions with one another as we share a cup of coffee. Coffee makes conversation and we embrace coffee, to stay or to go, in the daily rhythm of our busy and global social existence. The practice and sociality of coffee consumption provide...... the coffee industry with the opportunity to make money on our coffee preferences – indeed, also for those of us who actually dislike the taste of coffee. Would you prefer coffee mixed and stirred with non-coffee products such as salt, caramel and licorice? Then you are one of us in the modern age of coffee...

  4. Drinking Water - National Drinking Water Clearinghouse

    Science.gov (United States)

    Savings Septic Unsafe Disposable Wipe Woes FacebookLogo FOCUS AREAS Drinking Water Wastewater Training Security Conservation & Water Efficiency Water We Drink Source Water Protection SORA/COI EPA MOU CartIcon Links Listserv Educators Homeowners Operators Small Systems Drinking Water Read On Tap Latest

  5. Investigation of Drinking Water Quality in Kosovo

    Directory of Open Access Journals (Sweden)

    Fatlume Berisha

    2013-01-01

    Full Text Available In the recent years, not much environmental monitoring has been conducted in the territory of Kosovo. This study represents the first comprehensive monitoring of the drinking water situation throughout most of the territory of Kosovo. We present the distribution of major and minor trace elements in drinking water samples from Kosovo. During our study we collected 951 samples from four different sources: private-bored wells; naturally flowing artesian water; pumped-drilled wells; and public water sources (tap water. The randomly selected drinking water samples were investigated by routine water analyses using inductively coupled plasma mass spectrometry (ICPMS for 32 elements (Li, Be, B, Na, Mg, Al, K, Ca, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Ga, As, Rb, Sr, Mo, Ag, Cd, Sn, Sb, Te, Ba, Tl, Pb, Bi, Th, U. Even though there are set guidelines for elemental exposure in drinking water worldwide, in developing countries, such as Kosovo, the lack of monitoring drinking water continues to be an important health concern. This study reports the concentrations of major and minor elements in the drinking water in Kosovo. Additionally, we show the variation of the metal concentration within different sources. Of the 15 regulated elements, the following five elements: Mn, Fe, Al, Ni, As, and U were the elements which most often exceeded the guidelines set by the EU and/or WHO.

  6. Less-Restrictive Food Intake During Labor in Low-Risk Singleton Pregnancies: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Ciardulli, Andrea; Saccone, Gabriele; Anastasio, Hannah; Berghella, Vincenzo

    2017-03-01

    To evaluate benefits and harms of food intake during labor. Electronic databases such as MEDLINE and ClinicalTrials.gov were searched from their inception until October 2016. We included randomized trials comparing a policy of less-restrictive food intake with a policy of more restrictive food intake during labor. The primary outcome was the mean duration of labor. Meta-analysis was performed using the random-effects model of DerSimonian and Laird to produce summary treatment effects in terms of either a relative risk or a mean difference with 95% confidence interval (CI). Ten trials, including 3,982 laboring women, were included. All the studies involved laboring singletons considered at low risk because they had no obstetric or medical complications that would increase the likelihood of cesarean delivery. In three studies, women were allowed to select from a low-residue diet throughout the course of labor. One study had honey date syrup as the allowed food intake. Five studies had carbohydrate drinks as food intake in labor. The last one was the only trial that allowed unrestrictive food intake. In the included studies, all women in the intervention group were allowed the assigned food intake until delivery, whereas women in a control group were allowed only ice chips, water, or sips of water until delivery. A policy of less-restrictive food intake was associated with a significantly shorter duration of labor (mean difference -16 minutes, 95% CI -25 to -7). No other benefits or harms in obstetric or neonatal outcome were noticed. Regurgitation during general anesthesia and Mendelson syndrome did not occur in either group. Women with low-risk singleton pregnancies who were allowed to eat more freely during labor had a shorter duration of labor. A policy of less-restrictive food intake during labor did not influence other obstetric or neonatal outcomes nor did it increase the incidence of vomiting. Operative delivery rates were similar.

  7. Biological stability in drinking water distribution systems : A novel approach for systematic microbial water quality monitoring

    NARCIS (Netherlands)

    Prest, E.I.E.D.

    2015-01-01

    Challenges to achieve biological stability in drinking water distribution systems Drinking water is distributed from the treatment facility to consumers through extended man-made piping systems. The World Health Organization drinking water guidelines (2006) stated that “Water entering the

  8. Drinking Game Studies

    DEFF Research Database (Denmark)

    Debus, Michael S.

    2016-01-01

    The paper examines research on drinking game participation from a game studies ontological perspective, covering definition, classification and problems with the, in the studies implied, underlying ontology of drinking games.......The paper examines research on drinking game participation from a game studies ontological perspective, covering definition, classification and problems with the, in the studies implied, underlying ontology of drinking games....

  9. Summary guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Halsnaes, K.; Painuly, J.P.; Turkson, J.; Meyer, H.J.; Markandya, A.

    1999-09-01

    This document is a summary version of the methodological guidelines for climate change mitigation assessment developed as part of the Global Environment Facility (GEF) project Economics of Greenhouse Gas Limitations; Methodological Guidelines. The objectives of this project have been to develop a methodology, an implementing framework and a reporting system which countries can use in the construction of national climate change mitigation policies and in meeting their future reporting obligations under the FCCC. The methodological framework developed in the Methodological Guidelines covers key economic concepts, scenario building, modelling tools and common assumptions. It was used by several country studies included in the project. (au) 13 refs.

  10. Nonvisible tumors on multiparametric magnetic resonance imaging does not predict low-risk prostate cancer

    Directory of Open Access Journals (Sweden)

    Seung Hwan Lee

    2015-12-01

    Conclusions: Even though cancer foci were not visualized by postbiopsy MRI, the pathological tumor volumes and extent of GS upgrading were relatively high. Therefore, nonvisible tumors by multiparametric MRI do not appear to be predictive of low-risk PCA.

  11. Interconnection Guidelines

    Science.gov (United States)

    The Interconnection Guidelines provide general guidance on the steps involved with connecting biogas recovery systems to the utility electrical power grid. Interconnection best practices including time and cost estimates are discussed.

  12. Effluent Guidelines

    Science.gov (United States)

    Effluent guidelines are national standards for wastewater discharges to surface waters and municipal sewage treatment plants. We issue the regulations for industrial categories based on the performance of treatment and control technologies.

  13. Features of alcohol harm reduction advertisements that most motivate reduced drinking among adults: an advertisement response study.

    Science.gov (United States)

    Wakefield, Melanie A; Brennan, Emily; Dunstone, Kimberley; Durkin, Sarah J; Dixon, Helen G; Pettigrew, Simone; Slater, Michael D

    2017-04-20

    To improve the effectiveness of alcohol harm reduction mass media campaigns, this study aimed to (1) identify existing advertisements (ads) with greatest potential to motivate reduced alcohol consumption, (2) assess consistency across audience subgroups in ad effectiveness and (3) identify ad features associated with effectiveness. Cross-sectional online ad response study with random assignment to view ads. 2174 Australian adult weekly drinkers recruited from an online panel. Participants were randomly assigned to view three of 83 English-language alcohol harm reduction ads. Each ad was viewed and rated by a mean of 79 participants. After viewing each ad, participants reported the extent to which they felt motivated to reduce their drinking. Ads were ranked from most to least motivating using predicted means adjusted for demographic characteristics and alcohol consumption. We compared the characteristics of the top-ranked 15% of ads (most motivating) with the middle 70% and bottom 15%. An ad about the link between alcohol and cancer (' Spread ') was most motivating, whereas an ad that encouraged drinking water instead of beer (' Add nothing ') was least motivating. Top-ranked ads were more likely than other ads to feature a 'why change' message and less likely to carry a 'how to change' message; more likely to address long-term harms; more likely to be aimed at the general adult drinking population and more likely to include drinking guidelines. There was substantial overlap in top-ranked ads for younger versus older adults, men versus women and high-risk versus low-risk drinker subgroups. The effectiveness of alcohol harm reduction campaigns may be improved by directly communicating alcohol's long-term harms to the general adult population of drinkers along with drinking guidelines. By doing so, campaigns can also efficiently influence high-risk drinkers and key demographic subgroups. Published by the BMJ Publishing Group Limited. For permission to use (where not

  14. OSART guidelines

    International Nuclear Information System (INIS)

    1988-02-01

    The IAEA Operational Safety Review Team (OSART) programme provides advice and assistance to Member States to enhance the operational safety of nuclear power plants. These OSART Guidelines provide overall guidance for the experts to ensure the consistency and comprehensiveness of the operational safety review. Specific guidelines are provided as guide for the systematic review in the following areas important to operational safety: management, organization and administration, training and qualification, operations, maintenance, technical support, radiation protection, chemistry, emergency planning and preparedness

  15. New England's Drinking Water | Drinking Water in New ...

    Science.gov (United States)

    2017-07-06

    Information on Drinking Water in New England. Major Topics covered include: Conservation, Private Wells, Preventing Contamination, Drinking Water Sources, Consumer Confidence Reports, and Drinking Water Awards.

  16. Low-risk susceptibility alleles in 40 human breast cancer cell lines

    International Nuclear Information System (INIS)

    Riaz, Muhammad; Elstrodt, Fons; Hollestelle, Antoinette; Dehghan, Abbas; Klijn, Jan GM; Schutte, Mieke

    2009-01-01

    Low-risk breast cancer susceptibility alleles or SNPs confer only modest breast cancer risks ranging from just over 1.0 to1.3 fold. Yet, they are common among most populations and therefore are involved in the development of essentially all breast cancers. The mechanism by which the low-risk SNPs confer breast cancer risks is currently unclear. The breast cancer association consortium BCAC has hypothesized that the low-risk SNPs modulate expression levels of nearby located genes. Genotypes of five low-risk SNPs were determined for 40 human breast cancer cell lines, by direct sequencing of PCR-amplified genomic templates. We have analyzed expression of the four genes that are located nearby the low-risk SNPs, by using real-time RT-PCR and Human Exon microarrays. The SNP genotypes and additional phenotypic data on the breast cancer cell lines are presented. We did not detect any effect of the SNP genotypes on expression levels of the nearby-located genes MAP3K1, FGFR2, TNRC9 and LSP1. The SNP genotypes provide a base line for functional studies in a well-characterized cohort of 40 human breast cancer cell lines. Our expression analyses suggest that a putative disease mechanism through gene expression modulation is not operative in breast cancer cell lines

  17. Drinking or Not Drinking in Pregnancy

    DEFF Research Database (Denmark)

    Niclasen, Janni

    2014-01-01

    Studies investigating associations between prenatal exposure to low-moderate doses of alcohol and mental health development in childhood are inconsistent. The aim of the present study was to compare women who drink and who do not drink alcohol in pregnancy on a number of potential confounding...

  18. Healthy Drinks for Kids

    Science.gov (United States)

    ... drinks (not including 100% fruit juice). If soda habits start when kids are little, chances are they ... Alternative to Water? Energy Drinks and Food Bars: Power or Hype? A Guide to Eating for Sports ...

  19. Myths about drinking alcohol

    Science.gov (United States)

    ... Not Have a Problem Because I Only Drink Wine and Beer Problem drinking is not about what ... this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial ...

  20. Growth recovery lines are more common in infants at high vs. low risk for abuse

    International Nuclear Information System (INIS)

    Zapala, Matthew A.; Tsai, Andy; Kleinman, Paul K.

    2016-01-01

    Growth recovery lines, also known as growth arrest lines, are transverse radiodense metaphyseal bands that develop due to a temporary arrest of endochondral ossification caused by local or systemic insults. To determine if growth recovery lines are more common in infants at high risk versus low risk for abuse. Reports of American College of Radiology compliant skeletal surveys (1999-2013) were reviewed with clinical records. Infants at low risk for abuse had a skull fracture without significant intracranial injury, history of a fall and clinical determination of low risk (child protection team/social work assessment). Infants at high risk had significant intracranial injury, retinal hemorrhages, other skeletal injuries and clinical determination of high risk. There were 52 low-risk infants (mean: 4.7 months, range: 0.4-12 months) and 21 high-risk infants (mean: 4.2 months, range: 0.8-9.1 months). Two blinded radiologists independently evaluated the skeletal survey radiographs of the knees/lower legs for the presence of at least one growth recovery line. When growth recovery lines are scored as probably present or definitely present, their prevalence in the low-risk group was 38% (standard deviation [SD] = 8%; reader 1 = 17/52, reader 2 = 23/52) vs. 71% (SD = 7%; reader 1 = 16/21, reader 2 = 14/21) in the high-risk group (P < 0.001; odds ratio 4.0, 95% CI: 1.7-9.5). Growth recovery lines are encountered at a significantly higher rate in infants at high risk vs. low risk for abuse. This suggests that abused infants are prone to a temporary disturbance in endochondral ossification as a result of episodic physiological stresses. (orig.)

  1. Relationships Between Perceived Family Gambling and Peer Gambling and Adolescent Problem Gambling and Binge-Drinking.

    Science.gov (United States)

    Zhai, Zu Wei; Yip, Sarah W; Steinberg, Marvin A; Wampler, Jeremy; Hoff, Rani A; Krishnan-Sarin, Suchitra; Potenza, Marc N

    2017-12-01

    The study systematically examined the relative relationships between perceived family and peer gambling and adolescent at-risk/problem gambling and binge-drinking. It also determined the likelihood of at-risk/problem gambling and binge-drinking as a function of the number of different social groups with perceived gambling. A multi-site high-school survey assessed gambling, alcohol use, presence of perceived excessive peer gambling (peer excess-PE), and family gambling prompting concern (family concern-FC) in 2750 high-school students. Adolescents were separately stratified into: (1) low-risk, at-risk, and problem/pathological gambling groups; and, (2) non-binge-drinking, low-frequency-binge-drinking, and high-frequency-binge-drinking groups. Multinomial logistic regression showed that relative to each other, FC and PE were associated with greater likelihoods of at-risk and problem/pathological gambling. However, only FC was associated with binge-drinking. Logistic regression revealed that adolescents who endorsed either FC or PE alone, compared to no endorsement, were more likely to have at-risk and problem/pathological gambling, relative to low-risk gambling. Adolescents who endorsed both FC and PE, compared to PE alone, were more likely to have problem/pathological gambling relative to low-risk and at-risk gambling. Relative to non-binge-drinking adolescents, those who endorsed both FC and PE were more likely to have low- and high-frequency-binge-drinking compared to FC alone or PE alone, respectively. Family and peer gambling individually contribute to adolescent at-risk/problem gambling and binge-drinking. Strategies that target adolescents as well as their closely affiliated family and peer members may be an important step towards prevention of harm-associated levels of gambling and alcohol use in youths.

  2. Methodological guidelines

    International Nuclear Information System (INIS)

    Halsnaes, K.; Callaway, J.M.; Meyer, H.J.

    1999-01-01

    The guideline document establishes a general overview of the main components of climate change mitigation assessment. This includes an outline of key economic concepts, scenario structure, common assumptions, modelling tools and country study assumptions. The guidelines are supported by Handbook Reports that contain more detailed specifications of calculation standards, input assumptions and available tools. The major objectives of the project have been provided a methodology, an implementing framework and a reporting system which countries can follow in meeting their future reporting obligations under the FCCC and for GEF enabling activities. The project builds upon the methodology development and application in the UNEP National Abatement Coasting Studies (UNEP, 1994a). The various elements provide countries with a road map for conducting climate change mitigation studies and submitting national reports as required by the FCCC. (au) 121 refs

  3. Methodological guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Halsnaes, K.; Callaway, J.M.; Meyer, H.J.

    1999-04-01

    The guideline document establishes a general overview of the main components of climate change mitigation assessment. This includes an outline of key economic concepts, scenario structure, common assumptions, modelling tools and country study assumptions. The guidelines are supported by Handbook Reports that contain more detailed specifications of calculation standards, input assumptions and available tools. The major objectives of the project have been provided a methodology, an implementing framework and a reporting system which countries can follow in meeting their future reporting obligations under the FCCC and for GEF enabling activities. The project builds upon the methodology development and application in the UNEP National Abatement Coasting Studies (UNEP, 1994a). The various elements provide countries with a road map for conducting climate change mitigation studies and submitting national reports as required by the FCCC. (au) 121 refs.

  4. AIDS guidelines.

    Science.gov (United States)

    Berger, R

    1986-04-30

    The Sun article, "Employers finding that AIDS in the workplace is a managerial nightmare" (April 3), did not accurately portray the status of AIDS in the workplace. The AIDS virus, HTLV III, is transmitted by body fluids, primarily semen and blood, and there is no known risk of transmitting the virus by casual contact in the workplace. The Center for Disease Control (CDC) released guidelines for child care workers last August. Guidelines on preventing transmission of AIDS in the workplace were issued by CDC in November 1985. These guidelines specifically discussed health care, personal service, and food service workers. The recommendations were against routine screening. Furthermore, employment should not be restricted on the basis of a positive HTLV III antibody test. A person with HTLV III infection should be exempt from the workplace only if there are circumstances interfering with job performance. In Maryland, the Governor's Task Force on AIDS has gone on record as endorsing CDC guidelines related to employment. Furthermore, the task force condemns discrimination based on the disease AIDS, AIDS Related Complex (ARC), or HTLV III infection. Increasingly AIDS patients are being considered legally disabled and therefore are protected by federal and state laws prohibiting discrimination on the basis of a handicap. Marylanders who are subjected to mandatory HTLV III screening in the workplace, or if discriminated against on the basis of HTLV III inefction, should contact the Maryland Commission on Human Relations, the Maryland Department of Health and Mental Hygiene, or the Health Education Resource Organization (HERO). All 3 of these resources guarantee confidentiality. It is only by employees reporting incidents that a nightmare in the workplace can be avoided in Maryland. full text

  5. GRADE guidelines

    DEFF Research Database (Denmark)

    Guyatt, Gordon H; Thorlund, Kristian; Oxman, Andrew D

    2013-01-01

    Presenting continuous outcomes in Summary of Findings tables presents particular challenges to interpretation. When each study uses the same outcome measure, and the units of that measure are intuitively interpretable (e.g., duration of hospitalization, duration of symptoms), presenting differences...... and absolute effects, presenting the ratio of the means of intervention and control groups, and presenting the results in minimally important difference units. We outline the merits and limitations of each alternative and provide guidance for meta-analysts and guideline developers....

  6. ASCOT guidelines

    International Nuclear Information System (INIS)

    1994-05-01

    These guidelines describe an approach used in conducting an Assessment of Safety Culture in Organizations Team (ASCOT) review. They are intended to assist the team members in conducting their reviews and at the same time provide guidance to hosts preparing to receive an ASCOT review. They may also be used by any organization wishing to conduct their own self-assessment of safety culture, independent of an ASCOT review

  7. Revised dietary guidelines for Koreans.

    Science.gov (United States)

    Jang, Young Ai; Lee, Haeng Shin; Kim, Bok Hee; Lee, Yoonna; Lee, Hae Jeung; Moon, Jae Jin; Kim, Cho-il

    2008-01-01

    With rapidly changing dietary environment, dietary guidelines for Koreans were revised and relevant action guides were developed. First, the Dietary Guidelines Advisory Committee was established with experts and government officials from the fields of nutrition, preventive medicine, health promotion, agriculture, education and environment. The Committee set dietary goals for Koreans aiming for a better nutrition state of all after a thorough review and analysis of recent information related to nutritional status and/or problems of Korean population, changes in food production/supply, disease pattern, health policy and agricultural policy. Then, the revised dietary guidelines were proposed to accomplish these goals in addition to 6 different sets of dietary action guides to accommodate specific nutrition and health problems of respective age groups. Subsequently, these guidelines and guides were subjected to the focus group review, consumer perception surveys, and a public hearing for general and professional comments. Lastly, the language was clarified in terms of public understanding and phraseology. The revised Dietary guidelines for Koreans are as follows: eat a variety of grains, vegetables, fruits, fish, meat, poultry and dairy products; choose salt-preserved foods less, and use less salt when you prepare foods; increase physical activity for a healthy weight, and balance what you eat with your activity; enjoy every meal, and do not skip breakfast; if you drink alcoholic beverages, do so in moderation; prepare foods properly, and order sensible amounts; enjoy our rice-based diet.

  8. Determinants of prenatal health care utilisation by low-risk women : A prospective cohort study

    NARCIS (Netherlands)

    Feijen-de Jong, Esther I.; Jansen, Danielle E. M. C.; Baarveld, Frank; Boerleider, Agatha W.; Spelten, Evelien; Schellevis, Francois; Reijneveld, Sijmen A.

    Background: Prenatal health care is pivotal in providing adequate prevention and care to pregnant women. Aim: We examined the determinants of inadequate prenatal health care utilisation by low-risk women in primary midwifery-led care in the Netherlands. Methods: We used longitudinal data from the

  9. Determinants of prenatal health care utilisation by low-risk women: a prospective cohort study.

    NARCIS (Netherlands)

    Feijen-de Jong, E.I.; Jansen, D.E.M.C.; Baarveld, F.; Boerleider, A.W.; Spelten, E.; Schellevis, F.; Reijneveld, S.A.

    2015-01-01

    Background: Prenatal health care is pivotal in providing adequate prevention and care to pregnant women. Aim: We examined the determinants of inadequate prenatal health care utilisation by low-risk women in primary midwifery-led care in the Netherlands. Methods: We used longitudinal data from the

  10. Determinants of prenatal health care utilisation by low-risk women: A prospective cohort study

    NARCIS (Netherlands)

    Feijen-de Jong, E.I.; Jansen, D.E.M.C.; Baarveld, F.; Boerleider, A.W.; Spelten, E.; Schellevis, F.; Reijneveld, S.A.

    2015-01-01

    Background: Prenatal health care is pivotal in providing adequate prevention and care to pregnant women. Aim: We examined the determinants of inadequate prenatal health care utilisation by low-risk women in primary midwifery-led care in the Netherlands. Methods: We used longitudinal data from the

  11. 29 CFR 99.530 - Criteria for a low-risk auditee.

    Science.gov (United States)

    2010-07-01

    ... management of Federal awards and provide a waiver. (c) There were no deficiencies in internal control which... periods) in which they were classified as Type A programs: (1) Internal control deficiencies which were... 29 Labor 1 2010-07-01 2010-07-01 true Criteria for a low-risk auditee. 99.530 Section 99.530 Labor...

  12. 7 CFR 3052.530 - Criteria for a low-risk auditee.

    Science.gov (United States)

    2010-01-01

    ... management of Federal awards and provide a waiver. (c) There were no deficiencies in internal control which... periods) in which they were classified as Type A programs: (1) Internal control deficiencies which were... 7 Agriculture 15 2010-01-01 2010-01-01 false Criteria for a low-risk auditee. 3052.530 Section...

  13. 76 FR 16234 - Prompt Corrective Action; Amended Definition of Low-Risk Assets

    Science.gov (United States)

    2011-03-23

    ...; Amended Definition of Low-Risk Assets AGENCY: National Credit Union Administration (NCUA). ACTION: Final... to reflect the absence of credit risk. Having considered the public comments addressing the Interim...), (f) and (g); 12 CFR 702.204(a)-(b). For a credit union that is subject to an additional Risk-Based...

  14. 75 FR 66298 - Prompt Corrective Action; Amended Definition of Low-Risk Assets

    Science.gov (United States)

    2010-10-28

    ...; Amended Definition of Low-Risk Assets AGENCY: National Credit Union Administration (NCUA). ACTION: Interim...-weighting of zero, reflecting the absence of credit risk. The amendment will expand the definition of ``low... exists today, the NGNs held by a natural person credit union would fall within the ``investments'' risk...

  15. Peripheral arterial tonometry cannot detect patients at low risk of coronary artery disease

    NARCIS (Netherlands)

    M.M. van den Heuvel (Mieke); O. Sorop (Oana); P. Musters (Paul); R.T. van Domburg (Ron); T.W. Galema (Tjebbe); D.J.G.M. Duncker (Dirk); W.J. van der Giessen (Wim); K. Nieman (Koen)

    2015-01-01

    textabstractBackground Endothelial dysfunction precedes coronary artery disease (CAD) and can be measured by peripheral arterial tonometry (PAT). We examined the applicability of PAT to detect a low risk of CAD in a chest pain clinic. Methods In 93 patients, PAT was performed resulting in reactive

  16. High- and Low-Risk Characteristics of Youth: The Five Cs of Competency.

    Science.gov (United States)

    McWhirter, J. Jeffries; And Others

    1994-01-01

    Identifies and discusses five basic skill strengths or skill deficits that mark critical difference between low-risk and high-risk youth. The "Five Cs of Competency" described include critical school competencies, concept of self and self-esteem, communication skills, coping ability, and control. Contends that these characteristics discriminate…

  17. Biomarkers and low risk in heart failure. Data from COACH and TRIUMPH

    NARCIS (Netherlands)

    Meijers, Wouter C.; de Boer, Rudolf A.; van Veldhuisen, Dirk J.; Jaarsma, Tiny; Hillege, Hans L.; Maisel, Alan S.; Di Somma, Salvatore; Voors, Adriaan A.; Peacock, W. Frank

    2015-01-01

    AimTraditionally, risk stratification in heart failure (HF) emphasizes assessment of high risk. We aimed to determine if biomarkers could identify patients with HF at low risk for death or HF rehospitalization. Methods and resultsThis analysis was a substudy of The Coordinating Study Evaluating

  18. Active surveillance can reduce overtreatment in patients with low-risk prostate cancer

    DEFF Research Database (Denmark)

    Thomsen, Frederik Birkebæk; Røder, Martin Andreas; Hvarness, Helle

    2013-01-01

    The incidence of prostate cancer in Denmark rose approximately 50% from 2000 to 2009 in parallel with the introduction of prostate-specific antigen (PSA)-testing. Available evidence indicates a significant overtreatment of patients with low-risk prostate cancer. Active surveillance has been...

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

    NARCIS (Netherlands)

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

    2018-01-01

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

  20. Bad experience, good birthing: Dutch low-risk pregnant women with a history of sexual abuse

    NARCIS (Netherlands)

    van der Hulst, Leonie A. M.; Bonsel, Gouke J.; Eskes, Martine; Birnie, Erwin; van Teijlingen, Edwin; Bleker, Otto P.

    2006-01-01

    OBJECTIVE: The long-term effects on women in childbirth with a history of sexual abuse have only been studied to a limited degree. We estimated the prevalence of lifetime experience among low-risk pregnant women (non-clinical) in The Netherlands as well as the association with (1) psycho-social

  1. Mother-Child Interactional Patterns in High- and Low-Risk Mothers.

    Science.gov (United States)

    Dolz, Laura; Cerezo, M. Angeles; Milner, Joel S.

    1997-01-01

    A study of 10 high-risk (of child physical abuse) and 10 demographically similar low-risk Spanish mother-child dyads investigated interactional patterns in the home. High-risk mothers made fewer neutral approaches to their children, displayed more negative behaviors toward their children, and made more indiscriminate responses to their children's…

  2. Risk factors that predicted problem drinking in Danish men at age thirty

    DEFF Research Database (Denmark)

    Knop, Joachim; Penick, Elizabeth C; Jensen, Per

    2003-01-01

    records and a series of structured interviews and psychometric tests at ages 19-20 and 30 years. The present analysis focuses on the degree to which premorbid differences between the high- and low-risk groups later predicted lifetime drinking problems at age 30 (n = 241). RESULTS: As expected lifetime...... alcohol abuse/dependence by age 30 was reported significantly more often in the high-risk group. Of the 394 premorbid variables tested, 68 were found to distinguish the high- from the low-risk group before any subjects had developed a drinking problem. Of these 68 variables, 28 (41%) were also associated...... with DSM-III-R alcohol abuse/dependence at age 30. These 28 putative markers were reduced to 12 that were entered into a multiple regression analysis to search for the most powerful unique predictors of alcoholism. Four of the 28 putative markers were independently associated with problem drinking at age...

  3. Dietary guidelines

    DEFF Research Database (Denmark)

    Jelsøe, Erling

    2015-01-01

    to food and eating and the emergence of proposals for integrated guidelines. It explores the conflicts and controversies that have arisen in the wake of the various proposals and identifies a number of different types of conflicts. These relate to conflicts of interests between the various actors involved...... and political resistance against initiatives that are perceived as being in conflict with the values of a market economy and free trade. Furthermore, there are controversies that can be broadly characterised as relating to the politics of knowledge and have to do with the differentiation of expertise...

  4. Cost-effective treatment of low-risk carcinoma not invading bladder muscle.

    Science.gov (United States)

    Green, David A; Rink, Michael; Cha, Eugene K; Xylinas, Evanguelos; Chughtai, Bilal; Scherr, Douglas S; Shariat, Shahrokh F; Lee, Richard K

    2013-03-01

    Study Type - Therapy (cost effectiveness analysis) Level of Evidence 2a What's known on the subject? and What does the study add? Bladder cancer is one of the costliest malignancies to treat throughout the life of a patient. The most cost-effective management for low-risk non-muscle-invasive bladder cancer is not known. The current study shows that employing cystoscopic office fulguration for low-risk appearing bladder cancer recurrences can materially impact the cost-effectiveness of therapy. In a follow-up protocol where office fulguration is routinely employed for low-risk bladder cancers, peri-operative intravesical chemotherapy may not provide any additional cost-effectiveness benefit. To examine the cost-effectiveness of fulguration vs transurethral resection of bladder tumour (TURBT) with and without perioperative intravesical chemotherapy (PIC) for managing low-risk carcinoma not invading bladder muscle (NMIBC). Low-risk NMIBC carries a low progression rate, lending support to the use of office-based fulguration for small recurrences rather than traditional TURBT. A Markov state transition model was created to simulate treatment of NMIBC with vs without PIC, with recurrence treated by formal TURBT vs treatment with fulguration. Costing data were obtained from the Medicare Resource Based Relative Value Scale. Data regarding the success of PIC were obtained from the peer-reviewed literature, as were corresponding utilities for bladder cancer-related procedures. Sensitivity analyses were performed. At 5-year follow-up, a strategy of fulguration without PIC was the most cost-effective (mean cost-effectiveness = US $654.8/quality-adjusted life year), despite a lower recurrence rate with PIC. Both fulguration strategies dominated each TURBT strategy. Sensitivity analysis showed that fulguration without PIC dominated all other strategies when the recurrence rate after PIC was increased to ≥14.2% per year. Similarly, the cost-effectiveness of TURBT becomes more

  5. Characteristics of high- and low-risk individuals in the PRIORITY study

    DEFF Research Database (Denmark)

    Tofte, N; Lindhardt, M; Adamova, K

    2018-01-01

    variable. In a logistic regression model including clinical variables known to be associated with diabetic kidney disease, estimated GFR, gender, log urinary albumin:creatinine ratio and use of renin-angiotensin system-blocking agents remained significant determinants of the CKD273 high-risk group: area......AIM: To compare clinical baseline data in individuals with Type 2 diabetes and normoalbuminuria, who are at high or low risk of diabetic kidney disease based on the urinary proteomics classifier CKD273. METHODS: We conducted a prospective, randomized, double-blind, placebo-controlled international...... multicentre clinical trial and observational study in participants with Type 2 diabetes and normoalbuminuria, stratified into high- or low-risk groups based on CKD273 score. Clinical baseline data for the whole cohort and stratified by risk groups are reported. The associations between CKD273 and traditional...

  6. Predictive value of late decelerations for fetal acidemia in unselective low-risk pregnancies.

    Science.gov (United States)

    Sameshima, Hiroshi; Ikenoue, Tsuyomu

    2005-01-01

    We evaluated the clinical significance of late decelerations (LD) of intrapartum fetal heart rate (FHR) monitoring to detect low pH (LD (occasional, 50%; recurrent, > or = 50%) and severity (reduced baseline FHR accelerations and variability) of LD, and low pH (test, and one-way analysis of variance with the Bonferroni/Dunn test. In the 5522 low-risk pregnancies, 301 showed occasional LD and 99 showed recurrent LD. Blood gases and pH values deteriorated as the incidence of LD increased and as baseline accelerations or variability was decreased. Positive predictive value for low pH (LD, and > 50% in recurrent LD with no baseline FHR accelerations and reduced variability. In low-risk pregnancies, information on LD combined with acceleration and baseline variability enables us to predict the potential incidence of fetal acidemia.

  7. Willingness to pay for a cure of low-risk melanoma patients in Germany.

    Science.gov (United States)

    Augustin, Matthias; Blome, Christine; Forschner, Andrea; Gutzmer, Ralf; Hauschild, Axel; Heinzerling, Lucie; Livingstone, Elisabeth; Loquai, Carmen; Schadendorf, Dirk; Utikal, Jochen; Wagner, Tobias; Wilden, Sophia; Kähler, Katharina C

    2018-01-01

    Malignant melanoma is potentially life-threatening but in most cases curable if detected early. Willingness to pay (WTP) is a preference-based construct that reflects burden of disease by assessment of the monetary value for a hypothetical cure from disease. Since WTP (directly as total amount of money) has not been assessed so far in patients with low risk melanoma, it was interesting to gain insights in this patient population and then, in a second step, compare it directly with the WTP of their treating dermato-oncologists. WTP was assessed in 125 patients with low-risk melanoma and additionally in 105 treating physicians, asking for the one-time and continuous payments they would be willing to make for a sustainable cure, both as absolute sums and as percentages of monthly income. The median WTP based on one-time payment was €10,000 for patients and €100,000 for physicians; relative numbers were 100% versus 300% of monthly income. For continuous monthly payments, WTP was €500 for patients and €1000 for physicians, relative numbers 25% and 50% of income, respectively. Even after controlling for income differences, there was a significantly higher WTP in physicians for all four questions. Compared to patients with chronic skin diseases such as vitiligo, rosacea, atopic eczema and psoriasis, patients with low-risk melanoma showed a significantly higher WTP. Our data suggest that there is a relevant burden of disease even in patients with low-risk tumors. Higher WTP of physicians underlines the prevalence of differences in disease perception.

  8. Allergy Testing in Children With Low-Risk Penicillin Allergy Symptoms.

    Science.gov (United States)

    Vyles, David; Adams, Juan; Chiu, Asriani; Simpson, Pippa; Nimmer, Mark; Brousseau, David C

    2017-08-01

    Penicillin allergy is commonly reported in the pediatric emergency department (ED). True penicillin allergy is rare, yet the diagnosis results from the denial of first-line antibiotics. We hypothesize that all children presenting to the pediatric ED with symptoms deemed to be low-risk for immunoglobulin E-mediated hypersensitivity will return negative results for true penicillin allergy. Parents of children aged 4 to 18 years old presenting to the pediatric ED with a history of parent-reported penicillin allergy completed an allergy questionnaire. A prespecified 100 children categorized as low-risk on the basis of reported symptoms completed penicillin allergy testing by using a standard 3-tier testing process. The percent of children with negative allergy testing results was calculated with a 95% confidence interval. Five hundred ninety-seven parents completed the questionnaire describing their child's reported allergy symptoms. Three hundred two (51%) children had low-risk symptoms and were eligible for testing. Of those, 100 children were tested for penicillin allergy. The median (interquartile range) age at testing was 9 years (5-12). The median (interquartile range) age at allergy diagnosis was 1 year (9 months-3 years). Rash (97 [97%]) and itching (63 [63%]) were the most commonly reported allergy symptoms. Overall, 100 children (100%; 95% confidence interval 96.4%-100%) were found to have negative results for penicillin allergy and had their labeled penicillin allergy removed from their medical record. All children categorized as low-risk by our penicillin allergy questionnaire were found to have negative results for true penicillin allergy. The utilization of this questionnaire in the pediatric ED may facilitate increased use of first-line penicillin antibiotics. Copyright © 2017 by the American Academy of Pediatrics.

  9. First-line chemotherapy in low-risk gestational trophoblastic neoplasia.

    LENUS (Irish Health Repository)

    Alazzam, Mo'iad

    2012-01-01

    This is an update of a Cochrane review that was first published in Issue 1, 2009. Gestational trophoblastic neoplasia (GTN) is a rare but curable disease arising in the fetal chorion during pregnancy. Most women with low-risk GTN will be cured by evacuation of the uterus with or without single-agent chemotherapy. However, chemotherapy regimens vary between treatment centres worldwide and the comparable benefits and risks of these different regimens are unclear.

  10. Spirituality and low-risk consumption of alcohol in young adults

    OpenAIRE

    Díaz Heredia, Luz Patricia; Muñoz Sánchez, Alba Idaly

    2013-01-01

    The relationship between spirituality and health, as well as it effect on adopting healthy behaviors, is a topic of interest for nursing and, in general, for social and life sciences. Spirituality, as a human realm, is a relevant research theme that is often related to the promotion of health in individuals. Studies indicate that spirituality is related to mental and physical health, being a protective and promoting factor of healthy behaviors, among them low-risk consumption of alcohol in yo...

  11. Image-Guided Hypofractionated Radiotherapy in Low-Risk Prostate Cancer Patients

    Directory of Open Access Journals (Sweden)

    Maurizio Valeriani

    2014-01-01

    Full Text Available Aim. To evaluate efficacy and toxicity of image-guided hypofractionated radiotherapy (HFRT in the treatment of low-risk prostate cancer. Outcomes and toxicities of this series of patients were compared to another group of 32 low-risk patients treated with conventional fractionation (CFRT. Methods. Fifty-nine patients with low-risk prostate cancer were analysed. Total dose for the prostate and proximal seminal vesicles was 60 Gy delivered in 20 fractions. Results. The median follow-up was 30 months. The actuarial 4-year overall survival, biochemical free survival, and disease specific survival were 100%, 97.4%, and 97.4%, respectively. Acute grade 1-2 gastrointestinal (GI and genitourinary (GU toxicity rates were 11.9% and 40.7%, respectively. Grade 1 GI and GU late toxicity rates were 8.5% and 13.6%, respectively. No grade ≥2 late toxicities were recorded. Acute grade 2-3 GU toxicity resulted significantly lower (P=0.04 in HFRT group compared to the CFRT group. The cumulative 4-year incidence of grade 1-2 GU toxicity was significantly higher (P<0.001 for HFRT patients. Conclusions. Our study demonstrated that hypofractionated regimen provided excellent biochemical control in favorable risk prostate cancer patients. The incidence of GI and GU toxicity was low. However, HFRT presented higher cumulative incidence of low-grade late GU toxicity than CFRT.

  12. Visual performance in preterm infants with brain injuries compared with low-risk preterm infants.

    Science.gov (United States)

    Leonhardt, Merçè; Forns, Maria; Calderón, Caterina; Reinoso, Marta; Gargallo, Estrella

    2012-08-01

    Neonatal brain injuries are the main cause of visual deficit produced by damage to posterior visual pathways. While there are several studies of visual function in low-risk preterm infants or older children with brain injuries, research in children of early age is lacking. To assess several aspects of visual function in preterm infants with brain injuries and to compare them with another group of low-risk preterm infants of the same age. Forty-eight preterm infants with brain injuries and 56 low-risk preterm infants. The ML Leonhardt Battery of Optotypes was used to assess visual functions. This test was previously validated at a post-menstrual age of 40 weeks in newborns and at 30-plus weeks in preterm infants. The group of preterm infants with brain lesions showed a delayed pattern of visual functions in alertness, fixation, visual attention and tracking behavior compared to infants in the healthy preterm group. The differences between both groups, in the visual behaviors analyzed were around 30%. These visual functions could be identified from the first weeks of life. Our results confirm the importance of using a straightforward screening test with preterm infants in order to assess altered visual function, especially in infants with brain injuries. The findings also highlight the need to provide visual stimulation very early on in life. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. Nitrates in the drinking water of southern Punjab

    International Nuclear Information System (INIS)

    Ahmed, K.

    2000-01-01

    Four major cities of Southern Punjab were investigated for the nitrate-level in sources of drinking water. Values greater than the guideline value were obtained for 12 percent of the samples collected from Bahawalpur city, 23 percent from the city of Bahawalnagar and 7.3 percent from the city of Sadiqabad. For the city of Rahim Yar Khan, all the values were within the WHO Guidelines. Areas with higher contents of nitrate were latter investigated in detail. (author)

  14. What did you drink yesterday? Public health relevance of a recent recall method used in the 2004 Australian National Drug Strategy Household Survey.

    Science.gov (United States)

    Stockwell, Tim; Zhao, Jinhui; Chikritzhs, Tanya; Greenfield, Tom K

    2008-06-01

    To (i) compare the Yesterday method with other methods of assessing alcohol use applied in the 2004 Australian National Drug Strategy Household Survey (NDSHS) in terms of extent of under-reporting of actual consumption assessed from sales data; and (ii) illustrate applications of the Yesterday method as a means of variously measuring the size of an Australian 'standard drink', the extent of risky/high-risk alcohol use, unrecorded alcohol consumption and beverage-specific patterns of risk in the general population. The homes of respondents who were eligible and willing to participate. A total of 24 109 Australians aged 12 years and over. The 2004 NDSHS assessed drug use, experiences and attitudes using a 'drop and collect' self-completion questionnaire with random sampling and geographic (State and Territory) and demographic (age and gender) stratification. Self-completion questionnaire using quantity-frequency (QF) and graduated-frequency (GF) methods plus two questions about consumption 'yesterday': one in standard drinks, another with empirically based estimates of drink size and strength. The Yesterday method yielded an estimate of 12.8 g as the amount of ethanol in a typical Australian standard drink (versus the official 10 g). Estimated coverage of the 2003-04 age 12+ years per-capita alcohol consumption in Australia (9.33 ml of ethanol) was 69.17% for GF and 64.63% for the QF when assuming a 12.8 g standard drink. Highest coverage of 80.71% was achieved by the detailed Yesterday method. The detailed Yesterday method found that 60.1% of Australian alcohol consumption was above low-risk guidelines; 81.5% for 12-17-year-olds, 84.8% for 18-24-year-olds and 88.8% for Indigenous respondents. Spirit-based drinks and regular strength beer were most likely to be drunk in this way, low- and mid-strength beer least likely. Compared to more widely used methods, the Yesterday method minimizes under-reporting of overall consumption and provides unique data of public health

  15. Intelligent Structured Intermittent Auscultation (ISIA): evaluation of a decision-making framework for fetal heart monitoring of low-risk women

    Science.gov (United States)

    2014-01-01

    Background Research-informed fetal monitoring guidelines recommend intermittent auscultation (IA) for fetal heart monitoring for low-risk women. However, the use of cardiotocography (CTG) continues to dominate many institutional maternity settings. Methods A mixed methods intervention study with before and after measurement was undertaken in one secondary level health service to facilitate the implementation of an initiative to encourage the use of IA. The intervention initiative was a decision-making framework called Intelligent Structured Intermittent Auscultation (ISIA) introduced through an education session. Results Following the intervention, medical records review revealed an increase in the use of IA during labour represented by a relative change of 12%, with improved documentation of clinical findings from assessments, and a significant reduction in the risk of receiving an admission CTG (RR 0.75, 95% CI, 0.60 – 0.95, p = 0.016). Conclusion The ISIA informed decision-making framework transformed the practice of IA and provided a mechanism for knowledge translation that enabled midwives to implement evidence-based fetal heart monitoring for low risk women. PMID:24884597

  16. Survival benefit associated with adjuvant androgen deprivation therapy combined with radiotherapy for high- and low-risk patients with nonmetastatic prostate cancer

    International Nuclear Information System (INIS)

    Zeliadt, Steven B.; Potosky, Arnold L.; Penson, David F.; Etzioni, Ruth

    2006-01-01

    Background: The use of adjuvant androgen deprivation therapy (ADT) combined with radiotherapy has become common in low-risk patients, although clinical trials have focused primarily on high-risk patients. This study examines the effectiveness of adjuvant ADT combined with radiotherapy for a wide range of patients treated in the 1990s. Methods and Materials: Prostate cancer survival was examined in a population based cohort of 31,643 patients aged 65 to 85 years who were diagnosed with nonmetastatic prostate cancer and treated with external beam radiotherapy and/or brachytherapy. Instrumental variable analysis methods were used to control for selection bias. Results: Patients with stage T3/T4 disease who received adjuvant ADT experienced improved 5-year and 8-year survival. No survival advantage was observed for men with T1/T2 disease during this interval. Conclusion: High-risk patients who receive primary radiotherapy have benefited from adjuvant ADT, whereas low-risk patients with disease confined to the prostate have not yet benefited from adjuvant therapy within the first 8 years after treatment. These findings are consistent with practice guidelines, which recommend adjuvant ADT for patients with high-risk disease

  17. Perinatal mortality and morbidity in a nationwide cohort of 529,688 low-risk planned home and hospital births

    NARCIS (Netherlands)

    de jonge, A.; van der Goes, B. Y.; Ravelli, A. C. J.; Amelink-Verburg, M. P.; Mol, B. W.; Nijhuis, J. G.; Bennebroek Gravenhorst, J.; Buitendijk, S. E.

    2009-01-01

    OBJECTIVE: To compare perinatal mortality and severe perinatal morbidity between planned home and planned hospital births, among low-risk women who started their labour in primary care. DESIGN: A nationwide cohort study. SETTING: The entire Netherlands. POPULATION: A total of 529,688 low-risk women

  18. Heavy metal pollution in drinking water - a global risk for human ...

    African Journals Online (AJOL)

    Water resources in the world have been profoundly influenced over the last years by human activities, whereby the world is currently facing critical water supply and drinking water quality problems. In many parts of the world heavy metal (HM) concentrations in drinking water are higher than some international guideline ...

  19. Determination of sources and analysis of micro-pollutants in drinking water

    International Nuclear Information System (INIS)

    Md Pauzi Abdullah; Soh Shiau Chian

    2004-01-01

    The objectives of the research are (I) to develop and validate method performance of solid phase micro-extraction (SPME); (II) to identify, monitor and assess the volatile organic compounds (VOCs) in drinking water supplies and (III) to evaluate the relevancy of the guidelines set in the National Standard for Drinking Water Quality 2001

  20. Biomarkers and low risk in heart failure. Data from COACH and TRIUMPH.

    Science.gov (United States)

    Meijers, Wouter C; de Boer, Rudolf A; van Veldhuisen, Dirk J; Jaarsma, Tiny; Hillege, Hans L; Maisel, Alan S; Di Somma, Salvatore; Voors, Adriaan A; Peacock, W Frank

    2015-12-01

    Traditionally, risk stratification in heart failure (HF) emphasizes assessment of high risk. We aimed to determine if biomarkers could identify patients with HF at low risk for death or HF rehospitalization. This analysis was a substudy of The Coordinating Study Evaluating Outcomes of Advising and Counselling in Heart Failure (COACH) trial. Enrolment of HF patients occurred before discharge. We defined low risk as the absence of death and/or HF rehospitalizations at 180 days. We tested a diverse group of 29 biomarkers on top of a clinical risk model, with and without N-terminal pro-B-type natriuretic peptide (NT-proBNP), and defined the low risk biomarker cut-off at the 10th percentile associated with high positive predictive value. The best performing biomarkers together with NT-proBNP and cardiac troponin I (cTnI) were re-evaluated in a validation cohort of 285 HF patients. Of 592 eligible COACH patients, the mean (± SD) age was 71 (± 11) years and median (IQR) NT-proBNP was 2521 (1301-5634) pg/mL. Logistic regression analysis showed that only galectin-3, fully adjusted, was significantly associated with the absence of events at 180 days (OR 8.1, 95% confidence interval 1.06-50.0, P = 0.039). Galectin-3, showed incremental value when added to the clinical risk model without NT-proBNP (increase in area under the curve from 0.712 to 0.745, P = 0.04). However, no biomarker showed significant improvement by net reclassification improvement on top of the clinical risk model, with or without NT-proBNP. We confirmed our results regarding galectin-3, NT-proBNP, and cTnI in the independent validation cohort. We describe the value of various biomarkers to define low risk, and demonstrate that galectin-3 identifies HF patients at (very) low risk for 30-day and 180-day mortality and HF rehospitalizations after an episode of acute HF. Such patients might be safely discharged. © 2015 The Authors European Journal of Heart Failure © 2015 European Society of

  1. Use of advanced treatment technologies among men at low risk of dying from prostate cancer.

    Science.gov (United States)

    Jacobs, Bruce L; Zhang, Yun; Schroeck, Florian R; Skolarus, Ted A; Wei, John T; Montie, James E; Gilbert, Scott M; Strope, Seth A; Dunn, Rodney L; Miller, David C; Hollenbeck, Brent K

    2013-06-26

    The use of advanced treatment technologies (ie, intensity-modulated radiotherapy [IMRT] and robotic prostatectomy) for prostate cancer is increasing. The extent to which these advanced treatment technologies have disseminated among patients at low risk of dying from prostate cancer is uncertain. To assess the use of advanced treatment technologies, compared with prior standards (ie, traditional external beam radiation treatment [EBRT] and open radical prostatectomy) and observation, among men with a low risk of dying from prostate cancer. Using Surveillance, Epidemiology, and End Results (SEER)-Medicare data, we identified a retrospective cohort of men diagnosed with prostate cancer between 2004 and 2009 who underwent IMRT (n = 23,633), EBRT (n = 3926), robotic prostatectomy (n = 5881), open radical prostatectomy (n = 6123), or observation (n = 16,384). Follow-up data were available through December 31, 2010. The use of advanced treatment technologies among men unlikely to die from prostate cancer, as assessed by low-risk disease (clinical stage ≤T2a, biopsy Gleason score ≤6, and prostate-specific antigen level ≤10 ng/mL), high risk of noncancer mortality (based on the predicted probability of death within 10 years in the absence of a cancer diagnosis), or both. In our cohort, the use of advanced treatment technologies increased from 32% (95% CI, 30%-33%) to 44% (95% CI, 43%-46%) among men with low-risk disease (P risk of noncancer mortality (P use of these advanced treatment technologies among men with both low-risk disease and high risk of noncancer mortality increased from 25% (95% CI, 23%-28%) to 34% (95% CI, 31%-37%) (P use of advanced treatment technologies for men unlikely to die from prostate cancer increased from 13% (95% CI, 12%-14%), or 129.2 per 1000 patients diagnosed with prostate cancer, to 24% (95% CI, 24%-25%), or 244.2 per 1000 patients diagnosed with prostate cancer (P risk disease, high risk of noncancer mortality, or both, the use of

  2. National Trends and Predictors of Androgen Deprivation Therapy Use in Low-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yang, David D. [Harvard Medical School, Boston, Massachusetts (United States); Muralidhar, Vinayak [Department of Medicine, Harvard Medical School, Boston, Massachusetts (United States); Brigham and Women' s Hospital, Boston, Massachusetts (United States); Mahal, Brandon A. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Labe, Shelby A.; Nezolosky, Michelle D.; Vastola, Marie E.; King, Martin T.; Martin, Neil E.; Orio, Peter F. [Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Brigham and Women' s Hospital, Boston, Massachusetts (United States); Choueiri, Toni K. [Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Brigham and Women' s Hospital, Boston, Massachusetts (United States); Trinh, Quoc-Dien [Division of Urological Surgery, Harvard Medical School, Boston, Massachusetts (United States); Brigham and Women' s Hospital, Boston, Massachusetts (United States); Spratt, Daniel E. [Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts (United States); University of Michigan, Ann Arbor, Michigan (United States); Hoffman, Karen E. [Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts (United States); The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Feng, Felix Y. [Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts (United States); Departments of Urology & Medicine and Helen Diller Family Comprehensive Cancer Center, University of California at San Francisco, San Francisco, California (United States); and others

    2017-06-01

    Purpose: Androgen deprivation therapy (ADT) is not recommended for low-risk prostate cancer because of its lack of benefit and potential for harm. We evaluated the incidence and predictors of ADT use in low-risk disease. Methods and Materials: Using the National Cancer Database, we identified 197,957 patients with low-risk prostate cancer (Gleason score of 3 + 3 = 6, prostate-specific antigen level <10 ng/mL, and cT1-T2a) diagnosed from 2004 to 2012 with complete demographic and treatment information. We used multiple logistic regression to evaluate predictors of ADT use and Cox regression to examine its association with all-cause mortality. Results: Overall ADT use decreased from 17.6% in 2004 to 3.5% in 2012. In 2012, 11.5% of low-risk brachytherapy patients and 7.6% of external beam radiation therapy patients received ADT. Among 82,352 irradiation-managed patients, predictors of ADT use included treatment in a community versus academic cancer program (adjusted odds ratio [AOR], 1.60; 95% confidence interval [CI], 1.50-1.71; P<.001; incidence, 14.0% vs 6.0% in 2012); treatment in the South (AOR, 1.51), Midwest (AOR, 1.81), or Northeast (AOR, 1.90) versus West (P<.001); and brachytherapy use versus external beam radiation therapy (AOR, 1.32; 95% CI, 1.27-1.37; P<.001). Among 25,196 patients who did not receive local therapy, predictors of primary ADT use included a Charlson-Deyo comorbidity score of ≥2 versus 0 (AOR, 1.42; 95% CI, 1.06-1.91; P=.018); treatment in a community versus academic cancer program (AOR, 1.61; 95% CI, 1.37-1.90; P<.001); and treatment in the South (AOR, 1.26), Midwest (AOR, 1.52), or Northeast (AOR, 1.28) versus West (P≤.008). Primary ADT use was associated with increased all-cause mortality in patients who did not receive local therapy (adjusted hazard ratio, 1.28; 95% CI, 1.14-1.43; P<.001) after adjustment for age and comorbidity. Conclusions: ADT use in low-risk prostate cancer has declined nationally but may remain an issue

  3. Drinking Water Treatability Database (TDB)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Drinking Water Treatability Database (TDB) presents referenced information on the control of contaminants in drinking water. It allows drinking water utilities,...

