Post-construction monitoring for birds and bats : an examination of methods and issues

Energy Technology Data Exchange (ETDEWEB)

Ebner, D.; Korpijaakko, C. [Stantec Consulting Ltd., Surrey, BC (Canada)

2009-07-01

The Canadian Environmental Assessment Act (CEAA) stipulates that bird and bat monitoring studies should be conducted following the construction of most wind turbine projects in Canada. The objectives of the monitoring studies are to verify the accuracy of the environmental assessment; determine the effectiveness of any measures taken to mitigate the adverse environmental effects of a project; and to evaluate the cumulative effects on species diversity and numbers. This presentation discussed post-construction monitoring for birds and bats and provided an examination of methods and issues. It emphasized why post-construction monitoring is important. Environmental effects that were examined in the presentation were changes in breeding birds; changes in passage migrants or wintering birds; changes in bat activity; and mortality monitoring/carcass surveys. The key issues regarding the design and implementation of post-construction monitoring programs include variation in field and analytical methods; protocols implemented that can add uncertainty and bias to estimates of mortality; and comparisons of project-specific results with other projects. Other topics that were addressed included federal requirements; provincial requirements; post-construction surveys and carcass searches; search efficiency and analysis. The presentation concluded with a discussion regarding the need for standardization. figs.

Risk evaluation and monitoring in multiple sclerosis therapeutics.

Science.gov (United States)

Clanet, Michel C; Wolinsky, Jerry S; Ashton, Raymond J; Hartung, Hans-Peter; Reingold, Stephen C

2014-09-01

Risk for multiple sclerosis (MS) disease-modifying therapies (DMT) must be assessed on an ongoing basis. Early concerns regarding the first-approved DMTs for MS have been mitigated, but recently licensed therapies have been linked to possibly greater risks. The objective of this review is to discuss risk assessment in MS therapeutics based on an international workshop and comprehensive literature search and recommend strategies for risk assessment/monitoring. Assessment and perception of therapeutic risks vary between patients, doctors and regulators. Acceptability of risk depends on the magnitude of risk and the demonstrated clinical benefits of any agent. Safety signals must be distinguishable from chance occurrences in a clinical trial and in long-term use of medications. Post-marketing research is crucial for assessing longer-term safety in large patient cohorts. Reporting of adverse events is becoming more proactive, allowing more rapid identification of risks. Communication about therapeutic risks and their relationship to clinical benefit must involve patients in shared decision making. It is difficult to produce a general risk-assessment algorithm for all MS therapies. Specific algorithms are required for each DMT in every treated-patient population. New and evolving risks must be evaluated and communicated rapidly to allow patients and physicians to be well informed and able to share treatment decisions. © The Author(s) 2013.

Gestational Diabetes Mellitus: Post-partum Risk and Follow Up.

Science.gov (United States)

Poola-Kella, Silpa; Steinman, Rachel A; Mesmar, Bayan; Malek, Rana

2018-01-31

Women with gestational diabetes mellitus (GDM) are at an increased risk for developing metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease. In this review, we will discuss postpartum cardiovascular and diabetes risk in women with a history of GDM and different ways to improve postpartum screening. This review involves a comprehensive literature review on gestational diabetes and postpartum risk for cardiovascular disease and diabetes mellitus as well as post-partum screening methods. Cardiovascular risk post-partum is potentiated by increased inflammatory markers leading to worsening atherosclerosis and cardiovascular events downstream. Decreased insulin sensitivity and β cell compensation, recurrent GDM, maternal factors such as pre and post-partum weight gain and lactation may contribute to T2DM risk. Postpartum glucose testing is essential in screening women as hyperglycemia in pregnancy has long term effects on both cardiovascular disease and diabetes risk on the mother. Long and short term improvement to post-partum glucose testing is essential to decreasing cardiometabolic and diabetes risk in women with gestational diabetes mellitus. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

An overview of passive remote sensing for post-fire monitoring

Directory of Open Access Journals (Sweden)

2005-01-01

Full Text Available Monitoring of forest burnt areas has several aims: to locate and estimate the extent of such areas; to assess the damages suffered by the forest stands; to check the ability of the ecosystem to naturally recover after the fire; to support the planning of reclamation interventions; to assess the dynamics (pattern and speed of the natural recovery; to check the outcome of any eventual restoration intervention. Remote sensing is an important source of information to support all such tasks. In the last decades, the effectiveness of remotely sensed imagery is increasing due to the advancement of tools and techniques, and to the lowering of the costs, in relative terms. For an effective support to post-fire management (burnt scar perimeter mapping, damage severity assessment, post-fire vegetation monitoring, a mapping scale of at least 1:10000-1:20000 is required: hence, the selection of remotely sensed data is restricted to aerial imagery and to satellite imagery characterized by high (HR and, above all, very high (VHR spatial resolution. In the last decade, HR and VHR passive remote sensing has widespread, providing affordable multitemporal and multispectral pictures of the considered phenomena, at different scales (spatial, temporal and spectral resolutions with reference to the monitoring needs. In the light of such a potential, the integration of GPS field survey and HR (Landsat 7, Spot HVR and VHR satellite imagery (Ikonos, Quickbird, Spot 5 is currently sought as a highly viable option for the post-fire monitoring.

First year post-construction monitoring of birds at Wind Turbine Test Centre Østerild

DEFF Research Database (Denmark)

Therkildsen, Ole Roland; Balsby, Thorsten Johannes Skovbjerg; Groom, Geoffrey Brian

2015-01-01

The Department of Bioscience, Aarhus University was commissioned by the DanishNature Agency to undertake a bird monitoring programme of a national testcentre for wind turbines near Østerild in Thy, Denmark. Here we present the results from the first year of the post-construction studies. Whooper...... swan, taiga bean goose, pink-footed goose, common crane, light-bellied brent goose, white-tailed eagle and nightjar were included as focal species in the ornithological investigations. In addition, species specific data on all bird species occurring regularly in the study area were collected....... On the basis of an intermediate assessment of collision risk, the potential impacts of the combined structures on the bird species occurring in the study area were considered unlikely to be significant. However, given the uncertainties in the assessment,  the post-construction programme will continue...

Post-accident monitoring systems in Prototype Fast Breeder Reactor

International Nuclear Information System (INIS)

Suriya Murthy, N.; Sivasailanathan, Vidhya; Ananth, Allu; Roy, Kallol

2018-01-01

PFBR is a 500 MW(e) MOX fueled and sodium cooled fast reactor (SFR) under advanced stage of commissioning at Kalpakkam. Currently, the main vessel is preheated and sodium has been charged into two secondary loops that are operated in recirculation mode. In order to characterize the radiation field and contamination, the workplace monitoring is undertaken using installed monitors that are commissioned and made operational. This helps to ensure radiological protection during normal operating conditions. On the other hand, radiological monitoring in emergency conditions is quite different. For undertaking the mitigative accident management, a set of specialized nuclear instruments called post-accident monitoring systems (PAMS) which include radiation monitors are stipulated. The Fukushima Daiichi accident emphasized the importance and need for reliable accident monitoring instrumentation to indicate the safety functions during the progression and aftermath of accident in NPP. In PFBR, the PAMS are integrated with other monitoring systems in design stage itself to manage the measurements and indicating the safety functions for implementing EOP and SAMG

Probabilistic Risk Assessment for Astronaut Post Flight Bone Fracture

Science.gov (United States)

Lewandowski, Beth; Myers, Jerry; Licata, Angelo

2015-01-01

Introduction: Space flight potentially reduces the loading that bone can resist before fracture. This reduction in bone integrity may result from a combination of factors, the most common reported as reduction in astronaut BMD. Although evaluating the condition of bones continues to be a critical aspect of understanding space flight fracture risk, defining the loading regime, whether on earth, in microgravity, or in reduced gravity on a planetary surface, remains a significant component of estimating the fracture risks to astronauts. This presentation summarizes the concepts, development, and application of NASA's Bone Fracture Risk Module (BFxRM) to understanding pre-, post, and in mission astronaut bone fracture risk. The overview includes an assessment of contributing factors utilized in the BFxRM and illustrates how new information, such as biomechanics of space suit design or better understanding of post flight activities may influence astronaut fracture risk. Opportunities for the bone mineral research community to contribute to future model development are also discussed. Methods: To investigate the conditions in which spaceflight induced changes to bone plays a critical role in post-flight fracture probability, we implement a modified version of the NASA Bone Fracture Risk Model (BFxRM). Modifications included incorporation of variations in physiological characteristics, post-flight recovery rate, and variations in lateral fall conditions within the probabilistic simulation parameter space. The modeled fracture probability estimates for different loading scenarios at preflight and at 0 and 365 days post-flight time periods are compared. Results: For simple lateral side falls, mean post-flight fracture probability is elevated over mean preflight fracture probability due to spaceflight induced BMD loss and is not fully recovered at 365 days post-flight. In the case of more energetic falls, such as from elevated heights or with the addition of lateral movement

[Establishment of model of traditional Chinese medicine injections post-marketing safety monitoring].

Science.gov (United States)

Guo, Xin-E; Zhao, Yu-Bin; Xie, Yan-Ming; Zhao, Li-Cai; Li, Yan-Feng; Hao, Zhe

2013-09-01

To establish a nurse based post-marketing safety surveillance model for traditional Chinese medicine injections (TCMIs). A TCMIs safety monitoring team and a research hospital team engaged in the research, monitoring processes, and quality control processes were established, in order to achieve comprehensive, timely, accurate and real-time access to research data, to eliminate errors in data collection. A triage system involving a study nurse, as the first point of contact, clinicians and clinical pharmacists was set up in a TCM hospital. Following the specified workflow involving labeling of TCM injections and using improved monitoring forms it was found that there were no missing reports at the ratio of error was zero. A research nurse as the first and main point of contact in post-marketing safety monitoring of TCM as part of a triage model, ensures that research data collected has the characteristics of authenticity, accuracy, timeliness, integrity, and eliminate errors during the process of data collection. Hospital based monitoring is a robust and operable process.

Adiposity, post-diagnosis weight change, and risk of cardiovascular events among early-stage breast cancer survivors.

Science.gov (United States)

Cespedes Feliciano, Elizabeth M; Kwan, Marilyn L; Kushi, Lawrence H; Weltzien, Erin K; Castillo, Adrienne L; Caan, Bette J

2017-04-01

Little research examines whether adiposity or post-diagnosis weight changes influence Cardiovascular disease (CVD) among breast cancer patients for whom effects may differ due to treatment and recovery. We studied Stage I-III breast cancer survivors 18 to  diagnosis and weight and waist circumference (WC) around 24 months post diagnosis. Using Cox models for time to incident coronary artery disease, heart failure, valve abnormality, arrhythmia, stroke, or CVD death, we examined at-diagnosis body mass index (BMI, n = 3109) and post-diagnosis WC (n = 1898) and weight change (n = 1903, stable, ±5 to  diagnosis, 25% of women gained and 14% lost ≥10-lbs; mean (SD) WC was 90 (15) cm. Over a median of 8.28 years, 915 women developed CVD. BMI 25-30-kg/m 2 (vs. BMI diagnosis weight change had no association with CVD. Extreme adiposity and any elevation in WC increased risk of CVD among breast cancer survivors; however, changes in weight in the early post-diagnosis period were not associated with CVD. Survivors with high WC and existing CVD risk factors should be monitored.

Predicting self-monitoring skills using textual posts on Facebook

NARCIS (Netherlands)

He, Qiwei; Glas, Cornelis A.W.; Kosinski, Michal; Stillwell, David J.; Veldkamp, Bernard P.

2014-01-01

The popularity of the social networking site Facebook (FB) has grown unprecedented during the past five years. The research question investigated is whether posts on FB would also be applicable for the prediction of users’ psychological traits such as self-monitoring (SM) skill that is supposed to

75 FR 36089 - Payment System Risk Policy; Daylight Overdraft Posting Rules

Science.gov (United States)

2010-06-24

... FEDERAL RESERVE SYSTEM [OP-1385] Payment System Risk Policy; Daylight Overdraft Posting Rules... Payment System Risk Policy, the Board is announcing posting rules for a new same-day automated clearing... Kirkpatrick, Senior Financial Services Analyst, Payment System Risk (202-452-2796), or Jennifer Davidson...

Design and implementation of an online risk monitor

International Nuclear Information System (INIS)

Majdara, A.; Nematollah, M. R.; Haddad, K.; Sepanloo, K.

2006-01-01

Probabilistic Safety Assessment is a powerful method for evaluating the safety of nuclear facilities. Probabilistic Safety Assessment models are the basis of online risk monitors, which can be utilized for monitoring the online risk. In this paper a newly developed risk monitor called Safety Assessment Tool is presented, and its main features and capabilities are introduced. Some of these features are: graphical event/fault tree developing interface, a 30-day risk profile, performing importance analysis, different administrative levels, and handling time dependent failure data. Safety Assessment Tool can be utilized in nuclear power plants, research reactors, etc. as an online assistant to manage safety issues and prevent high-risk configurations

Post Launch Monitoring of food products : what can be learned from pharmacovigilance

NARCIS (Netherlands)

van Puijenbroek, E P; Hepburn, P A; Herd, T M; van Grootheest, A C

Post Launch Monitoring (PLM) is one of the new approaches that are used in assessing the safety of novel foods or ingredients. It shares a close resemblance with procedures applied in the field of medicines, where Post Marketing Surveillance (PMS) has been carried out since the beginning of the

Novelty detection methods for online health monitoring and post data analysis of turbopumps

International Nuclear Information System (INIS)

Lei Hu; Niaoqing, Hu; Xinpeng, Zhang; Fengshou, Gu; Ming, Gao

2013-01-01

As novelty detection works when only normal data are available, it is of considerable promise for health monitoring in cases lacking fault samples and prior knowledge. We present two novelty detection methods for health monitoring of turbopumps in large-scale liquid propellant rocket engines. The first method is the adaptive Gaussian threshold model. This method is designed to monitor the vibration of the turbopumps online because it has minimal computational complexity and is easy for implementation in real time. The second method is the one-class support vector machine (OCSVM) which is developed for post analysis of historical vibration signals. Via post analysis the method not only confirms the online monitoring results but also provides diagnostic results so that faults from sensors are separated from those actually from the turbopumps. Both of these two methods are validated to be efficient for health monitoring of the turbopumps.

Intestinal Adenovirus Shedding Before Allogeneic Stem Cell Transplantation Is a Risk Factor for Invasive Infection Post-transplant

Directory of Open Access Journals (Sweden)

Karin Kosulin

2018-02-01

Full Text Available Human adenoviruses (HAdV are a major cause of morbidity and mortality in pediatric human stem cell transplant (HSCT recipients. Our previous studies identified the gastrointestinal tract as a site of HAdV persistence, but the role of intestinal virus shedding pre-transplant for the risk of ensuing invasive infection has not been entirely elucidated. Molecular HAdV monitoring of serial stool samples using RQ-PCR was performed in 304 children undergoing allogeneic HSCT. Analysis of stool and peripheral blood specimens was performed pre-transplant and at short intervals until day 100 post-HSCT. The virus was detected in the stool of 129 patients (42%, and 42 tested positive already before HSCT. The patients displaying HAdV shedding pre-transplant showed a significantly earlier increase of intestinal HAdV levels above the critical threshold associated with high risk of invasive infection (p < 0.01. In this subset of patients, the occurrence of invasive infection characterized by viremia was significantly higher than in patients without HAdV shedding before HSCT (33% vs 7%; p < 0.0001. The data demonstrate that intestinal HAdV shedding before HSCT confers a greatly increased risk for invasive infection and disseminated disease post-transplant, and highlights the need for timely HAdV monitoring and pre-emptive therapeutic considerations in HSCT recipients.

Dynamic Relationships Between Parental Monitoring, Peer Risk Involvement and Sexual Risk Behavior Among Bahamian Mid-Adolescents.

Science.gov (United States)

Wang, Bo; Stanton, Bonita; Deveaux, Lynette; Li, Xiaoming; Lunn, Sonja

2015-06-01

Considerable research has examined reciprocal relationships between parenting, peers and adolescent problem behavior; however, such studies have largely considered the influence of peers and parents separately. It is important to examine simultaneously the relationships between parental monitoring, peer risk involvement and adolescent sexual risk behavior, and whether increases in peer risk involvement and changes in parental monitoring longitudinally predict adolescent sexual risk behavior. Four waves of sexual behavior data were collected between 2008/2009 and 2011 from high school students aged 13-17 in the Bahamas. Structural equation and latent growth curve modeling were used to examine reciprocal relationships between parental monitoring, perceived peer risk involvement and adolescent sexual risk behavior. For both male and female youth, greater perceived peer risk involvement predicted higher sexual risk behavior index scores, and greater parental monitoring predicted lower scores. Reciprocal relationships were found between parental monitoring and sexual risk behavior for males and between perceived peer risk involvement and sexual risk behavior for females. For males, greater sexual risk behavior predicted lower parental monitoring; for females, greater sexual risk behavior predicted higher perceived peer risk involvement. According to latent growth curve models, a higher initial level of parental monitoring predicted decreases in sexual risk behavior, whereas both a higher initial level and a higher growth rate of peer risk involvement predicted increases in sexual risk behavior. Results highlight the important influence of peer risk involvement on youths' sexual behavior and gender differences in reciprocal relationships between parental monitoring, peer influence and adolescent sexual risk behavior.

Deep Vadose Zone Treatability Test for the Hanford Central Plateau: Interim Post-Desiccation Monitoring Results

Energy Technology Data Exchange (ETDEWEB)

Truex, Michael J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Oostrom, Martinus [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Strickland, Christopher E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Johnson, Timothy C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Johnson, Christian D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Clayton, Ray E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Chronister, Glen B. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2013-09-01

A field test of desiccation is being conducted as an element of the deep vadose zone treatability test program. Desiccation technology relies on removal of water from a portion of the subsurface such that the resultant low moisture conditions inhibit downward movement of water and dissolved contaminants. Previously, a field test report (Truex et al. 2012a) was prepared describing the active desiccation portion of the test and initial post-desiccation monitoring data. Additional monitoring data have been collected at the field test site during the post-desiccation period and is reported herein along with interpretation with respect to desiccation performance. This is an interim report including about 2 years of post-desiccation monitoring data.

[Necessity of applying pharmacovigilance in post-marketing safety monitoring of traditional Chinese medicine injections].

Science.gov (United States)

Wang, Hai-Nan; Chen, Wen; Fu, Zheng; Du, Wen-min; He, Jia

2008-03-01

Traditional Chinese medicine (TCM) injection has become one of the hotspots in the new TCM research and development. The serious adverse drug reactions happened in clinical have arosed attention widely in the whole society. It's very urgent to monitor the post-marketing safety of TCM injections. This paper elucidated the pharmacovigilance's necessity in the post-marketing safety monitoring of TCM injections, basing on the reason of safety problem of TCM injections and the future developing trend of adverse drug reaction monitoring. Also, this paper introduced the rapid signal detection method of spontaneous reporting system database by data mining technology.

[Risk factors in post partum depression].

Science.gov (United States)

Marino, Monica; Battaglia, Eliana; Massimino, Marta; Aguglia, Eugenio

2012-01-01

It is commonly believed that pregnancy is a time of good mental health. However it has been observed, until recently, that many pregnant women, above all in post partum period, manifest depressive symptoms like sadness, social withdrawal and lack of motivation. The consequences are enormous, for mother mental health and for the psychical development of the baby. It becomes therefore necessary to screening and to precociously intervene on these pathological conditions and thanks also to the suitable knowledge of the risk factors for the potential development of depression post partum.

Completion of risk assessment and monitoring within forensic psychiatry.

Science.gov (United States)

Galappathie, Nuwan; Heeramun, Ragini; Jethwa, Krishma

2009-04-01

There is a clear need for high standards of risk assessment and monitoring within forensic psychiatry. This has been highlighted by a number of high profile homicide enquires which have called for better standards of multidisciplinary risk assessment and monitoring. There are no national standards for risk assessment. We conducted a study to audit electronically the completion rate of a service-designed risk assessment document within Fromside, a medium secure unit in the UK. The completion rates for key sections of 64 risk assessment documents were assessed. Only 48 of the 64 (75%) documents were electronically available. The completion rates ranged from 59/64 (92%) for the retrospective risk review to 46/64 (72%) for relapse indicators. Only 35/64 (55%) risk documents were updated within the last three months. We found that the use of risk profile documents has helped achieve good standards of risk assessment, however greater priority needs to be given to ongoing monitoring. We recommend that consideration is given to the development of national guidelines for multidisciplinary risk assessment and monitoring.

Flex Sensor Based Biofeedback Monitoring for Post-Stroke Fingers Myopathy Patients

Science.gov (United States)

Garda, Y. R.; Caesarendra, W.; Tjahjowidodo, T.; Turnip, A.; Wahyudati, S.; Nurhasanah, L.; Sutopo, D.

2018-04-01

Hands are one of the crucial parts of the human body in carrying out daily activities. Accidents on the hands decreasing in motor skills of the hand so that therapy is necessary to restore motor function of the hand. In addition to accidents, hand disabilities can be caused by certain diseases, e.g. stroke. Stroke is a partial destruction of the brain. It occurs if the arteries that drain blood to the brain are blocked, or if torn or leak. The purpose of this study to make biofeedback monitoring equipment for post-stroke hands myopathy patients. Biofeedback is an alternative method of treatment that involves measuring body functions measured subjects such as skin temperature, sweat activity, blood pressure, heart rate and hand paralysis due to stroke. In this study, the sensor used for biofeedback monitoring tool is flex sensor. Flex sensor is a passive resistive device that changes its resistance as the sensor is bent. Flex sensor converts the magnitude of the bend into electrical resistance, the greater the bend the greater the resistance value. The monitoring used in this biofeedback monitoring tool uses Graphical User Interface (GUI) in C# programming language. The motivation of the study is to monitor and record the progressive improvement of the hand therapy. Patients who experienced post-stroke can see the therapy progress quantitatively.

Lessons learned from post-construction bird and bat monitoring

Energy Technology Data Exchange (ETDEWEB)

Stephenson, D.E. [Natural Resource Solutions, Waterloo, ON (Canada)

2010-07-01

This PowerPoint presentation presented recommendations for a successful post-construction bat mortality monitoring strategy. A range of metrics are offered in the literature for establishing a search radius from the base of wind turbines, and changes in radius can have a significant impact on the outcomes of bat monitoring programs. Changes in ground-cover or areas with agricultural crops can obscure bat carcasses. Scavengers can also remove carcasses. Frequent scavenger tests are required to ensure that bat mortality rates are accurately represented. The full area under wind turbines must be regularly monitored instead of radial subsamples. A search radius must be established as part of an accurate strategy. Monitoring crews must be trained to look for carcasses in varied terrains, including under foliage, plants, and crops. Turbine operators must also consider that the presence of a single bat carcass may, after applying adjustments, represent 5 dead animals. Conservative adjustment assumptions may overwhelm the collected data. tabs., figs.

Post-ERCP acute pancreatitis and its risk factors.

Science.gov (United States)

Iorgulescu, A; Sandu, I; Turcu, F; Iordache, N

2013-03-15

Endoscopic retrograde cholangiopancreatography (ERCP) is a complex endoscopic technique that evolved from a diagnostic to a mainly therapeutic procedure. This was due to the identification of post-procedural complications that can follow both simple ERCP and that associated with the instrumentation of the biliary and pancreatic ductals. The identification of post ERCP complications in a proportion of 5 to 10% of cases, with a mortality rate of 0.33%, imposed their analysis and study of risk factors involved in their occurrence. The significance of post ERCP complications reveals the necessity of their avoidance by adopting additional measures if risk factors are identified. We have retrospectively analyzed 900 cases that underwent ERCP in the Surgery Department of "Sf. Ioan" Clinical Hospital in a period of 17 years. The complications of the procedure were studied. Among them, a special attention was given to post-ERCP acute pancreatitis (pERCP-AP), the most common complication that occurred in the study group. We also tried to find out and highlight the risk factors for this complication. ERCP is a relatively safe invasive procedure, yet it has complications (8% of cases), some of them potentially fatal (mortality 0.43%). The most common complications after ERCP are acute pancreatitis (3.7%), papillary bleeding (1.04%), retroperitoneal duodenal perforation (0.69%) and biliary septic complications like acute cholecystitis and cholangitis (1.21%). Acute pancreatitis is by far the most common complication. Risk factors for its occurrence are difficult sphincterotomy with precut use, failure of CBD desobstruction, pancreatic sphincterotomy, repeated injection of contrast in the pancreatic ductal system, dysfunction of the sphincter of Oddi and the absence of changes of chronic pancreatitis. When risk factors are identified, the patients' selection must be very strict and diagnostic ERCP should be avoided in favor of non-invasive diagnostic methods (MRI

Financial risks of post-closure custodial care for the Barnwell radioactive waste disposal facility - 16155

International Nuclear Information System (INIS)

Baird, Robert D.; Newberry, William F.

2009-01-01

This paper reports evaluations of the adequacy of the Barnwell Extended Care Fund in light of identified risks, with the conclusion that the fund is sufficient to cover the costs and uncertainties associated with planned post-closure care of the Barnwell, South Carolina low-level radioactive waste disposal facility. It reviews background information pertinent to the facility's post-closure monitoring and maintenance and describes financial responsibility for post-closure activities. It identifies and briefly characterizes the activities planned to be conducted following facility closure and presents the midrange estimate of planned post-closure costs. The paper identifies and quantifies sources of uncertainty in activities and costs planned for post-closure care and presents 50-, 80-, and 95-percent confidence levels of planned costs. The fund is currently sufficient to cover some but not all of the costs that might be incurred as a result of unplanned events. The paper identifies, characterizes, and quantifies unplanned events, possible consequences, and probabilities of occurrence. The paper presents costs that might be incurred in responding to the unplanned initiating events and identifies levels of confidence that the fund is adequate to cover such costs. (authors)

Endoscopy versus radiology in post-procedural monitoring after peroral endoscopic myotomy (POEM).

Science.gov (United States)

Nast, Jan Friso; Berliner, Christoph; Rösch, Thomas; von Renteln, Daniel; Noder, Tania; Schachschal, Guido; Groth, Stefan; Ittrich, Harald; Kersten, Jan F; Adam, Gerhard; Werner, Yuki B

2018-03-15

The newly developed technique of peroral endoscopic myotomy (POEM) has been shown to be effective in several short- and mid-term studies. Limited information is available about the adequacy of immediate post-POEM monitoring tests. POEM was performed under general anesthesia in 228 patients (59.6% male, mean age 45.6 ± 15.5 years). Post-procedural checks comprised clinical and laboratory examination, and, during post-procedure days 1-5, endoscopy and-in the first 114 cases-radiologic examination using water-soluble contrast (1st group); the remaining patients underwent post-procedure controls without radiology (2nd group). Main outcome was value of endoscopic compared to radiologic control for recognition of early adverse events. In the first group, routine fluoroscopic contrast swallow suggested minor leakages at the mucosal entry site in two cases which was confirmed endoscopically in only one. Endoscopy revealed two minor entry site leakages and, in six additional cases, dislocated clips without leakage (overall 5.3%). All eight patients underwent reclipping and healed without clinical sequelae. In the 2nd group, endoscopy showed 5 clip dislocations (all reclipped) and one ischemic cardiac perforation in a patient with clinical deterioration on post-POEM day 1 who had to undergo surgery after confirmation of leakage by CT. Radiologic monitoring (contrast swallow) after POEM is not useful and can be omitted. Even routine endoscopic monitoring for detection and closure of minor defects of the mucosal entry site yields limited information with regards to final outcome; major complications are very rare and probably associated with clinical deterioration. Clinical Trials Gov Registration number of the main study: NCT01405417.

Deep Vadose Zone Treatability Test for the Hanford Central Plateau. Interim Post-Desiccation Monitoring Results, Fiscal Year 2015

Energy Technology Data Exchange (ETDEWEB)

Truex, Michael J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Strickland, Christopher E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Oostrom, Martinus [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Johnson, Christian D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Tartakovsky, Guzel D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Johnson, Timothy C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Clayton, Ray E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Chronister, Glen B. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2015-09-01

A field test of desiccation is being conducted as an element of the Deep Vadose Zone Treatability Test Program. The active desiccation portion of the test has been completed. Monitoring data have been collected at the field test site during the post-desiccation period and are reported herein. This is an interim data summary report that includes about 4 years of post-desiccation monitoring data. The DOE field test plan proscribes a total of 5 years of post-desiccation monitoring.

A risk-based approach to liquid effluent monitoring

Energy Technology Data Exchange (ETDEWEB)

Hull, L.C.

1995-10-01

DOE Order 5400.1 identifies six objectives of a liquid effluent monitoring program. A strategy is proposed that meets these objective in one of two ways: (1) by showing that effluent concentrations are below concentration limits set by permits or are below concentrations that could cause environmental problems or (2) by showing that concentrations in effluent have not changed from a period when treatment processes were in control and there were no unplanned releases. The intensity of liquid effluent monitoring should be graded to the importance of the source being monitored. This can be accomplished by determining the risk posed by the source. A definition of risk is presented that defines risk in terms of the statistical probability of exceeding a release limit and the time available to recover from an exceedance of a release limit. Three examples are presented that show this approach to grading an effluent monitoring program can be implemented at the Idaho National Engineering Laboratory and will reduce monitoring requirements.

A risk-based approach to liquid effluent monitoring

International Nuclear Information System (INIS)

Hull, L.C.

1995-10-01

DOE Order 5400.1 identifies six objectives of a liquid effluent monitoring program. A strategy is proposed that meets these objective in one of two ways: (1) by showing that effluent concentrations are below concentration limits set by permits or are below concentrations that could cause environmental problems or (2) by showing that concentrations in effluent have not changed from a period when treatment processes were in control and there were no unplanned releases. The intensity of liquid effluent monitoring should be graded to the importance of the source being monitored. This can be accomplished by determining the risk posed by the source. A definition of risk is presented that defines risk in terms of the statistical probability of exceeding a release limit and the time available to recover from an exceedance of a release limit. Three examples are presented that show this approach to grading an effluent monitoring program can be implemented at the Idaho National Engineering Laboratory and will reduce monitoring requirements

Post-transplant monitoring of soluble CD30 level as predictor of graft outcome: a single center experience from China.

Science.gov (United States)

Wang, Dong; Wu, Weizhen; Yang, Shunliang; Wang, Qinghua; Tan, Jianming

2012-12-01

There are no reliable parameters for post-transplantation immunological monitoring, which might enable recipient-tailored immunosuppressive therapy. 250 renal graft recipients were enrolled and detected for sCD30 level pre-transplantation, and on days 5 and 14, and on months 1, 3, 6, 12, 24, 36, 48 and 60 post-transplantation. Analysis was performed on correlation between sCD30 level and acute rejection, lung infection, or graft loss respectively. sCD30 levels descended to a nadir with a mean of 10.2 ± 3.8 U/mL on day 30 post-transplantation, then rose gradually, and approached 21.8 ± 10.1 U/mL on month 3, 34.2 ± 16.5 U/mL on month 6, and 42.9 ± 29.5 U/mL on month 12, then presented a stable level. Recipients with AR had significantly higher sCD30 levels than those without AR on days 5 and 14 post-transplantation. Recipients with pneumonia had significantly lower sCD30 levels within 3 months post-transplantation than those without pneumonia. Significantly higher sCD30 levels were recorded in recipients who suffered graft loss than those with normal graft function on days 5 and 14, and on months 6, 12, and 24. High sCD30 level (≥ 48.3 U/mL) at month 12 post-transplantation has an obvious detrimental effect on renal graft survival (p=0.000, HR=9.075). Serum sCD30 level might reflect immune state of renal graft recipients. Post-transplantation sequential monitoring of sCD30 level is necessary, which might not only identify recipients at the risk of acute rejection and graft loss, but also chosen as an independent predictor of pneumonia in renal transplant recipients. Copyright © 2012 Elsevier B.V. All rights reserved.

Risk factors of post renal transplant hyperparathyroidism

International Nuclear Information System (INIS)

Jahromi, Alireza Hamidian; Roozbeh, Jamshid; Raiss-Jalali, Ghanbar Ali; Dabaghmanesh, Alireza; Jalaeian, Hamed; Bahador, Ali; Nikeghbalian, Saman; Salehipour, Mehdi; Salahi, Heshmat; Malek-Hosseini, Ali

2009-01-01

It is well recognized that patients with end stage renal diseases (ESRD) have hyper-plastic parathyroid glands. In most patients, a decrease in parathyroid hormone (PTH) occurs by about 1 year after renal transplantation. However, some renal transplant recipients continue to have elevated level of PTH. We prospectively evaluated 121 patients undergoing renal transplantation between August 2000 and 2002. The duration of dialysis, calcium (Ca), phosphorus (P), albumin, creatinine and iPTH levels were recorded prior to transplantation and three months and one year after transplantation. These 121 patients were on dialysis for an average period of 17.4 months prior to transplantation. An increase in the serum Ca and a decrease in serum P and iPTH level was seen in the patients after transplantation (P< 0.001). Hyperparathyroidism was in 12 (9.9%) and 7 (5.7%) patients three months and one year after transplantation respectively. Elderly patients and patients with longer duration on dialysis had an increased risk of developing post transplant hyperparathyroidism and hypercalcemia in the first year post transplant (P< 0.05). In conclusion age and duration on dialysis before transplantation seems to be important risk factors for post transplant hyperparathyroidism. (author)

[Post-marketing drug safety-risk management plan(RMP)].

Science.gov (United States)

Ezaki, Asami; Hori, Akiko

2013-03-01

The Guidance for Risk Management Plan(RMP)was released by the Ministry of Health, Labour and Welfare in April 2012. The RMP consists of safety specifications, pharmacovigilance plans and risk minimization action plans. In this paper, we outline post-marketing drug safety operations in PMDA and the RMP, with examples of some anticancer drugs.

Risk monitor-a tool for computer aided risk assessment for NPPs

International Nuclear Information System (INIS)

Vinod, Gopika; Saraf, R.K.; Babar, A.K.; Kushwaha, H.S.; Hadap, Nikhil

2001-01-01

Considerable changes occur in components status and system design and subsequent operation due to changes in plant configuration and their operating procedures. These changes are organised because some components are randomly down and other can be planned for test, maintenance and repair. This results in a fluctuation of risk level over operating time, which is termed as risk profile. Probabilistic Safety Assessment (PSA) is an analytical technique for assessing the risk by integrating diverse aspects of design and operation of a Nuclear Power Plant. Risk can be defined as the product of the probability of an accident and the consequences from that accident. Reactor Safety Division of BARC has developed PC based tool, which can assess the risk profile. This package can be used to optimise the operation in Nuclear Power Plants with respect to a minimum risk level over the operating time, and is termed as Risk Monitor. Risk Monitor is user friendly and can re-evaluate core damage frequency for changes in component status, test interval, initiating event frequency etc. Plant restoration advice, when the plant is in high risk configuration, current status of all plant equipment, and equipment prioritization are also provided by the package. (author)

Integrated functional modeling method for NPP plant DiD risk monitor and its application for conventional PWR

Energy Technology Data Exchange (ETDEWEB)

Yoshikawa, Hidekazu; Yang, Ming; Zhang, Zhijian [Harbin Engineering University, Harbin (China)

2014-08-15

The development of a new risk monitor system is introduced in this paper, which can be applied not only to severe accident prevention in daily operation but also to serve as to mitigate the radiological hazard just after severe accident happens and long term management of post-severe accident consequences. The summary of the fundamental method is summarized on how to configure the Plant Defense in-Depth (Did) Risk Monitor by object-oriented software system based on functional modeling approach. Following the authors??preceding preliminary study for AP1000, the way of realizing the proposed method of configuring the plant Did risk monitor was investigated for a safety-enhanced Japanese PWR design to meet with the tight anti-severe accident requirements set by national regulation in Japan after Fukushima Daiichi accident. The result of this example practice of the presented preliminary study for Japanese PWR was for the level 4 of the Did in case of beyond design basis accident, that is, loss of all AC power + RCP seal LOCA, against the former case of AP1000 for level 3 Did in case of large LOCA.

Chapter 4. Predicting post-fire erosion and sedimentation risk on a landscape scale

Science.gov (United States)

MacDonald, L.H.; Sampson, R.; Brady, D.; Juarros, L.; Martin, Deborah

2000-01-01

Historic fire suppression efforts have increased the likelihood of large wildfires in much of the western U.S. Post-fire soil erosion and sedimentation risks are important concerns to resource managers. In this paper we develop and apply procedures to predict post-fire erosion and sedimentation risks on a pixel-, catchment-, and landscape-scale in central and western Colorado.Our model for predicting post-fire surface erosion risk is conceptually similar to the Revised Universal Soil Loss Equation (RUSLE). One key addition is the incorporation of a hydrophobicity risk index (HY-RISK) based on vegetation type, predicted fire severity, and soil texture. Post-fire surface erosion risk was assessed for each 90-m pixel by combining HYRISK, slope, soil erodibility, and a factor representing the likely increase in soil wetness due to removal of the vegetation. Sedimentation risk was a simple function of stream gradient. Composite surface erosion and sedimentation risk indices were calculated and compared across the 72 catchments in the study area.When evaluated on a catchment scale, two-thirds of the catchments had relatively little post-fire erosion risk. Steeper catchments with higher fuel loadings typically had the highest post-fire surface erosion risk. These were generally located along the major north-south mountain chains and, to a lesser extent, in west-central Colorado. Sedimentation risks were usually highest in the eastern part of the study area where a higher proportion of streams had lower gradients. While data to validate the predicted erosion and sedimentation risks are lacking, the results appear reasonable and are consistent with our limited field observations. The models and analytic procedures can be readily adapted to other locations and should provide useful tools for planning and management at both the catchment and landscape scale.

Evaluation of test intervals strategies with a risk monitor

International Nuclear Information System (INIS)

Soerman, J.

2005-01-01

The Swedish nuclear power utility Oskarshamn Power Group (OKG), is investigating how the use of a risk monitor can facilitate and improve risk-informed decision-making at their nuclear power plants. The intent is to evaluate if risk-informed decision-making can be accepted. A pilot project was initiated and carried out in 2004. The project included investigating if a risk monitor can be used for optimising test intervals for diesel- and gas turbine generators with regard to risk level. The Oskarhamn 2 (O2), PSA Level 1 model was converted into a risk monitor using RiskSpectrum RiskWatcher (RSRW) software. The converted PSA model included the complete PSA model for the power operation mode. RSRW then performs a complete requantification for every analysis. Time dependent reliability data are taken into account, i.e. a shorter test interval will increases the components availability (possibility to e.g. start on demand). The converted O2 model was then used to investigate whether it would be possible to balance longer test intervals for diesel generators, gas turbine generators and high pressure injection system with shorter test intervals for the low pressure injection system, while maintaining a low risk level at the plant. The results show that a new mixture of test intervals can be implemented with only marginally changes in the risk calculated with the risk monitor model. The results indicate that the total number of test activities for the systems included in the pilot study could be reduced by 20% with a maintained level of risk. A risk monitor taking into account the impact from test intervals in availability calculations for components is well suited for evaluation of test interval strategies. It also enables the analyst to evaluate the risk level over a period of time including the impact the actual status of the plant may have on the risk level. (author)

Post-encoding emotional arousal enhances consolidation of item memory, but not reality-monitoring source memory.

Science.gov (United States)

Wang, Bo; Sun, Bukuan

2017-03-01

The current study examined whether the effect of post-encoding emotional arousal on item memory extends to reality-monitoring source memory and, if so, whether the effect depends on emotionality of learning stimuli and testing format. In Experiment 1, participants encoded neutral words and imagined or viewed their corresponding object pictures. Then they watched a neutral, positive, or negative video. The 24-hour delayed test showed that emotional arousal had little effect on both item memory and reality-monitoring source memory. Experiment 2 was similar except that participants encoded neutral, positive, and negative words and imagined or viewed their corresponding object pictures. The results showed that positive and negative emotional arousal induced after encoding enhanced consolidation of item memory, but not reality-monitoring source memory, regardless of emotionality of learning stimuli. Experiment 3, identical to Experiment 2 except that participants were tested only on source memory for all the encoded items, still showed that post-encoding emotional arousal had little effect on consolidation of reality-monitoring source memory. Taken together, regardless of emotionality of learning stimuli and regardless of testing format of source memory (conjunction test vs. independent test), the facilitatory effect of post-encoding emotional arousal on item memory does not generalize to reality-monitoring source memory.

Rational risk-based decision support for drinking water well managers by optimized monitoring designs

Science.gov (United States)

Enzenhöfer, R.; Geiges, A.; Nowak, W.

2011-12-01

Advection-based well-head protection zones are commonly used to manage the contamination risk of drinking water wells. Considering the insufficient knowledge about hazards and transport properties within the catchment, current Water Safety Plans recommend that catchment managers and stakeholders know, control and monitor all possible hazards within the catchments and perform rational risk-based decisions. Our goal is to supply catchment managers with the required probabilistic risk information, and to generate tools that allow for optimal and rational allocation of resources between improved monitoring versus extended safety margins and risk mitigation measures. To support risk managers with the indispensable information, we address the epistemic uncertainty of advective-dispersive solute transport and well vulnerability (Enzenhoefer et al., 2011) within a stochastic simulation framework. Our framework can separate between uncertainty of contaminant location and actual dilution of peak concentrations by resolving heterogeneity with high-resolution Monte-Carlo simulation. To keep computational costs low, we solve the reverse temporal moment transport equation. Only in post-processing, we recover the time-dependent solute breakthrough curves and the deduced well vulnerability criteria from temporal moments by non-linear optimization. Our first step towards optimal risk management is optimal positioning of sampling locations and optimal choice of data types to reduce best the epistemic prediction uncertainty for well-head delineation, using the cross-bred Likelihood Uncertainty Estimator (CLUE, Leube et al., 2011) for optimal sampling design. Better monitoring leads to more reliable and realistic protection zones and thus helps catchment managers to better justify smaller, yet conservative safety margins. In order to allow an optimal choice in sampling strategies, we compare the trade-off in monitoring versus the delineation costs by accounting for ill

Assessment of the effectiveness of the post-Fukushima food monitoring campaign in the first year after the nuclear accident: A hypothesis

International Nuclear Information System (INIS)

Steinhauser, Georg

2016-01-01

The purpose of this study was to assess whether or not the food monitoring campaign after the Fukushima nuclear accident has been successful in reducing the number of above-limit-food from reaching the consumers. The hypothesis of this study is that the fraction of “post-market” food can be used for this purpose, when the post-market fraction in the above-limit (p′) items is compared to the post-market fraction in the entity of food items (p) that have been screened for radionuclides ("1"3"4Cs and "1"3"7Cs). Indeed the post-market fraction in most vegetarian produce decreased significantly in the above-limit food items (p′/p   1), indicating a much lower effectiveness of the monitoring action for beef. The author speculates that, by following the governmental monitoring manual (which gives “meat” only second priority), the sudden exceedances caught the monitoring agencies unprepared and triggered a much higher density monitoring of beef with the delay of several weeks. Even then, many above limit items reached the market (mainly because the monitoring during this period had focused on the post-market). Therefore, it is likely that some above-limit beef has been consumed by the public. For other meat products, the fraction of post-market samples was very low, which does not allow for the validation of the effectiveness of the monitoring campaign. Overall, the monitoring seemed to have been more effective for vegetarian produce than for meat. - Highlights: • The fraction of post-market food above the regulatory indicates the effectiveness of the monitoring campaign. • Monitoring of vegetables has been more effective than of meat. • Beef had the highest fraction of exceedances in the post-market fraction.

The future of monitoring in clinical research - a holistic approach: linking risk-based monitoring with quality management principles.

Science.gov (United States)

Ansmann, Eva B; Hecht, Arthur; Henn, Doris K; Leptien, Sabine; Stelzer, Hans Günther

2013-01-01

Since several years risk-based monitoring is the new "magic bullet" for improvement in clinical research. Lots of authors in clinical research ranging from industry and academia to authorities are keen on demonstrating better monitoring-efficiency by reducing monitoring visits, monitoring time on site, monitoring costs and so on, always arguing with the use of risk-based monitoring principles. Mostly forgotten is the fact, that the use of risk-based monitoring is only adequate if all mandatory prerequisites at site and for the monitor and the sponsor are fulfilled.Based on the relevant chapter in ICH GCP (International Conference on Harmonisation of technical requirements for registration of pharmaceuticals for human use - Good Clinical Practice) this publication takes a holistic approach by identifying and describing the requirements for future monitoring and the use of risk-based monitoring. As the authors are operational managers as well as QA (Quality Assurance) experts, both aspects are represented to come up with efficient and qualitative ways of future monitoring according to ICH GCP.

VIDEOR: cultural heritage risk assessment and monitoring on the Web

Science.gov (United States)

Monteleone, Antonio; Dore, Nicole; Giovagnoli, Annamaria; Cacace, C.

2016-08-01

Cultural heritage is constantly threatened by several factors, such as anthropic activities (e.g. urbanization, pollution) and natural events (e.g. landslides, subsidence) that compromise cultural assets conservation and integrity over time. Italy is the country with the highest number of UNESCO cultural and natural World Heritage sites (51) containing both monuments and archaeological assets of global significance that need to be preserved for future generations, as declared and requested both by UNESCO and the European Commission. VIDEOR, the first web-service completely dedicated to cultural heritage, arises as support tool to institutions and organisations responsible of CH safeguard, with the goal to guarantee a constant and continuous monitoring of cultural assets considered to be at risk. Thanks to its services, VIDEOR allows a periodic situation evaluation, performed with the use of satellite remote sensing data (both optical and SAR) and aerial platform remote sensing data (UAVs), these last used when satellites identify a critical situation that requires deeper analyses. This constant and periodic monitoring will allow not only always updated information about the asset health status, but also early warnings launched by the operative center (NAIS) directly to experts of the responsible institutions (ISCR) after risk identification. The launch of early warnings will be essential for triggering promptly activities of preventive restoration, a less expensive way of intervention if compared to the post-event restoration, both in economic terms and in terms of historical preservation of a country.

A risk-adjusted O-E CUSUM with monitoring bands for monitoring medical outcomes.

Science.gov (United States)

Sun, Rena Jie; Kalbfleisch, John D

2013-03-01

In order to monitor a medical center's survival outcomes using simple plots, we introduce a risk-adjusted Observed-Expected (O-E) Cumulative SUM (CUSUM) along with monitoring bands as decision criterion.The proposed monitoring bands can be used in place of a more traditional but complicated V-shaped mask or the simultaneous use of two one-sided CUSUMs. The resulting plot is designed to simultaneously monitor for failure time outcomes that are "worse than expected" or "better than expected." The slopes of the O-E CUSUM provide direct estimates of the relative risk (as compared to a standard or expected failure rate) for the data being monitored. Appropriate rejection regions are obtained by controlling the false alarm rate (type I error) over a period of given length. Simulation studies are conducted to illustrate the performance of the proposed method. A case study is carried out for 58 liver transplant centers. The use of CUSUM methods for quality improvement is stressed. Copyright © 2013, The International Biometric Society.

Barriers and post-closure monitoring (AL121125)

International Nuclear Information System (INIS)

Bostick, K.V.; Janecky, D.

1995-01-01

This project focuses on the rapid implementation of near-surface barriers, biotreatment, and post-closure monitoring technology. It uses water-permeable and biologic barriers that chemically capture and/or degrade contaminants without significantly altering the natural water flow regime. Barrier approaches are being tested for two different applications. The first is the use of barriers for confinement of chemical contaminants for in-trench treatments with leach systems or an in-place bioreactor. The second is an enhancement of the current practice of emplacing grout or clay slurry walls into direct horizontal surface and subsurface water flows around a contaminated area by integrating permeable reactive barriers and petroleum reservoir gel/foam/polymer technology

Risk Monitoring through Traceability Information Model

OpenAIRE

Juan P. Zamora; Wilson Adarme; Laura Palacios

2012-01-01

This paper shows a traceability framework for supply risk monitoring, beginning with the identification, analysis, and evaluation of the supply chain risk and focusing on the supply operations of the Health Care Institutions with oncology services in Bogota, Colombia. It includes a brief presentation of the state of the art of the Supply Chain Risk Management and traceability systems in logistics operations, and it concludes with the methodology to integrate the SCRM model with the traceabili...

Comparison of recreational health risks associated with surfing and swimming in dry weather and post-storm conditions at Southern California beaches using quantitative microbial risk assessment (QMRA).

Science.gov (United States)

Tseng, Linda Y; Jiang, Sunny C

2012-05-01

Southern California is an increasingly urbanized hotspot for surfing, thus it is of great interest to assess the human illness risks associated with this popular ocean recreational water sport from exposure to fecal bacteria contaminated coastal waters. Quantitative microbial risk assessments were applied to eight popular Southern California beaches using readily available enterococcus and fecal coliform data and dose-response models to compare health risks associated with surfing during dry weather and storm conditions. The results showed that the level of gastrointestinal illness risks from surfing post-storm events was elevated, with the probability of exceeding the US EPA health risk guideline up to 28% of the time. The surfing risk was also elevated in comparison with swimming at the same beach due to ingestion of greater volume of water. The study suggests that refinement of dose-response model, improving monitoring practice and better surfer behavior surveillance will improve the risk estimation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Risk factors in pregnancy for post-traumatic stress and depression after childbirth.

Science.gov (United States)

Söderquist, J; Wijma, B; Thorbert, G; Wijma, K

2009-04-01

The objective of this study was to find risk factors in pregnancy for post-traumatic stress and depression 1 month after childbirth. Furthermore, the relation between post-traumatic stress and depression was explored. A prospective longitudinal study. Pregnant women in Linköping and Kalmar, Sweden. A total of 1224 women were assessed in pregnancy, week 12-20 and 32, as well as 1 month postpartum. Post-traumatic stress and depression after delivery were assessed 1 month postpartum. Potential risk factors were assessed in early and late pregnancy. Variables measured during pregnancy were trait anxiety, depression, fear of childbirth, childbirth-related traumatic stress, stress coping capacity, social support, parity, educational level, age, gestation week, parity, educational level, civil status, previous psychological/psychiatric counselling, and previous experience of any traumatic events. Delivery mode was assessed from the medical records. Prevalence of post-traumatic stress (criteria A, B, C, D, E, and F according to DSM-IV) and depression (Beck's depression inventory). One month postpartum, 12 (1.3%) women had post-traumatic stress (met symptom criteria B, C, and D for post-traumatic stress disorder according to Diagnostic and statistical manual of mental disorders, 4th edition [DSM-IV]). The most important risk factors in pregnancy were depression in early pregnancy (OR=16.3), severe fear of childbirth (OR=6.2), and 'pre'-traumatic stress (in view of the forthcoming delivery) in late pregnancy (OR=12.5). The prevalence of depression was 5.6%. Post-traumatic stress and depression were positively related 1 month postpartum and were predicted by mainly the same factors. Risk factors for post-traumatic stress and depression after childbirth can be assessed in early pregnancy. Post-traumatic stress and depression also seem to share the same underlying vulnerability factors.

Risk and Outbreak Communication: Lessons from Taiwan's Experiences in the Post-SARS Era.

Science.gov (United States)

Hsu, Yu-Chen; Chen, Yu-Ling; Wei, Han-Ning; Yang, Yu-Wen; Chen, Ying-Hwei

In addition to the impact of a disease itself, public reaction could be considered another outbreak to be controlled during an epidemic. Taiwan's experience with SARS in 2003 highlighted the critical role played by the media during crisis communication. After the SARS outbreak, Taiwan's Centers for Disease Control (Taiwan CDC) followed the WHO outbreak communication guidelines on trust, early announcements, transparency, informing the public, and planning, in order to reform its risk communication systems. This article describes the risk communication framework in Taiwan, which has been used to respond to the 2009-2016 influenza epidemics, Ebola in West Africa (2014-16), and MERS-CoV in South Korea (2015) during the post-SARS era. Many communication strategies, ranging from traditional media to social and new media, have been implemented to improve transparency in public communication and promote civic engagement. Taiwan CDC will continue to maintain the strengths of its risk communication systems and resolve challenges as they emerge through active evaluation and monitoring of public opinion to advance Taiwan's capacity in outbreak communication and control. Moreover, Taiwan CDC will continue to implement the IHR (2005) and to promote a global community working together to fight shared risks and to reach the goal of "One World, One Health."

Architecture and design of third Qinshan nuclear power plant risk monitor

Energy Technology Data Exchange (ETDEWEB)

Wang, F.; Li, Y.; Wang, J.; Wang, J.; Hu, L. [Inst. of Nuclear Energy Safety Technology, Chinese Academy of Sciences, Hefei, Anhui, 230031 (China); School of Nuclear Science and Technology, Univ. of Science and Technology of China, No.350 Shushanhu Road, Shushan District, Hefei, Anhui, 230031 (China)

2012-07-01

Risk monitor is a real-time analysis tool to determine the point-in-time risk based on actual plant configuration, which is an important application of PSA (Probabilistic Safety Assessment). In this study the status and development trend of risk monitor were investigated and a risk monitor named TQRM (Third Qinshan nuclear power plant Risk Monitor) was developed. The B/S architecture and the two key computing methods pre-solved and resolving PSA model method adopted in TQRM were introduced. The functions and technical features were also presented. Now TQRM has been on-line for more than one year and used in the operation and maintenance of TQNPP. The experience demonstrates that TQRM's results are accurate and real-time, the architecture is stable, and it could be extended and maintained conveniently for any other Risk-Informed Application. (authors)

In-hospital risk prediction for post-stroke depression: development and validation of the Post-stroke Depression Prediction Scale.

Science.gov (United States)

de Man-van Ginkel, Janneke M; Hafsteinsdóttir, Thóra B; Lindeman, Eline; Ettema, Roelof G A; Grobbee, Diederick E; Schuurmans, Marieke J

2013-09-01

The timely detection of post-stroke depression is complicated by a decreasing length of hospital stay. Therefore, the Post-stroke Depression Prediction Scale was developed and validated. The Post-stroke Depression Prediction Scale is a clinical prediction model for the early identification of stroke patients at increased risk for post-stroke depression. The study included 410 consecutive stroke patients who were able to communicate adequately. Predictors were collected within the first week after stroke. Between 6 to 8 weeks after stroke, major depressive disorder was diagnosed using the Composite International Diagnostic Interview. Multivariable logistic regression models were fitted. A bootstrap-backward selection process resulted in a reduced model. Performance of the model was expressed by discrimination, calibration, and accuracy. The model included a medical history of depression or other psychiatric disorders, hypertension, angina pectoris, and the Barthel Index item dressing. The model had acceptable discrimination, based on an area under the receiver operating characteristic curve of 0.78 (0.72-0.85), and calibration (P value of the U-statistic, 0.96). Transforming the model to an easy-to-use risk-assessment table, the lowest risk category (sum score, depression, which increased to 82% in the highest category (sum score, >21). The clinical prediction model enables clinicians to estimate the degree of the depression risk for an individual patient within the first week after stroke.

Associations of contextual risk and protective factors with fathers’ parenting practices in the post-deployment environment

Science.gov (United States)

Davis, Laurel; Hanson, Sheila K.; Zamir, Osnat; Gewirtz, Abigail H.; DeGarmo, David S.

2015-01-01

Deployment separation and reunifications are salient contexts that directly impact effective family functioning and parenting for military fathers. Yet, we know very little about determinants of post-deployed father involvement and effective parenting. The present study examined hypothesized risk and protective factors of observed parenting for 282 post-deployed fathers who served in the Army National Guard/Reserves. Pre-intervention data were employed from fathers participating in the After Deployment, Adaptive Parenting Tools (ADAPT) randomized control trial. Parenting practices were obtained from direct observation of father-child interaction and included measures of problem solving, harsh discipline, positive involvement, encouragement, and monitoring. Risk factors included combat exposure, negative life events, months deployed, and PTSD symptoms. Protective factors included education, income, dyadic adjustment, and social support. Results of a structural equation model predicting an effective parenting construct indicated that months deployed, income, and father age were most related to observed parenting, explaining 16% of the variance. We are aware of no other study utilizing direct parent-child observations of father’s parenting skills following overseas deployment. Implications for practice and preventive intervention are discussed. PMID:26213794

Monitoring post

DEFF Research Database (Denmark)

Hansen, Pelle Guldborg; Jespersen, Andreas Maaløe

2013-01-01

This blog reports on the rumour that White House considers establishing a nudge unit similar to the UK Behavioural Insights Team. Given The Nudging Networks purpose and the work of the iNudgeYou-team this post is updated continuously to follow the US debate as it unfolds. Which issues are raised...

Pre- and post-transplant monitoring of soluble CD30 levels as predictor of acute renal allograft rejection.

Science.gov (United States)

Wang, Dong; Wu, Guo-Jun; Wu, Wei-Zhen; Yang, Shun-Liang; Chen, Jin-Hua; Wang, He; Lin, Wen-Hong; Wang, Qing-Hua; Zeng, Zhang-Xin; Tan, Jian-Ming

2007-06-01

Identification of renal graft candidates at high risk of impending acute rejection (AR) and graft loss may be helpful for patient-tailored immunosuppressive regimens and renal graft survival. To investigate the feasibility with soluble CD30 (sCD30) as predictor of AR, sCD30 levels of 70 patients were detected on day 0 pre-transplant and day 1, 3, 5, 7, 10, 14, 21, and 30 post-transplant. AR episodes in 6 months were recorded and then patients were divided into Group AR (n=11) and Group UC (n=59). Results showed that the patients had higher pre-transplant sCD30 levels than healthy people. A significant decrease of sCD30 was observed on the first day post-transplant and continued until day 14 post-transplant. Soluble CD30 presented a stable level from day 14 to 30 post-transplant. Pre-transplant sCD30 levels of Group AR were much higher than those of Group UC (PsCD30 levels than those of Group UC on day 1, 3, 5, 7, 10 and 14 (PsCD30 level presented a significantly delayed decrease in the patients of Group AR. Statistical results showed that the highest value of area under ROC curve (0.95) was obtained on day 5 post-transplant, suggesting that sCD30 levels on day 5 are of high predictive value. Therefore, sCD30 level may be a good marker of increased alloreactivity and of significant predictive value. It's necessary to monitor the variation of sCD30 in the early period post-transplant.

A Risk-Based Multi-Objective Optimization Concept for Early-Warning Monitoring Networks

Science.gov (United States)

Bode, F.; Loschko, M.; Nowak, W.

2014-12-01

Groundwater is a resource for drinking water and hence needs to be protected from contaminations. However, many well catchments include an inventory of known and unknown risk sources which cannot be eliminated, especially in urban regions. As matter of risk control, all these risk sources should be monitored. A one-to-one monitoring situation for each risk source would lead to a cost explosion and is even impossible for unknown risk sources. However, smart optimization concepts could help to find promising low-cost monitoring network designs.In this work we develop a concept to plan monitoring networks using multi-objective optimization. Our considered objectives are to maximize the probability of detecting all contaminations and the early warning time and to minimize the installation and operating costs of the monitoring network. A qualitative risk ranking is used to prioritize the known risk sources for monitoring. The unknown risk sources can neither be located nor ranked. Instead, we represent them by a virtual line of risk sources surrounding the production well.We classify risk sources into four different categories: severe, medium and tolerable for known risk sources and an extra category for the unknown ones. With that, early warning time and detection probability become individual objectives for each risk class. Thus, decision makers can identify monitoring networks which are valid for controlling the top risk sources, and evaluate the capabilities (or search for least-cost upgrade) to also cover moderate, tolerable and unknown risk sources. Monitoring networks which are valid for the remaining risk also cover all other risk sources but the early-warning time suffers.The data provided for the optimization algorithm are calculated in a preprocessing step by a flow and transport model. Uncertainties due to hydro(geo)logical phenomena are taken into account by Monte-Carlo simulations. To avoid numerical dispersion during the transport simulations we use the

Post-deportation risks for failed asylum seekers

Directory of Open Access Journals (Sweden)

Jill Alpes

2017-02-01

Full Text Available What happens to people who are deported after their asylum applications have failed? Many who are deported are at risk of harm when they return to their country of origin but there is little monitoring done of deportation outcomes.

Mare Risk Analysis monitor

International Nuclear Information System (INIS)

Fuente Prieto, I.; Alonso, P.; Carretero Fernandino, J. A.

2000-01-01

The Nuclear Safety Council's requirement that Spanish power plants comply with the requirements of the Maintenance Rule associated with plant risk assessment during power operation, arising from the partial unavailability of systems due to the maintenance activities, has led to need for additional tools to facilitate compliance with said requirements. While the impact on risk produced by individual equipment unavailabilities can easily be evaluated, either qualitatively or quantitatively, the process becomes more complicated when un programmed unavailabilities simultaneously occur in various systems, making it necessary to evaluate their functional impact. It is especially complex in the case of support systems that can affect the functionality of multiple systems. In view of the above, a computer application has been developed that is capable of providing the operator with quick answers based on the specific plant model in order to allow fast risk assessment using the information compiled as part of the Probabilistic Safety Analysis. The paper describes the most important characteristics of this application and the basic design requirements of the MARE Risk Monitor. (Author)

Defending Democracy: Citizen Participation in Election Monitoring in Post-Authoritarian Indonesia

Directory of Open Access Journals (Sweden)

Dini Suryani

2015-02-01

Full Text Available The collapse of the authoritarian regime in 1998 has made Indonesia as one of the most democratic country in Southeast Asia. To ensure the quality of democracy, in particular electoral democracy, supervision and monitoring of elections has a veryimportant role. Although the Badan Pengawas Pemilu (Bawaslu or Election Supervisory Body of Indonesiahas experienced institutional strengthening, this institution has not yet become effective in supervisingand monitoring the elections. Therefore, electionmonitoring conducted by non-state agencies, particularly the citizens become important to complement the performance of Bawaslu. This article aimsto explore how the election monitoring conducted by citizens in the aftermath of post authoritarian era,affect the quality of Indonesian democracy. This article argues that although the citizen participation in monitoring the elections is likely to decline, but thecrowd sourced method that appeared in the 2014election has succeeded in improving the quality of the electoral process as well as defending the democratic regime in Indonesia.

Risk to life due to flooding in post-Katrina New Orleans

Science.gov (United States)

Miller, A.; Jonkman, S. N.; Van Ledden, M.

2015-01-01

Since the catastrophic flooding of New Orleans due to Hurricane Katrina in 2005, the city's hurricane protection system has been improved to provide protection against a hurricane load with a 1/100 per year exceedance frequency. This paper investigates the risk to life in post-Katrina New Orleans. In a flood risk analysis the probabilities and consequences of various flood scenarios have been analyzed for the central area of the city (the metro bowl) to give a preliminary estimate of the risk to life in the post-Katrina situation. A two-dimensional hydrodynamic model has been used to simulate flood characteristics of various breaches. The model for estimation of fatality rates is based on the loss of life data for Hurricane Katrina. Results indicate that - depending on the flood scenario - the estimated loss of life in case of flooding ranges from about 100 to nearly 500, with the highest life loss due to breaching of the river levees leading to large flood depths. The probability and consequence estimates are combined to determine the individual risk and societal risk for New Orleans. When compared to risks of other large-scale engineering systems (e.g., other flood prone areas, dams and the nuclear sector) and acceptable risk criteria found in literature, the risks for the metro bowl are found to be relatively high. Thus, despite major improvements to the flood protection system, the flood risk to life of post-Katrina New Orleans is still expected to be significant. Indicative effects of reduction strategies on the risk level are discussed as a basis for further evaluation and discussion.

POST-LAUNCHING MONITORING ACTIVITIES FOR NEW TRANSACTIONAL BANKING PRODUCTS ADDRESSED TO SMES (CONSIDERATIONS

Directory of Open Access Journals (Sweden)

Giuca Simona-Mihaela

2014-07-01

Full Text Available The current paper has the aim to provide guidelines for post-launching monitoring activities and steps related to new transactional banking products addressed to SMEs. While the pre-launching activities have the purpose of accurately defining the objectives, assumptions and estimations, the purpose of the post-launching plan is to identify: if the final objectives of a product launching have been met, on one hand, to analyze results in the sense of identifying an efficient action plan in order to overcome the lack of results (if case, but most important, to identify opportunities for optimizing the products and for communicating properly the value proposition. This paper also presents schemes for monitoring the results from a business case and for motivating the sales force, as an essential step in increasing the sales. Therefore, alternatives of incentive campaigns are presented, as sustainable campaigns with to purpose to achieve an expected success rate. As an additional support guideline for the sales force, some scenarios and post-sales actions are presented, together with an example of portfolio analysis considering potential per client. Considering the methods and details presented in the current paper, one can identify the importance and find out how to monitor the results after launching a new transactional product addressed to SMEs, can understand and design an incentive scheme and also define actions to be taken in order to increase revenues from a newly launched transactional product.

An Ethical Justification for Expanding the Notion of Effectiveness in Vaccine Post-Market Monitoring: Insights from the HPV Vaccine in Canada.

Science.gov (United States)

Komparic, Ana; Smith, Maxwell J; Thompson, Alison

2016-04-01

Health regulators must carefully monitor the real-world safety and effectiveness of marketed vaccines through post-market monitoring in order to protect the public's health and promote those vaccines that best achieve public health goals. Yet, despite the fact that vaccines used in collective immunization programmes should be assessed in the context of a public health response, post-market effectiveness monitoring is often limited to assessing immunogenicity or limited programmatic features, rather than assessing effectiveness across populations. We argue that post-market monitoring ought to be expanded in two ways to reflect a 'public health notion of post-market effectiveness', which incorporates normative public health considerations: (i) effectiveness monitoring should yield higher quality data and grant special attention to underrepresented and vulnerable populations; and (ii) the scope of effectiveness should be expanded to include a consideration of the various social factors that maximize (and minimize) a vaccine's effectiveness at the population level, paying particular attention to how immunization programmes impact related health gradients. We use the case of the human papillomavirus vaccine in Canada to elucidate how expanding post-market effectiveness monitoring is necessary to close the gap between clinical practice and public health, and to ensure that vaccines are effective in a morally relevant sense.

Initiating Events Modeling for On-Line Risk Monitoring Application

International Nuclear Information System (INIS)

Simic, Z.; Mikulicic, V.

1998-01-01

In order to make on-line risk monitoring application of Probabilistic Risk Assessment more complete and realistic, a special attention need to be dedicated to initiating events modeling. Two different issues are of special importance: one is how to model initiating events frequency according to current plant configuration (equipment alignment and out of service status) and operating condition (weather and various activities), and the second is how to preserve dependencies between initiating events model and rest of PRA model. First, the paper will discuss how initiating events can be treated in on-line risk monitoring application. Second, practical example of initiating events modeling in EPRI's Equipment Out of Service on-line monitoring tool will be presented. Gains from application and possible improvements will be discussed in conclusion. (author)

Monitoring post-fire vegetation rehabilitation projects: A common approach for non-forested ecosystems

Science.gov (United States)

Wirth, Troy A.; Pyke, David A.

2007-01-01

Emergency Stabilization and Rehabilitation (ES&R) and Burned Area Emergency Response (BAER) treatments are short-term, high-intensity treatments designed to mitigate the adverse effects of wildfire on public lands. The federal government expends significant resources implementing ES&R and BAER treatments after wildfires; however, recent reviews have found that existing data from monitoring and research are insufficient to evaluate the effects of these activities. The purpose of this report is to: (1) document what monitoring methods are generally used by personnel in the field; (2) describe approaches and methods for post-fire vegetation and soil monitoring documented in agency manuals; (3) determine the common elements of monitoring programs recommended in these manuals; and (4) describe a common monitoring approach to determine the effectiveness of future ES&R and BAER treatments in non-forested regions. Both qualitative and quantitative methods to measure effectiveness of ES&R treatments are used by federal land management agencies. Quantitative methods are used in the field depending on factors such as funding, personnel, and time constraints. There are seven vegetation monitoring manuals produced by the federal government that address monitoring methods for (primarily) vegetation and soil attributes. These methods vary in their objectivity and repeatability. The most repeatable methods are point-intercept, quadrat-based density measurements, gap intercepts, and direct measurement of soil erosion. Additionally, these manuals recommend approaches for designing monitoring programs for the state of ecosystems or the effect of management actions. The elements of a defensible monitoring program applicable to ES&R and BAER projects that most of these manuals have in common are objectives, stratification, control areas, random sampling, data quality, and statistical analysis. The effectiveness of treatments can be determined more accurately if data are gathered using

The applicability of animal health surveillance systems for post-market monitoring of potential adverse effects of genetically modified (GM) feed.

Science.gov (United States)

Vince, L; Kleter, G A; Kostov, K; Pfeiffer, D U; Guitian, J

2018-04-20

A facultative post market monitoring of potential health impacts of genetically modified (GM) feedstuffs on livestock consuming these feeds after pre-market risk assessment is under ongoing consideration. Within the IPAFEED database, scientific studies on health effects beyond performance in livestock and the results of a systematic search for evidence of outcome effects due to GM feed are consolidated. These outcomes were reviewed and checked for consistency in order to identify plausible syndromes suitable for conducting surveillance. The 24 selected studies showed no consistent changes in any health parameter. There were no repeated studies in any species by GM crop type and animal species. As such, there is insufficient evidence to inform the design of surveillance systems for detecting known adverse effects. Animal health surveillance systems have been proposed for the post market monitoring of potential adverse effects in animals. Such systems were evaluated for their applicability to the detection of hypothetical adverse effects and their strengths and weaknesses to detect syndromes of concern are presented. For known adverse effects, applied controlled post-market studies may yield conclusive and high-quality evidence. For detecting unknown adverse effects, the use of existing surveillance systems may still be of interest. A simulation tool developed within the project can be adapted and applied to existing surveillance systems to explore their applicability to the detection of potential adverse effects of GM feed. Copyright © 2018. Published by Elsevier Ltd.

Amchitka Mud Pit Sites 2006 Post-Closure Monitoring and Inspection Report, Amchitka Island, Alaska, Rev. No.: 0

Energy Technology Data Exchange (ETDEWEB)

Matthews, Patrick

2006-09-01

In 2001, the U.S. Department of Energy (DOE), National Nuclear Security Administration (NNSA/NSO) remediated six areas associated with Amchitka mud pit release sites located on Amchitka Island, Alaska. This included the construction of seven closure caps. To ensure the integrity and effectiveness of remedial action, the mud pit sites are to be inspected every five years as part of DOE's long-term monitoring and surveillance program. In August of 2006, the closure caps were inspected in accordance with the ''Post-Closure Monitoring and Inspection Plan for Amchitka Island Mud Pit Release Sites'' (Rev. 0, November 2005). This post-closure monitoring report provides the 2006 cap inspection results.

Risk factors for post-tonsillectomy hemorrhage.

Science.gov (United States)

Ikoma, Ryo; Sakane, Sayaka; Niwa, Kazutomo; Kanetaka, Sayaka; Kawano, Toshiro; Oridate, Nobuhiko

2014-08-01

The aim of the present study was to investigate the rate of post-tonsillectomy hemorrhage (PTH) in a single institution and to evaluate the clinical risk factors for PTH. We reviewed the records of 692 patients who underwent tonsillectomy (TE) at Yokohama Minami Kyosai Hospital in Japan. PTH grades were grouped into three categories according to the severity of the hemorrhagic episode: (I) minimal hemorrhage that stopped after noninvasive treatment, (II) hemorrhage requiring treatment with local anesthesia, and (III) hemorrhage requiring reoperation under general anesthesia in the operating room. Clinical risk factors such as sex, age (adults vs. children), TE indication, surgeon's skill level, operative time, ligature type, and duration of antibiotic administration for PTH were investigated. Among the 692 patients, 80 (11.6%) showed PTH, with primary and secondary hemorrhage accounting for 1.6% and 10.0%, respectively. A category III PTH was observed in 18 patients; thus, the overall risk of reoperation was 2.6%. The PTH episode most frequently occurred on postoperative days 5 and 6. The frequency of PTH was significantly higher in male patients and in adults (Pdefinition of PTH. Clinical risk factors for PTH were adult age and male gender. The surgeon's skill level was an additional risk factor for category III PTH. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Management of bank risks in the system of internal financial monitoring

Directory of Open Access Journals (Sweden)

O.V. Lysenok

2015-09-01

Full Text Available Risk is an integral part of banking activities. That is why there are many researches on definition, measurement and monitoring of banking risks. Nowadays it is important to improve the risk management process of legalization (laundering of proceeds from crime or terrorist financing, especially in the present conditions of socio-economic development. This will improve the quality of financial monitoring in the country as a whole and will reduce the risk of attracting banks to laundering money from crime. The article reviews and examines modern management techniques and risk assessment of laundering proceeds from crime. The authors make suggestions to strengthen the tracking and detection of illegal schemes and appropriate approaches to «launder» criminal money. They also offer an appropriate model to manage the risks which accompany the process of laundering the proceeds from crime. According to the study carried out the authors provide their conclusions and recommendations to improve risk management in the system of internal financial monitoring of banks.

An Overview of Risk Factors Associated to Post-partum Depression in Asia.

Science.gov (United States)

Mehta, Shubham; Mehta, Nidhi

2014-03-04

Post partum depression (PPD) is an important complication of child-bearing. It requires urgent interventions as it can have long-term adverse consequences if ignored, for both mother and child. If PPD has to be prevented by a public health intervention, the recognition and timely identification of its risk factors is must. We in this review have tried to synthesize the results of Asian studies examining the risk factors of PPD. Some risk factors, which are unique to Asian culture, have also been identified and discussed. We emphasize on early identification of these risk factors as most of these are modifiable and this can have significant implications in prevention of emergence of post partum depression, a serious health issue of Asian women.

An overview of risk factors associated to post-partum depression in Asia

Directory of Open Access Journals (Sweden)

Shubham Mehta

2014-03-01

Full Text Available Post partum depression (PPD is an important complication of child-bearing. It requires urgent interventions as it can have long-term adverse consequences if ignored, for both mother and child. If PPD has to be prevented by a public health intervention, the recognition and timely identification of its risk factors is must. We in this review have tried to synthesize the results of Asian studies examining the risk factors of PPD. Some risk factors, which are unique to Asian culture, have also been identified and discussed. We emphasize on early identification of these risk factors as most of these are modifiable and this can have significant implications in prevention of emergence of post partum depression, a serious health issue of Asian women.

A Decade of Monitoring HIV Epidemics in Nigeria: Positioning for Post-2015 Agenda.

Science.gov (United States)

Akinwande, Oluyemisi; Bashorun, Adebobola; Azeez, Aderemi; Agbo, Francis; Dakum, Patrick; Abimiku, Alashle; Bilali, Camara; Idoko, John; Ogungbemi, Kayode

2017-07-01

Nigeria accounts for 9% of the global HIV burden and is a signatory to Millennium Development Goals as well as the post-2015 Sustainable Development Goals. This paper reviews maturation of her HIV M&E system and preparedness for monitoring of the post-2015 agenda. Using the UNAIDS criteria for assessing a functional M&E system, a mixed-methods approach of desk review and expert consultations, was employed. Following adoption of a multi-sectoral M&E system, Nigeria experienced improved HIV coordination at the National and State levels, capacity building for epidemic appraisals, spectrum estimation and routine data quality assessments. National data and systems audit processes were instituted which informed harmonization of tools and indicators. The M&E achievements of the HIV response enhanced performance of the National Health Management Information System (NHMIS) using DHIS2 platform following its re-introduction by the Federal Ministry of Health, and also enabled decentralization of data management to the periphery. A decade of implementing National HIV M&E framework in Nigeria and the recent adoption of the DHIS2 provides a strong base for monitoring the Post 2015 agenda. There is however a need to strengthen inter-sectoral data linkages and reduce the rising burden of data collection at the global level.

Numerical analysis on hydrogen stratification and post-inerting of hydrogen risk

International Nuclear Information System (INIS)

Peng, Cheng; Tong, Lili; Cao, Xuewu

2016-01-01

Highlights: • A three-dimensional computational model was built and the applicability was discussed. • The formation of helium stratification was further studied. • Three influencing factors on the post-inerting of hydrogen risk were analyzed. - Abstract: In the case of severe accidents, the risk of hydrogen explosion threatens the integrity of the nuclear reactor containment. According to nuclear regulations, hydrogen control is required to ensure the safe operation of the nuclear reactor. In this study, the method of Computational Fluid Dynamics (CFD) has been applied to analyze process of hydrogen stratification and the post-inerting of hydrogen risk in the Large-Scale Gas Mixing Facility. A three-dimensional computational model was built and the applicability of different turbulence models was discussed. The result shows that the helium concentration calculated by the standard k–ε turbulence model is closest to the experiment data. Through analyzing the formation of helium stratification at different injection velocities, it is found that when the injection mass flow is constant and the injection velocity of helium increases, the mixture of helium and air is enhanced while there is rarely influence on the formation of helium stratification. In addition, the influences of mass flow rate, injection location and direction and inert gas on the post-inerting of hydrogen risk have been analyzed and the results are as follows: with the increasing of mass flow rate, the mitigation effect of nitrogen on hydrogen risk will be further improved; there is an obvious local difference between the mitigation effects of nitrogen on hydrogen risk in different injection directions and locations; when the inert gas is injected at the same mass flow rate, the mitigation effect of steam on hydrogen risk is better than that of nitrogen. This study can provide technical support for the mitigation of hydrogen risk in the small LWR containment.

78 FR 70046 - Payment System Risk Policy; Daylight Overdraft Posting Rules

Science.gov (United States)

2013-11-22

... FEDERAL RESERVE SYSTEM [Docket No. OP--1471] Payment System Risk Policy; Daylight Overdraft... Reserve Policy on Payment System Risk (PSR policy) to eliminate certain posting rules to conform with... Services Analyst (202- 452-2404), Division of Reserve Bank Operations and Payment Systems. For users of...

Credit Monitoring – a Core of Credit Risk Management: Theory and Experience

Directory of Open Access Journals (Sweden)

Daiva Jurevičienė

2013-11-01

Full Text Available Purpose of the article: Purpose of the article is to identify credit monitoring as a keystone of credit risk management in banks. CRM is widely discussed in scientific literature and in reports of institutions undertaking credit risk or supervisory bodies. However majority of such investigations are based on implementation of numerous quantitative or qualitative methods used for credit risk assessment before granting a loan or for credit portfolio risk management. There is a lack of information or investigations made on estimation of the need of credit monitoring in credit risk management process. Scientific aim: Scientific aim is to structure the early warning signs that reflect the condition of credits. Methodology/methods: The paper is based on analysis and resumption of various scientific and professional articles related to organization of credit process in banks. It combines results of assessments of credit monitoring importance in credit risk management process made by theoretical studies as well as investigation of experts. Findings: Finding of the article is presentation of credit monitoring tools that should be applied for corporate (and individual clients via modification of original credit agreement. Conclusions: (limits, implications etc Conclusion of the article is that credit monitoring is a keystone in credit risk management process. The purpose of credit monitoring is to detect in time possible worsening of the loan and to react (make changes in loan agreement. The simplest tool for credit monitoring is to identify early warning signs in time that could be assorted into four groups: EWS of business environment; EWS with regard to management, EWS regarding collateral, EWS in financial analysis. Limitation of investigation is impossibility of evaluation of importance of monitoring process in practice except investigation of experts (employees directly responsible for credit business.

Drug- and herb-induced liver injury: Progress, current challenges and emerging signals of post-marketing risk.

Science.gov (United States)

Raschi, Emanuel; De Ponti, Fabrizio

2015-07-08

Drug-induced liver injury (DILI) and herb-induced liver injury is a hot topic for clinicians, academia, drug companies and regulators, as shown by the steadily increasing number of publications in the past 15 years. This review will first provide clues for clinicians to suspect idiosyncratic (unpredictable) DILI and succeed in diagnosis. Causality assessment remains challenging and requires careful medical history as well as awareness of multifaceted aspects, especially for herbs. Drug discontinuation and therapy reconciliation remain the mainstay in patent's management to minimize occurrence of acute liver failure. The second section will address novel agents associated with liver injury in 2014 (referred to as "signals"), especially in terms of clinical, research and drug development implications. Insights will be provided into recent trends by highlighting the contribution of different post-marketing data, especially registries and spontaneous reporting systems. This literature scrutiny suggests: (1) the importance of post-marketing databases as tools of clinical evidence to detect signals of DILI risk; and (2) the need for joining efforts in improving predictivity of pre-clinical assays, continuing post-marketing surveillance and design ad hoc post-authorization safety studies. In this context, ongoing European/United States research consortia and novel pharmaco-epidemiological tools (e.g., specialist prescription event monitoring) will support innovation in this field. Direct oral anticoagulants and herbal/dietary supplements appear as key research priorities.

Remote Monitoring of Post-eruption Volcano Environment Based-On Wireless Sensor Network (WSN): The Mount Sinabung Case

Science.gov (United States)

Soeharwinto; Sinulingga, Emerson; Siregar, Baihaqi

2017-01-01

An accurate information can be useful for authorities to make good policies for preventive and mitigation after volcano eruption disaster. Monitoring of environmental parameters of post-eruption volcano provides an important information for authorities. Such monitoring system can be develop using the Wireless Network Sensor technology. Many application has been developed using the Wireless Sensor Network technology, such as floods early warning system, sun radiation mapping, and watershed monitoring. This paper describes the implementation of a remote environment monitoring system of mount Sinabung post-eruption. The system monitor three environmental parameters: soil condition, water quality and air quality (outdoor). Motes equipped with proper sensors, as components of the monitoring system placed in sample locations. The measured value from the sensors periodically sends to data server using 3G/GPRS communication module. The data can be downloaded by the user for further analysis.The measurement and data analysis results generally indicate that the environmental parameters in the range of normal/standard condition. The sample locations are safe for living and suitable for cultivation, but awareness is strictly required due to the uncertainty of Sinabung status.

Chronic Post Inguinal Herniorraphy Pain: Prevalence and Risk Factors

African Journals Online (AJOL)

Background: Inguinal hernia is a common surgical condition. Whereas complications associated with hernia repair are well documented, chronic postoperative groin pain has received less attention. Objective: To review the frequency and associated risk factors for chronic post herniorrhaphy groin pain at a tertiary urban ...

Online application of a risk management system for risk assessment and monitoring at NPPs

Energy Technology Data Exchange (ETDEWEB)

Yang, Jun, E-mail: youngjun51@hotmail.com [Key Laboratory of Fundamental Science on Nuclear Safety and Simulation Technology, Harbin Engineering University (China); Yang, Ming, E-mail: yangming@hrbeu.edu.cn [Key Laboratory of Fundamental Science on Nuclear Safety and Simulation Technology, Harbin Engineering University (China); Wang, Wenlin, E-mail: wlwang0618@126.com [Key Laboratory of Fundamental Science on Nuclear Safety and Simulation Technology, Harbin Engineering University (China); Li, Fengjun, E-mail: leefengjun@163.com [China Nuclear Power Engineering Co. Ltd (China)

2016-08-15

Highlights: • A generic GO-FLOW modeling structure is proposed for easily Living PSA development and analysis. • Hierarchical and modularized scheme is applied in the development of Living PSA models and database. • A risk management system is developed by GO-FLOW method. • Functional testing is conducted on the risk management system for performance evaluation. • The fast solution time derived from Living PSA application is supportive in plant safety management. - Abstract: The paper presents a risk management system on the basis of Living PSA models which are developed under a proposed generic GO-FLOW modeling method with a hierarchical and modular structure. The design of the risk management system is aiming at assisting plant personnel to manage maintenance plan and system configuration, and conduct system reliability monitoring, risk monitoring and risk management quickly and conveniently through graphical user interfaces without going deep into the details of building, updating and analyzing reliability and risk models. The performance of the proposed risk management system was tested on a full-scale simulator of PWR nuclear power plant and demonstrated that the fast solution time derived from utilization of hierarchical and modularized Living PSA models is strongly supportive for instantaneous risk assessment as well as for daily risk management at NPPs.

Annual report, RCRA post-closure monitoring and inspections for the mercury landfill hazardous waste trenches for the period October 1995--October 1996

Energy Technology Data Exchange (ETDEWEB)

Emer, D.F.; Smith, J.L.

1997-01-01

The Area 23 Hazardous Waste Trenches were closed in-place in September 1993. Post-closure monitoring of the Area 23 Hazardous Waste Trenches began in October 1993. The post-closure monitoring program is used to verify that the Area 23 Hazardous Waste Trench covers are performing properly, and that there is no water infiltrating into the waste trenches. The performance of the Area 23 Hazardous Waste Trenches is currently monitored using 30 neutron access tubes positioned on and along the margins of the covers. Soil moisture measurements are obtained in the soils directly beneath the trenches and compared to baseline conditions from the first year of post-closure operation. This report documents the post-closure activities between October 1995 and October 1996.

Annual report, RCRA post-closure monitoring and inspections for the mercury landfill hazardous waste trenches for the period October 1995--October 1996

International Nuclear Information System (INIS)

Emer, D.F.; Smith, J.L.

1997-01-01

The Area 23 Hazardous Waste Trenches were closed in-place in September 1993. Post-closure monitoring of the Area 23 Hazardous Waste Trenches began in October 1993. The post-closure monitoring program is used to verify that the Area 23 Hazardous Waste Trench covers are performing properly, and that there is no water infiltrating into the waste trenches. The performance of the Area 23 Hazardous Waste Trenches is currently monitored using 30 neutron access tubes positioned on and along the margins of the covers. Soil moisture measurements are obtained in the soils directly beneath the trenches and compared to baseline conditions from the first year of post-closure operation. This report documents the post-closure activities between October 1995 and October 1996

Minimally traumatic stapes surgery for otosclerosis: Risk reduction of post-operative vertigo

Directory of Open Access Journals (Sweden)

An-Suey Shiao

2018-06-01

Full Text Available Background: The author (Dr. Shiao modified traditional stapes surgery (TSS specifically for patients with otosclerosis. The proposed technique, referred to as minimally traumatic stapes surgery (MTSS, reduces the risk of subjective discomfort (i.e. vertigo and tinnitus following surgery. This paper compares the effectiveness of MTSS with that of TSS. Methods: The medical records of patients with otosclerosis after stapes surgery (TSS or MTSS were analyzed. Outcome variables included post-operative vertigo, tinnitus, and hearing success. Multivariate logistic regression analysis was used to determine the correlation between surgical technique and outcome variables. Results: TSS was performed in 23 otosclerosis ears and MTSS was performed in 33 otosclerosis ears. The risk of post-operative vertigo was significantly lower among patients that underwent MTSS (27% than among those that underwent TSS (83%, p < 0.001. No differences in the incidence of tinnitus were observed between the two groups. Post-operative audiometric outcomes were also equivalent between the two groups. However, multivariate logistic regression analysis revealed a correlation between post-operative vertigo and surgical technique (p < 0.001. Conclusion: MTSS involves a lower risk of vertigo than does TSS. MTSS helps to prevent damage to the footplate, thereby reducing the risk of footplate floating. Therefore, MTSS provides a means to overcome some of the limitations associated with the narrow surgical field in Asian patients. Keywords: Footplate floating, Minimally traumatic, Otosclerosis, Stapes surgery, Vertigo

Acute lung injury complicating blood transfusion in post-partum hemorrhage: incidence and risk factors.

Science.gov (United States)

Teofili, Luciana; Bianchi, Maria; Zanfini, Bruno A; Catarci, Stefano; Sicuranza, Rossella; Spartano, Serena; Zini, Gina; Draisci, Gaetano

2014-01-01

We retrospectively investigated the incidence and risk factors for transfusion-related acute lung injury (TRALI) among patients transfused for post-partum hemorrhage (PPH). We identified a series of 71 consecutive patients with PPH requiring the urgent transfusion of three or more red blood cell (RBC) units, with or without transfusion of fresh frozen plasma (FFP) and/or platelets (PLT). Clinical records were then retrieved and examined for respiratory distress events. According to the 2004 consensus definition, cases of new-onset hypoxemia, within 6 hours after transfusion, with bilateral pulmonary changes, in the absence of cardiogenic pulmonary edema were identified as TRALI. If an alternative risk factor for acute lung injury was present, possible TRALI was diagnosed. Thirteen cases of TRALI and 1 case of possible TRALI were identified (overall incidence 19.7%). At univariate analysis, patients with TRALI received higher number of RBC, PLT and FFP units and had a longer postpartum hospitalization. Among the diseases occurring in pregnancy- and various pre-existing comorbidities, only gestational hypertension and pre-eclampsia, significantly increased the risk to develop TRALI (p = 0.006). At multivariate analysis including both transfusion- and patient-related risk factors, pregnancy-related, hypertensive disorders were confirmed to be the only predictors for TRALI, with an odds ratio of 27.7 ( 95% CI 1.27-604.3, p=0.034). Patients suffering from PPH represent a high-risk population for TRALI. The patients with gestational hypertension and pre-eclampsia, not receiving anti-hypertensive therapy, have the highest risk. Therefore, a careful monitoring of these patients after transfusions is recommended.

Generating evidence on a risk-based monitoring approach in the academic setting – lessons learned

Directory of Open Access Journals (Sweden)

Belinda von Niederhäusern

2017-02-01

Full Text Available Abstract Background In spite of efforts to employ risk-based strategies to increase monitoring efficiency in the academic setting, empirical evidence on their effectiveness remains sparse. This mixed-methods study aimed to evaluate the risk-based on-site monitoring approach currently followed at our academic institution. Methods We selected all studies monitored by the Clinical Trial Unit (CTU according to Risk ADApted MONitoring (ADAMON at the University Hospital Basel, Switzerland, between 01.01.2012 and 31.12.2014. We extracted study characteristics and monitoring information from the CTU Enterprise Resource Management system and from monitoring reports of all selected studies. We summarized the data descriptively. Additionally, we conducted semi-structured interviews with the three current CTU monitors. Results During the observation period, a total of 214 monitoring visits were conducted in 43 studies resulting in 2961 documented monitoring findings. Our risk-based approach predominantly identified administrative (46.2% and patient right findings (49.1%. We identified observational study design, high ADAMON risk category, industry sponsorship, the presence of an electronic database, experienced site staff, and inclusion of vulnerable study population to be factors associated with lower numbers of findings. The monitors understand the positive aspects of a risk-based approach but fear missing systematic errors due to the low frequency of visits. Conclusions We show that the factors mostly increasing the risk for on-site monitoring findings are underrepresented in the current risk analysis scheme. Our risk-based on-site approach should further be complemented by centralized data checks, allowing monitors to transform their role towards partners for overall trial quality, and success.

BARC-risk monitor- a tool for operational safety assessment in nuclear power plants

International Nuclear Information System (INIS)

Vinod, Gopika; Saraf, R.K.; Babar, A.K.; Hadap, Nikhil

2000-12-01

Probabilistic safety assessment has become a key tool as on today to identify and understand nuclear power plant vulnerabilities. As a result of the availability of these PSA studies, there is a desire to use them to enhance plant safety and to operate the nuclear stations in the most efficient manner. Risk monitor is a PC based tool, which computes the real time safety level and assists plant personnel to manage day-to-day activities. Risk monitor is a PC based user friendly software tool used for modification and re-analysis of a nuclear power plant. Operation of risk monitor is based on PSA methods for assisting in day to day applications. Risk monitoring programs can assess the risk profile and are used to optimise the operation of nuclear power plants with respect to a minimum risk level over the operating time. This report presents the background activities of risk monitor, its application areas and also gives the status of such tools in international scenarios. The software is based on the PSA model of Kaiga generating station and would be applicable to similar design configuration. (author)

Managing Key Risks in Post-Merger IS Integration

DEFF Research Database (Denmark)

Alaranta, Mar; Mathiassen, L

2014-01-01

Mergers and acquisitions (M&A) require organizations to blend together different information system (IS) configurations. Unfortunately, less than 50 percent of M&A's achieve their goals, with IS integration being a major problem. Here, the authors offer a framework to help managers prepare for......, analyze, and mitigate risks during post-merger IS integration. They identify key risks relating to IS integration content, process, and context, and present five strategies for mitigating those risks. Their framework aims to help managers proactively reduce the impact of adverse events. Adopting...... the framework supported by their templates is straightforward and the time and resources required are minimal. When properly executed, adoption increases the likelihood of successful merger outcomes; the framework is thus a valuable addition to the management tool box and can be applied in collaboration...

InSAR deformation monitoring of high risk landslides

Science.gov (United States)

Singhroy, V.; Li, J.

2013-05-01

During the past year there were at least twenty five media reports of landslides and seismic activities some fatal, occurring in various areas in Canada. These high risk geohazards sites requires high resolution monitoring both spatially and temporally for mitigation purposes, since they are near populated areas and energy, transportation and communication corridors. High resolution air photos, lidar and satellite images are quite common in areas where the landslides can be fatal. Radar interferometry (InSAR) techniques using images from several radar satellites are increasingly being used in slope stability assessment. This presentation provides examples of using high-resolution (1-3m) frequent revisits InSAR techniques from RADARSAT 2 and TerraSAR X to monitor several types of high-risk landslides affecting transportation and energy corridors and populated areas. We have analyses over 200 high resolution InSAR images over a three year period on geologically different landslides. The high-resolution InSAR images are effective in characterizing differential motion within these low velocity landslides. The low velocity landslides become high risk during the active wet spring periods. The wet soils are poor coherent targets and corner reflectors provide an effective means of InSAR monitoring the slope activities.

Longitudinal associations between BMI, waist circumference, and cardiometabolic risk in US youth: monitoring implications.

Science.gov (United States)

Jago, R; Mendoza, J A; Chen, T; Baranowski, T

2013-03-01

This study examined whether change in body mass index (BMI) or waist circumference (WC) is associated with change in cardiometabolic risk factors and differences between cardiovascular disease specific and diabetes specific risk factors among adolescents. We also sought to examine any differences by gender or baseline body mass status. The article is a longitudinal analysis of pre- and post-data collected in the HEALTHY trial. Participants were 4,603 ethnically diverse adolescents who provided complete data at 6th and 8th grade assessments. The main outcome measures were percent change in the following cardiometabolic risk factors: fasting triglycerides, systolic and diastolic blood pressure, high density lipoprotein cholesterol, and glucose as well as a clustered metabolic risk score. Main exposures were change in BMI or WC z-score. Models were run stratified by gender; secondary models were additionally stratified by baseline BMI group (normal, overweight, or obese). Analysis showed that when cardiometabolic risk factors were treated as continuous variables, there was strong evidence (P fasting glucose and the combined risk factor score for both boys and girls. There was some evidence that change in WC z-score was associated with some cardiovascular risk factors, but change in WC z-score was consistently associated with changes in fasting glucose. In conclusion, routine monitoring of BMI should be continued by health professionals, but additional information on disease risk may be provided by assessing WC. Copyright © 2013 The Obesity Society.

Vocal cord paralysis post patent ductus arteriosus ligation surgery: risks and co-morbidities.

Science.gov (United States)

Rukholm, Gavin; Farrokhyar, Forough; Reid, Diane

2012-11-01

1. To determine the prevalence of left vocal cord paralysis (LVCP) post patent ductus arteriosus (PDA) ligation at a Tertiary Care Centre. 2. To identify risk factors associated with LVCP. 3. To identify co-morbidities associated with LVCP. 4. To determine the frequency of pre- and post-operative nasopharyngolaryngoscopic (NPL) examination in this patient population. Retrospective chart review of all infants who underwent PDA ligation surgery at a tertiary care academic hospital between July 2003 and July 2010. Data on patient age, gender, weight, method of PDA ligation, and results of NPL scoping were collected, as well as patient co-morbidities post PDA ligation. One hundred and fifteen patients underwent PDA ligation surgery. Four patients were excluded due to bilateral vocal cord paralysis. Of the remaining 111 patients, nineteen patients (17.1%) were found to have LVCP. Low birth weight was identified as a significant risk factor for LVCP (p=0.002). Gastroesophageal reflux was identified as a significant co-morbidity associated with LVCP post PDA ligation (p=0.002). Only 0.9% of patients were scoped pre-operatively, and 27.9% were scoped postoperatively. LVCP is associated with multiple morbidities. The authors strongly recommend routine post-operative scoping of all patients post PDA ligation surgery, and preoperative scoping when possible. A prospective study is warranted, in order to confirm the prevalence of LVCP as well as risk factors and associated co-morbidities. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

Indicators for Universal Health Coverage: can Kenya comply with the proposed post-2015 monitoring recommendations?

Science.gov (United States)

Obare, Valerie; Brolan, Claire E; Hill, Peter S

2014-12-20

Universal Health Coverage (UHC), referring to access to healthcare without financial burden, has received renewed attention in global health spheres. UHC is a potential goal in the post-2015 development agenda. Monitoring of progress towards achieving UHC is thus critical at both country and global level, and a monitoring framework for UHC was proposed by a joint WHO/World Bank discussion paper in December 2013. The aim of this study was to determine the feasibility of the framework proposed by WHO/World Bank for global UHC monitoring framework in Kenya. The study utilised three documents--the joint WHO/World Bank UHC monitoring framework and its update, and the Bellagio meeting report sponsored by WHO and the Rockefeller Foundation--to conduct the research. These documents informed the list of potential indicators that were used to determine the feasibility of the framework. A purposive literature search was undertaken to identify key government policy documents and relevant scholarly articles. A desk review of the literature was undertaken to answer the research objectives of this study. Kenya has yet to establish an official policy on UHC that provides a clear mandate on the goals, targets and monitoring and evaluation of performance. However, a significant majority of Kenyans continue to have limited access to health services as well as limited financial risk protection. The country has the capacity to reasonably report on five out of the seven proposed UHC indicators. However, there was very limited capacity to report on the two service coverage indicators for the chronic condition and injuries (CCIs) interventions. Out of the potential tracer indicators (n = 27) for aggregate CCI-related measures, four tracer indicators were available. Moreover the country experiences some wider challenges that may impact on the implementation and feasibility of the WHO/World Bank framework. The proposed global framework for monitoring UHC will only be feasible in Kenya if

Prior inpatient admission increases the risk of post-operative infection in hepatobiliary and pancreatic surgery.

Science.gov (United States)

Dong, Zachary M; Chidi, Alexis P; Goswami, Julie; Han, Katrina; Simmons, Richard L; Rosengart, Matthew R; Tsung, Allan

2015-12-01

Hepatobiliary and pancreatic (HPB) operations have a high incidence of post-operative nosocomial infections. The aim of the present study was to determine whether hospitalization up to 1 year before HPB surgery is associated with an increased risk of post-operative infection, surgical-site infection (SSI) and infection resistant to surgical chemoprophylaxis. A retrospective cohort study of patients undergoing HPB surgeries between January 2008 and June 2013 was conducted. A multivariable logistic regression model was used for controlling for potential confounders to determine the association between pre-operative admission and post-operative infection. Of the 1384 patients who met eligibility criteria, 127 (9.18%) experienced a post-operative infection. Pre-operative hospitalization was independently associated with an increased risk of a post-operative infection [adjusted odds ratio (aOR): 1.61, 95% confidence interval [CI]: 1.06-2.46] and SSI (aOR: 1.79, 95% CI: 1.07-2.97). Pre-operative hospitalization was also associated with an increased risk of post-operative infections resistant to standard pre-operative antibiotics (OR: 2.64, 95% CI: 1.06-6.59) and an increased risk of resistant SSIs (OR: 3.99, 95% CI: 1.25-12.73). Pre-operative hospitalization is associated with an increased incidence of post-operative infections, often with organisms that are resistant to surgical chemoprophylaxis. Patients hospitalized up to 1 year before HPB surgery may benefit from extended spectrum chemoprophylaxis. © 2015 International Hepato-Pancreato-Biliary Association.

Integrated Monitoring and Modeling of Carbon Dioxide Leakage Risk Using Remote Sensing, Ground-Based Monitoring, Atmospheric Models and Risk-Indexing Tools

Science.gov (United States)

Burton, E. A.; Pickles, W. L.; Gouveia, F. J.; Bogen, K. T.; Rau, G. H.; Friedmann, J.

2006-12-01

Correct assessment of the potential for CO2 leakage to the atmosphere or near surface is key to managing the risk associated with CO2 storage. Catastrophic, point-source leaks, diffuse seepage, and low leakage rates all merit assessment. Smaller leaks may be early warnings of catastrophic failures, and may be sufficient to damage natural vegetation or crops. Small leaks also may lead to cumulative build-up of lethal levels of CO2 in enclosed spaces, such as basements, groundwater-well head spaces, and caverns. Working with our ZERT partners, we are integrating a variety of monitoring and modeling approaches to understand how to assess potential health, property and environmental risks across this spectrum of leakage types. Remote sensing offers a rapid technique to monitor large areas for adverse environmental effects. If it can be deployed prior to the onset of storage operations, remote sensing also can document baseline conditions against which future claims of environmental damage can be compared. LLNL has been using hyperspectral imaging to detect plant stress associated with CO2 gas leakage, and has begun investigating use of NASA's new satellite or airborne instrumentation that directly measures gas compositions in the atmosphere. While remote sensing techniques have been criticized as lacking the necessary resolution to address environmental problems, new instruments and data processing techniques are demonstrated to resolve environmental changes at the scale associated with gas-leakage scenarios. During the shallow low-flow- CO2 release field experiments planned by ZERT, for the first time, we will have the opportunity to ground- truth hyperspectral data by simultaneous measurement of changes in hyperspectral readings, soil and root zone microbiology, ambient air, soil and aquifer CO2 concentrations. When monitoring data appear to indicate a CO2 leakage event, risk assessment and mitigation of that event requires a robust and nearly real-time method for

Epstein-Barr virus load monitoring: its role in the prevention and management of post-transplant lymphoproliferative disease.

Science.gov (United States)

Rowe, D T; Webber, S; Schauer, E M; Reyes, J; Green, M

2001-06-01

The Epstein-Barr virus load in the peripheral blood at the time of diagnosis of post-transplant lymphoproliferative disease (PTLD) is elevated 1000- to 10,000-fold compared to the level detected in normal latency. With the use of quantitative polymerase chain reaction (PCR), changes in the viral load over time can be measured with a two- to fourfold accuracy. This has allowed early detection of first-time infections and reactivations that may lead to PTLD and has provided an opportunity to intervene before symptomatic disease has occurred. Viral load monitoring has also been used to follow patients with PTLD and, along with other parameters, provided an assessment of the effectiveness of therapeutic protocols. Viral load monitoring has led to the discovery that at least two-thirds of transplant recipients become persistent viral load carriers. While the persistent load appears to be largely carried in latently infected memory B cells, more work is needed to clearly define this type of persistent infection and determine the risks associated with it. New diagnostic tests need to be developed to distinguish the persistent latent viral loads from viral loads that are likely to become symptomatic PTLD.

Post market surveillance in the german medical device sector - current state and future perspectives.

Science.gov (United States)

Zippel, Claus; Bohnet-Joschko, Sabine

2017-08-01

Medical devices play a central role in the diagnosis and treatment of diseases but also bring the potential for adverse events, hazards or malfunction with serious consequences for patients and users. Medical device manufacturers are therefore required by law to monitor the performance of medical devices that have been approved by the competent authorities (post market surveillance). Conducting a nationwide online-survey in the German medical device sector in Q2/2014 in order to explore the current status of the use of post market instruments we obtained a total of 118 complete data sets, for a return rate of 36%. The survey included manufacturers of different sizes, producing medical devices of all risk classes. The post market instruments most frequently reported covered the fields of production monitoring and quality management as well as literature observation, regulatory vigilance systems, customer knowledge management and market observation while Post Market Clinical Follow-up and health services research were being used less for product monitoring. We found significant differences between the different risk classes of medical devices produced and the intensity of use of post market instruments. Differences between company size and the intensity of instruments used were hardly detected. Results may well contribute to the development of device monitoring which is a crucial element of the policy and regulatory system to identify device-related safety issues. Copyright © 2017 Elsevier B.V. All rights reserved.

A model for post-occlusive reactive hyperemia as measured with laser-Doppler perfusion monitoring

NARCIS (Netherlands)

de Mul, FFM; Morales, F; Smit, AJ; Graaff, R

To facilitate the quantitative analysis of post-occlusive reactive fiyper emia (POR11), measured with laser-Doppler perfusion monitoring (LDPM) on extremities, we present a flow model for the dynamics of the perfusion of the tissue during PORH, based on three parameters: two time constants (tau(1)

Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy: nationwide cohort study.

Science.gov (United States)

Behrens, Ida; Basit, Saima; Melbye, Mads; Lykke, Jacob A; Wohlfahrt, Jan; Bundgaard, Henning; Thilaganathan, Baskaran; Boyd, Heather A

2017-07-12

Objectives  To determine how soon after delivery the risk of post-pregnancy hypertension increases in women with hypertensive disorders of pregnancy and how the risk evolves over time. Design  Nationwide register based cohort study. Setting  Denmark. Populations  482 972 primiparous women with a first live birth or stillbirth between 1995 and 2012 (cumulative incidence analyses), and 1 025 118 women with at least one live birth or stillbirth between 1978 and 2012 (Cox regression analyses). Main outcome measures  10 year cumulative incidences of post-pregnancy hypertension requiring treatment with prescription drugs, and hazard ratios estimated using Cox regression. Results  Of women with a hypertensive disorder of pregnancy in a first pregnancy in their 20s, 14% developed hypertension in the first decade post partum, compared with 4% of women with normotensive first pregnancies in their 20s. The corresponding percentages for women with a first pregnancy in their 40s were 32% and 11%, respectively. In the year after delivery, women with a hypertensive disorder of pregnancy had 12-fold to 25-fold higher rates of hypertension than did women with a normotensive pregnancy. Rates in women with a hypertensive disorder of pregnancy were threefold to 10-fold higher 1-10 years post partum and remained twice as high even 20 or more years later. Conclusions  The risk of hypertension associated with hypertensive disorders of pregnancy is high immediately after an affected pregnancy and persists for more than 20 years. Up to one third of women with a hypertensive disorder of pregnancy may develop hypertension within a decade of an affected pregnancy, indicating that cardiovascular disease prevention in these women should include blood pressure monitoring initiated soon after pregnancy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

An Updated Methodology for Enhancing Risk Monitors with Integrated Equipment Condition Assessment

Energy Technology Data Exchange (ETDEWEB)

Ramuhalli, Pradeep [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hirt, Evelyn H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Coles, Garill A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Bonebrake, Christopher A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Ivans, William J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Wootan, David W. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Mitchell, Mark R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2014-07-18

Small modular reactors (SMRs) generally include reactors with electric output of ~350 MWe or less (this cutoff varies somewhat but is substantially less than full-size plant output of 700 MWe or more). Advanced SMRs (AdvSMRs) refer to a specific class of SMRs and are based on modularization of advanced reactor concepts. Enhancing affordability of AdvSMRs will be critical to ensuring wider deployment, as AdvSMRs suffer from loss of economies of scale inherent in small reactors when compared to large (~greater than 600 MWe output) reactors and the controllable day-to-day costs of AdvSMRs will be dominated by operation and maintenance (O&M) costs. Technologies that help characterize real-time risk are important for controlling O&M costs. Risk monitors are used in current nuclear power plants to provide a point-in-time estimate of the system risk given the current plant configuration (e.g., equipment availability, operational regime, and environmental conditions). However, current risk monitors are unable to support the capability requirements listed above as they do not take into account plant-specific normal, abnormal, and deteriorating states of active components and systems. This report documents technology developments towards enhancing risk monitors that, if integrated with supervisory plant control systems, can provide the capability requirements listed and meet the goals of controlling O&M costs. The report describes research results on augmenting an initial methodology for enhanced risk monitors that integrate real-time information about equipment condition and POF into risk monitors. Methods to propagate uncertainty through the enhanced risk monitor are evaluated. Available data to quantify the level of uncertainty and the POF of key components are examined for their relevance, and a status update of this data evaluation is described. Finally, we describe potential targets for developing new risk metrics that may be useful for studying trade-offs for economic

Mare Risk Analysis monitor; Monitor de analisis de riesgos mare

Energy Technology Data Exchange (ETDEWEB)

Fuente Prieto, I.; Alonso, P.; Carretero Fernandino, J. A. [Empresarios Agrupados, A. I.E. Madrid (Spain)

2000-07-01

The Nuclear Safety Council's requirement that Spanish power plants comply with the requirements of the Maintenance Rule associated with plant risk assessment during power operation, arising from the partial unavailability of systems due to the maintenance activities, has led to need for additional tools to facilitate compliance with said requirements. While the impact on risk produced by individual equipment unavailabilities can easily be evaluated, either qualitatively or quantitatively, the process becomes more complicated when un programmed unavailabilities simultaneously occur in various systems, making it necessary to evaluate their functional impact. It is especially complex in the case of support systems that can affect the functionality of multiple systems. In view of the above, a computer application has been developed that is capable of providing the operator with quick answers based on the specific plant model in order to allow fast risk assessment using the information compiled as part of the Probabilistic Safety Analysis. The paper describes the most important characteristics of this application and the basic design requirements of the MARE Risk Monitor. (Author)

HIV/AIDS Knowledge, Self-Efficacy for Limiting Sexual Risk Behavior and Parental Monitoring.

Science.gov (United States)

Mahat, Ganga; Scoloveno, Mary Ann; Scoloveno, Robert

2016-01-01

The purpose of this study was to explore HIV/AIDS knowledge, self-efficacy for sexual risk behaviors, and parental monitoring in a sample of 140 7th and 9th grade adolescents studying in an urban high school in the United States. Further, the study examined differences in HIV/AIDS knowledge, self-efficacy and parental monitoring by grade and gender. This study also investigated the effectiveness of an HIV/AIDS peer education program, Teens for AIDS Prevention (TAP), on improving adolescents' HIV/AIDS knowledge. A quasi-experimental design was used to examine effects of the peer education program (TAP) on adolescents' HIV/AIDS knowledge. Pearson-product-moment correlation coefficients were calculated to examine the relationships among the variables. Independent t-tests were used to compare adolescents' HIV/AIDS knowledge, self-efficacy, and parental monitoring scores by grade and gender. Paired t-tests were used to determine differences in pre-intervention and post-intervention HIV/AIDS knowledge. The results showed that HIV/AIDS knowledge improved significantly in both 7th and 9th grade students after the intervention. HIV/AIDS knowledge was associated with self-efficacy; however it was not associated with parental monitoring. There were no significant differences in HIV/AIDS knowledge and self-efficacy by gender. However, there was a significant difference in parental monitoring by gender. Pediatric nurses are well-positioned to develop and implement evidence-based programs for adolescents. It is essential that pediatric nurses, in conjunction with other professionals and parent groups, take the initiative in implementing peer education programs in schools and community centers to promote healthy behaviors among adolescents. Copyright © 2016 Elsevier Inc. All rights reserved.

Monitoring raptors post-breeding migration on the Elba island, Arcipelago Toscano; years 2005-2006

Directory of Open Access Journals (Sweden)

Lorenzo Vanni

2012-09-01

Full Text Available Raptors post-reproductive migration was monitored over a two year period (2005-2006 in Arcipelago Toscano. This paper is a first attempt to analyze the migration patterns of the most abundant species (Circus aeruginosus, Pernis apivorus and Accipiter nisus, trying to define their timing and peak passage period.

Maternal anxiety, risk factors and parenting in the first post-natal year.

Science.gov (United States)

Seymour, M; Giallo, R; Cooklin, A; Dunning, M

2015-03-01

The antecedents and consequences of maternal post-natal anxiety have received comparatively less attention than depression despite being one of the most frequently reported mental health difficulties experienced by parents following childbirth. The aim of this study was to extend emerging literature on post-natal anxiety by investigating the prevalence of maternal anxiety symptoms, and its relationship with parenting behaviours (i.e. warmth, hostility) and experiences (i.e. parenting efficacy and satisfaction) within the first post-natal year. The psychosocial risk factors for post-natal anxiety symptoms were also explored. A community sample of 224 Australian mothers of infants (aged 0-12 months) completed a self-report questionnaire. Mothers in the current sample reported significantly more symptoms of anxiety compared with a normative sample. Approximately 18% of mothers reported mild to extremely severe symptoms of anxiety, with a high proportion experiencing co-morbid depressive symptoms. Maternal anxiety was associated with low parenting warmth, involvement, efficacy and satisfaction, and high parenting hostility. Yet, co-morbid depression and anxiety was more strongly associated with these parenting behaviours and experiences than anxiety alone. A range of psychosocial risk factors (e.g. education, sleep, relationship quality) were associated with maternal post-natal anxiety symptoms, providing opportunities for early identification and targeted early intervention. © 2014 John Wiley & Sons Ltd.

Post-Flight Back Pain Following International Space Station Missions: Evaluation of Spaceflight Risk Factors

Science.gov (United States)

Laughlin, M. S.; Murray, J. D.; Wear, M. L.; Van Baalen, M.

2016-01-01

INTRODUCTION Back pain during spaceflight has often been attributed to the lengthening of the spinal column due to the absence of gravity during both short and long-duration missions. Upon landing and re-adaptation to gravity, the spinal column reverts back to its original length thereby causing some individuals to experience pain and muscular spasms, while others experience no ill effects. With International Space Station (ISS) missions, cases of back pain and injury are more common post-flight, but little is known about the potential risk factors. Thus, the purpose of this project was to perform an initial evaluation of reported post-flight back pain and injury cases to relevant spaceflight risk factors in United States astronauts that have completed an ISS mission. METHODS All US astronauts who completed an ISS mission between Expeditions (EXP) 1 and 41 (2000-2015) were included in this evaluation. Forty-five astronauts (36 males and 9 females) completed 50 ISS missions during the study time period, as 5 astronauts completed 2 ISS missions. Researchers queried medical records of the 45 astronauts for occurrences of back pain and injury. A case was defined as any reported event of back pain or injury to the cervical, thoracic, lumbar, sacral, or coccyx spine regions. Data sources for the cases included the Flight Medicine Clinic's electronic medical record; Astronaut Strength, Conditioning and Rehabilitation electronic documentation; the Private Medical Conference tool; and the Space Medicine Operations Team records. Post-flight cases were classified as an early case if reported within 45 days of landing (R + 45) or a late case if reported from R + 46 to R + 365 days after landing (R + 1y). Risk factors in the astronaut population for back pain include age, sex, prior military service, and prior history of back pain. Additionally, spaceflight specific risk factors such as type of landing vehicle and onboard exercise countermeasures were included to evaluate their

Finite Element Analysis of Grouting Compactness Monitoring in a Post-Tensioning Tendon Duct Using Piezoceramic Transducers

Directory of Open Access Journals (Sweden)

Tianyong Jiang

2017-09-01

Full Text Available With the development of the post-tensioning technique, prestressed concrete structures have been widely used in civil engineering. To ensure the long-term effectiveness of the prestressed tendon, the grouting quality of the tendon duct is one of the important factors. However, it is still a challenge to monitor the grouting quality of post-tensioning tendon ducts, due to the invisibility of the grouting. The authors’ previous work proposed a real-time method that employed a stress wave-based active sensing approach with piezoceramic transducers to monitor the grouting compactness of a Post-Tensioning Tendon Duct (PTTD. To further understand the piezoceramic induced stress wave propagation in the PTTD with different grouting levels, this paper develops a two-dimensional finite element model for monitoring the grouting compactness of the tendon duct with a piezoceramic transducer. A smart aggregate (SA developed to utilize one Lead Zirconate Titanate (PZT transducer with marble protection is installed in the center location of the tendon duct as an actuator. Two PZT patches are bonded on the bottom and top surface of the tendon duct as the sensors. The analysis results show that the finite element analysis results are in good agreement with the experimental results, which demonstrates that the finite element analysis is feasible and reliable. For the top half of the specimen, not much stress wave could be detected before the full grouting level, except for negligible signals that may propagate through the walls of the tendon duct. When the tendon duct grouting is at 100%, the stress wave propagates to the top of the specimen, and the displacements are symmetric in both left-right and top-bottom directions before the stress waves reach the boundary. The proposed two-dimensional finite element model has the potential to be implemented to simulate the stress wave propagation principle for monitoring grouting compaction of the post-tensioning tendon

Finite Element Analysis of Grouting Compactness Monitoring in a Post-Tensioning Tendon Duct Using Piezoceramic Transducers.