  4. Energy Drinks. Prevention Update

    Science.gov (United States)

    Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2010

    2010-01-01

    High-caffeine soft drinks have existed in the United States since at least the 1980s beginning with Jolt Cola. Energy drinks, which have caffeine as their primary "energy" component, began being marketed as a separate beverage category in the United States in 1997 with the introduction of the Austrian import Red Bull. Energy drink…

  5. Quality of Drinking Water

    Science.gov (United States)

    Roman, Harry T.

    2009-01-01

    The quality of drinking water has been gaining a great deal of attention lately, especially as water delivery infrastructure continues to age. Particles of various metals such as lead and copper, and other substances like radon and arsenic could be entering drinking water supplies. Spilled-on-the-ground hydrocarbon-based substances are also…

  6. The Drinking Game

    Science.gov (United States)

    Poe, Marshall

    2010-01-01

    Americans have been wrestling with college drinking for so long that they've forgotten there was a time when they didn't. Prior to World War II there were a number of "crises" on American campuses--loutish behavior at football games, the introduction of the research-heavy "German Method," the corruption of coeds--but excessive college drinking was…

  7. Binge Drinking PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This PSA is based on the October, 2010 CDC Vital Signs report which indicates that drinking too much, including binge drinking, causes more than 79,000 deaths in the U.S. each year and is the third leading preventable cause of death.

  8. Binge drinking in pregnancy

    DEFF Research Database (Denmark)

    Kesmodel, Ulrik Schiøler

    2001-01-01

    Independent of average alcohol intake, the effect of binge drinking on adverse pregnancy outcomes in humans is only sporadically reported, but most studies in humans have found little or no effect of binge drinking on several adverse pregnancy outcomes. In a representative sample of 371 pregnant...... Danish women, the agreement between two different measures of binge drinking during the first half of pregnancy obtained from interviews and questionnaires was assessed, and the frequency and pattern of binge drinking were described. The percentage of agreement between the methods ranged between 81......% and 86%. The proportion of women who reported binge drinking depended on the definition of pregnancy, but the proportion peaked in week 3 measured from the last menstrual period and thereafter declined to approximately 1 percent in week 7. On the basis of this 1998 study, it is suggested that most human...

  9. Nitrate in drinking water

    DEFF Research Database (Denmark)

    Schullehner, Jörg

    is highly decentralized and fully relying on simple treated groundwater. At the same time, Denmark has an intensive agriculture, making groundwater resources prone to nitrate pollution. Drinking water quality data covering the entire country for over 35 years are registered in the public database Jupiter......Annual nationwide exposure maps for nitrate in drinking water in Denmark from the 1970s until today will be presented based on the findings in Schullehner & Hansen (2014) and additional work on addressing the issue of private well users and estimating missing data. Drinking water supply in Denmark....... In order to create annual maps of drinking water quality, these data had to be linked to 2,852 water supply areas, which were for the first time digitized, collected in one dataset and connected to the Jupiter database. Analyses of the drinking water quality maps showed that public water supplies...

  10. Planned home compared with planned hospital births in the Netherlands: intrapartum and early neonatal death in low-risk pregnancies.

    Science.gov (United States)

    van der Kooy, Jacoba; Poeran, Jashvant; de Graaf, Johanna P; Birnie, Erwin; Denktasş, Semiha; Steegers, Eric A P; Bonsel, Gouke J

    2011-11-01

    The purpose of our study was to compare the intrapartum and early neonatal mortality rate of planned home birth with planned hospital birth in community midwife-led deliveries after case mix adjustment. The perinatal outcome of 679,952 low-risk women was obtained from the Netherlands Perinatal Registry (2000-2007). This group represents all women who had a choice between home and hospital birth. Two different analyses were performed: natural prospective approach (intention-to-treat-like analysis) and perfect guideline approach (per-protocol-like analysis). Unadjusted and adjusted odds ratios (ORs) were calculated. Case mix was based on the presence of at least one of the following: congenital abnormalities, small for gestational age, preterm birth, or low Apgar score. We also investigated the potential risk role of intended place of birth. Multivariate stepwise logistic regression was used to investigate the potential risk role of intended place of birth. Intrapartum and neonatal death at 0-7 days was observed in 0.15% of planned home compared with 0.18% in planned hospital births (crude relative risk 0.80, 95% confidence interval [CI] 0.71-0.91). After case mix adjustment, the relation is reversed, showing nonsignificant increased mortality risk of home birth (OR 1.05, 95% CI 0.91-1.21). In certain subgroups, additional mortality may arise at home if risk conditions emerge at birth (up to 20% increase). Home birth, under routine conditions, is generally not associated with increased intrapartum and early neonatal death, yet in subgroups, additional risk cannot be excluded.

  11. ASSET guidelines

    International Nuclear Information System (INIS)

    1990-11-01

    The IAEA Assessment of Safety Significant Events Team (ASSET) Service provides advice and assistance to Member States to enhance the overall level of plant safety while dealing with the policy of prevention of incidents at nuclear power plants. The ASSET programme, initiated in 1986, is not restricted to any particular group of Member States, whether developing or industrialized, but is available to all countries with nuclear power plants in operation or approaching commercial operation. The IAEA Safety Series publications form common basis for the ASSET reviews, including the Nuclear Safety Standards (NUSS) and the Basic Safety Principles (Recommendations of Safety Series No. 75-INSAG-3). The ASSET Guidelines provide overall guidance for the experts to ensure the consistency and comprehensiveness of their review of incident investigations. Additional guidance and reference material is provided by the IAEA to complement the expertise of the ASSET members. ASSET reviews accept different approaches that contribute to ensuring an effective prevention of incidents at plants. Suggestions are offered to enhance plant safety performance. Commendable good practices are identified and generic lessons are communicated to other plants, where relevant, for long term improvement

  12. Toxicological relevance of emerging contaminants for drinking water quality

    NARCIS (Netherlands)

    Schriks, M.; Heringa, M.B.; van der Kooij, M.M.E.; de Voogt, P.; van Wezel, A.P.

    2010-01-01

    The detection of many new compounds in surface water, groundwater and drinking water raises considerable public concern, especially when human health based guideline values are not available it is questioned if detected concentrations affect human health. In an attempt to address this question, we

  13. Assessment of heavy metals concentration in drinking water ...

    African Journals Online (AJOL)

    The concentration of all the metals were considerably found to be below the limit permitted by WHO's drinking water guidelines (WHO 2005). Findings suggest that continues water quality monitoring should be carried out to check the concentration levels of heavy metals in that area, to prevent them from been above the limit ...

  14. Concentration of Heavy Metals in Drinking Water from Urban Areas ...

    African Journals Online (AJOL)

    Bheema

    guideline is set by WHO (2008) for Zinc level in drinking water, of the samples analyzed,. 94.02% comply the New Zealand standard and 97.01% comply all the maximum admissible limits referred in the present study. In general, the results of the present study have shown that some of the physico-chemical parameters have ...

  15. A pharmacoeconomic analysis of the use of single MMC instillation in low risk NMIBC in Italy

    Directory of Open Access Journals (Sweden)

    Renzo Colombo

    2013-03-01

    Full Text Available BACKGROUND: Bladder cancer accounts for 5-10% of all cancers in Europe and up to 85% patients presents a noninvasive tumor, whose treatment of choice is the transurethral bladder resection (TURB paired with adjuvant intravesical chemotherapy or immunotherapy. Despite several clinical trials showed that this treatment is safe and decreases recurrences by 17% to 44% this practice is limited for many reasons. The study objective is to analyze the economical advantages of the single immediate post operative Mitomycin C instillation in Non Muscle-invasive Bladder Cancer (NMIBC low-risk patients.METHODS: A cost-benefit analysis was performed evaluating the economical gain that would raised from a scenario with a single immediate post operative mitomycin C instillation in each low-risk NMIBC patient who underwent to TURB. Net present value and cost-benefit ratio were calculated and sensitivity analyses were performed. Base case analysis was performed considering tumor recurrence rate reduction of 11.7% and a TURB costs of 2,167.0 €, while sensitivity analyses were performed using a recurrence rate reduction of 19.2% and 15.0% and a TURB cost of 2,472.93 €. The discount rate was 2%.RESULTS: The single immediate post operative instillation of mitomycin C resulted to be cost-beneficial with a cost-benefit ratio that goes from 0.48 to 0.79 when compared to TURB alone raising a Net Present Value that goes from 660,284.39 € to 2,650,530.79 €.CONCLUSION: This study demonstrates that even assuming conservative parameters for recurrence rates reduction, a single immediate post operative mitomycin C instillation in low risk NMIBC patients would lower not only the recurrence rate but also the caring cost for bladder cancer.

  16. Unilateral Prostate Cancer Cannot be Accurately Predicted in Low-Risk Patients

    International Nuclear Information System (INIS)

    Isbarn, Hendrik; Karakiewicz, Pierre I.; Vogel, Susanne

    2010-01-01

    Purpose: Hemiablative therapy (HAT) is increasing in popularity for treatment of patients with low-risk prostate cancer (PCa). The validity of this therapeutic modality, which exclusively treats PCa within a single prostate lobe, rests on accurate staging. We tested the accuracy of unilaterally unremarkable biopsy findings in cases of low-risk PCa patients who are potential candidates for HAT. Methods and Materials: The study population consisted of 243 men with clinical stage ≤T2a, a prostate-specific antigen (PSA) concentration of <10 ng/ml, a biopsy-proven Gleason sum of ≤6, and a maximum of 2 ipsilateral positive biopsy results out of 10 or more cores. All men underwent a radical prostatectomy, and pathology stage was used as the gold standard. Univariable and multivariable logistic regression models were tested for significant predictors of unilateral, organ-confined PCa. These predictors consisted of PSA, %fPSA (defined as the quotient of free [uncomplexed] PSA divided by the total PSA), clinical stage (T2a vs. T1c), gland volume, and number of positive biopsy cores (2 vs. 1). Results: Despite unilateral stage at biopsy, bilateral or even non-organ-confined PCa was reported in 64% of all patients. In multivariable analyses, no variable could clearly and independently predict the presence of unilateral PCa. This was reflected in an overall accuracy of 58% (95% confidence interval, 50.6-65.8%). Conclusions: Two-thirds of patients with unilateral low-risk PCa, confirmed by clinical stage and biopsy findings, have bilateral or non-organ-confined PCa at radical prostatectomy. This alarming finding questions the safety and validity of HAT.

  17. Preferred place of birth: characteristics and motives of low-risk nulliparous women in the Netherlands.

    Science.gov (United States)

    van Haaren-Ten Haken, Tamar; Hendrix, Marijke; Nieuwenhuijze, Marianne; Budé, Luc; de Vries, Raymond; Nijhuis, Jan

    2012-10-01

    to explores preferences, characteristics and motives regarding place of birth of low-risk nulliparous women in the Netherlands. a prospective cohort study of low-risk nulliparous women and their partners starting their pregnancy in midwifery-led care or in obstetric-led care. Data were collected using a self-administered questionnaire, including questions on demographic, psychosocial and pregnancy factors and statements about motives with regard to place of birth. Depression, worry and self-esteem were explored using the Edinburgh Depression Scale (EDS), the Cambridge Worry Scale (CWS) and the Rosenberg Self Esteem Scale (RSE). participants were recruited in 100 independent midwifery practices and 14 hospitals from 2007 to 2011. 550 low-risk nulliparous women; 231 women preferred a home birth, 170 women a hospital birth in midwifery-led care and 149 women a birth in obstetric-led care. Significant differences in characteristics were found in the group who preferred a birth in obstetric-led care compared to the two groups who preferred midwifery-led care. Those women were older (F (2,551)=16.14, pbirth is driven by a desire for greater personal autonomy, whereas women's choice for a hospital birth is driven by a desire to feel safe and control risks. the characteristics of women who prefer a hospital birth are different than the characteristics of women who prefer a home birth. It appears that for women preferring a hospital birth, the assumed safety of the hospital is more important than type of care provider. This brings up the question whether women are fully aware of the possibilities of maternity care services. Women might need concrete information about the availability and the characteristics of the services within the maternity care system and the risks and benefits associated with either setting, in order to make an informed choice where to give birth. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2016-03-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second p age and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1 INTRODUCTION 1.1 Subheading of the Content 1.1.1 Subheading of the Content For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from http://www.teachingenglish.org

  19. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2015-03-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1 INTRODUCTION 1.1 Subheading of the content 1.1.1 Subheading of the content For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples: Back Matter| 79 80 | STUDIES IN ENGLISH LANGUAGE AND EDUCATION, Volume 1, Number 1, March 2014 Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v

  20. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2015-10-01

    Full Text Available Guidelines for Article Submission   SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION 1.1      Subheading of the Content  1.1.1   Subheading of the Content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from

  1. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2014-03-01

    Full Text Available Guidelines for Article Submission   SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION 1.1      Subheading of the content  1.1.1   Subheading of the content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from

  2. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2014-09-01

    Full Text Available Guidelines for Article Submission   SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION 1.1      Subheading of the content  1.1.1   Subheading of the content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from

  3. Perioperative pulmonary aspiration is infrequent and low risk in pediatric anesthetic practice.

    Science.gov (United States)

    Kelly, Christopher J; Walker, Robert W M

    2015-01-01

    Recent studies have reported perioperative pulmonary aspiration in pediatric practice to be an uncommon problem associated with low morbidity and mortality. This paper examines the recent publications in both the adult and pediatric literature and looks at some of the potential risk factors involved, both patient and anesthetic, in the development of aspiration of gastric contents. We also look at the risk of severe morbidity following pulmonary aspiration and speculate on possible reasons behind the assertion that pulmonary aspiration in pediatric anesthetic practice is rare and a low-risk event. © 2014 John Wiley & Sons Ltd.

  4. A case series of Nasopharyngeal Carcinoma among Indians, a low risk population, in Perak State, Malaysia.

    Science.gov (United States)

    Anusha, B; Philip, R; Norain, K; Harvinder, S; Gurdeep, S M

    2012-12-01

    Nasopharyngeal carcinoma (NPC) is rare among people of Indian ethnicity. A short retrospective case review of clinical records of Indian patients diagnosed with nasopharyngeal carcinoma in a period of 5 years was conducted. Their slides were further subjected to EBV encoded RNA (EBER) - In- situ Hybridization (ISH). The histologic subtype was nonkeratinizing carcinoma in all 4 patients. All were Epstein Barr Virus (EBV) positive. We believe that the crucial factor responsible for nasopharyngeal carcinoma is genetics; either a genetic susceptibility among high risk groups or genetic resistance/immunity in low risk groups. Further genetic studies are required to look for somatic or inherited chromosomal mutations among the various risk populations.

  5. Clinically low-risk prostate cancer: evaluation with transrectal doppler ultrasound and functional magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Maria Inês Novis

    2011-01-01

    Full Text Available OBJECTIVES: To evaluate transrectal ultrasound, amplitude Doppler ultrasound, conventional T2-weighted magnetic resonance imaging, spectroscopy and dynamic contrast-enhanced magnetic resonance imaging in localizing and locally staging low-risk prostate cancer. INTRODUCTION: Prostate cancer has been diagnosed at earlier stages and the most accepted classification for low-risk prostate cancer is based on clinical stage T1c or T2a, Gleason score <6, and prostate-specific antigen (PSA <10 ng/ml. METHODS: From 2005 to 2006, magnetic resonance imaging was performed in 42 patients, and transrectal ultrasound in 26 of these patients. Seven patients were excluded from the study. Mean patient age was 64.94 years and mean serum PSA was 6.05 ng/ml. The examinations were analyzed for tumor identification and location in prostate sextants, detection of extracapsular extension, and seminal vesicle invasion, using surgical pathology findings as the gold standard. RESULTS: Sixteen patients (45.7% had pathologically proven organ-confined disease, 11 (31.4% had positive surgical margin, 8 (28.9% had extracapsular extension, and 3 (8.6% presented with extracapsular extension and seminal vesicle invasion. Sensitivity, specificity, positive predictive value (PPV, negative predictive value (NPV and accuracy values for localizing low-risk prostate cancer were 53.1%, 48.3%, 63.4%, 37.8% and 51.3% for transrectal ultrasound; 70.4%, 36.2%, 65.1%, 42.0% and 57.7% for amplitude Doppler ultrasound; 71.5%, 58.9%, 76.6%, 52.4% and 67.1% for magnetic resonance imaging; 70.4%, 58.7%, 78.4%, 48.2% and 66.7% for magnetic resonance spectroscopy; 67.2%, 65.7%, 79.3%, 50.6% and 66.7% for dynamic contrast-enhanced magnetic resonance imaging, respectively. Sensitivity, specificity, PPV, NPV and accuracy values for detecting extracapsular extension were 33.3%, 92%, 14.3%, 97.2% and 89.7% for transrectal ultrasound and 50.0%, 77.6%, 13.7%, 95.6% and 75.7% for magnetic resonance imaging

  6. Perceived agricultural runoff impact on drinking water.

    Science.gov (United States)

    Crampton, Andrea; Ragusa, Angela T

    2014-09-01

    Agricultural runoff into surface water is a problem in Australia, as it is in arguably all agriculturally active countries. While farm practices and resource management measures are employed to reduce downstream effects, they are often either technically insufficient or practically unsustainable. Therefore, consumers may still be exposed to agrichemicals whenever they turn on the tap. For rural residents surrounded by agriculture, the link between agriculture and water quality is easy to make and thus informed decisions about water consumption are possible. Urban residents, however, are removed from agricultural activity and indeed drinking water sources. Urban and rural residents were interviewed to identify perceptions of agriculture's impact on drinking water. Rural residents thought agriculture could impact their water quality and, in many cases, actively avoided it, often preferring tank to surface water sources. Urban residents generally did not perceive agriculture to pose health risks to their drinking water. Although there are more agricultural contaminants recognised in the latest Australian Drinking Water Guidelines than previously, we argue this is insufficient to enhance consumer protection. Health authorities may better serve the public by improving their proactivity and providing communities and water utilities with the capacity to effectively monitor and address agricultural runoff.

  7. Toxicological risk assessment and prioritization of drinking water relevant contaminants of emerging concern.

    Science.gov (United States)

    Baken, Kirsten A; Sjerps, Rosa M A; Schriks, Merijn; van Wezel, Annemarie P

    2018-06-13

    Toxicological risk assessment of contaminants of emerging concern (CEC) in (sources of) drinking water is required to identify potential health risks and prioritize chemicals for abatement or monitoring. In such assessments, concentrations of chemicals in drinking water or sources are compared to either (i) health-based (statutory) drinking water guideline values, (ii) provisional guideline values based on recent toxicity data in absence of drinking water guidelines, or (iii) generic drinking water target values in absence of toxicity data. Here, we performed a toxicological risk assessment for 163 CEC that were selected as relevant for drinking water. This relevance was based on their presence in drinking water and/or groundwater and surface water sources in downstream parts of the Rhine and Meuse, in combination with concentration levels and physicochemical properties. Statutory and provisional drinking water guideline values could be derived from publically available toxicological information for 142 of the CEC. Based on measured concentrations it was concluded that the majority of substances do not occur in concentrations which individually pose an appreciable human health risk. A health concern could however not be excluded for vinylchloride, trichloroethene, bromodichloromethane, aniline, phenol, 2-chlorobenzenamine, mevinphos, 1,4-dioxane, and nitrolotriacetic acid. For part of the selected substances, toxicological risk assessment for drinking water could not be performed since either toxicity data (hazard) or drinking water concentrations (exposure) were lacking. In absence of toxicity data, the Threshold of Toxicological Concern (TTC) approach can be applied for screening level risk assessment. The toxicological information on the selected substances was used to evaluate whether drinking water target values based on existing TTC levels are sufficiently protective for drinking water relevant CEC. Generic drinking water target levels of 37 μg/L for

  8. Prospective evaluation of a clinical guideline recommending hospital length of stay in upper gastrointestinal tract hemorrhage.

    Science.gov (United States)

    Hay, J A; Maldonado, L; Weingarten, S R; Ellrodt, A G

    Upper gastrointestinal tract hemorrhage (UGIH) is a common and potentially life-threatening disorder. Resource utilization can vary without adverse effect on patient outcome. Clinical practice guidelines are a potential solution to reduce variation in practice while improving patient outcomes. To validate prospectively the safety, acceptability, and impact of a clinical practice guideline defining the medically appropriate length of stay (LOS) for patients hospitalized with UGIH. Prospective, controlled time-series study with an alternate-month design. Outcome surveyors and patients were blinded to study group allocation. GUIDELINE: A retrospectively validated scoring system using 4 independent variables: hemodynamics, time from bleeding, comorbidity, and esophagogastroduodenoscopy (EGD) findings to predict risk of adverse events. The quantitative risk for the low-risk subset was 0.6% (95% confidence interval [CI], 0.0%-2.0%) for subsequent complications and 0% (95% CI, 0.0%-0.9%) for life-threatening complications from this retrospective evaluation. A 1000-bed, not-for-profit, university-affiliated teaching hospital. Consecutive adult patients hospitalized for acute UGIH. Concurrent feedback of guideline recommendation (same-day hospital discharge) to physicians caring for patients at low risk for complication. No risk information was provided during control months. Seventy percent (209/299) of UGIH patients achieved low-risk status according to the guideline and were therefore potentially suitable for early discharge from the hospital. Providing real-time quantitative risk information (intervention group only) was associated with an increase in guideline compliance from 30% to 70% (Preduction of 1.7 days per patient; P<.001). No differences in complications, patient health status, or patient satisfaction were found when measured 1 month after discharge. An independent variable predicting decreased hospital LOS for low-risk UGIH patients was early EGD

  9. Guidelines for Description

    NARCIS (Netherlands)

    Links, P.; Horsman, Peter; Kühnel, Karsten; Priddy, M.; Reijnhoudt, Linda; Merenmies, Mark

    2013-01-01

    The Guidelines follow the conceptual metadata model (deliverable 17.2). They include guidelines for description of collection-holding institutions, document collections, organisations, personalities, events, camps and ghettos. As much as possible the guidelines comply with the descriptive standards

  10. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2015-12-01

    Full Text Available Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s.  http://www.icmje.org/recommendations/browse/manuscript-preparation/preparing-for-submission.html Preparing for SubmissionPAGE CONTENTSGeneral PrinciplesReporting GuidelinesManuscript SectionsTitle PageAbstractIntroductionMethodsResultsDiscussionReferencesTablesIllustrations (FiguresUnits of MeasurementAbbreviations and Symbols1. General PrinciplesThe text of articles reporting original research is usually divided into Introduction, Methods, Results, and Discussion sections. This so-called “IMRAD” structure is not an arbitrary publication format but a reflection of the process of scientific discovery. Articles often need subheadings within these sections to further organize their content. Other types of articles, such as meta-analyses, may require different formats, while case reports, narrative reviews, and editorials may have less structured or unstructured formats.Electronic formats have created opportunities for adding details or sections, layering information, cross-linking, or extracting portions of articles in electronic versions. Supplementary electronic-only material should be submitted and sent for peer review simultaneously with the primary manuscript.2. Reporting GuidelinesReporting guidelines have been developed for different study designs; examples include CONSORT for randomized trials, STROBE for observational studies, PRISMA for systematic reviews and meta-analyses, and STARD for studies of diagnostic accuracy. Journals are encouraged to ask authors to follow these guidelines because

  11. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2016-06-01

    Full Text Available AUTHOR GUIDELINES Indian Journal of Community Health (IJCH accepts only online submission of manuscript(s by using Open Journal software (OJS at http://www.iapsmupuk.org/journal/index.php/IJCH/login Online SubmissionsAlready have a Username/Password for Indian Journal of Community Health (IJCH? GO TO LOGINNeed a Username/Password?GO TO REGISTRATIONNote: Registration and login are required to submit items online and to track the status of current submissions.Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s. http://www.icmje.org/recommendations/browse/manuscript-preparation/preparing-for-submission.html Preparing for SubmissionGeneral PrinciplesReporting GuidelinesManuscript SectionsTitle PageAbstractIntroductionMethodsResultsDiscussionReferencesTablesIllustrations (FiguresUnits of MeasurementAbbreviations and Symbols 1. General PrinciplesThe text of articles reporting original research is usually divided into Introduction, Methods, Results, and Discussion sections. This so-called “IMRAD” structure is not an arbitrary publication format but a reflection of the process of scientific discovery. Articles often need subheadings within these sections to further organize their content. Other types of articles, such as meta-analyses, may require different formats, while case reports, narrative reviews, and editorials may have less structured or unstructured formats.Electronic formats have created opportunities for adding details or sections, layering information, cross-linking, or extracting portions of articles in electronic versions. Supplementary electronic

  12. Drinking Water FAQ

    Science.gov (United States)

    ... 90 different contaminants in public drinking water, including E.coli , Salmonella , and Cryptosporidium species. More information regarding the ... page. Water Quality Indicators: Total Coliforms Fecal Coliforms / Escherichia coli (E. coli) pH Contaminants: Nitrate Volatile Organic Compounds ( ...

  13. Disinfection of drinking water

    International Nuclear Information System (INIS)

    Ensenauer, P.

    1977-01-01

    Some methods for disinfecting drinking water are described, e.g. UV irradiation (optimal wavelength 210-250mm) with the advantage of constant water composition and the resulting danger of re-infection. (AJ) [de

  14. Disinfection of drinking water

    Energy Technology Data Exchange (ETDEWEB)

    Ensenauer, P

    1977-01-01

    Some methods for disinfecting drinking water are described, e.g. UV irradiation (optimal wavelength 210-250mm) with the advantage of constant water composition and the resulting danger of re-infection.

  15. Drinking Water Distribution Systems

    Science.gov (United States)

    Learn about an overview of drinking water distribution systems, the factors that degrade water quality in the distribution system, assessments of risk, future research about these risks, and how to reduce cross-connection control risk.

  16. Risks of underage drinking

    Science.gov (United States)

    ... a higher risk of depression, anxiety, and low self-esteem. Drinking during puberty can also change hormones in ... the first to achieve this important distinction for online health information and services. Learn more about A. ...

  17. SDWISFED Drinking Water Data

    Data.gov (United States)

    U.S. Environmental Protection Agency — SDWIS/FED is EPA's national regulatory compliance database for the drinking water program. It includes information on the nation's 160,000 public water systems and...

  18. AUTHOR GUIDELINES

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2014-12-01

    Full Text Available AUTHOR GUIDELINESIndian Journal of Community Health (IJCH accepts only online submission of manuscript(s by using Open Journal software (OJS at http://www.iapsmupuk.org/journal/index.php/IJCH/loginOnline SubmissionsAlready have a Username/Password for Indian Journal of Community Health (IJCH? GO TO LOGINNeed a Username/Password?GO TO REGISTRATIONNote: Registration and login are required to submit items online and to track the status of current submissions.Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s.SectionsEditorial:On issues of current public health needAbout 1000 – 1200 wordsReferences: 5 – 10 (PubMed - Citation preferredInvited Commentary:Brief, provocative, opinionated communicationsOn issues of current public health needMain Text: 750-1000 words excluding referencesReferences: 5 – 10 (PubMed - Citation preferredOriginal Article:Articles from Original ResearchStructured abstract: 250 wordsMain Text: 2500 - 3000 words, IMRD formatKey Words: 5 - 8References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4*Certificate of clearance from respective Institutional Ethical Committee (IECReview Article:On subject of public health relevanceAbstract: 250 wordsMain Text: 2500 - 3000 wordsKey Words: 3 - 4References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4Short Communication / Article:Short report of a research project / outbreakMain Text : 1000 – 1200 wordsReferences: 10 – 15 (PubMed - Citation preferredTable / Figure: 01*Certificate of clearance from respective Institutional Ethical Committee (IECReport from the field

  19. Factors Associated With Mortality in Low-Risk Pediatric Critical Care Patients in The Netherlands.

    Science.gov (United States)

    Verlaat, Carin W; Visser, Idse H; Wubben, Nina; Hazelzet, Jan A; Lemson, Joris; van Waardenburg, Dick; van der Heide, Douwe; van Dam, Nicolette A; Jansen, Nicolaas J; van Heerde, Mark; van der Starre, Cynthia; van Asperen, Roelie; Kneyber, Martin; van Woensel, Job B; van den Boogaard, Mark; van der Hoeven, Johannes

    2017-04-01

    To determine differences between survivors and nonsurvivors and factors associated with mortality in pediatric intensive care patients with low risk of mortality. Retrospective cohort study. Patients were selected from a national database including all admissions to the PICUs in The Netherlands between 2006 and 2012. Patients less than 18 years old admitted to the PICU with a predicted mortality risk lower than 1% according to either the recalibrated Pediatric Risk of Mortality or the Pediatric Index of Mortality 2 were included. None. In total, 16,874 low-risk admissions were included of which 86 patients (0.5%) died. Nonsurvivors had more unplanned admissions (74.4% vs 38.5%; p < 0.001), had more complex chronic conditions (76.7% vs 58.8%; p = 0.001), were more often mechanically ventilated (88.1% vs 34.9%; p < 0.001), and had a longer length of stay (median, 11 [interquartile range, 5-32] d vs median, 3 [interquartile range, 2-5] d; p < 0.001) when compared with survivors. Factors significantly associated with mortality were complex chronic conditions (odds ratio, 3.29; 95% CI, 1.97-5.50), unplanned admissions (odds ratio, 5.78; 95% CI, 3.40-9.81), and admissions in spring/summer (odds ratio, 1.67; 95% CI, 1.08-2.58). Nonsurvivors in the PICU with a low predicted mortality risk have recognizable risk factors including complex chronic condition and unplanned admissions.

  20. Stereotactic body radiotherapy for low-risk prostate cancer: five-year outcomes

    Directory of Open Access Journals (Sweden)

    King Christopher R

    2011-01-01

    Full Text Available Abstract Purpose Hypofractionated, stereotactic body radiotherapy (SBRT is an emerging treatment approach for prostate cancer. We present the outcomes for low-risk prostate cancer patients with a median follow-up of 5 years after SBRT. Method and Materials Between Dec. 2003 and Dec. 2005, a pooled cohort of 41 consecutive patients from Stanford, CA and Naples, FL received SBRT with CyberKnife for clinically localized, low-risk prostate cancer. Prescribed dose was 35-36.25 Gy in five fractions. No patient received hormone therapy. Kaplan-Meier biochemical progression-free survival (defined using the Phoenix method and RTOG toxicity outcomes were assessed. Results At a median follow-up of 5 years, the biochemical progression-free survival was 93% (95% CI = 84.7% to 100%. Acute side effects resolved within 1-3 months of treatment completion. There were no grade 4 toxicities. No late grade 3 rectal toxicity occurred, and only one late grade 3 genitourinary toxicity occurred following repeated urologic instrumentation. Conclusion Five-year results of SBRT for localized prostate cancer demonstrate the efficacy and safety of shorter courses of high dose per fraction radiation delivered with SBRT technique. Ongoing clinical trials are underway to further explore this treatment approach.

  1. Foot length measurements of newborns of high and low risk pregnancies

    Directory of Open Access Journals (Sweden)

    Ana Karina Marques Salge

    Full Text Available Abstract OBJECTIVE Comparing foot length measurements of newborns in high and low risk pregnancies at a public hospital in Goiânia, GO, Brazil. METHOD A cross-sectional study carried out between April, 2013 and May, 2015, with a sample consisting of 180 newborns; 106 infants of women from high-risk pregnancies and 74 of women from low-risk pregnancies. Data were descriptively analyzed. Foot length measurement was performed using a stiff transparent plastic ruler, graduated in millimeters. The length of both feet was measured from the tip of the hallux (big toe to the end of the heel. RESULTS A statistically significant relationship was found between the foot length and newborn’s weight, between the cephalic and thoracic perimeters in the high-risk group and between the cephalic perimeter in the control group. CONCLUSION There is a need for creating cut-off points to identify newborns with intrauterine growth disorders using foot length.

  2. Milk intake is not associated with low risk of diabetes or overweight-obesity

    DEFF Research Database (Denmark)

    Bergholdt, Helle K M; Nordestgaard, Børge G; Ellervik, Christina

    2015-01-01

    BACKGROUND: High dairy/milk intake has been associated with a low risk of type 2 diabetes observationally, but whether this represents a causal association is unknown. OBJECTIVE: We tested the hypothesis that high milk intake is associated with a low risk of type 2 diabetes and of overweight-obesity......, observationally and genetically. DESIGN: In 97,811 individuals from the Danish general population, we examined the risk of incident type 2 diabetes and of overweight-obesity by milk intake observationally and by LCT-13910 C/T genotype [polymorphism (rs4988235) upstream from the lactase (LCT) gene], where TT...... and TC genotypes are associated with lactase persistence and CC with nonpersistence. RESULTS: Observationally for any compared with no milk intake, the HR for type 2 diabetes was 1.10 (95% CI: 0.98, 1.24; P = 0.11), whereas the OR for overweight-obesity was 1.06 (1.02, 1.09; P = 0.002). Median milk...

  3. Vaginal flora alterations and clinical symptoms in low-risk pregnant women.

    Science.gov (United States)

    Gondo, Fausto; da Silva, Márcia G; Polettini, Jossimara; Tristao, Andréa da R; Peracoli, José C; Witkin, Steven S; Rudge, Marilza V C

    2011-01-01

    To evaluate associations between alterations in vaginal flora and clinical symptoms in low-risk pregnant women. Vaginal specimens from 245 pregnant women were analyzed by microscopy for vaginal flora. Signs and symptoms of vaginal infection were determined by patient interviews and gynecologic examinations. Abnormal vaginal flora was identified in 45.7% of the subjects. The final clinical diagnoses were bacterial vaginosis (21.6%), vaginal candidosis (10.2%), intermediate vaginal flora (5.2%), aerobic vaginitis (2.9%), mixed flora (2.9%) and other abnormal findings (2.9%). The percentage of women with or without clinical signs or symptoms was not significantly different between these categories. The presence of vaginal odor or vaginal discharge characteristics was not diagnostic of any specific flora alteration; pruritus was highly associated with candidosis (p vaginal odor was associated with bacterial vaginosis (p = 0.0026). The prevalence of atypical vaginal flora is common in our low-risk pregnant population and is not always associated with pathology. The occurrence of specific signs or symptoms does not always discriminate between women with different types of atypical vaginal flora or between those with abnormal and normal vaginal flora. Copyright © 2010 S. Karger AG, Basel.

  4. Ureteral diameter in low-risk vesicoureteral reflux in infancy and childhood

    International Nuclear Information System (INIS)

    Hellstroem, M.; Hjaelmaas, K.; Jacobsson, B.; Jodal, U.; Oestra Sjukhuset, Goeteborg; Oestra Sjukhuset, Goeteborg

    1986-01-01

    In order to improve the accuracy of the grading of vesicoureteral reflux (VUR), reference values for ureteral diameter at micturition cystourethrography (MCUG) were established in infants and children with low-risk VUR. Low-risk VUR was defined as VUR not associated with infection, obstruction, calculi, duplication, malformations (except for hypospadia) or neurogenic bladder disturbances. Forty-six children (age 1 day - 14 years) were selected by examining the records of 12000 MCUG:s performed 1960-1983. Ureteral diameter was measured at the widest point of the ureter on the films from MCUG:s and urographies. Ureteral diameter was slightly larger at MCUG than at urography in the same individuals but the difference was not significant. The ureteral diameter at MCUG also correlated closely to normal values at urography in a previous study. It is proposed that the reference values obtained at MCUG in the present investigation can be used for the differentiation between dilatation and no dilatation in the grading of VUR. (orig.)

  5. Binge Drinking PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2010-10-05

    This PSA is based on the October, 2010 CDC Vital Signs report which indicates that drinking too much, including binge drinking, causes more than 79,000 deaths in the U.S. each year and is the third leading preventable cause of death.  Created: 10/5/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 10/5/2010.

  6. High-Risk and Low-Risk Human Papillomavirus and the Absolute Risk of Cervical Intraepithelial Neoplasia or Cancer

    DEFF Research Database (Denmark)

    Thomsen, Louise T; Frederiksen, Kirsten; Munk, Christian

    2014-01-01

    OBJECTIVE: To determine the absolute risk of cervical intraepithelial neoplasia (CIN) grade 3 or cervical cancer (CIN 3 or worse) after detection of low-risk human papillomavirus (HPV) and after a negative high-risk HPV test. METHODS: In this prospective cohort study, consecutive liquid......-based cervical cytology samples were collected from women screened for cervical cancer in Copenhagen, Denmark, during 2002-2005. Samples were tested with a clinical test for 13 high-risk and five low-risk HPV types. The cohort (N=35,539; aged 14-90 years) was monitored in a nationwide pathology register for up...... cytology. Detection of low-risk HPV does not predict CIN 3 or worse. Cervical cancer screening should not include testing for low-risk HPV types. LEVEL OF EVIDENCE: II....

  7. Trichomonas vaginalis infection in a low-risk women attended in Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre

    Directory of Open Access Journals (Sweden)

    Norhayati Moktar

    2016-08-01

    Conclusions: The present study reported zero incidence rate of trichomoniasis. The low incidence rate was postulated due to all women who participated in this study were categorized into a low-risk group.

  8. A Systematic Approach to Discussing Active Surveillance with Patients with Low-risk Prostate Cancer.

    Science.gov (United States)

    Ehdaie, Behfar; Assel, Melissa; Benfante, Nicole; Malhotra, Deepak; Vickers, Andrew

    2017-06-01

    Physicians report difficulty convincing patients with prostate cancer about the merits of active surveillance (AS); as a result, a majority of patients unnecessarily choose to undergo radical treatment. To develop and evaluate a systematic approach for physicians to counsel patients with low-risk prostate cancer to increase acceptance of AS. A systematic counseling approach was developed and piloted in one clinic. Then five surgeons participated in a 1-h training session in which they learned about the approach. A total of 1003 patients with Gleason 3+3 prostate cancer were included in the study. We compared AS rates for 761 patients who were counseled over a 24-mo period before the training intervention with AS rates for 242 patients who were counseled over a 12-mo period afterwards, controlling for temporal trends and case mix. A systematic approach for communicating the merits of AS using appropriate framing techniques derived from principles studied by negotiation scholars. The rate of AS acceptance by patients for management of low-risk prostate cancer. In the pilot phase, 81 of 86 patients (94%) accepted AS after counseling by the physician who developed the counseling approach. In the subsequent study, the cohort for the training intervention comprised 1003 consecutive patients, 80% of whom met the Epstein criteria for very low-risk disease. The proportion of patients who selected AS increased from 69% before the training intervention to 81% afterwards. After adjusting for time trends and case mix, the rate of AS after the intervention was 9.1% higher (95% confidence interval -0.4% to 19.4%) than expected, a relative reduction of approximately 30% in the risk of unnecessary curative treatment. A systematic approach to counseling can be taught to physicians in a 1-h lecture. We found evidence that even this minimal intervention can decrease overtreatment. Our novel approach offers a framework to help address cancer screening-related overtreatment that occurs

  9. Exploring Perceptions and Behaviors about Drinking Water in Australia and New Zealand: Is It Risky to Drink Water, When and Why?

    Directory of Open Access Journals (Sweden)

    Andrea Crampton

    2016-02-01

    Full Text Available Consumers in most developed countries, including Australia and New Zealand, presume their drinking water is safe. How social perceptions about drinking water are formed, however, remains inadequately explored in the research literature. This research contributes exploratory insights by examining factors that affect consumer perceptions and behaviors. Individual perceptions of drinking water quality and actions undertaken to mitigate perceived risks were collected during 183 face-to-face interviews conducted at six research sites. Qualitative thematic analysis revealed the majority did not consider drinking water a “risky” activity, trusted water management authorities to manage all safety issues and believed self-evaluation of drinking water’s taste and appearance were sufficient measures to ensure safe consumption. Quantitatively, significant relationships emerged between water quality perceptions and sex, employment status, drinking water treatment and trust in government to provide safe water. Expert advice was rarely sought, even by those who believed drinking tap water posed some health risks. Generational differences emerged in media usage for drinking water advice. Finally, precautionary measures taken at home and abroad often failed to meet national drinking water guidelines. Three major conclusions are drawn: a. broad lack of awareness exists about the most suitable and safe water treatment activities, as well as risks posed; b. health literacy and interest may be improved through greater consumer involvement in watershed management; and c. development of health campaigns that clearly communicate drinking water safety messages in a timely, relevant and easily understandable fashion may help mitigate actual risks and dispel myths.

  10. [Draft of the best medical treatment in patients with low-risk thyroid cancer].

    Science.gov (United States)

    Vlček, Petr; Nováková, Dagmar; Vejvalka, Jan; Zimák, Jaroslav; Křenek, Martin; Vošmiková, Květuše; Smutný, Svatopluk; Bavor, Petr; Astl, Jaromír; Lukáš, Jindřich

    2015-09-01

    The incidence of well-differentiated low-risk thyroid cancer have increased globally over the last three decades. Thyroid cancer treatment relates to a suitable surgical procedure and the use of adjuvant radio-iodine therapy in selected patients. Evaluation of prognostic factors and risk stratification are critical for determining appropriate treatment. Survival of patients with low-risk thyroid cancer is excellent. Appropriate choice of medical treatment resulted in full recovery in most patients. Relapse risk increases with the size of the primary tumor, along with the findings of the risk factors in men. Our study included a total of 1 980 patients in whom were diagnosed T1a and T1b tumors between the years 2003 to 2012. The population included 1 675 women (84.6 %) of average age of 45.22 years and 305 men (15.4 %) of average age of 50.0 years. The bulk of the file represented papillary carcinomas (1 868; 94.4 %), and smaller group of follicular carcinomas (112; 5.6 %). Patients were divided into four groups according to tumor size. Patients were evaluated according to risk factors: unifocality no other risk factors, multifocality - more bearings in thyroid tumor, metastases in regional lymph nodes, distant metastases or combination of risk factors. Group A: In the monitored set of 678 patients with papillary and follicular microcarcinoma up to 5 mm, during histological input, the findings revealed one bearing (unifocal type of cancer) in 566 patients. Multifocality was found in 112 patients, local nodal metastasis were demonstrated in 24 cases and pulmonary metastasis was discove-red in 1 case. Group B: In this group there were 576 study patients with papillary and follicular microcarcinoma size of 5-10 mm. Histological findings were captured input one bearing carcinoma in 434 patients, 142 patients with multifocality, in 53 cases of local nodal metastasis, and 1 case of bone metastases. Group C: In this group there were 467 study patients with papillary

  11. Fear of childbirth and emergency caesarean section in low-risk nulliparous women

    DEFF Research Database (Denmark)

    Jespersen, Cecilie; Hegaard, Hanne Kristine; Schroll, Anne-Mette

    2014-01-01

    OBJECTIVE: To assess the association between fear of childbirth (FOC) and emergency caesarean section. DESIGN: A prospective cohort study of low-risk nulliparous women at term. SETTING: Nine obstetric departments in Denmark, May 2004-July 2005. POPULATION: A total of 2598 nulliparous women...... in spontaneous labor with a single fetus in cephalic presentation at term. METHODS: Self-reported FOC was assessed at 37 weeks of gestation by the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) version A and at admission to the labor ward by the Delivery Fear Scale (DFS). Mode of delivery...... was recorded by the attending staff. Logistic regression analyses were used to estimate unadjusted and adjusted odds ratios (OR). MAIN OUTCOME MEASURES: Risk of emergency caesarean section in women who feared childbirth. RESULTS: FOC (W-DEQ sum score ≥ 85 and DFS sum score ≥ 70) was not associated...

  12. Providing reliable equipment to IAEA through a low risk transition plan

    International Nuclear Information System (INIS)

    Green, L.; Weinstock, E.V.; Karlin, E.W.

    1988-01-01

    The development and production of safeguards equipment is a complex process containing many potential pitfalls between the conceptual design and its implementation in the field. The conditions for equipment use are especially demanding. At the same time, the consequences of failure may be serious. Repeated failure may result in the loss of credibility of safeguards. Expensive back up measures such as re-verification of inventories may be required. Inspectors may come to distrust the equipment. Finally, the expense of maintaining the equipment may be excessive. It is therefore essential that the process for bringing equipment for the conceptual stage to actual routine use minimizes the risk of producing equipment that is unsuitable for the job. Fortunately, approaches for accomplishing this have already been developed in both the industrial and commercial sectors. One such approach, the Low Risk Transition Plan (LRTP) is described to show it can be applied to the production of reliable safeguards equipment

  13. Determinants of prenatal health care utilisation by low-risk women: a prospective cohort study.

    Science.gov (United States)

    Feijen-de Jong, Esther I; Jansen, Danielle E M C; Baarveld, Frank; Boerleider, Agatha W; Spelten, Evelien; Schellevis, François; Reijneveld, Sijmen A

    2015-06-01

    Prenatal health care is pivotal in providing adequate prevention and care to pregnant women. We examined the determinants of inadequate prenatal health care utilisation by low-risk women in primary midwifery-led care in the Netherlands. We used longitudinal data from the population-based DELIVER study with 20 midwifery practices across the Netherlands in 2009 and 2010 as the experimental setting. The participants were 3070 pregnant women starting pregnancy care in primary midwifery care. We collected patient-reported data on potential determinants of prenatal care utilisation derived from the Andersen model. Prenatal health care utilisation was measured by a revised version of the Kotelchuck Index, which measures a combination of care entry and number of visits. Low-risk pregnant women (not referred during pregnancy) were more likely to use prenatal care inadequately if they intended to deliver at a hospital, if they did not use folic acid adequately periconceptionally, or if they were exposed to cigarette smoke during pregnancy. Among those who were referred to secondary care, women reporting a chronic illnesses or disabilities, and women who did not use folic acid periconceptionally were more likely to make inadequate use of prenatal care. Inadequate prenatal health care use in primary midwifery care is more likely in specific groups, and the risk groups differ when women are referred to secondary care. The findings suggest routes that can target interventions to women who are at risk of not adequately using prenatal prevention and care services. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  14. Factors associated with the prevalence of periodontal disease in low-risk pregnant women

    Science.gov (United States)

    2012-01-01

    Objective To evaluate the prevalence of periodontal disease (PD) among Brazilian low-risk pregnant women and its association with sociodemographic factors, habits and oral hygiene. Method This cross-sectional study included 334 low-risk pregnant women divided in groups with or without PD. Indexes of plaque and gingival bleeding on probing, probing pocket depth, clinical attachment level and gingival recession were evaluated at one periodontal examination below 32 weeks of gestation. Independent variables were: age, race/color, schooling, marital status, parity, gestational age, smoking habit, alcohol and drugs consumption, use of medication, presence of any systemic diseases and BMI (body mass index). Statistical analyses provided prevalence ratios and their respective 95%CI and also a multivariate analysis. Results The prevalence of PD was 47% and significantly associated with higher gestational age (PR 1.40; 1.01 - 1.94 for 17-24 weeks and PR 1.52; 1.10 - 2.08 for 25-32 weeks), maternal age 25-29 years, obesity (PR 1.65; 1.02 - 2.68) and the presence of gingival bleeding on probing (ORadj 2.01, 95%CI 1.41 - 2.88). Poor oral hygiene was associated with PD by the mean values of plaque and bleeding on probing indexes significantly greater in PD group. Conclusions The prevalence of PD is high and associated with gingival bleeding on probing, more advanced gestational age and obesity. A program of oral health care should be included in prenatal care for early pregnancy, especially for low-income populations. PMID:22273008

  15. Outcome of pregnancy subsequent to chemotherapy with actinomycin-D in low risk gestational trophoblastic neoplasia

    Directory of Open Access Journals (Sweden)

    Soheila Aminimoghaddam

    2017-07-01

    Methods: A retrospective cohort study was conducted on patients with GTN who were referred to Firoozgar and Mirza Koochak Khan teaching hospitals during 10 years, starting from 2004. The inclusion criterion was patients with low-risk persistent GTN after molar pregnancy, EP, and abortion, that treated with single agent chemotherapy actinomycin-D. After following the patients for 12 months, patients with serum βHCG lower than 5 mIU/ml, who intended to have child were allowed to become pregnant. The following items were observed in the study: age, body mass index (BMI, parity, chemotherapy duration, and pregnancy outcomes such as spontaneous abortion or preterm labor, pre-eclampsia, stillbirth, fetal malformation, and repeated molar pregnancy. Results: 74 patients were monitored, 83.78% of them had uncomplicated pregnancy and labor, 4.05% had the abortion, 4.05% had second molar pregnancy, 2.7% had pre-eclampsia, 5.40% had preterm labor. Moreover, stillbirth and malformation did not occur in this study even after chemotherapy treatment. There was not any significant correlation between age, BMI, parity, and chemotherapy duration with pregnancy outcomes. Conclusion: The outcomes of pregnancy after chemotherapy with actinomycin-D is similar to the general population who did not have chemotherapy. The abortion rate and repeated molar pregnancy were similar between population and sample too. Thus, the study shows that the cured patients with low-risk GTN have as much chance of having a normal pregnancy as normal women. In other words, treatment with actinomycin-D does not have any adverse effect in future pregnancies.

  16. Prospective Validation of Modified NEXUS Cervical Spine Injury Criteria in Low-risk Elderly Fall Patients

    Directory of Open Access Journals (Sweden)

    John Tran

    2016-05-01

    Full Text Available Introduction: The National Emergency X-radiography Utilization Study (NEXUS criteria are used extensively in emergency departments to rule out C-spine injuries (CSI in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation. Methods: This is a prospective, observational cohort study of geriatric fall patients who presented to a Level I trauma center and were not triaged to the trauma bay. Providers enrolled non-intoxicated patients at baseline mental status with no lateralizing neurologic deficits. They recorded midline neck tenderness, signs of trauma, and presence of other distracting injury. Results: We enrolled 800 patients. One patient fall event was excluded due to duplicate enrollment, and four were lost to follow up, leaving 795 for analysis. Average age was 83.6 (range 65-101. The numbers in parenthesis after the negative predictive value represent confidence interval. There were 11 (1.4% cervical spine injuries. One hundred seventeen patients had midline tenderness and seven of these had CSI; 366 patients had signs of trauma to the face/neck, and 10 of these patients had CSI. Using signs of trauma to the head/neck as the only distracting injury and baseline mental status as normal alertness, the modified NEXUS criteria was 100% sensitive (CI [67.9-100] with a negative predictive value of 100 (98.7-100. Conclusion: Our study suggests that a modified NEXUS criteria can be safely applied to low-risk elderly falls.

  17. Prospective Validation of Modified NEXUS Cervical Spine Injury Criteria in Low-risk Elderly Fall Patients.

    Science.gov (United States)

    Tran, John; Jeanmonod, Donald; Agresti, Darin; Hamden, Khalief; Jeanmonod, Rebecca K

    2016-05-01

    The National Emergency X-radiography Utilization Study (NEXUS) criteria are used extensively in emergency departments to rule out C-spine injuries (CSI) in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation. This is a prospective, observational cohort study of geriatric fall patients who presented to a Level I trauma center and were not triaged to the trauma bay. Providers enrolled non-intoxicated patients at baseline mental status with no lateralizing neurologic deficits. They recorded midline neck tenderness, signs of trauma, and presence of other distracting injury. We enrolled 800 patients. One patient fall event was excluded due to duplicate enrollment, and four were lost to follow up, leaving 795 for analysis. Average age was 83.6 (range 65-101). The numbers in parenthesis after the negative predictive value represent confidence interval. There were 11 (1.4%) cervical spine injuries. One hundred seventeen patients had midline tenderness and seven of these had CSI; 366 patients had signs of trauma to the face/neck, and 10 of these patients had CSI. Using signs of trauma to the head/neck as the only distracting injury and baseline mental status as normal alertness, the modified NEXUS criteria was 100% sensitive (CI [67.9-100]) with a negative predictive value of 100 (98.7-100). Our study suggests that a modified NEXUS criteria can be safely applied to low-risk elderly falls.

  18. Distinct evolutionary mechanisms for genomic imbalances in high-risk and low-risk neuroblastomas

    Directory of Open Access Journals (Sweden)

    Gisselsson David

    2007-09-01

    Full Text Available Abstract Background Neuroblastoma (NB is the most common extracranial solid tumour of childhood. Several genomic imbalances correlate to prognosis in NB, with structural rearrangements, including gene amplification, in a near-diploid setting typically signifying high-risk tumours and numerical changes in a near-triploid setting signifying low-risk tumours. Little is known about the temporal sequence in which these imbalances occur during the carcinogenic process. Methods We have reconstructed the appearance of cytogenetic imbalances in 270 NBs by first grouping tumours and imbalances through principal component analysis and then using the number of imbalances in each tumour as an indicator of evolutionary progression. Results Tumours clustered in four sub-groups, dominated respectively by (1 gene amplification in double minute chromosomes and few other aberrations, (2 gene amplification and loss of 1p sequences, (3 loss of 1p and other structural aberrations including gain of 17q, and (4 whole-chromosome gains and losses. Temporal analysis showed that the structural changes in groups 1–3 were acquired in a step-wise fashion, with loss of 1p sequences and the emergence of double minute chromosomes as the earliest cytogenetic events. In contrast, the gains and losses of whole chromosomes in group 4 occurred through multiple simultaneous events leading to a near-triploid chromosome number. Conclusion The finding of different temporal patterns for the acquisition of genomic imbalances in high-risk and low-risk NBs lends strong support to the hypothesis that these tumours are biologically diverse entities, evolving through distinct genetic mechanisms.

  19. Factors associated with the prevalence of periodontal disease in low-risk pregnant women

    Directory of Open Access Journals (Sweden)

    Vogt Marianna

    2012-01-01

    Full Text Available Abstract Objective To evaluate the prevalence of periodontal disease (PD among Brazilian low-risk pregnant women and its association with sociodemographic factors, habits and oral hygiene. Method This cross-sectional study included 334 low-risk pregnant women divided in groups with or without PD. Indexes of plaque and gingival bleeding on probing, probing pocket depth, clinical attachment level and gingival recession were evaluated at one periodontal examination below 32 weeks of gestation. Independent variables were: age, race/color, schooling, marital status, parity, gestational age, smoking habit, alcohol and drugs consumption, use of medication, presence of any systemic diseases and BMI (body mass index. Statistical analyses provided prevalence ratios and their respective 95%CI and also a multivariate analysis. Results The prevalence of PD was 47% and significantly associated with higher gestational age (PR 1.40; 1.01 - 1.94 for 17-24 weeks and PR 1.52; 1.10 - 2.08 for 25-32 weeks, maternal age 25-29 years, obesity (PR 1.65; 1.02 - 2.68 and the presence of gingival bleeding on probing (ORadj 2.01, 95%CI 1.41 - 2.88. Poor oral hygiene was associated with PD by the mean values of plaque and bleeding on probing indexes significantly greater in PD group. Conclusions The prevalence of PD is high and associated with gingival bleeding on probing, more advanced gestational age and obesity. A program of oral health care should be included in prenatal care for early pregnancy, especially for low-income populations.

  20. How will alcohol sales in the UK be affected if drinkers follow government guidelines?

    Science.gov (United States)

    Baumberg, Ben

    2009-01-01

    The proportion of alcohol consumption that is above government guidelines ('risky drinking') has been estimated in several countries, suggesting that reductions in risky drinking would lead to significant declines in total alcohol consumption. However, this has not previously been conducted transparently in the UK. Furthermore, existing studies have under-explored the importance of several methodological decisions, as well as not closely examining the meaning of these figures for debates on 'corporate social responsibility' (CSR). Secondary analysis of the amount of alcohol consumption above various government guidelines in four British datasets for 2000-2002: the National Diet and Nutrition Survey; the General Household Survey; Smoking, Drinking and Drug Use among Young People; and the March 2002 ONS Omnibus Survey. Risky drinking accounts for 55-82% of the total consumption by 18- to 64-year olds, depending on the definition of risky drinking used. If only alcohol above the government guidelines is counted, this falls to 22-47%. Consumption by underage drinkers accounts for 4.5% of the total consumption, while consumption by drink-drivers accounts for 0.5-8.0% depending on the assumptions made. Methodologically, the study shows that at least two decisions have considerable importance: the definition of risky drinking used and whether we count all drinking (as in most previous studies) or only drinking above guidelines. Substantively, these studies do not directly show that drink companies' profitability would be affected by declines in risky drinking. Nevertheless, they are valuable for present debate in themselves and form the basis of a more complex analysis of alcohol CSR.

  1. Time to revisit arsenic regulations: comparing drinking water and rice.

    Science.gov (United States)

    Sauvé, Sébastien

    2014-05-17

    Current arsenic regulations focus on drinking water without due consideration for dietary uptake and thus seem incoherent with respect to the risks arising from rice consumption. Existing arsenic guidelines are a cost-benefit compromise and, as such, they should be periodically re-evaluated. Literature data was used to compare arsenic exposure from rice consumption relative to exposure arising from drinking water. Standard risk assessment paradigms show that arsenic regulations for drinking water should target a maximum concentration of nearly zero to prevent excessive lung and bladder cancer risks (among others). A feasibility threshold of 3 μg As l(-1) was determined, but a cost-benefit analysis concluded that it would be too expensive to target a threshold below 10 μg As l(-1). Data from the literature was used to compare exposure to arsenic from rice and rice product consumption relative to drinking water consumption. The exposure to arsenic from rice consumption can easily be equivalent to or greater than drinking water exposure that already exceeds standard risks and is based on feasibility and cost-benefit compromises. It must also be emphasized that many may disagree with the implications for their own health given the abnormally high cancer odds expected at the cost-benefit arsenic threshold. Tighter drinking water quality criteria should be implemented to properly protect people from excessive cancer risks. Food safety regulations must be put in place to prevent higher concentrations of arsenic in various drinks than those allowed in drinking water. Arsenic concentrations in rice should be regulated so as to roughly equate the risks and exposure levels observed from drinking water.

  2. Drinking to the Limit

    DEFF Research Database (Denmark)

    Järvinen, Margaretha; Ellersgaard, Christoph Houman; Larsen, Anton Grau

    2014-01-01

    of economic, cultural and inherited capital are more responsive to alcohol-related health messages than respondents (and especially males) occupying positions low in the social space. This, however, does not mean that respondents from dominant groups have ‘safe’ drinking habits, as these are defined......The aim of this article is to analyse social status differences in alcohol norms and practices seen from the perspective of ‘health governance’. Survey data on 1442 employees in a middle-sized, Danish firm are used to construct a Bourdieu-inspired social space, tied to four forms of capital......: economic, cultural, inherited and organisational. A range of variables measuring alcohol norms, drinking practices and alcohol-related problems are then inserted into the space. This article identifies status differences in the employees’ drinking patterns indicating that respondents with large amounts...

  3. A brief overview on radon measurements in drinking water.

    Science.gov (United States)

    Jobbágy, Viktor; Altzitzoglou, Timotheos; Malo, Petya; Tanner, Vesa; Hult, Mikael

    2017-07-01

    The aim of this paper is to present information about currently used standard and routine methods for radon analysis in drinking waters. An overview is given about the current situation and the performance of different measurement methods based on literature data. The following parameters are compared and discussed: initial sample volume and sample preparation, detection systems, minimum detectable activity, counting efficiency, interferences, measurement uncertainty, sample capacity and overall turnaround time. Moreover, the parametric levels for radon in drinking water from the different legislations and directives/guidelines on radon are presented. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Data on fluoride concentration level in villages of Asara (Alborz, Iran) and daily fluoride intake based on drinking water consumption.

    Science.gov (United States)

    Akhavan, Giti; Dobaradaran, Sina; Borazjani, Jaleh Mohajeri

    2016-12-01

    In the present data article, fluoride concentration levels of drinking water (with spring or groundwater sources) in 10 villages of Asara area located in Alborz province were determined by the standard SPADNS method using a spectrophotometer (DR/2000 Spectrophotometer, USA). Daily fluoride intakes were also calculated based on daily drinking water consumption. The fluoride content were compared with EPA and WHO guidelines for drinking water.

  5. British Columbia water quality guidelines (criteria): 1998 edition

    Energy Technology Data Exchange (ETDEWEB)

    Nagpal, N.K.; Pommen, L.W.; Swain, L.G.

    1998-08-01

    British Columbia has developed water quality guidelines in order that water quality data can be assessed and site-specific water quality objectives can be prepared. The guidelines provide benchmarks for the assessment of water quality and setting water quality objectives. Guidelines are provided to protect the following six major water uses: drinking water, aquatic life, wildlife, recreation/aesthetics, agriculture, and industrial. Water quality encompasses the physical, chemical and biological quality of the water, sediment and biota. Among other quality criteria the guide provides maximum approved concentrations for nitrogen, aluminum, copper, cyanide, lead, mercury, and molybdenum. 30 tabs.

  6. Pre-Feedback Risk Expectancies and Reception of Low-Risk Health Feedback: Absolute and Comparative Lack of Reassurance.

    Science.gov (United States)

    Gamp, Martina; Renner, Britta

    2016-11-01

    Personalised health-risk assessment is one of the most common components of health promotion programs. Previous research on responses to health risk feedback has commonly focused on the reception of bad news (high-risk feedback). The reception of low-risk feedback has been comparably neglected since it is assumed that good news is reassuring and readily received. However, field studies suggest mixed responses to low-risk health feedback. Accordingly, we examine whether pre-feedback risk expectancies can mitigate the reassuring effects of good news. In two studies (N = 187, N = 565), after assessing pre-feedback risk expectancies, participants received low-risk personalised feedback about their own risk of developing (the fictitious) Tucson Chronic Fatigue Syndrome (TCFS). Study 2 also included peer TCFS risk status feedback. Afterwards, self- and peer-related risk perception for TCFS was assessed. In both studies, participants who expected to be at high risk but received good news (unexpected low-risk feedback) showed absolute lack of reassurance. Specifically, they felt at significantly greater TCFS risk than participants who received expected good news. Moreover, the unexpected low-risk group even believed that their risk was as high as (Study 1) or higher (Study 2) than that of their peers (comparative lack of reassurance). Results support the notion that high pre-feedback risk expectancies can mitigate absolute and comparative reassuring effects of good news. © 2016 The International Association of Applied Psychology.

  7. Alcohol use and safe drinking

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001944.htm Alcohol use and safe drinking To use the sharing features on this page, please enable JavaScript. Alcohol use involves drinking beer, wine, or hard liquor. ...

  8. College Drinking - Changing the Culture

    Science.gov (United States)

    ... about college alcohol policies College Drinking - Changing the Culture This is your one-stop resource for comprehensive ... More about special features College Drinking - Changing the Culture This is your one-stop resource for comprehensive ...

  9. Drinking Water in your Home

    Science.gov (United States)

    Many people choose to filter or test the drinking water that comes out of their tap or from their private well for a variety of reasons. And whether at home, at work or while traveling, many Americans drink bottled water.

  10. Rethinking Drinking: Questions and Answers

    Science.gov (United States)

    ... standard drinks you're being served in a restaurant or bar that uses large glasses and generous ... drinking habits. For more information, see A Family History of Alcoholism: Are You at Risk? Pace yourself: ...

  11. Who drinks where: youth selection of drinking contexts.

    Science.gov (United States)

    Lipperman-Kreda, Sharon; Mair, Christina F; Bersamin, Melina; Gruenewald, Paul J; Grube, Joel W

    2015-04-01

    Different drinkers may experience specific risks depending on where they consume alcohol. This longitudinal study examined drinking patterns, and demographic and psychosocial characteristics associated with youth drinking in different contexts. We used survey data from 665 past-year alcohol-using youths (ages 13 to 16 at Wave 1) in 50 midsized California cities. Measures of drinking behaviors and drinking in 7 contexts were obtained at 3 annual time points. Other characteristics included gender, age, race, parental education, weekly disposable income, general deviance, and past-year cigarette smoking. Results of multilevel regression analyses show that more frequent past-year alcohol use was associated with an increased likelihood of drinking at parties and at someone else's home. Greater continued volumes of alcohol (i.e., heavier drinking) was associated with increased likelihood of drinking at parking lots or street corners. Deviance was positively associated with drinking in most contexts, and past-year cigarette smoking was positively associated with drinking at beaches or parks and someone else's home. Age and deviance were positively associated with drinking in a greater number of contexts. The likelihood of youth drinking at parties and someone else's home increased over time, whereas the likelihood of drinking at parking lots/street corners decreased. Also, deviant youths progress to drinking in their own home, beaches or parks, and restaurants/bars/nightclubs more rapidly. The contexts in which youths consume alcohol change over time. These changes vary by individual characteristics. The redistribution of drinking contexts over the early life course may contribute to specific risks associated with different drinking contexts. Copyright © 2015 by the Research Society on Alcoholism.

  12. Rethink Your Drink!

    Centers for Disease Control (CDC) Podcasts

    2016-08-11

    In this podcast for kids, the Kidtastics talk about the importance of drinking a lot of water.  Created: 8/11/2016 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 8/11/2016.

  13. Absence of survival benefit of radioactive iodine (RAI) after thyroidectomy in low risk differentiated thyroid cancer (DTC) patients

    International Nuclear Information System (INIS)

    Schwartz, C.; Fieffe, S.; Pochart, J.M.; Bonnetain, F.; Gauthier, M.; Cueff, A.; Crevisy, E.; Dygai-Cochet, I.; Toubeau, M.

    2012-01-01

    After thyroidectomy, the goal of the first dose of radioactive iodine (RAI) is remnant ablation to facilitate the initial staging with the post-therapy scan and to facilitate the early detection of recurrences. The purpose of this study is to the survival benefit of RAI in low-risk thyroid cancer patients. Using Cancer thyroid registry of Marne Ardennes (1041 patients) and hospital data base of centre Leclerc (257 patients), we included all differentiated thyroid cancer (DTC) patients at low risk from 1975 to 2005. Median follow-up was 10.3 years, during which 19 recurrences, 61 other malignant diseases and 105 deaths were registered. 387 patients (30%) received no RAI and 911 had RAI (70%). If we confirmed that some clinical characteristics were associated with RAI intake, the study failed to demonstrate any survival benefit of RAI in low risk DTC patients

  14. Absence of survival benefit of radioactive iodine (RAI) after thyroidectomy in low risk differentiated thyroid cancer (DTC) patients

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, C.; Fieffe, S.; Pochart, J.M. [Endocrinology Nuclear Medicine, Institut Jean Godinot, Reims (France); Bonnetain, F.; Gauthier, M.; Cueff, A. [Statistics and Epidemiology, Centre Georges Francois Leclerc, Dijon (France); Crevisy, E.; Dygai-Cochet, I.; Toubeau, M. [Nuclear Medicine, Centre Georges Francois Leclerc, Dijon (France)

    2012-07-01

    After thyroidectomy, the goal of the first dose of radioactive iodine (RAI) is remnant ablation to facilitate the initial staging with the post-therapy scan and to facilitate the early detection of recurrences. The purpose of this study is to the survival benefit of RAI in low-risk thyroid cancer patients. Using Cancer thyroid registry of Marne Ardennes (1041 patients) and hospital data base of centre Leclerc (257 patients), we included all differentiated thyroid cancer (DTC) patients at low risk from 1975 to 2005. Median follow-up was 10.3 years, during which 19 recurrences, 61 other malignant diseases and 105 deaths were registered. 387 patients (30%) received no RAI and 911 had RAI (70%). If we confirmed that some clinical characteristics were associated with RAI intake, the study failed to demonstrate any survival benefit of RAI in low risk DTC patients

  15. Physical Activity Guidelines

    Science.gov (United States)

    ... use this site. health.gov Physical Activity Guidelines Physical Activity Physical activity is key to improving the health of the Nation. Based on the latest science, the Physical Activity Guidelines for Americans is an essential resource for ...

  16. Drinking games and contextual factors of 21st birthday drinking.

    Science.gov (United States)

    Neighbors, Clayton; Rodriguez, Lindsey M; Rinker, Dipali V; DiBello, Angelo M; Young, Chelsie M; Chen, Chun-Han

    2014-09-01

    21st birthday celebrations are among the highest risks for alcohol use throughout emerging adulthood and celebrants often experience a range of alcohol-related consequences. The present research considered what happens when drinking games are paired with an already high-risk event (i.e., 21st birthday celebrations) and how drinking games compare with other contextual factors on 21st birthdays. Approximately four days after turning 21, 1124 college students (55% women) completed an online survey assessing alcohol use and related consequences experienced during their birthday celebrations. Participants were also asked whether drinking games and other contextual factors were associated with their celebrations. Overall, 18% of participants reported playing drinking games during their 21st birthday celebrations. These individuals reported consuming more alcohol, had higher estimated BACs, and experienced more negative consequences than those who did not play drinking games. The association between playing drinking games and alcohol use and negative consequences was stronger for men. The effect of drinking games on negative consequences was mediated through elevated BAC levels. Receiving bar specials, having drinks purchased, playing drinking games, and loud music were uniquely and significantly associated with all alcohol outcomes. Together, these results suggest that drinking games are part of a larger context of risk contributing to extreme drinking on 21st birthdays. Furthermore, these results will help to facilitate interventions that are more individually tailored to target specific contextual risks, behaviors, and events.

  17. What does the alcohol industry mean by 'Responsible drinking'? A comparative analysis.

    Science.gov (United States)

    Maani Hessari, N; Petticrew, M

    2018-03-01

    The alcohol industry uses responsible drinking messaging as a central element of its corporate social responsibility (CSR) activities. It has been argued that such messaging is vague, and potentially part of broader CSR activities to protect industry interests at the expense of public health. This study aimed to identify how industry defines responsible drinking, and in what contexts it is used. This was a qualitative documentary analysis of publicly available documents and web pages, including company web pages, press releases, reports and blogs from a representative selection of alcohol producers, and industry social aspect/public relations organizations; these were compared to health NGOs and Public Health England. All materials were coded iteratively using NVivo, and results were analysed using the hermeneutic approach. The term 'responsible drinking' was used almost exclusively by industry or industry-funded organizations. 'Responsible drinking' was not clearly defined with relation to any particular level of alcohol consumption, and government alcohol guidelines were rarely referenced. Responsible drinking is a strategically ambiguous, industry-affiliated term that allows for multiple interpretations. Industry sources rarely reference government drinking guidelines in the context of responsible drinking, stressing individual responsibility and risk management. Public health practitioners should be aware of these distinctions, and use clear language regarding lower risk drinking.

  18. HTLV-I/II and blood donors: determinants associated with seropositivity in a low risk population

    Directory of Open Access Journals (Sweden)

    Bernadette Catalan Soares

    2003-08-01

    Full Text Available OBJECTIVE: Blood donors in Brazil have been routinely screened for HTLV-I/II since 1993. A study was performed to estimate the prevalence of HTLV-I/II infection in a low risk population and to better understand determinants associated with seropositivity. METHODS: HTLV-I/II seropositive (n=135, indeterminate (n=167 and seronegative blood donors (n=116 were enrolled in an open prevalence prospective cohort study. A cross-sectional epidemiological study of positive, indeterminate and seronegative HTLV-I/II subjects was conducted to assess behavioral and environmental risk factors for seropositivity. HTLV-I/II serological status was confirmed using enzyme-linked immunosorbent assay (EIA and Western blot (WB. RESULTS: The three groups were not homogeneous. HTLV-I/II seropositivity was associated to past blood transfusion and years of schooling, a marker of socioeconomic status, and use of non-intravenous illegal drugs. CONCLUSIONS: The study results reinforce the importance of continuous monitoring and improvement of blood donor selection process.

  19. Peripheral QCT: a low risk procedure to identify women predisposed to osteoporosis

    International Nuclear Information System (INIS)

    Mueller, A.; Rueegsegger, E.; Rueegsegger, P.

    1989-01-01

    A low-risk procedure is described for the precise quantitation of changes of trabecular and cortical bone density at peripheral measuring sites. The method is based on quantitative computed tomography (QCT). Bone parameters are calculated for a sample volume common to all examinations of a patient. This is achieved by matching stacks of tomograms according to the cross sectional area of the bone measured. With the help of a special-purpose CT system the described procedure enables a reproducibility for trabecular and cortical bone parameters of 0.3% (1 SD) at a local radiation dose of of 0.1 mSv (10 mrem). The method was used to assess the individual changes in bone density of 39 perimenopausal women during an observation period of 2 to 3 years. The results are grouped according to their menstrual state. Regularly menstruating women experience minute or no changes in bone density. After menopause the interindividual differences are considerable: some women lose bone excessively, others remain relatively stable. The frequency distribution of the rate of bone loss appears to be bimodal. Hence women can be classified in fast losers and slow losers. We conclude that the rate of bone loss may be most helpful in the identification of those women predisposed to osteoporosis. (author)

  20. Early psychomotor development of low-risk preterm infants: Influence of gestational age and gender.

    Science.gov (United States)

    Romeo, Domenico M; Brogna, Claudia; Sini, Francesca; Romeo, Mario G; Cota, Francesco; Ricci, Daniela

    2016-07-01

    The influence of gestational age and gender in the neurodevelopment of infants during the first year of age is not yet fully elucidated. The purpose of this study was to identify the early occurrence of neurodevelopmental differences, between very preterm, late preterm and term born infants and the possible influence of the gender on the neurodevelopment in early infancy. A total of 188 low-risk infants, 69 very preterms, 71 late-preterms, and 48 term infants were assessed at 3, 6, 9, 12 months corrected age using the Hammersmith Infant Neurological Examination (HINE). At two years of age infants performed the Mental Developmental Index (MDI) of the Bayley Scales of Infant Development. The main results indicate that both very preterms and late-preterms showed significant lower global scores than term born infants at each evaluation (p development of infants assessed during the first 2 years of life. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  1. Periodontal disease and some adverse perinatal outcomes in a cohort of low risk pregnant women

    Directory of Open Access Journals (Sweden)

    Cecatti Jose G

    2010-11-01

    Full Text Available Abstract Objective To evaluate the association of periodontal disease (PD in pregnancy with some adverse perinatal outcomes. Method This cohort study included 327 pregnant women divided in groups with or without PD. Indexes of plaque and gingival bleeding on probing, probing pocket depth, clinical attachment level and gingival recession were evaluated at one periodontal examination below 32 weeks of gestation. The rates of preterm birth (PTB, low birth weight (LBW, small for gestational age (SGA neonates and prelabor rupture of membranes (PROM were evaluated using Risk Ratios (95%CI and Population Attributable Risk Fractions. Results PD was associated with a higher risk of PTB (RRadj. 3.47 95%CI 1.62-7.43, LBW (RRadj. 2.93 95%CI 1.36-6.34 and PROM (RRadj. 2.48 95%CI 1.35-4.56, but not with SGA neonates (RR 2.38 95%CI 0.93 - 6.10. Conclusions PD was a risk factor for PT, LBW and PROM among Brazilian low risk pregnant women.

  2. Maternal and newborn morbidity by birth facility among selected United States 2006 low-risk births.

    Science.gov (United States)

    Wax, Joseph R; Pinette, Michael G; Cartin, Angelina; Blackstone, Jacquelyn

    2010-02-01

    We sought to evaluate perinatal morbidity by delivery location (hospital, freestanding birth center, and home). Selected 2006 US birth certificate data were accessed online from the Centers for Disease Control and Prevention. Low-risk maternal and newborn outcomes were tabulated and compared by birth facility. A total of 745,690 deliveries were included, of which 733,143 (97.0%) occurred in hospital, 4661 (0.6%) at birth centers, and 7427 (0.9%) at home. Compared with hospital deliveries, home and birthing center deliveries were associated with more frequent prolonged and precipitous labors. Home births experienced more frequent 5-minute Apgar scores home and birthing center deliveries were associated with less frequent chorioamnionitis, fetal intolerance of labor, meconium staining, assisted ventilation, neonatal intensive care unit admission, and birthweight Home births are associated with a number of less frequent adverse perinatal outcomes at the expense of more frequent abnormal labors and low 5-minute Apgar scores. Copyright 2010 Mosby, Inc. All rights reserved.

  3. Placental histological inflammation and reproductive tract infections in a low risk pregnant population in Latvia.

    Science.gov (United States)

    Rezeberga, Dace; Lazdane, Gunta; Kroica, Juta; Sokolova, Ludmila; Donders, Gilbert G G

    2008-01-01

    To investigate the correlation of reproductive tract infections (RTI) and endogenous vaginal flora at first antenatal consultation with placental histological inflammation. In a follow-up study, 154 low risk women with no miscarriage risk factors were examined for the presence of Neisseria gonorrhoeae, Trichomonas vaginalis, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, Gardnerella vaginalis, Streptococcus agalactiae (GBS), Staphylococcus aureus, Enterococcus faecalis (GDS) and bacterial vaginosis (BV). At delivery, outcome data were collected and the histology of the placenta was studied. Some 85 (56.3%) of all pregnant women had RTI or endogenous vaginal flora. Placental histological inflammation correlated with genital tract colonisation with G. vaginalis (p =0.013), BV (p =0.031), S. aureus (p =0.04) and aerobic vaginitis (p =0.017). BV and BV-related G. vaginalis correlated with the presence of parietal and placental chorioamnionitis in 53.8 and 43.5% of cases. Genital tract colonisation with GDS and other aerobic flora in combination with inflammatory vaginitis correlated with the presence of funisitis in 33.3 and 40.0% of cases. Mycoplasmas increased the risk for intrauterine infection only when present in combination with other RTIs (p =0.023). Histological placental inflammation is associated with both BV and genital tract colonisation with aerobic bacteria, while funisitis is associated with colonisation of aerobic bacteria at first prenatal visit before the 17th gestational week.

  4. Obesity and pregnancy: a transversal study from a low-risk maternity.

    Science.gov (United States)

    Calderon, Ana Carolina S; Quintana, Silvana M; Marcolin, Alessandra C; Berezowski, Aderson T; Brito, Luiz Gustavo O; Duarte, Geraldo; Cavalli, Ricardo C

    2014-07-28

    Obesity is a public health problem and is increasing in all populations, including pregnant women. It influences maternal and neonatal outcomes; however, data are scarce in developing countries. We aimed to compare perinatal results between obese and non-obese pregnant women in a low-risk maternity. Transversal study of 1,779 40-week-pregnancies from 2005 to 2009 that completed a standard questionnaire with sociodemographic, obstetrical and neonatal variables and performed an ultrasound with amniotic fluid index (AFI) measurement and foetal vitality (FBP, non-stress test). They were analysed about their association with obesity on pregnancy. When compared with non-obese women, the group of obese patients had higher systolic (118.1 vs 109.2 mmHg; p < 0.01) and diastolic (76.6 vs 70.4 mmHg; p < 0.01) pressure levels, AFI (12.52 vs. 9.61 cm; p = 0.02), presence of meconium on labour (20.52 vs. 14.67%; p = 0.02), birthweight (3602 vs. 3437 g; p < 0.01) and caesarean section (39.74 vs. 29.98%, p < 0.01). Labour induction before 40 weeks in the antenatal period associated with foetal weight estimation should be considered as a recommendation for decreasing high percentages of caesarean delivery found in obese women.

  5. Identifying Emergency Department Patients at Low Risk for a Variceal Source of Upper Gastrointestinal Hemorrhage.

    Science.gov (United States)

    Klein, Lauren R; Money, Joel; Maharaj, Kaveesh; Robinson, Aaron; Lai, Tarissa; Driver, Brian E

    2017-11-01

    Assessing the likelihood of a variceal versus nonvariceal source of upper gastrointestinal bleeding (UGIB) guides therapy, but can be difficult to determine on clinical grounds. The objective of this study was to determine if there are easily ascertainable clinical and laboratory findings that can identify a patient as low risk for a variceal source of hemorrhage. This was a retrospective cohort study of adult ED patients with UGIB between January 2008 and December 2014 who had upper endoscopy performed during hospitalization. Clinical and laboratory data were abstracted from the medical record. The source of the UGIB was defined as variceal or nonvariceal based on endoscopic reports. Binary recursive partitioning was utilized to create a clinical decision rule. The rule was internally validated and test characteristics were calculated with 1,000 bootstrap replications. A total of 719 patients were identified; mean age was 55 years and 61% were male. There were 71 (10%) patients with a variceal UGIB identified on endoscopy. Binary recursive partitioning yielded a two-step decision rule (platelet count > 200 × 10 9 /L and an international normalized ratio [INR] study must be externally validated before widespread use, patients presenting to the ED with an acute UGIB with platelet count of >200 × 10 9 /L and an INR of upper gastrointestinal hemorrhage. © 2017 by the Society for Academic Emergency Medicine.

  6. 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.

  7. Risk indicators for dystocia in low-risk nulliparous women: a study on lifestyle and anthropometrical factors

    DEFF Research Database (Denmark)

    Kjaergaard, H; Dykes, A K; Ottesen, B

    2010-01-01

    We examined background information and course of labour from a cohort of 2,810 low-risk nulliparas to identify possible lifestyle and anthropometrical risk indicators for dystocia. Criteria for dystocia: cervical dilatation or =4 h per week appeared protective for dystocia (OR 0.63, CI 0.45-0.89)......We examined background information and course of labour from a cohort of 2,810 low-risk nulliparas to identify possible lifestyle and anthropometrical risk indicators for dystocia. Criteria for dystocia: cervical dilatation or =4 h per week appeared protective for dystocia (OR 0.63, CI 0...

  8. Visitor's Computer Guidelines | CTIO

    Science.gov (United States)

    Visitor's Computer Guidelines Network Connection Request Instruments Instruments by Telescope IR Instruments Guidelines Library Facilities Outreach NOAO-S EPO Program team Art of Darkness Image Gallery EPO/CADIAS ‹› You are here CTIO Home » Astronomers » Visitor's Computer Guidelines Visitor's Computer

  9. Energy drinks: potions of illusion.

    Science.gov (United States)

    Bedi, Nidhi; Dewan, Pooja; Gupta, Piyush

    2014-07-01

    Energy drinks are widely consumed by adolescents as these claim to improve performance, endurance and alertness. Recent reports have shown that there are no real health benefits of these drinks. On the contrary, certain adverse effects due to energy drinks have come to the forefront, casting a big question-mark on their safety and utility. This review discusses the present status of energy drinks, their active ingredients and their safety. We conclude that energy drinks, despite having some short pleasant effects, can be harmful for the body and are best avoided.

  10. Soft drink "pouring rights": marketing empty calories to children.

    Science.gov (United States)

    Nestle, M

    2000-01-01

    Healthy People 2010 objectives call for meals and snacks served in schools to contribute to overall diets that meet federal dietary guidelines. Sales in schools of foods and drinks high in calories and low in nutrients undermine this health objective, as well as participation in the more nutritious, federally sponsored, school lunch programs. Competitive foods also undermine nutrition information taught in the classroom. Lucrative contracts between school districts and soft drink companies for exclusive rights to sell one brand are the latest development in the increasing commercialization of school food. These contracts, intended to elicit brand loyalty among young children who have a lifetime of purchases ahead of them, are especially questionable because they place schools in the position of "pushing" soft drink consumption. "Pouring rights" contracts deserve attention from public health professionals concerned about the nutritional quality of children's diets.

  11. The Myriad Influences of Alcohol Advertising on Adolescent Drinking.

    Science.gov (United States)

    Berey, Benjamin L; Loparco, Cassidy; Leeman, Robert F; Grube, Joel W

    2017-06-01

    This review investigates effects of alcohol advertising on adolescent drinking. Prior reviews focused on behavioral outcomes and long-term effects. In contrast, the present review focuses on subgroups with greater exposure to alcohol advertising, research methods to study alcohol advertising, potential mechanisms underlying relationships between adolescent exposure to alcohol advertising and increased drinking and points to prevention/intervention strategies that may reduce effects of alcohol advertising. Alcohol advertising influences current and future drinking. Further, evidence suggests adolescents may be targeted specifically. Alcohol advertisements may influence behavior by shifting alcohol expectancies, norms regarding alcohol use, and positive attitudes. Media literacy programs may be an effective intervention strategy. Adolescents are exposed to large quantities of alcohol advertisements, which violates guidelines set by the alcohol industry. However, media literacy programs may be a promising strategy for adolescents to increase critical thinking and create more realistic expectations regarding alcohol.

  12. Assessment of quality of drinking water in Amasaman, Accra (Ghana)

    International Nuclear Information System (INIS)

    Quarcoo, G.; Hodgson, I. O. A.; Ampofo, J. A.; Cobbina, S. J.; Koku, J. E.

    2014-01-01

    The physico-chemical and microbial quality attributes of untreated water samples from hand dug wells and treated water delivered by tankers (mobile services) were assessed to determine the susceptibility of Amasaman community to water borne diseases. The physico-chemical parameters of all the water sources for domestic use were within the World Health Organization (WHO) drinking water guidelines and Ghana Standards (GS), with the exception of turbidity and colour which showed higher values for the well waters. With respect to the microbial quality, the waters from the hand-dug wells and tanker services showed presence of both total and faecal coliforms, at levels higher than WHO and GS values of zero counts per 100 mL for drinking water. The poor microbial quality (presence of coliform bacteria) of all the water samples suggested susceptibility and exposure of the community to waterborne diseases on continuously drinking the available water. (au)

  13. CERN’s Drinking Water

    CERN Multimedia

    GS Department

    CERN’s drinking water is monitored on a regular basis. A certified independent laboratory takes and analyses samples to verify that the water complies with national and European regulations for safe drinking water. Nevertheless, the system that supplies our drinking water is very old and occasionally, especially after work has been carried out on the system, the water may become cloudy or discoloured, due to traces of corrosion. For this reason, we recommend: Never use hot water from the tap for drinking or cooking. If you need hot water, then draw water from the cold water tap and heat it. Only drink or cook with cold water. Let the cold water run until it is clear before drinking or making your tea or coffee. If you have any questions about the quality of CERN’s drinking water, please contact: Jerome Espuche (GS/SEM), Serge Deleval (EN/CV) or Jonathan Gulley (DG/SCG).

  14. The new hypertension guidelines.

    Science.gov (United States)

    Stern, Ralph H

    2013-10-01

    The Canadian Hypertension Education Program (CHEP) has published guidelines annually since 2000. The CHEP guidelines are a model of concise, comprehensive, up-to-date, evidence-rated guidelines for physicians who diagnose and treat hypertension. The guidelines address measurement of blood pressure and the definition of hypertension, secondary hypertension evaluation and treatment, and blood pressure targets and medication choices in patients with and without compelling indications. This review describes CHEP's process for developing guidelines and provides an overview of the 2013 recommendations. ©2013 Wiley Periodicals, Inc.

  15. Foot length measurements of newborns of high and low risk pregnancies.

    Science.gov (United States)

    Salge, Ana Karina Marques; Rocha, Érika Lopes; Gaíva, Maria Aparecida Munhoz; Castral, Thaíla Correa; Guimarães, Janaína Valadares; Xavier, Raphaela Maioni

    2017-03-09

    Comparing foot length measurements of newborns in high and low risk pregnancies at a public hospital in Goiânia, GO, Brazil. A cross-sectional study carried out between April, 2013 and May, 2015, with a sample consisting of 180 newborns; 106 infants of women from high-risk pregnancies and 74 of women from low-risk pregnancies. Data were descriptively analyzed. Foot length measurement was performed using a stiff transparent plastic ruler, graduated in millimeters. The length of both feet was measured from the tip of the hallux (big toe) to the end of the heel. A statistically significant relationship was found between the foot length and newborn's weight, between the cephalic and thoracic perimeters in the high-risk group and between the cephalic perimeter in the control group. There is a need for creating cut-off points to identify newborns with intrauterine growth disorders using foot length. Comparar as medidas do comprimento hálux-calcâneo de recém-nascidos em gestações de alto e baixo risco em um hospital público de Goiânia, GO. Estudo transversal, realizado no período de abril de 2013 a maio de 2015, cuja amostra constituiu-se de 180 recém-nascidos, 106 filhos de mulheres com gestação de alto risco e 74 de mulheres com gestação de baixo risco. Os dados foram analisados descritivamente. A medida do comprimento hálux-calcâneo foi realizada utilizando-se de régua plástica transparente rígida, graduada em milímetros. Foram medidos ambos os pés, aferindo-se o comprimento da ponta do hálux até a extremidade do calcâneo. Foi encontrada relação estatisticamente significante entre o comprimento hálux-calcâneo e o peso do recém-nascido, entre os perímetros cefálico e torácico no grupo de alto risco e entre o perímetro cefálico no grupo controle. Existe necessidade da criação de pontos de corte para identificar recém-nascidos com desvios de crescimento intrauterino utilizando-se do comprimento hálux-calcâneo. Comparar las mediciones

  16. Guideline of guidelines: asymptomatic microscopic haematuria.

    Science.gov (United States)

    Linder, Brian J; Bass, Edward J; Mostafid, Hugh; Boorjian, Stephen A

    2018-02-01

    The aim of the present study was to review major organizational guidelines on the evaluation and management of asymptomatic microscopic haematuria (AMH). We reviewed the haematuria guidelines from: the American Urological Association; the consensus statement by the Canadian Urological Association, Canadian Urologic Oncology Group and Bladder Cancer Canada; the American College of Physicians; the Joint Consensus Statement of the Renal Association and British Association of Urological Surgeons; and the National Institute for Health and Care Excellence. All guidelines reviewed recommend evaluation for AMH in the absence of potential benign aetiologies, with the evaluation including cystoscopy and upper urinary tract imaging. Existing guidelines vary in their definition of AMH (role of urine dipstick vs urine microscopy), the age threshold for recommending evaluation, and the optimal imaging method (computed tomography vs ultrasonography). Of the reviewed guidelines, none recommended the use of urine cytology or urine markers during the initial AMH evaluation. Patients should have ongoing follow-up after a negative initial AMH evaluation. Significant variation exists among current guidelines for AMH with respect to who should be evaluated and in what manner. Given the patient and health system implications of balancing appropriately focused and effective diagnostic evaluation, AMH represents a valuable future research opportunity. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  17. How dogs drink water

    Science.gov (United States)

    Gart, Sean; Socha, Jake; Vlachos, Pavlos; Jung, Sunghwan

    2014-11-01

    Animals with incomplete cheeks (i.e. dogs and cats) need to move fluid against gravity into the body by means other than suction. They do this by lapping fluid with their tongue. When a dog drinks, it curls its tongue posteriorly while plunging it into the fluid and then quickly withdraws its tongue back into the mouth. During this fast retraction fluid sticks to the ventral part of the curled tongue and is drawn into the mouth due to inertia. We show several variations of this drinking behavior among many dog breeds, specifically, the relationship between tongue dynamics and geometry, lapping frequency, and dog weight. We also compare the results with the physical experiment of a rounded rod impact onto a fluid surface. Supported by NSF PoLS #1205642.

  18. Ultrasonographic study and Doppler flow velocimetry of maternal kidneys and liver in low-risk pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Daher, Cibele Helena; Gomes, Andrea Cavalanti; Kobayashi, Sergio; Chammas, Maria Cristina, E-mail: cibeledaher@hotmail.com [Universidade de Sao Paulo (In-Rad/HC-FMUSP), Sao Paulo, SP (Brazil). Hospital das Clinicas. Inst. de Radiologia; Cerri, Giovanni Guido [Universidade de Sao Paulo (FMUSP), Sao Paulo, SP (Brazil). Fac. de Medicina

    2015-05-15

    Objective: longitudinal study with B-mode ultrasonography and Doppler ultrasonography of maternal kidneys and liver in low-risk pregnancy, to establish and quantify normality parameters, correlating them with physiological changes. Materials and methods: twenty-five pregnant women were assessed and selected to participate in the study, each of them undergoing four examinations at the first, second, third trimesters and postpartum. Results: findings during pregnancy were the following: increased renal volume, pyelocaliceal dilatation with incidence of 45.4% in the right kidney, and 9% in the left kidney; nephrolithiasis, 18.1% in the right kidney, 13.6% in the left kidney. With pyelocaliceal dilatation, mean values for resistivity index were: 0.68 for renal arteries; 0.66 for segmental arteries; 0.64 for interlobar arteries; 0.64 for arcuate arteries. Without pyelocaliceal dilatation, 0.67 for renal arteries; 0.64 for segmental arteries; 0.63 for interlobar arteries; and 0.61 for arcuate arteries. Portal vein flow velocities presented higher values in pregnancy, with mean value for maximum velocity of 28.9 cm/s, and 22.6 cm/s postpartum. The waveform pattern of the right hepatic vein presented changes persisting in the postpartum period in 31.8% of the patients. Cholelithiasis was observed in 18.1% of the patients. Conclusion: alterations in renal volume, pyelocaliceal dilatation, nephrolithiasis, cholelithiasis, changes in portal vein flow velocity, alterations in waveform pattern of the right hepatic vein, proved to be significant. (author)

  19. Applicator-guided volumetric-modulated arc therapy for low-risk endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cilla, Savino, E-mail: savinocilla@gmail.com [Medical Physics Unit, Fondazione di ricerca e cura “Giovanni Paolo II,” Università Cattolica del Sacro Cuore, Campobasso (Italy); Macchia, Gabriella [Radiation Oncology Unit, Fondazione di ricerca e cura “Giovanni Paolo II,” Università Cattolica del Sacro Cuore, Campobasso (Italy); Sabatino, Domenico [Medical Physics Unit, Fondazione di ricerca e cura “Giovanni Paolo II,” Università Cattolica del Sacro Cuore, Campobasso (Italy); Digesù, Cinzia; Deodato, Francesco [Radiation Oncology Unit, Fondazione di ricerca e cura “Giovanni Paolo II,” Università Cattolica del Sacro Cuore, Campobasso (Italy); Piermattei, Angelo [Physics Institute, Università Cattolica del Sacro Cuore, Rome (Italy); De Spirito, Marco [Medical Physics Unit, Fondazione di ricerca e cura “Giovanni Paolo II,” Università Cattolica del Sacro Cuore, Campobasso (Italy); Morganti, Alessio G. [Radiation Oncology Unit, Fondazione di ricerca e cura “Giovanni Paolo II,” Università Cattolica del Sacro Cuore, Campobasso (Italy); Radiation Oncology Unit, Università Cattolica del Sacro Cuore, Rome (Italy)

    2013-04-01

    The aim of this study was to report the feasibility of volumetric-modulated arc therapy (VMAT) in the postoperative irradiation of the vaginal vault. Moreover, the VMAT technique was compared with 3D conformal radiotherapy (3D-CRT) and fixed-field intensity-modulated radiotherapy (IMRT), in terms of target coverage and organs at risk sparing. The number of monitor units and the delivery time were analyzed to score the treatment efficiency. All plans were verified in a dedicated solid water phantom using a 2D array of ionization chambers. Twelve patients with endometrial carcinoma who underwent radical hystero-adenexectomy and fixed-field IMRT treatments were retrospectively included in this analysis; for each patient, plans were compared in terms of dose-volume histograms, homogeneity index, and conformity indexes. All techniques met the prescription goal for planning target volume coverage, with VMAT showing the highest level of conformity at all dose levels. VMAT resulted in significant reduction of rectal and bladder volumes irradiated at all dose levels compared with 3D-CRT. No significant differences were found with respect to IMRT. Moreover, a significant improvement of the dose conformity was reached by VMAT technique not only at the 95% dose level (0.74 vs. 0.67 and 0.62) but also at 50% and 75% levels of dose prescription. In addition, VMAT plans showed a significant reduction of monitor units by nearly 28% with respect to IMRT, and reduced treatment time from 11 to <3 minutes for a single 6-Gy fraction. In conclusion, VMAT plans can be planned and carried out with high quality and efficiency for the irradiation of vaginal vault alone, providing similar or better sparing of organs at risk to fixed-field IMRT and resulting in the most efficient treatment option. VMAT is currently our standard approach for radiotherapy of low-risk endometrial cancer.