Science.gov (United States)

Jiang, Tianyong; Zheng, Junbo; Huo, Linsheng; Song, Gangbing

2017-09-29

With the development of the post-tensioning technique, prestressed concrete structures have been widely used in civil engineering. To ensure the long-term effectiveness of the prestressed tendon, the grouting quality of the tendon duct is one of the important factors. However, it is still a challenge to monitor the grouting quality of post-tensioning tendon ducts, due to the invisibility of the grouting. The authors' previous work proposed a real-time method that employed a stress wave-based active sensing approach with piezoceramic transducers to monitor the grouting compactness of a Post-Tensioning Tendon Duct (PTTD). To further understand the piezoceramic induced stress wave propagation in the PTTD with different grouting levels, this paper develops a two-dimensional finite element model for monitoring the grouting compactness of the tendon duct with a piezoceramic transducer. A smart aggregate (SA) developed to utilize one Lead Zirconate Titanate (PZT) transducer with marble protection is installed in the center location of the tendon duct as an actuator. Two PZT patches are bonded on the bottom and top surface of the tendon duct as the sensors. The analysis results show that the finite element analysis results are in good agreement with the experimental results, which demonstrates that the finite element analysis is feasible and reliable. For the top half of the specimen, not much stress wave could be detected before the full grouting level, except for negligible signals that may propagate through the walls of the tendon duct. When the tendon duct grouting is at 100%, the stress wave propagates to the top of the specimen, and the displacements are symmetric in both left-right and top-bottom directions before the stress waves reach the boundary. The proposed two-dimensional finite element model has the potential to be implemented to simulate the stress wave propagation principle for monitoring grouting compaction of the post-tensioning tendon duct.

Efforts Toward an Early Warning Crop Monitor for Countries at Risk

Science.gov (United States)

Budde, M. E.; Verdin, J. P.; Barker, B.; Humber, M. L.; Becker-Reshef, I.; Justice, C. O.; Magadzire, T.; Galu, G.; Rodriguez, M.; Jayanthi, H.

2015-12-01

Assessing crop growing conditions is a crucial aspect of monitoring food security in the developing world. One of the core components of the Group on Earth Observations - Global Agricultural Monitoring (GEOGLAM) targets monitoring Countries at Risk (component 3). The Famine Early Warning Systems Network (FEWS NET) has a long history of utilizing remote sensing and crop modeling to address food security threats in the form of drought, floods, pest infestation, and climate change in some of the world's most at risk countries. FEWS NET scientists at the U.S. Geological Survey Earth Resources Observation and Science (EROS) Center and the University of Maryland Department of Geography have undertaken efforts to address component 3, by promoting the development of a collaborative Early Warning Crop Monitor (EWCM) that would specifically address Countries at Risk. A number of organizations utilize combinations of satellite earth observations, field campaigns, network partner inputs, and crop modeling techniques to monitor crop conditions throughout the world. Agencies such as the Food and Agriculture Organization of the United Nations (FAO), United Nations World Food Programme (WFP), and the European Commission's Joint Research Centre (JRC) provide agricultural monitoring information and reporting across a broad number of areas at risk and in many cases, organizations routinely report on the same countries. The latter offers an opportunity for collaboration on crop growing conditions among agencies. The reduction of uncertainty and achievement of consensus will help strengthen confidence in decisions to commit resources for mitigation of acute food insecurity and support for resilience and development programs. In addition, the development of a collaborative global EWCM will provide each of the partner agencies with the ability to quickly gather crop condition information for areas where they may not typically work or have access to local networks. Using a framework

Development of a risk monitoring system for nuclear power plants based on GO-FLOW methodology

Energy Technology Data Exchange (ETDEWEB)

Yang, Jun, E-mail: youngjun51@hotmail.com [College of Nuclear Science and Technology, Harbin Engineering University, No. 145 Nantong Street, Nangang District, Harbin 150001 (China); Yang, Ming, E-mail: yangming@hrbeu.edu.cn [College of Nuclear Science and Technology, Harbin Engineering University, No. 145 Nantong Street, Nangang District, Harbin 150001 (China); Yoshikawa, Hidekazu, E-mail: yosikawa@kib.biglobe.ne.jp [Symbio Community Forum, Kyoto (Japan); Yang, Fangqing, E-mail: yfq613@163.com [China Nuclear Power Technology Research Institute, 518000 (China)

2014-10-15

Highlights: • A method for developing Living PSA is proposed. • Living PSA is easy to update with online modification to system model file. • A risk monitoring system is designed and developed using the GO-FLOW. • The risk monitoring system is useful for plant daily operation risk management. - Abstract: The paper presents a risk monitoring system developed based on GO-FLOW methodology which is a success-oriented system reliability modeling technique for phased mission as well as time-dependent problems analysis. The risk monitoring system is designed to receive information on plant configuration changes either from equipment failures, operator interventions, or maintenance activities, then update the Living PSA model with online modification to the system GO-FLOW model file which contains all the functional modes of equipment represented by a proposed generalized GO-FLOW modeling structure, and display risk values graphically. The risk monitoring system can be used to assist safety engineers and plant operators in their maintenance management and daily operation risk management at NPPs.

Development of a risk monitoring system for nuclear power plants based on GO-FLOW methodology

International Nuclear Information System (INIS)

Yang, Jun; Yang, Ming; Yoshikawa, Hidekazu; Yang, Fangqing

2014-01-01

Highlights: • A method for developing Living PSA is proposed. • Living PSA is easy to update with online modification to system model file. • A risk monitoring system is designed and developed using the GO-FLOW. • The risk monitoring system is useful for plant daily operation risk management. - Abstract: The paper presents a risk monitoring system developed based on GO-FLOW methodology which is a success-oriented system reliability modeling technique for phased mission as well as time-dependent problems analysis. The risk monitoring system is designed to receive information on plant configuration changes either from equipment failures, operator interventions, or maintenance activities, then update the Living PSA model with online modification to the system GO-FLOW model file which contains all the functional modes of equipment represented by a proposed generalized GO-FLOW modeling structure, and display risk values graphically. The risk monitoring system can be used to assist safety engineers and plant operators in their maintenance management and daily operation risk management at NPPs

Remote Sensing Techniques in Monitoring Post-Fire Effects and Patterns of Forest Recovery in Boreal Forest Regions: A Review

Directory of Open Access Journals (Sweden)

Thuan Chu

2013-12-01

Full Text Available The frequency and severity of forest fires, coupled with changes in spatial and temporal precipitation and temperature patterns, are likely to severely affect the characteristics of forest and permafrost patterns in boreal eco-regions. Forest fires, however, are also an ecological factor in how forest ecosystems form and function, as they affect the rate and characteristics of tree recruitment. A better understanding of fire regimes and forest recovery patterns in different environmental and climatic conditions will improve the management of sustainable forests by facilitating the process of forest resilience. Remote sensing has been identified as an effective tool for preventing and monitoring forest fires, as well as being a potential tool for understanding how forest ecosystems respond to them. However, a number of challenges remain before remote sensing practitioners will be able to better understand the effects of forest fires and how vegetation responds afterward. This article attempts to provide a comprehensive review of current research with respect to remotely sensed data and methods used to model post-fire effects and forest recovery patterns in boreal forest regions. The review reveals that remote sensing-based monitoring of post-fire effects and forest recovery patterns in boreal forest regions is not only limited by the gaps in both field data and remotely sensed data, but also the complexity of far-northern fire regimes, climatic conditions and environmental conditions. We expect that the integration of different remotely sensed data coupled with field campaigns can provide an important data source to support the monitoring of post-fire effects and forest recovery patterns. Additionally, the variation and stratification of pre- and post-fire vegetation and environmental conditions should be considered to achieve a reasonable, operational model for monitoring post-fire effects and forest patterns in boreal regions.

Risk factors for developing post-traumatic stress disorder following childbirth

DEFF Research Database (Denmark)

Andersen, Louise Bjørkholt; Melvaer, Lisa B; Videbech, Poul

2012-01-01

Background. Approximately 1-2% of women suffer from post-traumatic stress disorder (PTSD) postnatally. This review aims to elucidate how women at risk can be identified. Methods. A systematic search of the published literature was carried out using the MEDLINE database (November 2003 to 29(th...

Risk factors for post-thrombotic syndrome in patients with a first deep venous thrombosis

NARCIS (Netherlands)

Tick, L. W.; Kramer, M. H. H.; Rosendaal, F. R.; Faber, W. R.; Doggen, C. J. M.

2008-01-01

BACKGROUND: Post-thrombotic syndrome (PTS) is a chronic complication of deep venous thrombosis (DVT). OBJECTIVES: To determine the risk of PTS after DVT and to assess risk factors for PTS. METHODS: Patients were recruited from the Multiple Environmental and Genetic Assessment (MEGA) study of risk

A Study on the Estimation Method of Risk Based Area for Jetty Safety Monitoring

Directory of Open Access Journals (Sweden)

Byeong-Wook Nam

2015-09-01

Full Text Available Recently, the importance of safety-monitoring systems was highlighted by the unprecedented collision between a ship and a jetty in Yeosu. Accordingly, in this study, we introduce the concept of risk based area and develop a methodology for a jetty safety-monitoring system. By calculating the risk based areas for a ship and a jetty, the risk of collision was evaluated. To calculate the risk based areas, we employed an automatic identification system for the ship, stopping-distance equations, and the regulation velocity near the jetty. In this paper, we suggest a risk calculation method for jetty safety monitoring that can determine the collision probability in real time and predict collisions using the amount of overlap between the two calculated risk based areas. A test was conducted at a jetty control center at GS Caltex, and the effectiveness of the proposed risk calculation method was verified. The method is currently applied to the jetty-monitoring system at GS Caltex in Yeosu for the prevention of collisions.

A risk stratification algorithm using non-invasive respiratory volume monitoring to improve safety when using post-operative opioids in the PACU.

Science.gov (United States)

Voscopoulos, Christopher; Theos, Kimberly; Tillmann Hein, H A; George, Edward

2017-04-01

Late detection of respiratory depression in non-intubated patients compromises patient safety. SpO 2 is a lagging indicator of respiratory depression and EtCO 2 has proven to be unreliable in non-intubated patients. A decline in minute ventilation (MV) is the earliest sign of respiratory depression. A non-invasive respiratory volume monitor (RVM) that provides accurate, continuous MV measurements enables clinicians to predict and quantify respiratory compromise. For this observational study, practitioners were blinded to the RVM measurements and pain management followed the usual routine. Patients were stratified by their MV on PACU admission and classified as "At-Risk" or "Not-At-Risk," with progression to "Low MV" status following opioids assessed for each category. The purpose was to determine if stratifying based on MV on PACU arrival could identify patients at higher risk for respiratory depression. Ability to identify in advance patients at higher risk for respiratory depression following standard opioid dosing would drive changes in pain management and improve patient care. RVM and opioid administration data from 150 PACU patients following elective joint-replacement surgery were collected in an observational study. "Predicted" MV (MV PRED ) and "Percent Predicted" (MV MEASURED /MV PRED  × 100 %) were calculated for each patient using standard formulas. Prior to opioid administration, patients were classified as either "Not-At-Risk" (MV ≥ 80 % MV PRED ) or "At-Risk" (MV safety across the continuum of care.

Childhood trauma increases the risk of post-traumatic stress disorder in response to first-episode psychosis.

Science.gov (United States)

Bendall, Sarah; Alvarez-Jimenez, Mario; Hulbert, Carol A; McGorry, Patrick D; Jackson, Henry J

2012-01-01

To investigate the relationship between childhood trauma, post-traumatic stress symptoms due to the experience of childhood trauma, and post-traumatic stress symptoms due to the experience of psychosis. The current study assessed childhood trauma and post-traumatic stress disorder (PTSD) symptoms as a result of both childhood trauma and psychosis using the Impact of Events Scale - Revised, in a group of 36 people with first-episode psychosis. Reported rates of clinical level post-psychotic PTSD symptoms, childhood trauma and childhood trauma-related clinical level PTSD symptoms were 47% (95% CI 31-64%), 64% (95% CI 48-80%) and 39% (95% CI 23-55%), respectively. Reporting childhood trauma increased the risk of developing post-psychosis PTSD 27-fold (95% CI 2.96-253.80, p = 0.01). Having childhood trauma-related PTSD increased the risk of developing post-psychosis PTSD 20-fold (95% CI 3.38-123.25, p = 0.01). These risks were not explained by illness factors such as duration of untreated psychosis, age of onset or severity of psychotic symptoms. Those without post-psychotic PTSD symptoms at clinical levels were unlikely to report childhood trauma (6%; 95% CI 3-8%). These results suggest the cognitive, social and biological consequences of childhood trauma can prevent effective recovery from the trauma of acute first-episode psychosis resulting in post-psychotic PTSD. Treatment strategies for post-psychotic PTSD must address childhood trauma and related PTSD.

Real-time risk monitoring in business processes : a sensor-based approach

NARCIS (Netherlands)

Conforti, R.; La Rosa, M.; Fortino, G.; Hofstede, ter A.H.M.; Recker, J.; Adams, M.

2013-01-01

This article proposes an approach for real-time monitoring of risks in executable business process models. The approach considers risks in all phases of the business process management lifecycle, from process design, where risks are defined on top of process models, through to process diagnosis,

Dutch monitor on stress and physical load : risk factors, consequences, and preventive action

NARCIS (Netherlands)

Houtman, I.L.D.; Goudswaard, A.; Dhondt, S.; Grinten, M.P. van der; Hildebrandt, V.H.; Poel, E.G.T. van der

1998-01-01

Objectives - Due to recent changes in legislation on occupational health and safety, a national monitor on stress and physical load was developed in The Netherlands to monitor (a) risks and consequences of stress and physical load at work, (b) preventive actions in companies to reduce these risks,

is there an increased risk of post-operative surgical site infection

African Journals Online (AJOL)

2012-09-06

Sep 6, 2012 ... requiring implant orthopaedic surgery are at an increased risk for post-operative surgical ... further studies should determine the effect of reduced CD4 counts, viral load .... Language not Enlish, French, Ducth or German (n=2).

Methodology for Designing Operational Banking Risks Monitoring System

Science.gov (United States)

Kostjunina, T. N.

2018-05-01

The research looks at principles of designing an information system for monitoring operational banking risks. A proposed design methodology enables one to automate processes of collecting data on information security incidents in the banking network, serving as the basis for an integrated approach to the creation of an operational risk management system. The system can operate remotely ensuring tracking and forecasting of various operational events in the bank network. A structure of a content management system is described.

Using the web tool GIS SPIDER for monitoring the state of forest cover in the pre- and post-fire periods

Directory of Open Access Journals (Sweden)

J. Villodre

2013-09-01

Full Text Available Pre- and post-wildland fire management will be improved by the knowledge of the stand conditions. Different types of quantitative and qualitative data, such as water stress, cover temperature or the Normalized Difference Vegetation Index (NDVI are critical for understanding fire risk, fire severity or vegetation recovering after the fire. Even though, there is a lack of easy accessible measurements about these topics. In this vein, remote sensing provides suitable information and in a global view about the canopy state: water balance, fire risk or the primary productivity estimation. It allows the monitoring of large areas in different temporal and spatial resolutions and with low cost. The output information can be disseminated using tools such as web-GIS based systems. In this paper the SPIDER (System of Participatory Information, Decision support, and Expert knowledge for irrigation and River basin water Management tool is presented, which allows monitoring canopy conditions before and after fires in a simple way and friendly environment. SPIDER is also able to analyse environmental conditions in almost the entire Iberian Peninsula, with a temporal resolution that ranges among 1 to 16 days. Images of NDVI, surface temperatures and water stress are based on MODIS aqua satellite images.Results show the potential of the system to the analysis of vegetation anomalies, monitoring of water stress, fire severity or the vegetation recovery after fire, in a dynamic way. The database allows multitemporal analysis of different parameters related to the state of the vegetation, growing, water deficit and fire severity degree. Further analysis of these data provides relevant information such as drought effects or catastrophic events in the vegetation.

Results from a post-launch monitoring survey on consumer purchases of foods with added phytosterols in five European countries.

Science.gov (United States)

Willems, Julie I; Blommaert, Mireille A E; Trautwein, Elke A

2013-12-01

Phytosterols (plant sterols and stanols), in the form of phytosterol-esters, are used in food products as active ingredients to lower elevated blood low density lipoprotein-cholesterol concentrations. In Europe, plant sterol-esters gained Novel Foods authorisation in 2000. As a requirement of the authorisation, Unilever developed a post-launch monitoring program to monitor the use of products with added phytosterols. This paper reports findings from the 2011 post-launch monitoring survey on consumer purchase behaviour of foods with added phytosterols. 91,000 households in the Netherlands, Belgium, United Kingdom, France and Germany were included. 11,612 purchased foods with added phytosterols, including spreads, salad dressings, milk- and yoghurt-type products. The results show that 71-82% of households purchasing products with added phytosterols were 1-2 person households. These households were also purchasing the majority of the volume sold in each country (75-85%). The average phytosterol intakes per household were 0.35-0.86 g/day; well below the 1.5-3.0 g/day phytosterols needed to achieve a significant blood cholesterol lowering benefit. Post-launch monitoring is an accepted and useful tool to estimate the consumption behaviour amongst different consumer groups. Data show that average phytosterol intakes per household were well below 1g/day, suggesting that overconsumption is unlikely. Copyright © 2013 Elsevier Ltd. All rights reserved.

Pre- to post-immigration sexual risk behaviour and alcohol use among recent Latino immigrants in Miami.

Science.gov (United States)

Berger Cardoso, Jodi; Ren, Yi; Swank, Paul; Sanchez, Mariana; De La Rosa, Mario

2016-10-01

Retrospective pre-immigration data on sexual risk and alcohol use behaviours was collected from 527 recent Latino immigrants to the USA, aged 18-34. Two follow-up assessments (12 months apart) reported on post-immigration behaviours. Using a mixed model growth curve analysis, a six-level sexual risk change variable was constructed combining measures of sexual partners and condom use. The mixed model growth curve was also used to examine associations between changes in sexual risk behaviour and changes in alcohol use and for testing interaction effects of gender and documentation status. Results suggest that individuals with high sexual risk behaviour at pre-immigration converge to low/moderate risk post-immigration, and that those who were sexually inactive or had low sexual risk at pre-immigration increased their risk post-immigration. Individuals with moderately higher initial but decreasing sexual risk behaviour showed the steepest decline in alcohol use, but their drinking at Time 3 was still higher than individuals reporting low sexual risk at Time 1. On average, men drank more than women, except women in one of the highest sexual risk categories at Time 1 - who seemed to drink as much, if not more, than men. Undocumented men reported more frequent drinking than documented men. In contrast, undocumented women reported lower alcohol use than documented women.

Monitoring risk-adjusted medical outcomes allowing for changes over time.

Science.gov (United States)

Steiner, Stefan H; Mackay, R Jock

2014-10-01

We consider the problem of monitoring and comparing medical outcomes, such as surgical performance, over time. Performance is subject to change due to a variety of reasons including patient heterogeneity, learning, deteriorating skills due to aging, etc. For instance, we expect inexperienced surgeons to improve their skills with practice. We propose a graphical method to monitor surgical performance that incorporates risk adjustment to account for patient heterogeneity. The procedure gives more weight to recent outcomes and down-weights the influence of outcomes further in the past. The chart is clinically interpretable as it plots an estimate of the failure rate for a "standard" patient. The chart also includes a measure of uncertainty in this estimate. We can implement the method using historical data or start from scratch. As the monitoring proceeds, we can base the estimated failure rate on a known risk model or use the observed outcomes to update the risk model as time passes. We illustrate the proposed method with an example from cardiac surgery. © The Author 2013. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Minimising post-operative risk using a Post-Anaesthetic Care Tool (PACT): protocol for a prospective observational study and cost-effectiveness analysis.

Science.gov (United States)

Street, Maryann; Phillips, Nicole M; Kent, Bridie; Colgan, Stephen; Mohebbi, Mohammadreza

2015-06-01

While the risk of adverse events following surgery has been identified, the impact of nursing care on early detection of these events is not well established. A systematic review of the evidence and an expert consensus study in post-anaesthetic care identified essential criteria for nursing assessment of patient readiness for discharge from the post-anaesthetic care unit (PACU). These criteria were included in a new nursing assessment tool, the Post-Anaesthetic Care Tool (PACT), and incorporated into the post-anaesthetic documentation at a large health service. The aim of this study is to test the clinical reliability of the PACT and evaluate whether the use of PACT will (1) enhance the recognition and response to patients at risk of deterioration in PACU; (2) improve documentation for handover from PACU nurse to ward nurse; (3) result in improved patient outcomes and (4) reduce healthcare costs. A prospective, non-randomised, pre-implementation and post-implementation design comparing: (1) patients (n=750) who have surgery prior to the implementation of the PACT and (2) patients (n=750) who have surgery after PACT. The study will examine the use of the tool through the observation of patient care and nursing handover. Patient outcomes and cost-effectiveness will be determined from health service data and medical record audit. Descriptive statistics will be used to describe the sample and compare the two patient groups (pre-intervention and post-intervention). Differences in patient outcomes between the two groups will be compared using the Cochran-Mantel-Haenszel test and regression analyses and reported as ORs with the corresponding 95% CIs. This study will test the clinical reliability and cost-effectiveness of the PACT. It is hypothesised that the PACT will enable nurses to recognise and respond to patients at risk of deterioration, improve handover to ward nurses, improve patient outcomes, and reduce healthcare costs. Published by the BMJ Publishing Group

An Overview of Risk Factors Associated to Post-partum Depression in Asia

OpenAIRE

Mehta, Shubham; Mehta, Nidhi

2014-01-01

Post partum depression (PPD) is an important complication of child-bearing. It requires urgent interventions as it can have long-term adverse consequences if ignored, for both mother and child. If PPD has to be prevented by a public health intervention, the recognition and timely identification of its risk factors is must. We in this review have tried to synthesize the results of Asian studies examining the risk factors of PPD. Some risk factors, which are unique to Asian culture, have also b...

Application of quality risk management to set viable environmental monitoring frequencies in biotechnology processing and support areas.

Science.gov (United States)

Sandle, Tim

2012-01-01

Environmental monitoring programs are essential for pharmaceutical facilities in order to assess the level of environmental control. For biotechnology facilities there is little advice as to the frequency at which viable environmental monitoring should be conducted. This paper outlines an approach, based on the principles of quality risk management, for the development of a framework from which monitoring frequencies can be determined. This involved the identification of common hazards and the evaluation those hazards in terms of the severity of contamination and the probability of contamination occurring. These elements of risk were evaluated for different cleanrooms and the relative risks ranked. Once the risk scores were calculated, the methods for detecting risks within the cleanrooms were assessed. Risk filtering was then used to group different cleanrooms based on their relative risks and detection methods against predetermined monitoring frequencies. Through use of case study examples, the paper presents the model and describes how appropriate frequencies for the environmental monitoring of cleanrooms can be set. Cleanrooms in which biotechnology pharmaceutical processing takes place are subject to environmental monitoring. The frequency at which such monitoring should be performed can be difficult to determine. This paper uses quality risk assessment methods to construct a framework for determining monitoring frequencies and illustrates the suitability of the framework through a case study.

Development of full power risk monitoring system for UCN 3 and 4 nuclear power plants

International Nuclear Information System (INIS)

Kim, Seung Hwan; Jang, Seung Chul; Kim, Kil Yoo; Han, Sang Hoon; Jung, Won Dae

2002-03-01

This report describes full power risk monitoring system (DynaRM) of NPPs which evaluates the current plant risk and monitor the risk change caused by the configuration change due to preventive maintenance or periodic maintenance activities. In order to calculate the core damage frequency, the inoperable equipment's basic event should be submitted to a quantification engine. DynaRM uses a risk monitor model converted from PSA model as the quantification engine, which can respond fast for the various equipment configuration changes. DynaRM is developed to solve these kinds of problems and difficulties. The main two key features of DynaRM are real time risk monitoring and real time maintenance plan decision supporting. With DynaRM, the plant risk can be calculated automatically only with out of service equipment information and equipment maintenance scheduling is easy by modifying the detail schedule plan. We have developed the DynaRM for the Korean standard nuclear power plant and it is currently using at Ulchin 3,4 NPP. The adaptation for the other NPPs is also easy with a little modification since DynaRM was developed by considering it to be used in the other NPPs. Moreover, we also expect DynaRM will be a good advisory tool for the plant risk monitoring and maintenance scheduling

Depressive symptoms, post-traumatic stress symptoms and suicide risk among graduate students: The mediating influence of emotional regulatory self-efficacy.

Science.gov (United States)

Zeng, Baoer; Zhao, Jiubo; Zou, Laiquan; Yang, Xueling; Zhang, Xiaoyuan; Wang, Wanjun; Zhao, Jingbo; Chen, Jie

2018-06-01

The current study was to examine the relationship among depressive symptoms, post-traumatic stress symptoms, emotion regulatory self-efficacy and suicide risk. A cross-sectional survey was conducted among 3257 graduate students from a medical college of China. Lifetime prevalence of suicidal ideation, plan and attempt were 25.7%, 1.6%, 1.1%, respectively, with one-year suicidal ideation showing at 6.3%. Structural equation modeling was employed to examine the relative contribution of depressive symptoms, post-traumatic stress symptoms and emotion regulatory self-efficacy on suicide risk. Structural equation model had a highly satisfactory fit [χ 2  = 7.782, df = 4, p = 0.096; RMSEA = 0.021; CFI = 0.992; GFI = 0.997]. Post-traumatic stress symptoms had a direct effect and an indirect effect on suicide risk via emotion regulatory self-efficacy. Depressive symptoms also had a direct effect and an indirect effect on suicide risk via emotion regulatory self-efficacy. The depressive and post-traumatic stress symptoms increased the risk of suicide risk, but the variable of emotion regulatory self-efficacy would be served as a buffering factor, decreasing the risk of suicide. The interaction term of depressive symptoms and post-traumatic stress symptoms had a direct effect on suicide risk. A significant interactive effect of depressive and post-traumatic stress symptoms on suicide risk was found. Copyright © 2018 Elsevier B.V. All rights reserved.

Risk factors for Epstein-Barr virus-related post-transplant lymphoproliferative disease after allogeneic hematopoietic stem cell transplantation.

Science.gov (United States)

Uhlin, Michael; Wikell, Helena; Sundin, Mikael; Blennow, Ola; Maeurer, Markus; Ringden, Olle; Winiarski, Jacek; Ljungman, Per; Remberger, Mats; Mattsson, Jonas

2014-02-01

Allogeneic hematopoietic stem cell transplantation is a successful treatment for hematologic malignancies and a variety of genetic and metabolic disorders. In the period following stem cell transplantation, the immune-compromised milieu allows opportunistic pathogens to thrive. Epstein-Barr virus-associated post-transplant lymphoproliferative disease can be a life-threatening complication for transplanted patients because of suppressed T-cell-mediated immunity. We analyzed possible risk factors associated with post-transplant lymphoproliferative disease in a cohort of over 1,000 patients. The incidence of post-transplant lymphoproliferative disease was 4%. Significant risk factors identified by multivariate analysis were: human leukocyte antigen-mismatch (PEpstein-Barr virus mismatch recipient-/donor+ (Pdisease grade II to IV (P=0.006), pre-transplant splenectomy (P=0.008) and infusion of mesenchymal stromal cells (P=0.015). The risk of post-transplant lymphoproliferative disease has increased in more recent years, from less than 2% before 1998 to more than 6% after 2011. Additionally, we show that long-term survival of patients with post-transplant lymphoproliferative disease is poor despite initial successful treatment. The 3-year survival rate among the 40 patients with post-transplant lymphoproliferative disease was 20% as opposed to 62% among patients without post-transplant lymphoproliferative disease (Pdisease after transplantation in need of pre-emptive measures.

Development of intergrated accident management assessment technology; development of interface modules of risk-monitoring system

Energy Technology Data Exchange (ETDEWEB)

Kang, S. K.; Park, S. K.; Seok, H.; Kim, D. K.; Han, J. K.; Park, B. R. [KOPEC, Taejeon (Korea)

2002-03-01

Based on the development of interface modules with FORTE.- DynaRM can quantify risk model very fast (Very frequent risk model quantification is needed for configuration risk management).- risk monitoring system technology transfer to foreign NPPs. Contribution to component failure and maintenance control automation with the development of Tagging control System. On-Line risk monitoring system development by joint team between Korea Atomic Energy Research Institute and KOPEC is a request by KEPCO. The softwares developed in this study is easily implemented at domestic NPPs without extra study or cost. Economic benefit and Software export to foreign NPPs are expected because of the development of technology related to risk monitoring system and its management. 6 refs., 3 figs., 1 tab. (Author)

The predictive value of CHADS₂ risk score in post myocardial infarction arrhythmias - a Cardiac Arrhythmias and RIsk Stratification after Myocardial infArction (CARISMA) substudy

DEFF Research Database (Denmark)

Ruwald, Anne-Christine Huth; Gang, Uffe; Thomsen, Poul Erik Bloch

2014-01-01

BACKGROUND: Previous studies have shown substantially increased risk of cardiac arrhythmias and sudden cardiac death in post-myocardial infarction (MI) patients. However it remains difficult to identify the patients who are at highest risk of arrhythmias in the post-MI setting. The purpose...... of this study was to investigate if CHADS₂ score (congestive heart failure, hypertension, age ≥75 years, diabetes and previous stroke/TCI [doubled]) can be used as a risk tool for predicting cardiac arrhythmias after MI. METHODS: The study included 297 post-MI patients from the CARISMA study with left....... Patients were stratified according to CHADS₂ score at enrollment. Congestive heart failure was defined as LVEF ≤40% and NYHA class II, III or IV. RESULTS: We found significantly increased risk of an arrhythmic event with increasing CHADS₂ score (CHADS₂ score=1-2: HR=2.1 [1.1-3.9], p=0.021, CHADS₂ score ≥ 3...

[Guidance of FDA risk evaluation and mitigation strategy and enlightenment to drug risk management of post-marketing Chinese medicine].

Science.gov (United States)

Li, Yuanyuan; Xie, Yanming

2011-10-01

The FDA risk evaluation and mitigation strategy (REMS) aims to drugs or biological products known or potential serious risk management. Analysis with the example of the content of the Onsolis REMS named FOCOS. Our country can be reference for the analysis of relevant experience and establish a scientific evaluation mechanism, strengthen the drug risk consciousness, promote the rational drug use, organic combined with the before-marketing and post-marketing evaluation of traditional Chinese medicine, and promote the evaluation of risk management of the drug development and improvement.

On the change of fall-out measured by monitoring post at the time of nuclear explosion

International Nuclear Information System (INIS)

Nagai, Tatsuo; Honda, Tadashi; Imai, Toshio

1977-01-01

The measurement of the spatial distribution of gamma-ray by monitoring posts has been continued. The measurement has been made with scintillation counters. The annual variation of gamma dose in no-rain season was recorded as background. The depth of snow showed some correlation with the level of the background gamma dose. Natural radioactivity in the air emitted from the terrestrial surface may cause the activity of the air. The relation between rain and dose rate was investigated. The higher dose rate than the background was seen during rain fall. The increase of dose rate was observed after the Chinese nuclear explosion. After the analysis of data from various monitoring posts, the trace line of fall-out activity was determined. The trace of 500 mb, which means about 10 KT of explosion, did not cross Japan, and the trace of 300 mb, meaning 100 KT of explosion, was just over Japan. The movement of the fall out along the trace line was definitely observed. (Kato, T.)

An Interoperable System toward Cardiac Risk Stratification from ECG Monitoring

Directory of Open Access Journals (Sweden)

Cristina Soguero-Ruiz

2018-03-01

Full Text Available Many indices have been proposed for cardiovascular risk stratification from electrocardiogram signal processing, still with limited use in clinical practice. We created a system integrating the clinical definition of cardiac risk subdomains from ECGs and the use of diverse signal processing techniques. Three subdomains were defined from the joint analysis of the technical and clinical viewpoints. One subdomain was devoted to demographic and clinical data. The other two subdomains were intended to obtain widely defined risk indices from ECG monitoring: a simple-domain (heart rate turbulence (HRT, and a complex-domain (heart rate variability (HRV. Data provided by the three subdomains allowed for the generation of alerts with different intensity and nature, as well as for the grouping and scrutinization of patients according to the established processing and risk-thresholding criteria. The implemented system was tested by connecting data from real-world in-hospital electronic health records and ECG monitoring by considering standards for syntactic (HL7 messages and semantic interoperability (archetypes based on CEN/ISO EN13606 and SNOMED-CT. The system was able to provide risk indices and to generate alerts in the health records to support decision-making. Overall, the system allows for the agile interaction of research and clinical practice in the Holter-ECG-based cardiac risk domain.

An Interoperable System toward Cardiac Risk Stratification from ECG Monitoring

Science.gov (United States)

Mora-Jiménez, Inmaculada; Ramos-López, Javier; Quintanilla Fernández, Teresa; García-García, Antonio; Díez-Mazuela, Daniel; García-Alberola, Arcadi

2018-01-01

Many indices have been proposed for cardiovascular risk stratification from electrocardiogram signal processing, still with limited use in clinical practice. We created a system integrating the clinical definition of cardiac risk subdomains from ECGs and the use of diverse signal processing techniques. Three subdomains were defined from the joint analysis of the technical and clinical viewpoints. One subdomain was devoted to demographic and clinical data. The other two subdomains were intended to obtain widely defined risk indices from ECG monitoring: a simple-domain (heart rate turbulence (HRT)), and a complex-domain (heart rate variability (HRV)). Data provided by the three subdomains allowed for the generation of alerts with different intensity and nature, as well as for the grouping and scrutinization of patients according to the established processing and risk-thresholding criteria. The implemented system was tested by connecting data from real-world in-hospital electronic health records and ECG monitoring by considering standards for syntactic (HL7 messages) and semantic interoperability (archetypes based on CEN/ISO EN13606 and SNOMED-CT). The system was able to provide risk indices and to generate alerts in the health records to support decision-making. Overall, the system allows for the agile interaction of research and clinical practice in the Holter-ECG-based cardiac risk domain. PMID:29494497

Clinical characteristics, risk factors and pre-surgical evaluation of post-infectious epilepsy.

Science.gov (United States)

Sellner, J; Trinka, E

2013-03-01

Epilepsy is a frequent complication of central nervous system (CNS) infections. Post-infectious epilepsy is commonly refractory to medical treatment and plays a pivotal role for the poor long-term outcome of CNS infections. To provide an overview of clinical characteristics and risk factors of seizures associated with CNS infections. In addition, to summarize the state of the art of anticonvulsive treatment and the pre-surgical evaluation process in refractory cases. A comprehensive literature search for articles published between January 1970 and December 2011 was carried out. The occurrence of seizures during the acute course of meningitis, encephalitis and brain abscess is the main risk factor for the development of post-infectious epilepsy. There is a shortage of trials evaluating the efficacy of prophylactic and symptomatic treatment during the course of acute infection. Moreover, there are no randomized-controlled trials studying anticonvulsive drugs and their combinations for the management of post-infectious epilepsy. In a selected group of patients, however, medically refractory focal epilepsy is potentially curable by surgery. Further studies are required to improve the pathogenetic understanding of post-infectious epilepsy in order to develop preventive measures as well as to evaluate additional medical and surgical treatment strategies for the patients currently not considered for surgery. © 2012 The Author(s) European Journal of Neurology © 2012 EFNS.

Prevalence and risk factors of childbirth-related post-traumatic stress symptoms.

Science.gov (United States)

Modarres, Maryam; Afrasiabi, Sedigheh; Rahnama, Parvin; Montazeri, Ali

2012-09-03

There is evidence that traumatic birth experiences are associated with psychological impairments. This study aimed to estimate the prevalence of childbirth-related post-traumatic stress symptoms and its obstetric and perinatal risk factors among a sample of Iranian women. This was a cross-sectional study carried out in Bushehr, Iran during a 3-months period from July to September 2009. Data were collected from all women attending eleven healthcare centers for postnatal care 6 to 8 weeks after childbirth. Those who had a traumatic delivery were identified and entered into the study. In order to assess childbirth-related post-traumatic stress, the Post-traumatic Symptom Scale-Interview (PSS-I) was administered. Data on demographic, obstetric and perinatal characteristics also were collected. Multivariate logistic regression was performed to examine the association between childbirth-related post-traumatic stress and demographic and obstetric and perinatal variables. In all, 400 women were initially evaluated. Of these, 218 women (54.5%) had a traumatic delivery and overall, 80 women (20%) were found to be suffering from post-partum post-traumatic stress disorder (PTSD). Multiple logistic regression analysis revealed that post-partum PTSD was associated with educational level, gestational age at delivery, number of prenatal care visits, pregnancy complications, pregnancy intervals, labor duration, and mode of delivery. The findings indicated that the prevalence of traumatic birth experiences and post-partum PTSD were relatively high among Iranian women. The findings also indicated that obstetric and perinatal variables were independently the most significant contributing factors to women's post-partum PTSD. It seems that a better perinatal care and supportive childbirth might help to reduce the burden of post-partum PTSD among this population.

Risk Factors of Erythrocytosis Post Renal Transplantation

Directory of Open Access Journals (Sweden)

Razeghi Effat

2008-01-01

Full Text Available Post-transplant erythrocytosis (PTE is characterized by persistently ele-vated hematocrit level 0 51%. This complication is reported to develop in 10-20% of renal allografts recipients, mostly 2 years after kidney transplantation. PTE is self-limited in 25% of the patients; however it may persist in patients with an increased susceptibility for thrombosis and potential fatal outcome. To evaluate the prevalence and risk factors of PTE in our center, we reviewed the records of 235 patients who received renal allografts from 1999 to 2004. Polycythemia was found in 45 (19% patients. There was no significant correlation of polycythemia and age, history of hypertension, diabetes, pre-transplant hematocrit level, pre-transplant history of transfusion, graft′s function, and source of kidney. A significantly higher proportion of PTE patients were males, patients with history of polycystic kidney disease, and patients with glomerulonephritis. We conclude that PTE is an important complication of kidney transplantation. There are several risk factors that should be addressed to prevent this complication.

Perceived parental monitoring and health risk behavior among public secondary school students in El Salvador.

Science.gov (United States)

Springer, Andrew E; Sharma, Shreela; de Guardado, Alba Margarita; Nava, Francisco Vázquez; Kelder, Steven H

2006-12-28

Although parental monitoring has received considerable attention in studies of U.S. adolescents, few published studies have examined how parents' knowledge of their children's whereabouts may influence health risk behaviors in adolescents living in Latin America. We investigated the association between perceived parental monitoring and substance use, fighting, and sexual behaviors in rural and urban Salvadoran adolescents (n = 982). After adjusting for several sociodemographic covariates, multilevel regression analyses indicated that students reporting low parental monitoring were between 2 to 3.5 times more likely to report risk behaviors examined. The promotion of specific parenting practices such as parental monitoring may hold promise for reducing adolescent risk behaviors in El Salvador.

Study of Commercial Bank Risk Monitoring Model in Individual Consumption Credit

Institute of Scientific and Technical Information of China (English)

刘春红

2003-01-01

With the development of individual consumption credit (ICC) in China, commercial banks have been exposed to more and more risks. The loan failure has been an important problem that the banking must face and revolve. This paper develops a factor system to explain how the borrower's risk is affected, and then establishes a risk monitoring model with AHP to pre-warn the banks how much the risk is.

Data-driven risk identification in phase III clinical trials using central statistical monitoring

OpenAIRE

Timmermans, Catherine; Venet, David; Burzykowski, Tomasz

2016-01-01

Our interest lies in quality control for clinical trials, in the context of risk-based monitoring (RBM). We specifically study the use of central statistical monitoring (CSM) to support RBM. Under an RBM paradigm, we claim that CSM has a key role to play in identifying the "risks to the most critical data elements and processes" that will drive targeted oversight. In order to support this claim, we first see how to characterize the risks that may affect clinical trials. We then discuss how CS...

Minimal Residual Disease Diagnostics and Chimerism in the Post-Transplant Period in Acute Myeloid Leukemia

Directory of Open Access Journals (Sweden)

Ulrike Bacher

2011-01-01

Full Text Available In acute myeloid leukemia (AML, the selection of poor-risk patients for allogeneic hematopoietic stem cell transplantation (HSCT is associated with rather high post-transplant relapse rates. As immunotherapeutic intervention is considered to be more effective before the cytomorphologic manifestation of relapse, post-transplant monitoring gains increasing attention in stem cell recipients with a previous diagnosis of AML. Different methods for detection of chimerism (e.g., microsatellite analysis or quantitative real-time PCR are available to quantify the ratio of donor and recipient cells in the post-transplant period. Various studies demonstrated the potential use of mixed chimerism kinetics to predict relapse of the AML. CD34+-specific chimerism is associated with a higher specificity of chimerism analysis. Nevertheless, a decrease of donor cells can have other causes as well. Therefore, efforts continue to introduce minimal residual disease (MRD monitoring based on molecular mutations in the post-transplant period. The NPM1 (nucleophosmin mutations can be monitored by sensitive quantitative real-time PCR in subsets of stem cell recipients with AML, but for approximately 20% of patients, suitable molecular mutations for post-transplant MRD monitoring are not available so far. This emphasizes the need for an expansion of the panel of MRD markers in the transplant setting.

Self-Monitoring Kidney Function Post Transplantation: Reliability of Patient-Reported Data.

Science.gov (United States)

van Lint, Céline; Wang, Wenxin; van Dijk, Sandra; Brinkman, Willem-Paul; Rövekamp, Ton Jm; Neerincx, Mark A; Rabelink, Ton J; van der Boog, Paul Jm

2017-09-26

The high frequency of outpatient visits after kidney transplantation is burdensome to both the recovering patient and health care capacity. Self-monitoring kidney function offers a promising strategy to reduce the number of these outpatient visits. The objective of this study was to investigate whether it is safe to rely on patients' self-measurements of creatinine and blood pressure, using data from a self-management randomized controlled trial. For self-monitoring creatinine, each participant received a StatSensor Xpress-i Creatinine Meter and related test material. For self-monitoring blood pressure, each participant received a Microlife WatchBP Home, an oscillometric device for blood pressure self-measurement on the upper arm. Both devices had a memory function and the option to download stored values to a computer. During the first year post transplantation, 54 patients registered their self-measured creatinine values in a Web-based Self-Management Support System (SMSS) which provided automatic feedback on the registered values (eg, seek contact with hospital). Values registered in the SMSS were compared with those logged automatically in the creatinine device to study reliability of registered data. Adherence to measurement frequency was determined by comparing the number of requested with the number of performed measurements. To study adherence to provided feedback, SMSS-logged feedback and information from the electronic hospital files were analyzed. Level of adherence was highest during months 2-4 post transplantation with over 90% (42/47) of patients performing at least 75% of the requested measurements. Overall, 87.00% (3448/3963) of all registered creatinine values were entered correctly, although values were often registered several days later. If (the number of) measured and registered values deviated, the mean of registered creatinine values was significantly lower than what was measured, suggesting active selection of lower creatinine values

Data-driven risk identification in phase III clinical trials using central statistical monitoring.

Science.gov (United States)

Timmermans, Catherine; Venet, David; Burzykowski, Tomasz

2016-02-01

Our interest lies in quality control for clinical trials, in the context of risk-based monitoring (RBM). We specifically study the use of central statistical monitoring (CSM) to support RBM. Under an RBM paradigm, we claim that CSM has a key role to play in identifying the "risks to the most critical data elements and processes" that will drive targeted oversight. In order to support this claim, we first see how to characterize the risks that may affect clinical trials. We then discuss how CSM can be understood as a tool for providing a set of data-driven key risk indicators (KRIs), which help to organize adaptive targeted monitoring. Several case studies are provided where issues in a clinical trial have been identified thanks to targeted investigation after the identification of a risk using CSM. Using CSM to build data-driven KRIs helps to identify different kinds of issues in clinical trials. This ability is directly linked with the exhaustiveness of the CSM approach and its flexibility in the definition of the risks that are searched for when identifying the KRIs. In practice, a CSM assessment of the clinical database seems essential to ensure data quality. The atypical data patterns found in some centers and variables are seen as KRIs under a RBM approach. Targeted monitoring or data management queries can be used to confirm whether the KRIs point to an actual issue or not.

Predicting the risks of venous thromboembolism versus post-pancreatectomy haemorrhage: analysis of 13 771 NSQIP patients

Science.gov (United States)

Tzeng, Ching-Wei D; Katz, Matthew H G; Lee, Jeffrey E; Fleming, Jason B; Pisters, Peter W T; Vauthey, Jean-Nicolas; Aloia, Thomas A

2014-01-01

Background The fear of an early post-pancreatectomy haemorrhage (PPH) may prevent surgeons from prescribing post-operative venous thromboembolism (VTE) chemoprophylaxis. The primary hypothesis of this study was that the national post-pancreatectomy early PPH rate was lower than the rate of VTE. The secondary hypothesis was that patients at high risk for post-discharge VTE could be identified, potentially facilitating the selective use of extended chemoprophylaxis. Patients and methods All elective pancreatectomies were identified in the 2005 to 2010 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database. Factors associated with 30-day rates of (pre-versus post-discharge) VTE, early PPH (transfusions > 4 units within 72 h) and return to the operating room (ROR) with PPH were analysed. Results Pancreaticoduodenectomies (PD) and distal pancreatectomies (DP) numbered 9140 (66.4%) and 4631 (33.6%) out of 13 771 pancreatectomies, respectively. Event rates included: VTE (3.1%), PPH (1.1%) and ROR+PPH (0.7%). PD and DP had similar VTE rates (P > 0.05) with 31.9% of VTE occurring post-discharge. Independent risk factors for late VTE included obesity [odds ratio (OR), 1.5], age ≥ 75 years (OR, 1.8), DP (OR, 2.4) and organ space infection (OR, 2.1) (all P pancreatectomy VTE outnumber early haemorrhagic complications, which are rare. The fear of PPH should not prevent routine and timely post-pancreatectomy VTE chemoprophylaxis. Because one-third of VTE occur post-discharge, high-risk patients may benefit from post-discharge chemoprophylaxis. PMID:23869628

Post mitigation impact risk analysis for asteroid deflection demonstration missions

Science.gov (United States)

Eggl, Siegfried; Hestroffer, Daniel; Thuillot, William; Bancelin, David; Cano, Juan L.; Cichocki, Filippo

2015-08-01

Even though mankind believes to have the capabilities to avert potentially disastrous asteroid impacts, only the realization of mitigation demonstration missions can validate this claim. Such a deflection demonstration attempt has to be cost effective, easy to validate, and safe in the sense that harmless asteroids must not be turned into potentially hazardous objects. Uncertainties in an asteroid's orbital and physical parameters as well as those additionally introduced during a mitigation attempt necessitate an in depth analysis of deflection mission designs in order to dispel planetary safety concerns. We present a post mitigation impact risk analysis of a list of potential kinetic impactor based deflection demonstration missions proposed in the framework of the NEOShield project. Our results confirm that mitigation induced uncertainties have a significant influence on the deflection outcome. Those cannot be neglected in post deflection impact risk studies. We show, furthermore, that deflection missions have to be assessed on an individual basis in order to ensure that asteroids are not inadvertently transported closer to the Earth at a later date. Finally, we present viable targets and mission designs for a kinetic impactor test to be launched between the years 2025 and 2032.

Acute cellular rejection is a risk factor for bronchiolitis obliterans syndrome independent of post-transplant baseline FEV1

DEFF Research Database (Denmark)

Burton, C.M.; Iversen, M.; Carlsen, J.

2009-01-01

BACKGROUND: Post-transplant baseline forced expiratory volume in 1 second (FEV(1)) constitutes a systematic bias in analyses of bronchiolitis obliterans syndrome (BOS). This retrospective study evaluates risk factors for BOS adjusting for the confounding of post-transplant baseline FEV(1). METHODS......-specific hazard of BOS (hazard ratio 1.4, confidence interval 1.1 to 1.8, p = 0.009). The absolute value of baseline FEV(1) was a significant confounder in all survival and competing risk analyses of BOS (p ... an independent risk factor for the development of BOS after adjusting for the confounding of post-transplant baseline FEV(1) Udgivelsesdato: 2009/9...

Perceived Parental Monitoring and Health Risk Behavior among Public Secondary School Students in El Salvador

Directory of Open Access Journals (Sweden)

Andrew E. Springer

2006-01-01

Full Text Available Although parental monitoring has received considerable attention in studies of U.S. adolescents, few published studies have examined how parents' knowledge of their children's whereabouts may influence health risk behaviors in adolescents living in Latin America. We investigated the association between perceived parental monitoring and substance use, fighting, and sexual behaviors in rural and urban Salvadoran adolescents (n = 982. After adjusting for several sociodemographic covariates, multilevel regression analyses indicated that students reporting low parental monitoring were between 2 to 3.5 times more likely to report risk behaviors examined. The promotion of specific parenting practices such as parental monitoring may hold promise for reducing adolescent risk behaviors in El Salvador.

Analysis of post-tensioned girders structural behaviour using continuous temperature and strain monitoring

Science.gov (United States)

Bednarski, Ł.; Sieńko, R.; Howiacki, T.

2017-10-01

This article presents the possibility of using structural health monitoring system data for the analysis of structure’s operation during its life cycle. Within the specific case study it was proved, that continuous, automatic and long term monitoring of selected physical quantities such as strains and temperatures, can significantly improve the assessment of technical condition by identifying hazardous phenomena. In this work the analysis of structural behaviour of post-tensioned girders within the roofing of sport halls in Cracow, Poland, was performed based on measurement results and verified by numerical model carried out in SOFiSTiK software. Thanks to the possibility of performing calculations in real time and informing the manager of the object about abnormalities it is possible to manage the structure in effective way by, inter alia, planning the renovations or supporting decisions about snow removal.

Post-traumatic stress disorder following myocardial infarction: prevalence and risk factors.

Science.gov (United States)

Roberge, Marie-Anne; Dupuis, Gilles; Marchand, André

2010-05-01

Post-traumatic stress disorder (PTSD) is associated with negative impacts on physical health. Victims of a myocardial infarction (MI) who develop PTSD may be particularly affected by these impacts due to their cardiovascular vulnerability. Post-traumatic reactions in this population are not well known. To examine the prevalence of PTSD after MI and its risk factors, and to validate a prediction model for PTSD symptoms. Patients hospitalized for MI (n=477) were recruited in three hospitals. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and questionnaires concerning PTSD symptoms and general measures were administered to patients during hospitalization and at one-month follow-up. Four per cent of the patients had PTSD and 12% had partial PTSD. The perception of a threat to life, the intensity of acute stress disorder and depression symptoms several days after the MI, a history of referral to a psychologist or psychiatrist, and female sex were risk factors for the intensity of PTSD symptoms in a sequential multiple regression analysis (R=0.634). The prediction model was validated by applying the regression equation to 48 participants who were not included in the initial regression (R=0.633). The risk factors for development of PTSD symptoms identified in the present study could be used to facilitate the detection of patients at risk for developing PTSD symptoms so they can later be offered psychological interventions as needed.

Development of a risk monitor for research reactor

International Nuclear Information System (INIS)

Agrawal, Mayank; Mathur, D.; Joshi, N.S.; Varde, P.V.

2014-01-01

The traditional approach to engineering asset management, which primarily includes management and operation and maintenance activities, in a nuclear plant is based on engineering judgment. Here, the defence-in-depth and conservative criteria form the basis of decisions. Ideally, it is expected that the decisions should be based on performance of systems, structures and components (SSC), which should also take plant safety margin into consideration. Probabilistic methods are widely used as a compliment to deterministic methods in assessing safety of nuclear reactors. A risk-based operations and maintenance management system has been developed for a research reactor. The results of a level-1 PSA study in terms of minimal cut-set equations along with other engineering plant information forms major input for this system. The system is expected to be operational in plant control room conditions in support of routine decisions. This paper presents one of the main applications of the plant Level-1 Probabilistic Safety Assessment, developed from plant specific data i.e. a risk monitor. The risk monitor has several applications that support in decision making. It is expected that the use of this system in real-time scenario will provide improved understanding of safety on one hand while enabling enhancement of plant economics on the other. Some the case studies are discussed here. (author)

Mechanical Harvesting Effectively Controls Young Typha spp. Invasion and Unmanned Aerial Vehicle Data Enhances Post-treatment Monitoring

Directory of Open Access Journals (Sweden)

Shane C. Lishawa

2017-04-01

Full Text Available The ecological impacts of invasive plants increase dramatically with time since invasion. Targeting young populations for treatment is therefore an economically and ecologically effective management approach, especially when linked to post-treatment monitoring to evaluate the efficacy of management. However, collecting detailed field-based post-treatment data is prohibitively expensive, typically resulting in inadequate documentation of the ecological effects of invasive plant management. Alternative approaches, such as remote detection with unmanned aerial vehicles (UAV, provide an opportunity to advance the science and practice of restoration ecology. In this study, we sought to determine the plant community response to different mechanical removal treatments to a dominant invasive wetland macrophyte (Typha spp. along an age-gradient within a Great Lakes coastal wetland. We assessed the post-treatment responses with both intensive field vegetation and UAV data. Prior to treatment, the oldest Typha stands had the lowest plant diversity, lowest native sedge (Carex spp. cover, and the greatest Typha cover. Following treatment, plots that were mechanically harvested below the surface of the water differed from unharvested control and above-water harvested plots for several plant community measures, including lower Typha dominance, lower native plant cover, and greater floating and submerged aquatic species cover. Repeated-measures analysis revealed that above-water cutting increased plant diversity and aquatic species cover across all ages, and maintained native Carex spp. cover in the youngest portions of Typha stands. UAV data revealed significant post-treatment differences in normalized difference vegetation index (NDVI scores, blue band reflectance, and vegetation height, and these remotely collected measures corresponded to field observations. Our findings suggest that both mechanically harvesting the above-water biomass of young Typha stands

Development of a risk index for the prediction of chronic post-surgical pain.

Science.gov (United States)

Althaus, A; Hinrichs-Rocker, A; Chapman, R; Arránz Becker, O; Lefering, R; Simanski, C; Weber, F; Moser, K-H; Joppich, R; Trojan, S; Gutzeit, N; Neugebauer, E

2012-07-01

The incidence of chronic post-surgical pain (CPSP) after various common operations is 10% to 50%. Identification of patients at risk of developing chronic pain, and the management and prevention of CPSP remains inadequate. The aim of this study was to develop an easily applicable risk index for the detection of high-risk patients that takes into account the multifactorial aetiology of CPSP. A comprehensive item pool was derived from a systematic literature search. Items that turned out significant in bivariate analyses were then analysed multivariately, using logistic regression analyses. The items that yielded significant predictors in the multivariate analyses were compiled into an index. The cut-off score for a high risk of developing CPSP with an optimal trade-off between sensitivity and specificity was identified. The data of 150 patients who underwent different types of surgery were included in the analyses. Six months after surgery, 43.3% of the patients reported CPSP. Five predictors multivariately contributed to the prediction of CPSP: capacity overload, preoperative pain in the operating field, other chronic preoperative pain, post-surgical acute pain and co-morbid stress symptoms. These results suggest that several easily assessable preoperative and perioperative patient characteristics can predict a patient's risk of developing CPSP. The risk index may help caregivers to tailor individual pain management and to assist high-risk patients with pain coping. © 2011 European Federation of International Association for the Study of Pain Chapters.

Monitoring of Grouting Compactness in a Post-Tensioning Tendon Duct Using Piezoceramic Transducers

Directory of Open Access Journals (Sweden)

Tianyong Jiang

2016-08-01

Full Text Available A post-tensioning tendon duct filled with grout can effectively prevent corrosion of the reinforcement, maintain bonding behavior between the reinforcement and concrete, and enhance the load bearing capacity of concrete structures. In practice, grouting of the post-tensioning tendon ducts always causes quality problems, which may reduce structural integrity and service life, and even cause accidents. However, monitoring of the grouting compactness is still a challenge due to the invisibility of the grout in the duct during the grouting process. This paper presents a stress wave-based active sensing approach using piezoceramic transducers to monitor the grouting compactness in real time. A segment of a commercial tendon duct was used as research object in this study. One lead zirconate titanate (PZT piezoceramic transducer with marble protection, called a smart aggregate (SA, was bonded on the tendon and installed in the tendon duct. Two PZT patch sensors were mounted on the top outside surface of the duct, and one PZT patch sensor was bonded on the bottom outside surface of the tendon duct. In the active sensing approach, the SA was used as an actuator to generate a stress wave and the PZT sensors were utilized to detect the wave response. Cement or grout in the duct functions as a wave conduit, which can propagate the stress wave. If the cement or grout is not fully filled in the tendon duct, the top PZT sensors cannot receive much stress wave energy. The experimental procedures simulated four stages during the grout pouring process, which includes empty status, half grouting, 90% grouting, and full grouting of the duct. Experimental results show that the bottom PZT sensor can detect the signal when the grout level increases towards 50%, when a conduit between the SA and PZT sensor is formed. The top PZT sensors cannot receive any signal until the grout process is completely finished. The wavelet packet-based energy analysis was adopted in this

Framework for ensuring appropriate maintenance of baseline PSA and risk monitor models in a nuclear power plant

International Nuclear Information System (INIS)

Vrbanic, I.; Sorman, J.

2005-01-01

The necessity of observing both long term and short term risk changes many times imposes the need for a nuclear power plant to have a baseline PSA model to produce an estimate of long term averaged risk and a risk monitor to produce a time-dependent risk curve and/or safety functions status at points in time or over a shorter time period of interest. By nature, a baseline PSA reflects plant systems and operation in terms of average conditions and provides time-invariant quantitative risk metrics. Risk monitor, on the other hand, requires condition-specific modeling to produce a quantitative and/or qualitative estimate of plant's condition-specific risk metrics. While risk monitor is used for computing condition-specific risk metrics over time, a baseline PSA model is needed for variety of other risk oriented applications, such as assessments of proposed design modifications or risk ranking of equipment. Having in mind their importance and roles, it is essential that both models, i.e. baseline PSA model and risk monitor are maintained in the way that they represent, as accurately as practically achievable, the actual plant status (e.g. systems' design and plant's procedures in effect) and its history (e.g. numbers of equipment failures and demands that influence relevant PSA parameters). Paper discusses the requirements for appropriate maintenance of plant's baseline PSA model and risk monitor model and presents the framework for plant's engineering and administrative procedures that would ensure they are met. (author)

Re-conceptualising prenatal life stressors in predicting post-partum depression: cumulative-, specific-, and domain-specific approaches to calculating risk.

Science.gov (United States)

Liu, Cindy H; Tronick, Ed

2013-09-01

Prenatal life stress predicts post-partum depression (PPD); however, studies generally examine individual stressors (a specific approach) or the summation of such exposure (a cumulative approach) and their associations with PPD. Such approaches may oversimplify prenatal life stress as a risk factor for PPD. We evaluated approaches in assessing prenatal life stress as a predictor of PPD diagnosis, including a domain-specific approach that captures cumulative life stress while accounting for stress across different life stress domains: financial, relational, and physical health. The Pregnancy Risk Assessment Monitoring System, a population-based survey, was used to analyse the association of prenatal life stressors with PPD diagnoses among 3566 New York City post-partum women. Specific stressors were not associated with PPD diagnosis after controlling for sociodemographic variables. Exposure to a greater number of stressors was associated with PPD diagnosis, even after adjusting for both sociodemographic variables and specific stressors [odds ratio (OR) = 3.1, 95% confidence interval (CI) = 1.5, 6.7]. Individuals reporting a moderate-to-high number of financial problems along with a moderate-to-high number of physical problems were at greater odds of PPD (OR = 4.2, 95% CI = 1.2, 15.3); those with a moderate-to-high number of problems in all three domains were at over fivefold increased odds of PPD (OR = 5.5, CI = 1.1, 28.5). In assessing prenatal stress, clinicians should consider the extent to which stressors occur across different life domains; this association appears stronger with PPD diagnosis than simple assessments of individual stressors, which typically overestimate risk or cumulative exposures. © 2013 John Wiley & Sons Ltd.

HIV risk and awareness and interest in pre-exposure and post-exposure prophylaxis among sheltered women in Miami.

Science.gov (United States)

Doblecki-Lewis, Susanne; Lester, Larissa; Schwartz, Bryanna; Collins, Constance; Johnson, Rai; Kobetz, Erin

2016-09-01

Pre- and non-occupational post-exposure prophylaxis for the prevention of HIV infection are recommended for adults at substantial risk of HIV. Women experiencing homelessness have increased risk of HIV infection compared with stably-housed women. We conducted a survey of 74 sheltered women at Lotus House Women's Shelter (Lotus House) in Miami to assess risk behaviour as well as knowledge and perception of pre- and non-occupational post-exposure prophylaxis in this population. Of surveyed women, 58.1% engaged in vaginal and/or anal sex while sheltered, and of sexually-active women 55.4% reported inconsistent condom use. 83.8% of women reported no concern regarding HIV acquisition due to their behaviour. Few women surveyed (20.8%) had previously heard of pre- or non-occupational post-exposure prophylaxis. The majority (58.3%) of respondents indicated receptiveness to these prevention methods when introduced. Those indicating that they would consider pre- or non-occupational post-exposure prophylaxis were significantly younger than those indicating that they would not consider these prevention strategies (p = 0.004). Education and referral for pre- and non-occupational post-exposure prophylaxis should be considered for sheltered women at risk of HIV infection. Additional research to optimise implementation of biomedical prevention strategies in this population is needed. © The Author(s) 2015.

PERAN PRODUCT CUES AND RISK AVERSION PADA PURCHASE INTENTION DAN POST PURCHASE FEELINGS

Directory of Open Access Journals (Sweden)

Sri Rejeki Ekasasi

2015-11-01

Full Text Available AbstractThe research aimed to investigate the influence of extrinsic cues and intrinsic cues and risk aversion towards purchase intention and post-purchase feeling of counterfeited computer software and music CD. This research study collected data from two populations which are students and employee. Approximately 128 respondents involved to give respond for the survey. The analysis using Structural Equation Model (SEM show that product cues and risk aversion give different significant impact towards purchase intention and post-purchase feeling of counterfeited computer software and music CD. The research concluded that risk aversion and extrinsic cues has a significant influence to purchase intention of counterfeited computer software while it does not appear similar result to music CD. Moreover, the study revealed that for both counterfeited computer software and music CD, the purchase intention is proven to have negative significant influence towards post-purchase feelings.Keywords: risk aversion, extrinsic cues, intrinsic cues, purchase intention, post-purchase feelingsAbstrakTujuan dari penelitian ini adalah untuk melihat pengaruh atribut ekstrinsik dan intrinsic produk serta aspek menolak resiko terhadap niat beli dan perasaan paska beli software computer dan CD music bajakan. Penelitian ini diharapkan akan memperoleh sebuah model dengan pendekatan cultural dan strategi bisnis untuk memblokir atau mengurangi produk bajakan yang dapat diakses konsumen di pasar. Data primer akan dikumpulkan dari dua populasi, kelompok mahasiswa dan kelompok pekerja, dari empat kota besar di Indonesia yaitu Jakarta, Semarang, Surabaya, dan Yogyakarta. Lebih kurang 128 responden terlibat dalam penelitian ini. Hasil penelitian menunjukkan bahwa aspek atribut produk yang bersifat ekstrinsik dan aspek menolak resiko terbukti memiliki hubungan signifikan mempengaruhi niat beli software computer, akan tetapi lain tidak demikian pada niat beli CD music bajakan

Ultrasound-guided fine needle aspiration versus core needle biopsy: comparison of post-biopsy hematoma rates and risk factors.

Science.gov (United States)

Chae, In Hye; Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Park, Vivian Y; Kwak, Jin Young

2017-07-01

To compare post-biopsy hematoma rates between ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy, and to investigate risk factors for post-biopsy hematoma. A total of 5304 thyroid nodules which underwent ultrasound guided biopsy were included in this retrospective study. We compared clinical and US features between patients with and without post-biopsy hematoma. Associations between these features and post-biopsy hematoma were analyzed. Post-biopsy hematoma rate was 0.8% (43/5121) for ultrasound guided-fine needle aspiration and 4.9% (9/183) for ultrasound guided-core needle biopsy (P core needle biopsy (9/179, 5.0%) than with ultrasound guided-fine needle aspiration (9/1138, 0.8%) (P core needle biopsy was the only significant risk factor for post-biopsy hematoma (adjusted Odds Ratio, 6.458, P core needle biopsy than in ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy was the only independent factor of post-biopsy hematoma in thyroid nodules.

Construction Condition and Damage Monitoring of Post-Tensioned PSC Girders Using Embedded Sensors.

Science.gov (United States)

Shin, Kyung-Joon; Lee, Seong-Cheol; Kim, Yun Yong; Kim, Jae-Min; Park, Seunghee; Lee, Hwanwoo

2017-08-10

The potential for monitoring the construction of post-tensioned concrete beams and detecting damage to the beams under loading conditions was investigated through an experimental program. First, embedded sensors were investigated that could measure pre-stress from the fabrication process to a failure condition. Four types of sensors were installed on a steel frame, and the applicability and the accuracy of these sensors were tested while pre-stress was applied to a tendon in the steel frame. As a result, a tri-sensor loading plate and a Fiber Bragg Grating (FBG) sensor were selected as possible candidates. With those sensors, two pre-stressed concrete flexural beams were fabricated and tested. The pre-stress of the tendons was monitored during the construction and loading processes. Through the test, it was proven that the variation in thepre-stress had been successfully monitored throughout the construction process. The losses of pre-stress that occurred during a jacking and storage process, even those which occurred inside the concrete, were measured successfully. The results of the loading test showed that tendon stress and strain within the pure span significantly increased, while the stress in areas near the anchors was almost constant. These results prove that FBG sensors installed in a middle section can be used to monitor the strain within, and the damage to pre-stressed concrete beams.

Technical Report on Preliminary Methodology for Enhancing Risk Monitors with Integrated Equipment Condition Assessment

Energy Technology Data Exchange (ETDEWEB)

Ramuhalli, Pradeep; Coles, Garill A.; Coble, Jamie B.; Hirt, Evelyn H.

2013-09-17

Small modular reactors (SMRs) generally include reactors with electric output of ~350 MWe or less (this cutoff varies somewhat but is substantially less than full-size plant output of 700 MWe or more). Advanced SMRs (AdvSMRs) refer to a specific class of SMRs and are based on modularization of advanced reactor concepts. AdvSMRs may provide a longer-term alternative to traditional light-water reactors (LWRs) and SMRs based on integral pressurized water reactor concepts currently being considered. Enhancing affordability of AdvSMRs will be critical to ensuring wider deployment. AdvSMRs suffer from loss of economies of scale inherent in small reactors when compared to large (~greater than 600 MWe output) reactors. Some of this loss can be recovered through reduced capital costs through smaller size, fewer components, modular fabrication processes, and the opportunity for modular construction. However, the controllable day-to-day costs of AdvSMRs will be dominated by operation and maintenance (O&M) costs. Technologies that help characterize real-time risk are important for controlling O&M costs. Risk monitors are used in current nuclear power plants to provide a point-in-time estimate of the system risk given the current plant configuration (e.g., equipment availability, operational regime, and environmental conditions). However, current risk monitors are unable to support the capability requirements listed above as they do not take into account plant-specific normal, abnormal, and deteriorating states of active components and systems. This report documents technology developments that are a step towards enhancing risk monitors that, if integrated with supervisory plant control systems, can provide the capability requirements listed and meet the goals of controlling O&M costs. The report describes research results from an initial methodology for enhanced risk monitors by integrating real-time information about equipment condition and POF into risk monitors.

NPP post-accident monitoring system based on unmanned aircraft vehicle:concept, design principles

International Nuclear Information System (INIS)

Sachenko, A.A.; Kochan, V.V.; Kharchenko, V.S.; Yanovskij, M.Eh.; Yastrebenetskij, M.A.; Fesenko, G.V.

2016-01-01

The paper presents a concept of designing the post-accident system for monitoring the equipment and territory of nuclear power plant after a severe accident based on unmanned aircraft vehicle (UAVs). Wired power and communications networks are found out as the most vulnerable ones during the accident monitoring, and informativity, reliability and veracity are recognized as system basic parameters. It is proposed to equip measurement and control modules with backup wireless communication channels and deploy the repeaters network based on UAVs to ensure the informativity. Modules possess the backup power battery, and repeaters appear in the appropriate places after the accident to provide the survivability. Moreover, an optimization of UAVs' location is proposed according to the minimum energy consumption criterion. To ensure the veracity, it is expected to design the noise-immune protocol for message exchange and archiving and self-diagnostics of all system components

Analysis on risk factors for post-stroke emotional incontinence

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Xiao-chun ZHANG

2018-01-01

Full Text Available Objective To investigate the occurrence rate and related risk factors for post-stroke emotional incontinence (PSEI. Methods The clinical data [sex, age, body mass index (BMI, education, marital status, medical history (hypertension, heart disease, diabetes, hyperlipemia, smoking and drinking and family history of stroke] of 162 stroke patients were recorded. Serum homocysteine (Hcy level was examined. Head CT and/or MRI were used to indicate stroke subtype, site of lesion and number of lesion. Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-Ⅴ Chinese version and Hamilton Depression Rating Scale-17 Items (HAMD-17 were used to evaluate the degree of depression. House diagnostic standard was used to diagnose PSEI. Univariate and multivariate backward Logistic regression analysis was used to screen related risk factor for PSEI. Spearman rank correlation analysis was used to discuss the correlation between PSEI and post-stroke depression (PSD. Results Among 162 stroke patients, 12 cases were diagnosed as PSEI (7.41% . The ratio of age < 60 years in PSEI group was significantly higher than non-PSEI group (P = 0.045. The ratio of smoking in PSEI group was significantly lower than non-PSEI group (P = 0.036. Univariate and multivariate backward Logistic regression analysis showed age < 60 years was independent risk factor for PSEI (OR = 4.000, 95%CI: 1.149-13.924; P = 0.029. Ten cases were combined with PSD in 12 PSEI patients, and the co-morbidity rate of PSEI and PSD was83.33%. Spearman rank correlation analysis showed PSEI was positively related to PSD (rs = 0.305, P = 0.000. Conclusions PSEI is common affective disorder in stroke patients, which easily happens in patients under 60 years of age. DOI: 10.3969/j.issn.1672-6731.2017.12.010

Audit of co-management and critical care outreach for high risk postoperative patients (The POST audit).

Science.gov (United States)

Story, D A; Shelton, A; Jones, D; Heland, M; Belomo, R

2013-11-01

Co-management and critical care outreach for high risk surgical patients have been proposed to decrease postoperative complications and mortality. We proposed that a clinical project with postoperative comanagement and critical care outreach, the Post Operative Surveillance Team: (POST), would be associated with decreased hospital length of stay. We conducted a retrospective before (control group) and after (POST group) audit of this hospital program. POST was staffed for four months in 2010 by two intensive care nurses and two senior registrars who conducted daily ward rounds for the first five postoperative days on high risk patients undergoing inpatient general or urological surgery. The primary endpoint was length of hospital stay and secondary endpoints were Medical Emergency Team (MET) calls, cardiac arrests and in-hospital mortality. There were 194 patients in the POST group and 1,185 in the control group. The length of stay in the POST group, median nine days (Inter-quartile range [IQR]: 5 to 17 days), was longer than the control group, median seven days (IQR: 4 to 13 days): difference two days longer (95.0% confidence interval [95.0% CI]: 1 to 3 days longer, P audit found that the POST service was not associated with reduced length of stay. Models of co-management, different to POST, or with different performance metrics, could be tested.

Visualization of radiation dose big data acquired by monitoring posts

International Nuclear Information System (INIS)

Hashimoto, Takeyuki; Jumonji, Hiromichi

2014-01-01

Currently, in Fukushima Prefecture, 3625 radiation dose monitoring posts is available, and the radiation data is acquired every 10 minutes. However, an effective visualization of such an enormous amount of data has not been sufficiently performed. In this study, pull out the meaningful information from the big data, to achieve an effective visualization. By comparing the physical attenuation with the radiation dose changes, we can predict the trend of environment attenuation. We visualize the influence of the environment by plotting the results to the map. As a result, the difference in the increase or decrease depending on the location appeared. Under the influence of snow cover, a phenomenon that radiation dose is reduced in winter were also seen. We considered that these results will be effective for the policies of decontamination and the estimation of the amount of snow as water resources. (author)

Monitoring post-fire recovery of shrublands in Mediterranean-type ecosystems using MODIS and TM/ETM+ data

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Hope, Allen; Albers, Noah; Bart, Ryan

2010-05-01

Wildland fires in Mediterranean-Type Ecosystems (MTEs) are episodic events that dramatically alter land-cover conditions. Monitoring post-fire vegetation recovery is important for land management applications such as the scheduling of prescribed burns, post-fire resource management and soil erosion control. Full recovery of MTE shrublands may take many years and have a prolonged effect on water, energy and carbon fluxes in these ecosystems. Comparative studies of fynbos ecosystems in the Cape Floristic Region of South Africa (Western Cape Region) and chaparral ecosystems of California have demonstrated that there is a considerable degree of convergence in some aspects of post-fire vegetation regeneration and marked differences in other aspects. Since these MTEs have contrasting rainfall and soil nutrient conditions, an obvious question arises as to the similarity or dissimilarity in remotely sensed post-fire recovery pathways of vegetation stands in these two regions and the extent to which fire severity and drought impact the rate of vegetation recovery. Post-fire recovery pathways of chaparral and fynbos vegetation stands were characterized using the normalized difference vegetation index (NDVI) based on TM/ETM+ and MODIS (250 m) data. Procedures based on stands of unburned vegetation (control) were implemented to normalize the NDVI for variations associated with inter-annual differences in rainfall. Only vegetation stands that had not burned for 20 years were examined in this study to eliminate potential effects of variable fire histories on the recovery pathways. Post-fire recovery patterns of vegetation in both regions and across different vegetation types were found to be very similar. Post-fire stand age was the primary control over vegetation recovery and the NDVI returned to pre-fire values within seven to 10 years of the fires. Droughts were shown to cause slight interruptions in recovery rates while fire severity had no discernable effect. Intra

Risk Behaviors of Youth Living With HIV: Pre- and Post-HAART

Science.gov (United States)

Lightfoot, Marguerita; Swendeman, Dallas; Rotheram-Borus, Mary Jane; Comulada, W. Scott; Weiss, Robert

2005-01-01

Objective: To examine the transmission behavior among youth living with HIV (YLH), pre- and post-HAART. Methods: Two cohorts were recruited: (1) 349 YLH during 1994 to 1996 and (2) 175 YLH during 1999 to 2000, after the wide availability of HAART. Differences in sexual and substance-use risk acts and quality of life were examined. Results:…

Geological storage of CO2: risks analysis, monitoring and measures. Final report

International Nuclear Information System (INIS)

Abou Akar, A.; Audibert, N.; Audigane, P.; Baranger, P.; Bonijoly, D.; Carnec, C.; Czernichowski, I.; Debeglia, N.; Fabriol, H.; Foerster, E.; Gaus, I.; Le Nindre, Y.; Michel, K.; Morin, D.; Roy, S.; Sanjuan, B.; Sayedi, D.

2005-01-01

To use the CO 2 geological storage as a coherent solution in the greenhouse gases reduction it needs to answer to safety and monitoring conditions. In this framework the BRGM presents this study in six chapters: risks analysis, the monitoring methods (geochemistry, geophysics, aerial monitoring, biochemistry, hydrogeology), the metrology, the corrosion problems, the thermal, hydrodynamical, geochemical and mechanical simulation and the today and future regulations. (A.L.B.)

Predicting post-vaccination autoimmunity: who might be at risk?

Science.gov (United States)

Soriano, Alessandra; Nesher, Gideon; Shoenfeld, Yehuda

2015-02-01

Vaccinations have been used as an essential tool in the fight against infectious diseases, and succeeded in improving public health. However, adverse effects, including autoimmune conditions may occur following vaccinations (autoimmune/inflammatory syndrome induced by adjuvants--ASIA syndrome). It has been postulated that autoimmunity could be triggered or enhanced by the vaccine immunogen contents, as well as by adjuvants, which are used to increase the immune reaction to the immunogen. Fortunately, vaccination-related ASIA is uncommon. Yet, by defining individuals at risk we may further limit the number of individuals developing post-vaccination ASIA. In this perspective we defined four groups of individuals who might be susceptible to develop vaccination-induced ASIA: patients with prior post-vaccination autoimmune phenomena, patients with a medical history of autoimmunity, patients with a history of allergic reactions, and individuals who are prone to develop autoimmunity (having a family history of autoimmune diseases; asymptomatic carriers of autoantibodies; carrying certain genetic profiles, etc.). Copyright © 2014 Elsevier Ltd. All rights reserved.

A modified risk assessment scoring system for post laser in situ keratomileusis ectasia in topographically normal patients

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Mohammad Miraftab

2014-01-01

Conclusion: Our modified ectasia risk scoring system for patients with normal corneal topography can predict post LASIK ectasia risk with acceptable sensitivity and specificity. However, there are still unidentified risk factors for which further studies are required.

Cigarette smoking is an independent risk factor for post-stroke delirium.

Science.gov (United States)

Lim, Tae Sung; Lee, Jin Soo; Yoon, Jung Han; Moon, So Young; Joo, In Soo; Huh, Kyoon; Hong, Ji Man

2017-03-23

Post-stroke delirium is a common problem in the care of stroke patients, and is associated with longer hospitalization, high short-term mortality, and an increased need for long-term care. Although post-stroke delirium occurs in approximately 10 ~ 30% of patients, little is known about the risk factors for post-stroke delirium in patients who experience acute stroke. A total of 576 consecutive patients who experienced ischemic stroke (mean age, 65.2 years; range, 23-93 years) were screened for delirium over a 2-year period in an acute stroke care unit of a tertiary referral hospital. We screened for delirium using the Confusion Assessment Method. Once delirium was suspected, we evaluated the symptoms using the Korean Version of the Delirium Rating Scale-Revised-98. Neurological deficits were assessed using the National Institutes of Health Stroke Scale at admission and discharge, and functional ability was assessed using the Barthel Index and modified Rankin Scale at discharge and 3 months after discharge. Thirty-eight (6.7%) patients with stroke developed delirium during admission to the acute stroke care unit. Patients with delirium were significantly older (70.6 vs. 64.9 years of age, P = .001) and smoked cigarettes more frequently (40% vs. 24%, P = .033) than patients without delirium. In terms of clinical features, the delirium group experienced a significantly higher rate of major hemispheric stroke (55% vs. 26%, P delirium were older age, history of cigarette smoking, and major hemispheric stroke. Abrupt cessation of cigarette smoking may be a risk factor for post-stroke delirium in ischemic stroke patients. The development of delirium after stroke is associated with worse outcome and longer hospitalization.

Risk management and post-marketing surveillance of CNS drugs.

Science.gov (United States)

Henningfield, Jack E; Schuster, Charles R

2009-12-01

Drugs affecting the central nervous system span a broad range of chemical entities, dosage forms, indications, and risks. Unintended consequences include potential abuse and overdose in non-patient drug abusers, deliberate tampering of drug dosage forms, and criminal behavior associated with diversion. Regulators must consider diverse factors to find the appropriate conditions of approval to minimize unintended consequences while enabling a level of access desired by health care providers and patients. This commentary appears as part of a special issue of Drug and Alcohol Dependence that focuses on risk management and post-marketing surveillance and addresses key issues that pose real-world challenges to pharmaceutical sponsors and regulators in particular. For example, in the U.S., Controlled Substances Act drug scheduling can be considered a risk management strategy but its legal authorities and administrative processes are independent from those of risk management (including Risk Evaluation and Mitigation Strategies or REMS); better harmonization of these approaches is vital from drug development and regulatory perspectives. Risk management would ideally be implemented on a strong science foundation demonstrating that the tools employed to mitigate risks and ensure safe use are effective. In reality, research and evaluation of tools in this area is in its infancy and will necessarily be an evolutionary process; furthermore, there is little precedent for linking interventions and program evolution to unintended consequences such as regional outbreaks of abuse and diversion. How such issues are resolved has the potential to stimulate or stifle innovations in drug development and advance or imperil health care.

Risk Factors for Post-stroke Depression: A Meta-analysis

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Yu Shi

2017-07-01

Full Text Available Background: Stroke not only impacts patients physically but also economically. Post-stroke depression (PSD, as a common complication of stroke, always obstructs the process of stroke rehabilitation. Accordingly, defining the risk factors associated with PSD has extraordinary importance. Although there have been many studies investigating the risk factors for PSD, the results are inconsistent.Objectives: The objectives of this study were to identify the risk factors for PSD by evidence-based medicine.Data sources: A systematic and comprehensive database search was performed of PubMed, Medline, CENTRAL, EMBASE.com, the Cochrane library and Web of Science for Literature, covering publications from January 1, 1998 to November 19, 2016.Study Selection: Studies on risk factors for PSD were identified, according to inclusion and exclusion criteria. The risk of bias tool, described in the Cochrane Handbook version 5.1.0, was used to assess the quality of each study. Meta-analysis was performed using RevMan 5.3 software.Results: Thirty-six studies were included for review. A history of mental illness was the highest ranking modifiable risk factor; other risk factors for PSD were female gender, age (<70 years, neuroticism, family history, severity of stroke, and level of handicap. Social support was a protective factor for PSD.Conclusion: There are many factors that have effects on PSD. The severity of stroke is an important factor in the occurrence of PSD. Mental history is a possible predictor of PSD. Prevention of PSD requires social and family participation.

The Effect of the Post 2001 Reforms on FMD Risks of the International Live Animal Trade.

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Shanafelt, David W; Perrings, C

2018-02-27

The 2001 UK foot and mouth disease (FMD) epidemic marked a change in global FMD management, focusing less on trade isolation than on biosecurity within countries where FMD is endemic. Post 2001 policy calls for the isolation of disease-free zones in FMD-endemic countries, while increasing the opportunities for trade. The impact of the change on disease risk has yet to be tested. In this paper, we estimate an empirical model of disease risk that tests for the impact of trade volumes before and after 2001, controlling for biosecurity measures. In the pre 2001 regime, we find that poor biosecurity was associated with the probability of reporting an outbreak. In the post 2001 regime, the risks changed, with trade being a much greater source of risk. We discuss the trade-off between trade restrictions and biosecurity measures in the management of FMD disease risks.

POST Traumatic Stress Disorder in Emergency Workers: Risk Factors and Treatment

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Argentero, Piergiorgio; Dell'Olivo, Bianca; Setti, Ilaria

Post traumatic stress disorder (PTSD) are emergent phenomena resulting from exposure to a traumatic event that causes actual or threatened death or injury and produces intense fear, helplessness, or horror. In order to assess the role of different factors contributing to this kind of emergent phenomenon prevalence rates across gender, cultures, and samples exposed to different traumas are examined. Risk factors for PTSD, including pre-existing individual-based factors, features of the traumatic event, and post-trauma interventions are examined as well. Several characteristics of the trauma, related to cognitions, post-trauma social support and therapeutic interventions for PTSD are also considered. Further work is needed in order to analyze the inter-relationships among these factors and underlying mechanisms. The chaotic nature of traumatic processes, the multiple and interactive impacts on traumatic events require a comprehensive perspective aimed at planning effective interventions. Treatment outcome studies recommended the combined use of training and therapies as first-line treatment for PTSD.

Benefit of general anesthesia monitored by bispectral index compared with monitoring guided only by clinical parameters. Systematic review and meta-analysis

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Carlos Rogério Degrandi Oliveira

Full Text Available Abstract Background: The bispectral index parameter is used to guide the titration of general anesthesia; however, many studies have shown conflicting results regarding the benefits of bispectral index monitoring. The objective of this systematic review with meta-analysis is to evaluate the clinical impact of monitoring with the bispectral index parameter. Methods: The search for evidence in scientific information sources was conducted during December 2013 to January 2015, the following primary databases: Medline/PubMed, LILACS, Cochrane, CINAHL, Ovid, SCOPUS and TESES. The criteria for inclusion in the study were randomized controlled trials, comparing general anesthesia monitored, with bispectral index parameter with anesthesia guided solely by clinical parameters, and patients aged over 18 years. The criteria for exclusion were studies involving anesthesia or sedation for diagnostic procedures, and intraoperative wake-up test for surgery of the spine. Results: The use of monitoring with the bispectral index has shown benefits reducing time to extubation, orientation in time and place, and discharge from both the operating room and post anesthetic care unit. The risk of nausea and vomiting after surgery was reduced by 12% in patients monitored with bispectral index. Occurred a reduction of 3% in the risk of cognitive impairment postoperatively at 3 months postoperatively and 6% reduction in the risk of postoperative delirium in patients monitored with bispectral index. Furthermore, the risk of intraoperative memory has been reduced by 1%. Conclusion: Clinically, anesthesia monitoring with the BIS can be justified because it allows advantages from reducing the recovery time after waking, mainly by reducing the administration of general anesthetics as well as the risk of adverse events.

Application of Risk Management for Control and Monitoring Systems

CERN Document Server

Grau, S; Balda, F; Chouvelon, A

2001-01-01

This paper presents an application of the state of the art and new trends for risk management of safety-related control and monitoring systems, currently applied in the industry. These techniques not only enable to manage safety and reliability issues but they also help in the control of quality and economic factors affected by the availability and maintenance of the system. The method includes an unambiguous definition of the system in terms of functions and a systematic analysis of hazardous situations, undesired events and possible malfunctions. It also includes the identification and quantification of the risk associated to the system. The required risk reduction is specified in terms of safety integrity levels. The safety integrity level results in requirements, preventive measures, possible improvements and recommendations to assure the satisfactory management of the risk.

A New Method for Post-introduction Risk Assessment of Biological Invasions Among Introduced Shrubs in Developing Countries.

Science.gov (United States)

Seburanga, J L; Bizuru, E; Mwavu, E N; Kampungu, K G; Gatesire, T; Kaplin, B A

2016-03-01

Risk-assessment methods are useful in collecting data that can help decision making to prevent the introduction of new species that have the potential of invading as well as in management of established taxa. Not only the complexity and unaffordability of available pre-introduction risk-assessment models make them rarely or inconsistently applied in the least-developed countries, but also there is lack of tools to assess the status of already introduced plant species. In this study, an affordable and rapid method of assessment of invasiveness among introduced plant species was developed and tested in Rwanda. This method defines three invasion stages (potential, effective, and suppressive invaders) and four levels of risk assessment: post-introduction assessment of species inherent invasive potential (Level 1), post-establishment assessment of species capacity of regeneration (Level 2), post-naturalization assessment of species range of occurrence and ability for long-distance dispersal (Level 3), and post-naturalization assessment of species ability to outcompete other plants in the community and transform the landscape (Level 4). A review of invasive species in Rwanda was developed through desk review, examination of herbarium records, and vegetation surveys. This method should be applicable in other countries that lack the means for a more conventional scientific investigation or under any circumstance where a quick and inexpensive assessment is needed. The method could be useful to environmental managers for timely intervention with strategies specific to different stages of invasion (post-introduction, post-establishment, or post-naturalization) and allocate resources accordingly.

Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy

DEFF Research Database (Denmark)

Behrens, Ida; Basit, Saima; Melbye, Mads

2017-01-01

Objectives To determine how soon after delivery the risk of post-pregnancy hypertension increases in women with hypertensive disorders of pregnancy and how the risk evolves over time.Design Nationwide register based cohort study.Setting Denmark.Populations 482 972 primiparous women with a first l...

Risk factors associated with short-term post-treatment outcomes of clinical mastitis.

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Pinzón-Sánchez, C; Ruegg, P L

2011-07-01

The objectives of this study were to characterize 60-d outcomes after treatment of mild (abnormal milk) and moderate (abnormal milk and abnormal udder) cases of clinical mastitis (CM) occurring in a single quarter of cows on Wisconsin farms (n=4) and to determine risk factors associated with those outcomes. Duplicate milk samples were collected from the affected quarter of each cow for microbiological analysis at the onset of CM (PRE) and 21 d later (POST). Cows were treated only in the affected quarter using an intramammary product containing 125 mg of ceftiofur. Bacteriological cure was defined as absence of pathogens in the POST sample obtained from the enrolled quarter. Recurrence was defined for the cow when CM occurred after the milk-withholding period for the enrolled case of CM. Retention in the herd was defined when a cow was retained within the herd for the 60-d follow-up period. Somatic cell count reduction (SCCR) was defined at the cow level as somatic cell count (SCC) below 200,000 cells/mL at the Dairy Herd Improvement Association test day occurring between 21 to 55 d post-treatment. The effects of farm, days in milk, parity, severity, microbiological diagnosis at PRE, previous milk yield, previous SCC, previous occurrence of CM and treatment duration on selected post-treatment outcomes were assessed using Chi-squared analysis and logistic regression. Microbiological results at PRE were distributed as: Escherichia coli (n=14), Klebsiella spp. (n=11), Enterobacter spp. (n=8), Serratia spp. (n=7), other gram-negative species (n=3), Streptococcus spp. (n=25), coagulase-negative staphylococci (n=4); Staphylococcus aureus (n=1); Streptococcus agalactiae (n=1), other gram-positive species (n=9), and culture negative (n=60). Treated quarters were more likely to experience bacteriological cure when the cow experienced CM for the first time in the lactation and when no pathogen was recovered from PRE milk samples obtained from the enrolled quarter. Parity and

Pharmaceuticals in tap water: human health risk assessment and proposed monitoring framework in China.

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Leung, Ho Wing; Jin, Ling; Wei, Si; Tsui, Mirabelle Mei Po; Zhou, Bingsheng; Jiao, Liping; Cheung, Pak Chuen; Chun, Yiu Kan; Murphy, Margaret Burkhardt; Lam, Paul Kwan Sing

2013-07-01

Pharmaceuticals are known to contaminate tap water worldwide, but the relevant human health risks have not been assessed in China. We monitored 32 pharmaceuticals in Chinese tap water and evaluated the life-long human health risks of exposure in order to provide information for future prioritization and risk management. We analyzed samples (n = 113) from 13 cities and compared detected concentrations with existing or newly-derived safety levels for assessing risk quotients (RQs) at different life stages, excluding the prenatal stage. We detected 17 pharmaceuticals in 89% of samples, with most detectable concentrations (92%) at risk levels, but 4 (i.e., dimetridazole, thiamphenicol, sulfamethazine, and clarithromycin) were found to have at least one life-stage RQ ≥ 0.01, especially for the infant and child life stages, and should be considered of high priority for management. We propose an indicator-based monitoring framework for providing information for source identification, water treatment effectiveness, and water safety management in China. Chinese tap water is an additional route of human exposure to pharmaceuticals, particularly for dimetridazole, although the risk to human health is low based on current toxicity data. Pharmaceutical detection and application of the proposed monitoring framework can be used for water source protection and risk management in China and elsewhere.

Post monitoring of a cyclodextrin remeditated chlorinated solvent contaminated aquifer

Science.gov (United States)

Blanford, W. J.

2006-12-01

Hydroxypropyl-â-cyclodextrin (HPâCD) has been tested successfully in the laboratory and in the field for enhanced flushing of low-polarity contaminants from aquifers. The cyclodextrin molecule forms a toroidal structure, which has a hydrophobic cavity. Within this cavity, organic compounds of appropriate shape and size can form inclusion complexes, which is the basis for the use of cyclodextrin in groundwater remediation. The hydrophilic exterior of the molecule makes cyclodextrin highly water-soluble. The solubility of cyclodextrins can be further enhanced by adding functional groups, such as hydroxypropyl groups, to the cyclodextrin core. The aqueous solubility of HPâCD exceeds 950 g/L. These high solubilities are advantageous for field applications because they permit relatively high concentrations of the flushing agent. In order for cyclodextrin to become a feasible remediative alternative, it must be demonstrate a short term resistance to biodegradation during field application, but ultimately biodegrade so as not to pose a long term presence in the aquifer. The potential for degradation of cyclodextrin as well as changes in the chlorinated solvents and groundwater geochemistry were examined during the post monitoring of a field demonstration in a shallow aquifer at Little Creek Naval Amphibious Base in Virginia. It was found that a portion of the cyclodextrin remaining in the aquifer after the cessation of field activities biodegraded during the 425 days of post monitoring. This degradation also led to the degradation of the chlorinated solvents trichloroethylene and 1,1-trichloroethane through both biological and chemical processes. The aquifer remained anaerobic with average dissolved oxygen levels below 0.5 mg/L. Dissolved nitrate and sulfate concentrations within the cyclodextrin plume decreased due their being used as terminal electron acceptors during the degradation of the cyclodextrin. The concentrations of total iron at the field site showed no

Monitoring and risk assessment of pesticides in irrigation systems in Debra Zeit, Ethiopia.

NARCIS (Netherlands)

Teklu, Berhan M.; Adriaanse, Pauline; Brink, Van den Paul J.

2016-01-01

Since Ethiopia is going through a rapid transformation of its agricultural sector, we assessed the human health and environmental risks due to the past use of organochlorine pesticides (OCPs) as well as the risks of the current pesticide use by farmers. A monitoring programme and risk assessment

A risk-based monitoring framework for the long term management of used fuel

International Nuclear Information System (INIS)

Garisto, N.C.

2006-01-01

The Nuclear Waste Management Organization has a mandate from the Government of Canada to consult with the public and to recommend an approach for managing Canada's used nuclear fuel. Three main fuel management methods are being explored and evaluated by the Nuclear Waste Management Organization: disposal in a Deep Geological Repository (DGR); reactor-site extended storage (RES); and centralized extended storage (CES), either above ground or below ground. The used nuclear fuel management system, whether a DGR or an extended storage system will require monitoring. In this study, a risk-based monitoring framework was developed for the used fuel management program. The proposed approach addresses the unique challenges of used fuel management being implemented in a multi-stakeholder process, including: (i) the complexity of the facilities; (ii) the need to consider both science-based risk and perceived risk in the monitoring plans; and (iii) the difficulty in conducting 'invasive' measurements of sealed systems, particularly over a very long time frame. (author)

Prevalence, Reasons for Use, and Risk Perception of Electronic Cigarettes Among Post-Acute Coronary Syndrome Smokers.

Science.gov (United States)

Busch, Andrew M; Leavens, Eleanor L; Wagener, Theodore L; Buckley, Maria L; Tooley, Erin M

2016-01-01

The use of electronic cigarettes (e-cigarettes) has risen dramatically in recent years. However, there are currently no published data on the use of e-cigarettes among cardiac patients. The current study reports on the prevalence, reasons for use, and perceived risks of e-cigarettes among patients with post-acute coronary syndrome (ACS). The relationship between e-cigarette use and post-ACS tobacco smoking cessation is also explored. Participants were drawn from a randomized trial of smoking cessation treatments following hospitalization for ACS. The current study focused on 49 participants who completed e-cigarette questions at 24 weeks post-ACS. Of the 49 of participants, 51.0% reported ever use of an e-cigarette and 26.5% reported using an e-cigarette at some time during the 24 weeks post-ACS. Ever use and post-ACS use were both significantly associated with lower rates of abstinence from tobacco cigarettes. Participants perceived e-cigarettes as less harmful to cardiac health than tobacco use and Chantix (varenicline), and similarly harmful as nicotine replacement therapy. Participant perceived likelihood of experiencing a heart attack in the next year was 34.6% if they were to regularly use only e-cigarettes, significantly lower than the perceived risk of recurrence if they were to regularly smoke only tobacco cigarettes (56.2%) and significantly higher than the perceived risk of recurrence if they were to use no nicotine (15.2%). A significant minority of patients are using e-cigarettes post-ACS. Providers should be prepared to discuss potential discrepancies between patient beliefs about the safety of e-cigarettes and the current state of the science.

Post-traumatic stress symptoms and post-traumatic growth in 223 childhood cancer survivors: predictive risk factors

Directory of Open Access Journals (Sweden)

Marta eTremolada

2016-02-01

Full Text Available With modern therapies and supportive care, survival rates of childhood cancer have increased considerably. However, there are long-term psychological sequelae of these treatments that may not manifest until pediatric survivors are into adulthood. The prevalence of post-traumatic stress disorder (PTSD in young adult survivors of childhood cancer ranges from 6.2% to 22%; associated risk factors are young age at the assessment, female gender, low education level and some disease-related factors. The aim of this study was to investigate, in adolescent and young adult (AYA survivors of childhood cancer, the incidence and severity of post-traumatic stress symptoms (PTSS, and to identify the risk factors and the associated post-traumatic growth (PTG index.Participants were 223 AYA cancer survivors recruited during follow-up visits in the Oncohematology Clinic of the Department of Child and Woman’s Health, University of Padua. Data were collected from self-report questionnaires on PTSS incidence, PTG mean score, perceived social support, and medical and socio-demographic factors. Ex-patients’ mean age at the assessment was 19.33 years (SD = 3.01, 15-25, 123 males and 100 females, with a mean of years off-therapy of 9.64 (SD=4.17. Most (52.5% had survived an hematological disorder and 47.5% a solid tumor when they were aged, on average, 8.02 years (SD=4.40.The main results indicated a moderate presence of clinical (≥9 symptoms: 9.4% and sub-clinical PTSS (6-8 symptoms: 11.2%, with the avoidance criterion most often encountered. Re-experience symptoms and PTG mean score were significantly associated (r=0.24 p=0.0001. A hierarchical regression model (R2 = 0.08; F = 1.46; p = 0.05 identified female gender (β = 0.16; p = 0.05 and less perceived social support (β = -0.43; p = 0.05 as risk factors to developing PTSS. Another hierarchical regression model assessed the possible predictors of the PTG total score (R2 = 0.36; F = 9.1; p = 0.0001, with

Ureteric stent dwelling time: a risk factor for post-ureteroscopy sepsis.

Science.gov (United States)

Nevo, Amihay; Mano, Roy; Baniel, Jack; Lifshitz, David A

2017-07-01

To evaluate the association between stent dwelling time and sepsis after ureteroscopy, and identify risk factors for sepsis in this setting. The prospectively collected database of a single institution was queried for all patients who underwent ureteroscopy for stone extraction between 2010 and 2016. Demographic, clinical, preoperative and operative data were collected. The primary study endpoint was sepsis within 48 h of ureteroscopy. Logistic regressions were performed to identify predictors of post-ureteroscopy sepsis in the ureteroscopy cohort and specifically in patients with prior stent insertion. Between October 2010 and April 2016, 1 256 patients underwent ureteroscopy for stone extraction. Risk factors for sepsis included prior stent placement, female gender and Charlson comorbidity index. A total of 601 patients had a ureteric stent inserted before the operation and were included in the study cohort, in which the median age was 56 years, 90 patients were women (30%), and 97 patients were treated for positive preoperative urine cultures (16.1%). Postoperative sepsis, Sepsis rates after stent dwelling times of 1, 2, 3 and >3 months were 1, 4.9, 5.5 and 9.2%, respectively. On multivariate analysis, stent dwelling time, stent insertion because of sepsis, and female gender were significantly associated with post-ureteroscopy sepsis in patients with prior stent placement. Patients who undergo ureteroscopy after ureteric stent insertion have a higher risk of postoperative sepsis. Prolonged stent dwelling time, sepsis as an indication for stent insertion, and female gender are independent risk factors. Stent placement should be considered cautiously, and if inserted, ureteroscopy should be performed within 1 month. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

ACUTE LUNG INJURY COMPLICATING BLOOD TRANSFUSION IN POST-PARTUM HEMORRHAGE: INCIDENCE AND RISK FACTORS.

Directory of Open Access Journals (Sweden)

Luciana Teofili

2014-10-01

Conclusions. Patients suffering from PPH represent a high-risk population for TRALI. In particular, patients with gestational hypertension and pre-eclampsia   have the highest risk, particularly if they are not receiving anti-hypertensive therapy. A careful monitoring of these patients after transfusions is therefore recommended.

Predictors of depressive symptoms in older Japanese primiparas at 1 month post-partum: A risk-stratified analysis.

Science.gov (United States)

Iwata, Hiroko; Mori, Emi; Tsuchiya, Miyako; Sakajo, Akiko; Maehara, Kunie; Ozawa, Harumi; Morita, Akiko; Maekawa, Tomoko; Aoki, Kyoko; Tamakoshi, Koji

2016-01-01

Older maternal age has become more common in Japan. Studies suggest that older maternal age and primiparity are associated with post-partum depression. The present study aimed to identify predictors of post-partum depression in older Japanese primiparas at 1 month post-partum. Participants were 479 primiparas aged 35 years and over, drawn from a prospective cohort study. Data were collected using self-report questionnaires. Depression was measured with the Japanese version of the Edinburgh Postnatal Depression Scale. Stepwise logistic regression analysis was conducted on binary outcome variables of depression at 1 month post-partum, along with a stratified analysis based on the risk status of depression. Five predictors were identified: (i) the depression score during hospital stay; (ii) financial burden; (iii) dissatisfaction with appraisal support; (iv) physical burden in daily life; and (v) concerns about infant caretaking. Stratified analysis identified dissatisfaction with instrumental support in the low-risk group, and the Child-care Value Scale score as unique predictors in the high-risk group. These results highlight the importance of early assessment of depressive symptoms and the provision of continuous care. © 2015 Japan Academy of Nursing Science.

Design considerations for post accident monitoring system of a research reactor

International Nuclear Information System (INIS)

Jang, Gwi Sook; Park, Je Yun; Kim, Young Ki

2012-01-01

The Post Accident Monitoring System (PAMS) provides primary information for operators to assess the plant conditions and perform their role in bringing the plant to a safe condition during an accident. The PAMS of NPP (Nuclear Power Plant) in KOREA provides the continuous display of the PAM category 1 parameters specified in R.G 1.97, Rev. 03. Recently the PAMS of NPP has been designed according to R.G 1.97, Rev. 04. There is no PAMS at the HANARO in KOREA, but recently RRs (Research Reactors) around the world are going to have PAMS for various multi purposes. We should determine the design considerations for PAMS in a Korean RR based on the design state analysis. Thus, this paper proposes strategies on the design considerations for the PAMS of a Korean RR

Prediction of chronic post-operative pain: pre-operative DNIC testing identifies patients at risk.

Science.gov (United States)

Yarnitsky, David; Crispel, Yonathan; Eisenberg, Elon; Granovsky, Yelena; Ben-Nun, Alon; Sprecher, Elliot; Best, Lael-Anson; Granot, Michal

2008-08-15

Surgical and medical procedures, mainly those associated with nerve injuries, may lead to chronic persistent pain. Currently, one cannot predict which patients undergoing such procedures are 'at risk' to develop chronic pain. We hypothesized that the endogenous analgesia system is key to determining the pattern of handling noxious events, and therefore testing diffuse noxious inhibitory control (DNIC) will predict susceptibility to develop chronic post-thoracotomy pain (CPTP). Pre-operative psychophysical tests, including DNIC assessment (pain reduction during exposure to another noxious stimulus at remote body area), were conducted in 62 patients, who were followed 29.0+/-16.9 weeks after thoracotomy. Logistic regression revealed that pre-operatively assessed DNIC efficiency and acute post-operative pain intensity were two independent predictors for CPTP. Efficient DNIC predicted lower risk of CPTP, with OR 0.52 (0.33-0.77 95% CI, p=0.0024), i.e., a 10-point numerical pain scale (NPS) reduction halves the chance to develop chronic pain. Higher acute pain intensity indicated OR of 1.80 (1.28-2.77, p=0.0024) predicting nearly a double chance to develop chronic pain for each 10-point increase. The other psychophysical measures, pain thresholds and supra-threshold pain magnitudes, did not predict CPTP. For prediction of acute post-operative pain intensity, DNIC efficiency was not found significant. Effectiveness of the endogenous analgesia system obtained at a pain-free state, therefore, seems to reflect the individual's ability to tackle noxious events, identifying patients 'at risk' to develop post-intervention chronic pain. Applying this diagnostic approach before procedures that might generate pain may allow individually tailored pain prevention and management, which may substantially reduce suffering.

The critical role of volcano monitoring in risk reduction

Directory of Open Access Journals (Sweden)

R. I. Tilling

2008-01-01

Full Text Available Data from volcano-monitoring studies constitute the only scientifically valid basis for short-term forecasts of a future eruption, or of possible changes during an ongoing eruption. Thus, in any effective hazards-mitigation program, a basic strategy in reducing volcano risk is the initiation or augmentation of volcano monitoring at historically active volcanoes and also at geologically young, but presently dormant, volcanoes with potential for reactivation. Beginning with the 1980s, substantial progress in volcano-monitoring techniques and networks – ground-based as well space-based – has been achieved. Although some geochemical monitoring techniques (e.g., remote measurement of volcanic gas emissions are being increasingly applied and show considerable promise, seismic and geodetic methods to date remain the techniques of choice and are the most widely used. Availability of comprehensive volcano-monitoring data was a decisive factor in the successful scientific and governmental responses to the reawakening of Mount St. elens (Washington, USA in 1980 and, more recently, to the powerful explosive eruptions at Mount Pinatubo (Luzon, Philippines in 1991. However, even with the ever-improving state-of-the-art in volcano monitoring and predictive capability, the Mount St. Helens and Pinatubo case histories unfortunately still represent the exceptions, rather than the rule, in successfully forecasting the most likely outcome of volcano unrest.

Post-market clinical research conducted by medical device manufacturers: a cross-sectional survey.

Science.gov (United States)

Ross, Joseph S; Blount, Katrina L; Ritchie, Jessica D; Hodshon, Beth; Krumholz, Harlan M

2015-01-01

In the US, once a medical device is made available for use, several requirements have been established by the US Food and Drug Administration (FDA) to ensure ongoing post-market surveillance of device safety and effectiveness. Our objective was to determine how commonly medical device manufacturers initiate post-market clinical studies or augment FDA post-market surveillance requirements for higher-risk devices that are most often approved via the FDA's pre-market approval (PMA) pathway. We conducted a cross-sectional survey of 47 manufacturers with operations in California, Minnesota, and Massachusetts who market devices approved via the PMA pathway. Among 22 respondents (response rate =47%), nearly all self-reported conducting post-market clinical research studies, commonly between 1 and 5; only 1 respondent reported never conducting post-market clinical research studies. While manufacturers most often engaged in these studies to satisfy FDA requirements, other reasons were reported, including performance monitoring and surveillance and market acceptance initiatives. Risks of conducting and not conducting post-market clinical research studies were described through open-ended response to questions. Medical device manufacturers commonly initiate post-market clinical studies at the request of the FDA. Clinical data from these studies should be integrated into national post-market surveillance initiatives.

Linking indices for biodiversity monitoring to extinction risk theory.

Science.gov (United States)

McCarthy, Michael A; Moore, Alana L; Krauss, Jochen; Morgan, John W; Clements, Christopher F

2014-12-01

Biodiversity indices often combine data from different species when used in monitoring programs. Heuristic properties can suggest preferred indices, but we lack objective ways to discriminate between indices with similar heuristics. Biodiversity indices can be evaluated by determining how well they reflect management objectives that a monitoring program aims to support. For example, the Convention on Biological Diversity requires reporting about extinction rates, so simple indices that reflect extinction risk would be valuable. We developed 3 biodiversity indices that are based on simple models of population viability that relate extinction risk to abundance. We based the first index on the geometric mean abundance of species and the second on a more general power mean. In a third index, we integrated the geometric mean abundance and trend. These indices require the same data as previous indices, but they also relate directly to extinction risk. Field data for butterflies and woodland plants and experimental studies of protozoan communities show that the indices correlate with local extinction rates. Applying the index based on the geometric mean to global data on changes in avian abundance suggested that the average extinction probability of birds has increased approximately 1% from 1970 to 2009. © 2014 The Authors. Conservation Biology published by Wiley Periodicals, Inc., on behalf of the Society for Conservation Biology.

Sex and drug risk behavior pre- and post-emigration among Latino migrant men in post-Hurricane Katrina New Orleans

Science.gov (United States)

Mills, Jennifer; Burton, Nicole; Schmidt, Norine; Salinas, Oscar; Hembling, John; Aran, Alberto; Shedlin, Michele; Kissinger, Patricia

2012-01-01

High rates of sex and drug risk behaviors have been documented among Latino migrant men in the U.S. Whether these behaviors were established in the migrants’ home countries or were adopted in the U.S. has not been described and has implications for prevention strategies. Quarterly surveys were conducted to gather information on selected sex and drug risk practices of Latino migrant men who arrived in New Orleans after Hurricane Katrina seeking work. Both kappa scores and McNemar’s tests were performed to determine if practice of these behaviors in home country was similar to practice post-emigration to the U.S. Female sex worker (FSW) patronage, same sex encounters (MSM), and crack cocaine use was more likely to occur post-rather than pre-emigration. Of those who ever engaged in these selected behaviors, most adopted the behavior in the U.S. (i.e. 75.8% of FSW patrons, 72.7% of MSM participants, and 85.7% of crack cocaine users), with the exception of binge drinking (26.8%). Men who were living with a family member were less likely to adopt FSW patronage OR=0.27, CI=0.10-0.76, whereas men who earned >$465 per week were more likely to adopt crack cocaine use OR=6.29 CI=1.29, 30.57. Interventions that facilitate the maintenance of family cohesion and provide strategies for financial management may be useful for reducing sex and drug risk among newly arrived migrants. PMID:22669638

Knowledge-based software design for Defense-in-Depth risk monitor system and application for AP1000

International Nuclear Information System (INIS)

Ma Zhanguo; Yoshikawa, Hidekazu; Yang Ming; Nakagawa, Takashi

2017-01-01

As part of the new risk monitor system, the software for the plant Defense-in-Depth (DiD) risk monitor system was designed based on the state-transition and finite-state machine, and then the knowledge-based software was developed by object-oriented method utilizing the Unified Modeling Language (UML). Currently, there are mainly two functions in the developed plant DiD risk monitor software that are knowledge-base editor which is used to model the system in a hierarchical manner and the interaction simulator that simulates the interactions between the different actors in the model. In this paper, a model for playing its behavior is called an Actor which is modeled at the top level. The passive safety AP1000 power plant was studied and the small-break loss-of-coolant accident (SBLOCA) design basis accident transient is modeled using the plant DiD risk monitor software. Furthermore, the simulation result is shown for the interactions between the actors which are defined in the plant DiD risk monitor system as PLANT actor, OPERATOR actor, and SUPERVISOR actor. This paper shows that it is feasible to model the nuclear power plant knowledge base using the software modeling technique. The software can make the large knowledge base for the nuclear power plant with small effort. (author)

Behavioral Monitoring of Sexual Offenders Against Children in Virtual Risk Situations: A Feasibility Study

Directory of Open Access Journals (Sweden)

Peter Fromberger

2018-03-01

Full Text Available The decision about unsupervised privileges for sexual offenders against children (SOC is one of the most difficult decisions for practitioners in forensic high-security hospitals. Facing the possible consequences of the decision for the society, a valid and reliable risk management of SOCs is essential. Some risk management approaches provide frameworks for the construction of relevant future risk situations. Due to ethical reasons, it is not possible to evaluate the validity of constructed risk situations in reality. The aim of the study was to test if behavioral monitoring of SOCs in high-immersive virtual risk situations provides additional information for risk management. Six SOCs and seven non-offender controls (NOC walked through three virtual risk situations, confronting the participant with a virtual child character. The participant had to choose between predefined answers representing approach or avoidance behavior. Frequency of chosen answers were analyzed in regards to knowledge of the participants about coping skills and coping skills focused during therapy. SOCs and NOCs behavior differed only in one risk scenario. Furthermore, SOCs showed in 89% of all cases a behavior not corresponding to their own belief about adequate behavior in comparable risk situations. In 62% of all cases, SOCs behaved not corresponding to coping skills they stated that therapists focused on during therapy. In 50% of all cases, SOCs behaved in correspondence to coping skills therapists stated that they focused on during therapy. Therapists predicted the behavior of SOCs in virtual risk situations incorrect in 25% of all cases. Thus, virtual risk scenarios provide the possibility for practitioners to monitor the behavior of SOCs and to test their decisions on unsupervised privileges without endangering the community. This may provide additional information for therapy progress. Further studies are necessary to evaluate the predictive and ecological validity

Behavioral Monitoring of Sexual Offenders Against Children in Virtual Risk Situations: A Feasibility Study.

Science.gov (United States)

Fromberger, Peter; Meyer, Sabrina; Jordan, Kirsten; Müller, Jürgen L

2018-01-01

The decision about unsupervised privileges for sexual offenders against children (SOC) is one of the most difficult decisions for practitioners in forensic high-security hospitals. Facing the possible consequences of the decision for the society, a valid and reliable risk management of SOCs is essential. Some risk management approaches provide frameworks for the construction of relevant future risk situations. Due to ethical reasons, it is not possible to evaluate the validity of constructed risk situations in reality. The aim of the study was to test if behavioral monitoring of SOCs in high-immersive virtual risk situations provides additional information for risk management. Six SOCs and seven non-offender controls (NOC) walked through three virtual risk situations, confronting the participant with a virtual child character. The participant had to choose between predefined answers representing approach or avoidance behavior. Frequency of chosen answers were analyzed in regards to knowledge of the participants about coping skills and coping skills focused during therapy. SOCs and NOCs behavior differed only in one risk scenario. Furthermore, SOCs showed in 89% of all cases a behavior not corresponding to their own belief about adequate behavior in comparable risk situations. In 62% of all cases, SOCs behaved not corresponding to coping skills they stated that therapists focused on during therapy. In 50% of all cases, SOCs behaved in correspondence to coping skills therapists stated that they focused on during therapy. Therapists predicted the behavior of SOCs in virtual risk situations incorrect in 25% of all cases. Thus, virtual risk scenarios provide the possibility for practitioners to monitor the behavior of SOCs and to test their decisions on unsupervised privileges without endangering the community. This may provide additional information for therapy progress. Further studies are necessary to evaluate the predictive and ecological validity of behavioral

[Diagnostic accuracy of malignancy risk index II in post-menopausal women with adnexal tumours].

Science.gov (United States)

Treviño-Báez, Joaquín Darío; Cantú-Cruz, Javier Alejandro; Medina-Mercado, Javier; Abundis, Alberto

2016-01-01

The purpose of the diagnostic evaluation of adnexal tumours is to exclude the possibility of malignancy. The malignancy risk index II identifies patients at high risk for ovarian cancer. The cut-off value is greater than 200. To evaluate the diagnostic accuracy of malignancy risk index II in post-menopausal women with adnexal tumours in relation to the histopathological results. A total of 138 women with an adnexal mass were studied. The malignancy risk index II was determined in all of them. They were divided into two groups according to the histopathology results; 69 patients with benign tumours and 69 patients with malignant tumours. A diagnostic test type analysis was performed with respect to the results of malignancy risk index II ≤ 200 or greater than this. The percentages and 95% confidence intervals were calculated. The accuracy was 81.8% (75.5-88.3), sensitivity 76.8% (66.9-86.7), specificity 87% (79.1-94.9), with a positive predictive value of 85.5% (76.7-94.3), and a negative predictive value of 78.9% (69.7-88.1). The positive likelihood ratio was 590, and the negative likelihood ratio was 0.266. The malignancy risk index II has good performance in the proper classification of post-menopausal women with adnexal masses, both benign and malignant, with an accuracy of 81.8%. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Hydraulic analysis of river training cross-vanes as part of post-restoration monitoring

Directory of Open Access Journals (Sweden)

T. A. Endreny

2011-07-01

Full Text Available River restoration design methods are incrementally improved by studying and learning from monitoring data in previous projects. In this paper we report post-restoration monitoring data and simulation analysis for a Natural Channel Design (NCD restoration project along 1600 m of the Batavia Kill (14 km² watershed in the Catskill Mountains, NY. The restoration project was completed in 2002 with goals to reduce bank erosion and determine the efficacy of NCD approaches for restoring headwater streams in the Catskill Mountains, NY. The NCD approach used a reference-reach to determine channel form, empirical relations between the project site and reference site bankfull dimensions to size channel geometry, and hydraulic and sediment computations based on a bankfull (1.3 yr return interval discharge to test channel capacity and sediment stability. The NCD project included 12 cross-vanes and 48 j-hook vanes as river training structures along 19 meander bends to protect against bank erosion and maintain scour pools for fish habitat. Monitoring data collected from 2002 to 2004 were used to identify aggradation of pools in meander bends and below some structures. Aggradation in pools was attributed to the meandering riffle-pool channel trending toward step-pool morphology and cross-vane arms not concentrating flow in the center of the channel. The aggradation subsequently caused flow splitting and 4 partial point bar avulsions during a spring 2005 flood with a 25-yr return interval. Processing the pre-flood monitoring data with hydraulic analysis software provided clues the reach was unstable and preventative maintenance was needed. River restoration and monitoring teams should be trained in robust hydraulic analytical methods that help them extend project restoration goals and structure stability.