  20. Thyroid nodules with minimal cystic changes have a low risk of malignancy

    International Nuclear Information System (INIS)

    Na, Dong Gyu; Kim, Dae Sik; Kim, Soo Jin; Kim, Ji Hoon

    2016-01-01

    The goal of this study was to determine the risk of malignancy of thyroid nodules with minimal cystic changes. A total of consecutive 1,000 thyroid nodules (≥1 cm) with final diagnoses from two institutions were included in this study. The risk of malignancy of thyroid nodules was analyzed according to the internal content, which was categorized as purely solid, minimally cystic (cystic changes ≤10%), and partially cystic (cystic changes >10%). We also assessed the risk of malignancy of nodules with minimal cystic changes depending on echogenicity and presence of any suspicious ultrasonografic (US) features. The overall frequency of purely solid, minimally cystic, and partially cystic nodules was 730/1,000 (73%), 61/1,000 (6.1%), and 209/1,000 (20.9%), respectively, with risks of malignancy of 14.8% (108/730), 3.3% (2/61), and 3.3% (7/209), respectively. The risk of malignancy of nodules with minimal cystic changes was significantly lower than that of purely solid nodules (P=0.013). The risk of malignancy of nodules with minimal cystic changes was also lower than that of purely solid nodules in the group of hypoechoic nodules (P=0.063) and in the group of nodules with suspicious US features (P=0.028), but was not significantly different from that of partially cystic nodules regardless of echogenicity or the presence of suspicious US features (P≥0.652). Thyroid nodules with minimal cystic changes have a low risk of malignancy, similar to that of partially cystic nodules regardless of echogenicity or the presence of suspicious US features. The US lexicon could define solid nodules as nodules with purely solid internal content in order to enhance the accuracy of estimated risks of malignancy

  1. Utilization of prostate brachytherapy for low risk prostate cancer: Is the decline overstated?

    Science.gov (United States)

    Safdieh, Joseph; Wong, Andrew; Weiner, Joseph P; Schwartz, David; Schreiber, David

    2016-08-01

    Several prior studies have suggested that brachytherapy utilization has markedly decreased, coinciding with the recent increased utilization of intensity modulated radiation therapy, as well as an increase in urologist-owned centers. We sought to investigate the brachytherapy utilization in a large, hospital-based registry. Men with prostate cancer diagnosed between 2004-2012 and treated with either external beam radiation and/or prostate brachytherapy were abstracted from the National Cancer Database. In order to be included, men had to be clinically staged as T1c-T2aNx-0Mx-0, Gleason 6, PSA ≤ 10.0 ng/ml. Descriptive statistics were used to analyze brachytherapy utilization over time and were compared via χ(2). Multivariate logistic regression was used to assess for covariables associated with increased brachytherapy usage. There were 89,413 men included in this study, of which 37,054 (41.6%) received only external beam radiation, and 52,089 (58.4%) received prostate brachytherapy. The use of brachytherapy declined over time from 62.9% in 2004 to 51.3% in 2012 (p facilities (60.8% in 2004 to 47.0% in 2012, p facilities (63.7% in 2004 to 53.0% in 2012, p facilities than those who lived further. The use of intensity modulated radiation therapy increased during this same time period from 18.4% in 2004 to 38.2% in 2012 (p usage. In this hospital-based registry, prostate brachytherapy usage has declined for low risk prostate cancer as intensity modulated radiation therapy usage has increased. However, it still remains the treatment of choice for 51.3% of patients as of 2012.

  2. Association of Trichomonas vaginalis and cytological abnormalities of the cervix in low risk women.

    Directory of Open Access Journals (Sweden)

    Gilbert G G Donders

    Full Text Available OBJECTIVE: Is Trichomonas vaginalis (TV an inducing factor for the development of (pre-cancerous lesions of the cervix? DESIGN: Cross sectional study. SETTING: Screening healthy Belgian women with low infection risk. SAMPLE: 63,251 consecutive liquid based cervical samples. METHODS: Real time quantitative PCR for presence of TV, 18 HPV types and Pap smear analysis of cytologic abnormalities. MAIN OUTCOME MEASURES: Association of TV and HPV with cervix dysplasia. RESULTS: The overall prevalence of TV DNA was 0.37%, of low risk HPV 2%, of high risk HPV 13.2%, and 8.8 % had cytological abnormalities. Both LR-HPV and HR-HPV were significantly associated with all cytological abnormalities. Presence of TV was associated with LR- and HR-HPV, ASC-US and HSIL, but not with other abnormalities. All women with TV and HSIL also had HR-HPV, while the latter was present in only 59% of women with TV and ASC-US. Amongst HPV negative women, TV was found in 1.3% of women with ASC-US, but only in 0.03% of women with normal cytology (OR 4.2, CL95% 2.1-8.6. In HR-HPV positive women, presence of TV increased the likelihood of cytological abnormalities somewhat (P=0.05, mainly due to an increase in ASC-US and LSIL, but not HSIL. CONCLUSIONS: We conclude that TV infection is associated with both LR and HR-HPV infection of the cervix, as well as with ASC-US and HSIL. TV is a concomitant STI, but is not thought to be a co-factor in the causation of HSIL and cervical cancer. However, TV may cause false positive diagnoses of ASC-US.

  3. Ultrasonographic study and Doppler flow velocimetry of maternal kidneys and liver in low-risk pregnancy

    International Nuclear Information System (INIS)

    Daher, Cibele Helena; Gomes, Andrea Cavalanti; Kobayashi, Sergio; Chammas, Maria Cristina; Cerri, Giovanni Guido

    2015-01-01

    Objective: longitudinal study with B-mode ultrasonography and Doppler ultrasonography of maternal kidneys and liver in low-risk pregnancy, to establish and quantify normality parameters, correlating them with physiological changes. Materials and methods: twenty-five pregnant women were assessed and selected to participate in the study, each of them undergoing four examinations at the first, second, third trimesters and postpartum. Results: findings during pregnancy were the following: increased renal volume, pyelocaliceal dilatation with incidence of 45.4% in the right kidney, and 9% in the left kidney; nephrolithiasis, 18.1% in the right kidney, 13.6% in the left kidney. With pyelocaliceal dilatation, mean values for resistivity index were: 0.68 for renal arteries; 0.66 for segmental arteries; 0.64 for interlobar arteries; 0.64 for arcuate arteries. Without pyelocaliceal dilatation, 0.67 for renal arteries; 0.64 for segmental arteries; 0.63 for interlobar arteries; and 0.61 for arcuate arteries. Portal vein flow velocities presented higher values in pregnancy, with mean value for maximum velocity of 28.9 cm/s, and 22.6 cm/s postpartum. The waveform pattern of the right hepatic vein presented changes persisting in the postpartum period in 31.8% of the patients. Cholelithiasis was observed in 18.1% of the patients. Conclusion: alterations in renal volume, pyelocaliceal dilatation, nephrolithiasis, cholelithiasis, changes in portal vein flow velocity, alterations in waveform pattern of the right hepatic vein, proved to be significant. (author)

  4. Association of Trichomonas vaginalis and cytological abnormalities of the cervix in low risk women.

    Science.gov (United States)

    Donders, Gilbert G G; Depuydt, Christophe E; Bogers, John-Paul; Vereecken, Annie J

    2013-01-01

    Is Trichomonas vaginalis (TV) an inducing factor for the development of (pre-)cancerous lesions of the cervix? Cross sectional study. Screening healthy Belgian women with low infection risk. 63,251 consecutive liquid based cervical samples. Real time quantitative PCR for presence of TV, 18 HPV types and Pap smear analysis of cytologic abnormalities. Association of TV and HPV with cervix dysplasia. The overall prevalence of TV DNA was 0.37%, of low risk HPV 2%, of high risk HPV 13.2%, and 8.8 % had cytological abnormalities. Both LR-HPV and HR-HPV were significantly associated with all cytological abnormalities. Presence of TV was associated with LR- and HR-HPV, ASC-US and HSIL, but not with other abnormalities. All women with TV and HSIL also had HR-HPV, while the latter was present in only 59% of women with TV and ASC-US. Amongst HPV negative women, TV was found in 1.3% of women with ASC-US, but only in 0.03% of women with normal cytology (OR 4.2, CL95% 2.1-8.6). In HR-HPV positive women, presence of TV increased the likelihood of cytological abnormalities somewhat (P=0.05), mainly due to an increase in ASC-US and LSIL, but not HSIL. We conclude that TV infection is associated with both LR and HR-HPV infection of the cervix, as well as with ASC-US and HSIL. TV is a concomitant STI, but is not thought to be a co-factor in the causation of HSIL and cervical cancer. However, TV may cause false positive diagnoses of ASC-US.

  5. Acceptability of a novel vaginal microbicide during a safety trial among low-risk women.

    Science.gov (United States)

    Bentley, M E; Morrow, K M; Fullem, A; Chesney, M A; Horton, S D; Rosenberg, Z; Mayer, K H

    2000-01-01

    The increasing recognition that women who are unable or unwilling to discuss or use condoms with their sexual partners need female-controlled methods for preventing sexually transmitted diseases (STDs), including HIV, has led to considerable focus on the development of vaginal microbicides. While many such products are being tested for safety and effectiveness, clinical trials generally overlook another key factor in a product's impact on infection rates-its acceptability to users. A Phase I clinical trial of a microbicidal gel included an assessment of the product's acceptability among 27 low-risk participants. Information on acceptability was gathered from structured interviews, participants' daily diaries and unstructured exit interviews. Participants reported only minor side effects of product use, such as itching, burning and difficulty urinating; two women developed candida infections while participating in the study. None of the side effects could be conclusively linked to use of the gel. Some women noted product discharge and messiness as drawbacks of the method, but this experience varied according to how often the women applied the gel. For example, one-third of those who used it once daily said that at least some of the time, it was too "wet or drippy," compared with two-thirds of women who inserted the gel twice a day. However, participants considered these "nuisance factors" that could be outweighed by the potential protective characteristics of the product. The majority reported that they would use the product if it were available and proven efficacious, and if they perceived that they were at risk of STD infection. Additional testing of this product is urgently needed. Furthermore, as other products approach Phase I testing, acceptability assessments should be a key component of clinical trials.

  6. Quantification of CT images for the classification of high- and low-risk pancreatic cysts

    Science.gov (United States)

    Gazit, Lior; Chakraborty, Jayasree; Attiyeh, Marc; Langdon-Embry, Liana; Allen, Peter J.; Do, Richard K. G.; Simpson, Amber L.

    2017-03-01

    Pancreatic cancer is the most lethal cancer with an overall 5-year survival rate of 7%1 due to the late stage at diagnosis and the ineffectiveness of current therapeutic strategies. Given the poor prognosis, early detection at a pre-cancerous stage is the best tool for preventing this disease. Intraductal papillary mucinous neoplasms (IPMN), cystic tumors of the pancreas, represent the only radiographically identifiable precursor lesion of pancreatic cancer and are known to evolve stepwise from low-to-high-grade dysplasia before progressing into an invasive carcinoma. Observation is usually recommended for low-risk (low- and intermediate-grade dysplasia) patients, while high-risk (high-grade dysplasia and invasive carcinoma) patients undergo resection; hence, patient selection is critically important in the management of pancreatic cysts.2 Radiologists use standard criteria such as main pancreatic duct size, cyst size, or presence of a solid enhancing component in the cyst to optimally select patients for surgery.3 However, these findings are subject to a radiologist's interpretation and have been shown to be inconsistent with regards to the presence of a mural nodule or solid component.4 We propose objective classification of risk groups based on quantitative imaging features extracted from CT scans. We apply new features that represent the solid component (i.e. areas of high intensity) within the cyst and extract standard texture features. An adaptive boost classifier5 achieves the best performance with area under receiver operating characteristic curve (AUC) of 0.73 and accuracy of 77.3% for texture features. The random forest classifier achieves the best performance with AUC of 0.71 and accuracy of 70.8% with the solid component features.

  7. Radioactivity in drinking water supplies in Western Australia.

    Science.gov (United States)

    Walsh, M; Wallner, G; Jennings, P

    2014-04-01

    Radiochemical analysis was carried out on 52 drinking water samples taken from public outlets in the southwest of Western Australia. All samples were analysed for Ra-226, Ra-228 and Pb-210. Twenty five of the samples were also analysed for Po-210, and 23 were analysed for U-234 and U-238. Ra-228 was found in 45 samples and the activity ranged from water. The estimated doses ranged from 0.001 to 2.375 mSv y(-1) with a mean annual dose of 0.167 mSv y(-1). The main contributing radionuclides to the annual dose were Ra-228, Po-210 and Ra-226. Of the 52 drinking water samples tested, 94% complied with the current Australian Drinking Water Guidelines, while 10% complied with the World Health Organization's radiological guidelines which many other countries use. It is likely that these results provide an overestimate of the compliance, due to limitations, in the sampling technique and resource constraints on the analysis. Because of the increasing reliance of the Western Australian community on groundwater for domestic and agricultural purposes, it is likely that the radiological content of the drinking water will increase in the future. Therefore there is a need for further monitoring and analysis in order to identify problem areas. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  8. Soft Drink “Pouring Rights”: Marketing Empty Calories to Children

    OpenAIRE

    Nestle, Marion

    2000-01-01

    Healthy People 2010 objectives call for meals and snacks served in schools to contribute to overall diets that meet federal dietary guidelines. Sales in schools of foods and drinks high in calories and low in nutrients undermine this health objective, as well as participation in the more nutritious, federally sponsored, school lunch programs. Competitive foods also undermine nutrition information taught in the classroom. Lucrative contracts between school districts and soft drink companies fo...

  9. Extended heart failure clinic follow-up in low-risk patients

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Videbaek, Lars

    2013-01-01

    BackgroundOutpatient follow-up in specialized heart failure clinics (HFCs) is recommended by current guidelines and implemented in most European countries, but the optimal duration of HFC programmes has not been established. Nor is it known whether all or only high-risk patients, e.g. identified...... by NT-proBNP, might benefit from an extended HFC follow-up.Methods and resultsIn a multi-centre setting, we randomly assigned 921 clinically stable systolic heart failure (HF) outpatients on optimal medical therapy to undergo either an extended follow-up in the HFC (n = 461) or referral back...

  10. Active surveillance for low-risk prostate cancer in Austria: the online registry of the Qualitätspartnerschaft Urologie (QuapU).

    Science.gov (United States)

    Eredics, Klaus; Dorfinger, Karl; Kramer, Gero; Ponholzer, Anton; Madersbacher, Stephan

    2017-06-01

    Active surveillance (AS) is a well-recognized strategy to reduce the risk of overtreatment in men with low-risk prostate cancer. No data on this approach are available from Austria. The Qualitätspartnerschaft Urologie (QuapU) developed an online database for patients managed with AS in Austria. Principal inclusion/exclusion criteria corresponded to those of the S3 prostate cancer guideline of German urologists: prostate-specific antigen (PSA) 4-10 ng/ml: 85%). The prostate volume averaged 39 ml. The mean time under AS was 17.5 months (12 months: 40%). The AS adherence at 12 months was 85% and at 24 months 76%. To date, a total of 23 patients (17.6%) stopped AS. The most frequent reasons for discontinuing AS were patient wish for active treatment (43.5%) and PSA progression (30.4%). A histological progression was rarely seen (6.1%) and the control biopsy rate was low (19.8%). This study is the first description of AS in Austria and documents the feasibility of an online registry for AS. The data confirm the international experience with this approach with acceptable adherence rates.

  11. A national standard for psychosocial safety climate (PSC): PSC 41 as the benchmark for low risk of job strain and depressive symptoms.

    Science.gov (United States)

    Bailey, Tessa S; Dollard, Maureen F; Richards, Penny A M

    2015-01-01

    Despite decades of research from around the world now permeating occupational health and safety (OHS) legislation and guidelines, there remains a lack of tools to guide practice. Our main goal was to establish benchmark levels of psychosocial safety climate (PSC) that would signify risk of job strain (jobs with high demands and low control) and depression in organizations. First, to justify our focus on PSC, using interview data from Australian employees matched at 2 time points 12 months apart (n = 1081), we verified PSC as a significant leading predictor of job strain and in turn depression. Next, using 2 additional data sets (n = 2097 and n = 1043) we determined benchmarks of organizational PSC (range 12-60) for low-risk (PSC at 41 or above) and high-risk (PSC at 37 or below) of employee job strain and depressive symptoms. Finally, using the newly created benchmarks we estimated the population attributable risk (PAR) and found that improving PSC in organizations to above 37 could reduce 14% of job strain and 16% of depressive symptoms in the working population. The results provide national standards that organizations and regulatory agencies can utilize to promote safer working environments and lower the risk of harm to employee mental health. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  12. Anxiety and depression in breast cancer patients at low risk of recurrence compared with the general population: a valid comparison?

    NARCIS (Netherlands)

    Groenvold, M.; Fayers, P. M.; Sprangers, M. A.; Bjorner, J. B.; Klee, M. C.; Aaronson, N. K.; Bech, P.; Mouridsen, H. T.

    1999-01-01

    Breast cancer and its treatment have been associated with psychological morbidity. In this study our aim was to quantify the excess anxiety and depression resulting from breast cancer. We compared 538 newly diagnosed breast cancer patients at low risk of recurrence (87.0% responded) to 872 women

  13. Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study

    NARCIS (Netherlands)

    de Jonge, J.; Mesman, J.A.J.M.; Manniën, J.; Zwart, J.J.; van Dillen, J.; van Roosmalen, J.

    2013-01-01

    Objectives: To test the hypothesis that low risk women at the onset of labour with planned home birth have a higher rate of severe acute maternal morbidity than women with planned hospital birth, and to compare the rate of postpartum haemorrhage and manual removal of placenta. Design: Cohort study

  14. Outcome of planned home and planned hospital births in low risk pregnancies: prospective study in midwifery practices in the Netherlands.

    NARCIS (Netherlands)

    Wiegers, T.A.; Keirse, M.J.N.C.; Zee, J. van der; Berghs, G.A.H.

    1996-01-01

    Objective: To investigate the relation between the intended place of birth (home or hospital) and perinatal outcome in women with low risk pregnancies after controlling for parity and social, medical, and obstetric background. Design: Analysis of prospective data from midwives and their clients.

  15. High incidence of pseudotumours after hip resurfacing even in low risk patients; results from an intensified MRI screening protocol.

    NARCIS (Netherlands)

    Weegen, W. van der; Smolders, J.M.; Sijbesma, T.; Hoekstra, H.J.; Brakel, K.; Susante, J.L.C. van

    2013-01-01

    We intensified our screening protocol for the presence of pseudotumours in a consecutive series of patients with a hip resurfacing arthroplasty (HRA), to establish whether we should be alert to the presence of 'silent' pseudotumours. Patients categorised with high risk (11 hips) and low risk (10

  16. Identification of patients with low-risk pulmonary embolism suitable for outpatient treatment using the pulmonary embolism severity index (PESI).

    LENUS (Irish Health Repository)

    McCabe, A

    2013-06-01

    There is increasing evidence that outpatient treatment of patients with low-risk stable pulmonary embolism (PE) is safe, effective and potentially reduces costs. It is not clear how many patients presenting to an Irish Emergency Department (ED) are potentially suitable for outpatient management.

  17. Adverse outcomes in maternity care for women with a low risk profile in The Netherlands: a case series analysis

    NARCIS (Netherlands)

    Martijn, L.; Jacobs, A.; Amelink-Verburg, M.; Wentzel, R.; Buitendijk, S.; Wensing, M.

    2013-01-01

    BACKGROUND: This study aimed to perform a structural analysis of determinants of risk of critical incidents in care for women with a low risk profile at the start of pregnancy with a view on improving patient safety. METHODS: We included 71 critical incidents in primary midwifery care and subsequent

  18. [Adverse outcomes in maternity care for women with a low risk profile in The Netherlands: a case series analysis

    NARCIS (Netherlands)

    Martijn, L.M.; Jacobs, A.; Amelink-Verburg, M.P.; Wentzel, R.; Buitendijk, S.E.; Wensing, M.

    2014-01-01

    BACKGROUND: This study aimed to perform a structural analysis of determinants of risk of critical incidents in care for women with a low risk profile at the start of pregnancy with a view on improving patient safety. METHODS: We included 71 critical incidents in primary midwifery care and subsequent

  19. Problematic Drinking Among Postgraduate Students: Binge Drinking, Prepartying, and Mixing Alcohol With Energy Drinks.

    Science.gov (United States)

    Rutledge, Patricia C; Bestrashniy, Jessica R B M; Nelson, Toben F

    2016-07-02

    Although problematic alcohol use has been studied extensively in undergraduate students, little is known about problematic drinking among postgraduate students. This study examined binge drinking, prepartying, and mixing alcohol with energy drinks to determine: (1) the extent to which postgraduate students engage in these drinking behaviors, (2) how postgraduate students differ from undergraduate students in these behaviors, and (3) the demographic risk factors for these behaviors in postgraduate (and undergraduate) students. This study utilized data from n = 695 students (n = 298 postgraduate; n = 397 undergraduate) who participated in the Healthy Minds Study at a large, public university in the Midwestern US. Past-two-week binge drinking, past-year and past-30-day prepartying, and past-30-day mixing alcohol with energy drinks were reported by 26.2%, 28.6%, 14.9%, and 8.1% of postgraduate students, respectively. Multivariate analyses indicated that postgraduate status was a significant negative predictor of binge drinking and prepartying, and that status interacted with age in predicting prepartying such that the effect of age on prepartying was negative for postgraduate students and nonsignificant for undergraduates. Age was a significant negative predictor of mixing alcohol with energy drinks for all students. This study makes a unique contribution to the literature by providing information on problematic drinking in postgraduate students. Although there was evidence of "maturing out," a substantial number of postgraduate students were found to engage in binge drinking and prepartying, and a not insubstantial number of them were found to mix alcohol with energy drinks.

  20. Pathologic C-spine fracture with low risk mechanism and normal physical exam.

    Science.gov (United States)

    Hunter, Andrew; McGreevy, Jolion; Linden, Judith

    2017-09-01

    Cervical spinal fracture is a rare, but potentially disabling complication of trauma to the neck. Clinicians often rely on clinical decision rules and guidelines to decide whether or not imaging is necessary when a patient presents with neck pain. Validated clinical guidelines include the Canadian C-Spine Rule and the Nexus criteria. Studies suggest that the risks of a pathologic fracture from a simple rear end collision are negligible. We present a case of an individual who presented to an emergency department (ED) after a low speed motor vehicle collision complaining of lateral neck pain and had multiple subsequent visits for the same complaint with negative exam findings. Ultimately, he was found to have a severely pathologic cervical spine fracture with notable cord compression. Our objective is to discuss the necessity to incorporate clinical decision rules with physician gestalt and the need to take into account co-morbidities of a patient presenting after a minor MVC. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Late-Life Drinking Problems: The Predictive Roles of Drinking Level vs. Drinking Pattern.

    Science.gov (United States)

    Holahan, Charles J; Brennan, Penny L; Schutte, Kathleen K; Holahan, Carole K; Hixon, J Gregory; Moos, Rudolf H

    2017-05-01

    Research on late-middle-aged and older adults has focused primarily on average level of alcohol consumption, overlooking variability in underlying drinking patterns. The purpose of the present study was to examine the independent contributions of an episodic heavy pattern of drinking versus a high average level of drinking as prospective predictors of drinking problems. The sample comprised 1,107 adults ages 55-65 years at baseline. Alcohol consumption was assessed at baseline, and drinking problems were indexed across 20 years. We used prospective negative binomial regression analyses controlling for baseline drinking problems, as well as for demographic and health factors, to predict the number of drinking problems at each of four follow-up waves (1, 4, 10, and 20 years). Across waves where the effects were significant, a high average level of drinking (coefficients of 1.56, 95% CI [1.24, 1.95]; 1.48, 95% CI [1.11, 1.98]; and 1.85, 95% CI [1.23, 2.79] at 1, 10, and 20 years) and an episodic heavy pattern of drinking (coefficients of 1.61, 95% CI [1.30, 1.99]; 1.61, 95% CI [1.28, 2.03]; and 1.43, 95% CI [1.08, 1.90] at 1, 4, and 10 years) each independently increased the number of drinking problems by more than 50%. Information based only on average consumption underestimates the risk of drinking problems among older adults. Both a high average level of drinking and an episodic heavy pattern of drinking pose prospective risks of later drinking problems among older adults.

  2. Energy drink use, problem drinking and drinking motives in a diverse sample of Alaskan college students

    Directory of Open Access Journals (Sweden)

    Monica C. Skewes

    2013-08-01

    Full Text Available Background. Recent research has identified the use of caffeinated energy drinks as a common, potentially risky behaviour among college students that is linked to alcohol misuse and consequences. Research also suggests that energy drink consumption is related to other risky behaviours such as tobacco use, marijuana use and risky sexual activity. Objective. This research sought to examine the associations between frequency of energy drink consumption and problematic alcohol use, alcohol-related consequences, symptoms of alcohol dependence and drinking motives in an ethnically diverse sample of college students in Alaska. We also sought to examine whether ethnic group moderated these associations in the present sample of White, Alaska Native/American Indian and other ethnic minority college students. Design. A paper-and-pencil self-report questionnaire was completed by a sample of 298 college students. Analysis of covariance (ANCOVA was used to examine the effects of energy drink use, ethnic group and energy drink by ethnic group interactions on alcohol outcomes after controlling for variance attributed to gender, age and frequency of binge drinking. Results. Greater energy drink consumption was significantly associated with greater hazardous drinking, alcohol consequences, alcohol dependence symptoms, drinking for enhancement motives and drinking to cope. There were no main effects of ethnic group, and there were no significant energy drink by ethnic group interactions. Conclusion. These findings replicate those of other studies examining the associations between energy drink use and alcohol problems, but contrary to previous research we did not find ethnic minority status to be protective. It is possible that energy drink consumption may serve as a marker for other health risk behaviours among students of various ethnic groups.

  3. Extreme weather events: Should drinking water quality management systems adapt to changing risk profiles?

    Science.gov (United States)

    Khan, Stuart J; Deere, Daniel; Leusch, Frederic D L; Humpage, Andrew; Jenkins, Madeleine; Cunliffe, David

    2015-11-15

    Among the most widely predicted and accepted consequences of global climate change are increases in both the frequency and severity of a variety of extreme weather events. Such weather events include heavy rainfall and floods, cyclones, droughts, heatwaves, extreme cold, and wildfires, each of which can potentially impact drinking water quality by affecting water catchments, storage reservoirs, the performance of water treatment processes or the integrity of distribution systems. Drinking water guidelines, such as the Australian Drinking Water Guidelines and the World Health Organization Guidelines for Drinking-water Quality, provide guidance for the safe management of drinking water. These documents present principles and strategies for managing risks that may be posed to drinking water quality. While these principles and strategies are applicable to all types of water quality risks, very little specific attention has been paid to the management of extreme weather events. We present a review of recent literature on water quality impacts of extreme weather events and consider practical opportunities for improved guidance for water managers. We conclude that there is a case for an enhanced focus on the management of water quality impacts from extreme weather events in future revisions of water quality guidance documents. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Quantifying the Transition from Active Surveillance to Watchful Waiting Among Men with Very Low-risk Prostate Cancer.

    Science.gov (United States)

    Van Hemelrijck, Mieke; Garmo, Hans; Lindhagen, Lars; Bratt, Ola; Stattin, Pär; Adolfsson, Jan

    2017-10-01

    Active surveillance (AS) is commonly used for men with low-risk prostate cancer (PCa). When life expectancy becomes too short for curative treatment to be beneficial, a change from AS to watchful waiting (WW) follows. Little is known about this change since it is rarely documented in medical records. To model transition from AS to WW and how this is affected by age and comorbidity among men with very low-risk PCa. National population-based healthcare registers were used for analysis. Using data on PCa characteristics, age, and comorbidity, a state transition model was created to estimate the probability of changes between predefined treatments to estimate transition from AS to WW. Our estimates indicate that 48% of men with very low-risk PCa starting AS eventually changed to WW over a life course. This proportion increased with age at time of AS initiation. Within 10 yr from start of AS, 10% of men aged 55 yr and 50% of men aged 70 yr with no comorbidity at initiation changed to WW. Our prevalence simulation suggests that the number of men on WW who were previously on AS will eventually stabilise after 30 yr. A limitation is the limited information from clinical follow-up visits (eg, repeat biopsies). We estimated that changes from AS to WW become common among men with very low-risk PCa who are elderly. This potential change to WW should be discussed with men starting on AS. Moreover, our estimates may help in planning health care resources allocated to men on AS, as the transition to WW is associated with lower demands on outpatient resources. Changes from active surveillance to watchful waiting will become more common among men with very low-risk prostate cancer. These observations suggest that patients need to be informed about this potential change before they start on active surveillance. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  5. Quantifying the benefits of achieving or maintaining long-term low risk profile for cardiovascular disease: The Doetinchem Cohort Study.

    Science.gov (United States)

    Hulsegge, Gerben; Smit, Henriëtte A; van der Schouw, Yvonne T; Daviglus, Martha L; Verschuren, W M Monique

    2015-10-01

    Studies investigating the relation between risk profiles and cardiovascular disease have measured risk at baseline only. We investigated maintenance and changes of risk profiles over time and their potential impact on incident cardiovascular disease. Population-based cohort study. Risk factors were measured at baseline (1987-1991) among 5574 cardiovascular disease-free adults aged 20-59 years. They were classified into four risk categories according to smoking status, presence of diabetes and widely accepted cut-off values for blood pressure, total cholesterol/HDL-ratio and body mass index. Categories were subdivided (maintenance, deterioration, improvement) based on risk factor levels at six and 11 years of follow-up. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for cardiovascular disease incidence 5-10 years following the risk-change period were fitted using Cox proportional hazards models. Only 12% of participants were low risk at baseline, and only 7% maintained it. Participants who maintained a low risk profile over 11 years had seven times lower risk of cardiovascular disease (HR: 0.14, 95% CI: 0.05-0.41) than participants with long-term high risk profile, whereas those low risk at baseline whose profile deteriorated had three times lower risk (HR: 0.36, 95% CI: 0.18-0.71). Our results suggest that, within each baseline risk profile group, compared with a stable profile, improving profiles may be associated with up to two-fold lower HRs, and deteriorating profiles with about two-fold higher HRs. Our study, using long-term risk profiles, demonstrates the full benefits of low risk profile. These findings underscore the importance of achieving and maintaining low risk from young adulthood onwards. © The European Society of Cardiology 2014.

  6. Radiological risk comparison guidelines

    International Nuclear Information System (INIS)

    Hallinan, E.J.; Muhlestein, L.D.; Brown, L.F.; Yoder, R.E.

    1992-01-01

    An important aspect of DOE safety analyses is estimating potential accident risk. The estimates are used to: determine if additional controls are needed, identify Safety Class Items, and demonstrate adequate risk reduction. Thus, guidelines are needed to measure comparative risks. The Westinghouse M ampersand O Nuclear Facility Safety Committee and the Safety Envelope Working Group have developed radiological risk guidelines for comparing the risks from individual accident analyses. These guidelines were prepared under contract with the US Department of Energy. These guidelines are based on historical DOE guidelines and current requirements, and satisfy DOE and technical community proposals. for goals that demonstrate acceptable risk. The guidelines consist of a frequency versus consequence curve for credible accidents. Offsite and onsite guidelines are presented. The offsite risk acceptance guidelines are presented in Figure 1. The guidelines are nearly isorisk for anticipated events where impacts are chronic, and provide additional reduction for unlikely events where impacts may be acute and risk uncertainties may be significant. The guidelines are applied to individual release accident scenarios where a discrete frequency and consequence has been estimated. The guideline curves are not to be used for total risk assessments. Common cause events are taken into consideration only for an individual facility. Frequencies outside the guideline range are considered to be local site option (analyst judgement) as far as assessments of risk acceptance are concerned. If the curve is exceeded, then options include either a more detailed analysis or imposing additional preventive or mitigative features. Another presentation discusses implementation in detail. Additional work is needed to provide risk comparison guidelines for releases from multiple facilities and for toxic releases

  7. Determination of sources and analysis of micro-pollutants in drinking water

    International Nuclear Information System (INIS)

    Md Pauzi Abdullah; Soh Shiau Chian

    2005-01-01

    The objectives of the study are to develop and validate selected analytical methods for the analysis of micro organics and metals in water; to identify, monitor and assess the levels of micro organics and metals in drinking water supplies; to evaluate the relevancy of the guidelines set in the National Standard of Drinking Water Quality 2001; and to identify the sources of pollution and to carryout risk assessment of exposure to drinking water. The presentation discussed the progress of the work include determination of VOCs (Volatile organic compounds) in drinking water using SPME (Solid phase micro-extraction) extraction techniques, analysis of heavy metals in drinking water, determination of Cr(VI) with ICPES (Inductively coupled plasma emission spectrometry) and the presence of halogenated volatile organic compounds (HVOCs), which is heavily used by agricultural sector, in trace concentrations in waters

  8. Determination of heavy metals in Damascus drinking water using total reflection x-ray fluorescence

    International Nuclear Information System (INIS)

    Bakraji, E. H.; Karajo, J.

    2000-01-01

    Total reflection x-ray fluorescence spectrometry and chemical preconcentration have applied for multi-elemental analysis of Damascus drinking water. Water was taken directly from taps of several city sectors and analyzed for the following trace elements: Ti, V, Cr, Fe, Co, Ni, Cu, Zn, Se and Pb. The detection limits were found to be in the range of 0.1 to 0.4 μg/l. The mean levels of trace elements in the Damascus drinking water were below the World Health Organization drinking water quality guidelines. (author)

  9. Identification of Patients at Very Low Risk of Local Recurrence After Breast-Conserving Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Sally L., E-mail: ssmith11@bccancer.bc.ca [Radiation Therapy Program and Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver Island Centre, University of British Columbia, Victoria, British Columbia (Canada); Truong, Pauline T. [Radiation Therapy Program and Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver Island Centre, University of British Columbia, Victoria, British Columbia (Canada); Lu, Linghong; Lesperance, Mary [Department of Mathematics and Statistics, University of Victoria, Victoria, British Columbia (Canada); Olivotto, Ivo A. [Division of Radiation Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta (Canada)

    2014-07-01

    Purpose: To identify clinical and pathological factors that identify groups of women with stage I breast cancer with a 5-year risk of local recurrence (LR) ≤1.5% after breast-conserving therapy (BCS) plus whole-breast radiation therapy (RT). Methods and Materials: Study subjects were 5974 patients ≥50 years of age whose cancer was diagnosed between 1989 and 2006, and were referred with pT1 pN0 invasive breast cancer treated with BCS and RT. Cases of 5- and 10-year LR were examined using Kaplan-Meier methods. Recursive partitioning analysis was performed in patients treated with and without endocrine therapy to identify combinations of factors associated with a 5-year LR risk ≤1.5%. Results: The median follow-up was 8.61 years. Median age was 63 years of age (range, 50 to 91). Overall 5-year LR was 1.5% (95% confidence interval [CI], 1.2%-1.9%) and 10-year LR was 3.4% (95% CI, 2.8%-4.0%). Of 2830 patients treated with endocrine therapy, patient subsets identified with 5-year LR ≤1.5% included patients with grade 1 histology (n=1038; LR, 0.2%; 95% CI, 0%-0.5%) or grade 2 histology plus ≥60 years of age (n=843; LR, 0.5%; 95% CI, 0%-1.0%). Ten-year LR for these groups were 0.8% (95% CI, 0.1%-1.6%) and 0.9% (95% CI, 0.2%-1.6%), respectively. Of 3144 patients treated without endocrine therapy, patients with grade 1 histology plus clear margins had 5-year LR ≤1.5% (n=821; LR, 0.6%; 95% CI, 0.1%-1.2%). Ten-year LR for this group was 2.2% (95% CI, 1.0%-3.4%). Conclusions: Histologic grade, age, margin status, and use of endocrine therapy identified 45% of a population-based cohort of female patients over age 50 with stage I breast cancer with a 5-year LR risk ≤1.5% after BCS plus RT. Prospective study is needed to evaluate the safety of omitting RT in patients with such a low risk of LR.

  10. Utilization of prostate brachytherapy for low risk prostate cancer: Is the decline overstated?

    Directory of Open Access Journals (Sweden)

    Joseph Safdieh

    2016-08-01

    Full Text Available Purpose : Several prior studies have suggested that brachytherapy utilization has markedly decreased, coinciding with the recent increased utilization of intensity modulated radiation therapy, as well as an increase in urologist-owned centers. We sought to investigate the brachytherapy utilization in a large, hospital-based registry. Material and methods: Men with prostate cancer diagnosed between 2004-2012 and treated with either external beam radiation and/or prostate brachytherapy were abstracted from the National Cancer Database. In order to be included, men had to be clinically staged as T1c-T2aNx-0Mx-0, Gleason 6, PSA ≤ 10.0 ng/ml. Descriptive statistics were used to analyze brachytherapy utilization over time and were compared via χ2. Multivariate logistic regression was used to assess for covariables associated with increased brachytherapy usage. Results : There were 89,413 men included in this study, of which 37,054 (41.6% received only external beam radiation, and 52,089 (58.4% received prostate brachytherapy. The use of brachytherapy declined over time from 62.9% in 2004 to 51.3% in 2012 (p < 0.001. This decline was noted in both academic facilities (60.8% in 2004 to 47.0% in 2012, p < 0.001 as well as in non-academic facilities (63.7% in 2004 to 53.0% in 2012, p < 0.001. The decline was more pronounced in patients who lived closer to treatment facilities than those who lived further. The use of intensity modulated radiation therapy increased during this same time period from 18.4% in 2004 to 38.2% in 2012 (p < 0.001. On multivariate analysis, treatment at an academic center, increasing age, decreasing distance from the treatment center, and years of diagnosis from 2006-2012 were significantly associated with reduced brachytherapy usage. Conclusions : In this hospital-based registry, prostate brachytherapy usage has declined for low risk prostate cancer as intensity modulated radiation therapy usage has increased. However, it still

  11. Auto-segmentation of low-risk clinical target volume for head and neck radiation therapy.

    Science.gov (United States)

    Yang, Jinzhong; Beadle, Beth M; Garden, Adam S; Gunn, Brandon; Rosenthal, David; Ang, Kian; Frank, Steven; Williamson, Ryan; Balter, Peter; Court, Laurence; Dong, Lei

    2014-01-01

    To investigate atlas-based auto-segmentation methods to improve the quality of the delineation of low-risk clinical target volumes (CTVs) of unilateral tonsil cancers. Sixteen patients received intensity modulated radiation therapy for left tonsil tumors. These patients were treated by a total of 8 oncologists, who delineated all contours manually on the planning CT image. We chose 6 of the patients as atlas cases and used atlas-based auto-segmentation to map each the atlas CTV to the other 10 patients (test patients). For each test patient, the final contour was produced by combining the 6 individual segmentations from the atlases using the simultaneous truth and performance level estimation algorithm. In addition, for each test patient, we identified a single atlas that produced deformed contours best matching the physician's manual contours. The auto-segmented contours were compared with the physician's manual contours using the slice-wise Hausdorff distance (HD), the slice-wise Dice similarity coefficient (DSC), and a total volume overlap index. No single atlas consistently produced good results for all 10 test cases. The multiatlas segmentation achieved a good agreement between auto-segmented contours and manual contours, with a median slice-wise HD of 7.4 ± 1.0 mm, median slice-wise DSC of 80.2% ± 5.9%, and total volume overlap of 77.8% ± 3.3% over the 10 test cases. For radiation oncologists who contoured both the test case and one of the atlas cases, the best atlas for a test case had almost always been contoured by the oncologist who had contoured that test case, indicating that individual physician's practice dominated in target delineation and was an important factor in optimal atlas selection. Multiatlas segmentation may improve the quality of CTV delineation in clinical practice for unilateral tonsil cancers. We also showed that individual physician's practice was an important factor in selecting the optimal atlas for atlas-based auto

  12. Problem drinking - detection and assessment in general practice.

    Science.gov (United States)

    Demirkol, Apo; Haber, Paul; Conigrave, Katherine

    2011-08-01

    Alcohol has long been an integral part of the social life of many Australians. However, alcohol is associated with significant harm to drinkers, and also to nondrinkers. This article explores the role of the general practitioner in the detection and assessment of problem drinking. Excessive alcohol use is a major public health problem and the majority of people who drink excessively go undetected. General practitioners are in a good position to detect excessive alcohol consumption; earlier intervention can help improve outcomes. AUDIT-C is an effective screening tool for the detection of problem drinking. National Health and Medical Research Council guidelines suggest that no more than two standard drinks on each occasion will keep lifetime risk of death from alcohol related disease or injury at a low level. Once an alcohol problem is detected it is important to assess for alcohol dependence, other substance use, motivation to change, psychiatric comorbidities and examination and investigation findings that may be associated with excessive alcohol use. A comprehensive assessment of the impact and risk of harm of the patient's drinking to themselves and others is vital, and may require several consultations.

  13. CERN’s Drinking Water

    CERN Multimedia

    GS Department

    2009-01-01

      CERN’s drinking water is monitored, with regular samples being taken and analysed by a certified independent laboratory, which checks on compliance with national and European regulations for safe drinking water. Nevertheless, the drinking water network is very old and occasionally, especially after work has been carried out on the network, the clarity and colour of the water can be adversely affected due to high levels of corrosion in suspension. Some basic recommendations should always be followed:   Never use hot water from the tap for drinking or cooking. If you need hot water, then draw water from the cold water tap before heating it. Only drink or cook with cold water. Let the cold water run until you notice that the water has become clear.   If you have questions about the quality of CERN’s drinking water, then please contact: Jerome Espuche (GS/SEM), Serge Deleval (EN/CV) or Jonathan Gulley (DG/SCG).

  14. CERN’s Drinking Water

    CERN Multimedia

    GS Department

      CERN’s drinking water is monitored, with regular samples being taken and analysed by a certified independent laboratory, which checks on compliance with national and European regulations for safe drinking water. Nevertheless, the drinking water network is very old and occasionally, especially after work has been carried out on the network, the clarity and colour of the water can be adversely affected due to high levels of corrosion in suspension. Some basic recommendations should always be followed: Never use hot water from the tap for drinking or cooking. If you need hot water, then draw water from the cold water tap before heating it. Only drink or cook with cold water. Let the cold water run until you notice that the water has become clear. If you have questions about the quality of CERN’s drinking water, then please contact: Jerome Espuche (GS/SEM), Serge Deleval (EN/CV) or Jonathan Gulley (DG/SCG).

  15. Increases in Problem Drinking

    Science.gov (United States)

    ... AUD based on the new guidelines. They conducted face-to-face interviews with over 36,000 U.S. adults. They ... Institute on Drug Abuse (NIDA). NIH Office of Communications and Public Liaison Building 31, Room 5B52 Bethesda, ...

  16. A new paradigm in low-risk papillary microcarcinoma: active surveillance

    Directory of Open Access Journals (Sweden)

    Alex González Bóssolo

    2017-09-01

    Full Text Available Classical papillary thyroid microcarcinoma (PTMC is a variant of papillary thyroid carcinoma (PTC known to have excellent prognosis. It has a mortality of 0.3%, even in the presence of distance metastasis. The latest American Thyroid Association guidelines state that although lobectomy is acceptable, active surveillance can be considered in the appropriate setting. We present the case of a 37-year-old female with a history of PTMC who underwent surgical management consisting of a total thyroidectomy. Although she has remained disease-free, her quality of life has been greatly affected by the sequelae of this procedure. This case serves as an excellent example of how first-line surgical treatment may result more harmful than the disease itself.

  17. Public informations guidelines

    International Nuclear Information System (INIS)

    1986-06-01

    The purpose of these Public Information Guidelines is to provide principles for the implementation of the NWPA mandate and the Mission Plan requirements for the provision of public information. These Guidelines set forth the public information policy to be followed by all Office of Civilian Radioactive Waste Management (OCRWM) performance components. The OCRWM offices should observe these Guidelines in shaping and conducting public information activities

  18. Public informations guidelines

    Energy Technology Data Exchange (ETDEWEB)

    None

    1986-06-01

    The purpose of these Public Information Guidelines is to provide principles for the implementation of the NWPA mandate and the Mission Plan requirements for the provision of public information. These Guidelines set forth the public information policy to be followed by all Office of Civilian Radioactive Waste Management (OCRWM) performance components. The OCRWM offices should observe these Guidelines in shaping and conducting public information activities.

  19. Uranium contamination of drinking water in Kazakhstan and Uzbekistan

    International Nuclear Information System (INIS)

    Kawabata, Y.; Aparin, V.; Shiraishi, K.; Ko, S.; Yamamoto, M.; Nagaia, M.; Katayama, Y.

    2006-01-01

    Uranium is a naturally occurring radioactive metal, and is widely distributed in the Earth's crust. But it is concentrated in certain rock formations. Most of the uranium for nuclear weapon produced in the Soviet Union during the Cold War came from Central Asia. Uranium has negative effects on the human body, both as a carcinogen and as a kidney toxin. WHO (2004) prescribed that uranium concentrations in drinking water should be less than 15 mcg/l for only chemical aspects of uranium addressed. We determined high uranium concentrations in drinking water in the central region of Uzbekistan (Y. KAWABATA et al. 2004). In this area, some discharge water from farmland has higher uranium concentration. Irrigation systems Kyzyl-orda in Republic of Kazakhstan and in Karakalpakstan in the Republic of Uzbekistan have drains deeper than 5 m, in order to protect against salinization. Water in these drains can mix with ground water. In this area, ground water is used for drinking water. We investigated uranium concentrations in water in Kazakhstan and Uzbekistan. In the half of drinking water sampling points, uranium concentrations exceeded the WHO (2004) guideline level for drinking water. Uranium is a suspected carcinogen that can also have a toxic effect on kidney. However, WHO addresses only the chemical aspects of uranium by giving uranium concentrations in drinking water. The effect of uranium exposure from drinking water on people in these areas is significant. The uranium concentration in the Aral Sea was higher than that in sea water. Aral Sea is accumulating uranium. (author)

  20. Using Sleep Interventions to Engage and Treat Heavy-Drinking College Students: A Randomized Pilot Study

    Science.gov (United States)

    Fucito, Lisa M.; DeMartini, Kelly S.; Hanrahan, Tess H.; Yaggi, Henry Klar; Heffern, Christina; Redeker, Nancy S.

    2017-01-01

    Background Continued high alcohol consumption levels by college students highlight the need for more effective alcohol interventions and novel treatment engagement strategies. The purpose of this study was to investigate a behavioral sleep intervention as a means to engage heavy-drinking college students in treatment and reduce alcohol use and alcohol-related consequences. Methods Heavy-drinking college students (N=42) were assigned to 1 of 2 web-based interventions comprised of 4 modules delivered over 4 weeks. The experimental intervention focused primarily on sleep and included evidence-based sleep content (i.e., stimulus control instructions, sleep scheduling (consistent bed/rise times; ideal sleep duration for adolescents/young adults), sleep hygiene advice, relaxation training, cognitive strategies to target sleep-disruptive beliefs) and alcohol content (i.e., normative and blood alcohol level feedback, moderate drinking guidelines, controlled drinking strategies, effects of alcohol on sleep and the body, advice to moderate drinking for improved sleep) in young adults. The healthy behaviors control condition provided basic advice about nutrition, exercise, sleep (i.e., good sleep hygiene only) and drinking (i.e., effects of alcohol on the body, moderate drinking guidelines, advice to moderate drinking for sleep). Participants in both conditions monitored their sleep using daily web-based diaries and a wrist-worn sleep tracker. Results Recruitment ads targeting college students with sleep concerns effectively identified heavy-drinking students. The program generated a high number of inquiries and treatment completion rates were high. Both interventions significantly reduced typical week drinking and alcohol-related consequences and improved sleep quality and sleep-related impairment ratings. The control condition yielded greater reductions in total drinks in a heaviest drinking week. The effects on drinking were larger than those observed in typical brief

  1. IMAGE Programming Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Stehfest, E; De Waal, L.

    2010-09-15

    This document describes the requirements and guidelines for the software of the IMAGE system. The motivation for this report was a substantial restructuring of the source code for IMAGE version 2.5. The requirements and guidelines relate to design considerations as well as to aspects of maintainability and portability. The design considerations determine guidelines about subjects, such as program structure, model hierarchy, the use of data modules, and the error message system. Maintainability and portability aspects determine the guidelines on, for example, the Fortran 90 standard, naming conventions, code lay-out, and internal documentation.

  2. Guidelines for radiological interventions

    International Nuclear Information System (INIS)

    Kauffmann, G.W.

    1998-01-01

    The German Radiological Society, in cooperation with other German professional bodies, set up draft Guidelines for Radiological Interventions and submitted them to the professional community for discussion. The Guidelines are meant to assess the potential of radiological interventions as treatment alternatives to surgery or aggressive therapy such as chemotherapy. In fact, technical practicability on its own is insufficient to warrant intervention. The Guidelines are systematically compiled notions and recommendations whose aim it is to provide support to physicians and patients in choosing suitable medical care provisions (prevention, diagnosis, therapy, aftertreatment) in specific circumstances. A complete Czech translation of the Guidelines is given. (P.A.)

  3. Talking to your teen about drinking

    Science.gov (United States)

    ... has been drinking. How Problems at Home Might Influence Children to Drink Risky drinking or alcohol use in the home can lead to the same habits in children. At an early age, children become aware of the drinking patterns of their parents. Children are more likely to drink if: Conflict ...

  4. Drinking water quality of Sukkur municipal corporation

    International Nuclear Information System (INIS)

    Kandhar, I.A.; Ansari, A.K.