Identification of patients at risk for ischaemic cerebral complications after carotid endarterectomy with TCD monitoring

DEFF Research Database (Denmark)

Horn, J; Naylor, A R; Laman, D M

2005-01-01

Transcranial Doppler (TCD) monitoring for micro embolic signals (MES), directly after carotid endarterectomy (CEA) may identify patients at risk of developing ischaemic complications. In this retrospective multicentre study, this hypothesis was investigated.......Transcranial Doppler (TCD) monitoring for micro embolic signals (MES), directly after carotid endarterectomy (CEA) may identify patients at risk of developing ischaemic complications. In this retrospective multicentre study, this hypothesis was investigated....

Comparison of pre-filter and post-filter ionised calcium monitoring in continuous veno-venous hemodiafiltration (CVVHD-F with citrate anti-coagulation.

Directory of Open Access Journals (Sweden)

Matthew J Brain

Full Text Available It is widespread practice during citrate anticoagulated renal replacement therapy to monitor circuit ionised calcium (iCa2+ to evaluate the effectiveness of anticoagulation. Whether the optimal site to sample the blood path is before or after the haemofilter is a common question.Using a prospectively collected observational dataset from intensive care patients receiving pre-dilution continuous veno-venous haemodiafiltration (CVVHD-F with integrated citrate anticoagulation we compared paired samples of pre and post filter iCa2+ where the target range was 0.3-0.5 mmol.L-1 as well as concurrently collected arterial iCa2+. Two nested mixed methods linear models were fitted to the data describing post vs pre filter iCa2+, and the relationship of pre, post and arterial samples.An 11 bed general intensive care unit.450 grouped samples from 152 time periods in seven patients on CRRT with citrate anticoagulation.The relationship of post to pre-filter iCa2+ was not 1:1 with post = 0.082 + 0.751 x pre-filter iCa2+ (95% CI intercept: 0.015-0.152, slope 0.558-0.942. Variation was greatest between patients rather than between circuits within the same patient or citrate dose. Compared to arterial iCa2+ there was no significant difference between pre and post-filter sampling sites (F-value 0.047, p = 0.827.These results demonstrate that there is minimal difference between pre and post filter samples for iCa2+ monitoring of circuit anticoagulation in citrate patients relative to the arterial iCa2+ in CVVHD-F however compared to pre-filter sampling, post filter sampling has a flatter response and greater variation.

Critical parameters and measurement methods for post closure monitoring: A review of the state of the art and recommendations for further studies

International Nuclear Information System (INIS)

Morrison, H.F.; Majer, E.L.; Tsang, C.F.

1987-05-01

Both NRC and EPA regulations require programs of post closure monitoring to detect substantial and detrimental deviations from expected performance. The unexpected in this case would involve anomalous stress changes that might rupture the canisters or changes in the hydrologic regime that might accelerate corrosion. In the event of leakage brought about by any means transport of radionuclides to the accessible environment could occur through unexpected changes in the hydrologic flow regime caused either by the long term effects of the thermal loading by the waste or by changes in regional stress or hydrology. Studies of performance confirmation have identified six parameters or conditions that should be monitored that are associated with the thermal, mechanical and hydrologic phenomena introduced by the waste heat: temperature, stress, displacement, pore pressure, groundwater velocity and permeability. Since it is the thermal load that continues to increase after decommissioning, and which continues to alter the stress field and the hydrological regime, these same six parameters remain the critical ones in post closure monitoring. At two of the repository sites fractures have been clearly shown to be critical in modelling and performance confirmation; at the tuff site fluid saturation is also a critical parameter and for all the sites estimates of the groundwater velocity through the site are very important. Changes in fracture properties, saturation and fluid flow are thus of continuing importance in post closure monitoring. 14 refs., 19 figs

Post-Closure Inspection and Monitoring Report for Corrective Action Unit 110: Area 3 WMD U-3ax/bl Crater, Nevada Test Site, Nevada

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office; Bechtel Nevada

2006-08-01

This Post-Closure Inspection and Monitoring Report provides the results and inspections and monitoring for Corrective Action Unit 110: Area 3 Waste Management Division U-3ax/bl Crater, Nevada Test Site, Nevada. This report includes an analysis and summary of the site inpsections, repairs and maintenance, meteorological information, and soil moisture monitoring data obtained at Corrective Action Unit 110, for the annual period July 2005 thrugh June 2006.

Use of carabids for the post-market environmental monitoring of genetically modified crops

Czech Academy of Sciences Publication Activity Database

Skoková Habuštová, Oxana; Svobodová, Zdeňka; Cagáň, Ľ.; Sehnal, František

2017-01-01

Roč. 9, č. 4 (2017), č. článku 121. E-ISSN 2072-6651 R&D Projects: GA MŠk(CZ) 7AMB14SK096 Grant - others:projekt VEGA(SK) 1/0732/14; GA ČR(CZ) L200961652 Institutional support: RVO:60077344 Keywords : Carabidae * surrogate * post-market environmental monitoring Subject RIV: GF - Plant Pathology, Vermin, Weed, Plant Protection OBOR OECD: GM technology (crops and livestock), livestock cloning, marker assisted selection, diagnostics (DNA chips and biosensing devices for the early/accurate detection of diseases) biomass feedstock production technologies, biopharming Impact factor: 3.030, year: 2016 http://www.mdpi.com/2072-6651/9/4/121

Post-Traumatic Stress Disorder and Health Risk Behaviors among Afghanistan and Iraq War Veterans Attending College

Science.gov (United States)

Widome, Rachel; Kehle, Shannon M.; Carlson, Kathleen F.; Laska, Melissa Nelson; Gulden, Ashley; Lust, Katherine

2011-01-01

Objective: To determine if post-traumatic stress disorder (PTSD) is associated with health risk behaviors among Operations Enduring and Iraqi Freedom (OEF/OIF) veterans attending college. Method: Using 2008 Boynton College Student Health Survey data, we tested associations between self-reported PTSD diagnosis and self-reported risk behaviors…

Antepartum Fetal Monitoring and Spectral Analysis of Preterm Birth Risk

Science.gov (United States)

Păsăricără, Alexandru; Nemescu, Dragoş; Arotăriţei, Dragoş; Rotariu, Cristian

2017-11-01

The monitoring and analysis of antepartum fetal and maternal recordings is a research area of notable interest due to the relatively high value of preterm birth. The interest stems from the improvement of devices used for monitoring. The current paper presents the spectral analysis of antepartum heart rate recordings conducted during a study in Romania at the Cuza Voda Obstetrics and Gynecology Clinical Hospital from Iasi between 2010 and 2014. The study focuses on normal and preterm birth risk subjects in order to determine differences between these two types or recordings in terms of spectral analysis.

Deep Vadose Zone Treatability Test for the Hanford Central Plateau: Interim Post-Desiccation Monitoring Results, Fiscal Year 2014

Energy Technology Data Exchange (ETDEWEB)

Truex, Michael J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Strickland, Christopher E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Johnson, Christian D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Johnson, Timothy C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Clayton, Ray E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Chronister, Glen B. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2014-09-01

Over decades of operation, the U.S. Department of Energy (DOE) and its predecessors have released nearly 2 trillion L (450 billion gal.) of liquid into the vadose zone at the Hanford Site. Much of this discharge of liquid waste into the vadose zone occurred in the Central Plateau, a 200 km² (75 mi²) area that includes approximately 800 waste sites. Some of the inorganic and radionuclide contaminants in the deep vadose zone at the Hanford Site are at depths below the limit of direct exposure pathways, but may need to be remediated to protect groundwater. The Tri-Party Agencies (DOE, U.S. Environmental Protection Agency, and Washington State Department of Ecology) established Milestone M 015 50, which directed DOE to submit a treatability test plan for remediation of technetium-99 (Tc-99) and uranium in the deep vadose zone. These contaminants are mobile in the subsurface environment and have been detected at high concentrations deep in the vadose zone, and at some locations have reached groundwater. Testing technologies for remediating Tc-99 and uranium will also provide information relevant for remediating other contaminants in the vadose zone. A field test of desiccation is being conducted as an element of the DOE test plan published in March 2008 to meet Milestone M 015 50. The active desiccation portion of the test has been completed. Monitoring data have been collected at the field test site during the post-desiccation period and are reported herein. This is an interim data summary report that includes about 3 years of post-desiccation monitoring data. The DOE field test plan proscribes a total of 5 years of post-desiccation monitoring.

Changes in Student Knowledge and Views of Geohazards, Societal Risks, and Monitoring at Active Plate Boundaries Using a Data-Rich Curriculum

Science.gov (United States)

Selkin, P. A.; Goodell, L. P.; Teasdale, R.

2015-12-01

The "Living on the Edge: Building Resilient Societies on Active Plate Margins" curriculum consists of six data-rich activities, each intended for a 50-minute class, in which students assess risk at active plate boundaries due to earthquakes and volcanoes. Developed as part of the InTeGrate NSF STEP Center the peer-reviewed, publically available materials (http://serc.carleton.edu/104296) have been used at several institutions in diverse classroom settings including small laboratory sections, large lecture courses, medium-sized upper division courses and professional development programs for middle and high school teachers. Pre- and post-instruction surveys measured content knowledge and geoscience literacy, self-efficacy in using geologic data to assess hazards and risk, and attitudes towards the value of monitoring plate margins. The activities have overall positive effects on knowledge of geohazard concepts. Views about the value of scientific practice also became more positive: 74% of students indicated they "agree" or "strongly agree" that monitoring geologic activity has value to them personally (even if they don't live on an active plate margin) and 94% indicated that such monitoring is valuable to society. Most became more confident in evaluating geologic hazard and risk (>60% of students self-described increased confidence by one or more Likert levels). Student knowledge of both the types and limits of data in forecasting geological hazards and their effects also improved. However, attitudes toward sustainability and geoscience careers did not change. Learning and attitudinal improvements are true for all classroom types, but the degree of change varies with class size and the amount of time spent on activities. Learning data and instructor feedback suggest that interactive classroom activities that use real-world data to address societally relevant issues increase student learning and enhance students' ability to synthesize scientific information.

Monitoring needs to perform ecological risk assessments in Switzerland

Energy Technology Data Exchange (ETDEWEB)

Kraeuchi, N.

1999-07-01

There is enormous pressure to come up with answers to questions asked by politicians and the public concerning the development of the environment and the potential risks society might be confronted with. Forests for example are expected to fulfill specific functions (e.g., timber production, protection of soil and water resources, recreation). As the environmental and social context itself is rapidly changing it is unknown what uses of a forest will appear in the future. The changing social and ecological context under which forestry operates is therefore calling for an appropriate management mode to deal with uncertainties. There is a need to act, monitor the results, learn from the past, adapt to new conditions through planning and to accept a philosophy of managing an ecosystem with the purpose of reducing potential future socio-ecological and environmental risk by understanding potential problems before they arise. Thus, ecosystem-based management must follow established ecological principles and appropriate guidelines must be derived from a thorough understanding of the origin of the risks potentially threatening the forests and the relevant ecosystem processes. In order to evaluate the likelihood that adverse ecological effects may occur as a result of exposure to one or more stressors long-term monitoring data, information, assumptions and uncertainties need to be systematically evaluated and analyzed. This is needed to understand and predict the relationships between stressors and ecological effects in a way that is useful for environmental decision making.

[Design and Application of High-risk Pregnancy Monitoring & Warning Internet Platform Based on Internet of Things].

Science.gov (United States)

Lu, Heqing; Zhang, Xiaofeng; Li, Bin

2017-09-30

Through illustrating the designing of high-risk pregnancy maternal-fetal monitoring system based on the internet of things, this paper introduced the specific application of using wearable medical devices to provide maternal-fetal mobile medical services. With the help of big data and cloud obstetrics platform, the monitoring and warning network was further improved, the level-to-level administration of high-risk pregnancy was realized, the level of perinatal health care was enhanced and the risk of critical emergency of pregnancy decreased.

Elevated post-void residual volume in a geriatric post-hip fracture assessment in women-associated factors and risk of mortality.

Science.gov (United States)

Nuotio, Maria S; Luukkaala, Tiina; Tammela, Teuvo

2018-04-09

Multiple factors contribute to elevated post-void residual urine volumes (PVR), but they may indicate detrusor underactivity (DU), especially in older women. The aim here was to examine factors associated with and prognostic significance of elevated PVR in a geriatric post-hip fracture assessment in a female population. Consecutive female hip fracture patients (n = 409) aged 65 years and older were included. PVR was measured by bladder scanner. PVR of 160 ml or more was deemed elevated. Age-adjusted univariate logistic regression analyses were conducted to examine the association of the domains of the comprehensive geriatric assessment (CGA) with elevated PVR. Cox proportional hazards model was used to determine the age-adjusted association of an elevated PVR with 1-year mortality. Of the patients, 64 (15.6%) had elevated PVR. Having urinary or fecal incontinence, difficulties in physical activities of daily living, malnutrition, poor performance on Timed Up and Go and Elderly Mobility Scale were significantly associated with elevated PVR. Difficulties in instrumental activities of daily living, renal dysfunction, constipation, polypharmacy, nocturia, cognitive impairment and depressive mood were not associated with elevated PVR. Elevated PVR significantly increased the risk of mortality 1 year post hip fracture. Elevated PVR is relatively common in older female hip fracture patients and associated with physical functioning, malnutrition and risk of mortality. Even though a causal relationship cannot be confirmed, the findings may suggest a relationship between DU and physical frailty. PVR deserves to be included in the CGA of frail older patients including women.

Risk of cervical cancer after completed post-treatment follow-up of cervical intraepithelial neoplasia

DEFF Research Database (Denmark)

Rebolj, Matejka; Helmerhorst, Theo; Habbema, Dik

2012-01-01

To compare the risk of cervical cancer in women with histologically confirmed cervical intraepithelial neoplasia who returned to routine screening after having completed post-treatment follow-up with consecutive normal smear test results with women with a normal primary smear test result....

Parental monitoring, parent-adolescent communication about sex, and sexual risk among young men who have sex with men.

Science.gov (United States)

Thoma, Brian C; Huebner, David M

2014-08-01

Parental monitoring and parent-adolescent communication about sex protect against HIV-related sexual risk behaviors among heterosexual adolescents, but it is unknown if these findings generalize to young men who have sex with men (YMSM). Sexual orientation-specific stressors, including "coming out" to parents, complicate the family context of YMSM. We examined associations between parental monitoring, communication about sex, outness to cohabitating parents, and sexual behaviors. Ethnically diverse YMSM ages 14-19 provided cross-sectional data (n = 257). Monitoring and outness to parents interacted to predict recent same-sex unprotected anal intercourse (UAI). For YMSM who reported mixed or uncertain outness to parents, higher levels of perceived parental monitoring were associated with greater risk of UAI. Higher levels of communication about sex were associated with greater risk of UAI for YMSM out to parents. Parental monitoring and communication about sex might not protect YMSM against sexual risk in the same way they protect heterosexual youth. Future research should examine whether adapted forms of family factors could protect YMSM, and family-based HIV risk-reduction interventions for YMSM should be attuned to the unique ways family factors function within this group.

Risk factors for chronic post-traumatic stress disorder (PTSD) in SARS survivors.

Science.gov (United States)

Mak, Ivan Wing Chit; Chu, Chung Ming; Pan, Pey Chyou; Yiu, Michael Gar Chung; Ho, Suzanne C; Chan, Veronica Lee

2010-01-01

Post-traumatic stress disorder (PTSD) is one of the most prevalent long-term psychiatric diagnoses among survivors of severe acute respiratory syndrome (SARS). The objective of this study was to identify the predictors of chronic PTSD in SARS survivors. PTSD at 30 months after the SARS outbreak was assessed by the Structured Clinical Interview for the DSM-IV. Survivors' demographic data, medical information and psychosocial variables were collected for risk factor analysis. Multivariate logistic regression analysis showed that female gender as well as the presence of chronic medical illnesses diagnosed before the onset of SARS and avascular necrosis were independent predictors of PTSD at 30 months post-SARS. Associated factors included higher-chance external locus of control, higher functional disability and higher average pain intensity. The study of PTSD at 30 months post-SARS showed that the predictive value of acute medical variables may fade out. Our findings do not support some prior hypotheses that the use of high dose corticosteroids is protective against the development of PTSD. On the contrary, the adversity both before and after the SARS outbreak may be more important in hindering recovery from PTSD. The risk factor analysis can not only improve the detection of hidden psychiatric complications but also provide insight for the possible model of care delivery for the SARS survivors. With the complex interaction of the biopsychosocial challenges of SARS, an integrated multidisciplinary clinic setting may be a superior approach in the long-term management of complicated PTSD cases. Copyright © 2010 Elsevier Inc. All rights reserved.

Wolfe Island Ecopower Centre post construction follow-up plan bird and bat resources monitoring report no. 2 : executive summary

International Nuclear Information System (INIS)

2010-05-01

The 197.8 MW Wolfe Island EcoPower Centre consists of 86 wind turbine generators (WTGs), each with a capacity of 2.3 MW, plus ancillary facilities and supporting electrical infrastructure on the Kingston mainland. This report presented the results of a post-construction monitoring program for the period between July 1 and December 31, 2009. Field surveys included bird and bat mortality monitoring; disturbance effects monitoring of foraging migratory waterfowl; and disturbance effects monitoring of wintering raptors. During the mortality monitoring reporting period, 100 carcasses of 33 bird species were collected along with 180 carcasses of 5 bat species. This report concluded that mortality and disturbance effects monitoring should proceed in 2010, but with some modifications to the current method of alternating once-weekly/twice-weekly carcass search schedule for each turbine. It was suggested that in order to reduce uncertainty surrounding the scavenger correction factor, half of the WTGs should be the subject of once-weekly carcass searches, and the other half should be searched twice-weekly. Mortality rates would be calculated separately.

Wolfe Island Ecopower Centre post construction follow-up plan bird and bat resources monitoring report no. 2 : executive summary

Energy Technology Data Exchange (ETDEWEB)

NONE

2010-05-15

The 197.8 MW Wolfe Island EcoPower Centre consists of 86 wind turbine generators (WTGs), each with a capacity of 2.3 MW, plus ancillary facilities and supporting electrical infrastructure on the Kingston mainland. This report presented the results of a post-construction monitoring program for the period between July 1 and December 31, 2009. Field surveys included bird and bat mortality monitoring; disturbance effects monitoring of foraging migratory waterfowl; and disturbance effects monitoring of wintering raptors. During the mortality monitoring reporting period, 100 carcasses of 33 bird species were collected along with 180 carcasses of 5 bat species. This report concluded that mortality and disturbance effects monitoring should proceed in 2010, but with some modifications to the current method of alternating once-weekly/twice-weekly carcass search schedule for each turbine. It was suggested that in order to reduce uncertainty surrounding the scavenger correction factor, half of the WTGs should be the subject of once-weekly carcass searches, and the other half should be searched twice-weekly. Mortality rates would be calculated separately.

Information support of monitoring of technical condition of buildings in construction risk area

Science.gov (United States)

Skachkova, M. E.; Lepihina, O. Y.; Ignatova, V. V.

2018-05-01

The paper presents the results of the research devoted to the development of a model of information support of monitoring buildings technical condition; these buildings are located in the construction risk area. As a result of the visual and instrumental survey, as well as the analysis of existing approaches and techniques, attributive and cartographic databases have been created. These databases allow monitoring defects and damages of buildings located in a 30-meter risk area from the object under construction. The classification of structures and defects of these buildings under survey is presented. The functional capabilities of the developed model and the field of it practical applications are determined.

Post-challenge hyperglycemia is a significant risk factor for the development of hepatocellular carcinoma in patients with chronic hepatitis C

International Nuclear Information System (INIS)

Takahashi, Hirokazu; Mizuta, Toshihiko; Eguchi, Yuichiro

2011-01-01

Several epidemiological studies have reported that diabetes mellitus is a risk factor for hepatocellular carcinoma (HCC) in hepatitis C virus (HCV)-positive patients. However, it is unclear whether or not post-challenge hyperglycemia is a risk factor. The purpose of this study was to determine the association between post-challenge hyperglycemia and hepatocarcinogenesis in HCV-positive patients. A total of 203 HCV-RNA-positive subjects (108 males, mean age 54.3±10.8 years; 95 females, mean age 56.6±10.3 years; genotype 1b/2a/2b/3a: 152/38/12/1) who underwent liver biopsy and a 75-g oral glucose tolerance test, and who were treated with interferon (IFN) were enrolled in this study. None of the subjects had been treated with antidiabetic drugs. The subjects underwent ultrasonography and/or computed tomography every 6 months after the end of the IFN therapy. Thirteen patients, including one patient who achieved a sustained viral response (SVR) with IFN, developed HCC. On multivariate analysis, male sex, age >65 years, excessive alcohol consumption, non-SVR, liver steatosis area >5% in liver specimens, and 120-min post-challenge hyperglycemia were risk factors for the development of HCC. After matching subjects for sex, age, alcohol intake, and response to the IFN therapy, advanced fibrosis stages [hazard ratio (HR) 2.8], liver steatosis (HR 5.4), and 120-min post-challenge hyperglycemia (HR 4.9) were significant risk factors for the development of HCC. Furthermore, after matching for the fibrosis stage, liver steatosis (HR 5.7) and 120-min post-challenge hyperglycemia (HR 6.9) remained as significant factors for HCC development. Post-challenge hyperglycemia is an independent risk factor for HCC in HCV-positive patients. (author)

Frequency and risk factors of blood transfusion in abdominoplasty in post-bariatric surgery patients: data from the nationwide inpatient sample.

Science.gov (United States)

Masoomi, Hossein; Rimler, Jonathan; Wirth, Garrett A; Lee, Christine; Paydar, Keyianoosh Z; Evans, Gregory R D

2015-05-01

There are limited data regarding blood transfusion following abdominoplasty, especially in post-bariatric surgery patients. The purpose of this study was to evaluate (1) the frequency and outcomes of blood transfusion in post-bariatric surgery patients undergoing abdominoplasty and (2) the predictive risk factors of blood transfusion in this patient population. Using the Nationwide Inpatient Sample database, the authors examined the clinical data of patients with a history of bariatric surgery who underwent abdominoplasty from 2007 to 2011 in the United States. A total of 20,130 post-bariatric surgery patients underwent abdominoplasty during this period. Overall, 1871 patients (9.3 percent) received blood transfusion. Chronic anemia patients had the highest rate of blood transfusion (25.6 percent). Post-bariatric surgery patients who received blood transfusion experienced a significantly higher complication rate (10.1 percent versus 4.8 percent; p blood transfusion. The blood transfusion rate in post-bariatric surgery abdominoplasty patients is not insignificant. Chronic anemia and congestive heart failure are the two major predictors of transfusion. Modifying risk factors such as anemia before abdominoplasty might significantly decrease the possibility of blood transfusion. Risk, III.

Use of risk-adjusted CUSUM charts to monitor 30-day mortality in Danish hospitals

Directory of Open Access Journals (Sweden)

Rasmussen TB

2018-04-01

Full Text Available Thomas Bøjer Rasmussen, Sinna Pilgaard Ulrichsen, Mette Nørgaard Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark Background: Monitoring hospital outcomes and clinical processes as a measure of clinical performance is an integral part of modern health care. The risk-adjusted cumulative sum (CUSUM chart is a frequently used sequential analysis technique that can be implemented to monitor a wide range of different types of outcomes.Objective: The aim of this study was to describe how risk-adjusted CUSUM charts based on population-based nationwide medical registers were used to monitor 30-day mortality in Danish hospitals and to give an example on how alarms of increased hospital mortality from the charts can guide further in-depth analyses.Materials and methods: We used routinely collected administrative data from the Danish National Patient Registry and the Danish Civil Registration System to create risk-adjusted CUSUM charts. We monitored 30-day mortality after hospital admission with one of 77 selected diagnoses in 24 hospital units in Denmark in 2015. The charts were set to detect a 50% increase in 30-day mortality, and control limits were determined by simulations.Results: Among 1,085,576 hospital admissions, 441,352 admissions had one of the 77 selected diagnoses as their primary diagnosis and were included in the risk-adjusted CUSUM charts. The charts yielded a total of eight alarms of increased mortality. The median of the hospitals’ estimated average time to detect a 50% increase in 30-day mortality was 50 days (interquartile interval, 43;54. In the selected example of an alarm, descriptive analyses indicated performance problems with 30-day mortality following hip fracture surgery and diagnosis of chronic obstructive pulmonary disease.Conclusion: The presented implementation of risk-adjusted CUSUM charts can detect significant increases in 30-day mortality within 2 months, on average, in most

Risk monitors - The State of the Art in their Development and Use at Nuclear Power Plants - Produced on behalf of IAEA and OECD/NEA WGRisk

International Nuclear Information System (INIS)

Shepherd, C.H.; Yllera, F.J.; Kaufer, B.; Henneke, D.W.; Gaynor, D.; Sedlak, J.; Evans, M.G.K.; Boneham, P.; Horne, B.; Guymer, P.; Hatfield, M.; Hewitt, J.; Shanley, L.; Sorman, J.; Chao, C.C.; Pullen, R.; Reinhart, F.M.; Lantaron, A.; Huerta, A.; Vojnovic, D.; Hollo, E.; Fukuda, M.; De Gelder, P.; Schulz, R.; Lanore, J.M.

2004-01-01

This report provides a description of the state-of-the-art in the development and use of Risk Monitors at nuclear power plants in the Member States. The work has been carried out jointly by IAEA and OECD WGRisk. The information presented in this report has been obtained from three questionnaires on the development and use of Risk Monitors, software and Regulatory perspectives; from OECD and IAEA Workshops on Risk Monitors; and from IAEA consultants meetings and WGRisk Task Group meetings. Some of the work carried out to produce the report has been funded by the United Kingdom Nuclear Installations Inspectorate. The aim is to produce a report that describes the state of the art in the development of Risk Monitors and their use at nuclear power plants. This will: - define the terminology that relates to Risk Monitors as used in this report, - describe the state of the art in the development and use of Risk Monitors at nuclear power plants, and indicate future developments, - provide information on the software packages available for Risk Monitors, - identify the issues that need to be addressed in the development of a Living PSA for use in a Risk Monitor application and give guidance on how these issues can be resolved, - give information on the issues relating to the design of the Risk Monitor operator interface so that it gives a tool that can be used by all station staff, - discuss the issues that relate to the qualitative and quantitative risk measures addressed by Risk Monitors such as the definition of the Operational Safety Criteria which define the risk levels, the calculation of the Allowed Configuration Time and the definition of the qualitative risk levels that relate to the availability of safety systems, - give insights into the costs involved, the benefits that can be obtained from Risk Monitors and their limitations, and - discuss the regulatory perspective on the use of Risk Monitors to provide risk information that can be used during nuclear power

Monitoring of newborns at high risk for brain injury

OpenAIRE

Pisani, Francesco; Spagnoli, Carlotta

2016-01-01

Due to the increasing number of surviving preterm newborns and to the recognition of therapeutic hypothermia as the current gold standard in newborns with hypoxic-ischaemic encephalopathy, there has been a growing interest in the implementation of brain monitoring tools in newborns at high risk for neurological disorders. Among the most frequent neurological conditions and presentations in the neonatal period, neonatal seizures and neonatal status epilepticus, paroxysmal non-epileptic motor p...

Brief communication: Post-seismic landslides, the tough lesson of a catastrophe

Directory of Open Access Journals (Sweden)

X. Fan

2018-01-01

Full Text Available The rock avalanche that destroyed the village of Xinmo in Sichuan, China, on 24 June 2017, brought the issue of landslide risk and disaster chain management in highly seismic regions back into the spotlight. The long-term post-seismic behaviour of mountain slopes is complex and hardly predictable. Nevertheless, the integrated use of field monitoring, remote sensing and real-time predictive modelling can help to set up effective early warning systems, provide timely alarms, optimize rescue operations, and perform secondary hazard assessments. We believe that a comprehensive discussion on post-seismic slope stability and on its implications for policy makers can no longer be postponed.

Brief communication: Post-seismic landslides, the tough lesson of a catastrophe

Science.gov (United States)

Fan, Xuanmei; Xu, Qiang; Scaringi, Gianvito

2018-01-01

The rock avalanche that destroyed the village of Xinmo in Sichuan, China, on 24 June 2017, brought the issue of landslide risk and disaster chain management in highly seismic regions back into the spotlight. The long-term post-seismic behaviour of mountain slopes is complex and hardly predictable. Nevertheless, the integrated use of field monitoring, remote sensing and real-time predictive modelling can help to set up effective early warning systems, provide timely alarms, optimize rescue operations, and perform secondary hazard assessments. We believe that a comprehensive discussion on post-seismic slope stability and on its implications for policy makers can no longer be postponed.

Risk Identification in a Smart Monitoring System Used to Preserve Artefacts Based on Textile Materials

Science.gov (United States)

Diaconescu, V. D.; Scripcariu, L.; Mătăsaru, P. D.; Diaconescu, M. R.; Ignat, C. A.

2018-06-01

Exhibited textile-materials-based artefacts can be affected by the environmental conditions. A smart monitoring system that commands an adaptive automatic environment control system is proposed for indoor exhibition spaces containing various textile artefacts. All exhibited objects are monitored by many multi-sensor nodes containing temperature, relative humidity and light sensors. Data collected periodically from the entire sensor network is stored in a database and statistically processed in order to identify and classify the environment risk. Risk consequences are analyzed depending on the risk class and the smart system commands different control measures in order to stabilize the indoor environment conditions to the recommended values and prevent material degradation.

Post-market clinical research conducted by medical device manufacturers: a cross-sectional survey

Directory of Open Access Journals (Sweden)

Ross JS

2015-05-01

Full Text Available Joseph S Ross, Katrina L Blount, Jessica D Ritchie, Beth Hodshon, Harlan M Krumholz Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, USA Background: In the US, once a medical device is made available for use, several requirements have been established by the US Food and Drug Administration (FDA to ensure ongoing post-market surveillance of device safety and effectiveness. Our objective was to determine how commonly medical device manufacturers initiate post-market clinical studies or augment FDA post-market surveillance requirements for higher-risk devices that are most often approved via the FDA's pre-market approval (PMA pathway. Methods and results: We conducted a cross-sectional survey of 47 manufacturers with operations in California, Minnesota, and Massachusetts who market devices approved via the PMA pathway. Among 22 respondents (response rate =47%, nearly all self-reported conducting post-market clinical research studies, commonly between 1 and 5; only 1 respondent reported never conducting post-market clinical research studies. While manufacturers most often engaged in these studies to satisfy FDA requirements, other reasons were reported, including performance monitoring and surveillance and market acceptance initiatives. Risks of conducting and not conducting post-market clinical research studies were described through open-ended response to questions. Conclusion: Medical device manufacturers commonly initiate post-market clinical studies at the request of the FDA. Clinical data from these studies should be integrated into national post-market surveillance initiatives. Keywords: FDA, PMA pathway, post-market surveillance

Suicide Attempt Risk in Youths: Utility of the Harkavy-Asnis Suicide Scale for Monitoring Risk Levels

Science.gov (United States)

Asarnow, Joan; McArthur, David; Hughes, Jennifer; Barbery, Veronica; Berk, Michele

2012-01-01

The Harkavy-Asnis Suicide Scale (HASS), one of the few self-report scales assessing suicidal behavior was evaluated and ideation, was evaluated and predictors of suicide attempts (SAs) were identified with the goal of developing a model that clinicians can use for monitoring SA risk. Participants were 131 pediatric emergency department (ED)…

System Design Strategies of Post-Accident Monitoring System for a PGSFR in Korea

International Nuclear Information System (INIS)

Jang, Gwi-sook; Jeong, Kwang-il; Keum, Jong-yong; Seong, Seung-hwan

2013-06-01

Monitoring systems of a PGSFR (Prototype Gen-IV Sodium-cooled Fast Reactor) in Korea provide alarms, integrity information in the reactor building, sodium-water reaction information in the steam generator, fuel failure information, and supporting information for maintenance and inspection. In particular, a Post-Accident Monitoring System (PAMS) provides primary information for operators to assess the plant conditions and perform their role in bringing the plant to a safe condition during an accident. Some PAM variables can be allocated as more two types. It is important for system designers to confirm the suitability of the selection of PAM variables. In addition, the PAMS is a position 4 display against common cause failures of safety I and C systems. The position 4 display should be independent and diverse from the safety I and C systems. The diversity of safety I and C equipment has led to an increase in the design and verification and validation cost. Thus, this paper proposes the system design strategies on the PAMS design problems of the PGSFR in KOREA. The results will be input into a conceptual system design for the PAMS of the PGSFR in KOREA. (authors)

Evaluation of Pre- and Post- Redevelopment Groundwater Chemical Analyses from LM Monitoring Wells

International Nuclear Information System (INIS)

Kamp, Susan; Dayvault, Jalena

2016-01-01

This report documents the efforts and analyses conducted for the Applied Studies and Technology (AS&T) Ancillary Work Plan (AWP) project titled Evaluation of Pre- and Post- Redevelopment Groundwater Sample Laboratory Analyses from Selected LM Groundwater Monitoring Wells. This effort entailed compiling an inventory of nearly 500 previous well redevelopment events at 16 U.S. Department of Energy Office of Legacy Management (LM) sites, searching the literature for impacts of well redevelopment on groundwater sample quality, and-the focus of this report-evaluating the impacts of well redevelopment on field measurements and sample analytical results. Study Catalyst Monitoring well redevelopment, the surging or high-volume pumping of a well to loosen and remove accumulated sediment and biological build-up from a well, is considered an element of monitoring well maintenance that is implemented periodically during the lifetime of the well to mitigate its gradual deterioration. Well redevelopment has been conducted fairly routinely at a few LM sites in the western United States (e.g., the Grand Junction office site and the Gunnison processing site in Colorado), but at most other sites in this region it is not a routine practice. Also, until recently (2014-2015), there had been no specific criteria for implementing well redevelopment, and documentation of redevelopment events has been inconsistent. A catalyst for this evaluation was the self-identification of these inconsistencies by the Legacy Management Support contractor. As a result, in early 2015 Environmental Monitoring Operations (EMO) staff began collecting and documenting additional field measurements during well redevelopment events. In late 2015, AS&T staff undertook an independent internal evaluation of EMO's well redevelopment records and corresponding pre- and post-well-redevelopment groundwater analytical results. Study Findings Although literature discussions parallel the prevailing industry

Evaluation of Pre- and Post- Redevelopment Groundwater Chemical Analyses from LM Monitoring Wells

Energy Technology Data Exchange (ETDEWEB)

Kamp, Susan [Navarro Reserch and Engineering, Oak Ridge, TN (United States); Dayvault, Jalena [US Department of Energy, Washington, DC (United States). Office of Legacy Management

2016-05-01

This report documents the efforts and analyses conducted for the Applied Studies and Technology (AS&T) Ancillary Work Plan (AWP) project titled Evaluation of Pre- and Post- Redevelopment Groundwater Sample Laboratory Analyses from Selected LM Groundwater Monitoring Wells. This effort entailed compiling an inventory of nearly 500 previous well redevelopment events at 16 U.S. Department of Energy Office of Legacy Management (LM) sites, searching the literature for impacts of well redevelopment on groundwater sample quality, and—the focus of this report—evaluating the impacts of well redevelopment on field measurements and sample analytical results. Study Catalyst Monitoring well redevelopment, the surging or high-volume pumping of a well to loosen and remove accumulated sediment and biological build-up from a well, is considered an element of monitoring well maintenance that is implemented periodically during the lifetime of the well to mitigate its gradual deterioration. Well redevelopment has been conducted fairly routinely at a few LM sites in the western United States (e.g., the Grand Junction office site and the Gunnison processing site in Colorado), but at most other sites in this region it is not a routine practice. Also, until recently (2014–2015), there had been no specific criteria for implementing well redevelopment, and documentation of redevelopment events has been inconsistent. A catalyst for this evaluation was the self-identification of these inconsistencies by the Legacy Management Support contractor. As a result, in early 2015 Environmental Monitoring Operations (EMO) staff began collecting and documenting additional field measurements during well redevelopment events. In late 2015, AS&T staff undertook an independent internal evaluation of EMO's well redevelopment records and corresponding pre- and post-well-redevelopment groundwater analytical results. Study Findings Although literature discussions parallel the prevailing industry

Assessing hospitals' clinical risk management: Development of a monitoring instrument

Directory of Open Access Journals (Sweden)

Pfeiffer Yvonne

2010-12-01

Full Text Available Abstract Background Clinical risk management (CRM plays a crucial role in enabling hospitals to identify, contain, and manage risks related to patient safety. So far, no instruments are available to measure and monitor the level of implementation of CRM. Therefore, our objective was to develop an instrument for assessing CRM in hospitals. Methods The instrument was developed based on a literature review, which identified key elements of CRM. These elements were then discussed with a panel of patient safety experts. A theoretical model was used to describe the level to which CRM elements have been implemented within the organization. Interviews with CRM practitioners and a pilot evaluation were conducted to revise the instrument. The first nationwide application of the instrument (138 participating Swiss hospitals was complemented by in-depth interviews with 25 CRM practitioners in selected hospitals, for validation purposes. Results The monitoring instrument consists of 28 main questions organized in three sections: 1 Implementation and organizational integration of CRM, 2 Strategic objectives and operational implementation of CRM at hospital level, and 3 Overview of CRM in different services. The instrument is available in four languages (English, German, French, and Italian. It allows hospitals to gather comprehensive and systematic data on their CRM practice and to identify areas for further improvement. Conclusions We have developed an instrument for assessing development stages of CRM in hospitals that should be feasible for a continuous monitoring of developments in this important area of patient safety.

Assessing hospitals' clinical risk management: Development of a monitoring instrument.

Science.gov (United States)

Briner, Matthias; Kessler, Oliver; Pfeiffer, Yvonne; Wehner, Theo; Manser, Tanja

2010-12-13

Clinical risk management (CRM) plays a crucial role in enabling hospitals to identify, contain, and manage risks related to patient safety. So far, no instruments are available to measure and monitor the level of implementation of CRM. Therefore, our objective was to develop an instrument for assessing CRM in hospitals. The instrument was developed based on a literature review, which identified key elements of CRM. These elements were then discussed with a panel of patient safety experts. A theoretical model was used to describe the level to which CRM elements have been implemented within the organization. Interviews with CRM practitioners and a pilot evaluation were conducted to revise the instrument. The first nationwide application of the instrument (138 participating Swiss hospitals) was complemented by in-depth interviews with 25 CRM practitioners in selected hospitals, for validation purposes. The monitoring instrument consists of 28 main questions organized in three sections: 1) Implementation and organizational integration of CRM, 2) Strategic objectives and operational implementation of CRM at hospital level, and 3) Overview of CRM in different services. The instrument is available in four languages (English, German, French, and Italian). It allows hospitals to gather comprehensive and systematic data on their CRM practice and to identify areas for further improvement. We have developed an instrument for assessing development stages of CRM in hospitals that should be feasible for a continuous monitoring of developments in this important area of patient safety.

Noninvasive hemoglobin monitoring in critically ill pediatric patients at risk of bleeding.

Science.gov (United States)

García-Soler, P; Camacho Alonso, J M; González-Gómez, J M; Milano-Manso, G

2017-05-01

To determine the accuracy and usefulness of noninvasive continuous hemoglobin (Hb) monitoring in critically ill patients at risk of bleeding. An observational prospective study was made, comparing core laboratory Hb measurement (LabHb) as the gold standard versus transcutaneous hemoglobin monitoring (SpHb). Pediatric Intensive Care Unit of a tertiary University Hospital. Patients weighing >3kg at risk of bleeding. SpHb was measured using the Radical7 pulse co-oximeter (Masimo Corp., Irvine, CA, USA) each time a blood sample was drawn for core laboratory analysis (Siemens ADVIA 2120i). Sociodemographic characteristics, perfusion index (PI), pleth variability index, heart rate, SaO 2 , rectal temperature, low signal quality and other events that can interfere with measurement. A total of 284 measurements were made (80 patients). Mean LabHb was 11.7±2.05g/dl. Mean SpHb was 12.32±2g/dl (Pearson 0.72, R 2 0.52). The intra-class correlation coefficient was 0.69 (95%CI 0.55-0.78)(p<0.001). Bland-Altman analysis showed a mean difference of 0.07 ±1.46g/dl. A lower PI and higher temperature independently increased the risk of low signal quality (OR 0.531 [95%CI 0.32-0.88] and 0.529 [95%CI 0.33-0.85], respectively). SpHb shows a good overall correlation to LabHb, though with wide limits of agreement. Its main advantage is continuous monitoring of patients at risk of bleeding. The reliability of the method is limited in cases with poor peripheral perfusion. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Operative Start Time Does Not Affect Post-Operative Infection Risk.

Science.gov (United States)

Guidry, Christopher A; Davies, Stephen W; Willis, Rhett N; Dietch, Zachary C; Shah, Puja M; Sawyer, Robert G

2016-10-01

Surgical care is delivered 24 h a day at most institutions. Alarmingly, some authors have found that certain operative start times are associated with greater morbidity and mortality rates. This effect has been noted in both the public and private sector. Although some of these differences may be related to process, they may also be caused by the human circadian rhythm and corresponding changes in host defenses. We hypothesized that the time of day of an operation would impact the frequency of certain post-operative outcomes significantly. Cases at a single tertiary-care center reported to the American College of Surgeons National Surgical Quality Improvement Program over a 10-year period were identified. Operative start times were divided into six-hour blocks, with 6 am to noon serving as the reference. Standard univariable techniques were applied. Multivariable logistic regression with mixed effects modeling then was used to determine the relation between operative start times and infectious outcomes, controlling for surgeon clustering. Statistical significance was set at p operative infectious complication. Seventy percent of these infections (n = 1,506) were surgical site infections. On univariable analysis considering all cases, nighttime and evening operations had higher rates of post-operative infections than those in performed during the day (9.1% from 6 am to noon; 9.7% from noon to 6 pm; 14.8% from 6 pm to midnight; and 14.4% from midnight to 6 am; p operative start time was not associated with the risk of post-operative infection, even when emergency cases were considered independently. Our data suggest that operative start times have no correlation with post-operative infectious complications. Further work is required to identify the source of the time-dependent outcome variability observed in previous studies.

Post decommissioning monitoring of uranium mines; a watershed monitoring program based on biological response

International Nuclear Information System (INIS)

Russel, C.; Coggan, A.; Ludgate, I.

2006-01-01

Rio Algom Limited and Denison Mines own and operated uranium mines in the Elliot Lake area. The mines operated from the late 1950's to the mid 1960's and again for the early 1970's to the 1990's when the mines ceased operations. There are eleven decommissioned mines in the Serpent River watershed. At the time of decommissioning each mine had it's own monitoring program, which had evolved over the operating life of the mine and did not necessarily reflect the objectives associated with the monitoring of decommissioned sites. In order to assess the effectiveness of the decommissioning plans and monitoring the cumulative effects within the watershed, a single watershed monitoring program was developed in 1999: the Serpent River Watershed Monitoring Program which focused on water and sediment quality within the watershed and response of the biological community over time. In order to address other 'source area' monitoring, three complimentary objective-focused programs were developed 1) the In- Basin Monitoring Program, 2) the Source Area Monitoring Program and 3) the TMA Operational Monitoring Program. Through development this program framework and monitoring programs that were objective- focused, more meaningful data has been provided while providing a significant reduction in the cost of monitoring. These programs allow for the reduction in scope over time in response to improvement in the watershed. This talk will describe the development of these programs, their implementation and effectiveness. (author)

Maternal health, antenatal and at 8 weeks after delivery, in home versus in-hospital fetal monitoring in high-risk pregnancies

NARCIS (Netherlands)

Monincx, W. M.; Birnie, E.; Zondervan, H. A.; Bleker, O. P.; Bonsel, G. J.

2001-01-01

To assess maternal health outcome, comparing high-risk pregnant women to either domiciliary monitoring or in-hospital monitoring, and a low risk pregnant group. Paper and pencil questionnaire, distributed antenatal and 8 weeks after the delivery. A university hospital. Three groups: 130 high-risk

Dutch monitor on stress and physical load: risk factors, consequences, and preventive action.

Science.gov (United States)

Houtman, I L; Goudswaard, A; Dhondt, S; van der Grinten, M P; Hildebrandt, V H; van der Poel, E G

1998-02-01

Due to recent changes in legislation on occupational health and safety, a national monitor on stress and physical load was developed in The Netherlands to monitor (a) risks and consequences of stress and physical load at work, (b) preventive actions in companies to reduce these risks, and (c) organisational and environmental variables that facilitate preventive actions. Information was gathered from employers, employees, and employees' representatives. The monitor was used with a nationally representative sample of companies in industry, wholesale trade, and banking and finance, 782 companies in total. The information from the employees, aggregated at the company level, was not found to be correlated with that from the employer from the same companies. Although many employers do recognise risk factors for both physical load and stress as a problem they often seem to underestimate the problem when compared with employees or their representatives. This is particularly the case for psychosocial risk factors. Also, the perception of outcome measures, especially employers who consider emotional exhaustion to be work related, were fewer than the employees' representatives of the same organisation. Preventive measures on physical load are much more popular than measures against stress. It is the responsibility of the employer to take more preventive action of all kinds. They need to recognise risk factors as problems and health outcomes to be related to work. Employees of larger companies should participate with employers to consider effective measures, and more use should be made of support at branch level. For specific preventive measures, specific predictors emerged. Except for measures to prevent work stress, information from employees did not sufficiently contribute to the initiation of preventive measures in the workplace.

"Soldier's Heart": A Genetic Basis for Elevated Cardiovascular Disease Risk Associated with Post-traumatic Stress Disorder.

Science.gov (United States)

Pollard, Harvey B; Shivakumar, Chittari; Starr, Joshua; Eidelman, Ofer; Jacobowitz, David M; Dalgard, Clifton L; Srivastava, Meera; Wilkerson, Matthew D; Stein, Murray B; Ursano, Robert J

2016-01-01

"Soldier's Heart," is an American Civil War term linking post-traumatic stress disorder (PTSD) with increased propensity for cardiovascular disease (CVD). We have hypothesized that there might be a quantifiable genetic basis for this linkage. To test this hypothesis we identified a comprehensive set of candidate risk genes for PTSD, and tested whether any were also independent risk genes for CVD. A functional analysis algorithm was used to identify associated signaling networks. We identified 106 PTSD studies that report one or more polymorphic variants in 87 candidate genes in 83,463 subjects and controls. The top upstream drivers for these PTSD risk genes are predicted to be the glucocorticoid receptor (NR3C1) and Tumor Necrosis Factor alpha (TNFA). We find that 37 of the PTSD candidate risk genes are also candidate independent risk genes for CVD. The association between PTSD and CVD is significant by Fisher's Exact Test ( P = 3 × 10 -54 ). We also find 15 PTSD risk genes that are independently associated with Type 2 Diabetes Mellitus (T2DM; also significant by Fisher's Exact Test ( P = 1.8 × 10 -16 ). Our findings offer quantitative evidence for a genetic link between post-traumatic stress and cardiovascular disease, Computationally, the common mechanism for this linkage between PTSD and CVD is innate immunity and NFκB-mediated inflammation.

[Study on building index system of risk assessment of post-marketing Chinese patent medicine based on AHP-fuzzy neural network].

Science.gov (United States)

Li, Yuanyuan; Xie, Yanming; Fu, Yingkun

2011-10-01

Currently massive researches have been launched about the safety, efficiency and economy of post-marketing Chinese patent medicine (CPM) proprietary Chinese medicine, but it was lack of a comprehensive interpretation. Establishing the risk evaluation index system and risk assessment model of CPM is the key to solve drug safety problems and protect people's health. The clinical risk factors of CPM exist similarities with the Western medicine, can draw lessons from foreign experience, but also have itself multi-factor multivariate multi-level complex features. Drug safety risk assessment for the uncertainty and complexity, using analytic hierarchy process (AHP) to empower the index weights, AHP-based fuzzy neural network to build post-marketing CPM risk evaluation index system and risk assessment model and constantly improving the application of traditional Chinese medicine characteristic is accord with the road and feasible beneficial exploration.

Bulletin of Forest Fire risk in Albania- The experience of the Albania National Centre for forecast and Monitoring of Natural Risks

Science.gov (United States)

Berdufi, I.; Jaupaj, O.; Marku, M.; Deda, M.; Fiori, E.; D'Andrea, M.; Biondi, G.; Fioruci, P.; Massabò, M.; Zorba, P.; Gjonaj, M.

2012-04-01

In the territory of Albania usually every year around 1000 ha are affected by forest fires, from which about 500 ha are completely destroyed. The number of forest fires (nf), with the burning surface (bs) in years has been like this: during the years 1988-1998: nf / bs = 2.19, 1998-2001: nf / bs = 5.66, year 2002 -2005: nf / bs = 8.2, and during the years 2005-2006: nf / bs = 11.9, while economic losses in a year by forest fires is about 2 million of Euro. The increase in years of these figures and the last floods which happened in the last two years in Shkoder, led to an international cooperation, that between the Italian Civil Protection Department and the Albania General Directorate of Civil Emergency. The focus of this cooperation was the building capacity of the Albanian National System of Civil Protection in forecasting, monitoring and prevention forest fires and floods risks. As a result of this collaboration the "National Center for the Forecast and Monitoring of Natural Risks", was set up at the Institute of Geosciences, Energy, Water and Environment. The Center is the first of its kind in Albania. The mission of the Center is the prediction and monitoring of the forest fire and flood risk in the Albanian territory, as a tools for risk reduction and mitigation. The first step to achieve this strategy was the implementation of the forest fires risk forecast model "RISICO". RISICO was adapted for whole Albania territory by CIMA Research Foundation. The Center, in the summer season, issues a daily bulletin. The bulletin reports the potential risk scenarios related with the ignition and propagation of fires in Albania. The bulletin is broadcasted through email or fax within 12.00 AM of each working day. It highlights where and when severe risk conditions may occur within the next 48 hours

An anatomic risk model to screen post endovascular aneurysm repair patients for aneurysm sac enlargement.

Science.gov (United States)

Png, Chien Yi M; Tadros, Rami O; Beckerman, William E; Han, Daniel K; Tardiff, Melissa L; Torres, Marielle R; Marin, Michael L; Faries, Peter L

2017-09-01

Follow-up computed tomography angiography (CTA) scans add considerable postimplantation costs to endovascular aneurysm repairs (EVARs) of abdominal aortic aneurysms (AAAs). By building a risk model, we hope to identify patients at low risk for aneurysm sac enlargement to minimize unnecessary CTAs. 895 consecutive patients who underwent EVAR for AAA were reviewed, of which 556 met inclusion criteria. A Probit model was created for aneurysm sac enlargement, with preoperative aneurysm morphology, patient demographics, and operative details as variables. Our final model included 287 patients and had a sensitivity of 100%, a specificity of 68.9%, and an accuracy of 70.4%. Ninety-nine (35%) of patients were assigned to the high-risk group, whereas 188 (65%) of patients were assigned to the low-risk group. Notably, regarding anatomic variables, our model reported that age, pulmonary comorbidities, aortic neck diameter, iliac artery length, and aneurysms were independent predictors of post-EVAR sac enlargement. With the exception of age, all statistically significant variables were qualitatively supported by prior literature. With regards to secondary outcomes, the high-risk group had significantly higher proportions of AAA-related deaths (5.1% versus 1.1%, P = 0.037) and Type 1 endoleaks (9.1% versus 3.2%, P = 0.033). Our model is a decent predictor of patients at low risk for post AAA EVAR aneurysm sac enlargement and associated complications. With additional validation and refinement, it could be applied to practices to cut down on the overall need for postimplantation CTA. Copyright © 2017 Elsevier Inc. All rights reserved.

How well does the Post-fire Erosion Risk Management Tool (ERMiT) really work?

Science.gov (United States)

Robichaud, Peter; Elliot, William; Lewis, Sarah; Miller, Mary Ellen

2016-04-01

The decision of where, when, and how to apply the most effective postfire erosion mitigation treatments requires land managers to assess the risk of damaging runoff and erosion events occurring after a fire. The Erosion Risk Management Tool (ERMiT) was developed to assist post fire assessment teams identify high erosion risk areas and effectiveness of various mitigation treatments to reduce that risk. ERMiT is a web-based application that uses the Water Erosion Prediction Project (WEPP) technology to estimate erosion, in probabilistic terms, on burned and recovering forest, range, and chaparral lands with and without the application of mitigation treatments. User inputs are processed by ERMiT to combine rain event variability with spatial and temporal variabilities of hillslope burn severity and soil properties which are then used as WEPP inputs. Since 2007, the model has been used in making hundreds of land management decisions in the US and elsewhere. We use eight published field study sites in the Western US to compare ERMiT predictions to observed hillslope erosion rates. Most sites experience only a few rainfall events that produced runoff and sediment except for a California site with a Mediterranean climate. When hillslope erosion occurred, significant correlations occurred between the observed hillslope erosion and those predicted by ERMiT. Significant correlation occurred for most mitigation treatments as well as the five recovery years. These model validation results suggest reasonable estimates of probabilistic post-fire hillslope sediment delivery when compared to observation.

Technical Needs for Enhancing Risk Monitors with Equipment Condition Assessment for Advanced Small Modular Reactors

Energy Technology Data Exchange (ETDEWEB)

Coble, Jamie B.; Coles, Garill A.; Ramuhalli, Pradeep; Meyer, Ryan M.; Berglin, Eric J.; Wootan, David W.; Mitchell, Mark R.

2013-04-04

Advanced small modular reactors (aSMRs) can provide the United States with a safe, sustainable, and carbon-neutral energy source. The controllable day-to-day costs of aSMRs are expected to be dominated by operation and maintenance costs. Health and condition assessment coupled with online risk monitors can potentially enhance affordability of aSMRs through optimized operational planning and maintenance scheduling. Currently deployed risk monitors are an extension of probabilistic risk assessment (PRA). For complex engineered systems like nuclear power plants, PRA systematically combines event likelihoods and the probability of failure (POF) of key components, so that when combined with the magnitude of possible adverse consequences to determine risk. Traditional PRA uses population-based POF information to estimate the average plant risk over time. Currently, most nuclear power plants have a PRA that reflects the as-operated, as-modified plant; this model is updated periodically, typically once a year. Risk monitors expand on living PRA by incorporating changes in the day-by-day plant operation and configuration (e.g., changes in equipment availability, operating regime, environmental conditions). However, population-based POF (or population- and time-based POF) is still used to populate fault trees. Health monitoring techniques can be used to establish condition indicators and monitoring capabilities that indicate the component-specific POF at a desired point in time (or over a desired period), which can then be incorporated in the risk monitor to provide a more accurate estimate of the plant risk in different configurations. This is particularly important for active systems, structures, and components (SSCs) proposed for use in aSMR designs. These SSCs may differ significantly from those used in the operating fleet of light-water reactors (or even in LWR-based SMR designs). Additionally, the operating characteristics of aSMRs can present significantly different

Experience with neutron flux monitoring systems qualified for post-accident monitoring

International Nuclear Information System (INIS)

Shugars, H.G.; Miller, J.F.

1995-01-01

In this paper we discuss the environmental requirements for excore neutron flux monitors that are qualified for use during and after postulated accidents in Pressurized Water Reactors (PWRs). We emphasize PWRs designed in the United States, which are similar to those used also in parts of Western Europe and Eastern Asia. We then discuss design features of the flux monitoring systems necessary to address the environmental, functional, and regulatory requirements, and the experience with these systems. (author). 9 refs, 2 figs

How should work the thyroid monitoring for inhabitants of the destroyed area and its adjacent areas

International Nuclear Information System (INIS)

Nishizawa, Kunihide; Ito, Shigeki

2011-01-01

The general method of the exposure dose evaluation and the thyroid monitoring for it are explained and stressed. The vast area environmental contamination around the Fukushima Daiichi Nuclear Power Station accident brought about the anxiety of health risks for the inhabitants, especially probabilistic outbreak of cancer owing to radiation exposure. The report concludes that for the post traumatic stress disorder (PTSD) mental care and thyroid monitoring are necessary. (S. Ohno)

Peri-anaesthetic complications in an equine referral hospital: Risk factors for post anaesthetic colic.

Science.gov (United States)

Jago, R C; Corletto, F; Wright, I M

2015-11-01

Peri-anaesthetic complications are relatively common in equine patients and further investigations are warranted to identify manageable risk factors. To report morbidity and mortality rates and identify associated risk factors for horses undergoing general anaesthesia, within a predominantly racing Thoroughbred (TB) population. Single centre retrospective observational study. Anaesthetic and case records of all horses ≥12 months old undergoing general anaesthesia at Newmarket Equine Hospital between August 2010 and April 2012 were analysed, excluding emergency abdominal/dystocia procedures or traumatology cases with cardiovascular compromise. Mortality and morbidity rates were calculated and described. Uni- and multivariable analyses were used to investigate the relationship between the principal complication, post anaesthetic colic (PAC) and risk factors. A total of 1067 anaesthetic records of 1021 horses were included in the study; of these, 702 horses (65.8%) were TB, 169 (15.8%) developed a complication within 7 days of general anaesthesia and 10 (0.94%) died as a result. The most prevalent morbidity was PAC, 111 horses (10.5%) developed colic within 7 days of general anaesthesia. Thoroughbred horses (odds ratio [OR] 2.93, 95% confidence interval [CI] 1.73-4.96) and horses receiving sodium benzylpenicillin (NaBP) (OR 2.77, 95% CI 1.69-4.50) were at increased risk of PAC. Thoroughbred racehorses were identified as at increased risk of PAC in this study and might benefit from more critical evaluation of post anaesthetic gastrointestinal function. An alternative to the administration of NaBP for prophylactic antimicrobial therapy needs to be further investigated if its role in PAC is confirmed by other studies. © 2015 EVJ Ltd.

Cortical surface area reduction in identification of subjects at high risk for post-traumatic stress disorder: A pilot study.

Science.gov (United States)

Hu, Hao; Sun, Yawen; Su, Shanshan; Wang, Yao; Qiu, Yongming; Yang, Xi; Zhou, Yan; Xiao, Zeping; Wang, Zhen

2018-01-01

Victims of motor vehicle accidents often develop post-traumatic stress disorder, which causes significant social function loss. For the difficulty in treating post-traumatic stress disorder, identification of subjects at high risk for post-traumatic stress disorder is essential for providing possible intervention. This paper aims to examine the cortical structural traits related to susceptibility to post-traumatic stress disorder. To address this issue, we performed structural magnetic resonance imaging study in motor vehicle accident victims within 48 hours from the accidents. A total of 70 victims, available for both clinical and magnetic resonance imaging data, enrolled in our study. Upon completion of 6-month follow-up, 29 of them developed post-traumatic stress disorder, while 41 of them didn't. At baseline, voxelwise comparisons of cortical thickness, cortical area and cortical volume were conducted between post-traumatic stress disorder group and trauma control group. As expected, several reduced cortical volume within frontal-temporal loop were observed in post-traumatic stress disorder. For cortical thickness, no between-group differences were observed. There were three clusters in left hemisphere and one cluster in right hemisphere showing decreased cortical area in post-traumatic stress disorder patients, compared with trauma controls. Peak voxels of the three clusters in left hemisphere were separately located in superior parietal cortex, insula and rostral anterior cingulate cortex. The finding of reduced surface area of left insula and left rostral anterior cingulate cortex suggests that shrinked surface area in motor vehicle accident victims could act as potential biomarker of subjects at high risk for post-traumatic stress disorder.

Development and Testing of a Friction-Based Post-Installable Sensor for Subsea Fiber-Optic Monitoring Systems

Science.gov (United States)

Bentley, Nicole; Brower, David; Le, Suy Q.; Seaman, Calvin; Tang, Henry

2017-01-01

This paper presents the design and development of a friction-based coupling device for a fiber-optic monitoring system that can be deployed on existing subsea structures. This paper provides a summary of the design concept, prototype development, prototype performance testing, and design refinements of the device. The results of the laboratory testing of the first prototype performed at the National Aeronautics and Space Administration (NASA) Johnson Space Center (JSC) are included in this paper. Limitations of the initial design were identified and future design improvements were proposed. These new features will enhance the coupling of the device and improve the monitoring system measurement capabilities. A major challenge of a post-installed instrumentation monitoring system is to ensure adequate coupling between the instruments and the structure of interest for reliable measurements. Friction-based coupling devices have the potential to overcome coupling limitations caused by marine growth and soil contamination on subsea structures, flowlines or risers. The work described in this paper investigates the design of a friction-based coupling device (friction clamp), which is applicable for pipelines and structures that are suspended in the water column and those that are resting on the seabed. The monitoring elements consist of fiber-optic sensors that are bonded to a metal clamshell with a high-friction coating. The friction clamp has a single hinge design to facilitate the operation of the clamp and dual rows of opposing fasteners to distribute the clamping force on the structure. The friction clamp can be installed by divers in shallow depths or by remotely operated vehicles in deep-water applications. NASA-JSC was involved in the selection and testing of the friction coating, and in the design and testing of the prototype clamp device. Four-inch diameter and eight-inch diameter sub-scale friction clamp prototypes were built and tested to evaluate the strain

Development and Testing of a Friction-Based Post-Installable Fiber-Optic Monitoring System for Subsea Applications

Science.gov (United States)

Bentley, Nicole L.; Brower, David V.; Le, Suy Q.; Seaman, Calvin H.; Tang, Henry H.

2017-01-01

This paper presents the design and development of a friction-based coupling device for a fiber-optic monitoring system capable of measuring pressure, strain, and temperature that can be deployed on existing subsea structures. A summary is provided of the design concept, prototype development, prototype performance testing, and subsequent design refinements of the device. The results of laboratory testing of the first prototype performed at the National Aeronautics and Space Administration (NASA) Johnson Space Center (JSC) are also included. Limitations of the initial concept were identified during testing and future design improvements were proposed and later implemented. These new features enhance the coupling of the sensor device and improve the monitoring system measurement capabilities. A major challenge of a post-installed instrumentation monitoring system is to ensure adequate coupling between the instruments and the structure of interest for reliable measurements. Friction-based devices have the potential to overcome coupling limitations caused by marine growth and soil contamination on flowlines, risers, and other subsea structures. The work described in this paper investigates the design and test of a friction-based coupling device (herein referred to as a friction clamp) which is suitable for pipelines and structures that are suspended in the water column as well as for those that are resting on the seabed. The monitoring elements consist of fiberoptic sensors that are bonded to a stainless steel clamshell assembly with a high-friction surface coating. The friction clamp incorporates a single hinge design to facilitate installation of the clamp and dual rows of opposing fasteners to distribute the clamping force along the structure. The friction clamp can be modified to be installed by commercial divers in shallow depths or by remotely operated vehicles in deep-water applications. NASA-JSC was involved in the selection and testing of the friction coating

Development and Testing of a Friction-Based Post-Installable Sensor for Subsea Fiber-Optic Monitoring System

Science.gov (United States)

Bentley, Nicole L.; Brower, David V.; Le, Suy Q.; Seaman, Calvin H.; Tang, Henry H.

2017-01-01

This paper presents the design and development of a friction-based coupling device for a fiber-optic monitoring system that can be deployed on existing subsea structures. This paper provides a summary of the design concept, prototype development, prototype performance testing, and design refinements of the device. The results of the laboratory testing of the first prototype performed at the National Aeronautics and Space Administration (NASA) Johnson Space Center (JSC) are included in this paper. Limitations of the initial design were identified and future design improvements were proposed. These new features will enhance the coupling of the device and improve the monitoring system measurement capabilities. A major challenge of a post-installed instrumentation monitoring system is to ensure adequate coupling between the instruments and the structure of interest for reliable measurements. Friction-based coupling devices have the potential to overcome coupling limitations caused by marine growth and soil contamination on subsea structures, flowlines or risers. The work described in this paper investigates the design of a friction-based coupling device (friction clamp), which is applicable for pipelines and structures that are suspended in the water column and those that are resting on the seabed. The monitoring elements consist of fiber-optic sensors that are bonded to a metal clamshell with a high-friction coating. The friction clamp has a single hinge design to facilitate the operation of the clamp and dual rows of opposing fasteners to distribute the clamping force on the structure. The friction clamp can be installed by divers in shallow depths or by remotely operated vehicles in deep-water applications. NASA-JSC was involved in the selection and testing of the friction coating, and in the design and testing of the prototype clamp device. Four-inch diameter and eight-inch diameter sub-scale friction clamp prototypes were built and tested to evaluate the strain

First year post-construction monitoring of bats and birds at Wind Turbine Test Centre Østerild

DEFF Research Database (Denmark)

The Department of Bioscience, Aarhus University was commissioned by the Danish Nature Agency to undertake a bat and bird monitoring programme of a national test centre for wind turbines near Østerild in Thy, Denmark. Here we present the results from the first year of the post-construction studies...... and lakes. High activities were recorded throughout the monitoring period at ponds and lakes. Overall, the bat activity level was higher in 2013 than in 2011 at ponds and lakes. Bat activity was higher near the wind turbines than at nearby forest edges. These differences suggest that bats exploit the food...... resources that accumulate on the turbine towers some nights. Whooper swan, taiga bean goose, pink-footed goose, common crane, light-bellied brent goose, white-tailed eagle and nightjar were included as focal species in the ornithological investigations. In addition, species specific data on all bird species...

A comparison of internal versus external risk-adjustment for monitoring clinical outcomes

NARCIS (Netherlands)

Koetsier, Antonie; de Keizer, Nicolette; Peek, Niels

2011-01-01

Internal and external prognostic models can be used to calculate severity of illness adjusted mortality risks. However, it is unclear what the consequences are of using an external model instead of an internal model when monitoring an institution's clinical performance. Theoretically, using an

Data Analyses and Modelling for Risk Based Monitoring of Mycotoxins in Animal Feed

Directory of Open Access Journals (Sweden)

H.J. (Ine van der Fels-Klerx

2018-01-01

Full Text Available Following legislation, European Member States should have multi-annual control programs for contaminants, such as for mycotoxins, in feed and food. These programs need to be risk based implying the checks are regular and proportional to the estimated risk for animal and human health. This study aimed to prioritize feed products in the Netherlands for deoxynivalenol and aflatoxin B1 monitoring. Historical mycotoxin monitoring results from the period 2007–2016 were combined with data from other sources. Based on occurrence, groundnuts had high priority for aflatoxin B1 monitoring; some feed materials (maize and maize products and several oil seed products and complete/complementary feed excluding dairy cattle and young animals had medium priority; and all other animal feeds and feed materials had low priority. For deoxynivalenol, maize by-products had a high priority, complete and complementary feed for pigs had a medium priority and all other feed and feed materials a low priority. Also including health consequence estimations showed that feed materials that ranked highest for aflatoxin B1 included sunflower seed and palmkernel expeller/extracts and maize. For deoxynivalenol, maize products were ranked highest, followed by various small grain cereals (products; all other feed materials were of lower concern. Results of this study have proven to be useful in setting up the annual risk based control program for mycotoxins in animal feed and feed materials.

Data Analyses and Modelling for Risk Based Monitoring of Mycotoxins in Animal Feed

Science.gov (United States)

van der Fels-Klerx, H.J. (Ine); Adamse, Paulien; Punt, Ans; van Asselt, Esther D.

2018-01-01

Following legislation, European Member States should have multi-annual control programs for contaminants, such as for mycotoxins, in feed and food. These programs need to be risk based implying the checks are regular and proportional to the estimated risk for animal and human health. This study aimed to prioritize feed products in the Netherlands for deoxynivalenol and aflatoxin B1 monitoring. Historical mycotoxin monitoring results from the period 2007–2016 were combined with data from other sources. Based on occurrence, groundnuts had high priority for aflatoxin B1 monitoring; some feed materials (maize and maize products and several oil seed products) and complete/complementary feed excluding dairy cattle and young animals had medium priority; and all other animal feeds and feed materials had low priority. For deoxynivalenol, maize by-products had a high priority, complete and complementary feed for pigs had a medium priority and all other feed and feed materials a low priority. Also including health consequence estimations showed that feed materials that ranked highest for aflatoxin B1 included sunflower seed and palmkernel expeller/extracts and maize. For deoxynivalenol, maize products were ranked highest, followed by various small grain cereals (products); all other feed materials were of lower concern. Results of this study have proven to be useful in setting up the annual risk based control program for mycotoxins in animal feed and feed materials. PMID:29373559

Identifying crime victims who are at high risk for post traumatic stress disorder: developing a practical referral instrument

NARCIS (Netherlands)

Wohlfarth, T.; Winkel, F. W.; van den Brink, W.

2002-01-01

Objective To construct a practical instrument for the identification and referral of crime victims who are at high risk for post traumatic stress disorder (PTSD). Method: Crime victims filing a complaint at a police station were asked to fill out a questionnaire probing risk factors for PTSD (n

Lessons learned from a review of post-accident sampling systems, high range effluent monitors and high concentration particulate iodine samplers

International Nuclear Information System (INIS)

Hull, A.P.; Knox, W.H.; White, J.R.

1987-01-01

Post-accident sampling systems (PASS), high range gaseous effluent monitors and sampling systems for particulates and iodine in high concentrations have been reviewed at twenty-one licensee sites in Region I of the US Nuclear Regulatory Commission which includes fifteen BWR's and fourteen PWR's. Although most of the installed PASS met the criteria, the highest operational readiness was found in on-line systems that were also used for routine sampling and analysis. The detectors used in the gaseous effluent monitors included external ion chambers, GM tubes, organic scintillators and Cd-Te solid state crystals. Although all were found acceptable, each had its own inherent limitations in the conversion of detector output to the time varying concentration of a post-accident mixture of noble gases. None of the installed particulate and iodine samplers fully met all of the criteria. Their principal limitations included a lack of documentation showing that they could obtain a representative sample and that many of them would collect of an excessive amount of activity at the design criteria. 10 refs., 4 figs., 5 tabs

Early amplitude‐integrated electroencephalography for monitoring neonates at high risk for brain injury

Directory of Open Access Journals (Sweden)

Gabriel Fernando Todeschi Variane

2017-09-01

Conclusion: This study supports previous results and demonstrates the utility of amplitude‐integrated electroencephalography for monitoring brain function and predicting early outcome in the studied groups of infants at high risk for brain injury.

Transcranial motor evoked potential monitoring outcome in the high-risk brain and spine surgeries: Correlation of clinical and neurophysiological data - An Indian perspective

Directory of Open Access Journals (Sweden)

Poornima Amit Shah

2013-01-01

Full Text Available Objective: The objective of this study is to assess the safety, feasibility and clinical value of transcranial motor evoked potential (MEP monitoring by electrical stimulation. Setting: Clinical neurophysiology department of tertiary reach hospital. Materials and Methods: MEP monitoring was attempted in 44 "high risk" patients. Intraoperative surgical, anesthesia and neurophysiological findings were documented prospectively. MEP monitoring results were correlated with motor outcome. Results: The success for reliable MEP recording from the lower limbs was 75%. Incidence of new permanent post-operative motor deficit was zero. Nearly, 76.5% of the cases (13 out of 17 cases who showed unobtainable and unstable MEP outcome had lesion location in the spine as compared with 23.5% (4 out of 17 cases that had lesion location in the brain. Chi-square test demonstrated a statistically significant difference between these two groups (P = 0.0020. Out of these 13 spine surgery cases, 8 (62% were operated for deformity. Seven out of 12 (60% patients less than 12 years of age had a poor MEP monitoring outcome suggesting that extremes of age and presence of a spine deformity may be associated with a lesser incidence of successful MEP monitoring. No complications related to the repetitive transcranial electrical stimulation for eliciting MEP were observed. Conclusion: MEP monitoring is safe. The protocol used in this study is simple, feasible for use and has a fairly high success rate form the lower limbs. Pediatric age group and spine lesions, particularly deformities have an adverse effect on stable MEP recording.

Evaluation of spot and passive sampling for monitoring, flux estimation and risk assessment of pesticides within the constraints of a typical regulatory monitoring scheme.

Science.gov (United States)

Zhang, Zulin; Troldborg, Mads; Yates, Kyari; Osprey, Mark; Kerr, Christine; Hallett, Paul D; Baggaley, Nikki; Rhind, Stewart M; Dawson, Julian J C; Hough, Rupert L

2016-11-01

In many agricultural catchments of Europe and North America, pesticides occur at generally low concentrations with significant temporal variation. This poses several challenges for both monitoring and understanding ecological risks/impacts of these chemicals. This study aimed to compare the performance of passive and spot sampling strategies given the constraints of typical regulatory monitoring. Nine pesticides were investigated in a river currently undergoing regulatory monitoring (River Ugie, Scotland). Within this regulatory framework, spot and passive sampling were undertaken to understand spatiotemporal occurrence, mass loads and ecological risks. All the target pesticides were detected in water by both sampling strategies. Chlorotoluron was observed to be the dominant pesticide by both spot (maximum: 111.8ng/l, mean: 9.35ng/l) and passive sampling (maximum: 39.24ng/l, mean: 4.76ng/l). The annual pesticide loads were estimated to be 2735g and 1837g based on the spot and passive sampling data, respectively. The spatiotemporal trend suggested that agricultural activities were the primary source of the compounds with variability in loads explained in large by timing of pesticide applications and rainfall. The risk assessment showed chlorotoluron and chlorpyrifos posed the highest ecological risks with 23% of the chlorotoluron spot samples and 36% of the chlorpyrifos passive samples resulting in a Risk Quotient greater than 0.1. This suggests that mitigation measures might need to be taken to reduce the input of pesticides into the river. The overall comparison of the two sampling strategies supported the hypothesis that passive sampling tends to integrate the contaminants over a period of exposure and allows quantification of contamination at low concentration. The results suggested that within a regulatory monitoring context passive sampling was more suitable for flux estimation and risk assessment of trace contaminants which cannot be diagnosed by spot

Development and Testing of a Post-Installable Deepwater Monitoring System Using Fiber-Optic Sensors

Science.gov (United States)

Seaman, Calvin H.; Brower, David V.; Le, Suy Q.; Tang, Henry H.

2015-01-01

This paper addresses the design and development of a fiber-optic monitoring system that can be deployed on existing deepwater risers and flowlines; and provides a summary of test article fabrication and the subsequent laboratory testing performed at the National Aeronautics and Space Administration-Johnson Space Center (NASA-JSC). A major challenge of a post-installed instrumentation system is to ensure adequate coupling between the instruments and the riser or flowline of interest. This work investigates the sensor coupling for pipelines that are suspended in a water column (from topside platform to seabed) using a fiber-optic sensor clamp and subsea bonding adhesive. The study involved the design, fabrication, and test of several prototype clamps that contained fiber-optic sensors. A mold was produced by NASA using 3-D printing methods that allowed the casting of polyurethane clamp test articles to accommodate 4-inch and 8-inch diameter pipes. The prototype clamps were installed with a subsea adhesive in a "wet" environment and then tested in the NASA Structures Test Laboratory (STL). The tension, compression, and bending test data showed that the prototype sensor clamps achieved good structural coupling, and could provide high quality strain measurement for active monitoring.

“Soldier's Heart”: A Genetic Basis for Elevated Cardiovascular Disease Risk Associated with Post-traumatic Stress Disorder

Science.gov (United States)

Pollard, Harvey B.; Shivakumar, Chittari; Starr, Joshua; Eidelman, Ofer; Jacobowitz, David M.; Dalgard, Clifton L.; Srivastava, Meera; Wilkerson, Matthew D.; Stein, Murray B.; Ursano, Robert J.

2016-01-01

“Soldier's Heart,” is an American Civil War term linking post-traumatic stress disorder (PTSD) with increased propensity for cardiovascular disease (CVD). We have hypothesized that there might be a quantifiable genetic basis for this linkage. To test this hypothesis we identified a comprehensive set of candidate risk genes for PTSD, and tested whether any were also independent risk genes for CVD. A functional analysis algorithm was used to identify associated signaling networks. We identified 106 PTSD studies that report one or more polymorphic variants in 87 candidate genes in 83,463 subjects and controls. The top upstream drivers for these PTSD risk genes are predicted to be the glucocorticoid receptor (NR3C1) and Tumor Necrosis Factor alpha (TNFA). We find that 37 of the PTSD candidate risk genes are also candidate independent risk genes for CVD. The association between PTSD and CVD is significant by Fisher's Exact Test (P = 3 × 10−54). We also find 15 PTSD risk genes that are independently associated with Type 2 Diabetes Mellitus (T2DM; also significant by Fisher's Exact Test (P = 1.8 × 10−16). Our findings offer quantitative evidence for a genetic link between post-traumatic stress and cardiovascular disease, Computationally, the common mechanism for this linkage between PTSD and CVD is innate immunity and NFκB-mediated inflammation. PMID:27721742

Monitoring the Effects of Forest Restoration Treatments on Post-Fire Vegetation Recovery with MODIS Multitemporal Data

Directory of Open Access Journals (Sweden)

Willem J. D. van Leeuwen

2008-03-01

Full Text Available This study examines how satellite based time-series vegetation greenness data and phenological measurements can be used to monitor and quantify vegetation recovery after wildfire disturbances and examine how pre-fire fuel reduction restoration treatments impact fire severity and impact vegetation recovery trajectories. Pairs of wildfire affected sites and a nearby unburned reference site were chosen to measure the post-disturbance recovery in relation to climate variation. All site pairs were chosen in forested uplands in Arizona and were restricted to the area of the Rodeo-Chediski fire that occurred in 2002. Fuel reduction treatments were performed in 1999 and 2001. The inter-annual and seasonal vegetation dynamics before, during, and after wildfire events can be monitored using a time series of biweekly composited MODIS NDVI (Moderate Resolution Imaging Spectroradiometer - Normalized Difference Vegetation Index data. Time series analysis methods included difference metrics, smoothing filters, and fitting functions that were applied to extract seasonal and inter-annual change and phenological metrics from the NDVI time series data from 2000 to 2007. Pre- and post-fire Landsat data were used to compute the Normalized Burn Ratio (NBR and examine burn severity at the selected sites. The phenological metrics (pheno-metrics included the timing and greenness (i.e. NDVI for the start, peak and end of the growing season as well as proxy measures for the rate of green-up and senescence and the annual vegetation productivity. Pre-fire fuel reduction treatments resulted in lower fire severity, which reduced annual productivity much less than untreated areas within the Rodeo-Chediski fire perimeter. The seasonal metrics were shown to be useful for estimating the rate of post-fire disturbance recovery and the timing of phenological greenness phases. The use of satellite time series NDVI data and derived pheno-metrics show potential for tracking vegetation

[Severe post-partum hemorrhage: descriptive study at the Robert-Debré Hospital maternity ward].

Science.gov (United States)

Reyal, F; Deffarges, J; Luton, D; Blot, P; Oury, J F; Sibony, O

2002-06-01

To analyze the prevalence, cause, treatment, and risk factors of severe post-partum hemorrhage (transfusion, surgery, radiology) observed at the maternity ward of the Robert-Debré Hospital, Paris. Method. This retrospective cohort was collected from a database including 19182 deliveries from 1992 to 1998. The entire medical file was reviewed in cases of severe hemorrhage. The prevalence of severe post-partum hemorrhage was 23 per 10,000 deliveries (44 patients). Transfusion was performed in 44/44 and hysterectomy in 3/44. Three patients were transferred to the intensive care unit. There were no deaths. At multivariate analysis, risk factors for severe post-partum hemorrhage were: abnormal placental insertion (OR=7.2; 95CI: 2.18-18.3), cesarean (OR=5.8; 95CI: 2.9-11.6), multiple pregnancy (OR=3.2; 95CI: 1.3-7.8), prematurity (OR=3, 95CI: 1.5-6.2), hypertension (OR=2.9; 95CI: 1.3-6.3). Twenty-six percent of the patients had no risk factors. The prevalence of severe pot-partum hemorrhage is low in our experience. The methodology used for this retrospective cohort does not enable an explanation. Intensive obstetrical care is necessary in case of abnormal placenta insertion. In 10 out of 44 cases, severe post-partum hemorrhage occurred in a context of insufficient monitoring, late or erroneous diagnosis, or incorrect treatment.

Risk Factors for Post-treatment Complex Regional Pain Syndrome (CRPS)

DEFF Research Database (Denmark)

Petersen, Pelle B; Mikkelsen, Kim Lyngby; Lauritzen, Jes B

2018-01-01

OBJECTIVES: Complex regional pain syndrome is a challenging condition that includes a broad spectrum of sensory, autonomic, and motor features predominantly in extremities recovering from a trauma. Few large-scale studies have addressed occurrence of and factors associated with complex regional......, gender, initial diagnosis, treatment, and amount of compensation were extracted. Multivariate logistic regressions were performed to identify variables associated with approval of the claim. For carpal tunnel syndrome (CTS) patients, we registered whether symptoms were bilateral or unilateral...... normal neurophysiology. CONCLUSIONS: Female gender, surgical treatment, and treatment to the upper limb were risk factors. Elective surgery accounted for a large number of post-treatment CRPS patients. In CTS patients developing CRPS, normal neurophysiological examination findings were common...

Available data sources for monitoring non-communicable diseases and their risk factors in South Africa

Directory of Open Access Journals (Sweden)

M Wandai

2017-04-01

Full Text Available Background. Health information systems for monitoring chronic non-communicable diseases (NCDs in South Africa (SA are relatively less advanced than those for infectious diseases (particularly tuberculosis and HIV and for maternal and child health. NCDs are now the largest cause of premature mortality owing to exposure to risk factors arising from obesity that include physical inactivity and accessible, cheap but unhealthy diets. The National Strategic Plan for the Prevention and Control of Non-Communicable Diseases 2013 - 17 developed by the SA National Department of Health outlines targets and monitoring priorities. Objectives. To assess data sources relevant for monitoring NCDs and their risk factors by identifying the strengths and weaknesses, including usability and availability, of surveys and routine systems focusing at national and certain sub-national levels. Methods. Publicly available survey and routine data sources were assessed for variables collected, their characteristics, frequency of data collection, geographical coverage and data availability. Results. Survey data sources were found to be quite different in the way data variables are collected, their geographical coverage and also availability, while the main weakness of routine data sources was poor quality of data. Conclusions. To provide a sound basis for monitoring progress of NCDs and related risk factors, we recommend harmonising and strengthening available SA data sources in terms of data quality, definitions, categories used, timeliness, disease coverage and biomarker measurement.

Monitoring In-Vivo the Mammary Gland Microstructure during Morphogenesis from Lactation to Post-Weaning Using Diffusion Tensor MRI.

Science.gov (United States)

Nissan, Noam; Furman-Haran, Edna; Shapiro-Feinberg, Myra; Grobgeld, Dov; Degani, Hadassa

2017-09-01

Lactation and the return to the pre-conception state during post-weaning are regulated by hormonal induced processes that modify the microstructure of the mammary gland, leading to changes in the features of the ductal / glandular tissue, the stroma and the fat tissue. These changes create a challenge in the radiological workup of breast disorder during lactation and early post-weaning. Here we present non-invasive MRI protocols designed to record in vivo high spatial resolution, T 2 -weighted images and diffusion tensor images of the entire mammary gland. Advanced imaging processing tools enabled tracking the changes in the anatomical and microstructural features of the mammary gland from the time of lactation to post-weaning. Specifically, by using diffusion tensor imaging (DTI) it was possible to quantitatively distinguish between the ductal / glandular tissue distention during lactation and the post-weaning involution. The application of the T 2 -weighted imaging and DTI is completely safe, non-invasive and uses intrinsic contrast based on differences in transverse relaxation rates and water diffusion rates in various directions, respectively. This study provides a basis for further in-vivo monitoring of changes during the mammary developmental stages, as well as identifying changes due to malignant transformation in patients with pregnancy associated breast cancer (PABC).

The prevalence and risk factors of post-inflammatory hyperpigmentation after fractional resurfacing in Asians.

Science.gov (United States)

Chan, Henry H L; Manstein, D; Yu, C S; Shek, S; Kono, T; Wei, W I

2007-06-01

Ablative laser resurfacing is considered to be the main therapeutic option for the treatment of wrinkles and acne scarring. However, in Asians, post-inflammatory hyperpigmentation (PIH) is a common adverse effect of laser resurfacing. Fractional resurfacing is a new concept of skin rejuvenation whereby zones of micro thermal injury are generated in the skin with the use of a 1,540-nm laser. The risk and prevalence of hyperpigmentation in dark-skinned patients using this approach have not been studied. To assess the prevalence and risk factors of PIH that is associated with the use of fractional resurfacing in Asians. A retrospective study of 37 Chinese patients who were treated with fractional resurfacing for acne scarring, skin rejuvenation, and pigmentation was carried out. In all of the cases, pre- and post-treatment clinical photographs (from standardized and cross-polarized views) were taken using the Canfield CR system. Two independent observers assessed the photographs. A prospective study of treatments of nine different density and energy levels that were applied to the forearms of 18 volunteers was also performed. Clinical photographs were assessed pre- and post-treatment for evidence of PIH. In the retrospective study, 119 treatment sessions were performed. Sixty-eight treatment sessions were high energy, low density; 51 sessions were low energy, high density. Patients who underwent a high energy but low-density treatment (range of energy 7-20 mJ; average energy 16.3 mJ, 1,000 MTZ) were associated with a lower prevalence of generalized PIH (7.1% vs. 12.4%) than those who underwent a low energy but high-density (range of energy 6-12 mJ; average energy 8.2 mJ, 2,000 MTZ) treatment. However, the difference was not statistically significant. Localized PIH occurred in the peri-oral area among patients who did not receive air cooling as an adjunctive therapy. Both the density and energy of the treatment determines the risk of PIH in dark-skinned patients

Risk-Based Radioactive Liquid Effluent Monitoring Requirements at the U. S. Department of Energy's Savannah River Site

International Nuclear Information System (INIS)

Jannik, G.T.

2001-01-01

For Department of Energy (DOE) facilities, clear regulatory guidance exists for structuring radiological air emissions monitoring programs. However, there are no parallel regulations for radiological liquid effluent monitoring programs. In order to bridge this gap and to technically justify liquid effluent monitoring decisions at DOE's Savannah River Site, a graded, risk-basked approach has been established to determine the monitoring and sampling criteria to be applied at each liquid discharge point

Nurse-assessed metabolic monitoring: a file audit of risk factor prevalence and impact of an intervention to enhance measurement of waist circumference.

Science.gov (United States)

Rosenbaum, Simon; Nijjar, Sukh; Watkins, Andrew; Garwood, Natasha; Sherrington, Catherine; Tiedemann, Anne

2014-06-01

The aim of the present study was to: (i) document the prevalence of risk factors for non-communicable diseases among mental health consumers (inpatients) with various diagnoses; and (ii) audit the frequency of waist circumference (WC) documentation before and after an intervention that involved a single nurse-education session, and change in assessment-form design. The study was undertaken in a private psychiatric hospital in Sydney, Australia. Twenty-five nurses participated in the educational intervention. File audits were performed prior to intervention delivery (n = 60), and 3 months' (n = 60), and 9 months' (n = 60) post-intervention. Files were randomly selected, and demographic (age, diagnosis) and risk factor (WC, body mass index (BMI), smoking status, blood pressure) data were extracted. WC was higher in this cohort compared to published general population means, and only 19% of patients had a BMI within the healthy range. In total, 37% of patients smoked, while 31% were hypertensive. At baseline, none of the audited files reported WC, which increased to 35 of the 60 (58%) files audited at the 3-month follow up. At the 9-month follow up, 25 of the 60 (42%) files audited reported a WC. In the 120 post-intervention files audited, only two patients refused measurement. These results illustrate the poor physical health of inpatients, and suggest that nurse-assessed metabolic monitoring can be enhanced with minimal training. © 2014 Australian College of Mental Health Nurses Inc.

The role of human error in risk analysis: Application to pre- and post-maintenance procedures of process facilities

International Nuclear Information System (INIS)

Noroozi, Alireza; Khakzad, Nima; Khan, Faisal; MacKinnon, Scott; Abbassi, Rouzbeh

2013-01-01

Human factors play an important role in the safe operation of a facility. Human factors include the systematic application of information about human characteristics and behavior to increase the safety of a process system. A significant proportion of human errors occur during the maintenance phase. However, the quantification of human error probabilities in the maintenance phase has not been given the amount of attention it deserves. This paper focuses on a human factors analysis in pre-and post- pump maintenance operations. The procedures for removing process equipment from service (pre-maintenance) and returning the equipment to service (post-maintenance) are considered for possible failure scenarios. For each scenario, human error probability is calculated for each activity using the Success Likelihood Index Method (SLIM). Consequences are also assessed in this methodology. The risk assessment is conducted for each component and the overall risk is estimated by adding individual risks. The present study is aimed at highlighting the importance of considering human error in quantitative risk analyses. The developed methodology has been applied to a case study of an offshore process facility

Is perceived parental monitoring associated with sexual risk behaviors of young Black males?

Directory of Open Access Journals (Sweden)

Richard Crosby

2015-01-01

Full Text Available This study determined whether perceived parental monitoring is associated with any of twelve selected outcomes related to sexual risk behaviors of young Black males. Recruitment occurred in clinics diagnosing and treating sexually transmitted infections. Young Black males living with a parent or guardian (N = 324 were administered a 9-item scale assessing level of perceived parental monitoring. The obtained range was 10–45, with higher scores representing more frequent monitoring. The mean was 29.3 (sd = 7.0. Eight of the twelve outcomes had significant associations with perceived parental monitoring (all in a direction indicating a protective effect. Of these eight, five retained significance in age-adjusted models were ever causing a pregnancy, discussing pregnancy prevention, safer sex, and condom use with sex partners, and using a condom during the last act of penile–vaginal sex. Monitoring by a parent figure may be partly protective against conceiving a pregnancy for Black males 15–23 years of age.

[Post-partum depressive symptoms: Prevalence, risk factors and relationship with quality of life].

Science.gov (United States)

Cherif, R; Feki, I; Gassara, H; Baati, I; Sellami, R; Feki, H; Chaabene, K; Masmoudi, J

2017-10-01

The objective of our study was to estimate the prevalence of the post-partum depressive symptomatology in a sample of Tunisian women, to study associated factors and to assess its relationship to quality of life. This is a prospective study carried out in two stages: during the first week (T1), then between sixth and eighth week post-partum (T2). Depressive symptomatology and quality of life were assessed respectively by the Edinburgh Postnatal Depression Scale and the World Health Organization Quality of Life scale. In the first stage, the prevalence of depressive symptomatology in the total sample (150 women) was 14.7% and was related to age above 35 years, low school level, personal psychiatric history, multiparity, caesarean delivery or forceps in the previous pregnancy and unplanned pregnancy. This prevalence was 19.8% among the 126 women reviewed in T2 and was correlated with the exaggerated sympathetic signs during pregnancy, namely perversion of taste and fatigue. Quality of life was strongly correlated with depressive symptoms in T1 and T2. Post-partum depressive symptoms were common in our sample and were correlated with quality of life. Therapeutic measures should be proposed for women with post-partum depressive symptoms and particularly with several risk factors in order to improve their quality of life. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Field efficacy evaluation and post-treatment contamination risk assessment of an ultraviolet disinfection and safe storage system.

Science.gov (United States)

Reygadas, Fermin; Gruber, Joshua S; Ray, Isha; Nelson, Kara L

2015-11-15

Inconsistent use of household water treatment and safe storage (HWTS) systems reduces their potential health benefits. Ultraviolet (UV) disinfection is more convenient than some existing HWTS systems, but it does not provide post-treatment residual disinfectant, which could leave drinking water vulnerable to recontamination. In this paper, using as-treated analyses, we report on the field efficacy of a UV disinfection system at improving household drinking water quality in rural Mexico. We further assess the risk of post-treatment contamination from the UV system, and develop a process-based model to better understand household risk factors for recontamination. This study was part of a larger cluster-randomized stepped wedge trial, and the results complement previously published population-level results of the intervention on diarrheal prevalence and water quality. Based on the presence of Escherichia coli (proportion of households with ≥ 1 E. coli/100 mL), we estimated a risk difference of -28.0% (95% confidence interval (CI): -33.9%, -22.1%) when comparing intervention to control households; -38.6% (CI: -48.9%, -28.2%) when comparing post- and pre-intervention results; and -37.1% (CI: -45.2%, -28.9%) when comparing UV disinfected water to alternatives within the household. We found substantial increases in post-treatment E. coli contamination when comparing samples from the UV system effluent (5.0%) to samples taken from the storage container (21.1%) and drinking glasses (26.0%). We found that improved household infrastructure, additional extractions from the storage container, additional time from when the storage container was filled, and increased experience of the UV system operator were associated with reductions in post-treatment contamination. Our results suggest that the UV system is efficacious at improving household water quality when used as intended. Promoting safe storage habits is essential for an effective UV system dissemination. The drinking

Performing Probabilistic Risk Assessment Through RAVEN

Energy Technology Data Exchange (ETDEWEB)

A. Alfonsi; C. Rabiti; D. Mandelli; J. Cogliati; R. Kinoshita

2013-06-01

The Reactor Analysis and Virtual control ENviroment (RAVEN) code is a software tool that acts as the control logic driver and post-processing engine for the newly developed Thermal-Hydraulic code RELAP-7. RAVEN is now a multi-purpose Probabilistic Risk Assessment (PRA) software framework that allows dispatching different functionalities: Derive and actuate the control logic required to simulate the plant control system and operator actions (guided procedures), allowing on-line monitoring/controlling in the Phase Space Perform both Monte-Carlo sampling of random distributed events and Dynamic Event Tree based analysis Facilitate the input/output handling through a Graphical User Interface (GUI) and a post-processing data mining module

A variable ordering heuristic for risk monitors based on zero-suppressed binary decision diagram

International Nuclear Information System (INIS)

Wang Jin; Wang Fang; Wang Jiaqun; Gu Xiaohui; Yuan Run; Li Yazhou; Hu Liqin; Wu Yican; Yin Yuan; FDS Team

2010-01-01

The probabilistic safety assessment model using for determining the instantaneous risk in a risk monitor are much more complex than the operational model using for determining the average risk. Therefore the development of a fast calculation engine is indispensable and challengeable. the scale of zero-suppressed binary decision diagram. In this paper an optimized method of variables ordering, which fully utilized that features of operational model, was proposed.Not only the theoretical demonstration but also the applications were also brought out. (authors)

Post-irradiation diarrhea

International Nuclear Information System (INIS)

Meerwaldt, J.H.

1984-01-01

In radiotherapy of pelvic cancers, the X-ray dose to be delivered to the tumour is limited by the tolerance of healthy surrounding tissue. In recent years, a number of serious complications of irradiation of pelvic organs were encountered. Modern radiotherapy necessitates the acceptance of a calculated risk of complications in order to achieve a better cure rate. To calculate these risks, one has to know the radiation dose-effect relationship of normal tissues. Of the normal tissues most at risk when treating pelvic tumours only the bowel is studied. In the literature regarding post-irradiation bowel complications, severe and mild complications are often mixed. In the present investigation the author concentrated on the group of patients with relatively mild symptoms. He studied the incidence and course of post-irradiation diarrhea in 196 patients treated for carcinoma of the uterine cervix or endometrium. The aims of the present study were: 1) to determine the incidence, course and prognostic significance of post-irradiation diarrhea; 2) to assess the influence of radiotherapy factors; 3) to study the relation of bile acid metabolism to post-irradiation diarrhea; 4) to investigate whether local factors (reservoir function) were primarily responsible. (Auth.)

A novel method for monitoring high-risk breast cancer with tumor markers

DEFF Research Database (Denmark)

Sölétormos, G; Nielsen, D; Schiøler, V

1993-01-01

cancer. METHODS: Ninety females with high-risk breast cancer were included in the study. Response evaluation was based upon clinical examination, x-rays or histology and elaborated marker criteria. RESULTS: During the marker monitoring period, metastases in four patients were confined to skin or lymph......BACKGROUND: An early and reliable diagnosis of metastatic spread has increased interest in serum tumor markers. This study investigated the ability of CA 15.3, CEA, and TPA to identify, predict, and exclude metastases in bone/viscera during adjuvant treatment and follow-up of high-risk breast...

Romantic Partner Monitoring After Breakups: Attachment, Dependence, Distress, and Post-Dissolution Online Surveillance via Social Networking Sites.

Science.gov (United States)

Fox, Jesse; Tokunaga, Robert S

2015-09-01

Romantic relationship dissolution can be stressful, and social networking sites make it difficult to separate from a romantic partner online as well as offline. An online survey (N = 431) tested a model synthesizing attachment, investment model variables, and post-dissolution emotional distress as predictors of interpersonal surveillance (i.e., "Facebook stalking") of one's ex-partner on Facebook after a breakup. Results indicated that anxious attachment predicted relational investment but also seeking relationship alternatives; avoidant attachment was negatively related to investment but positively related to seeking alternatives. Investment predicted commitment, whereas seeking alternatives was negatively related to commitment. Commitment predicted emotional distress after the breakup. Distress predicted partner monitoring immediately following the breakup, particularly for those who did not initiate the breakup, as well as current partner monitoring. Given their affordances, social media are discussed as potentially unhealthy enablers for online surveillance after relationship termination.

Geoinformation monitoring of the educational risk in educational institutions of higher education

Directory of Open Access Journals (Sweden)

Aleksandr N. Kolesenkov

2017-01-01

Full Text Available The effect, received by a person and society from mastering the basic professional educational programs is problematic to quantify, which leads to the emergence of a risk that characterizes the quality of management decision-making procedures for implementing the educational process in higher education institutions in terms of the level of achievement of the set criteria and indicators.The aim of the work is the development of technology for monitoring of the educational risk based on the geoinformation approach and methods of data mining. Assessment of the educational risk can be implemented through monitoring the quality of the implementation of the main professional educational programs of the institution.Monitoring of the educational risk in the implementation of the educational process in institutions of higher education means the collection, cataloging, pre-processing, analysis and visualization of the data, aimed at improving the efficiency and quality of providing educational services. To accomplish this goal, the following methods and approaches are used: geoinformation approach, cluster analysis, probability theory, data classification methods, forecasting methods, forecasting, and data visualization technologies.The scientific and methodological aspects of the development of the methodical, informational and instrumental support of the educational risk management system in educational institutions of higher education are examined. According to the results of the work, it is revealed that the use of geoinformation technologies increases the efficiency of management by the collection automation, processing and analysis of data on the implementation of educational programs.Modern geoinformation technologies provide the opportunity to create and integrate a system that has innovative analytical functionality, and implements new effective technologies, methods and algorithms in the tasks of monitoring the educational programs. The use of

Quantitative risk assessment of salmon louse-induced mortality of seaward-migrating post-smolt Atlantic salmon

Directory of Open Access Journals (Sweden)

Anja Bråthen Kristoffersen

2018-06-01

Full Text Available The Norwegian government recently implemented a new management system to regulate salmon farming in Norway, aiming to promote environmentally sustainable growth in the aquaculture industry. The Norwegian coast has been divided into 13 production zones and the volume of salmonid production in the zones will be regulated based on salmon lice effects on wild salmonids. Here we present a model for assessing salmon louse-induced mortality of seaward-migrating post-smolts of Atlantic salmon. The model quantifies expected salmon lice infestations and louse-induced mortality of migrating post-smolt salmon from 401 salmon rivers draining into Norwegian coastal waters. It is assumed that migrating post-smolts follow the shortest path from river outlets to the high seas, at constant progression rates. During this migration, fish are infested by salmon lice of farm origin according to an empirical infestation model. Furthermore, louse-induced mortality is estimated from the estimated louse infestations. Rivers draining into production zones on the West Coast of Norway were at the highest risk of adverse lice effects. In comparison, rivers draining into northerly production zones, along with the southernmost production zone, were at lower risk. After adjusting for standing stock biomass, estimates of louse-egg output varied by factors of up to 8 between production zones. Correlation between biomass adjusted output of louse infestation and densities of farmed salmon in the production zones suggests that a large-scale density-dependent host-parasite effect is a major driver of louse infestation rates and parasite-induced mortality. The estimates are sensitive to many of the processes in the chain of events in the model. Nevertheless, we argue that the model is suited to assess spatial and temporal risks associated with farm-origin salmon lice. Keywords: Density dependent, Sea lice, Transmission, Farmed salmon, Migration pathway, Migration time

Role of post-therapy 131Iodine SPECT-CT in risk stratification and management of patients with differentiated thyroid cancer

International Nuclear Information System (INIS)

Agarwal, K.; Bhattacharya, A.; Harishankar, C.N.B.; Manohar, K.; Mittal, B.R.

2010-01-01

Full text: To determine whether post therapy 131 I SPECT/CT changed the American Thyroid Association risk of recurrence classification and further management of the patients with differentiated thyroid carcinoma. Materials and Methods: In this prospective study, 33 consecutive patients with thyroid carcinoma (28 papillary, 4 follicular, 1 Hurthle cell) were included. Planar imaging and SPECT/CT were performed 4-7 days after the therapeutic administration of 1,221-5,180 MBq (33-140 mCi) of 131 I. SPECT/CT of the neck and upper chest were obtained for all subjects. Additional SPECT/CT scans of the abdomen or pelvis were acquired if planar imaging showed any abnormal focus of uptake. Planar and SPECT/CT images were interpreted independently, and sites of uptake were categorized as residual thyroid uptake, level VI cervical lymph node uptake, level II-V cervical lymph nodal uptake or distant metastasis. An experienced nuclear medicine physician determined if the imaging findings changed the patient's risk category and further management. Results: In 4 of 33 post surgical patients, SPECT/CT findings changed the initial ATA risk of recurrence classification. In 3 of these 4 patients, WB planar imaging showed distant metastases (1 in lung, 1 in spleen, 1 in left humerus), SPECT/CT confirming these to physiological uptake in breast and intestine and skin contamination respectively. This altered the risk of recurrence from high to intermediate category. In 1 of these 4 patients, WB planar imaging was suggestive of cervical lymph nodal metastasis, but SPECT/CT localized the abnormal focus of uptake to residual thyroid tissue, altering the risk of recurrence from intermediate to low. SPECT/CT changed the further post ablation management in 13 out of 33 patients. In 4/13 patients SPECT/CT detected cervical lymph nodes metastases, in 1/13 patient supraclavicular lymph node metastasis was detected, in 7/13 patients distant metastases was confirmed as physiological uptake or

Monitoring the impact of HPV vaccine in males—Considerations and challenges

Directory of Open Access Journals (Sweden)

Julia M.L. Brotherton

2016-12-01

Full Text Available In this article, we examine the issues involved if national or sub-national programs are considering extending post HPV vaccine introduction monitoring to include males. Vaccination programs are now being extended to include males in some countries, in order to improve population level HPV infection control and to directly prevent HPV-related disease in males such as anogenital warts and anal cancers. Coverage and adverse events surveillance are essential components of post-vaccination monitoring. Monitoring the impact of vaccination on HPV infection and disease in men raises some similar challenges to monitoring in females, such as the long time frame until cancer outcomes, and also different ones given that genital specimens suitable for monitoring HPV prevalence are not routinely collected for other diagnostic or screening purposes in males. Thus, dedicated surveillance strategies must be designed; the framework of these may be country-specific, dependent upon the male population that is offered vaccination, the health care infrastructure and existing models of disease surveillance such as STI networks. The primary objective of any male HPV surveillance program will be to document changes in the prevalence of HPV infection and disease due to vaccine targeted HPV types occurring post vaccination. The full spectrum of outcomes to be considered for inclusion in any surveillance plan includes HPV prevalence monitoring, anogenital warts, potentially pre-cancerous lesions such as anal squamous intraepithelial lesions (SIL, and cancers. Ideally, a combination of short term and long term outcome measures would be included. Surveillance over time in specific targeted populations of men who have sex with men and HIV-infected men (populations at high risk for HPV infection and associated disease could be an efficient use of resources to demonstrate impact. Keywords: Human papillomavirus, Males, Disease surveillance, Vaccine effectiveness

Radon in the workplace: Implications of studies of post-remediation monitoring

International Nuclear Information System (INIS)

Denman, A. R.; Parkinson, S.; Johnstone, M.; Crockett, R. G. M.; Phillips, P. S.

2004-01-01

Radon gas has been shown to cause an increased incidence of lung cancer. In affected areas, levels in the overground workplace can be sufficiently high to be a health risk and remediation is required. In the UK, the workplace Action Level is 400 Bq m -3 . The variation of radon levels in the workplace was studied both before and after remediation. In most rooms, remediation resulted in a greater reduction at night than during the working day. The dose reduction, and therefore the health benefit, to workers is less than that predicted by the drop in radon averaged over 24 h. In order to obtain a health benefit to 75% of workers in our series, the 24 h average radon level in each room must be reduced to -3 . It is recommended that UK Regulatory Agencies adopt a post-remediation workplace Action Level of 225 Bq m -3 . (authors)

Risk assessment and risk management at the Canadian Food Inspection Agency (CFIA): a perspective on the monitoring of foods for chemical residues.

Science.gov (United States)

Bietlot, Henri P; Kolakowski, Beata

2012-08-01

The Canadian Food Inspection Agency (CFIA) uses 'Ranked Risk Assessment' (RRA) to prioritize chemical hazards for inclusion in monitoring programmes or method development projects based on their relative risk. The relative risk is calculated for a chemical by scoring toxicity and exposure in the 'risk model scoring system' of the Risk Priority Compound List (RPCL). The relative ranking and the risk management options are maintained and updated in the RPCL. The ranking may be refined by the data generated by the sampling and testing programs. The two principal sampling and testing programmes are the National Chemical Residue Monitoring Program (NCRMP) and the Food Safety Action Plan (FSAP). The NCRMP sampling plans focus on the analysis of federally registered products (dairy, eggs, honey, meat and poultry, fresh and processed fruit and vegetable commodities, and maple syrup) for residues of veterinary drugs, pesticides, environmental contaminants, mycotoxins, and metals. The NCRMP is complemented by the Food Safety Action Plan (FSAP) targeted surveys. These surveys focus on emerging chemical hazards associated with specific foods or geographical regions for which applicable maximum residue limits (MRLs) are not set. The data from the NCRMP and FSAP also influence the risk management (follow-up) options. Follow-up actions vary according to the magnitude of the health risk, all with the objective of preventing any repeat occurrence to minimize consumer exposure to a product representing a potential risk to human health. © Her Majesty the Queen in Right of Canada 2012. Drug Testing and Analysis © 2012 John Wiley & Sons, Ltd.

Long-Term Non-Invasive ECG-Based Risk Stratification of Sudden Cardiac Death: Extended 5-Year Results

Directory of Open Access Journals (Sweden)

Elena Okisheva

2017-01-01

Evaluation of HRT, DC and mTWA during 24-hour ECG monitoring may define the high risk of cardiovascular mortality and SCD in post-MI patients especially during the first 12 months after the baseline examination.

Revision of Viable Environmental Monitoring in a Development Pilot Plant Based on Quality Risk Assessment: A Case Study.

Science.gov (United States)

Ziegler, Ildikó; Borbély-Jakab, Judit; Sugó, Lilla; Kovács, Réka J

2017-01-01

In this case study, the principles of quality risk management were applied to review sampling points and monitoring frequencies in the hormonal tableting unit of a formulation development pilot plant. In the cleanroom area, premises of different functions are located. Therefore a general method was established for risk evaluation based on the Hazard Analysis and Critical Control Points (HACCP) method to evaluate these premises (i.e., production area itself and ancillary clean areas) from the point of view of microbial load and state in order to observe whether the existing monitoring program met the emerged advanced monitoring practice. LAY ABSTRACT: In pharmaceutical production, cleanrooms are needed for the manufacturing of final dosage forms of drugs-intended for human or veterinary use-in order to protect the patient's weakened body from further infections. Cleanrooms are premises with a controlled level of contamination that is specified by the number of particles per cubic meter at a specified particle size or number of microorganisms (i.e. microbial count) per surface area. To ensure a low microbial count over time, microorganisms are detected and counted by environmental monitoring methods regularly. It is reasonable to find the easily infected places by risk analysis to make sure the obtained results really represent the state of the whole room. This paper presents a risk analysis method for the optimization of environmental monitoring and verification of the suitability of the method. © PDA, Inc. 2017.

Increased risk of post-operative complications in patients with Crohn's disease treated with anti-tumour necrosis factor α agents - a systematic review

DEFF Research Database (Denmark)

El-Hussuna, Alaa; Theede, Klaus; Olaison, Gunnar

2014-01-01

INTRODUCTION: Tumour necrosis factor α (TNF-α) plays a role in the immune defence, angiogenesis and collagen synthesis. Inhibition of these pathways may increase the risk of infections and impair wound healing in patients after surgery. Biologic treatments including anti-TNF-α agents are increasi......INTRODUCTION: Tumour necrosis factor α (TNF-α) plays a role in the immune defence, angiogenesis and collagen synthesis. Inhibition of these pathways may increase the risk of infections and impair wound healing in patients after surgery. Biologic treatments including anti-TNF-α agents...... are increasingly used in the treatment of inflammatory bowel disease. Taking into consideration the biologics' mechanism of action, fears have been expressed that they might increase the rate of post-operative complications. Results from 18 retrospective studies were conflicting, and meta-analyses based...... an increased risk of overall post-operative complications and an increased rate of infectious or anastomosis-related complications in patients receiving anti-TNF-α. CONCLUSION: The use of anti-TNF-α agents in Crohn's disease patients is associated with an increased risk of post-operative complications after...

MONITORING AND EARLY-WARNING OF METEOROLOGICAL RISK SITUATIONS IN OLTENIA

Directory of Open Access Journals (Sweden)

BURADA CRISTINA

2016-03-01

Full Text Available Among the natural hazards affecting the human well-being and properties, meterological events are first to come in mind, due to their frequency, (immediate effects and (improving predictability. Assesment of these components are the first step in risk management, when the knowledge on the hazard type and characteristics is essential for defining the vulnerability and exposure and thus for preparing the mitigation plans. The spatial scale of dangerous meteorological situations is, in most cases, the regional one, but sometimes the area of major intensity or even the area of manifestation is small enough (e.g. hail, heavy rain showers to be classifed as ‚local’. Furthermore, other factors like the local geographical features, population density, goods and properties at risk (e.g. cultivated areas, buildings, infrastructure etc come into play in defining the severity of the weather event and/or the needs for interventions aiming to reduce the effects of the weather situation. In this context, the monitoring of potentially dangerous meteorological conditions and the improved forecasting capabilities and accuracy become increasingly important. In this paper, we present a short overview of the severe meteorological events affecting the Oltenia region along with aspects regarding their monitoring, early-warning and socio-economical impact in the area of interest, with a focus on the Dolj county during the 2013-2015 period.

Evaluating elements of trust: Race and class in risk communication in post-Katrina New Orleans.

Science.gov (United States)

Battistoli, B F

2016-05-01

This study seeks to determine the relative influence of race and class on trust in sources of messages of environmental risk in post-Katrina New Orleans. It poses two hypotheses to test that influence: H1-African-Americans ("Blacks") trust risk message sources less than European American ("Whites") do and H2-The higher the socioeconomic class, the lower the trust in risk message sources. A 37-question telephone survey (landlines and cellphones) was conducted in Orleans Parish in 2012 (n = 414). The overall margin of error was ±4.8% at a 95% confidence interval. A hierarchical regression analysis revealed that the first hypothesis was rejected, while the second was supported. Additional data analysis revealed that frequency of use of sources of risk information appears to be a positive factor in building trust. © The Author(s) 2015.

“Soldier’s Heart”: A Genetic Basis for Elevated Cardiovascular Disease Risk Associated with Post-traumatic Stress Disorder

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Harvey B. Pollard

2016-09-01

Full Text Available Soldier’s Heart, is an American Civil War term linking post-traumatic stress disorder (PTSD with increased propensity for cardiovascular disease (CVD. We have hypothesized that there might be a quantifiable genetic basis for this linkage. To test this hypothesis we identified a comprehensive set of candidate risk genes for PTSD, and tested whether any were also independent risk genes for CVD. A functional analysis algorithm was used to identify associated signaling networks.We identified 106 PTSD studies that report one or more polymorphic variants in 87 candidate genes in 83,463 subjects and controls. The top upstream drivers for these PTSD risk genes are predicted to be the glucocorticoid receptor (NR3C1 and Tumor Necrosis Factor alpha (TNFA. We find that 37 of the PTSD candidate risk genes are also candidate independent risk genes for CVD. The association between PTSD and CVD is significant by Fisher’s Exact Test (P= 3*10-54. We also find 15 PTSD risk genes that are independently associated with Type 2 Diabetes Mellitus (T2DM; also significant by Fisher’s Exact Test (P= 1.8*10-16. Our findings offer quantitative evidence for a genetic link between post-traumatic stress and cardiovascular disease, Computationally, the common mechanism for this linkage between PTSD and CVD is innate immunity and NFκB-mediated inflammation.

Post-authorization safety surveillance of a liquid pentavalent vaccine in Guatemalan children.

Science.gov (United States)

Asturias, Edwin J; Contreras-Roldan, Ingrid L; Ram, Malathi; Garcia-Melgar, Ana J; Morales-Oquendo, Vilma; Hartman, Katharina; Rauscher, Martina; Moulton, Lawrence H; Halsey, Neal A

2013-12-02

Combination vaccines have improved the efficiency of delivery of new vaccines in low and middle-income countries. Post-authorization monitoring of adverse events (AEs) after vaccination with a liquid pentavalent DTwP-HepB-Hib combination vaccine was conducted in Guatemalan infants. A prospective observational safety study of the incidence of medical attended events (MAEs) and serious adverse events (SAEs) in children who received pentavalent and oral polio vaccines at 2, 4 and 6 months of age was conducted in two clinics at the Institute of Guatemala. Parents were contacted by telephone after each dose. All outpatient, emergency department visits, and hospitalizations were monitored. A self-controlled analysis was conducted to determine if there was evidence of increased risk of MAEs or SAEs following vaccines as compared to control time windows. Of 3000 recruited infants, 2812 (93.7%) completed the third dose and 2805 (93.5%) completed follow-up. Ten AEs in eight infants, of which four SAEs in four infants, were classified as related to the vaccine. Thirteen deaths were reported due to common illnesses of infancy, and none were judged to be related to the vaccine. The mortality rate (4.4 per 1000) was lower than expected for the population. The incidence-rate-ratio for healthcare visits was lower in post-vaccination time windows than for control windows; after the first vaccine dose, the rate ratios for the risk periods of 0-1, 2-6, and 7-30 days post-vaccination were 0.3, 0.5, and 0.7, respectively (all statistically significantly different from the reference value of 1.0 for the 31-60 day control period). The liquid pentavalent vaccine was associated with lower rates of health care visits and not associated with increases in SAEs or hospitalizations. Systems can be set up in low to middle income countries to capture all health care visits to monitor the safety of new vaccines. Copyright © 2013 Elsevier Ltd. All rights reserved.

Acceptance and Use of Mobile Technology for Health Self-Monitoring in Lung Transplant Recipients during the First Year Post-Transplantation.

Science.gov (United States)

Jiang, Yun; Sereika, Susan M; Dabbs, Annette DeVito; Handler, Steven M; Schlenk, Elizabeth A

2016-01-01

To describe lung transplant recipients (LTRs') acceptance and use of mobile technology for health self-monitoring during the first year post-transplantation, and explore correlates of the use of technology in the 0 to 2, >2 to ≤6, >6 to ≤12, and 0 to 12 months. Secondary analysis of data from 96 LTR assigned to use Pocket PATH(®), a smartphone application, for daily health self-monitoring in a randomized controlled trial. Use of Pocket PATH was categorized as low, moderate, and high use. Proportional odds models for ordinal logistic regression were employed to explore correlates of use of technology. LTR reported high acceptance of Pocket PATH at baseline. However, acceptance was not associated with actual use over the 12 months (p=0.45~0.96). Actual use decreased across time intervals (ptechnology training (p=0.02) in the first 2 months. Higher use from >2 to ≤6 months was associated with greater satisfaction with technology training (OR=3.37, p=0.01) and shorter length of hospital stay (OR=0.98, p=0.02). Higher use from >6 to ≤12 months was associated with older age (OR=1.05, p=0.02), lower psychological distress (OR=0.43, p=0.02), and better physical functioning (OR=1.09, p=0.01). Higher use over 12 months was also associated with older age (OR=1.05, p=0.007), better physical functioning (OR=1.13, p=0.001), and greater satisfaction with technology training (OR=3.05, p=0.02). Correlates were different for short- and long-term use of mobile technology for health self-monitoring in the first year post-transplantation. It is important to follow up with LTR with longer hospital stay, poor physical functioning, and psychological distress, providing ongoing education to improve their long-term use of technology for health self-monitoring.

Worldwide, 3-Year, Post-Marketing Surveillance Experience with Tofacitinib in Rheumatoid Arthritis.