    2002-01-01

    SMC (Sukkur Municipal Corporation) supply the (filtered/settled) water for domestic purpose to the consumers, through intermittent water supply, from Phases I to IV. The water supply distribution network is underground and at most places pass parallel to sewerage lines. The grab sampling technique was followed for collecting representative samples. The official US-EPA and standard methods of water analysis have been used for drinking water quality analysis. DR/2000 spectrophotometer has been used for monitoring: Nitrates, Fluorides, Sulfates, Copper, Chromium, Iron and manganese. The trace metals Cr/sup 6/, Fe/sup 2+/ and other contaminants like; Turbidity and TSS (Total Suspended Solids) have been found higher than World Health Organization (WHO-1993) guideline values. (author)

  5. Review and analysis of management guidelines of basal cell carcinoma

    International Nuclear Information System (INIS)

    Garcia Nunez, Hernan

    2013-01-01

    International guidelines for management of basal cell carcinoma are reviewed and analyzed for decision-making in the appropriate therapeutic behavior for patients. The different therapies for the treatment of basal cell carcinoma are described. Different therapies are evaluated according to the risk (low or high) of recurrence to determine the appropriate treatment. According to the evidence, low-risk tumors have responded to topical therapy, curettage and electrodesiccation, cryotherapy or simple resection, and high-risk tumors are managed with surgery, radiotherapy or Mohs' micrographic surgery [es

  6. Dietary patterns and significance of nutrition for women with low-risk pregnancy

    Directory of Open Access Journals (Sweden)

    Natália Sales de CARVALHO

    Full Text Available ABSTRACT Objective: To evaluate dietary patterns and significance of diet for pregnant women. Methods: Cross-sectional study carried out in eight health units in Fortaleza, Ceará, Brazil, with 201 pregnant women. The following instruments were used: a socio-economic and health questionnaire, the Free-Word Association Test, and a Food Frequency Questionnaire. Dietary patterns were identified using principal components and factor analysis. Poisson regression with 5% significance level was used. Results: Three dietary patterns were identified: current Brazilian pattern (beans, rice, processed meats, fats, refined grains, pasta and pastries, soft drink, sugar and sweets, cookies and crackers; healthy pattern (fruits and fruit juices, vegetables, whole grains, seafood, dairy products; and energy-rich pattern (salty deep-fried snacks, popcorn, packaged snacks, instant noodles, tubers, and chicken. Women who did not receive nutrition guidance during prenatal care showed less chance of adherence to the current Brazilian dietary pattern (PR=0.87, and therefore their level of consumption of foods commonly present in Brazilian diets was low. For most women, the significance of diet was reported as important and healthy, but it was not associated with any of the diet patterns identified. However, the women who did not consider that during pregnancy diet should be healthy showed greater chance of adherence to the energy-rich pattern (PR=1.18. This finding deserves special attention since excessive weight gain can have a negative effect on pregnancy. Conclusion: Nutrition guidance during prenatal care and the way pregnant women perceive their eating habits can influence their food choices during pregnancy.

  7. Joint Attention Development in Low-risk Very Low Birth Weight Infants at Around 18 Months of Age.

    Science.gov (United States)

    Yamaoka, Noriko; Takada, Satoshi

    2016-10-18

    The purpose of this study was to clarify the developmental characteristics of joint attention in very low birth weight (VLBW) infants with a low risk of complications. Section B of the Checklist for Autism in Toddlers (CHAT) was administered to 31 VLBW and 45 normal birth weight (NBW) infants aged 18-22 months, while the sessions were recorded with a video camera. A semi-structured observation scale was developed to assess infants' joint attention from the video footage, and was shown to be reliable. VLBW, compared to NBW, infants showed significantly poorer skills in 2 of 4 items on responding to joint attention, and in 6 of 10 items on initiating joint attention. VLBW infants need more clues in order to produce joint attention. The difficulty was attributed to insufficient verbal and fine motor function skills. Continuous follow-up evaluation is essential for both high-risk and low-risk VLBW infants and their parents.

  8. Bioassay guideline 2: guidelines for tritium bioassay

    International Nuclear Information System (INIS)

    1983-01-01

    This guideline is one of a series under preparation by the Federal-Provincial Working Group on Bioassay and In Vivo Monitoring Criteria. In this report tritium compounds have been grouped into four categories for the purpose of calculating Annual Limits on Intake and Investigation Levels: tritium gas, tritiated water, tritium-labelled compounds and nucleic acid precursors

  9. Rethink Your Drink.

    Science.gov (United States)

    Hartigan, Phyllis; Patton-Ku, Dana; Fidler, Cheri; Boutelle, Kerri N

    2017-03-01

    Sugar-sweetened beverages (SSBs) are linked to obesity; hospitals are a priority setting to reduce intake. This article describes the development, implementation, and results of a focused intervention to reduce SSB sales within a hospital setting. After a formative research process, Rethink Your Drink was launched at a children's hospital in San Diego. The initiative consisted of an educational intervention using the stoplight system to categorize beverages as red, yellow, or green based on sugar content. Beverage sales data were collected for 3 months prior, during the 12-month intervention, and for 4 months after the intervention ended. Monthly red beverage sales decreased from an average of 56% during baseline to 32% at the end of the data collection period (p sales increased from an average of 12.2% during baseline to 38% at the end of the data collection period (p Sales revenue for all drinks remained constant. The intervention resulted in a decrease in SSB sales and an increase in sales of healthier beverage choices. Such interventions can play an important role in obesity prevention and may be more feasible for smaller hospitals with limited resources.

  10. Evidence-based guidelines

    DEFF Research Database (Denmark)

    Rovira, Àlex; Wattjes, Mike P; Tintoré, Mar

    2015-01-01

    diagnosis in patients with MS. The aim of this article is to provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. These guidelines are based on an extensive review of the recent literature, as well as on the personal...

  11. Whitebark pine planting guidelines

    Science.gov (United States)

    Ward McCaughey; Glenda L. Scott; Kay L. Izlar

    2009-01-01

    This article incorporates new information into previous whitebark pine guidelines for planting prescriptions. Earlier 2006 guidelines were developed based on review of general literature, research studies, field observations, and standard US Forest Service survival surveys of high-elevation whitebark pine plantations. A recent study of biotic and abiotic factors...

  12. Guidelines for Learning Stations.

    Science.gov (United States)

    Fehrle, Carl C.; Schulz, Jolene

    Guidelines for designing and planning learning stations for pupils at the elementary grade level include suggestions on how to develop a station that will be successful in meeting the learners' needs. Instructions for the use of tapes at a station and matching pupils with stations are given, as are guidelines on classroom arrangement and record…

  13. D 59 Design Guidelines

    DEFF Research Database (Denmark)

    Burcharth, Hans F.; Lamberti, Alberto

    The present guidelines are specifically dedicated to Low Crested Structures on attempt to provide methodological tools both for the engineering design of structures and for prediction of performance and environmental impacts. It is anticipated that the guidelines will provide valuable inputs to c...

  14. Measure Guideline: Ventilation Cooling

    Energy Technology Data Exchange (ETDEWEB)

    Springer, D. [Alliance for Residential Building Innovation (ARBI), David, CA (United States); Dakin, B. [Alliance for Residential Building Innovation (ARBI), David, CA (United States); German, A. [Alliance for Residential Building Innovation (ARBI), David, CA (United States)

    2012-04-01

    The purpose of this measure guideline is to provide information on a cost-effective solution for reducing cooling system energy and demand in homes located in hot-dry and cold-dry climates. This guideline provides a prescriptive approach that outlines qualification criteria, selection considerations, and design and installation procedures.

  15. Maintenance Trades Guidelines

    Science.gov (United States)

    Weidner, Theodore J.

    2008-01-01

    In 2002, APPA published "Maintenance Staffing Guidelines for Educational Facilities," the first building maintenance trades staffing guideline designed to assist educational facilities professionals with their staffing needs. addresses how facilities professionals can determine the appropriate size and mix of their organization. Contents…

  16. Thyrotropin Suppressive Therapy for Low-Risk Small Thyroid Cancer: A Propensity Score-Matched Cohort Study.

    Science.gov (United States)

    Park, Suyeon; Kim, Won Gu; Han, Minkyu; Jeon, Min Ji; Kwon, Hyemi; Kim, Mijin; Sung, Tae-Yon; Kim, Tae Yong; Kim, Won Bae; Hong, Suck Joon; Shong, Young Kee

    2017-09-01

    Thyrotropin (TSH) suppression has improved the clinical outcomes of patients with differentiated thyroid cancer (DTC). However, the efficacy of TSH suppressive therapy (TST) is unclear in patients with low-risk DTC. This study aimed to evaluate the efficacy of TST and optimal TSH levels of patients with low-risk DTC. This retrospective propensity score-matched cohort study included DTC patients (n = 446) who underwent lobectomy from 2002 to 2008 with or without TST (TST group and No-TST group). Disease-free survival (DFS) and dynamic risk stratification were compared between both groups using serum TSH levels. Approximately 74% of TST patients and 11% of No-TST patients had suppressed serum TSH levels (<2 mIU/L). The median follow-up period was 8.6 years. During follow-up, the disease recurred in 10 (2.7%) patients, with no significant difference in DFS between the groups (p = 0.63). The proportion of patients with excellent treatment response was similar between the TST (65.2%) and No-TST (64.4%) groups. Incomplete biochemical response was noted in 17.2% of the TST group patients and 9.4% of the No-TST group patients. No significant difference was observed in the DFS between both groups by comparing serum TSH level (p = 0.57). TST did not improve clinical outcomes, and serum TSH levels were not associated with recurrence in patients with low-risk small DTC. No clinical benefits were shown for TSH suppression in low-risk patients who underwent lobectomy. Thus, levothyroxine is not necessary for patients without evidence of hypothyroidism.

  17. Accuracy of simple urine tests for diagnosis of urinary tract infections in low-risk pregnant women

    OpenAIRE

    Feitosa,Danielle Cristina Alves; Silva,Márcia Guimarães da; Parada,Cristina Maria Garcia de Lima

    2009-01-01

    Anatomic and physiological alterations during pregnancy predispose pregnant women to urinary tract infections (UTI). This study aimed to identify the accuracy of the simple urine test for UTI diagnosis in low-risk pregnant women. Diagnostic test performance was conducted in Botucatu, SP, involving 230 pregnant women, between 2006 and 2008. Results showed 10% UTI prevalence. Sensitivity, specificity and accuracy of the simple urine test were 95.6%, 63.3% and 66.5%, respectively, in relation to...

  18. [FRAX® thresholds to identify people with high or low risk of osteoporotic fracture in Spanish female population].

    Science.gov (United States)

    Azagra, Rafael; Roca, Genís; Martín-Sánchez, Juan Carlos; Casado, Enrique; Encabo, Gloria; Zwart, Marta; Aguyé, Amada; Díez-Pérez, Adolf

    2015-01-06

    To detect FRAX(®) threshold levels that identify groups of the population that are at high/low risk of osteoporotic fracture in the Spanish female population using a cost-effective assessment. This is a cohort study. Eight hundred and sixteen women 40-90 years old selected from the FRIDEX cohort with densitometry and risk factors for fracture at baseline who received no treatment for osteoporosis during the 10 year follow-up period and were stratified into 3 groups/levels of fracture risk (low20%) according to the real fracture incidence. The thresholds of FRAX(®) baseline for major osteoporotic fracture were: low riskX-ray absorptiometry (DXA-scan) for FRAX(®)≥ 5 (Intermediate and high risk) to reclassify by FRAX(®) with DXA-scan at high/low risk. These thresholds select 17.5% of women for DXA-scan and 10% for treatment. With these thresholds of FRAX(®), compared with the strategy of opportunistic case finding isolated risk factors, would improve the predictive parameters and reduce 82.5% the DXA-scan, 35.4% osteoporosis prescriptions and 28.7% cost to detect the same number of women who suffer fractures. The use of FRAX ® thresholds identified as high/low risk of osteoporotic fracture in this calibration (FRIDEX model) improve predictive parameters in Spanish women and in a more cost-effective than the traditional model based on the T-score ≤ -2.5 of DXA scan. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  19. [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.

  20. Association of spiritual/religious coping with depressive symptoms in high- and low-risk pregnant women.

    Science.gov (United States)

    Vitorino, Luciano M; Chiaradia, Raíssa; Low, Gail; Cruz, Jonas Preposi; Pargament, Kenneth I; Lucchetti, Alessandra L G; Lucchetti, Giancarlo

    2018-02-01

    To investigate the role of spiritual/religious coping (SRC) on depressive symptoms in high- and low-risk pregnant women. Spiritual/religious coping is associated with physical and mental health outcomes. However, only few studies investigated the role of these strategies during pregnancy and whether low- and high-risk pregnant women have different coping mechanisms. This study is a cross-sectional comparative study. This study included a total of 160 pregnant women, 80 with low-risk pregnancy and 80 with high-risk pregnancy. The Beck Depression Inventory, the brief SRC scale and a structured questionnaire on sociodemographic and obstetric aspects were used. General linear model regression analysis was used to identify the factors associated with positive and negative SRC strategies in both groups of pregnant women. Positive SRC use was high, whereas negative SRC use was low in both groups. Although we found no difference in SRC strategies between the two groups, negative SRC was associated with depression in women with high-risk pregnancy, but not in those with low-risk pregnancy. Furthermore, positive SRC was not associated with depressive symptoms in both groups. Results showed that only the negative SRC strategies of Brazilian women with high-risk pregnancies were associated with worsened mental health outcomes. Healthcare professionals, obstetricians and nurse midwives should focus on the use of negative SRC strategies in their pregnant patients. © 2017 John Wiley & Sons Ltd.

  1. A pilot audit of a protocol for ambulatory investigation of predicted low-risk patients with possible pulmonary embolism.

    Science.gov (United States)

    McDonald, A H; Murphy, R

    2011-09-01

    Patients with possible pulmonary embolism (PE) commonly present to acute medical services. Research has led to the identification of low-risk patients suitable for ambulatory management. We report on a protocol designed to select low-risk patients for ambulatory investigation if confirmatory imaging is not available that day. The protocol was piloted in the Emergency Department and Medical Assessment Area at the Royal Infirmary of Edinburgh. We retrospectively analysed electronic patient records in an open observational audit of all patients managed in the ambulatory arm over five months of use. We analysed 45 patients' records. Of these, 91.1% required imaging to confirm or refute PE, 62.2% received a computed tomography pulmonary angiogram (CTPA). In 25% of patients, PE was confirmed with musculoskeletal pain (22.7%), and respiratory tract infection (15.9%) the next most prevalent diagnoses. Alternative diagnoses was provided by CTPA in 32% of cases. We identified no adverse events or readmissions but individualised follow-up was not attempted. The data from this audit suggests this protocol can be applied to select and manage low-risk patients suitable for ambulatory investigation of possible PE. A larger prospective comparative study would be required to accurately define the safety and effectiveness of this protocol.

  2. Perinatal outcomes of low-risk planned home and hospital births under midwife-led care in Japan.

    Science.gov (United States)

    Hiraizumi, Yoshie; Suzuki, Shunji

    2013-11-01

    It has not been extensively studied whether planned home and planned hospital births under primary midwife-led care increase risk of adverse events among low-risk women in Japan. A retrospective cohort study was performed to compare perinatal outcome between 291 women who were given primary midwife-led care during labor and 217 women who were given standard obstetric shared care. Among 291 women with primary midwife-led care, 168 and 123 chose home deliver and hospital delivery, respectively. Perinatal outcomes included length of labor of 24 h or more, augmentation of labor pains, delivery mode, severe perineal laceration, postpartum hemorrhage of 1000 mL or more, maternal fever of 38°C or more and neonatal asphyxia (Apgar score, home delivery (34 vs 21%, P = 0.011). There were no significant differences in the incidence of adverse perinatal outcomes between women with obstetric shared care and women with primary midwife-led care (regardless of being hospital delivery or home delivery). Approximately one-quarter of low-risk women with primary midwife-led care required obstetric care during labor or postpartum. However, primary midwife-led care during labor at home and hospital for low-risk pregnant women was not associated with adverse perinatal outcomes in Japan. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

  3. Results of allogeneic stem cell transplantation in the Spanish MDS registry: prognostic factors for low risk patients.

    Science.gov (United States)

    Díez Campelo, M; Sánchez-Barba, M; de Soria, V Gómez-García; Martino, R; Sanz, G; Insunza, A; Bernal, T; Duarte, R; Amigo, M L; Xicoy, B; Tormo, M; Iniesta, F; Bailén, A; Benlloch, L; Córdoba, I; López-Villar, O; Del Cañizo, M C

    2014-10-01

    Although new agents have been approved for the treatment of MDS, the only curative approach is allogeneic hematopoietic stem cell transplantation (HSCT) and thus, in particular circumstances this procedure has been proposed as a treatment option for low risk patients. We have retrospectively analyzed the results of HSCT in 291 patients from the Spanish MDS registry with special attention to low risk MDS (LR-MDS) in order to define the variables that could impact their clinical evolution after transplantation. At 2 years OS was 51% and EFS was 50% (95% CI 0.7-4.5 years for OS and 95% CI 0.1-3.9 years for EFS). Among 43 LR-MDS, transplant-related mortality was 28%. At 3 years, OS was 67% (95% CI 264.7-8927.2 days for OS) and EFS was 64% (95% CI 0-9697.2 days for EFS). In the multivariate analysis only cytogenetics retained statistical significant effect on both OS (p=.047) and EFS (p=.046). Conditioning regimen could improve outcome among this subset of patients (OS 86% and RFS 100% for patients receiving RIC regimen). The present study confirms that specific disease characteristic as well as transplant characteristics have a significant impact on transplant outcome. Regarding low risk patients a non-myeloablative conditioning would be preferable especially in cases without high-risk cytogenetics. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Primary care guidelines

    DEFF Research Database (Denmark)

    Ijäs, Jarja; Alanen, Seija; Kaila, Minna

    2009-01-01

    OBJECTIVE: To describe the adoption of the national Hypertension Guideline in primary care and to evaluate the consistency of the views of the health centre senior executives on the guideline's impact on clinical practices in the treatment of hypertension in their health centres. DESIGN: A cross...... Guideline. RESULTS: Data were available from 143 health centres in Finland (49%). The views of head physicians and senior nursing officers on the adoption of the Hypertension Guideline were not consistent. Head physicians more often than senior nursing officers (44% vs. 29%, p ...: Hypertension Guideline recommendations that require joint agreements between professionals are less often adopted than simple, precise recommendations. More emphasis on effective multidisciplinary collaboration is needed....

  5. Global Imaging referral guidelines

    International Nuclear Information System (INIS)

    Kawooya, M.; Perez, M.; Lau, L.; Reeed, M.

    2010-01-01

    The medical imaging specialists called for global referral guidelines which would be made available to referring doctors. These referral guidelines should be:- Applicable in different health care settings, including resource-poor settings; Inclusive in terms of the range of clinical conditions; User-friendly and accessible (format/media); Acceptable to stakeholders, in particular to the referrers as the main target audience. To conceive evidence-based medicine as an integration of best research evidence with clinical expertise and patient values. The Direct recipients of the Referral Guidelines would be:- Referrers: general practitioners / family doctors; paediatricians; emergency department doctors; other specialists and health workers. Providers (medical imaging practitioners): radiologists; nuclear medicine physicians; radiographers; other appropriately qualified practitioners providing diagnostic imaging services. For the Referral Guidelines to be effective there need to be: Credibility evidence-based Practicality end user involvement Context local resources, disease profiles Endorsement, opinion leaders Implementation- policy, education, CPOE - Monitoring of the use clinical audit, report feedback. The aim of the Referral Guidelines Project was to: Produce global referral guidelines that are evidence-based, cost effective and appropriate for the local setting, and include consideration of available equipment and expertise (RGWG; SIGs); Include supporting information about radiation doses, potential risks, protection of children and pregnant women (introductory chapter); Facilitate the implementation of the guidelines through guidance and tools (e.g. implementation guides, checklists, capacity building tools, guides on stakeholders engagement, audit support criteria); Conduct pilot testing in different clinical settings from each of the six WHO regions; Promote the inclusion of the referral guidelines in the curricula of medical schools; Develop and implement

  6. Hostility, drinking pattern and mortality

    DEFF Research Database (Denmark)

    Boyle, Stephen H; Mortensen, Laust Hvas; Grønbaek, Morten

    2008-01-01

    This study examined the association of hostility to drinking pattern and whether this association mediated the relation of hostility to mortality.......This study examined the association of hostility to drinking pattern and whether this association mediated the relation of hostility to mortality....

  7. Biofilm in drinking water networks

    International Nuclear Information System (INIS)

    Cristiani, Pietrangela

    2005-01-01

    Bacterial growth in drinking waters is today controlled adding small and non toxic quantities of sanitising products. An innovative electrochemical biofilm monitoring system, already successfully applied in industrial waters, could be confirmed as an effective diagnostic tool of water quality also for drinking distributions systems [it

  8. Analysis of extreme drinking in patients with alcohol dependence using Pareto regression.

    Science.gov (United States)

    Das, Sourish; Harel, Ofer; Dey, Dipak K; Covault, Jonathan; Kranzler, Henry R

    2010-05-20

    We developed a novel Pareto regression model with an unknown shape parameter to analyze extreme drinking in patients with Alcohol Dependence (AD). We used the generalized linear model (GLM) framework and the log-link to include the covariate information through the scale parameter of the generalized Pareto distribution. We proposed a Bayesian method based on Ridge prior and Zellner's g-prior for the regression coefficients. Simulation study indicated that the proposed Bayesian method performs better than the existing likelihood-based inference for the Pareto regression.We examined two issues of importance in the study of AD. First, we tested whether a single nucleotide polymorphism within GABRA2 gene, which encodes a subunit of the GABA(A) receptor, and that has been associated with AD, influences 'extreme' alcohol intake and second, the efficacy of three psychotherapies for alcoholism in treating extreme drinking behavior. We found an association between extreme drinking behavior and GABRA2. We also found that, at baseline, men with a high-risk GABRA2 allele had a significantly higher probability of extreme drinking than men with no high-risk allele. However, men with a high-risk allele responded to the therapy better than those with two copies of the low-risk allele. Women with high-risk alleles also responded to the therapy better than those with two copies of the low-risk allele, while women who received the cognitive behavioral therapy had better outcomes than those receiving either of the other two therapies. Among men, motivational enhancement therapy was the best for the treatment of the extreme drinking behavior. Copyright 2010 John Wiley & Sons, Ltd.

  9. Physicochemical properties and the concentration of anions, major and trace elements in groundwater, treated drinking water and bottled drinking water in Najran area, KSA

    Science.gov (United States)

    Brima, Eid I.

    2017-03-01

    Basic information about major elements in bottled drinking water is provided on product labels. However, more information is needed about trace elements in bottled drinking water and other sources of drinking water to assess its quality and suitability for drinking. This is the first such study to be carried out in Najran city in the Kingdom of Saudi Arabia (KSA). A total of 48 water samples were collected from different sources comprising wells, stations for drinking water treatment and bottled drinking water (purchased from local supermarkets). The concentrations of 24 elements [aluminum (Al), arsenic (As), barium (Ba), calcium (Ca), cadmium (Cd), cobalt (Co), chromium (Cr), cesium (Cs), copper (Cu), iron (Fe), potassium (K), magnesium (Mg), manganese (Mn), molydenum (Mo), sodium (Na), nickel (Ni), lead (Pb), rubidium (Rb), selenium (Se), strontium (Sr), titanium (Ti), vanadium (V), uranium (U) and zinc (Zn)] were determined by inductively coupled plasma-mass spectrometry (ICP-MS). Anions (chlorine (Cl-), fluoride (F-), sulfate (SO4 2-) and nitrate (NO3 -) were determined by ion chromatography (IC). Electrical conductivity (EC), pH, total dissolved salts (TDS) and total hardness (TH) were also measured. All parameters of treated drinking water and bottled drinking water samples did not exceed the World Health Organization (WHO) 2008, US Environmental Protection Agency (USEPA 2009), Gulf Cooperation Council Standardization Organization (GSO) 2008 and Saudi Arabian Standards Organization (SASO) 1984 recommended guidelines. It is noteworthy that groundwater samples were not used for drinking purpose. This study is important to raise public knowledge about drinking water, and to promote public health.

  10. Risks and guidelines for the consumption of alcohol during pregnancy

    DEFF Research Database (Denmark)

    Kesmodel, Ulrik Schiøler

    2016-01-01

    Daily average intake of alcohol during pregnancy has consistently been associated with short term adverse outcomes such as miscarriage, preterm birth and intrauterine growth restriction, a large variety of malformations, as well as long term adverse outcomes such as foetal alcohol syndrome, mental...... in accordance with the official recommendations, although a large proportion of women of child bearing age and pregnant women drink alcohol, especially before recognition of pregnancy. The discrepancy between guidelines and the information practice of health personnel is likely to continue to exist because...... retardation and general impairment of cognitive functions including intelligence, attention, learning abilities as well as social and behavioural functions. Weekly average consumption and alcohol binge drinking (usually defined as ≥ 5 drinks on a single occasion) independently of high daily average intake has...

  11. Setting up low-risk bone marrow transplantation for children with thalassemia may facilitate pediatric cancer care

    Directory of Open Access Journals (Sweden)

    Lawrence B Faulkner

    2013-01-01

    Full Text Available Background: In many South Asian countries there is shortage of centers providing care for pediatric malignancies. This report describes the experience of the Cure2Children Foundation (C2C in supporting, both financially and professionally, the startup of two bone marrow transplant (BMT centers, one in Pakistan and one in India, for the cure of transfusion-dependent thalassemia. Even though transplantation is generally considered as a more complex and advanced step relatively to basic pediatric cancer care, the authors argue that BMT for low-risk thalassemia patients with a matched sibling is a relatively simple procedure amenable to focused training. Materials and Methods: Since 2008 the C2C, an Italian Nongovernmental Organization (NGO, has supported a BMT network in Pakistan. The primary aim of this project was to assess feasibility, outcomes, and costs of matched-related BMT for thalassemia in young low-risk children employing a well established and quite tolerable strategy employed in Italy. This initiative relied primarily on focused training and task-shift strategies within a structured cooperation program. The initial success of that strategy led to its replication in India with 100 total BMTs performed over the past 4 years, 91 of which were for thalassemia major. Results: Low-risk matched-related BMT in children younger than 5 years could deliver a 92% thalassemia-free survival with 100% performance score and no extensive chronic graft versus host disease (GVHD, for an average cost of 10,000 USD per BMT. Within an existing hospital facility, 50,000 USD were sufficient to renovate and fully equip a 2-3 bedded start up BMT unit capable of performing safe low-risk compatible marrow transplantation. Conclusions: In low resource settings matched-related low-risk BMT for thalassemia can be performed with outcomes comparable to richer countries and with a fraction of the costs. Within structured and intensive cooperation, good outcomes can be

  12. Should I drink responsibly, safely or properly? Confusing messages about reducing alcohol-related harm.

    Directory of Open Access Journals (Sweden)

    Sandra C Jones

    Full Text Available 'Responsible drinking' campaigns emerged in the early 1970s as a means of addressing hazardous drinking and its related consequences. While these were initially the product of public health agencies and health-related NGOs, they are increasingly being developed and disseminated by the alcohol industry. There is considerable debate as to whether industry-generated campaigns are designed to reduce hazardous drinking and related problems (as argued by their developers or are designed to avoid government regulation or even to increase sales. The aim of the present study was to explore the way that recent industry-developed responsible drinking campaigns are perceived and interpreted by the general public. That is, do they promote low-risk drinking, promote risky drinking, or just muddy the waters. Two sub-studies were conducted. The first, a mall intercept study with 180 adults in two Australian shopping districts, explored participants' understanding of slogans/taglines. The second, an online survey with 480 Australian adults, explored understandings and interpretations of television/online commercials. The results of the two studies revealed diversity in participants' interpretation of the 'responsible drinking' advertisements. Terminology utilised in industry-developed advertisements was found to be ambiguous; for example, what age group was being referred to in the tagline 'Kids and alcohol don't mix', and whether 'Drink Properly' meant not drinking to excess or drinking in a way that made you look more sophisticated. In Study Two, the government-developed campaign ('Know when to say when' was clearly interpreted as warning against risky consumption of alcohol; whereas the industry-developed campaigns ('How to drink properly', 'Kids absorb your drinking', 'Friends are waiting' were interpreted to have a range of different meanings, including some seemingly unrelated to alcohol. These findings are consistent with the literature evaluating anti

  13. Radiological indices of drinking waters on the north part of the bulgarian black sea coast

    International Nuclear Information System (INIS)

    Todorov, P.T.; Rusev, R.; Chuturkova, R.

    2005-01-01

    Bulgaria is a country which is located in the Eastern Europe. A drinking water sources on the North part of Bulgarian Black Sea coast have different radiological indices. The sources of drinking water can be lakes, rivers, wells, dam lakes and so on. Property estimation of the contents of Uranium (Ur), Radium (Ra 226), and total Beta activity, shows that concentrations of investigated parameters vary around TDI (tolerable daily intake). To Uranium for example the TDI yields a guideline value are 2 μg/litre if a 60 kg adult consuming 2 litres of drinking water per day and the provisional guideline value of Uranium which shows the health significance in drinking waters is 0.002 mg/1. The situation with the full Beta activity and Radium concentrations is the same. All these qualitative and quantitative indices are close to the provisional guideline values, but in some cases it is higher than the limit concentrations. The full Beta activity is measured in Becquerel per litre and values are around 0.193+7-20% Bq/1. The Radium concentration takes the dimensions of Bq/1 and it is about 0.009 Bq/l. No matter of the source of drinking water, contents of radiological indices is a very important element of the health care control

  14. Growth trajectories of alcohol information processing and associations with escalation of drinking in early adolescence.

    Science.gov (United States)

    Colder, Craig R; O'Connor, Roisin M; Read, Jennifer P; Eiden, Rina D; Lengua, Liliana J; Hawk, Larry W; Wieczorek, William F

    2014-09-01

    This longitudinal study provided a comprehensive examination of age-related changes in alcohol outcome expectancies, subjective evaluation of alcohol outcomes, and automatic alcohol associations in early adolescence. A community sample (52% female, 75% White/non-Hispanic) was assessed annually for 3 years (mean age at the first assessment = 11.6 years). Results from growth modeling suggested that perceived likelihood of positive outcomes increased and that subjective evaluations of these outcomes were more positive with age. Perceived likelihood of negative outcomes declined with age. Automatic alcohol associations were assessed with an Implicit Association Task (IAT), and were predominantly negative, but these negative associations weakened with age. High initial levels of perceived likelihood of positive outcomes at age 11 were associated with escalation of drinking. Perceived likelihood of negative outcomes was associated with low risk for drinking at age 11, but not with changes in drinking. Increases in positive evaluations of positive outcomes were associated with increases in alcohol use. Overall, findings suggest that at age 11, youth maintain largely negative attitudes and perceptions about alcohol, but with the transition into adolescence, there is a shift toward a more neutral or ambivalent view of alcohol. Some features of this shift are associated with escalation of drinking. Our findings point to the importance of delineating multiple aspects of alcohol information processing for extending cognitive models of alcohol use to the early stages of drinking.

  15. Alcohol use and pregnancy consensus clinical guidelines.

    Science.gov (United States)

    Carson, George; Cox, Lori Vitale; Crane, Joan; Croteau, Pascal; Graves, Lisa; Kluka, Sandra; Koren, Gideon; Martel, Marie-Jocelyne; Midmer, Deana; Nulman, Irena; Poole, Nancy; Senikas, Vyta; Wood, Rebecca

    2010-08-01

    to establish national standards of care for the screening and recording of alcohol use and counselling on alcohol use of women of child-bearing age and pregnant women based on the most up-to-date evidence. published literature was retrieved through searches of PubMed, CINAHL, and the Cochrane Library in May 2009 using appropriate controlled vocabulary (e.g., pregnancy complications, alcohol drinking, prenatal care) and key words (e.g., pregnancy, alcohol consumption, risk reduction). Results were restricted to literature published in the last five years with the following research designs: systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no language restrictions. Searches were updated on a regular basis and incorporated in the guideline to May 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment (HTA) and HTA-related agencies, national and international medical specialty societies, clinical practice guideline collections, and clinical trial registries. Each article was screened for relevance and the full text acquired if determined to be relevant. The evidence obtained was reviewed and evaluated by the members of the Expert Workgroup established by the Society of Obstetricians and Gynaecologists of Canada. The quality of evidence was evaluated and recommendations were made according to guidelines developed by the Canadian Task Force on Preventive Health Care. the quality of evidence was rated using the criteria described by the Canadian Task Force on Preventive Health Care (Table 1). the Public Health Agency of Canada and the Society of Obstetricians and Gynaecologists of Canada. these consensus guidelines have been endorsed by the Association of Obstetricians and Gynecologists of Quebec; the Canadian Association of Midwives; the Canadian Association of Perinatal, Women's Health and Neonatal Nurses (CAPWHN); the College of Family Physicians of

  16. Monitoring of gross alpha, gross beta and tritium activities in portuguese drinking waters

    International Nuclear Information System (INIS)

    Lopes, I.; Madruga, M.J.; Ferrador, G.O.; Sequeira, M.M.; Oliveira, E.J.; Gomes, A.R.; Rodrigues, F.D.; Carvalho, F.P.

    2006-01-01

    The gross beta and tritium activities in the forty Portuguese drinking waters analyzed using the ISO standard methods (Portuguese Guidelines) are below the guidance levels proposed in the Portuguese Drinking Water Quality Guidelines. In what concerns the gross alpha activity only 18% exceeded the recommended level. In general, it can be concluded that the ingestion of these drinking waters does not create a radiological hazard to the human consumption, however, more detailed analyses will be necessary mainly the determinations of the individual alpha emitters radionuclide concentrations. The minimum gross alpha and gross beta detectable activities by L.S.C. methodology are higher than for the proportional counting technique (ISO method). Higher concentration factors will be needed to reach lower required detection limits. (authors)

  17. Gender equality in university sportspeople's drinking.

    Science.gov (United States)

    O'Brien, Kerry S; Hunter, Jackie; Kypri, Kypros; Ali, Ajmol

    2008-11-01

    In large population-based alcohol studies males are shown consistently to drink more, and more hazardously, than females. However, research from some countries suggests that gender differences in drinking are converging, with females drinking more than in the past. Large population-based research may miss gender-based changes in drinking behaviours that occur in sub-populations most at risk of hazardous drinking. We examine gender differences in a sub-population where hazardous drinking is common and endorsed, namely university sportspeople. The Alcohol Use Disorders Identification Test (AUDIT) and a drinking motives measure were used to assess hazardous drinking behaviours and drinking motives in 631 university sportspeople (females = 331, 52%). There were no gender differences in AUDIT scores. However, drinking motives differed between genders, with coping motives being a significant predictor of hazardous drinking in females but not males. Hazardous drinking, including binge drinking (46.3%) and frequent binge drinking (35%), in New Zealand university sportspeople is high for both males and females. New Zealand university sportspeople are one population where gender differences in drinking are not apparent and run counter to European population based research and research in US sporting populations. Gender role equality in the university systems, and endorsement of drinking in sporting culture, may account for the lack of gender differences in this New Zealand sporting population. Future research on gender differences in drinking should examine sub-populations where gender role differentiation is low, and socio-cultural/structural factors supporting gender equality are high.

  18. [Energy drinks: an unknown risk].

    Science.gov (United States)

    Petit, Aymeric; Levy, Fanny; Lejoyeux, Michel; Reynaud, Michel; Karila, Laurent

    2012-05-01

    The term "energy drink" designates "any product in the form of a drink or concentrated liquid, which claims to contain a mixture of ingredients having the property to raise the level of energy and vivacity". The main brands, Red Bull, Dark Dog, Rockstar, Burn, and Monster, are present in food stores, sports venues, and bars among other soft drinks and fruit juices. Their introduction into the French market raised many reluctances, because of the presence of taurine, caffeine and glucuronolactone. These components present in high concentrations, could be responsible for adverse effects on health. The association of energy drinks and spirits is widely found among adolescents and adults who justify drinking these mixed drinks by their desire to drink more alcohol while delaying drunkenness. Given the importance of the number of incidents reported among the energy drinks consumers, it seemed appropriate to make a synthesis of available data and to establish causal links between the use of these products and the development of health complications. For a literature review, we selected scientific articles both in English and French published between 2001 and 2011 by consulting the databases Medline, Embase, PsycINFO and Google Scholar. The words used alone or in combination are "energy dinks", "caffeine", "taurine", "toxicity", "dependence". An occasional to a moderate consumption of these drinks seems to present little risk for healthy adults. However, excessive consumption associated with the use of alcohol or drugs in amounts that far exceed the manufacturers recommended amount, could be responsible for negative consequences on health, particularly among subjects with cardiovascular disease.

  19. EMI Messaging Guidelines

    CERN Document Server

    Cons, L.

    2011-01-01

    Guidelines for potential users of messaging within EMI. The goal is to provide enough practical information so that EMI product teams can start investigating whether using messaging in their products can be beneficial or not.

  20. London 2012 packaging guidelines

    OpenAIRE

    2013-01-01

    These guidelines are intended to provide supplemental advice to suppliers and licensees regarding the provisions of the LOCOG Sustainable Sourcing Code that relate to packaging design and materials selection.

  1. Curriculum Guidelines for Periodontics.

    Science.gov (United States)

    Journal of Dental Education, 1985

    1985-01-01

    Guidelines describe the interrelationships of this and other dental fields, give an overview of the curriculum and its primary educational objectives, and outline the suggested prerequisites, core content, specific behavioral objectives, sequencing, and faculty requirements. (MSE)

  2. Transparent Guideline Methodology Needed

    DEFF Research Database (Denmark)

    Lidal, Ingeborg; Norén, Camilla; Mäkelä, Marjukka

    2013-01-01

    As part of learning at the Nordic Workshop of Evidence-based Medicine, we have read with interest the practice guidelines for central venous access, published in your Journal in 2012.1 We appraised the quality of this guideline using the checklist developed by The Evidence-Based Medicine Working ...... are based on best currently available evidence. Our concerns are in two main categories: the rigor of development, including methodology of searching, evaluating, and combining the evidence; and editorial independence, including funding and possible conflicts of interest....... Group.2 Similar criteria for guideline quality have been suggested elsewhere.3 Our conclusion was that this much needed guideline is currently unclear about several aspects of the methodology used in developing the recommendations. This means potential users cannot be certain that the recommendations...

  3. Adopting preoperative fasting guidelines.

    Science.gov (United States)

    Anderson, Megan; Comrie, Rhonda

    2009-07-01

    In 1999, the American Society of Anesthesiologists adopted preoperative fasting guidelines to enhance the quality and efficiency of patient care. Guidelines suggest that healthy, non-pregnant patients should fast six hours from solids and two hours from liquids. Although these guidelines are in place, studies suggest that providers are still using the blanket statement "NPO after midnight" without regard to patient characteristics, the procedure, or the time of the procedure. Using theory to help change provider's beliefs may help make change more successful. Rogers' Theory of Diffusion of Innovations can assist in changing long-time practice by laying the groundwork for an analysis of the benefits and disadvantages of proposed changes, such as changes to fasting orders, while helping initiate local protocols instead of additional national guidelines.

  4. US Adults Drink 17 Billion Binge Drinks a Year

    Science.gov (United States)

    ... result in dangerous driving, risky sexual behavior, and violent behavior. Over time, binge drinking also increases the ... Am J Prev Med 2018; 54(4). Features Media Sign up for Features Get Email Updates To ...

  5. Sports and Energy Drinks: Should Your Child Drink Them?

    Science.gov (United States)

    ... and biking, or high-intensity exercise such as soccer, basketball, or hockey). These drinks contain carbohydrates (sugar), ... look like a quick way to fill any nutrition gaps in your child's diet, but these nutrients ...

  6. OSART guidelines. 1992 edition

    International Nuclear Information System (INIS)

    1992-01-01

    The IAEA Operational Safety Review Team (OSART) Guidelines provide overall guidance for the experts to ensure the consistency and comprehensiveness of the operational safety review. Specific guidelines are provided as a guide for the systematic review in the following areas important to operational safety: management, organization and administration, training and qualification, operations, maintenance, technical support, radiation protection, chemistry, emergency planning and preparedness. Additional guidance and reference material has been prepared by the IAEA to complement the expertise of the OSART members

  7. Electrical safety guidelines

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    The Electrical Safety Guidelines prescribes the DOE safety standards for DOE field offices or facilities involved in the use of electrical energy. It has been prepared to provide a uniform set of electrical safety standards and guidance for DOE installations in order to affect a reduction or elimination of risks associated with the use of electrical energy. The objectives of these guidelines are to enhance electrical safety awareness and mitigate electrical hazards to employees, the public, and the environment.

  8. Ecologo guidelines spark disagreement

    International Nuclear Information System (INIS)

    Anon.

    1999-01-01

    Defining what renewable means has been a challenge, but the authors of a new set of guidelines for the Ecologo certification of renewable low-impact electrcity expect after some delay to have the new rules on the street by March 2000.. There was contention in developing the guideline, according to Terra Choice Environmental Services, the company that created and applied criteria for Ecologo certification under the federal government's Environmetal Choice Program. Interim guidleines were developed and have been in place for renewable power since 1996, and have since been used to certify wood-waste biomass, landfill gas, small hydro and wind power plants, in addition to three green power marketing programs. The first draft of the revised guidelines was issued in March. It was one of the harder guidelines to have been worked on because Canadian power producers did not readily agree on what should qualify as renewable, particularly around the whole area of hydro. While small run-of-river hydro plants will continue to fit within the Ecologo guidelines, larger projects will not. Wind power producers are relatively happy with the latest version of TerraChoice's draft guidelines, released at the end of November. A significant revision of the original rules is a limit on the amount of older generation green power marketers who want to promote the green power Ecologo electricity can sell. At least 50% of their capacity must originate from plants installed after January 1, 1991

  9. Web Accessibility and Guidelines

    Science.gov (United States)

    Harper, Simon; Yesilada, Yeliz

    Access to, and movement around, complex online environments, of which the World Wide Web (Web) is the most popular example, has long been considered an important and major issue in the Web design and usability field. The commonly used slang phrase ‘surfing the Web’ implies rapid and free access, pointing to its importance among designers and users alike. It has also been long established that this potentially complex and difficult access is further complicated, and becomes neither rapid nor free, if the user is disabled. There are millions of people who have disabilities that affect their use of the Web. Web accessibility aims to help these people to perceive, understand, navigate, and interact with, as well as contribute to, the Web, and thereby the society in general. This accessibility is, in part, facilitated by the Web Content Accessibility Guidelines (WCAG) currently moving from version one to two. These guidelines are intended to encourage designers to make sure their sites conform to specifications, and in that conformance enable the assistive technologies of disabled users to better interact with the page content. In this way, it was hoped that accessibility could be supported. While this is in part true, guidelines do not solve all problems and the new WCAG version two guidelines are surrounded by controversy and intrigue. This chapter aims to establish the published literature related to Web accessibility and Web accessibility guidelines, and discuss limitations of the current guidelines and future directions.

  10. What do athletes drink during competitive sporting activities?

    Science.gov (United States)

    Garth, Alison K; Burke, Louise M

    2013-07-01

    Although expert groups have developed guidelines for fluid intake during sports, there is debate about their real-world application. We reviewed the literature on self-selected hydration strategies during sporting competitions to determine what is apparently practical and valued by athletes. We found few studies of drinking practices involving elite or highly competitive athletes, even in popular sports. The available literature revealed wide variability in fluid intake and sweat losses across and within different events with varied strategies to allow fluid intake. Typical drinking practices appear to limit body mass (BM) losses to ~2 % in non-elite competitors. There are events, however, in which mean losses are greater, particularly among elite competitors and in hot weather, and evidence that individual participants fail to meet current guidelines by gaining BM or losing >2 % BM over the competition activity. Substantial (>5 %) BM loss is noted in the few studies of elite competitors in endurance and ultra-endurance events; while this may be consistent with winning outcomes, such observations cannot judge whether performance was optimal for that individual. A complex array of factors influence opportunities to drink during continuous competitive activities, many of which are outside the athlete's control: these include event rules and tactics, regulated availability of fluid, need to maintain optimal technique or speed, and gastrointestinal comfort. Therefore, it is questionable, particularly for top competitors, whether drinking can be truly ad libitum (defined as "whenever and in whatever volumes chosen by the athlete"). While there are variable relationships between fluid intake, fluid balance across races, and finishing times, in many situations it appears that top athletes take calculated risks in emphasizing the costs of drinking against the benefits. However, some non-elite competitors may need to be mindful of the disadvantages of drinking beyond

  11. Physiologic partograph to improve birth safety and outcomes among low-risk, nulliparous women with spontaneous labor onset

    Science.gov (United States)

    Neal, Jeremy L.; Lowe, Nancy K.

    2011-01-01

    Oxytocin augmentation and cesarean rates among low-risk, term, nulliparous women with a spontaneous onset of labor in the United States approximate 50% and 26.5%, respectively. This indicates that the quality of obstetrical care is much less than optimal in this nation. Exorbitant oxytocin use, the intervention most commonly associated with preventable adverse perinatal outcomes, jeopardizes birth safety while the high cesarean rate in this high-volume group compromises population health and increases health care costs. Dystocia, characterized by the slow, abnormal progression of labor, is the most commonly reported indication for primary cesareans, accounting directly for approximately 50% of all nulliparous cesareans and indirectly for most repeat cesareans. Diagnoses of dystocia are most often based on ambiguously defined delays in cervical dilation beyond which labor augmentation is deemed justified. Dystocia is known to be over-diagnosed which undoubtedly contributes to contemporary oxytocin augmentation and primary cesarean rates. Labor attendants would benefit from an evidence-based framework for homogenous labor assessment. To this end, we present a physiologically-based partograph for `in-hospital' use in assessing the labors of low-risk, term, nulliparous women with spontaneous labor onset. This tool incorporates several evidence-based labor principles that combine to give needed clinical meaning to `dystocia' as a diagnosis. It is hypothesized that our partograph will safely limit diagnoses of dystocia to only the slowest 10% of low-risk, nulliparous women. This should, in turn, safe-guard against unnecessary, injudicious, and potentially harmful use of oxytocin when labor is already adequately progressing while also indicating when its use may be justified. We further hypothesize that cesareans performed for dystocia in this population will decrease by ≥ 50%. No significant influence on other labor process or labor outcome variables is expected with

  12. Safety and cost benefit of an ambulatory program for patients with low-risk neutropenic fever at an Australian centre.

    Science.gov (United States)

    Teh, Benjamin W; Brown, Christine; Joyce, Trish; Worth, Leon J; Slavin, Monica A; Thursky, Karin A

    2018-03-01

    Neutropenic fever (NF) is a common complication of cancer chemotherapy. Patients at low risk of medical complications from NF can be identified using a validated risk assessment and managed in an outpatient setting. This is a new model of care for Australia. This study described the implementation of a sustainable ambulatory program for NF at a tertiary cancer centre over a 12-month period. Peter MacCallum Cancer Centre introduced an ambulatory care program in 2014, which identified low-risk NF patients, promoted early de-escalation to oral antibiotics, and early discharge to a nurse-led ambulatory program. Patients prospectively enrolled in the ambulatory program were compared with a historical-matched cohort of patients from 2011 for analysis. Patient demographics, clinical variables (cancer type, recent chemotherapy, treatment intent, site of presentation) and outcomes were collected and compared. Total cost of inpatient admissions was determined from diagnosis-related group (DRG) codes and applied to both the prospective and historical cohorts to allow comparisons. Twenty-five patients were managed in the first year of this program with a reduction in hospital median length of stay from 4.0 to 1.1 days and admission cost from Australian dollars ($AUD) 8580 to $AUD2360 compared to the historical cohort. Offsetting salary costs, the ambulatory program had a net cost benefit of $AUD 71895. Readmission for fever was infrequent (8.0%), and no deaths were reported. Of relevance to hospitals providing cancer care, feasibility, safety, and cost benefits of an ambulatory program for low-risk NF patients have been demonstrated.

  13. Pattern recognition and functional neuroimaging help to discriminate healthy adolescents at risk for mood disorders from low risk adolescents.

    Science.gov (United States)

    Mourão-Miranda, Janaina; Oliveira, Leticia; Ladouceur, Cecile D; Marquand, Andre; Brammer, Michael; Birmaher, Boris; Axelson, David; Phillips, Mary L

    2012-01-01

    There are no known biological measures that accurately predict future development of psychiatric disorders in individual at-risk adolescents. We investigated whether machine learning and fMRI could help to: 1. differentiate healthy adolescents genetically at-risk for bipolar disorder and other Axis I psychiatric disorders from healthy adolescents at low risk of developing these disorders; 2. identify those healthy genetically at-risk adolescents who were most likely to develop future Axis I disorders. 16 healthy offspring genetically at risk for bipolar disorder and other Axis I disorders by virtue of having a parent with bipolar disorder and 16 healthy, age- and gender-matched low-risk offspring of healthy parents with no history of psychiatric disorders (12-17 year-olds) performed two emotional face gender-labeling tasks (happy/neutral; fearful/neutral) during fMRI. We used Gaussian Process Classifiers (GPC), a machine learning approach that assigns a predictive probability of group membership to an individual person, to differentiate groups and to identify those at-risk adolescents most likely to develop future Axis I disorders. Using GPC, activity to neutral faces presented during the happy experiment accurately and significantly differentiated groups, achieving 75% accuracy (sensitivity = 75%, specificity = 75%). Furthermore, predictive probabilities were significantly higher for those at-risk adolescents who subsequently developed an Axis I disorder than for those at-risk adolescents remaining healthy at follow-up. We show that a combination of two promising techniques, machine learning and neuroimaging, not only discriminates healthy low-risk from healthy adolescents genetically at-risk for Axis I disorders, but may ultimately help to predict which at-risk adolescents subsequently develop these disorders.

  14. Retrospective comparison of the Low Risk Ankle Rules and the Ottawa Ankle Rules in a pediatric population.

    Science.gov (United States)

    Ellenbogen, Amy L; Rice, Amy L; Vyas, Pranav

    2017-09-01

    A recent multicenter prospective Canadian study presented prospective evidence supporting the Low Risk Ankle Rules (LRAR) as a means of reducing the number of ankle radiographs ordered for children presenting with an ankle injury while maintaining nearly 100% sensitivity. This is in contrast to a previous prospective study which showed that this rule yielded only 87% sensitivity. It is important to further investigate the LRAR and compare them with the already validated Ottawa Ankle Rules (OAR) to potentially curb healthcare costs and decrease unnecessary radiation exposure without compromising diagnostic accuracy. We conducted a retrospective chart review of 980 qualifying patients ages 12months to 18years presenting with ankle injury to a commonly staffed 310 bed children's hospital and auxiliary site pediatric emergency department. There were 28 high-risk fractures identified. The Ottawa Ankle Rules had a sensitivity of 100% (95% CI 87.7-100), specificity of 33.1% (95% CI 30.1-36.2), and would have reduced the number of ankle radiographs ordered by 32.1%. The Low Risk Ankle Rules had a sensitivity of 85.7% (95% CI 85.7-96), specificity of 64.9% (95% CI 61.8-68), and would have reduced the number of ankle radiographs ordered by 63.1%. The latter rule missed 4 high-risk fractures. The Low Risk Ankle Rules may not be sensitive enough for use in Pediatric Emergency Departments, while the Ottawa Ankle Rules again demonstrated 100% sensitivity. Further research on ways to implement the Ottawa Ankle Rules and maximize its ability to decrease wait times, healthcare costs, and improve patient satisfaction are needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Prospective Analysis of Behavioral Economic Predictors of Stable Moderation Drinking Among Problem Drinkers Attempting Natural Recovery.

    Science.gov (United States)

    Tucker, Jalie A; Cheong, JeeWon; Chandler, Susan D; Lambert, Brice H; Pietrzak, Brittney; Kwok, Heather; Davies, Susan L

    2016-12-01

    allocation. Stable low-risk drinking, but not abstinence, requires such regulatory processes. Copyright © 2016 by the Research Society on Alcoholism.

  16. Prospective Analysis of Behavioral Economic Predictors of Stable Moderation Drinking Among Problem Drinkers Attempting Natural Recovery

    Science.gov (United States)

    Tucker, Jalie A.; Cheong, JeeWon; Chandler, Susan D.; Lambert, Brice H.; Pietrzak, Brittney; Kwok, Heather; Davies, Susan L.

    2016-01-01

    behavioral allocation. Stable low risk drinking, but not abstinence, requires such regulatory processes. PMID:27775161

  17. Relationship between polycythemia and in-hospital mortality in chronic obstructive pulmonary disease patients with low-risk pulmonary embolism

    Science.gov (United States)

    Guo, Lu; Chughtai, Aamer Rasheed; Jiang, Hongli; Gao, Lingyun; Yang, Yan; Yang, Yang; Liu, Yuejian

    2016-01-01

    Backgrounds Pulmonary embolism (PE) is frequent in subjects with chronic obstructive pulmonary disease (COPD) and associated with high mortality. This multi-center retrospective study was performed to investigate if secondary polycythemia is associated with in-hospital mortality in COPD patients with low-risk PE. Methods We identified COPD patients with proven PE between October, 2005 and October, 2015. Patients in risk classes III–V on the basis of the PESI score were excluded. We extracted demographic, clinical and laboratory information at the time of admission from medical records. All subjects were followed until hospital discharge to identify all-cause mortality. Results We enrolled 629 consecutive patients with COPD and PE at low risk: 132 of them (21.0%) with and 497 (79.0%) without secondary polycythemia. Compared with those without polycythemia, the polycythemia group had significantly lower forced expiratory volume in one second (FEV1) level (0.9±0.3 vs. 1.4±0.5, P=0.000), lower PaO2 and SpO2 as well as higher PaCO2 (P=0.03, P=0.03 and P=0.000, respectively). COPD patients with polycythemia had a higher proportion of arrhythmia in electrocardiogram (ECG) (49.5% vs. 35.7%, P=0.02), a longer hospital duration time (15.3±10.1 vs. 9.7±9.1, P=0.001), a higher mechanical ventilation rate (noninvasive and invasive, 51.7% vs. 30.3%, P=0.04 and 31.0% vs. 7.9%, P=0.04, respectively), and a higher in-hospital mortality (12.1% vs. 6.6%, P=0.04). Multivariate logistic regression analysis revealed that polycythemia was associated with mortality in COPD patients with low-risk PE (adjusted OR 1.11; 95% CI, 1.04–1.66). Conclusions Polycythemia is an independent risk factor for all-cause in-hospital mortality in COPD patients with PE at low risk. PMID:28066591

  18. Clinical governance and research ethics as barriers to UK low-risk population-based health research?

    Directory of Open Access Journals (Sweden)

    Douglas Flora

    2008-11-01

    Full Text Available Abstract Background Since the Helsinki Declaration was introduced in 1964 as a code of practice for clinical research, it has generally been agreed that research governance is also needed in the field of public health and health promotion research. Recently, a range of factors led to the development of more stringent bureaucratic procedures, governing the conduct of low-risk population-based health research in the United Kingdom. Methods Our paper highlights a case study of the application process to medical research ethics committees in the United Kingdom for a study of the promotion of physical activity by health care providers. The case study presented here is an illustration of the challenges in conducting low-risk population-based health research. Results Our mixed-methods approach involved a questionnaire survey of and semi-structured interviews with health professionals (who were all healthy volunteers. Since our study does not involve the participation of either patients or the general population, one would expect the application to the relevant research ethics committees to be a formality. This proved not to be the case! Conclusion Research ethics committees could be counter-productive, rather than protecting the vulnerable in the research process, they can stifle low-risk population-based health research. Research ethics in health services research is first and foremost the responsibility of the researcher(s, and we need to learn to trust health service researchers again. The burden of current research governance regulation to address the perceived ethical problems is neither appropriate nor adequate. Senior researchers/academics need to educate and train students and junior researchers in the area of research ethics, whilst at the same time reducing pressures on them that lead to unethical research, such as commercial funding, inappropriate government interference and the pressure to publish. We propose that non-invasive low-risk

  19. Responsibility for drinking water; Verantwortung fuer Trinkwasser

    Energy Technology Data Exchange (ETDEWEB)

    Lein, Peter [Ingenieurbuero Dipl.-Ing. Peter Lein, Berlin (Germany)

    2008-03-15

    Planners of drinking water supply systems, implementing sanitary companies as well as building owners probably can be made liable, if the user of drinking water supply systems suffer health damages by drinking water hygienic problems. The germinating of the drinking water with legionella often is the consequence of a not professional start-up of a plant immediately after completion.

  20. Radioactivity in drinking water: regulations, monitoring results and radiation protection issues

    Directory of Open Access Journals (Sweden)

    Cristina Nuccetelli

    2012-12-01

    Full Text Available INTRODUCTION: Drinking waters usually contain several natural radionuclides: tritium, radon, radium, uranium isotopes, etc. Their concentrations vary widely since they depend on the nature of the aquifer, namely, the prevailing lithology and whether there is air in it or not. AIMS: In this work a broad overview of the radioactivity in drinking water is presented: national and international regulations, for limiting the presence of radioactivity in waters intended for human consumption; results of extensive campaigns for monitoring radioactivity in drinking waters, including mineral bottled waters, carried out throughout the world in recent years; a draft of guidelines for the planning of campaigns to measure radioactivity in drinking water proposed by the Environmental Protection Agency (ARPA of Lombardia.

  1. Safe drinking during cancer treatment

    Science.gov (United States)

    ... ency/patientinstructions/000060.htm Drinking water safely during cancer treatment To use the sharing features on this page, please enable JavaScript. During and right after your cancer treatment, your body may not be able to protect ...

  2. Radiological investigation of drinking water

    International Nuclear Information System (INIS)

    Kunz, E.

    1981-01-01

    An analysis is made of the report ''Radiological investigation of drinking water'' submitted by a working group of WHO to the Brussels meeting held between Nov 7 and 10, 1978. Annex II is emphasized of the WHO publication bearing the title ''The revision of WHO standards for drinking water''. It is shown that the draft of the revision does not basically differ from the revision introduced in Czechoslovakia and published in a revised standard CSN 83 0611 Drinking Water from 1978, including its harmonization with the Decree 59/72 Collect. of Laws on the protection of health from ionizing radiation, and from the standard CSN 83 0523 Radiometric analysis of drinking water. It is also shown that the text of the working group report contains some incorrect or unclear statements and views, which is explained by the misunderstanding of some ICRP recommendations. (H.S.)

  3. Drinking Water State Revolving Fund

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Drinking Water State Revolving Fund (DWSRF) National Information Management System collects information that provide a record of progress and accountability for...

  4. CDC Vital Signs: Binge Drinking

    Science.gov (United States)

    ... costs include health care expenses, crime, and lost productivity. Binge drinking cost federal, state, and local governments ... National Center for Chronic Disease Prevention and Health Promotion , Division of Population Health , Alcohol and Public Health , ...

  5. Learning about Drinking Water: How Important are the Three Dimensions of Knowledge that Can Change Individual Behavior?

    OpenAIRE

    Fremerey, Christian; Bogner, Franz

    2014-01-01

    Clean drinking water, our most important resource, needs comprehensive protection. Due to its ubiquitous availability, the awareness of the importance of clean drinking water has partially vanished. Therefore, sensitizing within this context and improving individual ecological behavior has become an important issue in science curricula. We developed a student-centered guided-learning module based on nine workstations, with the themes: occurrence rates, purification methods, cleaning guideline...

  6. The Influence of Parental and Peer Drinking Behaviors on Underage Drinking and Driving by Young Men

    Science.gov (United States)

    Zhang, Lening; Wieczorek, William F.; Welte, John W.

    2012-01-01

    Background: Studies have consistently found that parental and peer drinking behaviors significantly influence adolescent drinking behavior and that adolescent drinking has a significant effect on their drinking-and-driving behavior. Building upon these studies, the present article assesses whether parental and peer drinking behaviors have direct…

  7. An Interactive Text Message Intervention to Reduce Binge Drinking in Young Adults: A Randomized Controlled Trial with 9-Month Outcomes.

    Directory of Open Access Journals (Sweden)

    Brian Suffoletto

    Full Text Available Binge drinking is associated with numerous negative consequences. The prevalence and intensity of binge drinking is highest among young adults. This randomized trial tested the efficacy of a 12-week interactive text message intervention to reduce binge drinking up to 6 months after intervention completion among young adults.Young adult participants (18-25 y; n = 765 drinking above the low-risk limits (AUDIT-C score >3/4 women/men, but not seeking alcohol treatment, were enrolled from 4 Emergency Departments (EDs in Pittsburgh, PA. Participants were randomized to one of three conditions in a 2:1:1 allocation ratio: SMS Assessments + Feedback (SA+F, SMS Assessments (SA, or control. For 12 weeks, SA+F participants received texts each Thursday querying weekend drinking plans and prompting drinking limit goal commitment and each Sunday querying weekend drinking quantity. SA+F participants received tailored feedback based on their text responses. To contrast the effects of SA+F with self-monitoring, SA participants received texts on Sundays querying drinking quantity, but did not receive alcohol-specific feedback. The control arm received standard care. Follow-up outcome data collected through web-based surveys were provided by 78% of participants at 3- months, 63% at 6-months and 55% at 9-months. Multiple imputation-derived, intent-to-treat models were used for primary analysis. At 9-months, participants in the SA+F group reported greater reductions in the number of binge drinking days than participants in the control group (incident rate ratio [IRR] 0.69; 95% CI .59 to.79, lower binge drinking prevalence (odds ratio [OR] 0.52; 95% CI 0.26 to 0.98], less drinks per drinking day (beta -.62; 95% CI -1.10 to -0.15 and lower alcohol-related injury prevalence (OR 0.42; 95% CI 0.21 to 0.88. Participants in the SA group did not reduce drinking or alcohol-related injury relative to controls. Findings were similar using complete case analyses.An interactive

  8. Contribution of Drinking Water Softeners to Daily Phosphate Intake in Slovenia

    Directory of Open Access Journals (Sweden)

    Gregor Jereb

    2017-10-01

    Full Text Available The cumulative phosphate intake in a typical daily diet is high and, according to several studies, already exceeds recommended values. The exposure of the general population to phosphorus via drinking water is generally not known. One of the hidden sources of phosphorus in a daily diet is sodium polyphosphate, commonly used as a drinking water softener. In Slovenia, softening of drinking water is carried out exclusively within the internal (household drinking water supply systems to prevent the accumulation of limescale. The aim of the study was to determine the prevalence of sodium phosphates in the drinking water in Slovenia in different types of buildings, to determine residents’ awareness of the presence of chemical softeners in their drinking water, and to provide an exposure assessment on the phosphorus intake from drinking water. In the current study, the presence of phosphates in the samples of drinking water was determined using a spectrophotometric method with ammonium molybdate. In nearly half of the samples, the presence of phosphates as water softeners was confirmed. The measured concentrations varied substantially from 0.2 mg PO4/L to 24.6 mg PO4/L. Nearly 70% of the respondents were not familiar with the exact data on water softening in their buildings. It follows that concentrations of added phosphates should be controlled and the consumers should be informed of the added chemicals in their drinking water. The health risks of using sodium polyphosphate as a drinking water softener have not been sufficiently investigated and assessed. It is highly recommended that proper guidelines and regulations are developed and introduced to protect human health from adverse effects of chemicals in water intended for human consumption.

  9. Contribution of Drinking Water Softeners to Daily Phosphate Intake in Slovenia.

    Science.gov (United States)

    Jereb, Gregor; Poljšak, Borut; Eržen, Ivan

    2017-10-06

    The cumulative phosphate intake in a typical daily diet is high and, according to several studies, already exceeds recommended values. The exposure of the general population to phosphorus via drinking water is generally not known. One of the hidden sources of phosphorus in a daily diet is sodium polyphosphate, commonly used as a drinking water softener. In Slovenia, softening of drinking water is carried out exclusively within the internal (household) drinking water supply systems to prevent the accumulation of limescale. The aim of the study was to determine the prevalence of sodium phosphates in the drinking water in Slovenia in different types of buildings, to determine residents' awareness of the presence of chemical softeners in their drinking water, and to provide an exposure assessment on the phosphorus intake from drinking water. In the current study, the presence of phosphates in the samples of drinking water was determined using a spectrophotometric method with ammonium molybdate. In nearly half of the samples, the presence of phosphates as water softeners was confirmed. The measured concentrations varied substantially from 0.2 mg PO4/L to 24.6 mg PO4/L. Nearly 70% of the respondents were not familiar with the exact data on water softening in their buildings. It follows that concentrations of added phosphates should be controlled and the consumers should be informed of the added chemicals in their drinking water. The health risks of using sodium polyphosphate as a drinking water softener have not been sufficiently investigated and assessed. It is highly recommended that proper guidelines and regulations are developed and introduced to protect human health from adverse effects of chemicals in water intended for human consumption.

  10. How well are European Society of Cardiology (ESC) guidelines adhered to in patients with syncope?

    LENUS (Irish Health Repository)

    O'Dwyer, C

    2010-01-01

    The ESC guidelines on syncope were published in 2001 and updated in 2004. Adherence to the recommendations enables early stratification of low and high risk patients and prevents unnecessary investigations and admissions. Vasovagal syncope (VVS) is the commonest cause of syncope in all age groups and a low risk condition. The study objective was to determine whether the ESC guidelines were adhered to prior to referral to a syncope unit; 100 consecutive patients with unexplained syncope (52 +\\/- 23 (15-91) years); 53 female. Sixty-six patients had VVS. Forty nine (75%) of patients with VVS had undergone unnecessary investigations prior to diagnosis and 31 (47%) were admitted to hospital for investigation. Research from other countries confirms that adherence to the ESC guidelines expediates accurate diagnosis, improves resource utilization and reduces health care cost. Greater awareness amongst Irish practitioners of guidelines may improve syncope management and reduce costs.

  11. Defining the implant treatment volume for patients with low risk prostate cancer: does the anterior base need to be treated?

    International Nuclear Information System (INIS)

    D'Amico, Anthony V.; Davis, Ann; Vargas, Sara O.; Renshaw, Andrew A.; Jiroutek, Michael; Richie, Jerome P.

    1999-01-01

    Purpose: An increased incidence of acute urinary retention has been reported after interstitial prostate radiation therapy when the anterior base of the prostate gland receives 100% of the prescription dose. The frequency of prostate cancer in this location as a function of the pre-treatment prostate specific antigen (PSA), biopsy Gleason score, and 1992 American Joint Commission on Cancer Staging (AJCC) was determined. Methods and Materials: One hundred four men treated at the Brigham and Women's Hospital with radical prostatectomy for clinically localized prostate cancer between 1995-1996 comprised the study population. Prostatectomy specimens were whole mounted and the location of each tumor foci enumerated. Results: Of 269 foci of prostate cancer found in 39 low-risk prostate cancer patients (PSA 1c,2a ), a single focus (0.37%) was noted in the anterior base. Conversely, 20/355 (5.6%) and 18/251 (7.2%) tumor foci were noted in the anterior base in 43 patients with intermediate risk and 24 patients with high-risk disease, respectively. Conclusions: A new definition of the treatment volume excluding the anterior base for low-risk prostate cancer patients may be justified

  12. Applying decision tree for identification of a low risk population for type 2 diabetes. Tehran Lipid and Glucose Study.

    Science.gov (United States)

    Ramezankhani, Azra; Pournik, Omid; Shahrabi, Jamal; Khalili, Davood; Azizi, Fereidoun; Hadaegh, Farzad

    2014-09-01

    The aim of this study was to create a prediction model using data mining approach to identify low risk individuals for incidence of type 2 diabetes, using the Tehran Lipid and Glucose Study (TLGS) database. For a 6647 population without diabetes, aged ≥20 years, followed for 12 years, a prediction model was developed using classification by the decision tree technique. Seven hundred and twenty-nine (11%) diabetes cases occurred during the follow-up. Predictor variables were selected from demographic characteristics, smoking status, medical and drug history and laboratory measures. We developed the predictive models by decision tree using 60 input variables and one output variable. The overall classification accuracy was 90.5%, with 31.1% sensitivity, 97.9% specificity; and for the subjects without diabetes, precision and f-measure were 92% and 0.95, respectively. The identified variables included fasting plasma glucose, body mass index, triglycerides, mean arterial blood pressure, family history of diabetes, educational level and job status. In conclusion, decision tree analysis, using routine demographic, clinical, anthropometric and laboratory measurements, created a simple tool to predict individuals at low risk for type 2 diabetes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Infant Feeding Attitudes and Practices of Spanish Low-Risk Expectant Women Using the IIFAS (Iowa Infant Feeding Attitude Scale).

    Science.gov (United States)

    Cotelo, María Del Carmen Suárez; Movilla-Fernández, María Jesús; Pita-García, Paula; Novío, Silvia

    2018-04-22

    The Iowa Infant Feeding Attitude Scale (IIFAS) has been shown to have good psychometric properties for English-speaking populations, but it has not been validated among low-risk pregnant women in Spain. The aim of this study was to assess the reliability and validity of the translated version of the IIFAS in order to examine infant feeding attitudes in Spanish women with an uncomplicated pregnancy. Low-risk expectant women ( n = 297) were recruited from eight primary public health care centres in Galicia (Spain). Questionnaires including both socio-demographic and breastfeeding characteristics and items about infant feeding were administered during the third trimester. Participants were contacted by telephone during the postpartum period to obtain information regarding their infant feeding status. Prediction validity and internal consistency were assessed. The translated IIFAS (69.76 ± 7.75), which had good psychometric properties (Cronbach's alpha = 0.785; area under the curve (AUC) of the receiver operating characteristic (ROC) curve = 0.841, CI 95% = 0.735⁻0.948), showed more positive attitudes towards breastfeeding than towards formula feeding, especially among mothers who intended to exclusively breastfeed. This scale was also useful for inferring the intent to breastfeed and duration of breastfeeding. This study provides evidence that the IIFAS is a reliable and valid tool for assessing infant feeding attitudes in Spanish women with an uncomplicated pregnancy.

  14. Results of implementation of a hospital-based strategy to reduce cesarean delivery among low-risk women in Canada.

    Science.gov (United States)

    Shoemaker, Esther S; Bourgeault, Ivy L; Cameron, Carol; Graham, Ian D; Hutton, Eileen K

    2017-11-01

    To assess the cesarean delivery (CD) rate among low-risk pregnancies before and after implementation of a hospital-based program in Canada. A prospective before-and-after study was conducted to assess the effects of the CARE (CAesarean REduction) strategy, which was developed and implemented at Markham Stouffville Hospital, Toronto, ON, Canada, in 2010 to reduce CD among low-risk women. Hospital records were reviewed to identify changes in the proportions of CD performed during 12 months (April 2009-March 2010) before implementation of the CARE strategy versus 12 months after implementation (April 2012-March 2013) at Markham Stouffville Hospital and 36 hospitals of the same level in the same province. At the intervention hospital, 30.3% (964/3181) of women underwent CD in 2009-2010, compared with 26.4% (803/3045) in 2012-2013 (difference -3.9%, PImplementation of the CARE strategy reduced rates of CD among the target population. © 2017 International Federation of Gynecology and Obstetrics.

  15. Comparison of frequency of obesity in high risk non diabetic young individuals with low risk non diabetic young individuals

    International Nuclear Information System (INIS)

    Shaikh, M.A.; Kumar, R.; Ghori, R.A.

    2011-01-01

    Objective: To assess the body mass index and waist circumferences of high risk non diabetic young individuals and compare them with low risk non diabetic young individuals. Method: A cross sectional, case control comparative study was conducted in the department of medicine, LUMHS from January 2008 to March 2009. Five hundred individuals 20-40 years of age were selected and divided into two groups i.e. Group A: high risk (250 individuals) and Group B: low risk (250 individuals) on the basis of same age and gender. Group A included those who had positive family history of type 2 DM in first degree relatives while group B had no family history of type 2 DM in first degree relatives. The blood pressure, BMI and Waist Circumference was measured and Fasting Blood Sugar was estimated in each individual. In each group 125 (50%) were males and 125 (50%) were females. Results: In group A 58% and in group B 28.8% individuals represented raised BMI whereas 42% in group A and 36% in group B individuals showed an increased waist circumference. Mean fasting blood glucose was significantly higher in Group A than in Group B (P=0.001). Conclusion: Impaired Fasting Glucose is strongly associated with family history of type 2 diabetes mellitus. Presence of obesity specially in high risk non-diabetic young individuals emphasize the need for routine health screening for early institution of preventive measures. (author)

  16. Validity Assessment of Low-risk SCORE Function and SCORE Function Calibrated to the Spanish Population in the FRESCO Cohorts.

    Science.gov (United States)

    Baena-Díez, José Miguel; Subirana, Isaac; Ramos, Rafael; Gómez de la Cámara, Agustín; Elosua, Roberto; Vila, Joan; Marín-Ibáñez, Alejandro; Guembe, María Jesús; Rigo, Fernando; Tormo-Díaz, María José; Moreno-Iribas, Conchi; Cabré, Joan Josep; Segura, Antonio; Lapetra, José; Quesada, Miquel; Medrano, María José; González-Diego, Paulino; Frontera, Guillem; Gavrila, Diana; Ardanaz, Eva; Basora, Josep; García, José María; García-Lareo, Manel; Gutiérrez-Fuentes, José Antonio; Mayoral, Eduardo; Sala, Joan; Dégano, Irene R; Francès, Albert; Castell, Conxa; Grau, María; Marrugat, Jaume

    2018-04-01

    To assess the validity of the original low-risk SCORE function without and with high-density lipoprotein cholesterol and SCORE calibrated to the Spanish population. Pooled analysis with individual data from 12 Spanish population-based cohort studies. We included 30 919 individuals aged 40 to 64 years with no history of cardiovascular disease at baseline, who were followed up for 10 years for the causes of death included in the SCORE project. The validity of the risk functions was analyzed with the area under the ROC curve (discrimination) and the Hosmer-Lemeshow test (calibration), respectively. Follow-up comprised 286 105 persons/y. Ten-year cardiovascular mortality was 0.6%. The ratio between estimated/observed cases ranged from 9.1, 6.5, and 9.1 in men and 3.3, 1.3, and 1.9 in women with original low-risk SCORE risk function without and with high-density lipoprotein cholesterol and calibrated SCORE, respectively; differences were statistically significant with the Hosmer-Lemeshow test between predicted and observed mortality with SCORE (P cardiovascular mortality observed in the Spanish population. Despite the acceptable discrimination capacity, prediction of the number of fatal cardiovascular events (calibration) was significantly inaccurate. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  17. The reliability of transabdominal cervical length measurement in a low-risk obstetric population: Comparison with transvaginal measurement.

    Science.gov (United States)

    Peng, Cheng-Ran; Chen, Chie-Pein; Wang, Kuo-Gon; Wang, Liang-Kai; Chen, Chen-Yu; Chen, Yi-Yung

    2015-04-01

    To determine the correlation between transabdominal (TA) and transvaginal (TV) cervical length measurement in a low-risk obstetric population in Taiwan. Women with a singleton pregnancy between 20 weeks and 24 weeks of gestation underwent postvoid TA and TV cervical length measurements. Differences between the measurements obtained using the two methods were evaluated. Two hundred and five women agreed to participate in the study. Paired TA and TV measurements were obtained in 174 women. The mean TA cervical length was 36.0 ± 4.9 mm and the mean TV cervical length was 37.6 ± 5.4 mm. The mean TA cervical length was shorter than the mean TV cervical length by 1.6 mm. The 5(th) percentile of TA and TV cervical length was 29 mm and 29.1 mm, respectively. The discrepancies between the two methods were not significantly correlated with maternal body mass index (BMI). All women with TV cervical length women in the present study, and the TA cervical length was closely correlated with the TV cervical length. The use of TA ultrasound could be an effective initial tool for cervical length screening in low-risk pregnant women. TA cervical length TV ultrasound. Copyright © 2015. Published by Elsevier B.V.

  18. Infant Feeding Attitudes and Practices of Spanish Low-Risk Expectant Women Using the IIFAS (Iowa Infant Feeding Attitude Scale

    Directory of Open Access Journals (Sweden)

    María del Carmen Suárez Cotelo

    2018-04-01

    Full Text Available The Iowa Infant Feeding Attitude Scale (IIFAS has been shown to have good psychometric properties for English-speaking populations, but it has not been validated among low-risk pregnant women in Spain. The aim of this study was to assess the reliability and validity of the translated version of the IIFAS in order to examine infant feeding attitudes in Spanish women with an uncomplicated pregnancy. Low-risk expectant women (n = 297 were recruited from eight primary public health care centres in Galicia (Spain. Questionnaires including both socio-demographic and breastfeeding characteristics and items about infant feeding were administered during the third trimester. Participants were contacted by telephone during the postpartum period to obtain information regarding their infant feeding status. Prediction validity and internal consistency were assessed. The translated IIFAS (69.76 ± 7.75, which had good psychometric properties (Cronbach’s alpha = 0.785; area under the curve (AUC of the receiver operating characteristic (ROC curve = 0.841, CI95% = 0.735–0.948, showed more positive attitudes towards breastfeeding than towards formula feeding, especially among mothers who intended to exclusively breastfeed. This scale was also useful for inferring the intent to breastfeed and duration of breastfeeding. This study provides evidence that the IIFAS is a reliable and valid tool for assessing infant feeding attitudes in Spanish women with an uncomplicated pregnancy.

  19. The impact of ultrasonographic placental architecture on antenatal course, labor and delivery in a low-risk primigravid population.

    LENUS (Irish Health Repository)

    Cooley, Sharon M

    2012-02-01

    OBJECTIVE: To ascertain the impact of placental architecture on antenatal course and labor delivery in a low-risk primigravid population. METHODS: This study involves prospective recruitment of 1011 low-risk primigravids with placental ultrasound at 22?24 weeks and 36 weeks. Detailed postnatal review of all mothers and infants was undertaken. Retrospective analysis of ultrasound and clinical outcome data was performed. RESULTS: Eight hundred ten women with complete outcome data were available. Anterior placentation was statistically associated with intrauterine growth restriction (IUGR) and preterm birth and fundal placentation was significantly associated with a higher incidence of pregnancy-induced hypertension and infants with a birthweight less than the 9th centile. Placental infarcts in the third trimester was significantly increased in cases complicated by pre-eclampsia (PET) and in cases with fetal acidosis. Placental calcification was associated a 40-fold increase in the incidence of IUGR. Placental lakes in the second trimester were more prevalent in patients with threatened miscarriage. Increased placental thickness was associated with a higher rate of fetal acidosis. The Grannum grade of the placenta was higher with threatened first or second trimester loss, PET and in infants born less than 9th centile for gestation. CONCLUSION: Placental site and architecture impact on the incidence of maternal and fetal disease.

  20. Design patterns for modelling guidelines

    NARCIS (Netherlands)

    Serban, Radu; Ten Teije, Annette; Marcos, Mar; Polo-Conde, Cristina; Rosenbrand, Kitty C J G M; Wittenberg, Jolanda; van Croonenborg, Joyce

    2005-01-01

    It is by now widely accepted that medical guidelines can help to significantly improve the quality of medical care. Unfortunately, constructing the required medical guidelines is a very labour intensive and costly process. The cost of guideline construction would decrease if guidelines could be

  1. Development of cancer treatment guidelines

    African Journals Online (AJOL)

    Krystyna Kiel

    2011-05-26

    May 26, 2011 ... KEYWORDS. Cancer;. Therapy;. Guidelines. Contents. 1. Why develop guidelines? ... Widely available guideline resources in cancer care. ... The use of guidelines in medicine has a long history. Many .... She has a negative family history. ... The patient has 1 cm grade 3 infiltrating ductal carcinoma.

  2. Japanese Guideline for Atopic Dermatitis

    Directory of Open Access Journals (Sweden)

    Ichiro Katayama

    2011-01-01

    The basics of treatment discussed in this guideline are based on the “Guidelines for the Treatment of Atopic Dermatitis 2008” prepared by the Health and Labour Sciences Research and the “Guidelines for the Management of Atopic Dermatitis 2009 (ADGL2009” prepared by the Atopic Dermatitis Guidelines Advisory Committee, Japanese Society of Allergology in principle.

  3. BWR emergency procedure guidelines

    International Nuclear Information System (INIS)

    Post, J.S.; Karner, E.F.; Stratman, R.A.

    1984-01-01

    This chapter describes plans for dealing with reactor accidents developed by the Boiling Water Reactor (BWR) Owners' Group in response to post-Three Mile Island US NRC requirements. The devised Emergency Procedure Guidelines (EPGs), applicable to all BWRs, are symptom-based rather than event-based. According to the EPGs, the operator does not need to identify what event is occurring in the plant in order to decide what action to take, but need only observe the symptoms (values and trends of key control parameters) which exist and take appropriate action to control these symptoms. The original objective was to provide reactor operator guidance in responding to a small break loss-of-coolant accident (LOCA), but subsequent revisions have included other types of reactor accidents. Topics considered include the reactor pressure vessel (RPV) control guideline, the primary containment control guideline, the secondary containment control guideline, the radioactivity release control guideline, multiple failures vs. the design basis, safe limits vs. technical specifications, the technical status, licensing, and implementation. The EPGs are based upon maintaining both adequate core cooling and primary containment integrity

  4. Are BTS guidelines followed?

    Science.gov (United States)

    2002-03-01

    In 1993, the British Thoracic Society (BTS) issued guidelines for the management of spontaneous pneumothorax. The study's aim was to determine the level of adherence to these guidelines at a London teaching hospital. A retrospective case note audit of 59 episodes was performed. In patients undergoing intervention, the initial procedure was simple aspiration in 32 (73 per cent) and chest tube insertion in 12 (27 per cent) cases, contrasting with the BTS recommendation that aspiration should be attempted first in all such patients. Simple aspiration was successful on 34 per cent of occasions. Successful aspiration was associated with a significantly shorter hospital stay (median 3, range 1-11 days) than either failed aspiration (7, 3-66 days) or chest tube insertion without aspiration (9, 3-16 days). Other areas where practice differed from the BTS guidelines were clamping of chest tubes and use of a pursestring suture for wound closure. A follow up questionnaire suggested a lack of familiarity with the guidelines. These findings indicate that current management of spontaneous pneumothorax deviates from the BTS guidelines in potentially important respects.

  5. Epidemiology of drinking, alcohol use disorders, and related problems in US ethnic minority groups.

    Science.gov (United States)

    Caetano, Raul; Vaeth, Patrice A C; Chartier, Karen G; Mills, Britain A

    2014-01-01

    This chapter reviews selected epidemiologic studies on drinking and associated problems among US ethnic minorities. Ethnic minorities and the White majority group exhibit important differences in alcohol use and related problems, including alcohol use disorders. Studies show a higher rate of binge drinking, drinking above guidelines, alcohol abuse, and dependence for major ethnic and racial groups, notably, Blacks, Hispanics, and American Indians/Alaskan Natives. Other problems with a higher prevalence in certain minority groups are, for example, cancer (Blacks), cirrhosis (Hispanics), fetal alcohol syndrome (Blacks and American Indians/Alaskan Natives), drinking and driving (Hispanics, American Indians/Alaskan Natives). There are also considerable differences in rates of drinking and problems within certain ethnic groups such as Hispanics, Asian Americans, and American Indians/Alaskan Natives. For instance, among Hispanics, Puerto Ricans and Mexican Americans drink more and have higher rates of disorders such as alcohol abuse and dependence than Cuban Americans. Disparities also affect the trajectory of heavy drinking and the course of alcohol dependence among minorities. Theoretic accounts of these disparities generally attribute them to the historic experience of discrimination and to minority socioeconomic disadvantages at individual and environmental levels. © 2014 Elsevier B.V. All rights reserved.

  6. [Preliminary Study on Cognitive Determinants Influencing Argentine Youngsters towards Intensive Alcohol Consumption or Binge Drinking].

    Science.gov (United States)

    Gómez, Raúl Ángel; Luque, Leticia Elizabeth; Tomas, María Teresa Cortés; Tort, Begoña Espejo; Giménez, José Antonio

    2012-06-01

    The current alcohol consumption pattern among youngsters and adolescents, characterized by heavy drinking during a few hours, several days a week, or binge drinking (binge drinking, concentrated drinking or long-gulp drinking) is a reality in many countries, including Spain and Argentina. To describe cognitive determinants in the behavior regarding excessive alcohol consumption (binge drinking) in 16-25 year subjects in Argentina. An ad hoc survey was conducted to assess cognitive determinants influencing heavy alcohol consumption, according to I. Ajzen's guidelines. There are significant statistic differences between the group of heavy drinkers and the group that does not reach such level of consumption in relation to behavioral beliefs, and control beliefs. Both groups recognized consumption is noxious and not safe; no differences were observed concerning normative beliefs. There is a complex interaction mong attitudinal factors, motivational and behavior control factors. Instruments require greater sensitivity and further in-depth analysis is required regardomg short, middle and long consequences generated by binge drinking and its role as a positive or negative reinforment. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  7. Pollution of water sources and removal of pollutants by advanced drinking-water treatment in China.

    Science.gov (United States)

    Wang, L; Wang, B

    2000-01-01

    The pollution of water resources and drinking water sources in China is described in this paper with basic data. About 90% of surface waters and over 60% of drinking water sources in urban areas have been polluted to different extents. The main pollutants present in drinking water sources are organic substances, ammonia nitrogen, phenols, pesticides and pathogenic micro-organisms, some of which cannot be removed effectively by the traditional water treatment processes like coagulation, sedimentation, filtration and chlorination, and the product water usually does not meet Chinese national drinking water standards, when polluted source water is treated. In some drinking-water plants in China, advanced treatment processes including activated carbon filtration and adsorption, ozonation, biological activated carbon and membrane separation have been employed for further treatment of the filtrate from a traditional treatment system producing unqualified drinking water, to make final product water meet the WHO guidelines and some developed countries' standards, as well as the Chinese national standards for drinking water. Some case studies of advanced water treatment plants are described in this paper as well.

  8. Neonicotinoid pesticides in drinking water in agricultural regions of southern Ontario, Canada.

    Science.gov (United States)

    Sultana, Tamanna; Murray, Craig; Kleywegt, Sonya; Metcalfe, Chris D

    2018-07-01

    Because of the persistence and solubility of neonicotinoid insecticides (NNIs), there is concern that these compounds may contaminate sources of drinking water. The objective of this project was to evaluate the distribution of NNIs in raw and treated drinking water from selected municipalities that draw their water from the lower Great Lakes in areas of southern Ontario, Canada where there is high intensity agriculture. Sites were monitored using Polar Organic Chemical Integrative Samplers (POCIS) and by collecting grab samples at six drinking water treatment plants. Thiamethoxam, clothianidin and imidacloprid were detected in both POCIS and grab samples of raw water. The frequency of detection of NNIs was much lower in treated drinking water, but some compounds were still detected at estimated concentrations in the low ng L -1 range. Thiamethoxam was detected in one grab sample of raw drinking water at a mean concentration of 0.28 μg L -1 , which is above the guidelines for drinking water recommended in some jurisdictions, including the European Union directive on pesticide levels water intended for human consumption. Further work is required to determine whether contamination of sources of drinking water with this class of insecticides is a global problem in agricultural regions. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Radioactivity of drinking water in Finland - basis for quality requirements; Talousveden radioaktiivisuus - perusteita laatuvaatimuksille

    Energy Technology Data Exchange (ETDEWEB)

    Maekelaeinen, I.; Huikuri, P.; Salonen, L.; Markkanen, M.; Arvela, H

    2001-07-01

    Several natural radioactive substances occur in drinking water in Finland, among which radon-222 is the most harmful from radiation protection viewpoint. Also long-lived alpha-active substances like uranium-238, uranium-234, polonium-210 and radium-226, as well as beta-active lead-210 and radium-228 occur in drinking water. Elevated concentrations are found only in ground water, those originating from bedrock being clearly higher than those from soil. Assessments based on dosimetry indicate that radioactivity in drinking water causes annually 20 fatal cancers. About 40% of cases is due to inhaled waterborn radon, 40% is due to ingested radon and 20% is due to other natural radioactive substances than radon. This report gives motivation for a proposition to restrict and monitor the radiation exposure from radioactive substances in drinking water, delivered by STUK to the Ministry of Social Affairs and Health in March 1999. The proposition introduces an action level of 300 Bq/l for radon concerning the waterworks. For other radionuclides except radon the action level proposed is 0.1 millisieverts per year (mSv/a), collectively. This new proposition does not bring in notable changes in the monitoring practice, although the calculated doses will change slightly. The proposed guideline for radon in private wells is 1000 Bq/l. According to the present monitoring data, less than 200 Finns served by waterworks use drinking water with radon concentration exceeding 300 Bq/l. Approximately 1000 waterworks consumers receive an annual dose that exceeds 0.1 mSv from other radionuclides than radon. About 20 000 Finns served by private wells use drinking water with radon concentration exceeding the STUK guideline 1 000 Bq/l. Radon can be removed from drinking water using aeration or granular activated carbon filtration (GAC), whereas uranium and radium can be effectively removed by ion exchange resins and lead and polonium using reverse osmosis. There are two methods to determine

  10. Comparing an Unstructured Risk Stratification to Published Guidelines in Acute Coronary Syndromes.

    Science.gov (United States)

    Beck, Ann-Jean C C; Hagemeijer, Anouk; Tortolani, Bess; Byrd, Bethany A; Parekh, Amisha; Datillo, Paris; Birkhahn, Robert

    2015-09-01

    Guidelines are designed to encompass the needs of the majority of patients with a particular condition. The American Heart Association (AHA) in conjunction with the American College of Cardiology (ACC) and the American College of Emergency Physicians (ACEP) developed risk stratification guidelines to aid physicians with accurate and efficient diagnosis and management of patients with acute coronary syndrome (ACS). While useful in a primary care setting, in the unique environment of an emergency department (ED), the feasibility of incorporating guidelines into clinical workflow remains in question. We aim to compare emergency physicians' (EP) clinical risk stratification ability to AHA/ACC/ACEP guidelines for ACS, and assessed each for accuracy in predicting ACS. We conducted a prospective observational cohort study in an urban teaching hospital ED. All patients presenting to the ED with chest pain who were evaluated for ACS had two risk stratification scores assigned: one by the treating physician based on clinical evaluation and the other by the AHA/ACC/ACEP guideline aforementioned. The patient's ACS risk stratification classified by the EP was compared to AHA/ACC/ACEP guidelines. Patients were contacted at 30 days following the index ED visit to determine all cause mortality, unscheduled hospital/ED revisits, and objective cardiac testing performed. We enrolled 641 patients presenting for evaluation by 21 different EPs. There was a difference between the physician's clinical assessment used in the ED, and the AHA/ACC/ACEP task force guidelines. EPs were more likely to assess patients as low risk (40%), while AHA/ACC/ACEP guidelines were more likely to classify patients as intermediate (45%) or high (45%) risk. Of the 119 (19%) patients deemed high risk by EP evaluation, 38 (32%) were diagnosed with ACS. AHA/ACC/ACEP guidelines classified only 57 (9%) patients low risk with 56 (98%) of those patients diagnosed with no ACS. In the ED, physicians are more efficient

  11. Recent advances in drinking water disinfection: successes and challenges.

    Science.gov (United States)

    Ngwenya, Nonhlanhla; Ncube, Esper J; Parsons, James

    2013-01-01

    Drinking water is the most important single source of human exposure to gastroenteric diseases, mainly as a result of the ingestion of microbial contaminated water. Waterborne microbial agents that pose a health risk to humans include enteropathogenic bacteria, viruses, and protozoa. Therefore, properly assessing whether these hazardous agents enter drinking water supplies, and if they do, whether they are disinfected adequately, are undoubtedly aspects critical to protecting public health. As new pathogens emerge, monitoring for relevant indicator microorganisms (e.g., process microbial indicators, fecal indicators, and index and model organisms) is crucial to ensuring drinking water safety. Another crucially important step to maintaining public health is implementing Water Safety Plans (WSPs), as is recommended by the current WHO Guidelines for Drinking Water Quality. Good WSPs include creating health-based targets that aim to reduce microbial risks and adverse health effects to which a population is exposed through drinking water. The use of disinfectants to inactivate microbial pathogens in drinking water has played a central role in reducing the incidence of waterborne diseases and is considered to be among the most successful interventions for preserving and promoting public health. Chlorine-based disinfectants are the most commonly used disinfectants and are cheap and easy to use. Free chlorine is an effective disinfectant for bacteria and viruses; however, it is not always effective against C. parvum and G. lamblia. Another limitation of using chlorination is that it produces disinfection by-products (DBPs), which pose potential health risks of their own. Currently, most drinking water regulations aggressively address DBP problems in public water distribution systems. The DBPs of most concern include the trihalomethanes (THMs), the haloacetic acids (HAAs), bromate, and chlorite. However, in the latest edition of the WHO Guidelines for Drinking Water Quality

  12. The Saudi Guidelines for the Diagnosis and Management of COPD

    Science.gov (United States)

    Khan, Javed H.; Lababidi, Hani M. S.; Al-Moamary, Mohamed S.; Zeitouni, Mohammed O.; AL-Jahdali, Hamdan H.; Al-Amoudi, Omar S.; Wali, Siraj O.; Idrees, Majdy M.; Al-Shimemri, Abdullah A.; Al Ghobain, Mohammed O.; Alorainy, Hassan S.; Al-Hajjaj, Mohamed S.

    2014-01-01

    The Saudi Thoracic Society (STS) launched the Saudi Initiative for Chronic Airway Diseases (SICAD) to develop a guideline for the diagnosis and management of chronic obstructive pulmonary disease (COPD). This guideline is primarily aimed for internists and general practitioners. Though there is scanty epidemiological data related to COPD, the SICAD panel believes that COPD prevalence is increasing in Saudi Arabia due to increasing prevalence of tobacco smoking among men and women. To overcome the issue of underutilization of spirometry for diagnosing COPD, handheld spirometry is recommended to screen individuals at risk for COPD. A unique feature about this guideline is the simplified practical approach to classify COPD into three classes based on the symptoms as per COPD Assessment Test (CAT) and the risk of exacerbations and hospitalization. Those patients with low risk of exacerbation (COPD patients, as manifested with ≥2 exacerbation or hospitalization in the past year irrespective of the baseline symptoms, are classified as Class III. Class I and II patients require bronchodilators for symptom relief, while Class III patients are recommended to use medications that reduce the risks of exacerbations. The guideline recommends screening for co-morbidities and suggests a comprehensive management approach including pulmonary rehabilitation for those with a CAT score ≥10. The article also discusses the diagnosis and management of acute exacerbations in COPD. PMID:24791168

  13. Social anxiety and drinking game participation among university students: the moderating role of drinking to cope.

    Science.gov (United States)

    Mulligan, Ellen J; George, Amanda M; Brown, Patricia M

    2016-11-01

    Few studies have examined the relationship of social anxiety with drinking game participation. Drinking games represent a popular form of drinking in university settings. Due to their structure, games may appeal to socially anxious drinkers, particularly among those seeking to fit in or cope with the social setting. To examine the relationship of social anxiety with frequency of drinking game participation among a university undergraduate sample and to investigate if drinking motives moderate this association. A total of 227 undergraduate students aged 18-24 years (73% female) who had consumed alcohol in the prior year were included in the current investigation. Hierarchical regression examined the influences of social anxiety and drinking motives on frequency of drinking game participation, as well the interactions of social anxiety with drinking for coping motives and conformity motives. Social anxiety failed to emerge as a significant predictor of frequency of drinking game participation. However, drinking to cope moderated the relationship of social anxiety with frequency of drinking game participation. Socially anxious students who drank to cope were more likely to participate in drinking games on occasions when they consumed alcohol than those who did not endorse this drinking motive. Results demonstrated the influence of drinking to cope in the relationship of social anxiety with frequency of drinking game participation. Future work should examine the relationship with other indicators of drinking game activity. Intervention efforts addressing social anxiety and drinking should consider motives for drinking, as well as drinking patterns.

  14. Hydrogeochemical contrast between brown and grey sand aquifers in shallow depth of Bengal Basin: consequences for sustainable drinking water supply.

    Science.gov (United States)

    Biswas, Ashis; Nath, Bibhash; Bhattacharya, Prosun; Halder, Dipti; Kundu, Amit K; Mandal, Ujjal; Mukherjee, Abhijit; Chatterjee, Debashis; Mörth, Carl-Magnus; Jacks, Gunnar

    2012-08-01

    Delineation of safe aquifer(s) that can be targeted by cheap drilling technology for tubewell (TW) installation becomes highly imperative to ensure access to safe and sustainable drinking water sources for the arsenic (As) affected population in Bengal Basin. This study investigates the potentiality of brown sand aquifers (BSA) as a safe drinking water source by characterizing its hydrogeochemical contrast to grey sand aquifers (GSA) within shallow depth (water guidelines, which warrants rigorous assessment of attendant health risk for Mn prior to considering mass scale exploitation of the BSA for possible sustainable drinking water supply. Copyright © 2012 Elsevier B.V. All rights reserved.

  15. Autoshaping of ethanol drinking: an animal model of binge drinking.

    Science.gov (United States)

    Tomie, Arthur; di Poce, Jason; Derenzo, Christopher C; Pohorecky, Larissa A

    2002-01-01

    To examine the hypothesis that Pavlovian autoshaping provides an animal learning model of drug abuse, two studies evaluated the induction of ethanol drinking by autoshaping procedures. In Experiment 1, the sipper tube conditioned stimulus (CS) contained saccharin/ethanol solution and was repeatedly paired with food as an unconditioned stimulus (US). The CS-US paired group consumed more of the 0.1% saccharin-6% ethanol solution than did the CS-US random group, revealing that autoshaping conditioned responses (CR) induce ethanol drinking not attributable to pseudo-conditioning. Experiment 2 employed saccharin-fading procedures and showed that the paired vs random group differences in ethanol drinking were maintained, even as the saccharin was eliminated from the solution. The results show that Pavlovian autoshaping procedures induce high volumes of ethanol drinking when the presentation of a sipper tube containing an ethanol solution precedes the response-independent delivery of food. The high volume of ethanol consumed in a brief period of time suggests that Pavlovian autoshaping may be a model of binge drinking.

  16. Human Papillomavirus - Prevalence of High-Risk and Low-Risk Types among Females Aged 14-59 Years, National Health and ...

    Science.gov (United States)

    ... Archive Data & Statistics Sexually Transmitted Diseases Figure 45. Human Papillomavirus — Prevalence of High-risk and Low-risk ... on the STD Data and Statistics page . * HPV = human papillomavirus. NOTE: Error bars indicate 95% confidence interval. ...

  17. Changing Drinking Styles in Denmark and Finland. Fragmentation of Male and Female Drinking Among Young Adults

    DEFF Research Database (Denmark)

    Demant, Jakob Johan; Torronen, Jukka

    2011-01-01

    A traditional heavy intoxication-oriented drinking style, “heroic drinking,” is a central drinking practice in Denmark and Finland, especially among men. However, it seems that another drinking style leading to intoxication, “playful drinking,” has become more prevalent in Denmark as well......, especially among men. However, it seems that another drinking style leading to intoxication, "playful drinking", has become more prevalent in Denmark as well as in Finland. Playful drinking is characterized by self-presentations in diverse forms of game situations where you need to play with different...... and Finland by analyzing how they discuss these two drinking styles in focus groups (N = 16).Read More: http://informahealthcare.com/doi/abs/10.3109/10826084.2011.569965 A traditional heavy intoxication-oriented drinking style, "heroic drinking", is a central drinking practice in Denmark and Finland...

  18. OSART guidelines. 1994 edition

    International Nuclear Information System (INIS)

    1994-05-01

    These guidelines have been prepared to provide a basic structure and common reference both across the various areas covered by an OSART mission and across all the missions in the programme. As such, they are addressed, principally, to the team members of OSART missions but they will also provide guidance to a host nuclear plant preparing to receive a mission. The guidelines are intended to help each expert to formulate his review in the light of this own experience. They are not all inclusive and should not limit the expert's investigations, but are better considered as illustrating the adequate requirements for his review

  19. Data Qualification guidelines

    International Nuclear Information System (INIS)

    Edwards, T.B.; Shine, E.P.

    1992-01-01

    Data Qualification (DQ) is a formal, technical process whose objective is to affirm that experimental data are suitable for their intended use. Although it is not possible to develop a fixed recipe for the DQ process to cover all test situations, these general guidelines have been developed for the Nuclear Engineering Section to establish a framework for qualifying data from steady-state processing. These guidelines outline the role of the DQ team providing insight into the planning and conducting of the DQ process

  20. Strategy Guideline: Demonstration Home

    Energy Technology Data Exchange (ETDEWEB)

    Savage, C.; Hunt, A.

    2012-12-01

    This guideline will provide a general overview of the different kinds of demonstration home projects, a basic understanding of the different roles and responsibilities involved in the successful completion of a demonstration home, and an introduction into some of the lessons learned from actual demonstration home projects. Also, this guideline will specifically look at the communication methods employed during demonstration home projects. And lastly, we will focus on how to best create a communication plan for including an energy efficient message in a demonstration home project and carry that message to successful completion.