Science.gov (United States)

Cohen, Stanley; Curtis, Jeffrey R; DeMasi, Ryan; Chen, Yan; Fan, Haiyun; Soonasra, Arif; Fleischmann, Roy

2018-06-01

Post-marketing surveillance (PMS) is an integral part of monitoring adverse events (AEs) following approval of new drugs. Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). An analysis of PMS reports was conducted to evaluate the safety of tofacitinib in a post-marketing setting. Worldwide tofacitinib PMS data received in the Pfizer safety database from November 6, 2012 (first marketing authorization of tofacitinib) to November 5, 2015 were analyzed. Serious AEs (SAEs) of interest were reviewed and reporting rates (RRs) were calculated by dividing the number of SAEs by the estimated 100 patient-years of exposure. Patient exposure was calculated based on estimated worldwide sales and an estimated daily regimen of tofacitinib 5 mg twice daily. During the 3-year reporting period, worldwide post-marketing exposure to tofacitinib since approval was estimated to be 34,223 patient-years. In total, 9291 case reports (82.9% non-serious) were received and 25,417 AEs, 102 fatal cases, and 4352 SAEs were reported. The RRs (per 100 patient-years) for SAEs of interest by Medical Dictionary for Regulatory Activities System Organ Class were 2.57 for infections, 0.91 for gastrointestinal disorders, 0.60 for respiratory disorders, 0.45 for neoplasms, 0.43 for cardiac disorders, and 0.12 for hepatobiliary disorders. Although there are limitations to these data, no new safety risks were revealed in this real-world setting compared with the safety profile identified in the tofacitinib RA clinical development program. Any risks identified through the tofacitinib development program and PMS will continue to be monitored through pharmacovigilance surveillance. Pfizer Inc.

Application of risk assessment techniques to microbial monitoring data: a South-African perspective

CSIR Research Space (South Africa)

Rodda, N

1993-01-01

Full Text Available (-1) and 5x10(-4) - 1x10(-2), respectively. A number of complicating factors were identified. Detection limits were high and volumes of water monitored were low. There was no information on viral pathogen removal during treatment. Application of risk...

Continuous glucose monitoring system and new era of early diagnosis of diabetes in high risk groups

Directory of Open Access Journals (Sweden)

Ashraf Soliman

2014-01-01

Full Text Available Continuous glucose monitoring (CGM systems are an emerging technology that allows frequent glucose measurements to monitor glucose trends in real time. Their use as a diagnostic tool is still developing and appears to be promising. Combining intermittent glucose self-monitoring (SGM and CGM combines the benefits of both. Significant improvement in the treatment modalities that may prevent the progress of prediabetes to diabetes have been achieved recently and dictates screening of high risk patients for early diagnosis and management of glycemic abnormalities. The use of CGMS in the diagnosis of early dysglycemia (prediabetes especially in high risk patients appears to be an attractive approach. In this review we searched the literature to investigate the value of using CGMS as a diagnostic tool compared to other known tools, namely oral glucose tolerance test (OGTT and measurement of glycated hemoglobin (HbA1C in high risk groups. Those categories of patients include adolescents and adults with obesity especially those with family history of type 2 diabetes mellitus, polycystic ovary syndrome (PCO, gestational diabetes, cystic fibrosis, thalassemia major, acute coronary syndrome (ACS, and after renal transplantation. It appears that the ability of the CGMS for frequently monitoring (every 5 min glucose changes during real-life settings for 3 to 5 days stretches the chance to detect more glycemic abnormalities during basal and postprandial conditions compared to other short-timed methods.

Perceived Parental Monitoring and Health Risk Behavior among Public Secondary School Students in El Salvador

OpenAIRE

Springer, Andrew E.; Sharma, Shreela; de Guardado, Alba Margarita; Nava, Francisco Vázquez; Kelder, Steven H.

2006-01-01

Although parental monitoring has received considerable attention in studies of U.S. adolescents, few published studies have examined how parents' knowledge of their children's whereabouts may influence health risk behaviors in adolescents living in Latin America. We investigated the association between perceived parental monitoring and substance use, fighting, and sexual behaviors in rural and urban Salvadoran adolescents (n = 982). After adjusting for several sociodemographic covariates, mul...

Impaired action self-monitoring and cognitive confidence among ultra-high risk for psychosis and first-episode psychosis patients.

Science.gov (United States)

Gawęda, Ł; Li, E; Lavoie, S; Whitford, T J; Moritz, S; Nelson, B

2018-01-01

Self-monitoring biases and overconfidence in incorrect judgments have been suggested as playing a role in schizophrenia spectrum disorders. Little is known about whether self-monitoring biases may contribute to early risk factors for psychosis. In this study, action self-monitoring (i.e., discrimination between imagined and performed actions) was investigated, along with confidence in judgments among ultra-high risk (UHR) for psychosis individuals and first-episode psychosis (FEP) patients. Thirty-six UHR for psychosis individuals, 25 FEP patients and 33 healthy controls (CON) participated in the study. Participants were assessed with the Action memory task. Simple actions were presented to participants verbally or non-verbally. Some actions were required to be physically performed and others were imagined. Participants were asked whether the action was presented verbally or non-verbally (action presentation type discrimination), and whether the action was performed or imagined (self-monitoring). Confidence self-ratings related to self-monitoring responses were obtained. The analysis of self-monitoring revealed that both UHR and FEP groups misattributed imagined actions as being performed (i.e., self-monitoring errors) significantly more often than the CON group. There were no differences regarding performed actions as being imagined. UHR and FEP groups made their false responses with higher confidence in their judgments than the CON group. There were no group differences regarding discrimination between the types of actions presented (verbal vs non-verbal). A specific type of self-monitoring bias (i.e., misattributing imagined actions with performed actions), accompanied by high confidence in this judgment, may be a risk factor for the subsequent development of a psychotic disorder. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Air quality monitoring of the post-operative recovery room and locations surrounding operating theaters in a medical center in Taiwan.

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Chin-Sheng Tang

Full Text Available To prevent surgical site infection (SSI, the airborne microbial concentration in operating theaters must be reduced. The air quality in operating theaters and nearby areas is also important to healthcare workers. Therefore, this study assessed air quality in the post-operative recovery room, locations surrounding the operating theater area, and operating theaters in a medical center. Temperature, relative humidity (RH, and carbon dioxide (CO2, suspended particulate matter (PM, and bacterial concentrations were monitored weekly over one year. Measurement results reveal clear differences in air quality in different operating theater areas. The post-operative recovery room had significantly higher CO2 and bacterial concentrations than other locations. Bacillus spp., Micrococcus spp., and Staphylococcus spp. bacteria often existed in the operating theater area. Furthermore, Acinetobacter spp. was the main pathogen in the post-operative recovery room (18% and traumatic surgery room (8%. The mixed effect models reveal a strong correlation between number of people in a space and high CO2 concentration after adjusting for sampling locations. In conclusion, air quality in the post-operative recovery room and operating theaters warrants attention, and merits long-term surveillance to protect both surgical patients and healthcare workers.

Air quality monitoring of the post-operative recovery room and locations surrounding operating theaters in a medical center in Taiwan.

Science.gov (United States)

Tang, Chin-Sheng; Wan, Gwo-Hwa

2013-01-01

To prevent surgical site infection (SSI), the airborne microbial concentration in operating theaters must be reduced. The air quality in operating theaters and nearby areas is also important to healthcare workers. Therefore, this study assessed air quality in the post-operative recovery room, locations surrounding the operating theater area, and operating theaters in a medical center. Temperature, relative humidity (RH), and carbon dioxide (CO2), suspended particulate matter (PM), and bacterial concentrations were monitored weekly over one year. Measurement results reveal clear differences in air quality in different operating theater areas. The post-operative recovery room had significantly higher CO2 and bacterial concentrations than other locations. Bacillus spp., Micrococcus spp., and Staphylococcus spp. bacteria often existed in the operating theater area. Furthermore, Acinetobacter spp. was the main pathogen in the post-operative recovery room (18%) and traumatic surgery room (8%). The mixed effect models reveal a strong correlation between number of people in a space and high CO2 concentration after adjusting for sampling locations. In conclusion, air quality in the post-operative recovery room and operating theaters warrants attention, and merits long-term surveillance to protect both surgical patients and healthcare workers.

Post-bronchoscopy pneumonia in patients suffering from lung cancer: Development and validation of a risk prediction score.

Science.gov (United States)

Takiguchi, Hiroto; Hayama, Naoki; Oguma, Tsuyoshi; Harada, Kazuki; Sato, Masako; Horio, Yukihiro; Tanaka, Jun; Tomomatsu, Hiromi; Tomomatsu, Katsuyoshi; Takihara, Takahisa; Niimi, Kyoko; Nakagawa, Tomoki; Masuda, Ryota; Aoki, Takuya; Urano, Tetsuya; Iwazaki, Masayuki; Asano, Koichiro

2017-05-01

The incidence, risk factors, and consequences of pneumonia after flexible bronchoscopy in patients with lung cancer have not been studied in detail. We retrospectively analyzed the data from 237 patients with lung cancer who underwent diagnostic bronchoscopy between April 2012 and July 2013 (derivation sample) and 241 patients diagnosed between August 2013 and July 2014 (validation sample) in a tertiary referral hospital in Japan. A score predictive of post-bronchoscopy pneumonia was developed in the derivation sample and tested in the validation sample. Pneumonia developed after bronchoscopy in 6.3% and 4.1% of patients in the derivation and validation samples, respectively. Patients who developed post-bronchoscopy pneumonia needed to change or cancel their planned cancer therapy more frequently than those without pneumonia (56% vs. 6%, ppneumonia, which we added to develop our predictive score. The incidence of pneumonia associated with scores=0, 1, and ≥2 was 0, 3.7, and 13.4% respectively in the derivation sample (p=0.003), and 0, 2.9, and 9.7% respectively in the validation sample (p=0.016). The incidence of post-bronchoscopy pneumonia in patients with lung cancer was not rare and associated with adverse effects on the clinical course. A simple 3-point predictive score identified patients with lung cancer at high risk of post-bronchoscopy pneumonia prior to the procedure. Copyright © 2017 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

Blood pressure self-monitoring in pregnancy (BuMP) feasibility study; a qualitative analysis of women's experiences of self-monitoring.

Science.gov (United States)

Hinton, Lisa; Tucker, Katherine L; Greenfield, Sheila M; Hodgkinson, James A; Mackillop, Lucy; McCourt, Christine; Carver, Trisha; Crawford, Carole; Glogowska, Margaret; Locock, Louise; Selwood, Mary; Taylor, Kathryn S; McManus, Richard J

2017-12-19

Hypertensive disorders in pregnancy are a leading cause of maternal and fetal morbidity worldwide. Raised blood pressure (BP) affects 10% of pregnancies worldwide, of which almost half develop pre-eclampsia. The proportion of pregnant women who have risk factors for pre-eclampsia (such as pre-existing hypertension, obesity and advanced maternal age) is increasing. Pre-eclampsia can manifest itself before women experience symptoms and can develop between antenatal visits. Incentives to improve early detection of gestational hypertensive disorders are therefore strong and self-monitoring of blood pressure (SMBP) in pregnancy might be one means to achieve this, whilst improving women's involvement in antenatal care. The Blood Pressure Self-Monitoring in Pregnancy (BuMP) study aimed to evaluate the feasibility and acceptability of SMBP in pregnancy. To understand women's experiences of SMBP during pregnancy, we undertook a qualitative study embedded within the BuMP observational feasibility study. Women who were at higher risk of developing hypertension and/or pre-eclampsia were invited to take part in a study using SMBP and also invited to take part in an interview. Semi-structured interviews were conducted at the women's homes in Oxfordshire and Birmingham with women who were self-monitoring their BP as part of the BuMP feasibility study in 2014. Interviews were conducted by a qualitative researcher and transcribed verbatim. A framework approach was used for analysis. Fifteen women agreed to be interviewed. Respondents reported general willingness to engage with monitoring their own BP, feeling that it could reduce anxiety around their health during pregnancy, particularly if they had previous experience of raised BP or pre-eclampsia. They felt able to incorporate self-monitoring into their weekly routines, although this was harder post-partum. Self-monitoring of BP made them more aware of the risks of hypertension and pre-eclampsia in pregnancy. Feelings of

NASA Infrared Telescope Facility Comet Halley monitoring program 2: Post-perihelion results

International Nuclear Information System (INIS)

Tokunaga, A.T.; Golisch, W.F.; Griep, D.M.; Kaminski, C.D.; Hanner, M.S.

1988-01-01

The post perihelion results of a 1 to 20 micrometer infrared monitoring program of Comet Halley are presented. These results complement previous observations of the pre-perihelion passages of Halley. The observations cover the time period of Mar. 1986 to the present time. During the time the comet was observable, two or more observations were obtained per month. The most interesting results were: (1) a detectable change in the J-H and H-K colors of Halley, and (2) a search for a nucleus rotation at J during 20 Feb. to 10 Mar. was unsuccessful. The perihelion J-H and K-K colors were constant at 0.48 + or - 0.01 and 0.17, respectively. A preliminary reduction of the data is given. It is concluded that the colors were at first similar to pre-perihelion and then changed from July onward to be bluer and more similar to the solar colors. This suggests that a change may have occurred in the composition of the dust coma of Halley in July 1986

The influence of parental monitoring and parent-adolescent communication on Bahamian adolescent risk involvement: a three-year longitudinal examination.

Science.gov (United States)

Wang, Bo; Stanton, Bonita; Li, Xiaoming; Cottrell, Lesley; Deveaux, Lynette; Kaljee, Linda

2013-11-01

The literature suggests that parental monitoring can best be conceptualized and measured through the domains of parental knowledge, youth disclosure, parental solicitation, and parental control. Using longitudinal data on 913 grade-six Bahamian students followed over a period of three years, we examined the unique and independent roles of these domains of parental monitoring and parent-adolescent communication in relation to adolescent involvement in delinquency, substance use, and sexual risk behaviors. The results obtained with mixed-effects models indicate that parental knowledge, youth disclosure, and parental control are negatively associated with both delinquency and substance use. Open parent-adolescent communication was associated with decreased sexual risk behavior, whereas problematic parent-adolescent communication was associated with increased sexual risk behavior. The results obtained with path models indicate that youth disclosure is a significant longitudinal predictor of reduced adolescent delinquency and that parental control during early adolescence predicted reduced substance use in middle adolescence. The findings suggest that parental knowledge, youth disclosure and parental control differ in their impacts on substance use, delinquency and sexual risk behaviors. Problematic parent-adolescent communication is consistently associated with increases in all three types of adolescent risk behaviors. Future parental monitoring interventions should focus on enhancing parents' interpersonal communication skills and emphasize the differences in and importance of the unique components of parental monitoring. Copyright © 2013. Published by Elsevier Ltd.

Rapid changes in small fish mercury concentrations in estuarine wetlands: Implications for wildlife risk and monitoring programs

Science.gov (United States)

Eagles-Smith, Collin A.; Ackerman, Joshua T.

2009-01-01

Small fish are commonly used to assess mercury (Hg) risk to wildlife and monitor Hg in wetlands. However, limited research has evaluated short-term Hg variability in small fish, which can have important implications for monitoring programs and risk assessment. We conducted a time-series study of Hg concentrations in two small fish species representing benthic (longjaw mudsuckers [Gillichthys mirabilis]) and pelagic (threespine sticklebacks [Gasterosteus aculeatus]) food-webs within three wetland habitats in San Francisco Bay Estuary. We simultaneously monitored prey deliveries, nest initiation, and chick hatching dates of breeding Forster's terns (Sterna forsteri), the most abundant nesting piscivore in the region. Mudsuckers and sticklebacks were the predominant prey fish, comprising 36% and 25% of tern diet, and Hg concentrations averaged (geometric mean ?? SE, ??g/g dw) 0.44 ?? 0.01 and 0.68 ?? 0.03, respectively. Fish Hg concentrations varied substantially over time following a quadratic form in both species, increasing 40% between March and May then decreasing 40% between May and July. Importantly, Forster's terns initiated 68% of nests and 31% of chicks hatched during the period of peak Hg concentrations in prey fish. These results illustrate the importance of short-term temporal variation in small fish Hg concentrations for both Hg monitoring programs and assessing wildlife risk.

Evaluation of risk and benefit in thermal effusivity sensor for monitoring lubrication process in pharmaceutical product manufacturing.

Science.gov (United States)

Uchiyama, Jumpei; Kato, Yoshiteru; Uemoto, Yoshifumi

2014-08-01

In the process design of tablet manufacturing, understanding and control of the lubrication process is important from various viewpoints. A detailed analysis of thermal effusivity data in the lubrication process was conducted in this study. In addition, we evaluated the risk and benefit in the lubrication process by a detailed investigation. It was found that monitoring of thermal effusivity detected mainly the physical change of bulk density, which was changed by dispersal of the lubricant and the coating powder particle by the lubricant. The monitoring of thermal effusivity was almost the monitoring of bulk density, thermal effusivity could have a high correlation with tablet hardness. Moreover, as thermal effusivity sensor could detect not only the change of the conventional bulk density but also the fractional change of thermal conductivity and thermal capacity, two-phase progress of lubrication process could be revealed. However, each contribution of density, thermal conductivity, or heat capacity to thermal effusivity has the risk of fluctuation by formulation. After carefully considering the change factor with the risk to be changed by formulation, thermal effusivity sensor can be a useful tool for monitoring as process analytical technology, estimating tablet hardness and investigating the detailed mechanism of the lubrication process.

CLIC Luminosity Monitoring

CERN Document Server

Apyan, Armen; Gschwendtner, Edda; Lefevre, Thibault; Tygier, Sam; Appleby, Robert B

2012-01-01

The CLIC post-collision line is designed to transport the un-collided beams and the products of the collided beams with a total power of 14 MW to the main beam dump. Luminosity monitoring for CLIC is based on high energy muons produced by beamstrahlung photons in the main dump. Threshold Cherenkov counters are proposed for the detection of these muons. The expected rates and layout for these detectors is presented. Another method for luminosity monitoring is to directly detect the beamstrahlung photons in the post-collision line. Full Monte Carlo simulation has been performed to address its feasibility.

Predictive Power of the NSQIP Risk Calculator for Early Post-Operative Outcomes After Whipple: Experience from a Regional Center in Northern Ontario.

Science.gov (United States)

Jiang, Henry Y; Kohtakangas, Erica L; Asai, Kengo; Shum, Jeffrey B

2017-05-02

NSQIP Risk Calculator was developed to allow surgeons to inform their patients about their individual risks for surgery. Its ability to predict complication rates and length of stay (LOS) has made it an appealing tool for both patients and surgeons. However, the NSQIP Risk Calculator has been criticized for its generality and lack of detail towards surgical subspecialties, including the hepatopancreaticobiliary (HPB) surgery. We wish to determine whether the NSQIP Risk Calculator is predictive of post-operative complications and LOS with respect to Whipple's resections for our patient population. As well, we wish to identify strategies to optimize early surgical outcomes in patients with pancreatic cancer. We conducted a retrospective review of patients who underwent elective Whipple's procedure for benign or malignant pancreatic head lesions at Health Sciences North (Sudbury, Ontario), a tertiary care center, from February 2014 to August 2016. Comparisons of LOS and post-operative complications between NSQIP-predicted and actual ones were carried out. NSQIP-predicted complications rates were obtained using the NSQIP Risk Calculator through pre-defined preoperative risk factors. Clinical outcomes examined, at 30 days post-operation, included pneumonia, cardiac events, surgical site infection (SSI), urinary tract infection (UTI), venous thromboembolism (VTE), renal failure, readmission, and reoperation for procedural complications. As well, mortality, disposition to nursing or rehabilitation facilities, and LOS were assessed. A total of 40 patients underwent Whipple's procedure at our center from February 2014 to August 2016. The average age was 68 (50-85), and there were 22 males and 18 females. The majority of patients had independent baseline functional status (39/40) with minimal pre-operative comorbidities. The overall post-operative morbidity was 47.5% (19/40). The rate of serious complication was 17.5% with four Clavien grade II, two grade III, and one grade

Association between post-dinner dietary intakes and nocturnal hypoglycemic risk in adult patients with type 1 diabetes.

Science.gov (United States)

Desjardins, Katherine; Brazeau, Anne-Sophie; Strychar, Irene; Leroux, Catherine; Gingras, Véronique; Rabasa-Lhoret, Rémi

2014-12-01

To describe (i) current bedtime nutritional practices and (ii) the association between post-dinner dietary intake and the occurrence of non-severe nocturnal hypoglycemia (NH) in real-life conditions among adult patients with type 1 diabetes using insulin analogs. One hundred adults (median [interquartile range]: age 46.4 [36.0-55.8] years, HbA1c 7.9 [7.3-8.6] % (63 [56-70] mmol/mol)) using multiple daily injections (n=67) or insulin pump (n=33) wore a blinded continuous glucose monitoring system and completed a food diary for 72-h. NH occurred on 28% of 282 nights analyzed. (i) Patients reported post-dinner dietary intakes on 63% of the evenings. They injected rapid-acting insulin boluses on 64 occasions (23% of 282 evenings). These insulin boluses were mostly injected with (n=37) dietary intakes. (ii) Post-dinner dietary intake was not associated with NH occurrence in univariate analyses. In multivariate analyses, the injection of rapid-acting insulin modulated the association between post-dinner dietary intake and NH: with insulin, post-dinner carbohydrate intake was positively associated with NH (odds ratio (OR): 1.16 [95% confidence interval, CI: 1.04-1.29] per 5g increase, p=0.008); without insulin, post-dinner protein intake was inversely associated with NH occurrence (OR [95% CI]: 0.88 [0.78-1.00] per 2g increase, p=0.048). NH remains frequent in adults with type 1 diabetes. There is a complex relationship between post-dinner dietary intake and NH occurrence, including the significant role of nutrient content and rapid-acting insulin injection that requires further investigation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Post-examination interpretation of objective test data: monitoring and improving the quality of high-stakes examinations--a commentary on two AMEE Guides.

Science.gov (United States)

Tavakol, Mohsen; Dennick, Reg

2012-01-01

As great emphasis is rightly placed upon the importance of assessment to judge the quality of our future healthcare professionals, it is appropriate not only to choose the most appropriate assessment method, but to continually monitor the quality of the tests themselves, in a hope that we may continually improve the process. This article stresses the importance of quality control mechanisms in the exam cycle and briefly outlines some of the key psychometric concepts including reliability measures, factor analysis, generalisability theory and item response theory. The importance of such analyses for the standard setting procedures is emphasised. This article also accompanies two new AMEE Guides in Medical Education (Tavakol M, Dennick R. Post-examination Analysis of Objective Tests: AMEE Guide No. 54 and Tavakol M, Dennick R. 2012. Post examination analysis of objective test data: Monitoring and improving the quality of high stakes examinations: AMEE Guide No. 66) which provide the reader with practical examples of analysis and interpretation, in order to help develop valid and reliable tests.

Solution Monitoring Evaluated by Proliferation Risk Assessment and Fuzzy Optimization Analysis for Safeguards in a Reprocessing Process

Directory of Open Access Journals (Sweden)

Mitsutoshi Suzuki

2013-01-01

Full Text Available Solution monitoring (SM has been used in a nuclear reprocessing plant as an additional measure to provide assurance that the plant is operated as declared. The inline volume and density monitoring equipment with dip tubes is important for safety and safeguards purposes and is a typical example of safeguards by design (SBD. Recently safety, safeguards, and security by design (3SBD are proposed to promote an efficient and effective generation of nuclear energy. In 3SBD, proliferation risk assessment has the potential to consider likelihood of the incidence and proliferation risk in safeguards. In this study, risk assessment methodologies for safeguards and security are discussed and several mathematical methods are presented to investigate risk notion applied to intentional acts of facility misuse in an uncertainty environment. Proliferation risk analysis with the Markov model, deterrence effect with the game model, and SBD with fuzzy optimization are shown in feasibility studies to investigate the potential application of the risk and uncertainty analyses in safeguards. It is demonstrated that the SM is an effective measurement system using risk-informed and cost-effective SBD, even though there are inherent difficulties related to the possibility of operator’s falsification.

Acute Lung Injury Complicating Blood Transfusion in Post-Partum Hemorrhage: Incidence and Risk Factors

OpenAIRE

Teofili, Luciana; Bianchi, Maria; Zanfini, Bruno A.; Catarci, Stefano; Sicuranza, Rossella; Spartano, Serena; Zini, Gina; Draisci, Gaetano

2014-01-01

Background. We retrospectively investigated the incidence and risk factors for transfusion-related acute lung injury (TRALI) among patients transfused for post-partum hemorrhage (PPH).  Methods. We identified a series of 71 consecutive patients with PPH requiring the urgent transfusion of three or more red blood cell (RBC) units, with or without fresh frozen plasma (FFP) and platelet (PLT) transfusion. Clinical records were then retrieved and examined for respiratory distress events. Accor...

Increased risk of post-operative complications in patients with Crohn’s disease treated with anti-tumour necrosis factor α agents - a systematic review

DEFF Research Database (Denmark)

El-Hussuna, Alaa; Theede, Klaus; Olaison, Per Olov Gunnar

2014-01-01

INTRODUCTION: Tumour necrosis factor α (TNF-α) plays a role in the immune defence, angiogenesis and collagen synthesis. Inhibition of these pathways may increase the risk of infections and impair wound healing in patients after surgery. Biologic treatments including anti-TNF-α agents are increasi......INTRODUCTION: Tumour necrosis factor α (TNF-α) plays a role in the immune defence, angiogenesis and collagen synthesis. Inhibition of these pathways may increase the risk of infections and impair wound healing in patients after surgery. Biologic treatments including anti-TNF-α agents...... are increasingly used in the treatment of inflammatory bowel disease. Taking into consideration the biologics' mechanism of action, fears have been expressed that they might increase the rate of post-operative complications. Results from 18 retrospective studies were conflicting, and meta-analyses based...... an increased risk of overall post-operative complications and an increased rate of infectious or anastomosis-related complications in patients receiving anti-TNF-α. CONCLUSION: The use of anti-TNF-α agents in Crohn's disease patients is associated with an increased risk of post-operative complications after...

Post-ischemic stroke rehabilitation is associated with a higher risk of fractures in older women: A population-based cohort study.

Science.gov (United States)

Huang, Huei Kai; Lin, Shu Man; Yang, Clement Shih Hsien; Liang, Chung Chao; Cheng, Hung Yu

2017-01-01

Rehabilitation can improve physical activity after stroke. However, patients may be more prone to falls and fractures because of balance and gait deficits. Few reports have studied the relationship between rehabilitation and subsequent fractures after ischemic stroke. To investigate whether post-stroke rehabilitation affects fracture risk. We conducted a population-based retrospective cohort study based on the Taiwan National Health Insurance Research Database. Patients with a newly diagnosed ischemic stroke between 2000 and 2012 were included. After propensity score matching, a total of 8,384 patients were enrolled. Half of the patients (4,192) received post-stroke rehabilitation within 1 month; the other half did not receive any post-stroke rehabilitation. Cox proportional hazards regression model was used to calculate hazard ratios (HRs) for fractures among patients with and without rehabilitation within 1 year after ischemic stroke. Patients were further stratified by sex and age (20-64 and ≥65 years). Patients receiving post-stroke rehabilitation had a higher incidence of fracture (6.2 per 100 person-years) than those who did not (4.1 per 100 person-years) after adjustment for sociodemographic and coexisting medical conditions [HR = 1.53, 95% confidence interval (CI) = 1.25-1.87, p rehabilitation had a significantly higher risk of fracture (HR = 1.62, 95% CI = 1.21-2.17, p = 0.001). Rehabilitation after ischemic stroke is associated with an increased fracture risk in older women.

A new risk and stochastic analysis of monitoring and remediation in subsurface contamination

Science.gov (United States)

Papapetridis, K.; Paleologos, E.

2012-04-01

risk analyses; contemporary risk analyses consider the cost of alternative remediation procedures by assuming that the contamination area to be remediated coincides with the area calculated at the time of detection. However, there is always a considerable lag between the time that a plume is detected and the time when remediation commences. This time lag constitutes a random variable that depends on available resources and technologies, as well as efficiency of administration decision-making. An expression is proposed that accounts for the delay between detection and remedial action in order to provide a correction to decision analyses that evaluate the economic worth of well monitoring. This expression illustrates that delays over 3 years are equivalent to reducing the monitoring performance of 12 wells to that of a much lower number of wells, or equally, having to consider higher failure costs than those assumed in current risk analyses.

Intimate partner violence as seen in post-conflict eastern Uganda: prevalence, risk factors and mental health consequences.

Science.gov (United States)

Kinyanda, Eugene; Weiss, Helen A; Mungherera, Margaret; Onyango-Mangen, Patrick; Ngabirano, Emmanuel; Kajungu, Rehema; Kagugube, Johnson; Muhwezi, Wilson; Muron, Julius; Patel, Vikram

2016-01-29

Conflict and post-conflict communities in sub-Saharan Africa have a high under recognised problem of intimate partner violence (IPV). Part of the reason for this has been the limited data on IPV from conflict affected sub-Saharan Africa. This paper reports on the prevalence, risk factors and mental health consequences of IPV victimisation in both gender as seen in post-conflict eastern Uganda. A cross-sectional survey was carried out in two districts of eastern Uganda. The primary outcome of IPV victimisation was assessed using a modified Intimate Partner Violence assessment questionnaire of the American Congress of Obstetricians and Gynaecologists. The prevalence of any form of IPV victimisation (physical and/or sexual and/or psychological IPV) in this study was 43.7 % [95 % CI, 40.1-47.4 %], with no statistically significant difference between the two gender. The factors significantly associated with IPV victimisation were: sub-county (representing ecological factors), poverty, use of alcohol, and physical and sexual war torture experiences. The mental health problems associated with IPV victimisation were probable problem alcohol drinking, attempted suicide and probable major depressive disorder. In post-conflict eastern Uganda, in both gender, war torture was a risk factor for IPV victimisation and IPV victimisation was associated with mental health problems.

Diclofenac Does Not Reduce the Risk of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis in Low-Risk Units.

Science.gov (United States)

Rainio, Mia; Lindström, Outi; Udd, Marianne; Louhimo, Johanna; Kylänpää, Leena

2017-08-01

Nonsteroidal anti-inflammatory drugs have an inhibitory role in pathogenesis of pancreatitis. Guidelines from the European Society of Gastrointestinal Endoscopy recommend routine rectal administration of 100 mg of diclofenac or indomethacin immediately before or after ERCP for all patients without contraindications. Our aim was to evaluate the effect of diclofenac in preventing post-ERCP pancreatitis (PEP) in a high-volume, low-PEP-risk ERCP unit. The rate and severity of PEP were compared in groups of 1000 historical controls prior to the routine use of diclofenac and in 1000 patients receiving 100 mg diclofenac before ERCP. PEP occurred in 56 (2.8%) of the 2000 patients, and the rate of the pancreatitis was 2.8% in control group and 2.8% in diclofenac group (p = 1.000). The PEP rate among the native papilla patients was 3.9% in control group and 3.6% in diclofenac group (p = 0.803). In subgroup analysis of patients with a high risk of PEP, diclofenac neither prevented PEP nor made its course milder. In an unselected patient population in a center with a low incidence of PEP, diclofenac seems to have no beneficial effect.

Advances in volcano monitoring and risk reduction in Latin America

Science.gov (United States)

McCausland, W. A.; White, R. A.; Lockhart, A. B.; Marso, J. N.; Assitance Program, V. D.; Volcano Observatories, L. A.

2014-12-01

We describe results of cooperative work that advanced volcanic monitoring and risk reduction. The USGS-USAID Volcano Disaster Assistance Program (VDAP) was initiated in 1986 after disastrous lahars during the 1985 eruption of Nevado del Ruiz dramatizedthe need to advance international capabilities in volcanic monitoring, eruption forecasting and hazard communication. For the past 28 years, VDAP has worked with our partners to improve observatories, strengthen monitoring networks, and train observatory personnel. We highlight a few of the many accomplishments by Latin American volcano observatories. Advances in monitoring, assessment and communication, and lessons learned from the lahars of the 1985 Nevado del Ruiz eruption and the 1994 Paez earthquake enabled the Servicio Geológico Colombiano to issue timely, life-saving warnings for 3 large syn-eruptive lahars at Nevado del Huila in 2007 and 2008. In Chile, the 2008 eruption of Chaitén prompted SERNAGEOMIN to complete a national volcanic vulnerability assessment that led to a major increase in volcano monitoring. Throughout Latin America improved seismic networks now telemeter data to observatories where the decades-long background rates and types of seismicity have been characterized at over 50 volcanoes. Standardization of the Earthworm data acquisition system has enabled data sharing across international boundaries, of paramount importance during both regional tectonic earthquakes and during volcanic crises when vulnerabilities cross international borders. Sharing of seismic forecasting methods led to the formation of the international organization of Latin American Volcano Seismologists (LAVAS). LAVAS courses and other VDAP training sessions have led to international sharing of methods to forecast eruptions through recognition of precursors and to reduce vulnerabilities from all volcano hazards (flows, falls, surges, gas) through hazard assessment, mapping and modeling. Satellite remote sensing data

Mortality of Parental Mountain Plovers (Charadrius montanus during the Post-hatching Stage.

Directory of Open Access Journals (Sweden)

Victoria J. Dreitz

2010-06-01

Full Text Available Monitoring, management, and conservation of grassland birds are topics of importance because of widespread population declines. Annual estimates of survival are available for many species, however knowledge of how survival varies on a seasonal basis remains poor. Information on the relative effects of breeding, overwintering, and migratory periods on population dynamics is necessary for effective management. Mortality risks often vary with the stage of the breeding cycle. In precocial species, mortality risks of adult birds are often higher during post-hatching care than prehatching. Using a multistate modeling approach, I investigated the influence of both environmental characteristics, measured by habitat, and individual characteristics, measured by sex and body mass, on post-hatching parental mortality of a declining grassland species, the Mountain Plover (Charadrius montanus. I found minimal evidence to support the effect of habitat, sex, or body mass on post-hatching parental mortality. Daily parental mortality was 0.0037 (SE = 0.0007, CI = 0.0026, 0.0053 and survival during the 30-day post-hatching period was 0.8943 (SE = 0.0187, CI = 0.8512, 0.9255. The findings from this study provide an understanding of the associations with today's grassland habitats and the dynamics of Mountain Plovers during the breeding season. Prior to assessing if alterations in habitats are acting more on post-hatching than the other stages of the annual cycle for the Mountain Plover, information on survival during other breeding stages and during migration is needed to assist in developing effective conservation and management plans.

Parental Monitoring Among Young Men Who Have Sex With Men: Associations With Sexual Activity and HIV-Related Sexual Risk Behaviors.

Science.gov (United States)

Thoma, Brian C

2017-09-01

Young men who have sex with men (YMSM) are at disproportionate risk for HIV infection. Parental monitoring is protective against adolescent sexual risk behavior among heterosexual adolescents, yet it is unclear whether these findings generalize to YMSM. YMSM experience unique family dynamics during adolescence, including coming out to parents and parental rejection of sexual orientation. The present study examined how theoretically derived parental monitoring constructs were associated with sexual activity and sexual risk behaviors among YMSM. YMSM aged 14-18 years completed a cross-sectional online survey (n = 646). Factor analysis was completed to determine factor structure of monitoring measure. Sexual behaviors were predicted from monitoring constructs and covariates within regression models. Parental knowledge and adolescent disclosure, parental solicitation, parental control, and adolescent secret-keeping emerged as four distinct monitoring constructs among YMSM. Higher knowledge and disclosure (b = -.32, p = .022), higher control (b = -.28, p = .006), lower solicitation (b = .31, p = .008), and lower secret-keeping (b = .25, p = .015) were associated with lower odds of sexual activity with males in the past 6 months. Higher knowledge and disclosure (b = -.12, p = .016), higher control (b = -.08, p = .039), and lower secret-keeping (b = .11, p = .005) were associated with having fewer recent sexual partners. Monitoring constructs were unassociated with condomless anal intercourse instances among sexually active YMSM. YMSM disclosure is closely tied with parental knowledge, and parents should foster relationships and home environments where YMSM are comfortable disclosing information freely. Effective parental monitoring could limit YMSM's opportunities for sexual activity, but monitoring is not sufficient to protect against HIV-related sexual risk behaviors among sexually active YMSM. Copyright © 2017 Society for Adolescent Health and

Identification of patients at risk for ischaemic cerebral complications after carotid endarterectomy with TCD monitoring

DEFF Research Database (Denmark)

Horn, J; Naylor, A R; Laman, D M

2005-01-01

Transcranial Doppler (TCD) monitoring for micro embolic signals (MES), directly after carotid endarterectomy (CEA) may identify patients at risk of developing ischaemic complications. In this retrospective multicentre study, this hypothesis was investigated....

Monitoring Immune Responses in Organ Recipients by Flow Cytometry

Directory of Open Access Journals (Sweden)

Al-Mukhalafi Zuha

2001-01-01

Full Text Available Allograft rejection remains a major barrier to successful organ transplan-tation. Cellular and humoral immune responses play a critical role in mediating graft rejection. During the last few years, monoclonal antibodies have been used as a new specific therapeutic approach in the prevention of allograft rejection. Recently, the technology of flow cytometry has become a useful tool for monitoring immunological responses in transplant recipients. The application of this valuable tool in clinical transplantation at the present time is aimed at, i determining the extent of immuno-suppressive therapy through T-cell receptor analysis of cellular components, ii monitoring levels of alloreactive antibodies to identify high-risk recipients (sensitized patients in the pre-operative period and iii to predict rejection by monitoring their development post-operatively. In future, further development of this technology may demonstrate greater benefit to the field of organ transplantation.

Maternal educational level and the risk of persistent post-partum glucose metabolism disorders in women with gestational diabetes mellitus.

Science.gov (United States)

Gante, Inês; Ferreira, Ana Carina; Pestana, Gonçalo; Pires, Daniela; Amaral, Njila; Dores, Jorge; do Céu Almeida, Maria; Sandoval, José Luis

2018-03-01

Gestational diabetes mellitus (GDM) occurs in 5-15% of pregnancies, and lower maternal educational attainment has been associated with higher risk of GDM. We aimed to determine if maternal education level is associated with persistent post-partum glucose metabolism disorders in women with GDM. Retrospective cohort study of women with GDM followed in 25 Portuguese health institutions between 2008 and 2012. Educational attainment was categorised into four levels. Prevalence of post-partum glucose metabolism disorders (type 2 diabetes mellitus, increased fasting plasma glucose or impaired glucose tolerance) was compared and adjusted odds ratios calculated controlling for confounders using logistic regression. We included 4490 women diagnosed with GDM. Educational level ranged as follows: 6.8% (n = 307) were at level 1 (≤ 6th grade), 34.6% (n = 1554) at level 2 (6-9th grade), 30.4% (n = 1364) at level 3 (10-12th grade) and 28.2% (n = 1265) at level 4 (≥ university degree). At 6 weeks post-partum re-evaluation, 10.9% (n = 491) had persistent glucose metabolism disorders. Educational levels 1 and 2 had a higher probability of persistent post-partum glucose metabolism disorders when compared to level 4 (OR = 2.37 [1.69;3.32], p women with GDM and associated with lower maternal educational level. Interventions aimed at this risk group may contribute towards a decrease in prevalence of post-partum glucose metabolism disorders.

Post-discharge heart failure monitoring program in Turkey: Hit-PoinT

Science.gov (United States)

Çavuşoğlu, Yüksel; Zoghi, Mehdi; Eren, Mehmet; Bozçalı, Evin; Kozdağ, Güliz; Şentürk, Tunay; Alicik, Güray; Soylu, Korhan; Sarı, İbrahim; Berilgen, Rida; Temizhan, Ahmet; Gencer, Erkan; Orhan, Ahmet Lütfü; Polat, Veli; Kaderli, Aysel Aydın; Aktoz, Meryem; Zengin, Halit; Aksoy, Mehmet; Selçuk, Mehmet Timur; Ergene, Oktay; Soran, Özlem

2017-01-01

Objective: The aim of this study was to assess the efficacy and feasibility of an enhanced heart failure (HF) education with a 6-month telephone follow- up program in post-discharge ambulatory HF patients. Methods: The Hit-Point trial was a multicenter, randomized, controlled trial of enhanced HF education with a 6-month telephone follow-up program (EHFP) vs routine care (RC) in patients with HF and reduced ejection fraction. A total of 248 patients from 10 centers in various geographical areas were randomized: 125 to EHFP and 123 to RC. Education included information on adherence to treatment, symptom recognition, diet and fluid intake, weight monitoring, activity and exercise training. Patients were contacted by telephone after 1, 3, and 6 months. The primary study endpoint was cardiovascular death. Results: Although all-cause mortality didn’t differ between the EHFP and RC groups (p=NS), the percentage of cardiovascular deaths in the EHFP group was significantly lower than in the RC group at the 6-month follow up (5.6% vs. 8.9%, p=0.04). The median number of emergency room visits was one and the median number of all cause hospitalizations and heart failure hospitalizations were zero. Twenty-tree percent of the EHFP group and 35% of the RC group had more than a median number of emergency room visits (p=0.05). There was no significant difference regarding the median number of all–cause or heart failure hospitalizations. At baseline, 60% of patients in EHFP and 61% in RC were in NYHA Class III or IV, while at the 6-month follow up only 12% in EHFP and 32% in RC were in NYHA Class III or IV (p=0.001). Conclusion: These results demonstrate the potential clinical benefits of an enhanced HF education and follow up program led by a cardiologist in reducing cardiovascular deaths and number of emergency room visits with an improvement in functional capacity at 6 months in post-discharge ambulatory HF patients. PMID:27488754

Prospective risk factors for post-deployment heavy drinking and alcohol or substance use disorder among US Army soldiers.

Science.gov (United States)

Campbell-Sills, Laura; Ursano, Robert J; Kessler, Ronald C; Sun, Xiaoying; Heeringa, Steven G; Nock, Matthew K; Sampson, Nancy A; Jain, Sonia; Stein, Murray B

2017-10-17

Investigations of drinking behavior across military deployment cycles are scarce, and few prospective studies have examined risk factors for post-deployment alcohol misuse. Prevalence of alcohol misuse was estimated among 4645 US Army soldiers who participated in a longitudinal survey. Assessment occurred 1-2 months before soldiers deployed to Afghanistan in 2012 (T0), upon their return to the USA (T1), 3 months later (T2), and 9 months later (T3). Weights-adjusted logistic regression was used to evaluate associations of hypothesized risk factors with post-deployment incidence and persistence of heavy drinking (HD) (consuming 5 + alcoholic drinks at least 1-2×/week) and alcohol or substance use disorder (AUD/SUD). Prevalence of past-month HD at T0, T2, and T3 was 23.3% (s.e. = 0.7%), 26.1% (s.e. = 0.8%), and 22.3% (s.e. = 0.7%); corresponding estimates for any binge drinking (BD) were 52.5% (s.e. = 1.0%), 52.5% (s.e. = 1.0%), and 41.3% (s.e. = 0.9%). Greater personal life stress during deployment (e.g., relationship, family, or financial problems) - but not combat stress - was associated with new onset of HD at T2 [per standard score increase: adjusted odds ratio (AOR) = 1.20, 95% CI 1.06-1.35, p = 0.003]; incidence of AUD/SUD at T2 (AOR = 1.54, 95% CI 1.25-1.89, p risk of alcohol-related problems post-deployment.

Risk Factors, Resilience, and Psychological Distress among Holocaust and Nonholocaust Survivors in the Post-9/11 Environment

Science.gov (United States)

Lamet, Ann; Szuchman, Lenore; Perkel, Linda; Walsh, Sandra

2009-01-01

Many older adults have experienced or witnessed devastating life events including wars, hurricanes, and explosions. This study examined retraumatization and the relationship between certain risk factors, resilience, and psychological distress in the post-9/11 environment among 120 community-dwelling older adults. Results indicate that Holocaust…

CRADA with Teledyne Electronic Technologies and Pacific Northwest National Laboratory (PNL-096): The Exposure-to-Risk monitoring system. Final letter report

Energy Technology Data Exchange (ETDEWEB)

Thrall, K.D.

1996-10-01

The purpose of this project was to demonstrate the ``Exposure-to- Risk`` monitoring system in an actual occupational environment. The system is a unique combination of existing hardware with proprietary software to create an integrated means of assessing occupational exposures to volatile organic compounds. One component of this system utilizes a portable mass spectrometer developed by Teledyne Electronic Technologies. Integration of the system was accomplished under Laboratory Directed Research and Development (LDRD) funding. Commercialization of the system will take place following demonstration in an actual occupational environment, and will include, in part, Teledyne Electronic Technologies. The Exposure-to-Risk monitoring system will benefit DOE by overcoming present-day limitations in worker health protection monitoring. There are numerous sites within the` DOE complex where many different hazardous chemicals are used on a routine basis. These chemicals range from paint stripers and cleaning solvents to chemical warfare agents, each having its own degree of potential adverse health risk to a worker. Thus, a real concern for DOE is to ensure that a worker is properly monitored to assess any adverse health risk from exposure to potentially hazardous chemicals. With current industrial hygiene technologies, this is an arduous task. The Exposure-to-Risk monitoring system integrates a patented breath-inlet device connecting a subject`s exhaled breath directly with a field-portable mass spectrometer with physiologically based pharmacokinetic (PBPK) modeling to estimate the target tissue dose following a chemical exposure. Estimation of the adverse health risk prediction follows from the exposure/dose calculation based on currently accepted methodologies. This new system can determine, in the field, the possible adverse health risks on a daily basis to an individual worker.

Literature review and meta-analysis of risk factors for delayed post-traumatic stress disorder in older adults after a fall.

Science.gov (United States)

Bloch, Frédéric

2017-02-01

To test the hypothesis that post-traumatic stress disorder (PTSD) can appear after a fall and try to identify predictive factors for its development in older fallers. Systematic literature review and meta-analyses of studies on PTSD post fall in older subjects. One hundred seventy-seven indexed articles were identified, of which three had complete data on PTSD post fall in older subjects. Only the odds ratio of the association between history of fall and occurrence of PTSD was significant (odds ratio = 2.79 (95% CI, 1.03-7.53). The trend in our results, even though limited, reveals two groups of subjects: frail subjects that are at risk of developing PTSD and subjects who seem to be resistant to its development. A clear description of these two groups may help us identify the population at risk for delayed PTSD who could then benefit from dedicated treatment. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Use of selective serotonin reuptake inhibitors and risk of re-operation due to post-surgical bleeding in breast cancer patients: a Danish population-based cohort study

Directory of Open Access Journals (Sweden)

Lash Timothy L

2010-01-01

Full Text Available Abstract Background Selective serotonin reuptake inhibitors (SSRI decrease platelet-function, which suggests that SSRI use may increase the risk of post-surgical bleeding. Few studies have investigated this potential association. Methods We conducted a population-based study of the risk of re-operation due to post-surgical bleeding within two weeks of primary surgery among Danish women with primary breast cancer. Patients were categorised according to their use of SSRI: never users, current users (SSRI prescription within 30 days of initial breast cancer surgery, and former users (SSRI prescription more than 30 days before initial breast cancer surgery. We calculated the risk of re-operation due to post-surgical bleeding within 14 days of initial surgery, and the relative risk (RR of re-operation comparing SSRI users with never users of SSRI adjusting for potential confounders. Results 389 of 14,464 women (2.7% were re-operated. 1592 (11% had a history of SSRI use. Risk of re-operation was 2.6% among never users, 7.0% among current SSRI users, and 2.7% among former users. Current users thus had an increased risk of re-operation due to post-operative bleeding (adjusted relative risk = 2.3; 95% confidence interval (CI = 1.4, 3.9 compared with never users. There was no increased risk of re-operation associated with former use of SSRI (RR = 0.93, 95% CI = 0.66, 1.3. Conclusions Current use of SSRI is associated with an increased risk of re-operation due to bleeding after surgery for breast cancer.

Decentralized Planning for Pre-Conflict and Post-Conflict ...

African Journals Online (AJOL)

Decentralized Planning for Pre-Conflict and Post-Conflict Management in the Bawku Municipal ... institutional arrangements for conflict monitoring and evaluation. Such processes are 'sine qua non' to pre-conflict and post-conflict prevention.

Wildfires and post-fire erosion risk in a coastal area under severe anthropic pressure associated with the touristic fluxes

Science.gov (United States)

Canu, Annalisa; Arca, Bachisio; Pellizzaro, Grazia; Valeriano Pintus, Gian; Ferrara, Roberto; Duce, Pierpaolo

2017-04-01

In the last decades a rapid and intense development of the tourism industry led to an increasing of anthropic pressure on several coastal areas of Sardinia. This fact not only modified the coastal aesthetics, but has also generated an increase of risk for the environment. This phenomenon affected also the ancient structure of the landscape with a negative impact mainly caused by the following factors: land abandonment, wildfire occurrence, post-fire erosion, urbanization. These regional changes can be analyzed in detail by considering the geo-diachronic dynamics. The main objectives of this work were i) to perform a diachronic analysis of land use and land cover dynamics, ii) to analyse the recent dynamics of wildfires, and iii) to predict the soil erosion risk in relation to land use change occurred between the 1950s and the 2000s. The study was realized in a coastal area located in North-East Sardinia where the geo-historical processes were summarized and organized in a geographic information system that has been employed to examine the landscape variations at three different time steps: 1954, 1977 and 2000. In addition, different scenarios of wildfire propagation were simulated by FlamMap in order to estimate the spatial pattern of fire danger factors in the study area. Afterwards, maps of post-fire soil erosion were produced to identify the temporal and spatial variations of the erosion risk. The results show how the changes in land use and the significant and rapid increase of the residential areas affect the risk of both wildfires and post-fire soil erosion. The study reveals the capabilities of this type of approach and can be used by management agencies and policy makers e in sustainable landscape management planning. This approach can be extended to other regions of the Mediterranean basin characterized by complex interactions among landscape and anthropic factors affecting the environmental risk.

Frequency and risk factors in the post-ercp pancreatitis in a tertiary care centre

International Nuclear Information System (INIS)

Leghari, A.; Ghazanfar, S.; Qureshi, S.; Taj, M.A.; Niaz, S.K.; Quraishy, M.S.

2013-01-01

Objective: To evaluate the frequency and associated factors in the post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Study Design: Cross-sectional analytical study. Place and Duration of Study: Endoscopy Suite of Surgical Unit IV, Civil Hospital, Karachi, from December 2009 to November 2010. Methodology: Patients undergoing ERCP were included. Patients who had presented with pancreatitis or raised amylase levels before procedure or patients who had previous history of surgery on the biliary or pancreatic systems were excluded from the study. Pearson chi-square and Fisher's exact test were used for qualitative data and t-test for quantitative data. Significance was taken as p=0.05. Odds ratio was calculated for the qualitative data using 95% confidence interval. Results: Age of the study population ranged from 9 to 90 years (mean age 46.5 A+- 14.94 years, median 45 years). Male to female ratio was 1:1.87. Pancreatitis was seen in 18 patients (3.6%), mild in 15 (3%), moderate in one (0.2%) and severe in 2 (0.4%). Mean amylase level at 4 hours and 24 hours was 280.93 A+- 539.13 and 168.83 A+- 338.34 respectively. Pancreatitis was seen in 15/326 (4.6%) females and 3/174 (1.72%) males. Statistically significant increased risk for pancreatitis was seen in difficult cannulation (9.8%, p = 0.006), prolonged cannulation time (7.6 minute, p = 0.002), pancreatic duct cannulation (13.7%, p = 0.001) and pancreatic duct contrast injection (13.4%, p < 0.001). Conclusion: The frequency of post-ERCP pancreatitis was 3.6%. Difficult cannulation, pancreatic duct cannulation, pancreatic duct contrast injection and balloon sphincteroplasty were associated with higher frequency of post-ERCP pancreatitis. Reuse of ERCP accessories poses no additional risk to the frequency of pancreatitis. (author)

Metabolic predictors of post-partum disease and culling risk in dairy cattle.

Science.gov (United States)

Seifi, Hesam A; Leblanc, Stephen J; Leslie, Ken E; Duffield, Todd F

2011-05-01

A retrospective study was conducted to determine the relationship between serum non-esterified fatty acids (NEFA), β-hydroxybutyrate (BHBA), glucose and calcium (Ca) with the occurrence of displaced abomasum (DA), clinical ketosis and culling in Holstein cows. Eight hundred and forty-nine cows from 16 farms were sampled weekly for the first 3 weeks post-partum. The cows were under clinical observation from calving until 60 days in milk (DIM) and during this time there were 22 cases of DA, 31 cases of clinical ketosis and 39 cows were culled. Elevated concentrations of BHBA were associated with DA, clinical ketosis and culling. In the first week after calving, cows with serum BHBA ≥1000μmol/L had 13.6 times greater odds of developing DA than cows with lower values. Serum NEFA and BHBA concentrations during week 1 were associated with the subsequent occurrence of clinical ketosis. The odds of clinical ketosis were 6.3 times greater in cows with serum NEFA ≥ 1.0mmol/L in the first week after calving. In addition, cows with BHB ≥1200μmol/L in the first week after calving, were at 4.7 times greater risk of developing clinical ketosis. In the first and second weeks after calving the serum Ca concentration was associated with subsequent culling. In addition, cows with NEFA concentration ≥ 1.0mmol/L were 3.6 times more likely to be culled within the following 2 months. The study indicated that early post-partum serum BHBA, NEFA and Ca concentrations have potential as indicators of disease and culling risk in dairy cows. Copyright © 2010 Elsevier Ltd. All rights reserved.

Use of selective serotonin reuptake inhibitors and risk of re-operation due to post-surgical bleeding in breast cancer patients: a Danish population-based cohort study

DEFF Research Database (Denmark)

Gärtner, Rune; Cronin-Fenton, Deirdre; Hundborg, Heidi Holmager

2010-01-01

Selective serotonin reuptake inhibitors (SSRI) decrease platelet-function, which suggests that SSRI use may increase the risk of post-surgical bleeding. Few studies have investigated this potential association.......Selective serotonin reuptake inhibitors (SSRI) decrease platelet-function, which suggests that SSRI use may increase the risk of post-surgical bleeding. Few studies have investigated this potential association....

Impact of Post-Discharge Disposition on Risk and Causes of Readmission Following Liver and Pancreas Surgery.

Science.gov (United States)

Chen, Qinyu; Merath, Katiuscha; Olsen, Griffin; Bagante, Fabio; Idrees, Jay J; Akgul, Ozgur; Cloyd, Jordan; Schmidt, Carl; Dillhoff, Mary; Beal, Eliza W; White, Susan; Pawlik, Timothy M

2018-03-22

The relationship between the post-discharge settings and the risk of readmission has not been well examined. We sought to identify the association between discharge destinations and readmission rates after liver and pancreas surgery. The 2013-2015 Medicare-Provider Analysis and Review (MEDPAR) database was reviewed to identify liver and pancreas surgical patients. Patients were subdivided into three groups based on discharge destination: home/self-care (HSC), home with home health assistance (HHA), and skilled nursing facility (SNF). The association between post-acute settings, readmission rates, and readmission causes was assessed. Among 15,141 liver or pancreas surgical patients, 60% (n = 9046) were HSC, 26.9% (n = 4071) were HHA, and 13.4% (n = 2024) were SNF. Older, female patients and patients with ≥ 2 comorbidities, ≥ 2 previous admissions, an emergent index admission, an index complication, and ≥ 5-day length of stay were more likely to be discharged to HHA or SNF compared to HSC (all P readmission, respectively. The HHA and SNF settings were also associated with a 33 and a 69% higher risk of 90-day readmission. There was no association between discharge destination and readmission causes. Among liver and pancreas surgical patients, HHA and SNF patients had a higher risk of readmission within 30 and 90 days. There was no difference in readmission causes and discharge settings. The association between discharge setting and the higher risk of readmission should be further evaluated as the healthcare system seeks to reduce readmission rates after surgery.

Risk Management in Mergers and Acquisitions

Directory of Open Access Journals (Sweden)

Dmitry O. Verdiev

2015-01-01

Full Text Available M&A statistics show that less than a third of newly merged companies has realized their planned synergistic effects and increased shareholder value. According to the author, such disgusting situation is due to improper planning and failure of corporate management to understand the importance of risk management in M&A. Lack of practice in identification, evaluation, mitigation and regular monitoring of risks leads to the situation when many companies merge despite the fact that the merger bears substantial risks. Corporate management fails to include risk mitigation expenses in merger costs. In many cases, risk mitigation expenses may be so substantive that the merger loses its attractiveness. Only few companies implement risk management methodology while planning M&A activity. This methodology may anticipate and minimize the consequences of various risk factors that negatively influence integration process. The article suggests an implementation of risk management best practice. This risk management best practice may act as an effective tool of successful realization of synergistic effects in M&A and may be helpful in increasing shareholder value in post-merger period. Risk management is conducted throughout the stages of merger and includes identification, analysis, assessment, management and monitoring of risks. Implementation of risk management at early stages of merger planning significantly decreases uncertainty in relation to achievement of financial and operational goals of newly merged company. The article provides with typical M&A risk matrix that may be adapted for specific M&A project. Risk matrix includes a register of risks sorted by stages of M&A deal, quality assessment of their probability, influence and impact on merger as well as risk mitigation methods.

Ionising radiation and risk of death from leukaemia and lymphoma in radiation-monitored workers (INWORKS)

Energy Technology Data Exchange (ETDEWEB)

Lorenz, Bernd

2015-07-01

Since July 2015 the study ''ionising radiation and risk of death from leukaemia and lymphoma in radiation-monitored workers (INWORKS) - an international cohort study'' is available. INWORKS comprised data from 300.000 occupational exposed and dosimetric monitored persons from France, USA and UK. The contribution is a critical discussion of this study with respect to the conclusion of a strong evidence of positive associations between protracted low-dose irradiation exposure and leukemia.

Prediction of incidence and bio-psycho-socio-cultural risk factors of post-partum depression immediately after birth in an Iranian population.