  1. Strategy Guideline. Demonstration Home

    Energy Technology Data Exchange (ETDEWEB)

    Hunt, A.; Savage, C.

    2012-12-01

    This guideline will provide a general overview of the different kinds of demonstration home projects, a basic understanding of the different roles and responsibilities involved in the successful completion of a demonstration home, and an introduction into some of the lessons learned from actual demonstration home projects. Also, this guideline will specifically look at the communication methods employed during demonstration home projects. And lastly, we will focus on how to best create a communication plan for including an energy efficient message in a demonstration home project and carry that message to successful completion.

  2. Hypercoagulability after energy drink consumption.

    Science.gov (United States)

    Pommerening, Matthew J; Cardenas, Jessica C; Radwan, Zayde A; Wade, Charles E; Holcomb, John B; Cotton, Bryan A

    2015-12-01

    Energy drink consumption in the United States has more than doubled over the last decade and has been implicated in cardiac arrhythmias, myocardial infarction, and even sudden cardiac death. We hypothesized that energy drink consumption may increase the risk of adverse cardiovascular events by increasing platelet aggregation, thereby resulting in a relatively hypercoagulable state and increased risk of thrombosis. Thirty-two healthy volunteers aged 18-40 y were given 16 oz of bottled water or a standardized, sugar-free energy drink on two separate occasions, 1-wk apart. Beverages were consumed after an overnight fast over a 30-min period. Coagulation parameters and platelet function were measured before and 60 min after consumption using thrombelastography and impedance aggregometry. No statistically significant differences in coagulation were detected using kaolin or rapid thrombelastography. In addition, no differences in platelet aggregation were detected using ristocetin, collagen, thrombin receptor-activating peptide, or adenosine diphosphate-induced multiple impedance aggregometry. However, compared to water controls, energy drink consumption resulted in a significant increase in platelet aggregation via arachidonic acid-induced activation (area under the aggregation curve, 72.4 U versus 66.3 U; P = 0.018). Energy drinks are associated with increased platelet activity via arachidonic acid-induced platelet aggregation within 1 h of consumption. Although larger clinical studies are needed to further address the safety and health concerns of these drinks, the increased platelet response may provide a mechanism by which energy drinks increase the risk of adverse cardiovascular events. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Nitrates in the drinking water of southern Punjab - Pakistan

    International Nuclear Information System (INIS)

    Ahmed, K.

    1999-01-01

    Four major cities of southern Punjab were investigated for the nitrate levels in drinking water sources. Values greater than the WHO guidelines were obtained for 12 percent of the samples collected from Bahawalpur city, 23 percent from the city of Bahawalnagar and 7.3 percent from the city of Sadiqabad. For the city of Rahim Yar Khan, all the values were within the guidelines. In these cities the values ranged from 0.44 - 42.2 mg/1, 0.43- 22.2 mg/1, 0.11 - 27.7 mg/1 and 0.041 -44.7 mg/1 as NO/sub 3/, respectively. Areas with higher nitrate contents were later investigated in detail. Control measures for reducing higher nitrate levels are suggested. (author)

  4. 77 FR 29167 - Effluent Limitations Guidelines and New Source Performance Standards for the Airport Deicing...

    Science.gov (United States)

    2012-05-16

    ... of drinking water sources (both surface and groundwater), creation of noxious odors and discolored... individual water bodies as the guidelines are developed; see Statement of Senator Muskie (October 4, 1972... biological process is contained in a sealed reactor, odors are eliminated. Based on EPA sampling results, the...

  5. Randomized trial of pragmatic education for low-risk COPD patients: impact on hospitalizations and emergency department visits.

    Science.gov (United States)

    Siddique, Haamid H; Olson, Raymond H; Parenti, Connie M; Rector, Thomas S; Caldwell, Michael; Dewan, Naresh A; Rice, Kathryn L

    2012-01-01

    Most interventions aimed at reducing hospitalizations and emergency department (ED) visits in patients with chronic obstructive pulmonary disease (COPD) have employed resource-intense programs in high-risk individuals. Although COPD is a progressive disease, little is known about the effectiveness of proactive interventions aimed at preventing hospitalizations and ED visits in the much larger population of low-risk (no known COPD-related hospitalizations or ED visits in the prior year) patients, some of whom will eventually become high-risk. We tested the effect of a simple educational and self-efficacy intervention (n = 2243) versus usual care (n = 2182) on COPD/breathing-related ED visits and hospitalizations in a randomized study of low-risk patients at three Veterans Affairs (VA) medical centers in the upper Midwest. Administrative data was used to track VA admissions and ED visits. A patient survey was used to determine health-related events outside the VA. Rates of COPD-related VA hospitalizations in the education and usual care group were not significantly different (3.4 versus 3.6 admissions per 100 person-years, respectively; 95% CI of difference -1.3 to 1.0, P = 0.77). The much higher patient-reported rates of non-VA hospitalizations for breathing-related problems were lower in the education group (14.0 versus 19.0 per 100 person-years; 95% CI -8.6 to -1.4, P = 0.006). Rates of COPD-related VA ED visits were not significantly different (6.8 versus 5.3; 95% CI -0.1 to 3.0, P = 0.07), nor were non-VA ED visits (32.4 versus 36.5; 95% CI -9.3 to 1.1, P = 0.12). All-cause VA admission and ED rates did not differ. Mortality rates (6.9 versus 8.3 per 100 person-years, respectively; 95% CI -3.0 to 0.4, P = 0.13) did not differ. An educational intervention that is practical for large numbers of low-risk patients with COPD may reduce the rate of breathing-related hospitalizations. Further research that more closely tracks hospitalizations to non-VA facilities is

  6. Randomized Phase III Noninferiority Study Comparing Two Radiotherapy Fractionation Schedules in Patients With Low-Risk Prostate Cancer

    Science.gov (United States)

    Dignam, James J.; Amin, Mahul B.; Bruner, Deborah W.; Low, Daniel; Swanson, Gregory P.; Shah, Amit B.; D’Souza, David P.; Michalski, Jeff M.; Dayes, Ian S.; Seaward, Samantha A.; Hall, William A.; Nguyen, Paul L.; Pisansky, Thomas M.; Faria, Sergio L.; Chen, Yuhchyau; Koontz, Bridget F.; Paulus, Rebecca; Sandler, Howard M.

    2016-01-01

    Purpose Conventional radiotherapy (C-RT) treatment schedules for patients with prostate cancer typically require 40 to 45 treatments that take place from > 8 to 9 weeks. Preclinical and clinical research suggest that hypofractionation—fewer treatments but at a higher dose per treatment—may produce similar outcomes. This trial was designed to assess whether the efficacy of a hypofractionated radiotherapy (H-RT) treatment schedule is no worse than a C-RT schedule in men with low-risk prostate cancer. Patients and Methods A total of 1,115 men with low-risk prostate cancer were randomly assigned 1:1 to C-RT (73.8 Gy in 41 fractions over 8.2 weeks) or to H-RT (70 Gy in 28 fractions over 5.6 weeks). This trial was designed to establish (with 90% power and an α of .05) that treatment with H-RT results in 5-year disease-free survival (DFS) that is not worse than C-RT by more than 7.65% (H-RT/C-RT hazard ratio [HR] < 1.52). Results A total of 1,092 men were protocol eligible and had follow-up information; 542 patients were assigned to C-RT and 550 to H-RT. Median follow-up was 5.8 years. Baseline characteristics were not different according to treatment assignment. The estimated 5-year DFS was 85.3% (95% CI, 81.9 to 88.1) in the C-RT arm and 86.3% (95% CI, 83.1 to 89.0) in the H-RT arm. The DFS HR was 0.85 (95% CI, 0.64 to 1.14), and the predefined noninferiority criterion that required that DFS outcomes be consistent with HR < 1.52 was met (P < .001). Late grade 2 and 3 GI and genitourinary adverse events were increased (HR, 1.31 to 1.59) in patients who were treated with H-RT. Conclusion In men with low-risk prostate cancer, the efficacy of 70 Gy in 28 fractions over 5.6 weeks is not inferior to 73.8 Gy in 41 fractions over 8.2 weeks, although an increase in late GI/genitourinary adverse events was observed in patients treated with H-RT. PMID:27044935

  7. Attitudes toward anticoagulant treatment among nonvalvular atrial fibrillation patients at high risk of stroke and low risk of bleed

    Directory of Open Access Journals (Sweden)

    Crivera C

    2016-05-01

    Full Text Available Concetta Crivera,1 Winnie W Nelson,1 Jeff R Schein,1 Edward A Witt2 1Janssen Scientific Affairs, LLC, Raritan, 2Kantar Health, Princeton, NJ, USA Background: Atrial fibrillation (AF is associated with an increased risk of stroke. Anticoagulant (AC therapies are effective at treating AF, but carry with them an increased risk of bleed. Research suggests that a large proportion of AF patients who have high risk of stroke and low risk of bleeding are not currently receiving AC treatment. The goal of this study was to understand the reasons why these patients do not engage in this potentially life-saving treatment.Method: Through a self-report online survey, using validated instruments, 1,184 US adults who self-reported a diagnosis of AF were screened for the risk of stroke and bleed. Of these patients, 230 (19.4% were at high risk of stroke, low risk of bleed, and not currently using an AC treatment, and were asked follow-up questions to assess their reasons for nontreatment, attitudes toward treatment, and attitudes toward dosing regimens.Results: The most common reasons patients stopped AC treatment were concerns regarding bleeding (27.8% and other medical concerns (26.6%, whereas the most common reason cited for not being prescribed an AC in the first place was the use of antiplatelet therapy as an alternative (57.1%. In both cases, potentially erroneous decisions regarding perceived stoke and/or bleeding risk were also a factor. Finally, the largest factors regarding attitudes toward treatment and dosing regimen were instructions from an authority figure (eg, physician, pharmacist and ease of use, respectively.Conclusion: Results suggest that many AF patients who are at high risk of stroke but at low risk of bleed may not be receiving AC due to potentially inaccurate beliefs about risk. This study also found that AF patients place trust in physicians above other factors such as cost when making treatment decisions. Increased education of

  8. Summary of principles for intervention in food and drinking water in a radiological emergency developed by several international organizations

    International Nuclear Information System (INIS)

    Sugiyama, Hideo

    1994-01-01

    After the Chernobyl accident in April 1986 it became clear that the guidelines on the management of the consequence of a nuclear accident were needed for action over long time scales and for dealing with the widespread radioactive contamination that affected many countries at distances far from the accident site. One of the major difficulties in area away from the site of a nuclear accident concerns decisions on the safety of contaminated food and drinking water. International organizations, ICRP, IAEA, WHO and several other organizations, have considered it appropriate to develop guidelines to assist national authorities in making decisions on the control of food in the event of widespread contamination by radionuclides in a radiological emergency. These guidelines and the recommendations for intervention in food and drinking water by WHO, ICRP and CEC are summarized, and the considerations and problems to adopt the guidelines are proposed in this paper. (author)

  9. Perceived peer drinking norms and responsible drinking in UK university settings.

    Science.gov (United States)

    Robinson, Eric; Jones, Andrew; Christiansen, Paul; Field, Matt

    2014-09-01

    Heavy drinking is common among students at UK universities. US students overestimate how much their peers drink and correcting this through the use of social norm messages may promote responsible drinking. We tested whether there is an association between perceived campus drinking norms and usual drinking behavior in UK university students and whether norm messages about responsible drinking correct normative misperceptions and increase students' intentions to drink responsibly. 1,020 UK university students took part in an online study. Participants were exposed to one of five message types: a descriptive norm, an injunctive norm, a descriptive and injunctive norm, or one of two control messages. Message credibility was assessed. Afterwards participants completed measures of intentions to drink responsibly and we measured usual drinking habits and perceptions of peer drinking. Perceptions of peer drinking were associated modestly with usual drinking behavior, whereby participants who believed other students drank responsibly also drank responsibly. Norm messages changed normative perceptions, but not in the target population of participants who underestimated responsible drinking in their peers at baseline. Norm messages did not increase intentions to drink responsibly and although based on accurate data, norm messages were not seen as credible. In this UK based study, although perceived social norms about peer drinking were associated with individual differences in drinking habits, campus wide norm messages about responsible drinking did not affect students' intentions to drink more responsibly. More research is required to determine if this approach can be applied to UK settings.

  10. College factors that influence drinking.

    Science.gov (United States)

    Presley, Cheryl A; Meilman, Philip W; Leichliter, Jami S

    2002-03-01

    The purpose of this article is to examine the aspects of collegiate environments, rather than student characteristics, that influence drinking. Unfortunately, the existing literature is scant on this topic. A literature review of articles primarily published within the last 10 years, along with some earlier "landmark" studies of collegiate drinking in the United States, was conducted to determine institutional factors that influence the consumption of alcohol. In addition, a demonstration analysis of Core Alcohol and Drug Survey research findings was conducted to further elucidate the issues. Several factors have been shown to relate to drinking: (1) organizational property variables of campuses, including affiliations (historically black institutions, women's institutions), presence of a Greek system, athletics and 2- or 4-year designation; (2) physical and behavioral property variables of campuses, including type of residence, institution size, location and quantity of heavy episodic drinking; and (3) campus community property variables, including pricing and availability and outlet density. Studies, however, tend to look at individual variables one at a time rather than in combination (multivariate analyses). Some new analyses, using Core Alcohol and Drug Survey data sets, are presented as examples of promising approaches to future research. Given the complexities of campus environments, it continues to be a challenge to the field to firmly establish the most compelling institutional and environmental factors relating to high-risk collegiate drinking.

  11. Occurrence and elimination of cyanobacterial toxins in drinking water treatment plants

    International Nuclear Information System (INIS)

    Hoeger, Stefan J.; Hitzfeld, Bettina C.; Dietrich, Daniel R.

    2005-01-01

    Toxin-producing cyanobacteria (blue-green algae) are abundant in surface waters used as drinking water resources. The toxicity of one group of these toxins, the microcystins, and their presence in surface waters used for drinking water production has prompted the World Health Organization (WHO) to publish a provisional guideline value of 1.0 μg microcystin (MC)-LR/l drinking water. To verify the efficiency of two different water treatment systems with respect to reduction of cyanobacterial toxins, the concentrations of MC in water samples from surface waters and their associated water treatment plants in Switzerland and Germany were investigated. Toxin concentrations in samples from drinking water treatment plants ranged from below 1.0 μg MC-LR equiv./l to more than 8.0 μg/l in raw water and were distinctly below 1.0 μg/l after treatment. In addition, data to the worldwide occurrence of cyanobacteria in raw and final water of water works and the corresponding guidelines for cyanobacterial toxins in drinking water worldwide are summarized

  12. Instructional Guidelines. Welding.

    Science.gov (United States)

    Fordyce, H. L.; Doshier, Dale

    Using the standards of the American Welding Society and the American Society of Mechanical Engineers, this welding instructional guidelines manual presents a course of study in accordance with the current practices in industry. Intended for use in welding programs now practiced within the Federal Prison System, the phases of the program are…

  13. pre-art guidelines

    African Journals Online (AJOL)

    Enrique

    2004-11-01

    Nov 1, 2004 ... As these guidelines address pre-ART issues, only conditions that occur at ... All HIV-infected adults who are immunosuppressed, i.e. ... therefore recommended that HIV-infected health care ... vaccine in severely immunosuppressed persons, i.e. those ... with residual insecticides, the use of larvicides, and.

  14. Curricular Guidelines for Endodontics.

    Science.gov (United States)

    Journal of Dental Education, 1981

    1981-01-01

    Guidelines developed by the Section on Endodontics of the American Association of Dental Schools for use by educational institutions as curriculum development aids are provided. Endodontics is that branch of dentistry dealing with diagnosis and treatment of oral conditions that arise as a result of pathoses of dental pulp. (MLW)

  15. Evidence-based guidelines

    DEFF Research Database (Denmark)

    Wattjes, Mike P; Rovira, Àlex; Miller, David

    2015-01-01

    . This use of MRI can help predict treatment response and assess the efficacy and safety of new therapies. In the second part of the MAGNIMS (Magnetic Resonance Imaging in MS) network's guidelines on the use of MRI in MS, we focus on the implementation of this technique in prognostic and monitoring tasks. We...

  16. Guidelines for Authors

    Indian Academy of Sciences (India)

    IAS Admin

    Please follow the instructions given below while preparing the manuscript. Articles which do not conform to the guidelines will not be considered. Authors are encouraged to submit their article in ASCII/MS Word/Latex version in a CD or by email to resonanc@ias.ernet.in. Title: Authors are requested to provide a) first title ...

  17. Formalization of Medical Guidelines

    Czech Academy of Sciences Publication Activity Database

    Peleška, Jan; Anger, Z.; Buchtela, David; Šebesta, K.; Tomečková, Marie; Veselý, Arnošt; Zvára, K.; Zvárová, Jana

    2005-01-01

    Roč. 1, - (2005), s. 133-141 ISSN 1801-5603 R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : GLIF model * formalization of guidelines * prevention of cardiovascular diseases Subject RIV: IN - Informatics, Computer Science

  18. Record Keeping Guidelines

    Science.gov (United States)

    American Psychologist, 2007

    2007-01-01

    These guidelines are designed to educate psychologists and provide a framework for making decisions regarding professional record keeping. State and federal laws, as well as the American Psychological Association's "Ethical Principles of Psychologists and Code of Conduct," generally require maintenance of appropriate records of psychological…

  19. GRADE Equity Guidelines 3

    DEFF Research Database (Denmark)

    Welch, Vivian A; Akl, Elie A; Pottie, Kevin

    2017-01-01

    OBJECTIVE: The aim of this paper is to describe a conceptual framework for how to consider health equity in the GRADE (Grading Recommendations Assessment and Development Evidence) guideline development process. STUDY DESIGN AND SETTING: Consensus-based guidance developed by the GRADE working grou...

  20. Field Campaign Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Voyles, J. W. [DOE ARM Climate Research Facility, Washington, DC (United States); Chapman, L. A. [DOE ARM Climate Research Facility, Washington, DC (United States)

    2015-12-01

    This document establishes a common set of guidelines for the Atmospheric Radiation Measurement (ARM) Climate Research Facility for planning, executing, and closing out field campaigns. The steps that guide individual field campaigns are described in the Field Campaign Tracking System and are specifically tailored to meet the scope of each field campaign.

  1. Curricular Guidelines for Neuroanatomy.

    Science.gov (United States)

    Journal of Dental Education, 1981

    1981-01-01

    Presented are the curricular guidelines for Neuroanatomy developed by the Section on Anatomical Sciences of the American Association of Dental Schools for use by individual educational institutions as curriculum development aids. Included are recommendations for primary educational goals, prerequisites, scope, content, behavioral objectives,…

  2. Space Guidelines for Libraries.

    Science.gov (United States)

    Wisconsin Coordinating Committee for Higher Education, Madison.

    The following guidelines are recommended: stack space--for each 10 volumes, one square foot of space; reading room--25 square feet per station x 20% of the total undergraduate population; carrel space--25% of the graduate enrollment x 45 square feet; office and auxilliary space--135 square feet x full time equivalent staff. (NI)

  3. Guidelines on testicular cancer

    NARCIS (Netherlands)

    Albers, Peter; Albrecht, Walter; Algaba, Ferran; Bokemeyer, Carsten; Cohn-Cedermark, Gabriella; Horwich, Alan; Klepp, Olbjoern; Laguna, M. Pilar; Pizzocaro, Giorgio

    2005-01-01

    To up-date the 2001 version of the EAU testicular cancer guidelines. A non-structured literature review until January 2005 using the MEDLINE database has been performed. Literature has been classified according to evidence-based medicine levels. Testicular cancer is a highly curable disease.

  4. Guidelines for Urban Labs

    DEFF Research Database (Denmark)

    Scholl, Christian; Agger Eriksen, Mette; Baerten, Nik

    2017-01-01

    urban lab initiatives from five different European cities: Antwerp (B), Graz and Leoben (A), Maastricht (NL) and Malmö (S). We do not pretend that these guidelines touch upon all possible challenges an urban lab may be confronted with, but we have incorporated all those we encountered in our...

  5. Radon legislation and national guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Aakerblom, G

    1999-07-01

    The International Commission on Radiological Protection (ICRP) and The Council of the European Union have recommended the Member States to take action against radon in homes and at workplaces. Within the EU project European Research into Radon in Construction Concerted Action, ERRICCA, the Topic Group on Legal and Building Code Impact was designated to study the current radon legislation and give advice regarding future enactment of laws and recommendations. On behalf of the Group, a questionnaire on radon legislation was sent out to nearly all European states and a selection of non-European states. Questions were asked regarding reference levels for dwellings, workplaces and drinking water, and about regulations or recommendations for building materials and city planning. All 15 EU Member States, 17 non-EU European countries and 10 non-European countries responded to the questionnaire. Their answers are considered current as of the end of 1998. Most European States and many non-European countries have recommended reference levels for dwellings and workplaces, and some have guidelines for measures against radon incorporated in their building codes and guidelines for construction techniques. However, only a few countries have enforced reference levels or regulations for planning and construction. The reference levels for indoor radon concentration in existing and new dwellings or workplaces are within the range 150-1000 Bq/m{sup 3}. Sweden is the only country (Out of 15 EU member states) which has enforced limits for existing dwellings. Sweden and the UK have both enforced levels for new dwellings. 7 non-European countries (Out of 17 responding countries) have enforced levels for existing dwellings and 9 have them for new dwellings. At the end of 1998, only Finland, Sweden, the Czech Republic, Romania, Russia and the Slovak Republic had limits for radon in water, although 8 countries were planning to introduce such limits. The present limits are within the range for

  6. Radon legislation and national guidelines

    International Nuclear Information System (INIS)

    Aakerblom, G.

    1999-07-01

    The International Commission on Radiological Protection (ICRP) and The Council of the European Union have recommended the Member States to take action against radon in homes and at workplaces. Within the EU project European Research into Radon in Construction Concerted Action, ERRICCA, the Topic Group on Legal and Building Code Impact was designated to study the current radon legislation and give advice regarding future enactment of laws and recommendations. On behalf of the Group, a questionnaire on radon legislation was sent out to nearly all European states and a selection of non-European states. Questions were asked regarding reference levels for dwellings, workplaces and drinking water, and about regulations or recommendations for building materials and city planning. All 15 EU Member States, 17 non-EU European countries and 10 non-European countries responded to the questionnaire. Their answers are considered current as of the end of 1998. Most European States and many non-European countries have recommended reference levels for dwellings and workplaces, and some have guidelines for measures against radon incorporated in their building codes and guidelines for construction techniques. However, only a few countries have enforced reference levels or regulations for planning and construction. The reference levels for indoor radon concentration in existing and new dwellings or workplaces are within the range 150-1000 Bq/m 3 . Sweden is the only country (Out of 15 EU member states) which has enforced limits for existing dwellings. Sweden and the UK have both enforced levels for new dwellings. 7 non-European countries (Out of 17 responding countries) have enforced levels for existing dwellings and 9 have them for new dwellings. At the end of 1998, only Finland, Sweden, the Czech Republic, Romania, Russia and the Slovak Republic had limits for radon in water, although 8 countries were planning to introduce such limits. The present limits are within the range for 50

  7. Hot Topics/New Initiatives | Drinking Water in New England ...

    Science.gov (United States)

    2017-07-06

    Information on Drinking Water in New England. Major Topics covered include: Conservation, Private Wells, Preventing Contamination, Drinking Water Sources, Consumer Confidence Reports, and Drinking Water Awards.

  8. Isolated port-site metastasis after surgical staging for low-risk endometrioid endometrial cancer: A case report.

    Science.gov (United States)

    Mautone, Daniele; Dall'asta, Andrea; Monica, Michela; Galli, Letizia; Capozzi, Vito Andrea; Marchesi, Federico; Giordano, Giovanna; Berretta, Roberto

    2016-07-01

    Port-site metastases (PSMs) are well-known potential complications of laparoscopic surgery for gynaecologic malignancies. The present case study reports PSM following laparoscopic surgery for Stage IA Grade 1 endometrioid endometrial cancer (EEC). The recurrence developed within 7 months following primary surgery and required surgical excision followed by adjuvant chemo-radio therapy. After 9 months, the patient remains disease-free. PSMs are rare complications following laparoscopic surgery. Amongst the 23 cases of endometrial cancer PSMs reported so far, only 4 followed EEC Stage IA Grade 1-2. The present study reports a rare case of PSM after Stage IA Grade 1 EEC. The clinical and prognostic relevance of PSMs has not been identified so far; and it is not known whether PSMs represent a local recurrence or a systemic recurrence. Surgeons should be aware that even low-risk EEC may be followed by PSMs and should take steps to prevent these rare recurrences.

  9. Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study.

    Science.gov (United States)

    de Jonge, Ank; Mesman, Jeanette A J M; Manniën, Judith; Zwart, Joost J; van Dillen, Jeroen; van Roosmalen, Jos

    2013-06-13

    To test the hypothesis that low risk women at the onset of labour with planned home birth have a higher rate of severe acute maternal morbidity than women with planned hospital birth, and to compare the rate of postpartum haemorrhage and manual removal of placenta. Cohort study using a linked dataset. Information on all cases of severe acute maternal morbidity in the Netherlands collected by the national study into ethnic determinants of maternal morbidity in the netherlands (LEMMoN study), 1 August 2004 to 1 August 2006, merged with data from the Netherlands perinatal register of all births occurring during the same period. 146 752 low risk women in primary care at the onset of labour. Severe acute maternal morbidity (admission to an intensive care unit, eclampsia, blood transfusion of four or more packed cells, and other serious events), postpartum haemorrhage, and manual removal of placenta. Overall, 92 333 (62.9%) women had a planned home birth and 54 419 (37.1%) a planned hospital birth. The rate of severe acute maternal morbidity among planned primary care births was 2.0 per 1000 births. For nulliparous women the rate for planned home versus planned hospital birth was 2.3 versus 3.1 per 1000 births (adjusted odds ratio 0.77, 95% confidence interval 0.56 to 1.06), relative risk reduction 25.7% (95% confidence interval -0.1% to 53.5%), the rate of postpartum haemorrhage was 43.1 versus 43.3 (0.92, 0.85 to 1.00 and 0.5%, -6.8% to 7.9%), and the rate of manual removal of placenta was 29.0 versus 29.8 (0.91, 0.83 to 1.00 and 2.8%, -6.1% to 11.8%). For parous women the rate of severe acute maternal morbidity for planned home versus planned hospital birth was 1.0 versus 2.3 per 1000 births (0.43, 0.29 to 0.63 and 58.3%, 33.2% to 87.5%), the rate of postpartum haemorrhage was 19.6 versus 37.6 (0.50, 0.46 to 0.55 and 47.9%, 41.2% to 54.7%), and the rate of manual removal of placenta was 8.5 versus 19.6 (0.41, 0.36 to 0.47 and 56.9%, 47.9% to 66.3%). Low risk

  10. The Effect of Parenting Style on Social Smiling in Infants at High and Low Risk for ASD.

    Science.gov (United States)

    Harker, Colleen M; Ibañez, Lisa V; Nguyen, Thanh P; Messinger, Daniel S; Stone, Wendy L

    2016-07-01

    This study examined how parenting style at 9 months predicts growth in infant social engagement (i.e., social smiling) between 9 and 18 months during a free-play interaction in infants at high (HR-infants) and low (LR-infants) familial risk for autism spectrum disorder (ASD). Results indicated that across all infants, higher levels of maternal responsiveness were concurrently associated with higher levels of social smiling, while higher levels of maternal directiveness predicted slower growth in social smiling. When accounting for maternal directiveness, which was higher in mothers of HR-infants, HR-infants exhibited greater growth in social smiling than LR-infants. Overall, each parenting style appears to make a unique contribution to the development of social engagement in infants at high- and low-risk for ASD.

  11. Differences in Neural Correlates of Speech Perception in 3 Month Olds at High and Low Risk for Autism Spectrum Disorder.

    Science.gov (United States)

    Edwards, Laura A; Wagner, Jennifer B; Tager-Flusberg, Helen; Nelson, Charles A

    2017-10-01

    In this study, we investigated neural precursors of language acquisition as potential endophenotypes of autism spectrum disorder (ASD) in 3-month-old infants at high and low familial ASD risk. Infants were imaged using functional near-infrared spectroscopy while they listened to auditory stimuli containing syllable repetitions; their neural responses were analyzed over left and right temporal regions. While female low risk infants showed initial neural activation that decreased over exposure to repetition-based stimuli, potentially indicating a habituation response to repetition in speech, female high risk infants showed no changes in neural activity over exposure. This finding may indicate a potential neural endophenotype of language development or ASD specific to females at risk for the disorder.

  12. Identifying emergency department patients with chest pain who are at low risk for acute coronary syndromes [digest].

    Science.gov (United States)

    Markel, David; Kim, Jeremy

    2017-07-21

    Though a minority of patients presenting to the emergency department with chest pain have acute coronary syndromes,identifying the patients who may be safely discharged and determining whether further testing is needed remains challenging. From the prehospital care setting to disposition and follow-up, this systematic review addresses the fundamentals of the emergency department evaluation of patients determined to be at low risk for acute coronary syndromes or adverse outcomes. Clinical risk scores are discussed, as well as the evidence and indications for confirmatory testing. The emerging role of new technologies, such as high-sensitivity troponin assays and advanced imaging techniques, are also presented. [Points & Pearls is a digest of Emergency Medicine Practice].

  13. Inspector qualification guidelines

    International Nuclear Information System (INIS)

    Batty, A.C.; Van Binnebeek, J.J.; Ericsson, P.O.; Fisher, J.C.; Geiger, P.; Grandame, M.; Grimes, B.K.; Joode, A. de; Kaufer, B.; Kinoshita, M.; Klonk, H.; Koizumi, H.; Maeda, N.; Maqua, M.; Perez del Moral, C.; Roselli, F.; Warren, T.; Zimmerman, R.

    1994-07-01

    The OECD Nuclear Energy Agency Committee on Nuclear Regulatory Activities (CNRA) has a Working Group on Inspection Practices (WGIP). The WGIP provides a forum for the exchange of Information and experience on the safety Inspection practices of regulatory authorities In the CNRA member countries. A consistent qualification process and well defined level of training for all Inspectors who participate In the safety Inspections are needed to provide consistent Inspections and reliable Inspection results. The WGIP organized in 1992 a workshop on the conduct of inspections, inspector qualification and training, and shutdown inspections at the Technical Training Center of the US NRC in Chattanooga, Tennessee. In the connection of workshop the WGIP identified a need to develop guidance for inspector qualification which could be used as a model by those who are developing their qualification practices. The inspector qualification journals of US NRC provided a good basis for the work. The following inspector qualification guideline has been developed for guidance of qualification of a new inspector recruited to the regulatory body. This guideline has been developed for helping the supervisors and training officers to give the initial training and familiarization to the duties of a new inspector in a controlled manner. US NRC inspector qualification journals have been used to define the areas of attention. This guideline provides large flexibility for application in different type organizations. Large organizations can develop separate qualification journals for each inspector positions. Small regulatory bodies can develop individual training programmes by defining the necessary training topics on case by case basis. E.g. the guideline can be used to define the qualifications of contracted inspectors used in some countries. The appropriate part would apply. Annex 1 gives two examples how this guideline could be applied

  14. Inspector qualification guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Batty, A. C.; Van Binnebeek, J. J.; Ericsson, P. O.; Fisher, J. C.; Geiger, P.; Grandame, M.; Grimes, B. K.; Joode, A. de; Kaufer, B.; Kinoshita, M.; Klonk, H.; Koizumi, H.; Maeda, N.; Maqua, M.; Perez del Moral, C.; Roselli, F.; Warren, T.; Zimmerman, R.

    1994-07-15

    The OECD Nuclear Energy Agency Committee on Nuclear Regulatory Activities (CNRA) has a Working Group on Inspection Practices (WGIP). The WGIP provides a forum for the exchange of Information and experience on the safety Inspection practices of regulatory authorities In the CNRA member countries. A consistent qualification process and well defined level of training for all Inspectors who participate In the safety Inspections are needed to provide consistent Inspections and reliable Inspection results. The WGIP organized in 1992 a workshop on the conduct of inspections, inspector qualification and training, and shutdown inspections at the Technical Training Center of the US NRC in Chattanooga, Tennessee. In the connection of workshop the WGIP identified a need to develop guidance for inspector qualification which could be used as a model by those who are developing their qualification practices. The inspector qualification journals of US NRC provided a good basis for the work. The following inspector qualification guideline has been developed for guidance of qualification of a new inspector recruited to the regulatory body. This guideline has been developed for helping the supervisors and training officers to give the initial training and familiarization to the duties of a new inspector in a controlled manner. US NRC inspector qualification journals have been used to define the areas of attention. This guideline provides large flexibility for application in different type organizations. Large organizations can develop separate qualification journals for each inspector positions. Small regulatory bodies can develop individual training programmes by defining the necessary training topics on case by case basis. E.g. the guideline can be used to define the qualifications of contracted inspectors used in some countries. The appropriate part would apply. Annex 1 gives two examples how this guideline could be applied.

  15. Outcomes of Low-Risk Ductal Carcinoma In Situ in Southeast Asian Women Treated With Breast Conservation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Fuh Yong, E-mail: fuhyong@yahoo.com [Department of Radiation Oncology, National Cancer Centre Singapore (Singapore); Wang, Fuqiang [Department of Radiation Oncology, National Cancer Centre Singapore (Singapore); Chen, John Ju [Department of Cancer Informatics, National Cancer Centre Singapore (Singapore); Tan, Chiew Har [Department of Radiation Oncology, National Cancer Centre Singapore (Singapore); Tan, Puay Hoon [Department of Pathology, Singapore General Hospital (Singapore)

    2014-04-01

    Purpose: To examine the outcomes of Southeast Asian (SEA) women with low-risk ductal carcinoma in situ (DCIS) treated with breast-conserving surgery (BCS) and adjuvant radiation therapy. Methods and Materials: Retrospective chart reviews of patients treated with BCS for DCIS from 1995 to 2011 were performed. Patients meeting the selection criteria from Eastern Cooperative Oncology Group 5194 were included. Most patients received adjuvant radiation therapy (RT) consisting of whole-breast RT delivered to 50 Gy followed by a 10-Gy boost to the tumor bed. Results: Of 744 patients with pathologic diagnosis of pure DCIS identified, 273 met the selection criteria: low-intermediate grade (LIG), n=219; high grade (HG), n=54. Median follow-up for these patients was 60 months. There were 8 ipsilateral breast tumor recurrences (IBTRs) in total, 7 of which were DCIS. The estimated actuarial IBTR rates at 5 and 10 years for the entire cohort are 1.8% and 4.3%, respectively. Of the 219 patients with LIG DCIS, 210 received RT and 9 did not. There were 7 IBTRs in LIG DCIS, 2 among the 9 patients who did not receive RT. The IBTR rates in LIG DCIS at 5 and 10 years are 2.3% and 4.2%, respectively. All patients with HG DCIS received RT. There was only 1 IBTR occurring beyond 5 years, giving an estimated IBTR rate of 4.5% at 10 years. Conclusions: SEA women with screen-detected DCIS have exceedingly low rates of IBTR after BCS, comparable to that observed in reports of similar patients with low-risk DCIS treated with adjuvant radiation.

  16. Outcomes of Low-Risk Ductal Carcinoma In Situ in Southeast Asian Women Treated With Breast Conservation Therapy

    International Nuclear Information System (INIS)

    Wong, Fuh Yong; Wang, Fuqiang; Chen, John Ju; Tan, Chiew Har; Tan, Puay Hoon

    2014-01-01

    Purpose: To examine the outcomes of Southeast Asian (SEA) women with low-risk ductal carcinoma in situ (DCIS) treated with breast-conserving surgery (BCS) and adjuvant radiation therapy. Methods and Materials: Retrospective chart reviews of patients treated with BCS for DCIS from 1995 to 2011 were performed. Patients meeting the selection criteria from Eastern Cooperative Oncology Group 5194 were included. Most patients received adjuvant radiation therapy (RT) consisting of whole-breast RT delivered to 50 Gy followed by a 10-Gy boost to the tumor bed. Results: Of 744 patients with pathologic diagnosis of pure DCIS identified, 273 met the selection criteria: low-intermediate grade (LIG), n=219; high grade (HG), n=54. Median follow-up for these patients was 60 months. There were 8 ipsilateral breast tumor recurrences (IBTRs) in total, 7 of which were DCIS. The estimated actuarial IBTR rates at 5 and 10 years for the entire cohort are 1.8% and 4.3%, respectively. Of the 219 patients with LIG DCIS, 210 received RT and 9 did not. There were 7 IBTRs in LIG DCIS, 2 among the 9 patients who did not receive RT. The IBTR rates in LIG DCIS at 5 and 10 years are 2.3% and 4.2%, respectively. All patients with HG DCIS received RT. There was only 1 IBTR occurring beyond 5 years, giving an estimated IBTR rate of 4.5% at 10 years. Conclusions: SEA women with screen-detected DCIS have exceedingly low rates of IBTR after BCS, comparable to that observed in reports of similar patients with low-risk DCIS treated with adjuvant radiation

  17. Factors contributing to postpartum blood-loss in low-risk mothers through expectant management in Japanese birth centres.

    Science.gov (United States)

    Eto, Hiromi; Hasegawa, Ayako; Kataoka, Yaeko; Porter, Sarah E

    2017-08-01

    To describe aspects of expectant midwifery care for low-risk women conducted in midwifery-managed birth centres during the first two critical hours after delivery and to compare differences between midwifery care, client factors and postpartum blood loss volume. As a secondary analysis from a larger study, this descriptive retrospective study examined data from birth records of 4051 women who birthed from 2001 to 2006 at nine (21%) of the 43 midwifery centres in Tokyo. Nonparametric and parametric analyses identified factors related to increased blood loss. Interviews to establish sequence of midwifery care were conducted. The midwifery centres provided care based on expectant management principles from birth to after expulsion of the placenta. Approximately 63.3% of women were within the normal limits of blood loss volume under 500g. A minority of women (12.9%) experienced blood loss between 500 and 800g and 4% had blood loss exceeding 1000g. Blood loss volume tended to increase with infant birth weight and duration of delivery. The total blood loss volume was significantly higher for primiparas than for multiparas during the critical two hours after delivery and for immediately after delivery, yet blood loss volume was significantly higher for multiparas than for primiparas during the first hour after delivery. Preventive uterine massage and umbilical cord clamping after placenta expulsion resulted in statistically significant less blood loss. Identified were two patterns of midwifery care based on expectant management principles from birth to after expulsion of the placenta. The practice of expectant management was not a significant factor for increased postpartum blood loss. These results detail specific midwifery practices and highlight the clinical significance of expectant management with low risk pregnant women experiencing a normal delivery. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  18. The value of routine mid-trimester ultrasound in low-risk pregnancies at primary care level

    Directory of Open Access Journals (Sweden)

    B van Dyk

    2008-12-01

    Full Text Available This study investigated the effect of routine second-trimester ultrasound scanning on obstetric management and pregnancy outcomes. This was an open cluster, randomised, controlled trial. Clusters of women with low-risk pregnancies presenting in the second trimester were randomised to receive an ultrasound scan followed by usual antenatal care, or to an unscanned control group undergoing conventional antenatal care only. Out of the 962 women randomised, follow-up was successful for 804 (83.6%, with 416 allocated to the ultrasound scan group and 388 controls. There were no significant differences between the ultrasound scan group and the control group in terms of prenatal hospitalisation, mode of delivery, miscarriage, perinatal mortality rate and low birthweight rate. Ultrasound dating was associated with a lower rate of induction of labour for post-term pregnancy (1.4% vs. 3.6%; P=0.049. However, ultrasound scanning in low-risk pregnancies was not associated with improvements in pregnancy outcome. Opsomming Hierdie studie het die effek van roetine mid-trimester ultraklankskandering op swangerskapsorg en –uitkomste ondersoek. Dit was ’n oop tros, lukrake, beheerde proef. Groepe vroue met laerisikoswanger- skap in die midtrimester is lukraak toegewys vir ’n ultraklank-skandering, gevolg deur voorgeskrewe voorgeboor-tesorg, of vir ’n kontrolegroep wat voorgeboortesorg volgens nasionaal voorgeskrewe protokol sonder skandering ontvang het. Van die 962 vroue wat aan die steekproef deelgeneem het kon data vir 804 (83.6% suksesvol opgevolg word, met 416 in die ultraklankgroep en 388 in die kontrolegroep. Geen beduidende verskille is tussen die twee groepe gevind ten opsigte van voorgeboorte-hospitalisasie, geboortemetode, miskraamstatistiek, perinatale komplikasies of laegeboortegewig nie. Ultraklankdatering van swangerskappe is met minder kraaminduksie (1.4% teen 3.6%; P=0.049 vir natrimesterswangerskap geassosieer. Roetine ultraklankskandering

  19. Omission of Breast Radiotherapy in Low-risk Luminal A Breast Cancer: Impact on Health Care Costs.

    Science.gov (United States)

    Han, K; Yap, M L; Yong, J H E; Mittmann, N; Hoch, J S; Fyles, A W; Warde, P; Gutierrez, E; Lymberiou, T; Foxcroft, S; Liu, F F

    2016-09-01

    The economic burden of cancer care is substantial, including steep increases in costs for breast cancer management. There is mounting evidence that women age ≥ 60 years with grade I/II T1N0 luminal A (ER/PR+, HER2- and Ki67 ≤ 13%) breast cancer have such low local recurrence rates that adjuvant breast radiotherapy might offer limited value. We aimed to determine the total savings to a publicly funded health care system should omission of radiotherapy become standard of care for these patients. The number of women aged ≥ 60 years who received adjuvant radiotherapy for T1N0 ER+ HER2- breast cancer in Ontario was obtained from the provincial cancer agency. The cost of adjuvant breast radiotherapy was estimated through activity-based costing from a public payer perspective. The total saving was calculated by multiplying the estimated number of luminal A cases that received radiotherapy by the cost of radiotherapy minus Ki-67 testing. In 2010, 748 women age ≥ 60 years underwent surgery for pT1N0 ER+ HER2- breast cancer; 539 (72%) underwent adjuvant radiotherapy, of whom 329 were estimated to be grade I/II luminal A subtype. The cost of adjuvant breast radiotherapy per case was estimated at $6135.85; the cost of Ki-67 at $114.71. This translated into an annual saving of about $2.0million if radiotherapy was omitted for all low-risk luminal A breast cancer patients in Ontario and $5.1million across Canada. There will be significant savings to the health care system should omission of radiotherapy become standard practice for women with low-risk luminal A breast cancer. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  20. Dose from drinking water Finland

    International Nuclear Information System (INIS)

    Maekelaeinen, Ilona; Salonen, Laina; Huikuri, Pia; Arvela, Hannu

    1999-01-01

    The dose from drinking water originates almost totally from naturally occurring radionuclides in the uranium-238 series, the most important nuclide being radon-222. Second comes lead-210, and third polonium-210. The mean age-group-weighted dose received by ingestion of drinking water is 0.14 mSv per year. More than half of the total cumulative dose of 750 manSv is received by the users of private wells, forming 13% of the population. The most exposed group comprises the users of wells drilled in bedrock, who receive 320 manSv while comprising only 4% of the population. The calculated number of annual cancer incidences due to drinking water is very sensitive to the dose-conversion factors of ingested radon used, as well as to the estimated lung cancer incidences caused by radon released from water into indoor air. (au)

  1. Energy Drinks and Binge Drinking Predict College Students' Sleep Quantity, Quality, and Tiredness.

    Science.gov (United States)

    Patrick, Megan E; Griffin, Jamie; Huntley, Edward D; Maggs, Jennifer L

    2018-01-01

    This study examines whether energy drink use and binge drinking predict sleep quantity, sleep quality, and next-day tiredness among college students. Web-based daily data on substance use and sleep were collected across four semesters in 2009 and 2010 from 667 individuals for up to 56 days each, yielding information on 25,616 person-days. Controlling for average levels of energy drink use and binge drinking (i.e., 4+ drinks for women, 5+ drinks for men), on days when students consumed energy drinks, they reported lower sleep quantity and quality that night, and greater next-day tiredness, compared to days they did not use energy drinks. Similarly, on days when students binge drank, they reported lower sleep quantity and quality that night, and greater next-day tiredness, compared to days they did not binge drink. There was no significant interaction effect between binge drinking and energy drink use on the outcomes.

  2. [Drinking water quality and safety].

    Science.gov (United States)

    Gómez-Gutiérrez, Anna; Miralles, Maria Josepa; Corbella, Irene; García, Soledad; Navarro, Sonia; Llebaria, Xavier

    2016-11-01

    The purpose of drinking water legislation is to guarantee the quality and safety of water intended for human consumption. In the European Union, Directive 98/83/EC updated the essential and binding quality criteria and standards, incorporated into Spanish national legislation by Royal Decree 140/2003. This article reviews the main characteristics of the aforementioned drinking water legislation and its impact on the improvement of water quality against empirical data from Catalonia. Analytical data reported in the Spanish national information system (SINAC) indicate that water quality in Catalonia has improved in recent years (from 88% of analytical reports in 2004 finding drinking water to be suitable for human consumption, compared to 95% in 2014). The improvement is fundamentally attributed to parameters concerning the organoleptic characteristics of water and parameters related to the monitoring of the drinking water treatment process. Two management experiences concerning compliance with quality standards for trihalomethanes and lead in Barcelona's water supply are also discussed. Finally, this paper presents some challenges that, in the opinion of the authors, still need to be incorporated into drinking water legislation. It is necessary to update Annex I of Directive 98/83/EC to integrate current scientific knowledge, as well as to improve consumer access to water quality data. Furthermore, a need to define common criteria for some non-resolved topics, such as products and materials in contact with drinking water and domestic conditioning equipment, has also been identified. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Application of a risk management system to improve drinking water safety.

    Science.gov (United States)

    Jayaratne, Asoka

    2008-12-01

    The use of a comprehensive risk management framework is considered a very effective means of managing water quality risks. There are many risk-based systems available to water utilities such as ISO 9001 and Hazard Analysis and Critical Control Point (HACCP). In 2004, the World Health Organization's (WHO) Guidelines for Drinking Water Quality recommended the use of preventive risk management approaches to manage water quality risks. This paper describes the framework adopted by Yarra Valley Water for the development of its Drinking Water Quality Risk Management Plan incorporating HACCP and ISO 9001 systems and demonstrates benefits of Water Safety Plans such as HACCP. Copyright IWA Publishing 2008.

  4. Estimation of uranium in drinking water samples collected from different locations across Tarapur, India

    International Nuclear Information System (INIS)

    Dusane, C.B.; Maity, Sukanta; Sahu, S.K.; Pandit, G.G.

    2015-01-01

    In this study, drinking water samples were collected from different locations across Tarapur, India for screening uranium contents. Uranium concentrations were determined by differential pulse adsorptive stripping voltammetry (DPASV). Uranium concentration in water samples varied in a wide range from 0.6-7.9 μg L -1 . Results were compared with the international water quality guidelines World Health Organization (WHO, 2011) and were found within the permissible limit. Results were also compared with the safe limit values for drinking water recommended by national organization like Atomic Energy Regulatory Board (AERB). (author)

  5. Home drinking-water purifiers

    International Nuclear Information System (INIS)

    Pizzichini, Massimo; Pozio, Alfonso; Russo, Claudio

    2005-01-01

    To salve the widespread problem of contaminated drinking water, home purifiers are now sold in Italy as well as other countries. This article describes how these devices work, how safe they are to use and how safe the water they produce, in the broad context of regulations on drinking water and mineral water. A new device being developed by ENEA to treat municipal water and ground water could provide greater chemical and bacteriological safety. However, the appearance of these new systems makes it necessary to update existing regulations [it

  6. PRACTICAL BARRIERS TO IMPLEMENTATION OF THYROID CANCER GUIDELINES IN THE ASIA-PACIFIC REGION.

    Science.gov (United States)

    Yang, Samantha Peiling; Ying, Lee Suat; Saw, Stephanie; Tuttle, R Michael; Venkataraman, Kavita; Su-Ynn, Chia

    2015-11-01

    Numerous published guidelines have described the optimal management of thyroid cancer. However, these rely on the clinical availability of diagnostic and therapeutic modalities. We hypothesized that the availability of medical resources and economic circumstances vary in Asia-Pacific countries, making it difficult to implement guideline recommendations into clinical practice. We surveyed participants at the 2009 and 2013 Congresses of the Association of Southeast Asian Nations Federation of Endocrine Societies by distributing questionnaires to attendees at registration. Responses were obtained from 268 respondents in 2009 and 163 respondents in 2013. Similar to the high prevalence of low-risk thyroid cancer observed in the Surveillance, Epidemiology, and End Results database, across the Asia-Pacific countries surveyed in 2009 and 2013, 50 to 100% of the respondents from the Philippines, Malaysia, Singapore, China, Taiwan, Thailand, Hong Kong, Korea, and Sri Lanka reported that more than 50% of the patients had low-risk thyroid cancer on follow-up. Importantly, there was much variation with regards to the perceived availability of investigation and treatment modalities. We found a wide variation in clinicians' perception of availability of diagnostic and therapeutic modalities in the face of a rise in thyroid cancer incidence and thyroid cancer management guidelines that emphasized their importance. The lack of availability of management tools and treatments will prove to be a major barrier to the implementation of thyroid cancer management guidelines in Southeast Asia, and likely in other parts of the world as well.

  7. Computerization of guidelines: towards a "guideline markup language".

    Science.gov (United States)

    Dart, T; Xu, Y; Chatellier, G; Degoulet, P

    2001-01-01

    Medical decision making is one of the most difficult daily tasks for physicians. Guidelines have been designed to reduce variance between physicians in daily practice, to improve patient outcomes and to control costs. In fact, few physicians use guidelines in daily practice. A way to ease the use of guidelines is to implement computerised guidelines (computer reminders). We present in this paper a method of computerising guidelines. Our objectives were: 1) to propose a generic model that can be instantiated for any specific guidelines; 2) to use eXtensible Markup Language (XML) as a guideline representation language to instantiate the generic model for a specific guideline. Our model is an object representation of a clinical algorithm, it has been validated by running two different guidelines issued by a French official Agency. In spite of some limitations, we found that this model is expressive enough to represent complex guidelines devoted to diabetes and hypertension management. We conclude that XML can be used as a description format to structure guidelines and as an interface between paper-based guidelines and computer applications.

  8. GUIDELINE Management of acute fever in children: Guideline for ...

    African Journals Online (AJOL)

    specific treatment, hospitalisation or specialist care, and those at low risk who can be ... Oral and rectal routes should not be used to measure body ..... dry mouth. • absence of tears. • sunken eyes. • poor overall appearance. • abnormal ...

  9. Fluoride Concentration of Drinking-Water of Qom, Iran

    Directory of Open Access Journals (Sweden)

    Ahmad Reza Yari

    2016-03-01

    Full Text Available Background and Purpose: Fluoride is a natural element essential for human nutrition due to its benefits for dental enamel. It is well-documented that standard amounts of fluoride in drinkingwater can decrease the rate of dental caries. This study was conducted with the aim of measuring fluoride concentration of drinking-water supplies and urban distribution system in Qom, Iran. Materials and Methods: Results were subsequently compared against national and international standards. All sources of drinking-water of rural and urban areas were examined. To measure fluoride, the standard SPADNS method and a DR/4000s spectrophotometer were used. Results: Results showed that the mean of fluoride concentration in rural areas, mainly supplied with groundwater sources, was 0.41 mg/L, that of the urban distribution system 0.82 mg/L, that of Ali-Abad station 0.11 mg/L, and that of the private water desalination system 0.24 mg/L. Due to the hot climate of Qom, fluoride concentration means of all sources were lower than the permissible standards set by Iranian Standards and the WHO guidelines (except those of some of the groundwater sources and urban distribution systems. Conclusion: It seems that in most of the drinking-water sources the average fluoride concentration is not enough to prevent dental caries or strengthen dental enamel. It is concluded that Qom’s drinkingwater would require at least 0.4 mg/L to reach the minimum desirable standard.

  10. Bacterial repopulation of drinking water pipe walls after chlorination.

    Science.gov (United States)

    Mathieu, Laurence; Francius, Grégory; El Zein, Racha; Angel, Edith; Block, Jean-Claude

    2016-09-01

    The short-term kinetics of bacterial repopulation were evaluated after chlorination of high-density polyethylene (HDPE) colonized with drinking water biofilms and compared with bare HDPE surfaces. The effect of chlorination was partial as a residual biofilm persisted and was time-limited as repopulation occurred immediately after water resupply. The total number of bacteria reached the same levels on both the bare and chlorinated biofilm-fouled HDPE after a seven-day exposure to drinking water. Due to the presence of a residual biofilm, the hydrophobicity of chlorinated biofilm-fouled surface exhibited much lower adhesion forces (2.1 nN) compared to bare surfaces (8.9 nN). This could explain the rapid repopulation after chlorination, with a twofold faster bacterial accumulation rate on the bare HDPE surface. γ-Proteobacteria dominated the early stages of repopulation of both surfaces and a shift in the dominance occurred over the colonization time. Such observations define a timescale for cleaning frequency in industrial environments and guidelines for a rinsing procedure using drinking water.

  11. Evaluation of drinking water quality in Rawalpindi and Islamabad

    International Nuclear Information System (INIS)

    Uzaira, R.; Sumreen, I.; Uzma, R.

    2005-01-01

    Drinking water quality of Rawalpindi and Islamabad was determined in terms of its microbiological and physicochemical characteristics. Water samples were collected from fifty schools of cantonment area Rawalpindi and fifty houses of Sector G-9/4 Islamabad. Survey revealed that surface and ground water are the two major sources of drinking water. Efficiency of domestic filtration units was determined by taking samples before and after filtration, whereas, level of contamination was assessed by collecting samples from storage and dispensing devices in schools. Water quality was determined by pH, conductivity, total dissolved solids, total hardness, concentration of anions and cations, coliforms, viable and colony counts using multiple tube fermentation, titrimetry, UV-Visible spectrophotometry and flame emission photometry. Drinking water quality of Islamabad was found to be better than Rawalpindi. However filtration showed no significant impact in improving water quality due to improper cleaning of filters. Samples were found to exceed WHO guidelines and EPA standards for total dissolved solids and microbiological parameters (WHO, 1996 and EPA, 1980) making water unfit for use due to poor sanitation and cross contamination with sewers in distribution network. (author)

  12. Guidelines for Better Heart Health

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Guidelines for Better Heart Health Past Issues / Winter 2007 ... women either had or did not have CVD. Guidelines at a Glance: Prevention should be tailored to ...

  13. 2012 Guidelines for Water Reuse

    Science.gov (United States)

    This manual is a revision of the "2004 Water Reuse Guidelines." This document is a summary of reuse guidelines, with supporting information, for the benefit of utilities of utilities and regulatory agencies, particularly EPA.

  14. Paralympic emblem guidelines: London 2012

    OpenAIRE

    2015-01-01

    The purpose of these guidelines is to preserve and enhance the value of the Emblem for the benefit of all authorised users. These guidelines apply to LOCOG and IPC creative, marketing and communications personnel, agencies and consultants only.

  15. Drinking Water Contaminants -- Standards and Regulations

    Science.gov (United States)

    ... and Research Centers Contact Us Share Drinking Water Contaminants – Standards and Regulations EPA identifies contaminants to regulate ... other partners to implement these SDWA provisions. Regulated Contaminants National Primary Drinking Water Regulations (NPDWRs) - table of ...

  16. Regulation Development for Drinking Water Contaminants

    Science.gov (United States)

    To explain what process and information underlies regulations including how the Safe Drinking Water Act applies to regulation development i.e. how does the drinking water law translate into regulations.

  17. Rethinking Drinking: Alcohol and Your Health

    Science.gov (United States)

    ... standard drinks you're being served in a restaurant or bar that uses large glasses and generous ... drinking habits. For more information, see A Family History of Alcoholism: Are You at Risk? Pace yourself: ...

  18. College Drinking: Get the Real Picture

    Science.gov (United States)

    ... environments. The walls of college sports arenas carry advertisements from alcohol industry sponsors. Alumni carry on the ... Environmental and peer influences combine to create a culture of drinking. This culture actively promotes drinking, or ...

  19. Lead and Drinking Water from Private Wells

    Science.gov (United States)

    ... type=”submit” value=”Submit” /> Healthy Water Home Lead and Drinking Water from Private Wells Recommend on ... remove lead from my drinking water? What is lead? Lead is a naturally occurring bluish-gray metal ...

  20. Basic Information about Your Drinking Water

    Science.gov (United States)

    ... Offices Regional Offices Labs and Research Centers Ground Water and Drinking Water Contact Us Share Basic Information about Your Drinking Water Infographic: How does your water system work? The ...

  1. Determinants of pregnant women's compliance with alcohol guidelines: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Anderson Amy E

    2012-09-01

    Full Text Available Abstract Background In 2009, Australian alcohol guidelines for pregnancy changed from low to no alcohol intake. Previous research found a high proportion of pregnant Australian women drank during pregnancy; however, there has been limited investigation of whether pregnant women comply with 2009 alcohol guidelines. The purpose of this study was to provide an assessment of pregnant women’s compliance with 2009 Australian alcohol guidelines and identify predictors of such compliance, including previous drinking behaviour. Methods Cross-sectional analysis of prospective data from the 1973–1978 cohort of the Australian Longitudinal Study on Women’s Health was conducted. Women aged 30–36 years who were pregnant at the 2009 survey and had data on alcohol use were included (n = 837. Compliance with 2009 alcohol guidelines for pregnancy was defined as no alcohol intake. Predictors of compliance were analysed using multivariate logistic regression, controlling for area of residence, in three separate models to account for multicollinearity between measures of previous alcohol intake (compliance with 2001 guidelines; frequency and quantity; bingeing. Private health insurance, household income, and illicit drug use were entered into all models and retained if significant. Results 72% of pregnant women did not comply with the 2009 alcohol guidelines and 82% of these women drank less than seven drinks per week, with no more than one or two drinks per drinking day. The odds of complying with abstinence increased by a factor of 3.48 (95% CI 2.39-5.05 for women who previously complied with the 2001 alcohol guidelines and decreased by a factor of 0.19 (95% CI 0.08-0.66 if household incomes were $36,400 or more. In other models the odds of complying were lower for women who consumed alcohol before pregnancy at least weekly (OR = 0.40, 95% CI 0.25-0.63 or binged (OR ≥ 0.18, 95% CI 0.10-0.31 and were higher for those who abstained (OR

  2. Guidelines for emergency laparoscopy

    Directory of Open Access Journals (Sweden)

    Sauerland Stefan

    2006-10-01

    Full Text Available Abstract Acute abdominal pain is a leading symptom in many surgical emergency patients. Laparoscopy allows for accurate diagnosis and immediate therapy of many intraabdominal pathologies. The guidelines of the EAES (European Association for Endoscopic Surgery provides scientifically founded recommendations about the role of laparoscopy in the different situations. Generally, laparoscopy is well suited for the therapy of the majority of diseases that cause acute abdominal pain.

  3. Severe accident management guidelines

    International Nuclear Information System (INIS)

    Uhle, Jennifer

    2014-01-01

    The events at Fukushima Daiichi have highlighted the importance of Severe Accident Management Guidelines (SAMGs). As the world has learned from the catastrophe and countries are considering changes to their nuclear regulatory programs, the content of SAMGs and their regulatory control are being evaluated. This presentation highlights several factors that are being addressed in the United States as rulemaking is underway pertaining to SAMGs. The question of how to be prepared for the unexpected is discussed with specific insights gleaned from Fukushima. (author)

  4. Guidelines on oncologic imaging

    International Nuclear Information System (INIS)

    1989-01-01

    The present issue of European Journal of Radiology is devoted to guidelines on oncologic imaging. 9 experts on imaging in suspected or evident oncologic disease have compiled a broad survey on strategies as well as techniques on oncologic imaging. The group gives advice for detecting tumours at specific tumour sites and use modern literature to emphasize their recommendations. All recommendations are short, comprehensive and authoritative. (orig./MG)

  5. Guidelines for Urban Labs

    DEFF Research Database (Denmark)

    Scholl, Christian; Agger Eriksen, Mette; Baerten, Nik

    2017-01-01

    These guidelines are intended for team members and managers of urban labs and, more generally, for civil servants and facilitators in cities working with experimental processes to tackle complex challenges. They aim to support the everyday practice of collaboratively experimenting and learning ho...... the result is inspiring and instructive for all those who want to wrap their minds around experimental co-creative approaches to urban governance and city development....

  6. Guideline Implementation: Hand Hygiene.

    Science.gov (United States)

    Goldberg, Judith L

    2017-02-01

    Performing proper hand hygiene and surgical hand antisepsis is essential to reducing the rates of health care-associated infections, including surgical site infections. The updated AORN "Guideline for hand hygiene" provides guidance on hand hygiene and surgical hand antisepsis, the wearing of fingernail polish and artificial nails, proper skin care to prevent dermatitis, the wearing of jewelry, hand hygiene product selection, and quality assurance and performance improvement considerations. This article focuses on key points of the guideline to help perioperative personnel make informed decisions about hand hygiene and surgical hand antisepsis. The key points address the necessity of keeping fingernails and skin healthy, not wearing jewelry on the hands or wrists in the perioperative area, properly performing hand hygiene and surgical hand antisepsis, and involving patients and visitors in hand hygiene initiatives. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  7. Cancer screening guidelines.

    Science.gov (United States)

    Zoorob, R; Anderson, R; Cefalu, C; Sidani, M

    2001-03-15

    Numerous medical organizations have developed cancer screening guidelines. Faced with the broad, and sometimes conflicting, range of recommendations for cancer screening, family physicians must determine the most reasonable and up-to-date method of screening. Major medical organizations have generally achieved consensus on screening guidelines for breast, cervical and colorectal cancer. For breast cancer screening in women ages 50 to 70, clinical breast examination and mammography are generally recommended every one or two years, depending on the medical organization. For cervical cancer screening, most organizations recommend a Papanicolaou test and pelvic examination at least every three years in patients between 20 and 65 years of age. Annual fecal occult blood testing along with flexible sigmoidoscopy at five-year to 10-year intervals is the standard recommendation for colorectal cancer screening in patients older than 50 years. Screening for prostate cancer remains a matter of debate. Some organizations recommend digital rectal examination and a serum prostate-specific antigen test for men older than 50 years, while others do not. In the absence of compelling evidence to indicate a high risk of endometrial cancer, lung cancer, oral cancer and ovarian cancer, almost no medical organizations have developed cancer screening guidelines for these types of cancer.

  8. Drinking-Water Nitrate, Methemoglobinemia, and Global Burden of Disease: A Discussion

    Science.gov (United States)

    Fewtrell, Lorna

    2004-01-01

    On behalf of the World Health Organization (WHO), I have undertaken a series of literature-based investigations examining the global burden of disease related to a number of environmental risk factors associated with drinking water. In this article I outline the investigation of drinking-water nitrate concentration and methemoglobinemia. The exposure assessment was based on levels of nitrate in drinking water greater than the WHO guideline value of 50 mg/L. No exposure–response relationship, however, could be identified that related drinking-water nitrate level to methemoglobinemia. Indeed, although it has previously been accepted that consumption of drinking water high in nitrates causes methemoglobinemia in infants, it appears now that nitrate may be one of a number of co-factors that play a sometimes complex role in causing the disease. I conclude that, given the apparently low incidence of possible water-related methemoglobinemia, the complex nature of the role of nitrates, and that of individual behavior, it is currently inappropriate to attempt to link illness rates with drinking-water nitrate levels. PMID:15471727

  9. The Quality and Accuracy of Mobile Apps to Prevent Driving After Drinking Alcohol.

    Science.gov (United States)

    Wilson, Hollie; Stoyanov, Stoyan R; Gandabhai, Shailen; Baldwin, Alexander

    2016-08-08

    Driving after the consumption of alcohol represents a significant problem globally. Individual prevention countermeasures such as personalized mobile app aimed at preventing such behavior are widespread, but there is little research on their accuracy and evidence base. There has been no known assessment investigating the quality of such apps. This study aimed to determine the quality and accuracy of apps for drink driving prevention by conducting a review and evaluation of relevant mobile apps. A systematic app search was conducted following PRISMA guidelines. App quality was assessed using the Mobile App Rating Scale (MARS). Apps providing blood alcohol calculators (hereafter "calculators") were reviewed against current alcohol advice for accuracy. A total of 58 apps (30 iOS and 28 Android) met inclusion criteria and were included in the final analysis. Drink driving prevention apps had significantly lower engagement and overall quality scores than alcohol management apps. Most calculators provided conservative blood alcohol content (BAC) time until sober calculations. None of the apps had been evaluated to determine their efficacy in changing either drinking or driving behaviors. This novel study demonstrates that most drink driving prevention apps are not engaging and lack accuracy. They could be improved by increasing engagement features, such as gamification. Further research should examine the context and motivations for using apps to prevent driving after drinking in at-risk populations. Development of drink driving prevention apps should incorporate evidence-based information and guidance, lacking in current apps.

  10. Consideration of rainwater quality parameters for drinking purposes: A case study in rural Vietnam.

    Science.gov (United States)

    Lee, Minju; Kim, Mikyeong; Kim, Yonghwan; Han, Mooyoung

    2017-09-15

    Rainwater, which is used for drinking purposes near Hanoi, Vietnam, was analysed for water quality based on 1.5 years of monitoring data. In total, 23 samples were collected from different points within two rainwater harvesting systems (RWHSs). Most parameters met the standard except micro-organisms. Coliform and Escherichia coli (E. coli) were detected when the rainwater was not treated with ultraviolet (UV) light; however, analysis of rainwater after UV sterilisation showed no trace of micro-organisms. The RWHSs appear to provide drinking water of relatively good quality compared with surface water and groundwater. The superior quality of the rainwater suggests the necessity for new drinking rainwater standards because applying all of the drinking water quality standards to rainwater is highly inefficient. The traditionally implemented standards could cause more difficulties for developing countries using RWHSs installed decentralized as a source of drinking water, particularly in areas not well supplied with testing equipment, because such countries must bear the expense and time for these measures. This paper proposes the necessity of rainwater quality guideline, which could serve as a safe and cost-effective alternative to provide an access to safe drinking water. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Women, Girls, and Binge Drinking

    Centers for Disease Control (CDC) Podcasts

    2013-08-01

    Bob Brewer, CDC's Alcohol Program Director, goes on the air to discuss the problem of binge drinking among women and girls.  Created: 8/1/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 8/1/2013.

  12. 144__Olukosi_drinking wate

    African Journals Online (AJOL)

    User

    and Giardia lamblia; nutrients (fertilizers), dissolved metals and metalloids (lead, mercury, arsenic and so on) and dissolved organics (WHO, 2011). The demand for drinking water in Kaduna state is supplied by ground water sources such as wells and boreholes, tap water in areas where it is available, packaged water and ...

  13. CFD in drinking water treatment

    NARCIS (Netherlands)

    Wols, B.A.

    2010-01-01

    Hydrodynamic processes largely determine the efficacy of drinking water treatment systems, in particular disinfection systems. A lack of understanding of the hydrodynamics has resulted in suboptimal designs of these systems. The formation of unwanted disinfection-by-products and the energy

  14. Uranium in Kosovo's drinking water.

    Science.gov (United States)

    Berisha, Fatlume; Goessler, Walter

    2013-11-01

    The results of this paper are an initiation to capture the drinking water and/or groundwater elemental situation in the youngest European country, Kosovo. We aim to present a clear picture of the natural uranium concentration in drinking water and/or groundwater as it is distributed to the population of Kosovo. Nine hundred and fifty-one (951) drinking water samples were analyzed by inductively coupled plasma mass spectrometry (ICPMS). The results are the first countrywide interpretation of the uranium concentration in drinking water and/or groundwater, directly following the Kosovo war of 1999. More than 98% of the samples had uranium concentrations above 0.01 μg L(-1), which was also our limit of quantification. Concentrations up to 166 μg L(-1) were found with a mean of 5 μg L(-1) and median 1.6 μg L(-1) were found. Two point six percent (2.6%) of the analyzed samples exceeded the World Health Organization maximum acceptable concentration of 30 μg L(-1), and 44.2% of the samples exceeded the 2 μg L(-1) German maximum acceptable concentrations recommended for infant food preparations. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Outcomes of peptic ulcer bleeding following treatment with proton pump inhibitors in routine clinical practice: 935 patients with high- or low-risk stigmata.

    Science.gov (United States)

    Lanas, Angel; Carrera-Lasfuentes, Patricia; García-Rodríguez, Luis A; García, Santiago; Arroyo-Villarino, María Teresa; Ponce, Julio; Bujanda, Luis; Calleja, José L; Polo-Tomas, Mónica; Calvet, Xavier; Feu, Faust; Perez-Aisa, Angeles

    2014-10-01

    To assess rates of further bleeding, surgery and mortality in patients hospitalized owing to peptic ulcer bleeding. Consecutive patients hospitalized for peptic ulcer bleeding and treated with a proton pump inhibitor (PPI) (esomeprazole or pantoprazole) were identified retrospectively in 12 centers in Spain. Patients were included if they had high-risk stigmata (Forrest class Ia-IIb, underwent therapeutic endoscopy and received intravenous PPI ≥120 mg/day for ≥24 h) or low-risk stigmata (Forrest class IIc-III, underwent no therapeutic endoscopy and received intravenous or oral PPI [any dose]). Of 935 identified patients, 58.3% had high-risk stigmata and 41.7% had low-risk stigmata. After endoscopy, 88.3% of high-risk patients and 22.1% of low-risk patients received intravenous PPI therapy at doses of at least 160 mg/day. Further bleeding within 72 h occurred in 9.4% and 2.1% of high- and low-risk patients, respectively (p peptic ulcer bleeding and treated with PPIs, patients with high-risk stigmata have a higher risk of further bleeding and surgery, but not of death, than those with low-risk stigmata.

  16. Monotherapy of aspirin or warfarin for prevention of ischemic stroke in low-risk atrial fibrillation: A Easter Asian population-based study.

    Science.gov (United States)

    Liu, Chieh-Yu; Chen, Hui-Chun

    2018-05-02

    This study aimed to investigate the effectiveness of monotherapy aspirin and warfarin for stroke prevention in low-risk atrial fibrillation (AF) by using a population-based cohort study in Taiwan. A newly diagnosed low-risk AF patient cohort were identified by using National Health Insurance Research Database (NHIRD) in Taiwan in 2008. The study cohort was observed with a follow-up of 2 years to examine the onset of ischemic stroke (IS) (to 2010). The longitudinal data were analyzed by using generalized estimation equations (GEE). A total of 8,065 newly-diagnosed low-risk AF patients were identified in 2008. 7.4% were prescribed with aspirin and 4.6% were prescribed with warfarin. The GEE results showed that low-risk AF patients with hypertension who received warfarin were associated with a statistically significant 58.4% reduction of IS risk (OR = 0.416, p = 0.024, 95% CI 0.194-0.891). Additionally, low-risk AF patients with hyperlipidemia who received warfarin were associated with a 69.3% reduction of IS risk (OR = 0.307, p = 0.044, 95% CI 0.097-0.969). Warfarin is suggested to be prescribed in preventing ischemic stroke for low-stroke-risk atrial fibrillation patients with hypertension and hyperlipidemia.

  17. Consumer protection on the drinking water market

    OpenAIRE

    Kosová, Martina

    2009-01-01

    The goal of Bachelor thesis is marketing research on consumer preferences and knowledge in the field of drinking water and also analyze and compare the price of tap water and bottled water. The theoretical part describes how the consumer market with drinking water is protected in the Czech Republic. They compared the advantages and disadvantages of both types of drinking water.

  18. Small Drinking Water Systems Communication and Outreach ...

    Science.gov (United States)

    As part of our small drinking water systems efforts, this poster highlights several communications and outreach highlights that EPA's Office of Research and Development and Office of Water have been undertaking in collaboration with states and the Association of State Drinking Water Administrators. To share information at EPA's annual small drinking water systems workshop

  19. Energy Drink Use Among Ohio Appalachian Smokers.

    Science.gov (United States)

    Davison, Genevieve; Shoben, Abigail; Pasch, Keryn E; Klein, Elizabeth G

    2016-10-01

    Caffeine-containing energy drinks have emerged as a public health concern due to their association with caffeine toxicity and alcohol use. Despite the fact that previous research has linked caffeine use in the form of coffee drinking to smoking, there is little research examining the association between energy drinks and smoking. The present study examines demographic and behavioral factors associated with energy drink use among a sample of rural Ohio Appalachian smokers. It was hypothesized that male gender, young age (21-30 years.) and alcohol use would be associated with energy drink use. A sample of adult smokers (n = 298) from Ohio Appalachian counties were interviewed regarding demographic and behavioral factors. Logistic regression analysis was used to assess the association between these factors and energy drink use. Seventy percent of Ohio Appalachian smokers studied had ever used an energy drink and 40 % had used an energy drink in the past month. Young age, male gender, and single marital status were associated with higher odds of ever having used an energy drink. Young age, and binge drinking were associated with higher odds of past 30-day use while abstinence from drinking was associated with lower odds of past 30-day use. Ohio Appalachian adult smokers had higher rates of energy drink use compared to previous estimates of ever or past month use found in other studies. The combined use of caffeine, nicotine, and alcohol warrants attention due to potential for health risk.

  20. 30 CFR 75.1718 - Drinking water.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Drinking water. 75.1718 Section 75.1718 Mineral... SAFETY STANDARDS-UNDERGROUND COAL MINES Miscellaneous § 75.1718 Drinking water. [Statutory Provisions] An adequate supply of potable water shall be provided for drinking purposes in the active workings of the mine...

  1. Drinking motives moderate the impact of pre-drinking on heavy drinking on a given evening and related adverse consequences-an event-level study

    OpenAIRE

    Kuntsche Emmanuel; Labhart Florian

    2013-01-01

    Aims: To test whether (i) drinking motives predict the frequency of pre drinking (i.e. alcohol consumption before going out); (ii) drinking motives predict HDGE (heavy drinking on a given evening: 4+ for women 5+ for men) and related adverse consequences (hangover injuries blackouts etc.) even when pre drinking is accounted for and (iii) drinking motives moderate the impact of pre drinking on HDGE and consequences. Design: Using the internet based cellphone optimized assessment technique (ICA...

  2. Effects of caesarean section on maternal health in low risk nulliparous women: a prospective matched cohort study in Shanghai, China

    Directory of Open Access Journals (Sweden)

    Gao Xiao-ling

    2010-12-01

    Full Text Available Abstract Background Rates of caesarean section are progressively increasing in many parts of the world. As a result of psychosocial factors there has been an increasing tendency for pregnant women without justifiable medical indications for caesarean section to ask for this procedure in China. A critical examination of this issue in relation to maternal outcomes is important. At present there are no clinical trials to help assess the risks and benefits of caesarean section in low risk women. To fill the gap left by trials, this indication-matched cohort study was carried out to examine prospectively the outcomes of caesarean section on women with no absolute obstetric indication compared with similar women who had vaginal delivery. Methods An indication-matched cohort study was undertaken to compare maternal outcomes following caesarean section with those undergoing vaginal delivery, in which the two groups were matched for non-absolute indications. 301 nulliparous women with caesarean section were matched successfully with 301 women who delivered vaginally in the Maternal and Children's Hospitals (MCHs in Shanghai, China. Logistic regression model or binomial regression model was used to estimate the relative risk (RR directly. Adjusted RRs were calculated adjusting for propensity score and medical indications. Results The incidence of total complications was 2.2 times higher in the caesarean section group during hospitalization post-partum, compared with the vaginal delivery group (RR = 2.2; 95% CI: 1.1-4.4. The risk of haemorrhage from the start of labour until 2 hours post-partum was significantly higher in the caesarean group (RR = 5.6; 95% CI: 1.2-26.9. The risk of chronic abdominal pain was significantly higher for the caesarean section group (RR = 3.6; 95% CI: 1.2-10.9 than for the vaginal delivery group within 12 months post-partum. The two groups had similar incidences of anaemia and complicating infections such as wound complications

  3. Planned home versus planned hospital births in women at low-risk pregnancy: A systematic review with meta-analysis.

    Science.gov (United States)

    Rossi, A Cristina; Prefumo, Federico

    2018-03-01

    New interest in home birth have recently arisen in women at low risk pregnancy. Maternal and neonatal morbidity of women planning delivery at home has yet to be comprehensively quantified. We aimed to quantify pregnancy outcomes following planned home (PHB) versus planned hospital birth (PHos). We did a systematic review of maternal and neonatal morbidity following planned home (PHB) versus planned hospital birth (PHos). We included prospective, retrospective, cohort and case-control studies of low risk pregnancy outcomes according to planning place of birth, identified from January 2000 to June 2017. We excluded studies in which high-risk pregnancy and composite morbidity were included. Outcomes of interest were: maternal and neonatal morbidity/mortality, medical interventions, and delivery mode. We pooled estimates of the association between outcomes and planning place of birth using meta-analyses. The study protocol is registered with PROSPERO, protocol number CRD42017058016. We included 8 studies of the 4294 records identified, consisting in 14,637 (32.6%) in PHB and 30,177 (67.4%) in PHos group. Spontaneous delivery was significantly higher in PHB than PHos group (OR: 2.075; 95%CI:1.654-2.063) group. Women in PHB group were less likely to undergo cesarean section compared with women in PHos (OR:0.607; 95%CI:0.553-0.667) group. PHB group was less likely to receive medical interventions than PHos group. The risk of fetal dystocia was lower in PHB than PHos group (OR:0.287; 95%CI:0.133-0.618). The risk of post-partum hemorrhage was lower in PHB than PHos group (OR:0.692; 95% CI.0.634-0.755). The two groups were similar with regard to neonatal morbidity and mortality. Births assisted at hospital are more likely to receive medical interventions, fetal monitoring and prompt delivery in case of obstetrical complications. Further studies are needed in order to clarify whether home births are as safe as hospital births. Copyright © 2018 Elsevier B.V. All rights

  4. Nurses' experiences of guideline implementation

    DEFF Research Database (Denmark)

    Alanen, Seija; Välimäki, Marita; Kaila, Minna

    2009-01-01

    AIMS: The aim of the study was to address the following questions: What kind of experiences do primary care nurses have of guideline implementation? What do nurses think are the most important factors affecting the adoption of guidelines? BACKGROUND: The implementation of clinical guidelines seems...... to be dependent on multiple context-specific factors. This study sets out to explore the experiences of primary care nurses concerning guideline implementation. DESIGN: Qualitative interview. METHODS: Data were generated by four focus group interviews involving nurses working in out-patient services in primary...... to nurses, (iii) factors related to the anticipated consequences and (iv) factors related to the patient group. Nurses' awareness and acceptance of guidelines and the anticipated positive consequences facilitate the implementation of guidelines. Organisational support, especially the adapting of guidelines...

  5. A review of clinical guidelines.

    LENUS (Irish Health Repository)

    Andrews, E J

    2012-02-03

    BACKGROUND: Clinical guidelines are increasingly used in patient management but few clinicians are familiar with their origin or appropriate application. METHODS: A Medline search using the terms \\'clinical guidelines\\' and \\'practice guidelines\\' was conducted. Additional references were sourced by manual searching from the bibliographies of articles located. RESULTS AND CONCLUSION: Clinical guidelines originated in the USA in the early 1980s, initially as a cost containment exercise. Significant improvements in the process and outcomes of care have been demonstrated following their introduction, although the extent of improvement varies considerably. The principles for the development of guidelines are well established but many published guidelines fall short of these basic quality criteria. Guidelines are only one aspect of improving quality and should be used within a wider framework of promoting clinical effectiveness. Understanding their limitations as well as their potential benefits should enable clinicians to have a clearer view of their place in everyday practice.

  6. Bacteriological quality of drinks from vending machines.

    Science.gov (United States)

    Hunter, P. R.; Burge, S. H.

    1986-01-01

    A survey on the bacteriological quality of both drinking water and flavoured drinks from coin-operated vending machines is reported. Forty-four per cent of 25 drinking water samples examined contained coliforms and 84% had viable counts of greater than 1000 organisms ml at 30 degrees C. Thirty-one flavoured drinks were examined; 6% contained coliforms and 39% had total counts greater than 1000 organisms ml. It is suggested that the D.H.S.S. code of practice on coin-operated vending machines is not being followed. It is also suggested that drinking water alone should not be dispensed from such machines. PMID:3794325

  7. Costs and effects of screening and treating low risk women with a singleton pregnancy for asymptomatic bacteriuria, the ASB study.

    Science.gov (United States)

    Kazemier, Brenda M; Schneeberger, Caroline; De Miranda, Esteriek; Van Wassenaer, Aleid; Bossuyt, Patrick M; Vogelvang, Tatjana E; Reijnders, Frans J L; Delemarre, Friso M C; Verhoeven, Corine J M; Oudijk, Martijn A; Van Der Ven, Jeanine A; Kuiper, Petra N; Feiertag, Nicolette; Ott, Alewijn; De Groot, Christianne J M; Mol, Ben Willem J; Geerlings, Suzanne E

    2012-06-21

    The prevalence of asymptomatic bacteriuria (ASB) in pregnancy is 2-10% and is associated with both maternal and neonatal adverse outcomes as pyelonephritis and preterm delivery. Antibiotic treatment is reported to decrease these adverse outcomes although the existing evidence is of poor quality. We plan a combined screen and treat study in women with a singleton pregnancy. We will screen women between 16 and 22 weeks of gestation for ASB using the urine dipslide technique. The dipslide is considered positive when colony concentration ≥105 colony forming units (CFU)/mL of a single microorganism or two different colonies but one ≥105 CFU/mL is found, or when Group B Streptococcus bacteriuria is found in any colony concentration. Women with a positive dipslide will be randomly allocated to receive nitrofurantoin or placebo 100 mg twice a day for 5 consecutive days (double blind). Primary outcomes of this trial are maternal pyelonephritis and/or preterm delivery before 34 weeks. Secondary outcomes are neonatal and maternal morbidity, neonatal weight, time to delivery, preterm delivery rate before 32 and 37 weeks, days of admission in neonatal intensive care unit, maternal admission days and costs. This trial will provide evidence for the benefit and cost-effectiveness of dipslide screening for ASB among low risk women at 16-22 weeks of pregnancy and subsequent nitrofurantoin treatment. Dutch trial registry: NTR-3068.

  8. Costs and effects of screening and treating low risk women with a singleton pregnancy for asymptomatic bacteriuria, the ASB study

    Directory of Open Access Journals (Sweden)

    Kazemier Brenda M

    2012-06-01

    Full Text Available Abstract Background The prevalence of asymptomatic bacteriuria (ASB in pregnancy is 2-10% and is associated with both maternal and neonatal adverse outcomes as pyelonephritis and preterm delivery. Antibiotic treatment is reported to decrease these adverse outcomes although the existing evidence is of poor quality. Methods/Design We plan a combined screen and treat study in women with a singleton pregnancy. We will screen women between 16 and 22 weeks of gestation for ASB using the urine dipslide technique. The dipslide is considered positive when colony concentration ≥105 colony forming units (CFU/mL of a single microorganism or two different colonies but one ≥105 CFU/mL is found, or when Group B Streptococcus bacteriuria is found in any colony concentration. Women with a positive dipslide will be randomly allocated to receive nitrofurantoin or placebo 100 mg twice a day for 5 consecutive days (double blind. Primary outcomes of this trial are maternal pyelonephritis and/or preterm delivery before 34 weeks. Secondary outcomes are neonatal and maternal morbidity, neonatal weight, time to delivery, preterm delivery rate before 32 and 37 weeks, days of admission in neonatal intensive care unit, maternal admission days and costs. Discussion This trial will provide evidence for the benefit and cost-effectiveness of dipslide screening for ASB among low risk women at 16–22 weeks of pregnancy and subsequent nitrofurantoin treatment. Trial registration Dutch trial registry: NTR-3068

  9. The effects of a "low-risk" diet on cell proliferation and enzymatic parameters of preneoplastic rat colon.

    Science.gov (United States)

    Goettler, D; Rao, A V; Bird, R P

    1987-01-01

    The relationship between various dietary constituents and colon cancer has been demonstrated by previous research. This study was conducted to investigate the combined effects of several dietary constituents on the preneoplastic stage of azoxymethane (AOM)-induced colon cancer in rats. A nutritionally adequate, "low-risk" (LR) diet was formulated through the modulation of dietary fat, fiber, protein, vitamins A and E, and selenium. Female F344 rats were given three weekly subcutaneous injections of AOM and were maintained on either the LR diet or a "high-risk" (HR) diet. After 12 weeks, the rats were killed and the following parameters were determined: pH of colon contents, fecal beta-glucuronidase activity, tissue ornithine decarboxylase (ODC) activity, and colonic labeling index. The pH of the colon contents and incremental labeling index were lower in the group given the LR diet and treated with AOM compared with the group given the HR diet and treated with AOM; however, no statistically significant dietary effects were observed for beta-glucuronidase and ODC activities. The results of this study indicated that the colons of rats fed the LR diet exhibited different proliferative characteristics than did the colons of rats fed the HR diet.

  10. Mycophenolate mofetil in low-risk renal transplantation in patients receiving no cyclosporine: a single-centre experience.

    LENUS (Irish Health Repository)

    Raheem, Omer A

    2011-05-28

    BACKGROUND: We assess our long-term experience with regards the safety and efficacy of Mycophenolate Mofetil (MMF) in our low risk renal transplant population and compared it retrospectively to Azathioprine (AZA) immunosuppressive regimen. Patients and methods. Between January 1999 and December 2005, 240 renal transplants received MMF as part of their immunosuppressive protocol (MMF group). AZA group of 135 renal transplants was included for comparative analysis (AZA group). Patients received Cyclosporine was excluded from this study. RESULTS: The incidence of biopsy proven 3-month acute rejections was 30 (12.5%) in MMF group and 22 (16%) in AZA group respectively (P = 0.307). Patient survival rates at 1 and 5 years for the MMF group were 97 and 94%, respectively, compared to 100% and 91% at 1 and 5 years respectively for the AZA group (P = 0.61). Graft survival rates at 1 and 5 years for the MMF group were 95 and 83%, respectively, compared to 97 and 84% at 1 and 5 years, respectively for the AZA group (P = 0.62). CONCLUSION: There was no difference in acute rejection episodes between MMF and AZA based immunotherapy. Additionally, we observed no significant difference concerning graft survival in the MMF group when compared to AZA group.

  11. Mycophenolate mofetil in low-risk renal transplantation in patients receiving no cyclosporine: a single-centre experience.

    LENUS (Irish Health Repository)

    2012-02-01

    BACKGROUND: We assess our long-term experience with regards the safety and efficacy of Mycophenolate Mofetil (MMF) in our low risk renal transplant population and compared it retrospectively to Azathioprine (AZA) immunosuppressive regimen. Patients and methods. Between January 1999 and December 2005, 240 renal transplants received MMF as part of their immunosuppressive protocol (MMF group). AZA group of 135 renal transplants was included for comparative analysis (AZA group). Patients received Cyclosporine was excluded from this study. RESULTS: The incidence of biopsy proven 3-month acute rejections was 30 (12.5%) in MMF group and 22 (16%) in AZA group respectively (P = 0.307). Patient survival rates at 1 and 5 years for the MMF group were 97 and 94%, respectively, compared to 100% and 91% at 1 and 5 years respectively for the AZA group (P = 0.61). Graft survival rates at 1 and 5 years for the MMF group were 95 and 83%, respectively, compared to 97 and 84% at 1 and 5 years, respectively for the AZA group (P = 0.62). CONCLUSION: There was no difference in acute rejection episodes between MMF and AZA based immunotherapy. Additionally, we observed no significant difference concerning graft survival in the MMF group when compared to AZA group.

  12. Psychological Distress in Healthy Low-Risk First-Time Mothers during the Postpartum Period: An Exploratory Study

    Directory of Open Access Journals (Sweden)

    Christina Murphey

    2017-01-01

    Full Text Available Psychological distress, defined as depression, anxiety, and insomnia in this study, can occur following the birth of a baby as new mothers, in addition to marked physiological changes, are faced with adapting to new roles and responsibilities. We investigated the cooccurrence of stress, depression, anxiety, and insomnia in mothers during the postpartum period; tested the feasibility of study methods and procedures for use in this population; and identified new mothers interest in using cranial electrotherapy stimulation (CES as an intervention for reducing psychological distress. We recruited healthy, low-risk, English speaking first-time mothers, ages 18–32 years, with healthy babies (N=33, within 12 months of an uncomplicated birth. Participants completed the PSS, HAM-D14, HAM-A17, and PSQI19. No problems were encountered with study procedures. Mothers reported a high interest (4.9 in the potential use of CES to treat or prevent the occurrence of psychological distress. All participants (N=33 reported moderate levels of depression and anxiety, while 75.8% (n=25 reported insomnia. PSS scores were within the norms for healthy women. Further research is recommended to investigate if our findings can be replicated or if different patterns of associations emerge. Implications for clinical practice are addressed.

  13. Trichomonas vaginalis infection in a low-risk women attended in Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre

    Institute of Scientific and Technical Information of China (English)

    Norhayati Moktar; Nor Liyana Ismail; Phoy Cheng Chun; Mohamad Asyrab Sapie; Nor Farahin Abdul Kahar; Yusof Suboh; Noraina Abdul Rahim; Nor Azlin Mohamed Ismail; Tengku Shahrul Anuar

    2016-01-01

    Objective: To investigate the presence of trichomoniasis among women attending the Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre.Methods: A total of 139 high vaginal swabs were taken from the subjects and sent to the laboratory in Amies gel transport media. The specimens were examined for the presence of Trichomonas vaginalis using wet mount, Giemsa staining and cultured in Diamond’s medium. Sociodemographic characteristics and gynaecological complaints were obtained in private using structured questionnaire applied by one investigator.Results: The median age was 32 years, with an interquartile interval of 9.96. Most of the subjects were Malays(76.9%) and the remaining were Chinese(15.1%), Indians(2.2%)and other ethnic groups(5.8%). One hundred and thirty eight(99.3%) of the women were married and 98.6% had less than 6 children. More than half(75.5%) of the women’s last child birth was less than 6 years ago. Forty seven percent of them were involved in supporting administrative work and 64.7% of the women gave a history of previous or current vaginal discharge.Conclusions: The present study reported zero incidence rate of trichomoniasis. The low incidence rate was postulated due to all women who participated in this study were categorized into a low-risk group.

  14. Trichomonas vaginalis infection in a low-risk women attended in Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre

    Institute of Scientific and Technical Information of China (English)

    Norhayati Moktar; Nor Liyana Ismail; Phoy Cheng Chun; Mohamad Asyrab Sapie; Nor Farahin Abdul Kahar; Yusof Suboh; Noraina Abdul Rahim; Nor Azlin Mohamed Ismail; Tengku Shahrul Anuar

    2016-01-01

    Objective: To investigate the presence of trichomoniasis among women attending the Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre. Methods: A total of 139 high vaginal swabs were taken from the subjects and sent to the laboratory in Amies gel transport media. The specimens were examined for the presence of Trichomonas vaginalis using wet mount, Giemsa staining and cultured in Diamond's medium. Sociodemographic characteristics and gynaecological complaints were obtained in private using structured questionnaire applied by one investigator. Results: The median age was 32 years, with an interquartile interval of 9.96. Most of the subjects were Malays (76.9%) and the remaining were Chinese (15.1%), Indians (2.2%) and other ethnic groups (5.8%). One hundred and thirty eight (99.3%) of the women were married and 98.6%had less than 6 children. More than half (75.5%) of the women's last child birth was less than 6 years ago. Forty seven percent of them were involved in supporting administrative work and 64.7% of the women gave a history of previous or current vaginal discharge. Conclusions: The present study reported zero incidence rate of trichomoniasis. The low incidence rate was postulated due to all women who participated in this study were categorized into a low-risk group.

  15. Accuracy of simple urine tests for diagnosis of urinary tract infections in low-risk pregnant women.

    Science.gov (United States)

    Feitosa, Danielle Cristina Alves; da Silva, Márcia Guimarães; de Lima Parada, Cristina Maria Garcia

    2009-01-01

    Anatomic and physiological alterations during pregnancy predispose pregnant women to urinary tract infections (UTI). This study aimed to identify the accuracy of the simple urine test for UTI diagnosis in low-risk pregnant women. Diagnostic test performance was conducted in Botucatu, SP, involving 230 pregnant women, between 2006 and 2008. Results showed 10% UTI prevalence. Sensitivity, specificity and accuracy of the simple urine test were 95.6%, 63.3% and 66.5%, respectively, in relation to UTI diagnoses. The analysis of positive (PPV) and negative (NPV) predictive values showed that, when a regular simple urine test was performed, the chance of UTI occurrence was small (NPV 99.2%). In view of an altered result for such a test, the possibility of UTI existence was small (PPV 22.4%). It was concluded that the accuracy of the simple urine test as a diagnostic means for UTI was low, and that performing a urine culture is essential for appropriate diagnosis.

  16. Morbidity in early adulthood among low-risk very low birth weight children in Turkey: a preliminary study.

    Science.gov (United States)

    Can, Gülay; Bilgin, Leyla; Tatli, Burak; Saydam, Reyhan; Coban, Asuman; Ince, Zeynep

    2012-01-01

    The objective of this study was to assess low-risk very low birth weight (VLBW) children, before the era of modern neonatal intensive care in Turkey, during adolescence. Forty-one VLBW adolescents were compared with 40 adolescents who had normal birth weight. The physical and neuromotor development, educational achievement and psychosocial status were assessed at a mean age of 17 +/- 1.6 years. VLBW adolescents were shorter than normal birth weight adolescents (p = 0.01). A major neurological abnormality (cerebral palsy) was seen in 12% and a minor neurological abnormality (tremor, coordination, behavioral and speech disorders) in 17%. VLBW adolescents had higher rates of visual problems (56% vs. 5%). School failure was present in 27%. There were no differences in behavioral problems or quality of life between the two groups, but VLBW adolescents did have a lower self-esteem score. Neurodevelopment and growth sequelae were a significant problem in VLBW adolescents. As early intervention might help to prevent or ameliorate potential problems, long-term follow-up is essential.

  17. Poster - 47: A parametrized prediction model of rectal toxicity in focal SBRT of low risk prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Stevens, Todd; Bauman, Glenn [Saint John Regional Hospital, London Regional Cancer Program (Canada)

    2016-08-15

    There has been a recent trend towards watchful waiting in place of intervention for early stage prostate cancer (CaP). However, this approach can allow for disease progression, and subsequent whole-gland therapies such as prostatectomy and whole gland irradiation can result in functional deficits or rectal toxicities or both. A controversial alternative approach for this patient cohort is the use of focal therapy, where the treatment is focussed on an identified dominant index lesion (DIL). This work aims to investigate the treatment parameters for focal SBRT of the prostate under which clinically acceptable rectal NTCP levels can be achieved. For each of 25 low risk CaP patients, a hypothetical 2 cc DIL was modeled in the right-posterior quadrant of the prostate, and was used to build a PTV as the target for SBRT simulation. An SBRT prescriptions of 41 Gy and 37 Gy in 5 fractions were chosen, corresponding to the boost levels used in previous CaP dose escalation studies. DVH data were exported and used to calculate rectal NTCP values based on the Lyman-Kutcher-Burman (LKB) model using the QUANTEC reccommended model parameters. Rectal NTCP dependence on DIL-to-rectum separation, dose level, and DIL volume were investigated. The final goal of this ongoing work is to create a map of the maximum allowable prescription dose for a given patient geometry that achieves a clinically acceptable rectal NTCP level.

  18. Characterization of the transport signals that mediate the nucleocytoplasmic traffic of low risk HPV11 E7

    Energy Technology Data Exchange (ETDEWEB)

    McKee, Courtney H.; Onder, Zeynep; Ashok, Aditya; Cardoso, Rebeca; Moroianu, Junona, E-mail: moroianu@bc.edu

    2013-08-15

    We previously discovered that nuclear import of low risk HPV11 E7 is mediated by its zinc-binding domain via a pathway that is independent of karyopherins/importins (Piccioli et al., 2010. Virology 407, 100–109). In this study we mapped and characterized a leucine-rich nuclear export signal (NES), {sub 76}IRQLQDLLL{sub 84}, within the zinc-binding domain that mediates the nuclear export of HPV11 E7 in a CRM1-dependent manner. We also identified a mostly hydrophobic patch {sub 65}VRLVV{sub 69} within the zinc-binding domain that mediates nuclear import of HPV11 E7 via hydrophobic interactions with the FG-repeats domain of Nup62. Substitutions of hydrophobic residues to alanine within the {sub 65}VRLVV{sub 69} sequence disrupt the nuclear localization of 11E7, whereas the R66A mutation has no effect. Overall the data support a model of nuclear entry of HPV11 E7 protein via hydrophobic interactions with FG nucleoporins at the nuclear pore complex. - Highlights: • HPV11 E7 has a leucine-rich nuclear export signal that mediates its nuclear export via CRM1. • HPV11 E7 interacts via its unique cNLS with the FG domain of Nup62. • Identification of a hydrophobic patch essential for nuclear localization of HPV11 E7.

  19. Characterization of the transport signals that mediate the nucleocytoplasmic traffic of low risk HPV11 E7

    International Nuclear Information System (INIS)

    McKee, Courtney H.; Onder, Zeynep; Ashok, Aditya; Cardoso, Rebeca; Moroianu, Junona

    2013-01-01

    We previously discovered that nuclear import of low risk HPV11 E7 is mediated by its zinc-binding domain via a pathway that is independent of karyopherins/importins (Piccioli et al., 2010. Virology 407, 100–109). In this study we mapped and characterized a leucine-rich nuclear export signal (NES), 76 IRQLQDLLL 84 , within the zinc-binding domain that mediates the nuclear export of HPV11 E7 in a CRM1-dependent manner. We also identified a mostly hydrophobic patch 65 VRLVV 69 within the zinc-binding domain that mediates nuclear import of HPV11 E7 via hydrophobic interactions with the FG-repeats domain of Nup62. Substitutions of hydrophobic residues to alanine within the 65 VRLVV 69 sequence disrupt the nuclear localization of 11E7, whereas the R66A mutation has no effect. Overall the data support a model of nuclear entry of HPV11 E7 protein via hydrophobic interactions with FG nucleoporins at the nuclear pore complex. - Highlights: • HPV11 E7 has a leucine-rich nuclear export signal that mediates its nuclear export via CRM1. • HPV11 E7 interacts via its unique cNLS with the FG domain of Nup62. • Identification of a hydrophobic patch essential for nuclear localization of HPV11 E7

  20. Incidence of low risk human papillomavirus in oral cancer: a real time PCR study on 278 patients.

    Science.gov (United States)

    Palmieri, A; Scapoli, L; Martinelli, M; Pezzetti, F; Girardi, A; Spinelli, G; Lucchese, A; Carinci, F

    2011-01-01

    Squamous cell carcinoma is the most frequent malignant tumour of the oral cavity. It is widely known that tobacco and alcohol consumption are the major causes of the development of oral squamous cell carcinoma (OSCC). The human papilloma virus infection has also been postulated as a risk factor for squamous cell carcinoma, although conflicting results have been reported. The aim of this study is to evaluate the presence of high-risk and low-risk type human papillomavirus in a large sample of squamous cell carcinoma limited to the oral cavity by means of quantitative real-time polymerase chain reaction. Data were obtained from 278 squamous cell carcinoma limited to oral cavity proper. Sequencing revealed that 5 samples were positive for HPV type 16, 5 for HPV type 11, and 1 for HPV type 6. Human papillomavirus 11 was detected in 5 tumours out of the 278 examined. The prevalence rate for Human papillomavirus 11 was 1.8% (C.I. 0.7-3.9). The matched case-controls analysis indicated that the prevalence among controls did not significantly differ with respect to cases and that Human papillomavirus 11 alone did not correlate with squamous cell carcinoma.