Science.gov (United States)

Abdollahi, Fatemeh; Zarghami, Mehran; Sazlina, Shariff-Ghazali; Zain, Azhar Md; Mohammad, Asghari Jafarabadi; Lye, Munn-Sann

2016-10-01

Post-partum depression (PPD) is the most prevalent mental problem associated with childbirth. The purpose of the present study was to determine the incidence of early PPD and possible relevant risk factors among women attending primary health centers in Mazandaran province, Iran for the first time. A longitudinal cohort study was conducted among 2279 eligible women during weeks 32-42 of pregnancy to determine bio-psycho-socio-cultural risk factors of depression at 2 weeks post-partum using the Iranian version of the Edinburgh Postnatal Depression Scale (EPDS). Univariate and hierarchical multiple logistic regression models were used for data analysis. Among 1,739 mothers whose EPDS scores were ≤ 12 during weeks 32-42 of gestation and at the follow-up study, the cumulative incidence rate of depression was 6.9% (120/1,739) at 2 weeks post-partum. In the multivariate model the factor that predicted depression symptomatology at 2 weeks post-partum was having psychiatric distress in pregnancy based on the General Health Questionnaire (GHQ) (OR = 1.06, (95% CI: 1.04-1.09), p = 0.001). The risk of PPD also lower in those with sufficient parenting skills (OR = 0.78 (95% CI: 0.69-0.88), p = 0.001), increased marital satisfaction (OR = 0.94 (95% CI: 0.9-0.99), p = 0.03), increased frequency of practicing rituals (OR = 0.94 (95% CI: 0.89-0.99), p = 0.004) and in those whose husbands had better education (OR = 0.03 (95% CI: 0.88-0.99), p = 0.04). The findings indicated that a combination of demographic, sociological, psychological and cultural risk factors can make mothers vulnerable to PPD.

Environmental radiation monitoring

International Nuclear Information System (INIS)

Watanabe, Isao

2011-01-01

The samples, pretreatment method, and measurement methods of 'Environmental radioactivity level by prefecture' of Ministry of Education, Culture, Sports, Science and Education (MEXT) is explained. It consists of 1), 'Environmental radioactivity level by prefecture' in normal period, 2) 'Strengthening of Monitoring of Environmental Radioactivity Level by Prefecture' of MEXT at emergency 3) strengthening of monitoring by Fukushima Daiichi nuclear accident, 4) radiation monitoring around the nuclear facility, 5) strengthening of monitoring by MEXT, and 6) quality of monitoring. The survey item and samples etc., of 'Environmental radioactivity level by prefecture', monitoring post, NaI (Tl) scintillation survey meter, sampling and pretreatment methods for radionuclide analysis in normal period, an example of germanium semiconductor detector, gamma ray spectrum of spaghetti from Italy by germanium semiconductor detector, flow chart of radionuclide analysis of fallout in normal period and emergency by germanium semiconductor detector, example of analytical method of radioactive strontium ( ion exchange method), outline of plutonium analytical method for emergency, sampling and pretreatment methods of radionuclides for strengthening, monitoring result around Fukushima Daiichi nuclear plant from June 23 to 24, 2011, change of air dose rate of monitoring post in Mito city from March 14 to 26, 2011, concentration of I-131 and Cs-137 in fallout in Hitachinaka city from March 19 to April 30, 2011, and change of concentration of I-131, Cs-134 and Cs-137 in tap water of Iitate village from March 20 to April 30, 2011, are illustrated. (S.Y.)

Post-assessment of pre-stressed containment structures by evaluation of monitored long term deformation results

International Nuclear Information System (INIS)

Wienand, B.

2015-01-01

The comparison of monitored long term deformations of containment structures with calculated values achieved by using design material parameters shows occasionally considerable deviations, partly caused by conservative assumptions in the containments design phase. Systematic post-assessment and adaption of the decisive parameters attains better coincidence. In the present investigation measured long-term deformations are first of all compared to pre-calculated values based on the material parameters defined in the design phase. Afterwards, the deformations deviations are minimized by repeating the calculation with assessed material parameters. This method appears to be a suitable method to predict the future containment structure long-term behavior and to achieve a possible life-time extension. The presented investigation was performed as part of NUGENIA ACCEPPT project which researches the ageing of concrete containment structures in nuclear power plants

Post-Traumatic Stress Disorder among Cardiac Patients: Prevalence, Risk Factors, and Considerations for Assessment and Treatment

Directory of Open Access Journals (Sweden)

Heather Tulloch

2014-12-01

Full Text Available There is increasing awareness of the impact of post-traumatic stress disorder (PTSD on physical health, particularly cardiovascular disease. We review the literature on the role of trauma in the development of cardiovascular risk factors and disease, aftermath of a cardiac event, and risk for recurrence in cardiac patients. We explore possible mechanisms to explain these relationships, as well as appropriate assessment and treatment strategies for this population. Our main conclusion is that screening and referral for appropriate treatments are important given the high prevalence rates of PTSD in cardiac populations and the associated impact on morbidity and mortality.

Institutionalising and streamlining development monitoring and evaluation in post-revolutionary Egypt: A readiness primer

Directory of Open Access Journals (Sweden)

Laila El Baradei

2014-12-01

Full Text Available This research provides first-hand information about the field of development monitoring and evaluation (DME in Egypt post the 2011 revolution. There is a great need for more effective, informative DME to hold government and development partners accountable for results achieved and meet people’s needs and expectations. Both online and offline interviews were conducted with a purposive sample of 61 representatives of different stakeholder groups working in the field of DME in Egypt. Findings pointed to a lack of interest and understanding of DME, difficulty with accessing data required for satisfactory evaluation and the perceived limited effect of DME work on public policy making. Respondents’ recommendations for enhanced performance included the presence of DME units in all government and NGO programmes, more intensive training to all parties concerned, creation of an umbrella DME agency, allocating of a sufficient budget and advocating for the cause.

POST-CLOSURE INSPECTION AND MONITORING REPORT FOR CORRECTIVE ACTION UNIT 112: AREA 23 HAZARDOUS WASTE TRENCHES, NEVADA TEST SITE, NEVADA; FOR THE PERIOD OCTOBER 2003 - SEPTEMBER 2004

International Nuclear Information System (INIS)

BECHTEL NEVADA

2004-01-01

Corrective Action Unit (CAU) 112, Area 23 Hazardous Waste Trenches, Nevada Test Site (NTS), Nevada, is a Resource Conservation and Recovery Act (RCRA) unit located in Area 23 of the NTS. This annual Post-Closure Inspection and Monitoring Report provides the results of inspections and monitoring for CAU 112. This report includes a summary and analysis of the site inspections, repair and maintenance, meteorological information, and neutron soil moisture monitoring data obtained at CAU 112 for the current monitoring period, October 2003 through September 2004. Inspections of the CAU 112 RCRA unit were performed quarterly to identify any significant physical changes to the site that could impact the proper operation of the waste unit. The overall condition of the covers and facility was good, and no significant findings were observed. The annual subsidence survey of the elevation markers was conducted on August 23, 2004, and the results indicated that no cover subsidence4 has occurred at any of the markers. The elevations of the markers have been consistent for the past 11 years. The total precipitation for the current reporting period, october 2003 to September 2004, was 14.0 centimeters (cm) (5.5 inches [in]) (National Oceanographic and Atmospheric Administration, Air Resources Laboratory, Special Operations and Research Division, 2004). This is slightly below the average rainfall of 14.7 cm (5.79 in) over the same period from 1972 to 2004. Post-closure monitoring verifies that the CAU 112 trench covers are performing properly and that no water is infiltrating into or out of the waste trenches. Sail moisture measurements are obtained in the soil directly beneath the trenches and compared to baseline conditions for the first year of post-closure monitoring, which began in october 1993. neutron logging was performed twice during this monitoring period along 30 neutron access tubes to obtain soil moisture data and detect any changes that may indicate moisture movement

Posting of workers : Enforcement problems and challenges

NARCIS (Netherlands)

Cremers, Jan

2013-01-01

Expert contribution to a final conference. According to the author, monitoring the process of posting and controlling the regular character of the cross-border provision of services with posted workers has proven to be a problematic area. Recent joint activities of the labour inspectorate have

40 CFR 194.42 - Monitoring.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Monitoring. 194.42 Section 194.42... § 194.42 Monitoring. (a) The Department shall conduct an analysis of the effects of disposal system...-closure and post-closure monitoring required pursuant to paragraphs (c) and (d) of this section. The...

Post-Traumatic Stress Disorder and Risk for Incident Rheumatoid Arthritis.

Science.gov (United States)

Lee, Yvonne C; Agnew-Blais, Jessica; Malspeis, Susan; Keyes, Katherine; Costenbader, Karen; Kubzansky, Laura D; Roberts, Andrea L; Koenen, Karestan C; Karlson, Elizabeth W

2016-03-01

To examine the association between symptoms of post-traumatic stress disorder (PTSD) and rheumatoid arthritis (RA) risk in a prospective cohort and to characterize the role of smoking in this relationship. A subset (n = 54,224) of the Nurses' Health Study II, a prospective cohort of female nurses, completed the Brief Trauma Questionnaire and a screen for PTSD symptoms. Participants were categorized based on trauma exposure and number of PTSD symptoms. Incident RA cases (n = 239) from 1989 to 2011 were identified. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) between PTSD symptoms and incident RA. To identify the impact of smoking, secondary and subgroup analyses were performed. In all analyses, PTSD and smoking were lagged 2 years before the development of RA. Compared to no history of trauma/PTSD symptoms, the HR for ≥4 PTSD symptoms and incident RA was 1.76 (95% CI 1.16-2.67) in models adjusted for age, race, and socioeconomic status. The risk for RA increased with an increasing number of PTSD symptoms (P = 0.01). When smoking was added to the model, the HR for RA remained elevated (HR 1.60 [95% CI 1.05-2.43]). In a subgroup analysis, excluding women who smoked before PTSD onset, results were unchanged (HR 1.68 [95% CI 1.04-2.70]). This study suggests that women with high PTSD symptomatology have an elevated risk for RA, independent of smoking, adding to emerging evidence that stress is an important determinant of physical health. © 2016, American College of Rheumatology.

How many or how much? Testing the relative influence of the number of social network risks versus the amount of time exposed to social network risks on post-treatment substance use.

Science.gov (United States)

Eddie, David; Kelly, John F

2017-06-01

Having high-risk, substance-using friends is associated with young adult substance use disorder (SUD) relapse. It is unclear, however, whether it is the total number of high-risk friends, or the amount of time spent with high-risk friends that leads to relapse. Unclear also, is to what extent low-risk friends buffer risk. This study examined the influence of number of high-risk and low-risk friends, and the amount time spent with these friends on post-treatment percent days abstinent (PDA). Young adult inpatients (N=302) were assessed at intake, and 3, 6, and 12 months on social network measures and PDA. Mixed models tested for effects of number of high- and low-risk friends, and time spent with these friends on PDA, and for net-risk friend effects to test whether low-risk friends offset risk. Within and across assessments, number of, and time spent with high-risk friends was negatively associated with PDA, while the inverse was true for low-risk friends. Early post-treatment, time spent with friends more strongly predicted PDA than number of friends. Participants were more deleteriously affected by time with high-risk friends the longer they were out of treatment, while contemporaneously protection conferred by low-risk friends increased. This interaction effect, however, was not observed with number of high- or low-risk friends, or number of friends net-risk. Young adult SUD patients struggling to break ties with high-risk friends should be encouraged to minimize time with them. Clinicians should also encourage patients to grow their social network of low-risk friends. Copyright © 2017 Elsevier B.V. All rights reserved.

Risk factors for post-operative periprosthetic fractures following primary total hip arthroplasty with a proximally coated double-tapered cementless femoral component

DEFF Research Database (Denmark)

Gromov, K; Bersang, A; Nielsen, C S

2017-01-01

ratio were recorded post-operatively. Periprosthetic fractures were identified and classified according to the Vancouver classification. Regression analysis was performed to identify risk factors for early periprosthetic fracture. RESULTS: The mean follow-up was 713 days (1 to 2058). A total of 48......AIMS: The aim of this study was to identify patient- and surgery-related risk factors for sustaining an early periprosthetic fracture following primary total hip arthroplasty (THA) performed using a double-tapered cementless femoral component (Bi-Metric femoral stem; Biomet Inc., Warsaw, Indiana...... periprosthetic fractures (3.0%) were identified during the follow-up and median time until fracture was 16 days, (interquartile range 10 to 31.5). Patients with femoral Dorr type C had a 5.2 times increased risk of post-operative periprosthetic fracture compared with type B, while female patients had a near...

Risk Factors and Predictive Model Development of Thirty-Day Post-Operative Surgical Site Infection in the Veterans Administration Surgical Population.

Science.gov (United States)

Li, Xinli; Nylander, William; Smith, Tracy; Han, Soonhee; Gunnar, William

2018-04-01

Surgical site infection (SSI) complicates approximately 2% of surgeries in the Veterans Affairs (VA) hospitals. Surgical site infections are responsible for increased morbidity, length of hospital stay, cost, and mortality. Surgical site infection can be minimized by modifying risk factors. In this study, we identified risk factors and developed accurate predictive surgical specialty-specific SSI risk prediction models for the Veterans Health Administration (VHA) surgery population. In a retrospective observation study, surgical patients who underwent surgery from October 2013 to September 2016 from 136 VA hospitals were included. The Veteran Affairs Surgical Quality Improvement Program (VASQIP) database was used for the pre-operative demographic and clinical characteristics, intra-operative characteristics, and 30-day post-operative outcomes. The study population represents 11 surgical specialties: neurosurgery, urology, podiatry, otolaryngology, general, orthopedic, plastic, thoracic, vascular, cardiac coronary artery bypass graft (CABG), and cardiac valve/other surgery. Multivariable logistic regression models were developed for the 30-day post-operative SSIs. Among 354,528 surgical procedures, 6,538 (1.8%) had SSIs within 30 days. Surgical site infection rates varied among surgical specialty (0.7%-3.0%). Surgical site infection rates were higher in emergency procedures, procedures with long operative duration, greater complexity, and higher relative value units. Other factors associated with increased SSI risk were high level of American Society of Anesthesiologists (ASA) classification (level 4 and 5), dyspnea, open wound/infection, wound classification, ascites, bleeding disorder, chemotherapy, smoking, history of severe chronic obstructive pulmonary disease (COPD), radiotherapy, steroid use for chronic conditions, and weight loss. Each surgical specialty had a distinct combination of risk factors. Accurate SSI risk-predictive surgery specialty

[Post-marketing reevaluation for potential quality risk and quality control in clinical application of traditional Chinese medicines].

Science.gov (United States)

Li, Hong-jiao; He, Li-yun; Liu, Bao-yan

2015-06-01

The effective quality control in clinical practices is an effective guarantee for the authenticity and scientificity of the findings. The post-marketing reevaluation for traditional Chinese medicines (TCM) focuses on the efficacy, adverse reaction, combined medication and effective dose of drugs in the market by expanded clinical trials, and requires a larger sample size and a wider range of patients. Therefore, this increases the difficulty of quality control in clinical practices. With the experience in quality control in clinical practices for the post-marketing reevaluation for Kangbingdu oral for cold, researchers in this study reviewed the study purpose, project, scheme design and clinical practice process from an overall point of view, analyzed the study characteristics of the post-marketing reevaluation for TCMs and the quality control risks, designed the quality control contents with quality impacting factors, defined key review contents and summarized the precautions in clinical practices, with the aim to improve the efficiency of quality control of clinical practices. This study can provide reference to clinical units and quality control-related personnel in the post-marketing reevaluation for TCMs.

Improving Blood Monitoring of Enzymes as Biomarkers of Risk from Anticholinergic Pesticides and Chemical Warfare Agents

National Research Council Canada - National Science Library

Wilson, Barry W

2006-01-01

Blood biomarkers are an important way to monitor exposure to anticholinergic pesticides and chemical warfare agents and to establish whether some personnel are at greater risk than others from exposure...

Improving Blood Monitoring of Enzymes as Biomarkers of Risk from Anticholinergic Pesticides and Chemical Warfare Agents

National Research Council Canada - National Science Library

Wilson, Barry W

2005-01-01

Blood biomarkers are an important way to monitor exposure to anticholinergic pesticides and chemical warfare agents and to establish whether some personnel are at greater risk than others from exposure...

A prospective study of pre-trauma risk factors for post-traumatic stress disorder and depression.

Science.gov (United States)

Wild, J; Smith, K V; Thompson, E; Béar, F; Lommen, M J J; Ehlers, A

2016-09-01

It is unclear which potentially modifiable risk factors best predict post-trauma psychiatric disorders. We aimed to identify pre-trauma risk factors for post-traumatic stress disorder (PTSD) or major depression (MD) that could be targeted with resilience interventions. Newly recruited paramedics (n = 453) were assessed for history of mental disorders with structured clinical interviews within the first week of their paramedic training and completed self-report measures to assess hypothesized predictors. Participants were assessed every 4 months for 2 years to identify any episodes of PTSD and MD; 386 paramedics (85.2%) participated in the follow-up interviews. In all, 32 participants (8.3%) developed an episode of PTSD and 41 (10.6%) an episode of MD during follow-up. In all but nine cases (2.3%), episodes had remitted by the next assessment 4 months later. At 2 years, those with episodes of PTSD or MD during follow-up reported more days off work, poorer sleep, poorer quality of life, greater burn-out; and greater weight-gain for those with PTSD. In line with theories of PTSD and depression, analyses controlling for psychiatric and trauma history identified several pre-trauma predictors (cognitive styles, coping styles and psychological traits). Logistic regressions showed that rumination about memories of stressful events at the start of training uniquely predicted an episode of PTSD. Perceived resilience uniquely predicted an episode of MD. Participants at risk of developing episodes of PTSD or depression could be identified within the first week of paramedic training. Cognitive predictors of episodes of PTSD and MD are promising targets for resilience interventions.

Risk analysis procedure for post-wildfire natural hazards in British Columbia

Science.gov (United States)

Jordan, Peter

2010-05-01

Following a severe wildfire season in 2003, and several subsequent damaging debris flow and flood events, the British Columbia Forest Service developed a procedure for analysing risks to public safety and infrastructure from such events. At the same time, the Forest Service undertook a research program to determine the extent of post-wildfire hazards, and examine the hydrologic and geomorphic processes contributing to the hazards. The risk analysis procedure follows the Canadian Standards Association decision-making framework for risk management (which in turn is based on international standards). This has several steps: identification of risk, risk analysis and estimation, evaluation of risk tolerability, developing control or mitigation strategies, and acting on these strategies. The Forest Service procedure deals only with the first two steps. The results are passed on to authorities such as the Provincial Emergency Program and local government, who are responsible for evaluating risks, warning residents, and applying mitigation strategies if appropriate. The objective of the procedure is to identify and analyse risks to public safety and infrastructure. The procedure is loosely based on the BAER (burned area emergency response) program in the USA, with some important differences. Our procedure focuses on identifying risks and warning affected parties, not on mitigation activities such as broadcast erosion control measures. Partly this is due to limited staff and financial resources. Also, our procedure is not multi-agency, but is limited to wildfires on provincial forest land; in British Columbia about 95% of forest land is in the publicly-owned provincial forest. Each fire season, wildfires are screened by size and proximity to values at risk such as populated areas. For selected fires, when the fire is largely contained, the procedure begins with an aerial reconnaissance of the fire, and photography with a hand-held camera, which can be used to make a

Risk of melanoma in people with HIV/AIDS in the pre- and post-HAART eras: a systematic review and meta-analysis of cohort studies.

Science.gov (United States)

Olsen, Catherine M; Knight, Lani L; Green, Adèle C

2014-01-01

Following the introduction of highly active antiretroviral therapy (HAART) the risk of AIDS-defining cancers decreased but incidence of many non-AIDS-defining cancers has reportedly increased in those with HIV/AIDS. Whether melanoma risk has also changed in HIV/AIDS patients post-HAART is unknown and therefore we evaluated this in comparison with the risk before HAART. Systematic review and meta-analysis. We searched Medline, Embase and ISI science citation index databases to April 2013. All cohort studies of patients diagnosed with HIV/AIDS that permitted quantitative assessment of the association with melanoma were eligible. Detailed quality assessment of eligible studies was conducted, focussing particularly on adjustment for ethnicity, a priori considered essential for an unbiased assessment of melanoma risk. Data were pooled using a random effects model. From 288 articles, we identified 21 that met the inclusion criteria, 13 presenting data for the post-HAART era and 8 for the pre-HAART era. Post-HAART the pooled relative risk (pRR) for the association between HIV/AIDS and melanoma was 1.26 (95% CI, 0.97-1.64) and 1.50 (95% CI 1.12-2.01) among studies that accounted for ethnicity, with evidence of significant heterogeneity (P = 0.004, I2 = 55.5). Pre-HAART pRRs were 1.26 (95% CI 1.11-1.43; P het = 0.82) and 1.28 (95% CI 1.10-1.49) among studies adjusted for ethnicity. People with HIV/AIDS remain at a significantly increased risk of developing melanoma in the post-HAART era. White skinned people with HIV/AIDS should be screened regularly and counselled against excessive sun exposure.

Final Technical Report: Development of Post-Installation Monitoring Capabilities

Energy Technology Data Exchange (ETDEWEB)

Polagye, Brian [University of Washington

2014-03-31

The development of approaches to harness marine and hydrokinetic energy at large-scale is predicated on the compatibility of these generation technologies with the marine environment. At present, aspects of this compatibility are uncertain. Demonstration projects provide an opportunity to address these uncertainties in a way that moves the entire industry forward. However, the monitoring capabilities to realize these advances are often under-developed in comparison to the marine and hydrokinetic energy technologies being studied. Public Utility District No. 1 of Snohomish County has proposed to deploy two 6-meter diameter tidal turbines manufactured by OpenHydro in northern Admiralty Inlet, Puget Sound, Washington. The goal of this deployment is to provide information about the environmental, technical, and economic performance of such turbines that can advance the development of larger-scale tidal energy projects, both in the United States and internationally. The objective of this particular project was to develop environmental monitoring plans in collaboration with resource agencies, while simultaneously advancing the capabilities of monitoring technologies to the point that they could be realistically implemented as part of these plans. In this, the District was joined by researchers at the Northwest National Marine Renewable Energy Center at the University of Washington, Sea Mammal Research Unit, LLC, H.T. Harvey & Associates, and Pacific Northwest National Laboratory. Over a two year period, the project team successfully developed four environmental monitoring and mitigation plans that were adopted as a condition of the operating license for the demonstration project that issued by the Federal Energy Regulatory Commission in March 2014. These plans address nearturbine interactions with marine animals, the sound produced by the turbines, marine mammal behavioral changes associated with the turbines, and changes to benthic habitat associated with colonization

Use of the Safety probabilistic analysis for the risk monitor before maintenance

International Nuclear Information System (INIS)

Gonzalez C, M.

2004-01-01

In this work the use of the Safety Probabilistic Analysis (APS) of the Laguna Verde Power plant to quantify the risk before maintenance is presented. Beginning to describe the nature of the Rule of Maintenance and their risk evaluations, it is planned about the paper of the APS for that purpose, and a systematic form to establish the reaches for this use open of the model is delineated. The work provides some technique details of the implantation methods of the APS like risk monitor, including the form of introducing the systems, trains and components to the user, as well as the fitness to the models and improvements to the used platform. There are covered some of the measures taken to achieve the objectives of preserving the base model approved, to facilitate the periodic realize, and to achieve acceptable times of execution for their efficient use. (Author)

Transparency in risk assessments - Presenting the 'expectation value' of post-closure risks from radioactive waste repositories

International Nuclear Information System (INIS)

Wilmot, R.D.; Galson, D.A.; Pollard, S.J.T.; Smith, R.E.; Yearsley, R.A.

1999-01-01

The Environment Agency of England and Wales (the 'Agency') has an extremely broad regulatory remit covering aspects of flood defence, integrated pollution control, water quality, waste management, abstraction control, navigation, fisheries, conservation and recreation. Risk assessment, as a regulatory and management tool plays an essential role in the targeting and prioritisation of this activity, as well as in aiding site-specific decisions on authorisations for abstraction, discharge and/or disposal. From a regulatory perspective, the majority of the Agency's risk assessment activity is focused on critically reviewing risk assessments submitted to the Agency in support of requests for authorisation. With increasing calls for openness in all areas of regulatory decision-making, new demands are being placed on risk assessments with a view to allowing far more transparency and traceability of 'process' and 'content' than has historically been the case. The Agency is responsible for the licensing of radioactive waste disposal facilities in England and Wales. It has issued guidance on what is expected of an application for an authorisation to dispose of low and intermediate level radioactive waste to land - the 'Guidance on Requirements for Authorisation' (the 'GRA'). The GRA includes a risk target and places a strong emphasis on confidence-building during the preparation and assessment of post-closure safety cases for such facilities. In this paper we discuss a recent study commissioned by the Agency which has examined the use of expectation value of risk in assessments and considered ways of improving transparency. The study has concluded that the expectation value is an appropriate measure of risk for comparison with a single-value criterion, provided that the scope of the assessment does not involve undue speculation regarding the FEPs (Features, Events and Processes) to be included. Low probability or speculative events and processes for which no data can be

INSTALLATION OF A POST-ACCIDENT CONFINEMENT HIGH-LEVEL RADIATION MONITORING SYSTEM IN THE KOLA NUCLEAR POWER STATION (UNIT 2) IN RUSSIA

Energy Technology Data Exchange (ETDEWEB)

GREENE,G.A.; GUPPY,J.G.

1998-09-01

This is the final report on the INSP project entitled, ``Post-Accident Confinement High-Level Radiation Monitoring System'' conducted by BNL under the authorization of Project Work Plan WBS 1.2.2.6 (Attachment 1). This project was initiated in February 1993 to assist the Russians in reducing risks associated with the continued operation of older Soviet-designed nuclear power plants, specifically the Kola VVER-440/230 Unit 2, through improved accident detection capability, specifically by the installation of a dual train high-level radiation detection system in the confinement of Unit 2 of the Kola NPP. The major technical objective of this project was to provide, install and make operational the necessary hardware inside the confinement of the Kola NPP Unit 2 to provide early and reliable warning of the release of radionuclides from the reactor into the confinement air space as an indication of the occurrence of a severe accident at the plant. In addition, it was intended to provide hands-on experience and training to the Russian plant workers in the installation, operation, calibration and maintenance of the equipment in order that they may use the equipment without continued US assistance as an effective measure to improve reactor safety at the plant.

INSTALLATION OF A POST-ACCIDENT CONFINEMENT HIGH-LEVEL RADIATION MONITORING SYSTEM IN THE KOLA NUCLEAR POWER STATION (UNIT 2) IN RUSSIA

International Nuclear Information System (INIS)

GREENE, G.A.; GUPPY, J.G.

1998-01-01

This is the final report on the INSP project entitled, ''Post-Accident Confinement High-Level Radiation Monitoring System'' conducted by BNL under the authorization of Project Work Plan WBS 1.2.2.6 (Attachment 1). This project was initiated in February 1993 to assist the Russians in reducing risks associated with the continued operation of older Soviet-designed nuclear power plants, specifically the Kola VVER-440/230 Unit 2, through improved accident detection capability, specifically by the installation of a dual train high-level radiation detection system in the confinement of Unit 2 of the Kola NPP. The major technical objective of this project was to provide, install and make operational the necessary hardware inside the confinement of the Kola NPP Unit 2 to provide early and reliable warning of the release of radionuclides from the reactor into the confinement air space as an indication of the occurrence of a severe accident at the plant. In addition, it was intended to provide hands-on experience and training to the Russian plant workers in the installation, operation, calibration and maintenance of the equipment in order that they may use the equipment without continued US assistance as an effective measure to improve reactor safety at the plant

Rice Bran Extract Reduces the Risk of Atherosclerosis in Post-Menopausal Vietnamese Women.

Science.gov (United States)

Nhung, Bui Thi; Tuyen, Le Danh; Linh, Vu Anh; Anh, Nguyen Do Van; Nga, Tran Thuy; Thuc, Vu Thi Minh; Yui, Kei; Ito, Yukihiko; Nakashima, Yuri; Yamamoto, Shigeru

2016-01-01

We investigated whether pre-germinated brown rice bran extract containing acylated steryl glucosides (PSG) reduces the risk of atherosclerosis in post-menopausal Vietnamese women. A total of 60 post-menopausal Vietnamese women (45-65 y old) with high LDL cholesterol levels (over 140 mg/dL) were randomly divided into PSG (n=30) and placebo (n=30) groups. The subjects in the PSG group were assigned a daily intake of 6 capsules containing 50 mg PSG, and the subjects in the placebo group were assigned a daily intake of 6 capsules containing corn oil for 6 mo. Before baseline and after month 2, month 4, and month 6 of the intervention, we conducted anthropometric measurements, blood biochemical examinations, a nutrition survey, and physical activity, flow-mediated dilation (FMD), and cardio-ankle vascular index (CAVI) measurements. Serum LDL cholesterol concentrations were significantly reduced from 163.6±25.3 (mg/dL) to 135.9±26.8 (mg/dL) compared to the placebo group (pVietnamese women with high LDL cholesterol.

Identification of risk factors for post-endoscopic retrograde cholangiopancreatography pancreatitis in a high volume center.

Science.gov (United States)

Phillip, Veit; Schwab, Miriam; Haf, David; Algül, Hana

2017-01-01

Pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). Several patients´ or procedure related risk factors for post-ERCP pancreatitis (PEP) have been suggested. The aim of this study was to validate the risk factors for PEP in a high-volume center. All patients undergoing first time ERCP at a tertiary referral center between December 2010 and October 2013 were retrospectively included. PEP was defined according to the Atlanta Classification. 344 patients were included in the final analysis. The risk to develop PEP was increased in patients with chronic pancreatitis (odds ratio 3.7) and after inadvertent cannulation of the pancreatic duct (odds ratio 2.2), which occurred in 26.5% of the patients. Inadvertent cannulation occurred significantly more frequently in patients with difficult cannulation of the papilla duodeni major (odds ratio 12.7; passociated with an increased risk for difficult cannulation (odds ratio 3.0). Inadvertent cannulation of the pancreatic duct is a procedure related risk factor for PEP. Measurements on preventing inadvertent cannulation of the pancreatic duct should be established and studies on prophylactic measurements should focus particularly on patients with inadvertent cannulation of the pancreatic duct.

Contemporary Welfare Regimes in Baltic States: Adapting Post-Communist Conditions to Post-Modern Challenges

Directory of Open Access Journals (Sweden)

Anu Toots

2010-11-01

Full Text Available This article revises the conventional approach to welfare state development in the post-communist world, according to which the main challenge for the Eastern European states is to catch up with Western European welfare regimes. The article argues that adjustment to the new social risks and volatile markets is more important today than the catching-up scenario. Based on social and labour market statistics for Estonia, Latvia and Lithuania, the article analyses how the Baltic States are coping with this adjustment challenge. Adaptation to the post-modern conditions can be regarded as successful if the stability of welfare spending is accompanied by the expanding and flexible employment and by the stable or decreasing level of poverty. The findings suggest that the opportunities to increase the flexibility and equality of the labour market provided by the breakdown of the communist regime were not used. Instead, the Baltic welfare states continue to focus on protecting against the old social risks by combining neoliberal and post-communist principles. Poor performance in meeting new social risks poses a greater challenge for the post-communist welfare states than their lag in terms of gross welfare expenditure.

[Consensus Document on post-exposure prophylaxis against HIV, HBV and HCV in adults and children].

Science.gov (United States)

2016-02-01

This consensus document is an update of occupational and non-occupational prophylaxis guidelines in HIV-patients, promoting appropriate use of them, from the standpoint of care. This document has been approved by expert panel of SPNS, GESIDA, SEMST and different scientific societies related, after reviewing the results of efficacy and safety clinical trials, cohort and pharmacokinetic studies published in biomedical journals (PubMed and Embase) or presented at conferences and different guidelines. The strength of the recommendation and gradation of their evidence are based on the GRADE system. We have developed recommendations for assessing the risk of transmission in different types of exposure situations in which post-exposure prophylaxis should be recommended, special circumstances to consider, patterns of antiretroviral with the start and duration of early monitoring of tolerance and adherence to treatment, the subsequent monitoring of exposed persons regardless of whether they received post-exposure prophylaxis or not, and the need of psychological support. These new guidelines updated previous recommendations regarding occupational post-exposure prophylaxis and non-occupational, in adults and children. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Post-Flight Back Pain Following International Space Station Missions: Evaluation of Spaceflight Risk Factors

Science.gov (United States)

Laughlin, Mitzi S.; Murray, Jocelyn D.; Wear, Mary L.; Van Baalen, Mary

2016-01-01

Back pain during spaceflight has often been attributed to the lengthening of the spinal column due to the absence of gravity during both short and long-duration missions. Upon landing and re-adaptation to gravity, the spinal column reverts back to its original length thereby causing some individuals to experience pain and muscular spasms, while others experience no ill effects. With International Space Station (ISS) missions, cases of back pain and injury are more common post-flight, but little is known about the potential risk factors.

Post-traumatic stress disorder and cardiovascular disease.

Science.gov (United States)

Edmondson, Donald; von Känel, Roland

2017-04-01

In this paper, a first in a Series of two, we look at the evidence for an association of post-traumatic stress disorder with incident cardiovascular disease risk and the mechanisms that might cause this association, as well as the prevalence of post-traumatic stress disorder due to cardiovascular disease events and its associated prognostic risk. We discuss research done after the publication of previous relevant systematic reviews, and survey currently funded research from the two most active funders in the field: the National Institutes of Health and the US Veterans Administration. We conclude that post-traumatic stress disorder is a risk factor for incident cardiovascular disease, and a common psychiatric consequence of cardiovascular disease events that might worsen the prognosis of the cardiovascular disease. There are many candidate mechanisms for the link between post-traumatic stress disorder and cardiovascular disease, and several ongoing studies could soon point to the most important behavioural and physiological mechanisms to target in early phase intervention development. Similarly, targets are emerging for individual and environmental interventions that might offset the risk of post-traumatic stress disorder after cardiovascular disease events. Copyright © 2017 Elsevier Ltd. All rights reserved.

Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy: nationwide cohort study

OpenAIRE

Behrens, Ida; Basit, Saima; Melbye, Mads; Lykke, Jacob A; Wohlfahrt, Jan; Bundgaard, Henning; Thilaganathan, Baskaran; Boyd, Heather A

2017-01-01

Objectives To determine how soon after delivery the risk of post-pregnancy hypertension increases in women with hypertensive disorders of pregnancy and how the risk evolves over time.Design Nationwide register based cohort study.Setting Denmark.Populations 482 972 primiparous women with a first live birth or stillbirth between 1995 and 2012 (cumulative incidence analyses), and 1 025 118 women with at least one live birth or stillbirth between 1978 and 2012 (Cox regression analyses).Main outco...

Prevalence and risk factors of chronic post-thoracotomy pain in Chinese patients from Peking Union Medical College Hospital.

Science.gov (United States)

Wang, Hai-Tang; Liu, Wei; Luo, Ai-Lun; Ma, Chao; Huang, Yu-Guang

2012-09-01

In clinical practice, the mechanisms underlying chronic post-surgical pain (CPSP) remain insufficiently understood. The primary goals of this study were to determine the incidence of chronic pain after thoracic surgery and to identify possible risk factors associated with the development of chronic post-thoracotomy pain in Chinese patients. The secondary goal was to determine whether the difference between pre- and post-operative white blood cell (WBC) counts could predict the prevalence of CPSP after thoracotomy. The impact of chronic pain on daily life was also investigated. We contacted by phone 607 patients who had undergone thoracotomy at our hospital during the period February 2009 to May 2010. Statistical comparisons were made between patients with or without CPSP. were ultimately analyzed from 466 qualified patients. The overall incidence of CPSP was 64.5%. Difference between pre- and post-operative WBC counts differed significantly between patients with or without CPSP (P factor for the development of CPSP following thoracotomy (P factors for chronic pain included younger age (operative pain (P = 0.005) and the duration of chest tube drainage (P factoring surgical patients during peri-operative period. Besides, age, diabetes mellitus, acute post-operative pain, and duration of chest tube drainage may also play a role in chronic post-surgical pain occurrence.

Primary tacrolimus (FK506) therapy and the long-term risk of post-transplant lymphoproliferative disease in pediatric liver transplant recipients.

Science.gov (United States)

Cacciarelli, T V; Reyes, J; Jaffe, R; Mazariegos, G V; Jain, A; Fung, J J; Green, M

2001-10-01

While the overall incidence of post-transplant lymphoproliferative disease (PTLD) in pediatric liver transplant recipients has been reported to be 4-11%, the long-term risk of PTLD associated with primary tacrolimus therapy is unknown. Therefore, in order to determine the incidence and long-term risk of PTLD, the present study examined 131 pediatric recipients who underwent liver transplantation (LTx) between October 1989 and December 1991 and received primary tacrolimus therapy. This cohort of children was evaluated over an extended time-period (until December 31 1996) with a mean follow-up of 6.3 yr. Actuarial Kaplan-Meier analysis was utilized to determine the risk of PTLD over time. The overall incidence of PTLD was 13% (17/131) with an average age of 4.3 +/- 0.75 yr at diagnosis. Pretransplant Epstein-Barr virus (EBV) serologies were negative in 82%, positive in 12%, and not available in 6% of the patients. The median time to diagnosis of PTLD post-Tx was 11.9 months (mean 16.4 +/- 3.9, range 1.7-63.0 months). Mean tacrolimus dose and plasma trough level (as evaluated by enzyme-linked immunosorbent assay [ELISA]) at the time of diagnosis was 0.32 +/- 0.06 mg/kg/day and 1.3 +/- 0.3 ng/mL, respectively. The cumulative long-term risk of PTLD was found to increase over time: 3% at 6 months, 8% at 1 yr, 12% at 2 yr, 14% at 3 yr, and 15% at 4 and 5 yr. Mortality from PTLD was 12% (two of 17 patients). Primary tacrolimus use in pediatric LTx has a long-term risk of PTLD approaching 15%, with the majority of episodes (78%) occurring in the first 2 yr, suggesting that intense EBV surveillance should occur early post-transplantation.

An Online Risk Monitor System (ORMS) to Increase Safety and Security Levels in Industry

International Nuclear Information System (INIS)

Zubair, M; Ur Rahman, Khalil; Ul Hassan, Mehmood

2013-01-01

The main idea of this research is to develop an Online Risk Monitor System (ORMS) based on Living Probabilistic Safety Assessment (LPSA). The article highlights the essential features and functions of ORMS. The basic models and modules such as, Reliability Data Update Model (RDUM), running time update, redundant system unavailability update, Engineered Safety Features (ESF) unavailability update and general system update have been described in this study. ORMS not only provides quantitative analysis but also highlights qualitative aspects of risk measures. ORMS is capable of automatically updating the online risk models and reliability parameters of equipment. ORMS can support in the decision making process of operators and managers in Nuclear Power Plants

An Online Risk Monitor System (ORMS) to Increase Safety and Security Levels in Industry

Science.gov (United States)

Zubair, M.; Rahman, Khalil Ur; Hassan, Mehmood Ul

2013-12-01

The main idea of this research is to develop an Online Risk Monitor System (ORMS) based on Living Probabilistic Safety Assessment (LPSA). The article highlights the essential features and functions of ORMS. The basic models and modules such as, Reliability Data Update Model (RDUM), running time update, redundant system unavailability update, Engineered Safety Features (ESF) unavailability update and general system update have been described in this study. ORMS not only provides quantitative analysis but also highlights qualitative aspects of risk measures. ORMS is capable of automatically updating the online risk models and reliability parameters of equipment. ORMS can support in the decision making process of operators and managers in Nuclear Power Plants.

Psychosocial risk factors and treatment of new onset and recurrent depression during the post-partum period.

Science.gov (United States)

Kettunen, Pirjo; Hintikka, Jukka

2017-07-01

When developing maternity care services, it is important to know how psychosocial factors affect the course of post-partum depression (PPD), and how depressed mothers are treated. The aim of this study is to assess how adverse childhood experiences, poor present support and violence, and low socioeconomic status (SES) associate with PPD, specifically in new onset and recurrent post-partum depression. The second aim is to assess the treatment received for PPD. This is a cross-sectional study. The study group comprises 104 mothers with a current episode of PPD, and a control group of 104 mothers without an episode. The Structured Clinical Interview for DSM-IV Axis I Disorders was used for data collection. Psychosocial risk factors, treatment issues, and the course of depression were assessed with a structured self-report questionnaire. In age-adjusted multivariate analyses, adverse childhood experiences, a low level of present support in close relationships, and a poor SES were associated significantly with PPD. Childhood adversity was associated with both new onset and recurrent depression. Nevertheless, a low level of support and a poor SES were also associated with recurrent depression. A quarter of mothers with a major depressive episode in the post-partum period attended psychiatric services. In mothers with new onset depression, the proportion was only 5%. There is an urgent need to develop the diagnostics of depression in maternity care services. An awareness of psychosocial risk factors might help in this. More depressed mothers should be referred to psychiatric services.

[Risk factors related to surgical site infection in elective surgery].

Science.gov (United States)

Angeles-Garay, Ulises; Morales-Márquez, Lucy Isabel; Sandoval-Balanzarios, Miguel Antonio; Velázquez-García, José Arturo; Maldonado-Torres, Lulia; Méndez-Cano, Andrea Fernanda

2014-01-01

The risk factors for surgical site infections in surgery should be measured and monitored from admission to 30 days after the surgical procedure, because 30% of Surgical Site Infection is detected when the patient was discharged. Calculate the Relative Risk of associated factors to surgical site infections in adult with elective surgery. Patients were classified according to the surgery contamination degree; patient with surgery clean was defined as no exposed and patient with clean-contaminated or contaminated surgery was defined exposed. Risk factors for infection were classified as: inherent to the patient, pre-operative, intra-operative and post-operative. Statistical analysis; we realized Student t or Mann-Whitney U, chi square for Relative Risk (RR) and multivariate analysis by Cox proportional hazards. Were monitored up to 30 days after surgery 403 patients (59.8% women), 35 (8.7%) developed surgical site infections. The factors associated in multivariate analysis were: smoking, RR of 3.21, underweight 3.4 hand washing unsuitable techniques 4.61, transfusion during the procedure 3.22, contaminated surgery 60, and intensive care stay 8 to 14 days 11.64, permanence of 1 to 3 days 2.4 and use of catheter 1 to 3 days 2.27. To avoid all risk factors is almost impossible; therefore close monitoring of elective surgery patients can prevent infectious complications.

Exposure monitoring and risk assessment of biphenyl in the workplace.

Science.gov (United States)

Kim, Hyeon-Yeong; Shin, Sae-Mi; Ham, Miran; Lim, Cheol-Hong; Byeon, Sang-Hoon

2015-05-13

This study was performed to assess exposure to and the risk caused by biphenyl in the workplace. Biphenyl is widely used as a heat transfer medium and as an emulsifier and polish in industry. Vapor or high levels of dust inhalation and dermal exposure to biphenyl can cause eye inflammation, irritation of respiratory organs, and permanent lesions in the liver and nervous system. In this study, the workplace environment concentrations were assessed as central tendency exposure and reasonable maximum exposure and were shown to be 0.03 and 0.12 mg/m³, respectively. In addition, the carcinogenic risk of biphenyl as determined by risk assessment was 0.14 × 10⁻⁴ (central tendency exposure) and 0.56 × 10⁻⁴ (reasonable maximum exposure), which is below the acceptable risk value of 1.0 × 10⁻⁴. Furthermore, the central tendency exposure and reasonable maximum exposure hazard quotients were 0.01 and 0.06 for oral toxicity, 0.05 and 0.23 for inhalation toxicity, and 0.08 and 0.39 for reproduction toxicity, respectively, which are all lower than the acceptable hazard quotient of 1.0. Therefore, exposure to biphenyl was found to be safe in current workplace environments. Because occupational exposure limits are based on socioeconomic assessment, they are generally higher than true values seen in toxicity experiments. Based on the results of exposure monitoring of biphenyl, the current occupational exposure limits in Korea could be reviewed.

Exposure Monitoring and Risk Assessment of Biphenyl in the Workplace

Directory of Open Access Journals (Sweden)

Hyeon-Yeong Kim

2015-05-01

Full Text Available This study was performed to assess exposure to and the risk caused by biphenyl in the workplace. Biphenyl is widely used as a heat transfer medium and as an emulsifier and polish in industry. Vapor or high levels of dust inhalation and dermal exposure to biphenyl can cause eye inflammation, irritation of respiratory organs, and permanent lesions in the liver and nervous system. In this study, the workplace environment concentrations were assessed as central tendency exposure and reasonable maximum exposure and were shown to be 0.03 and 0.12 mg/m3, respectively. In addition, the carcinogenic risk of biphenyl as determined by risk assessment was 0.14 × 10−4 (central tendency exposure and 0.56 × 10−4 (reasonable maximum exposure, which is below the acceptable risk value of 1.0 × 10−4. Furthermore, the central tendency exposure and reasonable maximum exposure hazard quotients were 0.01 and 0.06 for oral toxicity, 0.05 and 0.23 for inhalation toxicity, and 0.08 and 0.39 for reproduction toxicity, respectively, which are all lower than the acceptable hazard quotient of 1.0. Therefore, exposure to biphenyl was found to be safe in current workplace environments. Because occupational exposure limits are based on socioeconomic assessment, they are generally higher than true values seen in toxicity experiments. Based on the results of exposure monitoring of biphenyl, the current occupational exposure limits in Korea could be reviewed.

Monitoring of sport participation and injury risk in young athletes.

Science.gov (United States)

Malisoux, Laurent; Frisch, Anne; Urhausen, Axel; Seil, Romain; Theisen, Daniel

2013-11-01

Careful modulation of training characteristics in high-level sports optimizes performance and avoids inappropriate workloads and associated sports injury risk. The aims of this study were to compare sport participation characteristics in different youth sport categories and to investigate their relationship with injury. Prospective cohort follow-up. Young (12-19 years) high-level athletes (n=154) from a regional sport school were followed during 41 weeks regarding sport participation characteristics and traumatic and overuse sports injuries (time-loss definition). All data were self-recorded by the athletes in an electronic system "TIPPS" (Training and Injury Prevention Platform for Sports) and subject to a systematic data quality control. Volume and intensity (self-rated perceived exertion) of each sport session were used to compute weekly load, monotony and strain. Sport categories were defined as team, racket, and individual sports. All sport participation characteristics were dependent on sport category (psports were associated with lower injury risk (HR=0.37 and 0.34, p=0.001 and psports. Average sport participation characteristics were not related to injury according to the survival analysis. However, intensity during the week prior to injury was significantly higher (psport participation pattern and injury risk in young athletes. The monitoring method was sensitive to variations according to pertinent variables and might help identify athletes with increased sports injury risk. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Sexual behaviours, perception of risk of HIV infection, and factors associated with attending HIV post-test counselling in Ethiopia

NARCIS (Netherlands)

Sahlu, T.; Kassa, E.; Agonafer, T.; Tsegaye, A.; Rinke de Wit, T.; Gebremariam, H.; Doorly, R.; Spijkerman, I.; Yeneneh, H.; Coutinho, R. A.; Fontanet, A. L.

1999-01-01

OBJECTIVES: To describe sexual behaviours, perception of risk of HIV infection, and factors associated with attending HIV post-test counselling (PTC) among Ethiopian adults. METHODS: Data on socio-demographic characteristics, knowledge of HIV infection, sexual history, medical examination, and HIV

[Implementation of a post-discharge surgical site infection system in herniorrhaphy and mastectomy procedures].

Science.gov (United States)

San Juan Sanz, Isabel; Díaz-Agero-Pérez, Cristina; Robustillo-Rodela, Ana; Pita López, María José; Oliva Iñiguez, Lourdes; Monge-Jodrá, Vicente

2014-10-01

Monitoring surgical site infection (SSI) performed during hospitalization can underestimate its rates due to the shortening in hospital stay. The aim of this study was to determine the actual rates of SSI using a post-discharge monitoring system. All patients who underwent herniorraphy or mastectomy in the Hospital Universitario Ramón y Cajal from 1 January 2011 to 31 December 2011 were included. SSI data were collected prospectively according to the continuous quality improvement indicators (Indicadores Clinicos de Mejora Continua de la Calidad [INCLIMECC]) monitoring system. Post-discharge follow-up was conducted by telephone survey. A total of 409patients were included in the study, of whom 299 underwent a herniorraphy procedure, and 110 underwent a mastectomy procedure. For herniorrhaphy, the SSI rate increased from 6.02% to 7.6% (the post-discharge survey detected 21.7% of SSI). For mastectomy, the SSI rate increased from 1.8% to 3.6% (the post-discharge survey detected 50% of SSI). Post-discharge monitoring showed an increased detection of SSI incidence. Post-discharge monitoring is useful to analyze the real trend of SSI, and evaluate improvement actions. Post-discharge follow-up methods need to standardised. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Post-release monitoring of Antillean manatees: an assessment of the Brazilian rehabilitation and release programme

Science.gov (United States)

Normande, Iran C.; Malhado, Ana C. M.; Reid, James P.; Viana Junior, P.C.; Savaget, P. V. S.; Correia, R. A.; Luna, F. O.; R. J. Ladle,

2016-01-01

Mammalian reintroduction programmes frequently aim to reconnect isolated sub-populations and restore population viability. However, these long-term objectives are rarely evaluated due to the inadequacy of post-release monitoring. Here, we report the results of a unique long term telemetry-based monitoring programme for rehabilitated Antillean manatees (Trichechus manatus manatus) reintroduced into selected sites in northeast Brazil with the aim of reconnecting isolated relict populations. Twenty-one satellite-tagged rehabilitated manatees, 13 males and 8 females, were released into the wild from two sites between November 2008 and June 2013. Individual accumulation curves were plotted and home ranges were calculated through the fixed kernel method using 95% of the utilization distribution. The number and size of the Centres of Activity (COAs) were calculated using 50% of the utilization distribution. Manatees displayed a dichotomous pattern of movement, with individuals either characterized by sedentary habits or by much more extensive movements. Moreover, home range size was not significantly influenced by gender, age at release or release site. COAs were strongly associated with sheltered conditions within reefs and estuaries, and also by the presence of freshwater and feeding sites. Our data confirm that manatee reintroductions in Brazil have the potential to reconnect distant sub-populations. However, pre-release identification of potential long-distance migrants is currently unfeasible, and further analysis would be required to confirm genetic mixing of distant sub-populations.

Lung cancer risk in the electroplating industry in Lombardy, Italy, using the Italian occupational cancer monitoring (OCCAM) information system.

Science.gov (United States)

Panizza, Celestino; Bai, Edoardo; Oddone, Enrico; Scaburri, Alessandra; Massari, Stefania; Modonesi, Carlo; Contiero, Paolo; Marinaccio, Alessandro; Crosignani, Paolo

2012-01-01

Occupational Cancer Monitoring (OCCAM) is an Italian organization that monitors occupational cancers, by area and industrial sector, by retrieving cases and employment history from official databases. OCCAM previously estimated a relative risk (RR) of lung cancer of about 1.32 among "metal treatment" workers in Lombardy, northern Italy, potentially exposed to chrome and nickel. In the present study, lung cancer risk was estimated among electroplating workers only. Lombardy electroplating companies were identified from descriptions in Social Security files. Lung cancer risk was evaluated from 2001 to 2008 incident cases identified from hospital discharge records. The RR for lung cancer among electroplating workers was 2.03 (90% CI 1.33-3.10, 18 cases) for men; 3.00 (90% CI 1.38-9.03, 4 cases) for women. Electroplaters had higher risks than "metal treatment" workers. Although the risks were due to past exposure, case histories and recent acute effects indicate a present carcinogenic hazard in some Lombardy electroplating factories. Copyright © 2011 Wiley Periodicals, Inc.

Health risks encountered by Dutch medical students during an elective in the tropics and the quality and comprehensiveness of pre-and post-travel care

Directory of Open Access Journals (Sweden)

Vandenbroucke Jan P

2010-12-01

Full Text Available Abstract Background Clinical and research electives abroad offer medical students many unique experiences. However, participating in an unfamiliar health-care setting combined with limited medical experience may place students at risk of illness. To improve pre-and post-travel care, we assessed the health risks and the quality and comprehensiveness of pre-and post-travel care in a cohort of Dutch medical students returning form an elective abroad. Methods All medical students who had performed an elective in the tropics between July 2006 and December 2008 were sent an informative email asking them to complete a web-based questionnaire. Results 180 of 242 (74% students completed the questionnaire. Regarding the risk of bloodborne viral infection: 67% of all students and 32% of junior students engaged in procedures that constitute a risk of exposure to bloodborne viral infection, often in countries with high HIV prevalence rates. None of nine students who experienced possible or certain mucosal or percutaneous exposure to potentially infectious body fluids reported the exposure at the time it occurred and none used PEP. Regarding other health risks: 8 of 40 (20% students stopped using mefloquine due to adverse effects. This left a sizeable proportion unprotected in countries that are hyperendemic for malaria. Post-travel screening for schistosomiasis, tuberculosis (tuberculin skin test and carriage of methicillin-resistant Staphylococcus aureus (MRSA encompassed approximately half of all students who should have been screened. Conclusions Based on the results of this study we have adopted an integral set of measures to reduce the health risks associated with an elective abroad. The pre and post-travel consult has been centralized and standardized as well as the distribution of PEP. In addition we have developed a mandatory module on Global Health for all medical students planning an elective abroad.

Health risks encountered by Dutch medical students during an elective in the tropics and the quality and comprehensiveness of pre-and post-travel care.

Science.gov (United States)

Sharafeldin, Elhadi; Soonawala, Darius; Vandenbroucke, Jan P; Hack, Evelien; Visser, Leo G

2010-12-02

Clinical and research electives abroad offer medical students many unique experiences. However, participating in an unfamiliar health-care setting combined with limited medical experience may place students at risk of illness. To improve pre-and post-travel care, we assessed the health risks and the quality and comprehensiveness of pre-and post-travel care in a cohort of Dutch medical students returning form an elective abroad. All medical students who had performed an elective in the tropics between July 2006 and December 2008 were sent an informative email asking them to complete a web-based questionnaire. 180 of 242 (74%) students completed the questionnaire. Regarding the risk of bloodborne viral infection: 67% of all students and 32% of junior students engaged in procedures that constitute a risk of exposure to bloodborne viral infection, often in countries with high HIV prevalence rates. None of nine students who experienced possible or certain mucosal or percutaneous exposure to potentially infectious body fluids reported the exposure at the time it occurred and none used PEP. Regarding other health risks: 8 of 40 (20%) students stopped using mefloquine due to adverse effects. This left a sizeable proportion unprotected in countries that are hyperendemic for malaria. Post-travel screening for schistosomiasis, tuberculosis (tuberculin skin test) and carriage of methicillin-resistant Staphylococcus aureus (MRSA) encompassed approximately half of all students who should have been screened. Based on the results of this study we have adopted an integral set of measures to reduce the health risks associated with an elective abroad. The pre and post-travel consult has been centralized and standardized as well as the distribution of PEP. In addition we have developed a mandatory module on Global Health for all medical students planning an elective abroad.

Preliminary application of a novel algorithm to monitor changes in pre-flight total peripheral resistance for prediction of post-flight orthostatic intolerance in astronauts

Science.gov (United States)

Arai, Tatsuya; Lee, Kichang; Stenger, Michael B.; Platts, Steven H.; Meck, Janice V.; Cohen, Richard J.

2011-04-01

Orthostatic intolerance (OI) is a significant challenge for astronauts after long-duration spaceflight. Depending on flight duration, 20-80% of astronauts suffer from post-flight OI, which is associated with reduced vascular resistance. This paper introduces a novel algorithm for continuously monitoring changes in total peripheral resistance (TPR) by processing the peripheral arterial blood pressure (ABP). To validate, we applied our novel mathematical algorithm to the pre-flight ABP data previously recorded from twelve astronauts ten days before launch. The TPR changes were calculated by our algorithm and compared with the TPR value estimated using cardiac output/heart rate before and after phenylephrine administration. The astronauts in the post-flight presyncopal group had lower pre-flight TPR changes (1.66 times) than those in the non-presyncopal group (2.15 times). The trend in TPR changes calculated with our algorithm agreed with the TPR trend calculated using measured cardiac output in the previous study. Further data collection and algorithm refinement are needed for pre-flight detection of OI and monitoring of continuous TPR by analysis of peripheral arterial blood pressure.

Facility effluent monitoring plan for the 327 Facility

International Nuclear Information System (INIS)

1994-11-01

The 327 Facility [Post-Irradiation Testing Laboratory] provides office and laboratory space for Pacific Northwest Laboratory (PNL) scientific and engineering staff conducting multidisciplinary research in the areas of post-irradiated fuels and structural materials. The facility is designed to accommodate the use of radioactive and hazardous materials in the conduct of these activities. This report summarizes the airborne emissions and liquid effluents and the results of the Facility Effluent Monitoring Plan (FEMP) determination for the facility. The complete monitoring plan includes characterization of effluent streams, monitoring/sampling design criteria, a description of the monitoring systems and sample analysis, and quality assurance requirements

Awareness of cervical cancer risk factors and symptoms: cross-sectional community survey in post-conflict northern Uganda.

Science.gov (United States)

Mwaka, Amos D; Orach, Christopher G; Were, Edward M; Lyratzopoulos, Georgios; Wabinga, Henry; Roland, Martin

2016-08-01

Lack of awareness of risk factors and symptoms for cancer may lead to late diagnosis and poor prognosis. We assessed community awareness about cervical cancer risk factors and symptoms and perceptions about prevention and cure of cervical cancer in order to contribute data to inform interventions to improve cervical cancer survival. Cross-sectional population-based survey. We conducted this study in Gulu, a post-conflict district in Uganda in 2012. The sample included 448 persons aged 18 years and above, selected through a multi-stage stratified cluster sampling process. We collected data using a pretested structured questionnaire. Logistic regressions were used to determine magnitudes of associations between socio-demographic and outcome variables. Most participants (444/448) had heard about cervical cancer. Known risk factors including multiple sexual partners, human papillomavirus infection, and early onset of sexual activity, were recognized by 88%, 82%, and 78% of respondents respectively. 63% of participants believed that prolonged use of family planning pills and injections caused cervical cancer. The majority of participants recognized symptoms of cervical cancer including inter-menstrual bleeding (85%), post-menopausal bleeding (84%), and offensive vaginal discharge (83%). 70% of participants believed that cervical cancer is preventable and 92% believed that it could be cured if diagnosed at an early stage. Recognition of cervical cancer risk factors and symptoms was high among study participants. Targeted interventions including increasing availability of HPV vaccination, population-based cervical screening and diagnostic services can translate high awareness into actual benefits. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.